Small extracellular vesicles (sEVs)-derived circular RNAs (circRNAs) could regulate gene expression in recipient cells, and dysregulation of sEVs-derived circRNAs has been implicated in several diseases. However, the expression and function of sEVs-derived circRNAs in coronary heart atherosclerotic disease (CAD) remain unknown. In this study, we investigated global changes in the expression patterns of circRNAs in sEVs from CAD-related monocytes and identified circNPHP4 as a significantly upregulated circRNA. Knockdown of circNPHP4 inhibited heterogeneous adhesion between monocytes and coronary artery endothelial cells and reduced ICAM-1 and VCAM-1 expression. Investigations of the underlying mechanisms revealed that circNPHP4 contains a functional miR-1231-binding site. Mutation of the circNPHP4-binding sites in miR-1231 abolished the interaction, as indicated by a luciferase reporter assay. Furthermore, circNPHP4 affected the expression of miR-1231 and its target gene EGFR. Overexpression of miR-1231 blocked the inhibitory effect of circNPHP4 on heterogeneous adhesion. Moreover, downregulation of miR-1231 restored heterogeneous adhesion upon inhibition by circNPHP4 silencing. Additionally, circNPHP4 overexpression was correlated with aggressive clinicopathological characteristics in CAD patients. A multivariate logistic regression model and bootstrapping validation showed that circNPHP4 overexpression had a good risk prediction capability for CAD. The decision curve analysis revealed that using the CAD nomogram that included circNPHP4 overexpression to predict the risk of CAD was beneficial. Our results suggest that sEVs-derived circNPHP4 can serve as a potential target for CAD treatments or as a potential diagnostic marker for CAD patients.

Perioperative complications following pericardiectomy in patients with constrictive pericarditis can significantly affect cardiac function recovery and postoperative outcomes. The prognostic nutritional index (PNI), a well-established nutritional marker, has been shown to predict outcomes in various diseases. However, its role as a predictive factor in patients with tuberculous constrictive pericarditis undergoing pericardiectomy remains unclear. This study aimed to evaluate the association between preoperative PNI and adverse perioperative outcomes in this patient population. This retrospective cohort study included 158 patients with tuberculous constrictive pericarditis who underwent pericardiectomy between January 2016 and June 2024. Preoperative PNI was calculated using the formula: (10 × serum albumin [g/dL]) + (0.005 × total lymphocyte count [cells/mm³]). The optimal PNI cutoff value was determined via ROC curve analysis, and patients were categorized into two groups: PNI ≥ 36.11 and PNI < 36.11. Univariate and multivariate logistic regression analyses were performed to assess the association between PNI and adverse perioperative outcomes. Of the 158 patients, 67.7% had a PNI < 36.11. Significant differences were observed between the two groups in hemoglobin levels, platelet count, C-reactive protein, indirect bilirubin, lactate dehydrogenase, cholinesterase, B-type natriuretic peptide (BNP), D-dimer, positive ventricular septal bounce sign, pericardial calcification, pericardial effusion, and pleural effusion. Patients with PNI < 36.11 experienced longer total and postoperative hospital stays. The incidence of adverse perioperative events was 76.6% (82/107) in the PNI < 36.11 group. Both univariate logistic regression (OR = 4.324, 95% CI: 2.12–8.816) and multivariate logistic regression (OR = 3.586, 95% CI: 1.523–8.444) confirmed that lower PNI was significantly associated with increased adverse perioperative outcomes. A lower preoperative PNI is strongly associated with a higher incidence of adverse perioperative outcomes in patients undergoing pericardiectomy for tuberculous constrictive pericarditis. As a reliable indicator of preoperative nutritional status, PNI can serve as an independent risk factor and a modifiable clinical parameter to reduce adverse outcomes.

Study Design: Retrospective review. Objective: To evaluate the effectiveness of halo-pelvic traction and thoracoplasty for pulmonary artery pressure (PAP) and cardiopulmonary function in patients with severe spinal deformity. Summary of Background Data: The effect of severe spinal deformity on pulmonary arterial hypertension, cardiac structure, and function has received little attention before. Patients and Methods: A total of 21 patients with severe spinal deformity were included in our study; all patients were examined by echocardiography and pulmonary function test before and after treatment. The correlations between PAP and pulmonary function were examined using Pearson correlation analysis. Results: The PAP decreased from 58.67 ± 20.24 to 39.00 ± 12.51 mm Hg, and the PAP of 42.86% of the patients returned to normal after treatment. Right cardiac enlargement, left ventricular diastolic function, and pulmonary function were improved at the same time. The ratio of left ventricular to right ventricular diameter returned to normal. Moderate correlations (correlation coefficient: −0.513 to −0.559) between PAP and forced vital capacity and forced expiratory volume in the first second were identified. Conclusions: Pulmonary arterial hypertension, ventricular diastolic function, and pulmonary function were improved after halo-pelvic traction and thoracoplasty. A moderate negative correlation was identified between PAP and pulmonary function: the more pulmonary function improved, the more PAP decreased.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is an important method to alleviate cirrhotic portal hypertension. But the falling and fracture of the stent which detaches into the heart is a potentially fatal threat. Case presentation: We present a case of severe tricuspid regurgitation caused by detached stent falling into the right ventricle after transjugular intrahepatic portosystemic shunt. Conclusion: Great attention should be paid to the serious complication of stent fracture after TIPS especially when the dual stent technique is used in TIPS.