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Boga M, Suhai FI, Orbán G, Salló Z, Nagy KV, Szegedi L, Jokkel Z, Csőre J, Osztheimer I, Perge P, Gupta D, Merkely B, Gellér L, Szegedi N. Incidence and predictors of stroke and silent cerebral embolism following very high-power short-duration atrial fibrillation ablation. Europace 2023; 25:euad327. [PMID: 37931067 PMCID: PMC10653180 DOI: 10.1093/europace/euad327] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/22/2023] [Accepted: 10/02/2023] [Indexed: 11/08/2023] Open
Abstract
AIMS Cerebral thrombo-embolism is a dreaded complication of pulmonary vein isolation (PVI) for atrial fibrillation; its surrogate, silent cerebral embolism (SCE) can be detected by diffusion-weighted brain magnetic resonance imaging (bMRI). Initial investigations have raised a concern that very high-power, short-duration (vHPSD; 90 W/4 s) temperature-controlled PVI with the QDOT Micro catheter may be associated with a higher incidence of SCE compared with low-power long-duration ablation. We aimed to assess the incidence of procedural complications of vHPSD PVI with an emphasis on cerebral safety. METHODS AND RESULTS We enrolled 328 consecutive patients undergoing their PVI procedure using vHPSD. A subgroup of 61 consecutive patients underwent diffusion-weighted bMRI within 24 h of the procedure, and incidence and predictors of SCE were studied. The mean procedure time and left atrial dwell time for the overall cohort were 69.6 ± 24.1 and 46.5 ± 21.5 min, respectively. First-pass isolation was achieved in 82%. No stroke or transient ischaemic attack occurred. Silent cerebral embolism was identified in 5 of 61 patients (8.2%). Silent cerebral embolism following procedures was significantly associated with lower baseline generator impedance (105.8 vs. 112.6 Ω, P < 0.0001) and with intermittent loss of catheter-tissue contact during ablation (14.1% vs. 6.1%, P < 0.0001). CONCLUSION Very high-power, short-duration PVI is a safe technique with an excellent acute success rate. Silent cerebral embolism incidence in our cohort was below the previously reported range, with no clinically overt cerebral complications. Lower baseline generator impedance and loss of contact during ablation may contribute to a higher risk of SCEs.
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Affiliation(s)
- Márton Boga
- Heart and Vascular Center, Semmelweis University, Városmajor u. 68., Budapest 1122, Hungary
| | - Ferenc Imre Suhai
- Heart and Vascular Center, Semmelweis University, Városmajor u. 68., Budapest 1122, Hungary
| | - Gábor Orbán
- Heart and Vascular Center, Semmelweis University, Városmajor u. 68., Budapest 1122, Hungary
| | - Zoltán Salló
- Heart and Vascular Center, Semmelweis University, Városmajor u. 68., Budapest 1122, Hungary
| | - Klaudia Vivien Nagy
- Heart and Vascular Center, Semmelweis University, Városmajor u. 68., Budapest 1122, Hungary
| | - Levente Szegedi
- Heart and Vascular Center, Semmelweis University, Városmajor u. 68., Budapest 1122, Hungary
| | - Zsófia Jokkel
- Heart and Vascular Center, Semmelweis University, Városmajor u. 68., Budapest 1122, Hungary
| | - Judit Csőre
- Heart and Vascular Center, Semmelweis University, Városmajor u. 68., Budapest 1122, Hungary
| | - István Osztheimer
- Heart and Vascular Center, Semmelweis University, Városmajor u. 68., Budapest 1122, Hungary
| | - Péter Perge
- Heart and Vascular Center, Semmelweis University, Városmajor u. 68., Budapest 1122, Hungary
| | - Dhiraj Gupta
- Liverpool Heart and Chest Hospital, University of Liverpool, Liverpool, UK
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Városmajor u. 68., Budapest 1122, Hungary
| | - László Gellér
- Heart and Vascular Center, Semmelweis University, Városmajor u. 68., Budapest 1122, Hungary
| | - Nándor Szegedi
- Heart and Vascular Center, Semmelweis University, Városmajor u. 68., Budapest 1122, Hungary
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Behon A, Merkel ED, Schwertner WR, Kuthi LK, Veres B, Masszi R, Kovács A, Lakatos BK, Zima E, Gellér L, Kosztin A, Merkely B. Long-term outcome of cardiac resynchronization therapy patients in the elderly. GeroScience 2023; 45:2289-2301. [PMID: 36800059 PMCID: PMC10651580 DOI: 10.1007/s11357-023-00739-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 01/19/2023] [Indexed: 02/18/2023] Open
Abstract
Heart failure (HF) is a leading cause of mortality and hospitalization in the elderly. However, data are scarce about their response to device treatment such as cardiac resynchronization therapy (CRT). We aimed to evaluate the age-related differences in the effectiveness of CRT, procedure-related complications, and long-term outcome. Between 2000 and 2020, 2656 patients undergoing CRT implantation were registered and analyzed retrospectively. Patients were divided into 3 groups according to their age: group I, < 65; group II, 65-75; and group III, > 75 years. The primary endpoint was the echocardiographic response defined as a relative increase > 15% in left ventricular ejection fraction (LVEF) within 6 months, and the secondary endpoint was the composite of all-cause mortality, heart transplantation, or left ventricular assist device implantation. Procedure-related complications were also assessed. After implantation, LVEF showed significant improvement both in the total cohort [28% (IQR 24/33) vs. 35% (IQR 28/40); p < 0.01)] and in each subgroup (27% vs. 34%; p < 0.01, 29% vs. 35%; p < 0.01, 30% vs. 35%; p < 0.01). Response rate was similar in the 3 groups (64% vs. 62% vs. 56%; p = 0.41). During the follow-up, 1574 (59%) patients died. Kaplan-Meier curves revealed a significantly lower survival rate in the older groups (log-rank p < 0.001). The cumulative complication rates were similar among the three age groups (27% vs. 28% vs. 24%; p = 0.15). Our results demonstrate that CRT is as effective and safe therapy in the elderly as for young ones. The present data suggest that patients with appropriate indications benefit from CRT in the long term, regardless of age.
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Affiliation(s)
- Anett Behon
- Heart and Vascular Center, Semmelweis University, Varosmajor 68 H-1122, Budapest, Hungary
| | - Eperke Dóra Merkel
- Heart and Vascular Center, Semmelweis University, Varosmajor 68 H-1122, Budapest, Hungary
| | | | - Luca Katalin Kuthi
- Heart and Vascular Center, Semmelweis University, Varosmajor 68 H-1122, Budapest, Hungary
| | - Boglárka Veres
- Heart and Vascular Center, Semmelweis University, Varosmajor 68 H-1122, Budapest, Hungary
| | - Richard Masszi
- Heart and Vascular Center, Semmelweis University, Varosmajor 68 H-1122, Budapest, Hungary
| | - Attila Kovács
- Heart and Vascular Center, Semmelweis University, Varosmajor 68 H-1122, Budapest, Hungary
| | - Bálint Károly Lakatos
- Heart and Vascular Center, Semmelweis University, Varosmajor 68 H-1122, Budapest, Hungary
| | - Endre Zima
- Heart and Vascular Center, Semmelweis University, Varosmajor 68 H-1122, Budapest, Hungary
| | - László Gellér
- Heart and Vascular Center, Semmelweis University, Varosmajor 68 H-1122, Budapest, Hungary
| | - Annamária Kosztin
- Heart and Vascular Center, Semmelweis University, Varosmajor 68 H-1122, Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Varosmajor 68 H-1122, Budapest, Hungary.
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Saado I, Chia KS, Betz R, Alcântara A, Pettkó-Szandtner A, Navarrete F, D'Auria JC, Kolomiets MV, Melzer M, Feussner I, Djamei A. Effector-mediated relocalization of a maize lipoxygenase protein triggers susceptibility to Ustilago maydis. Plant Cell 2022; 34:2785-2805. [PMID: 35512341 PMCID: PMC9252493 DOI: 10.1093/plcell/koac105] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/17/2022] [Indexed: 05/07/2023]
Abstract
As the gall-inducing smut fungus Ustilago maydis colonizes maize (Zea mays) plants, it secretes a complex effector blend that suppresses host defense responses, including production of reactive oxygen species (ROS) and redirects host metabolism to facilitate colonization. We show that the U. maydis effector ROS burst interfering protein 1 (Rip1), which is involved in pathogen-associated molecular pattern (PAMP)-triggered suppression of host immunity, is functionally conserved in several other monocot-infecting smut fungi. We also have identified a conserved C-terminal motif essential for Rip1-mediated PAMP-triggered suppression of the ROS burst. The maize susceptibility factor lipoxygenase 3 (Zmlox3) bound by Rip1 was relocalized to the nucleus, leading to partial suppression of the ROS burst. Relocalization was independent of its enzymatic activity, revealing a distinct function for ZmLox3. Most importantly, whereas Zmlox3 maize mutant plants showed increased resistance to U. maydis wild-type strains, rip1 deletion strains infecting the Zmlox3 mutant overcame this effect. This could indicate that Rip1-triggered host resistance depends on ZmLox3 to be suppressed and that lox3 mutation-based resistance of maize to U. maydis requires functional Rip1. Together, our results reveal that Rip1 acts in several cellular compartments to suppress immunity and that targeting of ZmLox3 by Rip1 is responsible for the suppression of Rip1-dependent reduced susceptibility of maize to U. maydis.
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Affiliation(s)
- Indira Saado
- Gregor Mendel Institute (GMI), Austrian Academy of Sciences (OEAW), Vienna BioCenter 7(VBC),Vienna 1030, Austria
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Stadt Seeland D-06466, Germany
| | - Khong-Sam Chia
- Gregor Mendel Institute (GMI), Austrian Academy of Sciences (OEAW), Vienna BioCenter 7(VBC),Vienna 1030, Austria
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Stadt Seeland D-06466, Germany
| | - Ruben Betz
- Gregor Mendel Institute (GMI), Austrian Academy of Sciences (OEAW), Vienna BioCenter 7(VBC),Vienna 1030, Austria
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Stadt Seeland D-06466, Germany
| | - André Alcântara
- Gregor Mendel Institute (GMI), Austrian Academy of Sciences (OEAW), Vienna BioCenter 7(VBC),Vienna 1030, Austria
| | | | - Fernando Navarrete
- Gregor Mendel Institute (GMI), Austrian Academy of Sciences (OEAW), Vienna BioCenter 7(VBC),Vienna 1030, Austria
| | - John C D'Auria
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Stadt Seeland D-06466, Germany
| | | | - Michael Melzer
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Stadt Seeland D-06466, Germany
| | - Ivo Feussner
- Department of Plant Biochemistry, University of Göttingen, Albrecht-von-Haller Institute for Plant Sciences and Goettingen Center for Molecular Biosciences (GZMB), Göttingen 37077, Germany
| | - Armin Djamei
- Gregor Mendel Institute (GMI), Austrian Academy of Sciences (OEAW), Vienna BioCenter 7(VBC),Vienna 1030, Austria
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Stadt Seeland D-06466, Germany
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Kassay N, Toldi V, Tőzsér J, Szabó A. Cigarette smoke toxin hydroquinone and misfolding pancreatic lipase variant cooperatively promote endoplasmic reticulum stress and cell death. PLoS One 2022; 17:e0269936. [PMID: 35704637 PMCID: PMC9200355 DOI: 10.1371/journal.pone.0269936] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/31/2022] [Indexed: 01/07/2023] Open
Abstract
Mutation-induced protein misfolding of pancreatic secretory enzymes and consequent endoplasmic reticulum stress can cause chronic pancreatitis. A recent study revealed that cigarette smoke also increases the risk of the disease through endoplasmic reticulum stress. Here, we investigated the cumulative cellular effect of the G233E misfolding human pancreatic lipase variant and hydroquinone; a main toxic constituent of cigarette smoke, using mammalian cell lines. We found that hydroquinone reduces cell viability on a dose-dependent manner through programmed cell death, and diminishes lipase secretion without affecting its expression. Interestingly, hydroquinone decreased the viability more markedly in cells expressing the G233E lipase variant, than in cells producing wild-type lipase. The more substantial viability loss was due to increased endoplasmic reticulum stress, as demonstrated by elevated levels of X-box binding protein 1 mRNA splicing and immunoglobulin binding protein, NAD(P)H:quinone oxidoreductase 1 and C/EBP homologous protein expression. Unresolved endoplasmic reticulum stress, and especially up-regulation of the pro-apoptotic transcription factor C/EBP homologous protein were likely responsible for the increased cell death. Our observations demonstrated that the combination of hydroquinone and misfolding pancreatic lipase variant promote increased levels of endoplasmic reticulum stress and cell death, which may predispose to chronic pancreatitis.
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Affiliation(s)
- Norbert Kassay
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Molecular, Cell and Immune Biology, University of Debrecen, Debrecen, Hungary
| | - Vanda Toldi
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Molecular, Cell and Immune Biology, University of Debrecen, Debrecen, Hungary
| | - József Tőzsér
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - András Szabó
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Lisztes E, Mező E, Demeter F, Horváth L, Bősze S, István Tóth B, Borbás A, Herczeg M. Synthesis and Cell Growth Inhibitory Activity of Six Non-glycosaminoglycan-Type Heparin-Analogue Trisaccharides. ChemMedChem 2021; 16:1467-1476. [PMID: 33433040 PMCID: PMC8247843 DOI: 10.1002/cmdc.202000917] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/11/2021] [Indexed: 12/27/2022]
Abstract
The design and synthesis of heparin mimetics with high anticancer activity but no anticoagulant activity is an important task in medicinal chemistry. Herein, we present the efficient synthesis of five Glc-GlcA-Glc-sequenced and one Glc-IdoA-Glc-sequenced non-glycosaminoglycan, heparin-related trisaccharides with various sulfation/sulfonylation and methylation patterns. The cell growth inhibitory effects of the compounds were tested against four cancerous human cell lines and two non-cancerous cell lines. Two d-glucuronate-containing tetra-O-sulfated, partially methylated trisaccharides displayed remarkable and selective inhibitory effects on the growth of ovary carcinoma (A2780) and melanoma (WM35) cells. Methyl substituents on the glucuronide unit proved to be detrimental, whereas acetyl substituents were beneficial to the cytostatic activity of the sulfated derivatives.
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Affiliation(s)
- Erika Lisztes
- Department of PhysiologyUniversity of Debrecen PO Box 224012DebrecenHungary
| | - Erika Mező
- Department of Pharmaceutical ChemistryUniversity of DebrecenEgyetem tér 14032DebrecenHungary
| | - Fruzsina Demeter
- Department of Pharmaceutical ChemistryUniversity of DebrecenEgyetem tér 14032DebrecenHungary
- Doctoral School of ChemistryUniversity of DebrecenEgyetem tér 14032DebrecenHungary
- MTA-DE Molecular Recognition and Interaction Research Group, ELKHUniversity of DebrecenEgyetem tér 14032DebrecenHungary
| | - Lilla Horváth
- MTA-ELTE Research Group of Peptide ChemistryEötvös Loránd UniversityPázmány Péter sétány 1/a1117BudapestHungary
| | - Szilvia Bősze
- MTA-ELTE Research Group of Peptide ChemistryEötvös Loránd UniversityPázmány Péter sétány 1/a1117BudapestHungary
| | - Balázs István Tóth
- Department of PhysiologyUniversity of Debrecen PO Box 224012DebrecenHungary
| | - Anikó Borbás
- Department of Pharmaceutical ChemistryUniversity of DebrecenEgyetem tér 14032DebrecenHungary
| | - Mihály Herczeg
- Department of Pharmaceutical ChemistryUniversity of DebrecenEgyetem tér 14032DebrecenHungary
- MTA-DE Research Group for Oligosaccharide Chemistry, ELKHEgyetem tér 14032DebrecenHungary
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Tuboly E, Gáspár R, Ibor MO, Gömöri K, Kiss B, Strifler G, Hartmann P, Ferdinandy P, Bartekova M, Boros M, Görbe A. L-Alpha-glycerylphosphorylcholine can be cytoprotective or cytotoxic in neonatal rat cardiac myocytes: a double-edged sword phenomenon. Mol Cell Biochem 2019; 460:195-203. [PMID: 31280435 PMCID: PMC6745025 DOI: 10.1007/s11010-019-03580-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 06/25/2019] [Indexed: 12/12/2022]
Abstract
l-Alpha-glycerylphosphorylcholine (GPC) is a widely used food supplement. GPC has been shown to exert beneficial effects in several organs; however, the cardiac effects of GPC have yet to be investigated. The aim of the present study was therefore to map out the effects of GPC on cardiac myocytes, with or without ischemia–reperfusion insult. Neonatal rat cardiac myocytes were treated with GPC at 1, 10, 80, and 100 µM concentrations for 15 min, 3 h, or 24 h, respectively. Cell viability by calcein assay and the degree of oxidative stress by DHE (superoxide level) and H2DCF (total ROS accumulation) staining were measured. In separate experiments, cardiomyocytes were pre-treated with the optimal concentration of GPC for 3 h and then cells were exposed to 4 h of simulated ischemia followed by 2 h of reperfusion (SI/R). Cell viability was measured at the end of the SI/R protocol. In normoxic conditions, the 15-min and the 3-h GPC treatment did not affect cell viability, total ROS, and superoxide levels. Under SI/R conditions, the 3-h GPC treatment protected the cardiac myocytes from SI/R-induced cell death and did not alter the level of oxidative stress. The 24-h GPC treatment in normoxic conditions resulted in significant cell death and increased oxidative stress at each concentration. Here we provide the first evidence for the cytoprotective effect of short-term GPC treatment. However, long-term administration of GPC may exert cytotoxicity in a wide concentration range in cardiac myocytes. These results may draw attention to a comprehensive cardiac safety protocol for the testing of GPC.
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Affiliation(s)
- Eszter Tuboly
- Faculty of Medicine, Institute of Surgical Research, University of Szeged, Szeged, Hungary
| | - Renáta Gáspár
- Cardiovascular Research Group, Department of Biochemistry, University of Szeged, Szeged, Hungary
| | - Miguel Olias Ibor
- Cardiovascular Research Group, Department of Biochemistry, University of Szeged, Szeged, Hungary
| | - Kamilla Gömöri
- Cardiovascular Research Group, Department of Biochemistry, University of Szeged, Szeged, Hungary
- Pharmahungary Group, Szeged, Hungary
| | - Bernadett Kiss
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
| | - Gerda Strifler
- Faculty of Medicine, Institute of Surgical Research, University of Szeged, Szeged, Hungary
| | - Petra Hartmann
- Faculty of Medicine, Institute of Surgical Research, University of Szeged, Szeged, Hungary
| | - Péter Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- Pharmahungary Group, Szeged, Hungary
| | - Monika Bartekova
- Centre of Experimental Medicine, Institute for Heart Research, Slovak Academy of Sciences, Bratislava, Slovakia
- Faculty of Medicine, Institute of Physiology, Comenius University in Bratislava, Bratislava, Slovakia
| | - Mihály Boros
- Faculty of Medicine, Institute of Surgical Research, University of Szeged, Szeged, Hungary
| | - Anikó Görbe
- Cardiovascular Research Group, Department of Biochemistry, University of Szeged, Szeged, Hungary.
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary.
- Pharmahungary Group, Szeged, Hungary.
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