BACKGROUND: Older adults with heart disease often experience higher rates of comorbid anxiety and depression. This study examined depression and anxiety network structures among older adults with heart disease and their heart disease free peers.
METHODS: Network analyses of secondary cross-sectional data from the 2017 to 2018 wave of CLHLS were used to construct groups of older adults with and without heart disease using propensity score matching. Depression and anxiety symptoms were assessed using Center for Epidemiological Studies Depression Scale and Generalized Anxiety Disorder Scale, respectively. Central symptoms and bridge symptoms were identified using expected influence.
RESULTS: 1689 older adults with heart disease and matched control sample of 1689 older adults without heart disease were included. The prevalence and severity of depression and anxiety were significantly higher in older adults with heart disease compared to the control group. There was no significant difference in overall structures of depression and anxiety network models between two the groups. Key central symptoms and bridge symptoms within these groups were highly similar; GAD 2 \"Uncontrollable worrying\" and GAD 4 \"Trouble relaxing\" were identified as the most central symptoms, while GAD 1 \"Nervousness\" and CESD 1 \"Feeling bothered\" were identified as key bridge symptoms across both network models.
CONCLUSIONS: Depression and anxiety are more prevalent in older adults with heart disease than demographically-matched heart disease free controls. However, network structures of these symptoms do not differ between two groups. Accordingly, depression and anxiety psychosocial interventions developed for older adults without heart disease may also benefit older adults with heart disease.

OBJECTIVE: To determine if adding performance on the five-repetition sit-to-stand test (5-STS) to chronic obstructive pulmonary disease (COPD) high-risk criteria, proposed by the Spanish COPD guidelines (GesEPOC), affects mortality prognosis.
METHODS: Observational study of COPD outpatients involved prospective follow-up for 5 years. Patients were classified based on 5-STS performance and risk criteria proposed by GesEPOC version 2021. Outcome measures were 5-year mortality timing and rate. Kaplan-Meier curves and univariate and multivariate Cox proportional-hazard analyses, analysis of variance, and univariate and multivariate linear and logistic regression models were used.
RESULTS: One hundred and thirty-seven patients were included. Mean age was 66±8.3 years, and 87.6% were men. Of them, 115 (83.9%) were classified as high risk, 43 (34.4%) of whom had poor performance on the 5-STS. Overall mortality at 5 years was 27% and was significantly higher in the high-risk (29.6%) compared with the low-risk (13.6%) group. Among high-risk patients, mortality at 5 years was significantly worse with poor 5-STS performance (60.5%) compared with non-poor performance (11.1%). Poor performance on the 5-STS was independently associated with increased 5-year mortality risk (HR 4.70; 95% CI: 1.96-11.27) in a model adjusted for history of heart disease and dyspnea.
CONCLUSIONS: Among high-risk COPD patients, those with poor performance on the 5-STS have a significantly higher mortality at 5 years than those with non-poor 5-STS performance.

OBJECTIVE: Sarcopenic obesity (SO) has been found to increase the risk of metabolic disorders, however, its relationship with cardiometabolic multimorbidity (CMM) remains unexplored. This study aims to investigate the potential association between SO and CMM in the middle-aged and older population.
METHODS: Our study subjects were from CHARLS. SO was defined as the combination of impaired grip strength (grip strength <28 kg for men and <18 kg for women) and increased body mass index (BMI ≥25 kg/m2). CMM was defined as having two or more cardiometabolic diseases, including diabetes mellitus, stroke, and heart disease. The participants were divided into four groups according to their sarcopenia and obesity status, and logistic regression analysis was used to examine the association between SO and CMM.
RESULTS: A total of 15,252 study subjects were included in the cross-sectional study, with an average age of 60.6 years and a male proportion of 47.4%. In the cross-sectional analysis conducted in 2015, the prevalence of CMM was highest in the SO group (9.1%), followed by the obesity (3.7%) and sarcopenia (3.5%) group. After adjustment for confounding factors, SO [OR (95%CI): 2.453 (1.742-3.455)], sarcopenia [OR (95% CI): 1.601 (1.157-2.217)], obesity [OR (95% CI): 1.446 (1.107-1.888)] were all observed to be associated with CMM, with the strongest association in the SO group. Furthermore, in the longitudinal analysis, only the SO group demonstrated a significant risk for developing CMM [OR (95% CI): 2.302 (1.239-4.228)].
CONCLUSIONS: SO was independently and positively associated with CMM in middle-aged and older population.

Emerging evidence indicates that chemical exposures in the environment are overlooked drivers of cardiovascular diseases (CVD). Recent evidence suggests that micro- and nanoplastic (MNP) particles derived largely from the chemical or mechanical degradation of plastics might represent a novel CVD risk factor. Experimental data in preclinical models suggest that MNPs can foster oxidative stress, platelet aggregation, cell senescence, and inflammatory responses in endothelial and immune cells while promoting a range of cardiovascular and metabolic alterations that can lead to disease and premature death. In humans, MNPs derived from various plastics, including polyethylene and polyvinylchloride, have been detected in atherosclerotic plaques and other cardiovascular tissues, including pericardia, epicardial adipose tissues, pericardial adipose tissues, myocardia, and left atrial appendages. MNPs have measurable levels within thrombi and seem to accumulate preferentially within areas of vascular lesions. Their presence within carotid plaques is associated with subsequent increased incidence of cardiovascular events. To further investigate the possible causal role of MNPs in CVD, future studies should focus on large, prospective cohorts assessing the exposure of individuals to plastic-related pollution, the possible routes of absorption, the existence of a putative safety limit, the correspondence between exposure and accumulation in tissues, the timing between accumulation and CVD development, and the pathophysiological mechanisms instigated by pertinent concentrations of MNPs. Data from such studies would allow the design of preventive, or even therapeutic, strategies. Meanwhile, existing evidence suggests that reducing plastic production and use will produce benefits for the environment and for human health. This goal could be achieved through the UN Global Plastics Treaty that is currently in negotiation.

UNASSIGNED: The global prevalence of diabetic heart complication has been on the increase, and some of the drugs that are currently used to treat diabetes mellitus (DM) have not been able to mitigate this complication.
UNASSIGNED: This study determines the effect of Brazil nut (Bertholletia excelsa) and metformin on diabetic cardiomyopathy (DCM) in fructose/streptozotocin (STZ)-induced type 2 diabetic rats and also characterizes using Gas Chromatography Mass Spectrophotometry and Fourier Transform Infrared the bioactive compounds in 50% aqueous ethanol extract of Brazil nut.
UNASSIGNED: After inducing type 2 DM, 30 male albino Wistar rats were separated into five groups that comprised of six rats per group, and they were treated as follows: groups 1 (Control) and 2 (Diabetic control) rats received rat pellets and distilled water; group 3 (Diabetic + Brazil nut) received rat pellets and Brazil nut extract (100 mg/kg, orally) dissolved in distilled water, group 4 (Diabetic + metformin) received metformin (100 mg/kg, orally) dissolved in distilled water, while group 5 (Diabetic + Brazil nut + metformin) received oral administrations of Brazil nut (100 mg/kg) and metformin (100 mg/kg) dissolved in distilled water. This study lasted for 6 weeks. The dose of Brazil nut used was selected from our pilot study on the minimum therapeutic dose of different concentrations of Brazil nut extract.
UNASSIGNED: STZ administration induced insulin resistance, hyperglycemia, loss of weight, dyslipidemia, oxidative stress, inflammation, apoptosis, alteration of mammalian target of rapamycin, mitogen-activated protein kinase, heart function markers (creatine kinase MB, lactate dehydrogenase, and aspartate amino transaminase), and heart histology of the diabetic control, which was ameliorated after treatment with Brazil nut and metformin, but their combined treatment was better than the single treatments.
UNASSIGNED: This study shows that Brazil nut contains several bioactive compounds that support its biological properties as well as its candidature as a complementary therapy to metformin in mitigating cardiac complications arising from DM in rats.

暂无摘要。

BACKGROUND: Mesenchymal stem cells (MSCs), as living biodrugs, have entered advanced phases of clinical assessment for cardiac function restoration in patients with myocardial infarction and heart failure. While MSCs are available from diverse tissue sources, bone-marrow-derived MSCs (BM-MSCs) remain the most well-studied cell type, besides umbilical-cord-derived MSCs (UC-MSCs). The latter offers advantages, including noninvasive availability without ethical considerations.
OBJECTIVE: To compare the safety and efficacy of BM-MSCs and UC-MSCs in terms of left ventricular ejection fraction (LVEF), 6-min walking distance (6MWD), and major adverse cardiac events (MACEs).
METHODS: Five databases were systematically searched to identify randomized controlled trials (RCTs). Thirteen RCTs (693 patients) were included using predefined eligibility criteria. Weighted mean differences and odds ratio (OR) for the changes in the estimated treatment effects.
RESULTS: UC-MSCs significantly improved LVEF vs controls by 5.08% [95% confidence interval (CI): 2.20%-7.95%] at 6 mo and 2.78% (95%CI: 0.86%-4.70%) at 12 mo. However, no significant effect was observed for BM-MSCs vs controls. No significant changes were observed in the 6MWD with either of the two cell types. Also, no differences were observed for MACEs, except rehospitalization rates, which were lower only with BM-MSCs (odds ratio 0.48, 95%CI: 0.24-0.97) vs controls.
CONCLUSIONS: UC-MSCs significantly improved LVEF compared with BM-MSCs. Their advantageous characteristics position them as a promising alternative to MSC-based therapy.

BACKGROUND: There are diverse indications for heart transplantation (HTx), often categorized into ischemic (ICM) and nonischemic (NICM) cardiomyopathy. Although there is extensive research comparing the outcomes for these disease processes following certain therapeutic interventions, there are limited data on how recipient etiology impacts post-HTx survival. Our investigation seeks to identify this relationship.
METHODS: We conducted a retrospective analysis using adult HTx patients from the United Network for Organ Sharing database between 2000 and 2021. Patients with a combined heart-lung transplant or previous HTx were excluded. ICM included coronary artery disease (CAD) and ischemic dilated cardiomyopathy. NICM included nonischemic dilated (NIDCM), hypertrophic (HCM), and restrictive (RCM) cardiomyopathy. Overall survival was analyzed using Kaplan-Meier curves, log-rank tests, and multivariable Cox regression models.
RESULTS: A total of 42 268 patients were included in our study. Recipients with ICM were older and more likely to be males, obese, diabetics, and smokers. We found that patients with ICM had an increased incidence of transplant CAD (OR = 1.23, p < 0.001) and risk of mortality (hazard ratio [HR] = 1.22, p < 0.001) compared to NICM. When NICM was expanded, RCM had a similar hazard risk compared to ICM (HR = 1.03, p = 0.650), whereas both NIDCM (HR = 0.81, p < 0.001) and HCM (HR = 0.70, p < 0.001) had improved survival.
CONCLUSIONS: Our study provides evidence to suggest that ICM has decreased survival when compared to NICM. When NICM was expanded, RCM was found to have an increased mortality risk similar to ICM, whereas NIDCM and HCM both had superior outcomes. The clinical implication of this investigation will allow clinicians to better understand the prognosis of certain patient groups.

In therapeutic diagnostics, early diagnosis and monitoring of heart disease is dependent on fast time-series MRI data processing. Robust encryption techniques are necessary to guarantee patient confidentiality. While deep learning (DL) algorithm have improved medical imaging, privacy and performance are still hard to balance. In this study, a novel approach for analyzing homomorphivally-encrypted (HE) time-series MRI data is introduced: The Multi-Faceted Long Short-Term Memory (MF-LSTM). This method includes privacy protection. The MF-LSTM architecture protects patient\'s privacy while accurately categorizing and forecasting cardiac disease, with accuracy (97.5%), precision (96.5%), recall (98.3%), and F1-score (97.4%). While segmentation methods help to improve interpretability by identifying important region in encrypted MRI images, Generalized Histogram Equalization (GHE) improves image quality. Extensive testing on selected dataset if encrypted time-series MRI images proves the method\'s stability and efficacy, outperforming previous approaches. The finding shows that the suggested technique can decode medical image to expose visual representation as well as sequential movement while protecting privacy and providing accurate medical image evaluation.

BACKGROUND: High cognitive reserve (CR) has been related to lower dementia risk, but its association with heart disease (HD) is unknown. We aimed to explore the relation of CR to HD and cardiac structure and function.
RESULTS: Within the UK Biobank, 349 907 HD-free participants were followed up. A composite CR indicator involving education/occupation attainment/television viewing time/confiding frequency/social connection frequency/variety of leisure activities was generated, and further categorized into low/moderate/high levels. Incident HD, including coronary HD, cardiac arrhythmia, and heart failure, was ascertained on the basis of medical records. During the follow-up, a subsample (n=31 182) underwent cardiac magnetic resonance imaging to assess ventricular structure and function. Data were analyzed using Cox regression, Laplace regression, and linear regression. Compared with low CR, the hazard ratio and 95% CI of any HD for high CR was 0.78 (0.75-0.80) (including 0.68 [0.66-0.71] for coronary HD, 0.91 [0.87-0.95] for cardiac arrhythmia, and 0.63 [0.58-0.68] for heart failure). Furthermore, high CR was associated with delayed HD onset by 1.59 (95% CI, 1.37-1.82) years compared with low CR. In cardiac magnetic resonance imaging data analysis, compared with low CR, high CR was associated with larger left ventricular end-diastolic volume (β, 0.13 [95% CI, 0.09-0.17]), left ventricular end-systolic volume (β, 0.05 [95% CI, 0.01-0.10]), left ventricular stroke volume (β, 0.16 [95% CI, 0.12-0.21]), and left ventricular ejection fraction (β, 0.08 [95% CI, 0.03-0.13]).
CONCLUSIONS: High CR is associated with favorable HD health. Our findings suggest that the beneficial effect of CR is not limited to dementia but also HD.