Apolipoprotein A-I Mimetic Peptide D-4F Reduces Cardiac Hypertrophy and Improves Apolipoprotein A-I-Mediated Reverse Cholesterol Transport From Cardiac Tissue in LDL Receptor-null Mice Fed a Western Diet.

Epidemiological studies have suggested that hypercholesterolemia is an independent determinant of increased left ventricular (LV) mass. Because high-density lipoprotein and its major protein apolipoprotein A-I (apoA-I) mediate reverse cholesterol transport (RCT) and have cardiac protective effects, we hypothesized that the apoA-I mimetic peptide D-4F could promote RCT in cardiac tissue and decrease cardiac hypertrophy induced by hypercholesterolemia. Low-density lipoprotein receptor-null mice were fed by a Western diet for 18 weeks and then randomized to receive water, or D-4F 0.3 mg/mL, or D-4F 0.5 mg/mL added to drinking water for 6 weeks. After D-4F administration, an increase in high-density lipoprotein cholesterol and a decrease in low-density lipoprotein cholesterol, total cholesterol, and triglyceride in a trend toward dose-responsivity were found in cardiac tissue. Ultrasound biomicroscopy revealed a reduction in LV posterior wall end-diastolic dimension, and an increase in mitral valve E/A ratio and LV ejection fraction. Hematoxylin-eosin staining showed reduced LV wall thickness and myocardial cell diameter. The protein levels of ABCA1 and LXRα were elevated in cardiac tissue of D-4F treated mice compared with the controls (P < 0.05). These results demonstrated that D-4F treatment reduced cardiac hypertrophy, and improved cardiac performance in low-density lipoprotein receptor-null mice fed a Western diet, presumably through the LXRα-ABCA1 pathway associated with enhanced myocardial RCT.

Prevalence of cardiovascular disease in subjects hospitalized due to chronic obstructive pulmonary disease in Beijing from 2000 to 2010.

OBJECTIVES: To investigate the overall prevalence of cardiovascular disease (CVD) in subjects hospitalized for chronic obstructive pulmonary disease (COPD), and explore the prevalence of the major CVD complications and trends in patients with COPD over a 10-year period. METHODS: Medical records in the PLA General Hospital, Beijing Union Medical College Hospital, and Beijing Hospital from 2000/01/01 to 2010/03/03 were retrospectively reviewed. A total of 4960 patients with COPD were reviewed in the study (3570 males, mean age, 72.2 ± 10.5 years; 1390 females, mean age, 72.0 ± 10.4 years). RESULTS: The prevalence of CVD in COPD patients was 51.7%. The three most prevalent CVDs were ischemic heart disease (28.9%), heart failure (19.6%), and arrhythmia (12.6%). During the 10-year study period, the prevalence of various CVDs in COPD patients showed a gradual increasing trend with increasing age. There was higher morbidity due to ischemic heart disease (P < 0.01) in male COPD patients than in the female counterparts. However, heart failure (P < 0.01) and hypertension (P < 0.01) occurred less frequently in male COPD patients than in female COPD patients. Furthermore, the prevalence of ischemic heart disease decreased year by year. In addition to heart failure, various types of CVD complications in COPD patients tended to occur in younger subjects. The prevalence of all major types of CVD in women tended to increase year by year. CONCLUSIONS: The prevalence of CVD in patients hospitalized for COPD in Beijing was high. Age, sex and CVD trends, as well as life style changes, should be considered when prevention and control strategies are formulated.

Influence of low high-density lipoprotein cholesterol on arterial stiffening and left ventricular diastolic dysfunction in essential hypertension.

The authors investigated whether high-density lipoprotein (HDL) cholesterol plays a role in arterial stiffening and left diastolic dysfunction in essential hypertension. Carotid arterial stiffness parameter and left ventricular (LV) diastolic function index were evaluated in 217 patients with essential hypertension. The correlations of dyslipidemia, especially low HDL cholesterol, to LV diastolic function and arterial stiffness were investigated in these patients. Arterial stiffness parameter increased with the increasing of E/Em (LV diastolic function index: the ratio of transmitral peak velocity of early filling to peak early diastolic motion velocity of mitral annulus) (r = 0.26, P<.01). In univariate regression analysis, HDL cholesterol was inversely associated with arterial stiffness parameter and E/Em (r = -0.23 and r = -0.27, respectively, P<.01). The association of HDL cholesterol with arterial stiffness and LV diastolic function was observed in both men and women. Triglycerides were weakly correlated with arterial stiffness parameter and E/Em, while low-density lipoprotein and total cholesterol were not. In multiple regression analysis, only low HDL cholesterol was found as an independent predictor for both arterial stiffness and LV diastolic dysfunction. Enhanced arterial stiffness is associated with LV diastolic dysfunction. Low HDL cholesterol may lead to the deterioration of both arterial stiffness and LV diastolic function in patients with essential hypertension.

[Clinical usefulness of carotid arterial wave intensity in noninvasively assessing left ventricular performance in different hypertensive remodeling hearts].

OBJECTIVE: To evaluate wave intensity (WI) on left ventricular (LV) performance in the different hypertensive remolding hearts. METHODS: 105 hypertensive and 98 control subjects were underwent noninvasive evaluation of carotid arterial wave intensity, LV structure and function. RESULTS: (1) There were increasing trends in the levels of blood pressure, LV end-diastolic diameter and LV mass index in the control, normal geometry group, concentric remodeling group, concentric and eccentric hypertrophy group. LV ejection fraction increased in the concentric hypertrophy group and decreased in the eccentric hypertrophy group in which mid-wall fractional shortening showed a decreasing trend. LV diastolic filling pressure presented increased progression accompanied by LV remodeling (P < 0.05). (2) Transient acceleration wave intensity (W1) in hypertensive subjects were higher than that in the control (P < 0.05). Transient deceleration wave intensity (W2) was lower than that in the control (P < 0.05). (3) W1 in the concentric hypertrophy group was higher and lower in the eccentric hypertrophy, compared with that in the control group, normal geometry group and concentric remodeling group (P < 0.05). W2 was lower in concentric hypertrophy group and eccentric hypertrophy group than that in the control, normal geometry group and concentric remodeling group (P < 0.05). CONCLUSION: WI is a noninvasively obtained, clinically useful parameter for evaluation of LV performance.

[Evaluation on left ventricular function by non-invasive transient deceleration wave intensity (W2) of carotid artery].

OBJECTIVE: To evaluate transient deceleration wave intensity (W2) of carotid artery on left ventricular diastolic function. METHODS: 40 patients with hypertension and 43 healthy volunteers were enrolled and W2 of carotid artery of the both sides were measured. The parameters of left ventricular diastolic function by traditional and tissue Doppler imaging and NT-proBNP (N-terminal probrain natriuretic peptide) were measured. RESULTS: (1) W2 is not different between two sides of carotid artery. W2 in hypertension was lower than the control, especially in left side(1126 +/- 996 mmHg x m/s3 vs 1690 +/- 1126 mmHg x m/s3, P < 0.01). (2) The correlation of W2 and else parameters were analyzed. There were notably decreasing in left ventricular diastolic function of the hypertensive group than the control, for example, the ratio of peak velocity of early filling of mitral flow to peak early diastolic motion velocity of mitral annulus (E/Em, 9.37 +/- 3.32 vs 7.39 +/- 1.83, P < 0.01) and NT-proBNP (94.6 +/- 48.5 vs 45.2 +/- 13.8, P < 0.01). (3) The correlation analysis showed negative relation between W2 and E/Em (r = - 0.46, P < 0.05) and negative relation between W2 and NT-proBNP (r = -0.21, P < 0.05). CONCLUSION: New carotid W2 by non-invasive technology for hemodynamics is a deserving parameter in early evaluating left ventricular diastolic function.

[Surgical treatment of ascending aortic aneurysm by Bentall's procedure: report of 14 cases].

OBJECTIVE: To review our experience in surgical treatment of ascending aortic aneurysm (AAA) with aortic insufficiency in 14 cases of by Bentall's procedure. METHODS AND RESULTS: All the patients underwent replacement of the ascending aorta and aortic valve with composite valved vascular prosthesis and received direct implantation of the aortic graft of the coronary orifices (Bentall's procedure) with satisfactory results. Five patients had ascending aortic dissection and 4 had typical Marfan's syndrome. All the patients suffered severe aortic insufficiency while 2 had mitral insufficiency. Coronary orifices were implanted in situ in 13 cases while in 1 case, Cabrol's method was adopted. No death occurred during the surgery and in the subsequent follow-up, and all the patients had good recovery. CONCLUSION: Bentall's procedure can be effective in the treatment of AAA with aortic insufficiency.