Abstract: The ventricle assist device has emerged as an important therapeutic option in the treatment of both acute and chronic heart failure. The blood pumps which are the major components of ventricle assist devices have also progressed to the third generation. The magnetic and/or liquid levitation technologies have been applied into the third generation blood pumps. The impellers which drive blood are levitated in the blood pumps. The third generation blood pumps are mainly composed of the levitation system and the driving system. The development of the third generation blood pumps has three stages: the stage of foreign motor indirectly driving the impeller with the levitation and driving system separated, the stage of motor directly driving the impeller with the levitation and driving system separated, and the stage of levitation system integrated with the driving system. As the impellers do not contact with other structures, the third generation blood pumps possess the advantages of low thrombosis, less hemolysis and high energy efficiency ratio. Currently most of the third generation blood pumps are in the research stage, but a few number of them are used in clinical trials or applying stage. In this article, the history, classification, mechanism and research situation of the third generation blood pumps are reviewed.
Patients with acute heart failure (AHF) often experience dyspnea, and monitoring and quantifying their breathing patterns can provide reference information for disease and prognosis assessment. In this study, 39 AHF patients and 24 healthy subjects were included. Nighttime chest-abdominal respiratory signals were collected using wearable devices, and the differences in nocturnal breathing patterns between the two groups were quantitatively analyzed. Compared with the healthy group, the AHF group showed a higher mean breathing rate (BR_mean) [(21.03 ± 3.84) beat/min vs. (15.95 ± 3.08) beat/min, P < 0.001], and larger R_RSBI_cv [70.96% (54.34%–104.28)% vs. 58.48% (45.34%–65.95)%, P = 0.005], greater AB_ratio_cv [(22.52 ± 7.14)% vs. (17.10 ± 6.83)%, P = 0.004], and smaller SampEn (0.67 ± 0.37 vs. 1.01 ± 0.29, P < 0.001). Additionally, the mean inspiratory time (TI_mean) and expiration time (TE_mean) were shorter, TI_cv and TE_cv were greater. Furthermore, the LBI_cv was greater, while SD1 and SD2 on the Poincare plot were larger in the AHF group, all of which showed statistically significant differences. Logistic regression calibration revealed that the TI_mean reduction was a risk factor for AHF. The BR_ mean demonstrated the strongest ability to distinguish between the two groups, with an area under the curve (AUC) of 0.846. Parameters such as breathing period, amplitude, coordination, and nonlinear parameters effectively quantify abnormal breathing patterns in AHF patients. Specifically, the reduction in TI_mean serves as a risk factor for AHF, while the BR_mean distinguishes between the two groups. These findings have the potential to provide new information for the assessment of AHF patients.
Heart failure (HF) is a symptoms caused by various diseases. As the myocardial contractility and/or diastolic weakening, the cardiac output decreased, when it can not satisfy the needs of the body, a series of symptoms and signs occurs. HF is an end-stage performance of heart disease, and is also a major factor of mortality. The morbidity of heart failure increased as peoples enter the aging. Despite the continuous improvement of drug treatment,the morbidity and mortality of HF remains high. At present, nondrug treatment of heart failure get more and more attention to clinicians. Surgical methods gets more innovation.Medical intervention has been introducted new auxiliary facilities, and genetics and stem cell technology bring new hope to it’s treatment. This article reviews the HF surgery, nterventional treatment and its related gene and cell therapy and research recently.
Objective To cluster the symptoms of patients with chronic heart failure (CHF) through the cluster analysis, and to explore the relationships among symptom clusters of CHF, patients’ self-care behaviors and sleep quality, as well as the pathways influencing sleep quality of CHF patients. Methods A convenience sampling approach was used to provide a questionnaire survey to CHF patients who were being followed up with between January and December 2021. The Pittsburgh Sleep Quality Index, Memorial Symptom Assessment Scale-Heart Failure, European Heart Failure Self- care Behavior Scale and a self-created questionnaire on sociodemographic and clinical data characteristics were all included in the survey. Results A total of 304 CHF patients were included. Among them, there were 178 males and 126 females; the average age was (61.31±14.00) years; the average sleep quality score was (8.17±4.51) points, while the average overall self-care behavior score was (21.28±3.80) points. According to the cluster analysis of the symptoms of CHF patients, the patients’ symptoms were separated into clusters related to exhaustion, disease perception, and a single symptom of dry mouth. The sleep quality score was positively correlated with the following factors: age, number of comorbidities, overall score of symptom assessment, fatigue symptom cluster score, and illness perception symptom cluster score (P<0.05). There was no significant correlation between the self-care behavior score and sleep quality (P>0.05). However, sleep quality scores were negatively correlated with body mass index and education level, respectively (P<0.05). Age, gender, score of illness perception symptom cluster, and fatigue symptom cluster all had direct effects on sleep quality of 0.014, 0.206, 0.487, and 0.165 (P<0.05), respectively, according to path analysis. Self-care behavior also had a direct influence of 0.018 (P=0.686). Conclusions CHF patients have somewhat high levels of self-care behaviors, but they have poor sleep quality. They still have a lot of symptoms after being released. Sleep quality is significantly impacted by the patients’ age, body mass index, educational attainment, number of comorbidities, symptom ratings, fatigue symptom clusters, and disease perception symptom clusters. While the route effects of the patients’ self-care actions are not statistically significant, the age, gender, disease perception, and fatigue symptom cluster scores of CHF patients have a direct impact on the quality of their sleep. By managing the same clusters of symptoms, nursing staff can help patients with CHF feel better. They can also help patients sleep better by adopting practical measures.
ObjectiveTo explore the effect of type 2 diabetes mellitus (T2DM) on the vascular endothelial function of patients with heart failure with mid-range ejection fraction (HFmrEF), and the impact of endothelial function damage on the long-term prognosis of HFmrEF. Metohds87 patients with T2DM and heart failure with mid-range ejection fraction (T2DM-HFmrEF), 98 patients with HFmrEF alone, and 70 healthy control who had been hospitalized at the department of cardiology of the First Affiliated Hospital of Xinjiang Medical University from December 2018 to January 2020 were included. The levels of serum TNF-α, IL-6, vWF, eNOs and E-selectin were determined by enzyme-linked immunosorbent assay. The oxidative stress and vascular endothelial function related indicators of the 3 groups were analyzed. The primary endpoint (all-cause death, exacerbation of heart failure and rehospitalization, or exacerbation of heart failure) and secondary endpoint events (non-fatal myocardial infarction, stable and unstable angina pectoris, or stroke) were followed up for 1 year after discharge.ResultsThe levels of TNF-α, IL-6, vWF, and E-selectin in the HFmrEF combined with diabetes group were higher than those in the HFmrEF without diabetes group (P<0.05). Multivariate Cox regression analysis showed that BNP (HR=1.001, P=0.036), eNOs (HR=1.04, P<0.001), and IL-6 (HR=1.002, P<0.001) were related to the primary end point of all patients with HFmrEF. Glycated hemoglobin (HR=1.37, P=0.046), E-selectin (HR=1.01, P=0.003), vWF (HR=1.02, P=0.017), and IL-6 (HR=1.006, P=0.005) were related to the secondary end point of all patients with HFmrEF. The results of subgroup analyze showed that E-selectin (HR=1.014, P=0.012) and IL-6 (HR=1.008, P=0.007) were related to the secondary endpoint events in the HFmrEF combined with diabetes group, but were not related to the secondary end point events of the non-diabetic group (P>0.05).ConclusionsOxidative stress and vascular endothelial function damage may be involved in the pathogenesis of T2DM-HFmrEF. Serum IL-6 and E-selectin levels are related to the endpoint events in T2DM-HFmrEF patients.
Objective To systematically review the influence of frailty on the prognosis of non-cardiovascular surgery heart failure (HF) patients and to provide references for its prevention and management. Methods CNKI, VIP, CBM, WanFang Data, PubMed, EMbase, Web of Science, and The Cochrane Library were searched to collect cohort studies on the prognosis of non-cardiovascular surgery HF patients with frailty from inception to November 1st, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Then, meta-analysis was performed using RevMan 5.3 software and Stata 14.0 software. Results A total of 20 studies involving 11 127 patients were included. The results of meta-analysis showed that frailty increased the risk of all-cause mortality (HR=1.72, 95%CI 1.61 to 1.84, P<0.000 01), hospitalization (HR=2.06, 95%CI 1.26 to 3.37, P=0.004), and combined endpoint (HR=1.59, 95%CI 1.37 to 1.84, P<0.000 01) in non-cardiovascular surgery HF patients. Conclusion Current evidence shows that frailty can increase the risk of all-cause mortality, hospitalization, and combined endpoints in non-cardiovascular surgery HF patients. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To explore the effect of long non-coding RNA H19 (lncRNA H19) on chronic heart failure (CHF) rats and its possible mechanism. Methods CHF (SD male rats, with a weight of 300±10 g, 10 weeks old) rat model was established by abdominal aortic coarctation. The 84 rats successfully modeled were randomly divided into a model group, a si-NC group [transfected lncRNA H19 small interfering RNA (siRNA) negative control], a si-H19 group (transfected lncRNA H19 siRNA), a si-miR-NC group [transfected microRNA-214 (miR-214) siRNA negative control], a si-miR-214 group (transfected miR-214 siRNA), a si-H19+si-miR-NC group (co-transfected lncRNA H19 siRNA and miR-214 siRNA negative control), and a si-H19+si-miR-214 group (co-transfected lncRNA H19 siRNA and miR-214 siRNA), 12 rats in each group. Another 12 rats were set up in a sham operation group (rats were only threaded without ligation, and the other operations were the same as the model group). After 4 weeks of intervention, the cardiac function, serum myocardial injury markers, heart failure markers, inflammatory related factors, apoptosis related factors and myocardial histopathological changes were compared. The expressions of lncRNA H19 and miR-214 in myocardial tissue were detected by real-time fluorescence quantitative PCR, and the targeting relationship between lncRNA H19 and miR-214 was detected by double luciferase reporter gene. Results Compared with those in the sham operation group, the myocardium of rats in the model group was severely damaged and a large number of inflammatory cells infiltrated; the lncRNA H19, cardiac function indexes (left ventricular end systolic diameter, left ventricular end diastolic diameter), serum myocardial injury markers (creatine kinase MB, cardiac troponin I), heart failure markers (brain natriuretic peptide, N-terminal pro brain natriuretic peptide), inflammatory related factors (interleukin-1β, interleukin-18, tumor necrosis factor-α, interleukin-6), cardiomyocyte apoptosis rate, apoptosis related proteins [B lymphocytoma-2 (Bcl-2), Bcl-2 related X protein (Bax), cysteinyl aspartate specific proteinase-1 (Caspase-1)] in the myocardial tissue of the model group were significantly increased (P<0.05); miR-214 of myocardial tissue, cardiac function indexes (left ventricular ejection fraction, left ventricular fractional shortening) and Bcl-2/Bax ratio were significantly decreased (P<0.05). Compared with the model group, silencing lncRNA H19 could significantly improve the cardiac function and the changes of the above indexes in CHF rats, and reduce myocardial injury (P<0.05); down-regulation of miR-214 could significantly reverse the protective effect of si-H19 on myocardial injury in CHF rats (P<0.05). Conclusion Silencing lncRNA H19 can up-regulate the expression of miR-214, inhibit the expression of Caspase-1, inhibit the apoptosis and inflammatory reaction of cardiomyocytes, and alleviate myocardial injury in rats with CHF.
【摘要】目的探討B型腦鈉肽(BNP)與慢性充血性心力衰竭預后的關系。方法2008年1月10月收治的慢性充血性心力衰竭患者100例,均符合美國心臟病協會分級標準(NYHA)Ⅲ~Ⅳ級,快速檢測BNP,觀察心血管事件發生組與未發生組患者血漿BNP濃度差異。結果發生心血管事件患者血漿BNP濃度顯著升高,未發生心血管事件患者血漿BNP濃度下降。血漿BNP濃度與心血管事件發生有密切關系結論BNP水平可以指導心力衰竭患者的治療,并可以預測失代償期充血性心力衰竭患者的預后。
Objective To assess the effectiveness and safety of meglumine adenosine cyclophosphate (MAC) for chronic heart failure. Methods The databases such as Cochrane Central Register of Controlled Trials (Issue 3, 2011), MEDLINE (1950 to March 2011), EMbase (1980 to March 2011), CNKI (1995 to March 2011), and VIP (1989 to March 2011) were searched, and the relevant journals and conference proceedings were also manually retrieved. Then the studies were screened according to predefined inclusion and exclusion criteria, and their quality was evaluated. Meta-analyses were performed by using RevMan 5.0 software. Results Seventeen randomized controlled trials (RCTs) involving 1 281 patients were included. All of the included RCTs were Grade C in methodological quality. The results of meta-analyses showed that MAC plus routine treatment was superior to routine treatment in improving the left ventricular ejection fraction (WMD=5.75, 95%CI 3.61 to 7.89), stroke volume (SV) (WMD=5.55, 95%CI 3.71 to 7.38), E/A (WMD=0.09, 95%CI 0.05 to 0.14) and 6 min walk test (WMD=43.52, 95%CI 21.00 to 66.04). But MAC plus routine treatment was similar to routine treatment in regulating cardiac index (CO) (WMD=0.20, 95%CI –0.31 to 0.71) and heart rate (WMD=0.64, 95%CI –7.49 to 8.77). No significant adverse effects or allergic reactions were reported. Conclusion The current evidence shows that MAC may improve the left ventricular ejection fraction, stroke volume, E/A and 6 min walk test. Due to a high risk of selection bias and detection bias in the included studies, the evidence is insufficient to determine the effectiveness of MCA. Further large-scale trials are required to define the role of MAC in the treatment of chronic heart failure.