Xueying Chen

Electro-echocardiographic Indices to Predict Cardiac Resynchronization Therapy Non-response on Non-ischemic Cardiomyopathy

Cardiac resynchronization therapy (CRT) threw lights on heart failure treatment, however, parts of patients showed nonresponse to CRT. Unfortunately, it lacks effective parameters to predict CRT non-response. In present study, we try to seek effective electro-echocardiographic predictors on CRT non-response. This is a retrospective study to review a total of 227 patients of dyssynchronous heart failure underwent CRT implantation. Logistic analysis was performed between CRT responders and CRT non-responders. The primary outcome was the occurrence of improved left ventricular ejection fraction 1 year after CRT implantation. We concluded that LVEDV > 255 mL (OR = 2.236; 95% CI, 1.016–4.923) rather than LVESV > 160 mL (OR = 1.18; 95% CI, 0.544–2.56) and TpTe/QTc > 0.203 (OR = 5.206; 95% CI, 1.89–14.34) significantly predicted CRT non-response. Oppositely, S wave > 5.7 cm/s (OR = 0.242; 95% CI, 0.089–0.657), E/A > 1 (OR = 0.211; 95% CI, 0.079–0.566), E’/A’ > 1 (OR = 0.054; 95% CI, 0.017–0.172), CLBBB (OR = 0.141; 95% CI, 0.048–0.409), and QRS duration >160 ms (OR = 0.52; 95% CI, 0.305–0.922) surprisingly predicted low-probability of CRT non-response.

Comparison of single-coil lead versus dual-coil lead of implantable cardioverter defibrillator on lead-related venous complications in a canine model

PurposeDual- coil lead (DCL) of implantable cardioverter defibrillator (ICD) is preferred clinically in patients. However, it is related to higher risk of venous stenosis and thrombosis. The present study was done to compare the fibrosis and extraction of the leads between the single-coil lead (SCL) and DCL in animal models.MethodsThis was a chronic animal study with a follow-up duration of 6 months. Twenty mongrel dogs were randomly divided into DCL group or SCL group. Venography was performed before the sacrifice to evaluate the venous stenosis in vivo. The maximum pulling-out tension of the ICD lead was measured by a tensometer. Hematoxylin-eosin stain and toluidine blue O stain were applied to show the pathological changes of the superior vena cava (SVC) to evaluate the fibrosis and the thickness of the SVC adjacent to the leads.ResultsThe DCL group showed higher incidence of venous stenosis (OR = 31.5; 95% CI, 2.35–422.3; p = 0.005). It revealed increased tension to extract the leads in the DCL group (5.96 ± 1.86 vs. 3.68 ± 1.46 N, p = 0.027). The difference of venous wall thickness of SVC was 4.3 ± 0.3 fold-changes between two groups (p = 0.007). Moreover, the degree of venous wall fibrosis in DCL group was more serious than that it in SCL group (3.61 ± 1.26 vs. 1.08 ± 1.35 mm2, p = 0.015).ConclusionThe DCL was proved to increase thrombosis, fibrosis, and stenosis in the SVC. Likewise, the DCL was mechanically harder to be extracted than the SCL. Our study showed that lead-related complications of the DCLs were higher than those of the SCLs regardless of the equal defibrillation thresholds between them. Results of the present study would help to choose the proper lead which could be removed.

Electrocardiographic parameters effectively predict ventricular tachycardia/fibrillation in acute phase and abnormal cardiac function in chronic phase of ST-segment elevation myocardial infarction

Abnormal cardiac repolarization is closely associated with ventricular tachycardia/ventricular fibrillation (VT/VF). Myocardial ischemia and infarction aggravate cardiac repolarization dispersion, and VT/VF could be lethal in the early stage of ST‐segment elevation myocardial infarction (STEMI). Unfortunately, VT/VF cannot be effectively predicted in current clinical practice. The present study aimed to assess electrocardiographic parameters of the sinus rhythmic complex in relation to cardiac repolarization, e.g., QT interval and T‐peak to T‐end interval (TpTe), to independently predict VT/VF in acute STEMI. Additionally, we hypothesized that QT and TpTe of PVC would be also valuable to predict VT/VF in STEMI.

Mitochondrial calcium uniporter inhibition provides cardioprotection in pressure overload-induced heart failure through autophagy enhancement

BACKGROUND HF incurs high disease burden, and the effectiveness of known HF treatments is unsatisfactory. Therefore, seeking novel therapeutic target of HF is important. The present study aimed to investigate the role of the mitochondrial calcium uniporter (MCU) and its relationship with autophagy in overload-induced heart failure (HF). METHODS AND RESULTS In both early-stage and end-stage of pressure overload-induced HF, MCU appeared up-regulated along with heart enlargement, increased microtubule-associated proteins 1A/1B light chain 3B (LC3B) II/I ratio and autophagosome content, damaged cardiac function, and ventricular asynchrony. However, sequestosome-1 (SQSTM1/p62) level decreased indicating blockaded autophagic flux. Seven-week administration of MCU inhibitor ruthenium red improved cardiac function and mitigated its pathological change. MCU inhibition maintained mitochondrial integrity, increased LC3B II/I ratio, up-regulated Parkin and Pink1, and down-regulated SQSTM1/p62. MCU inhibition also alleviated ventricular asynchrony of HF, and this might be related to connexin-43 up-regulation. In vitro study validated intervention on MCU leading to elevation of autophagy and mitophagy. MCU inhibition could partly prevent from excessive cellular enlargement induced by isoprenaline. CONCLUSIONS In summary, MCU inhibition played an important role in pressure overload-induced heart failure through autophagy and mitophagy enhancement, and intervention on MCU offered cardioprotective effects. To our knowledge, the role of MCU in HF and its relationship with autophagy and mitophagy are firstly disclosed. Moreover, our study suggests that MCU inhibition could be explored as a novel therapeutic concept in HF.

Sparganosis Presenting as Pericardial Effusion and Lung Lesions

We herein report a rare form of sparganosis in a 29-year-old man presenting with pericardial effusion and lung lesions. The diagnosis was confirmed by the patients history of eating inadequately cooked snake, significant elevated eosinophils in the peripheral blood and pericardial effusion, and marked positive reactions against Sparganum mansoni antigen in the serum. After two consecutive doses of praziquantel treatment, the patients symptoms and laboratory and imaging findings were improved. Both specific antibody detection and follow-up of the patients eosinophils, serum antibody, and imaging changes are important for sparganosis diagnosis, particularly in cases without a subcutaneous lump or mass.

Atrial transseptal left ventricular lead implantation for cardiac resynchronization therapy using arteriovenous loop technique

To date, several techniques for transseptal left ventricular (LV) endocardial pacing for cardiac resynchronization therapy (CRT) have been proposed in patients for whom routine transvenous LV pacing is infeasible. These techniques are of varying difficulty and complexity, and some requires devices not easily accessible. We herein report a simple, safe and effective approach of atrial transseptal LV lead implantation using arteriovenous loop technique in a patient for whom transvenous LV implantation lead had failed.

Percutaneous closure of the inadvertent subclavian artery cannulation during pacemaker implantation

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