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Pubblicazioni recenti - cardiac surgery
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Changes in visual attention towards food cues after obesity surgery: An eye-tracking study.
J Psychiatr Res2020 Jul;129():214-221. doi: S0022-3956(20)30859-1.
Schäfer Lisa, Schmidt Ricarda, Müller Silke M, Dietrich Arne, Hilbert Anja,
Abstract
Research documented the effectiveness of obesity surgery (OS) for long-term weight loss and improvements in medical and psychosocial sequelae, and general cognitive functioning. However, there is only preliminary evidence for changes in attentional processing of food cues after OS. This study longitudinally investigated visual attention towards food cues from pre- to 1-year post-surgery. Using eye tracking (ET) and a Visual Search Task (VST), attentional processing of food versus non-food cues was assessed in n = 32 patients with OS and n = 31 matched controls without weight-loss treatment at baseline and 1-year follow-up. Associations with experimentally assessed impulsivity and eating disorder psychopathology and the predictive value of changes in visual attention towards food cues for weight loss and eating behaviors were determined. During ET, both groups showed significant gaze duration biases to non-food cues without differences and changes over time. No attentional biases over group and time were found by the VST. Correlations between attentional data and clinical variables were sparse and not robust over time. Changes in visual attention did not predict weight loss and eating disorder psychopathology after OS. The present study provides support for a top-down regulation of visual attention to non-food cues in individuals with severe obesity. No changes in attentional processing of food cues were detected 1-year post-surgery. Further studies are needed with comparable methodology and longer follow-ups to clarify the role of biased visual attention towards food cues for long-term weight outcomes and eating behaviors after OS.
Copyright © 2020 Elsevier Ltd. All rights reserved.
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The conductive function of biopolymer corrects myocardial scar conduction blockage and resynchronizes contraction to prevent heart failure.
Biomaterials2020 Aug;258():120285. doi: S0142-9612(20)30531-7.
He Sheng, Wu Jun, Li Shu-Hong, Wang Li, Sun Yu, Xie Jun, Ramnath Daniel, Weisel Richard D, Yau Terrence M, Sung Hsing-Wen, Li Ren-Ke,
Abstract
Myocardial fibrosis, resulting from ischemic injury, increases tissue resistivity in the infarct area, which impedes heart synchronous electrical propagation. The uneven conduction between myocardium and fibrotic tissue leads to dys-synchronous contraction, which progresses towards ventricular dysfunction. We synthesized a conductive poly-pyrrole-chitosan hydrogel (PPY-CHI), and investigated its capabilities in improving electrical propagation in fibrotic tissue, as well as resynchronizing cardiac contraction to preserve cardiac function. In an in vitro fibrotic scar model, conductivity increased in proportion to the amount of PPY-CHI hydrogel added. To elucidate the mechanism of interaction between myocardial ionic changes and electrical current, an equivalent circuit model was used, which showed that PPY-CHI resistance was 10 times lower, and latency time 5 times shorter, compared to controls. Using a rat myocardial infarction (MI) model, PPY-CHI was injected into fibrotic tissue 7 days post MI. There, PPY-CHI reduced tissue resistance by 30%, improved electrical conduction across the fibrotic scar by 33%, enhanced field potential amplitudes by 2 times, and resynchronized cardiac contraction. PPY-CHI hydrogel also preserved cardiac function at 3 months, and reduced susceptibility to arrhythmia by 30% post-MI. These data demonstrated that the conductive PPY-CHI hydrogel reduced fibrotic scar resistivity, and enhanced electrical conduction, to synchronize cardiac contraction.
Copyright © 2020 Elsevier Ltd. All rights reserved.
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Pulmonary and aortic valve endocarditis in a patient with a pacemaker.
Hellenic J Cardiol2020 Aug;():. doi: S1109-9666(20)30181-0.
Rorris Filippos-Paschalis, Tyrovolas Konstantinos, Niarchou Panagioula, Tsamatsoulis Michalis, Charitos Christos,
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Osteocalcin, Ovarian senescence, and Brain health.
Front Neuroendocrinol2020 Aug;():100861. doi: S0091-3022(20)30052-2.
Schatz Marc, Saravanan Sharnikha, d'Adesky Nathan D, Bramlett Helen, Perez-Pinzon Miguel A, Raval Ami P,
Abstract
Menopause, an inevitable event in a woman's life, significantly increases risk of bone resorption and diseases such as Alzheimer's, vascular dementia, cardiac arrest, and stroke. The sole role of bones, as traditionally regarded, is to provide structural support for skeletal muscles and allow for ambulation, however this concept is becoming quickly outdated. New literature has emerged that suggests the bone cell-derived hormone osteocalcin (OCN) plays a pivotal role in cognition. OCN levels are correlated with bone mass density and bone turnover, and thus are strongly influenced by the changes associated with menopause. The goal of the current review is to discuss potential gaps in our knowledge of OCN and cognition, discrepancies in methods of OCN quantification, and therapies to enhance circulating OCN. A discussion on implementing exercise or low frequency vibration interventions at the menopausal transition to reduce risk and severity of neurological diseases and associated cognitive decline is included.
Copyright © 2020. Published by Elsevier Inc.
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Comment on 'Clinical significance and inflammatory landscapes of a novel recurrence associated immune signature in early-stage lung adenocarcinoma'.
Cancer Lett2020 Aug;():. doi: S0304-3835(20)30391-8.
Chen Donglai, Wu Xuejie, Chen Yongbing, Chen Chang,
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Effects of intraoperative dexmedetomidine on the incidence of acute kidney injuryin pediatric cardiac surgery patients: A randomized controlled trial.
Paediatr Anaesth2020 Aug;():. doi: 10.1111/pan.13995.
Kim Eun-Hee, Lee Ji-Hyun, Kim Hee-Soo, Jang Young-Eun, Ji Sang-Hwan, Kim Woong-Han, Kwak Jae Gun, Kim Jin-Tae,
Abstract
BACKGROUND:
Perioperative dexmedetomidineuse has been reported to reduce the incidence of postoperative acute kidney injuryafter adult cardiac surgery. However, large-scale randomized controlled trials evaluating the effect of dexmedetomidine use on acute kidney injury in pediatric patients are lacking.
AIMS:
We investigated whether intraoperativedexmedetomidine could reduce the incidence of acute kidney injury in pediatric cardiac surgery patients.
METHODS:
In total, 141 pediatric patients were randomly assigned to dexmedetomidine or control groups. After anesthetic induction, patients in the dexmedetomidine group were administered 1 µg/kg of dexmedetomidine over 10 minutes, and an additional 0.5 µg/kg/hof dexmedetomidine during surgery. Additionally, 1 µg/kg of dexmedetomidine was infused immediately after cardiopulmonary bypass was initiated. The incidence of acute kidney injurywas defined following Kidney Disease Improving Global Outcomes guidelines.
RESULTS:
The final analysis included 139 patients. The incidence of acute kidney injury did not differ between dexmedetomidine and control groups (16.9% vs. 23.5%; odds ratio 0.661; 95% CI 0.285 to 1.525; p = 0.33). Similarly,neither the incidence of abnormal postoperative estimated glomerular filtration ratevalues (P = 0.96) differed between the two groups, northe incidence of arrhythmia, mechanical ventilation duration, length of stay in the intensive care unit,and hospitalization.
CONCLUSIONS:
Intraoperative dexmedetomidine did not reduce acute kidney injuryincidence in pediatric cardiac surgery patients.
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Comparison of regional analgesia techniques for pleurodesis pain in pediatric patients.
Paediatr Anaesth2020 Aug;():. doi: 10.1111/pan.13996.
Xie James, Mooney David P, Cravero Joseph,
Abstract
BACKGROUND:
Mechanical pleurodesis can prevent recurrence of spontaneous pneumothorax but is associated with significant postoperative pain. Adequate pain control is not only beneficial for patient comfort but also critical for mobilization and pulmonary recovery. Thoracic epidural catheters and paravertebral blocks (PVB) have been used to alleviate pain after thoracoscopic surgery. However, no studies have evaluated the safety and efficacy of PVB versus epidural analgesia versus no block in children undergoing pleurodesis.
METHODS:
In this retrospective case series review, data were extracted from a single institution's integrated patient outcomes database on children who underwent thoracoscopic pleurodesis from 2013 to 2018. Demographics, operative indication, procedure performed, and perioperative pain management were assessed by chart review. Patients whose operation was converted to thoracotomy, who had an underlying diagnosis of chronic pain, or who underwent pleurodesis for other indications were excluded. The primary outcomes were post-operative pain scores and opioid consumption. Secondary outcomes included PACU length of stay, hospital length of stay, functional outcomes during recovery, and any adverse events.
RESULTS:
66 patients met inclusion criteria: 23 received thoracic epidurals, 34 received PVBs, and 9 received no epidural/PVB. Patient characteristics did not significantly differ among groups. Although mean pain scores were statistically significantly lower in the epidural group on post-op day 1, all three groups' pain scores were in the 1 to 3 out of 10 range during the entire postoperative period. Thus, this statistical significance had little clinical significance as all groups had good pain control. The epidural group had significantly lower opioid consumption on post-op days 0 - 2 compared to PVB. No adverse events related to epidural or PVB were noted.
DISCUSSION:
We present the first analysis of epidural vs PVB (with comparison to no regional analgesia) following pleurodesis in children. Pain is well managed, regardless of the method; however, additional systemic opioid consumption was decreased in the epidural analgesia cohort. Prospective trials and comparisons with other analgesic techniques for pediatric thoracic surgeries are needed.
CONCLUSIONS:
Thoracic epidural analgesia offers a reduction in opioid use in the first two post-op days after pleurodesis but did not produce a clinically significant reduction in pain scores in comparison to PVB or no block.
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Prevalence of Cardiac and Metabolic Diseases among Alopecia Areata Patients.
J Eur Acad Dermatol Venereol2020 Aug;():. doi: 10.1111/jdv.16864.
Conic Rosalynn R Z, Chu Sherman, Tamashunas Nina L, Damiani Giovanni, Bergfeld Wilma,
Abstract
Alopecia areata (AA) is an autoimmune disease that may present with non-scarring alopecic patches to complete hair loss. Since other autoimmune diseases are associated with an increased risk of cardiac and metabolic diseases, we aimed to determine the prevalence of cardiac and metabolic comorbidities in AA. In this cross-sectional study, data were analyzed from the Explorys electronic aggregate database, a previously validated dataset which consists of over 50 million patients across 360 hospitals in the United States.
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Nkx2-5 Regulates the Proliferation and Migration of H9c2 Cells.
Med Sci Monit2020 Aug;26():e925388. doi: 10.12659/MSM.925388.
Wang Hongshu, Liu Yong, Han Shen, Zi Yunfeng, Zhang Yayong, Kong Ruize, Liu Zu, Cai Zhibin, Zhong Chongbin, Liu Wei, Li Lifeng, Jiang Lihong,
Abstract
BACKGROUND The protein NKX2-5 affects mammalian heart development. In mice, the disruption of Nkx2-5 has been associated with arrhythmias, abnormal myocardial contraction, abnormal cardiac morphogenesis, and death. However, the details of the mechanisms are unclear. This study was designed to investigate them. MATERIAL AND METHODS Rat cardiomyocytes from the H9c2 cell line were used in our study. First, we knocked down Nkx2-5 in the H9c2 cells and then validated consequent changes in cell proliferation and migration. We then used RNA sequencing to determine the changes in transcripts. Finally, we validated these results by quantitative reverse transcription-polymerase chain reaction. RESULTS We confirmed that Nkx2-5 regulates the proliferation and migration of H9c2 cells. In our experiments, Nkx2-5 regulated the expression of genes related to proliferation, migration, heart development, and disease. Based on bioinformatics analysis, knockdown of Nkx2-5 caused differential expression of genes involved in cardiac development, calcium ion-related biological activity, the transforming growth factor (TGF)-ß signaling pathway, pathways related to heart diseases, the MAPK signaling pathway, and other biological processes and signaling pathways. CONCLUSIONS Nkx2-5 may regulate proliferation and migration of the H9c2 cells through the genes Tgfb-2, Bmp10, Id2, Wt1, Hey1, and Cacna1g; rno-miR-1-3p; the TGF?ß signaling pathway; the MAPK signaling pathway; as well as other genes and pathways.
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Development of adoptive immunotherapy with KK-LC-1 specific TCR transduced ?? T cells against lung cancer cells.
Cancer Sci2020 Aug;():. doi: 10.1111/cas.14612.
Ichiki Yoshinobu, Shigematsu Yoshiki, Baba Tetsuro, Shiota Hironobu, Fukuyama Takashi, Nagata Yoshika, So Tetsuya, Yasuda Manabu, Takenoyama Mitsuhiro, Yasumoto Kosei,
Abstract
The present study analyzed the antitumor effect of ?? T cells transduced with TCR of the cancer-specific CTL to establish forceful cancer-specific adoptive immunotherapy. We cloned the TCR?? genes from the CTL showing HLA B15 restricted recognition of Kita-Kyushu Lung Cancer antigen-1 (KK-LC-1), a cancer/germline gene antigen, identified in a lung adenocarcinoma case (F1121). The TCR?? and CD8 genes were transduced into ?? T cells induced from peripheral blood lymphocytes of healthy volunteers stimulated with Zoledronate and IL-2. The KK-LC-1 specific TCR??-CD8-?? T cells showed cytotoxic activity against KK-LC-1 positive lung cancer cell line F1121L and produced IFN-? against F1121L and KK-LC-1 peptide pulsed F1121 EBV-B cells. These responses were blocked by human leukocyte antigen (HLA) class I and HLA B/C antibodies. An in vivo assay using NOD/SCID mice with xenotransplantation of human lung cancer cells was performed, and the TCR??-CD8 transduced ?? T cells (TCR??-CD8-?? T cells) were intraveously injected. Growth inhibition of KK-LC-1(+), HLA-B15(+) lung cancer cells was confirmed in mice with injection of the TCR??-CD8-?? T cells from one week after xenotransplantation of cancer cells but not in those treated two weeks after xenotransplantation. The resected specimens of the tumor, two weeks after xenotransplantation, highly expressed Fas-L but not programmed death ligand- 1 (PD-L1) by immunohistochemical staining. Fas-L highly expressed cancer cells xenotrasplanted 2weeks ago were resistant to TCR??-CD8-?? T cells injection. These results suggested that the apoptosis of Fas-positive TCR??-CD8-?? T cells may be induced by a Fas-mediated signal after interacting with Fas-L-positive cancer cells.
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Successful Integration of a Three-Dimensional Transthoracic Echocardiography-Derived Model with an Electroanatomic Mapping System to Guide Catheter Ablation of WPW.
J Cardiovasc Electrophysiol2020 Aug;():. doi: 10.1111/jce.14712.
Janson Christopher M, Nam Hannah H, Herz Christian, Lasso Andras, Cianciulli Alana, Jolley Matthew A,
Abstract
Three-dimensional trans-thoracic echo (3DE)-derived heart models have not previously been utilized to guide catheter ablation. In this case report, we describe creation of a 3DE model from TTE, import of the model into CARTO3, and successful use of the model as a guide during mapping and ablation of a right lateral accessory pathway. We believe this technique represents a valuable alternative to integration of CT or MRI-derived anatomic data, and that it has potential to improve definition of the AV valve annuli during catheter ablation of accessory pathways. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
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The impact of chronic kidney disease on outcomes following peripheral vascular intervention.
Clin Cardiol2020 Aug;():. doi: 10.1002/clc.23444.
Narcisse Dennis I, Weissler Elizabeth Hope, Rymer Jennifer A, Armstrong Ehrin J, Secemsky Eric A, Gray William A, Mustapha Jihad A, Adams George L, Ansel Gary M, Patel Manesh R, Jones William Schuyler,
Abstract
BACKGROUND:
Patients with chronic kidney disease (CKD) have worsened clinical outcomes following percutaneous coronary intervention; however, limited evidence exists in patients undergoing peripheral vascular intervention (PVI).
PURPOSE:
We aimed to assess the effect of CKD on outcomes following PVI for symptomatic peripheral artery disease.
METHODS:
Using patients from the LIBERTY 360 study, we compared the rates of 30?day and 1?year major adverse vascular events (MAVE), a composite of all-cause mortality, major amputation, and target vessel/lesion revascularization, between patients with and without CKD (estimated glomular filtration rate less than 60) following PVI. Multivariable adjustment was performed to assess for independent association between CKD and outcomes.
RESULTS:
Among 1189 patients enrolled, 378 patients (31.8%) had CKD. At 1 year, patients with CKD had higher rates of MAVE (34.6% vs 25.6%), all-cause mortality (11.9% vs 5.5%), and major amputation (5.9% vs 2.6%) when compared with patients without CKD (all P?
CONCLUSIONS:
Despite high procedural success and low amputation rates, patients with CKD remain at greater risk for MAVE and all-cause mortality after PVI. Further research is needed to determine treatment strategies to mitigate substantial mortality risk in this vulnerable population.
© 2020 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
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New developments in adult congenital heart disease.
Neth Heart J2020 Aug;28(Suppl 1):44-49. doi: 10.1007/s12471-020-01455-5.
Bouma B J, Sieswerda G T, Post M C, Ebels T, van Kimmenade R, de Winter R J, Mulder B J,
Abstract
Congenital heart disease (CHD) affects 0.8% of live births and over the past decades technical improvements and large-scale repair has led to increased survival into adulthood of over 95% of the new-born. A new group of patients, those who survived their congenital heart defect, has emerged but late complications including heart failure, pulmonary hypertension (PH), arrhythmias, aneurysms and endocarditis appeared numerous, with a huge impact on mortality and morbidity. However, innovations over the past years have changed the landscape of adult CHD dramatically. In the diagnostic process important improvements have been made in the use of MRI, biomarkers, e?health concepts and 3D visualisation of anatomy. Care is now concentrated in specialised centres, with a continuous emphasis on education and the introduction of weekly multidisciplinary consultations on diagnosis and intervention. Surgery and percutaneous intervention have been refined and new concepts applied, further reducing the burden of the congenital malformations. Research has matured from case series to global networks. Currently, adults with CHD are still facing high risks of early mortality and morbidity. By global collaboration and continuous education and development and innovation of our diagnostic and therapeutic arsenal, we will improve the perspectives of these young patients.
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Derivation and Validation of Novel Phenotypes of Multiple Organ Dysfunction Syndrome in Critically Ill Children.
JAMA Netw Open2020 Aug;3(8):e209271. doi: 10.1001/jamanetworkopen.2020.9271.
Sanchez-Pinto L Nelson, Stroup Emily K, Pendergrast Tricia, Pinto Neethi, Luo Yuan,
Abstract
Importance:
Multiple organ dysfunction syndrome (MODS) is a dynamic and heterogeneous process associated with high morbidity and mortality in critically ill children.
Objective:
To determine whether data-driven phenotypes of MODS based on the trajectories of 6 organ dysfunctions have prognostic and therapeutic relevance in critically ill children.
Design, Setting, and Participants:
This cohort study included 20?827 pediatric intensive care encounters among 14?285 children admitted to 2 large academic pediatric intensive care units (PICUs) between January 2010 and August 2016. Patients were excluded if they were older than 21 years or had undergone cardiac surgery. The 6 subscores of the pediatric Sequential Organ Failure Assessment (pSOFA) score were calculated for the first 3 days, including the subscores for respiratory, cardiovascular, coagulation, hepatic, neurologic, and renal dysfunctions. MODS was defined as a pSOFA subscore of at least 2 in at least 2 organs. Encounters were split in a 80:20 ratio for derivation and validation, respectively. The trajectories of the 6 subscores were used to derive a set of data-driven phenotypes of MODS using subgraph-augmented nonnegative matrix factorization in the derivation set. Data analysis was conducted from March to October 2019.
Exposures:
The primary exposure was phenotype membership. In the subset of patients with vasoactive-dependent shock, the interaction between hydrocortisone and phenotype membership and its association with outcomes were examined in a matched cohort.
Main Outcomes and Measures:
The primary outcome was in-hospital mortality. Secondary outcomes included persistent MODS on day 7, and vasoactive-free, ventilator-free, and hospital-free days. Regression analysis was used to adjust for age, severity of illness, immunocompromised status, and study site.
Results:
There were 14?285 patients with 20?827 encounters (median [interquartile range] age 5.2 years [1.5-12.7] years; 11?409 [54.8%; 95% CI, 54.1%-55.5%] male patients). Of these, 5297 encounters (25.4%; 95% CI, 24.8%-26.0%) were with patients who had MODS, of which 5054 (95.4%) met the subgraph count threshold and were included in the analysis. Subgraph augmented nonnegative matrix factorization uncovered 4 data-driven phenotypes of MODS, characterized by a combination of neurologic, respiratory, coagulation, and cardiovascular dysfunction, as follows: phenotype 1, severe, persistent encephalopathy (1019 patients [19.2%]); phenotype 2, moderate, resolving hypoxemia (1828 patients [34.5%]); phenotype 3, severe, persistent hypoxemia and shock (1012 patients [19.1%]); and phenotype 4, moderate, persistent thrombocytopenia and shock (1195 patients [22.6%]). These phenotypes were reproducible in a validation set of encounters, had distinct clinical characteristics, and were independently associated with outcomes. For example, using phenotype 2 as reference, the adjusted hazard ratios (aHRs) for death by 28 days were as follows: phenotype 1, aHR of 3.0 (IQR, 2.1-4.3); phenotype 3, aHR of 2.8 (IQR, 2.0-4.1); and phenotype 4, aHR of 1.8 (IQR, 1.2-2.6). Interaction analysis in a matched cohort of patients with vasoactive-dependent shock revealed that hydrocortisone had differential treatment association with vasoactive-free days across phenotypes. For example, patients in phenotype 3 who received hydrocortisone had more vasoactive-free days than those who did not (23 days vs 18 days; P for interaction?
Conclusions and Relevance:
In this study, data-driven phenotyping in critically ill children with MODS uncovered 4 distinct and reproducible phenotypes with prognostic relevance and possible therapeutic relevance. Further validation and characterization of these phenotypes is warranted.
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Extracorporeal Membrane Oxygenation for Patients With COVID-19 in Severe Respiratory Failure.
JAMA Surg2020 Aug;():. doi: 10.1001/jamasurg.2020.3950.
Mustafa Asif K, Alexander Philip J, Joshi Devang J, Tabachnick Deborah R, Cross Chadrick A, Pappas Pat S, Tatooles Antone J,
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In-hospital stroke after transcatheter aortic valve implantation: A UK observational cohort analysis.
Catheter Cardiovasc Interv2020 Aug;():. doi: 10.1002/ccd.29157.
Myat Aung, Buckner Luke, Mouy Florence, Cockburn James, Baumbach Andreas, Banning Adrian P, Blackman Daniel J, Curzen Nick, MacCarthy Philip, Mullen Michael, de Belder Mark, Cox Ian, Kovac Jan, Brecker Stephen, Turner Mark, Khogali Saib, Malik Iqbal S, Alsanjari Osama, Redwood Simon, Prendergast Bernard, Trivedi Uday, Robinson Derek, Ludman Peter, de Belder Adam, Hildick-Smith David,
Abstract
OBJECTIVES:
We sought to identify baseline demographics and procedural factors that might independently predict in-hospital stroke following transcatheter aortic valve implantation (TAVI).
BACKGROUND:
Stroke is a recognized, albeit infrequent, complication of TAVI. Established predictors of procedure-related in-hospital stroke; however, remain poorly defined.
METHODS:
We conducted an observational cohort analysis of the multicenter UK TAVI registry. The primary outcome measure was the incidence of in-hospital stroke.
RESULTS:
A total of 8,652 TAVI procedures were performed from 2007 to 2015. There were 205 in-hospital strokes reported by participating centers equivalent to an overall stroke incidence of 2.4%. Univariate analysis showed that the implantation of balloon-expandable valves caused significantly fewer strokes (balloon-expandable 96/4,613 [2.08%] vs. self-expandable 95/3,272 [2.90%]; p =?.020). After multivariable analysis, prior cerebrovascular disease (CVD) (odds ratio [OR] 1.51, 95% confidence interval [CI 1.05-2.17]; p =?.03), advanced age at time of operation (OR 1.02 [0.10-1.04]; p =?.05), bailout coronary stenting (OR 5.94 [2.03-17.39]; p =?.008), and earlier year of procedure (OR 0.93 [0.87-1.00]; p =?.04) were associated with an increased in-hospital stroke risk. There was a reduced stroke risk in those who had prior cardiac surgery (OR 0.62 [0.41-0.93]; p =?.01) and a first-generation balloon-expandable valve implanted (OR 0.72 [0.53-0.97]; p =?.03). In-hospital stroke significantly increased 30-day (OR 5.22 [3.49-7.81]; p
CONCLUSIONS:
In-hospital stroke after TAVI is associated with substantially increased early and late mortality. Factors independently associated with in-hospital stroke were previous CVD, advanced age, no prior cardiac surgery, and deployment of a predominantly first-generation self-expandable transcatheter heart valve.
© 2020 Wiley Periodicals LLC.
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Loss of supervillin causes myopathy with myofibrillar disorganization and autophagic vacuoles.
Brain2020 Aug;():. doi: awaa206.
Hedberg-Oldfors Carola, Meyer Robert, Nolte Kay, Abdul Rahim Yassir, Lindberg Christopher, Karason Kristjan, Thuestad Inger Johanne, Visuttijai Kittichate, Geijer Mats, Begemann Matthias, Kraft Florian, Lausberg Eva, Hitpass Lea, Götzl Rebekka, Luna Elizabeth J, Lochmüller Hanns, Koschmieder Steffen, Gramlich Michael, Gess Burkhard, Elbracht Miriam, Weis Joachim, Kurth Ingo, Oldfors Anders, Knopp Cordula,
Abstract
The muscle specific isoform of the supervillin protein (SV2), encoded by the SVIL gene, is a large sarcolemmal myosin II- and F-actin-binding protein. Supervillin (SV2) binds and co-localizes with costameric dystrophin and binds nebulin, potentially attaching the sarcolemma to myofibrillar Z-lines. Despite its important role in muscle cell physiology suggested by various in vitro studies, there are so far no reports of any human disease caused by SVIL mutations. We here report four patients from two unrelated, consanguineous families with a childhood/adolescence onset of a myopathy associated with homozygous loss-of-function mutations in SVIL. Wide neck, anteverted shoulders and prominent trapezius muscles together with variable contractures were characteristic features. All patients showed increased levels of serum creatine kinase but no or minor muscle weakness. Mild cardiac manifestations were observed. Muscle biopsies showed complete loss of large supervillin isoforms in muscle fibres by western blot and immunohistochemical analyses. Light and electron microscopic investigations revealed a structural myopathy with numerous lobulated muscle fibres and considerable myofibrillar alterations with a coarse and irregular intermyofibrillar network. Autophagic vacuoles, as well as frequent and extensive deposits of lipoproteins, including immature lipofuscin, were observed. Several sarcolemma-associated proteins, including dystrophin and sarcoglycans, were partially mis-localized. The results demonstrate the importance of the supervillin (SV2) protein for the structural integrity of muscle fibres in humans and show that recessive loss-of-function mutations in SVIL cause a distinctive and novel myopathy.
© The Author(s) (2020). Published by Oxford University Press on behalf of the Guarantors of Brain.
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Balloon angioplasty of bidirectional Glenn anastomosis.
Cardiol Young2020 Aug;():1-6. doi: 10.1017/S1047951120002292.
Matoq Amr, Radtke Wolfgang,
Abstract
OBJECTIVE:
We aim to assess the safety and efficacy of the transcatheter balloon dilation of superior cavopulmonary anastomosis (SCPA).
BACKGROUND:
SCPA stenosis can lead to impaired pulmonary blood flow, hypoxemia and development of veno-venous collaterals with right-to-left shunt. Balloon dilation of SCPA has been rarely reported and follow-up information is lacking.
METHODS:
We performed a retrospective review of patients who underwent cardiac catheterisation and angioplasty of SCPA and reviewed patient's demographics, diagnosis, SCPA surgery and post-operative course, catheterisation haemodynamics, procedural technique, angiography, and the findings of follow-up catheterisation.
RESULTS:
Between 2008 and 2017, seven patients showed significant narrowing of SCPA and underwent balloon angioplasty, all of whom had undergone bidirectional Glenn (BDG). Indications for cardiac catheterisation included persistent pleural effusion, hypoxemia, and echocardiographic evidence of BDG stenosis or routine pre-Fontan assessment. Five patients had bilateral SCPA. The procedure was successful in all cases with increase in the stenosis diameter from a median of 3.3 mm (range 1.2-4.7 mm) to a median of 4.7 mm (range 2.6-7.8 mm). All patients had at least one follow-up cardiac catheterisation. Only one patient required repeat angioplasty at the 2.3-month follow-up with no further recurrence. Sustained results and interval growth were noted in all other cases during up to 29 months of follow-up. No adverse events were encountered.
CONCLUSION:
Based on our small series, balloon angioplasty of BDG stenosis is feasible and safe and appears to provide sustained improvement with interval growth and only the rare recurrence of stenosis.
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Silencing hsa_circRNA_0008035 exerted repressive function on osteosarcoma cell growth and migration by upregulating microRNA-375.
Cell Cycle2020 Aug;():1-9. doi: 10.1080/15384101.2020.1792636.
Gong Gu, Han Zhifeng, Wang Wenjun, Xu Qinli, Zhang Jingzhe,
Abstract
Traditionally, circular RAN hsa_circ_0008035 was proven to function as a tumor inhibitor in gastric cancer. Nevertheless, much less was known about hsa_circ_0008035 in osteosarcoma (OSA). This project was undertaken to assess the role of hsa_circ_0008035 in OSA. Hsa_circ_0008035 level in serum of OSA patients, OSA tissues and cell lines were measured by reverse transcription-quantitative PCR. After downregulation or overexpression of hsa_circ_0008035, cell proliferation, apoptosis and migration were tested in MG63, SAOS-2 or hFOB1.19 cells. Meanwhile, the expression level of miR-375 was analyzed. The binding between hsa_circ_0008035 and miR-375 was confirmed using bioinformatics and luciferase assay. Subsequently, the effects of miR-375 inhibition on MG63 cell growth and migratory potential were reevaluated. Eventually, the activating status of Notch pathway was assessed by Western blot. Our results demonstrated that hsa_circ_0008035 was overexpressed in serum of OSA patients, OSA tissues and cells. Silencing hsa_circRNA_0008035 impeded OSA cell growth and migration, while hsa_circ_0008035 facilitated cell behaviors of hFOB1.19 cells. Additionally, hsa_circ_0008035 negatively modulated miR-375 expression. Meanwhile, miR-375 inhibition overturned the suppressive effects of silencing hsa_circRNA_0008035 on OSA cell behaviors. Furthermore, silencing hsa_circ_0008035 perturbed Notch pathway by adjusting miR-375 expression. In conclusion, silencing hsa_circRNA_0008035 exerted repressive function on OSA cell growth and migration and Notch pathway by accelerating miR-375.
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An international survey: Tobacco smoking cessation strategies within left ventricular assist device centers.
Int J Artif Organs2020 Aug;():391398820944931. doi: 10.1177/0391398820944931.
Combs Pamela, Cohen William, Siddiqi Umar A, Jeevanandam Valluvan,
Abstract
BACKGROUND:
Tobacco smoking is a significant source of morbidity in patients with a durable left ventricular assist device. While various cessation strategies have been investigated, the ability of ventricular assist device centers to implement a successful tobacco cessation program remains uncertain. We explored various cessation strategies employed by ventricular assist device centers and assessed perspectives of their effectiveness, as well as institutional investment in these programs.
METHODS:
A 37-question online self-report survey was created using Survey Monkey and distributed worldwide. We investigated (1) programmatic strategies utilized for smoking cessation, (2) the respondent's perspective on the effectiveness of these strategies, (3) the structure with which these therapies are administered, and (4) overall organizational support for these treatments.
RESULTS:
A total of 47 centers worldwide completed the survey. The most common methods of tobacco cessation were pharmacologic and nicotine replacement therapy (78% and 66%). However, only about half (47% and 50%, respectively) of the centers indicated that these strategies were effective. When asked whether a respondent's center perceives that tobacco smoking should be a deciding factor in destination therapy evaluations, nearly a third (15, 32%) responded in the affirmative.
CONCLUSION:
While significant overlap exists among centers regarding treatments used for smoking cessation with left ventricular assist device patients, the most common treatments are not thought to be effective. While the current recommendations require tobacco smoking cessation in only bridge-to-transplant patients and not destination therapy patients, a number of centers disagree with the national guidelines and believe smoking should be prohibited in both populations.
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