This paper tried to address how to apply the relative concepts and methods of evidence-based medicine in clinical practice of cardiology, especially in diagnosis and treatment, with an aim to promote the cardiovascular evidence-based medicine in China.
Sclerostin, as a bone-derived secreted glycoprotein, is a suppressor of Wnt signaling pathway. Recently, adverse cardiovascular events in the treatment of osteoporosis with sclerostin inhibitors have raised concerns about the association of sclerostin with atherosclerotic heart disease. Whether the role of sclerostin in atherosclerotic heart disease is harmful or beneficial is not clear. This article reviews the progress of the mechanisms of sclerostin in vascular calcification and atherosclerotic heart disease, focusing on the relationship between sclerostin and vascular calcification, the impact of its concentration changes on atherosclerotic heart disease, and the effect of sclerostin inhibitor on cardiovascular events.
With the heavier burden of cardiovascular disease, an abundance of papers emerge every year in the research hotspots, which cover a wide range of types and content. In order to let readers interested in the cardiovascular field quickly understand the research hotspots and research frontier, it is necessary to sort out and summarize the research topic in time. According to the discipline classification, we screened papers in cardiovascular field from the Essential Science Indicators (ESI) hot papers published in 2019. Methods such as bibliometrics, statistical description, hierarchical induction, analysis and interpretation were used a step further to reveal the context and characteristics of research in the field of cardiovascular diseases, summarize the latest progress and development direction in this field, and provide information and hints for the expansion of future research directions. A total of 297 papers were finally included, which were mainly in the field of clinical medicine; The country with the most publications was the United States, while China ranked the fifth in terms of contribution; the research institution with the highest number of published papers was Harvard University; the New England Journal of Medicine (NEJM) has published the most papers, with contribution also from journals such as Circulation, Europe Heart Journal, JAMA, and Lancet. All the papers were categorized into disease burden, disease risk, drug treatment, device treatment and surgical treatment, clinical diagnosis, basic research and others, so as to review and summarize the research front in the field of cardiovascular diseases.
Objective To explore the relationship between uric acid (UA) level and cardiovascular disease in patients with OSAHS and its clinical significance. Methods The electronic medical record system of the First hospital of Lanzhou University was used to collect 475 subjects who completed polysomnography (PSG) during hospitalization from January 2019 to May 2020. According to the Guidelines for the Diagnosis and Treatment of Obstructive Sleep Apnea Hypopnea Syndrome (Basic Version), the patients were divided into four group: control group [apnea-hypopnea index (AHI) <5 times/h, n=96], mild group (5≤AHI≤15 times/h, n=130), moderate group (15<AHI≤30 times/h, n=112), and severe group (AHI>30 times/h, n=137). The age, gender, body mass index (BMI), smoking history, drinking history, hypertension, diabetes mellitus, cardiovascular disease and biochemical indexes [including triglyceride, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, glucose, UA, blood urea nitrogen (BUN), serum creatinine, lactate dehydrogenase, homocysteine], PSG indexes were observed and compared among the four groups, and the differences were compared by appropriate statistical methods. Binary logistic regression model was used to evaluate the correlation between various risk factors and cardiovascular disease. Results There were statistically significant differences in age, gender, BMI, drinking history, hypertension and cardiovascular disease among the 4 groups (P<0.05). The levels of UA and BUN in mild, moderate and severe groups were higher than those in the control group, with statistical significance (P<0.05). With the increasing of OSAHS severity, the level of UA increased. There was statistical significance in the incidence of cardiovascular disease among the four groups (P<0.05), and the highest incidence of arrhythmia was found among the four groups. And the incidence of cardiovascular disease increases with the increasing of OSAHS severity. Binary Logistic regression analysis showed that the risk factors for cardiovascular disease in OSAHS patients were age, UA and BUN (P<0.05). Conclusions The occurrence of cardiovascular disease in OSAHS patients is positively correlated with the severity of OSAHS. The level of UA can be used as an independent risk factor for cardiovascular disease in OSAHS patients. Therefore, reducing the level of UA may have positive significance for the prevention and control of the prevalence and mortality of cardiovascular disease in OSAHS patients.
Cardiovascular disease is a leading cause of death in Chinese population. It is of great significance to further explore the pathogenesis of cardiovascular diseases. Ferroptosis is a recently discovered iron-dependent and non-apoptotic form of regulated cell death, which exerts a regulatory role in a variety of biological events. Some studies have shown that ferroptosis plays an important role in the development of cardiovascular diseases. According to newly scientific reports, we summarized the mechanism and regulation in ferroptosis, and reviewed the results of ferroptosis in common cardiovascular diseases such as cardiac ischemia-reperfusion/myocardial infarction, cardiomyopathy, cardiac hypertrophy, atherosclerosis and abdominal aortic aneurysm.
There are various examination methods for cardiovascular diseases. Non-invasive diagnosis and prognostic information acquisition are the current research hotspots of related imaging examinations. Positron emission tomography (PET)/magnetic resonance imaging (MRI) is a new advanced fusion imaging technology that combines the molecular imaging of PET with the soft tissue contrast function of MRI to achieve their complementary advantages. This article briefly introduces several major aspects of cardiac PET/MRI in the diagnosis of cardiovascular disease, including atherosclerosis, ischemic cardiomyopathy, nodular heart disease, and myocardial amyloidosis, in order to promote cardiac PET/MRI to be more widely used in precision medicine in this field.
The randomized controlled trial is the best evidence in the evidence-based medicine. The cardiovascular disease internal department is the typical example of the evidence-based medicine. A serial large-scale randomized controlled trials provided the evidence and improved clinical treatment level. For normal development of a large-scale randomized controlled trials need to enhance the standard management.
Cardiovascular disease is the leading cause of death in the world. The influence of diet on atherosclerotic cardiovascular disease (ASCVD) should not be underestimated. In 2022, the American College for Preventive Cardiology (ASPC) issued guidelines, which emphasized the importance of changing dietary patterns for the prevention of ASCVD and its risk factors, recommended the best diet for ASCVD prevention, and discussed dietary recommendations for ASCVD prevention in special populations. This paper interprets this guideline, aiming to provide help for clinical practice.
Cardiovascular diseases is the leading cause of threat to human life and health worldwide. Early risk assessment, timely diagnosis, and prognosis evaluation are critical to the treatment of cardiovascular diseases. Currently, the evaluation of diagnosis and prognosis of cardiovascular diseases mainly relies on imaging examinations such as coronary CT and coronary angiography, which are expensive, time-consuming, partly invasive, and require high professional competence of the operator, making it difficult to promote in the community or in areas where medical resources are scarce. The fundus microcirculation is a part of the human microcirculation and has similar embryological origins and physiopathological features to cardiovascular circulation. Several studies have revealed fundus imaging biomarkers associated with cardiovascular diseases, and developed and validated intelligent diagnosis and treatment models for cardiovascular diseases based on fundus imaging data. Fundus imaging is expected to be an important adjunct to cardiovascular disease diagnosis and treatment given its noninvasive and convenient nature. The purpose of this review is to summarize the current research status, challenges, and future prospects of the application of artificial intelligence based on multimodal fundus imaging data in cardiovascular disease diagnosis and treatment.