1
|
Tabi M, Padkins M, Burstein B, Younis A, Asher E, Bennett C, Jentzer JC. Association of Shock Index with Echocardiographic Parameters in Cardiac Intensive Care Unit. J Crit Care 2024; 79:154445. [PMID: 37890356 DOI: 10.1016/j.jcrc.2023.154445] [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: 07/18/2023] [Revised: 09/18/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND A high shock index (SI), the ratio of heart rate (HR) to systolic blood pressure (SBP), has been associated with unfavorable outcomes. We sought to determine the hemodynamic underpinnings of an elevated SI using 2-D and doppler Transthoracic Echocardiography (TTE) in unselected cardiac intensive care unit (CICU) patients. METHODS We included Mayo Clinic CICU admissions from 2007 to 2018 who were in sinus rhythm at the time of TTE. The SI was calculated using HR and SBP at the time of TTE. Patients were grouped according to SI: <0.7, 4012 (64%); 0.7-0.99, 1764 (28%); and ≥ 1.0, 513 (8%). Pearson's correlation coefficient was used to assess associations between continuous variables. RESULTS We included 6289 unique CICU patients, 58% of whom had acute coronary syndrome. The median age was 67.9 years old and 37.8% were females. The mean SI was 0.67 BPM/mmHg. As the SI increased, markers of left ventricular (LV) systolic function and forward flow decreased, including left ventricular ejection fraction (LVEF), fractional shortening, left ventricular outflow tract (LVOT) velocity time integral (VTI), stroke volume, LV stroke work index, and cardiac power output. Biventricular filling pressures increased, and markers of right ventricular function worsened with rising SI. Most TTE measurements reflecting LV function and forward flow were inversely correlated with SI, including LV stroke work index (r = -0.59) and LVOT VTI (r = -0.41), as were both systemic vascular resistance index (r = -0.43) and LVEF (r = -0.23). CONCLUSION CICU patients with elevated SI have worse biventricular function and systemic hemodynamics, particularly decreased stroke volume and related calculated TTE parameters. The SI is an easily available marker that can be used to identify CICU patients with unfavorable hemodynamics who may require further assessment.
Collapse
Affiliation(s)
- Meir Tabi
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America; Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Mitchell Padkins
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America
| | | | - Anan Younis
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America
| | - Elad Asher
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Courtney Bennett
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America
| | - Jacob C Jentzer
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America.
| |
Collapse
|
2
|
Schwab C, Domke LM, Hartmann L, Stenzinger A, Longerich T, Schirmacher P. Autopsy-based histopathological characterization of myocarditis after anti-SARS-CoV-2-vaccination. Clin Res Cardiol 2023; 112:431-440. [PMID: 36436002 PMCID: PMC9702955 DOI: 10.1007/s00392-022-02129-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [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: 07/22/2022] [Accepted: 11/17/2022] [Indexed: 11/28/2022]
Abstract
Cases of myocarditis, diagnosed clinically by laboratory tests and imaging have been described in the context of mRNA-based anti-SARS-CoV-2 vaccination. Autopsy-based description of detailed histological features of vaccine-induced myocarditis is lacking. We describe the autopsy findings and common characteristics of myocarditis in untreated persons who received anti-SARS-CoV-2 vaccination. Standardized autopsies were performed on 25 persons who had died unexpectedly and within 20 days after anti-SARS-CoV-2 vaccination. In four patients who received a mRNA vaccination, we identified acute (epi-)myocarditis without detection of another significant disease or health constellation that may have caused an unexpected death. Histology showed patchy interstitial myocardial T-lymphocytic infiltration, predominantly of the CD4 positive subset, associated with mild myocyte damage. Overall, autopsy findings indicated death due to acute arrhythmogenic cardiac failure. Thus, myocarditis can be a potentially lethal complication following mRNA-based anti-SARS-CoV-2 vaccination. Our findings may aid in adequately diagnosing unclear cases after vaccination and in establishing a timely diagnosis in vivo, thus, providing the framework for adequate monitoring and early treatment of severe clinical cases.
Collapse
Affiliation(s)
- Constantin Schwab
- Institute of Pathology, Heidelberg University Hospital, Universitätsklinikum Heidelberg, Pathologisches Institut, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | - Lisa Maria Domke
- Institute of Pathology, Heidelberg University Hospital, Universitätsklinikum Heidelberg, Pathologisches Institut, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
- German Center for Infection Research (DZIF), partner site Heidelberg, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Laura Hartmann
- Institute of Pathology, Heidelberg University Hospital, Universitätsklinikum Heidelberg, Pathologisches Institut, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
- German Center for Infection Research (DZIF), partner site Heidelberg, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Albrecht Stenzinger
- Institute of Pathology, Heidelberg University Hospital, Universitätsklinikum Heidelberg, Pathologisches Institut, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | - Thomas Longerich
- Institute of Pathology, Heidelberg University Hospital, Universitätsklinikum Heidelberg, Pathologisches Institut, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | - Peter Schirmacher
- Institute of Pathology, Heidelberg University Hospital, Universitätsklinikum Heidelberg, Pathologisches Institut, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany.
| |
Collapse
|
3
|
Giuste FO, Sequeira R, Keerthipati V, Lais P, Mirzazadeh A, Mohseni A, Zhu Y, Shi W, Marteau B, Zhong Y, Tong L, Das B, Shehata B, Deshpande S, Wang MD. Explainable synthetic image generation to improve risk assessment of rare pediatric heart transplant rejection. J Biomed Inform 2023; 139:104303. [PMID: 36736449 PMCID: PMC10031799 DOI: 10.1016/j.jbi.2023.104303] [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: 11/02/2022] [Revised: 12/23/2022] [Accepted: 01/29/2023] [Indexed: 02/05/2023]
Abstract
Expert microscopic analysis of cells obtained from frequent heart biopsies is vital for early detection of pediatric heart transplant rejection to prevent heart failure. Detection of this rare condition is prone to low levels of expert agreement due to the difficulty of identifying subtle rejection signs within biopsy samples. The rarity of pediatric heart transplant rejection also means that very few gold-standard images are available for developing machine learning models. To solve this urgent clinical challenge, we developed a deep learning model to automatically quantify rejection risk within digital images of biopsied tissue using an explainable synthetic data augmentation approach. We developed this explainable AI framework to illustrate how our progressive and inspirational generative adversarial network models distinguish between normal tissue images and those containing cellular rejection signs. To quantify biopsy-level rejection risk, we first detect local rejection features using a binary image classifier trained with expert-annotated and synthetic examples. We converted these local predictions into a biopsy-wide rejection score via an interpretable histogram-based approach. Our model significantly improves upon prior works with the same dataset with an area under the receiver operating curve (AUROC) of 98.84% for the local rejection detection task and 95.56% for the biopsy-rejection prediction task. A biopsy-level sensitivity of 83.33% makes our approach suitable for early screening of biopsies to prioritize expert analysis. Our framework provides a solution to rare medical imaging challenges currently limited by small datasets.
Collapse
Affiliation(s)
- Felipe O Giuste
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, 30332, GA, USA.
| | - Ryan Sequeira
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, 30332, GA, USA
| | - Vikranth Keerthipati
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, 30332, GA, USA
| | - Peter Lais
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, 30332, GA, USA
| | - Ali Mirzazadeh
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, 30332, GA, USA
| | - Arshawn Mohseni
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, 30332, GA, USA
| | - Yuanda Zhu
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, 30332, GA, USA
| | - Wenqi Shi
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, 30332, GA, USA
| | - Benoit Marteau
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, 30332, GA, USA
| | - Yishan Zhong
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, 30332, GA, USA
| | - Li Tong
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, 30332, GA, USA
| | - Bibhuti Das
- Department of Pediatric Cardiology, University of Mississippi Medical Center, Jackson, 39216, MS, USA
| | - Bahig Shehata
- Department of Pathology, Wayne State University School of Medicine, Detroit, 48201, MI, USA
| | - Shriprasad Deshpande
- Department of Pediatric Cardiology, Children's National Health System, Washington, 20010, DC, USA
| | - May D Wang
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, 30332, GA, USA; School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, 30332, GA, USA.
| |
Collapse
|
4
|
Abstract
UNLABELLED Multisystem Inflammatory Syndrome in Children is a rare form of COVID-19 that affects various organ systems and carries the risk of morbidity and mortality. Cardiac involvement is commonly observed in Multisystem Inflammatory Syndrome in Children cases; hence, this study was conducted to evaluate the cardiac findings of the Multisystem Inflammatory Syndrome in Children cases that were diagnosed and followed up in our hospital. MATERIALS AND METHODS The medical histories, laboratory results, cardiac findings, and treatments of the cases that were diagnosed with Multisystem Inflammatory Syndrome in Children between December 2020 and August 2021 were evaluated retrospectively. RESULTS Our study group consisted of 14 males and 12 females whose median age was 3.67 years. Of the 26 patients, 24 had echocardiographic findings and 12 cases had cardiac pathologies that were mostly mild. Among these, mitral valve insufficiency, coronary artery pathology, and pericardial effusion were the most common. Perivascular brightness, aortic and tricuspid insufficiency, systolic dysfunction, and tricuspid thrombosis were less common. The cardiac pathologies of all patients resolved in less than a month following treatment. CONCLUSION Although the cardiac pathologies of Multisystem Inflammatory Syndrome in Children cases disappear fairly rapidly, the long-term cardiac effects of this disease are not known clearly. To improve our current understanding of Multisystem Inflammatory Syndrome in Children, more multi-centred studies with long-term follow-up periods should be conducted, and treatment protocols for cases of different severities should be developed to maximise the treatments' efficacy.
Collapse
|
5
|
Sang CJ 3rd, Burkett A, Heindl B, Litovsky SH, Prabhu SD, Benson PV, Rajapreyar I. Cardiac pathology in COVID-19: a single center autopsy experience. Cardiovasc Pathol 2021; 54:107370. [PMID: 34273507 DOI: 10.1016/j.carpath.2021.107370] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/03/2021] [Accepted: 07/06/2021] [Indexed: 01/19/2023] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is commonly associated with myocardial injury and heart failure. The pathophysiology behind this phenomenon remains unclear, with many diverse and multifaceted hypotheses. To contribute to this understanding, we describe the underlying cardiac findings in fifty patients who died with coronavirus disease 2019 (COVID-19). Methods Included were autopsies performed on patients with a positive SARS-CoV-2 reverse-transcriptase-polymerase-chain reaction test from the index hospitalization. In the case of out-of-hospital death, patients were included if post-mortem testing was positive. Complete autopsies were performed according to a COVID-19 safety protocol, and all patients underwent both macroscopic and microscopic examination. If available, laboratory findings and echocardiograms were reported. Results The median age of the decedents was 63.5 years. The most common comorbidities included hypertension (90.0%), diabetes (56.0%) and obesity (50.0%). Lymphocytic inflammatory infiltrates in the heart were present in eight (16.0%) patients, with focal myocarditis present in two (4.0%) patients. Acute myocardial ischemia was observed in eight (16.0%) patients. The most common findings were myocardial fibrosis (80.0%), hypertrophy (72.0%), and microthrombi (66.0%). The most common causes of death were COVID-19 pneumonia in 18 (36.0%), COVID-19 pneumonia with bacterial superinfection in 12 (24.0%), and COVID-19 pneumonia with pulmonary embolism in 10 (20.0%) patients. Conclusions Cardiovascular comorbidities were prevalent, and pathologic changes associated with hypertensive and atherosclerotic cardiovascular disease were the most common findings. Despite markedly elevated inflammatory markers and cardiac enzymes, few patients exhibited inflammatory infiltrates or necrosis within cardiac myocytes. A unifying pathophysiologic mechanism behind myocardial injury in COVID-19 remains elusive, and additional autopsy studies are needed.
Collapse
|
6
|
Halvorson T, Blau J, Firchau D. Congenitally corrected transposition of the great arteries. Cardiovasc Pathol 2020; 50:107267. [PMID: 32818611 DOI: 10.1016/j.carpath.2020.107267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 11/25/2022] Open
Abstract
Congenitally corrected transposition of the great arteries (cc-TGA, also known as L-transposition) is a rare condition that represents approximately 0.5% of congenital heart disease. It is characterized by atrioventricular and ventriculoarterial discordance. Patients with cc-TGA are at risk for cardiac arrhythmias due to abnormalities of the conduction system. We present an autopsy case of a 49-year-old man with cc-TGA who died unexpectedly, likely as a result of a fatal arrhythmia. This case illustrates the cardiac pathology characteristic of cc-TGA and describes how to grossly identify inversion of the atrioventricular valves.
Collapse
Affiliation(s)
- Tracy Halvorson
- Department of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242.
| | - John Blau
- Department of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242
| | - Dennis Firchau
- Department of Pathology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242
| |
Collapse
|
7
|
Qiuying L, Chengfeng H, Xiaoshen Z. Intravenous leiomyomatosis extending into right heart: A case report. Turk Gogus Kalp Damar Cerrahisi Derg 2019; 28:386-9. [PMID: 32551173 DOI: 10.5606/tgkdc.dergisi.2020.18916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 01/31/2020] [Indexed: 11/21/2022]
Abstract
Intravenous leiomyomatosis is a rare and special tumor which is exclusively seen in premenopausal women. Herein, we present a 46-year-old female case diagnosed with intravenous leiomyomatosis through an exploratory sternotomy and pathological examination.
Collapse
|
8
|
Wu G, Lu ZH, Seo JH, Alselehdar SK, DeFrees S, Ledeen RW. Mice deficient in GM1 manifest both motor and non-motor symptoms of Parkinson's disease; successful treatment with synthetic GM1 ganglioside. Exp Neurol 2020; 329:113284. [PMID: 32165255 DOI: 10.1016/j.expneurol.2020.113284] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/11/2020] [Accepted: 03/08/2020] [Indexed: 12/15/2022]
Abstract
Parkinson's disease (PD) is a major neurodegenerative disorder characterized by a variety of non-motor symptoms in addition to the well-recognized motor dysfunctions that have commanded primary interest. We previously described a new PD mouse model based on heterozygous disruption of the B4galnt1 gene leading to partial deficiency of the GM1 family of gangliosides that manifested several nigrostriatal neuropathological features of PD as well as movement impairment. We now show this mouse also suffers three non-motor symptoms characteristic of PD involving the gastrointestinal, sympathetic cardiac, and cerebral cognitive systems. Treatment of these animals with a synthetic form of GM1 ganglioside, produced by transfected E. coli, proved ameliorative of these symptoms as well as the motor defect. These findings further suggest subnormal GM1 to be a systemic defect constituting a major risk factor in sporadic PD and indicate the B4galnt1(+/-) (HT) mouse to be a true neuropathological model that recapitulates both motor and non-motor lesions of this condition.
Collapse
Affiliation(s)
- Gusheng Wu
- Department of Pharmacology, Physiology and Neuroscience, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, United States
| | - Zi-Hua Lu
- Department of Pharmacology, Physiology and Neuroscience, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, United States
| | - Joon Ho Seo
- Department of Pharmacology, Physiology and Neuroscience, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, United States
| | - Samar K Alselehdar
- Department of Pharmacology, Physiology and Neuroscience, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, United States
| | | | - Robert W Ledeen
- Department of Pharmacology, Physiology and Neuroscience, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, United States.
| |
Collapse
|
9
|
Kubota H, Endo H, Ishii H, Tsuchiya H, Inaba Y, Terakawa K, Takahashi Y, Noma M, Takemoto K, Taniai S, Sakata K, Soejima K, Shimoyamada H, Kamma H, Kawakami H, Kaneko Y, Hirono S, Izumi D, Ozaki K, Minamino T, Yoshino H, Sudo K. Adult ALCAPA: from histological picture to clinical features. J Cardiothorac Surg 2020; 15:14. [PMID: 31931842 PMCID: PMC6958604 DOI: 10.1186/s13019-020-1048-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 01/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary anomaly that results in high mortality if left untreated. Our aim was to extend our knowledge of the histological, angiographic, and clinical characteristics of ALCAPA in order to deepen our understanding of this rare entity. CASE PRESENTATION We were involved in the assessment, treatment, and pathological evaluation of two adult ALCAPA patients who were rescued from ventricular fibrillation and then surgically treated to establish a dual coronary artery system. Histological studies indicated various chronic ischemic changes in the myocardium, patchy fibrosis, and severely thickened arteriolar walls in both ventricles. The first patient is alive and well 11.5 years after surgical correction without any implantable cardioverter defibrillator (ICD) activations. The second patient required re-do surgery 9 months after the initial operation but subsequently died. Histologically, chronic ischemic alteration of the myocardium and thickened arteriolar walls persisted even after surgical correction, and coronary angiography (CAG) showed an extremely slow flow phenomenon even after surgical correction in both patients. The average postoperative opacification rate in the first case was 7.36 + 1.12 (n = 2) in the RCA, 3.81 + 0.51 (n = 3) in the left anterior descending (LAD) artery, and 4.08 + 0.27 (n = 4) in the left circumflex (LCx) artery. The slow flow phenomenon may represent persistent high arteriolar resistance in both ventricles. CONCLUSIONS Seldom reported or new findings in adult ALCAPA were identified in two cases. More frequent diagnosis of adult ALCAPA can be expected because of the widespread availability of resuscitation and more advanced diagnostic modalities. Accumulation of pathological and clinical findings and confirmation of the long-term follow-up results after treatment may contribute to expanding our knowledge of this rare entity and establishing optimal treatment.
Collapse
Affiliation(s)
- Hiroshi Kubota
- Department of Cardiovascular Surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Hidehito Endo
- Department of Cardiovascular Surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hikaru Ishii
- Department of Cardiovascular Surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hiroshi Tsuchiya
- Department of Cardiovascular Surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Yusuke Inaba
- Department of Cardiovascular Surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | | | - Yu Takahashi
- Department of Cardiovascular Surgery, National Disaster Medical Center, Tachikawa, Japan
| | - Mio Noma
- Department of Cardiovascular Surgery, Tokyo Metropolitan Children's Medical Center, Fuchu, Japan
| | - Kazuya Takemoto
- Department of Internal Medicine, Jyukoukai Hospital, Miyoshi, Japan
| | - Seiichi Taniai
- Department of Cardiology, Kyorin University, Mitaka, Japan
| | - Konomi Sakata
- Department of Cardiology, Kyorin University, Mitaka, Japan
| | - Kyoko Soejima
- Department of Cardiology, Kyorin University, Mitaka, Japan
| | | | - Hiroshi Kamma
- Department of Pathology, Kyorin University, Mitaka, Japan
| | | | - Yukihiro Kaneko
- Department of Cardiovascular Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Satoru Hirono
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Daisuke Izumi
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazuyuki Ozaki
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | | |
Collapse
|
10
|
Rietdorf K, Coode EE, Schulz A, Wibbeler E, Bootman MD, Ostergaard JR. Cardiac pathology in neuronal ceroid lipofuscinoses (NCL): More than a mere co-morbidity. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165643. [PMID: 31863828 DOI: 10.1016/j.bbadis.2019.165643] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/12/2022]
Abstract
The neuronal ceroid lipofuscinoses (NCLs) are mostly seen as diseases affecting the central nervous system, but there is accumulating evidence that they have co-morbidities outside the brain. One of these co-morbidities is a decline in cardiac function. This is becoming increasingly recognised in teenagers and adolescents with juvenile CLN3, but it may also occur in individuals with other NCLs. The purpose of this review is to summarise the current knowledge of the structural and functional changes found in the hearts of animal models and people diagnosed with NCL. In addition, we present evidence of structural changes that were observed in a systematic comparison of the cardiomyocytes from CLN3Δex7/8 mice.
Collapse
|
11
|
Zheng Q, Delingette H, Ayache N. Explainable cardiac pathology classification on cine MRI with motion characterization by semi-supervised learning of apparent flow. Med Image Anal 2019; 56:80-95. [PMID: 31200290 DOI: 10.1016/j.media.2019.06.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 03/27/2019] [Accepted: 06/04/2019] [Indexed: 12/28/2022]
Abstract
We propose a method to classify cardiac pathology based on a novel approach to extract image derived features to characterize the shape and motion of the heart. An original semi-supervised learning procedure, which makes efficient use of a large amount of non-segmented images and a small amount of images segmented manually by experts, is developed to generate pixel-wise apparent flow between two time points of a 2D+t cine MRI image sequence. Combining the apparent flow maps and cardiac segmentation masks, we obtain a local apparent flow corresponding to the 2D motion of myocardium and ventricular cavities. This leads to the generation of time series of the radius and thickness of myocardial segments to represent cardiac motion. These time series of motion features are reliable and explainable characteristics of pathological cardiac motion. Furthermore, they are combined with shape-related features to classify cardiac pathologies. Using only nine feature values as input, we propose an explainable, simple and flexible model for pathology classification. On ACDC training set and testing set, the model achieves 95% and 94% respectively as classification accuracy. Its performance is hence comparable to that of the state-of-the-art. Comparison with various other models is performed to outline some advantages of our model.
Collapse
Affiliation(s)
- Qiao Zheng
- Université Côte d'Azur, Inria, 2004 Route des Lucioles, 06902 Sophia Antipolis, France.
| | - Hervé Delingette
- Université Côte d'Azur, Inria, 2004 Route des Lucioles, 06902 Sophia Antipolis, France
| | - Nicholas Ayache
- Université Côte d'Azur, Inria, 2004 Route des Lucioles, 06902 Sophia Antipolis, France
| |
Collapse
|
12
|
Udomkasemsab A, Prangthip P. High fat diet for induced dyslipidemia and cardiac pathological alterations in Wistar rats compared to Sprague Dawley rats. Clin Investig Arterioscler 2019; 31:56-62. [PMID: 30591270 DOI: 10.1016/j.arteri.2018.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/29/2018] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Wistar and Sprague Dawley (SD) rats are generally used as models for the cholesterol metabolism experiments. They are acceptable to high fat diet-induced disorders with individual variations, including dyslipidemia and abnormal cardiac pathology. OBJECTIVE To compare the effects of high fat diet in inducing dyslipidemia and cardiac pathological alterations between Wistar and SD rats. METHODS We compared the differences in plasma cholesterol levels and cardiac pathological alterations between Wistar and SD rats of standard diet (3.90 kcal/g) and high fat diet (5.40 kcal/g) after 4 weeks. RESULTS SD rats fed with high fat diet showed significantly enhanced LDL concentration and the decreased HDL concentration when compared to Wistar rats. Additionally, SD rats showed cardiac pathological alterations such as infiltration of mononuclear cells referring to inflammatory response and high amounts of perivascular fat playing a key role in the impairment of vascular functions. CONCLUSIONS Our results indicate that SD rats may be the more suitable model for dyslipidemia and alteration of cardiac pathology induced by high fat diet.
Collapse
|
13
|
Ishida N, Shimabukuro K, Yamaguchi S, Umeda E, Ogura H, Mitta S, Kimata R, Takemura H, Doi K. Surgical repair of partial anomalous pulmonary venous return with intact atrial septum in a 65-year-old woman: a case report. J Med Case Rep 2018; 12:350. [PMID: 30470244 PMCID: PMC6260651 DOI: 10.1186/s13256-018-1874-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partial anomalous pulmonary venous return is a rare congenital cardiac anomaly that usually involves the right pulmonary vein and an atrial septal defect. Isolated partial anomalous pulmonary venous return with an intact atrial septum is even rarer, and this condition is usually treated surgically in younger patients. We describe isolated partial anomalous pulmonary venous return in a 65-year-old woman who was treated by caval division with pericardial patch baffling through a surgically created atrial septal defect and reconstruction of the superior vena cava using a prosthetic graft. CASE PRESENTATION A 65-year-old Asian woman who presented with exertional dyspnea was diagnosed with isolated partial anomalous pulmonary venous return. The surgical indications and strategy were controversial because of the rarity of this pathology. She had an indication for surgery because she was symptomatic and had a high ratio of pulmonary to systemic blood flow. We considered that surgical procedures should avoid postoperative stenosis of a reconstructed flow tract, sinus node dysfunction, and thrombogenesis. We created a caval division with pericardial patch baffling through a surgically created atrial septal defect and reconstructed the superior vena cava using a prosthetic graft for the isolated partial anomalous pulmonary venous return. She has since remained free of exertional dyspnea, arrhythmia, and thrombotic complications. This surgical strategy is safe and effective for treating isolated partial anomalous pulmonary venous return in older symptomatic adults. CONCLUSIONS The long-term outcome of surgical repair of partial anomalous pulmonary venous return with an intact atrial septum in our patient, a symptomatic 65-year-old woman, was excellent.
Collapse
Affiliation(s)
- Narihiro Ishida
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu City, 501-1194, Japan.
| | - Katsuya Shimabukuro
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Shojiro Yamaguchi
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Etsuji Umeda
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Hiroki Ogura
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Shohei Mitta
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Ryutaro Kimata
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu City, 501-1194, Japan
| | - Hirofumi Takemura
- Department of Thoracic, Cardiovascular and General Surgery, Kanazawa University, Kanazawa City, 920-8641, Japan
| | - Kiyoshi Doi
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu City, 501-1194, Japan
| |
Collapse
|
14
|
Pedretti S, Cipriani M, Bonacina E, Vargiu S, Gil Ad V, Frigerio M, Lunati M. Refractory ventricular tachycardia caused by inflow cannula mechanical injury in a patient with left ventricular assist device: Catheter ablation and pathological findings. J Arrhythm 2017; 33:494-496. [PMID: 29021856 PMCID: PMC5634750 DOI: 10.1016/j.joa.2017.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 03/19/2017] [Accepted: 04/17/2017] [Indexed: 11/24/2022] Open
Abstract
In patients with left ventricular assist device (LVAD), a minority of post-operative ventricular tachycardias (VTs) is caused by contact between the inflow cannula and the endocardium. Currently, electrophysiologic characteristics and pathologic features of this condition are lacking. We report on a case of a successfully ablated mechanical VT. After VT recurrence, heart transplantation took place. Pathologic observations were consistent with direct tissue injury and inflammation, eventually contributing to persisting arrhythmias. Radiofrequency catheter ablation can be a safe and effective option to treat arrhythmias caused by inflow cannula interference in the short term, although a high recurrence rate is expected.
Collapse
Affiliation(s)
- Stefano Pedretti
- Electrophysiology Unit, “De Gasperis” Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Correspondence to: “De Gasperis” Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milano, Italy. Fax: +39 02 6444 2566.“De Gasperis” Cardio Center, ASST Grande Ospedale Metropolitano NiguardaPiazza Ospedale Maggiore 3Milano20162Italy
| | - Manlio Cipriani
- Heart Failure Unit, “De Gasperis” Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Edgardo Bonacina
- Clinical Pathology Unit - ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Sara Vargiu
- Electrophysiology Unit, “De Gasperis” Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Vered Gil Ad
- Heart Failure Unit, “De Gasperis” Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Maria Frigerio
- Heart Failure Unit, “De Gasperis” Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Maurizio Lunati
- Electrophysiology Unit, “De Gasperis” Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| |
Collapse
|
15
|
Favero G, Franceschetti L, Buffoli B, Moghadasian MH, Reiter RJ, Rodella LF, Rezzani R. Melatonin: Protection against age-related cardiac pathology. Ageing Res Rev 2017; 35:336-349. [PMID: 27884595 DOI: 10.1016/j.arr.2016.11.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [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: 10/17/2016] [Revised: 11/04/2016] [Accepted: 11/18/2016] [Indexed: 12/14/2022]
Abstract
Aging is a complex and progressive process that involves physiological and metabolic deterioration in every organ and system. Cardiovascular diseases are one of the most common causes of mortality and morbidity among elderly subjects worldwide. Most age-related cardiovascular disorders can be influenced by modifiable behaviours such as a healthy diet rich in fruit and vegetables, avoidance of smoking, increased physical activity and reduced stress. The role of diet in prevention of various disorders is a well-established factor, which has an even more important role in the geriatric population. Melatonin, an indoleamine with multiple actions including antioxidant properties, has been identified in a very large number of plant species, including edible plant products and medical herbs. Among products where melatonin has been identified include wine, olive oil, tomato, beer, and others. Interestingly, consumed melatonin in plant foods or melatonin supplementation may promote health benefits by virtue of its multiple properties and it may counteract pathological conditions also related to cardiovascular disorders, carcinogenesis, neurological diseases and aging. In the present review, we summarized melatonin effects against age-related cardiac alterations and abnormalities with a special focus on heart ischemia/reperfusion (IR) injury and myocardial infarction.
Collapse
Affiliation(s)
- Gaia Favero
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Lorenzo Franceschetti
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Barbara Buffoli
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Mohammed H Moghadasian
- Department of Human Nutritional Sciences, University of Manitoba and the Canadian Centre for Agri-Food Research in Health and Medicine, St. Boniface Hospital Research Centre, Winnipeg, MB, Canada
| | - Russel J Reiter
- Department of Cellular and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Luigi F Rodella
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Rita Rezzani
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
| |
Collapse
|
16
|
Wijngaarde CA, Blank AC, Stam M, Wadman RI, van den Berg LH, van der Pol WL. Cardiac pathology in spinal muscular atrophy: a systematic review. Orphanet J Rare Dis 2017; 12:67. [PMID: 28399889 PMCID: PMC5387385 DOI: 10.1186/s13023-017-0613-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 03/14/2017] [Indexed: 01/09/2023] Open
Abstract
Background Hereditary proximal spinal muscular atrophy (SMA) is a severe neuromuscular disease of childhood caused by homozygous loss of function of the survival motor neuron (SMN) 1 gene. The presence of a second, nearly identical SMN gene (SMN2) in the human genome ensures production of residual levels of the ubiquitously expressed SMN protein. Alpha-motor neurons in the ventral horns of the spinal cord are most vulnerable to reduced SMN concentrations but the development or function of other tissues may also be affected, and cardiovascular abnormalities have frequently been reported both in patients and SMA mouse models. Methods We systematically reviewed reported cardiac pathology in relation to SMN deficiency. To investigate the relevance of the possible association in more detail, we used clinical classification systems to characterize structural cardiac defects and arrhythmias. Conclusions Seventy-two studies with a total of 264 SMA patients with reported cardiac pathology were identified, along with 14 publications on SMA mouse models with abnormalities of the heart. Structural cardiac pathology, mainly septal defects and abnormalities of the cardiac outflow tract, was reported predominantly in the most severely affected patients (i.e. SMA type 1). Cardiac rhythm disorders were most frequently reported in patients with milder SMA types (e.g. SMA type 3). All included studies lacked control groups and a standardized approach for cardiac evaluation. The convergence to specific abnormalities of cardiac structure and function may indicate vulnerability of specific cell types or developmental processes relevant for cardiogenesis. Future studies would benefit from a controlled and standardized approach for cardiac evaluation in patients with SMA. Electronic supplementary material The online version of this article (doi:10.1186/s13023-017-0613-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- C A Wijngaarde
- Department of Neurology and Neurosurgery, F02.230, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands.
| | - A C Blank
- Department of Pediatric Cardiology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Stam
- Department of Neurology and Neurosurgery, F02.230, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands
| | - R I Wadman
- Department of Neurology and Neurosurgery, F02.230, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands
| | - L H van den Berg
- Department of Neurology and Neurosurgery, F02.230, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands
| | - W L van der Pol
- Department of Neurology and Neurosurgery, F02.230, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands.
| |
Collapse
|
17
|
Flanders JA Jr, Buoscio DA, Jacobs BA, Gamble KC. RETROSPECTIVE ANALYSIS OF ADULT-ONSET CARDIAC DISEASE IN FRANÇOIS' LANGURS (TRACHYPITHECUS FRANCOISI) HOUSED IN U.S. ZOOS. J Zoo Wildl Med 2016; 47:717-30. [PMID: 27691958 DOI: 10.1638/2015-0119.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cardiac disease is a common condition in captive primates, and multiple cases in François' langurs ( Trachypithecus francoisi ) were noted on review of the Species Survival Plan studbook. To determine the prevalence of cardiac disease in this species, surveys were distributed to current and previous holding institutions (n = 23) for the U.S. studbook population (n = 216). After exclusion of stillbirths (n = 48), animals less than 1 yr of age (n = 8), and animals housed internationally (n = 2), a study group (n = 158) was identified for this analysis. Robust data was received for 98.7% (n = 156) of the study group and antemortem and postmortem cardiac abnormalities were reported for 25.3% (n = 40) of these animals. Eight animals were reported as medically managed for clinical cardiac disease, and three of these were alive at the time of survey. Six of 11 animals with radiographic cardiac silhouette enlargement antemortem were noted with cardiomegaly on postmortem examination. Of 102 deceased animals in the study group, four were identified with dilated cardiomyopathy, and varying degrees of myocardial fibrosis was observed in 18 animals. Langurs with cardiac fibrosis were found to be significantly older than langurs without cardiac fibrosis (P = 0.003) and more commonly were male (P = 0.036). Screening tests for cardiac disease, such as thoracic radiographs and echocardiography, are recommended to diagnose affected animals earlier, to monitor progression of disease, and to guide treatment, although they should be interpreted with caution because of apparent insensitivity when compared with pathologic results.
Collapse
|
18
|
Klein SK, Redfern WS. Cardiovascular safety risk assessment for new candidate drugs from functional and pathological data: Conference report. J Pharmacol Toxicol Methods 2015; 76:1-6. [PMID: 26126834 DOI: 10.1016/j.vascn.2015.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 06/22/2015] [Accepted: 06/24/2015] [Indexed: 02/03/2023]
Abstract
This is a report on a 2-day joint meeting between the British Society of Toxicological Pathology (BSTP) and the Safety Pharmacology Society (SPS) held in the UK in November 2013. Drug induced adverse effects on the cardiovascular system are associated with the attrition of more marketed and candidate drugs than any other safety issue. The objectives of this meeting were to foster inter-disciplinary approaches to address cardiovascular risk assessment, improve understanding of the respective disciplines, and increase awareness of new technologies. These aims were achieved. This well attended meeting covered both 'purely functional' cardiovascular adverse effects of drugs (e.g., electrophysiological and haemodynamic changes) as well as adverse effects encompassing both functional and pathological changes. Most of the presentations focused on nonclinical safety data, with information on translation to human where known. To reflect the content of the presentations we have cited key references and review articles.
Collapse
Affiliation(s)
- Stephanie K Klein
- Drug Safety & Metabolism, Alderley Park, Macclesfield, Cheshire SK10 4TG, United Kingdom
| | - Will S Redfern
- Drug Safety & Metabolism, Alderley Park, Macclesfield, Cheshire SK10 4TG, United Kingdom.
| |
Collapse
|
19
|
Stauffer BL, Dockstader K, Russell G, Hijmans J, Walker L, Cecil M, Demos-Davies K, Medway A, McKinsey TA, Sucharov CC. Transgenic over-expression of YY1 induces pathologic cardiac hypertrophy in a sex-specific manner. Biochem Biophys Res Commun 2015; 462:131-7. [PMID: 25935483 DOI: 10.1016/j.bbrc.2015.04.106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/11/2015] [Indexed: 02/08/2023]
Abstract
YY1 can activate or repress transcription of various genes. In cardiac myocytes in culture YY1 has been shown to regulate expression of several genes involved in myocyte pathology. YY1 can also acutely protect the heart against detrimental changes in gene expression. In this study we show that cardiac over-expression of YY1 induces pathologic cardiac hypertrophy in male mice, measured by changes in gene expression and lower ejection fraction/fractional shortening. In contrast, female animals are protected against pathologic gene expression changes and cardiac dysfunction. Furthermore, we show that YY1 regulates, in a sex-specific manner, the expression of mammalian enable (Mena), a factor that regulates cytoskeletal actin dynamics and whose expression is increased in several models of cardiac pathology, and that Mena expression in humans with heart failure is sex-dependent. Finally, we show that sex differences in YY1 expression are also observed in human heart failure. In summary, this is the first work to show that YY1 has a sex-specific effect in the regulation of cardiac pathology.
Collapse
Affiliation(s)
- Brian L Stauffer
- Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA; Division of Cardiology, Denver Health and Hospital Authority, Denver, CO, USA
| | - Karen Dockstader
- Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Gloria Russell
- Pontificia Universidad Católica Madre y Maestra, Departamento de Medicina, Santiago, Dominican Republic
| | - Jamie Hijmans
- Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA
| | | | | | | | - Allen Medway
- Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Timothy A McKinsey
- Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Carmen C Sucharov
- Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA.
| |
Collapse
|
20
|
Barreiro M, Renilla A, Jimenez JM, Martin M, Al Musa T, Garcia L, Barriales V. Primary cardiac tumors: 32 years of experience from a Spanish tertiary surgical center. Cardiovasc Pathol 2013; 22:424-7. [PMID: 23727543 DOI: 10.1016/j.carpath.2013.04.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 04/29/2013] [Accepted: 04/29/2013] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Primary cardiac tumors are rare entities with an autopsy frequency ranging between 0.001% and 0.3%. Our objective was to review 32 years of experience from a Spanish tertiary surgical center. METHOD We collected data on 73 patients with a histopathological diagnosis of a primary cardiac tumor in a retrospective analysis from 1979 to 2012. Tissue samples were obtained either at surgery or from necropsy and subsequently divided into benign and malignant groups. RESULTS Benign neoplasms accounted for 84.9% of cases. The average age at diagnosis was 61 years, and tumors were twice as frequent among women. It was an incidental finding in one quarter of patients. In symptomatic patients, the typical presentation was of cardioembolic stroke or of congestive symptoms. Myxoma (93.5%) was the most common diagnosis, typically affecting the left atrium (74.2%). Surgical resection was curative for 95% of these patients. Malignant tumors represented 15.1% of cases with an average age at diagnosis of 50 years. Over 90% of these patients were symptomatic at presentation with the cardinal symptom being heart failure. Undifferentiated sarcoma was the most frequent malignant tumor (36.4%). Less than 20% of patients were alive 1 year after diagnosis despite the treatment. CONCLUSIONS In our study, primary cardiac tumors were insidious. The most common was left atrial myxoma in which surgical resection was considered curative. Undifferentiated sarcoma was the most frequent malignant tumor. Malignant neoplasms carried a worse prognosis with unsuccessful total excision and the presence of metastatic disease being markers of an adverse outcome.
Collapse
Affiliation(s)
- Manuel Barreiro
- Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | | | | | | | | | | | | |
Collapse
|