The PHQ-9 performs well and has acceptable psychometric properties for screening of patients with late-life depression in Chinese primary care settings.

The PHQ-9 performs well and has acceptable psychometric properties for screening of patients with depression in a Chinese primary care population.

Background/Aims: MicroRNAs (miRNAs) can be used as biomarkers for cardiovascular diseases, especially for heart failure. However, there are few reports on serum exosomal miRNA biomarkers in patients with acute heart failure (AHF) due to Dilated cardiomyopathy (DCM). Methods: We analyzed 3 different serum exosomal miRNAs (exo-miR-92b-5p, exo-miR-192-5p, and exo-miR-320a) in 43 patients with DCM-AHF and 34 healthy volunteers as a control group (CG) by using exosome separation followed by a quantitative reverse-transcript PCR assay. Exosomes were identified by electron microscopy, NaNOZS-90, and western blot analyses (CD63 and Hsp70). Results: Serum exo-miR-92b-5p expression was increased in DCM-AHF patients compared to the CG (Mann–Whitney U-test: P < 0.001). Exo-miR-92b-5p was positively related to age and some ultrasound data (Spearman’s correlation: exo-miR-92b-5p vs. age, r = 0.297, P = 0.014; exo-miR-92b-5p vs. left atrial diameter, r = 0.431, P < 0.001; exo-miR-92b-5p vs. left ventricular diastolic diameter, r = 0.419, P < 0.001; exo-miR-92b-5p vs. left ventricular systolic diameter, r = 0.446, P < 0.001). Exo-miR-92b-5p was also negatively related to other ultrasound data (Spearman’s correlation: exo-miR-92b-5p vs. left ventricular fraction shortening, r = -0.497, P < 0.001; exo-miR-92b-5p vs. left ventricular ejection fraction, r = -0.482, P < 0.001). The discrimination of DCM-AHF patients from the CG by exo-miR-92b-5p was demonstrated by a receiver operating characteristic curve (exo-miR-92b-5p: cutoff value = 0.0023, area under the curve = 0.808, P < 0.001, sensitivity = 62.8%, specificity = 85.3%). Conclusion: Serum exo-miR-92b-5p is a potential biomarker for the diagnosis of DCM-AHF.

Background: Circulating microRNA (miRNA) biomarkers have been extensively reported in cardiovascular diseases (CVDs). However, serum exosomal miRNA (exo-miRNA) as biomarker in patients with heart failure (HF) with reduced ejection fraction (HFrEF) remain largely unexplored. We sought to investigate the potential of three types of serum exo-miRNAs as biomarkers for diagnosis in HFrEF patients who were admitted in hospital because of acute heart failure (AHF). Methods: A total of 28 HFrEF patients hospitalized for AHF, including de novo AHF and acute decompensated HF, and 30 volunteers as control group (CG) from 2015 to 2017 were enrolled in this study. Serum exo-miRNAs were extracted and analyzed by NaNOZS-90, electron microscopy, and western blotting. Three types of serum exo-miRNAs (exo-miR-92b-5p,-192-5p, and-320a) were assessed by quantitative real time polymerase chain reaction (qRT-PCR). Results: The particle size was confirmed as 40-150 nm using NaNOZS-90 and transmission electron microscopy. Exosomal biomarkers CD63 and Hsp70 were readily detected. The expression level of serum exo-miRNAs were transformed into log2 −delta CT in the qPCR assay. The data showed that exo-miR-92b-5p was elevated in HFrEF patients compared with controls. Moreover, exo-miR-92b-5p was inversely correlated with the left ventricular fraction shortening (LVFS) and left ventricular ejection fraction (LVEF), whereas it was positively correlated with left atrial diameter (LAD), left ventricular diastolic diameters (LVDD) and systolic diameters (LVSD). A receiver operating characteristic (ROC) curve was generated for discrimination between HFrEF patients and controls based on exo-miR-92b-5p (P<0.001, sensitivity =71.4%, specificity =83.3%). Conclusions: Exo-miR-92b-5p levels in the serum may serve as a marker for HFrEF diagnosis.

Background Primary care is the most promising venue for the management of late-life depression in China. The current study was designed to establish the prevalence of major depressive disorder among older adults in primary care, and to examine the correlates, and the natural course of late-life depression over a year. Methods A sample of 1275 adults aged over 60 years was recruited from a primary care clinic in urban China for screening with PHQ-9, and 262 participants stratified by PHQ-9 score were interviewed to collect the presence of major depressive disorder (MDD), the availability of social support, and physical health and functional status. Participants were followed up for 12 months at 3-month intervals. Results The estimated prevalence of MDD was 11.3% with the SCID interview. Increasing age, female gender, and lower educational level, living alone, low support from family, high medical illness burden, and impairment of daily function were significantly associated with MDD in later life. Less than 1% of these patients received treatments. More than 60% of patients with MDD at baseline remained depressed throughout the 12 month follow-up period; and only 3 patients had been treated during the 12-month follow-up. Limitations The correlates of late-life depression observed here may not necessarily serve as risk factors guiding the development of future prevention strategies. Discussion In an urban Chinese primary care setting, late-life depression was found to be a common condition. Few patients with MDD received treatment for their condition, and the majority remained depressed over the following year.