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Polyunsaturated fatty acids (PUFAs) have diverse health-promoting effects, such as potentially protecting in immune, nervous, and cardiovascular systems by targeting a variety of sites, including most ion channels. Voltage-gated potassium channels of the KV7 family and large-conductance Ca2+- and voltage-activated K+ (BKCa) channels are expressed in many tissues, therefore, their physiological importance is evident from the various disorders linked to dysfunctional KV7 channels and BKCa channels. Thus, it is extremely important to learn how potassium channels are regulated by PUFAs. The aim of this review is to provide an overview of the effects of PUFAs on KV7 channels and BKCa channels functions, as well as the mechanisms underlying these effects. In summarizing reported effects of PUFAs on KV7 and BKCa channels mediated currents, we generally conclude that PUFAs increase the current amplitude, meanwhile, differential molecular and biophysical mechanisms are associated with the current increase. In KV7 channels the currents increasement are associated with a shift in the voltage dependence of channel opening and increased maximum conductance in KV7 channels, while in BKCa channels, they are associated with destabilization the pore domain closed conformation. Furthermore, PUFA effects are influenced by auxiliary subunits of KV7 and BKCa channels, associate with channels in certain tissues. although findings are conflicting. A better understanding of how PUFAs regulate KV7 and BKCa channels may offer insight into their physiological regulation and may lead to new therapeutic strategies and approaches.
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Objective Young and middle-aged people have become the fastest growing group of diabetes, but the compliance of regular exercise is poor. It is urgent to formulate effective intervention strategies or measures to promote the change of their behavior. The article is Objective ly based on the attitude-social influence-self efficacy model, to investigate the stages distribution and influencing factors of regular exercise behavior in young and middle-aged patients with type 2 diabetes.Methods A convenience sampling was used to select 430 young and middle-aged type 2 diabetic patients from the department of endocrinology in two Nanjing 3A grade hospitals. A cross-sectional survey was conducted with a general questionnaire, a regular exercise behavioral stage questionnaire, a diabetes behavioral attitude and social impact scale, and a diabetes self-efficacy scale.Results The proportion of regular exercise behavior in young and middle-aged patients with type 2 diabetes is as follows. There were 14.9% patients at the precontemplation, 25.8% at the contemplation,15.8% at the preparation, 12.3% at the action, 31.2% at the maintenance. Logistic regression analysis showed that on-the-job (OR=1.77), accepting health education (OR=0.49), HbA1c level (OR=0.78), attitude (OR=5.32), subjective norm (OR=2.43), social support (OR=1.87) and self-efficacy (OR=1.28) are main factors to affect the stages of physical activity (P<0.05) .Conclusion Most of the young and middle-aged patients with type 2 diabetes are in the pre-action stages of regular exercise behavior, which needs to be improved, and many factors can affect the stages of regular exercise behavior. Clinical medical staff should provide individualized interventions for these patients with reference to the characteristics of different behavioral stages of patients.
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<p><b>BACKGROUND</b>Females with acute myocardial infarction (AMI) have a higher risk of adverse outcomes because of receiving less evidence-based medical care. Our aim was to investigate the gender disparity in early death after ST-elevation myocardial infarction (STEMI) in the current era.</p><p><b>METHODS</b>A total of 1429 consecutive patients with STEMI in the Liaoning district were analyzed. We compared hospital care and cardiac event data by sex for in-patients with acute STEMI within 24 hours of symptom onset.</p><p><b>RESULTS</b>In the emergency reperfusion group (n = 754), in-hospital mortality occurred in 4.2% of the males and 11.2% of the females (P = 0.001). In the non-emergency reperfusion group (n = 675), in-hospital mortality occurred in 13.0% of the males and 22.9% of the females (P = 0.001). Multivariate Logistic regression analysis revealed female sex as an independent risk factor of death for STEMI patients during hospitalization (OR = 1.691, P = 0.007). After controlling for patients who died within 24 hr after admission, female sex was no longer an independent risk factor (OR = 1.409, P = 0.259).</p><p><b>CONCLUSION</b>Female sex was an independent risk factor for in-hospital mortality of STEMI patients, which is explained by an excess of very early deaths.</p>
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Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Angioplastia Coronária com Balão , Mortalidade Hospitalar , Infarto do Miocárdio , Mortalidade , Terapêutica , Fatores de Risco , Fatores SexuaisRESUMO
<p><b>BACKGROUND</b>In cardiology, it is controversial whether gender influences prognosis after acute myocardial infarction (MI). We examined the 30-day and 1-year prognosis for female patients with ST-elevation myocardial infarction (STEMI) in Liaoning province, and we analyzed factors that influenced these outcomes.</p><p><b>METHODS</b>This was a prospective, multicenter, observational study in which patient data were collected by questionnaire at the time of diagnosis and at approximately 30 days and 1 year later by telephone inquiries. Patients were diagnosed with STEMI between June 1, 2009 and June 1, 2010 at any of the 20 hospitals that gave treatment representative of current STEMI treatment in Liaoning Province. Unified follow-up questionnaire was used to visit the STEMI patients.</p><p><b>RESULTS</b>We analyzed data from a total of 1429 consecutive patients with STEMI in Liaoning province. Female patients were older (70.0 vs. 60.3, P < 0.001) and were less likely to receive emergency reperfusion therapy than male ones (39.2% vs. 58.0%, P < 0.001). Female gender was associated with higher unadjusted 30-day mortality rates (HR = 2.118, 95%CI: 1.572 - 2.854, P < 0.001) and higher unadjusted 1-year mortality rates (HR = 2.174, 95%CI: 1.659 - 2.848, P < 0.001). Multivariate Cox regression analysis showed that female gender was not an independent predictor of 30-day mortality rates (HR = 1.273, 95%CI: 0.929 - 1.745, P = 0.133) nor of 1-year mortality rates (HR = 1.112, 95%CI: 0.831 - 1.487, P = 0.475).</p><p><b>CONCLUSIONS</b>Women with STEMI appear to be at increased risk of 30-day and 1-year mortality compared with male STEMI patients, but this difference may be explained by older age and less frequent receipt of reperfusion therapy among the women.</p>
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Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , China , Infarto do Miocárdio , Mortalidade , Cirurgia Geral , Reperfusão Miocárdica , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
Objective To analyze the impact of body mass index (BMI) on the presentation,treatment,and clinical outcomes of patients with ST-segment elevated myocardial infarction (STEMI).Methods 1414 patients with STEMI who were admitted to the 20 hospitals in Liaoning region from May 2009 until May 2010 were enrolled.Patients were stratified according to the BMI levels as normal weight group (18.5 kg/m2≤BMI<24.0 kg/m2) (n=485),overweight (24.0 kg/m2≤BMI<28.0 kg/m2) (n=736),or obesity (BMI≥28.0 kg/m2) (n=193).Presentation,treatment and mortality during hospitalization,MACCE (cardiovascular death,non-fatal myocardial infarction,revascularization and stroke) were compared between the three groups at 3-month and 1-year follow-up.Results Obesity in patients with STEMI was associated with younger age (P<0.001),being male (P<0.001),with diabetes (P=0.013) or hypertension (P<0.001) and hyperlipidmia (P<0.001).A higher prevalence of reperfusion treatment (P = 0.018),mainly percutaneous coronary intervention (PCI) (P<0.001) was seen during the period of hospitalization.Rates of using other kinds of medicines as well as the mortalities during hospitalization,were similar among the groups with different BMI categories.At 3-month and 1-year follow-up,more use of asprin (3-months:P=0.018; 1-year:P=0.002) and β-receptor blockers were seen in the obesity group (3-months:P=0.025; 1-year:P=0.030) while the use of other drugs were not significantly different among the three groups.The incidence rates of MACCE were not significantly different among the BMI categories while the cumulative survival rate was similar between obese group and normal weight group.Results from the Cox proportional hazards analysis indicated that factors as age (HR=1.045,95% CI:1.028-1.062,P<0.001),diabetes (HR= 1.530,95% CI:1.107-2.301,P=0.041),hyperlipidmia (HR=2.127,95% CI:1.317-3.435,P=0.002),urgent PCI (HR=0.473,95%CI:0.307-0.728,P=0.001) and the use of β-receptor blockers at 3-months follow-up period (HR=0.373,95% CI:0.195-0.713,P=0.003) were significantly related to the incidence of MACCE at 1-year follow-up period.Conclusion Despite the fact that patients with obesity presented with STEMI at younger age and having received active treatment of reperfusion and medicine,both the 3-month and 1-year outcomes did not show significant difference among the BMI categories.
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Objective To analyze the impact of high-density lipoprotein cholesterol (HDL-C) levels at hospital admission on the incidence of major adverse cardiovascular events (MACCE) in patients with acute ST segment elevation myocardial infarction (ASTEMI).Methods 1067 patients with ASTEMI who were admitted to the 20 hospitals in Liaoning region and with lipid profile tested within the 24 hours of admission from May 2009 until May 2010,were enrolled.Data on basic demographic,clinical,status on admission and method of treatment were collected.Rate on various medical use and MACCE (cardiovascular death,non-fatal myocardial infarction,revascularization and stoke) were compared between the two groups through follow-up observation.Cox proportional hazard analysis was estimation.Results The median HDL-C level was 1.27 mmol/L,with 587 patients having HDL-C below and 489 patients HDL-C above the median level.The incidence rates of non-fatal myocardial infarction and MACCE at one-year follow-up period,was higher in low HDL-C group (4.8% vs.0.9%,P<0.001:23.7% vs.18.1%,P=0.03,respectively) At one month follow-up,the incidence rate of non-fatal myocardial infarction was higher in low HDL-C group (1.4% vs.0.0%,P=0.01 ).At six month follow-up,the incidence rates of non-fatal myocardial infarction and MACCE on one-year follow-up was higher in low HDL-C group (2.8% vs.0.4%,P=0.003; 18.3% vs.13.7%,P=0.04,respectively).Results from Cox proportional hazards analysis indicated that age ( HR =1.02,95% CI:1.006- 1.035,P =0.005 ),diabetes (HR =1.05,95% CI:1.053-2.171,P=0.03 ),HDL-C level ( HR =0.56,95%CI:0.340-0.921,P=- 0.02 ) were significantly related to the incidence of MACCE.Conclusion The incidence rates of one year and six month MACCE (mainly non-fatal myocardial infarction) and one month non-fatal myocardial infarction were significant higher in patients with low than high HDL-C levels at admission while kept on the ascending along with time.Age,diabetes,HDL-C level were independent risk factors related to the incidence of MACCE.
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Objective To investigate and analyze the impact of gender difference on outcome and prognosis of ST-segment elevation myocardial infarction (STEMI) in patients treated with primary percutaneous coronary intervention (PCI).Methods This was a prospective and multicentered observation study.All the patients with acute STEMI admitted to the hospitals from June 1st 2009 to June 1st 2010 were continuously recruited.In this study,a unified questionnaire was applied and the 382 patients satisfied the criteria.A unified follow-up questionnaire was used on patients who were discharged from the hospital.Results On average,the female patients were 8 years older than the males.The median “symptom-to-balloon time” was 312.5 minutes in females and 270.0 minutes in males,and it was significantly different (P=0.007).During hospitalization,a higher proportion of female patients developed heart failure,angina and bleeding.No gender differences were found on the in-hospital mortality rates and medical therapy recommended by the guideline.The female patients were more prone to multi-vessel disease than males (P=0.002).Success rates of primary PCI did not show any gender differences.One-month mortality and other cardiovascular events also did not show gender difference when the patients were followed for one month after being discharged.The rates of heart failure and re-hospitalization due to cardiac incidents among female patients were obviously higher than the males,three months after being discharged (P=0.007,respectively).However,the three-month and long-term cardiac mortality did not show differences related to gender.Female patients were associated with higher all-cause mortality than that in males,but there was no statistically significant difference (female 4.2% vs.male 1.6%;P=0.056).Data from multi-factor regression analysis showed that being female was not an independent predictor related to in-hospital mortality or during the follow-up period.Conclusion Being female was not an independent predictor of in-hospital mortality or during follow-up period among patients who were treated with primary PCI.Worse long-term outcome seen in female patients was likely to be explained by older age or longer pre-hospital delayed time.
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<p><b>BACKGROUND</b>Early loading statin therapy before percutaneous coronary intervention (PCI) is associated with reduced mortality and periprocedural myocardial injury. The aim of this study was to study the effect of rosuvastatin loading therapy before PCI in female patients with non-ST-segment elevation acute coronary syndrome (NSTEACS).</p><p><b>METHODS</b>Consecutive 117 female patients with NSTEACS were randomly assigned to either the group of rosuvastatin loading before PCI (20 mg 12 hours before angioplasty procedure, with a further 10 mg dose 2 hours before procedure, the loading dose group, n = 59) or the no rosuvastatin treatment group before PCI (control group, n = 58). Periprocedural myocardial injury, periprocedural changes of high sensitivity C-reactive protein (hs-CRP), interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-a in serum and the incidence of major adverse cardiac events (MACE) 3 months and 6 months later were assessed.</p><p><b>RESULTS</b>The incidence of periprocedural myocardial injury was higher in control group than loading dose group (CKMB: 10.17% vs. 25.86%, P = 0.027; Troponin I: 11.86% vs. 29.31%, P = 0.019). MACE occurred in 1.69% of patients in loading dose group and 12.07% of those in control group 3 months after procedure (P = 0.026), 3.39% vs. 17.24% at 6 months (P = 0.014). The levels of hs-CRP, IL-1, IL-6, and TNF-a in serum were not significantly different between the two groups before PCI, but after PCI they were significantly higher in control group.</p><p><b>CONCLUSIONS</b>High-dose rosuvastatin loading before PCI significantly reduced periprocedural myocardial injury and periprocedural inflammation cytokines release and improved 3-month and 6-month clinical outcomes in female patients with NSTEACS who underwent PCI.</p>
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Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Síndrome Coronariana Aguda , Metabolismo , Cirurgia Geral , Proteína C-Reativa , Metabolismo , Relação Dose-Resposta a Droga , Fluorbenzenos , Usos Terapêuticos , Inibidores de Hidroximetilglutaril-CoA Redutases , Usos Terapêuticos , Interleucina-1 , Metabolismo , Interleucina-6 , Metabolismo , Infarto do Miocárdio , Intervenção Coronária Percutânea , Métodos , Pirimidinas , Usos Terapêuticos , Rosuvastatina Cálcica , Sulfonamidas , Usos Terapêuticos , Fator de Necrose Tumoral alfa , MetabolismoRESUMO
<p><b>OBJECTIVE</b>To compare the differences on onset timing of acute ST segment elevation myocardial infarction (STEMI) in young and aged patients.</p><p><b>METHODS</b>The exact onset time of symptoms was obtained from 1024 consecutive patients with STEMI admitted to our hospital between January 2000 and May 2010. Patients were classified as the middle-aged group [< 65 years old, mean (52.2 ± 8.0) years, n = 536] and old group [≥ 65 years old, (72.2 ± 5.5) years, n = 488], the difference of the onset months, weeks, weekdays and hours between two groups was compared.</p><p><b>RESULTS</b>The high onset timing of STEMI in middle-aged group was October and February, Friday, Saturday and Wednesday, at 10 A.m. and 10 P.m. The high onset timing of STEMI in old group was October, January and March, Friday, Sunday and Monday, at 6 A.m. and 2 A.m. The incidences of STEMI in the old group were significant higher than in the middle-aged group in March (11.89%), on Sunday (15.97%) and Monday (17.42%), at 6 A.m. (6.35%) and 2 A.m. (5.74%) (all P < 0.05) while the onset rate was significant higher in February (9.89%), On Saturday (16.98%), At 8 P.m. (4.86%) and 10 P.m. (5.78%) in the middle-aged group than old group (all P < 0.05).</p><p><b>CONCLUSION</b>The onset timing of STEMI in old patients was significant different from the middle-aged patients suggesting the onset timing of STEMI changes with aging.</p>