Haifeng Pei

This study aimed to investigate the therapeutic effects of Poncirin on hypoxic pulmonary hypertension (HPH) and to elucidate the underlying mechanism, with a specific focus on transactive response DNA‐binding protein 43 (TDP43)‐mediated macrophage pyroptosis. A rat model of HPH was established using a hypobaric hypoxia chamber. In vitro, rat alveolar macrophages (NR8383 cells) and pulmonary artery smooth muscle cells (PASMCs) were cultured under normoxic or hypoxic (1% O ₂ ) conditions. TDP43 expression was modulated through small interfering RNA (siRNA)‐mediated knockdown or lentivirus‐mediated overexpression. Poncirin was administered at a dose of 30 mg/kg in vivo and at a concentration of 50 μM in vitro to assess its pharmacologic effects. The results demonstrated that TDP43 expression was markedly upregulated in lung tissues of rats with HPH and in hypoxia‐exposed NR8383 cells, and this was accompanied by increased macrophage accumulation around pulmonary arterioles. Hypoxia‐induced TDP43 upregulation promoted macrophage pyroptosis via activation of NLRP3, Caspase 1, and N‐GSDMD, leading to enhanced release of the inflammatory cytokine interleukin‐1β (IL‐1β), which in turn facilitated PASMCs proliferation. Poncirin significantly attenuated hypoxia‐induced macrophage pyroptosis and PASMCs proliferation in both in vivo and in vitro models by downregulating TDP43 expression. Collectively, these findings identify TDP43 as a key mediator in the pathogenesis of HPH and support Poncirin as a potential therapeutic agent for HPH through targeting of TDP43‐mediated macrophage pyroptosis.

Objective: This prospective cohort study aimed to investigate the temporal effects and additional characteristics of hyperbaric oxygen (HBO) intervention on heart rate variability (HRV) and autonomic nervous system (ANS) function in young adults. Methods: Portable single‐lead ambulatory ECG devices were used to collect HRV data. Fourteen young male participants underwent five daily 90‐min HBO sessions. HRV was measured before intervention (T0), 2 h after the fifth session (T1), and 1 month later (T2). Circadian variation characteristics were further investigated by segmenting data into daytime and nighttime periods and calculating ΔHRV. Results: Following five HBO sessions, the young adults showed progressive increases in HTI, TINN, and DFAα2 from T0 to T2, with TINN significantly higher at T2 than at T0 ( p < 0.05). Sympathetic tone‐related indices (daytime SDANN, SDNNI, and SD2) were significantly higher at T2 compared to T0 ( p < 0.05), and their corresponding ΔHRV values were significantly reduced at T2 ( p < 0.05). However, no significant changes were observed in vagal tone indicators (such as RMSSD, NN50, HF, SD1) or other HRV parameters. The maximal heart rate at T2 was significantly lower than at T0 ( p = 0.036). Conclusion: Five sessions of HBO intervention significantly enhanced the overall ANS function in young adults during the daytime 1 month post‐intervention, reduced heart rate and daytime sympathetic activity, and effectively narrowed circadian differences in both overall ANS and sympathetic function. No significant effects were observed on vagal tone related indices.

Objectives: The objectives of this study is to investigate the correlation between genotype polymorphism of aldehyde dehydrogenase 2 (ALDH2) and coronary artery disease (CAD) in atrial fibrillation patients. Methods: From November 2020 to December 2021, 80 patients with atrial fibrillation at a medical center in Chengdu were divided into two groups: CAD group ( n = 25) and non‐CAD group ( n = 55). The genotype composition ratio of ALDH2 (mutant‐type/wild‐type), blood biochemical indexes, the proportion of the history of lipid‐lowering drugs and time of taking lipid‐lowering drug were compared between the two groups. Results: The CAD group showed significantly lower levels of total cholesterol and low‐density lipoprotein cholesterol (LDL‐C) compared with the non‐CAD group ( p < 0.05), and the proportion and time of taking lipid‐lowering drugs in CAD group were significantly increased ( p < 0.05). The frequency of the ALDH2 genotype (mutant‐type/wild‐type) in the CAD group was notably elevated compared with that in the non‐CAD group ( p < 0.05). In patients with atrial fibrillation, the risk of CAD in patients with ALDH2 mutant genotype (GA + AA) was 5.849 times that of ALDH2 wild‐type genotype (GG) (95 % CI = 1.437–23.795, p < 0.05). The area under ROC curve of ALDH2 mutant genotype (GA + AA) was 0.624 (SE = 0.069, 95 % CI : 0.488–0.759). In patients with ALDH2 wild‐type (GG), the levels of total cholesterol and LDL‐C in CAD group were significantly lower than those in non‐CAD group ( p < 0.05). However, in patients with ALDH2 mutation genotype (GA + AA), the proportion of history of lipid‐lowering drugs in CAD group was significantly higher than that in non‐CAD group ( p < 0.05). Conclusions: The polymorphism of ALDH2 gene is a high risk factor for CAD in patients with atrial fibrillation. The ALDH2 mutation genotype (GA + AA) may reduce the lipid‐lowering efficacy of statins.

Cardiovascular risk factors such as hypertension, hyperlipidemia, and hyperglycemia are closely associated with ocular diseases including glaucoma, diabetic retinopathy, and dry eye syndrome. These conditions are characterized by microvascular damage, hemodynamic alterations, and pathological neovascularization, ultimately leading to significant visual impairment. Traditional treatments often suffer from limitations, such as invasiveness and poor target specificity, highlighting the urgent need for innovative therapeutic approaches. Recent advancements in biomaterials have substantially improved therapeutic efficacy, particularly in the areas of targeted drug delivery, smart sensors, and tissue repair. Smart sensors like contact lenses enable continuous monitoring of intraocular pressure, enhancing glaucoma management. Nanotechnology and drug delivery systems improve drug targeting and bioavailability, enhancing anti-angiogenic therapies. Additionally, biocompatible materials and nanomaterials have shown promise in promoting retinal and optic nerve repair, facilitating neural regeneration and reducing aberrant neovascularization. Despite ongoing challenges, the rapid evolution of materials science holds transformative potential for developing more effective and personalized treatments for ocular diseases.

Objective: This study aims to investigate changes in the autonomic nervous system (ANS) by analyzing the characteristics of heart rate variability (HRV).Methods: A portable 3-lead dynamic electrocardiogram monitoring device was used to collect HRV data from the participants. Based on the inclusion and exclusion criteria, a total of 52 volunteers from the Xinjiang Hetian area (ultra-high plateau group, approximately 5300 m altitude) and 56 volunteers from the Sichuan Chengdu area (plain group, approximately 500 m altitude) were enrolled for the 24-hour long-term HRV data collection. A cross-sectional comparison was made between the groups in terms of various HRV time-domain, frequency-domain, and nonlinear indices. The diurnal and nocturnal variations in HRV and ANS after prolonged residence in the ultra-high plateau were further explored by dividing the day into daytime and nighttime periods and calculating the ΔHRV values. Additionally, the participants’ heart rate and sleep conditions were analyzed.Results: Compared to the plain group, the ultra-high plateau group showed a significant reduction in overall HRV, with decreased indices of vagal activity (RMSSD, NN50, pNN50, HF, HF norm, and SD1) and increased indices of sympathetic activity (LF norm). The ANS balance indices were increased (LF/HF) and decreased (SD1/SD2), respectively. More importantly, although the diurnal and nocturnal trends of various HRV indices in the ultra-high plateau group were consistent with the plain group, the △HRV value analysis indicated that the ultra-high plateau group had increased △LF (95% CI: 10.20 to 271.60, P = 0.031) and △LF/HF (95% CI: −2.23 to −0.49, P < 0.001), and decreased △HF (95% CI: −383.10 to −35.50, P = 0.012) and △S (95% CI: −12149.47 to −2759.29, P = 0.001). Additionally, in the ultra-high plateau group, both the mean and minimum heart rates were elevated compared to the plain group (84.67 ± 1.37 vs. 73.2 ± 0.93 beats/min and 52.9 ± 1.37 vs. 47.57 ± 0.73 beats/min, respectively, P < 0.001), while the maximum heart rate was reduced (135.21 ± 1.63 vs. 144.43 ± 3.22 beats/min, P = 0.012). Furthermore, the ultra-high plateau group had a significant increase in the number of awakenings (18.27 ± 1.14 vs. 15.34 ± 1.43, P = 0.046) and the Apnea-Hypopnea Index (AHI) (20.14 ± 2.47 vs. 11.36 ± 0.76, P < 0.001).Conclusion: Prolonged residence in the ultra-high plateau reduces HRV, cardiac reserve capacity, and sleep quality in healthy young adults, diminishes the diurnal recovery capacity of the vagal nerve, and leads to a shift in ANS balance towards reduced vagal activity and enhanced sympathetic activity.

Purpose: The purpose of the study is to analyze the clinicopathological characteristics of essential hypertension (EH) in high‐altitude regions of China and provide evidence‐based guidance for rational diagnosis and treatment strategies in these areas. Methods: This cross‐sectional retrospective study enrolled two cohorts of EH patients from Qinghai (high altitude, ≥ 2500 m) and Chengdu (low altitude, 500 m) between 2020 and 2022. Participants were stratified based on their residential altitude. Clinical parameters, biochemical markers, cardiac imaging data, and antihypertensive regimens were systematically compared. Statistical analyses were conducted using SPSS software (Version 26.0). Results: Compared with patients with EH at low altitude, high‐altitude EH patients had a higher mean systolic/diastolic blood pressure and a lower percentage of compliance with blood pressure lowering and were more likely to have hyperuricemia (HUA) and abnormally elevated metabolic function ( p = 0.03). Significant cardiac structural changes occurred in patients with high‐altitude EH: increased pulmonary artery internal diameter ( p < 0.001). In addition, the proportion of angiotensin‐converting enzyme inhibitor, angiotensin II receptor blocker, β ‐blocker, and diuretic use was lower in patients with high‐altitude EH, while the proportion of SPC combination use was higher; conversely, the proportion of diuretic use was higher in patients with high‐altitude EH with comorbid HUA. Conclusion: EH in high‐altitude populations demonstrates distinct clinicopathological manifestations, including right ventricular overload and compensatory left cardiac adaptation. These findings underscore the necessity for altitude‐specific clinical guidelines to optimize hypertension management in these regions.

Background: The low-pressure, hypoxic environment characteristic of high-altitude regions significantly affects the cardiovascular and autonomic nervous system functions of individuals, consequently impairing their sleep quality. Heart rate variability, a non-invasive indicator of autonomic nervous system activity and balance within the cardiovascular system, has not been thoroughly investigated in terms of its patterns during acclimatization and de-acclimatization phases for individuals traveling to and residing in high-altitude areas and its relationship with sleep stability.Methods: Data was collected from 22 medical staff members who traveled from Chengdu to Yecheng, with measurements taken before leaving Chengdu, 1 week in Yecheng, 3 months in Yecheng, and 1 week after returning to Chengdu. The study analyzed changes in heart rate variability during acclimatization and de-acclimatization at 1,400 m above sea level. It also examined arrhythmia and sleep disorders based on circadian groups.Results: 1. Following 1 week of acclimatization to the sub-plateau environment of Yecheng, significant decreases were observed in SDANN, SDNN and SD2 indices compared to departure from Chengdu (P < 0.05). After 3 months of sub-plateau acclimatization, these indices significantly increased (P < 0.05). Upon returning to Chengdu and undergoing de-acclimatization for 1 week, these indices further significantly increased (P < 0.05). 2. During the period of sub-plateau acclimatization and de-acclimatization, significant changes were noted in average heart rate and minimum heart rate (P < 0.05), with the average heart rate showing a continuous decrease and the minimum heart rate exhibiting an initial increase followed by a decrease. No significant changes were observed in maximum heart rate or the incidence of arrhythmias (P > 0.05). 3. When stratified by day and night, the trends for SDANN, RMSSD, and TP were consistent with the overall trend at night (P < 0.05), but opposite during the day (P < 0.05). 4. During the sub-plateau acclimatization period, stable sleep duration was significantly reduced, and increased markedly after de-acclimatization, although it did not return to pre-acclimatization levels (P < 0.05).Conclusion: Acclimatization to the sub-plateau environment of Yecheng affects the autonomic nervous system, heart rate, and sleep in healthy adults. De-acclimatization can ameliorate these effects. Furthermore, the impact of sub-plateau acclimatization on the autonomic nervous system exhibits a distinct circadian rhythmicity.

Xiong, Shiqiang, Jun Hou, Haixia Yang, Meiting Gong, Xin Ma, Xuhu Yang, Hongyang Zhang, Yao Ma, Liang Gao, and Haifeng Pei. The profiles of venous thromboembolism at different high altitudes High Alt Med Biol. 25:223–225, 2024.—This study investigated the incidence of venous thromboembolism (VTE) in high altitude (HA) and very HA areas. Patients with deep vein thrombosis (DVT) or pulmonary embolism (PE) diagnosed between 2004 and 2022 in Yecheng, China, were retrospectively analyzed. The results showed that patients with PE at very HA had a higher risk of lower extremity DVT (OR 16.3 [95% CI 1.2–223.2], p = 0.036), than those at HA, especially in the early stages of very HA entry, and the harsh environment of very HA further exacerbated the risk of VTE. These findings emphasize the higher risk of PE development in very HA and the need for enhanced prevention and treatment in this area.

Background: Coronary vasospasm (CVS) is a common cardiovascular condition, yet its implications should not be underestimated. Regrettably, the current diagnostic and treatment standards for CVS in China are not standardized, severely affecting the quality of life for patients with this condition.Case presentation: A 68-year-old male presented to the hospital one month prior due to recurrent chest pain. Coronary angiography (CAG) revealed a mid-segment muscle bridge with plaque formation in the left anterior descending artery, followed by pharmacological balloon angioplasty. The primary diagnosis post-operation was acute non-ST elevation myocardial infarction (NSTEMI) and coronary artery myocardial bridging. This time, the patient experienced nocturnal chest pain with a dynamic increase in troponin levels. Emergency CAG showed the left anterior descending and right coronary arteries were fine, with segmental narrowing reaching 95%–99%. Intravascular ultrasound (IVUS) indicated negative remodeling of the mid-segment lumen associated with myocardial bridging, with the smallest lumen area being 2.19 mm². After intracoronary administration of nitroglycerin, the original most narrowed lumen area increased to 8.81 mm². Consequently, a definitive diagnosis of CVS with coronary artery myocardial bridging was made, and the medication treatment plan was promptly adjusted. The patient's symptoms disappeared, and he was discharged. Follow-up after more than three months showed no recurrence of symptoms.Conclusion: In cases where provocative agents are contraindicated, CAG combined with IVUS can optimize the differential diagnosis of CVS. There is an urgent need in China to improve epidemiological data on CVS and establish standardized diagnostic and treatment protocols.