1
|
Karbasion N, Xu Y, Snider JC, Bersi MR. Primary Mouse Aortic Smooth Muscle Cells Exhibit Region- and Sex-Dependent Biological Responses In Vitro. J Biomech Eng 2024; 146:060904. [PMID: 38421345 PMCID: PMC11005860 DOI: 10.1115/1.4064965] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/02/2024]
Abstract
Despite advancements in elucidating biological mechanisms of cardiovascular remodeling, cardiovascular disease (CVD) remains the leading cause of death worldwide. When stratified by sex, clear differences in CVD prevalence and mortality between males and females emerge. Regional differences in phenotype and biological response of cardiovascular cells are important for localizing the initiation and progression of CVD. Thus, to better understand region and sex differences in CVD presentation, we have focused on characterizing in vitro behaviors of primary vascular smooth muscle cells (VSMCs) from the thoracic and abdominal aorta of male and female mice. VSMC contractility was assessed by traction force microscopy (TFM; single cell) and collagen gel contraction (collective) with and without stimulation by transforming growth factor-beta 1 (TGF-β1) and cell proliferation was assessed by a colorimetric metabolic assay (MTT). Gene expression and TFM analysis revealed region- and sex-dependent behaviors, whereas collagen gel contraction was consistent across sex and aortic region under baseline conditions. Thoracic VSMCs showed a sex-dependent sensitivity to TGF-β1-induced collagen gel contraction (female > male; p = 0.025) and a sex-dependent proliferative response (female > male; p < 0.001) that was not apparent in abdominal VSMCs. Although primary VSMCs exhibit intrinsic region and sex differences in biological responses that may be relevant for CVD presentation, several factors-such as inflammation and sex hormones-were not included in this study. Such factors should be included in future studies of in vitro mechanobiological responses relevant to CVD differences in males and females.
Collapse
Affiliation(s)
- Niyousha Karbasion
- Department of Mechanical Engineering & Materials Science, Washington University at St. Louis, St. Louis, MO 63130
| | - Yujun Xu
- Department of Mechanical Engineering & Materials Science, Washington University at St. Louis, St. Louis, MO 63130
- Washington University in St. Louis
| | - J. Caleb Snider
- Department of Mechanical Engineering & Materials Science, Washington University at St. Louis, St. Louis, MO 63130
- Washington University in St. Louis
| | - Matthew R. Bersi
- Department of Mechanical Engineering & Materials Science, Washington University at St. Louis, St. Louis, MO 63130
| |
Collapse
|
2
|
Yau J, Chukwu P, Jedlicka SS, Ramamurthi A. Assessing trans-endothelial transport of nanoparticles for delivery to abdominal aortic aneurysms. J Biomed Mater Res A 2024; 112:881-894. [PMID: 38192169 DOI: 10.1002/jbm.a.37667] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 01/10/2024]
Abstract
Abdominal aortic aneurysms (AAAs) are localized, rupture-prone expansions of the abdominal aorta wall. In this condition, structural extracellular matrix (ECM) proteins of the aorta wall, elastic fibers and collagen fibers, that impart elasticity and stiffness respectively, are slowly degraded by overexpressed matrix metalloproteinases (MMPs) following an injury stimulus. We are seeking to deliver therapeutics to the AAA wall using polymer nanoparticles (NPs) that are capable of stimulating on-site matrix regeneration and repair. This study aimed to determine how NP shape and size impacts endocytosis and transmigration past the endothelial cell (EC) layer from circulation into the medial layer of the AAA wall. First, rod-shaped NPs were shown to be created based mechanical stretching of PLGA NPs while embedded in a PVA film with longer rod-shaped NPs created based of the degree in which the PVA films are stretched. Live/dead assay reveals that our PLGA NPs are safe and do not cause cell death. Immunofluorescence staining reveal cytokine activation causes endothelial dysfunction in ECs by increasing expression of inflammatory marker Integrin αVβ3 and decreasing expression of adhesion protein vascular endothelial (VE)-cadherin. We showed this disruption enable greater EC uptake and translocation of NPs. Fluorescence studies demonstrate high endothelial transmigration and endocytosis with rod-shaped NPs in cytokine activated ECs compared to healthy control cells, arguing for the benefits of using higher aspect ratio (AR) NPs for accumulation at the aneurysm site. We also demonstrated that the mechanisms of NP transmigration across an activated EC layer depend on NP AR. These results show the potential of using shape as a modality for enhancing permeation of NPs into the aneurysm wall. These studies are also significance to understanding the mechanisms that are likely engaged by NPs for penetrating the endothelial lining of aneurysmal wall segments.
Collapse
Affiliation(s)
- Jimmy Yau
- Department of Bioengineering, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Patience Chukwu
- Department of Bioengineering, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Sabrina S Jedlicka
- Department of Bioengineering, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Anand Ramamurthi
- Department of Bioengineering, Lehigh University, Bethlehem, Pennsylvania, USA
| |
Collapse
|
3
|
Murtha CM, Coats RD, Thiel GE, McBride ML, Segars L, Olinger AB. A cadaver study evaluating intraluminal anomalies of the left common iliac vein. J Vasc Surg Venous Lymphat Disord 2024; 12:101837. [PMID: 38301853 DOI: 10.1016/j.jvsv.2024.101837] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/13/2024] [Accepted: 01/20/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVE Intraluminal anomalies within the left common iliac vein, characteristic of iliac vein compression syndrome, are thought to result from compression by and pulsation of the overlying right common iliac artery. This cadaver study was designed to expand on the existing literature by surveying and photographing these spurs in addition to exploring whether certain factors, inherent to the cadaver, are associated with spur presence. METHODS Dissection to expose the aorta, inferior vena cava, and common iliac arteries and veins was performed in 51 cadavers. The spinal level at which the iliac vein confluence occurred was noted. The point at which the right common iliac artery crossed the left common iliac vein was examined for plaque presence. The overlying arterial structures were then transected to expose the venous system. The inferior vena cava was incised to facilitate observation into the mouth and full extent of the left common iliac vein. Spurs were photographed and documented. Statistical analysis was conducted to determine whether sex, body mass index (BMI), plaque presence, or level of the iliac vein confluence are associated with spur presence. RESULTS Spurs within the left common iliac vein were observed in 16 of 51 cadavers (31.4%). All spurs were located at the point that the right common iliac artery crossed the left common iliac vein. Using1 the classification system established by McMurrich, 67% of spurs (n = 10) were marginal and triangular; 25% (n = 4) were columnar. One marginal, linear spur (6%) and one partially obstructed spur with multiple synechiae (6%) were observed. Among this population, males were 73% less likely to have a spur (odds ratio, 0.269; P = .041). No significant relationship was found between plaque presence and spur presence (odds ratio, 0.933; P = .824) and no significant differences were noted between BMI and spur presence (χ2 = 1.752, P = .625). Last, a significantly greater percent of spurs was found within cadavers with an iliac vein confluence located at the L5/S1 disc space (χ2 = 9.650; P = .002). CONCLUSIONS Study findings show that spurs are more common when the confluence of the common iliac veins occurs at a lower spinal level. The level of the iliac vein confluence may be important in identifying patients at increased risk of venous disease. The findings also suggest that plaque within the right common iliac artery and BMI display no distinct relationship with spur presence. Further investigation is needed to understand exactly what factors lead to spur formation.
Collapse
Affiliation(s)
- Celeste M Murtha
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO.
| | | | - Grace E Thiel
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO
| | - Morgan L McBride
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO
| | - Larry Segars
- Department of Basic Sciences, College of Osteopathic Medicine, Kansas City University, Kansas City, MO
| | - Anthony B Olinger
- Department of Pathology and Anatomical Sciences, College of Osteopathic Medicine, Kansas City University, Kansas City, MO
| |
Collapse
|
4
|
Akita H, Asukai K, Mukai Y, Hasegawa S, Omori T, Miyata H, Ohue M, Sakon M, Wada H, Takahashi H. The preliminary analysis of lymphatic flow around the connective tissues surrounding SMA and SpA elucidates patients' oncological condition in borderline-resectable pancreatic cancer. BMC Surg 2024; 24:107. [PMID: 38614983 PMCID: PMC11015602 DOI: 10.1186/s12893-024-02398-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/27/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND In pancreatic ductal adenocarcinoma (PDAC), invasion of connective tissues surrounding major arteries is a crucial prognostic factor after radical resection. However, why the connective tissues invasion is associated with poor prognosis is not well understood. MATERIALS AND METHODS From 2018 to 2020, 25 patients receiving radical surgery for PDAC in our institute were enrolled. HyperEye Medical System (HEMS) was used to examine lymphatic flow from the connective tissues surrounding SMA and SpA and which lymph nodes ICG accumulated in was examined. RESULTS HEMS imaging revealed ICG was transported down to the paraaortic area of the abdominal aorta along SMA. In pancreatic head cancer, 9 paraaortic lymph nodes among 14 (64.3%) were ICG positive, higher positivity than LN#15 (25.0%) or LN#18 (50.0%), indicating lymphatic flow around the SMA was leading directly to the paraaortic lymph nodes. Similarly, in pancreatic body and tail cancer, the percentage of ICG-positive LN #16a2 was very high, as was that of #8a, although that of #7 was only 42.9%. CONCLUSIONS Our preliminary result indicated that the lymphatic flow along the connective tissues surrounding major arteries could be helpful in understanding metastasis and improving prognosis in BR-A pancreatic cancer.
Collapse
Affiliation(s)
- Hirofumi Akita
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan.
| | - Kei Asukai
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Yosuke Mukai
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Shinichiro Hasegawa
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Takeshi Omori
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Hiroshi Miyata
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Masayuki Ohue
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Masato Sakon
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Hiroshi Wada
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Hidenori Takahashi
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| |
Collapse
|
5
|
Xu Y, Shao S, Kang H, Xu Z, Wen G, Shan Y, Gong Z, Al-Sharabi A, Qu B, Ren Y, Zhang F, Guan J, Chen X. A unicentric center, multicenter, and mixed-type Castleman disease: Three case reports and a review of the literature. Medicine (Baltimore) 2024; 103:e37722. [PMID: 38608101 PMCID: PMC11018146 DOI: 10.1097/md.0000000000037722] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/05/2024] [Indexed: 04/14/2024] Open
Abstract
RATIONALE Due to the lack of specificity symptoms and site of onset of castleman disease (CD), it is difficult to diagnose and poses unique challenges for both patients and clinicians, leading to confusion in diagnosis and delays in treatment. To enhance understanding, we present 3 cases of CD treated at our hospital, including a single-center, multicenter, and mixed-type CD. PATIENT CONCERNS Case 1: A 53-year-old female patient was admitted with a chief complaint of "abdominal pain and fever for 10 days." Marked enlargement of inguinal lymph nodes on both sides was observed. Case 2: A 58-year-old female patient was admitted with the main complaint of "discovering a left lower abdominal mass during a routine checkup for the past 10 days." Upon deep palpation, a palpable mass of approximately 5.0 * 3.0 cm was identified in the left lower abdomen. Case 3: A 40-year-old male patient was admitted with the main complaint of "progressive right upper abdominal and lumbar back pain for over 6 months." Computed tomography examination revealed multiple nodular soft tissue masses between the abdominal aorta and inferior vena cava, with the largest measuring 5.0 * 4.0 cm. DIAGNOSES Based on the immunohistochemical results, the diagnoses for the 3 patients are as follows: Case 1: Multicentric Castleman's Disease (Mixed Type). Case 2: Pelvic Retroperitoneal Castleman Disease (Hyaline Vascular Type). Case 3: Castleman Disease Multicentric Type. INTERVENTION Case 1: cyclophosphamide 0.6-1 g + vincristine 2 mg + methylprednisolone 50 mg/5 days. Cyclophosphamide 1 g + prednisone 30-50 mg/5 days. This alternating chemotherapy cycle is repeated every 6 months. Case 2: Laparoscopic pelvic mass excision surgery. Case 3: Surgical excision of the mass. OUTCOMES Case 1: After a 43-month follow-up, the patient's general symptoms have improved compared to before, but regular chemotherapy is still necessary at present. Case 2: The patient did not take any medication postoperatively, and there has been no evidence of metastasis or recurrence during the 18-month follow-up. Case 3: The patient did not take any medication, and there has been no evidence of metastasis or recurrence during the 21-month follow-up. LESSONS SUBSECTIONS The lack of specific signs on imaging studies and nonspecific blood tests increases the difficulty of diagnosis. However, tissue biopsy remains a feasible option. Therefore, we recommend conducting thorough examinations for suspected CD patients to reduce misdiagnosis and determine the CD type for effective targeted treatment.
Collapse
Affiliation(s)
- Yang Xu
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Shuai Shao
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - HaoNan Kang
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - ZhaoHui Xu
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - GuoYi Wen
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Yan Shan
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - ZeZhong Gong
- Department of Minimal Invasive Intervention Radiology, Ganzhou People’s Hospital, Ganzhou, People’s Republic of China
| | - Abdulkarem Al-Sharabi
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - BoXin Qu
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - YanYing Ren
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Fan Zhang
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - JinMing Guan
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Xin Chen
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| |
Collapse
|
6
|
Christ C, Ocskay Z, Kovács G, Jakus Z. Characterization of Atherosclerotic Mice Reveals a Sex-Dependent Susceptibility to Plaque Calcification but No Major Changes in the Lymphatics in the Arterial Wall. Int J Mol Sci 2024; 25:4046. [PMID: 38612867 PMCID: PMC11012298 DOI: 10.3390/ijms25074046] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/20/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
Lymphatics participate in reverse cholesterol transport, and their presence in the arterial wall of the great vessels and prior experimental results suggest their possible role in the development of atherosclerosis. The aim of this study was to characterize the lymphatic vasculature of the arterial wall in atherosclerosis. Tissue sections and tissue-cleared aortas of wild-type mice unveiled significant differences in the density of the arterial lymphatic network throughout the arterial tree. Male and female Ldlr-/- and ApoE-/- mice on a Western diet showed sex-dependent differences in plaque formation and calcification. Female mice on a Western diet developed more calcification of atherosclerotic plaques than males. The lymphatic vessels within the aortic wall of these mice showed no major changes regarding the number of lymphatic junctions and end points or the lymphatic area. However, female mice on a Western diet showed moderate dilation of lymphatic vessels in the abdominal aorta and exhibited indications of increased peripheral lymphatic function, findings that require further studies to understand the role of lymphatics in the arterial wall during the development of atherosclerosis.
Collapse
Affiliation(s)
| | | | | | - Zoltán Jakus
- Department of Physiology, Semmelweis University School of Medicine, 1094 Budapest, Hungary; (C.C.); (Z.O.); (G.K.)
| |
Collapse
|
7
|
Liu C, Zhang H, Yang Y, Cao Y, Liang D. The association between vitamin C intake and the risk of abdominal aortic calcification: A population-based study. Clin Nutr ESPEN 2024; 60:254-260. [PMID: 38479919 DOI: 10.1016/j.clnesp.2024.02.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/07/2024] [Accepted: 02/12/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND The beneficial effects of dietary vitamin C intake on human health have received widespread attention from the population. However, the correlation between vitamin C intake and abdominal aortic calcification remains unclear. The authors aimed to investigate the relationship between dietary vitamin C intake and AAC in US adults. METHODS Our data for this study were obtained from the National Health and Nutrition Examination Survey (NHANES) 2013-2014, and participants had complete data on dietary vitamin C intake and AAC scores. We used weighted multivariate linear regression and multivariate logistic regression analyses to explore the independent relationship between vitamin C intake and AAC scores, along with subgroup analyses and restricted cubic splines. RESULTS A total of 2876 participants were enrolled in this study, with a mean AAC score of 1.47 ± 0.14 and a prevalence of severe AAC of 8.12%. We observed a 0.5 unit decrease in AAC scores in participants in the highest quartile compared to those in the lowest quartile of VitC intake. In contrast, there was no significant correlation between VitC intake and risk of severe AAC. Besides, subgroup analysis and interaction tests showed that there was no dependence of the association between VitC intake and AAC. CONCLUSION Dietary VitC intake was associated with reduced AAC scores, but there was no significant correlation between dietary VitC intake and risk of severe AAC.
Collapse
Affiliation(s)
- Chang Liu
- School of Medicine, Nankai University, Tianjin, China
| | - Hao Zhang
- The Eighth Medical Center, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China
| | - Yuwei Yang
- The Eighth Medical Center, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China
| | - Yan Cao
- The Eighth Medical Center, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China
| | - Dan Liang
- Department of Endocrine, People's Hospital of Chongqing Liangjiang New Area, Chongqing, China.
| |
Collapse
|
8
|
Hopper SE, Weiss D, Mikush N, Jiang B, Spronck B, Cavinato C, Humphrey JD, Figueroa CA. Central Artery Hemodynamics in Angiotensin II-Induced Hypertension and Effects of Anesthesia. Ann Biomed Eng 2024; 52:1051-1066. [PMID: 38383871 DOI: 10.1007/s10439-024-03440-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/30/2023] [Indexed: 02/23/2024]
Abstract
Systemic hypertension is a strong risk factor for cardiovascular, neurovascular, and renovascular diseases. Central artery stiffness is both an initiator and indicator of hypertension, thus revealing a critical relationship between the wall mechanics and hemodynamics. Mice have emerged as a critical animal model for studying effects of hypertension and much has been learned. Regardless of the specific mouse model, data on changes in cardiac function and hemodynamics are necessarily measured under anesthesia. Here, we present a new experimental-computational workflow to estimate awake cardiovascular conditions from anesthetized data, which was then used to quantify effects of chronic angiotensin II-induced hypertension relative to normotension in wild-type mice. We found that isoflurane anesthesia had a greater impact on depressing hemodynamics in angiotensin II-infused mice than in controls, which led to unexpected results when comparing anesthetized results between the two groups of mice. Through comparison of the awake simulations, however, in vivo relevant effects of angiotensin II-infusion on global and regional vascular structure, properties, and hemodynamics were found to be qualitatively consistent with expectations. Specifically, we found an increased in vivo vascular stiffness in the descending thoracic aorta and suprarenal abdominal aorta, leading to increases in pulse pressure in the distal aorta. These insights allow characterization of the impact of regionally varying vascular remodeling on hemodynamics and mouse-to-mouse variations due to induced hypertension.
Collapse
Affiliation(s)
- S E Hopper
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - D Weiss
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - N Mikush
- Translational Research Imaging Center, Yale School of Medicine, New Haven, CT, USA
| | - B Jiang
- Department of Thyroid and Vascular Surgery, 1st Hospital of China Medical University, Shen Yang, China
| | - B Spronck
- Department of Biomedical Engineering, Maastricht University, Maastricht, The Netherlands
| | - C Cavinato
- LMGC, Universite' Montpellier, CNRS, Montpellier, France
| | - J D Humphrey
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA.
| | - C A Figueroa
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
9
|
Ren S, Guidoin R, Xu Z, Deng X, Fan Y, Chen Z, Sun A. Narrative Review of Risk Assessment of Abdominal Aortic Aneurysm Rupture Based on Biomechanics-Related Morphology. J Endovasc Ther 2024; 31:178-190. [PMID: 36052406 DOI: 10.1177/15266028221119309] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
CLINICAL IMPACT Studies have shown that the biomechanical indicators based on multi-scale models are more effective in accurately assessing the rupture risk of AAA. To meet the need for clinical monitoring and rapid decision making, the typical morphological parameters associated with AAA rupture and their relationships with the mechanical environment have been summarized, which provide a reference for clinical preoperative risk assessment of AAA.
Collapse
Affiliation(s)
- Shuqi Ren
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Robert Guidoin
- Department of Surgery, Faculty of Medicine, Université Laval and CHU de Québec Research Centre, Quebec, QC, Canada
| | - Zaipin Xu
- College of Animal Science, Guizhou University, Guiyang, China
| | - Xiaoyan Deng
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Zengsheng Chen
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Anqiang Sun
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| |
Collapse
|
10
|
Keskin N, Bamac B, Cakir O, Colak T, Barut C. Superior mesenteric artery revisited using magnetic resonance angiography. Surg Radiol Anat 2024; 46:523-534. [PMID: 38376526 DOI: 10.1007/s00276-024-03323-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/12/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE We aimed to examine the superior mesenteric artery in detail by magnetic resonance angiography to provide an alternative to other imaging methods, to reduce the exposure time of patients and physicians to X-rays and the time spent in catheter angiography, to determine the variations, positions, and locations of the celiac trunk, and to provide detailed information for surgeons and interventional radiologists using this method. METHODS The procedures were approved by the Kocaeli University Medical School Non-Interventional Clinical Research Ethics Committee (10.04.2023, approval number: 2021/51). MR angiography images of 185 patients with abdominal imaging in PACS (Picture Archiving Communication Systems) were retrospectively registered. The level of origin of the superior mesenteric artery according to the vertebral column, angle of origin, distance between the superior mesenteric artery and branches of the abdominal aorta, and branching pattern of the superior mesenteric artery were evaluated. Parameters were evaluated according to gender and age using SPSS version 25. RESULTS The distance between superior mesenteric artery-inferior mesenteric artery and superior mesenteric artery-aortic bifurcation in males was higher than in females, and the difference was statistically significant. In females and the whole study group, a low, positive and significant relationship was found between age and superior mesenteric artery-sagittal angle. The most common origin site for the superior mesenteric artery, according to the vertebral column was found to be at L1 middle for males and L1 upper for females. The most common superior mesenteric artery branching pattern was classical type in both genders. CONCLUSION Individual evaluation of the superior mesenteric artery could reduce the risks during surgical interventions, considering the relationship of the superior mesenteric artery, especially with distally located vessels, and the gender differences for the angle of origin. Furthermore, considering that interventional radiologists choose the catheter according to the angle of origin of the artery during catheter angiography procedures, individual evaluation of patients taking into account gender and age is of utmost importance.
Collapse
Affiliation(s)
- Necmi Keskin
- Department of Anatomy, Kocaeli University, Kocaeli, Türkiye, Turkey
| | - Belgin Bamac
- Department of Anatomy, Kocaeli University, Kocaeli, Türkiye, Turkey
| | - Ozgur Cakir
- Department of Radiology, Kocaeli University, Kocaeli, Türkiye, Turkey
| | - Tuncay Colak
- Department of Anatomy, Kocaeli University, Kocaeli, Türkiye, Turkey
| | - Cagatay Barut
- Department of Anatomy, School of Medicine, Istanbul Medeniyet University, Istanbul, Türkiye, 34715, Turkey.
| |
Collapse
|
11
|
Shridas P, Ji A, Trumbauer AC, Noffsinger VP, Meredith LW, de Beer FC, Mullick AE, Webb NR, Karounos DG, Tannock LR. Antisense oligonucleotide targeting hepatic Serum Amyloid A limits the progression of angiotensin II-induced abdominal aortic aneurysm formation. Atherosclerosis 2024; 391:117492. [PMID: 38461759 PMCID: PMC11006562 DOI: 10.1016/j.atherosclerosis.2024.117492] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/07/2024] [Accepted: 02/23/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND AND AIMS Obesity increases the risk for abdominal aortic aneurysms (AAA) in humans and enhances angiotensin II (AngII)-induced AAA formation in C57BL/6 mice. We reported that deficiency of Serum Amyloid A (SAA) significantly reduces AngII-induced inflammation and AAA in both hyperlipidemic apoE-deficient and obese C57BL/6 mice. The aim of this study is to investigate whether SAA plays a role in the progression of early AAA in obese C57BL/6 mice. METHODS Male C57BL/6J mice were fed a high-fat diet (60% kcal as fat) throughout the study. After 4 months of diet, the mice were infused with AngII until the end of the study. Mice with at least a 25% increase in the luminal diameter of the abdominal aorta after 4 weeks of AngII infusion were stratified into 2 groups. The first group received a control antisense oligonucleotide (Ctr ASO), and the second group received ASO that suppresses SAA (SAA-ASO) until the end of the study. RESULTS Plasma SAA levels were significantly reduced by the SAA ASO treatment. While mice that received the control ASO had continued aortic dilation throughout the AngII infusion periods, the mice that received SAA-ASO had a significant reduction in the progression of aortic dilation, which was associated with significant reductions in matrix metalloprotease activities, decreased macrophage infiltration and decreased elastin breaks in the abdominal aortas. CONCLUSIONS We demonstrate for the first time that suppression of SAA protects obese C57BL/6 mice from the progression of AngII-induced AAA. Suppression of SAA may be a therapeutic approach to limit AAA progression.
Collapse
Affiliation(s)
- Preetha Shridas
- Department of Internal Medicine, University of Kentucky, Lexington, 40536, Kentucky, USA; Saha Cardiovascular Research Center, University of Kentucky, Lexington, 40536, Kentucky, USA.
| | - Ailing Ji
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, 40536, Kentucky, USA
| | - Andrea C Trumbauer
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, 40536, Kentucky, USA
| | - Victoria P Noffsinger
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, 40536, Kentucky, USA
| | - Luke W Meredith
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, 40536, Kentucky, USA
| | - Frederick C de Beer
- Department of Internal Medicine, University of Kentucky, Lexington, 40536, Kentucky, USA; Saha Cardiovascular Research Center, University of Kentucky, Lexington, 40536, Kentucky, USA
| | | | - Nancy R Webb
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, 40536, Kentucky, USA; Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, 40536, Kentucky, USA
| | - Dennis G Karounos
- Department of Internal Medicine, University of Kentucky, Lexington, 40536, Kentucky, USA; Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, 40536, Kentucky, USA; Department of Veterans Affairs, Lexington, 40536, Kentucky, USA
| | - Lisa R Tannock
- Department of Internal Medicine, University of Kentucky, Lexington, 40536, Kentucky, USA; Saha Cardiovascular Research Center, University of Kentucky, Lexington, 40536, Kentucky, USA
| |
Collapse
|
12
|
Li B, Lu HS, Daugherty A. Abdominal aortic aneurysms and platelets: infiltration, inflammation, and elastin disintegration. Cardiovasc Res 2024; 120:331-332. [PMID: 38193624 PMCID: PMC10981521 DOI: 10.1093/cvr/cvae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/08/2024] [Indexed: 01/10/2024] Open
Affiliation(s)
- Bowen Li
- Department of Physiology, Saha Cardiovascular Research Center, Saha Aortic Center, University of Kentucky, 741 South Limestone, BBSRB Room B243, Lexington, KY 40536, USA
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan, Hubei Province 430000, China
| | - Hong S Lu
- Department of Physiology, Saha Cardiovascular Research Center, Saha Aortic Center, University of Kentucky, 741 South Limestone, BBSRB Room B243, Lexington, KY 40536, USA
| | - Alan Daugherty
- Department of Physiology, Saha Cardiovascular Research Center, Saha Aortic Center, University of Kentucky, 741 South Limestone, BBSRB Room B243, Lexington, KY 40536, USA
| |
Collapse
|
13
|
Zhang LY, Zhang HY. Torso hemorrhage: noncompressible? never say never. Eur J Med Res 2024; 29:153. [PMID: 38448977 PMCID: PMC10919054 DOI: 10.1186/s40001-024-01760-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 02/29/2024] [Indexed: 03/08/2024] Open
Abstract
Since limb bleeding has been well managed by extremity tourniquets, the management of exsanguinating torso hemorrhage (TH) has become a hot issue both in military and civilian medicine. Conventional hemostatic techniques are ineffective for managing traumatic bleeding of organs and vessels within the torso due to the anatomical features. The designation of noncompressible torso hemorrhage (NCTH) marks a significant step in investigating the injury mechanisms and developing effective methods for bleeding control. Special tourniquets such as abdominal aortic and junctional tourniquet and SAM junctional tourniquet designed for NCTH have been approved by FDA for clinical use. Combat ready clamp and junctional emergency treatment tool also exhibit potential for external NCTH control. In addition, resuscitative endovascular balloon occlusion of the aorta (REBOA) further provides an endovascular solution to alleviate the challenges of NCTH treatment. Notably, NCTH cognitive surveys have revealed that medical staff have deficiencies in understanding relevant concepts and treatment abilities. The stereotypical interpretation of NCTH naming, particularly the term noncompressible, is the root cause of this issue. This review discusses the dynamic relationship between TH and NCTH by tracing the development of external NCTH control techniques. The authors propose to further subdivide the existing NCTH into compressible torso hemorrhage and NCTH' (noncompressible but REBOA controllable) based on whether hemostasis is available via external compression. Finally, due to the irreplaceability of special tourniquets during the prehospital stage, the authors emphasize the importance of a package program to improve the efficacy and safety of external NCTH control. This program includes the promotion of tourniquet redesign and hemostatic strategies, personnel reeducation, and complications prevention.
Collapse
Affiliation(s)
- Lian-Yang Zhang
- Department of Trauma Surgery, War Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Hua-Yu Zhang
- Department of Trauma Surgery, War Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China.
| |
Collapse
|
14
|
Zhang Y, Li G. Predicting feature genes correlated with immune infiltration in patients with abdominal aortic aneurysm based on machine learning algorithms. Sci Rep 2024; 14:5157. [PMID: 38431726 PMCID: PMC10908806 DOI: 10.1038/s41598-024-55941-6] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 02/29/2024] [Indexed: 03/05/2024] Open
Abstract
Abdominal aortic aneurysm (AAA) is a condition characterized by a pathological and progressive dilatation of the infrarenal abdominal aorta. The exploration of AAA feature genes is crucial for enhancing the prognosis of AAA patients. Microarray datasets of AAA were downloaded from the Gene Expression Omnibus database. A total of 43 upregulated differentially expressed genes (DEGs) and 32 downregulated DEGs were obtained. Function, pathway, disease, and gene set enrichment analyses were performed, in which enrichments were related to inflammation and immune response. AHR, APLNR, ITGA10 and NR2F6 were defined as feature genes via machine learning algorithms and a validation cohort, which indicated high diagnostic abilities by the receiver operating characteristic curves. The cell-type identification by estimating relative subsets of RNA transcripts (CIBERSORT) method was used to quantify the proportions of immune infiltration in samples of AAA and normal tissues. We have predicted AHR, APLNR, ITGA10 and NR2F6 as feature genes of AAA. CD8 + T cells and M2 macrophages correlated with these genes may be involved in the development of AAA, which have the potential to be developed as risk predictors and immune interventions.
Collapse
Affiliation(s)
- Yufeng Zhang
- Department of Vascular Surgery, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, 271000, Shandong, China
- Postdoctoral Workstation, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250021, Shandong, China
- Department of Pulmonary and Critical Care Medicine, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin Hospital Affiliated to Nanjing University of Chinese Medicine, Jiangyin, 214400, Jiangsu, China
| | - Gang Li
- Department of Vascular Surgery, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, 271000, Shandong, China.
| |
Collapse
|
15
|
Manenti A, Manco G, Silingardi R, Coppi F. Comment on: Influence of cardiometabolic medications on abdominal aortic aneurysm growth in the UK Aneurysm Growth Study: metformin and angiotensin-converting enzyme inhibitors associated with slower aneurysm growth. Br J Surg 2024; 111:znae055. [PMID: 38509639 DOI: 10.1093/bjs/znae055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/18/2024] [Indexed: 03/22/2024]
Affiliation(s)
- Antonio Manenti
- Department of Surgery, University of Modena and Reggio Emilia, Modnea, Italy
| | - Gianrocco Manco
- Department of Surgery, University of Modena and Reggio Emilia, Modnea, Italy
| | - Roberto Silingardi
- Department of Surgery, University of Modena and Reggio Emilia, Modnea, Italy
| | - Francesca Coppi
- Department of Cardiology, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
16
|
Corsi CAC, Sares CTG, Mestriner F, Michelon-Barbosa J, Dugaich VF, Martins TV, Násare AM, Rosales RRC, Jordani MC, Alves-Filho JC, Dos Reis RB, Ribeiro MS, Becari C. Isolation and primary culture of human abdominal aorta smooth muscle cells from brain-dead donors: an experimental model for vascular diseases. Cell Tissue Bank 2024; 25:187-194. [PMID: 37145371 DOI: 10.1007/s10561-023-10091-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 04/12/2023] [Indexed: 05/06/2023]
Abstract
Primary cell cultures are essential tools for elucidating the physiopathological mechanisms of the cardiovascular system. Therefore, a primary culture growth protocol of cardiovascular smooth muscle cells (VSMCs) obtained from human abdominal aortas was standardized. Ten abdominal aorta samples were obtained from patients diagnosed with brain death who were organ and tissue donors with family consent. After surgical ablation to capture the aorta, the aortic tissue was removed, immersed in a Custodiol® solution, and kept between 2 and 8 °C. In the laboratory, in a sterile environment, the tissue was fragmented and incubated in culture plates containing an enriched culture medium (DMEM/G/10% fetal bovine serum, L-glutamine, antibiotics and antifungals) and kept in an oven at 37 °C and 5% CO2. The aorta was removed after 24 h of incubation, and the culture medium was changed every six days for twenty days. Cell growth was confirmed through morphological analysis using an inverted optical microscope (Nikon®) and immunofluorescence for smooth muscle alpha-actin and nuclei. The development of the VSMCs was observed, and from the twelfth day, differentiation, long cytoplasmic projections, and adjacent cell connections occurred. On the twentieth day, the morphology of the VSMCs was confirmed by actin fiber immunofluorescence, which is a typical characteristic of VSMCs. The standardization allowed VSMC growth and the replicability of the in vitro test, providing a protocol that mimics natural physiological environments for a better understanding of the cardiovascular system. Its use is intended for investigation, tissue bioengineering, and pharmacological treatments.
Collapse
Affiliation(s)
- Carlos Alexandre Curylofo Corsi
- Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Division of Biophysics, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Claudia Tarcila Gomes Sares
- Division of Urology, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Division of Biophysics, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Fabiola Mestriner
- Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Division of Biophysics, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Jéssyca Michelon-Barbosa
- Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Division of Biophysics, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Vinicius Flora Dugaich
- Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Division of Biophysics, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Timna Varela Martins
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Division of Biophysics, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Alex Martins Násare
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Division of Biophysics, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Roberta Ribeiro Costa Rosales
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Division of Biophysics, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Maria Cecília Jordani
- Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Division of Biophysics, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - José Carlos Alves-Filho
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Division of Biophysics, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Rodolfo Borges Dos Reis
- Division of Urology, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Division of Biophysics, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Mauricio Serra Ribeiro
- Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Division of Biophysics, São Paulo School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Christiane Becari
- Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
- Department of Biological Sciences, School of Dentistry of Bauru - FOB/USP, University of São Paulo, Bauru, SP, Brazil.
| |
Collapse
|
17
|
Hu J, Xu J, Zhao J, Liu Y, Huang R, Yao D, Xie J, Lei Y. Colchicine ameliorates short-term abdominal aortic aneurysms by inhibiting the expression of NLRP3 inflammasome components in mice. Eur J Pharmacol 2024; 964:176297. [PMID: 38135264 DOI: 10.1016/j.ejphar.2023.176297] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Abdominal aortic aneurysms (AAA) are often associated with chronic inflammation and pose a significant risk to affected individuals. Colchicine, known for its anti-inflammatory properties, has shown promise in managing cardiovascular diseases. However, its specific role in the development of AAA remains poorly understood. METHODS AND RESULTS In this study, we employed a short-term AAA model induced by angiotensin II (Ang II, 1000 ng/kg/min) and calcium chloride (CaCl2, 0.5 mol/l) in male ApoE-/- and C57BL/6 mice (8-12 weeks old) to investigate the effects of colchicine on AAA progression. Colchicine (0.4 mg/kg) was administered orally once daily, starting on the same day as AAA induction. After a 4-week duration, we observed a significant reduction in AAA diameter, degradation of elastic fibers, and expression of components related to the Nucleotide-binding oligomerization domain-like receptor family protein 3 (NLRP3) inflammasome in the vessel wall of colchicine-treated mice compared to the saline group. Mechanistically, colchicine (5 μm/l, for 24h) inhibited the expression of NLRP3 inflammasome components through the P38-ERK/MicroRNA145-toll-like receptor 4 (TLR4) pathway in RAW264.7 cells. CONCLUSIONS Our study demonstrates the effectiveness of colchicine in suppressing NLRP3 inflammasome components, thereby delaying AAA progression in the Ang II and CaCl2-induced short-term model. These findings suggest the potential of colchicine as a pharmacological treatment option for AAA.
Collapse
Affiliation(s)
- Jiaxin Hu
- Cardiovascular Disease Center, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi, Hubei, China; Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China; Hubei Selenium and Human Health Institute, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, 445000, China
| | - Jiamin Xu
- Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Jiling Zhao
- Cardiovascular Disease Center, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi, Hubei, China
| | - Yuwei Liu
- Department of Medical Ultrasound, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi, Hubei, China
| | - Rui Huang
- Cardiovascular Disease Center, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi, Hubei, China
| | - Dejiang Yao
- Surgical Division III, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi, Hubei, China
| | - Jun Xie
- Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Anhui, China.
| | - Yuhua Lei
- Cardiovascular Disease Center, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi, Hubei, China.
| |
Collapse
|
18
|
Kazim M, Razian SA, Zamani E, Varandani D, Shahbad R, Desyatova A, Jadidi M. Variability in structure, morphology, and mechanical properties of the descending thoracic and infrarenal aorta around their circumference. J Mech Behav Biomed Mater 2024; 150:106332. [PMID: 38160644 DOI: 10.1016/j.jmbbm.2023.106332] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/04/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
Aortic diseases, such as aneurysms, atherosclerosis, and dissections, demonstrate a preferential development and progression around the aortic circumference, resulting in a highly heterogeneous disease state around the circumference. Differences in the aorta's structural composition and mechanical properties may be partly responsible for this phenomenon. Our goal in this study was to analyze the mechanical and structural properties of the human aorta at its lateral, anterior, posterior, and medial quadrants in two regions prone to circumferentially inhomogeneous diseases, descending Thoracic Aorta (TA) and Infrarenal Aorta (IFR). Human aortas were obtained from 10 donors (64 ± 11 years) and dissected from their loose surrounding tissue. Mechanical properties were determined in all four quadrants of TA and IFR using planar biaxial testing and fitted to three common constitutive models. The structure of tissues was assessed using Movat Pentachrome stained histology slides. We observed that the anterior quadrant exhibited the greatest thickness, followed by the lateral region, in both the TA and IFR. In TA, the posterior wall appeared as the stiffest location in most samples, while in IFR, the anterior wall was the stiffest. We observed a higher glycosaminoglycans content in the lateral and posterior regions of the IFR. We found elastin density to be similar in TA lateral, anterior, and posterior quadrants, while in IFR, the anterior region demonstrated the highest elastin density. Despite significant variations between subjects, this study highlights the distinct morphometrical, mechanical, and structural properties between the quadrants of both TA and IFR.
Collapse
Affiliation(s)
- Madihah Kazim
- Department of Biomechanics, University of Nebraska Omaha, Omaha, NE, USA
| | | | - Elham Zamani
- Department of Biomechanics, University of Nebraska Omaha, Omaha, NE, USA
| | - Dheeraj Varandani
- Department of Computer Science, University of Nebraska Omaha, Omaha, NE, USA
| | - Ramin Shahbad
- Department of Biomechanics, University of Nebraska Omaha, Omaha, NE, USA
| | | | - Majid Jadidi
- Department of Biomechanics, University of Nebraska Omaha, Omaha, NE, USA.
| |
Collapse
|
19
|
Sokolis DP. Layer-Specific Properties of the Human Infra-Renal Aorta During Aging Considering Pre/Post-Failure Damage. J Biomech Eng 2024; 146:021003. [PMID: 38019302 DOI: 10.1115/1.4064146] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 11/27/2023] [Indexed: 11/30/2023]
Abstract
There is little information on the layer-specific failure properties of the adult human abdominal aorta, and there has been no quantification of postfailure damage. Infra-renal aortas were thus taken from forty-seven autopsy subjects and cut into 870 intact-wall and layer strips that underwent uni-axial-tensile testing. Intact-wall failure stress did not differ significantly (p > 0.05) from the medial value longitudinally, nor from the intimal and medial values circumferentially, which were the lowest recorded values. Intact-wall failure stretch did not differ (p > 0.05) from the medial value in either direction. Intact-wall prefailure stretch (defined as failure stretch-stretch at the initiation of the concave phase of the stress-stretch response) did not differ (p > 0.05) from the intimal and medial values, and intact-wall postfailure stretch (viz., full-rupture stretch-failure stretch) did not differ (p > 0.05) from the adventitial value since the adventitia was the last layer to rupture, being most extensible albeit under residual tension. Intact-wall failure stress and stretch declined from 20 to 60 years, explained by steady declines throughout the lifetime of their medial counterparts, implicating beyond 60 years the less age-varying failure properties of the intima under minimal residual compression. The positive correlation of postfailure stretch with age counteracted the declining failure stretch, serving as a compensatory mechanism against rupture. Hypertension, diabetes, and coronary artery disease adversely affected the intact-wall and layer-specific failure stretches while increasing stiffness.
Collapse
Affiliation(s)
- Dimitrios P Sokolis
- Laboratory of Biomechanics, Center of Clinical, Experimental Surgery, and Translational Research, Biomedical Research Foundation of the Academy of Athens, 4 Soranou Ephesiou Street, Athens 115 27, Greece
| |
Collapse
|
20
|
Garabet W, Arnautovic A, Meurer L, Mulorz J, Rembe JD, Duran M, Süss JD, Schelzig H, Wagenhäuser MU. Analysis of Determinants for Suture-mediated Closure Device Failure During EVAR Procedures. Vasc Endovascular Surg 2024; 58:129-135. [PMID: 37450890 PMCID: PMC10768335 DOI: 10.1177/15385744231189356] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Endovascular aortic repair (EVAR) for elective and emergency infrarenal aortic pathologies is the primary approach for treatment nowadays. During such procedure, the suture-mediated closure device (SMCD) (Perclose ProGlideTM, Abbott Laboratories, Chicago, IL, USA) is commonly used. This study aimed to identify potential contributors for SMCD failure in a patient cohort of elective and emergency EVAR. METHODS Archived medical records from patients who underwent EVAR for aortic pathologies in elective and emergency setting at the University Hospital Düsseldorf, Germany were included. Patient's co-morbidities, access vessel morphologies and hemostasis-related blood parameters were evaluated on their association with SMCD failure applying different statistical methods. RESULTS A total of 71 patients (139 femoral accesses) was included. The mean age was 73.5 ± 8.4 years. Overall SMCD failure rate was 4.3%, 4.1% for elective and 5.9% for emergency cases, respectively. Total procedure time was longer for the SMCD failure group (323 ± 117.8 min vs 171 ± 43.7 min). The calcification status of the common femoral artery (CFA), the diameter of the aortic bifurcation, and dual anti-platelet therapy (DAPT) on the medication plan prior to the procedure were associated with SMCD failure. Univariate binary logistic regression analysis nominated several potentially relevant predictors for SMCD failure who underwent subsequent multivariable binary logistic regression analysis. Here, DAPT on the medication plan was identified as being promising in predicting SMCD failure (OR 30.5), while anterior plaque formation in the CFA maintained as only statistically relevant determinant (OR 44.9). CONCLUSIONS This study confirms the CFA calcification status to be associated with SMCD failure. Although discontinued prior to endovascular treatment, DAPT was also found to be associated with SMCD failure. Our results may advocate to perform obligatory platelet testing prior to EVAR to maximize patient safety.
Collapse
Affiliation(s)
- W Garabet
- Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Germany
| | - A Arnautovic
- Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Germany
| | - L Meurer
- Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Germany
| | - J Mulorz
- Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Germany
| | - JD Rembe
- Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Germany
| | - M Duran
- Department of Vascular and Endovascular Surgery, Marienhospital Gelsenkirchen, Germany
| | - JD Süss
- Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Germany
| | - H Schelzig
- Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Germany
| | - MU Wagenhäuser
- Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Germany
| |
Collapse
|
21
|
Fujita Y, Tanabe R. Diagnostic Ultrasound: On-Site Diagnosis of Type B Aortic Dissection During Cataract Surgery. A A Pract 2024; 18:e01745. [PMID: 38381459 PMCID: PMC10885863 DOI: 10.1213/xaa.0000000000001745] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
We report a case of aortic dissection occurring during cataract surgery under local anesthesia, which was diagnosed on-site by point-of-care ultrasound. Intimal flaps were detected in the abdominal aorta, whereas the parasternal view showed no abnormalities in the aortic root or left ventricular function. According to these ultrasound findings, a Stanford type B aortic dissection was more likely than a type A aortic dissection, and imminent death was unlikely. Therefore, we decided to resume and complete the surgery. Subsequent computed tomography (CT) confirmed the point-of-care diagnosis. The patient was transferred to a tertiary hospital for medical treatment.
Collapse
Affiliation(s)
| | - Ryo Tanabe
- Emergency Medicine, Kasaoka Daiichi Hospital, Kasaoka, Japan
| |
Collapse
|
22
|
Grigoriadis S, Georgiadi E, Sidiropoulos TA, Efthimiou E, Spiliopoulos S. Spinal Cord Ischemia after Lumbar Artery Embolization for Retroperitoneal Hemorrhage. J Vasc Interv Radiol 2024; 35:329-330. [PMID: 38272641 DOI: 10.1016/j.jvir.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/02/2023] [Accepted: 10/14/2023] [Indexed: 01/27/2024] Open
Affiliation(s)
- Stavros Grigoriadis
- Interventional Radiology Unit, 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece.
| | - Eleni Georgiadi
- Interventional Radiology Unit, 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece
| | - Theodoros A Sidiropoulos
- 4th Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Evgenia Efthimiou
- Interventional Radiology Unit, 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece
| | - Stavros Spiliopoulos
- Interventional Radiology Unit, 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece
| |
Collapse
|
23
|
Hu XY, Lin ZH, Gao DF. [A case of Brucellosis with abdominal aortic ulcer disease]. Zhonghua Xin Xue Guan Bing Za Zhi 2024; 52:88-90. [PMID: 38220462 DOI: 10.3760/cma.j.cn112148-20231117-00446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Affiliation(s)
- X Y Hu
- Department of Cardiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004,China
| | - Z H Lin
- Department of Cardiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004,China
| | - D F Gao
- Department of Cardiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004,China
| |
Collapse
|
24
|
Rall JM, Baker KJ, Sandoval ML, Flinn AN, Causey MW. Transition of Resuscitative Endovascular Balloon Occlusion of the Aorta from Zone 3 to Zone 1 to Treat Hemodynamic Collapse during Continued Hemorrhage. Mil Med 2024; 189:e285-e290. [PMID: 37552642 DOI: 10.1093/milmed/usad313] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 08/10/2023] Open
Abstract
INTRODUCTION Noncompressible torso hemorrhage (NCTH) accounts for most potentially survivable deaths on the battlefield. Treatment of NCTH is challenging, especially in far-forward environments with limited capabilities. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has shown promise in the care of patients with NCTH. REBOA involves introducing a balloon catheter into the descending aorta in a specific occlusion region (zones 1, 2, or 3) and acts as a hemorrhage control adjunct with resuscitative support. The balloon is placed in zone 3 in the infrarenal aorta for high junctional or pelvic injuries and in zone 1 proximal to the diaphragm for torso hemorrhage. Zone 1 REBOA provides more resuscitative support than zone 3; however, the potential for ischemia and reperfusion injuries is greater with zone 1 than with zone 3 REBOA placement. This study aims to determine the possible benefit of transitioning the REBOA balloon from zone 3 to zone 1 to rescue a patient with ongoing venous bleeding and impending cardiovascular collapse. MATERIALS AND METHODS Yorkshire male swine (70-90 kg, n = 6 per group) underwent injury to the femoral artery, which was allowed to bleed freely for 60 s, along with a simultaneous controlled venous hemorrhage. After 60 s, the arterial bleed was controlled with hemostatic gauze and zone 3 REBOA was inflated. Five hundred milliliters of Hextend was used for initial fluid resuscitation. The controlled venous bleed continued until a mean arterial pressure (MAP) of 30 mmHg was reached to create an impending cardiovascular collapse. The animals were then randomized into either continued zone 3 REBOA or transition from zone 3 to zone 1 REBOA. Following 30 min, a "hospital phase" was initiated, consisting of cessation of the venous hemorrhage, deflation of the REBOA balloon, and transfusion of one unit of whole blood administered along with saline and norepinephrine to maintain a MAP of 60 mmHg or higher. The animals then underwent a 2-h observation period. Survival, hemodynamics, and blood chemistries were compared between groups. RESULTS No significant differences between groups were observed in hemodynamic or laboratory values at baseline, postinitial injury, or when MAP reached 30 mmHg. Survival was significantly longer in animals that transitioned into zone 1 REBOA (log-rank analysis, P = .012). The average time of survival was 14 ± 10 min for zone 3 animals vs. 65 ± 59 min for zone 1 animals (P = .064). No animals in the zone 3 group survived to the hospital phase. Zone 1-treated animals showed immediate hemodynamic improvement after transition, with maximum blood pressure reaching near baseline values compared to those in the zone 3 group. CONCLUSIONS In this swine model of NCTH, hemodynamics and survival were improved when the REBOA balloon was transitioned from zone 3 to zone 1 during an impending cardiovascular collapse. Furthermore, these improved outcome data support the pursuit of additional research into mitigating ischemia-reperfusion insult to the abdominal viscera while still providing excellent resuscitative support, such as intermittent or partial REBOA.
Collapse
Affiliation(s)
- Jason M Rall
- Office of Science and Technology, 59th Medical Wing, JBSA Lackland, TX 78236, USA
| | - Kimberly J Baker
- Office of Science and Technology, 59th Medical Wing, JBSA Lackland, TX 78236, USA
| | - Melody L Sandoval
- Office of Science and Technology, 59th Medical Wing, JBSA Lackland, TX 78236, USA
| | - Ashley N Flinn
- Division of Vascular Surgery, San Antonio Military Medical Center, Fort Sam Houston, TX 78234, USA
| | - Marlin W Causey
- Division of Vascular Surgery, San Antonio Military Medical Center, Fort Sam Houston, TX 78234, USA
| |
Collapse
|
25
|
Doué M, Marques G, Okwieka A, Gorisse L, Piétrement C, Gillery P, Jaisson S. Accumulation of Carbamylation-Derived Products in Aneurysmal Aorta. J Vasc Res 2024; 61:51-58. [PMID: 38246153 DOI: 10.1159/000534613] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 10/11/2023] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION Carbamylation is a nonenzymatic post-translational modification of proteins characterized by the binding of isocyanic acid to amino groups of proteins, which leads to the alteration of their properties. An increase in serum carbamylation-derived products, including homocitrulline (HCit), has been shown to be associated with the development of cardiovascular diseases. METHODS HCit was quantified by LC-MS/MS within extracts of aneurysmal and control human aortas. A mouse model of aortic aneurysm (ApoE-/- mice perfused with angiotensin II and fed with sodium cyanate) was used to evaluate the role of carbamylation in aneurysm development. RESULTS HCit quantification showed a greater heterogeneity of values in aneurysmal aortas in comparison with control ones. At the maximum diameter of dilation, HCit values were significantly higher (+94%, p < 0.05) compared with less dilated areas. No differences were observed according to aneurysm size or when comparing ruptured and unruptured aneurysms. No significant effect of carbamylation on aneurysm development was observed using the animal model. CONCLUSIONS These results evidenced the accumulation of HCit within aneurysmal aortas but do not allow concluding about the exact participation of protein carbamylation in the development of human abdominal aortic aneurysms.
Collapse
Affiliation(s)
- Manon Doué
- University of Reims Champagne-Ardenne, CNRS, Extracellular Matrix and Cell Dynamics Unit (MEDyC) UMR, Reims, France
| | - Guillaume Marques
- Department of Vascular Surgery, University Hospital Center, Reims, France
| | - Anaïs Okwieka
- University of Reims Champagne-Ardenne, CNRS, Extracellular Matrix and Cell Dynamics Unit (MEDyC) UMR, Reims, France
| | - Laëtitia Gorisse
- University of Reims Champagne-Ardenne, CNRS, Extracellular Matrix and Cell Dynamics Unit (MEDyC) UMR, Reims, France
| | - Christine Piétrement
- University of Reims Champagne-Ardenne, CNRS, Extracellular Matrix and Cell Dynamics Unit (MEDyC) UMR, Reims, France
- Department of Pediatrics (Nephrology Unit), University Hospital Center, Reims, France
| | - Philippe Gillery
- University of Reims Champagne-Ardenne, CNRS, Extracellular Matrix and Cell Dynamics Unit (MEDyC) UMR, Reims, France
- Department of Biochemistry-Pharmacology-Toxicology, University Hospital Center, Reims, France
| | - Stéphane Jaisson
- University of Reims Champagne-Ardenne, CNRS, Extracellular Matrix and Cell Dynamics Unit (MEDyC) UMR, Reims, France
- Department of Biochemistry-Pharmacology-Toxicology, University Hospital Center, Reims, France
| |
Collapse
|
26
|
Meulenbroek AL, Steyerberg EW, Janssen TL, van Mil SR, Faes MC, van der Laan L. The Potential Value of Prehabilitation for Preventing Delirium in Elective Surgery for Aneurysms of the Abdominal Aorta. Clin Interv Aging 2024; 19:51-55. [PMID: 38223137 PMCID: PMC10787545 DOI: 10.2147/cia.s420861] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 11/05/2023] [Indexed: 01/16/2024] Open
Abstract
Objective Delirium is a common and serious postoperative complication in elderly patients undergoing abdominal aortic aneurysm (AAA) repair and is associated with a variety of adverse outcomes. Multimodal prehabilitation aims to identify and minimize potential risk factors for delirium and improve overall health. The aim of this study is to investigate the effect of multimodal prehabilitation on delirium incidence in elderly patients undergoing elective repair for AAA. Methods A single-centre cohort analysis was performed in the Netherlands for patients aged ≥70 years, undergoing elective repair for AAA (open surgery and endovascular aortic repair). Prehabilitation was gradually introduced between 2016 and 2019 and offered as standard care from 2019. The program was constructed to optimize overall health and included delirium risk assessment, home-based tailor-made exercises by a physical therapist, nutritional optimization by a dietician, iron infusion in case of anaemia and a comprehensive geriatric assessment by a geriatrician in case of frailty. The primary outcome was incidence of delirium within 30 days after surgery. Results A total of 81 control and 123 prehabilitation patients were included. A reduction in incidence of delirium was found (11.1% in the control group to 4.9% in the prehabilitation group), with too small numbers to reach statistical significance (p=0.09). Also, patients in the prehabilitation group had a small, non-significant decreased length of hospital stay (4 days) compared to the control group (5 days) (p=0.07). Conclusion Although no significant differences were found, we carefully conclude that this study provides some support for implementing multimodal prehabilitation for delirium prevention in elderly patients undergoing AAA repair. Further research with larger cohorts is necessary to identify and select patients that would most benefit from prehabilitation.
Collapse
Affiliation(s)
| | - Ewout W Steyerberg
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Ties L Janssen
- Department of Surgery, Amphia Hospital, Breda, the Netherlands
| | | | - Miriam C Faes
- Department of Geriatrics, Amphia Hospital, Breda, the Netherlands
| | - Lijckle van der Laan
- Department of Surgery, Amphia Hospital, Breda, the Netherlands
- Department of Cardiovascular Sciences, Research Group of Vascular Surgery, KU Leuven, Leuven, Belgium
| |
Collapse
|
27
|
Ge S, Xu Z. A novel wire-guided prefenestration technique for patients with type B aortic dissection: A case report. Medicine (Baltimore) 2024; 103:e36215. [PMID: 38181260 PMCID: PMC10766309 DOI: 10.1097/md.0000000000036215] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/30/2023] [Indexed: 01/07/2024] Open
Abstract
RATIONALE Acute type B aortic dissection (ABAD) is a fatal and severe cardiovascular disease. There are various strategies for dissection involving the left subclavian artery, but limited by the variety and cost of stents, the treatment brings certain obstacles. The aim of this study is to evaluate the effectiveness and safety of the wire-guided prefenestration technique for treating left subclavian artery involvement in patients with arterial dissection. PATIENT CONCERNS A 48-year-old man was transferred to our hospital due to persistent chest and back pain that had lasted for 6 hours. DIAGNOSES Preoperative computed tomography angiogram (CTA) of the thoracic and abdominal aorta diagnosed with ABAD that affected his left subclavian artery, who needed emergency endovascular treatment due to malperfusion of the lower limb arteries. INTERVENTIONS To perform the procedure, a guide wire was inserted through the left brachial artery, exited through the right femoral artery, and then entered the pre-fenestrated hole leading to the main stent. The stent was released while the guide wire was in position, and the left subclavian artery was reconstructed using viabahn. OUTCOMES Thoracic endovascular aortic repair was successfully completed for ABAD. A follow-up CT angiogram of the thoracic and abdominal aorta revealed positive vascular remodeling and no signs of significant internal leakage after one month. LESSONS This innovative approach offers a secure and efficient treatment option for aortic dissection in individuals who have undergone left subclavian artery reconstruction.
Collapse
Affiliation(s)
- Shuxiong Ge
- Department of Vascular Surgery, People’s Hospital affiliated to Ningbo University, Ningbo, Zhejiang, China
| | - Zhongyou Xu
- Department of Vascular Surgery, People’s Hospital affiliated to Ningbo University, Ningbo, Zhejiang, China
| |
Collapse
|
28
|
Fattahi N, Linné A, Roy J, Stenman M, Svensjö S, Nilsson O, Hultgren R. Prevalence of abdominal aortic aneurysm (AAA) in first-degree relatives: detecting AAA in adult offspring of AAA patients. BJS Open 2024; 8:zrad163. [PMID: 38195162 PMCID: PMC10776345 DOI: 10.1093/bjsopen/zrad163] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/15/2023] [Accepted: 12/05/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND First-degree relatives of patients with abdominal aortic aneurysm (AAA) may have an increased risk of developing the disease. The primary aim was to report the prevalence of AAA in adult male and female offspring of patients with AAA. The secondary aim was to explore the efficiency of a registry-based detection route, and the third aim was to report contemporary prevalence in the population. METHODS Adult offspring of individuals with AAA and matched controls were identified through national registries. The examination included questionnaires and ultrasound examinations of the infrarenal aorta. Aortic pathology was defined as an aortic diameter ≥25 mm, AAA ≥30 mm. RESULTS The participation rate among male and female adult offspring was 64% (350/543) and 69% (402/583), respectively. A lower participation rate was found in male and female controls (51% and 52%). No difference in prevalence of AAA was observed between male adult offspring and controls (0.9%, c.i. 0.2 to 2.3%) or in the female population (prevalence of 0.2% in adult offspring and controls). Aortic pathology and previously diagnosed AAA were detected in 5.3% (c.i. 3.3 to 8.0%) of male adult offspring and 2.3% (c.i. 1.1 to 4.2%) in controls. Aortic pathology was more prevalent among adult offspring of females with AAA. CONCLUSION The prevalence of AAA in the general population is low, but aortic pathology is notably higher among male first-degree relatives. Increased awareness should be directed towards individuals with a possible hereditary predisposition, particularly offspring of females with AAA and older smokers. Risk factor-based targeted screening of adult offspring of patients with AAA after registry-based detection should be further explored. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT4623268.
Collapse
Affiliation(s)
- Nina Fattahi
- Department of Clinical Science and Education, Karolinska Institutet at Södersjukhuset, Stockholm, Sweden
- Section of Vascular Surgery, Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - Anneli Linné
- Department of Clinical Science and Education, Karolinska Institutet at Södersjukhuset, Stockholm, Sweden
- Section of Vascular Surgery, Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - Joy Roy
- Department of Vascular Surgery, Karolinska University Hospital Stockholm, Stockholm, Sweden
- Stockholm Aneurysm Research Group, STAR, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Malin Stenman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Perioperative Medicine and Intensive Care Function, Karolinska University Hospital, Stockholm, Sweden
| | - Sverker Svensjö
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
- Department of Surgery, Falun County Hospital, Falun, Sweden
| | - Olga Nilsson
- Department of Vascular Surgery, Karolinska University Hospital Stockholm, Stockholm, Sweden
- Stockholm Aneurysm Research Group, STAR, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Rebecka Hultgren
- Department of Vascular Surgery, Karolinska University Hospital Stockholm, Stockholm, Sweden
- Stockholm Aneurysm Research Group, STAR, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
29
|
Yoshiura T, Masuda T, Kobayashi Y, Kikuhara Y, Ishibashi T, Nonaka H, Oku T, Sato T, Funama Y. Iodine contrast volume reduction in preoperative transcatheter aortic valve implantation computed tomography: Comparison with 64- and 256-multidetector row computed tomography. Radiography (Lond) 2024; 30:408-415. [PMID: 38176131 DOI: 10.1016/j.radi.2023.12.017] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/24/2023] [Accepted: 12/25/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION This study aimed to compare the vascular enhancement and radiation dose in preoperative transcatheter aortic valve implantation (TAVI) computed tomography (CT) with a reduced contrast medium (CM) using volume scans in 256-multidetector row CT (MDCT) with a standard CM using 64-MDCT. METHODS This study included 78 patients with preoperative TAVI CT with either 64- or 256-MDCT. The CM was injected at 1.5 mL/kg in the 64-MDCT group and 1.0 mL/kg in the 256-MDCT group. We compared vascular enhancement of the aortic root and access routes, image quality (IQ) scores, and radiation dose in both groups. RESULTS Despite the reduced CM (by 33 %) in the 256-MDCT group, the mean vascular enhancement of the right and left subclavian arteries was significantly higher than that in the 64-MDCT group [284 and 267 Hounsfield units (HU) vs. 376 and 359 HU; p < 0.05]; however, no significant differences in the mean vascular enhancement in the ascending aorta, abdominal aorta at the celiac level, and bilateral common femoral arteries were observed between the two groups (p > 0.05 for all). The median IQ scores at the aortic root were higher in the 256-MDCT group than in the 64-MDCT group (3 vs. 4; p < 0.05), and those at the femoral access routes were comparable (4 vs. 4; p = 0.33). The mean effective dose was significantly reduced by 30 % in the 256-MDCT group (23.6 vs. 16.3 mSv; p < 0.05). CONCLUSION In preoperative TAVI CT, volume scans using 256-MDCT provide comparable or better vascular enhancement and IQ with a 30 % reduction in CM and radiation dose than those using 64-MDCT. IMPLICATIONS FOR PRACTICE Volume scan using 256-MDCT for preoperative TAVI CT may reduce CM and radiation dose in TAVI patients with renal dysfunction.
Collapse
Affiliation(s)
- T Yoshiura
- Graduate School of Health Sciences, Kumamoto University, Kuhonji 4-24-1, Chuo-ku, Kumamoto, 860-0976, Japan; Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - T Masuda
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Matsushima 288, Okayama, 701-0193, Japan.
| | - Y Kobayashi
- Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - Y Kikuhara
- Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - T Ishibashi
- Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - H Nonaka
- Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - T Oku
- Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - T Sato
- Department of Medical Technology, Tsuchiya General Hospital, Nakajima-cho 3-30, Naka-ku, Hiroshima, 730-8655, Japan.
| | - Y Funama
- Department of Medical Radiation Sciences, Faculty of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan.
| |
Collapse
|
30
|
He Z, Ma L, Dan W, Cai X, Liu H, Mao L, Zhou X, Li G, Ding C, Wang T. Anomalous origin of the left suprarenal, inferior phrenic arteries and left ovarian artery in a human cadaver. Anat Sci Int 2024; 99:146-150. [PMID: 37566319 DOI: 10.1007/s12565-023-00738-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/02/2023] [Indexed: 08/12/2023]
Abstract
This report addresses three variants identified within a female cadaver. Specifically, these were an anomalous origin of the right suprarenal artery, an abnormal bilateral ovarian vein branch, and a arterial tortuosity of the left ovarian artery. Indeed, the cadaver evinced abnormal origins in the case of the middle suprarenal artery (MSA), right inferior phrenic artery (IPA), and the renal capsule artery (emanating from the right renal artery). The MSA and IPA shared a common trunk with the inferior suprarenal artery. It was additionally observed that the right ovarian vein anastomoses the branches from the right kidney posterior inferior along with those to the renal fat capsule. Abnormal origin was evident in the case of the left ovarian artery, and arterial tortuosity was apparent in the lower region of the vessels. This report addresses both the clinical import of these variations and their likely causes. In the subdiaphragmatic region, surgical success and prognosis may be impacted by such anomalies; accordingly surgeons must be aware of anatomical variants of the ovarian and suprarenal arteries.
Collapse
Affiliation(s)
- Zhicheng He
- Department of Clinical Medicine, Medical College of Wuhan University of Science and Technology, Wuhan, 430065, Hubei, People's Republic of China
| | - Lixin Ma
- Department of Clinical Medicine, Medical College of Wuhan University of Science and Technology, Wuhan, 430065, Hubei, People's Republic of China
| | - Wenyi Dan
- Department of Clinical Medicine, Medical College of Wuhan University of Science and Technology, Wuhan, 430065, Hubei, People's Republic of China
| | - Xinyi Cai
- Department of Clinical Medicine, Medical College of Wuhan University of Science and Technology, Wuhan, 430065, Hubei, People's Republic of China
| | - Hongrong Liu
- Department of Clinical Medicine, Medical College of Wuhan University of Science and Technology, Wuhan, 430065, Hubei, People's Republic of China
| | - Liyi Mao
- Department of Clinical Medicine, Medical College of Wuhan University of Science and Technology, Wuhan, 430065, Hubei, People's Republic of China
| | - Xuan Zhou
- Department of Clinical Medicine, Medical College of Wuhan University of Science and Technology, Wuhan, 430065, Hubei, People's Republic of China
| | - Guohui Li
- Department of Clinical Medicine, Medical College of Wuhan University of Science and Technology, Wuhan, 430065, Hubei, People's Republic of China
| | - Chugui Ding
- Department of Clinical Medicine, Medical College of Wuhan University of Science and Technology, Wuhan, 430065, Hubei, People's Republic of China
| | - Tao Wang
- Department of Anatomy, Medical College of Wuhan University of Science and Technology, Wuhan, People's Republic of China.
| |
Collapse
|
31
|
Khare HA, Binderup T, Hag AMF, Kjaer A. Longitudinal imaging of murine atherosclerosis with 2-deoxy-2-[ 18F]fluoro-D-glucose and [ 18F]-sodium fluoride in genetically modified Apolipoprotein E knock-out and wild type mice. Sci Rep 2023; 13:22983. [PMID: 38151517 PMCID: PMC10752895 DOI: 10.1038/s41598-023-49585-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 12/09/2023] [Indexed: 12/29/2023] Open
Abstract
In a longitudinal design, four arterial segments in mice were followed by positron emission tomography/computed tomography (PET/CT) imaging. We aimed to determine how the tracers reflected the development of atherosclerosis via the uptake of 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) for imaging inflammation and [18F]-sodium fluoride (Na[18F]F) for imaging active microcalcification in a murine model of atherosclerosis. Apolipoprotein E knock-out (ApoE) mice and C57 BL/6NtaC (B6) mice were divided into four groups. They received either normal chow (N = 7, ApoE mice and N = 6, B6 mice) for 32 weeks or a high-fat diet (N = 6, ApoEHFD mice and N = 9, B6HFD mice) for 32 weeks. The mice were scanned with [18F]FDG and Na[18F]F using a dedicated small animal PET/CT scanner at three timepoints. The tracer uptakes in four aortic segments (abdominal aorta, aortic arch, ascending aorta, and thoracic aorta) were measured and reported as SUVmax values. The uptake of [18F]FDG (SUVmax: 5.7 ± 0.5 vs 1.9 ± 0.2, 230.3%, p = < 0.0001) and Na[18F]F (SUVmax: 9.6 ± 1.8 vs 4.0 ± 0.3, 175%, p = 0.007) was significantly increased in the abdominal aorta of ApoEHFD mice at Week 32 compared to baseline abdominal aorta values of ApoEHFD mice. [18F]FDG uptake in the aortic arch, ascending aorta and the thoracic aorta of B6HFD mice at Week 32 showed a robust resemblance to the abdominal aorta uptake whereas the Na[18F]F uptake only resembled in the thoracic aorta of B6HFD mice at Week 32 compared to the abdominal aorta. The uptake of both [18F]FDG and Na[18F]F increased as the disease progressed over time, and the abdominal aorta provided a robust measure across mouse strain and diet. Therefore, it seems to be the preferred region for image readout. For [18F]FDG-PET, both B6 and ApoE mice provide valuable information and either mouse strain may be used in preclinical cardiovascular studies, whereas for Na[18F]F -PET, ApoE mice should be preferred.
Collapse
Affiliation(s)
- Harshvardhan A Khare
- Department of Clinical Physiology and Nuclear Medicine & Cluster for Molecular Imaging, Copenhagen University Hospital - Rigshospitalet & Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Tina Binderup
- Department of Clinical Physiology and Nuclear Medicine & Cluster for Molecular Imaging, Copenhagen University Hospital - Rigshospitalet & Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Mette Fisker Hag
- Department of Clinical Physiology and Nuclear Medicine & Cluster for Molecular Imaging, Copenhagen University Hospital - Rigshospitalet & Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Kjaer
- Department of Clinical Physiology and Nuclear Medicine & Cluster for Molecular Imaging, Copenhagen University Hospital - Rigshospitalet & Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
| |
Collapse
|
32
|
KAZAMA K, AIHARA N, KONDO T, KAWAI K, ONDA K, YAMADA K. Antemortem diagnosis of external iliac arterial thromboembolism in a calf using contrast-enhanced computed tomography: a case report. J Vet Med Sci 2023; 85:1281-1285. [PMID: 37866884 PMCID: PMC10788168 DOI: 10.1292/jvms.23-0363] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023] Open
Abstract
A 28-day-old Holstein calf with astasia (i.e., right hind limb flaccid paralysis) was referred to Large Animal Veterinary Educational Center. Thoracic radiographs showed an alveolar pattern and air bronchograms indicating pneumonia, whereas skeletal radiography showed muscle atrophy of the right hind limb but no abnormalities in the coxofemoral and stifle joints. Contrast-enhanced computed tomography revealed the pulmonary abscess in the right cranial pulmonary lobe and a thrombus (5 × 5 × 20 mm) in the right external iliac artery distal to the bifurcation of the abdominal aorta. These findings were confirmed via pathological examination. Streptococcus bovis/equinus complex colonies were isolated from the thrombus and pulmonary abscess. Thus, the pulmonary abscess was considered the infectious source of the thromboembolism in the right external iliac artery. Arterial thromboembolism should be included in the differential diagnoses in calves with astasia but without radiographic skeletal abnormalities.
Collapse
Affiliation(s)
- Kei KAZAMA
- Azabu University, School of Veterinary Medicine, Kanagawa,
Japan
| | - Naoyuki AIHARA
- Azabu University, School of Veterinary Medicine, Kanagawa,
Japan
| | - Taro KONDO
- Azabu University, School of Veterinary Medicine, Kanagawa,
Japan
| | - Kazuhiro KAWAI
- Azabu University, School of Veterinary Medicine, Kanagawa,
Japan
| | - Ken ONDA
- Azabu University, School of Veterinary Medicine, Kanagawa,
Japan
| | - Kazutaka YAMADA
- Azabu University, School of Veterinary Medicine, Kanagawa,
Japan
| |
Collapse
|
33
|
Jia P, Chen D, Zhu Y, Wang M, Zeng J, Zhang L, Cai Q, Lian D, Zhao C, Xu Y, Chu J, Lin S, Peng J, Lin W. Liensinine improves AngII-induced vascular remodeling via MAPK/TGF-β1/Smad2/3 signaling. J Ethnopharmacol 2023; 317:116768. [PMID: 37308031 DOI: 10.1016/j.jep.2023.116768] [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] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/04/2023] [Accepted: 06/09/2023] [Indexed: 06/14/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Liensinine(Lien, C37H42N2O6) is an alkaloid compound from plumula nelumbinis that demonstrates an antihypertensive effect. The protective effects of Lien on target organs during hypertension are still unclear. AIM OF THE STUDY This study aimed to understand the mechanism of Lien during the treatment of hypertension, with emphasis on vascular protection. MATERIALS AND METHODS Lien was extracted and isolated from plumula nelumbinis for further study. In vivo model of Ang II-induced hypertension, non-invasive sphygmomanometer was used to detect the blood pressure in and out of the context of Lien intervention. Ultrasound was used to detect the abdominal aorta pulse wave and media thickness of hypertensive mice, and RNA sequencing was used to detect the differential genes and pathways of blood vessels. The intersection of Lien and MAPK protein molecules was detected by molecular interconnecting technique. The pathological conditions of abdominal aorta vessels of mice were observed by HE staining. The expression of PCNA, α-SMA, Collagen Type Ⅰ and Collagen Type Ⅲ proteins were detected by IHC. The collagen expression in the abdominal aorta was detected by Sirius red staining. The MAPK/TGF-β1/Smad2/3 signaling and the protein expression of PCNA and α-SMA was detected by Western blot. In vitro, MAPK/TGF-β1/Smad2/3 signaling and the protein expression of PCNA and α-SMA were detected by Western blot, and the expression of α-SMA was detected by immunofluorescence; ELISA was used to detect the effect of ERK/MAPK inhibitor PD98059 on Ang Ⅱ-induced TGF-β1secrete; and the detection TGF-β1and α-SMA protein expression by Western blot; Western blot was used to detect the effect of ERK/MAPK stimulant12-O-tetradecanoyl phorbol-13-acetate (TPA) on the protein expression of TGF-β1 and α-SMA. RESULTS Lien displayed an antihypertensive effect on Ang Ⅱ-induced hypertension, reducing the pulse wave conduction velocity of the abdominal aorta and the thickness of the abdominal aorta vessel wall, ultimately improving the pathological state of blood vessels. RNA sequencing further indicated that the differential pathways expressed in the abdominal aorta of hypertensive mice were enriched in proliferation-related markers compared with the Control group. The profile of differentially expressed pathways was ultimately reversed by Lien. Particularly, MAPK protein demonstrated good binding with the Lien molecule. In vivo, Lien inhibited Ang Ⅱ-induced abdominal aorta wall thickening, reduced collagen deposition in the ventral aortic vessel, and prevented the occurrence of vascular remodeling by inhibiting MAPK/TGF-β1/Smad2/3 signaling activation. In addition, Lien inhibited the activation of Ang II-induced MAPK and TGF-β1/Smad2/3 signaling, attenuating the expression of PCNA and inhibiting the reduction of α-SMA, collectively playing a role in the inhibition of Ang Ⅱ-induced hypertensive vascular remodeling. PD98059 alone could inhibit Ang Ⅱ-induced elevation of TGF-β1 and the decrease of α-SMA expression. Further, PD98059 combined with Lien had no discrepancy with the inhibitors alone. Simultaneously TPA alone could significantly increase the expression of TGF-β1 and decrease the expression of α-SMA. Further, Lien could inhibit the effect of TPA. CONCLUSION This study helped clarify the protective mechanism of Lien during hypertension, elucidating its role as an inhibitor of vascular remodeling and providing an experimental basis for the research and development of novel antihypertensive therapies.
Collapse
Affiliation(s)
- Peizhi Jia
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China.
| | - Daxin Chen
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Collaborative Innovation Center for Integrative Medicine in Prevention and Treatment of Major Chronic Cardiovascular Diseases, Fuzhou, Fujian, 350122, China.
| | - Ying Zhu
- Fujian Health College, Fuzhou, Fujian, 350101, China.
| | - Meiling Wang
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China.
| | - Jianwei Zeng
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Innovation and Transformation Center, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China.
| | - Ling Zhang
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Collaborative Innovation Center for Integrative Medicine in Prevention and Treatment of Major Chronic Cardiovascular Diseases, Fuzhou, Fujian, 350122, China.
| | - Qiaoyan Cai
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Collaborative Innovation Center for Integrative Medicine in Prevention and Treatment of Major Chronic Cardiovascular Diseases, Fuzhou, Fujian, 350122, China.
| | - Dawei Lian
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Collaborative Innovation Center for Integrative Medicine in Prevention and Treatment of Major Chronic Cardiovascular Diseases, Fuzhou, Fujian, 350122, China.
| | - Chunyu Zhao
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China.
| | - Yaoyao Xu
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China.
| | - Jianfeng Chu
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Collaborative Innovation Center for Integrative Medicine in Prevention and Treatment of Major Chronic Cardiovascular Diseases, Fuzhou, Fujian, 350122, China.
| | - Shan Lin
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Collaborative Innovation Center for Integrative Medicine in Prevention and Treatment of Major Chronic Cardiovascular Diseases, Fuzhou, Fujian, 350122, China.
| | - Jun Peng
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Collaborative Innovation Center for Integrative Medicine in Prevention and Treatment of Major Chronic Cardiovascular Diseases, Fuzhou, Fujian, 350122, China; Scientific and Economic Integration Service Platform for Translational Medicine of Cardiovascular Diseases in Fujian Province, Fuzhou, Fujian, 350122, China.
| | - Wei Lin
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China; Innovation and Transformation Center, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, China.
| |
Collapse
|
34
|
Takamatsu A, Yoshida K, Watanabe S, Komori T, Inoue D, Taki J, Gabata T. Comparison of 18 F-FDG PET Findings of Pegfilgrastim-Induced Aortitis With Other Types of Large-Vessel Vasculitis : A Retrospective Observational Study. Clin Nucl Med 2023; 48:1028-1034. [PMID: 37703494 DOI: 10.1097/rlu.0000000000004847] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
PURPOSE OF THE REPORT To elucidate the PET/CT findings of pegfilgrastim-induced aortitis (PFIA) and compare them with those of other large-vessel vasculitis. METHODS We enrolled 45 patients diagnosed with the following: PFIA, n = 8; Takayasu arteritis (TA), n = 12; giant cell arteritis (GCA), n = 6; and immunoglobulin G4-related aortitis (IgG4-A), n = 19. Records of PET/CT performed before treatment initiation were collected. The aorta and its branches were divided into 16 anatomic regions. Presence of abnormal 18 F-FDG uptake in each region was determined and measured. RESULTS The 18 F-FDG-positive areas of PFIA were distributed in the regions of the ascending aorta to the suprarenal abdominal aorta, cervical branches of the aorta, and external iliac arteries, similar to those of TA. However, TA had a higher proportion of 18 F-FDG-positive areas than PFIA in almost all anatomic regions. These areas of GCA were widespread throughout the entire aorta and the upper and lower limbs, whereas those of IgG4-A were observed from the abdominal aorta to iliac arteries. SUV max , SUV peak , metabolic volume, and total lesion glycolysis were higher in GCA than in PFIA, TA, and IgG4-A. CONCLUSIONS Pegfilgrastim-induced aortitis distribution on PET/CT was frequently observed in the aorta, cervical branches, and extra iliac arteries. The low proportion of 18 F-FDG-positive areas in PFIA was different from that of TA, GCA, and IgG4-A. These findings may help identify and differentiate various aortitis types in clinical practice.
Collapse
Affiliation(s)
| | | | - Satoru Watanabe
- Nuclear Medicine, Kanazawa University Graduate School of Medical Sciences
| | | | | | | | | |
Collapse
|
35
|
Vacirca A, Mirandola V, Faggioli G, Pini R, Gargiulo M. The efficacy of CO2 angiography in the endovascular treatment of an acute iliac pseudoaneurysm. J Cardiovasc Surg (Torino) 2023; 64:653-656. [PMID: 37526443 DOI: 10.23736/s0021-9509.23.12735-2] [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] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
CO2 angiography has been used extensively for the endovascular treatment of aorto-iliac and femoral-popliteal-tibial pathologies, specifically in patients with chronic kidney disease or allergy to iodinated contrast medium (ICM). However, its use in urgent treatment of an acute pseudoaneurysm has never been described before. We report a case of a 39-year-old woman, allergic to iodine, with a recent kidney transplant, who presented in the emergency room with severe pain in the left iliac fossa. Angio CT-scan showed an acute pseudoaneurysm of the left common iliac artery. She was emergently treated with a stent-graft and CO2 was used as main contrast medium. The intraoperative angiographies performed with carbon dioxide showed very well the rupture site and the pseudoaneurysm; the latter were more clearly visible with CO2 compared with ICM. The reported case shows the efficacy of CO2 as contrast medium also in urgent settings and arterial ruptures. The lower viscosity of CO2 probably leads to an easier diffusion through the arterial lesion into the pseudoaneurysmal sac. Therefore, in this case the use of carbon dioxide not only guaranteed prevention of massive allergic reaction to iodine and preservation of postoperative renal function, but also resulted in higher image quality in the operating room.
Collapse
Affiliation(s)
- Andrea Vacirca
- Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Vascular Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria S. Orsola, Bologna, Italy
| | - Veronica Mirandola
- Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Gianluca Faggioli
- Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy -
- Vascular Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria S. Orsola, Bologna, Italy
| | - Rodolfo Pini
- Vascular Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria S. Orsola, Bologna, Italy
| | - Mauro Gargiulo
- Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Vascular Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria S. Orsola, Bologna, Italy
| |
Collapse
|
36
|
Ya'Qoub L, Cheng R, Simson M, Agrawal H. Coronary steal syndrome caused by a large saphenous venous graft aneurysm with a fistula communicating to the right atrium managed by transcatheter closure. J Invasive Cardiol 2023; 35. [PMID: 38108875 DOI: 10.25270/jic/23.00030] [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] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
A 71-year-old man with history of coronary artery disease status post coronary artery bypass grafting (CABG) in 1999 (left internal mammary artery-left anterior descending, saphenous venous graft [SVG]-diagonal, and SVG-right coronary artery [RCA], ascending aorta aneurysm [4.8 cm], infrarenal aorta aortic aneurysm status post endovascular aortic repair, heart failure with reduced ejection fraction of 25% status post cardiac resynchronization therapy-defibrillator) presented with decompensated heart failure. He was in monomorphic ventricular tachycardia; he was cardioverted and started on amiodarone and lidocaine. His vital signs remained stable.
Collapse
Affiliation(s)
- Lina Ya'Qoub
- Department of Cardiology, University of California-San Francisco, San Francisco, California, USA. E-mail:
| | - Richard Cheng
- Department of Cardiology, University of California-San Francisco, San Francisco, California, USA
| | - Marc Simson
- Department of Cardiology, University of California-San Francisco, San Francisco, California, USA
| | - Harsh Agrawal
- Department of Cardiology, University of California-San Francisco, San Francisco, California, USA
| |
Collapse
|
37
|
Buchholz J, Ronald J, Smith TP. Lumbar Artery Pseudoaneurysm following Inferior Vena Cava Filter Placement. J Vasc Interv Radiol 2023; 34:2265-2266. [PMID: 37634847 DOI: 10.1016/j.jvir.2023.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 08/20/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Joseph Buchholz
- Division of Vascular and Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina
| | - James Ronald
- Division of Vascular and Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina
| | - Tony P Smith
- Division of Vascular and Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina.
| |
Collapse
|
38
|
Lovell J, Lovelock T, Slater J, Thoo C. Chimney endovascular aortic repair is a viable salvage technique in a paravisceral pseudoaneurysm secondary to acute on chronic pancreatitis. Vascular 2023; 31:1076-1081. [PMID: 35738841 DOI: 10.1177/17085381221111012] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pseudoaneurysms of the abdominal aorta secondary to pancreatitis are an extremely rare clinical entity, however, can result in life threatening complications. OBJECTIVE To describe a chimney endovascular aneurysm repair (Ch-EVAR) for an acute pancreatitis related paravisceral aortic pseudoaneurym. METHOD Prospective data collected from subject. RESULTS We present a case of 23-year-old female who underwent a successful salvage Ch-EVAR for a ruptured paravisceral pseudoaneurysm secondary to acute on chronic pancreatitis. CONCLUSION Ch-EVAR may present a viable temporizing or definitive therapeutic treatment option for a paravisceral pseudoaneurysm, particularly in the setting of acute pancreatitis. Further studies are warranted to elucidate the long term viability of Ch-EVAR grafts in the suprarenal, paravisceral aortic position.
Collapse
Affiliation(s)
- Janaka Lovell
- Department of Vascular Surgery, Royal Hobart Hospital, Hobart, TAS, Australia
| | - Thomas Lovelock
- Department of Vascular Surgery, Royal Hobart Hospital, Hobart, TAS, Australia
| | - Jacqueline Slater
- Department of General Surgery, Royal Hobart Hospital, Hobart, TAS, Australia
| | - Catherine Thoo
- Department of Vascular Surgery, Royal Hobart Hospital, Hobart, TAS, Australia
| |
Collapse
|
39
|
Braspenning J, Verstraten A, Dirven M, Hesselink G, Schoon Y. [Preoperative geriatric screening in care path 'AAA']. Ned Tijdschr Geneeskd 2023; 167:D7627. [PMID: 38175563] [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] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
AIM Determining the added value of preoperative geriatric screening (POGS) in the care path 'Infrarenal abdominal aortic aneurysm'. DESIGN Retrospective observational study in a university hospital. METHOD For patients (>60 years) with non-acute aortic pathology, data on preoperative screening (including frailty measures) and treatment was automatically generated from medical records for the period 2018-2021 (42 months). Data has been analysed with descriptive and test statistics. Completeness of the data was checked manually by reading the medical files for the period 2020-2021 (24 months). RESULTS A total of 343 cases were included; POGS was performed in 90 patients (26%). In 84.2% of the cases the vascular surgeon adhered to the geriatrician's advice. In the other cases, the treatment is less (10.5%) or more (5.3%) intrusive than the POGS advice; the patient's preference seems to be particular decisive here. The geriatric advice is most consistent with the measures from the Clinical Frailty Scale. From the manual data collection, we learned that about 20% of the POGS were missing. CONCLUSION Introducing geriatric screening in the care pathway is likely to lead to a more considered choice by healthcare professionals as well as patients. The added value seems embraced by geriatricians and vascular surgeons as the adherence to the geriatric advice is strong. A cardiovascular nurse can use the Clinical Frailty Scale to select the patients that really need a geriatric advice. The advice is to include POGS in the care path 'Infrarenal abdominal aortic aneurysm' and possibly also in other care paths.
Collapse
Affiliation(s)
- Jozé Braspenning
- Radboudumc, Nijmegen. Centrum voor Geïntegreerde Zorg, afd. Geriatrie
- Contact: Jozé Braspenning
| | - Anne Verstraten
- Radboudumc, Nijmegen. Centrum voor Geïntegreerde Zorg, afd. Geriatrie
| | - Mark Dirven
- Radboudumc, Nijmegen. Afd. Hart- en vaatcentrum
| | - Gijs Hesselink
- Radboudumc, Nijmegen. Centrum voor Geïntegreerde Zorg, afd. Geriatrie
| | - Yvonne Schoon
- Radboudumc, Nijmegen. Centrum voor Geïntegreerde Zorg, afd. Geriatrie
| |
Collapse
|
40
|
Smith TN, Beaven A, Handford C, Sellon E, Parker PJ. Abdominal Aortic Junctional Tourniquet - Stabilized (AAJTS) can be applied both successfully and rapidly by Combat Medical Technicians (CMTs). BMJ Mil Health 2023; 169:493-498. [PMID: 34848491 DOI: 10.1136/bmjmilitary-2021-001881] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/06/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND 'Non-compressible' haemorrhage is the leading cause of preventable battlefield death, often requiring surgical or radiological intervention, which is precluded in the pre-hospital environment. One-fifth of such bleeds are junctional and therefore potentially survivable. We examine the use of the Abdominal Aortic Junctional Tourniquet - Stabilized (AAJTS) among UK Combat Medical Technicians (CMTs) as a device to control junctional haemorrhage with external compression of the abdominal aorta-compression of junctional haemorrhage previously considered 'non-compressible.' This follows animal studies showing that the AAJTS achieves control of haemorrhage and improves physiological parameters. METHODS CMTs were selected and applied the AAJTS to each other following a 1-hour training package. A consultant radiologist-operated hand-held ultrasound monitored flow changes in the subjects' common femoral artery. CMTs were then surveyed for their opinions as to utility and function. RESULTS 21 CMTs were screened and 17 CMTs participated with 34 total applications (16 day and 18 low-light). 27/34 (79%) achieved a successful application. The median application time was 75 s in daylight and 57 s in low-light conditions. There was no significant difference in Body Mass Index (p=0.23), median systolic blood pressure (p=0.19), nor class of CMT (p=0.10) between successful and unsuccessful applications. Higher systolic blood pressure was associated with longer application times (p=0.03). Users deemed the device easy to use (median score 4.4 on a 5-point Likert scale). CONCLUSION CMTs can use AAJTS successfully after a 1-hour training session in the majority of applications. Application was successful in both daylight and low-light conditions. Self-reported usability ratings were high.
Collapse
Affiliation(s)
- Thomas Nicholas Smith
- Foundation Year Medical Officers, Queen Elizabeth Hospital, Birmingham, West Midlands, UK
| | - A Beaven
- Orthopaedics, Queen Elizabeth Hospital, Birmingham, UK
| | - C Handford
- Orthopaedics, Queen Elizabeth Hospital, Birmingham, UK
| | - E Sellon
- Radiology, John Radcliffe Hospital, Oxford, Oxfordshire, UK
| | - P J Parker
- Orthopaedics, Queen Elizabeth Hospital, Birmingham, UK
| |
Collapse
|
41
|
Higuchi Y, Nomura T, Yoshida S, Kitamura M, Ono K, Shoji K, Wada N, Keira N, Tatsumi T. Emphysematous changes as red flag signs preceding rapidly progressive infectious aortic disease: two case reports. BMC Cardiovasc Disord 2023; 23:577. [PMID: 37990294 PMCID: PMC10664595 DOI: 10.1186/s12872-023-03619-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/16/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Infectious aortic disease is a rare and fatal disease, that requires the appropriate intervention. An accurate diagnosis should be promptly established. However, this is difficult because the clinical manifestations of this disease vary and are non-specific. CASE PRESENTATION (CASE 1) An 87-year-old male, presenting with generalized malaise and weight loss, was admitted for further examination. A chest computed tomography (CT) showed mediastinal emphysema. Empirical intravenous antibiotics were administered to address the non-specific infectious findings in the laboratory data. The treatment was effective, and the patient fully recovered. However, he was in shock due to aortic rupture and marked pseudo aneurysmal formation around the aortic arch day 25 of hospitalization. An emergency total aortic arch replacement was performed, and the patient was discharged. (CASE 2) An 82-year-old male who had undergone Y-graft replacement in the abdominal aorta 15 years previously was admitted due to general malaise and anorexia. Abdominal CT revealed emphysematous changes adjacent to the abdominal aorta. The patient responded favorably to empirical treatment with intravenous antibiotics and was discharged 19 days after admission. Four days after discharge, the patient went into cardiac arrest after an episode of hematemesis. Abdominal CT revealed an enlarged stomach and duodenum, filled with massive high-density contents proximal to the abdominal aorta. He died of hemorrhagic shock despite cardiopulmonary resuscitation. CONCLUSIONS Although emphysematous changes are rare, they are red flag signs during the early stage of infectious aortic disease. Thus, physicians should remain vigilant for this kind of critical sign.
Collapse
Affiliation(s)
- Yusuke Higuchi
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Tetsuya Nomura
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan.
| | - Shiori Yoshida
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Michitaka Kitamura
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Kenshi Ono
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Keisuke Shoji
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Naotoshi Wada
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Natsuya Keira
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Tetsuya Tatsumi
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| |
Collapse
|
42
|
Jia J, Zhang J, He Q, Wang M, Liu Q, Wang T, Chen X, Wang W, Xu H. Association between dietary vitamin C and abdominal aortic calcification among the US adults. Nutr J 2023; 22:58. [PMID: 37964312 PMCID: PMC10647183 DOI: 10.1186/s12937-023-00889-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of mortality, and vascular calcification has been highly correlated with CVD events. Abdominal aortic calcification (AAC) has been shown to predict subclinical CVD and incident CVD events. However, the relationship between vitamin C and abdominal aortic calcification remains unclear. OBJECTIVE To investigate the relationship of dietary vitamin C with AAC among the adult population in the US. METHODS The National Health and Nutrition Examination Survey (NHANES) 2013-2014 provided the data for the cross-sectional study. 2297 subjects (1089 males) were included in the study. Two scoring systems, AAC 24-point scale (Kauppila) and AAC 8-point scale (Schousboe), were used for the measurement of AAC score. Dietary vitamin C intake was calculated as the average of two rounds of 24-h interview recall data and classified in tertiles for analysis. We applied weighted multiple regression analyses to assess the relationship of dietary vitamin C with AAC score and the risk of having AAC. To ensure the robustness of the findings, subgroup and sensitivity analyses were performed. Additionally, smooth curve fittings, using generalized additive models (GAM) were employed to visualize potential nonlinear relationships. Furthermore, an exploratory analysis on the relationship of vitamin C supplements with AAC was also conducted. RESULTS The results showed that higher dietary vitamin C intake was related to a reduction in AAC score (AAC-24: β = -0.338, 95% confidence interval [CI] -0.565, -0.111, P = 0.004; AAC-8: β = -0.132, 95%CI -0.217, -0.047, P = 0.002), and lower risk of AAC (odds ratio [OR] = 0.807, 95%CI 0.659, 0.989, P = 0.038). However, the relationship of vitamin C supplements with AAC was not identified. CONCLUSIONS The study revealed that higher intake of dietary vitamin C rather than vitamin C supplements was related to reduced AAC score and lower risk of AAC, indicating that diets rich in vitamin C are recommended due to its potential benefits for protecting against vascular calcification and CVD among the adult population in the US.
Collapse
Affiliation(s)
- Jundi Jia
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Academy of Chinese Medical Sciences, Beijing, China
| | - Jie Zhang
- National Integrated Traditional and Western Medicine Center for Cardiovascular Disease, China-Japan Friendship Hospital, Beijing, China
| | - Qiao He
- Clinical Epidemiology and Evidence-Based Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Mingqi Wang
- Clinical Epidemiology and Evidence-Based Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qiyu Liu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tongxin Wang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Academy of Chinese Medical Sciences, Beijing, China
| | - Xuanye Chen
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Academy of Chinese Medical Sciences, Beijing, China
| | - Wen Wang
- Clinical Epidemiology and Evidence-Based Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Hao Xu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Academy of Chinese Medical Sciences, Beijing, China.
| |
Collapse
|
43
|
Xue K, Xing S. Blood urea nitrogen concentration is associated with severe abdominal aortic calcification in adults: a cross-sectional investigation. Sci Rep 2023; 13:19834. [PMID: 37964009 PMCID: PMC10645972 DOI: 10.1038/s41598-023-47109-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/09/2023] [Indexed: 11/16/2023] Open
Abstract
The purpose of this research is to examine the correlation between blood urea nitrogen (BUN) and severe abdominal aortic calcification (AAC) among American adults aged 40 years and older. A total of 2757 participants in the NHANES from 2013 to 2014 were included in the final analysis. BUN was measured by means of the enzymatic conductivity rate method. AAC scores were quantified by the Kauppila scoring system, and severe AAC was defined as an AAC score ≥ 6. Multivariable logistic regression and restricted cubic splines were used in the analyses. In the multivariable logistic regression model, the highest BUN level (log 2-transformed) was associated with an increased risk of severe AAC [odds ratio (OR) = 1.77, 95% CI 1.17, 2.71]. The restricted cubic spline plot displayed a reverse L-shaped association between BUN (log2-transformed) and severe AAC (p for nonlinearity < 0.001). In addition,the interactions of BUN were not discover. In general, there is a positive correlation between BUN and the risk of severe AAC.
Collapse
Affiliation(s)
- Kun Xue
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Shanshan Xing
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
| |
Collapse
|
44
|
Dalbosco M, Terzano M, Carniel TA, Fancello EA, Holzapfel GA. A two-scale numerical study on the mechanobiology of abdominal aortic aneurysms. J R Soc Interface 2023; 20:20230472. [PMID: 37907092 PMCID: PMC10618057 DOI: 10.1098/rsif.2023.0472] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/11/2023] [Indexed: 11/02/2023] Open
Abstract
Abdominal aortic aneurysms (AAAs) are a serious condition whose pathophysiology is related to phenomena occurring at different length scales. To gain a better understanding of the disease, this work presents a multi-scale computational study that correlates AAA progression with microstructural and mechanical alterations in the tissue. Macro-scale geometries of a healthy aorta and idealized aneurysms with increasing diameter are developed on the basis of existing experimental data and subjected to physiological boundary conditions. Subsequently, microscopic representative volume elements of the abluminal side of each macro-model are employed to analyse the local kinematics at the cellular scale. The results suggest that the formation of the aneurysm disrupts the micromechanics of healthy tissue, which could trigger collagen growth and remodelling by mechanosensing cells. The resulting changes to the macro-mechanics and microstructure of the tissue seem to establish a new homeostatic state at the cellular scale, at least for the diameter range investigated.
Collapse
Affiliation(s)
- Misael Dalbosco
- Institute of Biomechanics, Graz University of Technology, Graz, Austria
- GRANTE—Department of Mechanical Engineering, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Michele Terzano
- Institute of Biomechanics, Graz University of Technology, Graz, Austria
| | - Thiago A. Carniel
- Polytechnic School, Community University of Chapecó Region, Chapecó, Santa Catarina, Brazil
- Graduate Program in Health Sciences, Community University of Chapecó Region, Chapecó, Santa Catarina, Brazil
| | - Eduardo A. Fancello
- GRANTE—Department of Mechanical Engineering, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
- LEBm—University Hospital, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Gerhard A. Holzapfel
- Institute of Biomechanics, Graz University of Technology, Graz, Austria
- Department of Structural Engineering, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| |
Collapse
|
45
|
Yuan P, Hu Y. Injury of the common hepatic artery during esophagectomy caused by an anatomical variation branching from a common trunk with the left gastric artery: A case report. Asian J Surg 2023; 46:5007-5008. [PMID: 37591754 DOI: 10.1016/j.asjsur.2023.06.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 06/07/2023] [Indexed: 08/19/2023] Open
Affiliation(s)
- Peisong Yuan
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yang Hu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.
| |
Collapse
|
46
|
Cui T, Li S. Application of the "Hand as Foot" teaching method in anatomy of anterior abdominal aorta. Asian J Surg 2023; 46:5096-5097. [PMID: 37419812 DOI: 10.1016/j.asjsur.2023.06.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 06/15/2023] [Indexed: 07/09/2023] Open
Affiliation(s)
- Tao Cui
- Department of Emergency Medicine, Shengli Oilfield Central Hospital, China
| | - Shilei Li
- Department of Hepatobiliary Surgery, Shengli Oilfield Central Hospital, China.
| |
Collapse
|
47
|
Kaga T, Noda Y, Nagata S, Kawai N, Miyoshi T, Hyodo F, Kato H, Matsuo M. Comparison of image quality, arterial depiction, and radiation dose between two rapid kVp-switching dual-energy CT scanners in CT angiography at 40-keV. Jpn J Radiol 2023; 41:1298-1307. [PMID: 37212946 PMCID: PMC10613589 DOI: 10.1007/s11604-023-01448-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/11/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE To compare the quantitative parameters and qualitative image quality of dual-energy CT angiography (CTA) between two rapid kVp-switching dual-energy CT scanners. MATERIALS AND METHODS Between May 2021 and March 2022, 79 participants underwent whole-body CTA using either Discovery CT750 HD (Group A, n = 38) or Revolution CT Apex (Group B, n = 41). All data were reconstructed at 40-keV and with adaptive statistical iterative reconstruction-Veo of 40%. The two groups were compared in terms of CT numbers of the thoracic and abdominal aorta, and the iliac artery, background noise, signal-to-noise ratio (SNR) of the artery, CT dose-index volume (CTDIvol), and qualitative scores for image noise, sharpness, diagnostic acceptability, and arterial depictions. RESULTS The median CT number of the abdominal aorta (p = 0.04) and SNR of the thoracic aorta (p = 0.02) were higher in Group B than in Group A, while no difference was observed in the other CT numbers and SNRs of the artery (p = 0.09-0.23). The background noises at the thoracic (p = 0.11), abdominal (p = 0.85), and pelvic (p = 0.85) regions were comparable between the two groups. CTDIvol was lower in Group B than in Group A (p = 0.006). All qualitative scores were higher in Group B than in Group A (p < 0.001-0.04). The arterial depictions were nearly identical in both two groups (p = 0.005-1.0). CONCLUSION In dual-energy CTA at 40-keV, Revolution CT Apex improved qualitative image quality and reduced radiation dose.
Collapse
Affiliation(s)
- Tetsuro Kaga
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Yoshifumi Noda
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Shoma Nagata
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Nobuyuki Kawai
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Toshiharu Miyoshi
- Department of Radiology Services, Gifu University Hospital, Gifu, Japan
| | - Fuminori Hyodo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
- Institute for Advanced Study, Gifu University, Gifu, Japan
| | - Hiroki Kato
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| |
Collapse
|
48
|
Feng X, Kong Y, Yu H. An Exploratory Investigation into Optimal Indicators and Thresholds for Anemia Diagnosis Through Abdominal CT Plain Scans. Altern Ther Health Med 2023; 29:738-743. [PMID: 37708544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Objective This study aimed to assess the diagnostic utility and optimal thresholds of abdominal CT plain scans in identifying various degrees of anemia. Methods We included 40 participants in each of the mild, moderate, and severe anemia groups, totaling 120 participants, along with 40 healthy controls. We measured CT values of several abdominal structures, including the abdominal aorta (AA), inferior vena cava (IVC), liver, bilateral kidneys, spleen, and lumbar spinal cord (LSC), in both the normal and anemia groups. Additionally, we calculated the difference and ratio of CT values between AA and LSC and IVC and LSC. We analyzed the correlation between these parameters and hemoglobin (Hb) concentration. The most effective indicators and thresholds for diagnosing varying degrees of anemia using abdominal CT plain scans were identified. Results Significant differences were observed in hemoglobin concentration, CT values of AA, CT values of IVC, liver CT values, kidney CT values, and the ratios of CT values between AA and LSC, as well as IVC and LSC, among the four groups (P < .05). However, no significant differences were found in spleen CT values and CT values of LSC between the groups (P > .05). The CT values of AA, IVC, the ratios of AA to LSC, and IVC to LSC displayed significant positive linear correlations with hemoglobin concentration. Optimal thresholds for diagnosing mild, moderate, and severe anemia in AA were found to be 35.43, 33.2, and 30.2 HU, respectively, while for IVC, they were 34.18, 31.27, and 28.1 HU, respectively. Conclusions Among the various parameters obtained from abdominal CT plain scans, the CT value of the abdominal aorta demonstrated the highest diagnostic efficacy in distinguishing between different degrees of anemia.
Collapse
|
49
|
Hotek JC, Detwiler TJ, Chirinos JA, Regan CP. A generalized canine transfer function accurately reconstructs central aortic pressure waveforms to enable enhanced pulse wave analysis. J Pharmacol Toxicol Methods 2023; 124:107476. [PMID: 37931824 DOI: 10.1016/j.vascn.2023.107476] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/20/2023] [Accepted: 11/02/2023] [Indexed: 11/08/2023]
Abstract
Routine preclinical blood pressure evaluation is an important risk assessment tool. Although proximal aortic pressure is most relevant for key target organs, abdominal aortic pressures are more commonly recorded. Pulse pressure amplification and waveform distortion in abdominal waveforms make it inappropriate for central hemodynamic analytical methods without the use of a mathematical transfer function. Clinical transfer functions have been developed to estimate ascending aortic waveforms from brachial or radial artery waveforms in humans, but no preclinical analogues exist. The aim of this study was to develop a canine-specific transfer function to reconstruct thoracic aortic pressure waveforms from abdominal aortic data to enable the application of central hemodynamic analytical methods. Simultaneous abdominal and thoracic blood pressures were recorded from seven conscious, male beagle dogs administered 3 well-characterized pharmacologic standards and animals were appointed to a training (n = 3) or validation (n = 4) group at baseline and during dosing. A generalized transfer function was developed from the training group data and evaluated for its ability to synthesize thoracic pressure waves in the training and validation groups. Select hemodynamic parameters were evaluated in measured and synthesized thoracic data. There was a high degree of correlation between measured and synthesized thoracic parameters (r2 = 0.74-0.99). There was no difference between indices computed from synthesized or actual thoracic waveforms at baseline or after administration of pharmacologic standards. This work demonstrates that a generalized preclinical transfer function can reproduce thoracic pressure waves across a range of hemodynamic responses thus enabling the application of central hemodynamic analytical methods.
Collapse
Affiliation(s)
- Julia C Hotek
- Safety & Exploratory Pharmacology (SEP), Merck & Co., Inc., Rahway, NJ, USA.
| | | | - Julio A Chirinos
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | |
Collapse
|
50
|
Chowdhury MM, Tarkin JM. Could imaging microcalcification activity improve abdominal aortic aneurysm risk stratification after intervention? Heart 2023; 109:1654-1656. [PMID: 37463734 DOI: 10.1136/heartjnl-2023-322814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Affiliation(s)
- Mohammed M Chowdhury
- Vascular Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Section of Cardiorespiratory Medicine, Victor Phillip Dahdaleh Heart & Lung Research Institute, Cambridge University, Cambridge, UK
| | - Jason M Tarkin
- Section of Cardiorespiratory Medicine, Victor Phillip Dahdaleh Heart & Lung Research Institute, Cambridge University, Cambridge, UK
| |
Collapse
|