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Ulrikh E, Dikareva E, Govorov I, Komlichenko E, Pervunina T, Li O, Zhamborova O, Dzharbaeva A, Deynega V, Artemenko V, Urmancheeva A. Gestational Trophoblastic Disease with Coexisting Progressing Pregnancy: Personalised Treatment Modalities. Int J Clin Pract 2023; 2023:5502317. [PMID: 37927849 PMCID: PMC10622598 DOI: 10.1155/2023/5502317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 09/09/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose Gestational trophoblastic disease (GTD) coexisting with a steadily progressing pregnancy is an extremely rare condition presented in the literature as a single case or case series of successful delivery. The purpose of this study was to describe five cases of GTD and present possible management strategies for such patients. Methods Clinical data of five pregnancies with coexisting GTD were identified within the Almazov National Medical Research Centre from 2018 to 2021. Results Three cases of multiple pregnancies with complete hydatidiform moles and two cases of singleton pregnancies with intraplacental choriocarcinoma and invasive hydatidiform moles were identified. Three pregnancies were prolonged and ended with preterm deliveries. Malignant transformation of the GTD accounted for 60% of the cases. The condition of newborns was based on the level of prematurity and functional immaturity, and in all cases, it was aggravated by anemia. Conclusion GTD coexisting with progressing pregnancy is threatened by the risks of preterm delivery, miscarriage, hemorrhage, and disease progression and requires monitoring in a multidisciplinary clinic experienced in the management of patients with malignant tumors during pregnancy. In cases of prolonged pregnancy against the background of GTD, we suggest the following monitoring during pregnancy: pelvic, abdominal ultrasound/MRI (without contrast), prenatal invasive fetal karyotype testing in cases of singleton pregnancy, lung X-ray/CT with uterine shielding, weekly assessment of β-hCG levels, and dynamic monitoring of the fetus. The following postnatal monitoring should be performed: morphological examination of the placenta, weekly assessment of β-hCG levels up to normalization, then monthly assessment up to six months, and control of β-hCG level of the newborn.
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Affiliation(s)
- Elena Ulrikh
- Personalized Medicine Center, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russia
| | - Elena Dikareva
- Personalized Medicine Center, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russia
| | - Igor Govorov
- Personalized Medicine Center, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russia
| | - Eduard Komlichenko
- Personalized Medicine Center, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russia
| | - Tatiana Pervunina
- Personalized Medicine Center, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russia
| | - Olga Li
- Personalized Medicine Center, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russia
| | - Oksana Zhamborova
- Personalized Medicine Center, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russia
| | - Aminat Dzharbaeva
- Personalized Medicine Center, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russia
| | - Viktor Deynega
- Personalized Medicine Center, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russia
| | - Veronika Artemenko
- Personalized Medicine Center, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russia
| | - Adel Urmancheeva
- Personalized Medicine Center, Almazov National Medical Research Centre, Saint-Petersburg 197341, Russia
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Kofeynikova O, Alekseeva D, Vershinina T, Fetisova S, Peregudina O, Kovalchuk T, Yakovleva E, Sokolnikova P, Klyushina A, Chueva K, Kostareva A, Pervunina T, Vasichkina E. The phenotypic and genetic features of arrhythmogenic cardiomyopathy in the pediatric population. Front Cardiovasc Med 2023; 10:1216976. [PMID: 37781308 PMCID: PMC10541206 DOI: 10.3389/fcvm.2023.1216976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/04/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction The present study aimed to describe the phenotypic features and genetic spectrum of arrhythmogenic cardiomyopathy (ACM) presented in childhood and test the validity of different diagnostic approaches using Task Force Criteria 2010 (TFC) and recently proposed Padua criteria. Patients and methods Thirteen patients (mean age at diagnosis 13.6 ± 3.7 years) were enrolled using "definite" or "borderline" diagnostic criteria of ACM according to the TFC 2010 and the Padua criteria in patients <18 years old. Clinical data, including family history, 12-lead electrocardiogram (ECG), signal-averaged ECG, 24-h Holter monitoring, imaging techniques, genetic testing, and other relevant information, were collected. Results All patients were classified into three variants: ACM of right ventricle (ACM-RV; n = 6, 46.1%), biventricular ACM (ACM-BV; n = 3, 23.1%), and ACM of left ventricle (ACM-LV; n = 4, 30.8%). The most common symptoms at presentations were syncope (n = 6; 46.1%) and palpitations (n = 5; 38.5%). All patients had more than 500 premature ventricular contractions per day. Ventricular tachycardia was reported in 10 patients (76.9%), and right ventricular dilatation was registered in 8 patients (61.5%). An implantable cardiac defibrillator was implanted in 61.5% of cases, and three patients with biventricular involvement underwent heart transplantation. Desmosomal mutations were identified in 8 children (53.8%), including four patients with PKP2 variants, two with DSP variants, one with DSG2 variant, and one with JUP. Four patients carried compound heterozygous variants in desmosomal genes associated with left ventricular involvement. Conclusion Arrhythmias and structural heart disease, such as chamber dilatation, should raise suspicion of different ACM phenotypes. Diagnosis of ACM might be difficult in pediatric patients, especially for ACM-LV and ACM-BV forms. Our study confirmed that using "Padua criteria" in combination with genetic testing improves the diagnostic accuracy of ACM in children.
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Affiliation(s)
- Olga Kofeynikova
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Daria Alekseeva
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Tatiana Vershinina
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Svetlana Fetisova
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Olga Peregudina
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Tatiana Kovalchuk
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Elena Yakovleva
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Polina Sokolnikova
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Alexandra Klyushina
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Kseniia Chueva
- Department of Pediatric Cardiology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Anna Kostareva
- Institute of Molecular Biology and Genetics, Almazov National Medical Research Centre, Saint Petersburg, Russia
- Department of Women’s and Children’s Health and Center for Molecular Medicine, Karolinska Institutet (KI), Solna, Sweden
| | - Tatiana Pervunina
- Institute of Perinatology and Pediatrics, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Elena Vasichkina
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
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3
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Popova P, Anopova A, Vasukova E, Isakov A, Eriskovskaya A, Degilevich A, Pustozerov E, Tkachuk A, Pashkova K, Krasnova N, Kokina M, Nemykina I, Pervunina T, Li O, Grineva E, Shlyakhto E. Trial protocol for the study of recommendation system DiaCompanion with personalized dietary recommendations for women with gestational diabetes mellitus (DiaCompanion I). Front Endocrinol (Lausanne) 2023; 14:1168688. [PMID: 37361536 PMCID: PMC10290190 DOI: 10.3389/fendo.2023.1168688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/27/2023] [Indexed: 06/28/2023] Open
Abstract
Background Gestational diabetes mellitus (GDM) is a common complication of pregnancy associated with serious adverse outcomes for mothers and their offspring. Achieving glycaemic targets is the mainstream in the treatment of GDM in order to improve pregnancy outcomes. As GDM is usually diagnosed in the third trimester of pregnancy, the time frame for the intervention is very narrow. Women need to get new knowledge and change their diet very quickly. Usually, these patients require additional frequent visits to healthcare professionals. Recommender systems based on artificial intelligence could partially substitute healthcare professionals in the process of educating and controlling women with GDM, thus reducing the burden on the women and healthcare systems. We have developed a mobile-based personalized recommendation system DiaCompanion I with data-driven real time personal recommendations focused primarily on postprandial glycaemic response prediction. The study aims to clarify the effect of using DiaCompanion I on glycaemic levels and pregnancy outcomes in women with GDM. Methods Women with GDM are randomized to 2 treatment groups: utilizing and not utilizing DiaCompanion I. The app provides women in the intervention group the resulting data-driven prognosis of 1-hour postprandial glucose level every time they input their meal data. Based on the predicted glucose level, they can adjust their current meal so that the predicted glucose level falls within the recommended range below 7 mmol/L. The app also provides reminders and recommendations on diet and lifestyle to the participants of the intervention group. All the participants are required to perform 6 blood glucose measurements a day. Capillary glucose values are retrieved from the glucose meter and if not available, from the woman's diary. Additionally, data on glycaemic levels during the study and consumption of major macro- and micronutrients will be collected using the mobile app with electronic report forms in the intervention group. Women from the control group receive standard care without the mobile app. All participants are prescribed with insulin therapy if needed and modifications in their lifestyle. A total of 216 women will be recruited. The primary outcome is the percentage of postprandial capillary glucose values above target (>7.0 mmol/L). Secondary outcomes include the percentage of patients requiring insulin therapy during pregnancy, maternal and neonatal outcomes, glycaemic control using glycated hemoglobin (HbA1c), continuous glucose monitoring data and other blood glucose metrics, the number of patient visits to endocrinologists and acceptance/satisfaction of the two strategies assessed using a questionnaire. Discussion We believe that the approach including DiaCompanion I will be more effective in patients with GDM for improving glycaemic levels and pregnancy outcomes. We also expect that the use of the app will help reduce the number of clinic visits. Trial registration number ClinicalTrials.gov, Identifier NCT05179798.
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Affiliation(s)
- Polina Popova
- World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Anna Anopova
- World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Elena Vasukova
- World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Artem Isakov
- World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Angelina Eriskovskaya
- World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Andrey Degilevich
- World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Evgenii Pustozerov
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Alexandra Tkachuk
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Kristina Pashkova
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Natalia Krasnova
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Maria Kokina
- World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Irina Nemykina
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Tatiana Pervunina
- Institute of Perinatology and Pediatrics, Almazov National Medical Research Center, Saint Petersburg, Russia
| | - Olga Li
- Institute of Perinatology and Pediatrics, Almazov National Medical Research Center, Saint Petersburg, Russia
| | - Elena Grineva
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Evgeny Shlyakhto
- World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
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Vasichkina E, Kofeynikova O, Fetisova S, Starshinova AY, Sheyanova E, Vershinina T, Ryzhkov A, Skripnik A, Alekseeva D, Nechaeva E, Glushkova A, Kudlay D, Pervunina T, Starshinova A. Severe Course of COVID-19 and Long-COVID-19 in Children: Difficulties in Diagnosis. Life (Basel) 2023; 13:life13030781. [PMID: 36983936 PMCID: PMC10056761 DOI: 10.3390/life13030781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/11/2023] [Accepted: 03/12/2023] [Indexed: 03/17/2023] Open
Abstract
The question of COVID-19 and long-COVID-19 course in children remains unsolved. This infection in children, which is associated with COVID-19, can vary from asymptomatic to systemic damage of various systems. Multisystem inflammatory syndrome in children, associated with SARS-CoV-2 (MIS-C), is a serious condition in children and adolescents after experiencing COVID-19. Published data on MIS-C have indicated that the inflammation can be registered in the gastrointestinal tract (60–100%), as well as in cardiovascular (80%), nervous (29–58%), and respiratory (21–65%) systems. However, with the changing characteristics of SARS-CoV-2, the manifestations of COVID-19 and long-COVID-19 in children have also been changing. Currently, there is no clear understanding of the development of severe COVID-19 and MIS-C in children, especially after being exposed to patients with COVID-19. We presented two new clinical courses of multisystem inflammatory syndrome in children with severe multisystem damage after close contact to relatives with COVID-19 or long-COVID-19. Thus, high-risk children, who are positive for SARS-CoV-2 infection after contact with COVID-19 patients, should be clinically managed during the first few months. The identification of the disease complexity requires the involvement of neurologists, cardiologists, and other specialists.
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Affiliation(s)
- Elena Vasichkina
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Olga Kofeynikova
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Svetlana Fetisova
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Anastasia Y. Starshinova
- Medical Department, Saint Petersburg State Pediatric Medical University, St. Petersburg 194100, Russia
| | | | | | - Anton Ryzhkov
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Aleksey Skripnik
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Daria Alekseeva
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
- H.Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery, St. Petersburg 196603, Russia
| | | | - Anzhela Glushkova
- V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg 192019, Russia
| | - Dmitry Kudlay
- Pharmacology Department, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow 119435, Russia
- SSC Immunology Institute, FMBA Russia, Moscow 115552, Russia
| | - Tatiana Pervunina
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Anna Starshinova
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
- Correspondence:
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5
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Kaplina A, Zaikova E, Ivanov A, Volkova Y, Alkhova T, Nikiforov V, Latypov A, Khavkina M, Fedoseeva T, Pervunina T, Skorobogatova Y, Volkova S, Ulyantsev V, Kalinina O, Sitkin S, Petrova N. Intestinal microbiome changes in an infant with right atrial isomerism and recurrent necrotizing enterocolitis: A case report and review of literature. World J Clin Cases 2022; 10:10583-10599. [PMID: 36312470 PMCID: PMC9602219 DOI: 10.12998/wjcc.v10.i29.10583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/20/2022] [Accepted: 08/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Necrotizing enterocolitis (NEC) is a multifactorial disease that predominantly affects premature neonates. Intestinal dysbiosis plays a critical role in NEC pathogenesis in premature neonates. The main risk factor for NEC in term infants is mesenteric hypoperfusion associated with ductal-dependent congenital heart disease (CHD) that eventually leads to intestinal ischemia. The incidence of NEC in neonates with critical CHD is 6.8%-13%. However, the role of the intestinal microbiome in NEC pathogenesis in infants with ductal-dependent CHD remains unclear.
CASE SUMMARY A male term neonate with right atrial isomerism underwent modified Blalock-Taussig shunt placement on the 14th day of life and had persistent mesenteric hypoperfusion after surgery. The patient had episodes of NEC stage IIA on the 1st and 28th days after cardiac surgery. Fecal microbial composition was analyzed before and after cardiac surgery by sequencing region V4 of the 16S rRNA gene. Before surgery, species belonging to genera Veillonella and Clostridia and class Gammaproteobacteria were detected, Bifidobacteriaceae showed a low abundance. The first NEC episode was associated with postoperative hemodynamic instability, intestinal ischemia-reperfusion injury during cardiopulmonary bypass, and a high abundance of Clostridium paraputrificum (Clostridium sensu stricto I) (56.1%). Antibacterial therapy after the first NEC episode resulted in increased abundance of Gammaproteobacteria, decreased abundance of Firmicutes, and low alpha diversity. These changes in the microbial composition promoted the growth of Clostridium sensu stricto I (72.0%) before the second NEC episode.
CONCLUSION A high abundance of Clostridium sensu stricto I and mesenteric hypoperfusion may have contributed to NEC in the present case.
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Affiliation(s)
- Aleksandra Kaplina
- Research Laboratory of Physiology and Diseases of Newborns, Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Ekaterina Zaikova
- Research Laboratory of Autoimmune and Autoinflammatory Diseases, Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Artem Ivanov
- International Laboratory of Computer Technologies, ITMO University, St. Petersburg 197101, Russia
| | - Yulia Volkova
- Department of Cardiovascular Surgery for Children, Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Tatiana Alkhova
- Department of Neonatal Physiology with an ICU Ward, Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Vladimir Nikiforov
- Pediatric Cardiac Intensive Care Unit, Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Alexander Latypov
- Department of Cardiovascular Surgery for Children, Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Marina Khavkina
- Neonatal and Preterm Special Care Unit (2nd Stage Care), Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Tatiana Fedoseeva
- Research Laboratory of Physiology and Diseases of Newborns, Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Tatiana Pervunina
- Institute of Perinatology and Pediatrics, Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Yulia Skorobogatova
- Express Laboratory of Perinatal Centre, Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Svetlana Volkova
- Clinical Diagnostic Laboratory, Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Vladimir Ulyantsev
- International Laboratory of Computer Technologies, ITMO University, St. Petersburg 197101, Russia
| | - Olga Kalinina
- Research Laboratory of Autoimmune and Autoinflammatory Diseases, Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Stanislav Sitkin
- Epigenetics and Metagenomics Group, Institute of Perinatology and Pediatrics, Almazov National Medical Research Centre, St. Petersburg 197341, Russia
- Department of Internal Diseases, Gastroenterology and Dietetics, North-Western State Medical University named after I.I. Mechnikov, St. Petersburg 191015, Russia
| | - Natalia Petrova
- Research Laboratory of Physiology and Diseases of Newborns, Almazov National Medical Research Centre, St. Petersburg 197341, Russia
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Muravyev A, Vershinina T, Tesner P, Sjoberg G, Fomicheva Y, Čajbiková NN, Kozyreva A, Zhuk S, Mamaeva E, Tarnovskaya S, Jornholt J, Sokolnikova P, Pervunina T, Vasichkina E, Sejersen T, Kostareva A. Rare clinical phenotype of filaminopathy presenting as restrictive cardiomyopathy and myopathy in childhood. Orphanet J Rare Dis 2022; 17:358. [PMID: 36104822 PMCID: PMC9476594 DOI: 10.1186/s13023-022-02477-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background FLNC is one of the few genes associated with all types of cardiomyopathies, but it also underlies neuromuscular phenotype. The combination of concomitant neuromuscular and cardiac involvement is not often observed in filaminopathies and the impact of this on the disease prognosis has hitherto not been analyzed. Results Here we provide a detailed clinical, genetic, and structural prediction analysis of distinct FLNC-associated phenotypes based on twelve pediatric cases. They include early-onset restrictive cardiomyopathy (RCM) in association with congenital myopathy. In all patients the initial diagnosis was established during the first year of life and in five out of twelve (41.7%) patients the first symptoms were observed at birth. RCM was present in all patients, often in combination with septal defects. No ventricular arrhythmias were noted in any of the patients presented here. Myopathy was confirmed by neurological examination, electromyography, and morphological studies. Arthrogryposes was diagnosed in six patients and remained clinically meaningful with increasing age in three of them. One patient underwent successful heart transplantation at the age of 18 years and two patients are currently included in the waiting list for heart transplantation. Two died due to congestive heart failure. One patient had ICD instally as primary prevention of SCD. In ten out of twelve patients the disease was associated with missense variants and only in two cases loss of function variants were detected. In half of the described cases, an amino acid substitution A1186V, altering the structure of IgFLNc10, was found. Conclusions The present description of twelve cases of early-onset restrictive cardiomyopathy with congenital myopathy and FLNC mutation, underlines a distinct unique phenotype that can be suggested as a separate clinical form of filaminopathies. Amino acid substitution A1186V, which was observed in half of the cases, defines a mutational hotspot for the reported combination of myopathy and cardiomyopathy. Several independent molecular mechanisms of FLNC mutations linked to filamin structure and function can explain the broad spectrum of FLNC-associated phenotypes. Early disease presentation and unfavorable prognosis of heart failure demanding heart transplantation make awareness of this clinical form of filaminopathy of great clinical importance. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02477-5.
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Ulrikh E, Kalinina E, Dikareva E, Komlichenko E, Li O, Zhamborova O, Rizhinashvili I, Dzharbaeva A, Govorov I, Artemenko V, Bezrukikh V, Salogub G, Pervunina T, Urmancheeva A. Personalized treatment of malignant tumors during pregnancy. Medicine (Baltimore) 2022; 101:e29803. [PMID: 35777052 PMCID: PMC9239643 DOI: 10.1097/md.0000000000029803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The combination of pregnancy and cancer is a challenge for the patient and a problematic clinical dilemma for the doctor. In this retrospective observational cohort study, we have tried to analyze our experience in the management of such patients. This review includes 41 patients with malignant neoplasms detected during pregnancy who received treatment at the Almazov National Medical Research Centre from 2015-2021. The majority of patients received treatment during pregnancy (n=26, 63.4%): chemotherapy - 19 (46.3%) (in 2 cases in combination with surgery), surgical treatment - 7 (17, 1%) patients. In most cases, delivery was at term (n=28, 68.3%). All children born at term were mature and had no growth restriction, regardless of whether the mothers received treatment during pregnancy or not. When detecting cancer during pregnancy, an immediate follow-up examination is required to assess the extent of the tumor and current fetal state. If pregnancy prolongation is requested, the treatment should not be postponed, except for systemic chemotherapy in the first trimester of pregnancy, pelvic radiation at any term.
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Affiliation(s)
- E. Ulrikh
- Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia
- North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
- *Correspondence: Elena Ulrikh, Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia (e-mail: )
| | - E. Kalinina
- Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - E. Dikareva
- Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - E. Komlichenko
- Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - O. Li
- Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - O. Zhamborova
- Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - I. Rizhinashvili
- Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - A. Dzharbaeva
- Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - I. Govorov
- Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - V. Artemenko
- Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - V. Bezrukikh
- Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - G. Salogub
- Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - T. Pervunina
- Personalised medicine center, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - A. Urmancheeva
- North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
- National Medical Research Center of Oncology named after N.N. Petrov, St. Petersburg, Russia
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8
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Pavlov V, Fyodorov S, Zavjalov S, Pervunina T, Govorov I, Komlichenko E, Deynega V, Artemenko V. Simplified Convolutional Neural Network Application for Cervix Type Classification via Colposcopic Images. Bioengineering (Basel) 2022; 9:bioengineering9060240. [PMID: 35735482 PMCID: PMC9219648 DOI: 10.3390/bioengineering9060240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/14/2022] [Accepted: 05/26/2022] [Indexed: 11/16/2022] Open
Abstract
The inner parts of the human body are usually inspected endoscopically using special equipment. For instance, each part of the female reproductive system can be examined endoscopically (laparoscopy, hysteroscopy, and colposcopy). The primary purpose of colposcopy is the early detection of malignant lesions of the cervix. Cervical cancer (CC) is one of the most common cancers in women worldwide, especially in middle- and low-income countries. Therefore, there is a growing demand for approaches that aim to detect precancerous lesions, ideally without quality loss. Despite its high efficiency, this method has some disadvantages, including subjectivity and pronounced dependence on the operator’s experience. The objective of the current work is to propose an alternative to overcoming these limitations by utilizing the neural network approach. The classifier is trained to recognize and classify lesions. The classifier has a high recognition accuracy and a low computational complexity. The classification accuracies for the classes normal, LSIL, HSIL, and suspicious for invasion were 95.46%, 79.78%, 94.16%, and 97.09%, respectively. We argue that the proposed architecture is simpler than those discussed in other articles due to the use of the global averaging level of the pool. Therefore, the classifier can be implemented on low-power computing platforms at a reasonable cost.
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Affiliation(s)
- Vitalii Pavlov
- Higher School of Applied Physics and Space Technologies, Peter the Great St. Petersburg Polytechnic University, 195251 St. Petersburg, Russia; (S.F.); (S.Z.)
- Personalised Medicine Centre, 197341 St. Petersburg, Russia; (T.P.); (I.G.); (E.K.); (V.D.); (V.A.)
- Correspondence:
| | - Stanislav Fyodorov
- Higher School of Applied Physics and Space Technologies, Peter the Great St. Petersburg Polytechnic University, 195251 St. Petersburg, Russia; (S.F.); (S.Z.)
| | - Sergey Zavjalov
- Higher School of Applied Physics and Space Technologies, Peter the Great St. Petersburg Polytechnic University, 195251 St. Petersburg, Russia; (S.F.); (S.Z.)
| | - Tatiana Pervunina
- Personalised Medicine Centre, 197341 St. Petersburg, Russia; (T.P.); (I.G.); (E.K.); (V.D.); (V.A.)
| | - Igor Govorov
- Personalised Medicine Centre, 197341 St. Petersburg, Russia; (T.P.); (I.G.); (E.K.); (V.D.); (V.A.)
| | - Eduard Komlichenko
- Personalised Medicine Centre, 197341 St. Petersburg, Russia; (T.P.); (I.G.); (E.K.); (V.D.); (V.A.)
| | - Viktor Deynega
- Personalised Medicine Centre, 197341 St. Petersburg, Russia; (T.P.); (I.G.); (E.K.); (V.D.); (V.A.)
| | - Veronika Artemenko
- Personalised Medicine Centre, 197341 St. Petersburg, Russia; (T.P.); (I.G.); (E.K.); (V.D.); (V.A.)
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9
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Jevtic S, Carr D, Dobrzycka-Ambrozewicz A, Kotulzca-Jozwiak K, Lvova O, Pervunina T, Petryaikina Y, Shishimorov I, Vlodavets D, Nally S, Ramos H, Borowsky B. SMA - TREATMENT. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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Kovalchuk T, Yakovleva E, Fetisova S, Vershinina T, Lebedeva V, Lyubimtseva T, Lebedev D, Mitrofanova L, Ryzhkov A, Sokolnikova P, Fomicheva Y, Kozyreva A, Zhuk S, Smolina N, Zlotina A, Pervunina T, Kostareva A, Vasichkina E. Case Reports: Emery-Dreifuss Muscular Dystrophy Presenting as a Heart Rhythm Disorders in Children. Front Cardiovasc Med 2021; 8:668231. [PMID: 34026875 PMCID: PMC8137911 DOI: 10.3389/fcvm.2021.668231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/07/2021] [Indexed: 01/06/2023] Open
Abstract
Emery-Dreifuss muscular dystrophy (EDMD) is inherited muscle dystrophy often accompanied by cardiac abnormalities in the form of supraventricular arrhythmias, conduction defects and sinus node dysfunction. Cardiac phenotype typically arises years after skeletal muscle presentation, though, could be severe and life-threatening. The defined clinical manifestation with joint contractures, progressive muscle weakness and atrophy, as well as cardiac symptoms are observed by the third decade of life. Still, clinical course and sequence of muscle and cardiac signs may be variable and depends on the genotype. Cardiac abnormalities in patients with EDMD in pediatric age are not commonly seen. Here we describe five patients with different forms of EDMD (X-linked and autosomal-dominant) caused by the mutations in EMD and LMNA genes, presented with early onset of cardiac abnormalities and no prominent skeletal muscle phenotype. The predominant forms of cardiac pathology were atrial arrhythmias and conduction disturbances that progress over time. The presented cases discussed in the light of therapeutic strategy, including radiofrequency ablation and antiarrhythmic devices implantation, and the importance of thorough neurological and genetic screening in pediatric patients presenting with complex heart rhythm disorders.
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Affiliation(s)
- Tatiana Kovalchuk
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Elena Yakovleva
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Svetlana Fetisova
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Tatiana Vershinina
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Viktoriya Lebedeva
- Institute of Heart and Vessels, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Tamara Lyubimtseva
- Institute of Heart and Vessels, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Dmitriy Lebedev
- Institute of Heart and Vessels, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Lubov Mitrofanova
- Pathology Unit, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Anton Ryzhkov
- Radiology Unit, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Polina Sokolnikova
- Institute of Molecular biology and Genetics, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Yuliya Fomicheva
- Institute of Molecular biology and Genetics, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Alexandra Kozyreva
- Institute of Molecular biology and Genetics, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Sergey Zhuk
- Institute of Molecular biology and Genetics, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Natalia Smolina
- Institute of Molecular biology and Genetics, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Anna Zlotina
- Institute of Molecular biology and Genetics, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Tatiana Pervunina
- Institute of Perinatology and Pediatrics, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Anna Kostareva
- Institute of Molecular biology and Genetics, Almazov National Medical Research Centre, Saint Petersburg, Russia.,Department of Women's and Children's Health and Center for Molecular Medicine, Karolinska Institutet, Solna, Sweden
| | - Elena Vasichkina
- World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
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11
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Khudiakov A, Zaytseva A, Perepelina K, Smolina N, Pervunina T, Vasichkina E, Karpushev A, Tomilin A, Malashicheva A, Kostareva A. Sodium current abnormalities and deregulation of Wnt/β-catenin signaling in iPSC-derived cardiomyocytes generated from patient with arrhythmogenic cardiomyopathy harboring compound genetic variants in plakophilin 2 gene. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165915. [PMID: 32768677 DOI: 10.1016/j.bbadis.2020.165915] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 06/29/2020] [Accepted: 08/01/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Mutations in desmosomal genes linked to arrhythmogenic cardiomyopathy are commonly associated with Wnt/β-catenin signaling abnormalities and reduction of the sodium current density. Inhibitors of GSK3B were reported to restore sodium current and improve heart function in various arrhythmogenic cardiomyopathy models, but mechanisms underlying this effect remain unclear. We hypothesized that there is a crosstalk between desmosomal proteins, signaling pathways, and cardiac sodium channels. METHODS AND RESULTS To reveal molecular mechanisms of arrhythmogenic cardiomyopathy, we established human iPSC-based model of this pathology. iPSC-derived cardiomyocytes from patient carrying two genetic variants in PKP2 gene demonstrated that PKP2 haploinsufficiency due to frameshift variant, in combination with the missense variant expressed from the second allele, was associated with decreased Wnt/β-catenin activity and reduced sodium current. Different approaches were tested to restore impaired cardiomyocytes functions, including wild type PKP2 transduction, GSK3B inhibition and Wnt/β-catenin signaling modulation. Inhibition of GSK3B led to the restoration of both Wnt/β-catenin signaling activity and sodium current density in patient-specific cardiomyocytes while GSK3B activation led to the reduction of sodium current density. Moreover, we found that upon inhibition GSK3B sodium current was restored through Wnt/β-catenin-independent mechanism. CONCLUSION We propose that alterations in GSK3B-Wnt/β-catenin signaling pathways lead to regulation of sodium current implying its role in molecular pathogenesis of arrhythmogenic cardiomyopathy.
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Affiliation(s)
| | - Anastasia Zaytseva
- Almazov National Medical Research Centre, Saint-Petersburg, Russia; Sechenov Institute of Evolutionary Physiology and Biochemistry RAS, Saint-Petersburg, Russia
| | - Kseniya Perepelina
- Almazov National Medical Research Centre, Saint-Petersburg, Russia; Saint Petersburg State University, Saint-Petersburg, Russia
| | - Natalia Smolina
- Almazov National Medical Research Centre, Saint-Petersburg, Russia; Department of Women's and Children's Health, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | | | - Elena Vasichkina
- Almazov National Medical Research Centre, Saint-Petersburg, Russia
| | - Alexey Karpushev
- Almazov National Medical Research Centre, Saint-Petersburg, Russia
| | | | - Anna Malashicheva
- Almazov National Medical Research Centre, Saint-Petersburg, Russia; Saint Petersburg State University, Saint-Petersburg, Russia; Institute of Cytology RAS, Saint-Petersburg, Russia
| | - Anna Kostareva
- Almazov National Medical Research Centre, Saint-Petersburg, Russia; Department of Women's and Children's Health, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
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12
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Kozyrev I, Dokshin P, Kostina A, Kiselev A, Ignatieva E, Golovkin A, Pervunina T, Grekhov E, Gordeev M, Kostareva A, Malashicheva A. Insights Image for "Dysregulation of Notch signaling in cardiac mesenchymal cells of patients with Tetralogy of Fallot". Pediatr Res 2020; 88:139. [PMID: 32170193 DOI: 10.1038/s41390-020-0848-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Ivan Kozyrev
- Almazov National Medical Research Centre, St. Petersburg, Russia
| | - Pavel Dokshin
- Almazov National Medical Research Centre, St. Petersburg, Russia.,Saint Petersburg State University, Faculty of Biology, St. Petersburg, Russia
| | - Aleksandra Kostina
- Almazov National Medical Research Centre, St. Petersburg, Russia.,Institute of Cytology, Russian Academy of Sciences, St. Petersburg, Russia
| | - Artem Kiselev
- Almazov National Medical Research Centre, St. Petersburg, Russia
| | - Elena Ignatieva
- Almazov National Medical Research Centre, St. Petersburg, Russia
| | - Alexey Golovkin
- Almazov National Medical Research Centre, St. Petersburg, Russia
| | | | - Evgeny Grekhov
- Almazov National Medical Research Centre, St. Petersburg, Russia
| | - Mikhail Gordeev
- Almazov National Medical Research Centre, St. Petersburg, Russia
| | - Anna Kostareva
- Almazov National Medical Research Centre, St. Petersburg, Russia
| | - Anna Malashicheva
- Almazov National Medical Research Centre, St. Petersburg, Russia. .,Saint Petersburg State University, Faculty of Biology, St. Petersburg, Russia. .,Institute of Cytology, Russian Academy of Sciences, St. Petersburg, Russia.
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13
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Klauzen P, Perepelina K, Khudiakov A, Zlotina A, Fomicheva Y, Pervunina T, Vershinina T, Kostareva A, Malashicheva A. Generation of two induced pluripotent stem cell lines (FAMRCi005-A and FAMRCi005-B) from patient carrying genetic variant LMNA p.Asp357Val. Stem Cell Res 2020; 43:101719. [PMID: 32062135 DOI: 10.1016/j.scr.2020.101719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/13/2020] [Accepted: 01/25/2020] [Indexed: 11/25/2022] Open
Abstract
LMNA mutations are often linked to laminopathies characterized by tissue-specific disorders. We generated two induced pluripotent stem cells lines from patient carrying genetic variant LMNA p.Asp357Val associated with paroxysmal ventricular tachycardia and myopathy. Reprogramming of patient's peripheral blood mononuclear cells was performed using Sendai viruses. Characterization of the FAMRCi005-A and FAMRCi005-B lines revealed that generated iPSC lines expressed pluripotent stem cell markers, had normal karyotype and demonstrated triliniage differentiation ability. Generated cell lines can be used to investigate the molecular links between LMNA genetic variants and cardiac disorders.
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Affiliation(s)
- Polina Klauzen
- Saint Petersburg State University, Saint-Petersburg, Russian Federation; Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation; Institute of Cytology RAS, Saint-Petersburg, Russian Federation
| | - Kseniya Perepelina
- Saint Petersburg State University, Saint-Petersburg, Russian Federation; Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation.
| | - Aleksandr Khudiakov
- Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation
| | - Anna Zlotina
- Saint Petersburg State University, Saint-Petersburg, Russian Federation; Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation
| | - Yulia Fomicheva
- Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation
| | - Tatiana Pervunina
- Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation
| | - Tatiana Vershinina
- Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation
| | - Anna Kostareva
- Saint Petersburg State University, Saint-Petersburg, Russian Federation; Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation
| | - Anna Malashicheva
- Saint Petersburg State University, Saint-Petersburg, Russian Federation; Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation; Institute of Cytology RAS, Saint-Petersburg, Russian Federation
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14
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Irtyuga O, Sefieva J, Karelkina E, Gabrelyan A, Bautin A, Yakubov A, Li O, Pervunina T, Zazerskaya I, Moiseeva O. P2535Pregnant patients with pulmonary hypertension-the case of a medical centre. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Nowadays, Pulmonary Hypertension (PH) is one of the most pressing issues in cardiovascular disease. Subsequently, pregnant women have a high degree of risk of morbidity and mortality and this poses a big challenge. Studies show that very often PH occurs due to congenital heart disease and for this reason, it is recommended to avoid pregnancy or to terminate the pregnancy at an early stage. Women who choose to remain pregnant should be treated at specialized PH centers with the experience of managing PH during and after pregnancy.
Purpose
The main purpose of this study was to estimate the survival of pregnant pts with PH depending on the severity of PH and etiology.
Methods
8336 women during delivery on admission were screened from the period spanning January 2014 to December 2016. Of this number, 4268 (51%) the medical records of pregnant women with cardiovascular disease were retrospectively reviewed to identify patients with coexisting PH and pregnancies. Data on 98 (1.18%) pts with PH were identified and included in the study. All patients' PH severity was measured by Doppler echocardiography. Pulmonary artery systolic pressure value of 35 to 50 mm Hg, 51 to 70 mm Hg, or greater than 71 mm Hg measured by echocardiography corresponded to the mild, moderate, or severe PH, respectively. Demographics, characteristics of PH and pregnancy, management and outcomes were as well analyzed.
Results
54 cases (55%) were classified into WHO group 1, 40 cases (41%) in group 2 (reason –left heart disease), 4 cases (4%) in group 4 (reason - pulmonary thromboembolism), and none in group 3 or 5. The systolic pulmonary artery pressure was <50 mmHg in 70,4% of patients, 51–70 mmHg in 18,4% and ≥70 mmHg in 11,2% The median age was 28 years. All deaths occurred in women with PH in WHO group 1, with moderate or severe PH severity, and with NYHA grade of III to IV. Pulmonary vascular-targeted medications were used in all pts with severe PH and in some cases with moderate PH 14 pts (14%), but none was administered to pts with mild PH. During pregnancy, 9 pts took monotherapy of the sildenafil but 1 pregnant patient took a combination of therapy with iloprost. After delivery, 14 pts took monotherapy and 9 took combination therapy. This notwithstanding, 3 pts who took the combination therapy (3%), died within 15 days after delivery (9,14,15 days, respectively). All of them died from uncontrolled PH and heart failure after delivery.
Conclusion
Our study shows that maternal mortality is associated with the severity of PH. Mortality in pregnant patients with pulmonary hypertension is still the most discussed problem in cardiology and obstetrics. It is necessary to diagnose this disease at an early stage, prevent pregnancy in pts with severe to moderate PH as much as possible, continue observation, adequately apply therapy in order to help curtail this problem.
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Affiliation(s)
- O Irtyuga
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - J Sefieva
- Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russian Federation
| | - E Karelkina
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - A Gabrelyan
- Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russian Federation
| | - A Bautin
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - A Yakubov
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - O Li
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - T Pervunina
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - I Zazerskaya
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - O Moiseeva
- Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
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15
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Peters T, Jevtic S, Carr D, Kieloch A, Valentin M, Dobrzycka-Ambrozevicz A, Kotulska-Jóźwiak K, Litvinenko I, Lvova O, Pervunina T, Petryaikina E, Shishimorov I, Vlodavets D, Kakarieka A. P.274Serum neurofilament light chain in type 1 spinal muscular atrophy: second part of a branaplam phase II study. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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16
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Kiselev A, Vaz R, Knyazeva A, Khudiakov A, Tarnovskaya S, Liu J, Sergushichev A, Kazakov S, Frishman D, Smolina N, Pervunina T, Jorholt J, Sjoberg G, Vershinina T, Rudenko D, Arner A, Sejersen T, Lindstrand A, Kostareva A. De novo mutations in FLNC
leading to early-onset restrictive cardiomyopathy and congenital myopathy. Hum Mutat 2018; 39:1161-1172. [DOI: 10.1002/humu.23559] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 05/22/2018] [Accepted: 05/30/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Artem Kiselev
- Almazov National Medical Research Centre; Saint Petersburg Russia
| | - Raquel Vaz
- Department of Molecular Medicine and Surgery and Center for molecular medicine; Karolinska Institutet; Stockholm Sweden
| | | | | | - Svetlana Tarnovskaya
- Almazov National Medical Research Centre; Saint Petersburg Russia
- Peter the Great St.Petersburg Polytechnic University; Saint Petersburg Russia
| | - Jiao Liu
- Department of Physiology and Pharmacology; Karolinska Institutet; Stockholm Sweden
| | | | | | - Dmitrij Frishman
- Peter the Great St.Petersburg Polytechnic University; Saint Petersburg Russia
- Department of Bioinformatics; Technische Universität München; Wissenschaftszentrum Weihenstephan; Freising Germany
| | - Natalia Smolina
- Almazov National Medical Research Centre; Saint Petersburg Russia
- ITMO University; Saint Petersburg Russia
- Department of Women's and Children's Health and Center for Molecular Medicine; Karolinska Institute; Stockholm Sweden
| | | | - John Jorholt
- Department of Women's and Children's Health and Center for Molecular Medicine; Karolinska Institute; Stockholm Sweden
| | - Gunnar Sjoberg
- Department of Women's and Children's Health and Center for Molecular Medicine; Karolinska Institute; Stockholm Sweden
| | | | | | - Anders Arner
- Department of Physiology and Pharmacology; Karolinska Institutet; Stockholm Sweden
| | - Thomas Sejersen
- Department of Women's and Children's Health and Center for Molecular Medicine; Karolinska Institute; Stockholm Sweden
| | - Anna Lindstrand
- Department of Molecular Medicine and Surgery and Center for molecular medicine; Karolinska Institutet; Stockholm Sweden
- Clinical Genetics; Karolinska University Laboratory; Karolinska University Hospital; Stockholm Sweden
| | - Anna Kostareva
- Almazov National Medical Research Centre; Saint Petersburg Russia
- Department of Women's and Children's Health and Center for Molecular Medicine; Karolinska Institute; Stockholm Sweden
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17
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Kiselev A, Kornishina T, Sergushichev A, Smolina N, Klyushina A, Pervunina T, Bang ML, Sjoberg G, Sejersen T, Kostareva A. P72New variant in CMYA5 gene is associated with early-onset restrictive cardiomyopathy and autism-spectrum disorder. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Kiselev
- Almazov Federal Centre of Heart, Blood and Endocrinology, St. Petersburg, Russian Federation
| | - T Kornishina
- Pediatriuc Medical Academy, St. Petersburg, Russian Federation
| | - A Sergushichev
- ITMO University, Computer Science, ST. Petersburg, Russian Federation
| | - N Smolina
- Almazov Federal Centre of Heart, Blood and Endocrinology, St. Petersburg, Russian Federation
| | - A Klyushina
- Almazov Federal Centre of Heart, Blood and Endocrinology, St. Petersburg, Russian Federation
| | - T Pervunina
- Almazov Federal Centre of Heart, Blood and Endocrinology, St. Petersburg, Russian Federation
| | - M L Bang
- UOS of Milan and Humanitas Clinical and Research Center, Milan, Italy
| | - G Sjoberg
- Karolinska Institute, Stockholm, Sweden
| | | | - A Kostareva
- Almazov Federal Centre of Heart, Blood and Endocrinology, St. Petersburg, Russian Federation
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18
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Zlotina A, Pervunina T, Grekhov E, Kozyrev I, Kostareva A. P251Genomic microimbalances in children with combined congenital heart and kidney defects. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Zlotina
- Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation
| | - T Pervunina
- Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation
| | - E Grekhov
- Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation
| | - I Kozyrev
- Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation
| | - A Kostareva
- Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation
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19
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Khudiakov A, Kostina D, Zlotina A, Yany N, Sergushichev A, Pervunina T, Tomilin A, Kostareva A, Malashicheva A. Generation of iPSC line from patient with arrhythmogenic right ventricular cardiomyopathy carrying mutations in PKP2 gene. Stem Cell Res 2017; 24:85-88. [DOI: 10.1016/j.scr.2017.08.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/11/2017] [Accepted: 08/17/2017] [Indexed: 01/22/2023] Open
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20
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Kiselev A, Knyazeva A, Sergushichev A, Hudiakov A, Pervunina T, Vershinina T, Nikitina I, Rudenko D, Vasichkina E, Jornholt J, Sjoberg G, Sejersen T, Kostareva A. P5404Hotspot mutation in FLNC gene as a cause of restrictive cardiomyopathy associated with congenital myopathy development. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Zlotina A, Nikulina T, Yany N, Moiseeva O, Pervunina T, Grekhov E, Kostareva A. Ring chromosome 18 in combination with 18q12.1 (DTNA) interstitial microdeletion in a patient with multiple congenital defects. Mol Cytogenet 2016; 9:18. [PMID: 26893613 PMCID: PMC4758088 DOI: 10.1186/s13039-016-0229-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/10/2016] [Indexed: 11/20/2022] Open
Abstract
Background Ring chromosome 18 [r(18)] syndrome represents a relatively rare condition with a complex clinical picture including multiple congenital dysmorphia and varying degrees of mental retardation. The condition is cytogenetically characterized by a complete or mosaic form of ring chromosome 18, with ring formation being usually accompanied by the partial loss of both chromosomal arms. Here we observed a 20-year-old male patient who along with the features typical for r(18) carriers additionally manifested a severe congenital subaortic stenosis. To define the genetic basis of such a compound phenotype, standard cytogenetic and high-resolution molecular-cytogenetic analysis of the patient was performed. Case presentation Standard chromosome analysis of cultured lymphocytes confirmed 46, XY, r(18) karyotype. Array-based comparative genomic hybridization (array-CGH) allowed to define precisely the breakpoints of 18p and 18q terminal deletions, thus identifying the hemizygosity extent, and to reveal an additional duplication adjoining the breakpoint of the 18p deletion. Apart from the terminal imbalances, we found an interstitial microdeletion of 442 kb in size (18q12.1) that encompassed DTNA gene encoding α-dystrobrevin, a member of dystrophin-associated glycoprotein complex. While limited data on the role of DTNA missense mutations in pathogenesis of human cardiac abnormalities exist, a microdeletion corresponding to whole DTNA sequence and not involving other genes has not been earlier described. Conclusions A detailed molecular-cytogenetic characterization of the patient with multiple congenital abnormalities enabled to unravel a combination of genetic defects, namely, a ring chromosome 18 with terminal imbalances and DTNA whole-gene deletion. We suggest that such combination could contribute to the complex phenotype. The findings obtained allow to extend the knowledge of the role of DTNA haploinsufficiency in congenital heart malformation, though further comprehensive functional studies are required. Electronic supplementary material The online version of this article (doi:10.1186/s13039-016-0229-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Zlotina
- Almazov Federal Medical Research Centre, Saint-Petersburg, 197341 Russia ; Institute of translational Medicine, ITMO University, Saint-Petersburg, 199034 Russia ; Cytology and Histology Department, Saint Petersburg State University, Saint-Petersburg, 199034 Russia
| | - Tatiana Nikulina
- Almazov Federal Medical Research Centre, Saint-Petersburg, 197341 Russia
| | - Natalia Yany
- Almazov Federal Medical Research Centre, Saint-Petersburg, 197341 Russia
| | - Olga Moiseeva
- Almazov Federal Medical Research Centre, Saint-Petersburg, 197341 Russia
| | - Tatiana Pervunina
- Almazov Federal Medical Research Centre, Saint-Petersburg, 197341 Russia
| | - Eugeny Grekhov
- Almazov Federal Medical Research Centre, Saint-Petersburg, 197341 Russia
| | - Anna Kostareva
- Almazov Federal Medical Research Centre, Saint-Petersburg, 197341 Russia ; Department of Women's and Children's Health, Center for Molecular Medicine, Karolinska Institute, Stockholm, 17176 Sweden
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Pervunina T, Vershinina T, Kiselev A, Nikitina I, Grekhov E, Mitrofanova L, Sjoberg G, Kostareva A. Neonatal hypertrophic cardiomyopathy caused by double mutation in RAS pathway genes. Int J Cardiol 2015; 184:272-273. [DOI: 10.1016/j.ijcard.2015.02.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 02/21/2015] [Indexed: 11/15/2022]
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