Volume and function changes of left atrium and left ventricle in patients with ejection fraction preserved heart failure measured by a three dimensional dynamic heart model

The accurate diagnosis of HFpEF is still challenging and controversial. In this study, we used 3D-DHM technology to compare the differences of cardiac structure and function between HFpEF patients and healthy controls, as well as the differences of two-dimensional and three-dimensional cardiac function in HFpEF patients. Echocardiography with 3D-DHM and conventional two-dimensional (2D) methods were applied to measure the volume and function parameters of left atrium and ventricle of patients with HFpEF and healthy controls. Significant differences of 3D cardiac function indexes including LVESV, 3D-LVEF, ESL, SV, CI, EDmass, LAVmax, LAVmin, LAEF, and LAVI were observed between patients with HFpEF and controls (P < 0.05). However, no significant difference of LVEDV and EDL were observed (P > 0.05). In addition, we found no significant between-group difference in 2D cardiac function indexes such as LVDD and 2D-LVEF (P > 0.05), but the LAD, LVSD, LVPW, IVS, E, E/A, and E/e ' were significantly different between groups (P < 0.05). There was no significant difference between 3D-LVEF and 2D-LVEF in the control group (P > 0.05), while 3D-LVEF in the HFpEF group was lower than 2D-LVEF(P < 0.05). Among the two-dimensional and three-dimensional parameters of HFpEF patients, the parameters related to diastolic function changed more significantly than those of the normal group, and the three-dimensional LVEF of HFpEF patients decreased. The three-dimensional cardiac function parameters analyzed by DHM can provide more information regarding myocardial mechanics.

Flapless one-knot suture: a novel surgical technique for transscleral fixation of C-loop intraocular lenses

AIM

To describe a novel suture approach for transscleral fixation of C-loop intraocular lenses (IOL) and to compare the surgical outcomes with the four-haptics posterior chamber (PC)-IOL technique.

METHODS

We retrospectively analyzed 16 eyes of 16 patients who underwent transscleral fixation of C-loop PC-IOLs using a flapless one-knot suture technique, which were followed up for longer than 17mo. In this technique, the capsulorless IOL was suspended using a single suture for transscleral fixation of four feet. Then we compared its surgical outcomes and complications with the four-haptics PC-IOLs using the Student's t test and Chi-square test.

RESULTS

Sixteen patients of 16 eyes with a mean age of 58.3±10.1y (42-76y) who received transscleral C-loop IOL implantation due to trauma, vitrectomy, or cataract surgery with inadequate capsule support showed improved visual acuity. The difference was not significant between two IOLs except the surgery time (P>0.05). The mean operation times of C-loop IOL surgery was 24.1±1.83min and 31.3±4.47min of the four-haptics PC-IOL method (P<0.0001). In the C-loop IOLs group, there was statistical difference between the preoperative and the postoperative UCVA (logMAR, 1.20±0.50 vs 0.57±0.32, P=0.0003). There was no statistical difference between the preoperative and the postoperative BCVA (logMAR, 0.66±0.46 vs 0.40±0.23, P=0.056). However, there was no statistically significant difference in postoperative UCVA and BCVA between the two IOLs (P>0.05). We did not detect any optic capture, IOL decentration or dislocation, suture exposed, or cystoid macular edema in patients underwent C-loop IOLs surgery.

CONCLUSION

The novel flapless one-knot suture technique for transscleral fixation of C-loop IOL is a simple, reliable, and stable technique.

Long Noncoding RNA Kcna2 Antisense RNA Contributes to Ventricular Arrhythmias via Silencing Kcna2 in Rats With Congestive Heart Failure

BACKGROUND

Congestive heart failure (CHF) is a common cardiovascular disease that is often accompanied by ventricular arrhythmias. The decrease of the slow component of the delayed rectifier potassium current (I_Ks) in CHF leads to action potential (AP) prolongation, and the I_Ks is an important contributor to the development of ventricular arrhythmias. However, the molecular mechanisms underlying ventricular arrhythmias are still unknown.

METHODS AND RESULTS

Kcna2 and Kcna2 antisense RNA (Kcna2 AS) transcript expression was measured in rat cardiac tissues using quantitative real-time reverse transcription-polymerase chain reaction and Western blotting. There was a 43% reduction in Kcna2 mRNA in the left ventricular myocardium of rats with CHF. Kcna2 knockdown in the heart decreased the I_Ks and prolonged APs in cardiomyocytes, consistent with the changes observed in heart failure. Conversely, Kcna2 overexpression in the heart significantly attenuated the CHF-induced decreases in the I_Ks, AP prolongation, and ventricular arrhythmias. Kcna2 AS was upregulated ≈1.7-fold in rats with CHF and with phenylephrine-induced cardiomyocyte hypertrophy. Kcna2 AS inhibition increased the CHF-induced downregulation of Kcna2. Consequently, Kcna2 AS mitigated the decrease in the I_Ks and the prolongation of APs in vivo and in vitro and reduced ventricular arrhythmias, as detected using electrocardiography.

CONCLUSIONS

Ventricular Kcna2 AS expression increases in rats with CHF and contributes to reduced I_Ks, prolonged APs, and the occurrence of ventricular arrhythmias by silencing Kcna2. Thus, Kcna2 AS may be a new target for the prevention and treatment of ventricular arrhythmias in patients with CHF.

Epigallocatechin-3-Gallate Inhibits Matrix Metalloproteinase-9 and Monocyte Chemotactic Protein-1 Expression Through the 67-κDa Laminin Receptor and the TLR4/MAPK/NF-κB Signalling Pathway in Lipopolysaccharide-Induced Macrophages

BACKGROUND/AIMS

Epigallocatechin-3-gallate (EGCG), a major catechin found in green tea, has been shown to prevent cardiovascular diseases. Previously, Matrix metalloproteinase-9 (MMP-9), monocyte chemotactic protein-1 (MCP-1) and toll-like receptor 4 (TLR4) were confirmed to play an important role in atherosclerosis and plaque instability. Both TLR4 and its negative regulator, Toll-interacting protein (Tollip), could be mediated by EGCG. The present study aimed to examine the effect of physiological concentration of EGCG (1 µM) on the expression of MMP-9 and MCP-1 in lipopolysaccharide (LPS)-induced macrophages and the potential mechanisms underlying its actions.

METHODS

The RAW264.7 cell line was used. Western blot was used to determine MCP-1, TLR4, Tollip, Mitogen-activated protein kinase (MAPK) and Nuclear factor-κB (NF-κB) protein expression. MMP-9 activity was assayed by gelatine zymography. The mRNA expression of MMP-9 and MCP-1 was measured by realtime polymerase chain reaction (RT-PCR).

RESULTS

EGCG (1 µM) significantly suppressed the expression of MMP-9 and MCP-1 and inhibited MAPK and NF-κB in LPS-induced macrophages but was blocked by Tollip silencing. The expression of LPS-induced MMP-9 and MCP-1 and the phosphorylation of the ERK1/2, P38 and NF-κB pathway proteins decreased after TLR4 siRNA treatment. Furthermore, EGCG mediated TLR4 and Tollip expression through binding to 67-kDa laminin receptor (67LR).

CONCLUSION

The results of our study suggested that EGCG (1 µM) suppresses the TLR4/MAPK/NF-κB signalling pathway, decreases the expression of the plaque instability-mediating cytokines MMP-9 and MCP-1, and might prove to be effective in stabilizing atherosclerotic plaque.

Cloning, characterization, chromosomal mapping and tissue transcription analysis of porcine CREB2 and CREB3 genes

CREB2 and CREB3 are two important members of the ATF/CREB family, which negatively and positively regulates CRE-dependent transcription in vitro. Here we report the cloning, chromosome mapping and tissue transcription analysis of CREB2 and CREB3 in pigs. The full-length coding sequence of CREB2 and CREB3 is 1047 bp and 1098 bp, encoding 348 and 365 amino acids, respectively. Porcine CREB3 comprises nine exons and eight introns, whereas CREB2 consists of three exons and two introns. CREB2 and CREB3 were cytogenetically assigned to porcine chromosome 5p and 1q28, respectively. Tissue transcription analysis revealed that both porcine CREB2 and CREB3 mRNA were ubiquitously detected in all examined tissues. Additionally, we cloned the 5' flank genomic sequence of porcine CREB3 and characterized several putative transcription factor recognition sites including SP1, NF-kappaB, AP-1 and AP-2 in its promoter region. Our studies provide basic molecular information helpful for further investigation of the function of the two genes in pig models.