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Pamulapati V, Cuda CM, Smith TL, Jung J, Xiong L, Swaminathan S, Ho KJ. Inflammatory Cell Dynamics after Murine Femoral Artery Wire Injury: A Multi-Parameter Flow Cytometry-Based Analysis. Cells 2023; 12:689. [PMID: 36899827 PMCID: PMC10000449 DOI: 10.3390/cells12050689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
An acute inflammatory response following arterial surgery for atherosclerosis, such as balloon angioplasty, stenting, and surgical bypass, is an important driver of neointimal hyperplasia after arterial injury, which leads to recurrent ischemia. However, a comprehensive understanding of the dynamics of the inflammatory infiltrate in the remodeling artery is difficult to attain due to the shortcomings of conventional methods such as immunofluorescence. We developed a 15-parameter flow cytometry method to quantitate leukocytes and 13 leukocyte subtypes in murine arteries at 4 time points after femoral artery wire injury. Live leukocyte numbers peaked at 7 days, which preceded the peak neointimal hyperplasia lesion at 28 days. Neutrophils were the most abundant early infiltrate, followed by monocytes and macrophages. Eosinophils were elevated after 1 day, while natural killer and dendritic cells gradually infiltrated over the first 7 days; all decreased between 7 and 14 days. Lymphocytes began accumulating at 3 days and peaked at 7 days. Immunofluorescence of arterial sections demonstrated similar temporal trends of CD45+ and F4/80+ cells. This method allows for the simultaneous quantitation of multiple leukocyte subtypes from small tissue samples of injured murine arteries and identifies the CD64+Tim4+ macrophage phenotype as being potentially important in the first 7 days post-injury.
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Affiliation(s)
- Vivek Pamulapati
- Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Carla M. Cuda
- Division of Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Tracy L. Smith
- Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Jonathan Jung
- Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Liqun Xiong
- Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Suchitra Swaminathan
- Division of Rheumatology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Karen J. Ho
- Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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Soveral I, Guirado L, Escobar-Diaz MC, Alcaide MJ, Martínez JM, Rodríguez-Sureda V, Bijnens B, Antolin E, Llurba E, Bartha JL, Gómez O, Crispi F. Cord Blood Cardiovascular Biomarkers in Left-Sided Congenital Heart Disease. J Clin Med 2022; 11:jcm11237119. [PMID: 36498692 PMCID: PMC9737470 DOI: 10.3390/jcm11237119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/19/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
Fetal echocardiography has limited prognostic ability in the evaluation of left-sided congenital heart defects (left heart defects). Cord blood cardiovascular biomarkers could improve the prognostic evaluation of left heart defects. A multicenter prospective cohort (2013−2019) including fetuses with left heart defects (aortic coarctation, aortic stenosis, hypoplastic left heart, and multilevel obstruction (complex left heart defects) subdivided according to their outcome (favorable vs. poor), and control fetuses were evaluated in the third trimester of pregnancy at three referral centers in Spain. Poor outcome was defined as univentricular palliation, heart transplant, or death. Cord blood concentrations of N-terminal precursor of B-type natriuretic peptide, Troponin I, transforming growth factor β, placental growth factor, and soluble fms-like tyrosine kinase-1 were determined. A total of 45 fetuses with left heart defects (29 favorable and 16 poor outcomes) and 35 normal fetuses were included, with a median follow-up of 3.1 years (interquartile range 1.4−3.9). Left heart defects with favorable outcome showed markedly increased cord blood transforming growth factor β (normal heart median 15.5 ng/mL (6.8−21.4) vs. favorable outcome 51.7 ng/mL (13.8−73.9) vs. poor outcome 25.1 ng/mL (6.9−39.0), p = 0.001) and decreased placental growth factor concentrations (normal heart 17.9 pg/mL (13.8−23.9) vs. favorable outcome 12.8 pg/mL (11.7−13.6) vs. poor outcome 11.0 pg/mL (8.8−15.4), p < 0.001). Poor outcome left heart defects had higher N-terminal precursor of B-type natriuretic peptide (normal heart 508.0 pg/mL (287.5−776.3) vs. favorable outcome 617.0 pg/mL (389.8−1087.8) vs. poor outcome 1450.0 pg/mL (919.0−1645.0), p = 0.001) and drastically reduced soluble fms-like tyrosine kinase-1 concentrations (normal heart 1929.7 pg/mL (1364.3−2715.8) vs. favorable outcome (1848.3 pg/mL (646.9−2313.6) vs. poor outcome 259.0 pg/mL (182.0−606.0), p < 0.001). Results showed that fetuses with left heart defects present a distinct cord blood biomarker profile according to their outcome.
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Affiliation(s)
- Iris Soveral
- BCNatal, Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), 08028 Barcelona, Spain
- Obstetrics Department, Hospital General de Hospitalet, 08906 Barcelona, Spain
| | - Laura Guirado
- BCNatal, Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), 08028 Barcelona, Spain
| | - Maria C. Escobar-Diaz
- Pediatric Cardiology Department, Sant Joan de Déu Hospital, Esplugues de Llobregat, 08950 Barcelona, Spain
- Cardiovascular Research Group, Sant Joan de Deu Research Institute, Esplugues de Llobregat, 08028 Barcelona, Spain
| | - María José Alcaide
- Laboratory Medicine Department, Hospital Universitario La Paz, 28046 Madrid, Spain
- Research Institute IdiPAZ, 28029 Madrid, Spain
| | - Josep Maria Martínez
- BCNatal, Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), 08028 Barcelona, Spain
- Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona, 08007 Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), 28029 Madrid, Spain
| | - Víctor Rodríguez-Sureda
- BCNatal, Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), 08028 Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), 28029 Madrid, Spain
| | - Bart Bijnens
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Catalan Institution for Research and Advanced Studies ICREA, 08010 Barcelona, Spain
| | - Eugenia Antolin
- Research Institute IdiPAZ, 28029 Madrid, Spain
- Obstetrics and Gynecology Department, Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Elisa Llurba
- Obstetrics and Gynecology Department, Santa Creu i Sant Pau University Hospital, 08025 Barcelona, Spain
- Facultat de Medicina, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Jose L. Bartha
- Research Institute IdiPAZ, 28029 Madrid, Spain
- Obstetrics and Gynecology Department, Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Olga Gómez
- BCNatal, Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), 08028 Barcelona, Spain
- Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona, 08007 Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-932-27-9333
| | - Fàtima Crispi
- BCNatal, Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), 08028 Barcelona, Spain
- Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona, 08007 Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), 28029 Madrid, Spain
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3
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Jackson JL, Fox KR, Rausch JR, Swenski TN, Neville SP, Marousis NC, Korth CX, Cua CL, Garg V, Vannatta K. A Randomized Clinical Trial Demonstrating Feasibility and Preliminary Efficacy of a Videoconference-Delivered Physical Activity Lifestyle Intervention Among Adolescents With a Congenital Heart Defect. Ann Behav Med 2022; 56:673-684. [PMID: 34951444 PMCID: PMC9274981 DOI: 10.1093/abm/kaab105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Individuals with congenital heart defects are at increased risk for developing further cardiovascular complications, which can be mitigated by increasing physical activity. Given that positive health behaviors begin declining during older adolescence, it is vital to promote lifestyle changes in this population. PURPOSE The current study aims to (a) determine the feasibility/acceptability of the Congenital Heart Disease Physical Activity Lifestyle (CHD-PAL) intervention among adolescents (ages 15-18) with moderate and complex congenital heart defects, and (b) estimate the preliminary efficacy of CHD-PAL for increasing time spent in moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness and decreasing sedentary behavior. METHODS Eligible participants were randomized into either CHD-PAL (eight 30-min videoconferencing sessions over 20 weeks with an interventionist + Fitbit + exercise prescription) or a comparator (Fitbit + exercise prescription). RESULTS Sixty adolescents were randomized (76% recruitment rate; 94% of participants were retained from baseline to follow-up). Most adolescents (73%) and their parents/guardians (76%) reported that the trial was enjoyable. While there was no effect of arm on change in MVPA, sedentary behavior, or cardiorespiratory fitness for the entire sample, among those who engaged in <21 min of MVPA on average at baseline, adolescents in the CHD-PAL intervention had an increase of 16 min/day of MVPA more than comparators (d = 0.90). CONCLUSIONS The CHD-PAL intervention warrants examination in a larger trial to establish efficacy among those adolescents with a congenital heart defect who engage in <21 min of MVPA/day and should include follow-up assessments to examine effect durability. CLINICAL TRIALS REGISTRATION NCT03335475.
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Affiliation(s)
- Jamie L Jackson
- Center for Biobehavioral Health, Nationwide Children’s Hospital, NEOB, Third Floor, 700 Children’s Drive, Columbus, OH, USA
- Department of Pediatrics, Ohio State University, Columbus, OH, USA
| | - Kristen R Fox
- Center for Biobehavioral Health, Nationwide Children’s Hospital, NEOB, Third Floor, 700 Children’s Drive, Columbus, OH, USA
| | - Joseph R Rausch
- Center for Biobehavioral Health, Nationwide Children’s Hospital, NEOB, Third Floor, 700 Children’s Drive, Columbus, OH, USA
- Department of Pediatrics, Ohio State University, Columbus, OH, USA
| | - Taylor N Swenski
- Center for Biobehavioral Health, Nationwide Children’s Hospital, NEOB, Third Floor, 700 Children’s Drive, Columbus, OH, USA
| | - Steven P Neville
- Center for Biobehavioral Health, Nationwide Children’s Hospital, NEOB, Third Floor, 700 Children’s Drive, Columbus, OH, USA
| | - Noelle C Marousis
- Center for Biobehavioral Health, Nationwide Children’s Hospital, NEOB, Third Floor, 700 Children’s Drive, Columbus, OH, USA
| | - Christina X Korth
- Center for Biobehavioral Health, Nationwide Children’s Hospital, NEOB, Third Floor, 700 Children’s Drive, Columbus, OH, USA
| | - Clifford L Cua
- The Heart Center, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Vidu Garg
- Department of Pediatrics, Ohio State University, Columbus, OH, USA
- The Heart Center, Nationwide Children’s Hospital, Columbus, OH, USA
- Center for Cardiovascular Research, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Kathryn Vannatta
- Center for Biobehavioral Health, Nationwide Children’s Hospital, NEOB, Third Floor, 700 Children’s Drive, Columbus, OH, USA
- Department of Pediatrics, Ohio State University, Columbus, OH, USA
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4
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Wu Y, Jin X, Zhang Y, Zheng J, Yang R. Genetic and epigenetic mechanisms in the development of congenital heart diseases. WORLD JOURNAL OF PEDIATRIC SURGERY 2021; 4:e000196. [DOI: 10.1136/wjps-2020-000196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 02/06/2023] Open
Abstract
Congenital heart disease (CHD) is the most common of congenital cardiovascular malformations associated with birth defects, and it results in significant morbidity and mortality worldwide. The classification of CHD is still elusive owing to the complex pathogenesis of CHD. Advances in molecular medicine have revealed the genetic basis of some heart anomalies. Genes associated with CHD might be modulated by various epigenetic factors. Thus, the genetic and epigenetic factors are gradually accepted as important triggers in the pathogenesis of CHD. However, few literatures have comprehensively elaborated the genetic and epigenetic mechanisms of CHD. This review focuses on the etiology of CHD from genetics and epigenetics to discuss the role of these factors in the development of CHD. The interactions between genetic and epigenetic in the pathogenesis of CHD are also elaborated. Chromosome abnormalities and gene mutations in genetics, and DNA methylations, histone modifications and on-coding RNAs in epigenetics are summarized in detail. We hope the summative knowledge of these etiologies may be useful for improved diagnosis and further elucidation of CHD so that morbidity and mortality of children with CHD can be reduced in the near future.
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5
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Cardiovascular Risk Factors in Patients With Congenital Heart Disease. Can J Cardiol 2020; 36:1458-1466. [DOI: 10.1016/j.cjca.2020.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/02/2020] [Accepted: 06/18/2020] [Indexed: 12/26/2022] Open
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Castilla R, Gutierrez CPA, Azzato F, Ambrosio G, Milei J. Coronary Intimal Thickening: Once Again. Angiology 2019; 71:90-91. [PMID: 31462064 DOI: 10.1177/0003319719872625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Rocío Castilla
- Universidad de Buenos Aires, CONICET, Instituto de Investigaciones Cardiológicas (ININCA), Buenos Aires, Argentina
| | - Christopher P A Gutierrez
- Universidad de Buenos Aires, CONICET, Instituto de Investigaciones Cardiológicas (ININCA), Buenos Aires, Argentina
| | - Francisco Azzato
- Universidad de Buenos Aires, CONICET, Instituto de Investigaciones Cardiológicas (ININCA), Buenos Aires, Argentina
| | - Giuseppe Ambrosio
- Division of Cardiology, School of Medicine, University of Perugia, Perugia, Italy
| | - José Milei
- Universidad de Buenos Aires, CONICET, Instituto de Investigaciones Cardiológicas (ININCA), Buenos Aires, Argentina
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7
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Guerri-Guttenberg R, Castilla R, Cao G, Azzato F, Ambrosio G, Milei J. Coronary Intimal Thickening Begins in Fetuses and Progresses in Pediatric Population and Adolescents to Atherosclerosis. Angiology 2019; 71:62-69. [PMID: 31088126 DOI: 10.1177/0003319719849784] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The prevalence of coronary intimal thickening (IT) was assessed in fetuses and pediatric population. We studied the coronary arteries of 63 hearts obtained from fetuses, infants, children, and adolescents, deceased from noncardiac disease or trauma. Histomorphometric analysis, planimetry, and immunohistochemical studies were conducted. Intimal thickening consisted of proliferation of smooth muscle cells and scarce monocytes embedded in amorphous deposits within the internal elastic membrane (IEM). Intermingled lesions of intimal hyperplasia and parietal nonstenotic plaques were also observed. Intimal thickening was found in 10% of 20 fetuses, in 33.3% of 18 infants, 73.3% of 15 children, and 100% of 10 adolescents. A significant correlation (r = 0.671, P < 0.001) was found between the extent of IT and age. The IEM was duplicated or interrupted in 43% of patients, showing a positive correlation with the degree of IT (P = 0.01). Intimal thickening was predominantly found near bifurcation sites in the left anterior descending coronary artery (55.6%) and in zones free of bifurcation in the right coronary artery (75%). In conclusion, the prevalence and extension of IT lesions are higher at older ages within a young population. Intimal thickening may be regarded as the first event occurring in coronary preatherosclerosis, preceding lipid deposition.
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Affiliation(s)
- Roberto Guerri-Guttenberg
- Instituto de Investigaciones Cardiológicas (ININCA), Universidad de Buenos Aires-CONICET, Buenos Aires, Argentina
| | - Rocío Castilla
- Instituto de Investigaciones Cardiológicas (ININCA), Universidad de Buenos Aires-CONICET, Buenos Aires, Argentina
| | - Gabriel Cao
- Instituto de Investigaciones Cardiológicas (ININCA), Universidad de Buenos Aires-CONICET, Buenos Aires, Argentina
| | - Francisco Azzato
- Instituto de Investigaciones Cardiológicas (ININCA), Universidad de Buenos Aires-CONICET, Buenos Aires, Argentina
| | - Giuseppe Ambrosio
- Division of Cardiology, School of Medicine, University of Perugia, Perugia, Italy
| | - José Milei
- Instituto de Investigaciones Cardiológicas (ININCA), Universidad de Buenos Aires-CONICET, Buenos Aires, Argentina
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8
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Differences in Obesity Among Black and White Children, Adolescents, and Adults With Congenital Heart Disease. J Cardiovasc Nurs 2018; 34:71-75. [PMID: 30211814 DOI: 10.1097/jcn.0000000000000513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Congenital heart disease (CHD) survivors have an elevated risk for obesity-related comorbidities, but little is known about racial differences in obesity rates for this population. OBJECTIVE The authors aimed to compare rates of obesity in CHD survivors to national estimates using National Health and Nutrition Examination Assessment Survey (NHANES) and to characterize racial disparities in obesity among CHD survivors across age ranges. METHODS Retrospective chart review included 4496 CHD survivors (4050 white and 446 black) with a range of lesion severities from a pediatric and an adult medical center. RESULTS White children with CHD had a higher prevalence of obesity compared with NHANES estimates. In contrast, white young adults with CHD had a lower prevalence of obesity compared with NHANES. Blacks with CHD had a 58% increased risk of obesity in young adulthood and a 33% increased risk in late adulthood compared with whites with CHD. CONCLUSIONS Obesity interventions are needed among CHD survivors across the lifespan, particularly among adult non-Hispanic blacks.
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9
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Olsen M, Marino B, Kaltman J, Laursen H, Jakobsen L, Mahle W, Pearson G, Madsen N. Myocardial Infarction in Adults With Congenital Heart Disease. Am J Cardiol 2017; 120:2272-2277. [PMID: 29111211 DOI: 10.1016/j.amjcard.2017.08.050] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 08/27/2017] [Accepted: 08/31/2017] [Indexed: 11/29/2022]
Abstract
We compared the incidence and 30-day mortality of myocardial infarction (MI) in adults with congenital heart disease (CHD) relative to the general population. This cohort study used nationwide population-based medical databases to identify individuals born before 1982 and diagnosed with CHD in Denmark between 1963 and 2012. Patients were followed for first-time MI using data from the Danish National Registry of Patients. For each subject with CHD, we identified 10 controls from the general population, matched by sex and birth year. A unique personal identifier enabled follow-up for migration, death, or MI. We computed cumulative incidences and hazard ratios (HR) adjusted for birth year and sex for MI and 30-day mortality after MI. We identified 10,501 CHD adults alive at 30 years. By 70 years of age, the cumulative incidence of MI was 10% versus 6.5% for controls. The overall HR of MI in subjects with CHD compared with controls was 2.0 (95% CI 1.7 to 2.3). The 30-day mortality was 18% for the 296 subjects with CHD experiencing an MI during follow-up. The overall HR comparing 30-day mortality after MI between subjects with CHD and controls was 1.4 (95% CI 1.0 to 1.8). The greatest mortality was observed in adults with severe CHD (HR 2.7 [95% CI 1.5 to 5.0]). In conclusion, the incidence of MI and the 30-day mortality after MI for severe CHD were increased in adults with CHD compared with the general population. Underlying mechanisms need to be clarified.
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Affiliation(s)
- Morten Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.
| | - Bradley Marino
- Heart Center at the Ann & Robert H. Lurie Children's Hospital of Chicago; Department of Pediatrics and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jonathan Kaltman
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Henning Laursen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
| | - Lars Jakobsen
- Department of Cardiology, Aarhus University Hospital, Denmark
| | - William Mahle
- Department of Pediatrics, Division of Cardiology, Emory University Atlanta, Atlanta, Georgia
| | - Gail Pearson
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Nicolas Madsen
- Department of Pediatrics, Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
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10
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Donadoni F, Pichardo-Almarza C, Bartlett M, Dardik A, Homer-Vanniasinkam S, Díaz-Zuccarini V. Patient-Specific, Multi-Scale Modeling of Neointimal Hyperplasia in Vein Grafts. Front Physiol 2017; 8:226. [PMID: 28458640 PMCID: PMC5394124 DOI: 10.3389/fphys.2017.00226] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 03/30/2017] [Indexed: 11/16/2022] Open
Abstract
Neointimal hyperplasia is amongst the major causes of failure of bypass grafts. The disease progression varies from patient to patient due to a range of different factors. In this paper, a mathematical model will be used to understand neointimal hyperplasia in individual patients, combining information from biological experiments and patient-specific data to analyze some aspects of the disease, particularly with regard to mechanical stimuli due to shear stresses on the vessel wall. By combining a biochemical model of cell growth and a patient-specific computational fluid dynamics analysis of blood flow in the lumen, remodeling of the blood vessel is studied by means of a novel computational framework. The framework was used to analyze two vein graft bypasses from one patient: a femoro-popliteal and a femoro-distal bypass. The remodeling of the vessel wall and analysis of the flow for each case was then compared to clinical data and discussed as a potential tool for a better understanding of the disease. Simulation results from this first computational approach showed an overall agreement on the locations of hyperplasia in these patients and demonstrated the potential of using new integrative modeling tools to understand disease progression.
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Affiliation(s)
| | | | | | - Alan Dardik
- The Department of Surgery, Yale University School of MedicineNew Haven, CT, USA.,Veteran Affairs Connecticut Healthcare SystemWest Haven, CT, USA
| | - Shervanthi Homer-Vanniasinkam
- Mechanical Engineering, University College LondonLondon, UK.,Leeds Vascular Institute, Leeds General InfirmaryLeeds, UK.,Division of Surgery, University of WarwickWarwick, UK
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11
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Valenzuela DM, Ordovas KG. Radiologic evaluation of coronary artery disease in adults with congenital heart disease. Int J Cardiovasc Imaging 2015; 32:13-8. [PMID: 26342712 DOI: 10.1007/s10554-015-0760-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 08/29/2015] [Indexed: 12/31/2022]
Abstract
Improved surgical and medical therapy have prolonged survival in patients with congenital heart disease (CHD) such that general medical conditions like coronary artery disease (CAD) are now the main determinants of mortality. A summary of the association of CAD with CHD, as well as a discussion of the radiologic evaluation of the coronary arteries in adults with CHD is described herein. Cross sectional imaging to evaluate CAD in adults with CHD should follow the same appropriateness criteria as gender and aged matched patients without CHD. Coronary CT imaging may be particularly valuable in evaluating the coronary arteries in this patient population as invasive coronary angiography may prove challenging secondary to complicated or unconventional anatomy of the coronary arteries. Further, typical methods for evaluating CAD such as stress or echocardiography may be impractical in adults with CHD. Finally, delineating the anatomic relationship of the coronary arteries and their relationship with the sternum, chest wall, conduits, grafts, and valves is highly recommended in patients with CHD prior to reintervention to avoid iatrogenic complications.
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Affiliation(s)
- David M Valenzuela
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143-0628, USA
| | - Karen G Ordovas
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143-0628, USA.
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12
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Inverse expression of estrogen receptor alpha and apolipoprotein B in coronary intimal hyperplasia of surgically repaired congenital heart disease: A pre-atherosclerotic condition? Int J Cardiol 2014; 177:548-50. [DOI: 10.1016/j.ijcard.2014.08.100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 08/17/2014] [Indexed: 11/23/2022]
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13
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Lui GK, Fernandes S, McElhinney DB. Management of cardiovascular risk factors in adults with congenital heart disease. J Am Heart Assoc 2014; 3:e001076. [PMID: 25359401 PMCID: PMC4338694 DOI: 10.1161/jaha.114.001076] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 10/01/2014] [Indexed: 01/21/2023]
Affiliation(s)
- George K Lui
- Divisions of Cardiovascular Medicine and Pediatric Cardiology, Departments of Medicine and Pediatrics, Stanford University School of Medicine, Stanford, CA (G.K.L., S.F.)
| | - Susan Fernandes
- Divisions of Cardiovascular Medicine and Pediatric Cardiology, Departments of Medicine and Pediatrics, Stanford University School of Medicine, Stanford, CA (G.K.L., S.F.)
| | - Doff B McElhinney
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA (D.B.M.E.)
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14
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Cohen MS. Coronary Artery Disease Risk in Patients with Congenital Heart Disease. CURRENT CARDIOVASCULAR RISK REPORTS 2014. [DOI: 10.1007/s12170-014-0391-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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15
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Roche SL, Silversides CK. Hypertension, obesity, and coronary artery disease in the survivors of congenital heart disease. Can J Cardiol 2013; 29:841-8. [PMID: 23688771 DOI: 10.1016/j.cjca.2013.03.021] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 03/17/2013] [Accepted: 03/17/2013] [Indexed: 10/26/2022] Open
Abstract
Obesity, hypertension, and coronary artery disease are prevalent in the general population and well recognized as contributors to cardiac morbidity and mortality. With surgical and medical advances, there is a growing and aging population with congenital heart disease who are also at risk of developing these comorbidities. In addition, some congenital cardiac lesions predispose patients to conditions such as hypertension or coronary artery disease. The effect of these comorbidities on the structurally abnormal heart is not well understood, but might be very important, especially in those with residual abnormalities. Thus, in addition to surveillance for and treatment of late complications it is important for the congenital cardiologist to consider and aggressively manage acquired comorbidities. In this review we explore the prevalence of hypertension, obesity, and coronary artery disease, discuss congenital lesions that predispose to these conditions and review management strategies for this unique population.
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Affiliation(s)
- S Lucy Roche
- University of Toronto, Division of Cardiology, Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada.
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Justino H, Khairy P. Congenital heart disease and coronary atherosclerosis: a looming concern? Can J Cardiol 2013; 29:757-8. [PMID: 23680447 DOI: 10.1016/j.cjca.2013.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 03/13/2013] [Accepted: 03/14/2013] [Indexed: 11/20/2022] Open
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