CVIA Journal

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have been found to ameliorate major adverse cardiovascular events in patients with heart failure with preserved ejection fraction (HFpEF), but the exact mechanism is unknown. Ferroptosis is a form of programmed necrosis. In this article the authors verified that canagliflozin (CANA) ameliorates heart function in HFpEF rats, partly by regulating ferroptosis, which may be activated by AMPK/PGC-1α/Nrf2 signaling.

An HFpEF model was established and subjected to CANA treatment. Blood pressure was monitored, and echocardiography was performed at the 12^th week. Pathological examination was performed, and expression of ferroptosis-associated proteins and AMPK/PGC-1α/Nrf2 signaling related proteins was detected.

CANA had an antihypertensive effect and increased E/A ratios in HFpEF rats. Myocardial pathology was ameliorated, based on decreased cross-sectional area and intercellular fibrosis. Acyl-CoA synthetase long-chain family member 4 (ACSL4) expression increased, whereas ferritin heavy chain 1 (FTH1) expression decreased in HFpEF rats, which showed iron overload. CANA reversed changes in ACSL4 and FTH1, and decreased iron accumulation, but did not alter glutathione peroxidase 4 (GPX4) expression. The expression of AMPK/PGC-1α/Nrf2 signaling related proteins and heme oxygenase 1 (HO-1) in the HFpEF group decreased but was reverted after CANA treatment.

CANA regulates ferroptosis, potentially via activating AMPK/PGC-1α/Nrf2 signaling in HFpEF rats.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2022.0024

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Sai Ma, Lili He and Qingjuan Zuo et al. Canagliflozin Regulates Ferroptosis, Potentially via Activating AMPK/PGC-1α/Nrf2 Signaling in HFpEF Rats. CVIA. Vol. 7(1). DOI: 10.15212/CVIA.2022.0024

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Coronary no-reflow phenomenon (NRP), a common adverse complication in patients with ST-segment elevation myocardial infarction (STEMI) treated by percutaneous coronary intervention (PCI), is associated with poor patient prognosis. In this study, the correlation between the systemic immune-inflammation index (SII) and NRP in older patients with STEMI was studied, to provide a basis for early identification of high-risk patients and improve their prognosis.

Between January 2017 and June 2020, 578 older patients with acute STEMI admitted to the Department of Cardiology of Hebei General Hospital for direct PCI treatment were selected for this retrospective study. Patients were divided into an NRP group and normal-flow group according to whether NRP occurred during the operation. Clinical data and the examination indexes of the two groups were collected. Logistic regression was used to analyze the independent predictors of NRP, and the receiver operating characteristic curve was used to further analyze the ability of SII to predict NRP in older patients with STEMI.

Multivariate logistic analysis indicated that hypertension (OR=2.048, 95% CI:1.252–3.352, P=0.004), lymphocyte count (OR=0.571, 95% CI:0.368–0.885, P=0.012), platelet count (OR=1.009, 95% CI:1.005–1.013, P<0.001), hemoglobin (OR=1.015, 95% CI:1.003–1.028, P=0.018), multivessel disease (OR=2.237, 95% CI:1.407–3.558, P=0.001), and SII≥1814 (OR=3.799, 95% CI:2.190–6.593, P<0.001) were independent predictors of NRP after primary PCI in older patients with STEMI. Receiver operating characteristic curve analysis demonstrated that SII had a high predictive value for NRP (AUC=0.738; 95% CI:0.686–0.790), with the best cut-off value of 1814, a sensitivity of 52.85% and a specificity of 85.71%.

For older patients with STEMI undergoing primary PCI, SII is a valid predictor of NRP.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0005

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Jiaqi Wang, Feifei Zhang and Man Gao et al. The Systemic Immune Inflammatory Index Predicts No-Reflow Phenomenon after Primary Percutaneous Coronary Intervention in Older Patients with STEMI. CVIA. Vol. 7(1). DOI: 10.15212/CVIA.2023.0005

Announcing a new article publication for Cardiovascular Innovations and Applications journal.   Cardiac surgery-associated acute kidney injury (CSA-AKI) is a major complication that increases morbidity and mortality after cardiac surgery. Most established predictive models are limited to the analysis of nonlinear relationships and do not adequately consider intraoperative variables and early postoperative variables. Nonextracorporeal circulation coronary artery bypass grafting (off-pump CABG) remains the procedure of choice for most coronary surgeries, and refined CSA-AKI predictive models for off-pump CABG are notably lacking. Therefore, this study used an artificial intelligence-based machine learning approach to predict CSA-AKI from comprehensive perioperative data.

In total, 293 variables were analysed in the clinical data of patients undergoing off-pump CABG in the Department of Cardiac Surgery at the First Affiliated Hospital of Guangxi Medical University between 2012 and 2021. According to the KDIGO criteria, postoperative AKI was defined by an elevation of at least 50% within 7 days, or 0.3 mg/dL within 48 hours, with respect to the reference serum creatinine level. Five machine learning algorithms—a simple decision tree, random forest, support vector machine, extreme gradient boosting and gradient boosting decision tree (GBDT)—were used to construct the CSA-AKI predictive model. The performance of these models was evaluated with the area under the receiver operating characteristic curve (AUC). Shapley additive explanation (SHAP) values were used to explain the predictive model.

The three most influential features in the importance matrix plot were 1-day postoperative serum potassium concentration, 1-day postoperative serum magnesium ion concentration, and 1-day postoperative serum creatine phosphokinase concentration.

GBDT exhibited the largest AUC (0.87) and can be used to predict the risk of AKI development after surgery, thus enabling clinicians to optimise treatment strategies and minimise postoperative complications.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0006

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Sai Zheng, Yugui Li and Cheng Luo et al. Machine Learning for Predicting the Development of Postoperative Acute Kidney Injury After Coronary Artery Bypass Grafting Without Extracorporeal Circulation. CVIA. Vol. 7(1). DOI: 10.15212/CVIA.2023.0006

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Patients with persistent atrial fibrillation (PsAF) have a high risk of recurrence after catheter radiofrequency ablation. Nevertheless, no effective prognostic tools have been developed to identify these high-risk patients to date. This authors of this article sought to develop and validate a simple linear predictive model for predicting postoperative recurrence in patients with PsAF.
From June 2013 to June 2021, patients with PsAF admitted to our hospital were enrolled in this single-center, retrospective, observational study. The characteristics substantially associated with recurrence in patients with PsAF were screened through univariate and multivariate logistic regression analysis. The receiver operating characteristic curve was used to assess the predictive significance of the nomogram model after nomogram development. Furthermore, to assess the clinical value of the nomogram, we performed calibration curve and decision curve analyses.
A total of 209 patients were included in the study, 42 (20.10%) of whom were monitored up to 1 year for recurrent AF. The duration of AF episodes, left atrial diameter, BMI, CKMB, and alcohol consumption were found to be independent risk factors (P<0.05) and were integrated into the nomogram model development. The area under the curve was 0.895, the sensitivity was 93.3%, and the specificity was 71.4%, thus indicating the model’s excellent predictive ability. The C-index of the predictive nomogram model was 0.906. Calibration curve and decision curve analyses further revealed that the model had robust prediction and strong discrimination ability.
This simple, practical, and innovative nomogram can help clinicians in evaluation of the risk of PsAF recurrence after catheter ablation, thus facilitating preoperative evaluation, postoperative monitoring and ultimately the construction of more personalized therapeutic protocols.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0001

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Cong-Ying Deng, Ai-Lin Zou and Ling Sun et al. Development and Validation of a Postoperative Prognostic Nomogram to Predict Recurrence in Patients with Persistent Atrial Fibrillation: A Retrospective Cohort Study. CVIA. Vol. 7(1). DOI: 10.15212/CVIA.2023.0001

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  Acute type A aortic dissection (ATAAD) is a catastrophic disease with fatal outcomes. Malperfusion syndrome (MPS) is a serious complication of ATAAD, with an incidence of 20–40%. Many studies have shown that MPS is the main risk factor for poor ATAAD prognosis. However, a risk scoring system for ATAAD based on MPS is lacking. Here, we designed a risk scoring system for ATAAD to assess mortality through quantitative assessment of relevant organ malperfusion and subsequently develop rational treatment strategies.

This was a prospective observational study. Patients’ perioperative clinical data were collected to establish a database of ATAAD (N≥3000) and determine whether these patients had malperfusion complications. The Anzhen risk scoring system was established on the basis of organ malperfusion by using a random forest survival model and a logistics model. The better method was then chosen to establish a revised risk scoring system.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0002

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Bo Jia, Cheng Luo and Chengnan Li et al. The Anzhen Risk Scoring System for Acute Type A Aortic Dissection: A Prospective Observational Study Protocol. CVIA. Vol. 7(1). DOI: 10.15212/CVIA.2023.0002

Announcing a new article publication for Cardiovascular Innovations and Applications journal.   Spontaneous heparin-induced thrombocytopenia is a pro-thrombotic syndrome in which anti-heparin antibodies develop without heparin exposure.

A 78-year-old man who underwent a successful lumbar laminectomy presented to the hospital 5 days after discharge for stroke-like symptoms and was found to have acute infarcts of the bilateral frontal lobes. The patient was found to be severely thrombocytopenic and was incidentally found to have an inferior wall myocardial infarction. Further investigation led to the diagnosis of bilateral lower extremity deep vein thromboses. His overall clinical presentation prompted a detailed hematologic workup that indicated positivity for heparin-induced thrombocytopenia despite no previous exposure to heparin products.

This case study illustrates a patient with no prior lifetime heparin exposure who underwent laminectomy with subsequent development of acute infarcts of the bilateral frontal lobes, an inferior wall myocardial infarction, and bilateral lower extremity deep vein thromboses, with concern for sequelae of spontaneous heparin-induced thrombocytopenia.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0007

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Jong Kun Park, Ilan Vavilin and Jacob Zaemes et al. Spontaneous Heparin-Induced Thrombocytopenia Presenting as Concomitant Bilateral Cerebrovascular Infarction and Acute Coronary Syndrome. CVIA. Vol. 7(1). DOI: 10.15212/CVIA.2023.0007

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  This study was aimed at investigating the effects of preoperative treatment with a loading dose of statins combined with a PCSK9 inhibitor on coronary blood perfusion and short-term cardiovascular adverse events in patients with ST-segment elevation myocardial infarction (STEMI).   Sixty-five patients with STEMI who had visited the Shanxi Cardiovascular Disease Hospital between May 2018 and May 2021 were enrolled in the study. The enrolled patients had no history of oral statins or antiplatelet therapy. The patients were divided into a combined treatment group (loading dose of statins combined with PCSK9 inhibitors, 35 patients) and a routine treatment group (loading dose of statins only, 30 patients). The primary endpoints were thrombolysis in myocardial infarction (TIMI) blood flow grading, corrected TIMI frame count (CTFC), and TIMI myocardial perfusion grading (TMPG), immediately after and 30 days after the operation. The secondary endpoint was a composite endpoint of cardiovascular death, nonfatal myocardial infarction, and target vessel revascularization 30 days after the operation.   The combined treatment group had significantly lower CTFC (14.09 ± 8.42 vs 26 ± 12.42, P = 0.04) and better TMPG (2.74 ± 0.61 vs 2.5 ± 0.73, P = 0.04) than the routine treatment group immediately after the operation. Similarly, the combined treatment group had a significantly lower CTFC (16.29 ± 7.39 vs 26.23 ± 11.53, P = 0.04) and significantly better TMPG (2.94 ± 0.24 vs 2.76 ± 0.43, P = 0.01) than the routine treatment group 1 month after the operation.   Preoperative treatment with a loading dose of high-intensity statins combined with PCSK9 inhibitors increased coronary blood flow and myocardial perfusion after emergency thrombus aspiration in patients with STEMI. However, the treatment did not significantly decrease the incidence of cardiovascular death, nonfatal myocardial infarction, or target vessel revascularization.

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Effects of Loading-Dose Statins Combined with PCSK9 Inhibitor Pre-Treatment before Primary Percutaneous Coronary Intervention on the Short-Term Prognosis in Patients with ST-Segment Elevation Myocardial Infarction, An, Jian, Cardiovascular Innovations and Applications, 2022, https://doi.org/10.15212/CVIA.2022.0011

Announcing a new article publication for Cardiovascular Innovations and Applications journal.   Atrial fibrillation is the most common arrhythmia leading to cardiogenic stroke. Without membranous sructure between epicardial adipose tissue and atrial myocardium, epicardial adipose tissue directly covers the surface of the atrial myocardium. The formation of an epicardial adipose tissue inflammatory microenvironment, fibrosis, infiltration by epicardial adipose tissue, autonomic dysfunction and oxidative stress are important mechanisms that trigger and maintain atrial fibrillation. 

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: Role of Epicardial Adipose Tissue in Triggering and Maintaining Atrial Fibrillation, Tian, Ye, Cardiovascular Innovations and Applications, 2022, https://doi.org/10.15212/CVIA.2022.0012

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  Primary cardiac tumors are extremely uncommon. Here, the author of this article reports the case of a patient with a primary left ventricular interstitial tumor presenting with hemodynamically unstable ventricular tachycardia. In response to hemodynamically unstable ventricular tachycardia, an implantable cardioverter-defibrillator was inserted. One month after defibrillator implantation, the patient developed episodes of high ventricular tachycardia that could not be effectively terminated by catheter radiofrequency ablation, thus further confirming that the ventricular tachycardia was induced by the left ventricular interstitial tumor. 

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: A Rare Case of a Primary Cardiac Tumor Presenting as Fatal Ventricular Tachycardia, Guo, Xueya, Cardiovascular Innovations and Applications, 2022, https://doi.org/10.15212/CVIA.2022.0014 

Announcing a new article publication for Cardiovascular Innovations and Applications journal.   Sleep is essential to the normal psychological and physiological activities of the human body. Increasing evidence indicates that sleep deprivation is associated with the occurrence, development, and poor treatment effects of various arrhythmias. Sleep deprivation affects not only the peripheral nervous system but also the central nervous system, which regulates the occurrence of arrhythmias. In addition, sleep deprivation is associated with apoptotic pathways, mitochondrial energy metabolism disorders, and immune system dysfunction. Although studies increasingly suggest that pathological sleep patterns are associated with various atrial and ventricular arrhythmias, further research is needed to identify specific mechanisms and recommend therapeutic interventions. This article summarizes the findings of sleep deprivation in animal experiments and clinical studies, current challenges, and future research directions in the field of arrhythmias.

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. CVIA is indexed in the EMBASE, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ and Index Copernicus Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Article reference: The Role of Sleep Deprivation in Arrhythmias, Yin, Dechun, Cardiovascular Innovations and Applications, 2022, https://doi.org/10.15212/CVIA.2022.0013