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Pubblicazioni recenti - cardiovascular
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Anatomical and histological assessment of left bundle branch area pacing in human heart with refractory heart failure.
ESC Heart Fail2022 Jan;():. doi: 10.1002/ehf2.13806.
Zhang Jiefang, Pan Yiwen, Sun Yaxun, Fu Guosheng,
Abstract
As an emerging pacing technique, left bundle branch area pacing (LBBAP) has served as a physiological pacing modality that overcomes the limitations of His bundle pacing (HBP) or right ventricular pacing. Three patients with terminal heart failure who were waiting for heart transplantation and met the indications of pacemaker implantations received LBBAP. Symptoms were relieved and stabilized and eventually received heart transplantation. Diseased hearts from the recipients were dissected post-transplantation, and the direct visual of pacing lead locations in the interventricular septum were evaluated, and the histopathological examination around the lead was conducted for the first time in human. As a result, we found that the locations of LBBAP leads were matched with fluoroscopic views during the procedure and Masson's staining showed extensive fibrosis occur around the lead but did not result in high thresholds.
© 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
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Assessment of congestion and clinical outcomes in patients with chronic heart failure using shear wave elasticity.
ESC Heart Fail2022 Jan;():. doi: 10.1002/ehf2.13809.
Nakayama Rie, Takaya Yoichi, Nakamura Kazufumi, Takemoto Rika, Toh Norihisa, Ito Hiroshi,
Abstract
AIMS:
The relief of congestion is essential for the prevention of worsening heart failure (HF) resulting in hospitalizations. Assessment of the degree of organ congestion in the chronic phase of HF is important for determining therapeutic strategies. The aim of this study was to evaluate the efficacy of shear wave (SW) elasticity for assessing congestion and clinical outcomes in patients with chronic HF.
METHODS AND RESULTS:
We prospectively enrolled 345 consecutive patients with chronic HF who underwent SW elastography at outpatient clinic. Patients were divided into two groups according to the median value of SW elasticity: low group (SW elasticity
CONCLUSIONS:
The SW elasticity reflected haemodynamic congestion in patients with chronic HF, which was related to cardiac events.
© 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
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Thrombosis and Haemostasis 2021 Editors' Choice Papers.
Thromb Haemost2022 Jan;122(1):163-170. doi: 10.1055/s-0041-1741072.
Weber Christian, Rigby Anne, Lip Gregory Y H,
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A Rollercoaster Plunge into 2022.
Thromb Haemost2022 Jan;122(1):1-4. doi: 10.1055/s-0041-1741073.
Lip Gregory Y H, Rigby Anne, Weber Christian,
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Does Age Matter? Pulmonary Endarterectomy in the Elderly Patient with CTEPH.
Thorac Cardiovasc Surg2022 Jan;():. doi: 10.1055/s-0041-1740559.
Wiedenroth Christoph B, Bandorski Dirk, Ariobi Kanischka, Ghofrani H-Ardeschir, Lankeit Mareike, Liebetrau Christoph, Pruefer Diethard, Mayer Eckhard, Kriechbaum Steffen D, Guth Stefan,
Abstract
BACKGROUND:
?The gold standard treatment of patients with chronic thromboembolic pulmonary hypertension (CTEPH) is pulmonary endarterectomy (PEA). Little is known about the influence of advanced age on surgical outcome. Therefore, the aim of this study was to investigate the impact of patient's age on postoperative morbidity, mortality, and quality of life in a German referral center.
METHODS:
?Prospectively collected data from 386 consecutive patients undergoing PEA between 01/2014 and 12/2016 were analyzed. Patients were divided into three groups according to their age: group 1:???50 years, group 2:?>?50???70 years, group 3:?>?70 years.
RESULTS:
?After PEA, distinct improvements in pulmonary hemodynamics, physical capacity (World Health Organization [WHO] functional class and 6-minute walking distance) and quality of life were found in all groups. There were more complications in elderly patients with longer time of invasive ventilation, intensive care, and in-hospital stay. However, the in-hospital mortality was comparable (0% in group 1, 2.6% in group 2, and 2.1% in group 3 [?=?0.326]). Furthermore, the all-cause mortality at 1 year was 1.1% in group 1, 3.2% in group 2, and 6.3% in group 3 (?=?0.122).
CONCLUSIONS:
?PEA is an effective treatment for CTEPH patients of all ages accompanied by low perioperative and 1-year mortality. CTEPH patients in advanced age carefully selected by thorough preoperative evaluation should be offered PEA in expert centers to improve quality of life, symptoms, and pulmonary hemodynamics.
Thieme. All rights reserved.
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Surgical approach does not influence changes in circulating immune cell populations following lung cancer resection.
Lung Cancer2022 Jan;164():69-75. doi: S0169-5002(22)00001-0.
Deboever Nathaniel, McGrail Daniel J, Lee Younghee, Tran Hai T, Mitchell Kyle G, Antonoff Mara B, Hofstetter Wayne L, Mehran Reza J, Rice David C, Roth Jack A, Swisher Stephen G, Vaporciyan Ara A, Walsh Garrett L, Bernatchez Chantale, Vailati Negrao Marcelo, Zhang Jianjun, Wistuba Ignacio I, Heymach John V, Cascone Tina, Gibbons Don L, Haymaker Cara L, Sepesi Boris,
Abstract
INTRODUCTION:
The multimodal management of operable non-small cell lung cancer (NSCLC) continues to evolve rapidly. The immune milieu allowing for immunotherapeutic benefit can be affected by multiple parameters including clinicopathologic and genetic. Surgery induced physiological changes has received attention for modulating and affecting post-operative oncotaxis and immunosuppression. Here, we sought to investigate how surgical stress influences phenotype of peripheral blood mononuclear cells (PBMCs) in patients with NSCLC who underwent lobectomy.
METHODS:
Blood was prospectively collected from patients with Stage IA-IIIA NSCLC undergoing lung resection between 2016 and 2018. Samples were obtained pre-operatively, 24 h and 4 weeks after surgery. PBMCs were isolated and subject to high-dimensional flow cytometry, analyzing a total of 115 cell populations with a focus on myeloid cells, T cell activation, and T cell trafficking. We further evaluated how surgical approach influenced post-operative PBMC changes, whether the operation was conducted in an open fashion with thoracotomy, or with minimally invasive Video Assisted Thoracoscopic Surgery (VATS).
RESULTS:
A total of 76 patients met the inclusion criteria (Open n = 55, VATS n = 21). Surgical resection coincided with a decrease in T lymphocyte populations, including total CD3+ T cells, CD8+ T cells, and T effector memory cells, as well as an increase in monocytic myeloid-derived suppressor cells (mMDSC). Post-operative changes in PBMC populations were resolved after 4 weeks. Surgical-induced changes in immune populations were equivalent in patients undergoing open thoracotomy and VATS.
DISCUSSION:
Surgical stress resulted in transient reduction in T cells and T effector memory cells, and increase of mMDSC following resection in NSCLC patients. The immune profile modulation was similar regardless of surgical approach. These findings suggest that surgical approach does not seem to affect mononuclear cell lines obtained from peripheral blood. Thus, the decision regarding surgical approach should be patient centered, rather than based on post-operative treatment response optimization.
Copyright © 2022 Elsevier B.V. All rights reserved.
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Subjective social status and cardiometabolic risk markers in young adults.
Psychoneuroendocrinology2022 Jan;137():105666. doi: S0306-4530(22)00007-5.
Kempel Mia Klinkvort, Winding Trine Nøhr, Böttcher Morten, Andersen Johan Hviid,
Abstract
BACKGROUND:
Low subjective social status (SSS), the perceived status in the social hierarchy, is associated with cardiometabolic risk in middle-aged and older adults. However, most studies are cross-sectional and very little is known about the association in adolescence and young adulthood. The aims of this study were; a) to prospectively investigate the association between SSS at ages 15 and 28 and cardiometabolic risk at age 28-30 and b) to examine if such an association was independent of smoking, physical activity and objective measures of social position.
METHODS:
The study used questionnaire information at ages 15 and 28 from the West Jutland Cohort Study (N = 3681), health measurements from a sub-sample of the cohort (N = 264, age 28-30, 50% women) and information from population-based national registers. The independent variable was a measure of SSS evaluated by a 10-rung ladder scale and dichotomized at the 25th percentile of data from the cohort study population. The outcome measure was a composite score of cardiometabolic risk including measures of lipids, inflammation, blood pressure and glucose-metabolism. Co-variates included smoking, physical activity, childhood and adulthood socioeconomic position. Sex-stratified linear regression analyses were performed to evaluate the associations between SSS and cardiometabolic risk.
RESULTS:
In both sexes, low SSS at age 28, but not at age 15, was significantly associated with increased cardiometabolic risk at age 28-30. Neither smoking, physical activity, childhood or adulthood objective socioeconomic position fully explained the associations.
CONCLUSION:
In young adulthood, SSS was inversely related to cardiometabolic risk after accounting for smoking, physical activity and objective measures of socioeconomic position. These findings suggest that SSS could play a role in the social disparities in cardiometabolic risk in addition to traditional measures of socioeconomic position.
Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Ex vivo and in vivo suppression of SARS-CoV-2 with combinatorial AAV-RNAi expression vectors.
Mol Ther2022 Jan;():. doi: S1525-0016(22)00024-7.
Becker Jonas, Stanifer Megan Lynn, Leist Sarah Rebecca, Stolp Bettina, Maiakovska Olena, West Ande, Wiedtke Ellen, Börner Kathleen, Ghanem Ali, Ambiel Ina, Tse Longping Victor, Fackler Oliver Till, Baric Ralph Steven, Boulant Steeve, Grimm Dirk,
Abstract
accines, clinically relevant modalities to curb the pandemic by directly attacking the virus on a genetic level remain highly desirable and urgently needed. Here, we comprehensively illustrate the capacity of Adeno-associated virus (AAV) vectors co-expressing a cocktail of three short hairpin (sh)RNAs (RNAi triggers) directed against the SARS-CoV-2 RdRp and N genes as versatile and effective antivirals. In cultured monkey cells and in human gut organoids, our most potent vector, called SAVIOR (SARS virus repressor), suppressed SARS-CoV-2 infection to background levels. Strikingly, in control experiments using single shRNAs, multiple SARS-CoV-2 escape mutants quickly emerged from infected cells within 24-48 hours. Importantly, such adverse viral adaptation was fully prevented with the triple-shRNA AAV vector even during long-term cultivation. In addition, AAV-SAVIOR efficiently purged SARS-CoV-2 in a new model of chronically infected human intestinal cells. Finally, intranasal AAV-SAVIOR delivery using an AAV9 capsid moderately diminished viral loads and/or alleviated disease symptoms in hACE2-transgenic or wild-type mice infected with human or mouse SARS-CoV-2 strains, respectively. Our combinatorial and customizable AAV/RNAi vector complements ongoing global efforts to control the COVID-19 pandemic and holds great potential for clinical translation as an original and flexible, preventive or therapeutic antiviral measure.
Copyright © 2022. Published by Elsevier Inc.
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Pharmacological actions of Dieckol on modulation of platelet functions and thrombus formation via integrin ?? and cAMP signaling.
Pharmacol Res2022 Jan;():106088. doi: S1043-6618(22)00033-0.
Irfan Muhammad, Kwon Tae-Hyung, Kwon Hyuk-Woo, Rhee Man Hee,
Abstract
BACKGROUND AND PURPOSE:
Dieckol is a phlorotannin that can be found in seaweeds, particularly in Eisenia bicyclis (brown algae) and is known to have anti-oxidant, anti-inflammatory, and anti-microbial properties. It also possesses anti-thrombotic and pro-fibrinolytic activities; however, the mechanistic aspects of anti-platelet and anti-thrombotic activity are yet to be explored.
STUDY DESIGN:
and Methodology: We investigated the pharmacological effects of dieckol on the modulation of platelet functions using human, rat, and mice models. Inhibitory effects of dieckol on platelet aggregation were assessed using platelet-rich plasma and washed platelets, followed by measurement of dense granule secretions, fibrinogen binding to integrin ??, fibronectin adhesion assay, platelet spreading on immobilized fibrinogen, and clot retraction. Cyclic nucleotide signaling events were evaluated, such as cyclic-AMP production followed by vasodilator-stimulated phosphoprotein (VASP) stimulation. The in vivo anti-thrombotic potential was evaluated in mice using an acute pulmonary thromboembolism model and tail bleeding assay.
RESULTS:
Dieckol markedly inhibited platelet aggregation and granule secretion; furthermore, it down-regulated integrin ??-mediated inside-out and outside-in signaling events, including platelet adhesion, spreading, and clot retraction, whereas it upregulated the cAMP-PKA-VASP pathway. Dieckol-treated mice significantly survived the thrombosis than vehicle treated mice, without affecting hemostasis. Histological examinations of lungs revealed minimum occluded vasculature in dieckol-treated mice.
CONCLUSION:
Dieckol possesses strong anti-platelet and anti-thrombotic properties and is a potential therapeutic drug candidate to treat and prevent platelet-related cardiovascular disorders.
Copyright © 2022 Elsevier Ltd. All rights reserved.
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Multiplex genome editing of mammalian cells for producing recombinant heparin.
Metab Eng2022 Jan;():. doi: S1096-7176(22)00008-8.
Thacker Bryan E, Thorne Kristen J, Cartwright Colin, Park Jeeyoung, Glass Kimberly, Chea Annie, Kellman Benjamin P, Lewis Nathan E, Wang Zhenping, Di Nardo Anna, Sharfstein Susan T, Jeske Walter, Walenga Jeanine, Hogwood John, Gray Elaine, Mulloy Barbara, Esko Jeffrey D, Glass Charles A,
Abstract
Heparin is an essential anticoagulant used for treating and preventing thrombosis. However, the complexity of heparin has hindered the development of a recombinant source, making its supply dependent on a vulnerable animal population. In nature, heparin is produced exclusively in mast cells, which are not suitable for commercial production, but mastocytoma cells are readily grown in culture and make heparan sulfate, a closely related glycosaminoglycan that lacks anticoagulant activity. Using gene expression profiling of mast cells as a guide, a multiplex genome engineering strategy was devised to produce heparan sulfate with high anticoagulant potency and to eliminate contaminating chondroitin sulfate from mastocytoma cells. The heparan sulfate purified from engineered cells grown in chemically defined medium has anticoagulant potency that exceeds porcine-derived heparin and confers anticoagulant activity to the blood of healthy mice. This work demonstrates the feasibility of producing recombinant heparin from mammalian cell culture as an alternative to animal sources.
Copyright © 2022. Published by Elsevier Inc.
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Frailty influences the vascular responsiveness of elderly individuals with chronic heart failure.
Microvasc Res2022 Jan;():104316. doi: S0026-2862(22)00006-1.
Rech Daiana Aparecida, da Silveira Lucas Santos, Martins Edgar Manoel, de Oliveira Roque Ana Beatriz Alves, Althoff Amanda, Maiorana Andrew John, Vieira Ariany Marques, Karsten Marlus,
Abstract
INTRODUCTION:
Frailty is highly prevalent in heart failure (HF) patients. HF is associated with oxidative stress and chronic inflammation, which impair oxygen use by skeletal muscles. Little is known about the influence of frailty on vascular responsiveness and tissue oxygenation.
OBJECTIVE:
Analyze the influence of frailty on vascular responsiveness and muscle oxygenation in elderly individuals with and without HF.
METHODS:
Individuals aged ?60?years, with or without HF, were evaluated for frailty (phenotype). Near-infrared spectroscopy (NIRS) was used to assess muscle oxygenation at rest (oxygen saturation - StO and deoxyhemoglobin) and during handgrip exercise (minimum StO and maximum deoxyhemoglobin), and oxygenation variables.
STATISTICAL ANALYSIS:
Results were grouped according to the frailty phenotype: non-frail, pre-frail, and frail. Shapiro-Wilk test was used to assess normality. Data were compared using a two-way analysis of variance (ANOVA). Bonferroni post hoc test was applied to determine the influence of frailty or HF on NIRS variables. SPSS software was used in the analyses; p?0.05 was considered significant.
RESULTS:
55 elderly participants (61.8% female; 70.4?±?7.2?years old; 28 HF patients) participated in the study. 32.7% (n?=?18) were classified as non-frail, 43.3% (n?=?24) as pre-frail, and 23.6% (n?=?13) as frail. The analysis of vascular responsiveness (n?=?52) identified an influence (p?0.05) of frailty on the reperfusion rate (slope 2 and ?StO of nadir-peak) and desaturation during occlusion (area under the curve of StO) in HF patients. There was no influence of frailty or HF on muscle oxygenation at rest and during exercise (n?=?54; p?>?0.05).
CONCLUSION:
The coexistence of frailty and HF seems to impair vascular responsiveness, as frail elderly participants with HF presented lower reperfusion rates and higher desaturation levels during the arterial occlusion test. However, the presence of frailty or HF alone had no influence on muscle oxygenation at rest or during exercise.
Copyright © 2021. Published by Elsevier Inc.
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Hyperlipidemia and hypothyroidism.
Clin Chim Acta2022 Jan;():. doi: S0009-8981(22)00015-8.
Su Xin, Peng Hua, Chen Xiang, Wu Xijie, Wang Bin,
Abstract
Hypothyroidism is closely associated with increased serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG). The thyroid gland plays an important role in this process because thyroid hormones (THs) modulate cholesterol production, transformation and clearance. Although recent evidence suggests that thyroid-stimulating hormone (TSH) itself also participates in hyperlipidemia, the underlying mechanism remains unclear. Others demonstrated that the pathologic development of hypothyroidism-related hyperlipidemia was associated with down-regulated THs and up-regulated TSH in serum. This finding suggests a role for hypothyroidism in hyperlipidemia and potentially in related cardio-metabolic disease. Multiple newly identified modulatory biomarkers, such as proprotein convertase subtilisin/kexin type 9 (PCSK9), angiopoietin-like protein (ANGPTLs), and fibroblast growth factors (FGFs), might play a role in modulating the risk of hyperlipidemia induced by hypothyroidism. Moreover, hypothyroidism also contributes to the production of dysfunctional high-density lipoprotein (HDL) particles. In the present review, we examine the relationship between hypothyroidism with the risk and pathologic development of hyperlipidemia. We explore mechanisms by which hypothyroidism promotes hyperlipidemia in general and its contribution to cardio-metabolic disease specifically.
Copyright © 2022. Published by Elsevier B.V.
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Early detection of obstructive coronary artery disease in the asymptomatic high-risk population: objectives and study design of the EARLY-SYNERGY trial.
Am Heart J2022 Jan;():. doi: S0002-8703(22)00005-9.
Ties Daan, van Dorp Paulien, Pundziute Gabija, van der Aalst Carlijn M, Gratama Jan Willem C, Braam Richard L, Kuijpers Dirkjan, Lubbers Daniël D, van der Bilt Ivo A C, Westenbrink B Daan, Wolcherink Martijn J Oude, Doggen Carine J M, I?gum Ivana, Nijveldt Robin, de Koning Harry J, Vliegenthart Rozemarijn, Oudkerk Matthijs, van der Harst Pim,
Abstract
BACKGROUND:
Coronary artery disease (CAD) burden for society is expected to steeply increase over the next decade. Improved feasibility and efficiency of preventive strategies is necessary to flatten the curve. Acute myocardial infarction (AMI) is the main determinant of CAD-related mortality and morbidity, and predominantly occurs in individuals with more advanced stages of CAD causing subclinical myocardial ischemia (obstructive CAD; OCAD). Unfortunately, OCAD can remain subclinical until its destructive presentation with AMI or sudden death. Current primary preventive strategies are not designed to differentiate between non-OCAD and OCAD and the opportunity is missed to treat individuals with OCAD more aggressively.
METHODS:
ARLY-SYNERGY is a multicenter, randomized-controlled clinical trial in individuals with coronary artery calcium (CAC) presence to study (1.) the diagnostic yield of cardiac magnetic resonance stress myocardial perfusion imaging (CMR-MPI) for early OCAD diagnosis and (2) whether early OCAD diagnosis improves outcomes. Individuals with CAC score ?300 objectified in two population-based trials (ROBINSCA; ImaLife) are recruited for study participation. Eligible candidates are randomized 1:1 to cardiac magnetic resonance stress myocardial perfusion imaging (CMR-MPI) or no additional functional imaging. In the CMR-MPI arm, feedback on imaging results is provided to primary care provider and participant in case of guideline-based actionable findings. Participants are followed-up for clinical events, healthcare utilizationand quality of life.
CONCLUSIONS:
EARLY-SYNERGY is the first randomized-controlled clinical trial designed to test the hypothesis that subclinical OCAD is widely present in the general at-risk population and that early differentiation of OCAD from non-OCAD followed by guideline-recommended treatment improves outcomes.
Copyright © 2022. Published by Elsevier Inc.
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Sodium-Glucose Cotransporter-2 Inhibitors Versus Glucagon-like Peptide-1 Receptor Agonists and the Risk for Cardiovascular Outcomes in Routine Care Patients With Diabetes Across Categories of Cardiovascular Disease.
Ann Intern Med2022 Jan;175(1):W4. doi: 10.7326/L21-0708.
Patorno Elisabetta, Htoo Phyo T, Everett Brendan M, Kim Seoyoung C,
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Sodium-Glucose Cotransporter-2 Inhibitors Versus Glucagon-like Peptide-1 Receptor Agonists and the Risk for Cardiovascular Outcomes in Routine Care Patients With Diabetes Across Categories of Cardiovascular Disease.
Ann Intern Med2022 Jan;175(1):W4-W5. doi: 10.7326/L21-0709.
Patorno Elisabetta, Htoo Phyo T, Glynn Robert J, Schneeweiss Sebastian, Wexler Deborah J, Pawar Ajinkya, Bessette Lily G, Chin Kristyn, Everett Brendan M, Kim Seoyoung C,
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Sodium-Glucose Cotransporter-2 Inhibitors Versus Glucagon-like Peptide-1 Receptor Agonists and the Risk for Cardiovascular Outcomes in Routine Care Patients With Diabetes Across Categories of Cardiovascular Disease.
Ann Intern Med2022 Jan;175(1):W3. doi: 10.7326/L21-0707.
Bepo Lurit, Makam Anil N, Nguyen Oanh Kieu,
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Sodium-Glucose Cotransporter-2 Inhibitors Versus Glucagon-like Peptide-1 Receptor Agonists and the Risk for Cardiovascular Outcomes in Routine Care Patients With Diabetes Across Categories of Cardiovascular Disease.
Ann Intern Med -
TFEB signaling attenuates NLRP3-driven inflammatory responses in severe asthma.
Allergy2022 Jan;():. doi: 10.1111/all.15221.
Theofani Efthymia, Semitekolou Maria, Samitas Konstantinos, Mais Annie, Galani Ioanna E, Triantafyllia Vasiliki, Lama Joanna, Morianos Ioannis, Stavropoulos Athanasios, Jeong Se-Jin, Andreakos Evangelos, Razani Babak, Rovina Nikoletta, Xanthou Georgina,
Abstract
BACKGROUND:
NLRP3-driven inflammatory responses by circulating and lung-resident monocytes are critical drivers of asthma pathogenesis. Autophagy restrains NLRP3-induced monocyte activation in asthma models. Yet, the effects of autophagy and its master regulator, transcription factor EB (TFEB), on monocyte responses in human asthma remain unexplored. Here, we investigated whether activation of autophagy and TFEB signaling suppress inflammatory monocyte responses in asthmatic individuals.
METHODS:
Peripheral blood CD14 monocytes from asthmatic patients (n=83) and healthy controls (n=46) were stimulated with LPS/ATP to induce NLRP3 activation with or without the autophagy inducer, rapamycin. ASC specks, caspase-1 activation, IL-1? and IL-18 levels, mitochondrial function, ROS release and mTORC1 signaling were examined. Autophagy was evaluated by LC3 puncta formation, p62/SQSTM1 degradation and TFEB activation. In a severe asthma (SA) model, we investigated the role of NLRP3 signaling using Nlrp3 mice and/or MCC950 administration, and the effects of TFEB activation using myeloid-specific TFEB-overexpressing mice or administration of the TFEB activator, trehalose.
RESULTS:
We observed increased NLRP3 inflammasome activation, concomitant with impaired autophagy in circulating monocytes that correlated with asthma severity. SA patients also exhibited mitochondrial dysfunction and ROS accumulation. Autophagy failed to inhibit NLRP3-driven monocyte responses, due to defective TFEB activation and excessive mTORC1 signaling. NLRP3 blockade restrained inflammatory cytokine release and linked airway disease. TFEB activation restored impaired autophagy, attenuated NLRP3-driven pulmonary inflammation and ameliorated SA phenotype.
CONCLUSIONS:
Our studies uncover a crucial role for TFEB-mediated reprogramming of monocyte inflammatory responses, raising the prospect that this pathway can be therapeutically harnessed for the management of SA.
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A mock circulation loop to evaluate differential hypoxemia during peripheral venoarterial extracorporeal membrane oxygenation.
Perfusion2022 Jan;():2676591211056567. doi: 10.1177/02676591211056567.
Rozencwajg Sacha, Wu Eric L, Heinsar Silver, Stevens Michael, Chinchilla Josh, Fraser John F, Pauls Jo P,
Abstract
INTRODUCTION:
Peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO) creates a retrograde flow along the aorta competing with the left ventricle (LV) in the so-called 'mixing zone' (MZ). Detecting it is essential to understand which of the LV or the ECMO flow perfuses the upper body - particularly the brain and the coronary arteries - in case of differential hypoxemia (DH).
METHODS:
We described a mock circulation loop (MCL) that enabled experimental research on DH. We recreated the three clinical situations relevant to clinicians: where the brain is either totally perfused by the ECMO or the LV or both. In a second step, we used this model to investigate two scenarios to diagnose DH: (i) pulse pressure and (ii) thermodilution via injection of cold saline in the ECMO circuit.
RESULTS:
The presented MCL was able to reproduce the three relevant mixing zones within the aortic arch, thus allowing to study DH. Pulse pressure was unable to detect location of the MZ. However, the thermodilution method was able to detect whether the brain was totally perfused by the ECMO or not.
CONCLUSION:
We validated an differential hypoxemia model of cardiogenic shock supported by VA ECMO. This MCL could be used as an alternative to animal studies for research scenarios.
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Association of serum laboratory parameters with periprocedural myocardial infarction after a primary percutaneous coronary intervention.
Perfusion2022 Jan;():2676591211057502. doi: 10.1177/02676591211057502.
Deng Qiaoting, Hou Jingyuan, Deng Xunwei, Zhong Zhixiong,
Abstract
BACKGROUND:
Periprocedural myocardial infarction (PMI) is one of the mortality-related complications of percutaneous coronary intervention (PCI) and significantly affects short- and long-term adverse outcomes and immediate cardiovascular events. Our present study aimed to evaluate the association of preprocedural serum laboratory parameters and PMI in patients who received primary PCI and attempted to provide detailed data on the predictors of PCI-related PMI.
METHODS:
A total of 1184 consecutive coronary artery disease (CAD) patients who received primary and elective PCI between July 2015 and June 2017 were included and divided into control group and PMI group. The data of serum laboratory parameters were collected from the electronic database of Meizhou People's Hospital.
RESULTS:
The results indicated that preprocedural fasting blood glucose were higher in PMI group compared with the control group ( 6.11 mmol/L (
CONCLUSION:
Our results indicated preprocedural fasting blood glucose >6.11 mmol/L and LDL-C levels ?130 mg/dL may be useful predictors for PCI-related PMI. The study may provide a detailed data on the predictors of PCI-related PMI.
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