51
|
Joy G, Artico J, Kurdi H, Seraphim A, Lau C, Thornton GD, Oliveira MF, Adam RD, Aziminia N, Menacho K, Chacko L, Brown JT, Patel RK, Shiwani H, Bhuva A, Augusto JB, Andiapen M, McKnight A, Noursadeghi M, Pierce I, Evain T, Captur G, Davies RH, Greenwood JP, Fontana M, Kellman P, Schelbert EB, Treibel TA, Manisty C, Moon JC. Prospective Case-Control Study of Cardiovascular Abnormalities 6 Months Following Mild COVID-19 in Healthcare Workers. JACC Cardiovasc Imaging 2021; 14:2155-2166. [PMID: 33975819 PMCID: PMC8105493 DOI: 10.1016/j.jcmg.2021.04.011] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/08/2021] [Accepted: 04/08/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The purpose of this study was to detect cardiovascular changes after mild severe acute respiratory syndrome-coronavirus-2 infection. BACKGROUND Concern exists that mild coronavirus disease 2019 may cause myocardial and vascular disease. METHODS Participants were recruited from COVIDsortium, a 3-hospital prospective study of 731 health care workers who underwent first-wave weekly symptom, polymerase chain reaction, and serology assessment over 4 months, with seroconversion in 21.5% (n = 157). At 6 months post-infection, 74 seropositive and 75 age-, sex-, and ethnicity-matched seronegative control subjects were recruited for cardiovascular phenotyping (comprehensive phantom-calibrated cardiovascular magnetic resonance and blood biomarkers). Analysis was blinded, using objective artificial intelligence analytics where available. RESULTS A total of 149 subjects (mean age 37 years, range 18 to 63 years, 58% women) were recruited. Seropositive infections had been mild with case definition, noncase definition, and asymptomatic disease in 45 (61%), 18 (24%), and 11 (15%), respectively, with 1 person hospitalized (for 2 days). Between seropositive and seronegative groups, there were no differences in cardiac structure (left ventricular volumes, mass, atrial area), function (ejection fraction, global longitudinal shortening, aortic distensibility), tissue characterization (T1, T2, extracellular volume fraction mapping, late gadolinium enhancement) or biomarkers (troponin, N-terminal pro-B-type natriuretic peptide). With abnormal defined by the 75 seronegatives (2 SDs from mean, e.g., ejection fraction <54%, septal T1 >1,072 ms, septal T2 >52.4 ms), individuals had abnormalities including reduced ejection fraction (n = 2, minimum 50%), T1 elevation (n = 6), T2 elevation (n = 9), late gadolinium enhancement (n = 13, median 1%, max 5% of myocardium), biomarker elevation (borderline troponin elevation in 4; all N-terminal pro-B-type natriuretic peptide normal). These were distributed equally between seropositive and seronegative individuals. CONCLUSIONS Cardiovascular abnormalities are no more common in seropositive versus seronegative otherwise healthy, workforce representative individuals 6 months post-mild severe acute respiratory syndrome-coronavirus-2 infection.
Collapse
|
52
|
Sarmento JA, Silva MJ, Madureira AJ, Casanova J, Moreira J. Left-to-right extracardiac shunt: A wake-up call. Rev Port Cardiol 2021; 40:623-624. [PMID: 34392908 DOI: 10.1016/j.repce.2020.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/11/2020] [Indexed: 11/18/2022] Open
|
53
|
Kobayashi S, Murakami N, Oto Y, Toide H, Kimura N, Hayashi A, Higashi A, Inami S, Tanaka J, Koshikawa Y, Mizutani Y, Nakahara S, Ishikawa T, Sakai Y, Taguchi I. Subtle Cardiovascular Abnormalities in Prader-Willi Syndrome Might Begin in Young Adulthood. Intern Med 2021; 60:3377-3384. [PMID: 34719624 PMCID: PMC8627814 DOI: 10.2169/internalmedicine.7073-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective Patients with Prader-Willi syndrome (PWS) are known to have a high mortality rate. However, little is known about the exact reason for this, particularly in adults, because so few reports have been published. The present study examined cardiovascular abnormalities to determine the cause of death in adults with PWS. Methods From September 2017 to April 2019, a total of 18 adults with PWS, and, no history of cardiovascular diseases, were enrolled. We investigated the levels of the cardiovascular biomarkers: high-sensitivity C-reactive protein (hs-CRP) and troponin T (TnT). To estimate the cardiac function, we measured the left ventricular ejection fraction (LVEF), global longitudinal systolic strain (GLS) of the left ventricle, ratio of peak early mitral filling velocity (E) to early diastolic mitral annular velocity (E/e' ratio), mitral annular plane systolic excursion (MAPSE) and tricuspid annular plane systolic excursion (TAPSE) using standard and tissue Doppler echocardiography. Results The mean patient age was 28±9 years old. There were 11 men, and the mean body mass index was 45.1 kg/m2. Dyslipidemia (82%), diabetes mellitus (82%) and hypertension (83%) were commonly found as comorbidities. Most patients had elevated levels of hs-CRP (mean 1.007±0.538 mg/dL). The LVEF (mean 61%±5%) showed normal values, while the GLS (mean 15.0%±3.0%) was decreased. The TAPSE was mildly reduced (mean 16±3 mm). Conclusion These results suggest that subtle cardiovascular abnormalities have already begun in young adults with PWS. We need to manage obesity and the resultant obesity-related disorders in order to prevent heart failure and coronary atherosclerosis in PWS patients.
Collapse
|
54
|
|
55
|
Furukawa T, Otsuki N, Tomotsu M, Tatehara S, Morita N, Kojima Y, Teshima M, Shinomiya H, Nibu KI. Left non-recurrent inferior laryngeal nerve in a patient with right-sided aortic arch and aberrant left subclavian artery. Auris Nasus Larynx 2020; 48:317-321. [PMID: 32178945 DOI: 10.1016/j.anl.2020.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/08/2020] [Accepted: 02/18/2020] [Indexed: 11/19/2022]
Abstract
Non-recurrent inferior laryngeal nerve (NRILN) is rare but one of the important anatomical variations in thyroid and parathyroid surgery. Almost all cases were observed on the right side with aberrant right subclavian artery and left NRILN have been reported in only five cases so far. Here, we reported a 38 year-old Japanese male with left NRILN accompanying adenomatous goiter. He was referred to our hospital for the surgical treatment of left thyroid goiter. Preoperative computed tomography revealed right-sided aortic arch and aberrant left subclavian artery with no signs of complete situs inversus viscerum, suggesting possible left NRLN. Left hemithyroidectomy was performed using nerve monitoring system. Intraoperatively, left recurrent laryngeal nerve was not identified along tracheoesophageal groove, but directly originated from vagal nerve and was running horizontally to larynx. Mobility of vocal cords were not impaired and postoperative course was uneventful. During thyroid surgery for the patients with right-sided aortic arch, meticulous care should be taken using nerve monitoring system to avoid nerve injury.
Collapse
|
56
|
Masuzawa T, Takeno A, Murakami K, Kawai K, Sakamoto T, Katsura Y, Ohmura Y, Kagawa Y, Hata T, Takeda Y, Murata K. [Robot-Assisted Distal Gastrectomy for Gastric Cancer with Adachi Ⅵ Type Vascular Anomaly-A Case Report]. Gan To Kagaku Ryoho 2020; 47:516-518. [PMID: 32381934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We report a case of vascular anomaly of Adachi type Ⅵ. The common hepatic artery does not appear at the superior edge of the pancreas in Adachi type Ⅵ. A 67-year-old woman was diagnosed with gastric cancer. Preoperative computed tomography showed the vascular anomaly. The patient was treated successfully with robot-assisted distal gastrectomy by the da Vinci Surgical System®(da Vinci). The postoperative course was uneventful and the patient was discharged 10 days after surgery. The vascular anomaly makes the dissection of lymph nodes No. 8a and 9, difficult. Owing to wristed instruments with several joints and 3D-HD visualization, the da Vinci is superior to conventional laparoscopic surgery in completing detailed and complex procedures. Therefore, the da Vinci is useful for performing an extremely challenging gastrectomy procedure, as in this case.
Collapse
|
57
|
Chikamatsu G, Hiu T, Otsuka H, Shiozaki E, Nakamura H, Kawahara I, Moritsuka T, Ono T, Haraguchi W, Ushijima R, Tsutsumi K. [Endovascular Treatment of a Ruptured Aneurysm of the Right Vertebral Artery with an Aberrant Right Subclavian Artery]. NO SHINKEI GEKA. NEUROLOGICAL SURGERY 2020; 48:223-229. [PMID: 32201391 DOI: 10.11477/mf.1436204166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We report a rare case of the endovascular treatment of a ruptured aneurysm of the right vertebral artery with an aberrant right subclavian artery(ARSA). A 60-year-old woman was urgently admitted because of consciousness disturbance. Brain CT showed subarachnoid hemorrhage, and CT angiography showed a right vertebral ruptured aneurysm. Endovascular treatment of the aneurysm was performed via a transfemoral approach. During the endovascular treatment, the right subclavian artery was found to diverge from the descending aorta on the periphery of the left subclavian artery. An ARSA was detected, and the right vertebral artery(VA)originated from the ARSA. The guiding catheter was passed through the right VA via an ARSA, and the aneurysm was completely embolized. The patient was transferred to another hospital on day 44 without any motor weakness. To our knowledge, this is the first case of an ARSA with a ruptured aneurysm in the right VA for which endovascular treatment was successfully performed via the ARSA. In patients with an ARSA or aberrant left subclavian artery, the artery could merge with Kommerell's diverticulum(KD)at its origin and be histologically fragile. Thus, in patients with an ARSA, attention should be paid to catheterization to avoid injuring the KD. CT angiography of the aortic arch might be considered before endovascular treatment.
Collapse
|
58
|
Merlo A, Farber M, Ohana E, Pascarella L, Crowner J, Long J. Aberrant Right Subclavian Artery to Esophageal Fistula: A Rare Case and Its Management. Ann Thorac Surg 2020; 110:e85-e86. [PMID: 32035051 DOI: 10.1016/j.athoracsur.2019.12.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 12/08/2019] [Accepted: 12/16/2019] [Indexed: 11/17/2022]
Abstract
A 29-year-old woman underwent esophageal stent placement after developing esophageal stenosis in the setting of tracheoesophageal fistula repair in childhood. The patient developed hemoptysis from an esophageal to aberrant right subclavian artery fistula; this was managed with several staged procedures involving arterial stent placement, carotid-to-subclavian bypass, and aberrant subclavian artery ligation. The patient then underwent pericardial patch repair of her perforated esophagus. This case illustrates the importance of understanding congenital anatomy and frequent associations, such as tracheoesophageal fistula and aberrant right subclavian artery; furthermore, it demonstrates the importance of multidisciplinary care for complex cases.
Collapse
|
59
|
Purifoy E, Adachi I. Commentary: It isn't easy being single. J Thorac Cardiovasc Surg 2020; 159:1999-2000. [PMID: 31932057 DOI: 10.1016/j.jtcvs.2019.10.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 10/29/2019] [Indexed: 11/17/2022]
|
60
|
Braga SF, Ferreira J, Mesquita A. Rare Combination Of Anatomical Variations. REVISTA PORTUGUESA DE CIRURGIA CARDIO-TORACICA E VASCULAR : ORGAO OFICIAL DA SOCIEDADE PORTUGUESA DE CIRURGIA CARDIO-TORACICA E VASCULAR 2020; 27:59. [PMID: 32239832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Indexed: 06/11/2023]
|
61
|
Mandal C, Dutta PK. Study of Prevalence of Cardiovascular Abnormalities Using ECG & 2D- Echo in Chronic Kidney Disease Patients in Kolkata. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2020; 68:74. [PMID: 31979727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Chronic Kidney Disease patients face extraordinary risk for premature death, because of cardiovascular events. This increased risk of CV events may begin during early stages of CKD much before the onset of ESRD. Our study aim was to non-invasively identify prevalence of various asymptomatic cardiovascular abnormalities using ECG & Echo changes in patients with CKD. MATERIAL sample of 100 patients enrolled, 2D Echo & ECG was used after ethical approval and consent OBSERVATIONS mean age of patients 48.99±SD15.8 years. 82% presented within 6-months of diagnosis. Male:Female ratio = 2:1. Hypertension (44%) was the leading etiology, cardiovascular abnormalities detected in 72% by ECG & 56% by Echo. LVH was the commonest abnormality (14 by ECG, 34 by Echo, 9 by both). Females were 1.7 times more likely to be detected LVH by Echo than males. LVH was 2 times more in on-dialysis patients. Hyperkalemia & Pericardial Effusion in ECG were more evident in on-dialysis patients. Conduction abnormality were more common in patients on dialysis. Echo revealed LV diastolic dysfunction in 46, LV systolic dysfunction in 16, pericardial effusion in 19 patients CONCLUSIONS Asymptomatic cardiovascular abnormalities in such significant percentage of patients should enlighten the clinicians regarding CVD in CKD.
Collapse
|
62
|
Takago S, Kato H, Ueda H, No H, Yamamoto Y, Iino K, Kimura K, Takemura H. [Coil Embolization for an Aberrant Left Subclavian Artery Aneurysm with Kommerell's Diverticulum;Report of a Case]. KYOBU GEKA. THE JAPANESE JOURNAL OF THORACIC SURGERY 2019; 72:1019-1022. [PMID: 31701915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 67-year-old woman encountered a traffic accident and had chest computed tomography(CT) examination. It revealed a 24 mm Kommerell's diverticulum associated with a right-sided aortic arch and a 15 mm saccular aneurysm of an aberrant left subclavian artery. We performed intra-aneurysmal coil embolization for the left subclavian artery aneurysm after a balloon occlusion test of the left subclavian artery. The postoperative course was uneventful.
Collapse
|
63
|
Woods RK, Hraska V. Commentary: Single ventricle patients and shunts-ACute event is not pretty. J Thorac Cardiovasc Surg 2019; 158:1154-1155. [PMID: 31109708 DOI: 10.1016/j.jtcvs.2019.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 04/08/2019] [Indexed: 11/19/2022]
|
64
|
BLACKET RB, SINCLAIR-SMITH BC, PALMER AJ, HALLIDAY JH, MADDOX JK. EBSTEIN'S DISEASE : A REPORT OF FIVE CASES. ACTA ACUST UNITED AC 2017; 1:26-41. [PMID: 14934613 DOI: 10.1111/imj.1952.1.1.26] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
65
|
Hornberger LK. Re: Right ventricular outflow tract obstruction in complicated monochorionic twin pregnancy. S. J. Eschbach, L. S. T. M. Boons, E. Van Zwet, J. M. Middeldorp, F. J. C. M. Klumper, E. Lopriore, A. K. K. Teunissen, M. E. Rijlaarsdam, D. Oepkes, A. D. J. Ten Harkel, M. C. Haak. Ultrasound Obstet Gynecol 2017; 49: 737-743. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 49:693-694. [PMID: 28573773 DOI: 10.1002/uog.17518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
|
66
|
Patel HJ. Chimney, periscope, or snorkel technique to relieve dysphagia. J Thorac Cardiovasc Surg 2016; 153:809. [PMID: 27863770 DOI: 10.1016/j.jtcvs.2016.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 10/02/2016] [Accepted: 10/03/2016] [Indexed: 11/17/2022]
|
67
|
Weston J, Bromley R, Jackson CF, Adab N, Clayton‐Smith J, Greenhalgh J, Hounsome J, McKay AJ, Tudur Smith C, Marson AG. Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child. Cochrane Database Syst Rev 2016; 11:CD010224. [PMID: 27819746 PMCID: PMC6465055 DOI: 10.1002/14651858.cd010224.pub2] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND There is evidence that certain antiepileptic drugs (AEDs) are teratogenic and are associated with an increased risk of congenital malformation. The majority of women with epilepsy continue taking AEDs throughout pregnancy; therefore it is important that comprehensive information on the potential risks associated with AED treatment is available. OBJECTIVES To assess the effects of prenatal exposure to AEDs on the prevalence of congenital malformations in the child. SEARCH METHODS We searched the Cochrane Epilepsy Group Specialized Register (September 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 11), MEDLINE (via Ovid) (1946 to September 2015), EMBASE (1974 to September 2015), Pharmline (1978 to September 2015), Reprotox (1983 to September 2015) and conference abstracts (2010-2015) without language restriction. SELECTION CRITERIA We included prospective cohort controlled studies, cohort studies set within pregnancy registries and randomised controlled trials. Participants were women with epilepsy taking AEDs; the two control groups were women without epilepsy and women with epilepsy who were not taking AEDs during pregnancy. DATA COLLECTION AND ANALYSIS Three authors independently selected studies for inclusion. Five authors completed data extraction and risk of bias assessments. The primary outcome was the presence of a major congenital malformation. Secondary outcomes included specific types of major congenital malformations. Where meta-analysis was not possible, we reviewed included studies narratively. MAIN RESULTS We included 50 studies, with 31 contributing to meta-analysis. Study quality varied, and given the observational design, all were at high risk of certain biases. However, biases were balanced across the AEDs investigated and we believe that the results are not explained by these biases.Children exposed to carbamazepine (CBZ) were at a higher risk of malformation than children born to women without epilepsy (N = 1367 vs 2146, risk ratio (RR) 2.01, 95% confidence interval (CI) 1.20 to 3.36) and women with untreated epilepsy (N = 3058 vs 1287, RR 1.50, 95% CI 1.03 to 2.19). Children exposed to phenobarbital (PB) were at a higher risk of malformation than children born to women without epilepsy (N = 345 vs 1591, RR 2.84, 95% CI 1.57 to 5.13). Children exposed to phenytoin (PHT) were at an increased risk of malformation compared with children born to women without epilepsy (N = 477 vs 987, RR 2.38, 95% CI 1.12 to 5.03) and to women with untreated epilepsy (N = 640 vs 1256, RR 2.40, 95% CI 1.42 to 4.08). Children exposed to topiramate (TPM) were at an increased risk of malformation compared with children born to women without epilepsy (N = 359 vs 442, RR 3.69, 95% CI 1.36 to 10.07). The children exposed to valproate (VPA) were at a higher risk of malformation compared with children born to women without epilepsy (N = 467 vs 1936, RR 5.69, 95% CI 3.33 to 9.73) and to women with untreated epilepsy (N = 1923 vs 1259, RR 3.13, 95% CI 2.16 to 4.54). There was no increased risk for major malformation for lamotrigine (LTG). Gabapentin (GBP), levetiracetam (LEV), oxcarbazepine (OXC), primidone (PRM) or zonisamide (ZNS) were not associated with an increased risk, however, there were substantially fewer data for these medications.For AED comparisons, children exposed to VPA had the greatest risk of malformation (10.93%, 95% CI 8.91 to 13.13). Children exposed to VPA were at an increased risk of malformation compared with children exposed to CBZ (N = 2529 vs 4549, RR 2.44, 95% CI 2.00 to 2.94), GBP (N = 1814 vs 190, RR 6.21, 95% CI 1.91 to 20.23), LEV (N = 1814 vs 817, RR 5.82, 95% CI 3.13 to 10.81), LTG (N = 2021 vs 4164, RR 3.56, 95% CI 2.77 to 4.58), TPM (N = 1814 vs 473, RR 2.35, 95% CI 1.40 to 3.95), OXC (N = 676 vs 238, RR 3.71, 95% CI 1.65 to 8.33), PB (N = 1137 vs 626, RR 1.59, 95% CI 1.11 to 2.29, PHT (N = 2319 vs 1137, RR 2.00, 95% CI 1.48 to 2.71) or ZNS (N = 323 vs 90, RR 17.13, 95% CI 1.06 to 277.48). Children exposed to CBZ were at a higher risk of malformation than those exposed to LEV (N = 3051 vs 817, RR 1.84, 95% CI 1.03 to 3.29) and children exposed to LTG (N = 3385 vs 4164, RR 1.34, 95% CI 1.01 to 1.76). Children exposed to PB were at a higher risk of malformation compared with children exposed to GBP (N = 204 vs 159, RR 8.33, 95% CI 1.04 to 50.00), LEV (N = 204 vs 513, RR 2.33, 95% CI 1.04 to 5.00) or LTG (N = 282 vs 1959, RR 3.13, 95% CI 1.64 to 5.88). Children exposed to PHT had a higher risk of malformation than children exposed to LTG (N = 624 vs 4082, RR 1.89, 95% CI 1.19 to 2.94) or to LEV (N = 566 vs 817, RR 2.04, 95% CI 1.09 to 3.85); however, the comparison to LEV was not significant in the random-effects model. Children exposed to TPM were at a higher risk of malformation than children exposed to LEV (N = 473 vs 817, RR 2.00, 95% CI 1.03 to 3.85) or LTG (N = 473 vs 3975, RR 1.79, 95% CI 1.06 to 2.94). There were no other significant differences, or comparisons were limited to a single study.We found significantly higher rates of specific malformations associating PB exposure with cardiac malformations and VPA exposure with neural tube, cardiac, oro-facial/craniofacial, and skeletal and limb malformations in comparison to other AEDs. Dose of exposure mediated the risk of malformation following VPA exposure; a potential dose-response association for the other AEDs remained less clear. AUTHORS' CONCLUSIONS Exposure in the womb to certain AEDs carried an increased risk of malformation in the foetus and may be associated with specific patterns of malformation. Based on current evidence, LEV and LTG exposure carried the lowest risk of overall malformation; however, data pertaining to specific malformations are lacking. Physicians should discuss both the risks and treatment efficacy with the patient prior to commencing treatment.
Collapse
|
68
|
Miller TA, Zak V, Shrader P, Ravishankar C, Pemberton VL, Newburger JW, Shillingford AJ, Dagincourt N, Cnota JF, Lambert LM, Sananes R, Richmond ME, Hsu DT, Miller SG, Zyblewski SC, Williams RV. Growth Asymmetry, Head Circumference, and Neurodevelopmental Outcomes in Infants with Single Ventricles. J Pediatr 2016; 168:220-225.e1. [PMID: 26490132 PMCID: PMC4698012 DOI: 10.1016/j.jpeds.2015.09.041] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 07/10/2015] [Accepted: 09/10/2015] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To assess the variability in asymmetric growth and its association with neurodevelopment in infants with single ventricle (SV). STUDY DESIGN We analyzed weight-for-age z-score minus head circumference-for-age z-score (HCAZ), relative head growth (cm/kg), along with individual growth variables in subjects prospectively enrolled in the Infant Single Ventricle Trial. Associations between growth indices and scores on the Psychomotor Developmental Index (PDI) and Mental Developmental Index (MDI) of the Bayley Scales of Infant Development-II (BSID-II) at 14 months were assessed. RESULTS Of the 230 subjects enrolled in the Infant Single Ventricle trial, complete growth data and BSID-II scores were available in 168 (73%). Across the cohort, indices of asymmetric growth varied widely at enrollment and before superior cavopulmonary connection (SCPC) surgery. BSID-II scores were not associated with these asymmetry indices. In bivariate analyses, greater pre-SCPC HCAZ correlated with higher MDI (r = 0.21; P = .006) and PDI (r = 0.38; P < .001) and a greater HCAZ increase from enrollment to pre-SCPC with higher PDI (r = 0.15; P = .049). In multivariable modeling, pre-SCPC HCAZ was an independent predictor of PDI (P = .03), but not MDI. CONCLUSION In infants with SV, growth asymmetry was not associated with neurodevelopment at 14 months, but pre-SCPC HCAZ was associated with PDI. Asymmetric growth, important in other high-risk infants, is not a brain-sparing adaptation in infants with SV. TRIAL REGISTRATION Clinicaltrials.gov: NCT00113087.
Collapse
|
69
|
Zhang Y, Huang L, Wang C, Gao D, Zuo Z. Phenanthrene exposure produces cardiac defects during embryo development of zebrafish (Danio rerio) through activation of MMP-9. CHEMOSPHERE 2013; 93:1168-75. [PMID: 23859427 DOI: 10.1016/j.chemosphere.2013.06.056] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 06/15/2013] [Accepted: 06/18/2013] [Indexed: 05/06/2023]
Abstract
Phenanthrene (Phe) is one of the most abundant polycyclic aromatic hydrocarbons in the aquatic environment as a result of human activities. It is widely accepted that Phe has cardiotoxic effects. Even so, knowledge concerning the mechanism(s) of cardiac development toxicity is still limited. In this study, we exposed zebrafish embryos to environmentally relevant concentrations of Phe and then investigated its cardiotoxic effects and the mechanism(s) involved. Some cardiac morphogenetic defects, which was characterized by an abnormally looped and enlarged heart, dilated and thinner ventricular wall, and increased interstitial fibrosis, were observed in the Phe treated groups. The mRNA and protein expression levels of matrix metalloproteinase-9 (MMP-9), as well as the MMP-9 activity, were induced. Moreover, during co-treatment of the zebrafish embryos with MMP-9 inhibitor, the cardiac defects caused by Phe were attenuated. In addition, Phe exposure led to an up-regulation of transforming growth factor β (TGF-β), which plays a crucial role in mediating cardiac fibrosis. Taken together, our data indicated that the exposure to Phe of zebrafish embryos disrupted normal cardiac development, and that the cardiac defects induced by Phe were mediated by the MMP-9, while TGF-β was also involved in these cardiac defects.
Collapse
|
70
|
Abstract
A human multi-protein complex (WINAC), composed of SWI/SNF components and DNA replication-related factors, that directly interacts with the vitamin D receptor (VDR) through the Williams syndrome transcription factor (WSTF), was identified with an ATP-dependent chromatin remodeling activity. This novel ATP-dependent chromatin remodeling complex facilitates VDR-mediated transrepression as well as transactivation with its ATP-dependent chromatin remodeling activity and promoter targeting property for the activator to access to the DNA. It also suggested that in this complex, WSTF serves as a signaling sensor to receive intra-cellular singalings to switch the activity of WINAC as well as WICH, another ATP-dependent chromatin remodeling complex containing hSNF2h. By making WSTF-deficient mice, some of the heart defects as well as abnormal calcium metabolism observed in Williams syndrome are attributed to the abnormal chromatin remodeling activity caused by WSTF deficiency. Thus, we would propose to designate Williams syndrome as an epigenome-regulator disease.
Collapse
|
71
|
|
72
|
|
73
|
FALHOLT W, PEDERSEN A. COMPLETE TRANSPOSITION OF THE AORTA AND LEVOPOSITION OF THE PULMONARY ARTERY: REPORT OF A CASE, DIAGNOSED BY CARDIAC CATHETERIZATION. ACTA ACUST UNITED AC 2009; 266:393-99. [PMID: 14902388 DOI: 10.1111/j.0954-6820.1952.tb13388.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
74
|
CASTELLANOS A, GARCIA O, GONZALEZ E. Complete Interruption of the Aortic Arch with Transposition of the Great Vessels. Cardiology 2008; 34:53-64. [PMID: 13629499 DOI: 10.1159/000166396] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
75
|
BARRETT NR, DALEY R. A method of increasing the lung blood supply in cyanotic congenital heart disease. BRITISH MEDICAL JOURNAL 2007; 1:699-702. [PMID: 18118580 DOI: 10.1136/bmj.1.4607.699] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|