The Effectiveness of the Smartphone-Based WeChat Platform on Reducing Time to Diagnosis and Treatment of ST-segment Elevation Myocardial Infarction.

Background: This study evaluated the effectiveness of the smartphone-based WeChat platform in reducing the ischemia time of ST-segment elevation myocardial infarction (STEMI). Methods: A total of 198 STEMI patients who underwent primary percutaneous coronary intervention (PCI) from January 2022 to August 2022 in our hospital were enrolled in this retrospective cohort study. Patients were divided into two groups according to whether their electrocardiograms (ECGs) were posted on the WeChat platform. The two groups were compared for the following: diagnosis time of first ECG, time from first medical contact (FMC) to catheterization laboratory (CL) activity, bypass emergency department (ED) or critical care unit (CCU), time of door to wire, time of door to balloon, time of FMC to wire, heart failure during hospitalization, cardiogenic shock during hospitalization, malignant arrhythmia during hospitalization, death during hospitalization, total hospital cost, and length of stay. Results: The diagnosis time for the first ECG was 10.05 ± 3.30 mins in the control group and 2.50 ± 0.82 mins in the WeChat group (p < 0.05). The time from FMC to CL activity was significantly shorter in the WeChat group compared to the control group (p < 0.05). None of the control group patients bypassed the ED, compared to 80 (80%) of patients in the WeChat group (p < 0.05). The time from door to wire was 60.22 ± 12.73 mins in the WeChat group and 92.56 ± 20.23 mins in the control group (p < 0.05). The time of FMC to wire was also significantly shorter in the WeChat group than in the control group (p < 0.05). The WeChat group had a significantly lower rate of heart failure during hospitalization than the control group (p < 0.05). However, the two groups showed no significant differences for cardiogenic shock during hospitalization, malignant arrhythmia during hospitalization, death during hospitalization, total hospital cost, and length of stay. Conclusions: The smartphone-based WeChat platform demonstrated high efficacy and accessibility in reducing the ischemia time for STEMI patients. Our results indicate that social media platforms such as WeChat could be a useful approach for improving the prognosis of cardiovascular disease.

A novel biosensor-based microarray assay for the visualized detection of CYP2C19 *2, *3, *4 and *5 polymorphisms.

BACKGROUND: A number of studies have indicated that the conversion of clopidogrel to its active metabolite is reduced in patients who carry the CYP2C19 *2, *3, *4 or *5 loss-of-function allele, resulting in decreased response of platelet to clopidogrel treatment and worse cardiovascular outcome. The aim of this study was to develop a novel biosensor-based microarray to visually detect CYP2C19 polymorphisms. METHODS: The target DNA was amplified from regions flanking the respective alleles using 5'-biotinylated reverse primer, and plasmids were prepared for the respective alleles. High stringency reversed hybridization, horseradish peroxidase-labeled streptavidin reaction, and color development, with multiple washes in different steps, were carried out and the results were recorded with an optical camera. The gene chips were tested for specificity, detection limit, intra- and inter-batch variations using the constructed plasmids. Finally, 88 clinical samples were assayed with this microarray as well as direct sequencing. RESULTS: The results could be seen with the naked eye. Concordance tests indicated that for alleles *2, *3, *4, and *5, the κ values between this assay and plasmids all reached 1.000. The detection limit was 5×10² cells/mL. Concordance test between direct sequencing and the microarray assay using 88 clinical samples gave rise to the κ value of 0.983, and p<0.01, indicating very high concordance. CONCLUSIONS: This novel biosensor-based microarray assay can amplify the signal in situ so that it can be detected by simple instruments or even the naked eyes. It is promising for clinical application in hospital laboratories.

A novel variation of GDF3 in Chinese Han children with a broad phenotypic spectrum of non-syndromic CHDs.

BACKGROUND: The GDF3 gene plays a fundamental role in embryonic morphogenesis. Recent studies have indicated that GDF3 plays a previously unrecognised role in cardiovascular system development. Non-syndromic CHDs might be a clinically isolated manifestation of GDF3 mutations. The purpose of the present study was to identify potential pathological mutations in the GDF3 gene in Chinese children with non-syndromic CHDs, and to gain insight into the aetiology of non-syndromic CHDs. METHODS: A total of 200 non-syndromic CHDs patients and 202 normal control patients were sampled. There were two exons of the human GDF3 gene amplified using polymerase chain reaction. The polymerase chain reaction products were purified and directly sequenced. RESULTS: One missense mutation (c.C635T, p.Ser212 Leu, phenotype: isolated muscular ventricular septal defect) was found that has not been reported previously. CONCLUSIONS: To the best of our knowledge, this is the first study to investigate the role of the GDF3 gene in non-syndromic CHDs. Our results expand the spectrum of mutations associated with CHDs and first suggest the potentially disease-related GDF3 gene variant in the pathogenesis of CHDs.

Prevalence and Pattern of Congenital Heart Diseases in School Children in Dongguan, China.

BACKGROUND: To determine the prevalence and pattern of congenital heart disease (CHD) among elementary school children in Dongguan, China. METHODS: Between November 2011 and November 2012, 540,574 school children from 449 elementary schools were screened for CHD by trained doctors in Dongguan. The school children who were suspected to have CHD were referred to a pediatric cardiologist and/or an echocardiographer for a complete evaluation. RESULTS: The total prevalence of CHD was 2.14 per 1,000 school children (1,157/540,574). The most common form of CHD was isolated ventricular septal defect (37.77%; 437/1,157), followed by isolated atrial septal defect (20.22%; 234/1,157) and patent ductus arteriosus (9.94%; 115/1,157). With respect to sex, CHD was equally distributed between males and females. CONCLUSION: Our data show that the prevalence of CHD in Dongguan is not as high as expected and that isolated ventricular septal defect is the predominant pathology. Echocardiography plays a crucial role in the diagnosis of CHD.

The WeChat platform-based health education improves health outcomes among patients with stable coronary artery disease.

OBJECTIVE: The aim of this study was to evaluate the effect of the WeChat platform-based health education on patients with stable coronary artery disease (CAD) compared with usual care. METHODS: We conducted a randomized controlled trial that included patients with stable CAD who were admitted to the Bin Hai Wan Central Hospital of Dongguan between January 2020 and December 2020. Participants in the control group received a standard regimen of care. In the WeChat group, the patients were provided with the WeChat platform-based health education by multidisciplinary team members in addition to usual care. The coprimary outcome of the study was the blood pressure, lipid profile, fasting blood glucose, Hamilton Anxiety Scale (HAMA) scores, Hamilton Depression Scale (HAMD) scores and Seattle Angina Questionnaire (SAQ) scores at 12 months, relative to baseline levels. RESULTS: Between January 2020 and December 2020, 200 eligible CAD patients were randomly assigned to WeChat group (n = 100) or usual care group (n = 100). After 12 months, the number of participants who knew the risk factors, symptoms, diagnostic criteria, management methods and treating target of CAD was significantly larger in the WeChat group than at baseline (P < 0.05) and also larger than the post-intervention level of the control group (P < 0.05). The systolic blood pressure after intervention of the WeChat group significantly decreased compared to those of the control group (132.06 ± 8.87 mmHg vs 140.32 ± 9.42 mmHg; P < 0.05). After intervention, the triglycerides, total cholesterol, and low-density lipoprotein cholesterol of the WeChat group significantly decreased compared to those at baseline and significantly decreased than those in the control group (all P < 0.05). After the intervention, scores of HAMA and HAMD both significantly decreased in the two groups. Moreover, the decreases were more significant in the WeChat group than in the control group (5.78 ± 0.98 vs 8.54 ± 1.24; 6.27 ± 1.03 vs 8.63 ± 1.66; P < 0.05). The SAQ scores of WeChat group were significantly higher than those of the control group in all 5 dimensions at the 1-year follow-up (72.71 ± 10.83 vs 59.32 ± 9.86; 80.01 ± 11.56 vs 61.98 ± 11.02; 76.76 ± 12.64 vs 65.22 ± 10.72; 83.17 ± 13.06 vs 67.01 ± 12.86; 71.82 ± 12.78 vs 55.79 ± 11.90; all P < 0.05). CONCLUSION: This study showed the high efficacy of the WeChat platform-based health education in improving health outcomes in patients with CAD. PRACTICE IMPLICATIONS: This study highlighted the potential of social media as a helpful tool for health education among patients with CAD.

Congenital Heart Disease in Local and Migrant Elementary Schoolchildren in Dongguan, China.

The aim of this study was to determine the prevalence and treated status of congenital heart disease (CHD) in elementary schoolchildren and facilitate the long-term planning of health care, resource allocation, and development of targeted primary prevention strategies. From November 2011 to November 2012, 540,574 schoolchildren from 449 elementary schools were screened for CHD by trained doctors in Dongguan City. The schoolchildren who were suspected to have CHD were referred to a pediatric cardiologist and/or an echocardiographist for complete evaluation. Of them, 214,634 (39.7%) were local children and 325,940 (60.3%) were migrant children. The total prevalence of CHD was 2.14‰, and there was a significant difference (p <0.05) of the CHD prevalence between local (1.97‰) and migrant children (2.26‰). The treatment rates of CHD in local children and in migrant children were 63.51% and 47.21%, respectively (p <0.01). The commonest CHD was ventricular septal defect (43.13%), followed by atrial septal defect (25.84%) and patent ductus arteriosus (12.79%). With respect to gender, CHD was equally distributed between men and women. In conclusion, social, economic, and environmental risk factors that affect health of migrant children with CHD call for more attention from health policy makers and researchers in contemporary China. Efforts should be made to increase public health investment, establish health care manage system for children from migrant families, and increase the parents' awareness of preventing the CHD.