Abstract:Atherosclerosis and its complications are one of the diseases with the highest incidence and mortality in the world, and its early diagnosis and treatment are very important. At present, a variety of physiological and biochemical indicators have been used to diagnose atherosclerosis. However, the accuracy and ease of use of existing diagnostic indicators still cannot meet the clinical needs, and new, reliable and easy to measure biomarkers for early diagnosis and judgment of atherosclerosis and the risk of serious cardiovascular and cerebrovascular events caused by atherosclerosis are still very scarce. This article summarized the latest research progress of biomarkers related to atherosclerosis, such as hematology, genetics and omics, in order to provide basis for early diagnosis and treatment of atherosclerosis and related cardiovascular and cerebrovascular diseases induced by atherosclerosis.

Abstract:Aim To investigate the role and mechanism of RNA binding protein zinc finger protein 36 (ZFP36) in vascular calcification. Methods Human aortic smooth muscle cells were infected with ZFP36-overexpressing virus or transfected with ZFP36 siRNA, followed by high phosphate stimulation to observe the effect of overexpression or knockdown of ZFP36 on smooth muscle cell calcification; RNA immunoprecipitation and stability experiments were used to detect whether Runx2 was the target gene of ZFP36; Smooth muscle specific ZFP36 knockout mice were generated and vitamin D was used to induce vascular calcification. Alizarin Red and Von Kossa staining were used to observe calcification of aortic vessels, and Western blot was used to detect Runx2 protein expression.Results ZFP36 expression was elevated under calcification-stimulating conditions. Overexpression of ZFP36 alleviated high phosphate-induced smooth muscle cell calcification, while knockdown of ZFP36 exacerbated calcification. ZFP36 could bind to Runx2 mRNA and promote its degradation. At the cellular level, ZFP36 could inhibit smooth muscle cell calcification via Runx2. At the animal level, knockout of ZFP36 in smooth muscle exacerbated vascular calcification induced by vitamin D. Conclusion ZFP36 inhibits vascular calcification by targeting Runx2 mRNA and suppressing its expression in smooth muscle cells.

Abstract:Aim To investigate the role and regulatory mechanism of CREB regulated transcription coactivator 2 (CRTC2) in cardiomyocyte hypertrophy. Methods A pathological cardiomyocyte hypertrophy model was established in C57BL/6 mice by intraperitoneal injection of isoproterenol (ISO), the expression of CRTC2 in cardiac tissue was detected by Western blot. The CRTC2 knockout mice model was constructed, the cardiac function of mice was detected by small animal echocardiography, the collagen fiber content in mice cardiac tissue was detected by Masson staining, the cardiomyocyte hypertrophy related proteins:skeletal muscle α1-actin (ACTA1) and brain natriuretic peptide (BNP), as well as ferroptosis related proteins:acyl-CoA synthetase long chain family member 4 (ACSL4), solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4) in mice cardiac tissue were detected by Western blot, the iron ion content in mice cardiac tissue was detected by iron ion kit, to evaluate the correlation between CRTC2 and cardiomyocyte hypertrophy and ferroptosis. H9c2 cells were induced by ISO to construct an in vitro model of cardiomyocyte hypertrophy, the protein expressions of CRTC2, ACTA1, BNP, ACSL4, SLC7A11 and GPX4 were detected after intervention with ferroptosis inhibitor ferrostatin-1 (Fer-1). H9c2 cells with CRTC2 overexpression induced by ISO were used to construct an in vitro model of cardiomyocyte hypertrophy, the related indicators of cardiomyocyte hypertrophy and ferroptosis were detected to explore the mechanism of CRTC2 in cardiomyocyte hypertrophy. Results Compared with the control group, the expression of CRTC2 protein in the cardiac tissue of ISO induced cardiomyocyte hypertrophy mice was increased (P＜0.05). Compared with wild-type mice, CRTC2－/－ mice showed worsened cardiac function, manifested as increased left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular posterior wall thickness (LVPWT), heart weight/tibia length (HW/TL) and heart weight/body weight (HW/BW), decreased short axis shortening (FS) and ejection fraction (EF), increased collagen fiber content in cardiac tissue, upregulated expression of cardiomyocyte hypertrophy-related proteins ACTA1 and BNP, increased mRNA and protein expression of ferroptosis-related protein ACSL4, decreased mRNA and protein expression of SLC7A11 and GPX4, and elevated iron ion content in cardiac tissue (P＜0.05 or P＜0.01). In vitro experiments showed that compared with ISO group, the ISO＋Fer-1 group had no significant change in CRTC2 protein expression (P＞0.05), the expression of ACTA1 and BNP protein decreased, the surface area of cardiomyocyte reduced, the expression of ACSL4 protein decreased, and the expression of SLC7A11 and GPX4 proteins increased (P＜0.05 or P＜0.01). Compared with the ISO group, the LV-CRTC2＋ISO group showed a decrease in surface area of cardiomyocytes (P＜0.01), a decrease in ACTA1, BNP and ACSL4 protein expression, an increase in SLC7A11 and GPX4 protein expression, and a decrease in ROS and iron ion content (P＜0.05 or P＜0.01). Conclusion CRTC2 alleviates cardiomyocyte hypertrophy and protect cardiac function by suppressing ferroptosis in cardiomyocytes.

Abstract:Aim To investigate the predictive value of lipoprotein(a) [Lp(a)] combined with systemic inflammatory response index (SIRI) on in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) in patients with coronary heart disease. Methods The clinical data of 770 patients with coronary heart disease who underwent PCI in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Xinjiang Medical University from May 2012 to December 2024 and underwent coronary angiography six months after surgery were collected. According to the imaging results, the patients were divided into ISR group (n＝194) and non-ISR group (n＝576). Multivariate Logistic regression and random forest model were used to analyze the independent risk factors of ISR. Risk factors included in the analysis were glycated hemoglobin, SIRI, Lp(a), lymphocyte count, apolipoprotein A1 (ApoA1) and residual cholesterol. Results The levels of Lp(a) and SIRI in the ISR group were significantly higher than those in the non-ISR group (P＜0.05). ROC curve analysis showed that the area under the curve of the combined indicator of Lp(a) and SIRI was 0.789, which was higher than the 0.652 of the single indicator Lp(a) and 0.778 of SIRI. Conclusion Lp(a) and SIRI are independent risk factors for the occurrence of ISR after PCI, and the combination of Lp(a) and SIRI can better predict the occurrence of ISR.

Abstract:Aim To investigate the relationship between fat attenuation index (FAI) of pericoronary adipose tissue and coronary slow flow (CSF). Methods The clinical data of 135 hospitalized patients who underwent coronary angiography (CAG) due to chest tightness, chest pain and other similar symptoms from November 2023 to July 2024 were retrospectively collected. According to the blood flow grading criteria, the patients were divided into CSF group (n＝61) and normal blood flow group (n＝74). The basic information of the patients, the laboratory test results on the day of admission and the data of coronary CT angiography (CCTA) were also collected. Multivariate Logistic regression was used to analyze the risk factors for CSF. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of FAI in predicting CSF. Results The white blood cell count (WBC), fasting blood glucose (FBG), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and right coronary artery (RCA) FAI in the CSF group were 1.3,1.0,1.33 1.53 and 1.13 times that of those in the normal blood flow group, respectively (P＜0.05). The left ventricular ejection fraction (LVEF) in the CSF group was 94.78% of the normal blood flow group (P＜0.05). Multivariate Logistic regression analysis showed that elevated WBC (OR＝1.891), elevated FBG (OR＝1.774), decreased LVEF (OR＝0.094), elevated hs-CRP increased (OR＝1.124), increased RCA-FAI (OR＝1.077) were independent risk factors for CSF (P＜0.05). The results of ROC curve analysis showed that the area under the curve (AUC) of RCA-FAI in predicting CSF was 0.715 (95%CI:0.627～0.802), the optimal cut-off value was －81.5 HU, the sensitivity was 0.803, and the specificity was 0.581. Conclusion Elevated WBC, elevated FBG, decreased LVEF, increased hs-CRP, and increased RCA-FAI are risk factors for CSF. Among them, RCA-FAI has a good efficacy in predicting the occurrence of CSF, which can be used to identify high-risk CSF patients as early as possible and reduce the incidence of CSF.

Abstract:Aim To investigate the relationship between the triglyceride glucose-body mass index (TyG-BMI) and the extent of coronary artery disease in patients with premature coronary artery disease (PCAD). Methods A retrospective analysis was performed on the clinical data of 533 PCAD patients diagnosed by coronary angiography at Xuzhou Central Hospital from January 2023 to December 2023. Patients were divided into three groups based on TyG-BMI tertiles:group T1 (TyG-BMI≤228.27), group T2 (228.27＜TyG-BMI≤248.90), and group T3 (TyG-BMI＞248.90). The extent of coronary artery disease was quantitatively assessed using the Gensini score, which was categorized into low/mid-risk (Gensini score≤70) and high-risk (Gensini score＞70) groups. Univariate and multivariate Logistic regression models were used to analyze the relationship between TyG-BMI and the occurrence of high Gensini score coronary artery disease. Spearman correlation analysis was employed to assess the correlation between TyG-BMI and Gensini score. ROC curve was used to analyze the predictive value of TyG-BMI for severe coronary artery disease. Results Patients in group T3 had more multi-vessel lesions and higher Gensini scores (P＜0.001). Logistic regression analysis showed that a high level of the TyG-BMI was an independent risk factor for severe coronary artery disease in patients with PCAD (OR＝1.1,5%CI:1.021～1.040, P＜0.001). Compared with group T1, the risk for severe coronary artery disease in group T3 was 3.57-fold higher (OR＝3.7,5%CI:2.170～5.870, P＜0.001). Spearman correlation analysis showed that TyG-BMI was positively correlated with the severity of coronary artery disease (r＝0.202, P＜0.001). ROC curve analysis showed that the area under curve of TyG-BMI was 0.704 (95%CI:0.656～0.752), which was superior to that of the TyG index in predictive value (P＜0.05). Conclusion A high level of the TyG-BMI can be used as an effective predictor of severe coronary artery disease in patients with PCAD.

Abstract:Aim To explore the differences in metabolic indicators among patients with intracranial atherosclerosis of different severity levels and their predictive value for cerebral artery stenosis and occlusion. MethodsA total of 310 patients with suspected intracranial atherosclerosis who were treated in our hospital from February 2022 to February 2024 were selected, and they were divided into the normal group (n＝155) and the occlusion group (n＝155) based on whether cerebral artery stenosis and occlusion occurred. Patients in the occlusion group were divided into grade 1 group (n＝40), grade 2 group (n＝78) and grade 3 group (n＝37) according to the grade of intracranial atherosclerosis.The clinical data and serum calcium and phosphorus metabolism indicator levels of patients with different grades of atherosclerosis were compared. The generalized additive model (GAM) was used to analyze the relationship between the levels of serum calcium and phosphorus metabolism indicators and the grade of atherosclerosis. The clinical data of the occlusion group and the normal group were compared. Multivariate Logistic regression analysis was conducted to analyze the factors affecting cerebral artery stenosis and occlusion. The dose-response relationship between the levels of serum calcium and phosphorus metabolism indicators and cerebral artery stenosis and occlusion was analyzed. The differences in cerebral artery stenosis and occlusion under different grades of atherosclerosis and different levels of serum calcium and phosphorus metabolism indicators were compared. The generalized linear model was used to analyze the influence of the severity of intracranial atherosclerosis on the association between cerebral artery stenosis and occlusion and the levels of serum calcium and phosphorus metabolism indicators. Results With the increase of atherosclerosis grading level, the levels of fasting blood glucose (FBG), high sensitivity C-reactive protein (hs-CRP), apolipoprotein B (ApoB), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDLC), blood phosphorus, calcium-phosphorus product, and intact parathyroid hormone (iPTH) gradually increased, while the levels of apolipoprotein A (ApoA) and high density lipoprotein cholesterol (HDLC) gradually decreased (P＜0.05). The results of GAM analysis showed that blood phosphorus, calcium-phosphorus product and iPTH had a positive effect on atherosclerosis grading. Compared with normal group, the levels of FBG, hs-CRP, ApoB, TC, TG, LDLC, blood phosphorus, calcium-phosphorus product and iPTH were significantly higher in occlusion group, and the levels of ApoA and HDLC were significantly lower (P＜0.05). Compared with the normal group, there were significantly fewer patients with atherosclerosis grade 0 in the occlusion group (P＜0.05). ApoA≤1.02 g/L, ApoB＞1.09 g/L, TC＞5.31 mmol/L, TG＞2.53 mmol/L, LDLC＞3.12 mmol/L, HDLC≤1.26 mmol/L, blood phosphorus＞2.17 mmol/L, calcium-phosphorus product＞4.53 (mmol/L)², iPTH＞327.49 ng/L and atherosclerosis grade≥1 were the risk factors for cerebral artery stenosis and occlusion (P＜0.05). The correlation intensity of blood phosphorus, calcium-phosphorus product, iPTH and cerebral artery stenosis and occlusion showed a non-linear dose-response relationship (P＜0.001). With the increase of atherosclerosis grading, the positive correlation between cerebral artery stenosis and blood phosphorus, calcium-phosphorus product and iPTH gradually increased. Conclusion There were significant differences in the levels of metabolic indicators among patients with intracranial atherosclerosis of different severity levels, and they had predictive value for cerebral artery stenosis and occlusion.

Abstract:Aim To study the correlation between heart rate variability (HRV) and right ventricular dysfunction (RVD) in patients with heart failure with preserved ejection fraction (HFpEF) combined with atrial fibrillation (AF). Methods 128 patients with HFpEF and AF admitted to our hospital from January 1,2 to December 1,4 were selected as the research subjects. Based on the results of right heart function assessment, the patients were divided into two groups:the right ventricular dysfunction group (n＝53) and the normal right ventricular function group (n＝75). Spearman correlation was employed to assess the correlation between HRV parameters and right ventricular function parameters. A multi-factor generalized linear mixed-effects model was constructed, with HRV parameters as independent variables and RVD as the dependent variable. Restricted cubic splines were used to investigate the dose-response relationship between HRV parameters and the incidence of RVD. Additionally, the diagnostic value of HRV parameters and combined detection for RVD was analyzed using the ROC curve. Results The levels of HRV parameters (SDNN, SDANN, RMSSD, PNN50, LF and HF) and right ventricular function parameters (TAPSE, FAC and S′) in the right ventricular dysfunction group were significantly lower than those in the normal right ventricular function group (P＜0.05). Linear analysis revealed a significant positive correlation between HRV parameters and right ventricular function parameters (P＜0.05). Multifactor generalized linear mixed-effects model analysis demonstrated that SDNN, SDANN, RMSSD, PNN50, LF and HF were negatively correlated with the incidence of RVD (the β coefficients were －0.465, －0.205, －0.559, －0.293, －0.732, and －0.147, respectively, P＜0.05). Restricted cubic spline model analysis indicated a significant nonlinear relationship between HRV parameters and the incidence of RVD (P＜0.05). The AUC value of combined detection of HRV parameters was 0.946, with sensitivity and specificity of 93.56% and 94.57%, respectively. Conclusion There is a negative correlation between HRV and the incidence of RVD in patients with HFpEF combined with AF.This result offers a critical theoretical foundation for clinical assessment and therapeutic strategies.

Abstract:Proprotein convertase subtilisin/kexin type 9 (PCSK9) can modulate low density lipoprotein cholesterol (LDLC) levels, and its dysfunction is closely associated with the progression of atherosclerosis and cardiovascular diseases.Research has shown that PCSK9 inhibitors are highly effective in lowering lipids and have good safety and tolerability. New approaches to targeting PCSK9 inhibition are currently in different stages of clinical development. This review outlines the primary mechanisms of PCSK9 and its impact on the cardiovascular system,emphasizing the current emerging strategies for targeting PCSK9 in lipid-lowering treatments.

Abstract:Endovascular aneurysm repair (EVAR) is the most common treatment for abdominal aortic aneurysm. However, when the common iliac artery has expansion or aneurysm, there may be internal leakage at the distal end of the stent. In this case, the ideal endovascular repair should ensure the pelvic blood supply on the premise of complete exclusion of the aneurysm. It is feasible and safe to use iliac branch devices (IBD) to preserve unilateral or bilateral internal iliac arteries, and its technology and clinical results are equivalent to standard EVAR. But IBD has certain anatomical adaptability. In this paper, the current status of preservation of internal iliac artery with IBD is systematically reviewed.

Abstract:Cardiovascular disease (CVD) is a leading cause of death worldwide, posing a substantial burden on society. Transfer RNA-derived fragment (tRF) is a novel class of non-coding small RNA produced primarily through the specific cleavage of precursor or mature transfer RNA (tRNA). Unlike the canonical role of tRNA in amino acid transport, tRF plays important roles in regulating gene transcription, translation, and epigenetic modifications, thereby influencing pathophysiological processes such as cell proliferation, differentiation, and apoptosis. In recent years, with the widespread application of small RNA sequencing technologies, a growing number of studies have demonstrated close associations between tRF and the development and progression of various CVDs, making them a research hotspot in the field. This review systematically summarizes the origin, classification, functional mechanisms, and recent advances in tRF research related to CVD, aiming to provide new directions for understanding the pathogenesis of CVD and identifying potential therapeutic targets.

Abstract:Acute myocardial infarction still does great harm to the health and economy of modern society. Current studies have shown that thymosin β4 (Tβ4) can promote epicardial activation, protect cardiomyocytes by reducing apoptosis, promoting survival and migration, and inhibit the inflammatory response and fibrosis caused by myocardial infarction.Furthermore, it can induce neovascularization and improve mycardial blood supply. This article reviews the research progress of Tβ4 in the pathogenesis and treatment of acute myocardial infarction.