Prognostic value of growth differentiation factor-15 in Chinese patients with heart failure: A prospective observational study

  Background: Growth differentiation factor-15 (GDF-15), a biomarker associated with remodeling, oxidative stress and inflammation, has been used to stratify heart failure (HF) patients. However, its prognostic value in Chinese HF patients is still unknown. Methods: GDF-15 levels were examined on admission in 272 consecutive HF patients in Beijing Hospital (a Chinese tertiary medical center) by a commercial enzyme-linked immunosorbent assay. We recorded the incidence of all-cause mortality and/or readmission for HF during a median follow-up period of 558 days. Patients were stratified according to the tertiles of GDF-15. Results: Fifty-three (19.5%) patients died and 103 (37.9%) patients had major adverse cardiac events (MACE) which included the composite outcome of all-cause mortality or readmission for HF at the end of follow-up. Kaplan-Meier survival curves showed that the third tertile of GDF-15 was associated with increased rate of all-cause mortality (compared with the first and second tertiles, log rank p = 0.001 and 0.001, respectively) or MACE (compared with the first and second tertiles, log rank p = 0.002 and p < 0.001, respectively). In addition, multivariate Cox regression model showed that the highest tertile of GDF-15 was independently associated with increased risk of all-cause death (hazard ratio = 5.95, 95% confidence interval 1.88–18.78, p = 0.002) compared with the lowest tertile after adjustment for related clinical variables such as age, renal function or N-terminal pro-B-type natriuretic peptide.  Conclusions: Plasma GDF-15 is an independent predictor of all-cause mortality in Chinese patients with HF. It may potentially be used to stratify and prognosticate HF patients

Albumin Binding Function: The Potential Earliest Indicator for Liver Function Damage

Background. Currently there is no indicator that can evaluate actual liver lesion for early stages of viral hepatitis, nonalcoholic fatty liver disease (NAFLD), and cirrhosis. Aim of this study was to investigate if albumin binding function could better reflect liver function in these liver diseases. Methods. An observational study was performed on 193 patients with early NAFLD, viral hepatitis, and cirrhosis. Cirrhosis patients were separated according to Child-Pugh score into A, B, and C subgroup. Albumin metal ion binding capacity (Ischemia-modified albumin transformed, IMAT) and fatty acid binding capacity (total binding sites, TBS) were detected. Results. Both IMAT and TBS were significantly decreased in patients with NAFLD and early hepatitis. In hepatitis group, they declined prior to changes of liver enzymes. IMAT was significantly higher in cirrhosis Child-Pugh class A group than hepatitis patients and decreased in Child-Pugh class B and class C patients. Both IMAT/albumin and TBS/albumin decreased significantly in hepatitis and NAFLD group patients. Conclusions. This is the first study to discover changes of albumin metal ion and fatty acid binding capacities prior to conventional biomarkers for liver damage in early stage of liver diseases. They may become potential earliest sensitive indicators for liver function evaluation

Identification of urgent gaps in public and policymaker knowledge of heart failure: results of a global survey

Background: Despite advances in the treatment of heart failure (HF) with reduced ejection fraction, people with HF continue to have a high risk of mortality and hospitalisation. Patients also suffer from poor quality of life, with reduced societal and economic participation. The burden of HF on patients and healthcare systems is extraordinary, yet awareness remains low. This survey was conducted to identify gaps in general public and policymaker knowledge around HF. Methods: A closed-question web-based survey of the general public and policymakers was conducted between February and October 2020. Study outcomes assessed the participants’ awareness and understanding of HF symptoms, risk factors and mortality, and views around hospital admissions in their country. Responses were collected using multiple-choice questions. Results: The survey was completed by 26,272 general public respondents in 13 countries and 281 government and public sector policymakers in nine countries. While 99% of general public respondents had heard of HF, their understanding of the condition and its symptoms was poor, and only 6% identified that shortness of breath, fatigue, and leg swelling were the main symptoms of HF. Of policymaker respondents, 14% identified HF as the leading cause of avoidable hospitalisations, and only 4% recognised that ~ 87% of government spending on HF is related to hospitalisations. Conclusions: Major gaps were identified in the understanding of HF and the burden it places on patients and their caregivers, healthcare systems and society. This study confirms an ongoing need for national policy strategies and investment to raise awareness of the importance of HF prevention, early diagnosis, and implementation of effective treatments to reduce hospitalisations and death

Crystal structures and magnetic properties of novel two-dimensional iron tellurides flakes

Since the discovery of intrinsic magnetism in VX2 (X=S, Se and Te), two-dimensional transitional-metal dichalcogenides (2D TMDs), with hexagonal lattices, have become the emerging 2D confined systems showing potential intrinsic magnetic properties at the limit of a few atoms thickness. Often these 2D lattices also form other types of symmetries, like tetragonal or orthorhombic, but they have not been extensively investigated, mainly because of thermodynamic instability during crystal growth. In this study, we showed polymorphically controlled growth of 2D iron-telluride crystals of either hexagonal FeTe2 or tetragonal FeTe by varying the typical growth parameter, the flow rate of hydrogen gas. In addition, we also explored the possibility of the existence of intrinsic magnetism in the two different lattice structures. Furthermore, we demonstrated the different magnetism manifested by the two crystals by means of various characterization techniques.Bachelor of Engineering (Materials Engineering

Circulating microRNAs as novel biomarkers for heart failure

Objective: We Sought to identify circulating miRNAs suitable for HF diagnosis. Methods: In this study, a genome-wide plasma miRNA microarray was performed in 13 HF patients and 3 controls. The expression levels of selected differentially expressed, upregulated miRNAs (miR-3135b, miR-3908 and miR-5571-5p) were validated with quantitative real-time PCR (qRT-PCR) assays in an independent cohort of 33 HF patients and 20 controls. Results: Of all the miRNAs analyzed, miR-3135b (P<0.001), miR-3908 (P<0.001), and miR-5571-5p (P<0.001) were found to have significantly different expression levels in HF compared to controls. The Receiver operating characteristic (ROC) curves for miR-3135b, miR-3908, and miR-5571-5p revealed area under the curve (AUC) values of 1.00, 0.86, and 0.94, respectively. More importantly, miR-3135b and miR-3908 were able to discriminate heart failure with reduced ejection fraction (HFrEF) from heart failure with preserved ejection fraction (HFpEF) (P<0.05). The miR-5571-5p plasma level was significantly associated with NYHA class (P<0.001). Conclusion: This study demonstrated for the first time that some specific microRNAs (miR-3135b, miR-3908, and miR-5571-5p) are useful biomarkers for HF and for differentiating HFrEF from HFpEF. Keywords: miRNAs, heart failure, biomarker