Abstract:Objective This study was designed to analyze the impact of different tricuspid valve replacement positions(anatomical vs.supra-annular)on postoperative right heart function recovery and long-term prognosis.Methods A retrospective analysis was conducted on 120 patients who underwent tricuspid valve replacement,divided into an anatomical position group(97 cases)and a supra-annular position group(23 cases).Preoperative baseline data,intraoperative surgical indicators,early postoperative complications,and long-term follow-up outcomes were compared between the two groups.Cox regression analysis was used to identify factors related to prognosis.Results There were no significant differences between the anatomical and supra-annular groups concerning operation duration(332.5 min vs.372.5 min),cardiopulmonary bypass(CPB)time(144.5 min vs.146.5 min),or aortic cross-clamp time(99.5 min vs.100.5 min)(P>0.05).Additionally,no statistically significant differences were found in postoperative arrhythmia,conduction block,low cardiac output syndrome(LCOS),acute kidney injury(AKI),mortality,new-onset dialysis,or pacemaker implantation between the groups(P>0.05).Univariate analysis indicated that BMI(HR=0.817,P=0.025),preoperative NYHA functional class(HR=2.192,P=0.019),operation duration(HR=1.005,P=0.004),and CPB time(HR=1.005,P=0.046)were significantly associated with prognosis.Conversely,gender,age,diabetes,ejection fraction(EF),and severity of tricuspid regurgitation did not show significant correlation with prognosis.Multivariate analysis revealed that operation duration(HR=1.005,P=0.101)did not demonstrate independent statistical significance after adjusting for other variables.Kaplan-Meier survival analysis showed no significant difference in overall survival between the two groups during the follow-up period(Log-rank test P>0.05),suggesting that tricuspid valve replacement position(anatomical vs.supra-annular)has a limited impact on long-term survival.Conclusion The choice of replacement positions have a limited impact on right heart function recovery and long-term survival.Although not reaching statistical significance,the supra-annular group showed a potential advantage over the anatomical group in managing postoperative tricuspid regurgitation.Preoperative cardiac functional status and surgical complexity have a greater influence on prognosis.

Abstract:Atrial myxoma is a common benign cardiac tumor characterized by a loose structure that is prone to fragmentation and detachment due to the impact of blood flow.This can lead to complications such as cerebral embolism and pulmonary embolism.We report a rare case of tumor thrombus detachment and embolization to the coronary artery.The patient was an elderly female who presented with sudden chest tightness and pain without obvious causes.Routine electrocardiogram and myocardial enzyme spectrum indicated acute myocardial infarction,and cardiac ultrasound showed atrial myxoma and heart failure.The absence of symptoms indicative of other organ vascular embolism such as cerebral embolism and pulmonary embolism,complicated the diagnosis.This condition is easily misdiagnosed as a typical atrial myxoma accompanied by coronary atherosclerotic heart disease,leading to the potential oversight of the tumor thrombus.Upon the patient's arrival at our center,we conducted comprehensive examinations that accurately identified the underlying cause of her acute myocardial infarction,ultimately resulting in successful treatment.This case highlights the importance of proper diagnosis and management of acute myocardial infarction complicated by acute heart failure due to coronary artery occlusion caused by atrial myxoma.

Abstract:Objective To investigate the clinical features of individuals receiving surgical intervention for aortic valve conditions,assess postoperative cognitive function levels,and identify the primary risk factors associated with postoperative cognitive impairment.Methods A retrospective analysis was conducted on the clinical data of 182 patients diagnosed with aortic valve disease who underwent surgical intervention at Xinjiang Uygur Autonomous Region People's Hospital,between January 2021 and March 2024.These patients were categorized into two groups according to their cognitive function status six months after the surgery:one group exhibited normal cognitive function,while the other group showed cognitive impairment.The study examined the relationship between various variables and the development of cognitive dysfunction following surgery.Variables with a statistical significance of P<0.05 were subjected to both univariate and multivariate Logistic regression analyses to identify independent risk factors predisposing patients with aortic valve disease to postoperative cognitive dysfunction.Results At 6 months post-surgery,the incidence of postoperative cognitive dysfunction among patients with aortic valve disease was 28.02%(51/182).Analysis of individual factors revealed significant variations in the prevalence of postoperative cognitive dysfunction among patients undergoing aortic valve surgery,depending on their age,body mass index,history of smoking,presence of hypertension,diabetes,European System for Cardiac Operative Risk Evaluation(EuroSCORE)risk score,duration of the surgical procedure,postoperative infection and cerebrovascular accident characteristics(P<0.05).Both univariate and multivariate Logistic regression analyses identified that age,smoking history,hypertension,diabetes,EuroSCORE score,duration of surgery and perioperative cerebrovascular accident as independent risk factors contributing to postoperative cognitive dysfunction in patients with aortic valve disease(P<0.05).Conclusion Elderly patients with aortic valve disease,those with a history of smoking,concomitant hypertension and diabetes,a high EuroSCORE indicating increased surgical risk,and an extended operative time are at greater risk of developing cognitive impairment following surgical intervention.

Abstract:Objective Following myocardial infarction(MI),cardiomyocytes at the site of coronary occlusion undergo extensive loss due to ischemia and hypoxia,while excessive production of reactive oxygen species(ROS)further impedes myocardial repair.This study aimed to develop a microneedle patch loaded with catalase and characterized its physicochemical properties and biocompatibility.In vitro and in vivo studies were conducted to assess the antioxidant stress protection provided by the patch and its effects on cardiac function after myocardial infarction.Methods A bilayer degradable microneedle patch was created using hyaluronic acid(HA)as the base layer to load catalase,while methacrylated hyaluronic acid formed the microneedle patch tips.The patch was prepared by casting the materials into polydimethysiloxane(PDMS)microneedle molds.Results The prepared microneedles formed a 15 mm×15 mm square array,with each needle body approximately 700 μm in height.The hyaluronic acid(HA)in the base can degrade to release catalase,which decomposes ROS.In vitro studies demonstrated that the microneedles possess good biocompatibility and antioxidant capacity,with a hydrogen peroxide(H2O2)clearance rate reaching 62%.Their mechanical strength is approximately 0.32 N per needle,sufficient to penetrate cardiac tissue.Echocardiography indicated that the microneedle group effectively improved cardiac function in SD rats 28 days after MI.Masson staining further verified,at the tissue level,a reduction in collagen fiber deposition area at the infarct site.Conclusion The dual-layer degradable microneedle patch loaded with catalase represents a novel therapeutic strategy for MI repair.

Abstract:Objective To identify independent risk factors for perioperative adverse outcomes in patients with pulmonary atresia with intact ventricular septum(PA/IVS)who underwent biventricular repair,and to develop a visualized risk assessment model to support clinical decision-making.Methods This retrospective cohort study included 97 PA/IVS patients who underwent biventricular repair at Guangdong Provincial People's Hospital from June 1999 to June 2024.Patients were categorized into two groups:those with adverse outcomes(n=27)and those with normal outcome groups(n=70).Variables analyzed included gestational age,birth weight,tricuspid valve Z-score,right ventricular dimensions,and intraoperative parameters.Logistic regression analysis and ROC curves were utilized to identify risk factors and evaluate predictive performance.Results The cohort comprised 97 children with PA/IVS who underwent biventricular repair.The average gestational age and right ventricular transverse diameter in the adverse outcome group were significantly lower than those in the favorable outcome group[(36.2±2.6)weeks vs.(38.7±2.0)weeks,(11.9±2.5)mm vs.(14.4±4.7)mm,P<0.05].Additionally,the incidence of intraoperative aortic cross-clamping was higher in the adverse outcome group(74.1%vs.51.4%).Multivariate analysis identified three independent risk factors for short-term adverse outcomes:shorter gestational age(OR=0.555,95%CI 0.395-0.782,P=0.001),narrower right ventricular transverse diameter(OR=0.751,95%CI 0.614-0.912,P=0.004),and aortic cross-clamp(OR=5.18,95%CI 1.322-19.734,P=0.018).The nomogram created from these variables demonstrate excellent predictive ability(AUC=0.885),with gestational age being the strongest predictor(AUC=0.821).Conclusions For PA/IVS patients undergoing biventricular repair,shorter gestational age,narrower right ventricular transverse diameter,and aortic cross-clamp are significant predictors of adverse short-term outcomes.This risk assessment model provides evidence-based support for short-term postoperative risk stratification,optimization of surgical timing,and prevention of complication in PA/IVS patients.

Abstract:Ascending thoracic aortic aneurysm(ATAA)can progress to acute Stanford type A aortic dissection.Current,risk stratification predominantly relies on maximal aortic diameter;however,the frequent occurrence of dissection below established guideline thresholds—known as the"diameter paradox"—highlights the limitations of using a purely anatomical index.In this review,we examine recent advances in hemodynamic studies of ascending thoracic aortic aneurysm from the perspective of geometric remodeling and flow alteration.We elucidate the haemodynamic significance of parameters such as wall shear stress,oscillatory shear index and related parameters,and describe their characteristic patterns in different forms of ascending thoracic aortic aneurysm.Additionally,we discuss studies employing individualized computational fluid dynamics and fluid-structure interaction,which reveal associations between high wall stress zones or low shear stress zones and aneurysm expansion and dissection formation.Finally,we outline how emerging tools such as 4D blood flow MRI and artificial intelligence may facilitate the integration of hemodynamic metrics into operative threshold setting,surgical planning and postoperative surveillance,thereby supporting more individualized management approaches of ATAA.

Abstract:Objective To assess whether emergency surgical intervention reduces adverse clinical events in patients with infective endocarditis(IE)presenting with vegetation diameters of between 5 and 10 mm.Methods A retrospective analysis was conducted involving 268 patients diagnosed with IE and vegetation sizes ranging from 5 to 10 mm who were admitted to Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,between January 1,2019,and December 31,2024.Patients were stratified into an emergency surgery group,defined as those undergoing surgery,and a non-emergency surgery group.The primary endpoint was a composite outcome comprising all-cause mortality and postoperative new-onset embolic events.Results A total of 213 patients with IE who underwent surgical treatment were included in the analysis.Among these,92 patients(43.19%)received emergency surgery,while 121 patients(56.81%)underwent non-emergency surgery.Composite endpoint events occurred in 39 patients(18.31%),including 15 deaths(7.04%)and 24 postoperative new-onset embolic events(11.27%).Although the incidence of composite endpoint events and postoperative embolism was lower in the emergency surgery group compared with the non-emergency group[19 patients(20.65%)vs.20 patients(16.53%),P=0.44;11 patients(11.96%)vs.13 patients(10.74%),P=0.78,respectively],these differences did not reach statistical significance.All-cause mortality was marginally higher in the emergency surgery group,but this difference was also not statistically significant[8 patients(8.70%)vs.7 patients(5.79%),P=0.41].Multivariate Cox proportional hazards regression analysis identified advanced age(P=0.03,HR=1.31,95%CI 1.04-3.03),diabetes mellitus(P=0.04,HR=1.70,95%CI 1.02-2.83),staphylococcus aureus infection(P=0.03,HR=1.80,95%CI 1.06-3.54),prolonged duration of mechanical ventilation(P<0.01,HR=2.10,95%CI 1.55-2.85),and extended intensive care unit(ICU)stay(P=0.01,HR=1.43,95%CI 1.20-1.63)as independent predictors of adverse endpoint events.Conclusion Emergency surgical intervention did not confer a significant benefit in reducing all-cause mortality or postoperative mew-onset embolic event among IE patients with vegetation diameters of 5-10 mm.Independent factors associated with an increased risk of adverse outcomes included advanced age,diabetes mellitus,Staphylococcus aureus infection,prolonged mechanical ventilation,and extended ICU stay.

Abstract:Calcium/calmodulin-dependent protein kinase Ⅱ(CaMK Ⅱ)is a protein kinase found in cardiac and brain tissues,as well as in various other cell types.It plays a pivotal role in maintaining normal cardiac physiology.This kinase significantly influences cardiovascular homeostasis by regulating processes such as calcium cycling,electrophysiological activity,and gene expression.Recent studies have highlighted a strong association between abnormal CaMK Ⅱactivation and the pathogenesis of various cardiovascular diseases.Several CaMK Ⅱ inhibitors have demonstrated promising therapeutic effects in preliminary clinical studies,providing valuable insights for the development of novel cardiovascular therapies.This review offers a comprehensive analysis of the role and mechanisms of CaMK Ⅱ in cardiovascular diseases,presenting novel insights and directions for research in cardiovascular biology and medicine.

Abstract:Umbilical cord blood(UCB)autotransfusion is a perioperative blood conservation strategy with considerable clinical potential,particularly for neonates with congenital heart disease(CHD)who require open-heart surgery.This technique utilizes cord blood collected at birth as a natural autologous blood source for priming the cardiopulmonary bypass(CPB)circuit and for intraoperative transfusion,effectively reducing or even eliminating the need for allogeneic blood products.The standardized implementation of this approach has positive implications for reducing transfusion-related complications and improving perioperative safety and quality of life in children with CHD.Drawing on current domestic and international literature and taking into account China's healthcare context and clinical practices,this article systematically elaborates on the application of UCB autotransfusion within an integrated peripartum management model for CHD.It outlines the indications and contraindications,emphasizing the establishment of a comprehensive management protocol covering UCB collection,storage,quality control,transfusion,and adverse reaction management.

Abstract:Acute mountain sickness(AMS)remains a major threat for people who rapidly ascend to high altitude.This narrative review summarizes early-warning and monitoring studies published between 2021 and 2025,covering wearable continuous monitoring[nocturnal peripheral oxygen saturation(SpO2)and heart rate variability(HRV)],bedside lung ultrasound(LUS)with B-line scoring,multimodal magnetic resonance imaging(MRI),pre-ascent hematologic indices and multi-omics biomarkers,as well as regression-and machine-learning-based multimodal prediction models.Across modalities,a declining nocturnal SpO2 during ascent,increasing B-lines and hematologic panels combining hemoglobin,inflammatory,and metabolic indices can identify individuals at high risk of AMS before symptom onset.Multi-omics analyses of the transcriptome,proteome and metabolome reveal convergent signatures of immune activation,oxidative stress and energy-metabolism reprogramming,and have yielded compact biomarker sets composed of a few key molecules.However,most prediction models are derived from single-center,small samples of young volunteers,travelers or military personnel,use heterogeneous AMS definitions and lack rigorous external validation across different altitudes,ascent profiles and ethnic groups.Wearables,imaging,multi-omics and artificial intelligence therefore offer promising tools for proactive AMS surveillance,but future work should follow the Transparent Reporting of a multivariable prediction model for individual prognosis or diagnosis(TRIPOD)guideline and the TRIPOD+AI statement,develop and externally validate models in large multicenter cohorts,and implement them within a two-stage pathway of low-altitude baseline screening and dynamic monitoring during high-altitude exposure in high-risk populations.

Abstract:Objective To construct a comprehensive risk index(CRI)integrating insulin resistance marker(TyG-BMI)and smoking behavior,and develop a high-performance machine learning model for prehypertension risk prediction.Methods A retrospective cohort of 986 examinees from Nanjing Brain Hospital(2020-2025)was enrolled.The innovative CRI formula was established using an improved snow goose algorithm(ISGA)optimized via Cubic chaotic initialization and dimension-by-dimension Gaussian mutation to determine optimal decision variables.The core predictors were screened by Lasso regression,and six machine learning models were constructed.Class imbalance was addressed by SMOTE,and hyperparameters were tuned.The evaluation metrics included area under the receiver operating characteristic curve(ROC-AUC),area under the precision-recall curve(PR-AUC),calibration curves and decision curve analysis(DCA).SHAP interpreted model features.Results Lasso regression identified six key predictors for prehypertension risk:CRI,age,waist circumference,family history of hypertension,high density lipoprotein cholesterol(HDL-C)and glucose.Six machine learning models-Logistic Regression(LR),Support Vector Machine(SVM),Random Forest,Backpropagation Neural Network(BPNN),XGBoost and LightGBM were subsequently developed using these variables.The comparative analysis demonstrated LightGBM's superior discriminative performance,achieving a test set ROC-AUC of 0.9495 and PR-AUC of 0.9526,significantly outperforming the other models.DCA revealed substantial net benefit within the 1%to 90%threshold range,and the calibration curve exhibited a Brier score of 0.1084.SHAP analysis prioritized core predictors as follows:CRI,age,waist circumference,family history of hypertension,HDL-C and fasting blood glucose.Conclusion The chronic disease risk assessment model developed in this study,integrating swarm intelligence optimization and explainable AI(XAI),features a core innovative design based on integer-constrained weights.The model enables clinicians to perform reliable,quantifiable individual risk stratification.It thereby provides a practical tool foundation for optimizing early intervention strategies and healthcare resource allocation.

Abstract:Objective To evaluate the predictive value of the angiographic microvascular resistance(AMR)derived from single-position coronary angiography for major adverse cardiovascular events(MACE)in patients with ischaemia with non-obstructive coronary arteries(INOCA)after discharge.Methods A total of 331 patients who underwent coronary angiography(CAG)due to angina at the Department of Cardiology,Nanjing Drum Tower Hospital,between June 2021 and January 2024,were prospectively enrolled.The AMR was calculated using the AngioPlus Core software(Shanghai Pulsatile Medical Technology Co.,Ltd.).The patients were categorized into the MACE group and the non-MACE group based on the occurrence of MACE during follow-up.Additionally,they were stratified into the high-AMR and low-AMR groups according to the median AMR.Cox regression analysis,Kaplan-Meier survival curves and restricted cubic splines(RCS)were used to investigate the predictive value of single-vessel AMR and equivalent AMR(AMReq)for the prognosis of INOCA patients.Results The follow-up duration was one year,during which 45 patients(13.6%)experienced MACE.Compared with the non-MACE group,the MACE group had a higher AMReq[101.00(94.00,110.00)mmHg·s·m-1 vs.96.00(88.25,107.00)mmHg·s·m-1,P=0.023].In the adjusted multivariable Cox proportional hazards model,AMReq was identified as an independent risk factor for MACE within one year after discharge in INOCA patients.The RCS analysis demonstrated a positive linear relationship between AMReq and the risk of MACE within one year(Pnonlinear=0.306).Based on the median AMReq(96 mmHg·s·m-1),Kaplan-Meier survival analysis indicated that patients with AMReq≥96 mmHg·s·m-1 had a worse prognosis(P=0.012).Conclusion As a surrogate indicator for global coronary microvascular resistance,AMReq had independent predictive value for clinical adverse events in INOCA patients.

Abstract:Objective To investigate the relationship between the serum ferritin(SF),uncoupling protein 2(UCP2)and angiopoietin-like protein 4(ANGPTL4)and left ventricular hypertrophy(LVH)in maintenance hemodialysis(MHD)patients.Methods From February 2023 to February 2025,148 MHD patients treated in Handan First hospital were served as the study group.The presence of LVH was determined based on the left ventricular mass index(LVMI);and the patients were classified into the concurrent group(n=52)and the non concurrent group(n=96).Another 120 healthy individuals with normal kidney function who underwent physical check up in our hospital were considered as the control group.ELISA method was used to detect the serum SF,UCP2 and ANGPTL4.The relationship between LVMI and the serum SF,UCP2 and ANGPTL4 was explored.Multivariate Logistic regression was used to look for influencing factors of LVH in MHD patients.ROC curve was used to explore the predictive value of serum SF,UCP2 and ANGPTL4 for LVH in MHD patients.Results The expression levels of serum SF and ANGPTL4 in the study group were significantly higher than those in the control group[(376.05±82.46)μg/L vs.(216.75±48.27)μg/L,(36.49±6.15)ng/ml vs.(21.83±4.26)ng/ml].The serum UCP2 level was significantly lower than that of the control group[(3.15±0.32)μg/L vs.(4.26±0.53)μg/L,P<0.05].The levels of LVMI,C-reactive protein(CRP),serum SF and ANGPTL4 in the concurrent group were significantly higher than those in the non-concurrent group[(161.28±32.25)g/m2 vs.(103.92±16.38)g/m2,(8.59±1.23)mg/L vs.(6.98±1.35)mg/L,(426.31±69.18)μg/L vs.(348.82±55.35)μg/L,(42.59±9.26)ng/ml vs.(33.18±7.65)ng/ml].The levels of hemoglobin and serum UCP2 were significantly lower than those in the non-concurrent group[(82.96±12.46)g/L vs.(97.45±20.18)g/L,(2.79±0.38)μg/L vs.(3.34±0.49)μg/L,P<0.05].The serum SF and ANGPTL4 in MHD patients were positively correlated with LVMI,while the serum UCP2 was negatively correlated with LVMI(r=0.508,0.536,-0.469,P<0.05).Serum SF,UCP2,ANGPTL4,hemoglobin and CRP were the influencing factors of LVH in MHD patients(P<0.05).The AUC of serum SF,UCP2 and ANGPTL4 in predicting LVH in MHD patients were 0.846,0.763,and 0.859,respectively.The AUC of the combined prediction of the three indicators increased to 0.940,and the prediction efficiency of the combined model was significantly better than that of each single indicator(Zjoint-SF=2.667,P=0.008,Zjoint-UCP2=4.104,P=0.000,Zjoint-ANGPTL4=2.373,P=0.018),with 92.31%and 86.46%,of the sensitivity and specificity respectively.Conclusion The occurrence of LVH in MHD patients is closely related to the significantly increased levels of serum SF and ANGPTL4 and the significantly decreased level of UCP2.The combined detection of the three indicators can more effectively predict the risk of LVH than any single indicator,which is beneficial for the early diagnosis of LVH.

Abstract:Objective To explore the risk factors of bradycardia after percutaneous coronary intervention(PCI)in the elderly patients with ST-segment elevation myocardial infarction(STEMI)and construct a column chart model for the prediction.Methods A total of 282 elderly patients with STEMI who underwent percutaneous coronary intervention(PCI)at Rugao People's Hospital from January 2019 to January 2023 were enrolled as study subjects.The patients were separated into the non bradycardia group(n=217)and the bradycardia group(n=65)based on whether bradycardia occurred after surgery.All clinical basic data and serological indicators of the elderly STEMI patients were collected.Multivariate Logistic regression was used to analyze the influencing factorsI.R software was applied to construct a column chart model for predicting bradycardia in STEMI patients after PCI.ROC curves and calibration graphs were drawn to verify the model's differentiation and consistency.The clinical decision curves was drawn using the rmda package.Results There were significant differences in the location of lesions,the number of lesion branches,the absence of reflow during surgery and the levels of low-density lipoprotein cholesterol(LDL-C)and C-reactive protein(CRP)between the 2 groups after PCI(P<0.05).Lesion location,no intraoperative reflow,LDL-C and CRP were the independent risk factors for bradycardia in the elderly STEMI patients after PCI(P<0.05).Based on the aforementioned influencing factors,a regression model was established.The results indicated that the calibration curve slope for predicting post-PCI BC occurrence in the elderly STEMI patients approached 1.The Hosmer-Lemeshow goodness-of-fit test yielded χ2=8.395,P=0.396,demonstrating good consistency.The ROC curve results showed that the area under the curve(AUC)was 0.821(95%CI 0.771-0.864),indicated that the model had good predictive ability.When the probability of high-risk threshold was between 0.08 and 0.92,the clinical utility of using this nomogram model to predict the occurrence of BC in elderly patients with STEMI after PCI was relatively higher.Further focusing on clinically feasible thresholds,the core interval of 0.25 to 0.42 represented a relatively stable net benefit for the model,which was more aligned with the actual scenarios of clinical decision-making.The priority could be given to using the model for risk stratification and intervention decisions within this interval.Conclusion The location of the lesion,the absence of reflow during surgery,the content of LDL-C and CRP were the influencing factors for BC after PCI in elderly patients with STEMI.The model for the prediction would be good in the stratification and consistency.

Abstract:Objective This study aimed to evaluate the expression and function of tripartite motif-containing protein 59(TRIM59)in cardiac hypertrophy through animal and cardiomyocyte models,and to elucidate its underlying molecular mechanisms in pathological hypertrophy,thereby providing a potential therapeutic target for intervention.Methods From March to May 2025,a pressure-overload cardiac hypertrophy model was generated in mice via transverse aortic constriction(TAC)in the laboratory of Xinhua Hospital,Shanghai Jiao Tong University School of Medicine.Twenty-four mice were assigned to four groups(n=6 each):the Sham group,TAC-2W group,TAC-4W group and TAC-6W group,and a sham-operated group served as the control.The cardiac function was evaluated by transthoracic echocardiography,including ejection fraction(EF),fractional shortening(FS),left ventricular internal diameter in diastole(LVIDd)and left ventricular posterior wall diastole(LVPWd).The cardiac hypertrophy and myocardial fibrosis were assessed by hematoxylin-eosin(HE),Masson's trichrome and Sirius Red.RT-qPCR and Western blotting were employed to analyze the transcriptional and translational levels of hypertrophic markers(ANP,BNP and MYH7)and fibrotic markers(COL1A1,CTGF).In vitro,the neonatal rat cardiomyocytes(NRCM)and human cardiomyocyte cells(AC16)were transfected with small interfering RNA to suppress TRIM59 expression,thereby evaluating its regulatory role in hypertrophy,fibrosis,oxidative stress and apoptosis.All experiments were independently repeated at least three times,and statistical analyses were performed to ensure data robustness.Results The TRIM59 expression was markedly upregulated in TAC-induced pathological cardiac hypertrophy in mice,concomitantly with the elevation of hypertrophic and fibrotic markers.In the NRCM and AC16 cells,TRIM59 knockdown further augmented the expression of hypertrophy-and fibrosis-related genes and exacerbated oxidative stress and apoptosis.Moreover,the myocardial tissues from patients with hypertrophic cardiomyopathy also demonstrated significantly increased expression of TRIM59 and related molecules.Conclusion TRIM59 plays a critical protective role in pressure overload-induced pathological cardiac remodeling,and its upregulation may represent a compensatory regulatory response to myocardial injury.In contrast,the loss of TRIM59 markedly exacerbates cardiac hypertrophy,fibrosis and cellular damage,thereby disrupting myocardial homeostasis.TRIM59 may serve as a potential therapeutic target for the intervention of cardiac hypertrophy and heart failure.

Abstract:Artificial intelligence(AI)demonstrates significant potential in the field of non-invasive cardiovascular imaging,markedly enhancing the automation of imaging measurements and workflow efficiency.AI technologies are applied in echocardiography,cardiac CT,magnetic resonance imaging(MRI),and cardiac nuclear medicine imaging to aid disease detection,feature analysis,and prognostic prediction.Currently,AI applications require supervision by medical professionals,with promising prospects for future integration with patient management and diagnosis.

Abstract:The pathophysiological mechanisms of chronic heart failure are complex,involving multiple processes such as cardiomyocyte apoptosis and oxidative stress.The imbalance of the Ankyrin Repeat and SOCS Box Containing 10(Asb10)/Heat Shock Protein 70(HSP70)axis plays a key role in its development.Asb10,acting as an E3 ubiquitin ligase,mediates HSP70 degradation,thereby weakening its anti-apoptotic,antioxidant,and mitochondrial protective functions.Currently,strategies targeting this axis—including small molecule inhibitors,gene therapies,and biologics—have shown promising potential.When combined with conventional drugs like angiotensin-converting enzyme inhibitor(ACEI)and beta-blockers,these therapies can produce synergistic effects.However,challenges remain,including insufficient specificity and low delivery efficiency.Future research should focus on precise regulation and timely spatiotemporal dynamic interventions to advance chronic heart failure treatment from symptom-based approaches to mechanism-targeted therapies.

Abstract:The homeostatic regulation of the cardiovascular system often faces great challenges under the special physiological environmental stress of hypoxia in plateaus,and hypoxia is a key causative factor for cardiovascular diseases.Hypoxic pulmonary hypertension(HPH),as a common disease under chronic hypoxic exposure,is characterized by pulmonary vascular dynamic disorder and structural remodeling of the pulmonary vasculature and presents abnormal pulmonary vasoconstrictor response,vascular wall thickening and smooth muscle cell proliferation,which ultimately results in the persistent vicious circle of elevated pulmonary artery pressure.This paper provides new ideas for the clinical treatment of HPH by summarizing the modeling modality,pathological mechanisms and treatment methods of HPH.

Abstract:Objective To explore the current status,trends,driving factors and future projections of the burden of non-rheumatic calcific aortic valve disease(NR-CAVD)in China and globally from 1993 to 2023,providing a scientific basis for formulating and optimizing public health prevention and control strategies for elderly NR-CAVD in China.Methods This study is based on the Global Burden of Disease Study 2023 database,extracting data related to the burden of NR-CAVD in populations aged 60 and above in China and globally from 1993 to 2023.The primary indicators include age-standardized mortality mate(ASMR);age-standardized incidence rate(ASIR);age-standardized prevalence rate(ASPR).The age-period-cohort(APC)model was used to decompose age,period,and cohort effects and to assess their impacts on disease risk.The Bayesian APC model was further employed for robust and accurate projection of disease burden trends through 2038.Results Between 1993 and 2023,the age-standardized mortality rate for NR-CAVD in China remained at an extremely low level(2023:0.4/per 100,000),approximately 1/33 of the global rate(13/per 100,000),with a larger decrease(-29.5%vs.-4.6%).However,China's age-standardized incidence rate and age-standardized prevalence rate increased rapidly,with growth rates(74.5%and 84.8%,respectively)far exceeding the global increases(19.5%and 19.6%,respectively).APC model analysis showed that,in terms of age effect,both China and the global population experienced an increase in NR-CAVD mortality risk with age.In China,the incidence risk exhibited an accelerated increase in later years,while the prevalence risk increased linearly.In contrast,the global incidence and prevalence risks peaked in the elderly and then declined.The period effect was the key driver of the rising incidence and prevalence risks in China.The cohort effect showed a"U-shaped"change in the incidence risk in China,indicating a resurgence of risk in the new generation of elderly people.Projections until 2038 suggest that China will experience a modest increase in the ASMR of NR-CAVD by 7.84 per 100,000,while the ASIR and ASPR will rise by 13.62 per 100,000 and 7.60 per 100,000,respectively.In contrast,the global ASMR is projected to increase by 1.78 per 100,000,with the ASIR and ASPR declining by 14.52 per 100,000 and 12.31 per 100,000,respectively.The gap between China and global levels is expected to narrow gradually.Conclusion While the global burden of NR-CAVD is generally stable or declining,China faces a unique challenge with the continuous rapid increase in incidence and prevalence.Therefore,China's public health strategies should strengthen early screening in older adults and prioritize primary prevention focused on prehypertension,including earlier blood pressure management and lifestyle interventions,to curb the upward risk trajectory of NR-CAVD.

Abstract:Objective To investigate the association between the body roundness index(BRI)and carotid atherosclerosis(CAS)in newly diagnosed type 2 diabetes mellitus(T2DM)patients and evaluate the predictive value of BRI for CAS risk.Methods This study was a cross-sectional analysis of the clinical data of 772 newly diagnosed T2DM patients admitted to Cangzhou People's Hospital from February 15,2024 to June 10,2025.CAS was diagnosed based on carotid ultrasound examination,with a carotid intima-media thickness(CIMT)≥1.0 mm,carotid plaques and stenosis as the diagnostic criteria.Patients who met these criteria were classified as the CAS group(n=277),while the remaining patients were classified as the non-CAS group(n=495).The correlation between BRI and CAS was assessed using multivariate Logistic regression and restricted cubic splines(RCS).Receiver operating characteristic(ROC)curve analysis was conducted to compare the predictive abilities of body roundness index(BRI)and body mass index(BMI)for CAS.Results After adjusting for confounding factors,BRI was independently associated with the risk of CAS(OR=1.56,95%CI 1.37-1.77,P<0.001).Furthermore,compared to the lowest quartile of BRI,the risk of CAS increased in the second quartile(OR=2.11,95%CI 1.31-3.42,P=0.002),third quartile(OR=2.46,95%CI 1.54-3.98,P<0.001)and fourth quartile(OR=4.04,95%CI 2.55-6.48,P<0.001).RCS analysis showed a linear relationship between BRI and CAS(Poverall<0.001,Pnon-linear=0.494).ROC analysis indicated that BRI(AUC=0.65)had a higher AUC than BMI(AUC=0.59)in predicting CAS.Conclusion BRI is significantly associated with the risk of CAS in newly diagnosed T2DM patients.Given that this is a single-center study,the generalizability of the results should be cautious.