Cardiovascular diseases: Interplay of epigenetics

Several association studies have been carried out to elucidate the role of genetic variants in cardiovascular diseases (CVDs), while studies on the epigenome regulating gene expression changes are helping to understand the development of disease and factors promoting such changes. This review summarizes the different epigenetic aspects involved in cardiac development and disease along with current therapeutic interventions.     

Kruppel样因子与心肌重构机制的研究进展

Kruppel样因子是包含锌指结构的转录因子,是锌指蛋白超家族最大的亚家族。迄今为止,在哺乳动物中已经分离出17种Kruppel样因子。这类因子参与多种病理生理过程,包括细胞增殖、分化和凋亡等。有证据表明部分Kruppel样因子在心血管系统疾病的病理生理过程中发挥重要作用。现重点综述Kruppel样因子结构特点及其在心肌重构方面的作用机制。     

他汀类药物抗心肌肥厚的研究进展

心肌肥厚与多种心血管疾病发展过程有关,是心肌缺血、心律失常和心性猝死的危险因素,他汀类药物是目前临床应用最广泛、最有效的降脂药物,其可通过多种途径对抗心肌肥厚,从而阻止心肌肥厚的发生、发展,降低心脏疾病的病死率,现将近年这方面的研究进展综述如下。     

Molecular mechanisms of cardiac aging

Age-associated changes in cardiovascular structure/function are implicated in the markedly increased risk for cardiovascular disease in older persons. Aging not only prolongs exposure to several other cardiovascular risks, but also leads to intrinsic cardiac changes, which reduces cardiac functional reserve, predisposes the heart to stress and contributes to increased cardiovascular mortality in the elderly. Intrinsic cardiac aging in the murine model closely recapitulates age-related cardiac changes in humans, including left ventricular hypertrophy, fibrosis and diastolic dysfunction. Cardiac aging in mice is accompanied by accumulation of mitochondrial protein oxidation, increased mitochondrial DNA mutations, increased mitochondrial biogenesis, as well as decreased cardiac SERCA2 protein. All of these age-related changes are significantly attenuated in mice overexpressing catalase targeted to mitochondria (mCAT). These findings demonstrate the critical role of mitochondrial reactive oxygen species (ROS) in cardiac aging and support the potential application of mitochondrial antioxidants to cardiac aging and age-related cardiovascular diseases.     

Novel Effects of Macrolide Antibiotics on Cardiovascular Diseases

Macrolide antibiotics are broadly used for the treatment of various microbial infections. However, they are also known to have multiple biologic effects, such as alteration of inflammatory factors and matrix metalloproteinases (MMPs). Because of controversial results in clinical trials, the effects of macrolides on cardiovascular diseases are still to be elucidated. It has been reported that MMP activity is upregulated in various cardiovascular diseases, such as myocarditis, cardiac transplant rejection and myocardial infarction. However, little is known about the effects of macrolides on cardiovascular diseases. We have reported that clarithromycin suppressed the development of myocarditis, cardiac rejection and myocardial ischemia using animal models. In this article, we reviewed the roles of MMPs in cardiovascular diseases and the effects of macrolides on the prevention of adverse tissue remodeling.     

基于PubMed数据库及共词聚类分析的心脏康复研究热点

目的了解近5年国际范围内心脏康复研究的热点及现状,以期对我国心脏康复事业的发展方向起到一定的借鉴和指导作用。方法在PubMed数据库检索2013年11月至2018年11月发表的相关文献,采用Bicomb2.0软件和SPSS 22.0软件对主题词进行词频分析和共词聚类分析。结果共纳入4598篇文献,获得高频主题词81个,通过共词聚类分析总结出心脏康复研究的6个热点:心力衰竭患者的康复、运动能力的评估、心脏康复应用对象及病理生理学、心血管疾病二级预防、心脏康复指南及患者的依从性、心脏康复知信行。结论目前国内、外学者对于心脏康复研究日益增多,研究对象、研究主题趋于多样化,但高质量研究不多。我国可积极探索具有中国特色的心脏康复模式,加强对心血管疾病的二级预防的落实及心脏康复体系的规范化。     

β1肾上腺素受体自身抗体与心血管疾病的研究进展

近年来研究发现自身免疫机制参与心脏损伤,促进了心血管疾病的发生和发展.β1肾上腺素受体自身抗体(β1ARAb)是靶向心脏β1受体的自身抗体,可与心脏β1受体结合,激活相应细胞信号转导途径,在心肌病、心力衰竭、心房颤动等多种心血管疾病中起重要作用.对其作用机制的深入研究,有助于β1ARAb成为心血管疾病新的病因诊断标志物...     

Cardiovascular diseases: protective effects of melatonin

This brief review considers some of the cardiac diseases and conditions where free radicals and related reactants are believed to be causative. The report also describes the beneficial actions of melatonin against oxidative cardiovascular disorders. Based on the data available, melatonin seems to have cardioprotective properties via its direct free radical scavenger and its indirect antioxidant activity. Melatonin efficiently interacts with various reactive oxygen and reactive nitrogen species (receptor independent actions) and it also upregulates antioxidant enzymes and downregulates pro-oxidant enzymes (receptor-dependent actions). Moreover, melatonin enters all cells and subcellular compartments and crosses morphophysiologic barriers. These findings have implications for the protective effects of melatonin against cardiac diseases induced by oxidative stress. Melatonin attenuates molecular and cellular damages resulting from cardiac ischemia/reperfusion in which destructive free radicals are involved. Anti-inflammatory and antioxidative properties of melatonin are also involved in the protection against a chronic vascular disease, atherosclerosis. The administration of melatonin, as a result of its antioxidant features, has been reported to reduce hypertension and cardiotoxicity induced by clinically used drugs. The results described herein help to clarify the beneficial effects of melatonin against these conditions and define the potential clinical applicability of melatonin in cardiovascular diseases.     

Diabetic cardiomyopathy: do women differ from men?

Although many aspects of cardiovascular disease are similar between women and men, it is becoming increasingly obvious that there are significant differences as well. Premenopausal women ususally have a lower risk of cardiovascular diseases than age-matched men and postmenopausal women. However, the “female advantage” disappears once women are affilicted with diabetes mellitus. Heart diseases are twice as common in diabetic men and five times as common in diabetic women. It is believed that differences in sex hormones and intrinsic myocardial and endothelial functions between men and women may be responsible for this female “advantage” and “disadvantage” in normal and diabetic conditions. Most experimental and clinical studies on diabetes only included male subjects and failed to address this important gender difference in diabetic heart complications. Although female hearts may be better tolerated to stress (such as ischemia) insults than their male counterparts, female sex hormone such as estrogen may interact with certain risk factors under diabetes which may compromise the overall cardiac function. The benefit versus risk of estrogen replacement therapy on cardiac function and overall cardiovascular health in diabetes remains controversial. This review will focus on gender-related difference in diabetic heart complication—diabetic cardiomyopathy—and if gender differences in intrinsic myocardial contraction, polyol pathway metabolism, and advanced glycation endproduct formation and other neuroendocrinal regulatory mechanisms to the heart may contribute to disparity in diabetic cardiomyopathy between men and women.     

微小RNA对心脏衰老调控作用的研究进展

心脏衰老及增龄相关的心血管疾病仍是增加社会负担的严峻问题.揭示心脏衰老及衰老相关的心血管疾病的分子机制,为延缓衰老及疾病的早期诊断和治疗开辟了新思路.微小核糖核酸(miRNA)是一类短的非编码RNA,其可在转录后水平参与调控基因的表达.本文将重点介绍miRNA的结构和功能,miRNA对心脏衰老特征表现的影响,miRNA...     

The challenges of cardiac surgery for African children

In Africa the specific pattern of cardiovascular diseases and lack of adequate measures for disease prevention and control result in the frequent need for open-heart surgery for the management of complications of cardiomyopathies in children. Several strategies and innovative ways of providing cardiovascular surgical care in African countries have been used, from agreements to send patients overseas, to programmes for the creation of local services to provide comprehensive care locally. This article attempts to outline the challenges faced by underdeveloped countries in Africa wanting to embark on programmes of cardiac surgery and the need for several sectors of society to play a role in the process. It discusses issues related to the establishment of centres performing cardiac surgery in Africa, describes the treatment of congenital heart disease, and reviews the aspects of management of conditions highly prevalent in or mostly confined to this continent, such as rheumatic heart valve disease and endomyocardial fibrosis.     

空气污染与心率变异性关系的研究进展

心血管疾病是威胁中国居民健康的首要原因,空气污染是影响心血管疾病发生和发展的重要环境危险因素。心率变异性是评价自主神经功能的指标,并且与心血管疾病预后密切相关。研究表明,空气污染可能通过影响心脏自主神经功能而导致心血管疾病的发生,但目前研究结果并不一致。现对国内外空气污染与心率变异性关系的研究现状进行综述。     

2009年心脏病学进展

在2009年度内,心血管疾病防治研究领域取得了一系列研究进展。在冠心病、高血压、心力衰竭、血脂异常、心律失常等方面先后揭晓了一系列重要临床试验结果,为心血管疾病的防治注入了新理念。此外,基于新近获取的临床研究证据,一些权威学术机构更新并颁布了多种指南性文件,为相关疾病的规范化诊断与治疗提供了新依据。     

心源性猝死的遗传学基础研究进展

心源性猝死是多种疾病进展的最终结果,是组织结构、功能代谢以及遗传因素的协同促成的结果。虽然流行病学调查认为年龄、既往心肌梗死,低左心射血分数为心源性猝死的危险因素得到较广泛认同,但在大量心源性猝死事件观察中显示出强烈的遗传倾向。以遗传倾向作为风险评估的认识形成显然有助于对心源性猝死的预测及预防。现着重从流行病学、遗传学及"等位基因结构"疾病研究进展方面详细探讨有潜在高心源性猝死风险的心血管疾病的电生理及解剖结构遗传学基础。     

动脉粥样硬化的表观遗传调控

表观遗传调控指的是在DNA序列不变的情况下基因表达发生的可遗传性改变。目前,已知的表观遗传调控的主要机制包括DNA甲基化、组蛋白修饰和非编码RNA。大量研究证实,在心血管疾病、肿瘤和自身免疫性疾病等方面表观遗传调控发挥着重要作用。近年来,越来越多的研究表明,表观遗传调控在动脉粥样硬化的疾病病程中发挥着重要作用。本文将围绕DNA甲基化、组蛋白修饰和非编码RNA这三种主要的表观遗传调控对血管平滑肌细胞的调节来探讨表观遗传调控在动脉粥样硬化进程中的重要作用。     

HDAC在心脏病理性重构中的调控机制及意义——“精准医学”模式下的潜在干预靶点

心力衰竭(HF)是多种心血管疾病的最终临床转归,其中心脏病理性重构是HF重要的病理生理基础。目前尚缺乏针对心脏病理性重构的特异性治疗手段,因此目前对于HF的治疗尚无法从本质上改变其生物学特性。组蛋白去乙酰化酶(HDACs)作为一种重要的表观遗传调控机制,已经被证实参与调控多条心脏病理性进程通路。同时多种针对特定HDACs的靶向干预药物已经面试,这为HF的治疗提供了全新的视角和思路。本文将对HDACs在心脏病理性重构中的意义及潜在靶向干预靶点进行综述。     

心血管离子通道病的研究现状

心血管离子通道病是离子通道病的重要组成部分。作为原发或继发病因离子通道病变几乎参与了所有的心血管疾病的发生发展过程，是心脏性猝死的主要原因。本文对遗传性心脏离子通道病、获得性心脏离子通道病以及离子通道与血管疾病进行综述，并简要介绍了心血管离子通道病的治疗。