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Zhu Y, Zhang Y, Ding N, Zhao Y, Ye Z, Fan X, Liu Y, Shen L, Yi H, Li Z. The role of cardiac surgeons in online prenatal counselling for congenital heart disease. J Int Med Res 2019; 47:5270-5277. [PMID: 31452428 PMCID: PMC6833391 DOI: 10.1177/0300060519869079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective To explore the role of cardiac surgeons in prenatal online counselling for congenital heart disease. Methods From January 2014 to December 2017, the author consulted on 400 cases of foetal cardiovascular abnormalities through the Good Doctor Online and WeChat online platforms. The author made appropriate pregnancy recommendations to patients and families using patient ultrasound reports and medical histories. Followed-up patients who chose to continue their pregnancy received postnatal advice. Results There were 248 simple cardiac abnormalities and 152 complex cardiac abnormalities. Foetal chromosome examination detected 2 cases of trisomy 21 syndrome and 26 normal cases. Two mothers (0.8%) of simple cardiac abnormality foetuses and 103 (67.8%) mothers of complex cardiac abnormality foetuses chose induced abortion. A total of 246 mothers of simple cardiac abnormality foetuses chose to continue pregnancy and had good postnatal prognosis. Twenty-six mothers of complex cardiac abnormality foetuses chose to continue pregnancy; among these, there were 4 intrauterine deaths, 22 births, 4 deaths while awaiting surgery and 18 successful surgeries. Conclusion The Good Doctor Online and WeChat platforms facilitate communication with a wide audience. Cardiac surgeons can reduce the birth incidence and improve prenatal consultations for severe congenital heart disease through these platforms.
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Affiliation(s)
- Yaobin Zhu
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yaping Zhang
- Department of Heart Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Nan Ding
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yudong Zhao
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zankai Ye
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xing Fan
- Pediatric Heart Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yang Liu
- Pediatric Heart Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lei Shen
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hanlu Yi
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhiqiang Li
- Department of Cardiovascular Surgery II, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Reconstruction of the pulmonary artery by a novel biodegradable conduit engineered with perinatal stem cell-derived vascular smooth muscle cells enables physiological vascular growth in a large animal model of congenital heart disease. Biomaterials 2019; 217:119284. [PMID: 31255979 PMCID: PMC6658806 DOI: 10.1016/j.biomaterials.2019.119284] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/10/2019] [Accepted: 06/13/2019] [Indexed: 12/14/2022]
Abstract
Lack of growth potential of available grafts represents a bottleneck in the correction of congenital heart defects. Here we used a swine small intestinal submucosa (SIS) graft functionalized with mesenchymal stem cell (MSC)-derived vascular smooth muscle cells (VSMCs), for replacement of the pulmonary artery in piglets. MSCs were expanded from human umbilical cord blood or new-born swine peripheral blood, seeded onto decellularized SIS grafts and conditioned in a bioreactor to differentiate into VSMCs. Results indicate the equivalence of generating grafts engineered with human or swine MSC-derived VSMCs. Next, we conducted a randomized, controlled study in piglets (12–15 kg), which had the left pulmonary artery reconstructed with swine VSMC-engineered or acellular conduit grafts. Piglets recovered well from surgery, with no casualty and similar growth rate in either group. After 6 months, grafted arteries had larger circumference in the cellular group (28.3 ± 2.3 vs 18.3 ± 2.1 mm, P < 0.001), but without evidence of aneurism formation. Immunohistochemistry showed engineered grafts were composed of homogeneous endothelium covered by multi-layered muscular media, whereas the acellular grafts exhibited a patchy endothelial cell layer and a thinner muscular layer. Results show the feasibility and efficacy of pulmonary artery reconstruction using clinically available grafts engineered with allogeneic VSMCs in growing swine.
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103
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Lesnewich LM, Conway FN, Buckman JF, Brush CJ, Ehmann PJ, Eddie D, Olson RL, Alderman BL, Bates ME. Associations of depression severity with heart rate and heart rate variability in young adults across normative and clinical populations. Int J Psychophysiol 2019; 142:57-65. [PMID: 31195066 DOI: 10.1016/j.ijpsycho.2019.06.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 06/05/2019] [Accepted: 06/07/2019] [Indexed: 12/19/2022]
Abstract
Limitations of current depression treatments may arise from a lack of knowledge about unique psychophysiological processes that contribute to depression across the full range of presentations. This study examined how individual variations in heart rate (HR) and heart rate variability (HRV) are related to depressive symptoms across normative and clinical populations in 152 young adults (aged 18-35 years). Moderating effects of sex and antidepressant medication status were considered. Electrocardiogram data were collected during "vanilla" baseline and in response to positive and negative emotional cues. Linear regressions and repeated-measures mixed models were used to assess the relationships between Beck Depression Inventory-II (BDI-II) scores, sex, antidepressant use, and cardiovascular outcomes. Baseline models yielded significant main effects of BDI-II and sex on HR and significant interactions between antidepressant medication status and BDI-II on HRV outcomes. The main effects of BDI-II and sex on HR were no longer significant after controlling for cardiorespiratory fitness. Participants who denied current antidepressant use (n = 137) exhibited a negative association and participants who endorsed current antidepressant (n = 15) use exhibited a positive association between BDI-II scores and HRV. Emotional reactivity models were largely non-significant with the exception of a significant main effect of antidepressant medication status on high-frequency HRV reactivity. Results indicated antidepressant medication use may moderate the relationship between depression severity and cardiovascular functioning, but this requires replication given the modest proportion of medicated individuals in this study. Overall, findings suggest cardiovascular processes and cardiorespiratory fitness are linked to depression symptomatology and may be important to consider in depression treatment.
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Affiliation(s)
- Laura M Lesnewich
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, 607 Allison Road, Piscataway, NJ 08854, USA.
| | - Fiona N Conway
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Boulevard, Austin, TX 78712, USA.
| | - Jennifer F Buckman
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, 607 Allison Road, Piscataway, NJ 08854, USA; Department of Kinesiology and Health, Rutgers, The State University of New Jersey, 70 Lipman Drive, New Brunswick, NJ 08901, USA.
| | - Christopher J Brush
- Department of Kinesiology and Health, Rutgers, The State University of New Jersey, 70 Lipman Drive, New Brunswick, NJ 08901, USA.
| | - Peter J Ehmann
- Department of Kinesiology and Health, Rutgers, The State University of New Jersey, 70 Lipman Drive, New Brunswick, NJ 08901, USA.
| | - David Eddie
- Recovery Research Institute, Center for Addiction Medicine, Massachusetts General Hospital, Harvard Medical School, 151 Merrimac Street, Boston, MA 02114, USA.
| | - Ryan L Olson
- Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, 1921 Chestnut Street, Denton, TX 76203, USA.
| | - Brandon L Alderman
- Department of Kinesiology and Health, Rutgers, The State University of New Jersey, 70 Lipman Drive, New Brunswick, NJ 08901, USA.
| | - Marsha E Bates
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, 607 Allison Road, Piscataway, NJ 08854, USA; Department of Kinesiology and Health, Rutgers, The State University of New Jersey, 70 Lipman Drive, New Brunswick, NJ 08901, USA.
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104
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Streeter BW, Xue J, Xia Y, Davis ME. Electrospun Nanofiber-Based Patches for the Delivery of Cardiac Progenitor Cells. ACS APPLIED MATERIALS & INTERFACES 2019; 11:18242-18253. [PMID: 31021079 DOI: 10.1021/acsami.9b04473] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Congenital heart disease is the number one cause of birth defect-related death because it often leads to right ventricular heart failure (RVHF). One promising avenue to combat this RVHF is the use of cardiac patches composed of stem cells and scaffolds. Herein, we demonstrate a reparative cardiac patch by combining neonatal or child c-kit+ progenitor cells (CPCs) with a scaffold composed of electrospun polycaprolactone nanofibers. We examined different parameters of the patch, including the alignment, composition, and surface properties of the nanofibers, as well as the age of the CPCs. The patch based on uniaxially aligned nanofibers successfully aligned the CPCs. With the inclusion of gelatin in the nanofiber matrix and/or coating of fibronectin on the surface of the nanofibers, the metabolism of both neonatal and child CPCs was generally enhanced. The conditioned media collected from both patches based on aligned and random nanofibers could reduce the fibrotic gene expression in rat cardiac fibroblasts, following stimulation with transforming growth factor β. Furthermore, the conditioned media collected from the nanofiber-based patches could lead to the formation of tubes of human umbilical vein endothelial cells, indicating the pro-angiogenic capability of the patch. Taken together, the electrospun nanofiber-based patches are a suitable delivery vehicle for CPCs and can confer reparative benefit through anti-fibrotic and pro-angiogenic paracrine signaling.
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Affiliation(s)
- Benjamin W Streeter
- Wallace H. Coulter Department of Biomedical Engineering , Georgia Institute of Technology and Emory University School of Medicine , Atlanta , Georgia 30332 , United States
| | - Jiajia Xue
- Wallace H. Coulter Department of Biomedical Engineering , Georgia Institute of Technology and Emory University School of Medicine , Atlanta , Georgia 30332 , United States
| | - Younan Xia
- Wallace H. Coulter Department of Biomedical Engineering , Georgia Institute of Technology and Emory University School of Medicine , Atlanta , Georgia 30332 , United States
- School of Chemistry and Biochemistry, School of Chemical and Biological Engineering , Georgia Institute of Technology , Atlanta , Georgia 30332 , United States
| | - Michael E Davis
- Wallace H. Coulter Department of Biomedical Engineering , Georgia Institute of Technology and Emory University School of Medicine , Atlanta , Georgia 30332 , United States
- Division of Cardiology , Emory University School of Medicine , Atlanta , Georgia 30322 , United States
- Children's Heart Research and Outcomes (HeRO) Center , Children's Healthcare of Atlanta and Emory University , Atlanta , Georgia 30322 , United States
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105
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Babić Božović I, Stanković A, Živković M, Vraneković J, Mahulja-Stamenković V, Brajenović-Milić B. Maternal LINE-1 DNA Methylation and Congenital Heart Defects in Down Syndrome. Front Genet 2019; 10:41. [PMID: 30787943 PMCID: PMC6372553 DOI: 10.3389/fgene.2019.00041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 01/21/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Down syndrome (DS) is one of the most common chromosomal abnormalities associated with congenital heart defects (CHD), with approximately 40 to 60% of cases showing cardiac defects. This study assessed (i) the association between maternal LINE-1 methylation and the occurrence of CHDs in children with DS and (ii) the impact of endogenous maternal factors (MTHFR C677T polymorphism and maternal age) and exogenous maternal factors (cigarette smoking, alcohol intake, medication use, body mass index and dietary habits such as folate intake) on maternal LINE-1 methylation and on the occurrence of CHD in children with DS. Patients and Methods: The study included 90 mothers of children with DS of maternal origin (49% DS-CHD+ mothers/51% DS-CHD− mothers). LINE-1 DNA methylation was analyzed in peripheral blood lymphocytes by quantification of LINE-1 methylation using the MethyLight method. MTHFR C677T polymorphism genotyping was performed using PCR-RFLP. Results: LINE-1 methylation was not significantly different between DS-CHD+ and DS-CHD− mothers (P = 0.997). Combination of MTHFR C677T genotype/diet and BMI were significant independent predictors of LINE-1 DNA methylation in DS-CHD+ mothers (β −0.40, P = 0.01 and β −0.32, P = 0.03, respectively). In the analyzed multivariate model (model P = 0.028), these two factors explained around 72% of the variance in LINE-1 DNA methylation in mothers of children with DS and CHD. The group with the highest BMI (≥30 kg/m2) had significantly lower LINE-1 methylation than the group with normal BMI (Bonferroni post hoc P = 0.03) and the overweight group (Bonferroni post hoc P = 0.04). The lowest LINE-1 DNA methylation values were found in DS-CHD+ mothers with the CT+TT genotype and a low-folate diet; the values were significantly lower than the values in mothers with the CC genotype and a folate-rich diet (Bonferroni post hoc P = 0.04). Conclusion: Association between maternal LINE-1 methylation and CHD in children with DS was not found. Study showed that the MTHFR genotype/diet combination and BMI were significantly associated with LINE-1 methylation in mothers of children with DS-CHD+. These results highlight the need for a multifactorial approach to assess the roles of endogenous and exogenous maternal factors in maternal LINE-1 DNA methylation and the consequent pathologies in children. More extensive studies in a larger sample may help elucidate these relationships.
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Affiliation(s)
- Ivana Babić Božović
- Department of Medical Biology and Genetics, School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Aleksandra Stanković
- Laboratory for Radiobiology and Molecular Genetics, Vinča Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
| | - Maja Živković
- Laboratory for Radiobiology and Molecular Genetics, Vinča Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
| | - Jadranka Vraneković
- Department of Medical Biology and Genetics, School of Medicine, University of Rijeka, Rijeka, Croatia
| | - Vesna Mahulja-Stamenković
- Department of Gynaecology and Obstetrics, Clinical Hospital Centre Rijeka, University of Rijeka, Rijeka, Croatia
| | - Bojana Brajenović-Milić
- Department of Medical Biology and Genetics, School of Medicine, University of Rijeka, Rijeka, Croatia
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106
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Miksiunas R, Mobasheri A, Bironaite D. Homeobox Genes and Homeodomain Proteins: New Insights into Cardiac Development, Degeneration and Regeneration. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1212:155-178. [PMID: 30945165 DOI: 10.1007/5584_2019_349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cardiovascular diseases are the most common cause of human death in the developing world. Extensive evidence indicates that various toxic environmental factors and unhealthy lifestyle choices contribute to the risk, incidence and severity of cardiovascular diseases. Alterations in the genetic level of myocardium affects normal heart development and initiates pathological processes leading to various types of cardiac diseases. Homeobox genes are a large and highly specialized family of closely related genes that direct the formation of body structure, including cardiac development. Homeobox genes encode homeodomain proteins that function as transcription factors with characteristic structures that allow them to bind to DNA, regulate gene expression and subsequently control the proper physiological function of cells, tissues and organs. Mutations in homeobox genes are rare and usually lethal with evident alterations in cardiac function at or soon after the birth. Our understanding of homeobox gene family expression and function has expanded significantly during the recent years. However, the involvement of homeobox genes in the development of human and animal cardiac tissue requires further investigation. The phenotype of human congenital heart defects unveils only some aspects of human heart development. Therefore, mouse models are often used to gain a better understanding of human heart function, pathology and regeneration. In this review, we have focused on the role of homeobox genes in the development and pathology of human heart as potential tools for the future development of targeted regenerative strategies for various heart malfunctions.
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Affiliation(s)
- Rokas Miksiunas
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | - Ali Mobasheri
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | - Daiva Bironaite
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania.
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107
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Fragoso JM, Ramírez-Bello J, Martínez-Ríos MA, Peña-Duque MA, Posadas-Sánchez R, Delgadillo-Rodríguez H, Jiménez-Morales M, Posadas-Romero C, Vargas-Alarcón G. miR-196a2 (rs11614913) polymorphism is associated with coronary artery disease, but not with in-stent coronary restenosis. Inflamm Res 2018; 68:215-221. [PMID: 30560371 DOI: 10.1007/s00011-018-1206-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 12/02/2018] [Accepted: 12/10/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE The aim of the study was to evaluate the association of miRNA-146a G/C (rs2910164), and miRNA-196a2 C/T (rs11614913) polymorphisms with the presence of coronary artery disease (CAD) and/or restenosis in patients with coronary stent. MATERIALS AND METHODS The polymorphisms were determined in 218 patients with CAD who underwent coronary artery stenting (66 with restenosis and 152 without restenosis) and 611 healthy controls using 5' exonuclease TaqMan assays. RESULTS The distribution of both polymorphisms was similar in patients with and without restenosis. However, when the whole group of patients (with and without restenosis) was compared to healthy controls, under co-dominant, dominant and additive genetic models, the T allele of the miRNA-196a2 C/T (rs11614913) polymorphism was associated with increased risk of CAD (OR = 2.18, Pco-dom = 0.006, OR = 1.86, Pdom = 0.002, and OR = 1.52, Padd = 0.002, respectively). All models were adjusted for age, type 2 diabetes mellitus, dyslipidemia, hypertension and smoking habit. The "GT" haplotype was associated with increased risk of developing CAD (OR = 1.36, P = 0.046). CONCLUSIONS Our data suggests that the T allele of the miRNA-196a2 C/T (rs11614913) polymorphism is associated with the risk of developing CAD, but no association with restenosis was observed.
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Affiliation(s)
- José Manuel Fragoso
- Department of Molecular Biology, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, Del. Tlalpan, 14080, Mexico City, Mexico
| | - Julian Ramírez-Bello
- Endocrine and Metabolic Diseases Research Unit, Hospital Juárez de Mexico, Mexico City, Mexico
| | | | - Marco Antonio Peña-Duque
- Interventional Cardiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | | | | | - Mayra Jiménez-Morales
- Endocrine and Metabolic Diseases Research Unit, Hospital Juárez de Mexico, Mexico City, Mexico
| | - Carlos Posadas-Romero
- Department of Endocrinology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Gilberto Vargas-Alarcón
- Department of Molecular Biology, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, Del. Tlalpan, 14080, Mexico City, Mexico.
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108
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The roles of MTRR and MTHFR gene polymorphisms in congenital heart diseases: a meta-analysis. Biosci Rep 2018; 38:BSR20181160. [PMID: 30333252 PMCID: PMC6435561 DOI: 10.1042/bsr20181160] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/14/2018] [Accepted: 09/06/2018] [Indexed: 12/13/2022] Open
Abstract
Background: We performed the present study to better elucidate the correlations of methylenetetrahydrofolate reductase (MTHFR) and methionine synthase reductase (MTRR) gene polymorphisms with the risk of congenital heart diseases (CHD). Methods: Eligible articles were searched in PubMed, Medline, Embase and CNKI. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to detect any potential associations of MTHFR and MTRR gene polymorphisms with CHD. Results: A total of 47 eligible studies were finally included in our meta-analysis. Our overall analyses suggested that MTRR rs1801394, MTRR rs1532268, MTHFR rs1801131 and MTHFR rs1801133 polymorphisms were all significantly associated with the risk of CHD in certain genetic models. Further subgroup analyses according to ethnicity of study participants demonstrated that the MTRR rs1801394 polymorphism was significantly correlated with the risk of CHD only in Asians, whereas MTRR rs1532268, MTHFR rs1801133 and MTHFR rs1801131 polymorphisms were significantly correlated with the risk of CHD in both Asians and Caucasians. Conclusions: Our findings indicated that MTRR rs1532268, MTHFR rs1801131 and MTHFR rs1801133 polymorphisms may affect the risk of CHD in Asians and Caucasians, while the MTRR rs1801394 polymorphism may only affect in risk of CHD in Asians.
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109
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Wang W, Xu A, Xu H. The roles of vascular endothelial growth factor gene polymorphisms in congenital heart diseases: a meta-analysis. Growth Factors 2018; 36:232-238. [PMID: 30689460 DOI: 10.1080/08977194.2018.1513505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We performed this study to better elucidate the correlations between vascular endothelial growth factor (VEGF) gene polymorphisms and congenital heart diseases (CHD). Eligible articles were searched in PubMed, Medline, Embase and CNKI. Eighteen studies were finally included in our meta-analysis. A significant association with the risk of CHD was detected for the rs1570360 polymorphism in additive comparison in overall analyses. Further subgroup analyses according to ethnicity of study participants and type of disease demonstrated that the rs833061 polymorphism was significantly correlated with the risk of CHD in Asians under additive genetic model, and the rs3025039 polymorphism was significantly correlated with the risk of Tetralogy of Fallot (TOF) in dominant, recessive and allele models. In conclusion, our findings indicated that rs1570360 and rs833061 polymorphisms may affect the risk of CHD. In addition, the rs3025039 polymorphism may serve as a genetic biomarker of TOF.
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Affiliation(s)
- Weiping Wang
- a Department of Pediatrics , Changyi People's Hospital , Changyi , China
| | - Aiping Xu
- a Department of Pediatrics , Changyi People's Hospital , Changyi , China
| | - Hong Xu
- a Department of Pediatrics , Changyi People's Hospital , Changyi , China
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Mantakaki A, Fakoya AOJ, Sharifpanah F. Recent advances and challenges on application of tissue engineering for treatment of congenital heart disease. PeerJ 2018; 6:e5805. [PMID: 30386701 PMCID: PMC6204240 DOI: 10.7717/peerj.5805] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 09/21/2018] [Indexed: 12/11/2022] Open
Abstract
Congenital heart disease (CHD) affects a considerable number of children and adults worldwide. This implicates not only developmental disorders, high mortality, and reduced quality of life but also, high costs for the healthcare systems. CHD refers to a variety of heart and vascular malformations which could be very challenging to reconstruct the malformed region surgically, especially when the patient is an infant or a child. Advanced technology and research have offered a better mechanistic insight on the impact of CHD in the heart and vascular system of infants, children, and adults and identified potential therapeutic solutions. Many artificial materials and devices have been used for cardiovascular surgery. Surgeons and the medical industry created and evolved the ball valves to the carbon-based leaflet valves and introduced bioprosthesis as an alternative. However, with research further progressing, contracting tissue has been developed in laboratories and tissue engineering (TE) could represent a revolutionary answer for CHD surgery. Development of engineered tissue for cardiac and aortic reconstruction for developing bodies of infants and children can be very challenging. Nevertheless, using acellular scaffolds, allograft, xenografts, and autografts is already very common. Seeding of cells on surface and within scaffold is a key challenging factor for use of the above. The use of different types of stem cells has been investigated and proven to be suitable for tissue engineering. They are the most promising source of cells for heart reconstruction in a developing body, even for adults. Some stem cell types are more effective than others, with some disadvantages which may be eliminated in the future.
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Affiliation(s)
| | | | - Fatemeh Sharifpanah
- Department of Physiology, Faculty of Medicine, Justus Liebig University, Giessen, Germany
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111
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Ghafarzadeh M, Namdari P, Tarhani M, Tarhani F. A review of application of stem cell therapy in the management of congenital heart disease. J Matern Fetal Neonatal Med 2018; 33:1607-1615. [PMID: 30185081 DOI: 10.1080/14767058.2018.1520829] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Research on stem cells has been rapidly growing with impressive breakthroughs. Although merely a few of the laboratory researches have successfully transited to the clinical trial phase, the application of stem cells as a therapeutic option for some currently incapacitating diseases hold fascinating potentials. This review emphasis the various opportunities for the application of stem cell in the treatment of fetal diseases. First, we provide a brief commentary on the common stem cell strategy used in the treatment of congenital anomalies, thereafter we discuss how stem cell is being used in the management of some fetal disorders.
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Affiliation(s)
- Masoumeh Ghafarzadeh
- Faculty of Medicine, Department of Obstetrics and Genecology, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Parsa Namdari
- University of Debrecen Medical School, Debrecen, Hungary
| | - Mehrnoosh Tarhani
- Research Committee Student, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Fariba Tarhani
- Faculty of Medicine, Department of Paediatrics, Lorestan University of Medical Sciences, Khorramabad, Iran
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112
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Asabella AN, Cimino A, Altini C, Lavelli V, Rubini G. Lung Perfusion Imaging in Tetralogy of Fallot: A Case Report. Mol Imaging Radionucl Ther 2018; 27:146-148. [PMID: 30317856 PMCID: PMC6191732 DOI: 10.4274/mirt.04909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Congenital heart diseases, such as tetralogy of fallot (TOF), are the most common human birth defects that may cause pulmonary diseases. Lung perfusion scintigraphy (LPS) has an important role in evaluating pulmonary involvement in patients with these defects, both as part of the diagnostic work-up and for follow-up to guide best therapeutic strategy. Herein, we report a 10-year-old female patient with TOF who underwent LPS two years after cardiac surgery. The scan showed hypo-perfusion of the left respect to the right lung and abnormal uptake of Tc-99m-macroaggregated albumin in the kidneys and spleen, revealing the presence of a right-to-left shunt, and the necessity for further cardiac surgery. This case is a demonstrative example of the usefulness of LPS in patients with TOF, allowing an accurate evaluation of the best therapeutic strategy with the benefits of low radiation exposure, lack of side effects, reproducibility, management ease and good patient compliance.
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Affiliation(s)
| | | | - Corinna Altini
- Bari University Aldo Moro, Unit of Nuclear Medicine, Bari, Italy
| | | | - Giuseppe Rubini
- Bari University Aldo Moro, Unit of Nuclear Medicine, Bari, Italy
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113
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Jiang T, Huang M, Jiang T, Gu Y, Wang Y, Wu Y, Ma H, Jin G, Dai J, Hu Z. Genome-wide compound heterozygosity analysis highlighted 4 novel susceptibility loci for congenital heart disease in Chinese population. Clin Genet 2018; 94:296-302. [PMID: 29774522 DOI: 10.1111/cge.13384] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/25/2018] [Accepted: 05/15/2018] [Indexed: 01/25/2023]
Abstract
Genome-wide association studies (GWASs) have achieved great success in deciphering the genetic cause of congenital heart disease (CHD). However, the heritability of CHD remains to be clarified, and numerous genetic factors responsible for occurrence of CHD are yet unclear. In this study, we performed a genome-wide search for relaxed forms of compound heterozygosity (CH) in association with CHD using our existing GWAS data including 2265 individuals (957 CHD cases and 1308 controls). CollapsABEL was used to iteratively test the association between the CH genotype and the CHD phenotype in a sliding window manner. We highlighted 17 genetic loci showing suggestive CH-like associations with CHD (P < 5 × 10-8 ), among which 4 genetic loci had expression quantitative trait loci (eQTL) effects in blood (PeQTL < 0.01). After conditional association analysis, each loci had only 1 independently effective signal reaching the significance threshold (rs2071477/rs3129299 at 6p21.32, P = 2.47 × 10-10 ; rs10773097/rs2880921 at 12q24.31, P = 3.30 × 10-8 ; rs73032040/rs7259476 at 19q13.11, P = 1.14 × 10-8 ; rs10416386/rs4239517 at 19q13.31, P = 1.15 × 10-9 ), together explained 7.83% of the CHD variance. Among these 4 associated loci, outstanding candidates for CHD-associated genes included UBC, CFM2, ZNF302, LYPD3 and CADM4. Although replication studies with larger sample size are warranted, the first CH GWAS of CHD may extend our current knowledge of the genetic contributions to CHD in the Han Chinese population.
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Affiliation(s)
- T Jiang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - M Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - T Jiang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Y Gu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Y Wang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Y Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - H Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - G Jin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - J Dai
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Z Hu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
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Bollini S, Silini AR, Banerjee A, Wolbank S, Balbi C, Parolini O. Cardiac Restoration Stemming From the Placenta Tree: Insights From Fetal and Perinatal Cell Biology. Front Physiol 2018; 9:385. [PMID: 29695981 PMCID: PMC5904405 DOI: 10.3389/fphys.2018.00385] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/28/2018] [Indexed: 12/27/2022] Open
Abstract
Efficient cardiac repair and ultimate regeneration still represents one of the main challenges of modern medicine. Indeed, cardiovascular disease can derive from independent conditions upsetting heart structure and performance: myocardial ischemia and infarction (MI), pharmacological cardiotoxicity, and congenital heart defects, just to name a few. All these disorders have profound consequences on cardiac tissue, inducing the onset of heart failure over time. Since the cure is currently represented by heart transplantation, which is extremely difficult due to the shortage of donors, much effort is being dedicated to developing innovative therapeutic strategies based on stem cell exploitation. Among the broad scenario of stem/progenitor cell subpopulations, fetal and perinatal sources, namely amniotic fluid and term placenta, have gained interest due to their peculiar regenerative capacity, high self-renewal capability, and ease of collection from clinical waste material. In this review, we will provide the state-of-the-art on fetal perinatal stem cells for cardiac repair and regeneration. We will discuss different pathological conditions and the main therapeutic strategies proposed, including cell transplantation, putative paracrine therapy, reprogramming, and tissue engineering approaches.
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Affiliation(s)
- Sveva Bollini
- Regenerative Medicine Laboratory, Department of Experimental Medicine, University of Genova, Genova, Italy
| | - Antonietta R Silini
- Centro di Ricerca E. Menni, Fondazione Poliambulanza - Istituto Ospedaliero, Brescia, Italy
| | - Asmita Banerjee
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Susanne Wolbank
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Carolina Balbi
- Regenerative Medicine Laboratory, Department of Experimental Medicine, University of Genova, Genova, Italy
| | - Ornella Parolini
- Centro di Ricerca E. Menni, Fondazione Poliambulanza - Istituto Ospedaliero, Brescia, Italy.,Institute of Human Anatomy and Cell Biology, "A. Gemelli" Faculty of Medicine and Surgery, Catholic University of the Sacred Heart, Rome, Italy
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115
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Bagge CN, Henderson VW, Laursen HB, Adelborg K, Olsen M, Madsen NL. Risk of Dementia in Adults With Congenital Heart Disease: Population-Based Cohort Study. Circulation 2018; 137:1912-1920. [PMID: 29440121 DOI: 10.1161/circulationaha.117.029686] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 12/12/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND More children with congenital heart disease (CHD) are surviving to adulthood, and CHD is associated with risk factors for dementia. We compared the risk of dementia in CHD adults to that of the general population. METHODS In this cohort study, we used medical registries and a medical record review covering all Danish hospitals to identify adults with CHD diagnosed between 1963 and 2012. These individuals with CHD were followed from January 1, 1981, 30 years of age, or date of first CHD registration (index date for matched members of the general population cohort) until hospital diagnosis of dementia, death, emigration, or end of study (December 31, 2012). For each individual with CHD, we identified 10 members of the general population utilizing the Danish Civil Registration System matched on sex and birth year. We computed cumulative incidences and hazard ratios (HRs) of dementia, adjusting for sex and birth year. RESULTS The cumulative incidence of dementia was 4% by 80 years of age in 10 632 adults with CHD (46% male). The overall HR comparing adults with CHD with the general population cohort was 1.6 (95% confidence interval [CI], 1.3-2.0). The HR among individuals with CHD without extracardiac defects was 1.4 (95% CI, 1.1-1.8). Adults with mild-to-moderate CHD had an HR of 1.5 (95% CI, 1.1-2.0), whereas the HR was 2.0 (95% CI, 1.2-3.3) for severe CHD, including univentricular hearts. The HR for early onset dementia (<65 years of age) was 2.6 (95% CI, 1.8-3.8), whereas the late-onset HR was 1.3 (95% CI, 1.0-1.8). CONCLUSIONS CHD was associated with an increased risk of dementia compared with the general population, in particular for early onset dementia. Further understanding of dementia risk in the population with CHD is a potential target for future investigation.
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Affiliation(s)
- Carina N Bagge
- Departments of Clinical Epidemiology (C.N.B., V.W.H., H.B.L., K.A., M.O., N.L.M.)
| | - Victor W Henderson
- Departments of Clinical Epidemiology (C.N.B., V.W.H., H.B.L., K.A., M.O., N.L.M.).,Aarhus University Hospital, Denmark. Departments of Health Research and Policy (Epidemiology) and Neurology and Neurological Sciences, Stanford University, CA (V.W.H.)
| | - Henning B Laursen
- Departments of Clinical Epidemiology (C.N.B., V.W.H., H.B.L., K.A., M.O., N.L.M.)
| | - Kasper Adelborg
- Departments of Clinical Epidemiology (C.N.B., V.W.H., H.B.L., K.A., M.O., N.L.M.).,Cardiology (K.A.)
| | - Morten Olsen
- Departments of Clinical Epidemiology (C.N.B., V.W.H., H.B.L., K.A., M.O., N.L.M.).,Cardiology (K.A.)
| | - Nicolas L Madsen
- Departments of Clinical Epidemiology (C.N.B., V.W.H., H.B.L., K.A., M.O., N.L.M.).,Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (N.L.M.)
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Tsilimigras DI, Oikonomou EK, Moris D, Schizas D, Economopoulos KP, Mylonas KS. Stem Cell Therapy for Congenital Heart Disease: A Systematic Review. Circulation 2017; 136:2373-2385. [PMID: 29229621 DOI: 10.1161/circulationaha.117.029607] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 10/09/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Congenital heart disease (CHD) constitutes the most prevalent and heterogeneous group of congenital anomalies. Although surgery remains the gold standard treatment modality, stem cell therapy has been gaining ground as a complimentary or alternative treatment option in certain types of CHD. The aim of this study was to present the existing published evidence and ongoing research efforts on the implementation of stem cell-based therapeutic strategies in CHD. METHODS A systematic review was conducted by searching Medline, ClinicalTrials.gov, and the Cochrane library, along with reference lists of the included studies through April 23, 2017. RESULTS Nineteen studies were included in this review (8 preclinical, 6 clinical, and 5 ongoing trials). Various routes of cardiac stem cell delivery have been reported, including intracoronary, intramyocardial, intravenous, and epicardial. Depending on their origin and level of differentiation at which they are harvested, stem cells may exhibit different properties. Preclinical studies have mostly focused on modeling right ventricle dysfunction or failure and pulmonary artery hypertension by using pressure or volume overload in vitro or in vivo. Only a limited number of clinical trials on patients with CHD exist, and these primarily focus on hypoplastic left heart syndrome. Cell-based tissue engineering has recently been introduced, and research currently is focusing on developing cell-seeded grafts and patches that could potentially grow in parallel with whole body growth once implanted in the heart. CONCLUSIONS It seems that stem cell delivery to the diseased heart as an adjunct to surgical palliation may provide some benefits over surgery alone in terms of cardiac function, somatic growth, and quality of life. Despite encouraging preliminary results, stem cell therapies for patients with CHD should only be considered in the setting of well-designed clinical trials. More wet laboratory research experience is needed, and translation of promising findings to large clinical studies is warranted to clearly define the efficacy and safety profile of this alternative and potentially groundbreaking therapeutic approach.
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Affiliation(s)
- Diamantis I Tsilimigras
- School of Medicine (D.I.T.).,National and Kapodistrian University of Athens, Greece. Surgery Working Group (D.I.T., D.M., D.S., K.P.E)
| | | | - Demetrios Moris
- National and Kapodistrian University of Athens, Greece. Surgery Working Group (D.I.T., D.M., D.S., K.P.E).,Society of Junior Doctors, Athens, Greece. Department of Surgery, The Ohio State Comprehensive Cancer Center, The Ohio State University, Columbus (D.M.)
| | - Dimitrios Schizas
- First Department of Surgery, Laiko General Hospital (D.S.).,National and Kapodistrian University of Athens, Greece. Surgery Working Group (D.I.T., D.M., D.S., K.P.E)
| | - Konstantinos P Economopoulos
- National and Kapodistrian University of Athens, Greece. Surgery Working Group (D.I.T., D.M., D.S., K.P.E) .,Organ Engineering and Regeneration Laboratory (K.P.E.)
| | - Konstantinos S Mylonas
- Pediatrics Working Group (K.S.M.).,Department of Pediatric Surgery (K.S.M.), Massachusetts General Hospital, Harvard Medical School, Boston
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Percy ME, Lukiw WJ. Is heart disease a risk factor for low dementia test battery scores in older persons with Down syndrome? Exploratory, pilot study, and commentary. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2017; 66:22-35. [PMID: 33859818 PMCID: PMC8046177 DOI: 10.1080/20473869.2017.1301023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Certain heart conditions and diseases are common in Down syndrome (DS; trisomy 21), but their role in early onset dementia that is prevalent in older adults with DS has not been evaluated. To address this knowledge gap, we conducted a study of risk factors for low neurocognitive/behavioral scores obtained with a published dementia test battery (DTB). Participants were adults with DS living in New York (N = 29; average age 46 years). We asked three questions. 1. Does having any type of heart disease affect the association between DTB scores and chronological age? 2. Does thyroid status affect the association between heart disease and DTB scores? 3. Are the E4 or E2 alleles of apolipoprotein E (APOE) associated with DTB scores or with heart disease? METHOD The study was retrospective, pilot, and exploratory. It involved analysis of information in a database previously established for the study of aging in DS. Participants had moderate intellectual disability on average. Information for each person included: gender, age, a single DTB score obtained by combining results from individual subscales of the DTB, the presence or absence of heart disease, thyroid status (treated hypothyroidism or normal), and APOE genotype. Trends were visualized by inspection of graphs and contingency tables. Statistical methods used to evaluate associations included Pearson correlation analysis, Fisher's exact tests (2-tailed), and odds ratio analysis. P values were interpreted at the 95% confidence level without Bonferroni correction. P values >.05<.1 were considered trends. RESULTS The negative correlation between DTB scores and age was significant in those with heart disease but not in those without. Heart disease was significantly associated with DTB scores >1 SD below the sample mean; there was a strong association between heart disease and low DTB scores in those with treated hypothyroidism but not in those with normal thyroid status. The APOE genotype was weakly associated with heart disease (E4, predisposing; E2, protective) in males. CONCLUSIONS On the basis of the potentially important findings from the present study, large prospective studies are warranted to confirm and extend the observations. In these, particular heart conditions or diseases and other medical comorbidities in individuals should be documented.
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Affiliation(s)
- Maire E. Percy
- Department of Physiology, University of Toronto, Toronto, Canada
- Department of Obstetrics & Gynaecology, Toronto, Canada
- Surrey Place Centre, Toronto, Canada
| | - Walter J. Lukiw
- LSU Neuroscience Center, New OrleansLA, USA
- Department of Neurology, Louisiana State University Health Sciences Center, New OrleansLA, USA
- Department of Ophthalmology, Louisiana State University Health Sciences Center, New OrleansLA, USA
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118
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Zhang S, Guo GL, Yang LL, Sun LQ. Elevated serum levels of ghrelin and TNF-α in patients with cyanotic and acyanotic congenital heart disease. World J Pediatr 2017; 13:122-128. [PMID: 27878778 DOI: 10.1007/s12519-016-0068-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 06/29/2015] [Indexed: 10/20/2022]
Abstract
BACKGROUND The levels of ghrelin and tumor necrosis factor alpha (TNF-α) are considered biological markers of congenital heart diseases (CHD). The present meta-analysis was conducted to investigate the clinical significance of serum levels of ghrelin and TNF-α in children with (CHD). METHODS Chinese and English scientific literature databases were searched to retrieve published studies relevant to ghrelin, TNF-α and CHD. Manual search was additionally employed to identify other relevant studies from cross-references. The retrieved studies were screened on the basis of our stringent inclusion and exclusion criteria to select high quality case-control studies for meta-analysis. RESULTS We initially retrieved 108 published studies (20 in Chinese and 88 in English) from database searches. Finally, 6 case-control studies (5 in English and 1 in Chinese) were enrolled in our meta-analysis, and contained a total of 160 cyanotic congenital heart disease (CCHD) patients and 215 acyanotic congenital heart disease (ACHD) patients, along with 162 healthy controls. The results of meta-analysis showed that serum levels of ghrelin and TNF-α in CCHD or ACHD children were significantly higher than those in healthy controls. CONCLUSIONS Our meta-analysis results showed that serum levels of ghrelin and TNF-α are elevated in children with CHD, and could be used as effective biologic markers in early diagnosis of CHD.
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Affiliation(s)
- Sai Zhang
- Outpatient Department of Pediatrics, No.1 Hospital of Jilin University, Xinmin Street No.71, Changchun, 130021, China
| | - Gong-Liang Guo
- Department of Cardiology, the Third Hospital of Jilin University, Changchun, China
| | - Li-Li Yang
- Department of Gynecology and Obstetrics, No.1 Hospital of Jilin University, Changchun, China
| | - Li-Qun Sun
- Outpatient Department of Pediatrics, No.1 Hospital of Jilin University, Xinmin Street No.71, Changchun, 130021, China.
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Ghafarzadeh M, Namdari M, Eatemadi A. Stem cell therapies for congenital heart disease. Biomed Pharmacother 2016; 84:1163-1171. [PMID: 27780147 DOI: 10.1016/j.biopha.2016.10.055] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 10/16/2016] [Accepted: 10/17/2016] [Indexed: 01/15/2023] Open
Abstract
Congenital heart disease (CHD) is the most prevalent congenital anomaly in newborn babies. Cardiac malformations have been induced in different animal model experiments, by perturbing some molecules that take part in the developmental pathways associated with myocyte differentiation, specification, or cardiac morphogenesis. The exact epigenetic, environmental, or genetic, basis for these molecules perturbations is yet to be understood. But, scientist have bridged this gap by introducing autologous stem cell into the defective hearts to treat CHD. The choice of stem cells to use has also raised an issue. In this review, we explore different stem cells that have been recently used, as an update into the pool of this knowledge and we suggested the future perspective into the choice of stem cells to control this disease. We propose that isolating mesenchymal stem cells from neonate will give a robust heart regeneration as compared to adults. This source are easily isolated. To unveil stem cell therapy beyond its possibility and safety, further study is required, including largescale randomized, and clinical trials to certify the efficacy of stem cell therapy.
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Affiliation(s)
- Masoumeh Ghafarzadeh
- Assalian Hospital, Center for Obstetrics and Gynecology, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Mehrdad Namdari
- Department of Cardiology, Lorestan University of Medical Sciences, Postal address: 6997118544, Khoramabad, Iran.
| | - Ali Eatemadi
- Department of Medical Biotechnology, School of advance Science in Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Biotechnology, School of Medicine, Lorestan University of Medical Sciences, Lorestan, Iran
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120
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Apers S, Sevenants L, Budts W, Luyckx K, Moons P. Sense of coherence does not moderate the relationship between the perceived impact of stress on health and self-rated health in adults with congenital heart disease. Eur J Cardiovasc Nurs 2016; 15:529-536. [DOI: 10.1177/1474515115620314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 11/09/2015] [Accepted: 11/10/2015] [Indexed: 11/15/2022]
Affiliation(s)
- Silke Apers
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
| | - Lien Sevenants
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
| | - Werner Budts
- Division of Congenital and Structural Cardiology, University Hospitals Leuven, KU Leuven – University of Leuven, Belgium
| | - Koen Luyckx
- School Psychology and Child and Adolescent Development, KU Leuven – University of Leuven, Belgium
| | - Philip Moons
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
- Division of Congenital and Structural Cardiology, University Hospitals Leuven, KU Leuven – University of Leuven, Belgium
- Institute of Health and Care Sciences, Gothenburg University, Sweden
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121
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Pangesty AI, Arahira T, Todo M. Characterization of Tensile Mechanical Behavior of MSCs/PLCL Hybrid Layered Sheet. J Funct Biomater 2016; 7:jfb7020014. [PMID: 27271675 PMCID: PMC4932471 DOI: 10.3390/jfb7020014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 05/19/2016] [Accepted: 05/27/2016] [Indexed: 11/16/2022] Open
Abstract
A layered construct was developed by combining a porous polymer sheet and a cell sheet as a tissue engineered vascular patch. The primary objective of this study is to investigate the influence of mesenchymal stem cells (MSCs) sheet on the tensile mechanical properties of porous poly-(l-lactide-co-ε-caprolactone) (PLCL) sheet. The porous PLCL sheet was fabricated by the solid-liquid phase separation method and the following freeze-drying method. The MSCs sheet, prepared by the temperature-responsive dish, was then layered on the top of the PLCL sheet and cultured for 2 weeks. During the in vitro study, cellular properties such as cell infiltration, spreading and proliferation were evaluated. Tensile test of the layered construct was performed periodically to characterize the tensile mechanical behavior. The tensile properties were then correlated with the cellular properties to understand the effect of MSCs sheet on the variation of the mechanical behavior during the in vitro study. It was found that MSCs from the cell sheet were able to migrate into the PLCL sheet and actively proliferated into the porous structure then formed a new layer of MSCs on the opposite surface of the PLCL sheet. Mechanical evaluation revealed that the PLCL sheet with MSCs showed enhancement of tensile strength and strain energy density at the first week of culture which is characterized as the effect of MSCs proliferation and its infiltration into the porous structure of the PLCL sheet. New technique was presented to develop tissue engineered patch by combining MSCs sheet and porous PLCL sheet, and it is expected that the layered patch may prolong biomechanical stability when implanted in vivo.
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Affiliation(s)
- Azizah Intan Pangesty
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Fukuoka 816-8580, Japan.
| | | | - Mitsugu Todo
- Research Institute for Applied Mechanics, Kyushu University, Fukuoka 816-8580, Japan.
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122
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Begic Z, Dinarevic SM, Pesto S, Begic E, Dobraca A, Masic I. Evaluation of Diagnostic Methods in the Differentiation of Heart Murmurs in Children. Acta Inform Med 2016; 24:94-8. [PMID: 27147798 PMCID: PMC4851509 DOI: 10.5455/aim.2016.24.94-98] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 02/25/2016] [Indexed: 11/04/2022] Open
Abstract
Introduction: The most common clinical sign in pediatric cardiology is a heart murmur (organic and inorganic). Organic are sign of heart disease, while inorganic (basically divided into accidental and functional) murmurs occur on anatomically healthy heart. Aim: To determine the justification of the application of the methods of cardiac treatment. Patients and methods: Study included 116 children aged from 1 to 15 years, who were referred due to cardiac treatment to Pediatric Clinic, of Sarajevo University Clinical Center. Results: The first group consisted of children with innocent heart murmur, 97 (53 males). The second group consisted of patients with organic murmur, 19 (13 males). The average age of the first group was 7.69 (1.01–15.01) years old, and of the second group 3.15 (1.01- 8.06) years old, and there is a significant difference between these two groups (p <0.001). Medical history questions about potentially harmful habits of mother in pregnancy, found significant differences in the frequency of the existence of habits between the first and second groups of subjects (14.44% vs. 85.1%, p = 0.013). The values of the pulse of patients showed statistically significant difference (p = 0.012). The most common place of the murmurs’ appearance is the second left intercostal space. In the first group, the most common were vibratory (32.3%) and ejection (31.9%) and in the second the most common were holosystolic (73.7%) murmur. Analyzing the R/S ratio of V1, a significant difference among the two groups was found (mean 0.78 vs. the values for 1.45, p = 0.003). There is a significance in terms of developed hypertrophy of the heart cavities (BVH) between the two groups. The most common accidental murmur was classic vibratory Still’s murmurs (55.43%) and the most common congenital heart defects was ASD (36.8%). Conclusions: A heart murmur itself, should not be the purpose of auscultation. One of the tasks of pediatricians, pediatric cardiologists in particular would be to improve auscultation, as a sovereign method of heart murmurs assessment. Heart murmur assessment should be adapted to recognize whether heart murmur is innocent, or there is suspected or probable congenital heart defect.
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Affiliation(s)
- Zijo Begic
- Pediatric Clinic Sarajevo, Clinical center of Sarajevo University, Sarajevo, Bosnia and Herzegovina
| | | | - Senad Pesto
- Clinic for Emergency medicine, Clinical center of Sarajevo University, Bosnia and Herzegovina
| | - Edin Begic
- Clinic for Emergency medicine, Clinical center of Sarajevo University, Bosnia and Herzegovina
| | - Amra Dobraca
- Medical and Biological Engineering Society of BiH, Sarajevo, Bosnia and Herzegovina
| | - Izet Masic
- Department of Family medicine, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Zeng Z, Zhang H, Liu F, Zhang N. Current diagnosis and treatments for critical congenital heart defects. Exp Ther Med 2016; 11:1550-1554. [PMID: 27168772 PMCID: PMC4840484 DOI: 10.3892/etm.2016.3167] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 03/15/2016] [Indexed: 12/11/2022] Open
Abstract
Congenital heart defects (CHD) affect approximately 7% of infants, and account for 3% of all infant deaths. CHD is most often caused by the defects associated with ductus arteriosus, which is a vessel that usually closes shortly after birth. The types of CHD include tetralogy of fallot, hypoplastic left heart syndrome, pulmonary atresia, total anomalous pulmonary venous return, transposition of great arteries, tricuspid atresia and truncus arteriosus. There are some risk factors that can increase the chance of a fetus developing CHD such as prematurity, an existing CHD in a first-degree relative, genetic syndromes, infections in utero, maternal drug consumptions and disorders. CHD is diagnosed is through different techniques including pulse oximetry, echocardiograms and physical exams. In this review, we examined the current incidence of CHD, the risk factors associated with CHD, the current methods of diagnosis and surgical options used to repair the defects.
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Affiliation(s)
- Zhandong Zeng
- Department of Pediatric Surgery, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China
| | - Hongwei Zhang
- Department of Pediatric Surgery, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China
| | - Fengli Liu
- Department of Pediatric Surgery, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China
| | - Ning Zhang
- Department of Pediatric Surgery, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China
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The vital role the ductus arteriosus plays in the fetal diagnosis of congenital heart disease: Evaluation by fetal echocardiography in combination with an innovative cardiovascular cast technology. Int J Cardiol 2016; 202:90-6. [DOI: 10.1016/j.ijcard.2015.08.156] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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The impact of environmental factors on the occurrence of congenital heart disease in the form of hypoplastic left heart syndrome. POLISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2015; 12:204-7. [PMID: 26702275 PMCID: PMC4631911 DOI: 10.5114/kitp.2015.54455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 08/18/2015] [Accepted: 08/25/2015] [Indexed: 11/30/2022]
Abstract
Introduction Congenital heart defects are the most common abnormalities in neonatal age. Congenital heart defects occur with a frequency of 3-12/1000 births. A special group is constituted by children with hypoplastic left heart syndrome because their treatment is extremely complex, requiring three-stage surgery and the involvement of various specialists. Material and methods We analysed 100 infants with congenital heart defects in the form of hypoplastic left heart syndrome (HLHS). They were compared with a control group of 100 newborns without structural heart defects. The children's parents were asked to fill out a questionnaire consisting of 10 simple questions. It had been constructed in consultation with a psychologist in order not to offend the feelings of the parents affected by the illness of their offspring. Results Congenital heart defects were present in the family medical histories of 16 HLHS children and 11 healthy children (p = 0.4). Genetic disorders were present in the family medical histories of 13 HLHS children and 15 healthy children (p = 0.73). In the HLHS group, the mothers smoked cigarettes or were exposed to tobacco smoke in 32% of cases; in the control group, this proportion amounted to 23% (p = 0.76). Conclusions The study found no relationship between the occurrence of hypoplastic left heart syndrome in children and the parents’ age, the presence of genetic disorders, or heart defects in the family medical histories.
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Avolio E, Caputo M, Madeddu P. Stem cell therapy and tissue engineering for correction of congenital heart disease. Front Cell Dev Biol 2015; 3:39. [PMID: 26176009 PMCID: PMC4485350 DOI: 10.3389/fcell.2015.00039] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 06/10/2015] [Indexed: 01/08/2023] Open
Abstract
This review article reports on the new field of stem cell therapy and tissue engineering and its potential on the management of congenital heart disease. To date, stem cell therapy has mainly focused on treatment of ischemic heart disease and heart failure, with initial indication of safety and mild-to-moderate efficacy. Preclinical studies and initial clinical trials suggest that the approach could be uniquely suited for the correction of congenital defects of the heart. The basic concept is to create living material made by cellularized grafts that, once implanted into the heart, grows and remodels in parallel with the recipient organ. This would make a substantial improvement in current clinical management, which often requires repeated surgical corrections for failure of implanted grafts. Different types of stem cells have been considered and the identification of specific cardiac stem cells within the heterogeneous population of mesenchymal and stromal cells offers opportunities for de novo cardiomyogenesis. In addition, endothelial cells and vascular progenitors, including cells with pericyte characteristics, may be necessary to generate efficiently perfused grafts. The implementation of current surgical grafts by stem cell engineering could address the unmet clinical needs of patients with congenital heart defects.
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Affiliation(s)
- Elisa Avolio
- Division of Experimental Cardiovascular Medicine, School of Clinical Sciences, Bristol Heart Institute, University of Bristol Bristol, UK
| | - Massimo Caputo
- Congenital Heart Surgery, School of Clinical Sciences, Bristol Heart Institute, University of Bristol Bristol, UK
| | - Paolo Madeddu
- Division of Experimental Cardiovascular Medicine, School of Clinical Sciences, Bristol Heart Institute, University of Bristol Bristol, UK
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