Report on cardiovascular health and diseases in China 2021: an updated summary
In 2019, cardiovascular disease (CVD) accounted for 46.74% and 44.26% of all deaths in rural and urban areas, respectively. Two out of every five deaths were attributed to CVD. It is estimated that approximately 330 million individuals in China are affected by CVD. Among them, there are 13 million cases of stroke, 11.4 million cases of coronary heart disease, 5 million cases of pulmonary heart disease, 8.9 million cases of heart failure, 4.9 million cases of atrial fibrillation, 2.5 million cases of rheumatic heart disease, 2 million cases of congenital heart disease, 45.3 million cases of lower extremity artery disease, and 245 million cases of hypertension. With the dual challenges of population aging and a steady increase in the prevalence of metabolic risk factors, the burden of CVD in China is expected to continue rising. Consequently, new demands arise for CVD prevention, treatment, and the allocation of medical resources. Emphasizing primary prevention to reduce disease prevalence, increasing the allocation of medical resources for CVD emergency and critical care, and providing rehabilitation services and secondary prevention to reduce the risk of recurrence, rehospitalization, and disability among CVD survivors are of paramount importance. Hypertension, dyslipidemia, and diabetes affect millions of individuals in China. Since blood pressure, blood lipids, and blood sugar levels often rise insidiously, vascular disease and serious events such as myocardial infarction and stroke occur by the time they are detected in this population. Therefore, it is crucial to implement strategies and measures to prevent risk factors such as hypertension, dyslipidemia, diabetes, obesity, and smoking. Furthermore, greater efforts should be directed towards assessing cardiovascular health status and conducting research on early pathological changes to enhance prevention, treatment, and understanding of CVD.
Heart failure in the elderly
Heart failure (HF) is a clinical syndrome caused by structural and/or functional cardiac abnormalities, resulting in a reduced cardiac output and/or elevated intracardiac filling pressures at rest or during stress. HF is a major public health problem with high prevalence and incidence, involving both high morbidity and mortality, but also high economic costs. The incidence of HF progressively increases with age, reaching around 20% among people over 75 years old. Indeed, HF represents the leading cause of hospitalization in patients older than 65 years in Western countries. Hence, some authors even consider HF a geriatric syndrome, entailing worse prognosis and high residual disability, and often associating some complex comorbidities, common in older population, that may further complicate the course of the disease. On the other hand, however, clinical course and prognosis may be often difficult to predict. In this article, main pathophysiological issues related to the aging heart are addressed, together with key aspects related to both diagnosis and prognosis in elderly patients with HF. Besides, main geriatric conditions, common in the elderly population, are reviewed, highlighting the importance of a comprehensive and multidisciplinary approach.
MiR-21-5p-expressing bone marrow mesenchymal stem cells alleviate myocardial ischemia/reperfusion injury by regulating the circRNA_0031672/miR-21-5p/programmed cell death protein 4 pathway
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2023, 20(8): 555-566.
doi: 10.26599/1671-5411.2023.08.003
2023, 20(8): 577-585.
doi: 10.26599/1671-5411.2023.08.001
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, Available online ,
doi: 10.11909/j.issn.1671-5411.2022.12.011
Abstract:
OBJECTIVES To investigate proarrhythmic substrates of atrial fibrillation (AF) in a canine model of dehydromonophylline (DMCT)-induced pulmonary arterial hypertension (PAH). METHODS All cannines (n = 12) underwent baseline echocardiographic and hemodynamic examinations, 7 of which were injected with DMCT (3.0 mg/kg) to induce PAH via jugular vein cannulation. The control beagles (n = 5) were given the same dose of normal saline. Then, both groups were monitored by insertable cardiac monitors. Hemodynamic, echocardiographic, electrophysiological and histological examinations were performed 8 weeks later. RESULTS In PAH group, two died after the injection (mortality 28.6%). Thus, 10 beagles (PAH group: 5, control group: 5) underwent all the examinations. The pulmonary artery pressure increased significantly while the right atrium (RA) and right ventricle expanded slightly. Spontaneous AF episodes were recorded in all PAH canines 1 week after the injection. The AF burden increased rapidly from 1 week (7.6% ± 1.8%) and remained high after 2-3 weeks (32.0% ± 4.9% at 8 weeks). Compared with the control group, the PAH group had abbreviated effective refractory periods (ERPs), increased atrial ERP dispersion, and slower conduction velocities. Notably, AF susceptibility and atrial remodeling in RA was more significant those in LA, such as increased WOV (39.0 ± 6.5 vs. 28.0 ± 5.7 ms, P = 0.022), enlarged low voltage regions (7.66% ± 0.46% vs. 4.40% ± 0.55%, P < 0.0001) and fibrosis (8.22% ± 0.61% vs. 4.93% ± 0.60%, P < 0.0001). CONCLUSIONS DMCT-induced canine PAH model increased the incidence of spontaneous and induced AF. The electrophysiological and structural remodeling of the RA facilitated the AF genesis.
, Available online ,
doi: 10.11909/j.issn.1671-5411.2022.10.016
Abstract:
BACKGROUND The molecular mechanisms of heart failure (HF) remain poorly understood. Studies have increasingly found circular RNA (circRNA) exists in heart. The aim of this study is to acquire potential functions of circRNAs in HF. METHODS & RESULTS We integrated RNA sequencing data to identify the characteristics of circRNAs expressed in heart and found that most circRNAs screened were < 2000 nt (89%); moreover, Chromosome 1 and Y contained the largest and least number of circRNAs (10.59% and 0.2%), respectively. Subsequently, a total of 238 differentially expressed circRNAs (DECs) were found and 203 host genes were discovered after excluding duplicate host genes and intergenic circRNAs. However, only 4 of 203 host genes of DECs were checked in differentially expressed genes (DEGs) of HF. Another, Gene Oncology (GO) analysis of DECs host genes was performed to elucidate the underlying pathogenesis of HF, suggesting that binding and catalytic activity accounted for a great part of DECs. The pathways related to immune system, metabolism and signal transduction were significantly enriched. Additionally, 1052 potentially regulated miRNAs from the top 40 DECs were collected to construct a circRNA–miRNA network and found that 470 miRNAs can be regulated by multiple circRNA, while others were regulated by a single circRNA. And further comparison with the top 10 mRNAs and their targeted miRNAs in HF showed DDX3Y and UTY were regulated by the most and least circRNA, respectively. Finally, four selected randomly DECs were validated by qRT-PCR. CONCLUSION These data showed that circRNAs have species and tissue specific expression features; although circRNAs expression independent on host genes, same types of genes between DECs and DEGs worked in HF. CircRNAs could regulate miRNAs as molecular sponges. Our data would enhance understanding of the important roles of circRNAs and lay a foundation for future investigations of HF molecular functions.
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We would delightedly report that the 2020 SCI impact factor of Journal of Geriatric Cardiology（JGC，ISSN 1671-5411/ CN 11-5329/R） has increased from 2.491 to 3.327, according to the 2020 Journal Citation Reports (InCites, Clarivate Analytics), ranking 33/53 and 65/142 in the fields of Geriatrics & Gerontology and Cardiac & Cardiovascular Systems, respectively.
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