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Xu B, Kawata T, Nakao T, Nakanishi K, Hirokawa M, Sawada N, Kimura K, Abe Y, Komuro I, Yatomi Y, Daimon M. Mitral Valvular Coaptation-Zone Area Is Associated with the Severity of Atherosclerosis Assessed by Cardio-Ankle Vascular Index. Int Heart J 2021; 62:552-558. [PMID: 33994514 DOI: 10.1536/ihj.20-776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Preservation of the mitral valve (MV) size is essential for valve function, and a reduced MV coaptation-zone area increases the risk of developing functional mitral regurgitation (FMR). We aimed to determine if the MV leaflet and coaptation-zone areas were associated with the severity of atherosclerosis assessed by cardio-ankle vascular index (CAVI) in patients with normal left ventricle (LV) systolic function and size by real-time 3D echocardiography (RT3DE).We performed RT3DE analysis in 66 patients with normal LV size and ejection fraction who underwent 2D echocardiography and CAVI. MV coaptation-zone areas were measured by custom 3D software and indexed by body surface area (BSA). The associations of clinical factors and mean CAVI with MV leaflet and coaptation-zone areas were evaluated by univariable and multivariable linear regression analyses.On univariable analysis, MV leaflet area/BSA was significantly associated with age (r = -0.335, P = 0.0069) and mean CAVI (r = -0.464, P < 0.001), and MV coaptation-zone area was significantly associated with age (r = -0.626, P < 0.001), hypertension (r = -0.626, P < 0.001), dyslipidemia (r = -0.626, P < 0.001), E/e' (r = -0.626, P < 0.001), and CAVI (r = -0.740, P < 0.001). On multivariable analysis, mean CAVI was independently associated only with MV leaflet area/BSA (standardized coefficient = -0.611, P < 0.001) and MV coaptation-zone area/BSA (standardized coefficient = -0.74, P < 0.001).In patients with normal LV systolic function and size, MV leaflet and coaptation-zone areas might be reduced according to advancing atherosclerosis. Patients with atherosclerosis might be at increased risk of developing FMR.
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Affiliation(s)
- Boqing Xu
- Department of Clinical Laboratory, Graduate School of Medicine, The University of Tokyo
| | - Takayuki Kawata
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Tomoko Nakao
- Department of Clinical Laboratory, Graduate School of Medicine, The University of Tokyo
| | - Koki Nakanishi
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Megumi Hirokawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Naoko Sawada
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Koichi Kimura
- Department of General Medicine, The Institute of Medical Science, The University of Tokyo
| | - Yukio Abe
- Department of Cardiology, Osaka City General Hospital
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Yutaka Yatomi
- Department of Clinical Laboratory, Graduate School of Medicine, The University of Tokyo
| | - Masao Daimon
- Department of Clinical Laboratory, Graduate School of Medicine, The University of Tokyo.,Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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Rossi A, Barbieri A, Benfari G, Gaibazzi N, Erlicher A, Mureddu G, Frattini S, Faden G, Manicardi M, Beraldi M, Agostini F, Lazzarini V, Moreo A, Luigi Temporelli P, Magni G, Pressman G, Faggiano P. Heart valve calcification and cardiac hemodynamics. Echocardiography 2021; 38:525-530. [PMID: 33705585 DOI: 10.1111/echo.14994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/05/2021] [Accepted: 01/25/2021] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Heart valve calcification (VC) is associated with increased cardiovascular risk, but the hemodynamic and functional profile of patients affected by VC has not been fully explored. METHODS The study population was formed by consecutive unselected patients included in seven echocardiographic laboratories in a 2-week period. A comprehensive echocardiographic examination was performed. VC was defined by the presence of calcification on at least one valve. RESULTS Population was formed of 1098 patients (mean age 65 ± 15 years; 47% female). VC was present in 31% of the overall population. Compared with subjects without VC, VC patients were older (60 ± 14 vs 75 ± 9; P < .0001), had more hypertension (40% vs 57%; P = .0005), diabetes (11% vs 18%; P = .002), coronary artery disease (22% vs 38%; P = .04), and chronic kidney disease (4% vs 8%; P = .007). Furthermore, VC patients had lower ejection fraction (55 ± 14 vs 53 ± 25; P < .0001), worse diastolic function (E/e' 8.5 ± 4.6 vs 13.0 ± 7.1; P < .0001) and higher pulmonary artery pressure (29 ± 9 vs 37 ± 12; P < .0001). The association between VC and EF was not independent of etiology (p for VC 0.13), whereas the association with E/e' and PASP was independent in a full multivariate model (P < .0001 and P = .0002, respectively). CONCLUSION Heart valve calcification patients were characterized by a worse functional and hemodynamic profile compared to patients with normal valve. The association between VC and diastolic function and PASP were independent in comprehensive multivariate models.
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Affiliation(s)
- Andrea Rossi
- Section of Cardiology, Department of Medicine, School of Medicine, Verona, Italy
| | - Andrea Barbieri
- Department of Cardiology, Policlinico Hospital, Modena and Reggio Emilia University, Modena, Italy
| | - Giovanni Benfari
- Section of Cardiology, Department of Medicine, School of Medicine, Verona, Italy
| | | | | | | | | | - Giacomo Faden
- Cardiology Division, Pieve di Coriano, Brescia, Italy
| | - Marcella Manicardi
- Department of Cardiology, Policlinico Hospital, Modena and Reggio Emilia University, Modena, Italy
| | | | | | | | | | | | | | | | - Pompilio Faggiano
- Cardiology Division, Spedali Civili and University of Brescia, Brescia, Italy
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Affiliation(s)
- Stéphane Laurent
- From the Department of Pharmacology, European Georges Pompidou Hospital, Assistance Publique - Hôpitaux de Paris, Paris Cardiovascular Research Center, PARCC-Inserm U970 and Paris University, France
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Thimmapuram R, Bandettini WP, Shanbhag SM, Yu JH, O'Brien KJ, Gahl WA, Introne WJ, Chen MY. Aortic distensibility in alkaptonuria. Mol Genet Metab 2020; 130:289-296. [PMID: 32466960 DOI: 10.1016/j.ymgme.2020.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Alkaptonuria (AKU) is a rare inherited disorder of tyrosine metabolism resulting in an accumulation of homogentisic acid oxidation products in the joints and cardiovascular system. Aortic distensibility may be a non-invasive indicator of cardiovascular complications. Descending thoracic aortic distensibility in alkaptonuria has not been studied. METHODS Patients diagnosed with alkaptonuria underwent Magnetic Resonance Imaging (MRI) and gated non-contrast and contrast-enhanced cardiovascular computed tomography. Using MRI cine images, aortic distensibility of the descending thoracic aorta was determined. RESULTS Seventy-six patients with alkaptonuria were imaged. When compared to literature normal values, aortic distensibility in AKU was impaired (5.2 vs 6.2 × 10-3, p < .001). Aortic distensibility was inversely related to age (r = -0.6, p = .0001). Hypertensive patients with alkaptonuria had impaired distensibility compared to normotensive patients with alkaptonuria (4.6 vs 5.6 × 10-3, p = .03), and hyperlipidemic patients with alkaptonuria had impaired distensibility compared to non-hyperlipidemic patients with alkaptonuria (4.1 vs 6.0 × 10-3, p = .001). Male hypertensive patients with alkaptonuria had greater distensibility than their female counterparts (5.3 vs 2.9 × 10-3, p = .02). Similarly, male hyperlipidemic patients with alkaptonuria had greater distensibility than their female counterparts (4.8 vs 2.5 × 10-3, p < .01). Of patients with alkaptonuria, those with a coronary artery calcium (CAC) score greater than 100 had more impaired distensibility than those with a CAC score less than 100 (3.5 vs 5.1 × 10-3, p = .01) and those with aortic calcium score greater than 100 had impaired distensibility compared to those with an aortic calcium score less than 100 (3.2 vs 4.9 × 10-3, p = .02). Univariate analysis revealed age, aortic calcification, and hyperlipidemia to be significant factors of distensibility, and multiple regression analysis showed age as the only significant risk factor of distensibility. CONCLUSIONS Patients with alkaptonuria have impaired aortic distensibility, which is likely an early marker for reduced cardiovascular health. Variables such as age, hypertension, hyperlipidemia, and aortic and coronary calcification were associated with impaired distensibility.
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Affiliation(s)
- Rashmi Thimmapuram
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - W Patricia Bandettini
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - Sujata M Shanbhag
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - Jeannie H Yu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America; Veterans Affairs Medical Center, Long Beach, CA, United States of America
| | - Kevin J O'Brien
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - William A Gahl
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - Wendy J Introne
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - Marcus Y Chen
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America.
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Sun S, Li L, Dong L, Cheng J, Zhao C, Bao C, Wang H. Circulating mRNA and microRNA profiling analysis in patients with ischemic stroke. Mol Med Rep 2020; 22:792-802. [PMID: 32626985 PMCID: PMC7339759 DOI: 10.3892/mmr.2020.11143] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 12/03/2019] [Indexed: 12/15/2022] Open
Abstract
To provide insight into molecular diagnosis and individualized treatment of ischemic stroke (IS), several available datasets in IS were analyzed to identify the differentially expressed genes and microRNAs (miRNAs). Series matrix files from GSE22255 and GSE16561 (mRNA profiles), a well as GSE110993 (miRNA profile) were downloaded from the Gene Expression Omnibus database. System-level clustering was performed with GeneCluster 3.0 software, and gene annotation and pathway enrichment were performed with gene ontology analysis and Database for Annotation, Visualization and Integrated Discovery software. For a protein-protein interaction (PPI) network, Biological General Repository for Interaction Datasets and IntAct interaction information were integrated to determine the interaction of differentially expressed genes. The selected miRNA candidates were imported into the TargetScan, miRDB and miRecords databases for the prediction of target genes. The present study identified 128 upregulated and 231 downregulated genes in female stroke patients, and 604 upregulated and 337 downregulated genes in male stroke patients compared with sex- and age-matched controls. The construction of a PPI network demonstrated that male stroke patients exhibited YWHAE, CUL3 and JUN as network center nodes, and in female patients CYLD, FOS and PIK3R1 interactions were the strongest. Notably, these interactions are mainly involved in immune inflammatory response, apoptosis and other biological pathways, such as blood coagulation. Female and male upregulated genes were cross-validated with another set of Illumina HumanRef-8 v3.0 expression beadchip (GSE16561). Functional item association networks, gene function networks and transcriptional regulatory networks were successfully constructed, and the relationships between miRNAs and target genes were successfully predicted. The present study identified a number of transcription factors, including DEFA1, PDK4, SDPR, TCN1 and MMP9, and miRNAs, including miRNA (miR)-21, miR-143/145, miR-125-5p and miR-122, which may serve important roles in the development of cerebral stroke and may be important molecular indicators for the treatment of IS.
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Affiliation(s)
- Sujuan Sun
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050050, P.R. China
| | - Litao Li
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050050, P.R. China
| | - Lipeng Dong
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050050, P.R. China
| | - Jinming Cheng
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050050, P.R. China
| | - Congying Zhao
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050050, P.R. China
| | - Chu Bao
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050050, P.R. China
| | - Hebo Wang
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050050, P.R. China
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Altay H, Altın C, Coner A, Muderrisoglu H, Giray S. Parathyroid Hormone and Ischemic Cerebrovascular Event. Endocr Metab Immune Disord Drug Targets 2020; 19:1134-1140. [PMID: 30806331 DOI: 10.2174/1871530319666190215150410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/26/2019] [Accepted: 01/29/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Increased parathyroid hormone (PTH) level is associated with coronary artery disease, hypertension and left ventricular hypertrophy which are all predisposing factors for the ischemic cerebrovascular event (ICVE). Carotid intima-media thickness (CIMT) and aortic distensibility are the two early, subclinical predictors of atherosclerosis. The relation of PTH with CIMT and aortic distensibility in patients with ICVE has not been previously studied. OBJECTIVE Our aim was to study the relationship of PTH levels with aortic distensibility and CIMT in patients with ICVE. METHODS Sixty-four ICVE patients and 50 control group were enrolled in the study. PTH levels, aortic distensibility and CIMT were measured in all individuals. RESULTS PTH levels were significantly higher in ICVE patients than in the controls (60.1±21.6 vs. 52.3±6.2 pg/ml) (p=0. 008). PTH levels were found to be inversely correlated with aortic distensibility (r= -0. 420, p=0.001) and positively correlated with CIMT (r:0, 285, p=0,002). CONCLUSION The present study shows that PTH levels are increased in patients with acute ischemic cerebrovascular event compared to the control group. It also demonstrates that PTH levels are inversely related to aortic distensibility of ascending aorta and positively associated with CIMT.
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Affiliation(s)
- Hakan Altay
- Department of Cardiology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Cihan Altın
- Department of Cardiology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Ali Coner
- Department of Cardiology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Haldun Muderrisoglu
- Department of Cardiology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Semih Giray
- Neurology, Faculty of Medicine, Baskent University, Ankara, Turkey
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Affiliation(s)
- Alberto Giannoni
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
- Scuola Superiore Sant’Anna, Pisa, Italy
| | - Stefano Masi
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
- Department of Twin Research and Genetic Epidemiology, King’s College London, UK
- National Centre for Cardiovascular Preventions and Outcomes, Institute of Cardiovascular Science, University College London, UK
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