1.Application of cardiac magnetic resonance T1 mapping in cardiomyopathy and devel-opment of imaging technology
Jia DENG ; Huifang TANG ; Hong ZHOU ; Ying YU ; Wenmin YANG ; Jinbiao ZHOU ; Jinwei TIAN
Chinese Journal of Arteriosclerosis 2025;33(2):154-162
As cardiac magnetic resonance imaging technology advances,T1 mapping has emerged as a non-invasive method offering visual and quantitative insights into myocardial fibrosis,edema,and infiltration associated with cardiac dis-eases.The application of T1 mapping in myocardial diseases allows for evaluating both focal and diffuse myocardial fibro-sis,playing a crucial clinical role in the differentiation,treatment,and prognostic risk assessment of diseases.This arti-cle aims to provide a thorough overview of the clinical applications of T1 mapping in patients with cardiomyopathy,summa-rizing the commonly employed scanning techniques and imaging principles.
2.Correlation between soluble CD146 and systemic vasculitis
Jinwei GAO ; Zhao PENG ; Yao LIU ; Hongxia YU ; Yang WU ; Xinping TIAN
Chinese Journal of Internal Medicine 2025;64(6):532-541
Objective:To determine the correlation between serum soluble CD146 (sCD146) levels and disease activity in patients with systemic vasculitis and the potential of sCD146 as a novel biomarker.Methods:We recruited 304 patients from the systemic vasculitis cohort at Peking Union Medical College Hospital from July 2013 to December 2022. The cohort comprised 200 patients with Takayasu arteritis (TAK) and 104 with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). The patient′s demographic and clinical data, including age, sex, disease duration, disease type, laboratory results, and disease status, were extracted from the database. The serum sCD146 concentration was measured using a sandwich enzyme-linked immunosorbent assay (ELISA). Continuous variables were presented as mean±standard deviation if normally distributed, with between-group comparisons conducted using the t-test. For non-normally distributed data, median ( Q1, Q3) was used, and comparisons between groups were performed using the Mann-Whitney U test. Categorical data were expressed as percentages, and comparisons between groups were conducted using the Chi-square test or Fisher′s exact test,as appropriate. Kendall′s tau-b′s rank correlation coefficient was calculated to evaluate the correlation between sCD146 and variables associated with systemic vasculitis. A two-sided P value <0.05 was considered statistically significant. Results:Serum sCD146 levels were significantly lower in patients with active disease compared to those in remission in both cohorts [TAK: 246 (218, 287) vs. 277 (230, 322) μg/L, Z=-2.58, P=0.010; AAV: (301±90) vs. (344±81) μg/L, t=-2.56, P=0.007]. Serum sCD146 levels were positively correlated with age and disease duration (TAK: τ=0.09, 0.12, P=0.040, P=0.009; AAV: τ=0.28, 0.15, P<0.001, P=0.020). In patients with TAK, sCD146 levels were negatively correlated with IL-6, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and disease activity status ( τ=-0.17, -0.18, -0.16, -0.16; P=0.001, P<0.001, P=0.003, P=0.010). In patients with AAV, sCD146 levels were negatively correlated with platelet count (PLT),disease activity status,and the Birmingham Vasculitis Activity Score ( τ=-0.36, -0.27, -0.27; P<0.001, P=0.007, P=0.001). Conclusion:Serum sCD146 levels were significantly lower in patients with active systemic vasculitis than in remission, displaying a negative correlation with disease activity. These findings suggest that sCD146 has potential as a novel biomarker for assessing disease activity in systemic vasculitis.
3.Diagnostic value of a simplified confocal laser endomicroscopy healing score for deep remission in ulcerative colitis
Yue ZHENG ; Jixin ZHANG ; Jinwei WANG ; Yu TIAN ; Junxia LI ; Huahong WANG
Chinese Journal of Digestive Endoscopy 2025;42(5):384-390
Objective:To develop a simplified confocal laser endomicroscopy (CLE)-based healing scoring system for assistant diagnosis of deep remission in ulcerative colitis (UC).Methods:CLE images from consecutive UC patients in clinical remission or mild activity and healthy controls undergoing CLE at Peking University First Hospital from January 2017 to December 2019 were retrospectively analyzed. According to the diagnosis of inflammation in intestinal segments in the medical records of UC patients, CLE images were divided into two groups, the involved group (inflamed UC segment) and the control group (segments from healthy individuals and non-inflamed UC segments). CLE features differentiating the groups were identified, and univariable regression analysis was used to obtain indicators related to unhealed histological inflammation (Geboes score>2.0), forming a simplified CLE healing score using the significant indicators, and receiver operator characteristic (ROC) curve was drawn.Results:The study included 53 UC patients and 14 healthy controls, yielding 201 CLE segments (42 healthy, 69 non-inflamed, 90 inflamed). Eight CLE features differed significantly between the involved and the control groups ( P<0.001), including crypt distortion, crypt lumen irregularity, crypt proximity, crypt sparsity, crypt lumen fluorescein leakage, vascular fluorescein leakage, increased vessel diameter, and cellular infiltration. Univariable regression analysis indicated there were 4 indicators related to histological inflammation, including crypt distortion ( P=0.025, OR=3.613, 95% CI:1.174-11.114), crypt lumen irregularity ( P=0.021, OR=4.081, 95% CI: 1.233-13.511), crypt fluorescein leakage ( P=0.011, OR=5.486, 95% CI: 1.468-20.494) and increased vessel diameter ( P=0.002, OR=7.724, 95% CI: 2.062-28.938). These 4 indicators were combined to form a simplified CLE healing score and a ROC curve was plotted with AUC of 0.769 (95% CI:0.654-0.833). The optimal threshold for histological healing was the absence of all four features (score=0), with sensitivity and specificity of 83.1% (59/71) and 42.1% (8/19), respectively. Conclusion:The simplified CLE score demonstrates high sensitivity and correlates positively with histological healing, supporting its utility as an adjunct tool for assessing deep remission in UC.
4.Application of cardiac magnetic resonance T1 mapping in cardiomyopathy and devel-opment of imaging technology
Jia DENG ; Huifang TANG ; Hong ZHOU ; Ying YU ; Wenmin YANG ; Jinbiao ZHOU ; Jinwei TIAN
Chinese Journal of Arteriosclerosis 2025;33(2):154-162
As cardiac magnetic resonance imaging technology advances,T1 mapping has emerged as a non-invasive method offering visual and quantitative insights into myocardial fibrosis,edema,and infiltration associated with cardiac dis-eases.The application of T1 mapping in myocardial diseases allows for evaluating both focal and diffuse myocardial fibro-sis,playing a crucial clinical role in the differentiation,treatment,and prognostic risk assessment of diseases.This arti-cle aims to provide a thorough overview of the clinical applications of T1 mapping in patients with cardiomyopathy,summa-rizing the commonly employed scanning techniques and imaging principles.
5.Correlation between soluble CD146 and systemic vasculitis
Jinwei GAO ; Zhao PENG ; Yao LIU ; Hongxia YU ; Yang WU ; Xinping TIAN
Chinese Journal of Internal Medicine 2025;64(6):532-541
Objective:To determine the correlation between serum soluble CD146 (sCD146) levels and disease activity in patients with systemic vasculitis and the potential of sCD146 as a novel biomarker.Methods:We recruited 304 patients from the systemic vasculitis cohort at Peking Union Medical College Hospital from July 2013 to December 2022. The cohort comprised 200 patients with Takayasu arteritis (TAK) and 104 with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). The patient′s demographic and clinical data, including age, sex, disease duration, disease type, laboratory results, and disease status, were extracted from the database. The serum sCD146 concentration was measured using a sandwich enzyme-linked immunosorbent assay (ELISA). Continuous variables were presented as mean±standard deviation if normally distributed, with between-group comparisons conducted using the t-test. For non-normally distributed data, median ( Q1, Q3) was used, and comparisons between groups were performed using the Mann-Whitney U test. Categorical data were expressed as percentages, and comparisons between groups were conducted using the Chi-square test or Fisher′s exact test,as appropriate. Kendall′s tau-b′s rank correlation coefficient was calculated to evaluate the correlation between sCD146 and variables associated with systemic vasculitis. A two-sided P value <0.05 was considered statistically significant. Results:Serum sCD146 levels were significantly lower in patients with active disease compared to those in remission in both cohorts [TAK: 246 (218, 287) vs. 277 (230, 322) μg/L, Z=-2.58, P=0.010; AAV: (301±90) vs. (344±81) μg/L, t=-2.56, P=0.007]. Serum sCD146 levels were positively correlated with age and disease duration (TAK: τ=0.09, 0.12, P=0.040, P=0.009; AAV: τ=0.28, 0.15, P<0.001, P=0.020). In patients with TAK, sCD146 levels were negatively correlated with IL-6, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and disease activity status ( τ=-0.17, -0.18, -0.16, -0.16; P=0.001, P<0.001, P=0.003, P=0.010). In patients with AAV, sCD146 levels were negatively correlated with platelet count (PLT),disease activity status,and the Birmingham Vasculitis Activity Score ( τ=-0.36, -0.27, -0.27; P<0.001, P=0.007, P=0.001). Conclusion:Serum sCD146 levels were significantly lower in patients with active systemic vasculitis than in remission, displaying a negative correlation with disease activity. These findings suggest that sCD146 has potential as a novel biomarker for assessing disease activity in systemic vasculitis.
6.Diagnostic value of a simplified confocal laser endomicroscopy healing score for deep remission in ulcerative colitis
Yue ZHENG ; Jixin ZHANG ; Jinwei WANG ; Yu TIAN ; Junxia LI ; Huahong WANG
Chinese Journal of Digestive Endoscopy 2025;42(5):384-390
Objective:To develop a simplified confocal laser endomicroscopy (CLE)-based healing scoring system for assistant diagnosis of deep remission in ulcerative colitis (UC).Methods:CLE images from consecutive UC patients in clinical remission or mild activity and healthy controls undergoing CLE at Peking University First Hospital from January 2017 to December 2019 were retrospectively analyzed. According to the diagnosis of inflammation in intestinal segments in the medical records of UC patients, CLE images were divided into two groups, the involved group (inflamed UC segment) and the control group (segments from healthy individuals and non-inflamed UC segments). CLE features differentiating the groups were identified, and univariable regression analysis was used to obtain indicators related to unhealed histological inflammation (Geboes score>2.0), forming a simplified CLE healing score using the significant indicators, and receiver operator characteristic (ROC) curve was drawn.Results:The study included 53 UC patients and 14 healthy controls, yielding 201 CLE segments (42 healthy, 69 non-inflamed, 90 inflamed). Eight CLE features differed significantly between the involved and the control groups ( P<0.001), including crypt distortion, crypt lumen irregularity, crypt proximity, crypt sparsity, crypt lumen fluorescein leakage, vascular fluorescein leakage, increased vessel diameter, and cellular infiltration. Univariable regression analysis indicated there were 4 indicators related to histological inflammation, including crypt distortion ( P=0.025, OR=3.613, 95% CI:1.174-11.114), crypt lumen irregularity ( P=0.021, OR=4.081, 95% CI: 1.233-13.511), crypt fluorescein leakage ( P=0.011, OR=5.486, 95% CI: 1.468-20.494) and increased vessel diameter ( P=0.002, OR=7.724, 95% CI: 2.062-28.938). These 4 indicators were combined to form a simplified CLE healing score and a ROC curve was plotted with AUC of 0.769 (95% CI:0.654-0.833). The optimal threshold for histological healing was the absence of all four features (score=0), with sensitivity and specificity of 83.1% (59/71) and 42.1% (8/19), respectively. Conclusion:The simplified CLE score demonstrates high sensitivity and correlates positively with histological healing, supporting its utility as an adjunct tool for assessing deep remission in UC.
7.Research progress and current status of circular RNA in heart failure
Qin YANG ; Bingxin DU ; Yeying YANG ; Rui LI ; Jinwei TIAN ; Huibin LIU
Chinese Journal of Arteriosclerosis 2024;32(9):737-746
Circular RNA(circRNA)is a novel class of endogenous non-coding RNA with complex biological func-tions,participating in various physiological and pathological processes.Due to their relatively stable stucture and tissue-specific and temporal expression patterns,circRNA have become a recent focus of biomedical research.Heart failure(HF)is characterized by impaired ventricular filling and/or ejection function caused by primary myocardial injury and car-diac overload,leading to the inability of the heart to meet the metabolic demands of the body's tissues.It is the end stage of numerous cardiac diseases.Studies have found that circRNA may play a crucial regulatory role in the progression of HF,particularly in cardiomyocyte hypertrophy,cardiomyocyte apoptosis,autophagy and myocardial fibrosis.This review summarizes the formation,classification,functional forms,and roles in HF of circRNA,aiming to provide new insights for the prevention and treatment of HF.
8.The research progress of cardiac magnetic resonance for the assessment of coronary artery disease
Ying YU ; Jia DENG ; Yu CHEN ; Huifang TANG ; Jinwei TIAN
Chinese Journal of Arteriosclerosis 2024;32(12):1089-1096
Cardiac magnetic resonance(CMR)has the advantages of being radiation-free,multi-parameter,multi-sequence,and multi-planar,enabling one-stop assessment of cardiac motion and morphologic function,blood flow and per-fusion in patients with coronary artery disease.This article briefly introduces the typical imaging indicators of CMR and highlights the application in the diagnosis,treatment and prognostic assessment of coronary artery disease.
9.Relationship between white blood cell count and clinical classification in patients with coronary heart disease
Chaohui TANG ; Xiang PENG ; Jinwei TIAN ; Xia GU
Chinese Journal of Arteriosclerosis 2024;32(12):1051-1056
Aim To study the relationship between white blood cell count and clinical classification in patients with coronary heart disease and its clinical significance.Methods A total of 301 patients diagnosed with coronary heart disease in the Second Affiliated Hospital of Harbin Medical University from January 2022 to December 2023 were se-lected as the research subjects,and divided into stable angina pectoris(SAP)group and acute coronary syndrome(ACS)group based on their clinical manifestations and results of electrocardiogram,the differences of general data,biochemical indexes and cardiovascular indexes between the two groups were compared.Spearman correlation analysis was used to an-alyze the relationship between white blood cell count,neutrophil count and cardiovascular related indicators,including tro-ponin Ⅰ,N-terminal pro-brain natriuretic peptide(NT-proBNP),ejection fraction,left ventricular end-diastolic diameter(LVEDD),left atrial diameter,Gensini score,etc.ROC curve was employed to determine the cut-off point for diagno-sing ACS and SAP classification of coronary heart disease based on white blood cell count,and dividing patients into a group with normal white blood cell level and a group with above normal white blood cell level based on this cut-off point,the differences between the two groups were compared.Results The ratio of hyperlipidaemia history,white blood cell count,neutrophil count,C-reactive protein,platelet count,total cholesterol(TC),low density lipoprotein cholesterol(LDLC),troponin 1,NT-proBNP and Gensini score in the ACS group were significantly higher than those in the SAP group(all P<0.05),while the ratio of aspirin use,the ratio of statin use,and ejection fraction in the ACS group were low-er than those in the SAP group(all P<0.05).Spearman correlation analysis results showed that white blood cell count was positively correlated with C-reactive protein(r=0.443,P<0.001),troponin Ⅰ(r=0.333,P<0.001),NT-proBNP(r=0.245,P<0.001)and Gensini score(r=0.341,P<0.001),but negatively correlated with LVEDD(r=-0.212,P<0.001).Similarly,neutrophil count was positively correlated with C-reactive protein(r=0.430,P<0.001),troponin Ⅰ(r=0.325,P<0.001),NT-proBNP(r=0.292,P<0.001)and Gensini score(r=0.353,P<0.001),but negatively correlated with LVEDD(r=-0.175,P=0.002).The cut-off point of white blood cell count in the diagnosis of ACS was 9.35×109 L-1(sensitivity was 56.7%,specificity was 93.1%).The patients were divided into normal white blood cell level group(n=202)and above normal white blood cell level group(n=99).Hyperlipidemia,smoking history,TC,LDLC,C-reactive protein,troponin Ⅰ,NT-proBNP and Gensini scores in above normal white blood cell level group were significantly higher than those in the normal white blood cell level group(all P<0.05),while LVEDD was lower than that in the normal white blood cell level group(all P<0.05).Conclusion White blood cell count can easily identify the high-risk type of coronary heart disease,and the cut-off point for the diagnosis of ACS is 9.35×109 L-1.
10.Mechanism of Yangxin Dingji Capsules in Preventing Ventricular Arrhythmia Based on TAK1/MKK3/p38 MAPK Pathway
Mian LI ; Zheng ZHANG ; Xinyue LI ; Xue TIAN ; Wenlu ZHENG ; Jinwei WU ; Gang LIU ; Wenjie LIANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(20):86-95
ObjectiveTo explore the protective effect and mechanism of Yangxin Dingji capsules on isoproterenol (ISO)-induced ventricular arrhythmia in SD rat cardiomyocytes based on the transforming growth factor-β activated kinase 1 (TAK1)-mitogen-activated protein kinase kinase 3 (MKK3)-p38 mitogen-activated protein kinase (p38 MAPK) signaling pathway. MethodFifty male SPF-grade SD rats were randomly divided into a normal group, a model group, a propranolol group, a low-dose Chinese medicine group, and a high-dose Chinese medicine group. The ventricular arrhythmia model was constructed using the ISO "6+1" method. The propranolol group received propranolol at 0.015 g·kg-1·d-1. The Chinese medicine groups received Yangxin Dingji capsules at doses of 0.5、 2 g·kg-1·d-1, respectively. The normal and model groups were given an equal volume of 0.9% NaCl solution. Electrocardiogram (ECG) changes in SD rats were recorded using the BL-420F biological function experimental system. Hematoxylin-eosin (HE) staining was used to observe the pathological changes in the heart. Serum levels of cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and transforming growth factor-β1 (TGF-β1) were measured using enzyme-linked immunosorbent assay (ELISA). The mRNA expression of IL-1β and TNF-α was assessed using real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). Reactive oxygen species (ROS) expression was detected using immunofluorescence. Protein expression levels of TAK1, phosphorylated TAK1 (p-TAK1), MKK3, phosphorylated MKK3 (p-MKK3), p38 MAPK, phosphorylated p38 MAPK (p-p38 MAPK), nuclear factor-κB (NF-κB), phosphorylated NF-κB (p-NF-κB), IL-1β, and TNF-α were measured using Western blot or immunohistochemistry. ResultCompared with normal group, the model group showed significant ventricular arrhythmia in ECG, with an increased arrhythmia score (P<0.01). Pathological damage to myocardial tissue was evident, and serum levels of cTnI, CK-MB, IL-1β, TNF-α, and TGF-β1 were elevated (P<0.01). The mRNA and protein expression of IL-1β and TNF-α in myocardial tissue was also increased (P<0.01). ROS level and protein expression of p-TAK1, p-MKK3, p-p38 MAPK, and p-NF-κB were elevated in myocardial tissue (P<0.01). In the propranolol and Chinese medicine groups, the incidence of sustained ventricular tachycardia (SVT) and arrhythmia scores were significantly reduced compared to model group (P<0.05, P<0.01). Pathological damage to cardiomyocytes was alleviated, and levels of myocardial injury markers and inflammatory factors in serum and myocardial tissue were decreased. The ROS level in myocardial tissue was also reduced (P<0.01), with a noticeable reduction in related molecules in the p38 MAPK pathway (P<0.05, P<0.01). ConclusionThe expression of p38 MAPK pathway molecules was up-regulated in myocardial tissue of ISO-induced ventricular arrhythmia rats. Yangxin Dingji capsules may inhibit cardiac inflammation damage by regulating the expression of related molecules in the p38 MAPK pathway, thereby exerting a protective effect on myocardial cells, with TAK1 being a potential target.

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