1
|
Sjöberg P, Arheden H, Heiberg E, Stephensen S, Carlsson M. Haemodynamic left-ventricular changes during dobutamine stress in patients with atrial septal defect assessed with magnetic resonance imaging-based pressure-volume loops. Clin Physiol Funct Imaging 2022; 42:422-429. [PMID: 35838181 PMCID: PMC9796342 DOI: 10.1111/cpf.12781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/03/2022] [Accepted: 07/13/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Atrial septal defect (ASD) results in a left-to-right shunt causing right-ventricular (RV) volume overload and decreased cardiac output from the left ventricle. Pressure-volume (PV) loops enable comprehensive assessment of ventricular function and might increase understanding of the pathophysiology of ASD. The aim of this study was to investigate if left-ventricular (LV) haemodynamic response to stress in patients with ASD differs from controls. MATERIAL AND METHODS Patients with ASD (n = 18, age 51 ± 18) and healthy controls (n = 16, age 35 ± 13) underwent cardiac magnetic resonance (CMR) and brachial cuff pressure measurements at rest and during dobutamine stress. An in-house, validated method was used to compute PV loops. RESULTS Patients had lower stroke work, potential energy and external power at rest than controls (p < 0.001; p < 0.05; p < 0.05). Stroke work and external power increased and potential energy decreased during stress in patients (p < 0.05; p < 0.0001; p < 0.01) and controls (p < 0.0001; p < 0.001; p < 0.01). Contractility and arterial elastance at rest were higher in patients than controls (p < 0.01; p < 0.01). Contractility increased during stress in both groups (p < 0.0001; p < 0.001). There was no difference between patients and controls in arterio-ventricular coupling. CONCLUSION LV haemodynamic response to stress can be assessed using noninvasive PV loops derived from CMR and brachial blood pressure. Patients with ASD had normal LV energy efficiency, in contrast to other patient groups with decreased cardiac output. Data suggest that patients with ASD had an increased inotropic level at rest with high contractility and heart rate but were able to respond with a further increase during stress, albeit to not as high a cardiac output as controls.
Collapse
Affiliation(s)
- Pia Sjöberg
- Department of Clinical Sciences Lund, Skåne University Hospital, Clinical PhysiologyLund UniversityLundSweden
| | - Håkan Arheden
- Department of Clinical Sciences Lund, Skåne University Hospital, Clinical PhysiologyLund UniversityLundSweden
| | - Einar Heiberg
- Department of Clinical Sciences Lund, Skåne University Hospital, Clinical PhysiologyLund UniversityLundSweden,Wallenberg Centre for Molecular MedicineLund UniversityLundSweden
| | - Sigurdur Stephensen
- Department of Clinical Sciences Lund, Skåne University Hospital, Clinical PhysiologyLund UniversityLundSweden
| | - Marcus Carlsson
- Department of Clinical Sciences Lund, Skåne University Hospital, Clinical PhysiologyLund UniversityLundSweden
| |
Collapse
|
2
|
Pang L, Jiang X, Lian X, Chen J, Song EF, Jin LG, Xia ZY, Ma HC, Cai Y. Caloric restriction-mimetics for the reduction of heart failure risk in aging heart: with consideration of gender-related differences. Mil Med Res 2022; 9:33. [PMID: 35786219 PMCID: PMC9252041 DOI: 10.1186/s40779-022-00389-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 05/30/2022] [Indexed: 11/10/2022] Open
Abstract
The literature is full of claims regarding the consumption of polyphenol or polyamine-rich foods that offer some protection from developing cardiovascular disease (CVD). This is achieved by preventing cardiac hypertrophy and protecting blood vessels through improving the function of endothelium. However, do these interventions work in the aged human hearts? Cardiac aging is accompanied by an increase in left ventricular hypertrophy, along with diastolic and systolic dysfunction. It also confers significant cardiovascular risks for both sexes. The incidence and prevalence of CVD increase sharply at an earlier age in men than women. Furthermore, the patterns of heart failure differ between sexes, as do the lifetime risk factors. Do caloric restriction (CR)-mimetics, rich in polyphenol or polyamine, delay or reverse cardiac aging equally in both men and women? This review will discuss three areas: (1) mechanisms underlying age-related cardiac remodeling; (2) gender-related differences and potential mechanisms underlying diminished cardiac response in older men and women; (3) we select a few polyphenol or polyamine rich compounds as the CR-mimetics, such as resveratrol, quercetin, curcumin, epigallocatechin gallate and spermidine, due to their capability to extend health-span and induce autophagy. We outline their abilities and issues on retarding aging in animal hearts and preventing CVD in humans. We discuss the confounding factors that should be considered for developing therapeutic strategies against cardiac aging in humans.
Collapse
Affiliation(s)
- Lei Pang
- Department of Anesthesiology, the First Hospital of Jilin University, Changchun, 130021, China
| | - Xi Jiang
- Health Promotion Center, the First Hospital of Jilin University, Changchun, 130021, China
| | - Xin Lian
- Department of Urology, the First Hospital of Jilin University, Changchun, 130021, China
| | - Jie Chen
- Henry Fok School of Biology and Agriculture, Shaoguan University, Shaoguan, 512000, Guangdong, China
| | - Er-Fei Song
- Department of Metabolic and Bariatric Surgery, Jinan University First Affiliated Hospital, Guangzhou, 510630, China.,Department of Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China
| | - Lei-Gang Jin
- Department of Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China.,State Key Laboratory of Pharmaceutical Biotechnology, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China
| | - Zheng-Yuan Xia
- State Key Laboratory of Pharmaceutical Biotechnology, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China.,Department of Anesthesiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524000, Guangdong, China
| | - Hai-Chun Ma
- Department of Anesthesiology, the First Hospital of Jilin University, Changchun, 130021, China.
| | - Yin Cai
- Department of Health Technology and Informatics, the Hong Kong Polytechnic University, Hong Kong, China.
| |
Collapse
|
3
|
Wright SP, Sless RT, Mak S. Does increased arterial stiffness cause HFpEF in women? J Card Fail 2021; 28:212-214. [PMID: 34933098 DOI: 10.1016/j.cardfail.2021.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 11/28/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Stephen P Wright
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
| | - Ryan T Sless
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Susanna Mak
- Division of Cardiology, Department of Medicine, Mount Sinai Hospital/University Health Network, Toronto, Canada.
| |
Collapse
|
4
|
Cadeddu Dessalvi C, Pepe A, Penna C, Gimelli A, Madonna R, Mele D, Monte I, Novo G, Nugara C, Zito C, Moslehi JJ, de Boer RA, Lyon AR, Tocchetti CG, Mercuro G. Sex differences in anthracycline-induced cardiotoxicity: the benefits of estrogens. Heart Fail Rev 2020; 24:915-925. [PMID: 31256318 DOI: 10.1007/s10741-019-09820-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Anthracyclines are the cornerstone for many oncologic treatments, but their cardiotoxicity has been recognized for several decades. Female subjects, especially before puberty and adolescence, or after menopause, seem to be more at increased risk, with the prognostic impact of this sex issue being less consistent compared to other cardiovascular risk factors. Several studies imply that sex differences could depend on the lack of the protective effect of sex hormones against the anthracycline-initiated damage in cardiac cells, or on differential mitochondria-related oxidative gene expression. This is also reflected by the results obtained with different diagnostic methods, such as cardiovascular biomarkers and imaging techniques (echocardiography, magnetic resonance, and nuclear medicine) in the diagnosis and monitoring of cardiotoxicity, confirming that sex differences exist. The same is true about protective strategies from anthracycline cardiotoxicity. Indeed, first studied to withstand oxidative damage in response to ischemia/reperfusion (I/R) injury, cardioprotection has different outcomes in men and women. A number of studies assessed the differences in I/R response between male and female hearts, with oxidative stress and apoptosis being shared mechanisms between the I/R and anthracyclines heart damage. Sex hormones can modulate these mechanisms, thus confirming their importance in the pathophysiology in cardioprotection not only from the ischemia/reperfusion damage, but also from anthracyclines, fueling further cardio-oncologic research on the topic.
Collapse
Affiliation(s)
| | - Alessia Pepe
- Magnetic Resonance Imaging Unit, Fondazione G. Monasterio C.N.R.- Regione Toscana, Pisa, Italy
| | - Claudia Penna
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Alessia Gimelli
- Nuclear Medicine Unit, Fondazione G. Monasterio C.N.R.- Regione Toscana, Pisa, Italy
| | - Rosalinda Madonna
- Center of Aging Sciences and Translational Medicine - CESI-MeT, "G. d'Annunzio" University, Chieti, Italy
| | - Donato Mele
- Cardiology Unit, Emergency Department, University Hospital of Ferrara, Ferrara, Italy
| | - Ines Monte
- Department of General Surgery and Medical-Surgery Specialities- Cardiology, University of Catania, Catania, Italy
| | - Giuseppina Novo
- Department of Cardiology, University of Palermo, Palermo, Italy
| | - Cinzia Nugara
- Department of Cardiology, University of Palermo, Palermo, Italy
| | - Concetta Zito
- Department of Clinical and Experimental Medicine - Cardiology, University of Messina, Messina, Italy
| | - Javid J Moslehi
- Vanderbilt Ingram Cancer Center, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rudolf A de Boer
- University Medical Center Groningen, Department of Cardiology, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| | | | - Carlo Gabriele Tocchetti
- Department of Translational Medical Sciences, Federico II University, Naples, Italy. .,Interdepartmental Center for Clinical and Translational Research (CIRCET), Federico II University, Naples, Italy.
| | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| |
Collapse
|
5
|
Bouabdallaoui N, Rouleau J. Evolving towards a more realistic approach to the importance of left ventricular ejection fraction and sex in heart failure and its therapy. Eur J Heart Fail 2020; 22:800-803. [PMID: 32227549 DOI: 10.1002/ejhf.1805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 12/28/2022] Open
Affiliation(s)
- Nadia Bouabdallaoui
- Department of Medicine, The Montreal Heart Institute and Université de Montréal, Montreal, Canada
| | - Jean Rouleau
- Department of Medicine, The Montreal Heart Institute and Université de Montréal, Montreal, Canada
| |
Collapse
|
6
|
Cardiovascular sexual dimorphism in a diet-induced type 2 diabetes rodent model, the Nile rat (Arvicanthis niloticus). PLoS One 2018; 13:e0208987. [PMID: 30589871 PMCID: PMC6307866 DOI: 10.1371/journal.pone.0208987] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/28/2018] [Indexed: 12/12/2022] Open
Abstract
Background The Nile rat (Arvicanthis niloticus) is an emerging laboratory model of type 2 diabetes. When fed standard rodent chow, the majority of males progress from hyperinsulinemia by 2 months to hyperglycemia by 6 months, while most females remain at the hyperinsulinemia-only stage (prediabetic) from 2 months onward. Since diabetic cardiomyopathy is the major cause of type-2 diabetes mellitus (T2DM)-related mortality, we examined whether sexual dimorphism might entail cardiac functional changes. Our ultimate goal was to isolate the effect of diet as a modifiable lifestyle factor. Materials and methods Nile rats were fed either standard rodent chow (Chow group) or a high-fiber diet previously established to prevent type 2 diabetes (Fiber group). Cardiac function was determined with echocardiography at 12 months of age. To isolate the effect of diet alone, only the small subset of animals resistant to both hyperinsulinemia and hyperglycemia were included in this study. Results In males, Chow (compared to Fiber) was associated with elevated heart rate and mitral E/A velocity ratio, and with lower e’-wave velocity, isovolumetric relaxation time, and ejection time. Of note, these clinically atypical types of diastolic dysfunction occurred independently of body weight. In contrast, females did not exhibit changes in cardiovascular function between diets. Conclusions The higher prevalence of T2DM in males correlates with their susceptibility to develop subtle diastolic cardiac dysfunction when fed a Western style diet (throughout most of their lifespan) despite no systemic evidence of metabolic syndrome, let alone T2DM.
Collapse
|
7
|
Wainstein RV, Sasson Z, Mak S. Frequency-dependent left ventricular performance in women and men. Am J Physiol Heart Circ Physiol 2012; 302:H2363-71. [DOI: 10.1152/ajpheart.01125.2011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We aimed to determine whether sex differences in humans extend to the dynamic response of the left ventricular (LV) chamber to changes in heart rate (HR). Several observations suggest sex influences LV structure and function in health; moreover, this physiology is also affected in a sex-specific manner by aging. Eight postmenopausal women and eight similarly aged men underwent a cardiac catheterization-based study for force-interval relationships of the LV. HR was controlled by right atrial (RA) pacing, and LV +dP/d tmax and volume were assessed by micromanometer-tipped catheter and Doppler echocardiography, respectively. Analysis of approximated LV pressure-volume relationships was performed using a time-varying model of elastance. External stroke work was also calculated. The relationship between HR and LV +dP/d tmax was expressed as LV +dP/d tmax = b + mHR. The slope ( m) of the relationship was steeper in women compared with men (11.8 ± 4.0 vs. 6.1 ± 4.1 mmHg·s−1·beats−1·min−1, P = 0.01). The greater increase in contractility in women was reproducibly observed after normalizing LV +dP/d tmax to LV end-diastolic volume (LVVed) or by measuring end-systolic elastance. LVVed and stroke volume decreased more in women. Thus, despite greater increases in contractility, HR was associated with a lesser rise in cardiac output and a steeper fall in external stroke work in women. Compared with men, women exhibit greater inotropic responses to incremental RA pacing, which occurs at the same time as a steeper decline in external stroke work. In older adults, we observed sexual dimorphism in determinants of LV mechanical performance.
Collapse
Affiliation(s)
| | - Zion Sasson
- The Harold & Esther Mecklinger Family and Posluns Family Cardiac Catheterization Research Laboratory, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada; and
| | - Susanna Mak
- The Harold & Esther Mecklinger Family and Posluns Family Cardiac Catheterization Research Laboratory, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada; and
| |
Collapse
|
8
|
Mak S, Van Spall HG, Wainstein RV, Sasson Z. Strain, Strain Rate, and the Force Frequency Relationship in Patients with and without Heart Failure. J Am Soc Echocardiogr 2012; 25:341-8. [DOI: 10.1016/j.echo.2011.11.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Indexed: 10/14/2022]
|
9
|
Grossman A, Prokupetz A, Benderly M, Wand O, Assa A, Kalter-Leibovici O. Pulmonary Artery Pressure in Young Healthy Subjects. J Am Soc Echocardiogr 2012; 25:357-60. [DOI: 10.1016/j.echo.2011.11.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Indexed: 11/16/2022]
|
10
|
de Perrot M, McRae K, Shargall Y, Thenganatt J, Moric J, Mak S, Granton JT. Early Postoperative Pulmonary Vascular Compliance Predicts Outcome After Pulmonary Endarterectomy for Chronic Thromboembolic Pulmonary Hypertension. Chest 2011; 140:34-41. [DOI: 10.1378/chest.10-1263] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
11
|
Lindqvist P, Mörner S, Henein MY. Cardiac mechanisms underlying normal exercise tolerance: gender impact. Eur J Appl Physiol 2011; 112:451-9. [PMID: 21584684 DOI: 10.1007/s00421-011-1992-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2010] [Accepted: 04/30/2011] [Indexed: 10/18/2022]
Abstract
The aim of this study is to test our hypothesis that normal exercise tolerance differs according to gender and to identify potential functional cardiac relationships, which could explain those differences. A total of 44 healthy individuals with mean age of 49 ± 12 years (28-74 years, 22 males) constituted the study cohort. All individuals underwent resting and exercise Doppler echocardiogram simultaneously with peak oxygen uptake analysis (pVO(2)). At equal pVO(2), males achieved higher peak exercise workload (p < 0.001) and females higher heart rate (p < 0.001) but the two groups maintained similar indexed left ventricular (LV) stroke volume (SV) and cardiac output. Indexed LV end-diastolic (LVDVI) and end-systolic volumes (LVSVI) were smaller in females (p < 0.001 and p < 0.01, respectively), but filling time (FT) was shorter (p < 0.001) and they had higher early diastolic (E) velocity (p = 0.004), E/E (m) (myocardial E velocity) (p < 0.001) and global longitudinal strain rate atrial velocity (GLSRa') (p = 0.02), compared to males. In males, workload (p < 0.01), LVDVI (p < 0.01), LVSVI (p < 0.05), SVI (p < 0.001) directly but LV myocardial isovolumic relaxation time (IVRTm) (p < 0.01) inversely correlated with pVO(2). In females, mitral E velocity (p < 0.01), GLSRs' (p < 0.05) positively and LVFT negatively (p < 0.05) correlated with pVO(2). In a multivariable analysis SVI in males (p < 0.01) and GLSRs' in females (p < 0.01) were the strongest predictors for pVO(2). Thus, normal exercise capacity as determined by pVO(2) is related to the indexed stroke volume in males and left atrial pressure in females. These native normal differences between genders may explain the known vulnerability of women to endurance exercise compared to men.
Collapse
Affiliation(s)
- Per Lindqvist
- Department of Clinical Physiology, Heart Centre, Umeå University Hospital, 90185 Umeå, Sweden.
| | | | | |
Collapse
|
12
|
Physiologic basis and pathophysiologic implications of the diastolic properties of the cardiac muscle. J Biomed Biotechnol 2010; 2010:807084. [PMID: 20625419 PMCID: PMC2896897 DOI: 10.1155/2010/807084] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2009] [Revised: 02/15/2010] [Accepted: 03/21/2010] [Indexed: 12/17/2022] Open
Abstract
Although systole was for long considered the core of cardiac function, hemodynamic performance is evenly dependent on appropriate systolic and diastolic functions. The recognition that isolated diastolic dysfunction is the major culprit for approximately fifty percent of all heart failure cases imposes a deeper understanding of its underlying mechanisms so that better diagnostic and therapeutic strategies can be designed. Risk factors leading to diastolic dysfunction affect myocardial relaxation and/or its material properties by disrupting the homeostasis of cardiomyocytes as well as their relation with surrounding matrix and vascular structures. As a consequence, slower ventricular relaxation and higher myocardial stiffness may result in higher ventricular filling pressures and in the risk of hemodynamic decompensation. Thus, determining the mechanisms of diastolic function and their implications in the pathophysiology of heart failure with normal ejection fraction has become a prominent field in basic and clinical research.
Collapse
|
13
|
Zhang W, Kovács SJ. The age dependence of left ventricular filling efficiency. ULTRASOUND IN MEDICINE & BIOLOGY 2009; 35:1076-1085. [PMID: 19427107 PMCID: PMC2757544 DOI: 10.1016/j.ultrasmedbio.2009.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2008] [Revised: 11/19/2008] [Accepted: 01/24/2009] [Indexed: 05/27/2023]
Abstract
Echocardiography has emerged as the preferred modality by which diastolic function (DF) is assessed for clinical or research purposes. Echocardiographic indexes and parameters of DF such as E/A, DT, E/E', etc., deteriorate with advancing age. Whether the efficiency of filling depends on age is unknown. To better characterize the filling process and DF in causal rather than correlative terms, we have previously modeled diastole kinematically. We introduced and validated a dimensionless measure of DF termed the kinematic filling efficiency index (KFEI). In the present study, we determined the effect of aging on DF in terms of KFEI in 72 control subjects without cardiovascular-related diseases or pathologies. We also evaluated the age dependence of other conventional parameters of DF. In concordance with other noninvasive DF measures known to decrease with age, KFEI decreases and correlates very strongly with age (R2=0.80). Multivariate analysis showed that age is the single most important contributor to KFEI (p=0.003). We conclude that KFEI provides novel insight into DF impairment mechanisms because of aging. These results support the clinical value of KFEI and advance our ability to characterize DF in mechanistic and quantitative terms based on the efficiency of filling.
Collapse
Affiliation(s)
- Wei Zhang
- Cardiovascular Biophysics Laboratory, Cardiovascular Division, Department of Internal Medicine, Washington University School of Medicine and Department of Physics, College of Arts and Sciences, Washington University, St. Louis, MO 63110, USA
| | | |
Collapse
|
14
|
Floras JS, Mak S. Muscle sympathetic nerve activity in women and men following acute myocardial infarction: a meaningful difference? Eur Heart J 2009; 30:1692-4. [DOI: 10.1093/eurheartj/ehp239] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|