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https://www.readbyqxmd.com/read/29885944/cold-agglutinin-disease-complicating-management-of-aortic-dissection
#1
James Bras, Kelsey Uminski, Arjuna Ponnampalam
BACKGROUND: Cold agglutinin disease is characterized by acrocyanosis, hemolytic anemia, and occasionally, frank hemoglobinuria. Although cold agglutinins are commonly detected, they are rarely clinically significant due to subphysiologic temperatures at which agglutination occurs. Cardiovascular surgical procedures requiring hypothermia present a unique challenge for these patients, requiring modification of the conduct of cardiopulmonary bypass and cardioplegia. CASE REPORT: Herein we report a case of a patient with a prior history of symptomatic cold agglutinin disease and type A aortic dissection, presenting with dilation of his known diseased ascending aorta, requiring semi-urgent repair...
April 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29863610/resuscitation-of-endotheliopathy-and-bleeding-in-thoracic-aortic-dissections-the-viper-octa-randomized-clinical-pilot-trial
#2
Jakob Stensballe, Annette G Ulrich, Jens C Nilsson, Hanne H Henriksen, Peter S Olsen, Sisse R Ostrowski, Pär I Johansson
BACKGROUND: Thoracic aorta dissection is an acute critical condition associated with shock-induced endotheliopathy, coagulopathy, massive bleeding, and significant morbidity and mortality. Our aim was to compare the effect of coagulation support with solvent/detergent-treated pooled plasma (OctaplasLG) versus standard fresh frozen plasma (FFP) on glycocalyx and endothelial injury, bleeding, and transfusion requirements. METHODS: Investigator-initiated, single-center, blinded, randomized clinical pilot trial of adult patients undergoing emergency surgery for thoracic aorta dissection...
May 31, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29848500/in-vivo-molecular-characterization-of-abdominal-aortic-aneurysms-using-fibrin-specific-magnetic-resonance-imaging
#3
René M Botnar, Julia Brangsch, Carolin Reimann, Christian H P Janssen, Reza Razavi, Bernd Hamm, Marcus R Makowski
BACKGROUND: The incidence of abdominal aortic aneurysms (AAAs) will significantly increase during the next decade. Novel biomarkers, besides diameter, are needed for a better characterization of aneurysms and the estimation of the risk of rupture. Fibrin is a key protein in the formation of focal hematoma associated with the dissection of the aortic wall and the development of larger thrombi during the progression of AAAs. This study evaluated the potential of a fibrin-specific magnetic resonance (MR) probe for the in vivo characterization of the different stages of AAAs...
May 30, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29685513/expression-of-platelet-derived-growth-factor-b-is-upregulated-in-patients-with-thoracic-aortic-dissection
#4
Weixin Meng, Shangdian Liu, Dandan Li, Zonghong Liu, Hui Yang, Bo Sun, Hongyu Liu
OBJECTIVE: Thoracic aortic dissection (TAD) is a serious condition requiring urgent treatment to avoid catastrophic consequences. The inflammatory response is involved in the occurrence and development of TAD, possibly potentiated by platelet-derived growth factors (PDGFs). This study aimed to determine whether expression of PDGF-B (a subunit of PDGF-BB) was increased in TAD patients and to explore the factors responsible for its upregulation and subsequent effects on TAD. METHODS: Full-thickness ascending aorta wall specimens from TAD patients (n = 15) and control patients (n = 10) were examined for expression of PDGF-B and its receptor (PDGFRB) and in terms of morphology, inflammation, and fibrosis...
April 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29555322/increased-interleukin-11-levels-in-thoracic-aorta-and-plasma-from-patients-with-acute-thoracic-aortic-dissection
#5
Yao Xu, Jing Ye, Menglong Wang, Yuan Wang, Qingwei Ji, Ying Huang, Tao Zeng, Zhen Wang, Di Ye, Huimin Jiang, Jianfang Liu, Yingzhong Lin, Jun Wan
BACKGROUND: Interleukin (IL) 11 is closely related to tumor and hematological system diseases. Recent studies have demonstrated that IL-11 also participates in cardiovascular diseases, including ischemia-reperfusion mediated heart injury and acute myocardial infarction. This study aimed to investigate whether IL-11 is involved in acute thoracic aortic dissection (TAD). METHODS: Aortic tissue samples from normal donors and acute TAD patients were collected, and the expression of IL-11 in all aortic tissue was analyzed...
June 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29534905/oxygenation-impairment-after-total-arch-replacement-with-a-stented-elephant-trunk-for-type-a-dissection
#6
Yuwen Shen, Chuanzhen Liu, Changcun Fang, Jie Xi, Shuming Wu, Xinyan Pang, Guangmin Song
OBJECTIVE: To study the risk factors of oxygenation impairment in patients with type-A acute aortic dissection who underwent total arch replacement with a stented elephant trunk. METHODS: In this study, 169 consecutive patients were enrolled who were diagnosed with type-A acute aortic dissection and underwent a total arch replacement procedure at the Qilu Hospital of Shandong University between January 2015 and February 2017. Postoperative oxygenation impairment was defined as arterial oxygen partial pressure/inspired oxygen fraction ≤ 200 with positive end expiratory pressure ≥ 5 cm H2 O that occurred within 72 hours of surgery...
June 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29392348/determinants-of-increased-aortic-diameters-in-young-normotensive-patients-with-turner-syndrome-without-structural-heart-disease
#7
A Uçar, Melike Tuğrul, Bülent Oğuz Erol, Ensar Yekeler, Banu Aydın, Seher Yıldız, Kemal Nişli, Firdevs Baş, Şükran Poyrazoğlu, Feyza Darendeliler, Nurçin Saka, Aylin Yetim Şahin, Yasin Yılmaz, Rüveyde Bundak
Factors associated with aortic dilation and dissection in patients with Turner syndrome (TS) remain unclear. We assessed magnetic resonance imaging-based aortic diameters at nine predefined anatomic positions and examined associations of increased aortic diameters with B-type natriuretic peptide (BNP), A-type NP (ANP), growth hormone treatment, insulin-like growth factor 1 (IGF1), and estrogen status. Forty-seven patients with TS aged 7.3-21 years and 34 healthy peers were enrolled in this study. Aortic diameters were higher in patients with TS at three positions than in controls (p < 0...
April 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29367209/the-complement-c3a-c3ar-axis-promotes-development-of-thoracic-aortic-dissection-via-regulation-of-mmp2-expression
#8
Weihong Ren, Yan Liu, Xuerui Wang, Chunmei Piao, Youcai Ma, Shulan Qiu, Lixin Jia, Boya Chen, Yuan Wang, Wenjian Jiang, Shuai Zheng, Chang Liu, Nan Dai, Feng Lan, Hongjia Zhang, Wen-Chao Song, Jie Du
Thoracic aortic dissection (TAD), once ruptured, is devastating to patients, and no effective pharmaceutical therapy is available. Anaphylatoxins released by complement activation are involved in a variety of diseases. However, the role of the complement system in TAD is unknown. We found that plasma levels of C3a, C4a, and C5a were significantly increased in patients with TAD. Elevated circulating C3a levels were also detected in the developmental process of mouse TAD, which was induced by β-aminopropionitrile monofumarate (BAPN) treatment, with enhanced expression of C1q and properdin in mouse dissected aortas...
March 1, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/29360940/from-genetics-to-response-to-injury-vascular-smooth-muscle-cells-in-aneurysms-and-dissections-of-the-ascending-aorta
#9
Jean-Baptiste Michel, Guillaume Jondeau, Dianna M Milewicz
Vascular smooth muscle cells (vSMCs) play a crucial role in both the pathogenesis of Aneurysms and Dissections of the ascending thoracic aorta (TAAD) in humans and in the associated adaptive compensatory responses, since thrombosis and inflammatory processes are absent in the majority of cases. Aneurysms and dissections share numerous characteristics, including aetiologies and histopathological alterations: vSMC disappearance, medial areas of mucoid degeneration, and extracellular matrix (ECM) breakdown. Three aetiologies predominate in TAAD in humans: (i) genetic causes in heritable familial forms, (ii) an association with bicuspid aortic valves, and (iii) a sporadic degenerative form linked to the aortic aging process...
March 15, 2018: Cardiovascular Research
https://www.readbyqxmd.com/read/29279461/immunoglobulin-g-subclass-4-related-lymphoplasmacytic-thoracic-aortitis-in-a-patient-with-acute-type-a-aortic-dissection
#10
Tetsuro Uchida, Azumi Hamasaki, Yoshinori Kuroda, Mitsuaki Sadahiro, Nobuyuki Tamazawa, Rintaro Ohe, Mitsunori Yamakawa
Immunoglobulin G subclass 4-related disease (IgG4-RD) is a recently recognized systemic inflammatory disease characterized by an elevated serum IgG4 level and an IgG4-positive lymphocyte infiltrate mainly in exocrine tissues. Previous reports documented IgG4-RD in several cardiovascular disorders. We present a case of type A aortic dissection associated with IgG4-RD. A 52-year-old man diagnosed with a type A aortic dissection was referred for surgical treatment. He underwent emergency hemiarch reconstruction with a prosthetic graft...
December 27, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29218111/the-diagnostic-value-of-microrna-4787-5p-and-microrna-4306-in-patients-with-acute-aortic-dissection
#11
Lei Wang, Shijie Zhang, Zhigao Xu, Jingjing Zhang, Li Li, Guoqiang Zhao
Acute aortic dissection (AAD) is a life-threatening cardiovascular disease with the high morbidity and mortality. Imaging modalities are the gold standard for the diagnosis of AAD; however, they are not always available in emergency department. Biomarker-assisted diagnosis is important for the early treatment of AAD. The aim of the present study was to identify potential microRNA (miRNA) biomarkers for AAD. Differentially expressed plasma miRNAs between AAD patients and age-matched healthy volunteers were analyzed by miRNA microarray...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/29197606/elevated-plasma-levels-of-ldl-cholesterol-promote-dissecting-thoracic-aortic-aneurysms-in-angiotensin-ii-induced-mice
#12
Hiroki Tanaka, Yasunori Iida, Takayuki Iwaki, Yuko Suzuki, Hideto Sano, Chiharu Miyajima, Nobuhiro Zaima, Takeshi Sasaki, Ayato Sumioka, Shogo Hakamata, Hideyuki Shimizu, Kazuo Umemura, Tetsumei Urano
BACKGROUND: Plasma low-density lipoprotein (LDL) cholesterol is implicated in abdominal aorta (AA) and aortic dissection (AD); however, its role in the pathogenesis of AA and AD, a disease with a high mortality rate, is unknown. The existing animal models such as apolipoprotein E-deficient (Apoe-/- ) mice cannot reproduce all the conditions of AA/AD, including elevated LDL-cholesterol levels and spontaneous atheroma formation; therefore, a more reliable in vivo model is required. Here, we analyzed angiotensin II (Ang II)-induced mice with combined deficiency of the LDL receptor and the catalytic component of the apolipoprotein B-edisome complex (Ldlr-/- /Apobec1-/- [WKO]) to understand AA formation and AD occurrence in relation to plasma lipid composition...
April 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29146682/magnitude-of-soluble-st2-as-a-novel-biomarker-for-acute-aortic-dissection
#13
Yuan Wang, Xin Tan, Hai Gao, Hui Yuan, Rong Hu, Lixin Jia, Junming Zhu, Lizhong Sun, Hongjia Zhang, Lianjun Huang, Dong Zhao, Pei Gao, Jie Du
BACKGROUND: Misdiagnosis of acute aortic dissection (AAD) can lead to significant morbidity and death. Soluble ST2 (sST2) is a cardiovascular injury-related biomarker. The extent to which sST2 is elevated in AAD and whether sST2 can discriminate AAD from other causes of sudden-onset severe chest pain are unknown. METHODS: We measured plasma concentrations of sST2 (R&D Systems assay) in 1360 patients, including 1027 participants in the retrospective discovery set and 333 patients with initial suspicion of AAD enrolled in the prospective validation cohort...
January 16, 2018: Circulation
https://www.readbyqxmd.com/read/29104039/increased-levels-of-interleukin-22-in-thoracic-aorta-and-plasma-from-patients-with-acute-thoracic-aortic-dissection
#14
Jing Ye, Menglong Wang, Huimin Jiang, Qingwei Ji, Ying Huang, Jianfang Liu, Tao Zeng, Yao Xu, Zhen Wang, Yingzhong Lin, Jun Wan
BACKGROUND: Interleukin (IL)-22 plays important roles in the development of arterial disease, including atherosclerosis and hypertension. However, the relationship between IL-22 and acute thoracic aortic dissection (TAD) remains unknown. METHODS: Blood samples were collected from patients with chest pain who underwent computed tomography angiography of the thoracic aorta but had no known preoperative diagnosis of coronary artery disease, peripheral artery disease, arthritis, and/or membranous nephropathy...
November 3, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29080094/is-there-a-role-for-biomarkers-in-thoracic-aortic-aneurysm-disease
#15
Damian Balmforth, Amer Harky, Benjamin Adams, John Yap, Alex Shipolini, Neil Roberts, Rakesh Uppal, Mohamad Bashir
Thoracic aortic aneurysm (TAA) represents a major cause of mortality and morbidity in Western countries. The natural history of TAA is indolent, with patients usually being asymptomatic until a catastrophic event such as rupture or dissection ensues. As such, early diagnosis is crucial and the search is ongoing for a biomarker that can indicate the presence of TAA with sufficient accuracy to act as a screening tool. To date, no such marker has been developed for the diagnosis of non-familial or 'sporadic' TAA...
October 28, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29050867/acute-type-a-aortic-dissection-in-a-patient-with-paraganglioma
#16
Andreia Dos Santos Borrego, Pedro Carrilho Ferreira, Fausto J Pinto
Acute aortic dissection is the most common acute aortic syndrome. It is more prevalent in males and in the elderly, and has a high mortality. Hypertension is the main risk factor. Diagnosis is based on clinical features, laboratory tests and imaging exams. Treatment is usually surgical, although in some cases an endovascular approach is an alternative. Paraganglioma is an uncommon neuroendocrine tumor. Most produce catecholamines, and so usually manifest with hypertensive crisis, palpitations, headache and sweating...
October 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28986538/circulating-micrornas-a-novel-potential-biomarker-for-diagnosing-acute-aortic-dissection
#17
Jian Dong, Junmin Bao, Rui Feng, Zhiqing Zhao, Qingsheng Lu, Guokun Wang, Haiyan Li, Dingfeng Su, Jian Zhou, Qing Jing, Zaiping Jing
Acute aortic dissection (AAD) is a catastrophic emergency with high mortality and misdiagnosis rate. We aimed to determine whether circulating microRNAs allow to distinguish AAD from healthy controls and chest pain patients without AAD (CP). Plasma microRNAs expression were determined in 103 participants, including 37 AAD patients, 26 chronic aortic dissection patients, 17 healthy volunteers, 23 patients without AAD. We selected 16 microRNAs from microarray screening as candidates for further testing via qRT-PCR...
October 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28545284/-expression-profiles-and-clinical-implication-of-plasma-chemokines-in-patients-with-stanford-type-a-aortic-dissection
#18
F D Fan, Z J Xu, Q Zhou, D J Wang
Objective: To explore the plasma chemokines expressions and related clinical implication in patients with Stanford type A aortic dissection (AD). Methods: We retrospectively analyzed the data of 65 patients with Stanford type A aortic dissection, hypertensive patients and 11 healthy subjects admitted in our department from October 2013 to December 2014, they were divided into four groups: NH-CON group (11 healthy subjects), H-AD group (29 AD patients with hypertension), NH-AD group (21 AD patients without hypertension), and H-CON group (14 hypertension patients)...
April 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28507573/admission-d-dimer-testing-for-differentiating-acute-aortic-dissection-from-other-causes-of-acute-chest-pain
#19
Wenlong Li, Bi Huang, Li Tian, Yanmin Yang, Weili Zhang, Xiaojian Wang, Jingzhou Chen, Kai Sun, Rutai Hui, Xiaohan Fan
INTRODUCTION: The present study aims to evaluate the utility of D-dimer testing for differentiating the causes of acute chest pain, including acute aortic dissection (AAD), pulmonary embolism (PE), acute myocardial infarction (AMI), unstable angina (UA), and other uncertain diagnoses of chest pain. MATERIAL AND METHODS: Consecutive patients admitted for acute chest pain within 24 h from symptom onset were enrolled prospectively, and plasma D-dimer levels were measured on admission...
April 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28445810/circulating-cadmium-concentration-and-risk-of-aortic-aneurysms-a-nested-case-control-study-within-the-malm%C3%A3-diet-and-cancer-cohort
#20
Björn Fagerberg, Yan Borné, Gerd Sallsten, J Gustav Smith, Stefan Acosta, Margaretha Persson, Olle Melander, Niklas Forsgard, Anders Gottsäter, Bo Hedblad, Lars Barregard, Gunnar Engström
BACKGROUND AND AIMS: Diet and smoking expose the general population to cadmium (Cd), which is a toxic metal that accumulates in the arterial wall. In experimental studies, Cd causes reductions in proliferation of smooth muscle cells and cellular synthesis of procollagen. The aim of this study was to examine whether blood Cd levels, a valid measure of Cd exposure, are associated with increased risk of abdominal aortic aneurysm (AAA). METHODS: All middle-aged men and women enrolled in the Malmö Diet and Cancer study (n = 30 447) were followed from the baseline examination in 1991-1996 through 2009...
June 2017: Atherosclerosis
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