Prognostic implications of left ventricular torsion measured by feature-tracking cardiac magnetic resonance in patients with ST-elevation myocardial infarction.

AIMS: The prognostic implication of left ventricular (LV) torsion on ST-elevation myocardial infarction (STEMI) is unclear. METHODS AND RESULTS: We analysed cardiovascular magnetic resonance (CMR) findings of 420 patients from a registry study (NCT03768453). These patients received CMR examination within 1 week after timely primary percutaneous coronary intervention. LV torsion and other CMR indexes were measured. Compared with healthy control subjects, STEMI significantly decreased patients' LV torsion (1.04 vs. 1.63°/cm, P < 0.001). During follow-up (median, 52 months), the reduction of LV torsion was greater in patients with than without composite major adverse cardiac and cerebrovascular events (MACCEs, 0.79 vs. 1.08°/cm, P < 0.001). The risk of MACCEs would increase to 1.125- or 1.092-fold, and the risk of 1-year LV remodelling would increase to 1.110- or 1.082-fold for every 0.1°/cm reduction in LV torsion after adjustment for clinical or CMR parameters respectively. When divided dichotomously, patients with LV torsion≤ 0.802°/cm had significantly higher risk of MACCEs (40.2 vs. 12.3%, P < 0.001) and more remarkable LV remodelling (46.1 vs. 11.9%, P < 0.001) than patients with better LV torsion. The addition of LV torsion to conventional prognostic factors such as the LV ejection fraction and infarction size led to a better risk classification model of patients for both MACCEs and LV remodelling. Finally, tobacco use, worse post-PCI flow, and greater microvascular obstruction size were presumptive risk factors for reduced LV torsion. CONCLUSION: LV torsion measured by CMR is closely associated with the prognosis of STEMI and would be a promising indicator to improve patients' risk stratification. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov, NCT03768453.

Impact of Concomitant Impairments of the Left and Right Ventricular Myocardial Strain on the Prognoses of Patients With ST-Elevation Myocardial Infarction.

Background: The impact of concomitant impairments of left and right ventricular (LV and RV) strain on the long-term prognosis of acute ST-elevation myocardial infarction (STEMI) is not clear. Methods: We analyzed CMR images and followed up 420 first STEMI patients from the EARLY Assessment of MYOcardial Tissue Characteristics by CMR in STEMI (EARLY-MYO-CMR) registry (NCT03768453). These patients received timely primary percutaneous coronary intervention (PCI) within 12 h and CMR examination within 1 week (median, 5 days; range, 2-7 days) after infarction. Global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) of both ventricles were measured based on CMR cine images. Conventional CMR indexes were also assessed. Primary clinical outcome was composite major adverse cardiac and cerebrovascular events (MACCEs) including cardiovascular death, re-infarction, re-hospitalization for heart failure and stroke. In addition, CMR data from 40 people without apparent heart disease were used as control group. Results: Compared to controls, both LV and RV strains were remarkably reduced in STEMI patients. During follow-up (median: 52 months, interquartile range: 29-68 months), 80 patients experienced major adverse cardiac and cerebrovascular events (MACCEs) including cardiovascular death, re-infarction, heart failure, and stroke. LV-GCS > -11.20% was an independent predictor of MACCEs (P < 0.001). RV-GRS was the only RV strain index that could effectively predict the risk of MACCEs (AUC = 0.604, 95% CI [0.533, 0.674], P = 0.004). Patient with RV-GRS ≤ 38.79% experienced more MACCEs than those with preserved RV-GRS (log rank P < 0.001). Moreover, patients with the concomitant decrease of LV-GCS and RV-GRS were more likely to experience MACCEs than patients with decreased LV-GCS alone (log rank P = 0.010). RV-GRS was incremental to LV-GCS for the predictive power of MACCEs (continuous NRI: 0.327; 95% CI: 0.095-0.558; P = 0.006). Finally, tobacco use (P = 0.003), right coronary artery involvement (P = 0.002), and LV-GCS > -11.20% (P = 0.012) was correlated with lower RV-GRS. Conclusions: The concomitant decrease of LV and RV strain is associated with a worse long-term prognosis than impaired LV strain alone. Combination assessment of both LV and RV strain indexes could improve risk stratification of patients with STEMI. Trial Registration: ClinicalTrials.gov, NCT03768453. Registered 7 December 2018 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03768453.

Selective effect of nispex in inhibiting human cancer cell proliferation and inducing cell apoptosis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the in vitro anticancer effect of Nispex, the total flavonoids extract from Scurrula parasitic L.</p><p><b>METHODS</b>The cell proliferation inhibitory effects of Nispex on various kinds of tumor cells or non-tumor cells in human and rats were detected with MTT assay and colony forming assay respectively, the cell apoptosis induced by Nispex was detected by AO/EB fluorescence staining, TUNEL assay and AnnexinV-FITC/PI flow cytometry.</p><p><b>RESULTS</b>Nispex could significantly inhibit human cancer cell proliferation and induce human cancer cell apoptosis, especially to the proliferative cell group, but its inhibition on human non-tumor cell was insignificant, and showed no effect on murine cancer cells in the tested scope.</p><p><b>CONCLUSION</b>Nispex is a nature plant extract which shows good selectivity for killing human cancer cell.</p>

Study on cytotoxic activities on human leukemia cell line HL-60 by flavonoids extracts of Scurrula parasitica from four different host trees / 中国中药杂志

<p><b>OBJECTIVE</b>To compare the anticancer effects of flavonoids extracts of Scurrula parasitica from different host trees in vitro.</p><p><b>METHOD</b>80% ethanol extracts of S. parasitica parasitizing on Nernium indicum, Morus alba, Opsmanthus fragrans, and Sapindus mulorossi were purified by polyamides column chromatography, and the eluates of 30%, 50%, 70% and 90% ethanol were mixed as flavonoids extracts. Human acute myeloid leukemia cell line HL-60 was used to evaluate the cytotoxicity induced by flavonoids extracts of S. parasitica L with MTT assay. Apoptosis was detected by AO/EB fluorescence staining and DNA fragmentation analysis, apoptosis rates and cell cycle distribution were detected by flow cytometry analysis.</p><p><b>RESULT</b>Extract of S. parasitica parasitizing on N. indicum (NISPEX) was the most sensitive to HL-60 cells of the 4 different host trees, the IC50 value being 0.60 mg x L(-1); and extract of S. parasitica parasitizing on M. alba took the second place, the IC50 value, being 2.49 mg x L(-1); extract of S. parasitica parasitizing on O. fragrans had no effectiveness as high as 50 mg x L(-1) concentration. NISPEX induced HL-60 cell apoptosis and inhibited the cell proliferation in dose and time-dependent manner. Cell cycles were arrested at G0-G1 phase after treated with NISPEX.</p><p><b>CONCLUSION</b>Anticancer effects of S. parasitica correlated with the host trees. Flavonoids extracts of S. parasitica parasitizing on N. indicum exhibited comparatively better anticancer activity in vitro among the host trees studied. NISPEX is found to be a good candidate for anticancer.</p>