Is the European System for Cardiac Operative Risk Evaluation useful in Chinese patients undergoing heart valve surgery?

Background: The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is one of the most widely used risk models for the predicting mortality after cardiac surgery. The aim of this study was to validate the EuroSCORE model for predicting operative mortality in heart valve surgery on a Chinese multicenter database and comparing the performance of EuroSCORE with our new risk stratification system, the Sino System for Coronary Operative Risk Evaluation (SinoSCORE).

Methods: Data from patients undergoing heart valve surgery between January 2007 and December 2008 were retrospectively collected, from 43 hospitals in China.

Left ventricular reconstruction with no-patch technique: early and late clinical outcomes.

Background: Few studies have evaluated late clinical outcome of no-patch technique in patients with large left ventricular aneurysms. The objectives of this study were to evaluate a no-patch surgical technique to reconstruct the left ventricle in patients with left ventricular aneurysm and to assess early and late clinical outcomes.

Methods: In 1995, we began using a no-patch technique in patients with dyskinetic left ventricular aneurysms.

Identification of MicroRNAs involved in hypoxia- and serum deprivation-induced apoptosis in mesenchymal stem cells.

The use of bone marrow mesenchymal stem cell- (MSC) transplantation therapy for cardiac diseases is limited due to poor survival of implanted cells. MicroRNAs (miRNAs) have been reported to be involved in regulating almost all cellular processes, including apoptosis. In this study, we found that the miRNA profile was altered during apoptosis induced by hypoxia and serum deprivation (hypoxia/SD).

Short-term in vivo preclinical biocompatibility evaluation of FW-II axial blood pump in a sheep model.

We investigated the outcome of FW-II axial pump on healthy sheep (weight, 60-70 kg) for 2 weeks by perioperatively hematological and chemical tests, and circulating activated platelet and leukocyte-platelet aggregates measurements by flow cytometry assays. Complete necropsy and histopathological examinations and thorough pump inspection were performed at study termination for evidence of thrombi. In this experimental series, one sheep died of pulmonary edema, the other four sheep reached the scheduled endpoint of 14 days without device-related problems, and flow range was maintained at 2.

Comparison between drug-eluting stents and coronary artery bypass grafting for unprotected left main coronary artery disease: a meta-analysis of two randomized trials and thirteen observational studies.

Objective: The clinical outcomes for unprotected left main coronary artery (LMCA) between coronary artery bypass grafting (CABG) and drug-eluting stents (DES) are still controversial. The objective was to compare safety and efficacy between DES and CABG for unprotected LMCA.

Methods: Electronic databases and article references were systematically searched (2000-2010) to access relevant studies.

Do patients with complete transposition of the great arteries and severe pulmonary hypertension benefit from an arterial switch operation?

Background: Whether an arterial switch operation benefits patients with transposition of the great arteries and severe pulmonary hypertension (PH) remains controversial. Therefore, we evaluated the relationship between preoperative PH and early and midterm clinical outcomes after an arterial switch procedure.

Methods: In this retrospective study, 101 consecutive patients with transposition of the great arteries underwent an arterial switch operation between February 2004 and October 2007.

Risk factors and prevention of upper gastrointestinal hemorrhage after a coronary artery bypass grafting operation.

Purpose: Upper gastrointestinal (GI) hemorrhage is a serious complication of coronary artery bypass grafting (CABG). The aim of this study was to retrospectively investigate the risk factors and prevention of upper GI bleeding after CABG.

Methods: This study followed 6316 coronary patients who underwent CABG from 1998 to 2005.

Expression and secretion of interleukin-1β, tumour necrosis factor-α and interleukin-10 by hypoxia- and serum-deprivation-stimulated mesenchymal stem cells.

To understand the potential paracrine roles of interleukin-1β (IL-1β), tumour necrosis factor-α (TNF-α) and interleukin-10 (IL-10), the expression and secretion of these factors by rat bone marrow-derived mesenchymal cells stimulated by hypoxia (4% oxygen) and serum deprivation (hypoxia/SD) were investigated. We found that hypoxia/SD induced nuclear factor kappa Bp65-dependent IL-1β and TNF-α transcription. Furthermore, hypoxia/SD stimulated the translation of pro-IL-1β and its processing to mature IL-1β, although the translation of TNF-α was unchanged.

Apoptosis of mesenchymal stem cells induced by hydrogen peroxide concerns both endoplasmic reticulum stress and mitochondrial death pathway through regulation of caspases, p38 and JNK.

Poor survival of mesenchymal stem cells (MSCs) compromised the efficacy of stem cell therapy for myocardial infarction. The increase of exogenous reactive oxygen species (ROS) in infracted heart is one of the important factors that challenged the survival of donor MSCs. In the study we aimed to evaluate the effect of oxidative stress on the cell death of MSCs and investigate its mechanisms in order to help with the identification of new biological compounds to reduce donor cells damage.

Apical conicity ratio: a new index on left ventricular apical geometry after myocardial infarction.

Objective: Our objective was to introduce a new index to evaluate left ventricular aneurysm by quantitative analysis of left ventricular apical geometry.

Methods: A total of 116 selected subjects underwent magnetic resonance imaging, 28 healthy volunteers, 29 patients with dilated cardiomyopathy, and 59 patients with ischemic heart disease (26 with left ventricular aneurysm; 33 with no aneurysm). The apical conicity ratio was calculated as the ratio of left ventricular apical area over apical triangle.

Aspirin induces apoptosis in mesenchymal stem cells requiring Wnt/beta-catenin pathway.

Background And Objectives: Mesenchymal stem cells (MSC) are multipotent progenitor cells that are have found use in regenerative medicine. We have previously observed that aspirin, a widely used anti-inflammatory drug, inhibits MSC proliferation. Here we have aimed to elucidate whether aspirin induces MSC apoptosis and whether this is modulated through the Wnt/beta-catenin pathway.

A comparison before and after aprotinin was suspended in cardiac surgery: different results in the real world from a single cardiac center in China.

Objective: Use of aprotinin has been suspended in cardiac surgery since recent studies reported its risks associated with mortality and other adverse events. This study was to investigate the safety and efficacy of aprotinin through a comparison before and after aprotinin was suspended in cardiac surgery.

Methods: We designed a case-control study in two groups of patients who underwent cardiac surgery just before and after aprotinin was suspended in China.

Signal pathways involved in reverse remodeling of the hypertrophic rat heart after pressure unloading.

Background: The purpose of this study was to gain a better understanding of molecular changes associated with the beneficial reverse remodeling through heterotopic transplantation model of rat hypertrophic hearts.

Methods: Stable cardiac hypertrophy was induced by abdominal aortic constriction (AAC) in Lewis rats (6 weeks). Left ventricular (LV) pressure unloading was induced by heterotopic transplantation of hypertrophic hearts (AAC-HT) (2 weeks).

Surgery of left ventricular aneurysm: a propensity score-matched study of outcomes following different repair techniques.

To evaluate early and late outcomes of modified left ventricular reconstruction (VR) and linear repair (LR) of post-infarct left ventricular aneurysm (LVA). A total of 514 patients were consecutively operated on for LVA with modified VR technique in 145 and LR in 352 patients. Using the propensity score-matching method, we selected 202 patients (101 LRs vs.

Impact of off-pump techniques on sex differences in early and late outcomes after isolated coronary artery bypass grafts.

Background: Off-pump coronary artery bypass graft surgery (OPCAB) is associated with lower early mortality and benefits women disproportionately. The objective of this study was to assess the impact of off-pump techniques on sex differences in late outcomes.

Methods: We reviewed a clinical database of consecutive patients who underwent isolated coronary artery bypass graft surgery (CABG) at FuWai Hospital from 1999 to 2005.

Impact of renal dysfunction on long-term survival after isolated coronary artery bypass surgery.

Background: Preoperative renal dysfunction has been an important predictor for adverse cardiovascular events after coronary artery bypass grafting (CABG). In the past, serum creatinine was widely used to assess renal function. Until recently, estimated glomerular filtration rate (eGFR) was recommended in evaluating renal function.

[Effect of tannic acid treatment on the physico-chemical properties of glutaraldehyde-fixed bovine jugular vein].

Objective: To evaluate the effects of tannic acid (TA) treatment on the physico-chemical properties of glutaraldehyde (Glut)-fixed bovine jugular vein (BJV).

Methods: Fresh BJVs were treated with Glut or Glut/TA, respectively. The shrinkage temperature, resistance to collagenase or elastase digestion, bio-mechanical properties, and molecular structure of these prepared BJVs were evaluated by Fourier transform infrared spectroscopy.

[Lovastatin protects mesenchymal stem cells against hypoxia and serum deprivation-induced apoptosis through activation of PI3K/Akt and ERK1/2 signaling pathways].

Objective: To investigated the effect of lovastatin on hypoxia and serum deprivation (Hypoxia/SD) induced rat MSCs apoptosis in vitro and associated signaling pathway changes.

Methods: MSCs were isolated from Sprague-Dawley rats. The anti-apoptotic effects of lovastatin were detected using Hoechst33342 and annexin V-FITC/PI binding assay by Flow cytometric analysis.

In vivo experimental testing of the FW axial blood pump for left ventricular support in Fu Wai Hospital.

A fully implantable, axial flow blood pump has been developed in Fu Wai Hospital aiming for clinical use. This ventricular assist device (VAD), which was developed after numerous CFD analyses for the flow characteristics of the pump, is 58.5-mm long, 30-mm wide (including DC motor), and weighs 240 g.

Design and performance testing of an axial-flow ventricular assist device developed at the Fu Wai Hospital in Beijing.

Purpose: Various ventricular assist devices (VADs) have been developed for clinical use in recent years. The aim of a multidisciplinary research team at the Fuwai Hospital of the Peking Union Medical College is to design and develop an axial flow left ventricular assist device (LVAD) for adults.

Methods: Using Computational Fluid Dynamics (CFD), the inflow characteristics of the axial flow pump were analyzed.

Mitigated calcification of glutaraldehyde-fixed bovine pericardium by tannic acid in rats.

Background: Bioprosthetic heart valves derived from glutaraldehyde (Glut)-fixed xenografts have been widely used to replace diseased cardiac valves. However, calcification and degeneration are common following their implantation. Inflammation is closely associated with calcification of Glut-fixed xenografts via macrophage infiltration.

MicroRNA: novel regulators involved in the remodeling and reverse remodeling of the heart.

Background: MicroRNAs (miRNAs) may serve as potential diagnostic biomarkers and therapeutic targets in cardiovascular research. However, the association between miRNAs and heart remodeling/reverse remodeling has not been evaluated.

Methods: Lewis rats were divided into three groups: control animals, animals subjected to abdominal aortic constriction (AAC) and those with heterotopic transplantation of abdominal aortic constriction (AAC-HT), respectively.

Mesenchymal stem cells promote cardiomyocyte hypertrophy in vitro through hypoxia-induced paracrine mechanisms.

1. Mesenchymal stem cell (MSC) therapy for myocardial infarction has received increased attention since transplanted MSC were shown to improve cardiac function by transdifferentiating into cardiomyocytes and endothelial cells. However, recent studies have demonstrated that other mechanisms may contribute to the improvement in cardiac function observed after transplantation of MSC.

Design optimization of an axial blood pump with computational fluid dynamics.

A fully implantable, axial flow blood pump has been developed in our hospital. Both in vitro and in vivo tests showed that the hemolysis and thrombus characteristics of the pump were in an acceptable but not in an ideal range. Computational fluid dynamics (CFD) and in vitro test results showed that the pump worked at off-design point with a low hydraulic efficiency; CFD analysis also showed regions of reverse flow in the diffuser, which not only decreases the pump's hydrodynamic efficiency, but also increases its overall potential for blood trauma and thrombosis.

Embryonic stem cell transplantation for the treatment of myocardial infarction: immune privilege or rejection.

Stem cell transplantation (SCT) has emerged to be an appealing tool for repair medicine. In the treatment of ischemic heart diseases, SCT will be of great help because it is capable of replacing scar with new myocardial tissue. Among the many candidate cell lines for SCT, embryonic stem cells (ESCs) have their unique advantages.