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Kalkan ME, Kalkan AK, Gündeş A, Yanartaş M, Oztürk S, Gurbuz AS, Ozturk D, Iyigun T, Akcakoyun M, Emiroglu MY, Tuncer MA, Koksal C. Neutrophil to lymphocyte ratio: a novel marker for predicting hospital mortality of patients with acute type A aortic dissection. Perfusion 2015; 32:321-327. [PMID: 26467992 DOI: 10.1177/0267659115590625] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: The inflammatory process has been reported to be associated with aortic dissection (AD) from the development to the prognosis. The aim of the study was to investigate a relationship between the neutrophil to lymphocyte ratio (NLR) and in-hospital outcomes in patients with acute aortic dissection (AAD) who underwent surgical repair. Methods: One hundred and eighty-four patients who were admitted with the diagnosis of type A AAD who underwent surgical repair at two large tertiary hospitals. According to their NLR, 91 patients had high NLR (>6.0) and 93 patients had low NLR (⩽6.0). Results: The frequency of major bleeding, hospital-related infection, multi-organ dysfunction and mortality in hospital were higher in the high NLR group compared to the low NLR group. NLR, WBC count and operation duration were found to be independent predictors for in-hospital mortality. Conclusions: The novel inflammatory marker NLR may be used to predict worse outcomes and hospital mortality in patients with AAD treated by surgical repair.
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Affiliation(s)
- Mehmet Emin Kalkan
- Kartal Kosuyolu Education and Research Hospital, Cardiology Department, Istanbul, Turkey
| | - Ali Kemal Kalkan
- Mehmet Akif Ersoy Education and Research Hospital, Cardiology Department, Istanbul, Turkey
| | - Ahmet Gündeş
- Mersin University School of Medicine, Cardiology Department, Mersin, Turkey
| | - Mehmed Yanartaş
- Kartal Kosuyolu Education and Research Hospital, Cardiovascular Surgery Department, Istanbul, Turkey
| | - Semi Oztürk
- Kartal Kosuyolu Education and Research Hospital, Cardiology Department, Istanbul, Turkey
| | - Ahmet Seyfeddin Gurbuz
- Kartal Kosuyolu Education and Research Hospital, Cardiology Department, Istanbul, Turkey
| | - Derya Ozturk
- Mehmet Akif Ersoy Education and Research Hospital, Cardiology Department, Istanbul, Turkey
| | - Taner Iyigun
- Mehmet Akif Ersoy Education and Research Hospital, Cardiovascular Surgery Department, Istanbul, Turkey
| | - Mustafa Akcakoyun
- Kartal Kosuyolu Education and Research Hospital, Cardiology Department, Istanbul, Turkey
| | - Mehmet Yunus Emiroglu
- Kartal Kosuyolu Education and Research Hospital, Cardiology Department, Istanbul, Turkey
| | - Mehmet Altuğ Tuncer
- Kartal Kosuyolu Education and Research Hospital, Cardiovascular Surgery Department, Istanbul, Turkey
| | - Cengiz Koksal
- Kartal Kosuyolu Education and Research Hospital, Cardiovascular Surgery Department, Istanbul, Turkey
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102
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Fan X, Huang B, Lu H, Zhao Z, Lu Z, Yang Y, Zhang S, Hui R. Impact of Admission White Blood Cell Count on Short- and Long-term Mortality in Patients With Type A Acute Aortic Dissection: An Observational Study. Medicine (Baltimore) 2015; 94:e1761. [PMID: 26496299 PMCID: PMC4620771 DOI: 10.1097/md.0000000000001761] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Studies have shown inflammation is involved in the development of acute aortic dissection (AAD). The hypothesis that white blood cell count (WBCc) on admission may have an impact on the short- and long-term outcomes of type A AAD was tested in a large-scale, prospective observational cohort study.From 2008 to 2010, a total of 570 consecutive patients with type A AAD in Fuwai hospital were enrolled and were followed up. Baseline characteristics and WBCc on admission were collected. The primary outcomes were 30-day and long-term all-cause mortality.During a median of 1.89 years of follow-up, the 30-day and long-term all-cause mortality were 10.7% and 6.5%, respectively. Univariate Cox regression analysis identified admission WBCc as an independent predictor of 30-day mortality when considered as a continuous variable or as a categorical variable using the cutoff of 11.0 × 10 cells/L (all P < 0.05). After adjustment for age, sex, C-reactive protein, D-dimer, and surgical intervention, elevated admission WBCc (>11.0 × 10 cells/L) remained an independent predictor of 30-day mortality of AAD (hazard ratio = 3.31, 95% confidence interval 1.38-7.93, P = 0.007). No impact of admission WBCc was observed on the long-term all-cause mortality.In conclusion, elevated admission WBCc may be valuable as a predictor of 30-day mortality, and may be useful in the risk stratification of type A AAD during hospitalization.
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Affiliation(s)
- Xiaohan Fan
- From the State Key Laboratory of Cardiovascular Disease, Department of Cardiology (XF, BH, ZL, YY, SZ, RH); and Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Beijing, China (HL, ZZ)
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103
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Huang B, Yang Y, Lu H, Zhao Z, Zhang S, Hui R, Fan X. Impact of d-Dimer Levels on Admission on Inhospital and Long-Term Outcome in Patients With Type A Acute Aortic Dissection. Am J Cardiol 2015; 115:1595-600. [PMID: 25863830 DOI: 10.1016/j.amjcard.2015.02.067] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 02/26/2015] [Accepted: 02/26/2015] [Indexed: 01/16/2023]
Abstract
Limited studies with relatively small sample sizes have reported that elevated d-dimer levels on admission were associated with increased risk of short-term mortality in patients with type A acute aortic dissection (AAD). However, there were unavailable data regarding the impact of admission d-dimer levels on long-term outcomes. Our present study aimed to evaluate the association of admission d-dimer levels with both inhospital and long-term all-cause mortality in patients with type A AAD. A total of 212 consecutive patients with type A AAD were enrolled. d-Dimer levels were measured on admission, and patients were followed up prospectively. The primary end points were inhospital and long-term all-cause mortality. The median length of follow-up was 18.8 months (interquartile range 6.7 to 24.4 months). The inhospital and long-term all-cause mortality rates were 12.7% and 12.4%, respectively. Compared with the survivors, the nonsurvivors had significantly higher d-dimer levels (p <0.001). When divided into 4 groups according to admission d-dimer quartiles, patients in Q4 (>6.10 μg/ml) had the highest inhospital and long-term mortality among groups. After multivariate adjustment, the d-dimer level in Q4 (>6.10 μg/ml) was an independent risk factor for inhospital mortality (hazard ratio [HR] 6.12, 95% confidence interval 1.35 to 27.89, p = 0.019) in addition to surgical treatment; however, this was not an independent predictor for long-term mortality. In conclusion, our study with a relatively large sample size suggested that elevated admission d-dimer levels (>6.10 μg/ml) might be a predictor for increased risk of inhospital mortality, and urgent-emergent surgery might be needed in patients with elevated d-dimer levels on admission. However, d-dimer levels at admission failed to predict long-term mortality.
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Affiliation(s)
- Bi Huang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanmin Yang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haisong Lu
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhenhua Zhao
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shu Zhang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rutai Hui
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohan Fan
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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104
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Del Porto F, Proietta M, di Gioia C, Cifani N, Dito R, Fantozzi C, Ferri L, Fabriani L, Rossi M, Tritapepe L, Taurino M. FGF-23 levels in patients with critical carotid artery stenosis. Intern Emerg Med 2015; 10:437-44. [PMID: 25573621 DOI: 10.1007/s11739-014-1183-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 12/20/2014] [Indexed: 11/27/2022]
Abstract
The aim of this study was to evaluate fibroblast growth factor (FGF)-23 serum levels and its tissue expression in patients with critical carotid artery stenosis (CAS). We selected 35 patients with critical CAS undergoing carotid thromboendoarterectomy. In each patient, FGF-23 serum levels were evaluated just prior to the surgery (t0) and 30 min (t1) thereafter. Moreover, macrophage cytokines were measured at baselines. Carotid artery specimens were used for immune histochemistry. On the basis of the histology, the patients were divided into 2 groups: A with complicated plaque and B with uncomplicated plaque. Twenty complicated plaques (57.14%, group A,) and 15 uncomplicated (42.86%, group B) were evaluated: calcifications were present in 16/20 (80%) complicated plaques and in 6/15 (40%) uncomplicated plaques. An inflammatory infiltrate was observed in 26/35 carotid samples: 18/26 (69.23%) complicated and 8/26 (30.76%) uncomplicated. FGF-23(+) cells were present in 17/20 complicated (85%) and in 8 uncomplicated (53%) plaques. The double-staining immunofluorescence confirmed that macrophage cells (CD68(+)) were also positive for FGF-23 staining. Serum levels of FGF-23 were significantly higher in group A versus group B at t0 (p < 0.05) and t1 (p 0.0047). Moreover, in group A patients a significant increase of FGF-23 serum levels was observed at t1 in comparison with t0 (p 0.0011). Our results suggest that FGF-23 acts in the late phases of atherosclerotic disease and may potentially represent a marker of complications in critical CAS.
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Affiliation(s)
- Flavia Del Porto
- Dipartimento di Medicina Clinica e Molecolare, Facoltà di Medicina e Psicologia, UOC Medicina 3, Azienda Ospedaliera Sant'Andrea, Università "La Sapienza", Rome, Italy,
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105
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Vrsalovic M, Zeljkovic I, Presecki AV, Pintaric H, Kruslin B. C-reactive protein, not cardiac troponin T, improves risk prediction in hypertensives with type A aortic dissection. Blood Press 2015; 24:212-6. [PMID: 25936403 DOI: 10.3109/08037051.2015.1025607] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of the study was to evaluate prognostic role of inflammatory biomarkers, cardiac troponin T (cTnT) and D-dimer in type A acute aortic dissection (AAD) and to examine whether they might help in risk stratification beyond values of International Registry of Acute Aortic Dissection (IRAD) score. METHODS Baseline biomarkers were determined in 54 consecutive predominantly hypertensive patients with type A AAD and evaluated for in-hospital mortality. RESULTS After multivariable adjustment, the independent predictors of outcome were age (OR = 1.09; 95% CI 1.02-1.18), treatment strategy (OR = 0.11; 95% CI 0.02-0.06) and C-reactive protein (CRP) either as binary (OR = 7.06; 95% CI 1.34-37.36) or continuous variable (OR = 1.10; 95% CI 1.01-1.21). cTnT did not independently influence mortality. Receiver- operating characteristic (ROC) curve analysis showed significant link between CRP and outcome (area under the ROC curve, AUC = 0.79; p < 0.01). Values of CRP > 9.8 mg/l had 83% sensitivity and 80% specificity for predicting in-hospital mortality. Addition of CRP to IRAD score improved prediction of short-term outcome, AUC increased from 0.74 to 0.89 (p = 0.004). CONCLUSION Admission CRP has independent prognostic value in type A AAD and the addition of CRP to IRAD score improved discriminative capacity of in-hospital mortality irrespective of symptom duration and treatment strategy.
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106
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Cifani N, Proietta M, Tritapepe L, Di Gioia C, Ferri L, Taurino M, Del Porto F. Stanford-A acute aortic dissection, inflammation, and metalloproteinases: a review. Ann Med 2015; 47:441-6. [PMID: 26339779 DOI: 10.3109/07853890.2015.1073346] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Acute aortic dissection (AAD) is a life-threatening disease with an incidence of about 2.6-3.6 cases per 100,000/year. Depending on the site of rupture, AAD is classified as Stanford-A when the ascending aortic thoracic tract and/or the arch are involved, and Stanford-B when the descending thoracic aorta and/or aortic abdominal tract are targeted. It was recently shown that inflammatory pathways underlie aortic rupture in both type A and type B Stanford AAD. An immune infiltrate has been found within the middle and outer tunics of dissected aortic specimens. It has also been observed that the recall and activation of macrophages inside the middle tunic are key events in the early phases of AAD. Macrophages are able to release metalloproteinases (MMPs) and pro-inflammatory cytokines which, in turn, give rise to matrix degradation and neoangiogenesis. An imbalance between the production of MMPs and MMP tissue inhibitors is pivotal in the extracellular matrix degradation underlying aortic wall remodelling in dissections occurring both in inherited conditions and in atherosclerosis. Among MMPs, MMP-12 is considered a specific marker of aortic wall disease, whatever the genetic predisposition may be. The aim of this review is, therefore, to take a close look at the immune-inflammatory mechanisms underlying Stanford-A AAD.
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Affiliation(s)
- Noemi Cifani
- a Department of Clinical and Molecular Medicine , Faculty of Medicine and Psychology, Internal Medicine Unit, Sant' Andrea Hospital, Sapienza University of Rome , Rome , Italy.,b Department of Biology and Biotechnology' Charles Darwin' , Sapienza University of Rome , Rome , Italy
| | - Maria Proietta
- a Department of Clinical and Molecular Medicine , Faculty of Medicine and Psychology, Internal Medicine Unit, Sant' Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | - Luigi Tritapepe
- c Department of Anaesthesiology , Critical Medicine and PainTreatment, Faculty of Medicine and Odontology, Policlinico Umberto Primo, Sapienza University of Rome , Rome , Italy
| | - Cira Di Gioia
- d Department of Radiology , Oncology, and Anatomy& Pathology, Faculty of Medicine and Odontology, Policlinico Umberto Primo, Sapienza University of Rome , Rome , Italy
| | - Livia Ferri
- a Department of Clinical and Molecular Medicine , Faculty of Medicine and Psychology, Internal Medicine Unit, Sant' Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | - Maurizio Taurino
- e Department of Clinical and Molecular Medicine,Faculty of Medicine and Psychology , Vascular Surgery Unit, Sant' Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | - Flavia Del Porto
- a Department of Clinical and Molecular Medicine , Faculty of Medicine and Psychology, Internal Medicine Unit, Sant' Andrea Hospital, Sapienza University of Rome , Rome , Italy
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107
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Mellak S, Ait-Oufella H, Esposito B, Loyer X, Poirier M, Tedder TF, Tedgui A, Mallat Z, Potteaux S. Angiotensin II mobilizes spleen monocytes to promote the development of abdominal aortic aneurysm in Apoe-/- mice. Arterioscler Thromb Vasc Biol 2014; 35:378-88. [PMID: 25524776 DOI: 10.1161/atvbaha.114.304389] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Abdominal aortic aneurysm (AAA) is widespread among elderly people and results in progressive expansion and rupture of the aorta with high mortality. Macrophages, which are the main population observed within the site of aneurysm, are thought to derive from circulating monocytes although no direct evidence has been provided to date. In this study, we were particularly interested in understanding the trafficking behavior of monocyte subsets in AAA and their role in disease pathogenesis. APPROACH AND RESULTS Using bone marrow transplantation in Apoe(-/-) mice, we showed that circulating monocytes give rise to abdominal aortic macrophages in hypercholesterolemic mice submitted to angiotensin II (AngII). Detailed monitoring of monocyte compartmentalization revealed that lymphocyte antigen 6C(high) and lymphocyte antigen 6C(low) monocytes transiently increase in blood early after AngII infusion and differentially infiltrate the abdominal aorta. The splenic reservoir accounted for the mobilization of the 2 monocyte subsets after 3 days of AngII infusion. Spleen removal or lymphocyte deficiency in Apoe(-/-) Rag2(-/-) mice similarly impaired early monocyte increase in blood in response to AngII and protected against AAA development, independently of blood pressure. Reconstitution of Apoe(-/-) Rag2(-/-) mice with total splenocytes but not with B-cell-depleted splenocytes restored monocyte mobilization in response to AngII and enhanced susceptibility to AAA. CONCLUSIONS Taken together, the data show that lymphocyte antigen 6C(high) and lymphocyte antigen 6C(low) monocytes are mobilized from the spleen in response to AngII. Intriguingly, the process is dependent on the presence of B cells and significantly contributes to the development of AAA and the occurrence of aortic rupture.
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Affiliation(s)
- Safa Mellak
- From the INSERM Unit UMR-S 970, Paris Cardiovascular Research Center (PARCC), Université Paris Descartes, Sorbonne Paris Cité, Paris, France (S.M., H.A.-O., B.E., X.L., M.P., A.T., Z.M., S.P.); Réanimation Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Université Pierre-et-Marie Curie, Université Pierre-et-Marie Curie, Paris, France (H.A.-O.); Department of Immunology, Duke University Medical Center, Durham, NC (T.F.T.); and Department of Medicine, University of Cambridge, Cambridge, United Kingdom (Z.M.)
| | - Hafid Ait-Oufella
- From the INSERM Unit UMR-S 970, Paris Cardiovascular Research Center (PARCC), Université Paris Descartes, Sorbonne Paris Cité, Paris, France (S.M., H.A.-O., B.E., X.L., M.P., A.T., Z.M., S.P.); Réanimation Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Université Pierre-et-Marie Curie, Université Pierre-et-Marie Curie, Paris, France (H.A.-O.); Department of Immunology, Duke University Medical Center, Durham, NC (T.F.T.); and Department of Medicine, University of Cambridge, Cambridge, United Kingdom (Z.M.)
| | - Bruno Esposito
- From the INSERM Unit UMR-S 970, Paris Cardiovascular Research Center (PARCC), Université Paris Descartes, Sorbonne Paris Cité, Paris, France (S.M., H.A.-O., B.E., X.L., M.P., A.T., Z.M., S.P.); Réanimation Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Université Pierre-et-Marie Curie, Université Pierre-et-Marie Curie, Paris, France (H.A.-O.); Department of Immunology, Duke University Medical Center, Durham, NC (T.F.T.); and Department of Medicine, University of Cambridge, Cambridge, United Kingdom (Z.M.)
| | - Xavier Loyer
- From the INSERM Unit UMR-S 970, Paris Cardiovascular Research Center (PARCC), Université Paris Descartes, Sorbonne Paris Cité, Paris, France (S.M., H.A.-O., B.E., X.L., M.P., A.T., Z.M., S.P.); Réanimation Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Université Pierre-et-Marie Curie, Université Pierre-et-Marie Curie, Paris, France (H.A.-O.); Department of Immunology, Duke University Medical Center, Durham, NC (T.F.T.); and Department of Medicine, University of Cambridge, Cambridge, United Kingdom (Z.M.)
| | - Maxime Poirier
- From the INSERM Unit UMR-S 970, Paris Cardiovascular Research Center (PARCC), Université Paris Descartes, Sorbonne Paris Cité, Paris, France (S.M., H.A.-O., B.E., X.L., M.P., A.T., Z.M., S.P.); Réanimation Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Université Pierre-et-Marie Curie, Université Pierre-et-Marie Curie, Paris, France (H.A.-O.); Department of Immunology, Duke University Medical Center, Durham, NC (T.F.T.); and Department of Medicine, University of Cambridge, Cambridge, United Kingdom (Z.M.)
| | - Thomas F Tedder
- From the INSERM Unit UMR-S 970, Paris Cardiovascular Research Center (PARCC), Université Paris Descartes, Sorbonne Paris Cité, Paris, France (S.M., H.A.-O., B.E., X.L., M.P., A.T., Z.M., S.P.); Réanimation Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Université Pierre-et-Marie Curie, Université Pierre-et-Marie Curie, Paris, France (H.A.-O.); Department of Immunology, Duke University Medical Center, Durham, NC (T.F.T.); and Department of Medicine, University of Cambridge, Cambridge, United Kingdom (Z.M.)
| | - Alain Tedgui
- From the INSERM Unit UMR-S 970, Paris Cardiovascular Research Center (PARCC), Université Paris Descartes, Sorbonne Paris Cité, Paris, France (S.M., H.A.-O., B.E., X.L., M.P., A.T., Z.M., S.P.); Réanimation Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Université Pierre-et-Marie Curie, Université Pierre-et-Marie Curie, Paris, France (H.A.-O.); Department of Immunology, Duke University Medical Center, Durham, NC (T.F.T.); and Department of Medicine, University of Cambridge, Cambridge, United Kingdom (Z.M.)
| | - Ziad Mallat
- From the INSERM Unit UMR-S 970, Paris Cardiovascular Research Center (PARCC), Université Paris Descartes, Sorbonne Paris Cité, Paris, France (S.M., H.A.-O., B.E., X.L., M.P., A.T., Z.M., S.P.); Réanimation Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Université Pierre-et-Marie Curie, Université Pierre-et-Marie Curie, Paris, France (H.A.-O.); Department of Immunology, Duke University Medical Center, Durham, NC (T.F.T.); and Department of Medicine, University of Cambridge, Cambridge, United Kingdom (Z.M.)
| | - Stéphane Potteaux
- From the INSERM Unit UMR-S 970, Paris Cardiovascular Research Center (PARCC), Université Paris Descartes, Sorbonne Paris Cité, Paris, France (S.M., H.A.-O., B.E., X.L., M.P., A.T., Z.M., S.P.); Réanimation Médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Université Pierre-et-Marie Curie, Université Pierre-et-Marie Curie, Paris, France (H.A.-O.); Department of Immunology, Duke University Medical Center, Durham, NC (T.F.T.); and Department of Medicine, University of Cambridge, Cambridge, United Kingdom (Z.M.).
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108
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Kalkan AK, Cakmak HA, Kalkan ME, Tuncer MA, Aydin E, Yanartas M, Satilmisoglu MH, Aksu HU, Erturk M, Gul M, Arslantas U, Kirali MK. The Predictive Value of Admission Fragmented QRS Complex for In-Hospital Cardiovascular Mortality of Patients with Type 1 Acute Aortic Dissection. Ann Noninvasive Electrocardiol 2014; 20:454-63. [PMID: 25418574 DOI: 10.1111/anec.12232] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Fragmented QRS (fQRS) arises from impaired ventricular depolarization due to heterogeneous electrical activation of ischemic and/or infarcted ventricular myocardium. The short- and long-term prognostic values of fQRS have been reported for myocardial infarction, heart failure, fatal cardiac arrhythmias, and sudden cardiac death. The aim of this study was to investigate the predictive value of admission fQRS complex for in-hospital cardiovascular mortality of patients with type 1 acute aortic dissection (AAD). METHODS In this retrospective study, 203 consecutive patients with type 1 AAD who had been admitted to either of two large-volume tertiary hospitals between December 2008 and October 2013 were included. The patients were divided into two groups according to the presence or absence of the fQRS complex on admission. RESULTS In-hospital cardiovascular mortality (P < 0.001), major adverse cardiovascular events (P < 0.001), acute renal failure (P = 0.022), multiorgan dysfunction (P < 0.001), and acute decompensated heart failure (P < 0.001) were observed to be significantly more frequent in the fQRS-positive group than in the fQRS-negative group. fQRS (odds ratio [95% confidence interval]: 4.184 [1.927-9.082], P < 0.001), operation duration (4.184 [1.927-9.082], P = 0.001), and Killip class IV (3.900 [1.699-8.955], P = 0.001) were found to be significant independent predictors of in-hospital cardiovascular mortality after adjustment of other risk factors in the multivariate analysis. CONCLUSIONS fQRS is a simple, inexpensive, and readily available electrocardiographic entity that provides an additional risk stratification level beyond that provided by conventional risk parameters in predicting in-hospital cardiovascular mortality in type 1 AAD.
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Affiliation(s)
- Ali Kemal Kalkan
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey
| | - Huseyin Altug Cakmak
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey
| | - Mehmet Emin Kalkan
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
| | - Mehmet Altug Tuncer
- Department of Cardiovascular Surgery, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
| | - Ebuzer Aydin
- Department of Cardiovascular Surgery, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
| | - Mehmed Yanartas
- Department of Cardiovascular Surgery, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
| | - Muhammet Hulusi Satilmisoglu
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey
| | - Hale Unal Aksu
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey
| | - Mehmet Erturk
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey
| | - Mehmet Gul
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey
| | - Ugur Arslantas
- Department of Cardiology, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
| | - Mehmet Kaan Kirali
- Department of Cardiovascular Surgery, Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey
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Ren Z, Wang Z, Hu Z, Hu X, Zhang H, Wu H, Hu R, Liu H. Decreased expression of P54(nrb) /NonO correlates with collagen deposition and fibrosis in human aortic dissection. Histopathology 2014; 65:570-80. [PMID: 24720418 DOI: 10.1111/his.12434] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 04/09/2014] [Indexed: 12/29/2022]
Abstract
AIMS Aortic dissection (AD) is characterized by changes in the extracellular matrix, including fibrosis with collagen production. P54(nrb) /NonO is known to be involved in collagen formation. In this study, we examined whether AD is associated with abnormal P54(nrb) /NonO expression. METHODS AND RESULTS Aortic specimens and serum were obtained from 10 patients with AD and 10 controls. In-vitro cultures of vascular smooth muscle cells (VSMCs) and adventitial fibroblasts (AFs) were obtained from organ donors. P54(nrb) /NonO protein and mRNA levels were determined by Western blot, immunohistochemistry and quantitative real-time reverse transcription-polymerase chain reaction (quantitative real-time RT-PCR). To evaluate collagen expression, we stained tissue sections with Masson's trichrome. Serum concentration of TNF-α was determined by enzyme-linked immunosorbent assay (ELISA). Aortic P54(nrb) /NonO protein and mRNA were decreased in AD patients, compared with controls. Decreased P54(nrb) /NonO mRNA correlated significantly with increased collagen deposition and fibrosis in AD aortas. In VSMCs and AFs from normal human aortas, P54(nrb) /NonO was expressed strongly and localized to the nucleus. CONCLUSIONS Patients with AD exhibited significantly decreased expression of P54(nrb) /NonO. The significant correlation between P54(nrb) /NonO and collagen may point to novel thinking about collagen metabolism research in AD aorta.
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Affiliation(s)
- Zongli Ren
- Department of Cardiothoracic Surgery, Renmin Hospital of Wuhan University, Hubei, China
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110
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Pan S, Wu D, Teschendorff AE, Hong T, Wang L, Qian M, Wang C, Wang X. JAK2-centered interactome hotspot identified by an integrative network algorithm in acute Stanford type A aortic dissection. PLoS One 2014; 9:e89406. [PMID: 24586754 PMCID: PMC3933461 DOI: 10.1371/journal.pone.0089406] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Accepted: 01/20/2014] [Indexed: 12/18/2022] Open
Abstract
The precise mechanisms underlying dissections, especially those without connective tissue diseases or congenital vascular diseases, are incompletely understood. This study attempted to identify both the expression profile of the dissected ascending aorta and the interactome hotspots associated with the disease, using microarray technology and gene regulatory network analysis. There were 2,737 genes differentially expressed between patients with acute Stanford type A aortic dissection and controls. Eight interactome hotspots significantly associated with aortic dissection were identified by an integrative network algorithm. In particular, we identified a JAK2-centered expression module, which was validated in an independent gene expression microarray data set, and which was characterized by over-expressed cytokines and receptors in acute aortic dissection cases, indicating that JAK2 may play a key role in the inflammatory process, which potentially contributes to the occurrence of acute aortic dissection. Overall, the analytical strategy used in this study offered the possibility to identify functional relevant network modules and subsequently facilitated the biological interpretation in the complicated disease.
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Affiliation(s)
- Sun Pan
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Duojiao Wu
- Biomedical Research Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Andrew E. Teschendorff
- UCL Cancer Institute, University College London, London, United Kingdom
- CAS-MPG Partner Institute for Computational Biology, Shanghai, China
| | - Tao Hong
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Linyan Wang
- Biomedical Research Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mengjia Qian
- Biomedical Research Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chunsheng Wang
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- * E-mail: (CW); (XW)
| | - Xiangdong Wang
- Biomedical Research Center, Zhongshan Hospital, Fudan University, Shanghai, China
- * E-mail: (CW); (XW)
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Proietta M, Tritapepe L, Cifani N, Ferri L, Taurino M, Del Porto F. MMP-12 as a new marker of Stanford-A acute aortic dissection. Ann Med 2014; 46:44-8. [PMID: 24432723 DOI: 10.3109/07853890.2013.876728] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The study evaluated macrophage cytokines and macrophage metalloprotease (MMP)-12 levels in patients with Stanford-A acute aortic dissection (AAD) and in patients with critical carotid artery stenosis (CAS) compared with patients matched for age, sex, and traditional cardiovascular risk factors (RF). The aim was to identify possible early serum markers of risk for atherosclerotic complications. MATERIALS AND METHODS We selected 65 patients: 23 AAD patients, 21 CAS patients, 21 RF, and 10 healthy subjects (HS). In each patient and control serum, levels of interleukin (IL)-6, IL-8, tumour necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1, vascular endothelial growth factor (VEGF), and MMP-12 were assessed by ELISA. RESULTS A significant increase of MMP-12, IL-6, and IL-8 levels in AAD versus CAS was found. Moreover, MMP-12 was shown to be significantly higher in AAD versus RF, but not in CAS versus RF. A significant increase of IL-6, IL-8, MCP-1, TNF-α, and VEGF levels was observed both in AAD and CAS versus RF. CONCLUSIONS The results suggest that MMP-12 may be considered to be a specific marker of Stanford-A AAD. Furthermore, the study confirmed that in AAD and CAS macrophage cytokines play a key role in the progression of the atherosclerotic disease towards complications.
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Affiliation(s)
- Maria Proietta
- Dipartimento di Medicina Clinica e Molecolare, Facoltà di Medicina e Psicologia, Ospedale Sant'Andrea, 'Sapienza', Università di Roma , Italia , and UOS Aterosclerosi e Dislipidemia, 'Sapienza', Università di Roma , Italy
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112
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Del Porto F, Cifani N, Proietta M, Taurino M. MMP-12 and Macrophage Activation in Acute Aortic Dissection. Cardiology 2014; 128:314-5; discussion 316. [DOI: 10.1159/000361039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 02/27/2014] [Indexed: 12/22/2022]
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113
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Del Porto F, di Gioia C, Tritapepe L, Ferri L, Leopizzi M, Nofroni I, De Santis V, Della Rocca C, Mitterhofer AP, Bruno G, Taurino M, Proietta M. The multitasking role of macrophages in Stanford type A acute aortic dissection. Cardiology 2013; 127:123-9. [PMID: 24334970 DOI: 10.1159/000355253] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 08/16/2013] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The aim of the study was to determine whether the release by macrophages of matrix metalloproteinase (MMP)-12 and vascular endothelial growth factor (VEGF) - leading to inflammation, matrix degradation and neoangiogenesis - represents an effective pathway that underlies aortic wall remodeling in Stanford type A acute aortic dissection (AAD). METHODS Twenty-one consecutive patients with no genetic predisposition, with Stanford type A AAD were selected. In each patient, the levels of serum VEGF, MMP-12, serum interleukin (IL)-6, IL-8 and monocyte chemoattractant protein (MCP)-1 were evaluated using enzyme-linked immunosorbent assay. Ascending aortic specimens were collected for immunohistochemical identification of any presence of inflammatory infiltrate, VEGF and CD31 expression. RESULTS A significant increase in serum VEGF (p = 0.044), MMP-12 (p = 0.007), IL-6 (p = 0.0001), IL-8 (p = 0.0001) and MCP-1 (p = 0.0001) levels was observed in the AAD group compared to the control group. Furthermore, all AAD samples were positive for VEGF in the tunica media and showed vessel growth and immune-inflammatory infiltrate. A large number of cases (62.79%) showed inflammation at the edge of the dissection and approximately half (51.42%) showed neovessels growing at the edge of the dissection. CONCLUSIONS The results suggest that VEGF-mediated angiogenesis and matrix degradation play a role in AAD. Finally, we believe that MMP-12 should be considered a marker of AAD.
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Affiliation(s)
- Flavia Del Porto
- Dipartimento di Medicina Clinica e Molecolare, Facoltà di Medicina e Psicologia, Ospedale Sant'Andrea, Rome, Italy
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Li D, Liu S, Teng F, Yang W, Zhang L, Deng Y, Zhang T, Xu F, Xu J, Wang L, Wu W, Liu X, Xue S, Jiang B, Guo DA. Temporal change of leukocytes and chemokines in aortic dissection patient: Relationship to regional lesion on aorta. Int J Cardiol 2013; 168:3065-6. [DOI: 10.1016/j.ijcard.2013.04.094] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 04/06/2013] [Indexed: 10/26/2022]
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115
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Wu D, Shen YH, Russell L, Coselli JS, LeMaire SA. Molecular mechanisms of thoracic aortic dissection. J Surg Res 2013; 184:907-24. [PMID: 23856125 PMCID: PMC3788606 DOI: 10.1016/j.jss.2013.06.007] [Citation(s) in RCA: 162] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 05/31/2013] [Accepted: 06/05/2013] [Indexed: 12/22/2022]
Abstract
Thoracic aortic dissection (TAD) is a highly lethal vascular disease. In many patients with TAD, the aorta progressively dilates and ultimately ruptures. Dissection formation, progression, and rupture cannot be reliably prevented pharmacologically because the molecular mechanisms of aortic wall degeneration are poorly understood. The key histopathologic feature of TAD is medial degeneration, a process characterized by smooth muscle cell depletion and extracellular matrix degradation. These structural changes have a profound impact on the functional properties of the aortic wall and can result from excessive protease-mediated destruction of the extracellular matrix, altered signaling pathways, and altered gene expression. Review of the literature reveals differences in the processes that lead to ascending versus descending and sporadic versus hereditary TAD. These differences add to the complexity of this disease. Although tremendous progress has been made in diagnosing and treating TAD, a better understanding of the molecular, cellular, and genetic mechanisms that cause this disease is necessary to developing more effective preventative and therapeutic treatment strategies.
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Affiliation(s)
- Darrell Wu
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, BCM 390, One Baylor Plaza, Houston, Texas 77030
- Department of Cardiovascular Surgery, Texas Heart Institute at St. Luke’s Episcopal Hospital, 6770 Bertner Ave., Houston, Texas 77030
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, BCM 335, One Baylor Plaza, Houston, Texas 77030
| | - Ying H. Shen
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, BCM 390, One Baylor Plaza, Houston, Texas 77030
- Department of Cardiovascular Surgery, Texas Heart Institute at St. Luke’s Episcopal Hospital, 6770 Bertner Ave., Houston, Texas 77030
| | - Ludivine Russell
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, BCM 390, One Baylor Plaza, Houston, Texas 77030
- Department of Cardiovascular Surgery, Texas Heart Institute at St. Luke’s Episcopal Hospital, 6770 Bertner Ave., Houston, Texas 77030
| | - Joseph S. Coselli
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, BCM 390, One Baylor Plaza, Houston, Texas 77030
- Department of Cardiovascular Surgery, Texas Heart Institute at St. Luke’s Episcopal Hospital, 6770 Bertner Ave., Houston, Texas 77030
| | - Scott A. LeMaire
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, BCM 390, One Baylor Plaza, Houston, Texas 77030
- Department of Cardiovascular Surgery, Texas Heart Institute at St. Luke’s Episcopal Hospital, 6770 Bertner Ave., Houston, Texas 77030
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, BCM 335, One Baylor Plaza, Houston, Texas 77030
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Parolari A, Tremoli E, Songia P, Pilozzi A, Di Bartolomeo R, Alamanni F, Mestres CA, Pacini D. Biological features of thoracic aortic diseases. Where are we now, where are we heading to: established and emerging biomarkers and molecular pathways. Eur J Cardiothorac Surg 2013; 44:9-23. [PMID: 23293317 DOI: 10.1093/ejcts/ezs647] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Thoracic aortic aneurysms (TAAs) and aortic dissections (ADs) are among the main causes of mortality and morbidity in Western countries. For this reason, the diagnosis, prevention and prediction of TAAs and ADs have become a very active area of research; in fact, it is important to monitor and predict the evolution of these diseases over time. It is also critical, in cases of doubtful diagnosis, to receive some guidance from biochemical assays, particularly in the case of ADs. Although biological testing for disease prediction has already been discussed several times, the role of biomarkers in TAAs and ADs is still under discussion for routine patient screening, periodical follow-up or for prompt diagnosis in emergency conditions. In this review, we update the current knowledge and new trends regarding the role of biomarkers in thoracic aortic diseases, focusing on established and emerging biomarkers in the fields of genetics, inflammation, haemostasis and matrix remodelling as well as on substances released upon cell damage. Other than D-dimer, a sensitive but not a specific marker for the diagnosis of AD that has been widely tested by several authors and currently seems a viable option in ambiguous cases, the remaining markers have been most frequently assessed in limited or mixed patient populations. This currently precludes their widespread adoption as diagnostic or prognostic tools, even if many of these markers are conceptually promising. In years to come, we expect that future studies will further clarify the diagnostic and prognostic features of several established and emerging biomarkers that, to date, are still in the translational limbo separating biological discovery from a practical clinical role.
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Affiliation(s)
- Alessandro Parolari
- Dipartimento di Scienze Cardiovascolari, Università degli Studi di Milano, Milan, Italy.
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Balistreri C, Pisano C, D'Amico T, Palmeri C, Candore G, Maresi E, Ruvolo G. The Role of Inflammation in Type a Aortic Dissection: A Pilot Study. EUR J INFLAMM 2013. [DOI: 10.1177/1721727x1301100128] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Type A aortic dissection (TAAD) is a severe cardiovascular disease with high mortality rates. Current evidence suggests inflammation as the main mechanism of its complex pathophysiology. Accordingly, in this study the eventual presence of inflammatory cells in aorta specimens and any contribution of these cells in both apoptosis and metalloproteinase levels were assessed. The potential relationship between plasma inflammatory molecules and TAAD was also detected. In addition, implication in TAAD susceptibility of ten common and functional single nucleotide polymorphisms (SNP)s of six candidate genes (CCR5, TLR4, ACE, eNOs, MMP-9 and −2) was determined. Thus, histo-pathological and immunoistochemical aorta examination, TUNEL testing, genotyping of ten SNPs were performed. Levels of plasma inflammatory molecules were also determined using ELISA technique. A significant inflammatory infiltrate was observed in the examined aortas. Consistent with these data, significantly higher plasma levels of systemic inflammatory mediators characterized the cases. In addition, a high risk genotype significantly associated with TAAD susceptibility was identified. Thus, inflammation producing MMPs, cytokines and death mediators seem to be the shared pathological mechanism for TAAD in the population examined.
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Affiliation(s)
- C.R. Balistreri
- Department of Pathobiology and Medical and Forensic Biotechnologies, University of Palermo, Palermo, Italy
| | - C. Pisano
- Unit of Cardiac Surgery, Department of Surgery and Oncology, University of Palermo, Palermo, Italy
| | - T. D'Amico
- Unit of Cardiac Surgery, Department of Surgery and Oncology, University of Palermo, Palermo, Italy
| | - C. Palmeri
- Unit of Cardiac Surgery, Department of Surgery and Oncology, University of Palermo, Palermo, Italy
| | - G. Candore
- Department of Pathobiology and Medical and Forensic Biotechnologies, University of Palermo, Palermo, Italy
| | - E. Maresi
- Department of Pathologic Anatomy, University of Palermo, Palermo, Italy
| | - G. Ruvolo
- Unit of Cardiac Surgery, Department of Surgery and Oncology, University of Palermo, Palermo, Italy
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Demyanets S, Huber K, Wojta J. Vascular effects of glycoprotein130 ligands--part II: biomarkers and therapeutic targets. Vascul Pharmacol 2012; 57:29-40. [PMID: 22245786 DOI: 10.1016/j.vph.2011.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 12/15/2011] [Accepted: 12/25/2011] [Indexed: 12/13/2022]
Abstract
Glycoprotein130 (gp130) ligands are defined by the use of the common receptor subunit gp130 and comprise interleukin (IL)-6, oncostatin M (OSM), IL-11, leukemia inhibitory factor (LIF), cardiotrophin-1 (CT-1), cardiotrophin-like cytokine (CLC), ciliary neurotrophic factor (CNTF), IL-27 and neuropoietin (NP). In part I of this review we addressed the pathophysiological functions of gp130 ligands with respect to the vascular wall. In part II of this review on the vascular effects of gp130 ligands we will discuss data about possible use of these molecules as biomarkers to predict development or progression of cardiovascular diseases. Furthermore, the possibility to modulate circulating levels of gp130 ligands or their tissue expression by specific antibodies, soluble gp130 protein, renin-angiotensin-aldosterone system (RASS) inhibitors, statins, agonists of peroxisome proliferator-activated receptors (PPAR), hormone replacement therapy, nonsteroidal anti-inflammatory drugs (NSAID) or lifestyle modulating strategies are presented. Recent knowledge about the application of recombinant cytokines from the gp130 cytokine family as therapeutic agents in obesity or atherosclerosis is also summarized. Thus the purpose of this review is to cover a possible usefulness of gp130 ligands as biomarkers and targets for therapy in cardiovascular pathologies.
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Affiliation(s)
- Svitlana Demyanets
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
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