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Aortic disease

Dorothy A Perry, Lindsay M Thomson, Frank A Pigula, Brian D Polizzotti, James A DiNardo, Arthur Nedder, Kimberlee Gauvreau, John N Kheir
BACKGROUND: Hyperoxemia (arterial oxygen tension >100 mm Hg) may occur in critically ill patients and have effects on mixed venous saturation (SvO2 ) and on Fick-based estimates of cardiac output (CO). We investigated the effect of hyperoxemia on SvO2 and on assessments of CO using the Fick equation. METHODS: Yorkshire swine (n = 14) were anesthetized, intubated, and paralyzed for instrumentation. SvO2 (co-oximetry) and tissue oxygen tension (tPO2 , implantable electrodes) in brain and myocardium were measured during systematic manipulation of arterial oxygen tension (PaO2 ) using graded hyperoxia (fraction of inspired oxygen 0...
August 14, 2018: Acta Anaesthesiologica Scandinavica
Bumjung Kim, Cheolmin Jo, Ho-Young Choi, Kyungjin Lee
Historically, traditional herbal medicines (THMs) have been the conventional treatment strategy in the Korean medical system for treating many diseases. However, THMs have rarely been used to treat hypertension, and moreover few studies have investigated the interaction of blood pressure with the coadministration of synthetic antihypertensives. We aimed to evaluate the vasorelaxant and hypotensive effects of the traditional herbal prescription Cheonwangbosimdan (CWBSD; "Tianwangbuxindan" in Chinese) and the combination of CWBSD with amlodipine...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Nooraldaem Yousif, Slayman Obeid, Ronald Binder, Andrea Denegri, Mohammady Shahin, Christian Templin, Thomas F Lüscher
Backgound: The influence of gender on clinical outcomes following transcatheter aortic valve implantation (TAVI) was considerably discrepant in previous studies. We aimed to investigate the impact of gender in our registry. Methods: The study is a retrospective observational analysis of a prospectively designed cohort (546 consecutive patients treated at the University Hospital Zurich who were enrolled in Swiss TAVI Cohort from May 2008 to April 2014). The Study took place in University Heart Centre at University Hospital Zurich, Switzerland...
June 2018: Journal of Geriatric Cardiology: JGC
Ioannis A Tsolakis, Stavros K Kakkos, Chrysanthi P Papageorgopoulou, Peter Zampakis, Christina Kalogeropoulou, Spyros Papadoulas, George Lampropoulos, Konstantinos M Nikolakopoulos, Ioannis Ntouvas, Anastasia Kouri
OBJECTIVE: To compare two endograft types, the original GORE EXCLUDER AAA endoprosthesis (W. L. Gore & Associates, Flagstaff, Ariz) with the repositionable GORE EXCLUDER featuring the C3 delivery system, which allows repositioning of the proximal part of the graft to achieve accurate placement in relation to the renal arteries, in unselected patients with aortoiliac aneurysms. In a second nested, substudy we investigated the relative effect of the standard Gore and Gore Dryseal introducer sheaths on intraoperative transfusion needs...
August 11, 2018: Journal of Vascular Surgery
Jacques Scherman, Rodgers Manganyi, Paul Human, Timothy Pennel, Andre Brooks, Johan Brink, Peter Zilla
OBJECTIVE: Although the results of aortic valve replacement are well documented for industrialized countries, the outcome in patients with rheumatic aortic valve disease in low- to middle-income countries is less well explored. The aim of this study was to determine the long-term survival and clinical outcomes after isolated aortic valve replacement in patients with rheumatic heart disease in a Sub-Saharan country where follow-up of indigent patients is often challenging. METHODS: A retrospective review of 969 aortic valve replacements performed between 2003 and 2013 was conducted at Cape Town's Groote Schuur Hospital...
July 20, 2018: Journal of Thoracic and Cardiovascular Surgery
Amedeo Anselmi, Annamaria Dachille, Vincent Auffret, Majid Harmouche, Antoine Roisne, Marc Bedossa, Hervé Le Breton, Jean-Philippe Verhoye
Minimized length of hospitalization (LoS) and lower risk of hospitalization-related complications are key requirements in the treatment of aortic valve disease, mainly in the elderly candidates. Our objective was to evaluate evolution of LoS after surgical (SAVR) or transcatheter aortic valve implantation (TAVI) and its predictors. We enrolled 1,849 elderly (aged >75) patients receiving SAVR or TAVI from 2009 to 2016. In the surgical cohort (n = 1,006) the mean LoS slightly decreased from 13.81 ± 9.27 days (2009) to 10...
July 20, 2018: American Journal of Cardiology
Jessica O'Brien, Christopher M Reid, Nick Andrianopoulos, Andrew E Ajani, David J Clark, Henry Krum, Philippa Loane, Melanie Freeman, Martin Sebastian, Angela L Brennan, James Shaw, Anthony M Dart, Stephen J Duffy
Data from previous studies of patients with heart failure and coronary artery disease suggest that those with higher resting heart rates (HRs) have worse cardiovascular outcomes. We sought to evaluate whether HR immediately before percutaneous coronary intervention (PCI) is an independent predictor for 30-day outcome. We analyzed the outcome of 3,720 patients who had HR recorded before PCI from the Melbourne Interventional Group registry. HR and outcomes were analyzed by quintiles, and secondarily by dichotomizing into <70 or ≥70 beats/min...
July 4, 2018: American Journal of Cardiology
Seunghwan Choi, Minsik Park, Joohwan Kim, Wonjin Park, Suji Kim, Dong-Keon Lee, Jong Yun Hwang, Jongseon Choe, Moo-Ho Won, Sungwoo Ryoo, Kwon-Soo Ha, Young-Guen Kwon, Young-Myeong Kim
cGMP-dependent protein kinase 1 (PKG1) plays an important role in nitric oxide (NO)/cGMP-mediated maintenance of vascular smooth muscle cell (VSMC) phenotype and vasorelaxation. Inflammatory cytokines, including tumor necrosis factor-α (TNF-α), have long been understood to mediate several inflammatory vascular diseases. However, the underlying mechanism of TNF-α-dependent inflammatory vascular disease is unclear. Here, we found that TNF-α treatment decreased PKG1 expression in cultured VSMCs, which correlated with NF-κB-dependent biogenesis of miR-155-5p that targeted the 3'-untranslated region of PKG1 mRNA...
August 13, 2018: Journal of Biological Chemistry
Emily Lau, Doreen DeFaria Yeh
Cardiovascular disease contributes to approximately one third of all maternal mortality and remains a significant source of peri‑ and postpartum morbidity. As more women at risk for and with cardiovascular disease are desiring pregnancy, it is imperative that general cardiologists and obstetricians participate collaboratively in preconception counseling and are more facile with management of these lesions during peri‑ and postpartum periods. This review aims to address this growing need and highlights the management strategies for some of the major high risk cardiac conditions encountered during pregnancy including anticoagulation, cardiomyopathies as well as severe mitral and aortic stenosis; aortopathy, pulmonary hypertension, and severe congenital heart lesions will not be addressed...
July 22, 2018: Trends in Cardiovascular Medicine
Tirone E David, Maral Ouzounian, Carolyn M David, Myriam Lafreniere-Roula, Cedric Manlhiot
OBJECTIVE: The study objective was to examine the long-term results of the Ross procedure in a cohort of patients followed prospectively for more than 2 decades. METHODS: From 1990 to 2004, 212 consecutive patients with a median age (interquartile range) of 34 years (28-41) underwent the Ross procedure; 82% had congenital aortic valve disease. The technique of aortic root replacement was used in one half of the patients. Patients have been followed prospectively for a median (interquartile range) of 18...
July 18, 2018: Journal of Thoracic and Cardiovascular Surgery
Juliette Raffort, Giulia Chinetti, Fabien Lareyre
Recent antidiabetic drugs including GLP-1 receptor agonists and DPP-IV inhibitors have demonstrated protective effects in several cardiovascular diseases but their effect in abdominal aortic aneurysm (AAA) is far less known. AAA can be associated with extremely high rates of mortality and pharmacological treatments are still lacking underlining the real need to identify new therapeutic targets. The aim of this review was to summarize current knowledge on the role of GLP-1 pathway in AAA. A systematic literature review was performed and 6 relevant studies (2 clinical and 4 experimental) were included...
September 2018: Biochimie
Vera Lachmann, Marc Heimann, Christian Jung, Tobias Zeus, Pablo Emilio Verde, Malte Kelm, Florian Bönner
AIMThe study aims to test whether simultaneous measurement of fractional flow reserve (FFR), coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) is feasible, safe and effective during regadenoson-induced hyperemia.METHODS AND RESULTSFFR, CFR and IMR were measured simultaneously during regadenoson (Rapiscan 400μg) -induced hyperemia in 50 patients with stable coronary artery disease with a SYNTAX score of <22. Simultaneous measurement of FFR, CFR and IMR was technically feasible in all cases (50/50)...
July 30, 2018: Clinical Hemorheology and Microcirculation
Rafael Correa Apoloni, Antonio Eduardo Zerati, Nelson Wolosker, Glauco Fernandes Saes, Marina Wolosker, Taina Curado, Pedro Puech-Leao, Nelson De Luccia
BACKGROUNDS AND AIMS: atherosclerosis and Abdominal Aortic Aneurysms (AAA) have several similar risk factors but different pathogenesis. Inflammation of the arteries is common to both. Central obesity can act as an endocrine organ through the secretion of inflammatory cytokines and the perivascular fat has a local effect that could contributes to diseases of the abdominal aorta. While the relation between central obesity and atherosclerosis occlusive arterial disease has been demonstrated, the correlation with AAA has conflicting results...
August 10, 2018: Annals of Vascular Surgery
Michael S Koeckert, Eugene A Grossi, Patrick F Vining, Ramsey Abdallah, Mathew R Williams, Gary Kalkut, Didier F Loulmet, Elias A Zias, Michael Querijero, Aubrey C Galloway
OBJECTIVE: Medicare's Bundle Payment for Care Improvement(BPCI) Model 2 groups reimbursement for valve surgery into 90-day episodes of care(EOC) which include operative costs, inpatient stay, physician fees, post-acute care, and readmissions up to 90 days post-procedure. We analyzed our BPCI patients' 90-day outcomes to understand the late financial risks and implications of the bundle payment system for valve patients. METHODS: All BPCI valve patients from 10/2013 (start of risk-sharing phase) through 12/2015 were included...
August 10, 2018: Seminars in Thoracic and Cardiovascular Surgery
Shouta Akimoto, Jun-Ichi Suzuki, Norio Aoyama, Ryota Ikeuchi, Hajime Watanabe, Hiroyuki Tsujimoto, Kouji Wakayama, Hidetoshi Kumagai, Yuichi Ikeda, Hiroshi Akazawa, Issei Komuro
For the suppression of inflammation in the aneurysm development, we focused on inhibition of an important transcription factor, nuclear factor-kappa B (NF-κB), using a decoy strategy. We newly developed a novel bioabsorbable sheet that delivers NF-κB decoy oligodeoxynucleotide (ODN).We treated 5-week-old SD rats that were induced with abdominal aortic aneurysm (AAA) using 0.5 M CaCl2 with an NF-κB decoy sheet. Four weeks after AAA induction, aortic tissue was excised for further examinations. We showed that this bioabsorbable sheet could deliver the decoy ODN into the target tissues and dissolve within a week...
August 11, 2018: International Heart Journal
Ryoto Hourai, Satomi Kasashima, Shu-Ichi Fujita, Koichi Sohmiya, Masahiro Daimon, Yoshinobu Hirose, Takahiro Katsumata, Sachiko Kanki, Michishige Ozeki, Nobukazu Ishizaka
A 74-year-old man was admitted for preoperative screening of aortic stenosis. Five months before this admission, he was found to have elevated serum immunoglobulin G4 (IgG4; 2,010 mg/dL). Computed tomography (CT) showed a soft tissue mass surrounding the abdominal aorta, suggestive of IgG4-related periaortitis. CT coronary angiography showed perivascular thickening of the right coronary artery, and subsequent coronary angiography showed a multi-vessel disease. The patient underwent aortic valve replacement and coronary bypass surgery...
August 11, 2018: International Heart Journal
Jianfei Cai, Yinjia Zhang, Jun Zou, Yan Shen, Dan Luo, Huafang Bao, Yong Chen, Jingfen Ye, Jian-Long Guan
OBJECTIVE: This study aimed to investigate the correlation of serum uric acid (SUA) with risk and dilatation diameter of ascending aortic dilatation (AAD) in Behçet's disease (BD) patients. METHODS: Seventeen BD patients complicated with AAD and 20 BD patients without AAD were consecutively enrolled and categorized into AAD group and control group, respectively. Ascending aortic dilatation was determined by two-dimensional doppler echocardiographic examination, and AAD was defined as a diameter of ascending aorta ≥3...
August 12, 2018: Journal of Clinical Laboratory Analysis
Florence A Aeschlimann, Lillian Barra, Roaa Alsolaimani, Susanne M Benseler, Diane Hebert, Nader Khalidi, Ronald M Laxer, Damien Noone, Christian Pagnoux, Marinka Twilt, Rae Sm Yeung
OBJECTIVE: To compare the clinical features, efficacy and safety of treatment regimens, and outcomes of childhood- and adult-onset Takayasu Arteritis (TAK). METHODS: This is a retrospective cohort study comparing patients with childhood-onset TAK since 1986 and adult-onset TAK since 1988 followed at four centers in Ontario, Canada until 2015. Demographic, clinical, laboratory and angiographic features, treatment regimens and outcomes were recorded throughout the course of disease...
August 12, 2018: Arthritis & Rheumatology
Martina Gast, Bernhard H Rauch, Shinichi Nakagawa, Arash Haghikia, Andrzej Jasina, Jan Haas, Neetika Nath, Lars Jensen, Andrea Stroux, Andreas Böhm, Julian Friebel, Ursula Rauch, Carsten Skurk, Stefan Blankenberg, Tanja Zeller, Kannanganattu V Prasanth, Benjamin Meder, Andreas Kuss, Ulf Landmesser, Wolfgang Poller
Background: The immune system is considered a key driver of atherosclerosis, and beyond proteins and microRNAs (miRs), long noncoding RNAs (lncRNAs) are implicated in immune control. We previously described that lncRNA MALAT1 is involved in cardiac innate immunity in a myocarditis model. Here, we investigated the impact of MALAT1 deficiency upon atherosclerosis development. Methods and Results: Heterozygous MALAT1-deficient ApoE-/- mice displayed massive immune system dysregulation and atherosclerosis within two months even when kept on normal diet...
August 8, 2018: Cardiovascular Research
Seok Mei Lim, Beatrix Wong, Gail Brenda Cross, Reshma Merchant
An 85-year-old man with a history of aortic valve replacement presented with lower limb cramps. He was initially diagnosed with degenerative disc disease, but was found to have Lactococcus garvieae infective endocarditis with septic embolic strokes causing a central poststroke pain syndrome. Cardiothoracic surgery was deemed too high risk and the patient completed 6 weeks of intravenous antimicrobials as well as prolonged inpatient rehabilitation. Lactococcus garvieae is an aquaculture pathogen which typically affects elderly and immunocompromised patients...
2018: IDCases
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