Objective To develop and validate a nomogram model for predicting recurrence after radiofre-quency catheter ablation(RFCA)in patients with atrial fibrillation and heart failure using body surface electrocar-diogram indicators and clinical indicators.Methods We retrospectively analyzed 305 patients with atrial fibrilla-tion complicated with heart failure who underwent RFCA from January 2019 to January 2024.Patients were random-ized into training set(213 cases)and validation set(92 cases)at a ratio of 7:3 and followed up for at least 1 year.Based on the recurrence status,the patients were divided into recurrence group and non-recurrence group,with body surface electrocardiogram indicators and clinical indicators collected.Multivariate logistic regression analysis identified for risk factors for post RFCA recurrence,which were used to construct a nomogram.Model performance was assessed using the area under the receiver operating characteristic curve(AUC),Hosmer-Lemeshow test,calibration curves,and decision curve analysis(DCA).Results Among the 305 patients,84(27.54％)experi-enced recurrence after treatment.In the training set,61 patients had recurrence and 152 did not.No statistical differences were observed between the training set and the validation set(all P>0.05).In the training set,the recurrence group exhibited a higher proportion of persistent atrial fibrillation and significantly higher CHA2DS2-VASc scores,larger left atrial diameter,longer PR interval,and higher levels of NLR and NT-proBNP compared to the non-recurrence group(all P<0.05).Multivariate stepwise regression analysis revealed that high CHA2DS2-VASc score,long left atrial diameter,prolonged PR interval,and high NLR were independent risk factors of recurrence after RFCA(P<0.05)A four-factor prediction model was established as:Ln(P/1-P)=-12.87+0.84*CHA2DS2-VASc score+0.11* left atrial diameter+0.03*PR interval+0.31*NLR.The training and validation models showed AUCs of 0.85(95％CI:0.80～0.91)and 0.85(95％CI:0.76～0.94),respectively,suggesting that the model had good predictive efficiency.Hosmer-Lemeshow test results(χ2=2.43,P=0.965 for the training set;χ2=5.30,P=0.725 for the validation set)confirmed model fit,indicating that the fitted probability value was consistent with the actual probability value.Calibration curves after 1 000 times of Bootstrap repeated sampling showed the bias calibration curves of the training set and the validation set had good consistency with the actual curves,both close to the ideal curve.DCA revealed clinical utility across a wide threshold probability range(0.02～1.0 for the training set;0.04～1.0 for the validation set).Conclusion This nomogram,based on body surface electrocardiogram indicators and clinical indicators,effectively predicts post-RFCA recurrence in atrial fibrillation and heart failure patients,offering a useful tool for early assessment of recurrence risk.

Objective To develop and validate a nomogram model for predicting recurrence after radiofre-quency catheter ablation(RFCA)in patients with atrial fibrillation and heart failure using body surface electrocar-diogram indicators and clinical indicators.Methods We retrospectively analyzed 305 patients with atrial fibrilla-tion complicated with heart failure who underwent RFCA from January 2019 to January 2024.Patients were random-ized into training set(213 cases)and validation set(92 cases)at a ratio of 7:3 and followed up for at least 1 year.Based on the recurrence status,the patients were divided into recurrence group and non-recurrence group,with body surface electrocardiogram indicators and clinical indicators collected.Multivariate logistic regression analysis identified for risk factors for post RFCA recurrence,which were used to construct a nomogram.Model performance was assessed using the area under the receiver operating characteristic curve(AUC),Hosmer-Lemeshow test,calibration curves,and decision curve analysis(DCA).Results Among the 305 patients,84(27.54％)experi-enced recurrence after treatment.In the training set,61 patients had recurrence and 152 did not.No statistical differences were observed between the training set and the validation set(all P>0.05).In the training set,the recurrence group exhibited a higher proportion of persistent atrial fibrillation and significantly higher CHA2DS2-VASc scores,larger left atrial diameter,longer PR interval,and higher levels of NLR and NT-proBNP compared to the non-recurrence group(all P<0.05).Multivariate stepwise regression analysis revealed that high CHA2DS2-VASc score,long left atrial diameter,prolonged PR interval,and high NLR were independent risk factors of recurrence after RFCA(P<0.05)A four-factor prediction model was established as:Ln(P/1-P)=-12.87+0.84*CHA2DS2-VASc score+0.11* left atrial diameter+0.03*PR interval+0.31*NLR.The training and validation models showed AUCs of 0.85(95％CI:0.80～0.91)and 0.85(95％CI:0.76～0.94),respectively,suggesting that the model had good predictive efficiency.Hosmer-Lemeshow test results(χ2=2.43,P=0.965 for the training set;χ2=5.30,P=0.725 for the validation set)confirmed model fit,indicating that the fitted probability value was consistent with the actual probability value.Calibration curves after 1 000 times of Bootstrap repeated sampling showed the bias calibration curves of the training set and the validation set had good consistency with the actual curves,both close to the ideal curve.DCA revealed clinical utility across a wide threshold probability range(0.02～1.0 for the training set;0.04～1.0 for the validation set).Conclusion This nomogram,based on body surface electrocardiogram indicators and clinical indicators,effectively predicts post-RFCA recurrence in atrial fibrillation and heart failure patients,offering a useful tool for early assessment of recurrence risk.

Objective To investigate the protective effect of miR-328-3p on oxidized low-density lipoprotein(ox-LDL)-induced coronary artery endothelial cell injury and the potentially relevant mechanisms.Methods Human coronary artery endothelial cells(HCAECs)were induced with ox-LDL,and the cells were divided into a control group consisting of normal cells,an ox-LDL group receiving ox-LDL treatment,an ox-LDL+miR-NC group transfected with miR-NC and treated with ox-LDL,an ox-LDL+miR-328-3p group transfected with miR-328-3p and treated with ox-LDL,and ox-LDL+miR-328-3p+pcDNA group co-transfected miR-328-3p and pcDNA and treated with ox-LDL,and an ox-LDL+miR-328-3p+insulin-like growth factor 2(IGF2)group co-transfected miR-328-3p and IGF2 and treated with ox-LDL.The expression level of miR-328-3p was determined with RT-qPCR.Cell proliferation was determined by MTT.Cell apoptosis was measured by flow cytometry.Western blot was conducted to examine the protein expression levels of cleaved cas-3 and IGF2.ELISA was performed to determine the levels of tumor necrosis factor α(TNF-α),interleukin(IL)-6,and IL-1β.Dual luciferase reporter experiment was performed to verify the targeting relationship between miR-328-3p and IGF2.Results Compared with those of the control group,miR-328-3p expression level and cell activity were significantly reduced in the ox-LDL group(P＜0.05),while the apoptotic rate,the protein expression levels of cleaved cas-3,IGF2,Bax,and Bcl-2,and the levels of TNF-α,IL-6,and IL-1β were significantly increased(P＜0.05).Compared with those of the ox-LDL+miR-NC group,miR-328-3p expression level and cell activity significantly increased in the ox-LDL+miR-328-3p group(P＜0.05),while the apoptosis rate,the protein expression levels of cleaved cas-3 and IGF2,and the levels of TNF-α,IL-6,and IL-1β were significantly reduced.IGF2 was a functional target of miR-328-3p.Compared with those of the ox-LDL+miR-328-3p+pcDNA co-transfection group,the IGF2 protein level was significantly increased(P＜0.05)and cell activity was significantly decreased(P＜0.05)in the ox-LDL+miR-328-3p+IGF2 co-transfection group,while the apoptosis rate,cleaved cas-3 protein level,and the levels of TNF-α,IL-6,and IL-1β were significantly elevated(P＜0.05).Conclusion miR-328-3p inhibits ox-LDL-induced apoptosis and inflammatory in coronary artery endothelial cell injury through targeted negative regulation of IGF2.

OBJECTIVE: To study the effect of silencing LncRNA SNHG7 on hypoxia/reoxygenation (H/R)-induced cardiomyocyte injury and its targeted regulation on miR-181b-5p. METHODS: Rat cardiomyocytes H9c2 were cultured in vitro and randomly divided into control group, H/R group, H/R + si-NC group, H/R + si-SNHG7 group, H/R + si-SNHG7 + anti-miR-NC group and H/R + si-SNHG7 + anti-miR-181b-5p group. The content of lactate dehydrogenase (LDH), malondialedhyde (MDA) and the activity of superoxide dismutase (SOD) were detected. Flow cytometry was carried out to detect the rate of apoptosis. qRT-PCR was used to detect the expression of SNHG7 and miR-181b-5p. Dual luciferase report experiment was used to verify the targeting relationship between SNHG7 and miR-181b-5p. Western blotting was used to detect the expression of Bax and Bcl-2. RESULTS: Compared with the control group, the H/R group showed significantly increased SNHG7 expression in cardiomyocytes, reduced miR-181b-5p expression, higher levels of LDH and MDA, reduced activity of SOD, increased cell apoptosis rate, higher level of Bax protein, and reduced level of Bcl-2 protein (all P< 0.05). Compared with the H/R and H/R + si-NC groups, the H/R + si-SNHG7 group had significantly reduced level of LDH and MDA, increased activity of SOD, reduced apoptosis rate, reduced level of Bax protein, increased level of Bcl-2 protein (all P< 0.05). The dual luciferase report experiment confirmed that SNHG7 could target miR-181b-5p. Interference with the expression of miR-181b-5p could reduce the effect of silencing SNHG7 on H/R-induced cardiomyocyte oxidative stress and apoptosis. CONCLUSION Silencing SNHG7 may inhibit H/R-induced cardiomyocyte oxidative stress and apoptosis by up-regulating the expression of miR-181b-5p, thereby exerting a protective effect on cardiomyocytes.
Animals ; Apoptosis ; Hypoxia ; MicroRNAs/genetics* ; Myocardial Reperfusion Injury ; Myocytes, Cardiac ; RNA, Long Noncoding/genetics* ; Rats

Objective To investigate the modulation effects of mesenchymal stem cells(MSCs)overex-pressing IL-10 transplanted in a rat model of myocardial infarction and its possible mechanism. Methods The MI rats were established by left anterior descending coronary artery ligation and the rats were then randomly divided into three groups:group C(MSC+PBS),group P(pcDNA3-IL-10+MSC),group K(pcDNA3+MSC).Echocardiography and hemodynamic examinations were used to evaluate the cardiac function.Myocardial infarction size were evaluate were evaluate by Immumohistochemical stainingmyocardial.At the same time,Immunofluorescence and western blot was applied to show the expression of Caspase-3,TNF-α and IL-1β,respectively.Results The left ventricular ejec-tion fraction and fractional shortening in three groups showed no significant difference(P>0.05)at different time;There were no statistically significant differences between the groups K and group C and the left ventricular ejection fraction,fractional shortening in group P were highest(P<0.05);The left ventricular ejection fraction(Finteractive=2.564,Pinteractive=0.015)and fractional shortening(Finteractive=2.233,Pinteractive=0.022)have interactive effect in three groups.After 4 weeks,LVSP,+dp/dtmax and-dp/dtmax in group P were significantly higher than that of C group and K group,while the LVEDP was lower(P<0.01);immunofluorescence and Western blot showed that Caspase-3, TNF-α and IL-1β in group P were significantly lower than that of C group and K group,and the difference was statis-tically significant(P<0.05).Conclusion MSC overexpressing IL-10 can promote the recovery of cardiac function after MI,which may be related to inhibition of Caspase-3 apoptosis gene and TNF-α and IL-1β inflammatory factors.

BACKGROUND:Until now, it is stil unclear whether the stem cel transplantation triggersadverse effects on the myocardial electrical activity, resulting in the emergence of arrhythmia.
OBJECTIVE:To explore the effect of intracoronary transplantation of umbilical cord blood stem cels on arrhythmia score and incidence of ventricular arrhythmia.
METHODS:According to therapeutic strategies, 73patients with coronary heart disease were assigned to receive drug therapy in control group (n=38) and umbilical cord blood stem cel transplantation in observation group (n=35). Arrhythmia score, incidence of ventricular arrhythmia and adverse reactions were recorded and analyzed before and 1, 4, 8 weeks after transplantation.
RESULTS AND CONCLUSION:After treatment, arrhythmia scores were significantly reduced in the two groups, especialy in the observation group, to exhibit a continuous decline trend (P< 0.05). Compared with the control group, the incidence of ventricular arrhythmia was significantly lower in the observation (P< 0.05). However, there were no significant changes in the blood pressure, heart rate and blood oxygen saturation before and after transplantation, and no acute heart failure and death occurred in thetwo groups. These results suggest that the intracoronary transplantation of umbilical cord blood stem cels exhibits superiorities in the treatment of coronary artery disease, significantly reducing the arrhythmia score, reducing the incidence of ventricular arrhythmia, and resulting in less adverse reactions.

BACKGROUND:It is unclear whether the body differences in patients with different types of heart diseases affect the characteristics and performance of stem cel s. OBJECTIVE:To explore the biological characteristics of bone marrow mesenchymal stem cel s from patients with different types of heart diseases. METHODS:Bone marrow mesenchymal stem cel s were extracted using density gradient centrifugation from the bone marrow of 27 patients with coronary heart diseases and 20 patients with other heart diseases. Cel morphology was observed in the two groups. CD13, CD34, CD45, CD54, CD106 and CD44 positive expression was detected by flow cytometry. Cel proliferation was detected by MTT method, and the in vitro cel growth curves of the two groups were described. RESULTS AND CONCLUSION:The bone marrow mesenchymal stem cel s of the two groups showed a long spindle shape, and there was no significant difference in the cel morphology between the two groups. In al the patients, the positive rates of CD34 and CD455 were less than 3.0%, while the positive rates of CD13 and CD44 were higher than 95.0%. However, the positive rates of CD54 and CD106 were higher in patients with coronary heart disease as compared with those with other heart diseases (P<0.05). The in vitro growth curves of cel s in the two groups were basical y consistent, and the cel proliferation was only a little higher in the patients with other heart diseases compared with those with coronary heart disease. Experimental results show that different types of heart diseases in patients have no influence on morphology and proliferation of bone marrow mesenchymal stem cel s, but some function-related proteins may exhibit certain difference in their expressions.

ObjectiveTo explore the clinical significance of heart-type fatty acid-binding protein (H-FABP) in acute myocardial infarction(AMI) patients. MethodsThe level of H-FABP was assayed within 30 min, 1 h, 2 h, 4 h,6 h and 12 h by enzyme linked immunosorbent assay (ELISA) in 46 AMI patients, and cardiac troponin Ⅰ(cTnⅠ) and creatinine kinase(CK-MB) also was assayed by routine method.The diagnostic accuracy was compared among different methods. ResultsThe diagnostic accuracy of H-FABP[95.7％ (44/46)] was significantly higher than cTnⅠ[65.2％(30/46)] and CK-MB[41.3％ (19/46)](P ＜0.05). The levels of H-FABP, cTnⅠ and CK-MB significantly increased after AMI onset 4,6,12 hrespectively. ConclusionThe diagnosticaccuracy of H-FABP is higher and can be used as a parameter for the early diagnosis of AMI.