Cardiovascular disease (CVD) is one of the leading causes of death worldwide. Heart sound classification plays a key role in the early detection of CVD. The difference between normal and abnormal heart sounds is not obvious. In this paper, in order to improve the accuracy of the heart sound classification model, we propose a heart sound feature extraction method based on bispectral analysis and combine it with convolutional neural network (CNN) to classify heart sounds. The model can effectively suppress Gaussian noise by using bispectral analysis and can effectively extract the features of heart sound signals without relying on the accurate segmentation of heart sound signals. At the same time, the model combines with the strong classification performance of convolutional neural network and finally achieves the accurate classification of heart sound. According to the experimental results, the proposed algorithm achieves 0.910, 0.884 and 0.940 in terms of accuracy, sensitivity and specificity under the same data and experimental conditions, respectively. Compared with other heart sound classification algorithms, the proposed algorithm shows a significant improvement and strong robustness and generalization ability, so it is expected to be applied to the auxiliary detection of congenital heart disease.
Abstract: The amniotic fluidderived stem cells (AFSC) possess considerable advantageous characteristics including high proliferation potential, easy availability, low immunogenicity and oncogenicity，and accordance with medical ethnics. Moreover, they do not require the sacrifice of human embryos for their isolation and the cells can differentiate into all three kinds of germs. Accordingly，they initiate a new and very promising field in stem cell research and they will be a potential source of stem cells for therapies related to regeneration medicine of cardiovascular diseases. The research about the AFSC utilization in cardiovascular diseases is just started. Though there were some exciting breakthroughs, there still remain many challenges. In the article，we will discuss AFSC characteristics, influence of amniotic fluid harvesting time on stem cells, isolation and purification, emphasizing mainly on the potential of AFSC differentiation into cardiovascular cells, current situation and problems in this field.
Food and Drug Administration (FDA) has suspended the use of both celecoxib (Celebrex, Pfizer) and naproxen (Aleve, Bayer) in prevention large clinical trials after discovering that celecoxib and naproxen appeared to increase the risk of cardiovascular events with patients on placebo. FDA also advises patients who are currently taking over the counter naproxen products to carefully follow the instructions on the label. Pfizer suggested that alternatives to celecoxib should be considered based on individual patient needs and risk. The cardiovascular community responds differently.
The main cause of death in patients with end-stage renal disease (ESRD) is cardiovascular disease, and trimethylamine-N-oxide (TMAO) has been found to be one of the specific risk factors in the pathogenic process in recent years. TMAO is derived from intestinal bacterial metabolism of dietary choline, carnitine and other substances and subsequently catalyzed by flavin monooxygenase enzymes in the liver. The changes of intestinal bacteria in ESRD patients have contributed to the accumulation of gut-derived uremic toxins such as TMAO, indoxyl sulfate and indole-3-acetic acid. While elevated TMAO concentration accelerates atherosclerosis through mechanisms such as inflammation, increased scavenger receptor expression, and inhibition of reverse cholesterol transport. In this review, this research introduces the biological function, metabolic processes of TMAO and mechanisms by which TMAO promotes the progression of cardiovascular disease in ESRD patients and summarizes current interventions that may be used to reverse gut microbiota disturbances, such as activated carbon, fecal microbial transplantation, dietary improvement, probiotic and probiotic introduction. It also focuses on exploring intervention targets to reduce the gut-derived uremic toxin TMAO in order to explore the possibility of more cardiovascular disease treatments for ESRD patients.
In 2022, many excellent clinical studies emerged in the field of cardiovascular surgery. Selecting papers published in The New England Journal of Medicine and other top medicine and cardiology journals, this review focused on the research progress on 7 topics in the field of cardiovascular surgery: coronary artery surgery, vascular surgery, valvular surgery, structural heart disease, congenital heart disease, heart transplantation, perioperative management, and special population.
Objective To explore the effects of lecture-based learning (LBL), problem-based learning (PBL) or combination of both on the cardiovascular system anatomy teaching. Methods Nine classes majoring in clinical medicine of Grade 2009 were randomly divided into the LBL class, the PBL class and the PBL combined with LBL class. The examination scores and questionnaire were used to evaluate the teaching effect. Results The students of LBL class did well in the objective questions test, but badly in case analysis. On the contrary, the students of PBL class did well in case analysis, but were weak in objective questions test. However, the students of PBL combined with LBL class could get good grades in both of them. Questionnaire showed that the PBL teaching method, PBL and LBL combined method could improve their communicative ability, learning motivation, comprehensive analysis ability, language skills and so on. Conclusion Combination of PBL and LBL not only enhances students’ memories about the anatomic knowledge, but also helps students practice efficiently what they learned to analyze clinical cases. Furthermore, the method of PBL combined with LBL improves, to a certain extent, students’ comprehensive quality.
ObjectiveTo comprehensively review the status quo, contents, and problems of health technology assessments (HTAs) on cardiovascular and cerebrovascular diseases in Chinese rural. MethodsThe CNKI, VIP, WanFang Data and CBM databases were searched for the HTAs on cardiovascular and cerebrovascular diseases in Chinese rural up to October 31st, 2013. Two reviewers independently screened literatures and extracted data, and then the qualitative method was used to systematically analyze the literatures' information and results. ResultsA total of 34 studies were included. Of which, 23 were descriptive studies and 11 were experimental studies. The studied populations were patients and ordinary residents who had received the service of cardiovascular and cerebrovascular diseases health technology in rural, as well as the grassroots medical technical personnel and promotion staffs who had developed the health technologies. HTAs on cardiovascular and cerebrovascular diseases in rural mainly included western medicine health technologies and traditional Chinese medicine (TCM) health technologies. The contents of HTA of the included literatures mainly included:effectiveness, acceptability, requirements, economic characteristics, safety and technical specific property. The results of the included literatures showed that the type of diseases involved in cardiovascular and cerebrovascular diseases in rural were not widely enough, the fields involved in assessment contents were single, lack of rigorous and comprehensive study design. ConclusionWe need more HTAs of cardiovascular and cerebrovascular diseases in rural, we also need to strengthen early prevention, promote a wider range of cardiovascular and cerebrovascular diseases health technology, strengthen promotion and application of both TCM health technologies and the combination of TCM and western medicine health technologies in cardiovascular and cerebrovascular diseases.
Objective To introduce a novel approach using parallel placement of another oxygenator in the recirculation line as oxygen supply for oxygenator failure without circulatory arrest in cardiopulmonary bypass （CPB），and confirm its outcomes in an animal experiment. Methods A traditional piglet CPB model was established. Oxygenator failure model was established by reducing fraction of inspired oxygen （FiO2） from 80% to 21% after aortic cross-clamp and cardiac arrest in CPB. Another oxygenator was then parallel placed in the recirculation line to supply 100% oxygen.Dynamic changes in partial pressure of oxygen （PaO2），mixed venous oxygen saturation （SvO2），arterial oxygen saturation（SaO2） and blood pH of blood samples from the arterial perfusion duct were monitored with different blood flow of400 ml/min，800 ml/min and 1 100 ml/min. Results When FiO2 was reduced to 21%，PaO2 decreased to 64-67 mm Hg（P＜0.001），SaO2 decreased significantly to 88%-90% （P＜0.001），SvO2 decreased to 69%-72% （P＜0.001），and blood pH decreased too，all indicating oxygenator failure. After parallel placement of another oxygenator in the recirculation line was performed，PaO2，SaO2 and SvO2 all significantly increased，as well as blood pH. When the blood flow in the recirculation line achieved 33% or above of overall arterial perfusion flow，clinical oxygen demand was generally satisfied. Conclusion Parallel placement of another oxygenator in the recirculation line may be utilized as a treatment strategy for oxygenator failure without circulatory arrest and changeover of failed oxygenator.
Blood pressure variability (BPV) is a novel predictor related to blood pressure level, and a large number of studies based on the hypertension cohort have shown that BPV is an independent predictor of target organ damages and cardiovascular adverse outcomes. Due to the significant hemodynamic changes, BPV in patients with chronic kidney disease (CKD) and hemodialysis is higher than the simple hypertension cohort, suggesting that BPV may be of great significance to patients with chronic kidney disease and hemodialysis. In recent years, studies based on CKD and hemodialysis cohort have published in succession whose results revealed that BPV of this cohort is of great prognostic significance for predicting target organ damages and cardiovascular disease risks. This article aims to provide an overview on these research, so as to survey and predict the clinical significance of BPV in CKD and hemodialytic patients.
Objectives To evaluate the relationships between the Scavenger Receptor Class B1 (SCARB1) polymorphisms and susceptibility of cardiovascular diseases (CVDs). Methods Databases including PubMed, Web of Science, CNKI, WanFang Data and VIP were searched from inception to December 31st 2017 to collect case-control studies on relationships between Scavenger Receptor Class B1 (SCARB1) polymorphisms and susceptibility of CVDs. Paper screening, data extraction and assessment of risk of bias were carried out. Meta-analysis was then conducted by Stata 12.0 software. Results In total, 12 studies relevant to SCARB1 rs5888C/T, rs4238001 G/A and rs10846744 G/C polymorphisms were included. Meta-analysis showed that there was no significant association between the rs5888 C/T polymorphism and susceptibility of CVDs (C vs. T: OR=0.97, 95%CI 0.86 to 1.09, P=0.627), neither for the rs4238001 G/A (G vs. A: OR=0.87, 95%CI 0.64 to 1.17, P=0.344). However, the rs10846744 G/C polymorphism was significantly associated with CVDs risk (G vs. C: OR=1.30, 95%CI 1.11 to 1.52, P=0.001). Subgroup analysis showed that, for non-Asian subjects, there was a significant association between the rs5888 C/T polymorphism and susceptibility of CVDs (C vs. T: OR=0.82, 95% CI 0.68 to 0.99, P=0.040). Conclusions SCARB1 rs10864744 G/C polymorphism could be associated with risk of CVDs. Considering the quantity and quality limitation of the included studies, the conclusion has to be verified by more large-scale high quality studies.