Research Progress on the Cardiotoxicity of EGFR-TKIs in Non-Small Cell Lung Cancer.

OPINION STATEMENT: With the development of molecular biology and histology techniques, targeted therapy for non-small cell lung cancer (NSCLC) has emerged, which is highly effective and has marginal side effects. Epidermal growth factor receptor (EGFR) was the first driver gene discovered, whose three generations of therapeutic use have its characteristics and benefits in clinical practice. However, cardiovascular complications by EGFR-tyrosine kinase inhibitors (EGFR-TKIs) in preclinical studies have been increasingly reported, including heart failure, cardiomyopathy, and QT prolongation, among others. Cardiotoxicity of targeted drugs significantly affects the therapeutic effect of NSCLC and has become the second leading cause of death in NSCLC. The aim of the present review was to recognize the potential cardiotoxicity of third-generation targeted drugs in the treatment of NSCLC and their associated mechanisms to help clinicians identify and prevent it early in the treatment, minimize the cardiotoxicity of targeted drugs, and improve the therapeutic effect of patients.

Effect of Ti3SiC2 and Ti3AlC2 Particles on Microstructure and Wear Resistance of Microarc Oxidation Layers on TC4 Alloy.

Microarc oxidation (MAO) layers were prepared using 8g/L Na2SiO3 + 6g/L (NaPO3)6 + 4g/L Na2WO4 electrolyte with the addition of 2g/L Ti3SiC2/Ti3AlC2 particles under constant-current mode. The roughness, porosity, composition, surface/cross-sectional morphology, and frictional behavior of the prepared MAO layers were characterized by 3D real-color electron microscopy, scanning electron microscopy, X-ray energy spectrometry, X-ray diffractometry, and with a tribo-tester. The results showed that the addition of Ti3SiC2 and Ti3AlC2 to the electrolyte reduced the porosity of the prepared layers by 9% compared with that of the MAO layer without added particles. The addition of Ti3SiC2/Ti3AlC2 also reduced the friction coefficient and wear rate of the prepared layers by 35% compared with that of the MAO layer without added particles. It was found that the addition of Ti3AlC2 particles to the electrolyte resulted in the lowest porosity and the lowest wear volume.

Catheter ablation of atrial fibrillation in patients with heart failure and preserved ejection fraction: A meta-analysis.

BACKGROUND: Catheter ablation (CA) is an effective treatment for patients with atrial fibrillation (AF). The potential of CA to benefit AF patients with heart failure and preserved ejection fraction (HFpEF) is uncertain. HYPOTHESIS: CA may be safe and effective for patients with HFpEF. METHODS: The Medline, PubMed, Embase, and Cochrane Library databases were searched for studies evaluating CA for AF patients with HFpEF. RESULTS: A total of seven trials with 1696 patients were included. Pooled analyses demonstrated similar procedure and fluoroscopy time regarding the use of CA for patients with HFpEF and without HF (weighted mean difference [WMD]: 0.40; 95% confidence interval (CI): -0.01-0.81, p = .05 and [WMD: 0.05; 95% CI: -0.18-0.28, p = .68]). Moreover, CA was effective in maintaining sinus rhythm (SR) in patients with HFpEF and noninferior for patients without HF [risk ratio (RR): 0.92; 95% CI: 0.76-1.10, p = .34). Additionally, CA tended to significantly maintain SR (RR: 4.73; 95% CI: 1.86-12.03, p = .001) and reduce rehospitalization for HF compared with medical therapy (RR: 0.36; 95% CI: 0.19-0.71, p = .003). However, no significant differences were found between two groups regarding the mortality rate (p = .59). CONCLUSION: CA is a potential treatment strategy for patients with HFpEF and demonstrates equivalent efficacy to that of patients without HF. Moreover, the benefits of CA in maintaining SR and reducing rehospitalization of HF patients were significantly better than those of medical therapy. Additional randomized controlled trials are warranted to confirm our results.

Natural products from traditional Chinese medicine for the prevention and treatment of heart failure: progress and perspectives.

Heart failure (HF) is the end stage of several cardiovascular diseases with high mortality worldwide; however, current chemical drugs have not beneficial effect on reducing its mortality rate. Due to its properties of multiple targets components with multiple targets, natural products derived from traditional Chinese medicine (TCM) have exerts unique effects on the amelioration of the clinical symptoms of HF, yet, TCM is not widely used in the clinic since the potential therapeutic targets have not been fully investigated. Therefore, in this review, we briefly summarized the pathophysiological mechanism of HF and reviewed the published clinical evaluations of TCM and natural products from Chinese herbs to treat HF. Then, the therapeutic potential and the underlying mechanisms by which the natural products from Chinese herb exert their protective effects were further summarized. We concluded from this review that natural products from Chinese herbs have been shown to be more effective in treating HF by targeting multiple signaling pathways, including anticardiac hypertrophy, antifibrotic, anti-inflammatory, antioxidative and antiapoptotic activities. However, the major limitations of these compounds is that there are a lack of large scale, multicenter, randomized and controlled clinical trials for their use in treatment of HF, and the toxic effects of natural products from Chinese herbs also needed further investigation. Despite these limitations, further clinical trials and experimental studies will provide a better understanding of the mechanism of natural products from Chinese herbs and promote their wide use to treat HF.