Neutrophil extracellular traps (NETs) as special release products of neutrophils have received extensive attention. They are composed of decondensed chromatin and coated with nucleoproteins, including histones and some granulosa proteins. NETs can form a network structure to effectively capture and eliminate pathogens and prevent their spread. Not only that, recent studies have shown that NETs also play an important role in venous thrombosis. This review provides the most important updated evidence regarding the mechanism of NETs formation and the role of NETs in the process of venous thrombosis. The potential prophylactic and therapeutic value of NETs in venous thrombotic disease will also be discussed.

To study the effect of the angulation between the left pulmonary artery (LPA) and the main pulmonary artery on pulmonary haemodynamics. A 3D model of patient-specific pulmonary artery (PA) was reconstructed as an original model. Four models with descendent LPA angulation equalled to 120°, 110°, 100° and 90°, were reconstructed by computer-aided design for the virtual simulation of the pulmonary flow under different surgical strategies. Computational fluid dynamics was introduced to calculate the pulmonary blood flow in five models. Streamlines, wall shear stress, energy loss and flow distribution ratio were calculated and compared to determine the better haemodynamics in the pulmonary artery. Vortices were formed at the lower wall of the opening of right PA and LPA in models with LPA angles equal to or less than 100° (Models 3 and 4). Relative high wall shear stress areas at the lateral and lower wall of LPA opening had an ascendant tendency as the angle declined. Decreased flow distribution ratio to left lung (original model: 0.58, Model 1: 0.63, Model 2: 0.586, Model 3: 0.564, Model 4: 0.55) and increased energy loss (original model: 385.2 mV, Model 1: 239.4 mV, Model 2: 384.3 mV, Model 3: 430.9 mV, Model 4: 439.8 mV) in a cardiac cycle were noted as the angle reduced. Acute LPA angulation is associated with adverse haemodynamic performance. This should be particularly addressed during the reconstruction of pulmonary artery in the repair of tetralogy of Fallot.

Segmentation of left and right ventricles from 3D echocardiographic images is premised and key for quantitative analysis of cardiac function, which is important for pediatric cardiac diagnosis. Compared with 2D echocardiography, 3D echocardiography can fully represent ventricular structure without geometric inference. However, it usually takes experts several hours to obtain a 3D segmentation mask of the left and right ventricles. Therefore, a fast and automatic segmentation method is highly desired. Unfortunately, 3D echocardiography suffers from low contrast, unclear left and right ventricles borders, and blind zone. Existing segmentation methods usually have poor performance at ventricular boundaries. To deal with these problems, we propose a novel dual-branch TransV-Net (DBTV). DBTV comprises two parallel, interleaved, and relatively independent V-shaped encoder-decoder branches. The main branch acts on the original data to extract image features, and the auxiliary branch acts on edge maps to extract the additional edge features. To suppress noise and enhance the edge information, extra concatenations are added to bridge the features from the main and auxiliary branches. To reduce object missing caused by blind zone, a 3D transformer-based module is proposed in the bottom layer of the dual-branch structure to extract the global contexts. We do experiments on a self-collected dataset with 120 3D echocardiographic images from 60 cardiac sequences, and the dice score of 0.913 and 0.880 are obtained in the left and right ventricle segments, respectively. Each inference takes about two-thirds of a second for a single 3D frame.

Background: Several DNA methylation (DNAm) algorithms have recently emerged as robust predictors of aging and adverse health outcomes in older adults, offering valuable insights into cardiovascular disease (CVD) risk stratification. However, their predictive performance for CVD varies significantly. This study aimed to systematically investigate the associations of 12 widely used DNAm algorithms with CVD and mortality risk. Methods: Data from the NHANES (National Health and Nutrition Examination Survey) 1999 to 2002 were used to assess 12 DNAm algorithms (eg, HannumAgeacc, PhenoAgeacc, GrimAgeMortacc, GrimAge2Mortacc) in relation to CVD risk and mortality. Two cohorts were analyzed: one for CVD risk (n=1230) and another for CVD mortality risk (n=1606). DNAm was measured using the Infinium Methylation EPIC BeadChip kit (Illumina). Odds ratios (ORs) and hazard ratios (HRs), along with 95% CIs per SD increase of these DNAm algorithms, were calculated. Results: Significant associations were observed for GrimAgeMortacc and GrimAge2Mortacc with coronary heart disease and heart attack, with multivariable‐adjusted ORs per SD increase ranging from 2.15 to 2.76. However, several algorithms exhibited no significant association with self‐reported prevalent CVD. For mortality risk, HannumAgeacc, PhenoAgeacc, ZhangAgeacc, GrimAgeMortacc, and GrimAge2Mortacc were significantly associated with CVD mortality. The multivariable‐adjusted HRs per SD increase were 1.19 (95% CIs, 1.05–1.34), 1.13 (95% CIs, 1.01–1.26), 1.63 (95% CI, 1.08–2.47), 1.90 (95% CIs, 1.51–2.40), and 1.87 (95% CIs, 1.51–2.32), respectively. These associations were consistent across biological sex, age (≥50 and <65 versus ≥65 years), and race and ethnicity groups. Conclusions: DNAm algorithms, particularly GrimAgeMortacc and GrimAge2Mortacc, may serve as valuable tools for CVD risk stratification and mortality risk assessment.

This study introduced a combined computational fluid dynamics (CFD) and echocardiography methodology to simulate blood flow in the single right ventricle (SRV) and normal ventricles to study the intraventricular flow. Derived from echocardiographic image loops, CFD-based three-dimensional (3D) flow models of normal subject’s left ventricle (LV) and right ventricle (RV) and SRV with and without heart failure at three characteristic diastolic statuses were reconstructed. The CFD derived morphological and functional measurements in normal ventricles and the SRV were validated with echocardiography. The vortex in the normal ventricles and the SRV were studied. The morphological and functional measurements derived from CFD modeling and echocardiography were comparable, and both methods demonstrated the larger volume and higher spherical index in the SRV, in particular the SRV with heart failure. All the vortices in the SRV were smaller than those in the normal control subject’s LV and RV, notably with heart failure. Unlike normal LV and RV, no vortex ring was observed in the SRV. Echocardiography-based CFD demonstrated the feasibility of quantifying ventricular morphology and function; in addition, CFD can detect the abnormal flow pattern (smaller or obliterated vortices) in the SRV when compared with normal ventricles.

Total cavopulmonary connection (TCPC), a typical kind of Fontan procedure, is commonly used in the treatment of a functional single ventricle. The palliative cardiothoracic procedure is performed by connecting the superior vena cava and the inferior vena cava to the pulmonary arteries. Due to the difficulty of direct study in vivo, in this paper, computational fluid dynamics (CFD) was introduced to estimate the outcomes of patient‐specific TCPC configuration. We mainly focused on the influence of blood pulsation and respiration. Fast Fourier transforms method was employed to separate the measured flow conditions into the rate of breath and heart beat. Blood flow performance around the TCPC connection was investigated by analyzing the results of time‐varying energy losses, blood flow distribution rate, local pressure, and wall shear stress distributions. It was found that the value of energy loss including the influence of respiration was 1.5 times higher than the value of energy loss disregarding respiratory influences. The results indicated that the hemodynamic outcomes of TCPC treatment are obviously influenced by respiration. The influence of respiration plays an important role in estimating the results of TCPC treatment and thus should be included as one of the important conditions of computational haemodynamic analysis.