Prognostic and diagnostic accuracy of intracoronary electrocardiogram recorded during percutaneous coronary intervention: a meta-analysis.

OBJECTIVE: Intracoronary ECG (IC-ECG) recording has been shown to be sensitive and reliable for detecting myocardial viability and local myocardial ischaemia in some studies. But IC-ECG is neither widely used during percutaneous coronary intervention (PCI) nor recommended in guidelines. This up-to-date meta-analysis of published studies was conducted to evaluate the prognostic and diagnostic accuracy of IC-ECG recorded during PCI. METHODS: Relevant studies were identified by searches of MEDLINE until 19 June 2021. Observational and diagnostic studies which reported the prognostic or diagnostic accuracy of IC-ECG were included. Data were extracted independently by two authors. Summary estimates of clinical outcomes were obtained using a random effects model. Summary diagnostic accuracy was obtained by using a Bayesian bivariate random effects model. RESULTS: Of the 12 included studies, 7 studies reported the clinical outcomes (821 patients) and 6 studies reported the diagnostic accuracy (485 patients) of IC-ECG. The pooled ORs with 95% CIs of ST-segment elevation recorded by IC-ECG were 4.65 (1.69 to 12.77), 5.08 (1.10 to 23.44), 4.53 (0.79 to 25.90) and 1.83 (0.93 to 3.62) for major adverse cardiac events, myocardial infarction, cardiac death and revascularisation, respectively. The weighted mean difference were 6.49 (95% CIs 3.84 to 9.14) for ejection fraction when ST-segment resolution was recorded, and 0.86 (95% CIs -8.55 to 10.26) when ST-segment elevation was recorded. The pooled sensitivity and specificity of ST-segment elevation were 0.78 (95% credibility intervals 0.64 to 0.89) and 0.87 (95% credibility intervals 0.75 to 0.94), respectively. CONCLUSIONS: These findings provide quantitative data supporting that IC-ECG had promising diagnostic ability for local myocardial injury, and could predict clinical outcomes.

Inhibiting MicroRNA-497 Improves the Effects of Exercise Training on Myocardial Infarction.

Exercise training (ET) could improve myocardial infarction (MI), and microRNA-497 is highly associated with MI. This study aimed to investigate whether the regulation of miR-497 is involved in the positive effects of ET on MI. MI rat models induced by left anterior descending (LAD) were subjected to interval training and infarct size was observed. Blood and myocardial samples were collected from the rats for determining the expressions of miR-497. To evaluate the functions of miR-497, miR-497 agomir and antagomir were injected accordingly into grouped rats during ET, and subsequently, the expressions of apoptotic and inflammatory factors were determined. ET reduced the infarct size in MI rats and inhibited the levels of miR-497. MiR-497 agomir injection enlarged the infarct size, and reversed the shrunk infarct size induced by ET. However, miR-497 antagomir further promoted the positive effect on MI improved by ET. Chloride voltage-gated channel 3 (CLCN3) was identified as the most possible target for miR-497. Moreover, ET improving MI also involved the regulation of apoptotic and inflammatory factors. The mechanisms underlying the positive effects of ET on MI were highly associated with the regulation of miR-497.

Effect of Diabetes on the Assessment Role of 2-Oxoglutarate to the Severity of Chronic Heart Failure.

BACKGROUND: Serum 2-oxoglutarate can reflect the severity of chronic heart failure (CHF) in patients without diabetes. Whether this predictive role persists in type 2 diabetes mellitus (T2DM) patients is unclear. In this study, we investigated this predictive role in T2DM patients and whether 2-oxoglutarate can indicate the diastolic or systolic function of left ventricle. METHODS: One hundred eighty CHF patients (76 with T2DM) and 66 healthy controls were studied. 2-Oxoglutarate was assayed by liquid chromatography-mass spectrometry/mass spectrometry. Echocardiographic parameters, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and other parameters were measured. RESULTS: 2-Oxoglutarate was increased in CHF patients with or without T2DM compared with controls (both P<0.01). Patients with a lower left ventricular ejection fraction or a higher NT-proBNP or left ventricular end-diastolic volume index had higher levels of 2-oxoglutarate (median, 18.77 µg/mL versus 11.25 µg/mL; median, 14.06 µg/ml versus 9.39 µg/ml; median, 18.06 µg/mL versus 11.60 µg/mL, all P<0.05) in nondiabetic patients but not in T2DM patients. In multiple logistic regression analysis, NT-proBNP (OR=3.445, 95% CI=1.098 to 10.816, P=0.034) and left ventricular end-diastolic diameter (OR=2.544, 95% CI=1.033 to 6.268, P=0.042) were independently associated with increased 2-oxoglutarate in nondiabetic patients. CONCLUSIONS: The levels of 2-oxoglutarate can reflect the clinical severity of CHF in nondiabetic patients but not in those with T2DM, and it can be used as a potential indicator of the systolic dysfunction of the left ventricle.