Background: Tai Chi is an increasingly utilized aerobic rehabilitation exercise in the field of cardiovascular disease (CVD). However, there remains debate regarding its effects on physiological function and mental health in patients with coronary heart disease (CHD). This study aims to investigate the impact of Tai Chi-based rehabilitation exercises on physical and psychological health outcomes for CHD patients. Methods: By collecting data from 12 databases up to December 2022, we conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the effects of Tai Chi on the physical function and psychological health among CHD patients. Results: We analyzed twenty qualified studies involving 2095 patients. Meta-analyses revealed that compared with conventional therapy groups, those who participated in Tai Chi-based interventions demonstrated significant improvements in physical function as measured by six-minute walk test (6MWT) [mean difference (MD) = 56.40, 95% confidence interval (CI) (38.50, 74.29), p < 0.01], maximal oxygen consumption (VO2 max) [standardized mean difference (SMD) = 0. 57, 95% CI (0.12, 1.03), p = 0.01], New York Heart Association (NYHA) class [relative risk (RR) = 1.34, 95% CI (1.18, 1.53), p < 0.01] and physical health components (PHC) [SMD = 1.23, 95% CI (0.76, 1.69), p < 0.01]. Additionally, Tai Chi participants showed greater improvement than control groups across various psychological parameters including anxiety scales [SMD = –0.80, 95% CI (–1.33, –0.28), p = 0.003], depression scales [SMD = –0.77, 95% CI (–1.32, –0.23), p = 0.005] and mental health components (MHC) [SMD = 1.27, 95% CI (0.76, –1.78), p < 0.01]. The GRADEpro (Grade Guideline Development Tool) indicated evidence levels ranging from very low to moderate. Conclusions: The present meta-analysis demonstrates that mind-body rehabilitation exercises based on Tai Chi can improve both physical and psychological health outcomes for CHD patients. These findings suggest that this exercise pattern may be a potential option for cardiovascular rehabilitation. PROSPERO Registration: The protocol for this systematic review and meta-analysis has been registered with PROSPERO International Prospective Systematic Reviews (No: CRD42022370021, http://www.crd.york.ac.uk/PROSPERO).
Objective: The impact of uric acid on worsening of diastolic function and clinical outcomes in patients with coronary slow flow remains unclear.This study aims to investigate possible associations between serum uric acid, worsening of diastolic function, and major adverse cardiovascular events in coronary slow flow patients.Methods: Blood samples were obtained prospectively from 537 patients who had been angiographically diagnosed with coronary slow flow.Of those, 425 patients underwent comprehensive cardiac function assessment both before and after maximal treadmill exertion by stress echocardiography.The association between serum uric acid and major adverse cardiovascular events was examined using Cox proportional hazards regression model.Results: Among the 425 patients (mean age: 58 ± 11 years; 52.2% men), worsening of diastolic function occurred in 176 (41.4%) after exercise stress.Patients with worsening of diastolic function had elevated levels of serum uric acid compared to those without (5.7 [4.1, 6.7] vs 4.3 [3.6, 5.3] mg/dL, respectively; P < .001).Higher serum uric acid levels were also significantly associated with neutrophil counts and high-sensitive C-reactive protein in patients with worsening of diastolic function but not in those without.Multivariate regression analysis found serum uric acid to be an independent predictor of worsening of diastolic function (odds ratio = 1.87 [1.17-3.82],P = .023).Moreover, serum uric acid remained associated with major adverse cardiovascular events even after adjusting for echocardiographic and clinical variables (hazard ratio = 1.56 [1.03-2.89],P = .016). Conclusion:Serum uric acid is associated with worsening of diastolic function and may be mediated by inflammation.These findings indicate that uric acid is a risk factor for major adverse cardiovascular events in patients with coronary slow flow.
Acute myocardial infarction complicated by cardiogenic shock and left main coronary artery disease is called left main shock syndrome. It is reported that the morbility and mortality of the syndrome is approximately 0.46% and 55%-80%, respectively. However, the best treatment strategy in these cases is unknown. In this article, we present a patient with LMSS who successively underwent emergency percutaneous coronary intervention and coronary artery bypass grafting with hemodynamic support within 5 days. The patient is now on his three month uneventful out-patient follow-up.
To assess the effect of Tongxinluo on cytokines and myocardial no-reflow in early reperfusion of acute myocardial infarction (AMI).Forty mini-swine were divided into five groups randomly, sham group, control group, low dose (0.1 g/kg), medium dose (0.2 g/kg) and high dose (0. 4 g/kg) group of Tongxinluo (which were administered 2 h before reperfusion), eight swine in each group. Animals except those in the sham group were subjected to 1.5 h of coronary occlusion followed by 3 h of reperfusion. Serum contents of P-selectin, intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), interleukin 6 (IL-6) and interleukin 10 (IL-10), as well as myocardial contrast echocardiography (MCE) were evaluated at baseline, and after 1.5 h of AMI and 3 h of reperfusion.(1) Compared with that of the control group, high dose of Tongxinluo could reduce serum contents of P-selectin and ICAM-1 at 1.5 h of AMI (all P<0.05), and P-selectin, ICAM-1, VCAM-1, and IL-6 at 3 h of reperfusion significantly (all P< 0.05), accompanied by significantly elevated IL-10 (P<0.05). (2) Compared with that of control group, high dose of Tongxinluo could reduce no-reflow area at 3 h of reperfusion significantly [(6.59 +/- 1.73) cm2 vs (4.68 +/- 1.53) cm2, P<0.05].High dose of Tongxinluo could effectively reduce serum contents of adhesion and pro-inflammatory cytokines, regulate anti-inflammatory factor levels, and attenuate no-reflow area in the early reperfusion of AMI. It thus provided experimental basis for its clinical application.
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