Evaluation of the effect of kidney transplantation on left ventricular myocardial work by noninvasive pressure-strain loops.

Purpose: Kidney transplantation (KT) has the potential to reverse the cardiac changes caused by end-stage renal disease, and it may be inaccurate to analysis the left ventricular function by conventional echocardiography due to afterload. This study aimed to investigate the utility of pressure strain loops (PSLs) in evaluating left ventricular performance in patients underwent KT. Methods: We enrolled 60 patients with end-stage renal disease who underwent KT between January 2022 and July 2023, and 60 healthy controls with a similar distribution of gender and age to the patients. All participants underwent conventional echocardiography and three-dimensional speckle tracking echocardiography (3D-STE). Long axis, short axis, and four cavity images were collected and cardiac parameters were measured. The echocardiographic changes of cardiac structure and function of all patients before KT and about 12 months after KT were recorded. Left ventricular myocardial work parameters were acquired by PSLs, including the global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE) and global longitudinal strain (GLS). In addition, the correlation between PSLs and clinical data were explored. Results: Compared with controls, the conventional echocardiographic parameters, myocardial function indicators GWI and GCW appeared no difference in post-KT group, while the GWE and GLS decreased (p < 0.05), and the GWW increased (p < 0.05). Compared with pre-KT, the GLS, GWI, GCW and GWE increased in post-KT group, while the GWW decreased (all p < 0.05). The above indicators were correlated with left ventricular GLS and left ventricular ejection fraction. Conclusion: PSLs were more sensitive than traditional echocardiographic indicators in detecting changes in myocardial work and predicting left ventricular myocardial damage. This indicator could quantitatively evaluate myocardial work and provide a new and reliable non-invasive reference for clinical diagnosis and treatment of patients underwent KT.

The Correlation Between Cardiac Oxidative Stress and Inflammatory Cytokine Response Following Myocardial Infarction.

Our study was conducted to investigate the potential correlation between cardiac oxidative stress and inflammatory cytokine response following myocardial infarction. A total of 120 patients harboring acute myocardial infarction who underwent percutaneous coronary intervention (PCI) at our hospital were included. Their general clinical data were analyzed, and comparisons were made regarding the levels of inflammatory factors, oxidative stress markers, heart pump function, and cardiac function. The correlation between cardiac oxidative stress and inflammatory cytokine response was assessed using Pearson's linear correlation. Following treatment, significant reductions were seen in the serum levels of cortisol, thyroid-stimulating hormone (TSH), B-type natriuretic peptide (BNP), C-reactive protein (CRP), signal transducer and activator of transcription 3 (STAT3), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor (TNF), and catalase (CAT) compared to pre-treatment levels. Conversely, the levels of growth hormone (GH), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), total antioxidant capacity (T-AOC), cardiac output (CO), and cardiac index (CI) were significantly elevated. Serum cortisol (r = 0.481, P = .001), BNP (r = 0.437, P = .001), CRP (r = 0.542, P = .001), STAT3 (r = 0.835, P = .001), TSH (P = .001), IL-8 (r = 0.867, P = .001), TNF-α (r = 0.439, P = .001), and cardiac oxidative stress demonstrated significantly positive correlations (P < .05). Additionally, a significant negative correlation was found between GH (r = -0.654, P = .001) and immune balance (P < .05). This study evaluated the severity of myocardial infarction using indicators such as CO and CI. This study found a significant correlation between cardiac oxidative stress and inflammatory cytokines after myocardial infarction, suggesting their potential as predictors of myocardial infarction severity.

An inflammatory granuloma in right ventricular: Preliminarily diagnosed by echocardiography.

Inflammatory granuloma is a rare non neoplastic benign disease that rarely reported in the heart tissue, and surgical resection is the final treatment with satisfactory results. Hereinafter, we report a case of inflammatory granuloma in the right ventricle of a 25-year-old man who underwent multimodality imaging and successful resection of the mass. Results of the case suggested that when evaluating patients with cardiac mass in unusual locations, it was necessary to comprehensively consider multiple imaging features and combine laboratory examination to make clinical suspicion.

Multimodal imaging of primary cardiac angiosarcoma with brain metastasis.

Angiosarcoma is an extremely rare primary cardiac malignant tumor, with characteristics of early blood metastasis and radiochemotherapy resistance. Early diagnosis and timely treatment are of great significance to the prognosis of patients. Hereinafter, we report a case of angiosarcoma in the left atrium of a 61-year-old woman who underwent multimodality imaging and successful resection of the angiosarcoma. Results of the present case suggest that multimodal imaging plays an important role in detecting angiosarcoma and determining the treatment plan and prognosis for patients after treatment.

Analysis of Left Atrial Function after Percutaneous Intramyocardial Septal Radiofrequency Ablation in Hypertrophic Cardiomyopathy.

INTRODUCTION: The main goal of our research was to explore the effect of percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) on left atrial (LA) phasic function in hypertrophic cardiomyopathy (HCM). METHODS: The study included 13 patients who underwent PIMSRA at our hospital. The function of LA including reservoir, conduit, and booster pump was analyzed and compared before and 6 months after PIMSRA in HCM patients. LA reservoir function parameters contain maximal LA volume, minimal LA volume (LAV min), LA ejection fraction (LAEF), LA expansion index (LAEI), and reservoir strain; LA conduit function includes LA volume before atrial systole, LA passive volume, LA passive ejection fraction, and conduit strain; LA booster function involves LA booster volume, LA active ejection fraction, and LA contraction strain. Additionally, 20 healthy controls were selected to compare the LA function of HCM patients. RESULTS: The preoperative LA reservoir and conduit function in HCM patients were significantly impaired compared with the control group, while the change in booster pump function was not obvious. HCM patients at 6 months after PIMSRA had remarkably enhanced reservoir and conduit functions which were manifested by lower LAV min, higher LAEF, LAEI, reservoir, and conduit strain than before the operation, and the differences among these parameters between patients after PIMSRA and the healthy control group were not significant. However, with regard to LA contraction function, there was no significant improvement at 6 months after PIMSRA compared with before operation. CONCLUSION: PIMSRA is effective in the amelioration of LA reservoir and conduit function in patients with HCM but not in a marked improvement of LA contraction function in these individuals in short term.

Multimodal ultrasound imaging: A method to improve the accuracy of diagnosing thyroid TI-RADS 4 nodules.

Thyroid nodule is a common and frequently occurring disease in the neck in recent years, and ultrasound has become the preferred imaging diagnosis method for thyroid nodule due to its advantages of noninvasive, nonradiation, real-time, and repeatable. The thyroid imaging, reporting and data system (TI-RADS) classification standard scores suspicious nodules that are difficult to determine benign and malignant as grade 4, and further pathological puncture is recommended clinically, which may lead to a large number of unnecessary biopsies and operations. Including conventional ultrasound, ACR TI-RADS, shear wave elastography, super microvascular imaging, contrast enhanced ultrasound, "firefly," artificial intelligence, and multimodal ultrasound imaging used in combination. In order to identify the most clinically significant malignant tumors when reducing invasive operations. This article reviews the application and research progress of multimodal ultrasound imaging in the diagnosis of TI-RADS 4 thyroid nodules.

Positive lymph node ratio is an index in predicting prognosis for remnant gastric cancer with insufficient retrieved lymph node in R0 resection.

The staging system of remnant gastric cancer (RGC) has not yet been established, with the current staging being based on the guidelines for primary gastric cancer. Often, surgeries for RGC fail to achieve the > 15 lymph nodes needed for TNM staging. Compared with the pN staging system, lymph node ratio (NR) may be more accurate for RGC staging and prognosis prediction. We retrospectively analyzed the data of 208 patients who underwent R0 gastrectomy with curative intent and who have ≤ 15 retrieved lymph nodes (RLNs) for RGC between 2000 and 2014. The patients were divided into four groups on the basis of the NR cutoffs: rN0: 0; rN1: > 0 and ≤ 1/6; rN2: > 1/6 and ≤ 1/2; and rN3: > 1/2. The 5-year overall survival (OS) rates for rN0, rN1, rN2, and rN3 were 84.3%, 64.7%, 31.5%, and 12.7%, respectively. Multivariable analyses revealed that tumor size (p = 0.005), lymphovascular invasion (p = 0.023), and NR (p < 0.001), but not pN stage (p = 0.682), were independent factors for OS. When the RLN count is ≤ 15, the NR is superior to pN as an important and independent prognostic index of RGC, thus predicting the prognosis of RGC patients more accurately.

Nitrogen- and Oxygen-Containing Three-Dimensional Hierarchical Porous Graphitic Carbon for Advanced Supercapacitor.

Three-dimensional hierarchical porous graphitic carbon (HPGC) were synthesized via one-step carbonization-activation and a catalytic strategy. The method can not only improve the graphitization degree of carbon materials, but also offer plentiful interfaces for charge accumulation and short paths for ion/electron transport. Polypyrrole, potassium hydroxide, and nickel acetate were used as the carbon precursors, activating agent, and catalyst, respectively. The retraction and dissolution of Ni caused the change of pore size in the material and led to the interconnected micro/nano holes. Nickel acetate played a significant role in enhancing the electrical conductivity, introducing pseudocapacitance, and promoting ion diffusion. In the supercapacitor, HPGC electrode exhibited a remarkable specific capacitance of 336.3 F g-1 under 0.5 A g-1 current density and showed high rate capability, even with large current densities applied (up to 50 A g-1). Moreover, HPGC showed optimal cycling stability with 97.4% capacitance retention followed by 3000 charge-discharge cycles. The excellent electrochemical performances coupled with a facile large-scale synthesis procedure make HPGC a promising alternative for supercapacitors.

Improvement of T stage precision by integration of surgical and pathological staging in radically resected stage pT3-pT4b gastric cancer.

BACKGROUND: Both surgical TNM (sTNM) and pathological TNM (pTNM) staging are important clinicopathologic indexes of gastric cancer (GC). However, surgeons and pathologists might assess tumor depth differently in the same patient. To investigate the prognostic significance of sTNM status in patients with radically resected stage pT3-pT4b GC, we examined the relationship between sTNM and pTNM. METHODS: Clinicopathologic and survival data of 1289 patients with stage pT3-pT4b GC were studied retrospectively, in the aftermath of radical surgery. RESULTS: The unconformity for assessing tumor invasion depth were frequently exhibited between sT and pT staging. Comparison of 5-year OS among them, no significant differences were observed (pT3/sT3 vs pT3/sT4a, p=0.962; pT4a/sT4b vs pT4b/sT4b, p=0.508). Also, pT3/sT4b, pT4a/sT3 and pT4a/sT4a were homogeneity in prognosis. We proposed a revised pT stage in which surgical macroscopic T4b (sT4b) was incorporated into the pT stage, namely, patients in the pT3 stage with sT4b cancers were reclassified as being in the r-pT4a stage; patients in the pT4a stage with sT4b cancers were reclassified as being in the r-pT4b stage. In two-step multivariate analysis, revised pT stage proved more suitable for determining prognosis, surpassing both UICC/AJCC pT stage and sT stage as an independent prognostic index. CONCLUSIONS: Surgical T stage is a significant and independent prognostic index of overall survival (OS) in patients with radically resected advanced GC. Patients in the pT3/4a stage with sT4b cancers, are potentially underestimated, and should be considered higher stage in terms of prognostic.

Promoter Polymorphism of Toll-Like Receptor 4 is Associated with a Decreased Risk of Coronary Artery Disease: A Case-Control Study in the Chinese Han Population.

BACKGROUND Coronary artery disease (CAD) is considered a chronic inflammatory disease of the blood vessels. Toll-like receptor 4 (TLR4) is a transmembrane receptor involved in inflammatory reactions. The aim of this study was to determine the association between polymorphisms in the promoter region and 3'-untranslated region (3'-UTR) of TLR4, and the associated CAD risk. MATERIAL AND METHODS This study enrolled 424 participants with CAD and 424 controls without CAD. The polymorphisms in the promoter region and 3'-UTR of TLR4 were identified from the HapMap database, including rs10116253, rs10983755, and rs11536889. Genomic DNA was extracted from peripheral blood. Polymerase chain reaction-restriction fragment length polymorphism was performed to identify genotype polymorphisms. Relative luciferase activity was measured using the dual-luciferase reporter assay system. RESULTS TLR4 rs10116253 in the promoter region was associated with CAD risk. The variant (CC+TC) genotypes of rs10116253 were associated with a decreased CAD risk (OR 95% CI 0.73 (0.54-0.98), p=0.034). In the stratification analyses, the variant (CC+TC) genotypes of rs10116253 were observed to have a relationship with decreased CAD risk in the male subgroup (OR: 95% CI 0.68 (0.48-0.98), p=0.041). Moreover, the variant CC and (CC+TC) genotypes of rs10116253 were correlated with a decreased CAD risk in participants younger than 60-year-old (TC: OR (95% CI 0.62 (0.39-0.98), p=0.042; TC+CC: OR 95% CI 0.63 (0.41-0.98), p=0.039). Regarding rs10116253, the luciferase activity of the mutant C allele construct was lower than that of the wild T allele construct (5.215±0.009 vs. 5.304±0.041; p=0.087). CONCLUSIONS The results provided evidence of an association between the TLR4 rs10116253 in the promoter region and a reduced risk of CAD.

Toll-like receptor 4 rs11536889 is associated with angiographic extent and severity of coronary artery disease in a Chinese population.

Toll-like receptor 4 (TLR4) is a key modulator in many inflammation-related diseases. Polymorphisms in the TLR4 gene may alter TLR4 expression and affect the extent and severity of coronary artery disease (CAD). We analyzed 3 polymorphisms of TLR4 in 607 Chinese subjects who underwent coronary arteriography. Blood samples were collected to identify the polymorphisms. We evaluated the relationships between the polymorphisms and the number of vessels involved in coronary stenosis, Gensini scores, and Duke prognostic scores. We found that rs11536889 was associated with an increased risk of 3-vessel disease. When subjects with 3-vessel disease were compared to subjects with nonsignificant CAD, rs11536889 variant genotypes were associated with an increased risk of 3-vessel disease (GC/CC vs. GG: OR=2.06, 95%CI=1.21-3.51). When subjects with 3-vessel disease were compared to subjects with 1-vessel disease, rs11536889 variant genotypes were associated with an increased risk of 3-vessel disease (GC vs. GG: OR=2.14, 95%CI=1.20-3.79; GC/CC vs. GG: OR=2.06, 95%CI=1.20-3.54). When subjects with 3-vessel disease were compared to subjects with non-3-vessel disease, rs11536889 variant genotypes were associated with an increased risk of 3-vessel disease (GC vs. GG: OR=1.76, 95%CI=1.12-2.75; GC/CC vs. GG: OR=1.83, 95%CI=1.19-2.82). The TLR4 rs11536889 polymorphism was also related to Gensini score (P=0.02). The Gensini score was higher in subjects with the variant CC and GC/CC genotype than in subjects with the wild GG genotype (61.28± 1.84 and 57.64±34.82 vs. 51.27±34.57). Our results demonstrate that TLR4 rs11536889 polymorphism is a novel genetic factor in the development of CAD, influencing the extent and severity of CAD.

SNP-SNP Interaction between TLR4 and MyD88 in Susceptibility to Coronary Artery Disease in the Chinese Han Population.

The toll-like receptor 4 (TLR4)-myeloid differentiation factor 88 (MyD88)-dependent signaling pathway plays a role in the initiation and progression of coronary artery disease (CAD). We investigated SNP-SNP interactions between the TLR4 and MyD88 genes in CAD susceptibility and assessed whether the effects of such interactions were modified by confounding risk factors (hyperglycemia, hyperlipidemia and Helicobacter pylori (H. pylori) infection). Participants with CAD (n = 424) and controls (n = 424) without CAD were enrolled. Polymerase chain restriction-restriction fragment length polymorphism was performed on genomic DNA to detect polymorphisms in TLR4 (rs10116253, rs10983755, and rs11536889) and MyD88 (rs7744). H. pylori infections were evaluated by enzyme-linked immunosorbent assays, and the cardiovascular risk factors for each subject were evaluated clinically. The significant interaction between TLR4 rs11536889 and MyD88 rs7744 was associated with an increased CAD risk (p value for interaction = 0.024). In conditions of hyperglycemia, the interaction effect was strengthened between TLR4 rs11536889 and MyD88 rs7744 (p value for interaction = 0.004). In hyperlipidemic participants, the interaction strength was also enhanced for TLR4 rs11536889 and MyD88 rs7744 (p value for interaction = 0.006). Thus, the novel interaction between TLR4 rs11536889 and MyD88 rs7744 was related with an increased risk of CAD, that could be strengthened by the presence of hyperglycemia or hyperlipidemia.

Macroscopic Serosal Classification as a Prognostic Index in Radically Resected Stage pT3-pT4b Gastric Cancer.

BACKGROUND: Macroscopic serosal classification (MSC) is an important clinicopathologic index of gastric cancer (GC). To investigate the prognostic significance of MSC status in patients with radically resected stage pT3-pT4b GC, we examined the relationship between MSC type and pT stage. METHODS: Clinicopathologic and survival data of 1613 patients with stage pT3-pT4b GC were studied retrospectively, in the aftermath of radical surgery. RESULTS: MSC types, including reactive, nodular, tendonoid, and color-diffused type, correlated significantly with overall survival (OS) in this cohort, but prognosis was similar for all stages of color-diffused type GC. We proposed a revised pT stage in which color-diffused type cancers at pT3 or pT4a stage were reclassified into pT4b stage. In two-step multivariate analysis, revised pT stage (stage pT4b for all color-diffused types) proved more suitable for determining prognosis, surpassing both Union for International Cancer Control/American Joint Committee on Cancer pT stage and MSC type as an independent prognostic index. CONCLUSIONS: MSC type is a significant and independent prognostic index of OS in patients with radically resected stage pT3-pT4b GC. For prognostic purposes, tumors of color-diffused type at pT3 or pT4a stage should be considered stage pT4b disease.