Objective To explore the key genes, pathways and immune cell infiltration of bicuspid aortic valve (BAV) with ascending aortic dilation by bioinformatics analysis. Methods The data set GSE83675 was downloaded from the Gene Expression Omnibus database (up to May 12th, 2022). Differentially expressed genes (DEGs) were analyzed and gene set enrichment analysis (GSEA) was conducted using R language. STRING database and Cytoscape software were used to construct protein-protein interaction (PPI) network and identify hub genes. The proportion of immune cells infiltration was calculated by CIBERSORT deconvolution algorithm. Results There were 199 DEGs identified, including 19 up-regulated DEGs and 180 down-regulated DEGs. GSEA showed that the main enrichment pathways were cytokine-cytokine receptor interaction, pathways in cancer, regulation of actin cytoskeleton, chemokine signaling pathway and mitogen-activated protein kinase signaling pathway. Ten hub genes (EGFR, RIMS3, DLGAP2, RAPH1, CCNB3, CD3E, PIK3R5, TP73, PAK3, and AGAP2) were identified in PPI network. CIBERSORT analysis showed that activated natural killer cells were significantly higher in dilated aorta with BAV. Conclusions These identified key genes and pathways provide new insights into BAV aortopathy. Activated natural killer cells may participate in the dilation of ascending aorta with BAV.
Objective To explore the role of systolic and diastolic dysfunction in the prognosis of Chinese patients with coronary artery disease (CAD). Methods CAD patients who underwent coronary arteriography in the Department of Cardiology of West China Hospital between July 2008 and June 2012 were included in this study. All the patients underwent color Doppler echocardiographic examination. Based on patients’ systolic and diastolic cardiac function, left ventricular ejection fraction (LVEF) <55% was as the systolic dysfunction and the ratio of mitral peak velocity of early filling to early diastolic mitral annular velocity (E/e’) >15 was as the diastolic dysfuntion. They were divided into normal cardiac function group (LVEF≥55%, E/e’ ratio≤15), systolic and diastolic dysfunction group (LVEF<55%, E/e’ ratio>15), diastolic dysfunction group (LVEF≥55%, E/e’ ratio>15) and systolic dysfunction group (LVEF<55%, E/e’ ratio≤15). The end points of follow-up were all-cause death and a major cardiovascular event (MACE). Results A total of 985 patients with complete echocardiographic report were included in this study. During the follow-up of (21.4±9.7) months, 46 patients (4.7%) died, and 52 (5.4%) had a MACE. Systolic dysfunction concomitant with diastolic dysfunction group and systolic dysfunction group patients had a higher risk of 36-month all-cause death (4.8%, 10.7%,P<0.001) and a higher risk of 41-month MACE (8.6%, 7.6%,P=0.028). Single factor analysis of all-cause death mortality showed that compared with the normal group, all-cause death mortality was the highest in systolic and diastolic dysfunction group (P<0.05), followed by diastolic dysfunction group (P<0.05) and systolic dysfunction group (P>0.05). Single factor analysis of MACE showed that compared with the normal group, MACE was still the highest in systolic and diastolic dysfunction group (P<0.05), followed by systolic dysfunction group (P<0.05) and diastolic dysfunction group (P>0.05). A multivariate Cox regression model analysis showed that compared with the normal group, the risk of all-cause death was the highest in the systolic and diastolic dysfunction group [hazard ratio (HR)=2.96, 95% confidence interval (CI) (1.34, 6.54),P=0.007], followed by the systolic dysfunction group [HR=1.91, 95%CI (0.67, 5.42),P=0.224] and the diastolic dysfunction group [HR=0.95, 95%CI (0.40, 2.23),P=0.905]. Conclusion Compared with normal patients, patients with either systolic or diastolic dysfunction have a poorer prognosis, and patients with systolic dysfunction concomitant with diastolic dysfunction have the poorest prognosis.
Objective To explore the effect of antihypertensive therapy for hypertension patients from plateau area. Method A retrospective analysis of medical records for Tibetan patients with hypertension from October to December 2013 in Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region. Results The study recruited 165 patients. The rate of treatment, control, and compliance of hypertension patients were 86.7% (143/165), 23.8% (34/143), 43.4% (62/143), respectively. The main characteristics of hypertension treatment were higher proportions of single-drug therapy (81.1%, 116/143); among those the Tibetan drug (24.1%), calcium channel blockers (21.6%), diuretics (19.0%), and traditional compound preparation (18.1%) were most commonly used in the antihypertensive therapy. Conclusions The rate of treatment was high, but the rate of control and compliance were low in Tibetan patients with hypertension. It was necessary to carry out hypertension education to patients and strengthen the training of doctors at the plateau.
Objective To explore the risk factors for long-term death of patients with acute myocardial infarction (AMI) and reduced left ventricular ejection fraction (LVEF), and develop and validate a prediction model for long-term death. Methods This retrospective cohort study included 1013 patients diagnosed with AMI and reduced LVEF in West China Hospital of Sichuan University between January 2010 and June 2019. Using the RAND function of Excel software, patients were randomly divided into three groups, two of which were combined for the purpose of establishing the model, and the third group was used for validation of the model. The endpoint of the study was all-cause mortality, and the follow-up was until January 20th, 2021. Cox proportional hazard model was used to evaluate the risk factors affecting the long-term death, and then a prediction model based on those risk factors was established and validated. Results During a median follow-up of 1377 days, 296 patients died. Multivariate Cox regression analysis showed that age≥65 years [hazard ratio (HR)=1.842, 95% confidence interval (CI) (1.067, 3.179), P=0.028], Killip class≥Ⅲ[HR=1.941, 95%CI (1.188, 3.170), P=0.008], N-terminal pro-brain natriuretic peptide≥5598 pg/mL [HR=2.122, 95%CI (1.228, 3.665), P=0.007], no percutaneous coronary intervention [HR=2.181, 95%CI (1.351, 3.524), P=0.001], no use of statins [HR=2.441, 95%CI (1.338, 4.454), P=0.004], and no use of β-blockers [HR=1.671, 95%CI (1.026, 2.720), P=0.039] were independent risk factors for long-term death. The prediction model was established and patients were divided into three risk groups according to the total score, namely low-risk group (0-2), medium-risk group (4-6), and high-risk group (8-12). The results of receiver operating characteristic curve [area under curve (AUC)=0.724, 95%CI (0.680, 0.767), P<0.001], Hosmer-Lemeshow test (P=0.108), and Kaplan-Meier survival curve (P<0.001) showed that the prediction model had an efficient prediction ability, and a strong ability in discriminating different groups. The model was also shown to be valid in the validation group [AUC=0.758, 95%CI (0.703, 0.813), P<0.001]. Conclusions In patients with AMI and reduced LVEF, age≥65 years, Killip class≥Ⅲ, N-terminal pro-brain natriuretic peptide≥5598 pg/mL, no percutaneous coronary intervention, no use of statins, and no use of β-blockers are independent risk factors for long-term death. The developed risk prediction model based on these risk factors has a strong prediction ability.