心脏脂肪变性与肥胖相关性心脏病

肥胖病是心脏病的危险因素,传统观点认为,在肥胖患者中,由于血流动力学异常和脂代谢异常导致的心脏重构是患者易发展为冠状动脉性疾病和心力衰竭的原因。但最近研究发现,脂肪在心脏沉积可以直接损伤心脏,影响左室重建,导致扩张型心肌病。对肥胖动物模型的研究发现,心肌中脂质过度沉积可导致左室肥厚和缺血性、扩张型心肌病。通过基因治疗或药物干预降低心脏的脂质沉积,可以预防肥胖相关性心脏病的发生。临床研究也提示,心肌的脂质含量可以作为肥胖患者心脏病的生物指标,并且可以成为治疗的靶点。但这方面的研究才刚刚开始,有待进一步的研究。     

Relationship Between Heart Failure and Overactive Bladder

The prevalence of heart failure and overactive bladder, both of which are already quite common, will continue to increase as the population ages. Both create caregiver and self-management burdens, but additional research is needed to understand the burden overactive bladder creates for heart failure patients and their caregivers. Emerging evidence suggests a relationship between heart failure and overactive bladder in which they share a common pathophysiologic pathway via the parasympathetic system. The authors conducted a systematic literature review of overactive bladder in heart failure patients from 2007 to the present. Conflicting evidence exists for the role diuretics play in the prevalence of overactive bladder. Further research is needed to better understand the role of heart failure disease trajectory and its medical management in the natural history of overactive bladder.     

High-Sensitivity Troponin T and Incident Heart Failure in Older Men: British Regional Heart Study

Objective

The aim of this work was to study the association of high-sensitivity troponin T (hsTnT) with incident heart failure (HF), and implications for its use in prediction models.

瘦素与冠心病发病关系研究进展

自瘦素发现以来,人们对体内脂肪组织进行了大量的基础及临床研究,血清瘦素与冠心病的关系也受到广泛关注。大多数人的研究都支持高血清瘦素与冠心病的发生有密切关系,瘦素可通过多种途径参与,影响冠心病的发生和发展。现就瘦素与冠心病的发病关系作一综述。     

冠心病与同型半胱氨酸的相关性

近年来发现约 5 0 %的冠心病患者缺乏高血压、糖尿病、高脂血症及吸烟等传统的危险因素 ,而部分患者伴同型半胱氨酸的增高 ,同型半胱氨酸与冠心病发病之间的相关性正日益受到人们的关注。本文就同型半胱氨酸的代谢及其影响因素、与冠心病的关系、致动脉粥样硬化的机制及其防治等方面对其作一综述。     

血尿酸与心血管疾病关系的研究进展

血尿酸和心血管疾病之间的关系多年来一直存在争议。现综述近6年与此相关的流行病学资料和实验性研究结果,在心血管疾病高危人群中目前多数流行病学资料显示尿酸与心血管疾病之间独立相关,尽管这种相关性在健康人群中不如心血管疾病高危人群中强,10个研究中有6个显示血尿酸与心血管疾病之间独立相关。数个实验性研究提示血尿酸在心血管疾病的发病机制中可能有直接致病作用。     

血尿酸与心血管疾病的发生、发展及预后关系

近年来,越来越多的研究表明血尿酸在冠心病、高血压和心力衰竭的发生、发展过程中起重要作用.但是二者之间是否存在独立相关的关系及其相互作用的具体机制一直未能达成共识.现复习了血尿酸与冠心病、高血压、心力衰竭的关系及其作用机制的相关文献.到目前为止,尽管仍不能证明血尿酸可以作为心血管疾病的独立危险因子,但它确实可以作为心血管疾病的一个重要的预测因子.     

The Relationship Between HIV Infection and Cardiovascular Disease

Over 30 million people are currently living with human immunodeficiency virus (HIV) infection, and over 2 million new infections occur per year. HIV has been found to directly affect vascular biology resulting in an increased risk of cardiovascular disease compared to uninfected persons. Although HIV infection can now be treated effectively with combination antiretroviral medications, significant toxicities such as hyperlipidemia, diabetes, and excess cardiovascular co-morbidity; as well as the potential for significant drug-drug interactions between HIV and cardiovascular medications, present new challenges for the management of persons infected with HIV. We first review basic principles of HIV pathogenesis and treatment and then discuss relevant clinical management strategies that will be useful for cardiologists who might be involved in the care of HIV infected patients.Key Words: HIV, cardiology, treatment, natural history, review.     

血管生成素样蛋白6在心血管病方面的研究进展

血管生成素样蛋白6(ANGPTL6)作为一种肝细胞源性蛋白因子,能增加能量消耗抵抗肥胖;改善胰岛素敏感,降低胰岛素抵抗;促进表皮细胞再生;参与线粒体氧化磷酸化调节;同时改善缺血小鼠肢体再灌注,大大降低截肢风险,减低远期心血管并发症风险。许多研究提出ANGPTL6对糖尿病、肥胖和代谢综合征具有早期预测作用,在下肢动脉疾病和子痫患者血清中高表达。现就其与心血管性疾病相互关系做一综述。     

心血管疾病与患者心理状态的相关性

心血管疾病与患者的心理状态密切相关,心血管疾病可引起和加重抑郁和焦虑症,而抑郁和焦虑也可诱发和加重心血管疾病。     

Rho激酶抑制剂与心力衰竭关系的研究进展

Rho激酶抑制剂通过抑制钙敏化效应,抑制炎细胞的迁移和浸润,增加内皮型一氧化氮合成酶的表达等机制扩张冠状动脉血管,减少炎症介质的产生,促进一氧化氮生成,保护损伤心肌组织,抑制心室重构,从而达到改善心力衰竭的作用。现简要心力衰竭与Rho激酶抑制剂关系的研究进展。     

心力衰竭患儿心率变异与心功能关系的探讨（附30例报告）

对３０例心力衰竭（下称心衰）患儿和３０例健康儿童的心率变异（ＨＲＶ）进行了检测。结果显示：心衰患儿心率变异性小,体位变化对心率变异性影响小,心衰表现重者的ＨＲＶ小于心衰轻者,射血分数（ＥＦ）和ＨＲＶ系数呈直线正相关（Ｐ〈０．００１）,与高频成分呈直线正相关（Ｐ〈０．００１）,ＥＦ与低频成分呈直线正相关（Ｐ〈０．０１）,认为ＨＲＶ可反映心衰时自主神经功能情况,并与心功能密切相关。     

Hospital-Level Variation in Use of Cardiovascular Testing for Adults With Incident Heart Failure: Findings From the Cardiovascular Research Network Heart Failure Study

ObjectivesThis study aimed to characterize the use of cardiovascular testing for patients with incident heart failure (HF) hospitalization who participated in the National Heart, Lung, and Blood Institute sponsored Cardiovascular Research Network (CVRN) Heart Failure study.BackgroundHF is a common cause of hospitalization, and testing and treatment patterns may differ substantially between providers. Testing choices have important implications for the cost and quality of care.MethodsCrude and adjusted cardiovascular testing rates were calculated for each participating hospital. Cox proportional hazards regression models were used to examine hospital testing rates after adjustment for hospital-level patient case mix.ResultsOf the 37,099 patients in the CVRN Heart Failure study, 5,878 patients were hospitalized with incident HF between 2005 and 2008. Of these, evidence of cardiovascular testing was available for 4,650 (79.1%) patients between 14 days before the incident HF admission and ending 6 months after the incident discharge. We compared crude and adjusted cardiovascular testing rates at the hospital level because the majority of testing occurred during the incident HF hospitalization. Of patients who underwent testing, 4,085 (87.9%) had an echocardiogram, 4,345 (93.4%) had a systolic function assessment, and 1,714 (36.9%) had a coronary artery disease assessment. Crude and adjusted testing rates varied markedly across the profiled hospitals, for individual testing modalities (e.g., echocardiography, stress echocardiography, nuclear stress testing, and left heart catheterization) and for specific clinical indications (e.g., systolic function assessment and coronary artery disease assessment).ConclusionsFor patients with newly diagnosed HF, we did not observe widespread overuse of cardiovascular testing in the 6 months following incident HF hospitalization relative to existing HF guidelines. Variations in testing were greatest for assessment of ischemia, in which testing guidelines are less certain.     

铁代谢与心力衰竭关系的研究进展

心力衰竭(心衰)是由各种原因导致的心脏疾病的终末阶段,为当今社会常见的严重疾病,具有发病率高和死亡率高的特点.铁是人体必须的微量元素之一,以离子形式存在于肝、脾、肾、心、骨骼肌和脑等组织中,广泛参与人体的多种生理活动,而铁的代谢平衡是维持人体生命活动的重要部分.多项研究发现铁的代谢与心衰存在一定关系,影响心衰患者的疾病...     

血糖正常冠心病患者颈动脉与冠状动脉病变相关性分析

目的探讨血糖正常冠心瘸患者颈动脉粥样硬化对冠状动脉病变的预测价值。方法对177例确诊为冠心病的非糖尿病患者行颈动脉超声榆杏,依颈动脉超声结果分为颈动脉有斑块组与颈动脉无斑块组,冠状动脉造影结果使用Gensini评分。比较两组间Gensini评分,蚪根据有尤颈动脉粥样硬化预测冠心病的病变严重情况。结果两组问Gensini评分的对数值有显著差别．．有斑块组显著高于兀斑块组（P=0．017）,相关分析显示,颈动脉厚度与冠脉狭窄程度间无明显的线性关系,并不是颈动脉内中膜越厚,冠脉狭窄程度越严重。结论以l：提示颈动脉俐样硬化是冠状动脉粥样硬化有价值的预测因素,通过出现颈动脉粥样硬化可预测冠状动脉病变的仔在及其严重程度．但颈动脉粥样硬化程度勺冠脉病变严重程度无线性相关。     

Electrophysiologic Considerations in Congenital Heart Disease and Their Relationship to Heart Failure

Current survival rates for complex forms of congenital heart disease (CHD) are excellent, allowing for an ever-growing population of adult survivors. Previous interventions and complex physiology, including the systemic right ventricle and single ventricle circulations, predispose these patients to heart failure and arrhythmias. The relationship between arrhythmias and heart failure in CHD is complex: cause and effect are not always readily separated. Therefore, the assessment and management of these patients requires an understanding of the relationship between the 2, with careful review of risk factors and arrhythmia substrates. Several forms of CHD predispose to arrhythmias even in the absence of surgical intervention because of abnormalities of the conduction system and intrinsic structural malformations. Surgical interventions might result in sinus node dysfunction and propensity for supraventricular and ventricular arrhythmias. Arrhythmias are important risk factors for sudden death in the CHD population. Device therapies directed at maintaining chronotropic competence, cardiac resynchronization, and preventing sudden death are increasingly used. These challenges unique to CHD underscore recommendations for such complex patients to be referred to specialized centres with expertise in managing CHD and its complications. In this review, we explore the complex interplay between arrhythmogenesis, CHD, and heart failure.     

心血管疾病与心肌微血管病变关系研究现状

心血管疾病与心肌微血管病变关系密切,现对心肌微血管病变原因、机制及防治进展进行探讨,以提高对心肌微血管病变的认识水平。