Coronary heart disease and intestinal microbiota

Effect of care bundles based on importance degree analysis on postoperative comorbid state, coping style and disease management ability of patients with coronary heart disease

Coronary heart disease (CHD) is a significant global health concern, particularly among the elderly. While care bundles present a comprehensive strategy for clinical disorders, their application in CHD rehabilitation remains understudied. This research addresses this gap by investigating the effectiveness of care bundles in CHD patients. By analyzing important performance degrees, we aim to contribute valuable insights to bridge existing knowledge deficiencies. Our study strives to establish a theoretical foundation for the broader implementation of care bundles, potentially improving the quality of care and patient outcomes in CHD rehabilitation. This is a retrospective study. 360 patients with CHD who were admitted to our hospital from January 2019 to October 2022 were enrolled in this retrospective study and divided into the observation group (n = 180) and control group (n = 180) according to the different care that they received. All cases were given routine nursing after CHD operation, and the observation group was given care bundles on the basis of the analysis of important performance degrees. The perioperative indexes, self-management ability score, depression, anxiety, stress scale (DASS), coping styles, medical compliance and the incidence of complications were compared between the 2 groups. Aftercare, the time of hospitalization and getting out-of-bed in the observation group was notably shorter (P < .05). Aftercare, the scores of self-management ability and related dimensions in the observation group were notably higher (P < .05). After care, the score of depression (P < .001), anxiety (P = .003) and stress (P = .017) of the observation group were notably lower. Aftercare, the observation group face score was significantly higher than the control group (P = .005), while the observation group avoidance score (P = .028) and yield score (P < .001) were significantly lower than the control group scores. Aftercare, the compliance behavior of patients in the observation group was notably better (P = .013). Aftercare, the incidence of complications in the observation group was notably lower (P = .039). Care bundles based on the degree of importance analysis can play a positive role in postoperative comorbid state, coping styles and self-management ability of patients with CHD, which can improve the rehabilitation effects on patients.

A historical perspective and recent advances on the evolution of the relationship between acute and chronic pain and cardiovascular disease

The relationship between acute pain and the cardiovascular system was recognized approximately 50 years ago following the initial observation, along with several subsequent experimental studies, that hypertension can result in decreases in the perception of pain. These studies provided a strong impetus to study potential mechanisms to clarify commonalities between the regulatory pathways associated with pain and the cardiovascular system. Attention subsequently shifted to an emphasis on the impact of chronic pain on cardiovascular diseases and mortality with several large meta-analyses of longitudinal studies providing clear evidence that chronic widespread pain increases the risk for developing cardiovascular disease and is associated with excess morbidity and mortality. Cardiovascular associated mortality from myocardial infarction and stroke appears to be directly related to the duration and severity of chronic pain, a result often characterized as a 'dose-response' relationship. The availability and reproducibility of extensive large-scale observational and retrospective studies have emphasized the critical need for more research, including prospective studies, along with the need for the development of preclinical animal models, to better understand the relationship(s) and underlying mechanisms between chronic pain, associated comorbidities, and cardiovascular disease. Elucidation and a deeper understanding of these relationships, including a focus on the link between chronic pain, cardiovascular disease, and depression, could provide valuable information to guide the development of potential treatment interventions to aid in attenuating pain while preventing pain-associated cardiovascular disease, comorbidities, and mortality.

Cardiovascular-specific mortality and risk factors in colorectal Cancer patients: A cohort study based on registry data of over 500,000 individuals in the US

BACKGROUND

Colorectal cancer (CRC) is one of the most common cancers worldwide, and recent studies have found that CRC patients are at increased risk for cardiovascular disease (CVD). This study aimed to investigate competing causes of death and prognostic factors among a large cohort of CRC patients and to describe cardiovascular-specific mortality in relation to the US standard population.

METHODS

This registry-based cohort study identified patients diagnosed with CRC between 1973 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database in the US. Cumulative mortality functions, conditional standardized mortality ratios, and cause-specific hazard ratios were calculated.

RESULTS

Of the 563,298 eligible CRC patients included in this study, 407,545 died during the follow-up period. CRC was the leading cause of death, accounting for 49.8% of all possible competing causes of death. CVD was the most common non-cancer cause of death, accounting for 17.8% of total mortality. This study found that CRC patients have a significantly increased risk of cardiovascular-specific mortality compared to the US standard population, with the risk increasing with age and extended survival time.

CONCLUSION

This study highlights the need to develop multidisciplinary prevention and management strategies for CRC and CVD to improve CRC patients' survival and quality of life.

Diagnostic value of peripheral blood miR-296 combined with vascular endothelial growth factor B on the degree of coronary artery stenosis in patients with coronary heart disease

OBJECTIVE

Coronary heart disease (CHD) is a disorder resulting from organic and functional coronary artery stenosis (CAS), thus causing reduced oxygenated blood in the heart. miRNAs are useful biomarkers in the diagnosis of atherosclerosis, CHD, and acute coronary syndrome. Vascular endothelial growth factor (VEGF) is closely related to CHD. This study explored the correlation of miR-296 and VEGF-B expression levels in peripheral blood with CAS degree in CHD patients.

METHODS

Totally 220 CHD patients were enrolled and classified into mild-(71 cases)/moderate-(81 cases)/severe-CAS (68 cases) groups, with another 80 healthy cases as controls. The serum miR-296 and VEGF-B expression levels were detected using reverse transcription quantitative polymerase chain reaction. The correlation between miR-296 and CAS-related indexes was assessed via Pearson analysis. The binding relationship of miR-296 and VEGF-B was first predicted and their correlation was further analyzed via the Pearson method. The clinical diagnostic efficacy of miR-296 or VEGF-B on CAS degree was evaluated by the receiver operating characteristic curve.

RESULTS

Serum miR-296 was downregulated in CHD patients and was the lowest in patients with severe-CAS. miR-296 was negatively-correlated with high-sensitivity C-reactive protein, brain natriuretic peptide, and cardiac troponin I. miR-296 targeted VEGF-B. VEGF-B was upregulated in CHD patients and inversely-related to miR-296. Low expression of miR-296 and high expression of VEGF-B both had high clinical diagnostic values on CAS degree in CHD patients. miR-296 combined with VEGF-B increased the diagnostic value on CAS.

CONCLUSION

Low expression of miR-296 combined with high expression of its target VEGF-B predicts CAS degree in CHD patients.

Role of the renin-angiotensin system in the pathophysiology of coronary heart disease and heart failure: Diagnostic biomarkers and therapy with drugs and natural products

The renin-angiotensin system (RAS) plays a pivotal role in blood pressure regulation. In some cases, this steering mechanism is affected by various deleterious factors (mainly via the overactivation of the RAS) causing cardiovascular damage, including coronary heart disease (CHD) that can ultimately lead to chronic heart failure (CHF). This not only causes cardiovascular disability and absenteeism from work but also imposes significant healthcare costs globally. The incidence of cardiovascular diseases has escalated exponentially over the years with the major outcome in the form of CHD, stroke, and CHF. The involvement of the RAS in various diseases has been extensively researched with significant limelight on CHD. The RAS may trigger a cascade of events that lead to atherosclerotic mayhem, which causes CHD and related aggravation by damaging the endothelial lining of blood vessels via various inflammatory and oxidative stress pathways. Although there are various diagnostic tests and treatments available in the market, there is a constant need for the development of procedures and therapeutic strategies that increase patient compliance and reduce the associated side effects. This review highlights the advances in the diagnostic and treatment domains for CHD, which would help in subjugating the side effects caused by conventional therapy.

Effect of different doses of atorvastatin on collateral formation in coronary artery disease patients with coronary atherosclerosis

OBJECTIVE

The study aimed to explore the effect of different doses of atorvastatin on collateral formation in coronary artery disease (CAD) patients with coronary atherosclerosis.

METHODS

The study included 218 CAD patients who received treatment between January 2017 and January 2020 at our hospital. They were assigned to the high-dose group (40 mg atorvastatin) and the low-dose group (20 mg atorvastatin) using the random table method with 109 patients per group. The blood lipid levels, TNF-α, hs-CRP, NO, and coronary atherosclerosis collateral formation before and after treatment in the two groups were compared, and favorable factors of good coronary artery collateral circulation were analyzed by multivariate logistic regression analysis.

RESULTS

LDL-C, TG, and TC levels decreased, whereas HDL-C levels increased in the two groups after treatment. The high-dose group had lower LDL-C, TG, and TC levels but higher HDL-C levels than the low-dose group, and the difference was statistically significant ( P < 0.05). TNF-α and hs-CRP levels decreased while NO levels increased in both groups after treatment. The high-dose group had lower TNF-α and hs-CRP levels but higher NO levels than the low-dose group, and the difference was statistically significant ( P < 0.05).

CONCLUSION

High-dose atorvastatin could blood lipid levels of modulate CAD patients and promote coronary atherosclerosis collateral formation. In addition, hypertension, LDL-C, HDL-C, TNF-α, hs-CRP, and NO were independent determinants of good coronary artery collateral circulation.

Effect of CICARE Communication Mode on Disease Uncertainty, Self-Nursing Ability, and Quality of Life in Patients with Coronary Atherosclerotic Heart Disease after Percutaneous Coronary Intervention

Objective

To study the effect of CICARE (Connect, Introduce, Communicate, Ask, Respond, Exit) communication mode on disease uncertainty, self-nursing ability, and quality of life in patients with coronary atherosclerotic heart disease (CAD) after percutaneous coronary intervention (PCI).

Methods

From January 2021 to December 2021, 102 patients with CAD after PCI were randomly divided into a research group (n =51) and a control group (n =51). The former received CICARE communication model nursing intervention, and the latter received routine doctor-patient communication nursing. To study the scores of disease uncertainty scale (MUIS), Frankl treatment compliance scale (Frankl), self-care ability scale (exercise of self-care-a), quality of life scale (WHOQOL-BREF), and Newcastle nursing satisfaction scale (NSNS) before and 1 week after nursing.

Results

After one week of nursing, the MUIS score of the research group was lower than that of the control group, and the score of Frankl treatment compliance scale of the research group was higher than that of the control group. After 1 week of nursing, the ESCA score of the research group was higher compared to the control group (p < 0.05), and the WHOQOL-BREF score of the research group was higher compared to the control group (p < 0.05). After one week of nursing, the NSNS score of the research group was higher compared to the control group (p < 0.05).

Conclusion

The application value of CICARE communication mode nursing intervention in patients with CAD after PCI is more remarkable, and it is more helpful to reduce patients' disease uncertainty, enhance treatment compliance, promote patients' self-nursing ability, and strengthen quality of life and nursing satisfaction.

Pueraria lobata Targeted Preparation Improves the Clinical Symptoms of Cervical Spondylosis by Regulating the Balance of Gut Microbiota

BACKGROUND

Nanotargeted preparations can enhance the safety and effectiveness of medication by altering the pharmacokinetic behavior of drugs in the human body, and Pueraria lobata is shown to be effective in the treatment of neck and back pain.

PURPOSE

This study prepared a nano-Pueraria targeted preparation, in order to analyze its effect on improving the clinical symptoms of cervical spondylosis by adjusting the balance of intestinal flora.

METHODS

A total of 200 patients with cervical spondylosis admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine were enrolled and divided into an observation group and a control group. The control group was given Tuina therapy, and the observation group was given nano-Pueraria targeted preparation + Tuina therapy. The clinical symptoms and intestinal microflora of the two groups were examined before intervention.

RESULTS

It was found that the markedly effective of treatment efficacy of the observation group (98%) was higher than that of the control group (78%) after 15 days of intervention, and the clinical symptoms were obviously fewer than those of the control group. The distribution of gut microbiota showed that there were significant differences in the composition of gut microbiota between the two groups. Compared with the control group, the abundance of Firmicutes in the observation group was significantly higher, while the abundance of Bacteroidetes and Proteobacteria was significantly lower.

CONCLUSION

The targeted preparation of nano-Pueraria can improve the clinical symptoms of patients with cervical spondylosis by adjusting the balance of gut microbiota.

Why Do These Microbes Like Me and How Could There Be a Link with Cardiovascular Risk Factors?

Cardiovascular diseases are the most common causes of hospitalization, death, and disability in Europe. Due to high prevalence and ensuing clinical complications, they lead to very high social and economic costs. Despite the knowledge of classical cardiovascular risk factors, there is an urgent need for discovering new factors that may play a role in the development of cardiovascular diseases or potentially influence prognosis. Recently, particular attention has been drawn to the endogenous microflora of the human body, mostly those inhabiting the digestive system. It has been shown that bacteria, along with their host cells, create an interactive ecosystem of interdependencies and relationships. This interplay could influence both the metabolic homeostasis and the immune processes of the host, hence leading to cardiovascular disease development. In this review, we attempt to describe, in the context of cardiovascular risk factors, why particular microbes occur in individuals and how they might influence the host’s cardiovascular system in health and disease.

The Value of CTA Based on Gold Nanorod Contrast Agent in Coronary Artery Diagnosis and Plaque Property Analysis

Coronary CT angiography (CTA) with the characteristics of noninvasive and simple operation is widely used in the diagnosis of coronary artery stenosis. The choice of contrast agent exerts an important impact on the imaging quality of CTA. Conventional iodine contrast agents are easily excreted by the kidneys, from which the imaging window is short, and the imaging quality is poor. Metal nanomaterials have unique optical properties and have broad application prospects in imaging. Our aim is to explore the value of gold nanorod contrast agent in the diagnosis of coronary heart disease. A gold nanorod suspension was first prepared, and the prepared gold nanorod was uniform and had good dispersibility. It can be seen from the light absorption curve that there are two obvious peaks on the UV absorption peak of the gold nanorods. The gold nanorods were cultured in different solutions, and it was found that the particle size of the gold nanorods did not change significantly within 72 hours, indicating that the prepared gold nanorods had good stability. When observing the damage degree of mouse kidney tissue, it was shown that the damage degree of gold nanorod contrast agent to mouse kidney tissue was less than that of iodine contrast agent. The above results indicate that the gold nanorod contrast agent has good stability and safety. Therefore, our study demonstrated that the gold nanorod contrast agent has high value in the diagnosis of coronary arteries and the analysis of plaque properties.

Which Microbes Like My Diet and What Does It Mean for My Heart?

Cardiovascular diseases are the most common causes of hospitalization, death and disability in Europe. Despite our knowledge of nonmodifiable and modifiable cardiovascular classical risk factors, the morbidity and mortality in this group of diseases remains high, leading to high social and economic costs. Therefore, it is necessary to explore new factors, such as the gut microbiome, that may play a role in many crucial pathological processes related to cardiovascular diseases. Diet is a potentially modifiable cardiovascular risk factor. Fats, proteins, carbohydrates, vitamins and minerals are nutrients that are essential to the proper function of the human body. The style and composition of the human diet has changed over time, evolving from a hunter–gatherer diet to an industrialized and Westernized modern diet that includes processed products. The relationship between the gut microbiome, diet and cardiovascular diseases is complex and still not fully understood. In this review, we discuss, in the context of diet, why particular microbes occur in individuals and how they can influence the host’s cardiovascular system in health and disease. We investigate the role of particular microorganisms and changes in the Firmicutes/Bacteroidetes ratio.

NLRP3 inflammasome deficiency attenuates metabolic disturbances involving alterations in the gut microbial profile in mice exposed to high fat diet

Obesity-related diseases (e.g. type 2 diabetes mellitus and cardiovascular disorders) represent an increasing health problem worldwide. NLRP3 inflammasome activation may underlie obesity-induced inflammation and insulin resistance, and NLRP3 deficient mice exposed to high fat diet (HFD) appear to be protected from left ventricle (LV) concentric remodeling. Herein, we investigated if these beneficial effects were associated with alterations in plasma metabolites, using metabolomic and lipidomic analysis, and gut microbiota composition, using 16S rRNA sequencing of cecum content, comparing NLRP3 deficient and wild type (WT) mice on HFD and control diet. Obese NLRP3 deficient mice had lower systemic ceramide levels, potentially resulting attenuating inflammation, altered hepatic expression of fatty acids (FA) with lower mono-saturated FA and higher polyunsaturated FA levels, potentially counteracting development of liver steatosis, downregulated myocardial energy metabolism as assessed by proteomic analyses of LV heart tissue, and different levels of bile acids as compared with WT mice. These changes were accompanied by an altered composition of gut microbiota associated with decreased systemic levels of tri-methylamine-N-oxide and lipopolysaccharide, potentially inducing attenuating systemic inflammation and beneficial effects on lipid metabolism. Our findings support a role of NLRP3 inflammasome in the interface between metabolic and inflammatory stress, involving an altered gut microbiota composition.

Drug Discovery and Development of Novel Therapeutics for Inhibiting TMAO in Models of Atherosclerosis and Diabetes

Diabetes mellitus exists as a comorbidity with congestive heart failure (CHF). However, the exact molecular signaling mechanism linking CHF as the major form of mortality from diabetes remains unknown. Type 2 diabetic patients display abnormally high levels of metabolic products associated with gut dysbiosis. One such metabolite, trimethylamine N-oxide (TMAO), has been observed to be directly related with increased incidence of cardiovascular diseases (CVD) in human patients. TMAO a gut-liver metabolite, comes from the metabolic degenerative product trimethylamine (TMA) that is produced from gut microbial metabolism. Elevated levels of TMAO in diabetics and obese patients are observed to have a direct correlation with increased risk for major adverse cardiovascular events. The pro-atherogenic effect of TMAO is attributed to enhancing inflammatory pathways with cholesterol and bile acid dysregulation, promoting foam cell formation. Recent studies have revealed several potential therapeutic strategies for reducing TMAO levels and will be the central focus for the current review. However, few have focused on developing rational drug therapeutics and may be due to the gaps in knowledge for understanding the mechanism by which microbial TMA producing enzymes and hepatic flavin-containing monoxygenase (FMO) can work together in preventing elevation of TMAO levels. Therefore, it is critical to understand the advantages of developing a novel rational drug design strategy that manipulates FMO production of TMAO and TMA production by microbial enzymes. This review will focus on the inspection of FMO manipulation, as well as gut microbiota dysbiosis and its influence on metabolic disorders including cardiovascular disease and describe novel potential pharmacological therapeutic development.