Publications by authors named "Chung Lieh Hung"
The erythrocyte membrane is highly specialized with ∼one million anion exchanger-1 (AE1) per cell for rapid membrane permeation of HCO3-(aq), as most blood CO2(g) is carried in this hydrated anionic form. People with the GP.Mur blood type have more AE1 on their erythrocyte membrane, and they excrete CO2(g) more efficiently.
View Article and Find Full Text PDFBackground: Heart failure (HF) management lacks clarity regarding fluid balance strategies, with some studies suggesting potential benefits of liberal fluid intake. This review aims to evaluate both unrestricted and restricted fluid intake, including sodium restriction, in adult HF.
Methods: A thorough search of electronic databases, including PubMed, MEDLINE, and Cochrane Library, identified relevant studies examining fluid intake effects on adult heart failure patients, categorized by liberal or restricted intake, with subgroup analysis on sodium restriction.
Although several studies have demonstrated the cardiovascular (CV) implication of hypoalbuminemia and arterial calcification among hemodialysis patients, little is known regarding their cardiac correlates and relevant CV outcomes in asymptomatic individuals. We assessed the potential CV interrelation between serum albumin (SA) and aortic calcification. Among 2,723 asymptomatic individuals underwent cardiovascular health check-up, we assessed serum albumin (SA) level, thoracic aortic calcification (TAC) and coronary artery calcification (CAC) by multi-detector computed tomography, and ultrasound-determined carotid plaque burden.
View Article and Find Full Text PDFArticle Synopsis
- Fabry disease (FD) is an X-linked lysosomal storage disorder caused by mutations in the α-galactosidase A gene, leading to harmful buildup of glycosphingolipids in various tissues and classified into classic and late-onset phenotypes.
- Classic phenotype shows severely reduced enzyme activity, resulting in a progressive disease with multi-organ issues, while late-onset often presents with milder symptoms and mainly affects the heart due to some remaining enzyme activity.
- Early diagnosis through enzyme testing, imaging, and genotyping is crucial for effective treatment, which includes enzyme replacement therapy and new pharmacological options to prevent irreversible damage and optimize patient care based on genetic and gender considerations.
Heart disease can lead to physical disability and mortality, ranking second among the top 10 causes of death according to the Ministry of Health and Welfare. This study aims to examine the impact of the interactive assessment application on patients' public health knowledge. In this study, a single-group pretest and posttest experimental design was adopted.
View Article and Find Full Text PDFDiagnostic Yield and Model Prediction Using Wearable Patch Device in HFpEF.
Stud Health Technol Inform
July 2024
Heart failure (HF) is a prevalent global health issue projected to escalate, notably in aging populations. The study aimed to identify predictive markers for Heart Failure with preserved Ejection Fraction (HFpEF). We scrutinized vital parameters like age, BMI, eGFR, and comorbidities like atrial fibrillation, coronary artery disease (CAD), diabetes mellites (DM).
View Article and Find Full Text PDFBackground: Chronic fatigue syndrome (CFS) has been linked to several conditions, including infections, immune system changes, or emotional stress. Our study aimed to assess the risk of CFS after a pneumonia diagnosis using data from National Health Insurance Research Database of Taiwan.
Methods: In this nested case-control study, we identified 2,000,000 adult patients from a nationwide population-based health insurance claims database spanning from January 1, 2000, to December 31, 2017.
Article Synopsis
- - This research investigates how microRNA, specifically hsa-miR-134-5p, plays a role in the aging process of human endothelial progenitor cells (EPCs) and its impact on angiogenic activity.
- - Hsa-miR-134-5p is found to hinder the activity of the TAB1 protein, leading to reduced p38 activation, which is associated with improved angiogenesis in senescent EPCs.
- - The study suggests that hsa-miR-134-5p could potentially rejuvenate aged EPCs and that its expression levels in peripheral blood can be linked to cardiovascular risk assessment, especially in older adults.
Article Synopsis
- LV systolic strain is a potentially better indicator of heart function compared to LV ejection fraction (LVEF) in patients with mildly reduced ejection fraction heart failure (HFmrEF).
- A study involving 1,075 hospitalized HFmrEF patients demonstrated that LV strain is significantly associated with cardiac risk and clinical outcomes, outperforming LVEF in survival predictions.
- The research suggests that lower LV strain levels can more effectively indicate the benefits of angiotensin receptor-neprilysin inhibitor (ARNi) treatments compared to traditional LVEF, making it a valuable tool for risk assessment and therapy responsiveness in these patients.
The benefits of rapidly up-titrating evidence-based treatments following heart failure (HF) hospitalizations were demonstrated in the The Safety, Tolerability and Efficacy of Rapid Optimization, Helped by NT-proBNP Testing, of Heart Failure Therapies (STRONG-HF) trial and emphasized in contemporary HF guidelines. We aimed to assess up-titration patterns of guideline-directed medical treatments in the Taiwanese HF population. Combining data from the Taiwan Society of Cardiology - Heart Failure with reduced Ejection Fraction (TSOC-HFrEF) registry and the Treatment with Angiotensin Receptor neprilysin inhibitor for Taiwan Acute Heart Failure (TAROT-AHF) study cohort, we formed the "Taiwan real-world cohort".
View Article and Find Full Text PDFArticle Synopsis
- The study assessed how left atrial (LA) strain, particularly LA reservoir strain (LASr), predicts outcomes in patients with moderate to severe aortic stenosis (AS), especially in an Asian population, where data was limited.
- Findings indicated that LASr was significantly linked to all-cause death and major cardiovascular events, suggesting it could be a crucial marker for patient prognosis, while left ventricular global longitudinal strain (LVGLS) was only predictive in severe AS.
- The researchers propose that incorporating LASr into the AS staging process could improve outcome predictions for patients undergoing evaluations for treatment.
Background: Dapagliflozin, a sodium-glucose cotransporter 2 inhibitor, is an epochal oral antidiabetic drug that improves cardiorenal outcomes. However, the effect of early dapagliflozin intervention on left ventricular (LV) remodeling in patients with type 2 diabetes free from cardiovascular disease remains unclear.
Methods And Results: The ELUCIDATE trial was a prospective, open-label, randomized, active-controlled study that enrolled 76 patients with asymptomatic type 2 diabetes with LV ejection fraction ≥50%, randomized to the dapagliflozin 10 mg/day add-on or standard-of-care group.
Sodium Glucose Transporter 2 Inhibitors Versus Metformin on Cardiovascular and Renal Outcomes in Patients With Diabetes With Low Cardiovascular Risk: A Nationwide Cohort Study.
J Am Heart Assoc
April 2024
Article Synopsis
Article Synopsis
- Heart failure (HF) is a major global health issue, with similar death and rehospitalization rates across different types, but previous Taiwanese registries largely focused on hospitalized patients with HF reduced ejection fraction (HFrEF) before 2019, limiting their applicability to other types.
- The Taiwan Society of Cardiology Heart Failure Registry 2020 aims to enroll 3,370 patients from 27 hospitals, including both inpatients with acute decompensated HF and outpatients who were hospitalized within the last six months, and will collect detailed health data over a two-year follow-up.
- This registry is designed to provide insights into the epidemiology, guideline adherence, clinical outcomes, and disease progression for patients with all HF
Article Synopsis
- Heart failure with preserved ejection fraction (HFpEF) is a complex condition affecting the heart and other organs, leading to significant health issues, especially in younger patients in Asia with high rates of diabetes and kidney disease.
- The diagnosis involves a 2-step algorithm focusing on symptoms, ejection fraction, natriuretic peptide levels, and tests for heart abnormalities; if uncertain, additional stress testing may be required.
- Management includes controlling comorbidities, lifestyle changes like weight loss and exercise, and pharmacological treatments such as diuretics and SGLT2 inhibitors to improve patient outcomes.
Objective: To investigate whether hypotensive patients diagnosed with heart failure and reduced ejection fraction (HFrEF) might benefit from angiotensin receptor-neprilysin inhibitors (ARNis) in real-world practice because patients with baseline systolic blood pressure (SBP) of less than 100 mm Hg have been excluded from landmark trials.
Patients And Methods: In this multicenter study conducted between January 1, 2013, and December 31, 2021, a total of 7562 symptomatic patients with HFrEF were enrolled and grouped by SBP (hypotension was defined as an SBP of less than 100 mm Hg) and ARNi use as follows: group 1, hypotensive/non-ARNi users (n=484); group 2, hypotensive/ARNi users (n=308); group 3, nonhypotensive/non-ARNi users (n=4560); and group 4, nonhypotensive/ARNi users (n=2210). Inverse probability of treatment weighting was used to balance baseline characteristics for survival analysis.
Article Synopsis
- - Transdermal nicotine patches (TNPs) are used for nicotine replacement therapy, and this study investigates their effect on circulating endothelial progenitor cells (EPCs) in young healthy nonsmokers. - After a week of TNP usage, there was a significant increase in various types of EPCs, as well as improvements in the colony-forming ability and migration activity of early EPCs, suggesting enhanced angiogenesis. - Although pulse wave analysis showed no significant hemodynamic changes, a prolonged diastolic pressure time index hints at potential vascular benefits from TNP treatments, making it a viable option for improving blood flow and reducing tissue ischemia.
Peripheral artery disease (PAD) shares common clinical risk factors, for example, endothelial dysfunction, with preserved ejection fraction (LVEF) heart failure (HFpEF). Whether PAD is associated with preclinical systolic dysfunction and higher HF risk among individuals presenting preserved LVEF remains uncertain. We retrospectively included outpatients with at least one known or established cardiovascular (CV) risk factor with LVEF ≥ 50%.
View Article and Find Full Text PDFBackground: Iron deficiency is a common comorbidity in heart failure (HF) and is independently associated with a worse quality-of-life and exercise capacity, as well as increased risk of hospitalization, regardless of anemia status. Although international guidelines have provided recommendations for the management of iron deficiency in patients with HF, guidelines in Asia are less established, and practical use of guidelines for management of iron deficiency is limited in the region.
Methods: A panel comprising cardiologists from China, Hong Kong, India, Japan, Malaysia, Pakistan, Philippines, Singapore, South Korea, Taiwan, and Thailand convened to share insights and provide guidance for the optimal management of iron deficiency in patients with HF, tailored for the Asian community.
Background: Dyslipidemia is a known risk factor for cardiac dysfunction, and lipid-lowering therapy with statins reduces symptoms and reduces hospitalization related to left ventricular heart failure. Acute myocardial infarction (AMI) is a cause of morbidity and mortality worldwide. In this study, we aimed to determine the real-world AMI treatment drug combination used in Taiwan by using the NHI database to understand the treatment outcomes of current clinical medications prescribed for hyperlipidemia patients with AMI.
View Article and Find Full Text PDFArticle Synopsis
- Echocardiographic strain imaging is important for assessing heart function, and deep learning (DL) algorithms can automate its interpretation.
- An automated DL-based algorithm for measuring left ventricular strain was trained and validated using datasets from various studies, showing high accuracy compared to manual measurements.
- The study concluded that DL algorithms can interpret echocardiographic strain images effectively, potentially improving accessibility to cardiac assessments.
Article Synopsis
- Heart failure with normal ejection fraction (HFnEF) is relatively unexplored compared to other forms of heart failure, prompting researchers to study its characteristics and outcomes.
- In a study of 1,765 patients, a significant portion had HFnEF, distinguishing them from those with preserved but low ejection fraction by factors like lower coronary artery disease rates and differing echocardiographic patterns.
- Understanding the varied cardiac features among HFnEF patients might help develop more tailored treatment strategies for those with heart failure with preserved ejection fraction (HFpEF).
Article Synopsis
- SGLT2 inhibitors, specifically canagliflozin, were studied for their potential cardiovascular benefits in patients with type 2 diabetes mellitus, showing improvements in heart function and structure over 24 weeks.
- The study included 47 patients who experienced significant reductions in HbA1c, body weight, and systolic blood pressure, alongside enhanced hemodynamic parameters like stroke volume and cardiac output.
- Results indicated positive remodeling in the heart, such as reduced left atrial volume and improved strain measurements, suggesting mechanisms that may explain the cardioprotective effects seen in larger clinical trials.