Mitochondrial DNA (mtDNA) is the circulating genome in mitochondria, and it is easy to accumulate oxidative damage, causing mitochondrial dysfunction, and then cell dysfunction, and even tissue and body pathological changes, leading to diseases. As a pro-inflammatory, inflammatory, and even predictive factor, mtDNA is directly involved in the inflammatory response and the pathogenesis of many diseases. This article aims to review the current pathogenesis of mtDNA damage and its pathogenic role in various human diseases.
ObjectiveThrough comparing the efficacy of levosimendan with dopamine for severe valvular disease patients with atrial fibrillation surgery to explore the efficacy and safety of levosimendan used in cardiac surgery. MethodsWe allocated 48 severe valvular disease patients with atrial fibrillation surgery into a dopamine group (24 patients with 15 males and 9 females at age of 55.0 ± 17.4 years) and a levosimendan group (24 patients with 18 males and 6 females at age of 52.3 ± 16.2 years) by random digital table in the Affiliated Hospital of Luzhou Medical College between February and June 2014. The effects of the two groups were compared. ResultsHospitalization time (18.7±8.6 d vs 20.6±7.5 d, t=11.52, P=0.02) and the incidence of acute kidney injury(1/24 vs 5/24, χ2=25.30, P=0.01) in the levosimendan group were lower than those in the dopamine group. There was no statistical difference between the two groups in other early clinical outcomes. At each postoperative time point, there was no statistical difference in creatine kinase isoenzyme (CK-MB) between the two groups. While 6 to 48 hours after operation, there were significant differences in cardiac troponin (cTnI) and brain natriuretic peptide(BNP) level between the two groups (P < 0.05). Five days after operation, the left ventricular ejection fraction(LVEF) in the levosimendan group was higher than that in the dopamine group with statistical difference. ConclusionLevosimendan used for severe valvular disease with atrial fibrillation surgery is safe and effective, and has certain myocardial protection and renal protection effect, while its mechanism still needs further study.
The patient is a 71-year-old male with esophageal cancer and aortic vavle regurgitation. At present, the treatment strategy of such patients is controversial. For the elderly patients with esophageal cancer who do not need neoadjuvant treatment, considering the risk of cardiopulmonary bypass and the potential risk of esophageal cancer metastasis, we have successfully implemented apical catheter aortic valve implantation and minimally invasive three-incision thoracolaparoscopy combined with radical resection of esophageal cancer (McKeown) at the same period.