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Background: Ischemic heart disease is one of the leading causes of mortality worldwide, and thus calls for development of more effective therapeutic strategies. This study aimed to identify potential therapeutic targets for coronary heart disease (CHD) and myocardial infarction (MI) by investigating the causal relationship between plasma proteins and these conditions. Methods: A two-sample Mendelian randomization (MR) study was performed to evaluate more than 1600 plasma proteins for their causal associations with CHD and MI. The MR findings were further confirmed through Bayesian colocalization, Summary-data-based Mendelian Randomization (SMR), and Transcriptome-Wide Association Studies (TWAS) analyses. Further analyses, including enrichment analysis, single-cell analysis, MR analysis of cardiovascular risk factors, phenome-wide Mendelian Randomization (Phe-MR), and protein-protein interaction (PPI) network construction were conducted to verify the roles of selected causal proteins. Results: Thirteen proteins were causally associated with CHD, seven of which were also causal for MI. Among them, FES and PCSK9 were causal proteins for both diseases as determined by several analytical methods. PCSK9 was a risk factor of CHD (OR = 1.25, 95% CI: 1.13–1.38, P = 7.47E-06) and MI (OR = 1.36, 95% CI: 1.21–1.54, P = 2.30E-07), whereas FES was protective against CHD (OR = 0.68, 95% CI: 0.59–0.79, P = 6.40E-07) and MI (OR = 0.65, 95% CI: 0.54–0.77, P = 5.38E-07). Further validation through enrichment and single-cell analysis confirmed the causal effects of these proteins. Moreover, MR analysis of cardiovascular risk factors, Phe-MR, and PPI network provided insights into the potential drug development based on the proteins. Conclusions: This study investigated the causal pathways associated with CHD and MI, highlighting the protective and risk roles of FES and PCSK9, respectively. FES. Specifically, the results showed that these proteins are promising therapeutic targets for future drug development. [ABSTRACT FROM AUTHOR]

Luteolin-7-O-β-d-glucuronide (LGU) is a major active flavonoid glycoside compound that is extracted from Ixeris sonchifolia (Bge.) Hance, and it is a Chinese medicinal herb mainly used for the treatment of coronary heart disease, angina pectoris, cerebral infarction, etc. In the present study, the neuroprotective effect of LGU was investigated in an oxygen glucose deprivation (OGD) model and a middle cerebral artery occlusion (MCAO) rat model. In vitro, LGU was found to effectively improve the OGD-induced decrease in neuronal viability and increase in neuronal death by a 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and a lactate dehydrogenase (LDH) leakage rate assay, respectively. LGU was also found to inhibit OGD-induced intracellular Ca2+ overload, adenosine triphosphate (ATP) depletion, and mitochondrial membrane potential (MMP) decrease. By Western blotting analysis, LGU significantly inhibited the OGD-induced increase in expressions of receptor-interacting serine/threonine-protein kinase 3 (RIP3) and mixed lineage kinase domain-like protein (MLKL). Moreover, molecular docking analysis showed that LGU might bind to RIP3 more stably and firmly than the RIP3 inhibitor GSK872. Immunofluorescence combined with confocal laser analyses disclosed that LGU inhibited the aggregation of MLKL to the nucleus. Our results suggest that LGU ameliorates OGD-induced rat primary cortical neuronal injury via the regulation of the RIP3/MLKL signaling pathway in vitro. In vivo, LGU was proven, for the first time, to protect the cerebral ischemia in a rat middle cerebral artery occlusion (MCAO) model, as shown by improved neurological deficit scores, infarction volume rate, and brain water content rate. The present study provides new insights into the therapeutic potential of LGU in cerebral ischemia. [ABSTRACT FROM AUTHOR]

Rapid restoration of perfusion in ischemic myocardium is the most direct and effective treatment for coronary heart disease but may cause myocardial ischemia/reperfusion injury (MIRI). Cinnamaldehyde (CA, C9H8O), a key component in the well‐known Chinese medicine cinnamomum cassia, has cardioprotective effects against MIRI. This study aimed to observe the therapeutic effect of CA on MIRI and to elucidate its potential mechanism. H9C2 rat cardiomyocytes were pretreated with CA solution at 0, 10, and 100 μM, respectively and subjected to oxygen‐glucose deprivation/reoxygenation (OGD/R). Then the cell viability, the NF‐κB and caspase3 gene levels, the reduced glutathione (GSH)/oxidized glutathione (GSSG) ratio, superoxide dismutase (SOD) level, reactive oxygen species (ROS) generation, 4‐hydroxynonenal (4‐HNE), and malondialdehyde (MDA) were detected. The severity of DNA damage was assessed by tail moment (TM) values using alkaline comet assay. Besides, the DNA damage‐related proteins and the key proteins of the Nrf2 pathway were detected by western blot. CA treatment increased the cell viability, GHS/GSSG ratio, SOD level, PARP1, Nrf2, PPAR‐γ, and HO‐1 protein levels of H9C2 cardiomyocytes, while reducing NF‐κB, caspase3, ROS level, 4‐HNE and MDA content, γ‐H2AX protein level, and TM values. Inhibition of the Nrf2 pathway reversed the effect of CA on cell viability and apoptosis of OGD/R induced H9C2 cardiomyocytes. Besides, 100 μM CA was more effective than 10 μM CA. In the OGD/R‐induced H9C2 cardiomyocyte model, CA can protect cardiomyocytes from MIRI by attenuating lipid peroxidation and repairing DNA damage. The mechanism may be related to the activation of the Nrf2 pathway. [ABSTRACT FROM AUTHOR]

This article, published in the journal Thoracic & Cardiovascular Surgeon, examines the incidence and relevance of coronary heart disease in patients undergoing abdominal aortic aneurysm (AAA) repair. The study analyzed data from 652 patients who underwent elective AAA repair, with 532 of them having prior invasive coronary angiography. The results showed that 70% of patients had coronary heart disease, with 42% requiring coronary artery intervention. Preoperative revascularization was performed in 28% of patients, and postoperative revascularization was performed in 14% of patients. The study suggests that routine preoperative invasive coronary angiography can improve patient outcomes and potentially long-term survival in AAA patients. [Extracted from the article]

This article, titled "Coronary Artery Bypass Grafting in the Elderly: Analysis of a 12 Year-Experience in a Single Center," examines the surgical treatment of coronary heart disease in patients over the age of 75. The study analyzes data from 4,931 coronary artery bypass grafting (CABG) procedures performed between 2010 and 2021. The results show that elderly patients had a higher prevalence of female gender and left main stenoses. They also had a higher incidence of central neurological disease and extracardiac arteriopathy. The study suggests that a less complex surgical approach and the use of hybrid revascularization may result in shorter operation times and lower postoperative cardiovascular morbidity in elderly patients. However, older patients had an increased risk of postoperative renal failure and 30-day mortality due to more comorbidities. [Extracted from the article]

Heart failure is a leading cause of death in patients who have suffered a myocardial infarction. Despite the timely use of modern reperfusion therapies such as thrombolysis, surgical revascularization and balloon angioplasty, they are sometimes unable to prevent the development of significant areas of myocardial damage and subsequent heart failure. Research efforts have focused on developing strategies to improve the functional status of myocardial injury areas. Consequently, the restoration of cardiac function using cell therapy is an exciting prospect. This review describes the characteristics of various cell types relevant to cellular cardiomyoplasty and presents findings from experimental and clinical studies investigating cell therapy for coronary heart disease. Cell delivery methods, optimal dosage and potential treatment mechanisms are discussed. [ABSTRACT FROM AUTHOR]

Drug-eluting stents (DES) are the best choice of the current era to open the occluded arteries. Its success depends upon the concentration of the drug and overall release kinetics, which in turn is subjected to the polymeric drug carrier and mechanism of drug release at the target area. Each generation of DES possess different characteristics based on different aspects i.e., polymer type, coating layer thickness, and drug concentration have been discussed. This review paper discusses all the polymers utilized in DES systems and their release profiles when combined with multiple drugs for the treatment of coronary heart disease. Drug-coated metal stents are used to support and improve the quality of life of patients with cardiovascular diseases. This review describes the properties of drug-eluting stent from different generations and challenges they offered. Nature of polymeric drug carriers affects the inflammation, lesion healing, rate of restenosis, and thrombosis. Ongoing research in DES technology aims to avoid the challenges offered by non-erodible polymeric drug carriers. Third-generation DES utilizes PLA-based polymers which are biocompatible, flexible, and erodible. Bioresorbable DES is future of DES technology; however, it is still in primitive stages and overcoming the issues of mechanical strength and corrosion. [ABSTRACT FROM AUTHOR]

Background: Although coronary artery disease and coronary artery spasm (CAS) can lead to acute myocardial infarction, there are clear differences in treatment between coronary heart disease and CAS, and the therapeutic schedule should not be confused. Furthermore, electrocardiogram (ECG) "6+2" phenomenon is recommend as a specific ECG indicator for lesions in the left main coronary artery or multiple vessels. Currently, no reports of this phenomenon in CAS exist. Case Report: A 72-year-old man had history of recurrent chest pain for over 6 years, with episodes lasting about 10 min and resolving with rest. He experienced symptom recurrence and exacerbation due to substance abuse. He was admitted to our Emergency Department for chest pain at rest. His emergency ECG revealed a 6+2 phenomenon, accompanied by troponin levels exceeding 18 times the reference value. Promptly, we conducted coronary angiography, with unexpected normal findings. Following thorough assessment, we postulated the patient could have CAS. Subsequent to medical team intervention, the patient's ECG normalized, leading to his discharge upon condition stabilization. Conclusions: We report a case of CAS in a patient with ECG 6+2 phenomenon, without significant coronary artery stenosis. This differs from transient ST-segment elevation on ECG, a well-recognized hallmark of CAS; however, such a presentation has not been documented before. Additionally, treatment strategies for myocardial ischemic conditions stemming from coronary atherosclerosis diverge from those employed for CAS. Therefore, clinicians should advocate for coronary angiography whenever feasible. This approach serves to elucidate the underlying disease etiology and facilitates the administration of precision-targeted interventions for patients. [ABSTRACT FROM AUTHOR]

In the present study, we investigated the mechanism of safflower-danshen treatment for coronary artery disease (CAD) through bioinformatics, network pharmacology, and single-cell sequencing. To identify target genes for hydroxy safflower yellow pigment, tanshinone, danshinolic acid, and tanshinol, we employed various databases, including Comparative Toxicogenomics Database, Swiss target prediction, Binding Database Home, and TargetNet. By analyzing three CAD datasets obtained from the GEO database, we identified CAD-associated genes using differential analysis and a weighted gene coexpression network analysis (WGCNA). We integrated drug-disease genes and utilized the mcode plugin in Cytoscape to identify core subgroups in the drug-disease regulatory networks. The infiltration of 38 immune cells/functions was assessed using the ssGSEA algorithm. Additionally, single-cell RNA sequencing (SCS) was employed to examine the distribution of cellular subpopulations within the mcode regulatory network. Finally, we performed GO and KEGG enrichment analyses for drug target genes, disease genes, and mcode core subpopulation genes. Our results revealed 485 drug target genes obtained from four databases. Through differential analysis and WGCNA, we identified 617 disease genes associated with CAD. The mcode plugin analysis yielded a drug-disease core regulatory subpopulation consisting of 99 genes. The ssGSEA algorithm indicated that members of the TGF β family, chemokines, and interleukin receptors might play key roles in the immune regulation of safflower-danshen treatment for CAD. Furthermore, SCS results suggested that macrophages and monocytes might be core cell subpopulations within this context. GO and KEGG enrichment analyses highlighted endosome-bound organelles and nuclei as potentially important cellular components. In conclusion, safflower-danshen treatment for CAD might exert its therapeutic effects by modulating TGFβ family members, chemokines, interleukin receptors, macrophages, monocytes, endosome-bound organelles, and nuclei. [ABSTRACT FROM AUTHOR]

The article discusses the long-term consequences of sepsis, a condition resulting from a dysregulated immune response to infection. The study examines the incidence of immune-mediated inflammatory diseases (IMIDs) among sepsis survivors compared to survivors of acute myocardial infarction (AMI). The results show that sepsis survivors have a significantly higher incidence of IMIDs, with the risk increasing after 16 days from the original sepsis episode. The study suggests that the type of immune dysregulation in sepsis may also contribute to the development of cardiovascular diseases. The findings highlight the need for precision immunotherapy to address both short-term and long-term sepsis complications. [Extracted from the article]

Objective: To explore and analysis the values of three-dimensional ultrasound speckle technique combined with SYNTAX score in the diagnosis of coronary heart disease. Methods: From February 2022 to January 2023, 350 cases of patients with coronary heart disease diagnosed and treated in a certain hospital were selected as the study subjects. All patients were given three-dimensional ultrasound spot examination, and all patients were given SYNTAX score. The incidence of major adverse cardiovascular event (MACE) of the patients were followed up and recorded for correlation analysis. Results: In the 350 patients, the average follow-up time were 9.14-1.13 months until February 1, 2023. There were 45 cases of MACE (MACE group), accounting for 12.9 %, included 6 cases of cardiac death, 14 cases of coronary syndrome, 13 cases of revascularization, 7 cases of malignant arrhythmia, and 5 cases of heart failure. There were no significant difference in age, body mass index, sex, total cholesterol (TG), high-density lipoprotein (HDL-C), low density lipoprotein (LDL-C), triglyceride (TC) blood glucose compared between MACE group and non-MACE group (P>0.05). The three-dimensional ultrasound speckle parameter-right ventricular systolic peak strain rate (SRs) in the MACE group were higher than that in the non-MACE group (P<0.05), and the right ventricular late diastolic peak strain rate (SRa) and early diastolic peak strain rate (SRc) were significantly lower than those in the non-MACE group (P<0.05). The SYNTAX scores of the MACE group were significantly higher than that of the non-MACE group (P<0.05), and there were also significant difference in the proportion of people in the SYNTAX score grading compared between the two groups (P<0.05). In the 350 patients, Spearman analysis showed that SYNTAX score, SRs, SRc and SRa were positively correlated with the occurrence of MACE (P<0.05). Logistic regression analysis showed that SYNTAX score, SRs, SRc and SRa were important factors leaded to MACE (P<0.05). Conclusion: The incidence of MACE in patients with coronary heart disease after treatment is still relatively high, which is often accompanied by the increase of SYNTAX score. There are certain differences in the examination of three-dimensional ultrasound speckle technology. The combination of three-dimensional ultrasound speckle technology and SYNTAX score can effectively reflect the condition of patients with coronary heart disease. [ABSTRACT FROM AUTHOR]

Background: In the present study, the effects of extracorporeal cardiac shock waves combined with different concentrations of sulfur hexafluoride ultrasound microbubbles on myocardial ultrastructure in rats were observed. Methods: Thirty-six rats were randomly divided into 6 groups: control group (N), extracorporeal cardiac shock wave group, and combined group, i.e., extracorporeal cardiac shock wave combined with different concentrations of sulfur hexafluoride microbubble (0.225 mL/kg/min, 0.45 mL/kg/min, 0.9 mL/kg/min, 1.8 mL/kg/min). The combination of extracorporeal cardiac shock wave combined with sulfur hexafluoride microbubbles of different concentrations had no significant effect on hemodynamic indexes and left ventricular function in rats. Results: There were significant differences in cardiac troponin I (cTnI) and nitric oxide among different groups. Histopathology showed that inflammatory cells infiltrated in the shock wave+microbubble 0.9 and shock wave+microbubble 1.8 groups. The myocardial ultrastructural injury score of shock wave+microbubble1.8 group was significantly higher than that of the N group, shock wave group, shock wave+microbubble 0.225 group, and shock wave+microbubble 0.45 group. The score of shock wave+microbubble 0.9 group was higher than that of the control group (P=.009). Western blot results showed that the expression of vascular endothelial growth factor and endothelial nitric oxide synthase (eNOS) protein in the rats treated with extracorporeal cardiac shock wave combined with sulfur hexafluoride microbubbles of different concentrations was higher than that in the N group and shock wave group, with shock wave+microbubble 0.45 group having the strongest expression. Conclusion: Myocardial ultrastructure damage occurs when high concentrations of sulfur hexafluoride microbubbles are present, but a proper concentration of sulfur hexafluoride microbubbles could promote the cavitation effect of extracorporeal cardiac shock waves. Thus combination therapy may become a new paradigm in coronary heart disease, especially contributing to the treatment of refractory angina. Combination therapy may change coronary heart disease treatment, especially for refractory angina. [ABSTRACT FROM AUTHOR]

Salvianolate (Sal) is a medicinal composition that is widely used in China for the treatment of coronary heart disease and angina pectoris. The aim of the present study was to investigate the potential macrophage-mediated pro-angiogenic effects of Sal in vitro. In addition, another aim was to explore the effects of Sal in a rat model of transient middle cerebral artery occlusion (tMCAO) along with the potential mechanism by which it promotes angiogenesis. In this study, human umbilical vein endothelial cells (HUVECs) and Raw264.7 macrophages in vitro, and a rat tMCAO model in vivo were used to detect the pro-angiogenic effect and mechanism of Sal. The results of in vitro experiments showed that the viability, migration and tube formation of HUVECs were promoted by the supernatant of Sal-treated Raw264.7 macrophages (s-Sal) but not by Sal alone. s-Sal also increased the levels of phosphorylated (p-)VEGFR-2, p-AKT and p-p38 MAPK in HUVECs while Sal alone did not. In vivo, treatment with Sal significantly reduced the cerebral infarction volume and neurological deficit scores in the rat tMCAO model. Similar to the mechanism observed in the in vitro experiments, Sal treatment upregulated the protein expression of VEGF and VEGFR-2, in addition to the phosphorylation of VEGFR-2, AKT and p38, in the brain tissues of the tMCAO model rats. In summary, the results of the present study suggest that the mechanism of Sal-mediated angiogenesis is associated with stimulation of the VEGF/VEGFR-2 signaling pathway by macrophages. This suggests the potential of Sal as a therapeutic option for the treatment of acute cerebral ischemic injury, which may act via the promotion of angiogenesis. [ABSTRACT FROM AUTHOR]

In the treatment of coronary heart disease, the most promising approach for replacing lost contractile elements involves obtaining cardiomyocytes through cardiac differentiation of pluripotent cells. The objective of this study is to develop a technology for creating a functional layer of cardiomyocytes derived from iPSCs, capable of generating rhythmic activity and synchronous contractions. To expedite the maturation of cardiomyocytes, a renal subcapsular transplantation model was employed in SCID mice. Following explantation, the formation of the cardiomyocyte contractile apparatus was assessed using fluorescence and electron microscopy, while the cytoplasmic oscillation of calcium ions was evaluated through visualization using the fluorescent calcium binding dye Fluo-8. The results demonstrate that transplanted human iPSC-derived cardiomyocyte cell layers, placed under the fibrous capsules of SCID mouse kidneys (for up to 6 weeks), initiate the development of an organized contractile apparatus and retain functional activity along with the ability to generate calcium ion oscillations even after removal from the body. [ABSTRACT FROM AUTHOR]

The study aimed at the determination of risk factors, their relationship with the development of stenosing lesions of the coronary arteries in different ethnic groups in Kazakhstan. Primary coronary angiographies of n=640 patients diagnosed with coronary heart disease (CHD) (2017-2019) have been analysed (Almaty, Kazakhstan). The patients were subdivided into: Kazakhs (n=338) and Russians (n=302). In the Russian group, the chance of arterial hypertension incidence was higher (44% and 33%, p<0.05). In the Russian group, the percentage of obstructive CHD was higher than in the Kazakhs (66% and 57%, p<0.05). There was association between obstructive CHD and risk factors such as male sex, diabetes, smoking, and diastolic blood pressure (DBP) in the Kazakhs (p<0.05). In the Russian group, the relationship between development of CHD and age, level of total cholesterol and high-density lipoprotein (HDL) was higher (p<0.05). There is an association between smoking, diabetes, sex, DBP and the development of CHD in Kazakhs. In the Russian group, CHD was associated with risk factors such as older age, dyslipidaemia and arterial hypertension. There were significant ethnic differences in the risk factors and CHD, in the Russian group the probability of development of obstructive CHD was higher. There was an association between smoking, diabetes, sex, DBP and the development of CHD in Kazakhs. In the Russian group, CHD was associated with risk factors such as older age, dyslipidaemia and arterial hypertension. These finding indicate the need to develop differentiated programmes for the screening, preventive measures for different ethnic groups. [ABSTRACT FROM AUTHOR]

Objective: To observe the effects of Xintong oral liquid combined with metoprolol on vascular endothelial function, myocardial injury index and serum matrix metalloproteinases (MMP) - 2, MMP-7, MMP-8 and MMP-9 in patients with coronary heart disease with angina pectoris. Methods: According to the random number table method, 72 patients with coronary heart disease with angina pectoris who were admitted to our hospital from January 2021 to May 2022 were divided into control group (n=36) and study group (n=36). On the basis of conventional treatment, patients in the control group received metoprolol treatment, and patients in the study group received Xintong oral liquid combined with metoprolol treatment. The curative effect, adverse reaction rate, cardiac function indicators [left ventricular ejection fraction (LVEF) and cardiac output (CO)], clinical indicators (number of angina attacks, duration of each attack, dose of isosorbide nitrate tablets), endothelial function indicators [nitric oxide (NO) and vascular endothelial growth factor (VEGF), 6-ketone front row F1a (6-keto-PGF1a)], myocardial injury indicators [cardiac troponin I (cTnI), brain natriuretic peptide (BNP), creatine kinase isoenzyme (CK-MB)] and serum MMP-2, MMP-7, MMP-8, MMP-9 levels of two groups were compared. Results: The total effective rate of the study group (94.44%) was higher than (75.00%) of the control group (P<0.05). 2 weeks after treatment, LVEF and CO of the study group were higher than those of the control group (P<0.05). 2 weeks after treatment, the dose of isosorbide nitrate tablets, number of angina attacks of the study group were less than those of the control group, and the duration of each attack was shorter than that of the control group (P<0.05). 2 weeks after treatment, the NO, VEGF and 6-keto-PGF1a of the study group were higher than those of the control group (P<0.05). 2 weeks after treatment, the serum MMP-2, MMP-7, MMP-8 and MMP-9 levels of the study group were lower than those of the control group (P<0.05). 2 weeks after treatment, CK-MB, BNP and cTnI of the study group were lower than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Xintong oral liquid combined with metoprolol in the treatment of patients with coronary heart disease with angina pectoris can improve clinical symptoms, vascular endothelial function, myocardial injury indicators, cardiac function and serum MMP-2, MMP-7, MMP-8 and MMP-9 levels. [ABSTRACT FROM AUTHOR]

The study aims to investigate the effect of developmental endothelial locus-1(DEL-1) expression in atherosclerotic plaque formation and its mechanism. Human left coronary arteries were collected to detect the DEL-1 expression. The ApoE−/− mice were used to establish the atherosclerosis mice model. The left coronary artery and mouse aorta were stained with HE, Oil Red O, and Movat staining. The DEL-1 levels, chemokines CXC chemokine receptor 4 (CXCR4) and its ligand stromal cell-derived factor-1alpha (SDF-1 α), pathway protein glycogen synthase kinase-3β (GSK-3β), CCAAT enhanced binding protein β (C/EBPβ), and downstream inflammatory factors (C-X-C motif chemokine 2 (MIP-2or CXCL2), macrophage inflammatory protein-1alpha (MIP-1 α or CCL3),Tumor Necrosis Factor alpha (TNF- α) were detected by immunoblotting and immunohistochemistry. Pearson correlation coefficient was used to analyze the correlation between DEL-1 gene expression and inflammatory factors in the lesion group and the correlation between DEL-1 gene expression and structure-related indexes. Compared with Control group(CON), the intravascular plaque area was widened, accompanied by narrowed lumens. The number of plaque foam cells was significantly increased in the high fat and high cholesterol (AS group) or AAV9-eGFP group (P < 0.05). Compared to CON, the enhanced fluorescence intensity of DEL-1 with CD68 in the AS or AAV9-eGFP groups. Diminished fluorescence of DEL-1 with CD68 expression in AAV9-CXCR4 group compared to AS group or AAV9-eGFP group. The DEL-1 and its downstream proteins in AS group or AAV9-eGFP group were mainly accumulated in the macrophage cytoplasm. The DEL-1 expression level was significantly and positively correlated with plaque area, lumen stenosis, plaque foam cell count, TNFα, CXCL2, and CCL3 levels. DEL-1 inhibition decreases macrophagic inflammatory factors involved in atherosclerotic plaque formation. • This study is completed on the basis of previous work, so it has certain data support. • This study is the first to use the expression of DEL-1 in human coronary tissue in coronary artery disease and sudden cardiac death. • It explores the mechanism of DEL-1 in the development of coronary artery disease. • This study can add a reference to the coronary heart disease biomarker database. • It provides an experimental basis for the clinical prevention and treatment of coronary heart disease and the pathological diagnosis of sudden coronary death. [ABSTRACT FROM AUTHOR]

Identification and detection of thin-cap fibroatheroma (TCFA) from intravascular optical coherence tomography (IVOCT) images is critical for treatment of coronary heart diseases. Recently, deep learning methods have shown promising successes in TCFA identification. However, most methods usually do not effectively utilize multi-view information or incorporate prior domain knowledge. In this paper, we propose a multi-view contour-constrained transformer network (MVCTN) for TCFA identification in IVOCT images. Inspired by the diagnosis process of cardiologists, we use contour constrained self-attention modules (CCSM) to emphasize features corresponding to salient regions (i.e., vessel walls) in an unsupervised manner and enhance the visual interpretability based on class activation mapping (CAM). Moreover, we exploit transformer modules (TM) to build global-range relations between two views (i.e., polar and Cartesian views) to effectively fuse features at multiple feature scales. Experimental results on a semi-public dataset and an in-house dataset demonstrate that the proposed MVCTN outperforms other single-view and multi-view methods. Lastly, the proposed MVCTN can also provide meaningful visualization for cardiologists via CAM. [ABSTRACT FROM AUTHOR]

Aim To compare outcomes of two different surgical techniques of coronary artery bypass grafting (CABG) for treating isolated left anterior descending (LAD) coronary artery disease by full median sternotomy technique vs. minimally invasive approach via left anterior mini-thoracotomy. Methods This retrospective, observational study, which included 61 elective patients, was conducted at the Clinic for Cardiovascular Surgery of the Clinical Centre of the University of Sarajevo in the period from June 2019 to January 2022. Patients were divided in two groups according to the operative technique used, the sternotomy CABG group of 30 patients where the access considered full median sternotomy, and the minimally invasive CABG group where left anterior mini-thoracotomy was performed. The groups were compared by previously defined primary and secondary clinical postoperative outcomes. Results Out of 61 patients, the majority was males, 50 (82%). The analysis of the outcomes of the minimally invasive CABG surgery showed significantly shorter operative times (p=0.001), less postoperative drainage (p=0.001) and transfusion requirements, shorter mechanical ventilation duration (p=0.0001), low major adverse cardiac and cerebrovascular events rates, as well as shorter Intensive Care Unit stay days with mean of 3.3±1.442 days (p=0.025), but no total hospital stay days with mean of 6.7±1.832 days (p=0.075) compared to sternotomy CABG group. Conclusion Minimally invasive approach for CABG surgery in treating isolated single vessel LAD disease, together with the fasttrack protocol, offers a reasonable alternative to full median sternotomy, leading to faster patients' overall recovery and improving the quality of life. [ABSTRACT FROM AUTHOR]

Vascular stent implantation has become an important choice for the treatment of severe cardiovascular and cerebrovascular blockage. Rational design is vital to ensure the mechanical properties of the vascular stents, which are important both to the implantation and service as for clinical treatment of coronary heart disease. Therefore we proposed a wholly new non-uniform honeycomb stent E and compared with an inverted honeycomb-like shaped stent F and a honeycomb-like shaped stent G. To evaluate their properties, a finite element method (FEM) was used to simulate the implantation process (crimp, crimp recoil, expand, and expand recoil) of these three different kinds of stents. Results showed that the stent E exhibits better mechanical behaviour than the other two stents F and G as far as radial strength and axial shortening performances and that the distribution of equivalent stress among the stent E is more uniform than that among the other two stents F and G. After that, a three-point bending method was used to study the bending flexibility of these three vascular stents. Stent E shows high bending stiffness compared with stents F and G due to the existence of additional support bridges in its structure. This study can be helpful to the rational design of optimizable PLA stents for its practical clinical performance and therefore possibly improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of Shenshao tablets combined with metoprolol tartrate tablets on oxidative stress, vascular endothelial function and myocardial injury markers in patients with coronary heart disease and angina pectoris. Methods: Cases were selected from 110 patients with coronary heart disease and angina pectoris who were treated in our hospital from September 2018 to July 2021, According to the parity order of admission, the patients were divided into control group (55 cases) and observation group (55 cases). The patients in the control group were treated with metoprolol tartrate tablets, and the patients in the observation group were treated with Shenshao tablets combined with metoprolol tartrate tablets. The total clinical effective rate and ECG effective rate of the two groups were observed. The clinical symptoms and oxidative stress [superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-PX)], vascular endothelial function [endothelin (ET), vascular endothelial growth factor (VEGF), nitric oxide (NO)] and myocardial injury markers [cardiac troponin (cTn), creatine kinase isoenzyme (CK-MB), brain natriuretic peptide (BNP)] changes were compared between the two groups, the incidence of adverse reactions in the two groups was recorded. Results: Compared with the control group, the total clinical effective rate and ECG effective rate in the observation group were further increased (P<0.05). 12 weeks after treatment, the number of angina pectoris attacks in the observation group was less than that in the control group, the duration of angina pectoris was shorter than that in the control group, and the 6 min walking test distance was longer than that in the control group (P<0.05). 12 weeks after treatment, the levels of VEGF and ET in the observation group were lower than those in the control group, and the level of NO was higher than that in the control group (P<0.05). 12 weeks after treatment, the levels of CK-MB, cTn and BNP in the observation group were lower than those in the control group (P<0.05). 12 weeks after treatment, the level of MDA in the observation group was lower than that in the control group, and the levels of SOD and GSH-PX were higher than those in the control group (P<0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Shenshao tablet combined with metoprolol tartrate tablet in the treatment of patients with coronary heart disease and angina pectoris can promote the improvement of symptoms, reduce oxidative stress and vascular endothelial injury, and play a good myocardial protective effect. [ABSTRACT FROM AUTHOR]

Objective. This study was to study the efficacy of rosuvastatin, amlodipine, and aspirin in the treatment of hypertension with coronary heart disease and its effect on platelet aggregation. Methods. The participants included 60 patients with hypertension and coronary heart disease who were treated at our hospital between January 2020 and May 2021 and were randomly assigned to receive either rosuvastatin, amlodipine, and Ziyin Huoxue Recipe (observation group) or rosuvastatin, amlodipine, Ziyin Huoxue Recipe, and aspirin (experimental group), with 30 patients in each. Outcome measures included clinical effectiveness, blood pressure indicators, blood lipid indices, plasma viscosity, platelet aggregation, cardiac function, and adverse responses. Results. The clinical efficacy in the experimental group was significantly higher than that in the observation group (P < 0.05). The differences were found in blood pressure indices and blood lipid indices between the two groups before treatment (P > 0.05). However, after treatment, the blood pressure indices in the experimental group were significantly lower than those in the observation group (P < 0.05). After treatment, the blood lipid indices, plasma viscosity, and platelet aggregation in the experimental group were significantly lower than those in the observation group (P < 0.05). The left ventricular ejection fraction (LVEF) of patients in the experimental group after treatment was significantly higher than that of patients in the observation group (P < 0.05). There was no significant difference in the incidence of adverse reactions among patients in the two groups (P > 0.05). Conclusion. The clinical efficacy of rosuvastatin, amlodipine, and aspirin markedly reduces the blood pressure indices, blood lipid indices, plasma viscosity, and platelet aggregation of patients with hypertension and coronary heart disease, improves LVEF, and has a good safety profile. [ABSTRACT FROM AUTHOR]

Percutaneous coronary intervention (PCI) has become the primary treatment for patients with coronary heart disease because of its minimally invasive nature and high efficiency. Anatomical studies have shown that most coronary vessels gradually shrink, and the vessels gradually become thinner from the proximal to the distal end. In this paper, the effects of different stent expansion methods on the mechanical and hemodynamic behaviors of coronary vessels and stents were studied. To perform a structural-mechanical analysis of stent implantation, the coronary vessels with branching vessels and the coronary vessels with large bending curvature are selected. The two characteristic structures are implanted in equal diameter expansion mode and conical expansion mode, and the stress and mechanical behaviors of the coronary vessels and stents are analyzed. The results of the structural-mechanical analysis showed that the mechanical behaviors and fatigue performance of the cobalt-chromium alloy stent were good, and the different expansion modes of the stent had little effect on the fatigue performance of the stent. However, the equal diameter expansion mode increased distal coronary artery stress and the risk of vascular injury. The computational fluid dynamics analysis results showed that different stent expansion methods had varied effects on coronary vessel hemodynamics and that the wall shear stress distribution of conical stent expansion is more uniform compared with equal diameter expansion. Additionally, the vortex phenomenon is not apparent, the blood flow velocity is slightly increased, the hydrodynamic environment is more reasonable, and the risk of coronary artery injury is reduced. [ABSTRACT FROM AUTHOR]

Oleum Cinnamomi is a traditional medicine used by the Hmong, the essential oil obtained from Fructus Cinnamomi, for the treatment of coronary heart disease. Information regarding the efficient quality control markers of it is lacking, which has become a bottleneck restricting its development and utilization. Here, an integrated qualitative analysis approach based on a GC-MS and network pharmacology strategy was applied to explore quality control markers for the assessment of Oleum Cinnamomi. Firstly, the compounds of Oleum Cinnamomi were detected by GC-MS. In total, 57 chemical components were identified, mainly monoterpenes and sesquiterpenes, accounting for 83.05% of total essential oil components. Secondly, network pharmacology was adopted to explore the compounds linked to target genes of coronary heart disease. Fifty-two compounds were found, indicating the effectiveness of Oleum Cinnamomi in the treatment of coronary heart disease. Among them, 10 compounds, including eucalyptol, were chosen as potential effective compounds in Oleum Cinnamomi. Thirdly, an established GC-MS SIM method was validated and applied for the simultaneous determination of the contents of these 10 compounds using 20 sample batches of Oleum Cinnamomi. It was preliminarily found that the contents of these 10 compounds differed in Oleum Cinnamomi from different origins. Finally, quantitative analyte data were analyzed using multivariate statistical analysis to determine Oleum Cinnamomi quality. Four compounds (eucalyptol, p-cymene, sabinene, β-pinene) were identified as chemical markers for quality control. Accordingly, this study provides new strategies to explore the quality control markers and develops a novel method for the quality assessment of Oleum Cinnamomi. [ABSTRACT FROM AUTHOR]

Optical coherence tomography (OCT) with high resolution was found lucrative for coronary heart disease diagnosis and treatment such as evaluating the degree of vascular stenosis and guiding stent implantation. Lumen contour is an essential information for assessing the shape and stenosis of blood vessels. The automatic and accurate extraction of lumen contour can significantly reduce the burden of doctors and improve the efficiency of diagnosis and treatment of coronary heart disease. The existing contour segmentation methods have poor performance in extracting the contour of the image with a missing blood vessel wall. Therefore, this paper proposes a two-stage contour extraction method based on deep learning. First, the method uses the basic contour extraction network to complete the feature image extraction and coarse contour segmentation, then inputs the feature image into the attentional class feature (ACF) module, and uses the coarse segmentation results to guide the generation of the new feature map for the refined contour segmentation. Finally, the fully connected conditional random field (CRF) module is used for post-processing yielding a more refined and smooth segmentation boundary. The experiments show that compared with the other methods, the lumen contour segmentation method proposed in this paper can adequately resolve the problem of partial vessel wall absence in OCT images and improve the accuracy of lumen contour extraction. [ABSTRACT FROM AUTHOR]

Traditional Chinese medicine (TCM) has long been used to treat diabetes mellitus and angina. It has also gained widespread clinical applications in China as a common adjuvant treatment. Although there is high-quality evidence that TCM is effective in regulating glucose and lipid metabolism, the cardiovascular protective effect of TCM in the treatment of diabetes mellitus has not been fully elucidated, especially in patients with both diabetes mellitus and coronary heart disease (CHD). We systematically assessed the efficacy and safety of TCM for the adjuvant treatment of patients with CHD and diabetes mellitus and examined the pharmacological effects and potential mechanisms of TCM medication/herbs on diabetes mellitus with CHD. We found that TCM could improve the control effect of conventional treatment on cardiac function, hemorheology, blood glucose, blood lipid, and inflammation, thus reducing the frequency of angina and the incidence of cardiovascular events and all-cause mortality. These findings indicate that TCM may be used as a complementary approach for patients with diabetes mellitus and CHD. Nevertheless, more rigorously designed randomized controlled trials and long-term evaluations are needed to support these findings. [ABSTRACT FROM AUTHOR]

Denmark has experienced a remarkable reduction in CVD mortality over recent decades. The scale of the health contribution from the Danish regulation on industrially produced trans fatty acid (ITFA) has therefore long been of interest. Thus the objective was to determine health and equity benefits of the Danish regulation on ITFA content in Danish food, by quantifying the relative contributions of changes in ITFA intake, other risk factors and treatments on coronary heart disease (CHD) mortality decline from 1991 to 2007 in Denmark, stratified by socioeconomic group. To evaluate the effects of the ITFA ban (Danish Order no. 160 of March 2003) the Danish IMPACTSEC model was extended to quantify reductions in CHD deaths attributable to changes in ITFA (%E) intake between 1991–2007. Population counts were obtained from the Danish Central Office of Civil Registration, financial income from Statistics Denmark and ITFA intake from Dan-MONICA III (1991) and DANSDA (2005–2008). Participants were adults aged 25–84 years living in Denmark in 1991 and 2007, stratified by socioeconomic quintiles. The main outcome measure was CHD deaths prevented or postponed (DPP). Mean energy intake from ITFA was decimated between 1991 and 2007, falling from 1.1%E to 0.1%E in men and from 1·0%E to 0·1%E in women. Approximately 1,191 (95% CI 989–1,409) fewer CHD deaths were attributable to the ITFA reduction, representing some 11% of the overall 11,100 mortality fall observed in the period. The greatest attributable mortality falls were seen in the most deprived quintiles. Adding ITFA data to the original IMPACTsec model improved the overall model fit from 64% to 73%. In conclusion: Denmark's mandatory elimination of ITFA accounted for approximately 11% of the substantial reduction in CHD deaths observed between 1991 and 2007. The most deprived groups benefited the most, thus reducing inequalities. Adopting the Danish ITFA regulatory approach elsewhere could substantially reduce CHD mortality while improving health equity. [ABSTRACT FROM AUTHOR]

The study built on previous research that found exercise to be the most effective treatment for depression in coronary heart disease. At eight weeks, the study found that group exercise treatment resulted in a cost of €526 per patient who achieved remission from depression (i.e. was successfully treated). New research from the Healthcare Outcomes Research Centre and Department of Health Psychology at RCSI indicates that exercise is more cost-effective than psychotherapy or medication in the treatment of depression in individuals with coronary heart disease. [Extracted from the article]

This research was aimed at exploring the application value of optical coherence tomography (OCT) images under adaptive segmentation algorithm in the early diagnosis of coronary heart disease (CHD). Eighty-two patients with CHD were included, who were to undergo coronary angiography (CAG) to confirm their condition. According to the diagnostic criteria of CHD in the American Coronary Artery Surgery Study (CASS), the patients were divided into the stable plaque group (41 cases) and unstable plaque group (41 cases). Besides, 20 healthy volunteers were selected as the control group, and all of them underwent OCT scans. On the basis of a fourth-order partial differential equation (PDE) and active contour (AC) model, a novel adaptive image segmentation algorithm PDE-AC was constructed and used for OCT image processing. No significant difference was found in general clinical data and serological indicators in the control group compared to the other two groups (P > 0.05). The lipid plaque length, degree of stenosis, and lipid pool angle, macrophages and intimal erosion, and plaque fissure in the unstable plaque group were highly greater than those in the stable plaque group. The fibrous cap thickness (FCT) was significantly thinner than that in the stable plaque group (P < 0.05). The diagnostic sensitivity, specificity, and accuracy of OCT under PDE-AC algorithm for CHD (91.53%, 84.08%, and 95.38%) were markedly higher than those of single OCT (83.46%, 75.11%, and 88.02%) (P < 0.05). In summary, OCT images under PDE-AC algorithm did better than simple OCT images in the diagnosis of CHD. Lipid plaque length, degree of stenosis, and lipid pool angle, macrophage and intimal erosion, plaque fissure, and FCT were important indicators for judging plaque stability, having the better clinical application value. [ABSTRACT FROM AUTHOR]

The theory of "heart housing shen (mind)" elaborated on in Huangdi Neijing (Huangdi's Internal Classic) has important guiding significance in clinical practice. In view of the prevalence and morbidity of coronary heart disease with anxiety and depression, which is considered to be the disorder of heart's function, the heart failing to house shen could be used in explanation of its pathogenesis. This paper explains the theoretical connotation of "heart housing shen" and the intrinsic connection between such a theory and the coronary heart disease with anxiety and depression. Based on that, it is stated that "treatment to restore the heart's dual functions" and "simultaneous treatment of the body and mind" are the fundamental treatment principles for that disorder. Besides, as the onset of the coronary heart disease with anxiety and depression is also closely related to the liver, both the heart and liver should be addressed by nourishing the heart and calming the shen, promoting blood circulation and removing blood stasis, and regulating the liver qi to relieve qi stagnation. [ABSTRACT FROM AUTHOR]

This study intends to evaluate the characteristics of coronary microcirculatory function in patients with myocardial infarction undergoing reperfusion and its predictive value in assessing cardiac function, myocardial activity, recovery of ventricular wall motion after infarction, and distant myocardial remodeling by cardiac magnetic resonance technique (CMRI). Materials and Methods. The 293 cases of patients with myocardial infarction treated in our hospital from August 2017 to August 2021 were selected as the subjects of this retrospective study, 13 cases were shed due to transfer and moving, and the rest were divided into 140 cases each in the emergency and elective groups according to emergency percutaneous coronary intervention (PCI) and elective PCI. The patients' myocardial infarct volume ventricular volume, microcirculatory obstruction volume ventricular volume, microcirculatory obstruction volume/myocardial infarct volume, and LVEF, combined with BP and troponin T, were analysed by CMR for comparative analysis, hemodynamic, and cardiac function index differences. Results. The hemodynamics (CO, CI, SV, SI, LVSW1, and LCW) measured at different times were significantly different between the two groups; patients in the emergency group had significantly lower EDV and ESV than the elective group at 7-10 d postoperatively; and EDV, ESV, and LVEF improved in both groups after 3 months, while EDV, ESV, and LVEF improved significantly better in the emergency group than in the elective group, and the difference was statistically significant (P < 0.05). The myocardial infarct quality, VSM score, and ventricular wall motion abnormality score were significantly lower in the emergency group than in the elective group from 7 to 10 d after PCI; myocardial infarct quality, VSM score, and ventricular wall motion abnormality score improved in both groups at 3 months after PCI; and the degree of improvement of myocardial infarct quality and VSM score was significantly better in the emergency group than in the elective group (P < 0.05). Conclusion. Acute myocardial infarction patients with significant effect of emergency PCI treatment can be on their postmyocardial infarction left ventricular function, and in the treatment of coronary heart disease, myocardial infarction diagnosis has a certain reference value. [ABSTRACT FROM AUTHOR]

Pomadasys maculatus (Blotched-grunt, saddle grunter) generally, often known as the "Dhoter," is a commercially significant fish of the coast of India-Pakistan. Fishes are high in nutrients such as polyunsaturated fatty acids, amino acids, vitamins, and minerals. It is important in the prevention and treatment of coronary heart disease, asthma, eye problems and vitamin shortages. The natural crystalline material collected from the head of the Pomadasys maculatus fishes are used for various characterization techniques such as single crystal XRD, powder XRD, EDAX, SEM, FT-IR and FT-Raman, and the other biological properties of the Otolith stones are analyzed. The unit cell characteristics of the naturally collected otolith stones were determined using single crystal X-ray diffraction. The FT-IR and FT-Raman spectra investigated the various functional groups found in the otolith stones. The current study also sought to investigate the cytotoxicity, anti-inflammatory and wound healing properties of otolith stones found in Pomadasys maculatus fishes. One of the goals of this study is to determine whether otolith stones have cytotoxic effects on fibroblast cells. The inhibitory effects of otolith stones in LPS-stimulated RAW 264.7 macrophages were used to assess their anti-inflammatory properties. The wound scratch assay assured the otolith stone's wound healing efficacy. The EDAX analysis exhibits the various constituents present in otolith stones. [ABSTRACT FROM AUTHOR]

Coronary atherosclerotic heart disease (CHD) is a primary cardiovascular disease caused by atherosclerosis (AS), which is characterized by chronic inflammation and lipid oxidative deposition. Molecular hydrogen (H 2) is an effective anti-inflammatory agent and has potential to ameliorate glycolipid metabolism disorders, which is believed to exert beneficial effects on the prevention and treatment of CHD. It is suggested that H 2 reduces inflammation in CHD by regulating multiple pathways, including NF-κB inflammatory pathway, pyroptosis, mitophagy, endoplasmic reticulum (ER) stress, and Nrf2 antioxidant pathway. Additionally, H 2 may improve glycolipid metabolism by mediation of PI3K and AMPK signalling pathways, contributing to inhibition of the occurrence and development of CHD. This review elaborates pathogenesis of CHD and evaluates the role of H 2 in CHD. Moreover, possible molecular mechanisms have been discussed and speculated, aiming to provide more strategies and directions for subsequent studies of H 2 in CHD. [ABSTRACT FROM AUTHOR]

The prevention and treatment of coronary heart disease (CHD) is a difficult problem to be solved urgently. Genetic factors play a crucial role in CHD development. This study aimed to investigate the association of GAS5/METTL14/ESR1 polymorphisms with CHD susceptibility. We carried out a case–control study that included 506 patients and 506 healthy subjects to detect the correlation between GAS5/METTL14/ESR1 polymorphisms and CHD risk in a Chinese population. Odds ratios (OR) and 95% confidence intervals (CI) were computed to assess the associations. Our study showed that GAS5 rs17359906 (OR 2.32, p = 0.020) and rs75315904 (OR 0.41, p = 0.039) were related to the risk of CHD in females. ESR1 rs6927072 (OR 1.76, p = 0.007) and rs4870061 (OR 0.74, p = 0.036) correlated with CHD risk in age ≤ 60 years. GAS5 rs17359906 (OR 0.10, p = 0.032) and ESR1 rs3020308 (OR 2.73, p = 0.041) were associated with an increased susceptibility to CHD in smokers. We also found that METTL14 rs4834698 (OR 1.57, p = 0.044) and ESR1 rs4870061 (OR 0.62, p = 0.040) were associated with CHD susceptibility in non-drinkers. Besides, METTL14 rs17050450 (OR 0.48, p = 0.029) and ESR1 rs3853248 (OR 1.61, p = 0.018) had the susceptibility of CHD patients with diabetes. Our study indicated that GAS5/METTL14/ESR1 polymorphisms were associated with CHD risk, which might provide a new understanding of CHD in a Chinese population. [ABSTRACT FROM AUTHOR]

Background: Berberine (BBR) is an isoquinoline alkaloid found in the Berberis species. It was found to have protected effects in cardiovascular diseases. Here, we investigated the effect the regulatory function of long noncoding RNAs (lncRNAs) during the treatment of stable coronary heart disease (CHD) using BBR. We performed microarray analyses to identify differentially expressed (DE) lncRNAs and mRNAs between whole blood samples from 5 patients with stable CHD taking BBR and 5 no BBR volunteers. DE lncRNAs and mRNAs were validated by quantitative real-time PCR. Results: A total of 1703 DE lncRNAs and 912 DE mRNAs were identified. Kyoto Encyclopedia of Genes and Genomes pathway analysis indicated DE mRNAs might be associated with mammalian target of rapamycin and mitogen-activated protein kinase pathway. These pathways may be involved in the healing process after CHD. To study the relationship between mRNAs encoding transcription factors (DNA damage inducible transcript 3, sal-like protein 4 and estrogen receptor alpha gene) and CHD related de mRNAs, we performed protein and protein interaction analysis on their corresponding proteins. AKT and apoptosis pathway were significant enriched in protein and protein interaction network. BBR may affect downstream apoptosis pathways through DNA damage inducible transcript 3, sal-like protein 4 and estrogen receptor alpha gene. Growth arrest-specific transcript 5 might regulate CHD-related mRNAs through competing endogenous RNA mechanism and may be the downstream target gene regulated by BBR. Verified by the quantitative real-time PCR, we identified 8 DE lncRNAs that may relate to CHD. We performed coding and non-coding co-expression and competing endogenous RNA mechanism analysis of these 8 DE lncRNAs and CHD-related DE mRNA, and predicted their subcellular localization and N6-methyladenosine modification sites. Conclusion: Our research found that BBR may affect mammalian target of rapamycin, mitogen-activated protein kinase, apoptosis pathway and growth arrest-specific transcript 5 in the process of CHD. These pathways may be involved in the healing process after CHD. Our research might provide novel insights for functional research of BBR. [ABSTRACT FROM AUTHOR]

Coronary heart disease is a heart disease caused by coronary atherosclerosis, which seriously endangers human life and health. More and more studies have shown that diabetes is one of the main pathogenic factors of coronary heart disease and has an important relationship with coronary heart disease. At present, the mainstream treatment of coronary heart disease complicated with diabetes mellitus is the use of coronary angiography, which is the gold standard of treatment at present. However, it still has a certain risk, and most of the postoperative complications, the improvement method is to use FFR evaluation standard. At present, there are few special researches on this aspect. Therefore, this paper proposes the application research of FFR based on deep learning in the diagnosis of coronary heart disease complicated with diabetes mellitus. Through the core theoretical research on coronary heart disease complicated with diabetes mellitus and FFR, this paper analyzes that the existing coronary angiography is still in the development stage, which has a positive effect on the treatment of coronary heart disease and diabetes mellitus. On this basis, combined with FFR can play a better therapeutic effect. The second part is the establishment method of the related comparative experiment. This experiment adopts real coronary heart disease complicated with diabetes cases, through the way of random grouping, each group of 41 people, one group was FFRCT group, the other was FFRQCA group, and in order to ensure the experimental effect, a unified evaluation index is established. In the third part, the comparative analysis of the experimental methods of angina pectoris was carried out. Through the analysis of experimental data, it is shown that the safety, postoperative complications control and comprehensive treatment effect of this method are significantly improved compared with the traditional methods. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the efficacy of simvastatin plus aspirin in the treatment of coronary heart disease in the elderly, and its effect on cardiac function and inflammatory factor levels. Methods: Eighty-seven identified elderly patients with coronary heart disease who were admitted to Nantong First People's Hospital, Nantong, China between January 2020 and June 2021 were recruited and assigned at a ratio of 1:1 to receive either conventional treatment (group A) or simvastatin plus aspirin (group B). The clinical endpoint was treatment efficacy. Results: No significant differences were found between the two groups in respect of their baseline data (p > 0.05). Simvastatin plus aspirin was associated with a significantly higher treatment efficacy versus conventional treatment (p < 0.05). The patients, after joint therapy, had more cases of grade I cardiac function and fewer cases of grade III cardiac function, compared with conventional treatment group (p < 0.05). The application of simvastatin plus aspirin resulted in lower levels of triglycerides (TGs), total cholesterol (TC), fasting plasma glucose (FPG), low-density lipoprotein cholesterol (LDL-C), and highdensity lipoprotein cholesterol (HDL-C) than the conventional treatment (p < 0.05). Simvastatin plus aspirin was also associated with lower levels of interleukin (IL)-6 and hypersensitive-c-reactive-protein (hs-CRP) when compared with conventional treatment (p < 0.05). Furthermore, simvastatin plus aspirin produced a similar incidence of adverse events with conventional treatment (p > 0.05). Conclusion: Simvastatin/aspirin combination therapy is effective in the treatment of coronary heart disease in the elderly. It efficiently lowers glucose levels, lipid metabolism, and inflammatory factors, but enhances the cardiac function of patients. [ABSTRACT FROM AUTHOR]

Background: Coronary heart disease (CHD) has become the leading cause of death and one of the most serious epidemic diseases worldwide. CHD is characterized by urgency, danger and severity, and dynamic treatment strategies for CHD patients are needed. We aimed to build and validate an AI model for dynamic treatment recommendations for CHD patients with the goal of improving patient outcomes and learning best practices from clinicians to help clinical decision support for treating CHD patients.Methods: We formed the treatment strategy as a sequential decision problem, and applied an AI supervised reinforcement learning-long short-term memory (SRL-LSTM) framework that combined supervised learning (SL) and reinforcement learning (RL) with an LSTM network to track patients' states to learn a recommendation model that took a patient's diagnosis and evolving health status as input and provided a treatment recommendation in the form of whether to take specific drugs. The experiments were conducted by leveraging a real-world intensive care unit (ICU) database with 13,762 admitted patients diagnosed with CHD. We compared the performance of the applied SRL-LSTM model and several state-of-the-art SL and RL models in reducing the estimated in-hospital mortality and the Jaccard similarity with clinicians' decisions. We used a random forest algorithm to calculate the feature importance of both the clinician policy and the AI policy to illustrate the interpretability of the AI model.Results: Our experimental study demonstrated that the AI model could help reduce the estimated in-hospital mortality through its RL function and learn the best practice from clinicians through its SL function. The similarity between the clinician policy and the AI policy regarding the surviving patients was high, while for the expired patients, it was much lower. The dynamic treatment strategies made by the AI model were clinically interpretable and relied on sensible clinical features extracted according to monitoring indexes and risk factors for CHD patients.Conclusions: We proposed a pipeline for constructing an AI model to learn dynamic treatment strategies for CHD patients that could improve patient outcomes and mimic the best practices of clinicians. And a lot of further studies and efforts are needed to make it practical. [ABSTRACT FROM AUTHOR]

Background: The roots of Panax vietnamensis Ha et Grushv. (PV) are used in the preparation of local drugs to treat cardiovascular and cerebrovascular diseases. However, it is still not clear if the saponins extracted from PV show a protective effect against myocardial injury, and if so, what are its primary active ingredients. Materials and Methods: In this study, a rat model of ischemic myocardial injury induced by isoproterenol was established, and the effect of PV saponin extract (PVS) on the heart rate and changes in the S-T segment were studied. The compounds were isolated through chromatographic techniques. H9c2 damaged cells, after induction by H2O2, were established and then treated with ocotillol-type ginsenosides at a concentration of 0.5, 1, 3, 10, and 30 μg/mL. Then, the cell viability, rate of cellular apoptosis, and apoptosis-related protein expression levels were detected by MTT assay, flow cytometry, and Western blot analysis. Results: PVS inhibited the elevation in the S-T segment and heart rate in rats with myocardial ischemia induced by isoproterenol. Four ocotillol-type ginsenosides and six dammarane-type ginsenosides were isolated from the PVS. Ocotillol-type ginsenosides compounds 1, 2, and 3 showed the effect of increasing the cell viability of H9c2 cardiomyocytes after induction with H2O2, and of them, compound 3 showed the strongest activity. Furthermore, compound 3 significantly inhibited the apoptosis of H9c2 injured cells, decreased the expression level of Bax and caspase 3, and increased the expression level of Bcl-2. Conclusion: PVS shows positive effect against myocardial injury. Compound 3 isolated from PVS protected H9c2 cells from damage caused by H2O2 by inhibiting apoptosis. These results will provide an important reference for the treatment of coronary heart disease. [ABSTRACT FROM AUTHOR]

• Validated and fast LC-HRMS method for determination of PETN and its metabolites. • Determination of PEMN and PEDN sample concentrations in pregnant woman. • First detection of PEMN and PEDN in human umbilical cord blood. • PEMN and PEDN concentration comparison between ovine mother and fetus. • Subtle concentration differences between ligated and non-ligated ovine fetus. Pentaerythrityl tetranitrate (PETN) is an established drug in the treatment of coronary heart disease and heart failure. It is assumed, that the vasodilative and vasoprotective effects of PETN also have a positive impact on pregnant patients with impaired placental perfusion and studies evaluating the effect of PETN in risk pregnancies have been carried out. In the context of these clinical trials, measuring of serum levels of PETN and its metabolites pentaerythrityl trinitrate (PETriN), pentaerythrityl dinitrate (PEDN), pentaerythrityl mononitrate (PEMN) and pentaerythritol (PE) were required. To evaluate the transfer of PETN and its metabolites (PEXN) from the mother to the fetus using samples from a human clinical trial and animal study, the present work aimed to develop a rapid and simple method to simultaneously analyze PEXN in human and ovine samples. A method employing a rapid and simple liquid–liquid extraction followed by reversed-phase (C 18) liquid chromatography coupled to high-resolution mass spectrometry with negative electrospray ionization was developed and validated for the detection of PETN and PEXN in human and ovine samples. PE could only be qualitatively detected at higher concenrations. Method validation requirements, including accuracy, repeatability and intermediate precision were fulfilled in ovine and human samples for all other PEXN with exception PETriN in human samples. The recovery (RE) in ovine samples was 76.7 % ± 12 % for PEMN, 98 % ± 23 % for PEDN, 94 % ± 22 % for PETriN, in human samples RE was 59 % ± 16 % for PEMN, 67 % ± 19 % for PEDN, 71 % ± 17 %. The matrix effects (ME) in ovine samples were 90 % ± 11 % for PEMN, 70 % ± 30 % for PEDN, 107 % ± 17 % for PETriN, in human samples the ME were 93 % ± 13 % for PEMN, 84 % ± 17 % for PEDN, 98 % ± 16 % for PETriN. The limits of quantification (LOQ) in ovine samples were 1.0 ng/mL for PETriN and 0.1 ng/mL for PEMN and PEDN. The LOQs in human samples were 5.0 ng/mL for PETriN and 0.3 ng/mL for PEMN und PEDN. The newly developed method was used to analyze 184 ovine serum samples and 18 human plasma samples. In ovine maternal samples, the highest observed PEDN concentration was 3.5 ng/mL and the highest PEMN concentration was 10 ng/mL, the respective concentrations in fetal serum samples were 4.9 ng/mL for PEDN and 5.4 ng/mL for PEMN. PETriN was only detected in traces in maternal and fetal samples, whereas PETN could not be detected at all. In human maternal samples, the highest concentration for PEDN was 27 ng/mL and for PEMN 150 ng/mL. In umbilical cord plasma, concentrations of 2.3 ng/mL for PEDN and 73 ng/mL for PEMN were detected. Although the PEMN and PEDN concentrations in the human samples were several times higher than in ovine samples, neither PETN nor PETriN signals could be detected. These results demonstrated that the metabolites were transferred from mother to fetus with a slight time delay. [ABSTRACT FROM AUTHOR]

Background: In 2002–2003 disease management programs (DMPs) for type 2 diabetes and coronary heart disease were introduced in Germany to improve the management of these conditions. Today around 6 million Germans aged 56 and older are enrolled in one of the DMPs; however, their effect on health remains unclear. Methods: We estimated the impact of German DMPs on circulatory and all-cause mortality using a synthetic control study. Specifically, using routinely available data, we compared pre and post-intervention trends in mortality of individuals aged 56 and older for 1998–2014 in Germany to trends in other European countries. Results: Average circulatory and all-cause mortality in Germany and the synthetic control was 1.63 and 3.24 deaths per 100 persons. Independent of model choice, circulatory and all-cause mortality decreased non-significantly less in Germany than in the synthetic control; for the model with a 3 year time lag, for example, by 0.12 (95%-CI: − 0.20; 0.44) and 0.22 (95%-CI: − 0.40; 0.66) deaths per 100 persons, respectively. Further main analyses, as well as sensitivity and subgroup analyses supported these results. Conclusions: We observed no effect on circulatory or all-cause mortality at the population-level. However, confidence intervals were wide, meaning we could not reject the possibility of a positive effect. Given the substantial costs for administration and operation of the programs, further comparative effectiveness research is needed to clarify the value of German DMPs for type 2 diabetes and CHD. [ABSTRACT FROM AUTHOR]

Naoxintong capsule (NXT) is one of the most prevalent Traditional Chinese Medicine formulations in the treatment of coronary heart disease (CHD), yet the action of pharmacodynamic components remains unclear. To determine the basis by which pharmacodynamic components of NXT may be effective in the treatment of CHD. The protective effect of NXT (0.01–100 μg/mL) on 293 T and hy926 cells was determined by MTT assay for 24 h. Afterwards, to investigate the pharmacodynamic material basis of NXT in anti-inflammatory and antioxidant effects, based on previous UPLC/Q-TOF analysis, 293 T and hy926 cells were divided into control (treated with solvent), model (incubated with TNF-α, LPS or H2O2), intervention (treated with UPLC components) and positive groups. After 24 h of treatment, all cells were tested to verify the screening results. MOE software was applied to dock bioactive compounds with phosphoinositide 3-kinase (PI3K), then the protein expression and phosphate levels were determined by western blotting. NXT could significantly inhibit the expression of NF-κB, MMP-9 and NO in cells with IC50 values of 0.1178, 0.1182 and 0.1094 μg/mL. Based on the screening results, six components of NXT were identified (calycosin, ferulic acid, salvianolic acid B, ononin, salvianolic acid E, and salvianolic acid F) which can inhibit NF-κB, MMP-9, and NO simultaneously, while exerting cytoprotective effects by inhibiting the activation of the PI3K/AKT pathway under different conditions by virtue of their advantageous interaction with PI3K. These ingredients have outstanding therapeutic potential and may provide a scientific basis for the future application and research of NXT. [ABSTRACT FROM AUTHOR]

Aims. The main treatment for coronary heart disease is percutaneous coronary intervention (PCI), and drug-eluting stents are designed to inhibit vascular smooth muscle cell (VSMCs) proliferation and migration causing restenosis by releasing pharmacological agents into the vessel wall. Once drug-eluting stents are deployed, these pharmacological agents exert many biological effects in the coronary circulation, not only inhibition of VSMCs but also extension to vascular endothelial cells (VECs). The purpose of this study was to explore target molecules that inhibit VSMCs proliferation without affecting VECs. Methods. mRNA and protein expressions of transient receptor potential channels (TRPCs) in cultured VSMCs and VECs were determined by western blotting and RT-qPCR. VSMCs and VECs proliferation was evaluated using CCK-8 assays and western blotting of proliferating cell nuclear antigen (PCNA). Calcium backfilling assays were performed to detect intracellular calcium ion concentration in cultured VSMCs and VECs. Results. The TRPC6 expression was more abundant in VECs than VSMCs, while TRPC4 and TRPC5 expressions were more abundant in VSMCs than VECs. Knockdown of TRPC4 or TRPC5 alone had no remarkable inhibitory effect on VSMC proliferation. Synergistic knockdown of TRPC4 and TRPC5 inhibited the proliferation of VSMCs, declined the expression of the PCNA, and reduced the intracellular calcium ion concentration but not VECs. Conclusion. These data suggest that concurrent inhibition of TRPC4 and TRPC5 inhibits VSMCs proliferation without affecting VECs, thus providing novel targets for developing pharmacological agents for drug-eluting stents. [ABSTRACT FROM AUTHOR]

Objective: To Investigate The Effect Of Clopidogrel Bisulfate Combined With Rosuvastatin On Coagulation Function And Hemorheology In Patients With Coronary Heart Disease. Methods: 100 Patients With Coronary Heart Disease Who Were Admitted To Our Hospital From February 2018 To June 2020 Were Selected, They Were Divided Into Control Group And Observation Group According To Envelope Drawing Method, 50 Cases In Each Group. The Control Group Was Treated With Clopidogrel Bisulfate Combined With Atorvastatin, And The Observation Group Was Treated With Rosuvastatin On The Basis Of The Control Group. The Course Of Treatment Was 2 Months. The Curative Effect, Cardiac Function, Coagulation Function And Hemorheology Of The Two Groups Were Compared, And The Incidence Of Adverse Reactions During The Treatment Was Recorded. Results: The Total Effective Rate Of The Observation Group Was Higher Than That Of The Control Group (P<0.05). There Was No Difference In The Incidence Of Adverse Reactions Between The Two Groups (P>0.05). 2 Months After Treatment, The Left Ventricular Ejection Fraction (Lvef) Of The Observation Group Was Higher Than That Of The Control Group, And The Ventricular Wall Motion Score Index (Wmsi) Was Lower Than That Of The Control Group (P<0.05). 2 Months After Treatment, Fibrinogen (Fib) In The Observation Group Was Lower Than That In The Control Group, And The Activated Partial Thromboplastin Time (Aptt) And Prothrombin Time(pt) In The Observation Group Were Higher Than Those In The Control Group (P<0.05). 2 Months After Treatment, The Levels Of Total Cholesterol (Tc), Triglyceride (Tg) And Low Density Lipoprotein Cholesterol (Ldl-c) In The Observation Group Were Lower Than Those In The Control Group, And The Level Of High Density Lipoprotein Cholesterol(hdl-c) In The Observation Group Was Higher Than That In The Control Group (P<0.05). Conclusion: Clopidogrel Bisulfate Combined With Rosuvastatin In The Treatment Of Coronary Heart Disease Patients, Can Effectively Improve The Coagulation Function, Cardiac Function, Hemorheology, Safe And Effective. [ABSTRACT FROM AUTHOR]

Coronary heart disease (CHD) is currently the most common cause of death in the world. Diet plays a significant role in the treatment of CHD. The purpose of this review is to present the current knowledge on natural products, including soybeans, garlic, black coffee, tea, and monounsaturated fatty acids, as well as components of the Mediterranean diet and Portfolio diet in supporting the treatment of CHD. A literature search was carried out in a scientific search engine database. Combinations of the following terms were used: "coronary heart disease", "ischemic heart disease", and "natural preparation of CHD". Scientific publications were systematically examined to identify both direct and indirect evidence that met the aims of this review. Only articles that considered human subjects were included. After the selection process, a total of 28 articles were included in the review. The main findings were as follows: garlic ameliorates the function of the endothelium, blood pressure parameters, and lipid profiles. Coffee improves glucose metabolism and shows antioxidant and anti-inflammatory properties. Tea ameliorates the lipid profile. Monounsaturated fatty acids show antioxidant properties. The Mediterranean diet has antihypertensive and antioxidant properties and reduces inflammation. The Portfolio diet shows lipid-lowering and antioxidant properties. Diet in CHD is an extremely important factor supporting treatment and can significantly modify the parameters of cardiovascular risk. However, there is still a need for more research on the properties of natural products and their health effects. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of clopidogrel bisulfate combined with rosuvastatin on coagulation function and hemorheology in patients with coronary heart disease. Methods: 100 patients with coronary heart disease who were admitted to our hospital from February 2018 to June 2020 were selected, they were divided into control group and observation group according to envelope drawing method, 50 cases in each group. The control group was treated with clopidogrel bisulfate combined with atorvastatin, and the observation group was treated with rosuvastatin on the basis of the control group. The course of treatment was 2 months. The curative effect, cardiac function, coagulation function and hemorheology of the two groups were compared, and the incidence of adverse reactions during the treatment was recorded. Results: The total effective rate of the observation group was higher than that of the control group (P<0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). 2 months after treatment, the left ventricular ejection fraction (LVEF) of the observation group was higher than that of the control group, and the ventricular wall motion score index (WMSI) was lower than that of the control group (P<0.05). 2 months after treatment, fibrinogen (FIB) in the observation group was lower than that in the control group, and the activated partial thromboplastin time (APTT) and prothrombin time(PT) in the observation group were higher than those in the control group (P<0.05). 2 months after treatment, the levels of total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) in the observation group were lower than those in the control group, and the level of high density lipoprotein cholesterol(HDL-C) in the observation group was higher than that in the control group (P<0.05). Conclusion: Clopidogrel bisulfate combined with rosuvastatin in the treatment of coronary heart disease patients, can effectively improve the coagulation function, cardiac function, hemorheology, safe and effective. [ABSTRACT FROM AUTHOR]

This study investigates whether informing patients about their own results of a double-blinded atorvastatin challenge, combined with tailored lipid-lowering treatment, improved statin use and lipid control in coronary heart disease (CHD) patients with self-perceived SAMS. Keywords: coronary heart disease; lipid-lowering treatment; low-density lipoprotein cholesterol; statins; statin-associated muscle symptoms EN coronary heart disease lipid-lowering treatment low-density lipoprotein cholesterol statins statin-associated muscle symptoms 891 893 3 05/11/22 20220601 NES 220601 Dear Editor, Statin discontinuation due to self-perceived statin-associated muscle symptoms (SAMS) is a prevalent challenge associated with unfavourable lipid control and adverse outcomes [1, 2]. Tailored clinical management after blinded statin challenge improved the lipid control in coronary patients with self-perceived muscle side effects. [Extracted from the article]

Restenosis remains the main complication after percutaneous coronary interventions in patients with coronary heart disease. The causes of its development include, in particular, genetic factors. We studied polymorphic loci of genes encoding endothelin-1 (EDN1 rs5370), endothelin-1 receptor (EDNRA rs5333), endothelin-converting enzyme (ECE1 rs1076669), and endothelial NO synthase (eNOS rs1549758, eNOS rs1799983, and eNOS rs2070244) in the context of in-stent restenosis development. It was found that the analyzed polymorphisms of the endothelin system genes were more significant for patients aged ≥ 65 years, while the polymorphic loci of the endothelial NO synthase gene (eNOS rs1799983 and eNOS rs1549758) were predominantly associated with time of in-stent restenosis. The obtained results can be useful for comprehensive assessment of the restenosis risk factors and the choice of optimal treatment for patients with coronary heart disease before elective surgical intervention. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To systematically evaluate the efficacy and safety of Shexiang Baoxin Pills in the treatment of coronary heart disease and angina pectoris.METHODS: CNKI,VIP database,Wanfang database and PubMed were retrieved to collect the randomized controlled trial of Shexiang Baoxin Pills in the treatment of coronary heart disease and angina pectoris (the study group was treated with Shexiang Baoxin Pills alone or combined with conventional treatment,while the control group received Isosorbide mononitrate tablets alone or combined with conventional treatments) . The retrieval time was from the establishment of the database to Jan.2020,and the retrieval terms were "Shexiang Baoxin Pills","Isosorbide mononitrate tablets"and"coronary heart disease and angina pectoris".RevMan 5. 3 software was used for Meta-analysis.RESULTS: Totally 16 literature were included.Meta-analysis results showed that the clinical treatment effective rate (OR = 3. 47,95%CI = 2. 45-4. 91,P＜0. 000 01) and ECG effective rate (OR = 2. 40,95%CI = 1. 88-3. 07,P＜0. 000 01) in the study group were significantly better than those in the control group,and the incidence of adverse drug reactions was significantly lower than that of the control group (OR = 0. 24,95%CI = 0. 15-0. 39,P＜0. 000 01),and the differences were statistically significant.CONCLUSIONS: Compared with the treatment of Isosorbide mononitrate tablets,the efficacy of Shexiang Baoxin Pills in the treatment of coronary heart disease and angina pectoris is significant and the incidence of adverse drug reactions is lower. However,due to the small sample size and low quality of the included literature,the conclusion needs to be further verified. [ABSTRACT FROM AUTHOR]