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Background G6PD deficiency is a common inherited disorder worldwide and has a higher incidence rate in southern China. Many variants of G6PD result from point mutations in the G6PD gene, leading to decreased enzyme activity. This study aimed to analyse the genotypic and phenotypic characteristics of G6PD deficiency in Guangzhou, China. Methods In this study, a total of 20,208 unrelated participants were screened from 2020 to 2022. G6PD deficiency was further analysed by quantitative enzymatic assay and G6PD mutation analysis. The unidentified genotype of the participants was further ascertained by direct DNA sequencing. Results A total of 12 G6PD mutations were identified. Canton (c.1376G>T) and Kaiping (c.1388G>A) were the most common variants, and different mutations led to varying levels of G6PD enzyme activity. Comparing the enzyme activities of the 6 missense mutations between the sexes, we found significant differences (P 0.05) in the enzyme activities of both male hemizygotes and female heterozygotes. Two previously unreported mutations (c.1438A>T and c.946G>A) were identified. Conclusions This study provided detailed genotypes of G6PD deficiency in Guangzhou, which could be valuable for diagnosing and researching G6PD deficiency in this area.

Background: Misdiagnosis and underdiagnosis of pulmonary hypertension caused by fibrosing mediastinitis (PH-FM) are considerably prevalent due to unspecific symptoms and as well as the lack of awareness of this fatal disease. Objectives: The aim of this study was to evaluate the diagnostic accuracy of the chest X-ray (CXR) for screening the patients with PH-FM from those with pulmonary hypertension (PH). Design: This was a retrospective observational cohort study. Methods: The patients with suspected PH were recruited between October 2014 and October 2020. All the clinical data and CXR findings were collected. The sensitivity, specificity, and likelihood ratio of the CXR features were calculated. Logistic regression was used to identify the factors associated with the CXR characteristics and FM and to generate a prediction model. Finally, the diagnostic efficiency of the prediction model was evaluated using nomogram and internal validation. Results: The patients with PH-FM ( n = 36) and PH caused by the diseases other than FM (PH-non-FM, n = 62) were enrolled. The CXR features, including atelectasis, pleural effusion, consolidation, nodules, calcification, interlobular septal thickening, and interstitial reticulation, were more prevalent in patients with PH-FM than in those with PH-non-FM (all p Conclusion: In this study, atelectasis was the most specific and accurate CXR characteristic for identifying PH-FM in the PH patients. The combination of atelectasis, pleural effusion, prominent right heart border, tuberculosis, and lnBNP constituted a prediction model that distinguished the PH-FM patients from the PH-non-FM ones with good performance.

Although balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA) are effective in chronic thromboembolic pulmonary hypertension (CTEPH), the comparison of their efficacy and safety is still unclear. We identified studies through a systematic review of PubMed, Cochrane Library, and Embase and used a random effects meta-analysis model to synthesize estimates of weighted mean differences or combined effect size. In total, 54 studies were included in this meta-analysis. The survival rates at perioperative/in-hospital period, 2 years, and 3 years were 100%, 99%, and 97%, respectively, in BPA group and 93%, 90%, and 88%, respectively, in PEA group. The variation of 6-min walk distance was 141.80 m in BPA and 100.73 m in PEA when the follow-up was 1-6 months. At 1-month, 1-6-month, and 12-month follow-up, the changed results of mean pulmonary arterial pressure were - 18.31, - 17.00, and - 12.97 mmHg in BPA group and - 18.93, - 21.21, and - 21.35 mmHg in PEA group. At 1-month and 1-6-month follow-up, the changed values of pulmonary vascular resistance were - 542.24 and - 599.77 dyne•s•cm

Coronavirus disease 2019 (COVID‐19) causes a pandemic around the globe. Debilitating and even deadly complications have occurred to the millions. A recent study reported 31% of right ventricular dilation in the hospitalized COVID‐19 patients, which is significantly associated with the mortality. Therefore, we sought to search for the lines of evidence in the literature that COVID‐19 may contribute to right heart dysfunction. The relevant literature and data from PubMed, Embase, Cochrane Library databases, and Web of Science were searched using the MeSH terms including ‘COVID‐19’, ‘SARS‐CoV‐2’, ‘novel coronavirus pneumonia’, ‘novel coronavirus’, ‘right heart failure’, ‘right heart dysfunction’, ‘pulmonary hypertension’, ‘pulmonary embolism’, and various combinations. The collected literature and data were sorted and summarized. Literature reports that angiotensin‐converting enzyme 2 (ACE2) is the host receptor mediating the cell entry of severe acute respiratory syndrome coronavirus 2. Clinical and experimental evidence shows that loss of function of ACE2 aggravates pulmonary hypertension and gain of function of ACE2 exerts protection on cardiopulmonary circulation. Moreover, the patients with COVID‐19 are more susceptible to pulmonary embolism and severe pneumonia‐induced acute respiratory distress syndrome. Therefore, COVID‐19 may cause right heart dysfunction by inducing pulmonary hypertension, pulmonary embolism, and acute respiratory distress syndrome. Particular attention should be paid to the function of the right heart, the overlooked chamber in COVID‐19. Blood gas analysis, laboratory test of cardiac injury markers, physical examination, and echocardiography should be performed to identify right heart failure as early as possible. Once the right heart failure is confirmed, the therapeutic modalities following the guidelines of European Society of Cardiology should be employed to reduce mortality.

It is a conventional wisdom that a left-hand microwave cannot efficiently excite the spin wave (SW) in ferromagnets, due to the constraint of angular momentum conservation. In this work, we show that the left-hand microwave can drive nonreciprocal SWs in the presence of a strong ellipticity-mismatch between the microwave and precessing magnetization. A critical frequency is predicted, at which the left-hand microwave cannot excite SWs. Away from it the SW amplitude sensitively depends on the ellipticity of left-hand microwaves, in sharp contrast to the case driven by right-hand ones. By tuning the microwave frequency, we observe a switchable SW non-reciprocity in a ferromagnetic single layer. A mode-dependent mutual demagnetizing factor is proposed to explain this finding. Our work advances the understanding of the photon-magnon conversion, and paves the way to designing diode-like functionalities in nano-scaled magnonics.

Twisted magnons (TMs) carrying orbital angular momentum (OAM) have attracted much attention from the magnonic community. The fabrication of such novel magnon state however is still challenging. Here we present a simple method to generate TMs with arbitrary radial and azimuthal quantum numbers through the spin-to-orbital angular momentum conversion. The conversion rate from plane-wave magnons to twisted ones is shown to be insensitive to the quantum index. The spectrum of TMs in thin nanodisks is solved analytically, showing a good agreement with micromagnetic simulations. Moreover, we numerically study the propagation of TMs in magnetic nanodisk arrays and obtain the quantitative dependence of the decay length on quantum indexes. Our results are helpful for realizing TMs with large OAMs that are indispensable for future high-capacity magnonic communications and computings., Comment: 6 pages, 4 figures

Long-range interactions (LRIs) are ubiquitous in nature. Higher-order topological (HOT) insulator represents a new phase of matter. A critical issue is how LRI dictates the HOT phases. In this work, we discover four topologically distinct phases, i.e., HOT phase, the bound state in the continuum, Dirac semimetal (DSM) phase, and trivial insulator phase in a breathing kagome circuit with tunable LRIs. We find an emerging type-III corner state in the HOT phase, which splits from the edge state continuum and originates from the strong couplings between nodes at different edges. We experimentally detect this novel state by impedance and voltage measurements. In the DSM phase, the Dirac cone exhibits an itinerant feature with a tunable position that depends on the LRI strength. Our findings provide a deeper understanding of the LRI effect on exotic topological states and pave the way for regulating interactions in topolectrical circuits., Comment: (Accepted by Physical Review B)

The mathematical foundation of quantum mechanics is built on linear algebra, while the application of nonlinear operators can lead to outstanding discoveries under some circumstances, such as the prediction of positron, a direct outcome of the Dirac equation which stems from the square-root of the Klein-Gordon equation. In this article, we propose a model of square-root higher-order Weyl semimetal (SHOWS) by inheriting features from its parent Hamiltonians. It is found that the SHOWS hosts both “Fermi-arc” surface and hinge states that respectively connect the projection of the Weyl points on the side surface and arris. We theoretically construct and experimentally observe the exotic SHOWS state in three-dimensional (3D) stacked electric circuits with honeycomb-kagome hybridizations and double-helix interlayer couplings. Our results open the door for realizing the square-root topology in 3D solid-state platforms.

It is a conventional wisdom that the helical edge states of quantum spin Hall (QSH) insulator are particularly stable due to the topological protection of time-reversal symmetry. Here, we report the first experimental observation of an edge-dependent quantum (pseudo-)spin Hall effect by employing two Kekule electric circuits with molecule-zigzag and partially-bearded edges, where the chirality of the circulating current in the unit cell mimics the electron spin. We observe a helicity flipping of the topological in-gap modes emerging in opposite parameter regions for the two edge geometries. Experimental findings are interpreted in terms of the mirror winding number defined in the unit cell, the choice of which exclusively depends on the edge shape. Our work offers a deeper understanding of the boundary effect on the QSH phase, and pave the way for studying the spin-dependent topological physics in electric circuits.

We propose a method to generate magnetic skyrmions by focusing spin waves totally reflected by a curved film edge. Based on the principle of identical magnonic path length, we derive the edge contour that is parabolic and frequency-independent. Micromagnetic simulations are performed to verify our theoretical design. It is found that under proper conditions, magnetic droplet first emerges near the focal point where the spin-wave intensity has been significantly enhanced, and then converts to magnetic skyrmion accompanied by a change of the topological charge. The phase diagram about the amplitude and frequency of the driving field for skyrmion generation is obtained. Our finding would be helpful for the designment of spintronic devices combing the advantage of skyrmionics and magnonics., Comment: 5 pages, 5 figures

Background: Acute right heart failure (RHF) is the main cause of death in patients with acute pulmonary embolism and emergent pulmonary hypertension. However, the molecular mechanisms underpinning the acute RHF and the interactions between the right (RV) and left ventricles (LVs) under the diseased condition remain unknown. Methods and results: The Sprague Dawley male rats were randomly divided into the normal control, sham, and pulmonary artery banding (PAB) groups. One hour after the PAB operation, after measuring the haemodynamic and anatomical parameters, the free walls of RV and LV were harvested to detect the differential gene expression profiling by high-throughput RNA sequencing. The results showed that the PAB lead to 50–60% obstruction of the main pulmonary artery, which was accompanied by the significant elevation in the positive rate of rise in RV pressure and the maximum RV pressure as compared to the sham group. Moreover, compared with the counterparts in the sham group, the RV and LV in the PAB group exhibited 2057 differentially expressed genes (DEGs, 1159 upregulated and 898 downregulated) and 1196 DEGs (709 upregulated and 487 downregulated), respectively (DEG criteria: |log 2 fold change| ≥1, q value ≤0.05). In comparison to the sham group, the enriched pathways in the PAB group include nuclear factor-κB signalling pathway, extracellular matrix–receptor interaction, and nucleotide oligomerization domain-like receptor signalling pathway. Conclusions: The PAB rat model exhibited the haemodynamic and gene expression changes in the RV that lead to acute RHF. Further, the acute RHF induced by pressure overload also caused gene expression changes in the LV, suggesting the molecular interactions between the RV and LV under the diseased condition.

Pulmonary hypertension (PH) is a syndrome characterized by a persistent increase in pulmonary vascular resistance. Due to the lack of specificity in clinical manifestations, patients are usually diagnosed at the late stage of PH, which is hard to treat and often causes right heart failure and death. Furthermore, the regulation and pathogenesis of PH remain obscure. Recently, long noncoding RNAs (lncRNAs), a type of transcript longer than 200 nt that lacks protein-coding ability, have been found to substantially influence the incidence and progression of various diseases through regulating gene expression at the chromatin, transcriptional, post-transcriptional, translational, and even post-translational levels. The crucial roles of lncRNAs in PH have started to draw widespread attention. This review summarizes the regulatory, pathogenic, and diagnostic roles of lncRNAs in PH, in the hope to facilitate the search for early diagnostic markers of and effective therapeutic targets for this devastating disease.

As a common disease, hypertension (HTN) can lead to severe complications such as heart failure, renal failure and stroke. However, delayed diagnosis often happens because of no obvious symptoms in earlier stage. This paper addresses the issue through a novel cloud based auxiliary medical system for HTN. Nowadays, telemedicine has been used to diagnose and monitor HTN by sharing and consulting personal health status with doctors. Its high flexibility and processing ability have helped to reduce the overall cost of medical care and enhanced the control rate. Technically, telemedicine uses communication, holographic imaging and computer science to achieve the management for long-distance patients. This paper presents a novel system based on cloud computing and mobile Internet, which can provide telemedicine services for HTN patients. This system could help patients reduce costs, provide flexible communication platform and powerful computing services, and also automatically collect patients’ blood pressure status. As an auxiliary medical system, the data of patients can be processed with instant status feedbacks in the cloud environment, thus patients can actually know their current cardiac status and take necessary measures for efficient management. Also, related doctors could help patients resolve mild symptoms out of office. Keywords: Hypertension, Telemedicine, Cloud computing, Mobile internet

Background Increasing evidence suggests that ADSCs execute their paracrine function via the secretion of exosomes, especially under hypoxic conditions. However, the mechanisms by which ADSCs-derived exosomes (ADSC-exos) enhance angiogenesis under hypoxia remain unclear. Methods Exosomes were isolated from HIF-1α-modified ADSCs culture supernatants. To investigate the effects HIF-1α-ADSC-exos on HUVECs, cell growth, apoptosis, and tube formation assay were performed with or without HIF-1α-ADSC-exos. Moreover, to determine the function of HIF-1α-ADSC-exos, the therapeutic effects of ADSC-exos and HIF-1α-ADSC-exos were examined in PAH rats. Results Exosomes released by HIF-1α-modified ADSCs rescued the impaired angiogenic ability, migratory function, and inflammatory factors of hypoxia-injured HUVECs, with increased SDF-1α, Rac1, Rac2, VEGF and IL-10 expression. Furthermore, exos-HIF-1α activated SIRT3 to enhance angiogenesis in HUVECs and induced IL-10 expression to inhibit inflammatory response. Block SIRT3 or SDF-1α abolished the angiogenic effect in HUVECs. Conclusion Our findings indicated that the SIRT3 contributed a crucial role in HIF-1α-ADSC-exos in tissue repair under hypoxia.

Pulmonary hypertension (PH) is a progressive and severe disorder in pulmonary hemodynamics. PH can be fatal if not well managed. Fibrosing mediastinitis (FM) is a rare and benign fibroproliferative disease in the mediastinum, which may lead to pulmonary vessel compression and PH. PH caused by FM (PH-FM) is a pathologic condition belonging to group 5 in the World Health Organization PH classification. PH-FM has a poor prognosis because of a lack of effective therapeutic modalities and inappropriate diagnosis. With the development of percutaneous pulmonary vascular interventional therapy, the prognosis of PH-FM has been greatly improved in recent years. This article provides a comprehensive review on the epidemiology, pathophysiologic characteristics, clinical manifestations, diagnostic approaches, and treatment modalities of PH-FM based on data from published reports and our medical center with the goal of facilitating the diagnosis and treatment of this fatal disease.

Pulmonary thromboembolism (PTE) is the third leading cause of death in cardiovascular diseases. PTE is believed to be caused by thrombi detached from deep veins of lower extremities. The thrombi travel with systemic circulation to the lung and block pulmonary arteries, leading to sudden disruption of hemodynamics and blood gas exchange. However, this concept has recently been challenged by accumulating evidence demonstrating that de novo thrombosis may be formed in pulmonary arteries without deep venous thrombosis. On the other hand, chronic thromboembolic pulmonary hypertension (CTEPH), a subtype of pulmonary hypertension, could have different pathogenesis than traditional PTE. Therefore, this article summarized and compared the risk factors, the common and specific pathogenic mechanisms underlying PTE, in situ pulmonary artery thrombosis, and CTEPH at molecular and cellular levels, and suggested the therapeutic strategies to these diseases, aiming to facilitate understanding of pathogenesis, differential diagnosis, and precision therapeutics of the three pulmonary artery thrombotic diseases.

AimsThis study aimed to assess the clinical characteristics and long-term survival outcome in patients with Takayasu’s arteritis-associated pulmonary hypertension (TA-PH).Methods and resultsWe conducted a nationally representative cohort study of TA-PH using data from the National Rare Diseases Registry System of China. Patients with pulmonary artery involvement who fulfilled the diagnostic criteria of Takayasu’s arteritis and pulmonary hypertension were included. The primary outcome was the time from diagnosis of TA-PH to the occurrence of all-cause death. Between January 2007 and January 2019, a total of 140 patients were included, with a mean age of 41.4 years at diagnosis, and a female predominance (81%). Patients with TA-PH had severely haemodynamic and functional impairments at diagnosis. Significant improvements have been found in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and haemodynamic profiles in patients with TA-PH receiving drugs approved for pulmonary arterial hypertension. The overall 1-, 3-, and 5-year survival rates in TA-PH were 94.0%, 83.2%, and 77.2%, respectively. Predictors associated with an increased risk of all-cause death were syncope [adjusted hazard ratio (HR) 5.38 (95% confidence interval 1.77–16.34), P = 0.003], NT-proBNP level [adjusted HR 1.04 (1.03–1.06), P ConclusionPatients with TA-PH were predominantly female and had severely compromised haemodynamics. More than 80% of patients in our cohort survived for at least 3 years. Medical treatment was based on investigators’ personal opinions, and no clear risk-to-benefit ratio can be derived from the presented data.

Precise positioning of magnetic solitons requires controllable artificial pinning, while the accurate determination of the pinning profile remains a challenge. Here, we propose a topological solution to this problem. Taking the domain wall (DW) as a representative example, we study the collective dynamics of interacting DWs in a magnetic racetrack with pinning sites of alternate distances. By mapping the governing equations of DW motion to the Su-Schrieffer-Heeger model and evaluating the quantized Zak phase, we predict two topologically distinct phases in the racetrack. A robust edge state emerges at either one or both ends depending on the parity of the DW number and the ratio of alternating intersite lengths. We show that the in-gap DW oscillation frequency has a fixed value which depends only on the geometrical shape of the pinning notch, and is insensitive to device imperfections and inhomogeneities. The spring coefficient of the pinning potential can be quantified as the square of the robust DW frequency multiplied by its constant mass. Our findings pave the way to determining the pinning potential with high accuracy for generic magnetic solitons and suggest as well that the magnetic soliton-based racetrack is a unique playground to study topological phase transitions.

Recent acoustic and electrical-circuit experiments have reported the third-order (or octupole) topological insulating phase, while its counterpart in classical magnetic systems is yet to be realized. Here we explore the collective dynamics of magnetic vortices in three-dimensional breathing cuboids, and find that the vortex lattice can support zero-dimensional corner states, one-dimensional hinge states, two-dimensional surface states, and three-dimensional bulk states, when the ratio of alternating intralayer and interlayer bond lengths goes beyond a critical value. We show that only the corner states are stable against external frustrations because of the topological protection. Full micromagnetic simulations verify our theoretical predictions with good agreement., Comment: 8 pages, 7 figures

Pursuing topological phase and matter in a variety of systems is one central issue in current physical sciences and engineering. Similar to other (quasi-)particles, the collective gyration motion of magnetic spin textures (vortex, bubble, and skyrmion etc.) can also exhibit the behavior of waves. In this chapter, we review our recent work on topological dynamics of spin-texture based metamaterials. We first briefly introduce the topological structures, properties, and applications of magnetic solitons. Then we focus on the topological dynamics of spin texture lattice, uncovering the first-order topological insulator in two-dimensional honeycomb lattice of massive magnetic skyrmions, and the second-order topological insulator in breathing kagome and honeycomb lattice of vortices. Conclusion and outlook are drawn finally.

We predict the emergence of second-order topological insulators in the dynamics of spin-texture-based metamaterials. We propose that the quantized Chern number and the ${\mathbb{Z}}_{6}$ Berry phase can completely characterize the nontrivial topology. By studying the collective gyration of magnetic vortices in a breathing honeycomb lattice, we derive the full phase diagram and show that the topological ``zero-energy'' corner mode is protected by a generalized chiral symmetry in the sexpartite lattice, leading to particular robustness against disorder and defects. Interestingly, we observe corner states at either obtuse-angled or acute-angled corners, depending on whether the lattice boundary has an armchair or a zigzag shape. Full micromagnetic simulations confirm the theoretical predictions with good agreement. Our findings open up a promising route to realizing higher-order symmetry-protected corner states in magnetic systems and to finally achieving topological spintronic memories, imaging, and computing.

We study the topological phase in a dipolar-coupled two-dimensional breathing square lattice of magnetic vortices. By evaluating the quantized Chern number and ${\mathbb{Z}}_{4}$ Berry phase, we obtain the phase diagram and identify that the second-order topological corner states appear only when the ratio of alternating bond lengths goes beyond a critical value. Interestingly, we uncover three corner states at different frequencies ranging from subgigahertz to tens of gigahertz by solving the generalized Thiele's equation, which has no counterpart in natural materials. We show that the emerging corner states are topologically protected by a generalized chiral symmetry of the quadripartite lattice, leading to particular robustness against disorder and defects. Full micromagnetic simulations confirm theoretical predictions with great agreement. A vortex-based display device is designed as a demonstration of the real-world application of the second-order magnetic topological insulator. Our findings provide a route for realizing symmetry-protected multiband corner states that are promising to achieve spintronic higher-order topological devices.

Programmed death receptor-1 (PD-1) and its ligand, PD-L1, as negative co-stimulatory molecules, are indispensable for regulating both physiological and pathological immune responses. The PD-1/PD-L1-mediated signaling pathway has been studied extensively in cancer research and has become a hotspot for biopharmaceuticals and immunotherapy. Furthermore, monoclonal antibodies to PD-1 have just been approved by the US Food and Drug Administration to treat certain types of malignancies. Recent research has unveiled a close association between the PD-1/PD-L1 system and eye diseases. This review describes the expression and physiological functions of PD-1 and its ligand in ocular tissues and summarizes the pathogenic, regulatory, and therapeutic roles of PD-1/PD-L1 system in eye diseases, including uveal melanoma, autoimmune uveitis, autoimmune dry eye, sympathetic ophthalmia, Graves' ophthalmopathy, diabetic retinopathy, herpes simplex keratitis, and trachoma, with the intent of highlighting the potential of PD-1/PD-L1 as novel therapeutic targets or biomarkers for these ocular diseases.

Magnetometers with exceptional sensitivity are highly demanded in solving a variety of physical and engineering problems, such as measuring Earth's weak magnetic fields and prospecting mineral deposits and geological structures. It has been shown that the non-Hermitian degeneracy at exceptional points (EPs) can provide a new route for that purpose, because of the nonlinear response to external perturbations. One recent work [H. Yang et al. Phys. Rev. Lett. 121, 197201 (2018)] has made the first step to realize the second-order magnonic EP in ferromagnetic bilayers respecting the parity-time symmetry. In this paper, we generalize the idea to higher-order cases by considering ferromagnetic trilayers consisting of a gain, a neutral, and a (balanced-)loss layer. We observe both second- and third-order magnonic EPs by tuning the interlayer coupling strength, the external magnetic field, and the gain-loss parameter. We show that the magnetic sensitivity can be enhanced by three orders of magnitude comparing to the conventional magnetic tunneling junction-based sensors. Our results pave the way for studying high-order EPs in purely magnetic system and for designing magnetic sensors with ultrahigh sensitivity.

We report the experimental observation of second-order corner states in a two-dimensional breathing honeycomb topolectrical circuit with sixfold rotational symmetry [Formula: see text] through voltage measurements. The topological corner states originate from the nontrivial bulk topology, which can be characterized by the topological invariant associated with the rotation eigenspectrum. We confirm two types of corner states, both originate from the [Formula: see text] symmetry, while one of them is specially pinned to zero admittance because of the emerging chiral symmetry protection. We then examine the robustness of zero modes in the presence of next-nearest-neighbor hopping terms that destroy chiral symmetry but still preserve [Formula: see text] symmetry. Our work provides a paradigm in circuit systems to study the exotic topological physics.

A 60-year-old man presented with exertional dyspnea and refractory pleural effusion. According to the history of tuberculosis and computed tomographic pulmonary angiography, he was diagnosed by fibrosing mediastinitis with pulmonary arteries stenosis and pulmonary veins stenosis (right and left

// Yunshan Cao 1, 2 , Jiyang Song 1 , Shutong Shen 3 , Heling Fu 4 , Xiang Li 5 , Ying Xu 6 , Aqian Wang 1 , Xinli Li 3 and Min Zhang 7 1 Department of Cardiology, Gansu Provincial Hospital, Lanzhou 730000, China 2 Department of Heart Failure, Shanghai East Hospital, Tongji University School of Medicine, Research Center for Translational Medicine, Shanghai 200120, China 3 Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China 4 Animal Core Facility, Nanjing Medical University, Nanjing 210029, China 5 Department of Intensive Care, Minhang Hospital, Fudan University, Shanghai 201100, China 6 Intensive Care Unit, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China 7 Department of Pathology, Gansu Provincial Hospital, Lanzhou 730000, China Correspondence to: Yunshan Cao, email: yunshancao@126.com Min Zhang, email: sallyzhangmin@126.com Keywords: acute right dysfunction, trimedazidine, PRAS40, pulmonary artery banding Received: May 16, 2017 Accepted: August 08, 2017 Published: September 08, 2017 ABSTRACT The molecular mechanism underlying acute right heart failure (RHF) is poorly understood. We used pulmonary artery banding (PAB) to induce acute RHF characterized by a rapid rise of right ventricular pressure, and then a decrease in right ventricular pressure along with a decrease in blood pressure right after banding. We found higher brain natriuretic peptide (BNP) and beta-myosin heavy chain (βMHC) levels and lower alpha-myosin heavy chain (αMHC) levels in RHF rats than sham-operated rats. Hemodynamic indexes in rats with acute RHF were slightly improved by trimedazidine TMZ, a key inhibitor of fatty acid (FA) oxidation. TMZ also reversed downregulation of peroxisome proliferator-activated receptor gamma coactivator 1-beta (PGC-1β) and peroxisome proliferator-activated receptor alpha (PPARα) by PAB and up-regulates peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), peroxisome proliferator-activated receptor delta (PPARδ) and pyruvate dehydrogenase kinase isoform 4 (PDK4). In addition, TMZ reversed upregulation of phosphorylated Akt by PAB and increased phosphorylated proline-rich Akt-substrate 40 (PRAS40). Autophagy and apoptosis were not modified by PAB or TMZ. An acute RHF model was established in rats through 70% constriction of the pulmonary artery. TMZ treatment alleviated PAB-induced acute RHF by activating PRAS40 and upregulatingPGC-1α, PGC-1β, PPARα, PPARδ, and PDK4.