A Famous Chinese Prescription That Promotes Hcn4 Activity in Bone Marrow Mesenchymal Stem Cells is Shenfu Injection: Opinion

2021 ◽  
Vol 7 (4) ◽  
pp. 1-2
Author(s):  
Rong Li ◽  
Keyword(s):  
Sick Sinus Syndrome ◽  
Heart Function ◽  
Sinus Node ◽  
Heart Rhythm ◽  
Underlying Mechanism ◽  
Shenfu Injection ◽  
Chinese Herbal ◽  
Heart Rhythm Disorders ◽  
Marrow Mesenchymal Stem Cells ◽  
Pacemaker Insertion

Sick Sinus Syndrome (SSS) refers to a group of heart rhythm disorders caused by problems relating to the sinus node. Currently, there is no effective treatment for SSS, and an electronic pacemaker is required to support heart function in SSS patients. However, electronic pacemakers are associated with several defects. For example, external magnetic noise commonly interferes, leading to complications. In addition, some patients, especially children with congenitals inoatrial node dysfunction, are not suitable subjects for pacemaker insertion. Therefore, the search for new therapeutic strategies for treating cardiovascular diseases has become imperative. Shenfu injection (SFI), a Chinese herbal medicine, is effective in improving bradyarrhythmia. However, the underlying mechanism of SFI's therapeutic effect remains elusive.

scholarly journals Case Reports: Emery-Dreifuss Muscular Dystrophy Presenting as a Heart Rhythm Disorders in Children

2021 ◽  
Vol 8 ◽  
Author(s):  
Tatiana Kovalchuk ◽  
Elena Yakovleva ◽  
Svetlana Fetisova ◽  
Tatiana Vershinina ◽  
Viktoriya Lebedeva ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscular Dystrophy ◽  
Case Reports ◽  
Sinus Node ◽  
Heart Rhythm ◽  
Cardiac Abnormalities ◽  
Progressive Muscle Weakness ◽  
Cardiac Phenotype ◽  
Cardiac Symptoms ◽  
Heart Rhythm Disorders

Emery-Dreifuss muscular dystrophy (EDMD) is inherited muscle dystrophy often accompanied by cardiac abnormalities in the form of supraventricular arrhythmias, conduction defects and sinus node dysfunction. Cardiac phenotype typically arises years after skeletal muscle presentation, though, could be severe and life-threatening. The defined clinical manifestation with joint contractures, progressive muscle weakness and atrophy, as well as cardiac symptoms are observed by the third decade of life. Still, clinical course and sequence of muscle and cardiac signs may be variable and depends on the genotype. Cardiac abnormalities in patients with EDMD in pediatric age are not commonly seen. Here we describe five patients with different forms of EDMD (X-linked and autosomal-dominant) caused by the mutations in EMD and LMNA genes, presented with early onset of cardiac abnormalities and no prominent skeletal muscle phenotype. The predominant forms of cardiac pathology were atrial arrhythmias and conduction disturbances that progress over time. The presented cases discussed in the light of therapeutic strategy, including radiofrequency ablation and antiarrhythmic devices implantation, and the importance of thorough neurological and genetic screening in pediatric patients presenting with complex heart rhythm disorders.

scholarly journals GATA6 is a regulator of sinus node development and heart rhythm

2020 ◽  
Vol 118 (1) ◽  
pp. e2007322118
Author(s):  
Lara Gharibeh ◽  
Abir Yamak ◽  
Jamieson Whitcomb ◽  
Aizhu Lu ◽  
Mathieu Joyal ◽  
...  
Keyword(s):  
Molecular Basis ◽  
Human Heart ◽  
Sick Sinus Syndrome ◽  
Sinus Node ◽  
Pacemaker Implantation ◽  
Cardiac Pacemaker ◽  
Heart Rhythm ◽  
Important Regulator ◽  
Node Development ◽  
Specific Deletion

The sinus node (SAN) is the primary pacemaker of the human heart, and abnormalities in its structure or function cause sick sinus syndrome, the most common reason for electronic pacemaker implantation. Here we report that transcription factor GATA6, whose mutations in humans are linked to arrhythmia, is highly expressed in the SAN and its haploinsufficiency in mice results in hypoplastic SANs and rhythm abnormalities. Cell-specific deletion reveals a requirement for GATA6 in various SAN lineages. Mechanistically, GATA6 directly activates key regulators of the SAN genetic program in conduction and nonconduction cells, such as TBX3 and EDN1, respectively. The data identify GATA6 as an important regulator of the SAN and provide a molecular basis for understanding the conduction abnormalities associated with GATA6 mutations in humans. They also suggest that GATA6 may be a potential modifier of the cardiac pacemaker.

scholarly journals Emery-Dreifuss muscular dystrophy presenting as a heart rhythm disorders in children

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
T S Kovalchuk ◽  
E V Yakovleva ◽  
S G Fetisova ◽  
T L Vershinina ◽  
T M Pervunina ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Skeletal Muscle ◽  
Muscular Dystrophy ◽  
Atrial Flutter ◽  
Sinus Node ◽  
Heart Rhythm ◽  
Sinus Node Dysfunction ◽  
Supraventricular Arrhythmias ◽  
Heart Rhythm Disorders ◽  
The Mean

Abstract Introduction Emery-Dreifuss muscular dystrophy (EDMD) is an inherited muscle dystrophy often accompanied by cardiac abnormalities in the form of supraventricular arrhythmias, conduction defects, sinus node dysfunction. Cardiac phenotype typically arises years after skeletal muscle presentations, though, can be severe and life-threatening. The disease usually manifests during the third decade of life with elbow joint contractions and progressive muscle weakness and atrophy. Objective To present our clinical experience of diagnosis and treatment of arrhythmias in children with Emery-Dreifuss muscular dystrophy Materials and methods We enrolled 5 patients with different forms of EDMD (X-linked and autosomal dominant) linked to the mutations in EMD and LMNA genes, presented with early onset of cardiac abnormalities and no leading skeletal muscle phenotype. The predominant forms of cardiac pathology were atrial flutter, atrial fibrillation and conduction disturbances that progress over time. Clinical examination included physical examination, 12-lead electrocardiography, Holter ECG monitoring (HM), transthoracic echocardiography, neurological examination and biochemical and hormone tests. Also we performed CMR, electrophysiological study (EPS), treadmill test of some patients. One patient underwent an endomyocardial biopsy to exclude inflammatory heart disease. Target sequencing was performed using a panel of 108 or 172 genes Results We observed five patients with EDMD and cardiac debut during first-second decades of life: 3 with 1st subtype (variants in EMD gene) and 2 with 2nd subtype (variants in LMNA gene). All patients were males. The mean age of cardiac manifestation was 13,2±3,11 (from 9 to 16 y.o.). The mean follow-up period was 7,4±2,6 years. All patients presented with sinus node dysfunction and four out of five with AV conduction abnormalities. The leading arrhythmic phenotypes included various types of supraventricular arrhythmias: multifocal atrial tachycardia (AT) (n=4), premature atrial captures (PACs) (n=4), atrial flutter, (AF) (n=3), atrial fibrillation (AFib) (n=3) and AV nodal recurrent tachycardia (AVRNT). Heart rhythm disorders were the first manifestation in all three patients with 1st EDMD subtype. Radiofrequency ablation was performed in 2 patients, one of them received permanent pacemaker implantation. Conclusions In conclusion, while being the rare cases, heart rhythm disorders can represent the first and for a long time, the only clinical symptom of EDMD even in the pediatric group of patients. Therefore, thorough laboratory and neurological screening along with genetic studies, are of importance in each pediatric patient presenting with complex heart rhythm disorders of primary supraventricular origin to exclude EDMD or other neuromuscular disorders. FUNDunding Acknowledgement Type of funding sources: None.

Evaluation and Treatment of Arrhythmias

2012 ◽  
Author(s):  
Peter A. Brady
Keyword(s):  
Ventricular Arrhythmias ◽  
Heart Rate Response ◽  
Sinus Node ◽  
Heart Rhythm ◽  
Holter Monitoring ◽  
Cardiac Conduction ◽  
Electrophysiologic Study ◽  
Heart Rhythm Disorders ◽  
Response To Exercise ◽  
Treadmill Exercise Testing

Abnormal cardiac arrhythmias may be due to reentry, abnormal automaticity, or triggered activity. Reentrant rhythms may be microreentrant or macroreentrant. Ambulatory (Holter) monitoring is useful for the evaluation of both symptomatic and asymptomatic rhythm disturbances and their relationship to daily activity. Treadmill exercise testing is very useful in the evaluation of patients who present with bradycardia and symptoms of palpitations because it allows both documentation of the adequacy of heart rate response to exercise and the recording of the cardiac rhythm during exercise in a controlled setting with ECG monitoring. An electrophysiologic study is useful for assessing sinus node function and the cardiac conduction system and for attempting to induce atrial or ventricular arrhythmias that could explain the clinical presentation. Electrophysiologic study requires placement of electrode catheters in the heart to record and to stimulate heart rhythm. Several therapeutic options are available for heart rhythm disorders, including drug therapy, radiofrequency ablation, and device therapy.

Clinical and Morphological Features of Myocardial Damage and the Course of Fulminant Myocarditis on the Background of СOVID-19, Diagnosis and Treatment Tactics

2020 ◽  
Vol 75 (5S) ◽  
pp. 414-425
Author(s):  
Olga S. Oynotkinova ◽  
Evgenii L. Nikonov ◽  
Oleg V. Zayratyants ◽  
Elena V. Rzhevskaya ◽  
Evgenii V. Krukov ◽  
...  
Keyword(s):  
Myocardial Dysfunction ◽  
Myocardial Damage ◽  
Heart Rhythm ◽  
Microvascular Dysfunction ◽  
Symptomatic Treatment ◽  
Clinical Situation ◽  
Diagnosis And Treatment ◽  
Screening Tests ◽  
Fulminant Myocarditis ◽  
Heart Rhythm Disorders

In a review article based on my own clinical experience of managing patients with acute myocardial injury and fulminant myocarditis, taking into account expert recommendations on the clinical treatment of myocardial damage associated with novel coronavirus infection a National clinical geriatric medical research center, division of cardiovascular diseases, the Chinese geriatrics society, Department of cardiology, Beijing Medical Association and European clinics discusses the pathogenesis, diagnosis and treatment of myocardial damage and FM patients, infected with SARS-CoV-2 in the context of the COVID-19 pandemic. Clinical features and diagnostic criteria are presented, including screening tests of markers of myocardial damage in the form of a highly sensitive troponin test, a natriuretic peptide. The article discusses in detail the pathogenesis and mechanisms of myocardial damage, including immune mechanisms, cytokine storm, systemic inflammation with macro- and microvascular dysfunction and the development of myocardial dysfunction with acute heart failure, hypotension, cardiogenic shock and/or life-threatening heart rhythm disorders caused by hypoxia and metabolic disorders at the cellular level. Features of the clinical course of fulminant myocarditis in infected patients (SARS-CoV-2) in the conditions of the COVID-19 pandemic are presented. For the first time, a detailed histo-morphological analysis of pathological myocardial injuries and complications is presented on the basis of unique autopsy material on post-mortem diagnostics of various pathoanatomic autopsies of those who died from COVID-19 in Moscow. Based on the clinical, functional and morphological material, the Protocol of etiopathogenetic treatment is presented. The basis of standard therapy is considered antiviral drugs, immunoglobulin G, the use of monoclonal antibodies to interleukin-6, anticoagulants, glucocorticoids, depending on the clinical situation, cardioprotectors and symptomatic treatment are recommended to maintain the heart, which in combination can achieve a certain clinical effectiveness. As adjuvant cardioprotective targeted therapy, the sodium salt of phosphocreatine is considered in order to preserve the myocardium, maintain its contractility and vital activity.

scholarly journals RNAseq shows an all-pervasive day-night rhythm in the transcriptome of the pacemaker of the heart

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yanwen Wang ◽  
Cali Anderson ◽  
Halina Dobrzynski ◽  
George Hart ◽  
Alicia D’Souza ◽  
...  
Keyword(s):  
Heart Rate ◽  
Nervous System ◽  
Circadian Clock ◽  
Sick Sinus Syndrome ◽  
Sinus Node ◽  
Signalling Pathways ◽  
Resting Heart Rate ◽  
Ion Channel Regulation ◽  
Channel Regulation ◽  
Physiological Systems

AbstractPhysiological systems vary in a day-night manner anticipating increased demand at a particular time. Heart is no exception. Cardiac output is primarily determined by heart rate and unsurprisingly this varies in a day-night manner and is higher during the day in the human (anticipating increased day-time demand). Although this is attributed to a day-night rhythm in post-translational ion channel regulation in the heart’s pacemaker, the sinus node, by the autonomic nervous system, we investigated whether there is a day-night rhythm in transcription. RNAseq revealed that ~ 44% of the sinus node transcriptome (7134 of 16,387 transcripts) has a significant day-night rhythm. The data revealed the oscillating components of an intrinsic circadian clock. Presumably this clock (or perhaps the master circadian clock in the suprachiasmatic nucleus) is responsible for the rhythm observed in the transcriptional machinery, which in turn is responsible for the rhythm observed in the transcriptome. For example, there is a rhythm in transcripts responsible for the two principal pacemaker mechanisms (membrane and Ca2+ clocks), transcripts responsible for receptors and signalling pathways known to control pacemaking, transcripts from genes identified by GWAS as determinants of resting heart rate, and transcripts from genes responsible for familial and acquired sick sinus syndrome.

scholarly journals PLASMA CONCENTRATION OF ENDOTHELIN-1 IN PATIENTS WITH HYPERTENSION ASSOCIATED WITH OBESITY, DEPENDING ON THE LYS198ASN POLYMORPHISM OF THE ENDOTHELIN-1 GENE

2021 ◽  
Vol 9 (1) ◽  
pp. 87-94
Author(s):  
Yu.O. Smiianova
Keyword(s):  
Body Weight ◽  
Heart Rhythm ◽  
Pathological Process ◽  
Main Group ◽  
Overweight And Obesity ◽  
Control Group ◽  
Endothelin 1 ◽  
Normal Body ◽  
Heart Rhythm Disorders ◽  
Normal Body Weight

Endothelial dysfunction is considered one of the main mechanisms for the further development of arterial hypertension (AH) and its complications, and endothelin-1 (ЕТ-1) plays one of the key roles in this process. Endothelium is drawn into the pathological process at the earliest stages of AH development. ЕТ-1 is currently considered as a marker and predictor of the stage and consequences of AH, chronic heart failure (CHF), coronary heart disease (CHD), in particularly, acute myocardial infarction (MI), heart rhythm disorders, pulmonary hypertension, atherosclerotic vascular injury, target vascular disorders. One factor that may influence the level of ЕТ-1 is the endothelin-1 gene Lys198Asn polymorphism, which is considered by many researchers as a possible genetic marker of AH. However, the effect of this polymorphism on the level of plasma ЕТ-1 level in patients with AH of varying severity in Ukraine is understudied. The basis of this work were the materials of a complete examination of 160 patients with a verified diagnosis of AH I, stage II of 1, 2, 3 degrees (main group) and 110 apparently healthy persons (control group). Patients of the main group were divided into three subgroups: 1st group ­– 75 patients with normal body weight; 2nd group – 48 overweight patients; 3rd group – 37 patients with alimentary obesity. In obese patients, the waist circumference in women was around 103 (96–115) cm, and in men – 108 (105–116) cm, which indicates an abdominal type of obesity in these patients. As a result of the study, it was found that the level of ЕТ-1 is higher in patients with AH who suffer with overweight and obesity as compared with patients with AH and normal body weight. Also, the peptide level depends on the genotype of patients and is higher in AH patients with the genotype Asn198Asn and Lys198Asn as compared to carriers of the genotype Lys198Lys.

scholarly journals Feasibility of remote support for electrophysiological ablation procedures during CoVid-19 pandemics

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Muessigbrodt ◽  
F Demoniere ◽  
S Finoly ◽  
M Mommarche ◽  
J Inamo
Keyword(s):  
Atrial Flutter ◽  
Medical Training ◽  
Human Life ◽  
Heart Rhythm ◽  
Left Ventricular ◽  
Technical Support ◽  
Right Atrial ◽  
Global Challenge ◽  
Heart Rhythm Disorders ◽  
Technical Support Staff

Abstract   The COVID-19 pandemics is a global challenge with a huge impact on medicine, politics, economy, education, travel and many other aspects of human life. The treatment of heart rhythm disorders has also been affected by the disease itself and by restrictions in order to constrain the spread of the virus. Catheter ablations of cardiac arrhythmias are nowadays frequently guided by electro-anatomic mapping systems. Technical staff with medical training, or medical staff with technical training, is needed to assist the operator. Travel restrictions due to current COVID-19 pandemics have limited the in person availability for technical support staff. To overcome these limitations we explored the feasibility of remote support with an internet based communication platform. A total of 9 patients (87,5% male, mean age 66,6 years) with different arrhythmias (atrial fibrillation, left atrial flutter, typical right atrial flutter, left ventricular tachycardia), having undergone ablation procedures between October 2020 and February 2021, were included. Acute procedural success was obtained in 9 out of 9 procedures. No complications occurred. Our experience with remote support for electro-anatomic mapping for complex electrophysiological ablation procedures, show the feasibility and safety of this approach. It increases the availability of technical support at reduced costs and a reduced CO2 footprint. Remote support for electro-anatomic mapping may therefore facilitate continuous care for patients with arrhythmias during the COVID-19 pandemics. Due to its advantages beyond COVID-19 pandemics related problems, it will likely play a greater role in the future. FUNDunding Acknowledgement Type of funding sources: None.

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