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BackgroundThe prognostic significance of changes in left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) in patients with myocardial infarction remains unclear.MethodsThis study evaluated whether changes in LVEF and WMSI can predict clinical outcomes and LV remodeling in post-AMI patients. Using data from the Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH), 3,510 AMI patients who underwent percutaneous coronary intervention (PCI) were retrospectively analyzed. LVEF and WMSI were assessed via echocardiography at baseline and one-year post-PCI. The primary outcome was major cardiovascular adverse events (MACE), a composite of all-cause death, recurrent myocardial infarction (MI), and rehospitalization for heart failure at three years.ResultsAmong 3,510 AMI patients, 1,561 (44.5%) showed improvement in both LVEF and WMSI at one year after PCI, 1,150 (32.8%) experienced improvement in either LVEF or WMSI, while 799 (22.8%) had deterioration in both. The incidence of MACE was significantly lower in patients with improvement in both LVEF and WMSI (7.8% vs. 12.5% vs. 17.1%, P  < 0.001). These patients also exhibited the highest rate of LV reverse remodeling and the lowest rate of adverse remodeling. Both the random forest and logistic regression models identified changes in LVEF and WMSI as significant predictors of MACE and LV remodeling.ConclusionIn AMI patients, improvement in both LVEF and WMSI post-PCI was associated with a lower risk of MACE and a higher likelihood of LV reverse remodeling. These findings highlight the prognostic value of LVEF and WMSI changes in guiding long-term management strategies.

Background It was found that delayed activation wave often appeared in terminal QRS wave in non‐ST‐elevated myocardial infarction (NSTEMI) with culprit vessel in left circumflex artery (LCX), yet little is known about the similarities among non‐“N”‐wave non‐ST‐elevated myocardial infarction (N‐NSTEMI) and ST‐elevated myocardial infarction (STEMI). Hypothesis In AMI patients with the culprit vessel in LCX, “N” wave NSTEMI has a risk equivalent to STEMI. Methods All 874 patients admitted to Shenjing Hospital of China Medical University between January 1, 2013 and December 30, 2017 were included and whose coronary angiography (CAG) indicated the culprit vessel in LCX. Patients were divided into three groups: ST‐elevated myocardial infarction group (STEMI group, n = 322), “N” wave non‐ST‐elevated myocardial infarction group (N‐NSTEMI group, n = 232) and non‐“N”‐wave NSTEMI group (non N‐NSTEMI group, n = 320). The basic data and the incidence of MACE during hospitalization and 12 months were analyzed. Results In STEMI and N‐NSTEMI groups, AST, CK, CK‐MB, TnI, and stenosis severity were significantly higher than non N‐NSTEMI (P < .05). The lesions in the N‐NSTEMI and STEMI groups were more often located proximal LCX before giving rise to OM1 of LCX (P < .05), however, the non N‐NSTEMI group was often located distal LCX after giving rise to OM1 and the OM1 (P < .05). The incidence rates of all MACEs, all‐cause death, ST, TVR, and rUAP were similar in N‐NSTEMI and STEMI groups, which were greater than non N‐NSTEMI (P < .05). Both N‐NSTEMI and STEMI are independent risk factors for MACE (P < .05). Conclusion The basic data and the incidence of major adverse cardiac event were similar in N‐NSTEMI and STEMI patients, N‐NSTEMI has a risk equivalent to acute STEMI.

Acute myocardial infarction (AMI) is a common cardiovascular disease in clinic. Currently, there is no specific treatment for AMI. Carbon dots (CDs) have been reported to show excellent biological activities, which hold promise for the development of novel nanomedicines for the treatment of cardiovascular diseases. In this study, we firstly prepared CDs from the natural herb Carbonisata (CRC-CDs) by a green, simple calcination method. The aim of this study is to investigate the cardioprotective effect and mechanism of CRC-CDs on isoproterenol (ISO) -induced myocardial infarction (MI) in rats. The results showed that pretreatment with CRC-CDs significantly reduced serum levels of cardiac enzymes (CK-MB, LDH, AST) and lipids (TC, TG, LDL) and reduced st-segment elevation and myocardial infarct size on the ECG in AMI rats. Importantly, cardiac ejection fraction (EF) and shortening fraction (FS) were markedly elevated, as was ATPase activity. In addition, CRC-CDs could significantly increase the levels of superoxide dismutase (SOD), reduced glutathione (GSH), catalase (CAT), and reduce the levels of malondialdehyde (MDA) and reactive oxygen species (ROS) in myocardial tissue, thereby exerting cardioprotective effect by enhancing the antioxidant capacity of myocardial tissue. Moreover, the TUNEL staining image showed that positive apoptotic cells were markedly declined after CRC-CDs treatment, which indicate that CRC-CDs could inhibit cardiomyocyte apoptosis. Importantly, The protective effect of CRC-CDs on H O -pretreated H9c2 cells was also verified in vitro. Taken together, CRC-CDs has the potential for clinical application as an anti-myocardial ischemia drug candidate, which not only provides evidence for further broadening the biological application of cardiovascular diseases, but also offers potential hope for the application of nanomedicine to treat intractable diseases.

The respiratory rehabilitation technique is a crucial component of early cardiac recovery in geriatric patients with acute myocardial infarction (AMI). This study primarily investigated the effectiveness of a novel respiratory rehabilitation technique, metronomic breathing (MB), on geriatric patients after percutaneous coronary intervention for AMI and compliance with home-based rehabilitation compared to traditional respiratory rehabilitation. From June 2022 to March 2023, 75 acute myocardial infarction (AMI) patients admitted to the Shanghai Tenth People's Hospital Cardiovascular Department were consecutively enrolled. Ultimately, 46 patients completed the follow-up in this study-26 in the MB group and 20 in the control group-who underwent the novel MB technique and conventional abdominal breathing training. The primary endpoint of the study was left ventricular function measured by noninvasive hemodynamics three months after discharge. The secondary endpoints were compliance and quality of life after three months of home rehabilitation. After the intervention, several cardiac functional parameters (SV, SVI, CO, CI, LCW, and LCWI), myocardial contractility parameters (VI), and systemic vascular resistance parameters (SVR and SVRI) were significantly greater in the MB group than in the preintervention group (P < 0.05). Furthermore, post-treatment, the MB group exhibited greater SV, SVI, CO, CI, and VI; lower SVR, SVRI, and SBP; and a lower readmission rate three months later than did the control group. The SF-36 scores after three months of MB intervention, PE, BP, GH, VT, SF, RE, and MH, were all significantly greater than those before treatment (P < 0.05). Moreover, the MB group displayed greater compliance with home-based cardiac rehabilitation (P < 0.05). Compared to conventional respiratory rehabilitation training methods, short-term metronomic respiratory therapy is more effective for reducing systemic vascular resistance, enhancing left ventricular ejection function, enhancing quality of life, and increasing home-based rehabilitation compliance in geriatric patients following AMI with PCI.

Anogeissus acuminata (Roxb. ex DC.) is a folkloric medicinal plant in Asia; including Pakistan; used as a traditional remedy for cardiovascular disorders. This study was planned to establish a pharmacological basis for the trivial uses of Anogeissus acuminata in certain medical conditions related to cardiovascular systems and to explore the underlying mechanisms. Mechanistic studies suggested that crude extract of Anogeissus acuminata (Aa.Cr) produced in vitro cardio-relaxant and vasorelaxant effects in isolated paired atria and aorta coupled with in vivo decrease in blood pressure by invasive method; using pressure and force transducers connected to Power Lab Data Acquisition System. Moreover; Aa.Cr showed positive effects in left ventricular hypertrophy in Sprague Dawley rats observed hemodynamically by a decrease in cardiac cell size and fibrosis; along with absence of inflammatory cells; coupled with reduced levels of angiotensin converting enzyme (ACE) and renin concentration along with increased concentrations of nitric oxide (NO) and cyclic guanosine monophosphate (cGMP). In Acute Myocardial Infarction (AMI) model; creatine kinase (CK), creatine kinase-MB (CK-MB) and lactic acid dehydrogenase (LDH levels) were found to be decreased; along with decreased necrosis; edema and recruitment of inflammatory cells histologically. In vivo and ex vivo studies of Anogeissus acuminata provided evidence of vasorelaxant; hypotensive and cardioprotective properties facilitated through blockage of voltage-gated Ca++ ion channel; validating its use in cardiovascular diseases

Background： Recent studies show that microRNA- 145 （miRNA- 145 ） might be an attractive tumor biomarker of considerable prognostic value, but little is known about their relationship with acute myocardial infarction （AMI）. This study investigated the correlation between the level of miR-145 and AM1. Methods： One-hundred patients were divided into three groups： no coronary artery disease （CAD） group, non-ST segment elevation myocardial infarction group, and ST segment elevation myocardial infarction group. The plasma levels of miR-145 were quantified using real-time quantitative polymerase chain reaction. Logarithmic transformation of miRNA-145 levels （Ln_rniRNA-145） was used for statistical analysis due to the skewed data distribution. Results： Plasma levels of miR-145 were significantly lower in patients with AMI compared to patients in the non-CAD group （-6.38 ± 0.11 vs. -4.47 ＋ 0.17, P 〈 0.0001）. Compared to those without heart failure, the levels of miR-145 were significantly lower in patients with heart failure （-6.91 ± 0.20 vs. -5.35 ± 0.13, P 〈 0.0001）. We also found that the lower plasma levels of miRNA-145 significantly correlated with increased serum levels of B-type natriuretic peptide （Spearman ρ = -0.60, P 〈 0.0001）, troponin T （Spearman p = -0.62, P 〈 0.0001）, and decreased ejection fraction （Spearman ρ = 0.65, P 〈 0.0001）. In a multivariable linear regression analysis, AMI and heart failure were independently associated with lower Ln miRNA-145 （estimate -0.99, standard error [SE] 0.28; P = 0.001 and estimate -0.62, SE 0.21 ; P = 0.004）. Conclusions： Our results suggest that decreased plasma levels of miR-145 are associated with AMI. Circulating miR-145 may be useful in prognosticating cardiac function and the risk of developing heart failure.

Our study aimed to assess the effect of weekend versus weekday hospital admissions on all-cause mortality in patients with acute myocardial infarction (AMI) and COVID-19 during the COVID-19 pandemic. We analyzed data from the National Inpatient Sample (NIS) 2020, identifying patients with co-existing AMI and COVID-19 admitted on weekdays and weekends. Baseline demographics, comorbidities, and outcomes were assessed. A multivariable regression analysis was conducted, adjusting for confounders to determine the odds of all-cause mortality. Among 74,820 patients, 55,145 (73.7%) were admitted on weekdays, while 19,675 (26.3%) were admitted on weekends. Weekend admissions showed slightly higher proportions of men (61.3% vs. 60%) and whites (56.3% vs. 54.9%) with a median age of 73 years (range: 62-82). The overall all-cause mortality had an odds ratio (OR) of 1.00 (95% CI, 0.92-1.09; = 0.934). After adjusting for covariates, there was no significant associations between mortality and hospital type (rural: OR = 1.04; 95% CI, 0.78-1.39; = 0.789; urban teaching: OR = 1.04; 95% CI, 0.94-1.14; = 0.450) or geographic region (Northeast: OR = 1.16; 95% CI, 0.96-1.39; = 0.12; Midwest: OR = 0.99; 95% CI, 0.83-1.17; = 0.871; South: OR = 0.97; 95% CI, 0.85-1.12; = 0.697; West: OR = 0.94; 95% CI, 0.77-1.15; = 0.554). There was no significant difference in the rate of all-cause mortality among patients admitted for AMI and COVID-19 between weekdays and weekends.

Background/Aims: Researches have showed that cardiac shock wave therapy (CSWT) could improve left ventricular function and attenuate LV remodeling of the ischemic heart. Apoptosis plays an important role in myocardial infarction and determines heart function and prognosis. However, it is still not clear whether CSWT is sufficient to attenuate acute myocardial infarction (AMI) induced cardiomyocyte apoptosis in vivo. In this study, we used a rat model to examine whether CSWT could attenuate cardiomyocyte apoptosis after AMI and to explore potential mechanisms. Methods: We generated an AMI rat model to investigate the function and possible regulatory mechanisms of CSWT. All rats were randomly divided into four groups: the sham-operated only group, sham-operated with SW treatment group, AMI only group, and AMI treated with SW treatment group.The rats were treated with a left anterior descending coronary artery ligation for 12h and then treated with or without CSWT (800 shots at 0.1 mJ/ mm 2 ). Cytochrome c release was measured to analyze mitochondrial function and integrity. The apoptotic cell rate was determined by TUNEL assay. Western blot was used to analyze the cell apoptosis-, inflammation-, and survival-related signaling pathways. Results: First, the methodology of CSWT in the rat model of AMI was established. Second, CSWT attenuated the cardiomyocyte apoptosis rate in the infarct border zone. Third, CSWT suppressed the expression of apoptosis and inflammation molecules after AMI. Fourth, CSWT inhibited activation of the JNK pathway, which indicated inhibition of the cell inflammatory pathways and promotion of cardiomyocyte survival after AMI. Conclusion: These results indicate that CSWT exerts a protective effect against AMI-induced cardiomyocyte apoptosis, potentially by attenuating cytochrome c release from the mitochondria and inhibiting of the mitochondrial-dependent intrinsic apoptotic pathway. We also demonstrate that CSWT suppresses the JNK pathway and cardiomyocyte inflammation, which may also decrease cardiomyocyte apoptosis in vivo.