Background:The Brugada Electrocardiographic Indices Registry is a comprehensive data registry composed of patients with Brugada patterns on the electrocardiogram(ECG).The aim is to test the hypotheses that(i)ECG indic...Background:The Brugada Electrocardiographic Indices Registry is a comprehensive data registry composed of patients with Brugada patterns on the electrocardiogram(ECG).The aim is to test the hypotheses that(i)ECG indices combining both depolarization and repolarization abnormalities can better predict spontaneous ventricular arrhythmias than existing ECG markers in Brugada syndrome and(ii)that serial ECG measurements will provide additional information for risk stratifi cation,especially in asymptomatic patients.Methods:Patients with both Brugada pattern ECGs and Brugada syndrome are eligible for inclusion in this registry.Baseline characteristics and ECG variables refl ecting depolarization and repolarization will be determined.The primary outcome is spontaneous ventricular tachycardia/ventricular fi brillation or sudden cardiac death.Secondary outcomes are inducible ventricular tachycardia/ventricular fi brillation and syncope.Results:As of November 15,2019,39 investigators from 32 cities in 18 countries had joined this registry.As of December 15,2019,1383 cases had been enrolled.Conclusions:The Brugada Electrocardiographic Indices Registry will evaluate the disease life course,risk factors,and prognosis in a large series of Brugada patients.It will therefore provide insights for improving risk stratification.展开更多
Objective Mechanisms of pulmonary vein isolation(PVI)for atrial fibrillation remain controversy.This study aimed to investigate the impact of PVI on vagal modulation to atria.Methods Eighteen adult mongrel dogs under ...Objective Mechanisms of pulmonary vein isolation(PVI)for atrial fibrillation remain controversy.This study aimed to investigate the impact of PVI on vagal modulation to atria.Methods Eighteen adult mongrel dogs under general anesthesia were randomly divided into two groups.Bilateral cervical sympathovagal trunks were decentralized and sympathetic effects was blocked by metoprolol administration.Atrial electrical remodeling(AER)was established by rapid right atrial pacing at the rate of 600 bpm for 30 minutes.PVI was performed in group A.Atrial effective refractory period(ERP),vulnerability window(VW)of atrial fibrillation,and sinus rhythm cycle length(SCL)were measured at baseline and during vagal stimulation before and after atrial rapid pacing with and without PVI at fight atrial appendage(RAA),left atrial appendage(LAA),distal coronary sinus(CSd)and proximal coronary sinus(CSp).Results(1)Effects of PVI on vagal modulation:Shortening of SCL during vagal stimulation decreased significantly after PVI compared with that before PVI in group A(P<0.001).Shortening of ERP during vagal stimulation decreaseed significantly after PVI compared with that before PVI(P<0.05).VW of atrial fibrillation during vagal stimulation decreased significantly after PVI compared with that before PVI(P<0.05).(2)Effects of PVI on AER:shortening of ERP before and after atrial rapid pacing increased significantly at baseline and vagal stimulation in group B compared with that in group A(P<0.05).VW during vagal stimulation increased significantly after atrial rapid pacing in group B(P<0.05).Conclusion PVI attenuates the vagal modulation to the atria,thereby decreases the susceptibility to atrial fibrillation mediated by vagal activity.PVI releases AER,which maybe contributes to the vagal denervation.Our study indicates that PVI not only can eradicate triggered foci but also modify substrates for AF.展开更多
Background:Right ventricular pacing disrupts atrioventricular synchrony and increases the risk of atrial fi brillation(AF).However,whether algorithms for minimizing ventricular pacing reduce the incidence of AF remain...Background:Right ventricular pacing disrupts atrioventricular synchrony and increases the risk of atrial fi brillation(AF).However,whether algorithms for minimizing ventricular pacing reduce the incidence of AF remains controversial.Therefore,we conducted a systematic review and meta-analysis to compare the incidence of AF between minimizing ventricular pacing and conventional pacing protocols in patients with pacemakers implanted.Methods:The PubMed,Embase,and Cochrane Library databases were searched up to August 1,2017,for randomized controlled trials that reported the incidence of AF in patients with and without the use of algorithms for minimizing ventricular pacing.Results:Eleven studies comprising 5705 participants(61%males,mean age 71 years[standard deviation 11 years])were fi nally included in the analysis.The mean follow-up duration was 24 months.Use of algorithms for minimizing ventricular pacing signifi cantly reduced the incidence of AF,with an odds ratio of 0.74(95%confi dence interval 0.55–1.00;P<0.05).There was moderate heterogeneity among studies(I 2=63%).Conclusions:The incidence of AF was reduced by 26%with use of algorithms for minimizing ventricular pacing.The incorporation of such algorithms in routine clinical practice should in theory lead to a decrease in AF-related morbidity and mortality.展开更多
Mesenchymal stem cells(MSCs)delivered into the post-ischemic heart milieu have a low survival and retention rate,thus restricting the cardioreparative efficacy of MSC-based therapy.Chronic ischemia results in metaboli...Mesenchymal stem cells(MSCs)delivered into the post-ischemic heart milieu have a low survival and retention rate,thus restricting the cardioreparative efficacy of MSC-based therapy.Chronic ischemia results in metabolic reprogramming in the heart,but little is known about how these metabolic changes influence implanted MSCs.Here,we found that excessive branched-chain amino acid(BCAA)accumulation,a metabolic signature seen in the post-ischemic heart,was disadvantageous to the retention and cardioprotection of intramyocardially injected MSCs.Discovery-driven experiments revealed that BCAA at pathological levels sensitized MSCs to stress-induced cell death and premature senescence via accelerating the loss of histone 3 lysine 9 trimethylation(H3K9me3).A novel mTORC1/DUX4/KDM4E axis was identified as the cause of BCAA-induced H3K9me3 loss and adverse phenotype acquisition.Enhancing BCAA catabolic capability in MSCs via genetic/pharmacological approaches greatly improved their adaptation to the high BCAA milieu and strengthened their cardioprotective efficacy.We conclude that aberrant BCAA accumulation is detrimental to implanted MSCs via a previously unknown metabolite-signaling-epigenetic mechanism,emphasizing that the metabolic changes of the post-ischemic heart crucially influence the fate of implanted MSCs and their therapeutic benefits.展开更多
To the Editor:Cancer has been the leading cause of death worldwide and in China since 2010.[1]As advances are made in the treatment of cancer,the survival rate of cancer improves;at the same time,many cancer patients ...To the Editor:Cancer has been the leading cause of death worldwide and in China since 2010.[1]As advances are made in the treatment of cancer,the survival rate of cancer improves;at the same time,many cancer patients and cancer survivors suffer from cardiovascular disease(CVD)as a result of intense anticancer treatment.[2-4]To prevent and treat cardiovascular problems mediated by cancer treatments,a new medical discipline called cardiooncology was established.Although the field of cardiooncology has existed for 20 years,[5]its development in China is still in the early stages.展开更多
文摘Background:The Brugada Electrocardiographic Indices Registry is a comprehensive data registry composed of patients with Brugada patterns on the electrocardiogram(ECG).The aim is to test the hypotheses that(i)ECG indices combining both depolarization and repolarization abnormalities can better predict spontaneous ventricular arrhythmias than existing ECG markers in Brugada syndrome and(ii)that serial ECG measurements will provide additional information for risk stratifi cation,especially in asymptomatic patients.Methods:Patients with both Brugada pattern ECGs and Brugada syndrome are eligible for inclusion in this registry.Baseline characteristics and ECG variables refl ecting depolarization and repolarization will be determined.The primary outcome is spontaneous ventricular tachycardia/ventricular fi brillation or sudden cardiac death.Secondary outcomes are inducible ventricular tachycardia/ventricular fi brillation and syncope.Results:As of November 15,2019,39 investigators from 32 cities in 18 countries had joined this registry.As of December 15,2019,1383 cases had been enrolled.Conclusions:The Brugada Electrocardiographic Indices Registry will evaluate the disease life course,risk factors,and prognosis in a large series of Brugada patients.It will therefore provide insights for improving risk stratification.
基金the National NaturalScience Foundation of China(No.30770866)
文摘Objective Mechanisms of pulmonary vein isolation(PVI)for atrial fibrillation remain controversy.This study aimed to investigate the impact of PVI on vagal modulation to atria.Methods Eighteen adult mongrel dogs under general anesthesia were randomly divided into two groups.Bilateral cervical sympathovagal trunks were decentralized and sympathetic effects was blocked by metoprolol administration.Atrial electrical remodeling(AER)was established by rapid right atrial pacing at the rate of 600 bpm for 30 minutes.PVI was performed in group A.Atrial effective refractory period(ERP),vulnerability window(VW)of atrial fibrillation,and sinus rhythm cycle length(SCL)were measured at baseline and during vagal stimulation before and after atrial rapid pacing with and without PVI at fight atrial appendage(RAA),left atrial appendage(LAA),distal coronary sinus(CSd)and proximal coronary sinus(CSp).Results(1)Effects of PVI on vagal modulation:Shortening of SCL during vagal stimulation decreased significantly after PVI compared with that before PVI in group A(P<0.001).Shortening of ERP during vagal stimulation decreaseed significantly after PVI compared with that before PVI(P<0.05).VW of atrial fibrillation during vagal stimulation decreased significantly after PVI compared with that before PVI(P<0.05).(2)Effects of PVI on AER:shortening of ERP before and after atrial rapid pacing increased significantly at baseline and vagal stimulation in group B compared with that in group A(P<0.05).VW during vagal stimulation increased significantly after atrial rapid pacing in group B(P<0.05).Conclusion PVI attenuates the vagal modulation to the atria,thereby decreases the susceptibility to atrial fibrillation mediated by vagal activity.PVI releases AER,which maybe contributes to the vagal denervation.Our study indicates that PVI not only can eradicate triggered foci but also modify substrates for AF.
文摘Background:Right ventricular pacing disrupts atrioventricular synchrony and increases the risk of atrial fi brillation(AF).However,whether algorithms for minimizing ventricular pacing reduce the incidence of AF remains controversial.Therefore,we conducted a systematic review and meta-analysis to compare the incidence of AF between minimizing ventricular pacing and conventional pacing protocols in patients with pacemakers implanted.Methods:The PubMed,Embase,and Cochrane Library databases were searched up to August 1,2017,for randomized controlled trials that reported the incidence of AF in patients with and without the use of algorithms for minimizing ventricular pacing.Results:Eleven studies comprising 5705 participants(61%males,mean age 71 years[standard deviation 11 years])were fi nally included in the analysis.The mean follow-up duration was 24 months.Use of algorithms for minimizing ventricular pacing signifi cantly reduced the incidence of AF,with an odds ratio of 0.74(95%confi dence interval 0.55–1.00;P<0.05).There was moderate heterogeneity among studies(I 2=63%).Conclusions:The incidence of AF was reduced by 26%with use of algorithms for minimizing ventricular pacing.The incorporation of such algorithms in routine clinical practice should in theory lead to a decrease in AF-related morbidity and mortality.
基金supported by the National Key R&D Program of China(Grant No.2018YFA0107400)Program for National Natural Science Foundation of China(Grants No.82170337,81730011,81970721,and 81927805)Program for Chang-Jiang Scholars and Innovative Research Team in University(Grant No.PCSIRT-14R08).
文摘Mesenchymal stem cells(MSCs)delivered into the post-ischemic heart milieu have a low survival and retention rate,thus restricting the cardioreparative efficacy of MSC-based therapy.Chronic ischemia results in metabolic reprogramming in the heart,but little is known about how these metabolic changes influence implanted MSCs.Here,we found that excessive branched-chain amino acid(BCAA)accumulation,a metabolic signature seen in the post-ischemic heart,was disadvantageous to the retention and cardioprotection of intramyocardially injected MSCs.Discovery-driven experiments revealed that BCAA at pathological levels sensitized MSCs to stress-induced cell death and premature senescence via accelerating the loss of histone 3 lysine 9 trimethylation(H3K9me3).A novel mTORC1/DUX4/KDM4E axis was identified as the cause of BCAA-induced H3K9me3 loss and adverse phenotype acquisition.Enhancing BCAA catabolic capability in MSCs via genetic/pharmacological approaches greatly improved their adaptation to the high BCAA milieu and strengthened their cardioprotective efficacy.We conclude that aberrant BCAA accumulation is detrimental to implanted MSCs via a previously unknown metabolite-signaling-epigenetic mechanism,emphasizing that the metabolic changes of the post-ischemic heart crucially influence the fate of implanted MSCs and their therapeutic benefits.
文摘To the Editor:Cancer has been the leading cause of death worldwide and in China since 2010.[1]As advances are made in the treatment of cancer,the survival rate of cancer improves;at the same time,many cancer patients and cancer survivors suffer from cardiovascular disease(CVD)as a result of intense anticancer treatment.[2-4]To prevent and treat cardiovascular problems mediated by cancer treatments,a new medical discipline called cardiooncology was established.Although the field of cardiooncology has existed for 20 years,[5]its development in China is still in the early stages.
