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Lin J, Li S, Peng Y, Chen Y, Chen L, Lin Y. Symptom characteristics in patients undergoing acute type A aortic dissection surgery post-discharge phase: a prospective observational study. Eur J Med Res 2025; 30:416. [PMID: 40414928 DOI: 10.1186/s40001-025-02495-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Accepted: 03/22/2025] [Indexed: 05/27/2025] Open
Abstract
OBJECTIVES In recent years, most studies on symptom characteristics in patients undergoing cardiac surgery have focused on the preoperative and postoperative phases. Relatively little knowledge is available related to the post-discharge phase. In this context, this paper aimed to analyze the symptoms and needs of patients with acute type A aortic dissection (AAAD) during the post-discharge phase. METHODS We recruited and studied patients who underwent acute type A aortic dissection surgery at Fujian Heart Medical Center from June 2022 to August 2023. At 3 months following the surgery, these subjects were investigated using the general information questionnaire and relevant symptom assessment scales, including the Mini-Mental State Examination Scale (MMSE), Athens Insomnia Scale (AIS), Hospital Anxiety and Depression Scale (HADS), and Fatigue Severity Scale (FSS). Meanwhile, grip strength and average step per day were measured for the exercise endurance assessment. A latent class analysis (LCA) based on the symptoms was performed, and differences in demographic and disease characteristics among different subgroups of patients were identified and compared using multivariate logistic regression. RESULTS A total of 228 patients were enrolled and categorized into three latent classes: fatigue-sleep disturbance (44.3%), anxiety-locomotion decline (16.9%), and high symptom groups (38.8%). Results showed that patients with cardiopulmonary bypass time > 200 min, higher BMI, or decreased grip strength were more likely to be classified as the high symptom group and those were unemployment status have a higher possibility of being defined as the anxiety-locomotion decline group. CONCLUSIONS The symptom characteristics in patients with AAAD during the postoperative rehabilitation phrase exhibit heterogeneity. It is suggested that Clinical healthcare personnel improve the identification of symptoms in high-risk patients, particularly patients cardiopulmonary bypass time > 200 min, overweight or obese, unemployed status or decreased grip strength, relevant nursing interventions should be carried out to prevent the occurrence of surgical stress and complications in patients with AAAD early to improve the quality of life of patients.
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Affiliation(s)
- Jianlong Lin
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, No. 6, Xuefu South Road, Shangjie Town, Minhou County, Fuzhou, 350108, China
| | - Sailan Li
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, No. 6, Xuefu South Road, Shangjie Town, Minhou County, Fuzhou, 350108, China
| | - Yanchun Peng
- Department of Nursing, Union Hospital, Fujian Medical University, No. 29, Xinquan Road, Fuzhou, 350001, China
| | - Yaqin Chen
- The School of Nursing, Fujian Medical University, No. 1, Xuefu North Road, Fuzhou, Fujian, China
| | - Liangwan Chen
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, No. 6, Xuefu South Road, Shangjie Town, Minhou County, Fuzhou, 350108, China.
| | - Yanjuan Lin
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, No. 6, Xuefu South Road, Shangjie Town, Minhou County, Fuzhou, 350108, China.
- Department of Nursing, Union Hospital, Fujian Medical University, No. 29, Xinquan Road, Fuzhou, 350001, China.
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Ji S, Zheng D, Ma S, Guo S, Ma F, Yin C, Mi G. Exploring disease perception and experiences of postoperative patients with Stanford type A aortic dissection: a qualitative study. BMC Cardiovasc Disord 2025; 25:378. [PMID: 40389843 PMCID: PMC12087049 DOI: 10.1186/s12872-025-04805-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2025] [Accepted: 04/28/2025] [Indexed: 05/21/2025] Open
Abstract
BACKGROUND Stanford type A aortic dissection (TAAD) is a critical cardiovascular emergency characterized by acute onset, rapid progression, severe clinical manifestations, high mortality rates, and frequent complications. Patient's postoperative experiences are closely linked to their physical and mental health. Therefore, understanding their illness experience is essential to facilitate recovery. OBJECTIVE This study aimed to explore disease perception and postoperative experience of TAAD patients through semi-structured interviews, providing a formulation for developing standardized postoperative management protocols. METHODS A phenomenological qualitative study was conducted in the cardiac and vascular surgery department of a tertiary hospital in Ningxia Hui Autonomous Region between January and May 2023. Purposive sampling was used to recruit postoperative TAAD patients. Semi-structured interviews were conducted to explore disease perception and experiences. Interview data were analyzed using Colaizzi's seven-step analysis. RESULTS A total of 16 patients were interviewed. Based on the interview data, 296 codes were extracted and pooled into 17 subthemes, which were finally integrated into 4 themes related to disease perception and experiences: significant symptom burden, complex and varied psychological experiences, different coping styles, and diverse needs for health services. CONCLUSION Postoperative TAAD patients face numerous health challenges. Healthcare providers should closely monitor physical symptoms, systematically address psychological fluctuations, develop targeted interventions based on identified coping patterns, and design patient-centered care models to address unmet needs. These strategies may alleviate adverse experiences and enhance rehabilitation outcomes.
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Affiliation(s)
- Shuangdui Ji
- Department of Cardiac large vascular Surgery, Ningxia Medical University General Hospital, Yinchuan, China
| | - Donglian Zheng
- Department of Cardiac large vascular Surgery, Ningxia Medical University General Hospital, Yinchuan, China
| | - Shilin Ma
- Department of Cardiac large vascular Surgery, Ningxia Medical University General Hospital, Yinchuan, China
| | - Shuping Guo
- Department of Nursing, Ningxia Medical University General Hospital, No.804 of Shengli Street, Xingqing District, Yinchuan, Ningxia Hui Autonomous Region, 750000, China
| | - Fuzhen Ma
- Department of Cardiac large vascular Surgery, Ningxia Medical University General Hospital, Yinchuan, China
| | - Changqi Yin
- Department of Cardiac large vascular Surgery, Ningxia Medical University General Hospital, Yinchuan, China
| | - Guangli Mi
- Department of Nursing, Ningxia Medical University General Hospital, No.804 of Shengli Street, Xingqing District, Yinchuan, Ningxia Hui Autonomous Region, 750000, China.
- School of Nursing, Ningxia Medical University, Yinchuan, China.
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Li C, Dai M, Gu Q, Lu K, Ge C, Liu X, Li Z, Wang J, Wang J, Wei C, Tang X, Zheng Q, Gao P, Chen W. Incidence of the Stevens-Johnson syndrome spectrum and its patterns in urban China. J Dermatol 2025; 52:897-906. [PMID: 40125909 DOI: 10.1111/1346-8138.17692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 02/08/2025] [Accepted: 02/19/2025] [Indexed: 03/25/2025]
Abstract
Stevens-Johnson syndrome (SJS) spectrum is a series of rare, but life-threatening mucocutaneous hypersensitivity reactions. However, the epidemiological evidence of it is limited, especially in developing countries. The shape associations with age and its seasonal pattern are still uncertain. Therefore, this study aimed to describe the nationwide incidence of SJS spectrum, its associations with age and season, and its subsequent diagnosed diseases across urban China. By using national health insurance datasets from 2013 to 2017, this retrospective cohort study estimated the incidence of SJS spectrum and its associations in 23 Chinese provinces. SJS spectrum was defined to include SJS and/or toxic epidermal necrolysis (ICD-10 code: L51.1-2). First, age-specific incidence rates were estimated in each province and then pooled using a random-effects model. Relative risks (RR) of SJS spectrum in different seasons were estimated by Poisson regression. Diseases diagnosed within 6 months following SJS occurrence were described. In total, 9308 patients were identified (50.17% women, median age 45). The average standardized incidence rate of SJS spectrum was 3.43 (95% confidence interval [CI] 3.04-3.84) per million person-years, which increased by 0.57 (95% CI 0.29-0.84) per million person-years. Incidence rates were significantly higher among children age <10 years (5.48, 95% CI 4.02-7.09, p = 0.0036) and adults age ≥ 40 (5.50, 95% CI 4.35-6.78, p = 0.00085) than the group aged 10-40 years (3.12, 95% CI 2.29-4.07). The risk of SJS spectrum was highest in summer (vs autumn: RR = 1.83, 95% CI 1.72-1.93). The most frequently diagnosed disease within 6 months after the onset of SJS was respiratory disease (43.8%). In conclusion, this study provides evidence on the epidemiology of SJS spectrum in developing countries and supports the two-peak distribution of its incidence across age. Its high occurrence in summer needs further confirmation.
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Affiliation(s)
- Chaiquan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Mali Dai
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qinyi Gu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ke Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Chaoxiang Ge
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaofei Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Zhiming Li
- Department of Dermatology and Venereology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jingying Wang
- Department of Dermatology and Venereology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jinxi Wang
- Beijing Healthcom Data Technology, Beijing, China
| | - Chen Wei
- Beijing Healthcom Data Technology, Beijing, China
| | - Xun Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Qinxiang Zheng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Center for Real-World Evidence Evaluation, Peking University Clinical Research Institute, Beijing, China
| | - Wei Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Tan Q, Wang X, Xu W, Song K, Xiong Y, Jiang Z, Li J, Yu Y, Ye W, Shen Z, Teng X. Calpain inhibition as a novel therapeutic strategy for aortic dissection with acute lower extremity ischemia. Mol Med 2025; 31:144. [PMID: 40259242 PMCID: PMC12013106 DOI: 10.1186/s10020-025-01212-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Accepted: 04/14/2025] [Indexed: 04/23/2025] Open
Abstract
BACKGROUND Aortic dissection (AD) patients with malperfusion present significant challenges and are associated with high postoperative mortality rates. Limited data exist regarding the management of patients with AD and acute lower extremity ischemia. Early diagnosis of the extent of malperfusion and timely intervention are critical for improving patient prognosis. METHODS A total of 104 patients diagnosed with AD were enrolled in this observational retrospective study, of which 11 (10.6%) presented with lower limb ischemia (LLI). A comparative analysis was conducted on the clinical data of the AD group and the AD + LLI group. Plasma concentrations of SBDP145, a specific indicator of Calpain activity, were quantified in Control, AD, and AD + LLI groups using ELISA. To explore the role of Calpain in LLI and AD, pharmacological inhibition with Calpeptin and transgenic mice overexpressing calpastatin (Tg-CAST) were utilized in mouse models. RNA sequencing and functional assays were employed to identify the downstream effectors of Calpain. RESULTS Patients in the AD + LLI group exhibited significantly elevated leukocyte counts, percentages of neutrophils and lymphocytes, as well as increased serum levels of AST, creatinine, total cholesterol, low-density lipoprotein, uric acid, and creatine kinase compared to those in the AD group. Furthermore, the mean calcium ion concentration and Ca2+-dependent Calpain activation were significantly higher in the AD + LLI patients. Both endogenous and exogenous Calpain inhibitors effectively promoted the restoration of blood flow to ischemic hind limbs by inhibiting the inflammatory response and promoting vascular regeneration. Additionally, Calpain inhibition prevented the onset and progression of AD. RNA sequencing and Western Blot assays demonstrated that Calpain inhibition significantly increased levels of Fabp3, which is involved in the ischemia-induced fatty acid metabolism pathway. CONCLUSIONS Inhibition of Calpain has been demonstrated to decrease the incidence of AD and enhance the restoration of blood flow perfusion in ischemic lower extremities. This effect may be mediated by the upregulation of Fabp3. These findings highlight the potential for targeted interventions against Calpain as a novel therapeutic strategy in the treatment of cardiovascular disease.
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Affiliation(s)
- Qiwen Tan
- Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
- Suzhou Medical College, Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Xiaokang Wang
- Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
- Suzhou Medical College, Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Wanchuang Xu
- Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
| | - Kun Song
- Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
| | - Yifan Xiong
- Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
- Suzhou Medical College, Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Zhentong Jiang
- Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
- Suzhou Medical College, Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Jingjing Li
- Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
- Institute for Cardiovascular Science, Soochow University, 178 Ganjiang Road, Suzhou, 215006, China
| | - Yunsheng Yu
- Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China.
- Institute for Cardiovascular Science, Soochow University, 178 Ganjiang Road, Suzhou, 215006, China.
| | - Wenxue Ye
- Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China.
- Institute for Cardiovascular Science, Soochow University, 178 Ganjiang Road, Suzhou, 215006, China.
| | - Zhenya Shen
- Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
- Institute for Cardiovascular Science, Soochow University, 178 Ganjiang Road, Suzhou, 215006, China
| | - Xiaomei Teng
- Department of Cardiovascular Surgery, First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China.
- Institute for Cardiovascular Science, Soochow University, 178 Ganjiang Road, Suzhou, 215006, China.
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Meng F, Fang L, Zhou J, Zhou Y, Zhao J, Wang L. Decreased serum calcium levels predict severe complications after initial diagnosis in patients with acute type B aortic dissection: A retrospective cohort study. Drug Discov Ther 2025; 19:49-57. [PMID: 40010734 DOI: 10.5582/ddt.2025.01002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2025]
Abstract
This study sought to investigate the temporal variations in serum calcium concentrations among patients with acute type B aortic dissection (ATBAD) following initial diagnosis, document the incidence of severe complications, and evaluate their potential associations. In this retrospective analysis, we examined 42 consecutive patients diagnosed with ATBAD at Zhejiang Hospital between April 2019 and April 2024. Serum-ionized calcium levels were measured at admission and 24 hours post-admission. Based on changes in calcium levels, patients were categorized into either the elevated or decreased groups. Univariate and multivariate logistic regression analyses were performed to compare clinical characteristics and assess the incidence of severe complications following the initial diagnosis. The study further explored the association between 24-hour serum calcium levels, their dynamic changes, and the occurrence of severe complications in patients with ATBAD. The results showed that the decreased group had a significantly higher frequency of severe complications, including mortality, cardiac complications, acute renal failure, and organ hypoperfusion (P < 0.05), while no significant differences were observed for neurological or pulmonary complications (P > 0.05). Logistic regression revealed that a decline in serum calcium levels within 24 hours was an independent risk factor for severe complications (OR = 16.722, P = 0.03). The receiver operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.864. Decreased serum calcium concentration is an independent predictor of severe complications in ATBAD patients, significantly associated with mortality, cardiac complications, acute kidney injury, and inadequate organ perfusion. No significant correlation with neurological and pulmonary complications was observed.
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Affiliation(s)
- Fangzheng Meng
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Liang Fang
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China
| | - Jing Zhou
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yiyuan Zhou
- Department of Obstetrics, the First Affiliated Hospital, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Junfeng Zhao
- Department of Emergency, Zhejiang Hospital, Hangzhou, China
| | - Ling Wang
- Department of Obstetrics and Reproductive Immunology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Guizhou University of Traditional Chinese Medicine (TCM), Guiyang, China
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Gao J, Pan Q, Li SL, Chen S, Luo B, Chen L, Lin Y. Influencing factors of health promotion behaviour in patients with aortic dissection: a qualitative study using the COM-B model. BMJ Open 2025; 15:e076181. [PMID: 40044200 PMCID: PMC11883601 DOI: 10.1136/bmjopen-2023-076181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/03/2024] [Indexed: 03/09/2025] Open
Abstract
OBJECTIVES This study aimed to understand influencing factors of health promotion behaviour in patients with aortic dissection (AD) using the capability, opportunity, motivation, behaviour (COM-B) model of behaviour. DESIGN A descriptive qualitative design was adopted. Data were collected using face-to-face semi-structured interviews and analysed using directed content analysis. SETTING Fujian Medical University Union Hospital. PARTICIPANTS A purposive sample of 16 patients with AD. RESULTS The following themes and subthemes were identified. Psychological capability: (1) lack of disease knowledge; physical capability: (1) physical function limitation; (2) fatigue; physical opportunity: (1) limited access to disease knowledge; (2) communication between providers and patients; (3) objective condition restriction; social opportunity: (1) stigma; (2) social support; reflective motivation: (1) self-efficacy; (2) perceived benefits; (3) personal and family responsibilities; automatic motivation: (1) post-traumatic growth; (2) fear of disease progression. CONCLUSION This study adopted a novel approach to understanding factors affecting health promotion behaviour among patients with AD. Interventions can be implemented using the Behaviour Change Wheel framework and study findings to improve health promotion behaviour in this patient population.
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Affiliation(s)
- Jia Gao
- Department of Cardiac Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, China
| | - Qiong Pan
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China
| | - Sai Lan Li
- Department of Cardiac Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, China
| | - Shaolin Chen
- Department of Cardiology Nursing, Fujian Medical University Union Hospital, Fuzhou, China
| | - Baolin Luo
- Department of Cardiac Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, China
| | - Liangwan Chen
- Department of Cardiac Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yanjuan Lin
- Department of Cardiac Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, China
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China
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Hong X, Zhang Y, Fu W, Wang L. [Research progress on the role of ferroptosis in aortic dissection]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2024; 53:726-734. [PMID: 39694526 PMCID: PMC11736346 DOI: 10.3724/zdxbyxb-2024-0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 10/15/2024] [Indexed: 12/20/2024]
Abstract
Recent studies have shown that iron metabolism dysregulation and lipid peroxidation-induced ferroptosis, triggered by oxidative stress, play a key role in the development of aortic dissection. Dysregulated iron metabolism leads to excessive production of hydroxyl radicals due to abnormal iron levels and heme metabolism, while lipid peroxidation is linked to system Xc- dysfunction and accumulation of phospholipid hydroperoxides. These factors synergistically disrupt aortic homeostasis and drive ferroptosis in vascular cells, including endothelial and smooth muscle cells. Furthermore, disruptions in ferroptosis-related genes, along with risk factors such as smoking, epigenetic modifications such as protein methylation, and abnormalities in immune cells, particularly T cells, are closely linked to aortic dissection. Several small molecules and nanomaterials have shown potential in inhibiting ferroptosis in this context. This review elucidates the roles of ferroptosis in aortic dissection and proposes strategies for its targeted prevention and treatment.
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Affiliation(s)
- Xiang Hong
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361015, Fujian Province, China.
- Xiamen Municipal Vascular Disease Precise Diagnose & Treatment Lab, Xiamen 361015, Fujian Province, China.
| | - Yuchong Zhang
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Vascular Surgery Institute of Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai 200032, China]
| | - Weiguo Fu
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361015, Fujian Province, China
- Xiamen Municipal Vascular Disease Precise Diagnose & Treatment Lab, Xiamen 361015, Fujian Province, China
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Vascular Surgery Institute of Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai 200032, China]
| | - Lixin Wang
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361015, Fujian Province, China.
- Xiamen Municipal Vascular Disease Precise Diagnose & Treatment Lab, Xiamen 361015, Fujian Province, China.
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Vascular Surgery Institute of Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai 200032, China].
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Mu G, Cao X, Shao L, Shen H, Guo X, Gao Y, Su C, Fan H, Yu Y, Shen Z. Progress and perspectives of metabolic biomarkers in human aortic dissection. Metabolomics 2024; 20:76. [PMID: 39002042 DOI: 10.1007/s11306-024-02140-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 06/06/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Aortic dissection (AD) significantly threated human cardiovascular health, extensive clinical-scientific research programs have been executed to uncover the pathogenesis and prevention. Unfortunately, no specific biomarker was identified for the causality or development of human AD. AIM OF REVIEW Metabolomics, a high-throughput technique capable of quantitatively detecting metabolites, holds considerable promise in discovering specific biomarkers and unraveling the underlying pathways involved. Aiming to provide a metabolite prediction in human AD, we collected the metabolomics data from 2003 to 2023, and diligently scrutinized with the online system MetaboAnalyst 6.0. KEY SCIENTIFIC CONCEPTS OF REVIEW Based on the data obtained, we have concluded the metabolic dynamics were highly correlated with human AD. Such metabolites (choline, serine and uridine) were frequently involved in the AD. Besides, the pathways, including amino acids metabolism and lipids metabolism, were also dysregulated in the disease. Due to the current limitation of metabolism analysis, the integrative omics data including genomics, transcriptomics, and proteomics were required for developing the specific biomarker for AD.
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Affiliation(s)
- Gaohang Mu
- Department of Cardiovascular Surgery of the First Affiliated Hospital & Institute for Cardiovascular Science, Soochow University, Suzhou, 215123, Jiangsu, China
- Suzhou Medical College, Soochow University, Suzhou, 215123, Jiangsu, China
| | - Xiangyu Cao
- Department of Cardiovascular Surgery of the First Affiliated Hospital & Institute for Cardiovascular Science, Soochow University, Suzhou, 215123, Jiangsu, China
- Suzhou Medical College, Soochow University, Suzhou, 215123, Jiangsu, China
| | - Lianbo Shao
- Department of Cardiovascular Surgery of the First Affiliated Hospital & Institute for Cardiovascular Science, Soochow University, Suzhou, 215123, Jiangsu, China
- Suzhou Medical College, Soochow University, Suzhou, 215123, Jiangsu, China
| | - Han Shen
- Department of Cardiovascular Surgery of the First Affiliated Hospital & Institute for Cardiovascular Science, Soochow University, Suzhou, 215123, Jiangsu, China
- Suzhou Medical College, Soochow University, Suzhou, 215123, Jiangsu, China
| | - Xingyou Guo
- Department of Cardiovascular Surgery of the First Affiliated Hospital & Institute for Cardiovascular Science, Soochow University, Suzhou, 215123, Jiangsu, China
- Suzhou Medical College, Soochow University, Suzhou, 215123, Jiangsu, China
- Department of Vascular Surgery, Suqian First Hospital, Suqian, 223800, Jiangsu, China
| | - Yamei Gao
- Department of Cardiovascular Surgery of the First Affiliated Hospital & Institute for Cardiovascular Science, Soochow University, Suzhou, 215123, Jiangsu, China
- Suzhou Medical College, Soochow University, Suzhou, 215123, Jiangsu, China
| | - Chengkai Su
- Department of Cardiovascular Surgery of the First Affiliated Hospital & Institute for Cardiovascular Science, Soochow University, Suzhou, 215123, Jiangsu, China
- Suzhou Medical College, Soochow University, Suzhou, 215123, Jiangsu, China
| | - Hongyou Fan
- Department of Cardiovascular Surgery of the First Affiliated Hospital & Institute for Cardiovascular Science, Soochow University, Suzhou, 215123, Jiangsu, China
- Suzhou Medical College, Soochow University, Suzhou, 215123, Jiangsu, China
| | - You Yu
- Department of Cardiovascular Surgery of the First Affiliated Hospital & Institute for Cardiovascular Science, Soochow University, Suzhou, 215123, Jiangsu, China.
- Suzhou Medical College, Soochow University, Suzhou, 215123, Jiangsu, China.
| | - Zhenya Shen
- Department of Cardiovascular Surgery of the First Affiliated Hospital & Institute for Cardiovascular Science, Soochow University, Suzhou, 215123, Jiangsu, China.
- Suzhou Medical College, Soochow University, Suzhou, 215123, Jiangsu, China.
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9
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Li R, Liu Y, Jiang J. Case Report: The application of amplatzer vascular plug to repair aortic dissection intimal tears and false lumen. Front Cardiovasc Med 2024; 10:1337430. [PMID: 38259321 PMCID: PMC10801193 DOI: 10.3389/fcvm.2023.1337430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
In recent years, significant advancements have been made in endovascular therapy for aortic dissection, resulting in the development of various treatment methods. Nevertheless, there is a contentious discussion regarding the suitability of different treatment methods for addressing the unique features of individual lesions. Specifically, the matter of whether the presence of small intimal tears or multiple distal tears requires extensive aortic coverage with graft stents, which may block the blood supply to important organs, intercostal arteries, or lumbar arteries, remains unresolved. Further research is necessary to determine the need for complex fenestrated or branched endovascular aortic repair (F/B-EVAR) in the management of chronic post-dissection aneurysms involving visceral arteries. Our report highlights the successful endovascular repair of three patients with aortic dissection, encompassing one Stanford A type and two Stanford B types. Utilizing the Amplatzer Vascular Plug (AVP) alone or in combination with the coil embolization technique, we achieved favorable clinical outcomes. This article aims to provide valuable insights and new perspectives on the tailored management of aortic dissection by conducting a comprehensive examination of the subtle differences in the treatment processes and techniques applied to these three patients.
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Affiliation(s)
| | | | - Jianjun Jiang
- Department of General Surgery, Vascular Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
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Lin JL, Li SL, Peng YC, Chen LW, Lin YJ. Analysis of serum calcium change trajectories and prognostic factors in patients with acute type A aortic dissection. BMC Surg 2023; 23:362. [PMID: 38012635 PMCID: PMC10683301 DOI: 10.1186/s12893-023-02249-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/26/2023] [Indexed: 11/29/2023] Open
Abstract
OBJECTIVES This study aimed to analyze the correlation between serum calcium changes and short-term prognosis of patients with acute type A aortic dissection. METHODS Patients who underwent acute type A aortic dissection surgery at Fujian Heart Medical Center between June 2019 and June 2021 were retrospectively analyzed. RESULTS A total of 383 patients were enrolled. According to the changing track of serum calcium in patients after acute type A aortic dissection, three potential category tracks were determined: high-level (n = 85), medium-level (n = 259), and continuous low-level groups (n = 39). Using the medium-level group as the control, regression analysis showed that poor prognosis risk was increased in the group with continuous low serum calcium (odds ratio = 2.454, P < 0.05) and in the group with continuous low serum calcium > 48 h (odds ratio = 3.595, P < 0.05). Age (odds ratio = 1.063, P < 0.001), body mass index (odds ratio = 1.138, P < 0.05), hypertension (odds ratio = 3.697, P < 0.05), and the highest lactic acid within 72 h after surgery(odds ratio = 1.093, P < 0.05) were independent risk factors for poor prognosis after aortic dissection. CONCLUSION Continuous low serum calcium was an independent predictor of poor prognosis in patients with acute type A aortic dissection.
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Affiliation(s)
- Jian-Long Lin
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, Fujian, 350001, China
| | - Sai-Lan Li
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, Fujian, 350001, China
| | - Yan-Chun Peng
- Department of Nursing, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, Fujian, 350001, China
| | - Liang-Wan Chen
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, Fujian, 350001, China.
| | - Yan-Juan Lin
- Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, Fujian, 350001, China.
- Department of Nursing, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, Fujian, 350001, China.
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Song D, Liu D, Ning W, Chen Y, Yang J, Zhao C, Zhang H. Incidence, prevalence and characteristics of multimorbidity in different age groups among urban hospitalized patients in China. Sci Rep 2023; 13:18798. [PMID: 37914899 PMCID: PMC10620234 DOI: 10.1038/s41598-023-46227-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 10/30/2023] [Indexed: 11/03/2023] Open
Abstract
The aim of the study was to investigate the incidence, prevalence and characteristics of multimorbidity in urban inpatients of different age groups. This study used data from the National Insurance Claim for Epidemiology Research (NICER) to calculate the overall incidence, prevalence, geographic and age distribution patterns, health care burden, and multimorbidity patterns for multimorbidity in 2017. According to our study, the overall prevalence of multimorbidity was 6.68%, and the overall prevalence was 14.87% in 2017. The prevalence of multimorbidity increases with age. The pattern of the geographic distribution of multimorbidity shows that the prevalence of multimorbidity is relatively high in South East China. The average annual health care expenditure of patients with multimorbidity increased with age and rose rapidly, especially among older patients. Patients with cancer and chronic kidney disease have higher treatment costs. Patients with hypertension or ischemic heart disease had a significantly higher relative risk of multimorbidity than other included noncommunicable diseases (NCDs). Hyperlipidemia has generated the highest number of association rules, which may suggest that hyperlipidemia may be both a risk factor for other NCDs and an outcome of them.
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Affiliation(s)
- Dixiang Song
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Deshan Liu
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Weihai Ning
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Yujia Chen
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Jingjing Yang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Chao Zhao
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Hongwei Zhang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China.
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Zhang H, Yin L, Zhang Y, Qiu Z, Peng S, Wang Z, Sun B, Ding J, Liu J, Du K, Wang M, Sun Y, Chen J, Zhao H, Song T, Sun Y. Short-term effects of air pollution and weather changes on the occurrence of acute aortic dissection in a cold region. Front Public Health 2023; 11:1172532. [PMID: 37601173 PMCID: PMC10433911 DOI: 10.3389/fpubh.2023.1172532] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023] Open
Abstract
Background Air pollution and severe weather conditions can adversely affect cardiovascular disease emergencies. Nevertheless, it remains unclear whether air pollutants and low ambient temperature can trigger the occurrence of acute aortic dissection (AAD) in cold regions. Methods We applied a retrospective analysis to assess the short-term effects of air pollution and ambient temperature on the occurrence of AAD in Harbin, China. A total of 564 AAD patients were enrolled from a major hospital in Harbin between January 1, 2017, and February 5, 2021. Weather condition data and air pollutant concentrations, including fine particulate matter smaller than 10 μm (PM10) and 2.5 μm in diameter (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3), were collected every day. Conditional logistic regressions and correlation analysis were applied to analyze the relationship of environmental and atmospheric parameters with AAD occurrence at lags of 0 to 7 days. Specifically, we appraised the air quality index, CO, NO2, SO2, O3, PM10, PM2.5, temperature, dew point temperature, atmospheric pressure, and cloud amount. Results A total of 1,496 days at risk were assessed, of which 564 patients developed AAD. Specifically, AAD did not occur on 1,043 (69.72%) days, while 1 or more cases occurred on 453 (30.28%) days. Several pollution and weather predictors for AAD were confirmed by multilevel modeling. The air quality index (p = 0.0012), cloud amount (p = 0.0001), and concentrations of PM2.5 (p = 0.0004), PM10 (p = 0.0013), NO2 (p = 0.0007) and O3 (p = 0.0001) predicted AAD as early as 7 days before the incident (lag of 7 days) in the study period. However, only concentrations of the air pollutants NO2 (p = 0.0468) and O3 (p = 0.011) predicted the occurrence of AAD after the COVID-19 outbreak. Similar predictive effects were observed for temperature, dew point temperature, and atmospheric pressure (all p < 0.05) on all days. Conclusion The risk of AAD is closely related to air pollution and weather characteristics in Harbin. While causation was not determined, the impact of air pollutants on the risk of AAD was reduced after the COVID-19 outbreak.
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Affiliation(s)
- Haiyu Zhang
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Leilei Yin
- Department of Emergency, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yingtao Zhang
- School of Computer Science and Technology, Harbin Institute of Technology, Harbin, China
| | - Zhaowen Qiu
- School of Information and Computer Engineering, Northeast Forestry University, Harbin, Heilongjiang, China
| | - Sizheng Peng
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhonghua Wang
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Bo Sun
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jianrui Ding
- School of Computer Science and Technology, Harbin Institute of Technology, Weihai, Shandong, China
| | - Jing Liu
- Department of Cardiology, Harbin Second Hospital, Harbin, China
| | - Kai Du
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Mingxin Wang
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanming Sun
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jing Chen
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Hongyan Zhao
- Department of Medical Record, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tao Song
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yuhui Sun
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
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Jia Y, Li D, Yu J, Jiang W, Liu Y, Li F, Zeng R, Wan Z, Liao X. Angiogenesis in Aortic Aneurysm and Dissection: A Literature Review. Rev Cardiovasc Med 2023; 24:223. [PMID: 39076698 PMCID: PMC11266809 DOI: 10.31083/j.rcm2408223] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/17/2023] [Accepted: 03/06/2023] [Indexed: 07/31/2024] Open
Abstract
Aortic aneurysm and aortic dissection (AA/AD) are critical aortic diseases with a hidden onset and sudden rupture, usually resulting in an inevitable death. Several pro- and anti-angiogenic factors that induce new capillary formation in the existing blood vessels regulate angiogenesis. In addition, aortic disease mainly manifests as the proliferation and migration of endothelial cells of the adventitia vasa vasorum. An increasing number of studies have shown that angiogenesis is a characteristic change that may promote AA/AD occurrence, progression, and rupture. Furthermore, neocapillaries are leaky and highly susceptible to injury by cytotoxic agents, which promote extracellular matrix remodeling, facilitate inflammatory cell infiltration, and release coagulation factors and proteases within the wall. Mechanistically, inflammation, hypoxia, and angiogenic factor signaling play important roles in angiogenesis in AA/AD under the complex interaction of multiple cell types, such as smooth muscle cells, fibroblasts, macrophages, mast cells, and neutrophils. Therefore, based on current evidence, this review aims to discuss the manifestation, pathological role, and underlying mechanisms of angiogenesis involved in AA/AD, providing insights into the prevention and treatment of AA/AD.
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Affiliation(s)
- Yu Jia
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
| | - Dongze Li
- Department of Emergency Medicine and National Clinical Research Center for Geriatrics, Disaster Medicine Center, West China Hospital, Sichuan University West China School of Medicine, 610044 Chengdu, Sichuan, China
| | - Jing Yu
- Department of Emergency Medicine and National Clinical Research Center for Geriatrics, Disaster Medicine Center, West China Hospital, Sichuan University West China School of Medicine, 610044 Chengdu, Sichuan, China
| | - Wenli Jiang
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, 610041 Chengdu, Sichuan, China
| | - Yi Liu
- Department of Emergency Medicine and National Clinical Research Center for Geriatrics, Disaster Medicine Center, West China Hospital, Sichuan University West China School of Medicine, 610044 Chengdu, Sichuan, China
| | - Fanghui Li
- Department of Cardiology, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
| | - Rui Zeng
- Department of Cardiology, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
| | - Zhi Wan
- Department of Emergency Medicine and National Clinical Research Center for Geriatrics, Disaster Medicine Center, West China Hospital, Sichuan University West China School of Medicine, 610044 Chengdu, Sichuan, China
| | - Xiaoyang Liao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
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Yang L, Wang Y, He X, Liu X, Sui H, Wang X, Wang M. Develop ment and validation of a prognostic dynamic nomogram for in-hospital mortality in patients with Stanford type B aortic dissection. Front Cardiovasc Med 2023; 9:1099055. [PMID: 36698955 PMCID: PMC9868166 DOI: 10.3389/fcvm.2022.1099055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Background This study aimed to identify the risk factors for in-hospital mortality in patients with Stanford type B aortic dissection (TBAD) and develop and validate a prognostic dynamic nomogram for in-hospital mortality in these patients. Methods This retrospective study involved patients with TBAD treated from April 2002 to December 2020 at the General Hospital of Northern Theater Command. The patients with TBAD were divided into survival and non-survival groups. The data were analyzed by univariate and multivariate logistic regression analyses. To identify independent risk factors for in-hospital mortality, multivariate logistic regression analysis, least absolute shrinkage, and selection operator regression were used. A prediction model was constructed using a nomogram based on these factors and validated using the original data set. To assess its discriminative ability, the area under the receiver operating characteristic curve (AUC) was calculated, and the calibration ability was tested using a calibration curve and the Hosmer-Lemeshow test. Clinical utility was evaluated using decision curve analysis (DCA) and clinical impact curves (CIC). Results Of the 978 included patients, 52 (5.3%) died in hospital. The following variables helped predict in-hospital mortality: pleural effusion, systolic blood pressure ≥160 mmHg, heart rate >100 bpm, anemia, ischemic cerebrovascular disease, abnormal cTnT level, and estimated glomerular filtration rate <60 ml/min. The prediction model demonstrated good discrimination [AUC = 0.894; 95% confidence interval (CI), 0.850-0.938]. The predicted probabilities of in-hospital death corresponded well to the actual prevalence rate [calibration curve: via 1,000 bootstrap resamples, a bootstrap-corrected Harrell's concordance index of 0.905 (95% CI, 0.865-0.945), and the Hosmer-Lemeshow test (χ2 = 8.3334, P = 0.4016)]. DCA indicated that when the risk threshold was set between 0.04 and 0.88, the predictive model could achieve larger clinical net benefits than "no intervention" or "intervention for all" options. Moreover, CIC showed good predictive ability and clinical utility for the model. Conclusion We developed and validated prediction nomograms, including a simple bed nomogram and online dynamic nomogram, that could be used to identify patients with TBAD at higher risk of in-hospital mortality, thereby better enabling clinicians to provide individualized patient management and timely and effective interventions.
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Affiliation(s)
- Lin Yang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, Liaoning, China,Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Yasong Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Xiaofeng He
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Xuanze Liu
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Honggang Sui
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Xiaozeng Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China,*Correspondence: Xiaozeng Wang,
| | - Mengmeng Wang
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China,Mengmeng Wang,
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15
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Lin YJ, Lin JL, Peng YC, Li SL, Chen LW. TG/HDL-C ratio predicts in-hospital mortality in patients with acute type A aortic dissection. BMC Cardiovasc Disord 2022; 22:346. [PMID: 35915399 PMCID: PMC9341073 DOI: 10.1186/s12872-022-02793-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
Background In recent years, abnormalities in serum lipids and lipoproteins have been shown to be associated with cardiovascular disease risk. However, their prognostic value for acute type A aortic dissection is unclear. This study analyzed the correlation between triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio and in-hospital mortality in patients with AAAD, and aimed to investigate the clinical significance of preoperative blood lipids and lipoproteins on the prognosis of acute type A aortic dissection. Methods A total of 361 patients who underwent type A aortic dissection surgery in Fujian Cardiac Medical Center from June 2018 to March 2020 were retrospectively collected. According to the baseline TG/HDL-C ratio, the patients were divided into 3 groups according to the tertile method, the low TG/HDL-C ratio T1 group (< 1.18) and the middle TG/HDL-C ratio T2 group (1.18–1.70). T3 group with high TG/HDL-C ratio (> 1.70). Kaplan–Meier was used for survival analysis, and Cox proportional hazards regression model was used to analyze the factors affecting the prognosis of patients. The receiver operating characteristic (ROC) curve was used for the diagnostic efficacy. Results Among the 361 patients in this study, the mean age was 52.4 ± 11.3 years, 73 (20.2%) were female, and 82 (22.7%) died in hospital. Kaplan–Meier curve showed that with the increase of TG/HDL-C ratio, the risk of in-hospital death gradually increased (P < 0.001). Multivariate Cox regression analysis showed that age (HR = 1.031), body mass index (HR = 1.052), hypertension (HR = 3.491), white blood cells (HR = 1.073), TG/HDL-C ratio (HR = 1.604), MODS (HR = 1.652) was positively correlated with in-hospital mortality (P < 0.05). After adjusting for age, sex, and other risk factors, a significant association was found between the TG/HDL-C ratio and in-hospital mortality for acute type A aortic dissection (HR = 1.472, 95% CI, 1.354–3.451, P = 0.019). Conclusion Patients with type A aortic dissection have obvious abnormal blood lipid metabolism, and serum TG/HDL-C levels are positively correlated with in-hospital mortality in patients with AAAD.
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16
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Huang X, Wang Z, Shen Z, Lei F, Liu YM, Chen Z, Qin JJ, Liu H, Ji YX, Zhang P, Zhang XJ, Yang J, Cai J, She ZG, Li H. Projection of global burden and risk factors for aortic aneurysm - timely warning for greater emphasis on managing blood pressure. Ann Med 2022; 54:553-564. [PMID: 35139697 PMCID: PMC8843207 DOI: 10.1080/07853890.2022.2034932] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/21/2021] [Accepted: 01/23/2022] [Indexed: 01/16/2023] Open
Abstract
RATIONALE Aortic aneurysm (AA) is a serious condition that largely increases the risk of aortic dissection and sudden death. Exploring the global burden of disease and changes in risk factors for AA is essential for public health policy development. OBJECTIVE To project the death burden from AA and its attributable risk factors in the following decade based on the epidemiological data over the past 30 years. METHODS AND RESULTS We analysed the death burden of AA and trends of four risk factors from 1990-2019 using the updated 2019 Global Burden of Disease study database by Joinpoint regression analysis. Furthermore, we project the AA-related death burden for the next decade using the Bayesian age-period-cohort model. This study discovered that the global burden of death attributable to AA began to increase after decreasing for two decades. This upward trend will continue in the subsequent decade (average annual percent change: 0.318%, 95% CI: 0.288 to 0.348). Meanwhile, the disease burdens in all economic regions except high-middle socio-demographic index (SDI) regions will continuously increase in the next decade, with the fastest acceleration in the low-middle SDI region (average annual percent change: 1.183%, 95% CI: 1.166 to 1.200). Notably, high systolic blood pressure will surpass the contribution of smoking to become the most important risk factor for mortality due to AA. CONCLUSION This study discovered a rebounding trend in the aortic aneurysm-related death burden globally. High systolic blood pressure will be the top risk factor attributed to death from AA. Therefore, it should be considered as the first-degree risk factor in the guidance of AA management and criteria for population-based screening programs.Key messagesThe death burden of aortic aneurysms is beginning to rebound globally, and the trend will continue for the next decade.High systolic blood pressure will replace smoking as the most important risk factor associated with aortic aneurysm death.
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Affiliation(s)
- Xuewei Huang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Zhouxiang Wang
- Institute of Model Animal, Wuhan University, Wuhan, China
- Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhengjun Shen
- Huanggang Institute of Translation Medicine, Huanggang, China
- Department of Cardiology, Center Hospital of Huanggang, Huanggang, China
| | - Fang Lei
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Ye-Mao Liu
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Center Hospital of Huanggang, Huanggang, China
| | - Ze Chen
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Juan-Juan Qin
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Hui Liu
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Department of Gastroenterology, Tongren Hospital of Wuhan University & Wuhan Third Hospital, Wuhan, China
| | - Yan-Xiao Ji
- Institute of Model Animal, Wuhan University, Wuhan, China
- Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Peng Zhang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Xiao-Jing Zhang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Juan Yang
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Jingjing Cai
- Institute of Model Animal, Wuhan University, Wuhan, China
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhi-Gang She
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China
- Institute of Model Animal, Wuhan University, Wuhan, China
- Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
- Huanggang Institute of Translation Medicine, Huanggang, China
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Wang Y, Gao P, Li F, Du J. Insights on aortic aneurysm and dissection: Role of the extracellular environment in vascular homeostasis. J Mol Cell Cardiol 2022; 171:90-101. [DOI: 10.1016/j.yjmcc.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/06/2022] [Accepted: 06/29/2022] [Indexed: 11/29/2022]
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Yang H, Yang F, Luo M, Chen Q, Liu X, Zhang Y, Zhu G, Chen W, Li T, Shu C, Zhou Z. Metabolomic Profile Reveals That Ceramide Metabolic Disturbance Plays an Important Role in Thoracic Aortic Dissection. Front Cardiovasc Med 2022; 9:826861. [PMID: 35211530 PMCID: PMC8861291 DOI: 10.3389/fcvm.2022.826861] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/04/2022] [Indexed: 12/12/2022] Open
Abstract
Aims Thoracic aortic dissection (TAD) is a life-threatening disease with no effective drug therapy thus far. New therapeutic targets and indications for timely surgical intervention are urgently needed. Our aim is to investigate new pathological mechanisms and potential biomarkers of TAD through global metabolomic profiling of aortic aneurysm and dissection patients. Methods and Results We performed untargeted metabolomics to determine plasma metabolite concentrations in an aortic disease cohort, including 70 thoracic aortic aneurysm (TAA) and 70 TAD patients, as well as 70 healthy controls. Comparative analysis revealed that sphingolipid, especially its core metabolite C18-ceramide, was significantly distinguished in TAD patients but not in TAA patients, which was confirmed by subsequent quantitative analysis of C18-ceramide in a validation cohort. By analyzing our existing multiomics data in aortic tissue in a murine TAD model and TAD patients, we found that an enhanced ceramide de novo synthesis pathway in macrophages might contribute to the elevated ceramide. Inhibition of the ceramide de novo synthesis pathway by myriocin markedly alleviated BAPN-induced aortic inflammation and dissection in mice. In vitro studies demonstrated that exogenous C18-ceramide promoted macrophage inflammation and matrix metalloprotein (MMP) expression through the NLRP3-caspase 1 pathway. In contrast, inhibition of endogenous ceramide synthesis by myriocin attenuated lipopolysaccharide (LPS)-induced macrophage inflammation. Conclusions Our findings demonstrated that ceramide metabolism disturbance might play a vital role in TAD development by aggravating aortic inflammation through the NLRP3 pathway, possibly providing a new target for pharmacological therapy and a potential biomarker of TAD.
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Affiliation(s)
- Hang Yang
- State Key Laboratory of Cardiovascular Disease, Beijing Key Laboratory for Molecular Diagnostics of Cardiovascular Diseases, Diagnostic Laboratory Service, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fangfang Yang
- State Key Laboratory of Cardiovascular Disease, Beijing Key Laboratory for Molecular Diagnostics of Cardiovascular Diseases, Diagnostic Laboratory Service, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingyao Luo
- State Key Laboratory of Cardiovascular Disease, Center of Vascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qianlong Chen
- State Key Laboratory of Cardiovascular Disease, Beijing Key Laboratory for Molecular Diagnostics of Cardiovascular Diseases, Diagnostic Laboratory Service, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuanyu Liu
- State Key Laboratory of Cardiovascular Disease, Beijing Key Laboratory for Molecular Diagnostics of Cardiovascular Diseases, Diagnostic Laboratory Service, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yinhui Zhang
- State Key Laboratory of Cardiovascular Disease, Beijing Key Laboratory for Molecular Diagnostics of Cardiovascular Diseases, Diagnostic Laboratory Service, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guoyan Zhu
- State Key Laboratory of Cardiovascular Disease, Beijing Key Laboratory for Molecular Diagnostics of Cardiovascular Diseases, Diagnostic Laboratory Service, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wen Chen
- State Key Laboratory of Cardiovascular Disease, Beijing Key Laboratory for Molecular Diagnostics of Cardiovascular Diseases, Diagnostic Laboratory Service, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tianjiao Li
- State Key Laboratory of Cardiovascular Disease, Beijing Key Laboratory for Molecular Diagnostics of Cardiovascular Diseases, Diagnostic Laboratory Service, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chang Shu
- State Key Laboratory of Cardiovascular Disease, Center of Vascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhou Zhou
- State Key Laboratory of Cardiovascular Disease, Beijing Key Laboratory for Molecular Diagnostics of Cardiovascular Diseases, Diagnostic Laboratory Service, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Wei X, Jiang DS, Wan S. Cardiovascular Epidemiological Research in China: A Wake-up Call No One Can Afford to Ignore. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 17:100308. [PMID: 34734205 PMCID: PMC8551847 DOI: 10.1016/j.lanwpc.2021.100308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Xiang Wei
- Division of Cardiothoracic and Vascular Surgery, Sino-Swiss Heart-Lung Transplantation Institute, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Organ Transplantation; Ministry of Education; NHC Key Laboratory of Organ Transplantation; Key Laboratory of Organ Transplantation; Chinese Academy of Medical Sciences, Wuhan, Hubei, China
| | - Ding-Sheng Jiang
- Division of Cardiothoracic and Vascular Surgery, Sino-Swiss Heart-Lung Transplantation Institute, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Organ Transplantation; Ministry of Education; NHC Key Laboratory of Organ Transplantation; Key Laboratory of Organ Transplantation; Chinese Academy of Medical Sciences, Wuhan, Hubei, China
| | - Song Wan
- Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
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