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Pubblicazioni recenti - cardiac failure
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Examining anti-inflammatory therapies in the prevention of cardiovascular events: protocol for a systematic review and network meta-analysis of randomised controlled trials.
BMJ Open2022 Jun;12(6):e062702. doi: 10.1136/bmjopen-2022-062702.
Boczar Kevin Emery, Shin Sheojung, Bezzina Kathryn A, Geejo Aishwarya, Pearson Alexander Liam, Shahab Saba, Fehlmann Christophe A, Visintini Sarah, Beanlands Rob, Wells George A,
Abstract
INTRODUCTION:
Inflammation is emerging as an important risk factor for atherosclerotic cardiovascular disease and has been a recent target for many novel therapeutic agents. However, comparative evidence regarding efficacy of these anti-inflammatory treatment options is currently lacking.
METHODS AND ANALYSIS:
This systematic review will include randomised controlled trials evaluating the effect of anti-inflammatory agents on cardiovascular outcomes in patients with known cardiovascular disease. Studies will be retrieved from Medline, Embase, the Cochrane Central Register of Controlled Trials, as well as clinical trial registry websites, Europe PMC and conference abstract handsearching. No publication date or language restrictions will be imposed. Eligible interventions must have some component of anti-inflammatory agent. These include (but are not limited to): non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, prednisone, methotrexate, canakinumab, pexelizumab, anakinra, succinobucol, losmapimod, inclacumab, atreleuton, LP-PLA (darapladib) and sPLA (varespladib). The primary outcomes will include major adverse cardiac events (MACE), and each individual component of MACE (myocardial infarction, stroke and cardiovascular death). Key secondary outcomes will include unstable angina, heart failure, all-cause mortality, cardiac arrest and revascularisation. Screening, inclusion, data extraction and quality assessment will be performed independently by two reviewers. Network meta-analysis based on the random effects model will be conducted to compare treatment effects both directly and indirectly. The quality of the evidence will be assessed with appropriate tools including the Grading of Recommendations, Assessment, Development and Evaluation profiler or Confidence in Network Meta-Analysis tool.
ETHICS AND DISSEMINATION:
Ethics approval is not required for this systematic review. The findings will be disseminated through a peer-reviewed journal.
PROSPERO REGISTRATION NUMBER:
CRD42022303289.
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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Language matters: representations of 'heart failure' in English discourse-a large-scale linguistic study.
Open Heart2022 May;9(1):. doi: e001988.
Demmen Jane, Hartshorne-Evans Nick, Semino Elena, Sankaranarayanan Rajiv,
Abstract
AIMS:
Heart failure (HF) has a lower public profile compared with other serious health conditions, notably cancer. This discourse analysis study investigates the extent to which HF is discussed in general contemporary English, UK parliamentary debates and the ways in which HF is framed in discussions, when compared with two other serious health conditions, cancer and dementia.
METHODS:
The Oxford English Corpus (OEC) of 21st century English-language texts (2 billion words) and the UK Hansard Reports of parliamentary debates from 1945 to early 2021 were used to investigate the relative frequencies, contexts and use of the terms 'heart failure', 'cancer' and 'dementia'.
RESULTS:
In the OEC, the term 'heart failure' occurs 4.26 times per million words (pmw), 'dementia' occurs 3.68 times pmw and 'cancer' occurs 81.96 times pmw. Cancer is talked about 19 times more often than HF and 22 times more often than dementia. These are disproportionately high in relation to actual incidence: annual cancer incidence is 1.8 times that of the other conditions; annual cancer mortality is two times that caused by coronary heart disease (including HF) or dementia.'Heart failure' is used much less than 'cancer' in UK parliamentary debates (House of Commons and House of Lords) between 1945 and early 2021, and less than 'dementia' from 1990 onwards. Moreover, HF is even mentioned much less than pot-holes in UK roads and pavements. In 2018, for example, 'pot-hole/s' were mentioned over 10 times pmw, 37 times more often than 'heart failure', mentioned 0.28 times pmw. Discussions of HF are comparatively technical and formulaic, lacking survivor narratives that occur in discussions of cancer.
CONCLUSIONS:
HF is underdiscussed in contemporary English compared with cancer and dementia and underdiscussed in UK parliamentary debates, even compared with the less-obviously life-threatening topic of pot-holes in roads and pavements.
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
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Heart failure with reduced ejection fraction and diastolic dysfunction (HrEFwDD): Time for a new clinical entity.
Int J Cardiol -
Serum and Urine Osmolality as Predictors of Adequate Diuresis in Acute Decompensated Heart Failure: A Prospective Cohort Study.
Cardiorenal Med2022 Jun;():. doi: 10.1159/000525730.
Lo Kevin Bryan, Salacup Grace, Pelayo Jerald, Putthapiban Prapaipan, Swamy Sowmya, Nakity Rasha, Naranjo-Tovar Mario, Rangaswami Janani,
Abstract
Background Determination of adequacy of decongestion remains a significant challenge in the management of acute heart failure (AHF). Methods This is a prospective single center cohort study of patients (>18 years old) admitted for AHF on intravenous diuretics, with BNP > 100 pg/mL or echocardiographic findings of reduced ejection fraction or diastolic dysfunction, and at least 1 clinical sign of volume overload. Patients with eGFR?45mL/minute or on dialysis, and with exposure to contrast dye or nephrotoxins were excluded. Serum and spot urine osmolality were obtained early morning simultaneously daily for 5 days or until discharge. ROC curves were used to analyze the optimal cut-offs for the osmolality values in the prediction of heart failure readmissions Results Of the total 100 patients, 62% were male and 59% were Black American. The mean age was 64.41±12.53 and 34% had preserved ejection fraction. Patients with 30-day readmission had higher serum osmolality(mOsm/kg) on admission (305 [299-310] vs 298 [294-303] p=0.044) and had higher drop in serum osmolality between admission and discharge (-7.5 [-9.0,-1.25] vs -1.0 [-4.0,4.0] ;p=0.044). Serum osmolality on admission of >299 mOsm/kg (sensitivity:83%, specificity:61%) and drop in serum osmolality between admission and discharge of >2 mOsm/kg (sensitivity:83%, specificity:65%) was associated with 30-day HF readmissions. No patients discharged with urine osmolality more than 500 mOsm/kg had 30-day readmissions but this was not statistically significant p=0.334 Conclusion Measurement of serum osmolality and urine osmolality may have some utility in AHF, but interpretation should consider baseline values and dynamic changes to account for individual differences in sodium and water handling.
The Author(s). Published by S. Karger AG, Basel.
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Epoxyeicosatrienoic acid: A potential therapeutic target of heart failure with preserved ejection fraction.
Biomed Pharmacother2022 Jun;153():113326. doi: S0753-3322(22)00715-6.
Zhang Min, Shu Hongyang, Chen Chen, He Zuowen, Zhou Zhou, Wang Dao Wen,
Abstract
Heart failure with preserved ejection fraction (HFpEF) reduces the quality of life, costs substantial medical resources, and has a high mortality. However, we lack an effective therapy for HFpEF due to our limited knowledge of its mechanism. Therefore, it is crucial to explore novel therapeutics, such as those with endogenous protective roles, and seek new targeted therapies. Epoxyeicosatrienoic acids (EETs) are endogenous bioactive metabolites of arachidonic acids produced by cytochrome P450 (CYP) epoxygenases. EETs can function as endogenous cardioprotective factors with potent inhibitory roles in inflammation, endothelial dysfunction, cardiac remodeling, and fibrosis, which are the fundamental mechanisms of HFpEF. This suggests that EETs have the potential function to protect against HFpEF. Therefore, we present an overview of the ever-expanding world of EETs and how they might help alleviate the pathophysiology underlying HFpEF to provide new insights for research in this field.
Copyright © 2022. Published by Elsevier Masson SAS.
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Interleukin-35 ameliorates cardiovascular disease by suppressing inflammatory responses and regulating immune homeostasis.
Int Immunopharmacol2022 Jun;110():108938. doi: S1567-5769(22)00422-2.
Feng Jie, Wu Yanqing,
Abstract
The immune response is of great significance in the initiation and progression of a diversity of cardiovascular diseases involving pro-and anti-inflammatory cytokines. Interleukin-35 (IL-35), a cytokine of the interleukin-12 family, is a novel anti-inflammation and immunosuppressive cytokine, maintaining inflammatory suppression and regulating immune homeostasis. The role of IL-35 in cardiovascular diseases (CVDs) has aroused enthusiastic attention, a diversity of experimental or clinical evidence has indicated that IL-35 potentially has a pivot role in protecting against cardiovascular diseases, especially atherosclerosis and myocarditis. In this review, we initiate an overview of the relationship between Interleukin-35 and cardiovascular diseases, including atherosclerosis, acute coronary syndrome, pulmonary hypertension, abdominal aortic aneurysm, heart failure, myocardial ischemia-reperfusion, aortic dissection and myocarditis. Although the specific molecular mechanisms entailing the protective effects of IL-35 remain an unsolved issue, targeted therapies with IL-35 might provide a promising and effective solution to prevent and cure cardiovascular diseases.
Copyright © 2022 Elsevier B.V. All rights reserved.
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Glycyrrhiza uralensis promote the metabolism of toxic components of Aconitum carmichaeli by CYP3A and alleviate the development of chronic heart failure.
PLoS One2022 ;17(6):e0270069. doi: 10.1371/journal.pone.0270069.
Ni Lulu, Miao Ping, Jiang Jian, Wan Fang, Li Jiangan, Ai Min, Kong Lingzhong, Tu Su,
Abstract
Aconitum, as "the first drug of choice for invigorating Yang and saving lives", has been widely used for the treatment of heart failure. However, toxic components of Aconitum can easily lead to serious arrhythmia, even death (Y. CT., 2009; Zhang XM., 2018). In this study, a High Performance Liquid Chromatography (HPLC) method for the determination of aconitine (AC), mesaconitine (MA) and hypaconitine (HA) was established; The effect of Glycyrrhiza on CYP3A1 / 2 mRNA expression was detected by RT-PCR; SD rats were given Aconitum and compatibility of Glycyrrhizae and Aconitum by gavage respectively, the blood concentration of toxic components were determined by LC-MS / MS; The CHF rat model was established by intraperitoneal injection of adriamycin (2.5 mg / kg), and were randomly divided into model, Aconitum, the compatibility of Glycyrrhizae and Aconitum and Captopril group, 5 mice/group. After 4 weeks of gavage, the corresponding indexes were detected by ELISA and HPLC. The results showed that Ketoconazole significantly inhibited the metabolites of AC, MA and HA; Glycyrrhiza induced CYP3A gene expression; The level of ALD in the compatibility of Glycyrrhizae and Aconitum group was significantly lower than that in Aconitum group. After intervention with the compatibility of Glycyrrhizae and Aconitum, ATP increased, ADP decreased significantly. In conclusion, we found Glycyrrhiza promoted the metabolism of toxic components of Aconitum by up regulating the expression of CYP3A, and reduced the content of BNP, Ang II and ALD, improved the energy metabolism disorder of myocardium, alleviated the development of CHF.
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Neurohormonal Connections with Mitochondria in Cardiomyopathy and Other Diseases.
Am J Physiol Cell Physiol2022 Jun;():. doi: 10.1152/ajpcell.00167.2022.
Dorn Ii Gerald W,
Abstract
Neurohormonal signaling and mitochondrial dynamism are seemingly distinct processes that are almost ubiquitous among multicellular organisms. Both of these processes are regulated by GTPases, and disturbances in either can provoke disease. Here, inconspicuous pathophysiological connectivity between neurohormonal signaling and mitochondrial dynamism is reviewed in the context of cardiac and neurological syndromes. For both processes, greater understanding of basic mechanisms has evoked a reversal of conventional pathophysiological concepts. Thus, neurohormonal systems induced in, and previously thought to be critical for, cardiac functioning in heart failure are now pharmaceutically interrupted as modern standard of care. And, mitochondrial abnormalities in neuropathies that were originally attributed to an imbalance between mitochondrial fusion and fission are increasingly recognized as an interruption of axonal mitochondrial transport. The data are presented in a historical context to provided insight into how scientific thought has evolved and to foster an appreciation for how seemingly different areas of investigation can converge. Finally, some theoretical notions are presented to explain how different molecular and functional defects can evoke tissue-specific disease.
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High body mass index is a risk factor for transition to hemodialysis or hybrid therapy and peritoneal dialysis-related infection in Japanese patients undergoing peritoneal dialysis.
Int Urol Nephrol2022 Jun;():. doi: 10.1007/s11255-022-03252-y.
Hama Eriko Yoshida, Uchiyama Kiyotaka, Nagasaka Tomoki, Kusahana Ei, Nakayama Takashin, Yasuda Itaru, Morimoto Kohkichi, Washida Naoki, Itoh Hiroshi,
Abstract
PURPOSE:
Obesity may negatively impact the clinical outcomes of patients undergoing peritoneal dialysis (PD). However, the impact of obesity on PD-related outcomes remains unclear. We herein examined the association of high body mass index (BMI) with complete hemodialysis (HD) transfer, transition to HD and PD/HD hybrid therapy, peritonitis, catheter exit-site and tunnel infection (ESI/TI), and heart failure-related hospitalization.
METHODS:
This retrospective cohort study included 120 patients who underwent PD-catheter insertion between January 2008 and June 2018. BMI???25 kg/m at the time of PD-catheter insertion was defined as high BMI, and its association with outcomes was analyzed using the log-rank test and Cox proportional hazards models.
RESULTS:
The follow-up duration was 46.2 (23.3-75.3) months. The time until transfer to HD and hybrid therapy was significantly shorter in the high BMI group than that in the low BMI group, whereas the time until HD transfer was not significantly different between the two groups (P?0.001 and 0.18, respectively). Peritonitis-free and ESI/TI-free survivals were significantly shorter in the high BMI group than those in the low BMI group (P?=?0.006 and 0.03, respectively). After adjusting for age, sex, diabetes mellitus, and estimated glomerular filtration rate, high BMI remained a significant risk factor for transferring to HD and hybrid therapy, peritonitis, and ESI/TI (hazard ratio [HR] 2.60, P?0.001; HR 2.08, P?=?0.01; HR 2.64, P?=?0.02, respectively).
CONCLUSION:
BMI???25 kg/m is a risk factor for transition to HD and hybrid therapy, peritonitis, and ESI/TI, but not for complete HD transfer in Japanese patients with PD.
© 2022. The Author(s), under exclusive licence to Springer Nature B.V.
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Diagnosis of heart failure in the elderly: current status and future perspectives for echocardiographic diagnostic systems.
J Med Ultrason (2001)2022 Jun;():. doi: 10.1007/s10396-022-01223-5.
Seo Yoshihiro,
Abstract
Since Japan is experiencing a super-aged society, the number of heart failure patients (HF) is increasing remarkably. In particular, the increase in heart failure with preserved ejection fraction (HFpEF), which is common in the elderly, has characterized the last decade. The diagnosis of HFpEF by assessment of left ventricular (LV) diastolic dysfunction, which is also referred to as diastolic heart failure, is an important role assigned to echocardiography. The Doppler echocardiographic algorithm for the evaluation of LV diastolic function from the American Society of Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI) has been widely used to diagnose HFpEF. This article will focus on the HFpEF diagnostic algorithm proposed in 2018 by the Heart Failure Association of the European Society of Cardiology (HFA-PEFF score) based on autologous elderly cases. We compared the usefulness of the HFA-PEFF score with the ASE/EACVI algorithm. By comparing HFpEF patients with healthy elderly subjects and hypertensive patients with no history of HF, this paper will identify the usefulness and challenges of the HFA-PEFF score in the assessment of the elderly. The echocardiographic findings in at-risk or early-stage elderly patients with HFpEF will also be summarized. In addition, this review will describe future prospects for echocardiographic diagnostic systems for the prevention of HF onset and HF progression in the elderly and propose the concept of "early HFpEF".
© 2022. The Author(s), under exclusive licence to The Japan Society of Ultrasonics in Medicine.
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Soluble ST2: a valuable prognostic marker in heart failure.
Heart Fail Rev2022 Jun;():. doi: 10.1007/s10741-022-10258-2.
Savarimuthu Sugeevan, Goel Pavan, Harky Amer,
Abstract
Natriuretic peptides have been at the forefront of biomarker use in heart disease and have been universally recommended as the ideal biomarker in the setting of heart failure. Soluble ST2 is one such biomarker which has found value as a prognostic marker and can be used individually or along with natriuretic peptides in order to prognosticate patients with heart failure. Leading cardiovascular organisations have recognised this biomarker, though its role as a diagnostic marker is yet to be determined. We aim to investigate the role of sST2 in heart failure in the existing literature.
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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Prognostic impact of pre-interventional culprit artery thrombolysis in myocardial infarction (TIMI) flow in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention.
Egypt Heart J2022 Jun;74(1):52. doi: 10.1186/s43044-022-00289-3.
Shaaban Raouf, El Etriby Adel, Kamal Diaa, Mostafa Ahmad E,
Abstract
BACKGROUND:
Primary percutaneous coronary intervention (PCI) is considered the most preferred strategy in ST-segment elevation myocardial infarction (STEMI). However, the prognostic role of spontaneous re-canalization in STEMI patients is still not clear. The purpose of this study is to evaluate the impact of pre-procedural TIMI flow grade in the culprit coronary artery on the short and long term prognosis in Egyptian patients presented with STEMI and treated with primary PCI.
RESULTS:
A dual center, prospective observational study that was conducted in the period from January 2019 till June 2020 and enrolled 150 STEMI patients presented within 24 h from onset of chest pain. Initial angiography was done with analysis of TIMI flow grade in the infarct related artery. Of the 150 enrolled patients; 93 patients (62%) were found to have initial TIMI flow grade 0 (group A) and 57 patients (38%) had initial TIMI flow grade I-III (group B). There was a strong association between cardiac mortality and pre-procedural TIMI flow grade. 12 mortalities (8% of total study population) were recorded during our study period; in-hospital mortality was reported in 7 patients in group A, yet no mortalities were recorded in-hospital in group B (P value?=?0.033). At 1 year follow up; 5 mortalities were recorded in group A with no mortalities at all in group B (P value?=?0.005). There was a trend towards an increase in acute heart failure incidence in group A yet no statistically significant value was achieved (P value?=?0.112). Target lesion revascularization was reported in 8 patients in group A and in only 3 patients in group B (P value 0.446).
CONCLUSIONS:
Despite the evolution in primary PCI strategies and the continuous advancement in anti-thrombotic treatment; pre-interventional infarct related artery TIMI flow grade I-III is associated with better in hospital and 1 year outcome, specifically significantly lower cardiac mortality compared to patients who had TIMI flow grade 0 at initial angiography.
© 2022. The Author(s).
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Results of emergency colectomy in nonagenarians and octogenarians previously labeled as prohibitive surgical risk.
Eur J Trauma Emerg Surg2022 Jun;():. doi: 10.1007/s00068-022-02030-w.
Carr John Alfred, NeCamp Timothy,
Abstract
PURPOSE:
There are no standardized criteria for what constitutes prohibitive risk for emergency abdominal surgery.
METHODS:
A retrospective review was performed comparing two groups of patients having emergent colectomy. One group had previously been labeled as being prohibitive surgical risk and the other was a contemporary, non-prohibitive risk group also requiring emergency colectomy. All operations were performed by a single surgeon.
RESULTS:
There were 27 prohibitive risk patients and 81 non-prohibitive risk (control group) patients. The average age of the prohibitive risk group was 85 years (range 78-99) compared to the control group mean age of 52 years (18-79, p?0.00001). Prohibitive risk was due to extremes of age combined with congestive heart failure in 44%, followed by chronic obstructive pulmonary disease combined with heart failure in 19%. The groups were closely matched by the type of colectomy performed. The total complication rate was much higher in the prohibitive risk group compared to the non-prohibitive risk patients (81% versus 48%, p 0.005). But the 30-day mortality rate was similar between groups (7% versus 4%, p 0.6).
CONCLUSION:
Patients who are labeled as prohibitive surgical risk may be inaccurately assessed in the majority of cases. Additional research will need to be performed to evaluate the presence of quantifiable high-risk physiological conditions, and not just comorbidities, that place a patient at high risk of death after abdominal surgery. Until then, elderly patients should not be denied colectomy based upon comorbidities alone.
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
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Protective Effect of Cardiomyocyte-Specific Prolyl-4-Hydroxylase 2 Inhibition on Ischemic Injury in a Mouse MI Model.
J Am Coll Surg2022 Apr;():. doi: 10.1097/XCS.0000000000000241.
Pradeep Seetur R, Lim Sue Ting, Thirunavukkarasu Mahesh, Joshi Mandip, Cernuda Bryan, Palesty J Alexander, Maulik Nilanjana,
Abstract
BACKGROUND:
Our earlier studies showed that inhibiting prolyl-4-hydroxylase enzymes (PHD-1 and PHD-3) improves angiogenesis, heart function, and limb perfusion in mouse models via stabilizing hypoxia-inducible transcription factor-alpha (HIF-1?). The present study explored the effects of the prolyl-4-hydroxylase enzyme, PHD-2, on ischemic heart failure using cardiac-specific PHD-2 gene knockout (KO) mice (PHD2-/-).
STUDY DESIGN:
Adult wild-type (WT) and PHD2-/- mice, 8-12 weeks old, were subjected to myocardial infarction (MI) by irreversibly ligating the left anterior descending (LAD) coronary artery. All sham group mice underwent surgery without LAD ligation. Animals were divided into four groups 1) Wild-type Sham (WTS); Wild-Type myocardial infarction (WTMI); 3) PHD2KO Sham (PHD2-/-S); 4) PHD2KO myocardial infarction (PHD2-/-MI). Left ventricular tissue samples collected at various time points following surgery were used for microRNA expression profiling, Western blotting, immunohistochemical, and echocardiographic analysis.
RESULTS:
Volcano plot analysis revealed 19 differentially expressed miRNAs in the PHD2-/-MI compared to the WTMI group. Target analysis using Ingenuity Pathway Analysis showed several differentially regulated miRNAs targeting key signaling pathways such as Akt, VEGF, Ang-1, PTEN, apoptosis, and hypoxia pathways. Compared to the WTMI group, Western blot analysis showed increased HIF-1?, VEGF, phospho-AKT, and ?-catenin expression and reduced Bax expression for the PHD2-/-MI group post-MI. Echocardiographic analysis showed preserved heart functions, and picrosirius red staining revealed decreased fibrosis in PHD2-/-MI compared to the WTMI group.
CONCLUSION:
PHD2 inhibition showed preserved heart function, enhanced angiogenic factor expression, and decreased apoptotic markers after MI. Overall, PHD2 gene inhibition is a promising candidate for managing cardiovascular diseases.
Copyright © 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.
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Kaempferol-3-O-rutinoside exerts cardioprotective effects through NF-?B/NLRP3/Caspase-1 pathway in ventricular remodeling after acute myocardial infarction.
J Food Biochem2022 Jun;():e14305. doi: 10.1111/jfbc.14305.
Hua Fang, Li Jing Ya, Zhang Meng, Zhou Peng, Wang Liang, Ling Tie Jun, Bao Guan Hu,
Abstract
Ventricular remodeling (VR) after acute myocardial infarction (AMI) is the main pathogenesis of chronic heart failure (CHF). Kaempferol-3-O-rutinoside (KR) is the flavonoid glycoside with the highest content in Lu'an GuaPian tea, which has good pharmacological activities. However, the mechanism of KR against VR after AMI remains unclear. Molecular docking was used to predict the targets of KR on the NLRP3/Caspase-1 signaling pathway. Histological changes in the myocardium were visualized using HE staining, Masson staining. Cardiomyocyte apoptosis was detected using TUNEL. Immunohistochemistry was used to examine NLRP3, Caspase-1 p20, and GSDMD. IL-1? level in serum was detected using ELISA. Finally, the expressions of NF-?B p65, NLRP3, ASC, Caspase-1 p20, GSDMD, and IL-1? were measured using RT-PCR and Western blotting. Our results showed that KR had a good binding activity with NLRP3, Caspase-1, and GSDMD, significantly improved cardiac function, alleviated cardiac pathological changes, reduced the excessive deposition of myocardial interstitial collagen, and inhibited cardiomyocyte apoptosis in AMI rats. Furthermore, KR could decrease the IL-1? level and inhibit the expressions of NF-?B p65, NLRP3, ASC, Caspase-1 p20, GSDMD, and IL-1?. Our study suggests that KR can prevent and treat VR after AMI, and the protective effect is related to its regulatory NF-?B/NLRP3/Caspase-1 signaling pathway. PRACTICAL APPLICATIONS: Kaempferol-3-O-rutinoside is present in Carthamus tinctorius L., Nymphaea candida, Afgekia mahidoliae and green tea, which has good pharmacological activities against liver injury, cerebral ischemia/reperfusion injury, dementia, hyperglycemia, and myocardial infarction. Our previous study found that kaempferol-3-O-rutinoside had an obvious anti-inflammatory effect, and could significantly improve the cell survival rate of H9c2 myocardium inflammatory injury induced by LPS. In this study, kaempferol-3-O-rutinoside significantly improved cardiac function, alleviated cardiac pathological changes, reduced the excessive deposition of myocardial interstitial collagen, and inhibited cardiomyocyte apoptosis in AMI rats. Furthermore, kaempferol-3-O-rutinoside could decrease the IL-1? level and inhibit the expressions of NF-?B p65, NLRP3, ASC, Caspase-1, GSDMD and IL-1?, suggesting that kaempferol-3-O-rutinoside could regulate NF-?B/NLRP3/Caspase-1 signaling pathway.
© 2022 Wiley Periodicals LLC.
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Moth-eaten like impact of automated titanium fasteners on aortic valve bioprosthesis: A word of caution.
Eur J Cardiothorac Surg2022 Jun;():. doi: ezac357.
Santer David, Miazza Jules, Eckstein Friedrich,
Abstract
A 78?years old patient underwent his third biological aortic valve replacement (25?mm, Inspiris ResiliaTM, Edwards Lifesciences LLC, Irvine, USA) with COR-KNOT® (LSI Solutions, Victor, NY, USA) due to valve degeneration in 2018 at a foreign hospital. In 2021, the patient was diagnosed with severe aortic regurgitation and admitted to our hospital for his fourth surgery. Intraoperatively, a total of seven perforations in all three valve leaflets have been observed, which were obviously induced by the rigid metallic fasteners. Redo isolated aortic valve replacement (29?mm, Perimount Magna Ease, Edwards Lifesciences LLC, Irvine, USA) was performed with conventionally knotted, pledget enforced braided threads. Postoperative course was uneventful. This report shows that COR-KNOT® induced defects do not appear immediately after surgery but within the first four postoperative months. Since failure of aortic bioprostheses due to arotic insufficiency is often rated as "early degeneration" and degenerated aortic bioprostheses are mostly replaced by valve-in-valve strategy, the true incidence of this serious complication might be underestimated. COR-KNOT® should be used with caution in biological aortic valve replacement and patients should undergo close postoperative follow-ups.
© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
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DIAGNOSIS AND MANAGEMENT OF SUSPECTED CONGESTIVE HEART FAILURE SECONDARY TO DILATED CARDIOMYOPATHY IN A SAND TIGER SHARK () WITH ESTABLISHMENT OF PRELIMINARY NORMAL ECHOCARDIOGRAPHIC INDICES.
J Zoo Wildl Med2022 Jun;53(2):363-372. doi: 10.1638/2021-0127.
Hyatt Michael W, Gerlach Trevor J,
Abstract
Elasmobranch cardiac anatomy and physiology has been well described; however, there is a dearth of information regarding cardiac disease. In support of a clinical case of suspected congestive heart failure in a 22-yr-old male sand tiger shark (), a study was undertaken to identify feasible echocardiographic imaging planes and preliminary indices for this species. Eleven echocardiograms were performed on six apparently healthy sand tiger sharks. Echocardiographic parameters are presented using descriptive statistics, including mean, median, standard deviation (SD), minimum and maximum values. These data were utilized for the diagnosis and clinical management of the affected shark. The shark initially presented with increased respiratory effort, dependent, peripheral edema, and anemia. Echocardiography revealed atrial, ventricular, and sinus venosus dilation. As congestive heart failure secondary to dilated cardiomyopathy was strongly suspected, therapy was initiated with oral benazepril and torsemide, and later pimobendan. After a year of therapy, clinical signs resolved. Cardiac size and function improved on echocardiography with a reduction in sinus venosus dilation, maximum and minimum atrial and ventricular inner diameters, and an increase in atrial and ventricular fractional shortening. Cardiac disease in elasmobranchs may be underdiagnosed, so it may be necessary to develop standardized ultrasound techniques and cardiac measurements for each species of elasmobranch managed within zoos and aquaria.
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Post-Transplant Mortality and Graft Failure after Induction Immunosuppression Among Black Heart Transplant Recipients in the United States.
Am J Transplant2022 Jun;():. doi: 10.1111/ajt.17130.
Salia Soziema, Mostofsky Elizabeth, Gupta Suruchi, Lehman Laura, Barrera Francisco J, Liou Lathan, Motiwala Shweta R, Mittleman Murray A,
Abstract
Black heart transplant recipients are more likely to receive induction immunosuppression compared to other races because of higher rates of acute rejection, graft failure, and mortality. However, it is not known whether contemporary induction immunosuppression improves their post-transplant outcomes. To evaluate whether Black patients who were prescribed induction immunosuppression therapy have lower all-cause mortality or graft-failure rates compared to those who were not, we studied Black U.S. adult heart transplant recipients in the Scientific Registry of Transplant Recipients database (2008 - 2018). We used multivariable Cox proportional hazards regression analysis to compare the hazards of all-cause mortality or graft failure as a composite, for patients who were prescribed induction immunosuppression and those who were not. Among 5,160 recipients, 2,787 (54.0%) were prescribed induction immunosuppression and 2,373 (46.0%) were not. There was no evidence of survival differences according to induction immunosuppression for the composite of all-cause mortality or graft failure (aHR=?1.13, 95% CI 0.96 - 1.32), mortality (aHR=?1.14, 95% CI 0.97 - 1.34), graft failure (aHR=?1.05, 95% CI 0.82 - 1.34) and acute rejection (aHR=?1.00, 95% CI 0.89 - 1.12). Given the side effects of treatment, future guidelines should reconsider the recommendation for induction immunosuppression among Black patients.
This article is protected by copyright. All rights reserved.
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HEPATIC VASCULAR TUMORS IN CHILDREN: POTENTIAL RISKS, OPTIMAL IMAGING AND THE ROLE OF SURGICAL INTERVENTION.
Wiad Lek2022 ;75(5 pt 1):1064-1069. doi: 10.36740/WLek202205103.
Benzar Iryna M, Levytskyi Anatolii F, Diehtiarova Daria S, Godik Oleg S,
Abstract
OBJECTIVE:
The aim: To revise the case-series of hepatic vascular tumors (HVT), particularly to identify optimal visualization, management and role of surgical intervention.
PATIENTS AND METHODS:
Materials and methods: Out of 96 children with hepatic tumors who hospitalized in a single center from 2011 to 2020, 20 (20,8%) were diagnosed HVT. Hepatic Hemangiomas (HHs) were presented in 19 patients and Kaposiform hemangioendotelioma (KHE) in one case. To determine the type of HH we used radiological classification. For visualisation contrast-enhanced MRI (n=7, 30%) and cCT (n=15,70%) were used. Follow-up period was 14-77 months.
RESULTS:
Results: All HVT were revealed by sonogram at the age of 0-5 m, with 4 (20%) diagnosed prenatally. Male to female ratio was 3:2. Beta-blockers were prescribed to 12 patients with HHs. Treatment duration was from 6 to 24 month. Steroid therapy was initial in cases when it was impossible to prescribe the curative dose of beta-blockers. Complications of propranolol treatment were transitory bradycardia (n=7) and transitory hypoglycemia (n=2). After vincristine chemotherapy decreases the tumor size by 54%, that allowed a safe liver resection. 4 (20%) patients - two multifocal HHs, one diffuse HH and in patient with KHE manifested congestive heart failure and pulmonary hypertension Mortality rate is 5% (n=1), this patient died against progressive cardiovascular failure.
CONCLUSION:
Conclusions: life-threatening complication of HVT was congestive heart failure. Early treatment is beneficial for complications prevention. Surgical treatment is optional for KHE when can be removed safely.
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Prevalence and comorbidities of bronchiolitis in adults: A population-based study in South Korea.
Medicine (Baltimore)2022 Jun;101(25):e29551. doi: 10.1097/MD.0000000000029551.
Jeong Jae Seok, Kim Jong Seung, Yeom Sang Woo, Lee Min Gyu, You Yeon Seok, Lee Yong Chul,
Abstract
ABSTRACT:
Bronchiolitis generally refers to inflammation and/or fibrosis of the non-cartilaginous small airways located approximately from the 8th airway generation down to the terminal and respiratory bronchioles. In contrast to young children, the frequency of small airway infection in adult bronchiolitis appears less frequent and a number of other pathophysiological conditions have been implicated in adult bronchiolitis. However, little information is available on the exact medical burden of bronchiolitis such as its prevalence and comorbidities in the adult population. The aim of this study is to elucidate the prevalence and comorbidities of bronchiolitis. We used the Korea National Health Insurance Service-National Sample Cohort, which provides data for 1,000,000 individuals out of the entire population by 2% stratified random sampling according to age, sex, residential area, and level of household income. We defined the cause of bronchiolitis other than acute infection as a patient with diagnostic code J448 or J684 and over 20?years of age who visited a clinic or hospital in South Korea. Then, 1:1 propensity score matching was performed to define a non-bronchiolitis (control) group to compare the comorbidities and mortality in the 2 groups. The overall prevalence of bronchiolitis was 688 cases/1,000,000 population during the study period (95% confidence interval, 625-751). The most common comorbid clinical condition in adults with bronchiolitis was rhinitis (52.3%), followed by bronchial asthma (52.23%), hypertension (43.69%), gastroesophageal reflux disease (30.56%), sinusitis (28.72%), diabetes (22.77%), and osteoporosis (17.85%). Other common bronchiolitis-associated comorbidities were cerebrovascular disease (16.86%), angina (14.37%), peripheral vascular disease (13.42%), congestive heart failure (11.9%), and malignancy in any organ (10.6%). Healthcare costs for bronchiolitis increased steeply during the same period. Malignancy in any organ was the leading cause of mortality in the patient group, followed by bronchiolitis itself. Further larger prospective multiethnic cohort studies should be carried out in the near future.
Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.
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