Heart Diseases

心脏病
  • 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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  • 文章类型: Journal Article
    在全球范围内,心栓塞约占缺血性中风的25%,并且通常与更高的发病率和死亡率相关。颅内循环的心源性栓塞的潜在来源包括矛盾栓塞,心律失常,结构性心脏病,和心脏瓣膜病.为了确定患者缺血性卒中的病因,对心内结构的彻底调查,心律失常的评估,考虑心脏手术等高危事件至关重要.心脏栓塞性中风后的治疗可以根据潜在的心脏栓塞来源进行个性化治疗,以最大程度地减少复发性脑缺血事件的风险。
    Cardioembolism accounts globally for around 25% of ischemic strokes and is more often associated with higher rates of morbidity and mortality. Potential sources of cardioembolism into the intracranial circulation include paradoxic embolism, dysrhythmias, structural heart disease, and valvular heart disease. To identify the etiology of a patient\'s ischemic stroke, thorough investigation of the intracardiac structures, assessment of dysrhythmias, and consideration of high-risk events such as cardiac surgery are crucial. Treatment after cardioembolic stroke can be personalized based on the underlying cardioembolic source to minimize the risk of recurrent cerebral ischemic events.
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  • 文章类型: Case Reports
    肝细胞癌(HCC)是全球癌症相关死亡率的重要贡献者。虽然局部晚期HCC的急性和通常致命的表现主要存在于腹部内,至关重要的是要认识到,由于肝脏在体内独特的解剖位置,呼吸和循环系统也可能成为受害者。这里,我们介绍了一例63岁男性最近诊断为局部晚期HCC伴血管侵犯的病例.在接受靶向治疗和局灶性放疗后不久,患者出现反复继发感染和持续性膈缺损.坏死组织侵入胸膜腔,随后出现了肿瘤到支气管和肿瘤到心脏的瘘,导致呼吸系统和心血管系统之间的异常连接,导致循环中大量的空气栓塞。本报告强调了HCC患者治疗后继发感染的膈肌并发症的风险,特别是倾向于发展为膈肌缺陷的患者。
    Hepatocellular carcinoma (HCC) stands as a significant contributor to cancer-related mortality globally. While the acute and often fatal manifestations of locally advanced HCC primarily present within the abdomen, it is crucial to recognize that the respiratory and circulatory systems can also fall victim due to the liver\'s unique anatomical position within the body. Here, we present the case of a 63-year-old male recently diagnosed with locally advanced HCC with vascular invasion. Shortly after receiving target therapy and focal radiotherapy, the patient developed repeated secondary infections and a persistent diaphragmatic defect. As the necrotic tissue invaded the pleural space, subsequent tumor-to-bronchial and tumor-to-cardiac fistulas emerged, resulting in an abnormal connection between the respiratory and cardiovascular systems, leading to massive air emboli in circulation. This report highlights the risk of supradiaphragmatic complications in HCC patients with post-treatment secondary infections, particularly in patients predisposed to developing diaphragmatic defects.
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  • 文章类型: Journal Article
    活动依赖性神经保护性同源盒(ADNP)基因杂合从头突变是Helsmoortel-VanderAa综合征(HVDAS)的基础.这些突变中的大多数位于最后一个外显子,我们先前通过检测患者血液中的突变ADNPmRNA证明了从无义介导的衰变中逃脱。在这项研究中,在蛋白质水平上研究野生型和ADNP突变体,因此需要蛋白质的最佳检测。通过蛋白质印迹法检测ADNP是模糊的,报道的抗体导致没有独特ADNP信号的非特异性条带。使用阻断肽竞争测定法验证N端ADNP抗体(Aviva系统),允许区分不同样品材料中的特异性和非特异性信号,导致ADNP在150kDa左右的独特波段信号,高于其124kDa的理论分子量。用不同的C-末端抗体检测证实了在150kDa的观察分子量下的信号。我们的抗体小组随后通过免疫印迹进行了测试,比较亲本和纯合CRISPR/Cas9内切核酸酶介导的Adnp敲除细胞系,并显示150kDa信号消失,指示完整的ADNP。通过与人ADNP表达载体融合的GFPSpark和Flag标签N末端,我们通过定点诱变在大肠杆菌表达系统中引入患者突变后检测到野生型ADNP和突变形式。此外,我们还能够在携带ADNP患者突变的杂合细胞系中使用我们的C端抗体组可视化内源性ADNP,而截短的ADNP突变体只能用表位标签特异性抗体检测,表明添加表位标签可能有助于稳定蛋白质。然而,患者来源的hiPSCs的蛋白质印迹,永生化的类淋巴母细胞细胞系和死后患者的大脑材料未能检测到天然突变的ADNP蛋白。此外,在过表达裂解物中富含N-末端免疫沉淀活性ADNP抗体的截短突变体,而相同方法的实施未能在永生化的患者来源的淋巴母细胞细胞系中富集可能的天然突变蛋白。这项研究旨在提高对Helsmoortel-VanderAa综合征中突变ADNP蛋白分析的关键评估的认识。
    Heterozygous de novo mutations in the Activity-Dependent Neuroprotective Homeobox (ADNP) gene underlie Helsmoortel-Van der Aa syndrome (HVDAS). Most of these mutations are situated in the last exon and we previously demonstrated escape from nonsense-mediated decay by detecting mutant ADNP mRNA in patient blood. In this study, wild-type and ADNP mutants are investigated at the protein level and therefore optimal detection of the protein is required. Detection of ADNP by means of western blotting has been ambiguous with reported antibodies resulting in non-specific bands without unique ADNP signal. Validation of an N-terminal ADNP antibody (Aviva Systems) using a blocking peptide competition assay allowed to differentiate between specific and non-specific signals in different sample materials, resulting in a unique band signal around 150 kDa for ADNP, above its theoretical molecular weight of 124 kDa. Detection with different C-terminal antibodies confirmed the signals at an observed molecular weight of 150 kDa. Our antibody panel was subsequently tested by immunoblotting, comparing parental and homozygous CRISPR/Cas9 endonuclease-mediated Adnp knockout cell lines and showed disappearance of the 150 kDa signal, indicative for intact ADNP. By means of both a GFPSpark and Flag-tag N-terminally fused to a human ADNP expression vector, we detected wild-type ADNP together with mutant forms after introduction of patient mutations in E. coli expression systems by site-directed mutagenesis. Furthermore, we were also able to visualize endogenous ADNP with our C-terminal antibody panel in heterozygous cell lines carrying ADNP patient mutations, while the truncated ADNP mutants could only be detected with epitope-tag-specific antibodies, suggesting that addition of an epitope-tag possibly helps stabilizing the protein. However, western blotting of patient-derived hiPSCs, immortalized lymphoblastoid cell lines and post-mortem patient brain material failed to detect a native mutant ADNP protein. In addition, an N-terminal immunoprecipitation-competent ADNP antibody enriched truncating mutants in overexpression lysates, whereas implementation of the same method failed to enrich a possible native mutant protein in immortalized patient-derived lymphoblastoid cell lines. This study aims to shape awareness for critical assessment of mutant ADNP protein analysis in Helsmoortel-Van der Aa syndrome.
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  • 文章类型: Journal Article
    心脏病是世界上主要的死亡原因。基于心电图(ECG)的诊断模型通常受到高质量数据的稀缺性和数据不平衡问题的限制。为了应对这些挑战,我们提出了一个条件生成对抗网络(CECG-GAN)。该策略使得能够产生紧密近似ECG数据分布的样本。此外,CECG-GAN解决波形抖动,处理速度较慢,和数据集不平衡问题,通过变压器架构的集成。我们使用两个数据集评估了这种方法:MIT-BIH和CSPC2020。实验结果表明,CECG-GAN具有出色的性能指标。值得注意的是,百分比均方根差异(PRD)达到55.048,表明生成的和实际的ECG波形之间的高度相似性。此外,Fréchet距离(FD)约为1.139,均方根误差(RMSE)记录为0.232,平均绝对误差(MAE)记录为0.166。
    Heart disease is the world\'s leading cause of death. Diagnostic models based on electrocardiograms (ECGs) are often limited by the scarcity of high-quality data and issues of data imbalance. To address these challenges, we propose a conditional generative adversarial network (CECG-GAN). This strategy enables the generation of samples that closely approximate the distribution of ECG data. Additionally, CECG-GAN addresses waveform jitter, slow processing speeds, and dataset imbalance issues through the integration of a transformer architecture. We evaluated this approach using two datasets: MIT-BIH and CSPC2020. The experimental results demonstrate that CECG-GAN achieves outstanding performance metrics. Notably, the percentage root mean square difference (PRD) reached 55.048, indicating a high degree of similarity between generated and actual ECG waveforms. Additionally, the Fréchet distance (FD) was approximately 1.139, the root mean square error (RMSE) registered at 0.232, and the mean absolute error (MAE) was recorded at 0.166.
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  • 文章类型: Case Reports
    该报告描述了一名20多岁的男性,他有2个月的反复咯血和胸痛病史。慢性感染,如肺结核,被怀疑。过去,他曾接受过心包内包虫囊肿的手术切除。他的血液检查显示周围嗜酸性粒细胞增多,他的胸部X光检查显示左上区有囊性卵圆病变。CT肺血管造影显示,双侧节段和亚节动脉充盈缺损,左上叶囊性病变。进一步的工作,包括支气管肺泡灌洗培养和胸部MRI,确诊为包虫囊肿的肺包虫病。此病例说明了在没有其他危险因素的年轻男性中出现多系统包虫病。最初接受手术切除和抗蠕虫治疗。这种疾病后来复发,这需要长时间的药物治疗,使病人得到缓解.
    This report describes a male in his late 20s who presented with a 2-month history of recurrent haemoptysis and chest pain. A chronic infection, such as tuberculosis, was suspected. He had undergone surgical resection of an intrapericardial hydatid cyst in the past. His blood investigations showed peripheral eosinophilia, and his chest X-ray showed a cystic oval lesion in the left upper zone. A CT pulmonary angiogram revealed filling defects in the bilateral segmental and subsegmental arteries with a cystic lesion in the left upper lobe. Further workup, including bronchoalveolar lavage culture and MRI of the thorax, confirmed the diagnosis of a hydatid cyst of pulmonary echinococcosis. This case illustrates the presentation of multisystemic echinococcosis in a young male with no other risk factors, initially treated with surgical resection and antihelminthic therapy. The disease later recurred, which required prolonged medications, which brought the patient into remission.
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  • 文章类型: Dataset
    心脏磁共振成像(CMR)已成为心脏病的有价值的诊断工具。然而,CMR的一个显著缺点是成像速度慢,导致患者吞吐量低,临床诊断质量受损。有限的时间分辨率还会导致患者不适,并在图像中引入伪影。进一步降低其整体质量和诊断价值。人们对基于深度学习的CMR成像算法越来越感兴趣,该算法可以从高度欠采样的k空间数据中重建高质量的图像。然而,深度学习方法的发展需要大量的训练数据集,到目前为止,还没有公开提供给CMR。为了解决这个差距,我们发布了一个包含多对比度的数据集,多视图,来自300名受试者的多层和多线圈CMR成像数据。成像研究包括心脏电影和标测序列。“CMRxRecon”数据集包含原始k空间数据和自动校准线。我们的目标是通过引入标准化的评估标准并使研究社区可以自由访问数据集,从而促进最先进的CMR图像重建的进步。
    Cardiac magnetic resonance imaging (CMR) has emerged as a valuable diagnostic tool for cardiac diseases. However, a significant drawback of CMR is its slow imaging speed, resulting in low patient throughput and compromised clinical diagnostic quality. The limited temporal resolution also causes patient discomfort and introduces artifacts in the images, further diminishing their overall quality and diagnostic value. There has been growing interest in deep learning-based CMR imaging algorithms that can reconstruct high-quality images from highly under-sampled k-space data. However, the development of deep learning methods requires large training datasets, which have so far not been made publicly available for CMR. To address this gap, we released a dataset that includes multi-contrast, multi-view, multi-slice and multi-coil CMR imaging data from 300 subjects. Imaging studies include cardiac cine and mapping sequences. The \'CMRxRecon\' dataset contains raw k-space data and auto-calibration lines. Our aim is to facilitate the advancement of state-of-the-art CMR image reconstruction by introducing standardized evaluation criteria and making the dataset freely accessible to the research community.
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