SOSTIENICI
Pubblicazioni recenti - cardiovascular disease
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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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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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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.
This article is protected by copyright. All rights reserved.
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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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Diversity and determinants of the sigmoid septum and its impact on morphology of the outflow tract as revealed using cardiac computed tomography.
Echocardiography2022 Jan;():. doi: 10.1111/echo.15298.
Tsuda Daisuke, Mori Shumpei, Izawa Yu, Toh Hiroyuki, Suzuki Masataka, Takahashi Yu, Toba Takayoshi, Fujiwara Sei, Tanaka Hidekazu, Watanabe Yoshiaki, Kono Atsushi K, Hirata Ken-Ichi,
Abstract
BACKGROUND:
The sigmoid septum has been generally evaluated subjectively and qualitatively, without detailed examination of its diversity, impact on the morphology of the left ventricular outflow tract (LVOT), and anatomical background.
METHODS:
We enrolled 100 patients without any background cardiac diseases (67.5 ± 12.8 years old; 43% women) who underwent cardiac computed tomography. Basal septal morphology was evaluated using antero-superior and medial bulging angles (bidirectional angulation of the basal septum relative to the LVOT). The eccentricity index of the LVOT, area narrowing ratio (LVOT/virtual basal ring area), aortic-to-left ventricular axial angle (angulation of the aortic root relative to the left ventricle), and wedged height (non-coronary aortic sinus to inferior epicardium distance) were also quantified.
RESULTS:
The antero-superior bulging, medial bulging, aortic-to-left ventricular axial angles, LVOT eccentricity index, area narrowing ratio, and wedged height were 76° ± 17°, 166° ± 27°, 127° ± 9°, 1.8 ± 0.5, 1.0 ± 0.2, and 41.2 ± 9.1 mm, respectively. Both bulging angles were correlated with each other and contributed to the narrowing and deformation of the LVOT. Angulated aortic root was not correlated with either bidirectional septal bulge or LVOT narrowing. Clockwise rotation of the aortic root rotation was an independent predictor of prominent antero-superior septal bulge. Deeper aortic wedging was a common independent predictor of bidirectional septal bulge.
CONCLUSIONS:
The extent of septal bulge varies in normal hearts. Along with deep aortic wedging, the bidirectional bulge of the basal septum deforms and narrows the LVOT without affecting the virtual basal ring morphology.
© 2022 Wiley Periodicals LLC.
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Deduction and exploration of the evolution and function of vertebrate GFPT family.
Genes Genomics2022 Jan;():. doi: 10.1007/s13258-021-01188-8.
Wei Si-Ang, Xu Ran, Ji Yu-Yao, Ding Zhi-Wen, Zou Yun-Zeng,
Abstract
BACKGROUND:
Glutamine-fructose-6-phosphate aminotransferase (GFPT) is a key factor in the hexosamine metabolism pathway. It regulates the downstream factor O-GlcNAc to change cell function and plays an important role in the metabolism and immune process of tissues and organs. However, the evolutionary relationship of GFPT family proteins in vertebrates has not been elucidated.
OBJECTIVE:
To deduce and explore the evolution and function of vertebrate GFPT family.
METHODS:
18 GFPT sequences were obtained from Homo sapiens (H. sapiens), Trachypithecus francoisi (T. francoisi), Mus musculus (M. musculus), Rattus norvegicus (R. norvegicus), Gallus gallus (G. gallus), Zootoca vivipara (Z. vivipara), Xenopus tropicalis (X. tropicalis), Danio rerio (D. rerio), Rhincodon typus (R. typus), Plasmodium relictum from National Center for Biotechnology Information (NCBI). The physical and chemical characteristics and molecular evolution of GFPT family proteins and nucleic acid sequences were analyzed by ClustalX2, Gene Doc, MEGA-X, SMART, Datamonkey, R etc. RESULTS: Based on the neighbor-joining (NJ) phylogenetic tree and evolution fingerprints, GFPT family members of vertebrates can be divided into two groups: the GFPT1 group and the GFPT2 group. Seven positive selection sites were identified by IFEL and integrated methods mixed effects model of evolution (MEME) and fixed effects likelihood (REL). Finally, we predicted 28 phosphorylation sites and 18 ubiquitousness sites in the human GFPT1 sequence, 10 phosphorylation sites, and five ubiquitousness sites in GFPT2. Gene ontology (GO) analyzes the protein molecules and KEGG signaling pathways of vertebrates interacting with GFPT family proteins.
CONCLUSIONS:
Our work confirmed that higher animals GFPT family may have differentiated GFPT1 and GFPT2, which meets their own functional needs. This knowledge answers the question what the origin and evolution of GFPT family in vertebrates and provided the basis for disease treatment and function research of GFPT protein.
© 2022. The Author(s) under exclusive licence to The Genetics Society of Korea.
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Cardiovascular Risk Factors Drive Impaired Fasting Glucose to Type 2 Diabetes: Findings After a 9-Year Follow-Up in the PURE Study in Poland.
Adv Exp Med Biol2022 Jan;():. doi: 10.1007/5584_2021_701.
?wi?cicka-Klama Agnieszka, Po?tyn-Zaradna Katarzyna, Wo?yniec Maria, Szuba Andrzej, Zato?ska Katarzyna,
Abstract
This study aimed to evaluate the role of risk factors included in the Framingham Risk Score for hard coronary heart disease (CHD) in the development of type 2 diabetes (DM) in patients with impaired fasting glycemia (IFG) after a 9-year follow-up. The research was part of the Polish insight into the international Prospective Urban and Rural Epidemiology (PURE) study. The cohort consisted of 283 subjects aged 54.3 ± 8.9 years who were diagnosed with IFG at baseline and then completed after a 9-year follow-up. The main risk factors for both CHD and DM evaluated were smoking, arterial hypertension, abnormal lipid profile, and family medical history. Most participants had both untreated or poorly controlled hypertension and dyslipidemia. Those who developed full-fledged DM over time were older and had significantly higher levels of fasting plasma glucose, lipid parameters, and mean blood pressure records. In conclusion, we confirmed that early diagnosis of dyslipidemia and hypertension, along with the treatment optimization of these conditions, could prevent or reduce the risk of DM and adverse cardiovascular outcomes. The study highlighted a large-scale problem of the modifiable risk factors that could jeopardize the health status in patients with IFG in the long range and pointed to targeted preventive measures.
© 2022. The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Cardiovascular Morbidity in Individuals with Impaired FEV1.
Curr Cardiol Rep2022 Jan;():. doi: 10.1007/s11886-022-01636-1.
Mathew Joscilin, Nickel Nils Patrick,
Abstract
PURPOSE OF REVIEW:
This review is intended to give an overview of the epidemiology of cardiovascular morbidity and mortality in patients with impaired lung function with an emphasis on patients with COPD.
RECENT FINDINGS:
Despite shared risk factors, lung disease is an emerging independent risk factor for cardiovascular disease and cardio-vascular disease (CVD) outcomes. Both CVD and chronic lung disease contribute significantly to overall mortality. Especially patients with chronic obstructive pulmonary disease (COPD) are at high risk for CVD-related mortality. In patients with chronic lung disease, a low index of suspicion should be maintained to assess for CVD and vice versa. Early detection of chronic lung disease as a potentially modifiable CVD risk factor could have important impact on patient outcomes.
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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PCI or CABG for Left Main Disease: Does Disease Location Matter?
Curr Cardiol Rep2022 Jan;():. doi: 10.1007/s11886-021-01629-6.
Rajachandran Manu, Makhija Rakhee,
Abstract
PURPOSE OF REVIEW:
This review attempts to specifically assess impact of disease location in left main artery on mortality and cardiovascular outcomes in patients treated with percutaneous coronary intervention versus coronary artery bypass surgery.
RECENT FINDINGS:
The management of left main disease, once thought to be the sole province of cardiothoracic surgeon, has recently undergone a reappraisal by the cardiovascular medicine community. For many years, societal guideline recommendations advised bypass surgery as the "de rigeur" method of revascularization for unprotected left main disease. However, recent studies suggest that coronary intervention, especially with advances in drug-eluting stent technology, has mounted a serious challenge to surgical bypass in treatment of this disease. Although overall mortality rates are comparable for percutaneous coronary intervention and bypass surgery, left main disease location does influence long-term outcomes for percutaneous coronary intervention more than bypass surgery. A patient- and lesion-centered approach to treatment of this disease may provide optimal outcomes.
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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Emerging effects of tryptophan pathway metabolites and intestinal microbiota on metabolism and intestinal function.
Amino Acids2022 Jan;():. doi: 10.1007/s00726-022-03123-x.
Hyland Niall P, Cavanaugh Cassandre R, Hornby Pamela J,
Abstract
The metabolism of dietary tryptophan occurs locally in the gut primarily via host enzymes, with?~?5% metabolized by gut microbes. Three major tryptophan metabolic pathways are serotonin (beyond the scope of this review), indole, kynurenine and related derivatives. We introduce the gut microbiome, dietary tryptophan and the potential interplay of host and bacterial enzymes in tryptophan metabolism. Examples of bacterial transformation to indole and its derivative indole-3 propionic acid demonstrate associations with human metabolic disease and gut permeability, although causality remains to be determined. This review will focus on less well-known data, suggestive of local generation and functional significance in the gut, where kynurenine is converted to kynurenic acid and xanthurenic acid via enzymatic action present in both host and bacteria. Our functional data demonstrate a limited effect on intestinal epithelial cell monolayer permeability and on healthy mouse ileum. Other data suggest a modulatory effect on the microbiome, potentially in pathophysiology. Supportive of this, we found that the expression of mRNA for three kynurenine pathway enzymes were increased in colon from high-fat-fed mice, suggesting that this host pathway is perturbed in metabolic disease. These data, along with that from bacterial genomic analysis and germ-free mice, confirms expression and functional machinery of enzymes in this pathway. Therefore, the host and microbiota may play a significant dual role in either the production or regulation of these kynurenine metabolites which, in turn, can influence both host and microbiome, especially in the context of obesity and intestinal permeability.
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.
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Impact of continuous vs. interval training on oxygen extraction and cardiac function during exercise in type 2 diabetes mellitus.
Eur J Appl Physiol2022 Jan;():. doi: 10.1007/s00421-022-04884-9.
Van Ryckeghem Lisa, Keytsman Charly, De Brandt Jana, Verboven Kenneth, Verbaanderd Elvire, Marinus Nastasia, Franssen Wouter M A, Frederix Ines, Bakelants Elise, Petit Thibault, Jogani Siddharth, Stroobants Sarah, Dendale Paul, Bito Virginie, Verwerft Jan, Hansen Dominique,
Abstract
PURPOSE:
Exercise training improves exercise capacity in type 2 diabetes mellitus (T2DM). It remains to be elucidated whether such improvements result from cardiac or peripheral muscular adaptations, and whether these are intensity dependent.
METHODS:
27 patients with T2DM [without known cardiovascular disease (CVD)] were randomized to high-intensity interval training (HIIT, n?=?15) or moderate-intensity endurance training (MIT, n?=?12) for 24 weeks (3 sessions/week). Exercise echocardiography was applied to investigate cardiac output (CO) and oxygen (O) extraction during exercise, while exercise capacity [([Formula: see text] (mL/kg/min)] was examined via cardiopulmonary exercise testing at baseline and after 12 and 24 weeks of exercise training, respectively. Changes in glycaemic control (HbA1c and glucose tolerance), lipid profile and body composition were also evaluated.
RESULTS:
19 patients completed 24 weeks of HIIT (n?=?10, 66?±?11 years) or MIT (n?=?9, 61?±?5 years). HIIT and MIT similarly improved glucose tolerance (p?=?0.001, p?>?0.05), [Formula: see text] (mL/kg/min) (p?=?0.001, p?>?0.05), and exercise performance (W) (p?0.001, p?>?0.05). O extraction increased to a greater extent after 24 weeks of MIT (56.5%, p?=?0.009, p?=?0.001, p?=?0.007). CO and left ventricular longitudinal strain (LS) during exercise remained unchanged (p?>?0.05). A reduction in HbA1c was correlated with absolute changes in LS after 12 weeks of MIT (r?=?-?0.792, p?=?0.019, LS at rest) or HIIT (r?=?-?0.782, p?=?0.038, LS at peak exercise).
CONCLUSION:
In patients with well-controlled T2DM, MIT and HIIT improved exercise capacity, mainly resulting from increments in O extraction capacity, rather than changes in cardiac output. In particular, MIT seemed highly effective to generate these peripheral adaptations.
TRIAL REGISTRATION:
NCT03299790, initially released 09/12/2017.
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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Additive value of epicardial adipose tissue quantification to coronary CT angiography-derived plaque characterization and CT fractional flow reserve for the prediction of lesion-specific ischemia.
Eur Radiol2022 Jan;():. doi: 10.1007/s00330-021-08481-w.
Brandt Verena, Decker Josua, Schoepf U Joseph, Varga-Szemes Akos, Emrich Tilman, Aquino Gilberto, Bayer Richard R, Carson Landin, Sullivan Allison, Ellis Lauren, von Knebel Doeberitz Philipp L, Ebersberger Ullrich, Bekeredjian Raffi, Tesche Christian,
Abstract
OBJECTIVES:
Epicardial adipose tissue (EAT) from coronary CT angiography (CCTA) is strongly associated with coronary artery disease (CAD). We investigated the additive value of EAT volume to coronary plaque quantification and CT-derived fractional flow reserve (CT-FFR) to predict lesion-specific ischemia.
METHODS:
Patients (n?=?128, 60.6?±?10.5 years, 61% male) with suspected CAD who had undergone invasive coronary angiography (ICA) and CCTA were retrospectively analyzed. EAT volume and plaque measures were derived from CCTA using a semi-automatic software approach, while CT-FFR was calculated using a machine learning algorithm. The predictive value and discriminatory power of EAT volume, plaque measures, and CT-FFR to identify ischemic CAD were assessed using invasive FFR as the reference standard.
RESULTS:
Fifty-five of 152 lesions showed ischemic CAD by invasive FFR. EAT volume, CCTA???50% stenosis, and CT-FFR were significantly different in lesions with and without hemodynamic significance (all p?0.05). Multivariate analysis revealed predictive value for lesion-specific ischemia of these parameters: EAT volume (OR 2.93, p?=?0.021), CCTA???50% (OR 4.56, p?=?0.002), and CT-FFR (OR 6.74, p?0.001). ROC analysis demonstrated incremental discriminatory value with the addition of EAT volume to plaque measures alone (AUC 0.84 vs. 0.62, p?0.05). CT-FFR (AUC 0.89) showed slightly superior performance over EAT volume with plaque measures (AUC 0.84), however without significant difference (p?>?0.05).
CONCLUSIONS:
EAT volume is significantly associated with ischemic CAD. The combination of EAT volume with plaque quantification demonstrates a predictive value for lesion-specific ischemia similar to that of CT-FFR. Thus, EAT may aid in the identification of hemodynamically significant coronary stenosis.
KEY POINTS:
? CT-derived EAT volume quantification demonstrates high discriminatory power to identify lesion-specific ischemia. ? EAT volume shows incremental diagnostic performance over CCTA-derived plaque measures in detecting lesion-specific ischemia. ? A combination of plaque measures with EAT volume provides a similar discriminatory value for detecting lesion-specific ischemia compared to CT-FFR.
© 2022. The Author(s), under exclusive licence to European Society of Radiology.
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[Takayasu arteritis. Therapeutic alternatives and long term outcomes].
Medicina (B Aires)2022 ;82(1):74-80.
Santos José M, Casabé J Horacio, Fava Carlos, Godoy Armando Casandra L, Perandones Carlos E, Segura Mónica, Raffaelli Héctor, Favaloro Roberto R,
Abstract
The aim of this study was to describe the long term prognosis of 34 patients with Takayasu arteritis and the results of surgical and endovascular treatment. A total of 5 central surgeries and 53 endovascular procedures were performed including 18 bypass surgeries (33.8%) and 35 angioplasties (66.2%). The median follow-up was 7.5 years, interquartile range [IQR] 2.6-12.5. Among the 18 bypass surgeries 6 (33.3%) had events, while in the 35 patients with endovascular treatment there were 16 events (45.7%). The overall 1-, 3-, 5-, and 10-year death and arterial complication-free survival rates were 80% (95% CI between 74 and 89%), 68% (95% CI between 58 and 79%), 65% (95% CI between 54 and 76%) and 47% (95% CI between 41 and 62%). Both revascularization techniques were initially successful. In long term follow-up there was a high restenosis recurrence rate with endovascular treatment requiring repeated revascularization to the same vessel in 41% of the cases. Surgery had higher mortality in patients with aortic and ascending aortic valve disease, combined coronary artery disease and carotid disease. In long term follow up Takayasu arteritis frequently requires revascularization and restenosis or new lesions are common. Surgical treatment had better results with less restenosis than angioplasty.
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[Descriptive study of infection by SARS-CoV-2 in adults with diabetes].
Medicina (B Aires)2022 ;82(1):28-34.
Murujosa Ana C, Pasik Natalia I, Giuliani Quaglierini Sofía A, Aime Risso María, Burgos Mariana A, Grande Ratti María Florencia, Russo María Paula,
Abstract
The main objective was to estimate the prevalence of diabetes mellitus (DM) among patients with COVID-19, to explore associated factors; and to describe clinical evolution of hospitalized patients. A cross-sectional study was conducted, which included adults confirmed with COVID-19 between 03/12/2020 and 10/15/2020, at Hospital Italiano de Buenos Aires. From 6009 people with COVID-19, 408 had previous diagnosis of DM, yielding a prevalence of 6% (95%CI 6-7), higher prevalence was associated with age (12% in = 60 years and 3% in
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