Publications by authors named "Kou Gi Shyu"

Background: Atrial fibrillation (AF) is a common cardiac arrhythmia associated with significant morbidity and mortality. Rapid electrical stimulation (RES) of atrial fibroblasts plays a crucial role in AF pathogenesis, but the underlying molecular mechanisms remain unclear. This study investigates the regulatory axis involving MALAT1, miR-499a-5p, and SOX6 in human cardiac fibroblasts from adult atria (HCF-aa) under RES conditions.

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Background: Chronotropic incompetence (CI) severely limits exercise tolerance due to impaired heart rate responses. This study investigated whether pacemaker with closed-loop stimulation (DDD-CLS) pacing, which provides rate acceleration in response to exertion, could enhance lung function and cardiopulmonary capacity compared pacemaker without CLS pacing in patients with CI.

Methods: This randomized crossover trial included 32 patients with CI who were compared to each CLS and DDD pacing over 2 months.

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Background: Metastasis-associated lung adenocarcinoma transcript 1 ( MALAT1 ) plays a critical role in the pathophysiology of diabetes-related complications. However, whether macrophage-derived MALAT1 affects autophagic activity under hyperglycemic conditions is unclear. Therefore, we investigated the molecular regulatory mechanisms of macrophage-derived MALAT1 and autophagy under hyperglycemic conditions.

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Aims: This study aimed to investigate the effectiveness of closed-loop stimulation (CLS) pacing compared with the traditional DDD mode in patients with chronotropic incompetence (CI) using bicycle-based cardiopulmonary exercise testing (CPET).

Methods And Results: This single-centre, randomized crossover trial involved 40 patients with CI. Patients were randomized to receive either DDD-CLS or DDD mode pacing for 2 months, followed by a crossover to the alternative mode for an additional 2 months.

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Article Synopsis
  • A nationwide registry study is being conducted in Taiwan with 3,600 patients to better understand the treatment of acute coronary syndrome (ACS) by gathering data during and after hospitalization.
  • Data will be collected at three key time points: during hospitalization, 6 months, and 12 months post-discharge to assess the use of guideline-directed therapies and identify predictors of one-year health outcomes.
  • The study aims to improve ACS treatment by analyzing results over the next 20 years, enhancing knowledge about the adherence to medical guidelines and patient prognoses.
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Background: Patients admitted with acute decompensated heart failure (ADHF) have a poor prognosis and poor quality of life due to dyspnea and edema. Tolvaptan, a vasopressin V2 receptor antagonist, is an effective water diuretic. This study aimed to evaluate the efficacy and safety of a short course of tolvaptan to treat volume overload in patients with ADHF.

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Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) plays a crucial role in the pathophysiological process associated with diabetes-related complications. The effect of high glucose levels on macrophage-derived exosomal MALAT1 is unknown. Therefore, we investigated the molecular regulatory mechanisms controlling exosomal MALAT1 in macrophages under high glucose treatment and the therapeutic target of macrophage-derived exosomal MALAT1 using a balloon injury model of vascular disease in diabetic rats.

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Article Synopsis
  • Type 2 diabetes is a growing global health issue, with projections suggesting over half a billion cases by 2030, increasing risks for heart-related complications.
  • Two new types of diabetes medications have shown promise in reducing cardiovascular issues through various clinical trials.
  • The Taiwan Society of Cardiology has created a consensus pathway to better integrate these therapies into patient care, supporting existing clinical guidelines.
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Purpose: Atherosclerosis and its related clinical complications are the leading cause of death. MicroRNA (miR)-92a in the inflammatory endothelial dysfunction leads to atherosclerosis. Krüppel-like factor 2 (KLF2) is required for vascular integrity and endothelial function maintenance.

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Familial hypercholesterolemia (FH) is a common genetic disease that is estimated to affect at least 15 million people in the Asia Pacific region. Affected individuals are at significantly increased risk of premature atherosclerotic cardiovascular disease. A literature review was undertaken to provide an overview of the epidemiology, diagnosis, and management of FH across the region.

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Article Synopsis
  • A study was conducted to evaluate the effectiveness of a new once-daily extended-release carvedilol (carvedilol ER) formulation in lowering blood pressure among patients with hypertension, as opposed to the traditional twice-daily dosing.
  • A total of 134 patients were randomly assigned to receive either placebo, low-dose carvedilol ER, or high-dose carvedilol ER for 8 weeks, with the main goal of measuring systolic and diastolic blood pressure changes.
  • Results showed that while carvedilol ER was generally well tolerated, it did not lead to significant reductions in blood pressure compared to placebo, although higher doses showed some gradational improvement in blood pressure control.
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MicroRNAs that modulate transcription can regulate other microRNAs and are also up-regulated under pathological stress. MicroRNA-499 (miR-499), microRNA-208a (miR-208a) and B-cell lymphoma 2 (Bcl-2) play roles in cardiovascular diseases, such as direct reprogramming of cardiac fibroblast into cardiomyocyte and cardiomyocyte apoptosis. Whether miR208a, miR499 and Bcl-2 were critical regulators in cardiac fibroblast apoptosis under mechanical stretching conditions in human cardiac fibroblasts-adult atrial (HCF-aa) was investigated.

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Background: Heart rate trajectory with multiple heart rate measurements is considered to be a more sensitive predictor of outcomes than single heart rate measurements. The association of heart rate trajectory patterns with acute heart failure outcomes has not been well studied. We examined the association of heart rate trajectory patterns with post-discharge outcomes.

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Hyperbaric oxygen (HBO) improves angiogenesis. The effect of HBO on metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), a pro-angiogenic long non-coding RNA, in cardiac myocyte-derived exosomes and acute myocardial infarction (AMI) is unknown. We aimed to investigate whether MALAT1 is altered in cardiac myocyte-derived exosomes in response to HBO as well as the molecular regulatory mechanisms of MALAT1 in cardiac myocytes treated with HBO.

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Article Synopsis
  • * Clinical trials initiated after a 2008 FDA mandate on cardiovascular safety for new diabetes medications have shown that some new agents can reduce cardiovascular (CV) risks and improve outcomes compared to older treatments.
  • * The Taiwan Society of Cardiology and the Diabetes Association of Republic of China have developed updated treatment guidelines aimed at managing type 2 diabetes in patients with various cardiovascular conditions and risk factors.
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Up to 10% of patients with atrial fibrillation (AF) undergo percutaneous coronary intervention (PCI). A systematic review and network meta-analysis were conducted by searching PubMed, Embase, and the Cochrane database of systematic reviews for randomized control trials that studied the safety and efficacy of different antithrombotic strategies in these patients. Six studies, including 12,158 patients were included.

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MicroRNA 145 (miR-145) is a critical modulator of cardiovascular diseases. The downregulation of myocardial miR-145 is followed by an increase in disabled-2 (Dab2) expression in cardiomyocytes. (-)-epigallocatechin gallate (EGCG) is a flavonoid that has been evaluated extensively due to its diverse pharmacological properties including anti-inflammatory effects.

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Background: The recommended target low-density lipoprotein cholesterol (LDL-C) level for coronary artery disease (CAD) patients has been lowered from 100 to 70 mg/dL in several clinical guidelines for secondary prevention. We aimed to assess whether initiating statin treatment in CAD patients with baseline LDL-C 70-100 mg/dL in Taiwan could be cost-effective.

Methods: A Markov model was developed to simulate a hypothetical cohort of CAD patients with a baseline LDL-C level of 90 mg/dL.

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Visfatin is an adipocytokine with important roles in endothelial angiogenesis. Hyperbaric oxygen (HBO) has been widely used to treat various medical illness with enhanced angiogenesis. The molecular effects of HBO on visfatin under hypoxia are poorly understood.

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After the publication of the above paper, the authors noted that an incomplete version of the address was presented for the second author affiliation; essentially, 'School of Medicine' had been omitted from the address. Therefore, the author and affiliation details for this paper should have been presented as follows: Kou‑Gi Shyu1,2, Marappan Velusamy3, Chih‑Wei Hsia2, Chih‑Hao Yang2, Chih‑Hsuan Hsia2, Duen‑Suey Chou2, Thanasekaran Jayakumar2, Joen‑Rong Sheu2 And Jiun‑Yi Li2,4. 1Division of Cardiology, Shin Kong Wu Ho‑Su Memorial Hospital, Taipei 111; 2Graduate Institute of Medical Sciences and Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan, R.

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Background/purpose: Currently, data on the real-world use of dronedarone, an antiarrhythmic drug for atrial fibrillation (AF), are contradictory and often based on patient populations comprised of Caucasians. We prospectively investigated the efficacy and safety of dronedarone and risk factors related to treatment outcomes in a real-world use setting.

Methods: The prospective, observational, single-arm, multi-center study included a total of 824 Taiwanese patients with a diagnosis of paroxysmal or persistent AF and receiving dronedarone treatment.

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Background: No randomized controlled trials evaluating metformin therapy efficacy in patients with type 2 diabetes mellitus (DM) and acute coronary syndrome (ACS) have been reported. We aimed to examine the mortality benefit of metformin therapy in patients with type 2 DM and ACS, compared with non-metformin anti-diabetes agents users.

Methods: Data were extracted from the prospective nationwide ACS-DM Taiwan Society of Cardiology registry.

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Catalpol, an iridoid glycoside, is an isolated natural product of , which has been reported to have antidiabetic properties. This study investigated the vascular protective effects of catalpol in hyperglycemic rats with balloon-injured carotid arteries. Balloon injury stress led to the upregulation of monocyte chemoattractant protein-1 expression in rats with streptozotocin-induced diabetes.

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