Heart Diseases

心脏病
  • 文章类型: Journal Article
    冠状病毒(CoV)属于RNA病毒家族。已知该家族中的病毒在人类中引起轻度呼吸道疾病。导致冠状病毒-19疾病(COVID-19)的新型SARS-COV2病毒的起源是中国武汉市,它从那里传播以引起全球大流行。尽管肺部是19型冠状病毒病(COVID-19)的主要靶器官,自从它爆发以来,已知这种疾病会影响心脏,血管,肾,肠,肝脏和大脑。本文旨在总结冠状病毒病-19对心脏和肝脏的灾难性影响及其发病机制。
    本评论中使用的信息来自PubMed上发表的相关文章,谷歌学者,Google,世卫组织网站,CDC和其他来源。使用与COVID-19相关的关键搜索语句和短语来检索信息。原创研究文章,审查文件,研究信函和病例报告被用作信息来源。
    除了造成严重的肺损伤,据报道,COVID-19还影响并导致许多其他器官的功能障碍。COVID-19感染可通过下调膜结合活性血管紧张素转换酶(ACE)来影响人。ACE2表达不足的人更容易感染COVID-19。患者预先存在的合并症是使个体易患严重COVID-19的主要危险因素。
    疾病的严重程度及其广谱表型是直接和间接致病因素综合作用的结果。因此,协调许多治疗偏好的方案应该是使疾病降级并避免由于疾病引起的多器官损伤和功能障碍而导致的死亡的最佳替代方案。
    UNASSIGNED: Coronaviruses (CoVs) belong to the RNA viruses family. The viruses in this family are known to cause mild respiratory disease in humans. The origin of the novel SARS-COV2 virus that caused the coronavirus-19 disease (COVID-19) is the Wuhan city in China from where it disseminated to cause a global pandemic. Although lungs are the predominant target organ for Coronavirus Disease-19 (COVID-19), since its outbreak, the disease is known to affect heart, blood vessels, kidney, intestine, liver and brain. This review aimed to summarize the catastrophic impacts of Coronavirus disease-19 on heart and liver along with its mechanisms of pathogenesis.
    UNASSIGNED: The information used in this review was obtained from relevant articles published on PubMed, Google Scholar, Google, WHO website, CDC and other sources. Key searching statements and phrases related to COVID-19 were used to retrieve information. Original research articles, review papers, research letters and case reports were used as a source of information.
    UNASSIGNED: Besides causing severe lung injury, COVID-19 has also been reported to affect and cause dysfunction of many other organs. COVID-19 infection can affect people by downregulating membrane-bound active angiotensin-converting enzyme (ACE). People who have deficient ACE2 expression are more vulnerable to COVID-19 infection. The patients\' pre-existing co-morbidities are major risk factors that predispose individuals to severe COVID-19.
    UNASSIGNED: The disease severity and its broad spectrum phenotype is a result of combined direct and indirect pathogenic factors. Therefore, protocols that harmonize many therapeutic preferences should be the best alternatives to de-escalate the disease and obviate deaths caused as a result of multiple organ damage and dysfunction induced by the disease.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    背景:心血管疾病(CVDs)构成了重大的全球健康挑战,遗传学越来越被认为是传统风险因素之外的关键因素。这为全科医生(GP)提供了改进其方法的机会。
    目的:本文探讨了遗传学对CVD的影响及其对GP的影响。它讨论了单基因疾病,如遗传性心肌病和多基因风险,以及药物遗传学,旨在加强风险评估和个性化护理。
    结论:单基因疾病,由单基因突变驱动,表现出可预测的继承模式,包括遗传性心肌病和通道病,如长QT综合征。多基因风险涉及多种遗传变异影响CVD易感性,通过多基因风险评分进行精确的风险评估。药物遗传学根据基因概况定制药物干预措施,尽管诸如可访问性和道德考虑之类的挑战仍然存在。将遗传学纳入心血管护理有望减轻全球心血管疾病负担并改善患者预后。
    BACKGROUND: Cardiovascular diseases (CVDs) pose significant global health challenges, with genetics increasingly recognised as a key factor alongside traditional risk factors. This presents an opportunity for general practitioners (GPs) to refine their approaches.
    OBJECTIVE: This article explores the impact of genetics on CVDs and its implications for GPs. It discusses monogenic disorders like inherited cardiomyopathies and polygenic risks, as well as pharmacogenetics, aiming to enhance risk assessment and personalised care.
    CONCLUSIONS: Monogenic disorders, driven by single gene mutations, exhibit predictable inheritance patterns, including inherited cardiomyopathies and channelopathies such as Long QT syndrome. Polygenic risks involve multiple genetic variants influencing CVD susceptibility, addressed through polygenic risk scores for precise risk assessment. Pharmacogenetics tailor drug interventions based on genetic profiles, though challenges like accessibility and ethical considerations persist. Integrating genetics into cardiovascular care holds promise for alleviating the global CVD burden and improving patient outcomes.
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  • 文章类型: Journal Article
    胎儿心脏病的产前诊断可能会影响父母终止妊娠的决策。现有文献表明,严重性,无论是复杂性还是杀伤力,显著影响父母关于堕胎的决定。然而,关于胎儿心脏病严重程度如何影响父母决定的问题仍然存在,鉴于近期在术后结局方面的进展。因此,我们调查了胎儿心脏病产前诊断后与父母决定流产相关的危险因素.我们的分析包括妊娠22周前诊断为胎儿心脏病的73例(终止:n=37;续:n=36)妊娠。诊断时胎龄的增加降低了父母决定终止妊娠的可能性(模型1:调整后的比值比,0.94;95%置信区间0.89-0.99;模型2:0.950.90-0.997)。危重病(5.25;1.09-25.19)和并发心外或遗传异常(模型1:4.19,1.21-14.53;模型2:5.47,1.50-19.96)增加了选择流产的可能性。值得注意的是,复杂疾病对父母决定没有显著影响(0.56;0.14-2.20).这些结果表明,父母关于流产的决策可能会受到诊断时早期胎龄的影响。心脏病的致命性,心外或遗传异常,但如果产前诊断和父母咨询是在心血管专业机构提供的,则不是其复杂性。
    The prenatal diagnosis of fetal heart disease potentially influences parental decision-making regarding pregnancy termination. Existing literature indicates that the severity, whether in complexity or lethality, significantly influences parental decisions concerning abortion. However, questions remain as to how fetal heart disease severity impacts parental decisions, given recent advancements in postsurgical outcomes. Therefore, we investigated risk factors associated with parents\' decision-making regarding abortion following a prenatal diagnosis of fetal heart disease. Our analysis included 73 (terminated: n = 37; continued: n = 36) pregnancies with a fetal heart disease diagnosed before 22 weeks of gestation. Increased gestational age at diagnosis reduced the likelihood of parents\' decision on termination (Model 1: adjusted odds ratio, 0.94; 95% confidence interval 0.89-0.99; Model 2: 0.95 0.90-0.997). Critical disease (5.25; 1.09-25.19) and concurrent extracardiac or genetic abnormalities (Model 1: 4.19, 1.21-14.53; Model 2: 5.47, 1.50-19.96) increased the likelihood of choosing abortion. Notably, complex disease did not significantly influence parental decisions (0.56; 0.14-2.20). These results suggest that parental decision-making regarding abortion may be influenced by earlier gestational age at diagnosis, the lethality of heart disease, and extracardiac or genetic abnormalities, but not its complexity if prenatal diagnosis and parental counseling are provided at a cardiovascular-specialized facility.
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  • 文章类型: Journal Article
    在儿童癌症幸存者中,已知蒽环类药物引起的心功能障碍的遗传易感性,但这在青少年和年轻成人(AYA)患者中尚未得到充分证实。我们的目的是确定先前鉴定的与儿童癌症患者心脏功能障碍相关的变异是否类似地影响AYA癌症患者。在先前用蒽环类抗生素治疗的253AYA中选择45个变体用于分析。我们确定了与心功能不全相关的四种变异:SLC10A2:rs7319981(p=0.017),SLC22A17:rs4982753(p=0.019),HAS3:rs2232228(p=0.023),和RARG:rs2229774(p=0.050)。HAS3:rs2232228和SLC10A2:rs7319981在我们的AYA癌症幸存者群体中显示出显着的作用,其方向与儿童癌症幸存者中报告的方向相反。进一步分析宿主基因中的遗传变异与AYA癌症幸存者的心脏毒性的额外关联。然后在一组诱导的多能干细胞衍生的心肌细胞中评估宿主基因,以评估当用多柔比星处理时表达水平的变化。观察到HAS3和SLC22A17表达的显着上调(p<0.05),对RARG观察到的蒽环类抗生素响应性不显著。我们的研究表明,遗传对AYA癌症患者的心功能障碍有影响,但是儿童和AYA癌症幸存者之间的遗传学作用可能有所不同。
    There is a known genetic susceptibility to anthracycline-induced cardiac dysfunction in childhood cancer survivors, but this has not been adequately shown in adolescent and young adult (AYA) patients. Our aim was to determine if the previously identified variants associated with cardiac dysfunction in childhood cancer patients affect AYA cancer patients similarly. Forty-five variants were selected for analysis in 253 AYAs previously treated with anthracyclines. We identified four variants that were associated with cardiac dysfunction: SLC10A2:rs7319981 (p = 0.017), SLC22A17:rs4982753 (p = 0.019), HAS3:rs2232228 (p = 0.023), and RARG:rs2229774 (p = 0.050). HAS3:rs2232228 and SLC10A2:rs7319981 displayed significant effects in our AYA cancer survivor population that were in the opposite direction than that reported in childhood cancer survivors. Genetic variants in the host genes were further analyzed for additional associations with cardiotoxicity in AYA cancer survivors. The host genes were then evaluated in a panel of induced pluripotent stem cell-derived cardiomyocytes to assess changes in levels of expression when treated with doxorubicin. Significant upregulation of HAS3 and SLC22A17 expression was observed (p < 0.05), with non-significant anthracycline-responsivity observed for RARG. Our study demonstrates that there is a genetic influence on cardiac dysfunction in AYA cancer patients, but there may be a difference in the role of genetics between childhood and AYA cancer survivors.
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  • 文章类型: Journal Article
    目的:确定具有不同咳嗽发生情况的患者亚组,并评估这些亚组之间的差异。
    接受化疗(N=1,338)的门诊患者在两个化疗周期内完成了六次问卷调查。
    使用纪念症状评估量表评估咳嗽的发生。潜在类别分析用于识别具有不同咳嗽发生概况的亚组。使用参数和非参数检验来评估差异。
    结果:确定了四个不同的咳嗽特征(无,减少,增加,和高)。与高级成员相关的危险因素包括家庭年收入较低;吸烟史;自我报告的肺部疾病诊断,心脏病,背痛;还有肺癌。
    结论:临床医生需要评估所有癌症患者的咳嗽情况,并提供有针对性的干预措施。
    OBJECTIVE: To identify subgroups of patients with distinct cough occurrence profiles and evaluate for differences among these subgroups.
    UNASSIGNED: Outpatients receiving chemotherapy (N = 1,338) completed questionnaires six times over two chemotherapy cycles.
    UNASSIGNED: Occurrence of cough was assessed using the Memorial Symptom Assessment Scale. Latent class analysis was used to identify subgroups with distinct cough occurrence profiles. Parametric and nonparametric tests were used to evaluate for differences.
    RESULTS: Four distinct cough profiles were identified (None, Decreasing, Increasing, and High). Risk factors associated with membership in the High class included lower annual household income; history of smoking; self-reported diagnoses of lung disease, heart disease, and back pain; and having lung cancer.
    CONCLUSIONS: Clinicians need to assess all patients with cancer for cough and provide targeted interventions.
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  • 文章类型: Journal Article
    药物剂量的生理决定因素(PDODD)是一种有前途的精确剂量方法。这项研究调查了PDODD在疾病中的变化,并评估了PDODD的变分自动编码器(VAE)人工智能模型。PDODD面板包含20个生物标志物,和13肾,肝,糖尿病,和心脏疾病状态变量。人口特征,人体测量(体重,体表面积,腰围),血液(血浆体积,白蛋白),肾(肌酐,肾小球滤过率,尿流,和尿白蛋白与肌酐的比率),和肝(R值,肝脂肪变性指数,药物性肝损伤指数),血细胞(全身炎症指数,红细胞,淋巴细胞,中性粒细胞,和血小板计数)生物标志物,纳入了国家健康和营养检查调查(NHANES)的医学问卷答复。表格VAE(TVAE)生成模型是使用合成数据库Python库实现的。生成数据的联合分布与测试数据使用图形单变量进行比较,双变量,以及多维投影方法和分布邻近测度。与疾病进展相关的PDODD生物标志物如预期的那样在肾脏发生改变,肝,糖尿病,和心脏疾病。由TVAE生成的连续PDODD面板变量令人满意地逼近了测试数据中的分布。一些离散变量的TVAE生成的分布偏离了测试数据分布。TVAE生成的连续变量的年龄分布与测试数据相似。TVAE算法展示了作为连续PDODD的AI模型的潜力,并且可以用于生成用于临床试验模拟的虚拟群体。
    Physiological determinants of drug dosing (PDODD) are a promising approach for precision dosing. This study investigates the alterations of PDODD in diseases and evaluates a variational autoencoder (VAE) artificial intelligence model for PDODD. The PDODD panel contained 20 biomarkers, and 13 renal, hepatic, diabetes, and cardiac disease status variables. Demographic characteristics, anthropometric measurements (body weight, body surface area, waist circumference), blood (plasma volume, albumin), renal (creatinine, glomerular filtration rate, urine flow, and urine albumin to creatinine ratio), and hepatic (R-value, hepatic steatosis index, drug-induced liver injury index), blood cell (systemic inflammation index, red cell, lymphocyte, neutrophils, and platelet counts) biomarkers, and medical questionnaire responses from the National Health and Nutrition Examination Survey (NHANES) were included. The tabular VAE (TVAE) generative model was implemented with the Synthetic Data Vault Python library. The joint distributions of the generated data vs. test data were compared using graphical univariate, bivariate, and multidimensional projection methods and distribution proximity measures. The PDODD biomarkers related to disease progression were altered as expected in renal, hepatic, diabetes, and cardiac diseases. The continuous PDODD panel variables generated by the TVAE satisfactorily approximated the distribution in the test data. The TVAE-generated distributions of some discrete variables deviated from the test data distribution. The age distribution of TVAE-generated continuous variables was similar to the test data. The TVAE algorithm demonstrated potential as an AI model for continuous PDODD and could be useful for generating virtual populations for clinical trial simulations.
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  • 文章类型: Journal Article
    生物性别是生理的重要调节剂,并影响许多疾病的病理生物学。虽然心脏病是全球男性和女性死亡的头号原因,在器官和细胞尺度上存在性别差异,影响临床表现,诊断,和治疗。在这篇评论中,我们强调了心脏结构的基线性别差异,函数,和细胞信号传导,并讨论性激素和染色体对这些特征的贡献。心脏是一个明显的可塑性器官,通过改变形式和功能对生理和病理线索迅速做出反应。响应这些刺激的心脏重塑的性质和程度通常取决于生物学性别。我们讨论了压力和容量超负荷在适应性生理重塑和病理性心脏重塑中的器官和分子水平的性别差异,缺血,和遗传性心脏病。最后,我们提供了心脏性别差异研究的关键未来方向的观点.
    Biological sex is an important modifier of physiology and influences pathobiology in many diseases. While heart disease is the number one cause of death worldwide in both men and women, sex differences exist at the organ and cellular scales, affecting clinical presentation, diagnosis, and treatment. In this Review, we highlight baseline sex differences in cardiac structure, function, and cellular signaling and discuss the contribution of sex hormones and chromosomes to these characteristics. The heart is a remarkably plastic organ and rapidly responds to physiological and pathological cues by modifying form and function. The nature and extent of cardiac remodeling in response to these stimuli are often dependent on biological sex. We discuss organ- and molecular-level sex differences in adaptive physiological remodeling and pathological cardiac remodeling from pressure and volume overload, ischemia, and genetic heart disease. Finally, we offer a perspective on key future directions for research into cardiac sex differences.
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  • 文章类型: Journal Article
    心血管疾病(CVDs)的特征是心脏异常,血管,和血液流动。CVD包括一系列不同的健康问题。有几种类型的心血管疾病,比如中风,内皮功能障碍,血栓形成,动脉粥样硬化,斑块不稳定和心力衰竭。鉴定一种用于心脏病的新药需要更长的时间,其安全性有效性测试需要更长的研究和批准时间。本章探讨药物再利用,纳米疗法,以及基于植物的治疗方法,用于管理现有药物的CVD,从而节省了测试新药的时间和安全性问题。现有的药物如他汀类药物,ACE抑制剂,华法林,β受体阻滞剂,已发现阿司匹林和二甲双胍可用于治疗心脏病。为了更好的药物输送,纳米疗法通过靶向白细胞介素(IL)为心脏研究开辟了新的途径,TNF和其他蛋白质通过蛋白质组相互作用分析。纳米颗粒能够精确递送到动脉粥样硬化斑块,炎症区域,和受损的心脏组织。纳米治疗剂的进展,如药物洗脱支架和载药纳米颗粒正在改变心血管疾病的管理。植物性治疗,含有植物来源的植物化学物质,有潜在的心血管益处。这些植物化学物质可以减轻与CVD相关的风险因素。这些策略的整合为个性化开辟了新的途径,有效,和微创心血管护理。总之,传统药物,植物化学物质和纳米颗粒可以通过识别它们的信号通路来彻底改变未来的心脏保健,机制和相互作用组分析。
    Cardiovascular diseases (CVDs) are characterized by abnormalities in the heart, blood vessels, and blood flow. CVDs comprise a diverse set of health issues. There are several types of CVDs like stroke, endothelial dysfunction, thrombosis, atherosclerosis, plaque instability and heart failure. Identification of a new drug for heart disease takes longer duration and its safety efficacy test takes even longer duration of research and approval. This chapter explores drug repurposing, nano-therapy, and plant-based treatments for managing CVDs from existing drugs which saves time and safety issues with testing new drugs. Existing drugs like statins, ACE inhibitor, warfarin, beta blockers, aspirin and metformin have been found to be useful in treating cardiac disease. For better drug delivery, nano therapy is opening new avenues for cardiac research by targeting interleukin (IL), TNF and other proteins by proteome interactome analysis. Nanoparticles enable precise delivery to atherosclerotic plaques, inflammation areas, and damaged cardiac tissues. Advancements in nano therapeutic agents, such as drug-eluting stents and drug-loaded nanoparticles are transforming CVDs management. Plant-based treatments, containing phytochemicals from Botanical sources, have potential cardiovascular benefits. These phytochemicals can mitigate risk factors associated with CVDs. The integration of these strategies opens new avenues for personalized, effective, and minimally invasive cardiovascular care. Altogether, traditional drugs, phytochemicals along with nanoparticles can revolutionize the future cardiac health care by identifying their signaling pathway, mechanism and interactome analysis.
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  • 文章类型: Journal Article
    果蝇已被用作模型系统来识别和表征对发育的遗传贡献,稳态,并研究许多人类疾病的分子决定因素。虽然在遗传上存在许多差异,结构,和分子水平,许多信号成分和细胞机制在果蝇和人类之间是保守的。出于这个原因,果蝇可以并且已经被广泛用于建模,研究人类病理学。广泛的遗传资源使这个模型系统成为一个强大的系统。多年来,复杂且快速扩展的果蝇遗传工具包为遗传成分对人类疾病的贡献提供了有价值的新见解。Notch信号的活性在发育过程中至关重要,并且在后生动物中保持不变,并且与许多人类疾病有关。在这里,我们重点介绍了涉及Notch信号传导的机制的例子,这些机制已经从模拟黑腹果蝇的人类疾病中阐明,包括神经退行性疾病,先天性疾病,几种癌症,和心脏疾病。
    Drosophila melanogaster has been used as a model system to identify and characterize genetic contributions to development, homeostasis, and to investigate the molecular determinants of numerous human diseases. While there exist many differences at the genetic, structural, and molecular level, many signalling components and cellular machineries are conserved between Drosophila and humans. For this reason, Drosophila can and has been used extensively to model, and study human pathologies. The extensive genetic resources available make this model system a powerful one. Over the years, the sophisticated and rapidly expanding Drosophila genetic toolkit has provided valuable novel insights into the contribution of genetic components to human diseases. The activity of Notch signalling is crucial during development and conserved across the Metazoa and has been associated with many human diseases. Here we highlight examples of mechanisms involving Notch signalling that have been elucidated from modelling human diseases in Drosophila melanogaster that include neurodegenerative diseases, congenital diseases, several cancers, and cardiac disorders.
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