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Abreu A, Máximo J, Almeida C, Lourenço A, Leite-Moreira A. The additive effects of anaemia and transfusion on long-term survival after coronary artery bypass surgery. Eur J Cardiothorac Surg 2024; 65:ezad403. [PMID: 38058180 PMCID: PMC10924300 DOI: 10.1093/ejcts/ezad403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/20/2023] [Accepted: 12/05/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVES To compare the independent and combined effects of anaemia and red blood cell transfusion on late survival after isolated coronary artery bypass grafting. METHODS Retrospective analysis of 5243 consecutive patients undergoing primary isolated coronary artery bypass grafting, performed from 2000 to 2015, in a Portuguese Academic Hospital. We identified 1649 patients with preoperative anaemia (A+) and 1422 patients who received a perioperative transfusion (T+)-the 4 possible combinations allowed for the creation of 4 subgroups (A-/T-, A-/T+, A+/T- and A+/T+). The primary endpoint was all-cause mortality at 10 years. We employed inverse probability weighting to control for confounding variables. RESULTS Thirty-one percent of the patients had preoperative anaemia, and 27.0% had at least one packed red blood cell transfusion. Inverse probability weighting was effective in eliminating differences in all significant baseline characteristics. The primary endpoint of all-cause mortality at 10 years occurred in 568 patients (20.5%) in the A-/T- group, as compared with 204 (24.4%) in the A-/T+ group (hazard ratio, 1.14; 95% confidence interval, 1.00 to 1.31; P = 0.053), 358 (33.8%) in the A+/T- group (hazard ratio, 1.53; 95% confidence interval, 1.38 to 1.71; P < 0.001), 254 (43.6%) in the A+/T+ group (hazard ratio, 2.25; 95% confidence interval, 1.97 to 2.56; P < 0.001). CONCLUSIONS This longitudinal, population-level study emphasizes the adverse long-term outcomes of preoperative anaemia and perioperative red blood cell transfusion. It stresses the importance of an evidence-based, multimodal and multidisciplinary approach to conserving blood resources and optimizing outcomes in patients at high risk for transfusion.
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Affiliation(s)
- Armando Abreu
- Department of Surgery and Physiology, Cardiovascular R&D Center—UnIC@RISE, Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Cardiothoracic Surgery, São João University Hospital Center, Porto, Portugal
| | - José Máximo
- Department of Surgery and Physiology, Cardiovascular R&D Center—UnIC@RISE, Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Cardiothoracic Surgery, São João University Hospital Center, Porto, Portugal
| | - Cláudia Almeida
- Department of Anesthesiology, São João University Hospital Center, Porto, Portugal
| | - André Lourenço
- Department of Surgery and Physiology, Cardiovascular R&D Center—UnIC@RISE, Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Anesthesiology, São João University Hospital Center, Porto, Portugal
| | - Adelino Leite-Moreira
- Department of Surgery and Physiology, Cardiovascular R&D Center—UnIC@RISE, Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Cardiothoracic Surgery, São João University Hospital Center, Porto, Portugal
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Botnariuc D, Court S, Lourenço A, Gosling A, Royle G, Hussein M, Rompokos V, Veiga C. Evaluation of monte carlo to support commissioning of the treatment planning system of new pencil beam scanning proton therapy facilities. Phys Med Biol 2024; 69:045027. [PMID: 38052092 DOI: 10.1088/1361-6560/ad1272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/05/2023] [Indexed: 12/07/2023]
Abstract
Objective. To demonstrate the potential of Monte Carlo (MC) to support the resource-intensive measurements that comprise the commissioning of the treatment planning system (TPS) of new proton therapy facilities.Approach. Beam models of a pencil beam scanning system (Varian ProBeam) were developed in GATE (v8.2), Eclipse proton convolution superposition algorithm (v16.1, Varian Medical Systems) and RayStation MC (v12.0.100.0, RaySearch Laboratories), using the beam commissioning data. All models were first benchmarked against the same commissioning data and validated on seven spread-out Bragg peak (SOBP) plans. Then, we explored the use of MC to optimise dose calculation parameters, fully understand the performance and limitations of TPS in homogeneous fields and support the development of patient-specific quality assurance (PSQA) processes. We compared the dose calculations of the TPSs against measurements (DDTPSvs.Meas.) or GATE (DDTPSvs.GATE) for an extensive set of plans of varying complexity. This included homogeneous plans with varying field-size, range, width, and range-shifters (RSs) (n= 46) and PSQA plans for different anatomical sites (n= 11).Main results. The three beam models showed good agreement against the commissioning data, and dose differences of 3.5% and 5% were found for SOBP plans without and with RSs, respectively. DDTPSvs.Meas.and DDTPSvs.GATEwere correlated in most scenarios. In homogeneous fields the Pearson's correlation coefficient was 0.92 and 0.68 for Eclipse and RayStation, respectively. The standard deviation of the differences between GATE and measurements (±0.5% for homogeneous and ±0.8% for PSQA plans) was applied as tolerance when comparing TPSs with GATE. 72% and 60% of the plans were within the GATE predicted dose difference for both TPSs, for homogeneous and PSQA cases, respectively.Significance. Developing and validating a MC beam model early on into the commissioning of new proton therapy facilities can support the validation of the TPS and facilitate comprehensive investigation of its capabilities and limitations.
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Affiliation(s)
- D Botnariuc
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom
- Metrology for Medical Physics Centre, National Physical Laboratory, Hampton Road, Teddington, TW11 0LW, United Kingdom
| | - S Court
- Radiotherapy Physics Services, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, United Kingdom
| | - A Lourenço
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom
- Metrology for Medical Physics Centre, National Physical Laboratory, Hampton Road, Teddington, TW11 0LW, United Kingdom
| | - A Gosling
- Radiotherapy Physics Services, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, United Kingdom
| | - G Royle
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom
| | - M Hussein
- Metrology for Medical Physics Centre, National Physical Laboratory, Hampton Road, Teddington, TW11 0LW, United Kingdom
| | - V Rompokos
- Radiotherapy Physics Services, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, United Kingdom
| | - C Veiga
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom
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Guedes S, Perpétuo L, Veloso J, Lima T, Ferreira AF, Pires I, Savaiva F, Lourenço A, Moreira-Costa L, Leite-Moreira A, Barros A, Trindade F, Vitorino R. Comprehensive characterization of protein modifications using mass spectrometry and dry blood spots. Proteomics Clin Appl 2024:e2300102. [PMID: 38169112 DOI: 10.1002/prca.202300102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/19/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE The main objective of this study is to characterize and analyze modified peptides in DBS samples. This includes deciphering their specific PTMs and understanding their potential impact on the population or disease cohort under study. EXPERIMENTAL DESIGN Using mass spectrometry-based proteomic approaches, we performed a comprehensive analysis of DBS samples. Our focus was on the identification and quantification of modified peptides. We also took advantage of recent advances in DBS mass spectrometry to ensure accurate detection and quantification. RESULTS A comprehensive analysis identified 972 modified peptides in DBS samples. Of these, a subset of 211 peptides was consistently present in all samples, highlighting their potential biological importance and relevance. This indicates a diverse spectrum of PTMs in the proteome of DBS samples. CONCLUSIONS AND CLINICAL RELEVANCE Integration of mass spectrometry and proteomics has revealed a broad spectrum of modified peptides in DBS samples and highlighted their importance in biological processes and disease progression. Accurate detection of these PTMs may be critical for risk stratification and disease management. This study improves the understanding of molecular mechanisms underlying biological processes and disease development, providing important insights for clinical applications.
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Affiliation(s)
- Sofia Guedes
- LAQV/REQUIMTE, Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - Luís Perpétuo
- iBiMED, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Jacinta Veloso
- iBiMED, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Tânia Lima
- iBiMED, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Ana F Ferreira
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Inês Pires
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Francisca Savaiva
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - André Lourenço
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Liliana Moreira-Costa
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Adelino Leite-Moreira
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Antonio Barros
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Fábio Trindade
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Rui Vitorino
- LAQV/REQUIMTE, Department of Chemistry, University of Aveiro, Aveiro, Portugal
- iBiMED, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
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Cerqueira R, Moreira-Costa L, Beslika E, Leite-Moreira A, Silva J, da Costa Martins PA, Leite-Moreira A, Lourenço A, Mendes-Ferreira P. A Minimally Invasive Model of Aortic Stenosis in Swine. J Vis Exp 2023. [PMID: 37930007 DOI: 10.3791/65780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Large animal models of heart failure play an essential role in the development of new therapeutic interventions due to their size and physiological similarities to humans. Efforts have been dedicated to creating a model of pressure-overload induced heart failure, and ascending aortic banding while still supra-coronary and not a perfect mimic of aortic stenosis in humans, closely resembling the human condition. The purpose of this study is to demonstrate a minimally invasive approach to induce left ventricular pressure overload by placing an aortic band, precisely calibrated with percutaneously introduced high-fidelity pressure sensors. This method represents a refinement of the surgical procedure (3Rs), resulting in homogenous trans-stenotic gradients and reduced intragroup variability. Additionally, it enables swift and uneventful animal recovery, leading to minimal mortality rates. Throughout the study, animals were followed for up to 2 months after surgery, employing transthoracic echocardiography and pressure-volume loop analysis. However, longer follow-up periods can be achieved if desired. This large animal model proves valuable for testing new drugs, particularly those targeting hypertrophy and the structural and functional alterations associated with left ventricular pressure overload.
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Affiliation(s)
- Rui Cerqueira
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto; Department of Cardiothoracic Surgery, Hospital Universitário de São João
| | - Liliana Moreira-Costa
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto
| | - Evangelia Beslika
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto; CARIM School for Cardiovascular Diseases, Maastricht University
| | - André Leite-Moreira
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto
| | - Joana Silva
- CARIM School for Cardiovascular Diseases, Maastricht University; Mirabilis Therapeutics
| | | | - Adelino Leite-Moreira
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto; Department of Cardiothoracic Surgery, Hospital Universitário de São João
| | - André Lourenço
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto
| | - Pedro Mendes-Ferreira
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto;
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Maia J, Rodrigues AF, Dias AL, Azevedo B, Leite-Moreira A, Lourenço A, Almeida C. Kidney Injury after Cardiac Surgery: Prevention-Associated Cost Reduction. ACTA MEDICA PORT 2023; 36:567-587. [PMID: 36889336 DOI: 10.20344/amp.18755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 12/06/2022] [Indexed: 03/10/2023]
Abstract
INTRODUCTION Cardiac surgery may induce acute kidney injury and the need for renal replacement therapy. It is also associated with higher hospital costs, morbidity and mortality. The aims of this study were to investigate predictors of cardiac surgery associated acute kidney injury in our population and to determine the burden of acute kidney injury in elective cardiac surgery, evaluating the potential cost effectiveness of preventing it through the application of the Kidney Disease: Improving Global Outcomes bundle of care to high-risk patient groups identified by the [TIMP-2]x[IGFBP7] used as a screening test. MATERIAL AND METHODS In a University Hospital single-center retrospective cohort study we analyzed a consecutive sample of adults who underwent elective cardiac surgery between January and March 2015. A total of 276 patients were admitted during the study period. Data from all patients was analyzed until hospital discharge or the patient's death. The economic analysis was performed from the hospital costs' perspective. RESULTS Cardiac surgery associated acute kidney injury occurred in 86 patients (31%). After adjustment, higher preoperative serum creatinine (mg/L, ORadj = 1.09; 95% CI: 1.01 - 1.17), lower preoperative hemoglobin (g/dL, ORadj = 0.79; 95% CI: 0.67 - 0.94), chronic systemic hypertension (ORadj = 5.00; 95% CI: 1.67 - 15.02), an increase in cardiopulmonary bypass time (min, ORadj = 1.01; 95% CI: 1.00 - 1.01) and perioperative use of sodium nitroprusside (ORadj = 6.33; 95% CI: 1.80 - 22.28) remained significantly associated with cardiac surgery related acute kidney injury. The expected cumulative surplus cost for the hospital linked with cardiac surgery associated acute kidney injury (86 patients) was €120 695.84. Based on a median absolute risk reduction of 16.6%, by dosing kidney damage biomarkers in every patient and using preventive measures in high-risk patients, we would expect a break-even point upon screening 78 patients, which would translate, in our patient cohort, into an overall cost benefit of €7145. CONCLUSION Preoperative hemoglobin, serum creatinine, systemic hypertension, cardiopulmonary bypass time and perioperative use of sodium nitroprusside were independent predictors of cardiac surgery associated acute kidney injury. Our cost-effectiveness modelling suggests that the use of kidney structural damage biomarkers combined with an early prevention strategy could be associated with potential cost savings.
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Affiliation(s)
- João Maia
- Departamento de Anestesiologia. Centro Hospitalar e Universitário de São João. Porto. Portugal
| | | | - Ana Lídia Dias
- Departamento de Anestesiologia. Centro Hospitalar e Universitário de São João. Porto; Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - Bárbara Azevedo
- Departamento de Anestesiologia. Centro Hospitalar e Universitário de São João. Porto. Portugal
| | - André Leite-Moreira
- Departamento de Anestesiologia. Centro Hospitalar e Universitário de São João. Porto; Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - André Lourenço
- Departamento de Anestesiologia. Centro Hospitalar e Universitário de São João. Porto; Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - Cláudia Almeida
- Departamento de Anestesiologia. Centro Hospitalar e Universitário de São João. Porto. Portugal
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Lourenço A, Lee N, Charlwood F, Lambert J, Vera-Sánchez JA, Hussein M, Shipley D, Romano F, Lowe M, Clarke M, Lorentini S, Mazal A, Pettingell J, Palmans H, Thomas R. A portable primary-standard level graphite calorimeter for absolute dosimetry in clinical pencil beam scanning proton beams. Phys Med Biol 2023; 68:175005. [PMID: 37414003 DOI: 10.1088/1361-6560/ace50f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 07/06/2023] [Indexed: 07/08/2023]
Abstract
Objective. To report the use of a portable primary standard level graphite calorimeter for direct dose determination in clinical pencil beam scanning proton beams, which forms part of the recommendations of the proposed Institute of Physics and Engineering in Medicine (IPEM) Code of Practice (CoP) for proton therapy dosimetry.Approach. The primary standard proton calorimeter (PSPC) was developed at the National Physical Laboratory (NPL) and measurements were performed at four clinical proton therapy facilities that use pencil beam scanning for beam delivery. Correction factors for the presence of impurities and vacuum gaps were calculated and applied, as well as dose conversion factors to obtain dose to water. Measurements were performed in the middle of 10 × 10 × 10 cm3homogeneous dose volumes, centred at 10.0, 15.0 and 25.0 g·cm-2depth in water. The absorbed dose to water determined with the calorimeter was compared to the dose obtained using PTW Roos-type ionisation chambers calibrated in terms of absorbed dose to water in60Co applying the recommendations in the IAEA TRS-398 CoP.Main results.The relative dose difference between the two protocols varied between 0.4% and 2.1% depending on the facility. The reported overall uncertainty in the determination of absorbed dose to water using the calorimeter is 0.9% (k= 1), which corresponds to a significant reduction of uncertainty in comparison with the TRS-398 CoP (currently with an uncertainty equal or larger than 2.0% (k= 1) for proton beams).Significance. The establishment of a purpose-built primary standard and associated CoP will considerably reduce the uncertainty of the absorbed dose to water determination and ensure improved accuracy and consistency in the dose delivered to patients treated with proton therapy and bring proton reference dosimetry uncertainty in line with megavoltage photon radiotherapy.
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Affiliation(s)
- A Lourenço
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom
| | - N Lee
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
| | - F Charlwood
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester M20 4BX, United Kingdom
| | - J Lambert
- Rutherford Cancer Centre South Wales, Newport NP10 8FZ, United Kingdom
| | - J A Vera-Sánchez
- Centro de Protonterapia Quirónsalud, E-28223 Pozuelo de Alarcón, Madrid, Spain
| | - M Hussein
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom
| | - D Shipley
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
| | - F Romano
- Istituto Nazionale di Fisica Nucleare, Sezione di Catania, Via S Sofia 64, I-95123, Catania, Italy
| | - M Lowe
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester M20 4BX, United Kingdom
| | - M Clarke
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester M20 4BX, United Kingdom
| | - S Lorentini
- Protontherapy Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - A Mazal
- Centro de Protonterapia Quirónsalud, E-28223 Pozuelo de Alarcón, Madrid, Spain
| | - J Pettingell
- Rutherford Cancer Centre North East, Bedlington NE22 7FD, United Kingdom
| | - H Palmans
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- Medical Physics Group, MedAustron Ion Therapy Center, A-2700 Wiener Neustadt, Austria
| | - R Thomas
- Medical Radiation Science Group, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- University of Surrey, Faculty of Engineering and Physical Science, Guildford GU2 7XH, United Kingdom
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Neves JS, Leite AR, Conceição G, Gonçalves A, Borges-Canha M, Vale C, Von-Hafe M, Martins D, Miranda-Silva D, Leite S, Rocha-Oliveira E, Sousa-Mendes C, Chaves J, Lourenço IM, Grijota-Martínez C, Bárez-López S, Miranda IM, Almeida-Coelho J, Vasques-Nóvoa F, Carvalho D, Lourenço A, Falcão-Pires I, Leite-Moreira A. Effects of Triiodothyronine Treatment in an Animal Model of Heart Failure with Preserved Ejection Fraction. Thyroid 2023; 33:983-996. [PMID: 37140469 DOI: 10.1089/thy.2022.0717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Background: Low levels of triiodothyronine (T3) are common in patients with heart failure (HF). Our aim was to evaluate the effects of supplementation with low and replacement doses of T3 in an animal model of HF with preserved ejection fraction (HFpEF). Methods: We evaluated four groups: ZSF1 Lean (n = 8, Lean-Ctrl), ZSF1 Obese (rat model of metabolic-induced HFpEF, n = 13, HFpEF), ZSF1 Obese treated with a replacement dose of T3 (n = 8, HFpEF-T3high), and ZSF1 Obese treated with a low-dose of T3 (n = 8, HFpEF-T3low). T3 was administered in drinking water from weeks 13 to 24. The animals underwent anthropometric and metabolic assessments, echocardiography, and peak effort testing with maximum O2 consumption (VO2max) determination at 22 weeks, and a terminal hemodynamic evaluation at 24 weeks. Afterwhile myocardial samples were collected for single cardiomyocyte evaluation and molecular studies. Results: HFpEF animals showed lower serum and myocardial thyroid hormone levels than Lean-Ctrl. Treatment with T3 did not normalize serum T3 levels, but increased myocardial T3 levels to normal levels in the HFpEF-T3high group. Body weight was significantly decreased in both the T3-treated groups, comparing with HFpEF. An improvement in glucose metabolism was observed only in HFpEF-T3high. Both the treated groups had improved diastolic and systolic function in vivo, as well as improved Ca2+ transients and sarcomere shortening and relaxation in vitro. Comparing with HFpEF animals, HFpEF-T3high had increased heart rate and a higher rate of premature ventricular contractions. Animals treated with T3 had higher myocardial expression of calcium transporter ryanodine receptor 2 (RYR2) and α-myosin heavy chain (MHC), with a lower expression of β-MHC. VO2max was not influenced by treatment with T3. Myocardial fibrosis was reduced in both the treated groups. Three animals died in the HFpEF-T3high group. Conclusions: Treatment with T3 was shown to improve metabolic profile, myocardial calcium handling, and cardiac function. While the low dose was well-tolerated and safe, the replacement dose was associated with increased heart rate, and increased risk of arrhythmias and sudden death. Modulation of thyroid hormones may be a potential therapeutic target in HFpEF; however, it is important to take into account the narrow therapeutic window of T3 in this condition.
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Affiliation(s)
- João Sérgio Neves
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Ana Rita Leite
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Glória Conceição
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Alexandre Gonçalves
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Marta Borges-Canha
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Catarina Vale
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Internal Medicine, and Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Madalena Von-Hafe
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Pediatrics, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Diana Martins
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Daniela Miranda-Silva
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Sara Leite
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Estela Rocha-Oliveira
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Cláudia Sousa-Mendes
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Joana Chaves
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Inês Mariana Lourenço
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Carmen Grijota-Martínez
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Soledad Bárez-López
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Isabel M Miranda
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - João Almeida-Coelho
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Francisco Vasques-Nóvoa
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Internal Medicine, and Centro Hospitalar Universitário de São João, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Davide Carvalho
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- Faculty of Medicine of the University of Porto, Porto, Portugal
| | - André Lourenço
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Inês Falcão-Pires
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Adelino Leite-Moreira
- Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Cardiothoracic Surgery, Centro Hospitalar Universitário São João, Porto, Portugal
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8
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Nogueira-Ferreira R, Santos I, Ferreira R, Fontoura D, Sousa-Mendes C, Falcão-Pires I, Lourenço A, Leite-Moreira A, Duarte IF, Moreira-Gonçalves D. Exercise training impacts skeletal muscle remodelling induced by metabolic syndrome in ZSF1 rats through metabolism regulation. Biochim Biophys Acta Mol Basis Dis 2023; 1869:166709. [PMID: 37030522 DOI: 10.1016/j.bbadis.2023.166709] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 02/28/2023] [Accepted: 03/28/2023] [Indexed: 04/10/2023]
Abstract
Metabolic syndrome (MetS), characterized by a set of conditions that include obesity, hypertension, and dyslipidemia, is associated with increased cardiovascular risk. Exercise training (EX) has been reported to improve MetS management, although the underlying metabolic adaptations that drive its benefits remain poorly understood. This work aims to characterize the molecular changes induced by EX in skeletal muscle in MetS, focusing on gastrocnemius metabolic remodelling. 1H NMR metabolomics and molecular assays were employed to assess the metabolic profile of skeletal muscle tissue from lean male ZSF1 rats (CTL), obese sedentary male ZSF1 rats (MetS-SED), and obese male ZF1 rats submitted to 4 weeks of treadmill EX (5 days/week, 60 min/day, 15 m/min) (MetS-EX). EX did not counteract the significant increase of body weight and circulating lipid profile, but had an anti-inflammatory effect and improved exercise capacity. The decreased gastrocnemius mass observed in MetS was paralleled with glycogen degradation into small glucose oligosaccharides, with the release of glucose-1-phosphate, and an increase in glucose-6-phosphate and glucose levels. Moreover, sedentary MetS animals' muscle exhibited lower AMPK expression levels and higher amino acids' metabolism such as glutamine and glutamate, compared to lean animals. In contrast, the EX group showed changes suggesting an increase in fatty acid oxidation and oxidative phosphorylation. Additionally, EX mitigated MetS-induced fiber atrophy and fibrosis in the gastrocnemius muscle. EX had a positive effect on gastrocnemius metabolism by enhancing oxidative metabolism and, consequently, reducing susceptibility to fatigue. These findings reinforce the importance of prescribing EX programs to patients with MetS.
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Affiliation(s)
- Rita Nogueira-Ferreira
- UnIC@RISE, Department of Surgery and Physiology, Cardiovascular R&D Center, Faculty of Medicine of the University of Porto, Porto, Portugal.
| | - Inês Santos
- CICECO-Aveiro Institute of Materials, Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - Rita Ferreira
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - Dulce Fontoura
- UnIC@RISE, Department of Surgery and Physiology, Cardiovascular R&D Center, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Cláudia Sousa-Mendes
- UnIC@RISE, Department of Surgery and Physiology, Cardiovascular R&D Center, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Inês Falcão-Pires
- UnIC@RISE, Department of Surgery and Physiology, Cardiovascular R&D Center, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - André Lourenço
- UnIC@RISE, Department of Surgery and Physiology, Cardiovascular R&D Center, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Adelino Leite-Moreira
- UnIC@RISE, Department of Surgery and Physiology, Cardiovascular R&D Center, Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Cardiothoracic Surgery, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Iola F Duarte
- CICECO-Aveiro Institute of Materials, Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - Daniel Moreira-Gonçalves
- CIAFEL, Faculty of Sport, University of Porto, Porto, Portugal; ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal.
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9
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Cook H, Simard M, Niemann N, Gillies C, Osborne M, Hussein M, Rompokos V, Bouchard H, Royle G, Pettingell J, Palmans H, Lourenço A. Development of optimised tissue-equivalent materials for proton therapy. Phys Med Biol 2023; 68. [PMID: 36696694 DOI: 10.1088/1361-6560/acb637] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/25/2023] [Indexed: 01/26/2023]
Abstract
Objective. In proton therapy there is a need for proton optimised tissue-equivalent materials as existing phantom materials can produce large uncertainties in the determination of absorbed dose and range measurements. The aim of this work is to develop and characterise optimised tissue-equivalent materials for proton therapy.Approach. A mathematical model was developed to enable the formulation of epoxy-resin based tissue-equivalent materials that are optimised for all relevant interactions of protons with matter, as well as photon interactions, which play a role in the acquisition of CT numbers. This model developed formulations for vertebra bone- and skeletal muscle-equivalent plastic materials. The tissue equivalence of these new materials and commercial bone- and muscle-equivalent plastic materials were theoretical compared against biological tissue compositions. The new materials were manufactured and characterised by their mass density, relative stopping power (RSP) measurements, and CT scans to evaluate their tissue-equivalence.Main results. Results showed that existing tissue-equivalent materials can produce large uncertainties in proton therapy dosimetry. In particular commercial bone materials showed to have a relative difference up to 8% for range. On the contrary, the best optimised formulations were shown to mimic their target human tissues within 1%-2% for the mass density and RSP. Furthermore, their CT-predicted RSP agreed within 1%-2% of the experimental RSP, confirming their suitability as clinical phantom materials.Significance. We have developed a tool for the formulation of tissue-equivalent materials optimised for proton dosimetry. Our model has enabled the development of proton optimised tissue-equivalent materials which perform better than existing tissue-equivalent materials. These new materials will enable the advancement of clinical proton phantoms for accurate proton dosimetry.
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Affiliation(s)
- H Cook
- Department of Medical Physics and Biomedical Engineering, University College London, WC1E 6BT, United Kingdom
- Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
| | - M Simard
- Department of Medical Physics and Biomedical Engineering, University College London, WC1E 6BT, United Kingdom
- Centre de recherche du CHUM, 900 Saint Denis St, Montreal, Quebec H2X 0A9, Canada
- University of Montreal, 2900 Edouard Montpetit Blvd, Montreal, Quebec H3T 1J4, Canada
| | - N Niemann
- Barts Health NHS Trust, Clinical Physics Department, London, E1 2BL, United Kingdom
| | - C Gillies
- Medical Physics Department, Proton Therapy Centre, University College Hospital, WC1E 6AS, United Kingdom
| | - M Osborne
- Medical Physics Department, The Rutherford Cancer Centre Thames Valley, Reading, RG2 9LH, United Kingdom
| | - M Hussein
- Department of Medical Physics and Biomedical Engineering, University College London, WC1E 6BT, United Kingdom
- Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
| | - V Rompokos
- Medical Physics Department, Proton Therapy Centre, University College Hospital, WC1E 6AS, United Kingdom
| | - H Bouchard
- Centre de recherche du CHUM, 900 Saint Denis St, Montreal, Quebec H2X 0A9, Canada
- University of Montreal, 2900 Edouard Montpetit Blvd, Montreal, Quebec H3T 1J4, Canada
| | - G Royle
- Department of Medical Physics and Biomedical Engineering, University College London, WC1E 6BT, United Kingdom
| | - J Pettingell
- Medical Physics Department, The Rutherford Cancer Centre Thames Valley, Reading, RG2 9LH, United Kingdom
| | - H Palmans
- Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
- Medical Physics Group, MedAustron Ion Therapy Centre, A-2700 Wiener Neustadt, Austria
| | - A Lourenço
- Department of Medical Physics and Biomedical Engineering, University College London, WC1E 6BT, United Kingdom
- Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
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10
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Cardoso AF, Dias G, Faria B, Almeida F, Lourenço A. The spells of iatrogeny. Neth Heart J 2023; 31:214-215. [PMID: 36729254 PMCID: PMC10140226 DOI: 10.1007/s12471-023-01762-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 02/03/2023] Open
Affiliation(s)
- A F Cardoso
- Department of Cardiology, Hospital Senhora da Oliveira-Guimarães, Guimarães, Portugal.
| | - G Dias
- Department of Cardiology, Hospital Senhora da Oliveira-Guimarães, Guimarães, Portugal
| | - B Faria
- Department of Cardiology, Hospital Senhora da Oliveira-Guimarães, Guimarães, Portugal
| | - F Almeida
- Department of Cardiology, Hospital Senhora da Oliveira-Guimarães, Guimarães, Portugal
| | - A Lourenço
- Department of Cardiology, Hospital Senhora da Oliveira-Guimarães, Guimarães, Portugal
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Cardoso AF, Dias G, Faria B, Almeida F, Lourenço A. The spells of iatrogeny. Neth Heart J 2023; 31:210-211. [PMID: 36729253 PMCID: PMC10140219 DOI: 10.1007/s12471-023-01761-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 02/03/2023] Open
Affiliation(s)
- A F Cardoso
- Department of Cardiology, Hospital Senhora da Oliveira-Guimarães, Guimarães, Portugal.
| | - G Dias
- Department of Cardiology, Hospital Senhora da Oliveira-Guimarães, Guimarães, Portugal
| | - B Faria
- Department of Cardiology, Hospital Senhora da Oliveira-Guimarães, Guimarães, Portugal
| | - F Almeida
- Department of Cardiology, Hospital Senhora da Oliveira-Guimarães, Guimarães, Portugal
| | - A Lourenço
- Department of Cardiology, Hospital Senhora da Oliveira-Guimarães, Guimarães, Portugal
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Maia J, Rodrigues A, Rouxinol-Dias A, Azevedo B, Leite-Moreira A, Lourenço A, Almeida C. CARDIAC SURGERY ASSOCIATED KIDNEY INJURY: PREDICTORS, BIOMARKERS AND PREVENTION ASSOCIATED COST REDUCTION. J Cardiothorac Vasc Anesth 2022. [DOI: 10.1053/j.jvca.2022.09.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Silva J, Videira RF, Koop AM, Duygu B, Ottaviani L, Poels E, Leite S, van De Kolk KW, du Marchie Sarvaas GJ, Bartelds B, Lourenço A, Nascimento D, Pinto-do-Ó P, Falcão-Pires I, Goumans MJ, Berger R, da Costa Martins PA. MicroRNA-199b is involved in both LV and RV pathological remodeling through distinct molecular mechanisms. J Mol Cell Cardiol 2022. [DOI: 10.1016/j.yjmcc.2022.08.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Almeida-Coelho J, Barez-Lopez S, Borges-Canha M, Carvalho D, Conceição G, Falcão-Pires I, Fontoura D, Gonçalves A, Grijota-Martinez C, Leite AR, Leite S, Leite-Moreira A, Lourenço A, Miranda-Silva D, Obregon MJ, Vale C, Von-Hafe M, Neves JS. OR19-2 Treatment of Heart Failure with Preserved Ejection Fraction (HFpEF) with Low and High Dose of Triiodothyronine: an Animal Model of Metabolic Syndrome with HFpEF. J Endocr Soc 2022. [PMCID: PMC9625197 DOI: 10.1210/jendso/bvac150.1657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Low levels of triiodothyronine (T3) are common in patients with heart failure (HF). It has been proposed that the decreased levels of T3 contribute to metabolic and cardiac dysfunction in HF. We aimed to evaluate the effects of treatment with low dose and high dose of T3 in an animal model of HF with preserved ejection fraction (HFpEF). Materials and Methods We evaluated four groups: ZSF1 Lean (Lean-Ctrl, n=8), ZSF1 obese (rat model of metabolic syndrome with HFpEF, HFpEF-Ctrl, n=13), ZSF1 obese supplemented with a replacement dose of T3 (initially 0.04mg/ml, increased to 0.06mg/ml after 4 weeks; HFpEF-T3high, n=8), and ZSF1 Obese supplemented with a low-dose of T3 (0.03mg/mL; HFpEF-T3low, n=8). T3 was supplemented in drinking water from week 13 to 24. The animals were submitted to anthropometric and metabolic evaluation, echocardiography, VO2max evaluation, hemodynamic evaluation, single cardiomyocyte evaluation, and myocardial tissue collection at 24 weeks. Results HFpEF-Ctrl animals had lower serum and myocardial thyroid hormone levels than Lean-Ctrl. Treatment with low dose and high dose of T3 did not correct serum T3 levels, but increased myocardial T3 levels, with normalization of myocardial T3 levels in the HFpEF-T3high group. In comparison to HFpEF-Ctrl, body weight was significantly decreased in HFpEF-T3low and HFpEF-T3high groups (616±39g, 572±24g and 535±18g respectively, p<0.001). An improvement in glucose metabolism was observed only in HFpEF-T3high, with a decreased AUC of glucose during OGTT and insulin tolerance test. Both treated groups presented an improvement in diastolic function (with decreased isovolumetric relaxation time) and systolic function (with increased peak systolic velocity and decreased ejection time) comparing to HFpEF-Ctrl. These results were supported by enhanced Ca2+ transients during diastole and sarcomere relaxation. Comparing with HFpEF-Ctrl, animals treated with T3 had higher myocardial expression of the calcium transporter RYR2, of the transcriptional coactivator PGC-1α, and of the α-myosin heavy chain (MHC), with a lower expression of β-MHC. VO2max was improved with low-dose and high-dose T3 compared with HFpEF-Ctrl. Comparing with HFpEF-Ctrl, heart rate was increased with high-dose (277.9±30.2 vs 313.5±35.8, p=0.049) but not significantly with low-dose (277.9±30.2 vs 299.8±30.9 bpm, p=0.13). Mortality was increased in the HFpEF-T3high comparing with the other groups (no animals died during the protocol in the Lean-Ctrl, HFpEF-Ctrl and HFpEF-T3low groups; three animals had sudden death in the HFpEF-T3high group). Conclusion Treatment with T3 improves metabolic function, myocardial calcium handling, diastolic and systolic function, and exercise capacity in this animal model of HFpEF. While the low dose was well tolerated and safe, the high dose was associated with increased heart rate and a higher risk of sudden death. Modulation of thyroid hormones may be a potential therapeutic target in HFpEF; however such approaches must take into account a narrow therapeutic window of T3 in HFpEF. Presentation: Monday, June 13, 2022 11:15 p.m. - 11:30 a.m.
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Canha MB, Neves JS, Sousa-Mendes C, Conceição G, Leite AR, Madalena VH, Vale C, Fontoura D, Miranda-Silva D, Leite S, Gonçalves A, Almeida-Coelho J, Falcão-Pires I, Carvalho D, Leite-Moreira A, Lourenço A. RF36 | PSUN101 Liver and Adipose Tissue Effects of Triiodothyronine Treatment in an Animal Model of Metabolic Syndrome. J Endocr Soc 2022. [PMCID: PMC9624791 DOI: 10.1210/jendso/bvac150.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Metabolic syndrome (MS) associates to obesity and non-alcoholic fatty liver disease (NAFLD). Besides its high and rising prevalence, the therapeutical options are scarce. Studies show that thyroid hormones (TH) may ameliorate hepatic function and hepatic and extra-hepatic lipid deposition. Aim To evaluate the effects of triiodothyronine (T3) treatment in high and low dose on the liver and adipose tissue of an animal model of metabolic syndrome (ZSF1 rats). Material and methods Four groups of animals were evaluated: 1) ZSF1 lean rats (Ln, used as controls; n=8); 2) untreated ZSF1 obese rats (Ob; animal model of MS; n=10); 3) ZSF1 obese rats treated with high dose T3 (hT3; initially 0.04mg/mL and 0.06mg/mL after 4 weeks; n=5); 4) ZSF1 obese rats treated with low dose T3 (lT3; 0.03mg/mL; n=5). We performed anthropometric and oral glucose tolerance testing (OGTT). Tissues and blood were collected at the 24th week of age for histological evaluation and assessing the levels of thyroid hormones. Results The animals from hT3 and lT3 groups had similar weights and both were significantly heavier (tibial length/weight ratio of 14.7±0.6 and 14.1±0.7g/mm respectively) than Ln (10.7±0.6g/mm, p<0.01). The rats from lT3 group were also significantly lighter than Ob (15.3±1.0g/mm, p=0.042). Fasting glucose of hT3 (118.6±36.0mg/dL) was lower comparing to Ob (228.1±58.6mg/dL, p<0.01) and to lT3 (207.2±69.8mg/dL, p=0.048) and similar to Ln (82.1±9.1mg/dL, p=1.00). The evaluation of the area under the curve (AUC) of OGTT is in agreement with these results. The histological evaluation of the liver showed a ratio between lipids and surrounding tissue significantly lower in the treated groups (hT3 0.35±0.1 and lT3 0.34±0.1) compared to Ob (0.89±0.2, p<0.01) and similar to Ln (0.14±0.1, p=0.106 and p=0.124, respectively). The ratio between glycogen and surrounding tissue was not different between treated animals and either Ob or Ln. Concerning the adipose tissue, adipocyte area was similar between treated animals (hT3 7435±1031mm2 and lT3 6899±554mm2, p=1.00) and was significantly lower compared to Ob (9037±789mm2, p<0.01) and higher compared to Ln (2771±754mm2, p<0.01). The area of fibrosis was similar between hT3 and lT3 (7.7±1.1mm and 6.6±0. 5mm, respectively, p=1. 00), higher when comparing both groups with Ln (2.4±1.3mm, p<0.01) and lower when comparing both groups with Ob (13.5±2.2mm, p<0.01). Conclusion Treatment of obese ZSF1 animals with T3 improved the glycemic profile, and lipid and fibrous deposition in the liver and adipose tissue. The usage of low dose T3 does not seem different from high dose concerning these effects and might be associated with fewer adverse events. TH may, in the future, become an option when treating patients with MS and NAFLD. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m., Monday, June 13, 2022 12:42 p.m. - 12:47 p.m.
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Silva B, Saraiva F, Cerqueira R, Sousa F, S Barros A, Lourenço A, Almeida J, J Amorim M, Pinho P, Leite-Moreira A. Aortic Valve Surgery in Patients with Infective Endocarditis: Mid-Term Follow-up of Patients Treated With the ST. Jude Medical Trifecta Valve. Port J Card Thorac Vasc Surg 2022; 29:21-27. [PMID: 36197823 DOI: 10.48729/pjctvs.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND It is particularly difficult to choose the appropriate prosthesis to treat infective endocarditis. OBJECTIVES To investigate the outcomes after aortic valve replacement with a stented bioprosthesis (Trifecta) in patients with active or previous infective endocarditis. METHODS We performed a single-centre, retrospective study including consecutive patients with infective endocarditis who underwent aortic valve replacement between July 2011 and June 2019. Survival and reintervention were assessed as of December 2021. Hospital mortality was defined as death in-hospital or within 30-days of surgery. Kaplan-Meier method was used for time-to-event outcome assessment (all-cause mortality and reoperation). Data are median (minimum and maximum) or absolute (relative) frequencies. RESULTS We included 51 patients, median age of 69 (40 to 87) years, 78% male. The median follow-up time was 5.4 years and the maximum was 10 years. Most patients (71%) had native valve infective endocarditis and 16% had previous endocarditis. Surgery was urgent in 82%. Hospital mortality occurred in 10 patients (20%). After excluding these patients, 1-, 3-, 6-, and 9-years cumulative survival rates were 93%, 78%, 72%, and 72%, respectively. There were five bioprosthesis-related reoperations: 4 due to endocarditis at 1-year, 3-years, and 5-years on follow-up (n=1, 1 and 2, respectively) and 1 due to non-structural deterioration, 6-years after surgery. CONCLUSIONS Despite the small sample size, this report supports a satisfactory performance profile of the Trifecta bioprosthesis in the treatment of infective endocarditis.
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Affiliation(s)
- Bruno Silva
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal
| | - Francisca Saraiva
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal
| | - Rui Cerqueira
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal; Department of Cardiothoracic Surgery, Centro Hospitalar Universitário de São João, Portugal
| | - Francisca Sousa
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal
| | - António S Barros
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal
| | - André Lourenço
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal; Department of Anaesthesiology, Centro Hospitalar Universitário de São João, Portugal
| | - Jorge Almeida
- Department of Cardiothoracic Surgery, Centro Hospitalar Universitário de São João, Portugal
| | - Mário J Amorim
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal; Department of Cardiothoracic Surgery, Centro Hospitalar Universitário de São João, Portugal
| | - Paulo Pinho
- Department of Cardiothoracic Surgery, Centro Hospitalar Universitário de São João, Portugal
| | - Adelino Leite-Moreira
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal; Department of Cardiothoracic Surgery, Centro Hospitalar Universitário de São João, Portugal
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Ribeiro M, Lourenço A, Lemos M, Bastos J, Pereira J. A review: Circadian Rhythm Dysfunction and Bipolar Disorder. Eur Psychiatry 2022. [PMCID: PMC9567115 DOI: 10.1192/j.eurpsy.2022.1035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction Circadian rhythm (CR) dysfunction is a prominent feature in bipolar disorder (BD) and sleep disturbances are characteristic, although not essential to the diagnosis. Objectives To review the literature regarding the CR dysfunction and its impact on the onset and clinical course of BD. Methods We conducted a MEDLINE search using bipolar disorder, circadian rhythm and sleep as keywords, selecting studies written in English. Results CR dysfunction is a trait marker of BD. It’s known that during depressive episodes insomnia is present, with difficulty falling asleep/ maintaining sleep and early awakening. Regarding mania, decreased need for sleep is a critical marker. During the euthymic period significant alterations in sleep pattern have been described. It’s also known that changes in the sleep pattern occur prior to those in mood patterns, indicating that sleep dysregulation may trigger the onset of mood episodes or relapses. Therefore, CR disruption may be associated with the pathophysiology of BD and some factors have already been identified: irregularity of the sleep-wake rhythm, eveningness chronotype, abnormality of melatonin secretion, vulnerability of clock genes and the irregularity of social zeitgeber. Conclusions Disturbances of sleep are pervasive, and an essential feature of BD, worse during mood episodes, but still present during euthymic periods. It remains to determine whether circadian rhythm dysfunction is a trait marker or mood state dependent. Further studies are warranted to clarify this association. Disclosure No significant relationships.
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Lemos M, Lourenço A, Ribeiro M. Psychiatric manifestations of paraneoplastic syndromes. Eur Psychiatry 2022. [PMCID: PMC9567621 DOI: 10.1192/j.eurpsy.2022.1698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction Paraneoplastic syndromes (PS) result from indirect effects of neoplasms. In 50% of the cases the symptoms precede the diagnosis and run independently. PS may involve the peripheral or central nervous system, resulting in symptoms from sensory neuropathies to several neuropsychiatric manifestations. Objectives To review the psychiatric manifestations of paraneoplastic syndromes affecting the nervous system. Methods Selective literature review via PubMed search, using the keywords “paraneoplastic syndromes”, “endrocrine paraneoplastic syndromes”, “neuropsychiatric manifestations”, “limbic encephalitis”. Results The prevalence of PS varies with the type of cancer (<1% for breast and ovarian cancers; 3-5% for small cell lung cancer; 20% for thymomas). The general mechanisms behind PS are related to the production of substances by the tumor that directly or indirectly cause distant symptoms, the depletion of substances or the host response to the tumor. Frequently there are autoimmune phenomena involved, with the production of antineuronal antibodies that recognise various antigens at the nervous system. Paraneoplastic neurological disorders include limbic encephalits that can present subacutely with symptoms of depression, irritability, hallucinations, cognitive impairment associated with sleep alterations, confusion and seizures. Others include psoclonus-myoclonus ataxia syndrome, neuromyotonia and cramp fasciculation syndrome. Metabolic and endocrine paraneoplastic syndromes (hypercortisolism, carcinoid tumors, pancreatic cancer) can result from the production of cytokines and hormones by the tumor and produce mood disorders, confusional states and psychosis. Conclusions PS can be related to various neuropsychiatric manifestations affecting consciousness, cognition, mood and perception. The recognition of this association can alert for the possibility of a cancer diagnosis specially when facing a patient with unusual clinical presentation. Disclosure No significant relationships.
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Reynolds De Sousa T, Ribeiro M, Lourenço A, Novais F. Anhedonia. Depressive versus negative symptom. Eur Psychiatry 2022. [PMCID: PMC9562733 DOI: 10.1192/j.eurpsy.2022.570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Anhedonia is a symptom usually, and probably simplistically, defined as the inability to experience pleasure. It is considered one of the core symptoms of depression and a negative symptom of schizophrenia.
Objectives
We intend to explore whether previous studies found common or dissimilar experiences of anhedonia in depression and schizophrenia.
Methods
We performed a review of the published literature on the subject using PubMed. We conducted a search using ‘anhedonia’, ‘schizophrenia’, and ‘depression’ as keywords.
Results
There is different and diverging evidence on the matter. Historical reports associated schizophrenia with trait anhedonia, and depression with state anhedonia. More recently, some authors correlated appetitive anhedonia (lack of interest/desire) with schizophrenia, and consummatory anhedonia (lack of pleasure/enjoyment) with depression, but this was not corroborated by other studies. However, in line with it, there are findings of a normal physiological response to pleasurable stimuli among schizophrenics. Some authors propose that, in schizophrenia, this symptom might not represent an inability to feel pleasure but rather a deficient expression of its experience, as a part of blunted affect. Reward models highlight a deficit in reward learning in depression, but disorganization of reward processing and a focus on irrelevant clues in schizophrenia, which prevent patients from pursuing a pleasurable experience.
Conclusions
There are still limited studies comparing the experience of anhedonia in depression and schizophrenia. There seem to be significant differences between the two, but further studies are needed. In particular, this could be important in screening schizophrenic patients for depression.
Disclosure
No significant relationships.
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Lourenço A, Ribeiro M, Lemos M, Duarte A, Neves A. Global world, global hospitals. Ethnic differences and psychotic symptoms presentation – a review. Eur Psychiatry 2022. [PMCID: PMC9568105 DOI: 10.1192/j.eurpsy.2022.1622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction We live in a global world, where immigration is no longer just an escape, but also a demand and a desire. Globalization imposes the challenge of recognizing psychiatric illness in the most diverse of patients. Objectives To review the literature about the documentation of ethnic differences and the psychotic symptoms presentation. Methods We performed a MEDLINE search using the key words: ethnic differences and psychotic symptoms. We only included studies with full text published in English. Results
Since the 1970s, some studies have shown that there are differences in the manifestation of psychiatric illness in ethnic minorities. Most recent studies confirm this statement, mainly with an increase in immigration in the 20th century, with the receiving countries having an increase in the number of cases of psychosis (affective and non-affective). Belonging to an ethnic minority increases the risk of psychotic symptoms and experiences, witch is related to the patients perception of discrimination, social differences, family separation and the stress associated with immigration. On the other hand, these groups also have less access to health care. Conclusions Currently, professionals are more aware of the global world and what this implies in the manifestations of psychiatric illnesses. However, more studies will be needed to identify these natural differences. In this way, we will be able to help our patients anywhere and support their families. Disclosure No significant relationships.
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Duarte A, Laginhas C, Lourenço A, Simões I, Martins P. Is Praecox Feeling at risk of extinction? Eur Psychiatry 2022. [PMCID: PMC9567006 DOI: 10.1192/j.eurpsy.2022.569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Praecox feeling (PF) is a characteristic feeling of bizarreness or unease that a psychiatrist experiences when facing a patient with schizophrenia. This term, proposed by Rumke in 1941, was considered an important feature of a schizophrenia diagnosis. However, since the movement toward operational diagnostic methods in the late 1970s, it has fallen out of use. Objectives This work aims to discuss the role of Praecox Feeling in the clinical approach to schizophrenia diagnosis. Methods PubMed database was searched using combinations of the terms “praecox”, combined with “feeling” and “schizophrenia”. Results PF is sometimes experienced silently before the patient participates verbally. An experienced and attentive clinician can intuitively feels changes in the body posture, facial expression, the tone of the voice, motor behavior, and attitude that could look insignificant, but as a whole they present the patient as “definitely un-understandable.” Although there is lacking evidence to sustain the rehabilitation of the PF as a reliable and valid clinical criterion consistent with the operational approach, a broader scientific approach is called for. PF should not be trivialized, as is sometimes the case, into a quick diagnosis but could be a real determinant of medical decision. Conclusions Even though there may not be sufficient evidence to consider it valid clinical diagnostic criteria, it still appears to play an important role in the clinical decision-making process and should not be underestimated or stigmatized. This concept is not completely subjective and does rely on objective information, such as the patient’s behaviour and body language. Disclosure No significant relationships.
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Ribeiro M, Lourenço A, Lemos M, Duarte A. Levothyroxine supplementation among individuals with Subclinical Hypothyroidism and Depression | a review. Eur Psychiatry 2022. [PMCID: PMC9568179 DOI: 10.1192/j.eurpsy.2022.1437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Depression is known to be associated with changes in the hypothalamic-pituitary-thyroid axis and the brain is a major target organ for thyroid hormone. Overt hypothyroidism can cause symptoms compatible with depression. However, its relationship with subclinical hypothyroidism (SCH) is not well established. Objectives To review the literature regarding the effect of levothyroxine therapy among patients with SCH and coexistent depression. Methods We conducted a MEDLINE search using depression, subclinical hypothyroidism and levothyroxine as keywords, selecting studies written in English. Results SCH is defined as an elevated thyroid stimulating hormone with normal peripheric hormone levels. The association between SCH and depression is controversial. Some studies indicate that SCH had the same propensity with overt hypothyroidism, while others report that major affective symptoms are not associated with SCH, but are likely due to independent psychiatric diagnoses, which are common in the general population and occur with similar frequency in patients with SCH. Individuals with SCH are recommended to initiate levothyroxine replacement therapy only when their TSH level is above 10 mIU/L or if symptoms are present. There is a lack of evidence supporting the use of levothyroxine therapy to improve mental health outcomes and the majority of meta-analysis do not show relief of affective symptoms after levothyroxine therapy, among individuals with SCH. Conclusions Routine screening for depressive symptoms among individuals with SCH is important to prevent morbidity. Nevertheless, there is no evidence enduring levothyroxine supplementation in these cases. Further studies, with larger sample sizes and longer follow-up periods are needed to enlighten the potential benefit of this therapy. Disclosure No significant relationships.
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Lourenço A, Ribeiro M, Lemos M. Hospital environment and patient recovery – a review. Eur Psychiatry 2022. [PMCID: PMC9568128 DOI: 10.1192/j.eurpsy.2022.1946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Since the second half of the 20th century, studies have been carried out that prove the benefits of the hospital environment in the improvement and recovery of patients. In this way, it would be important to understand what has already been done within the reality of Psychiatry Department. Objectives To review the literature about the documentation of hospital environment influence in patients’ recovery. Methods We performed a MEDLINE search using the key words: hospital environment influence and patients’ recovery or patients healing. We only included studies with full text published in English. Results In the selected articles, we only found studies developed in the Surgery department; in one of them, the authors tested the presence of plants in the patients’ rooms and assessed lower blood pressure values, less pain and less anxiety than the control group; in another, they tested the presence of music and landscape, although there was no difference in terms of pain assessment, there was an improvement in the assessment of the postoperative experience. A review pointed some other aspects that patients linked with their recovery, such as: audio and visual environment; specifically, in anxiety, pain and stress. On the other hand, other studies address the influence of the hospital environment on the satisfaction of health care providers. Conclusions Although hospital environment has already demonstrated an impact on the patient recovery, none (in our review) was developed directly in a Psychiatric Department; further studies are needed to understand the impact on this kind of service. Disclosure No significant relationships.
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Cook H, Simard M, Niemann N, Gillies C, Palmans H, Hussein M, Bouchard H, Royle G, Lourenço A. OC-0937 Optimising tissue-equivalent materials for proton therapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02717-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cook H, Lambert J, Thomas R, Palmans H, Hussein M, Clark CH, Royle G, Pettingell J, Lourenço A. Development of a heterogeneous phantom to measure range in clinical proton therapy beams. Phys Med 2022; 93:59-68. [PMID: 34968893 DOI: 10.1016/j.ejmp.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/16/2021] [Accepted: 11/20/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE In particle therapy, determination of range by measurement or calculation can be a significant source of uncertainty. This work investigates the development of a bespoke Range Length Phantom (RaLPh) to allow independent determination of proton range in tissue. This phantom is intended to be used as an audit device. METHOD RaLPh was designed to be compact and allows different configurations of tissue substitute slabs, to facilitate measurement of range using radiochromic film. Fourteen RaLPh configurations were tested, using two types of proton fluence optimised water substitutes, two types of bone substitute, and one lung substitute slabs. These were designed to mimic different complex tissue interfaces. Experiments were performed using a 115 MeV mono-energetic scanning proton beam to investigate the proton range for each configuration. Validation of the measured film ranges was performed via Monte Carlo simulations and ionisation chamber measurements. The phantom was then assessed as an audit device, by comparing film measurements with Treatment Planning System (TPS) predicted ranges. RESULTS Varying the phantom slab configurations allowed for measurable range differences, and the best combinations of heterogeneous material gave agreement between film and Monte Carlo on average within 0.2% and on average within 0.3% of ionisation chamber measurements. Results against the TPS suggest a material density override is currently required to enable the phantom to be an audit device. CONCLUSION This study found that a heterogeneous phantom with radiochromic film can provide range verification as part of a dedicated audit for clinical proton therapy beams.
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Affiliation(s)
- H Cook
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom; Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom.
| | - J Lambert
- Medical Physics Department, The Rutherford Cancer Centre South Wales, Newport NP10 8FZ, United Kingdom
| | - R Thomas
- Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
| | - H Palmans
- Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom; Medical Physics Group, MedAustron Ion Therapy Center, A-2700 Wiener Neustadt, Austria
| | - M Hussein
- Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
| | - C H Clark
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom; Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom; Radiotherapy Physics, University College London Hospital, NW1 2BU, United Kingdom; Radiotherapy Trials Quality Assurance Group (RTTQA), Mount Vernon Cancer Centre, HA6 2RN, United Kingdom
| | - G Royle
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom
| | - J Pettingell
- Medical Physics Department, The Rutherford Cancer Centre South Wales, Newport NP10 8FZ, United Kingdom
| | - A Lourenço
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, United Kingdom; Medical Radiation Science, National Physical Laboratory, Teddington, TW11 0LW, United Kingdom
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Cunha PS, Laranjo S, Lourenço A, Rodrigues L, Cardoso I, Portugal G, Valente B, Delgado AS, Ferreira RC, Abreu A, Oliveira MM. Lockdown measures for COVID-19 outbreak and variation in physical activity in patients with heart failure and cardiac implantable devices. Int J Cardiol Heart Vasc 2021; 37:100906. [PMID: 34725644 PMCID: PMC8552563 DOI: 10.1016/j.ijcha.2021.100906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/16/2021] [Accepted: 10/24/2021] [Indexed: 10/27/2022]
Abstract
Aims The present study analysed the patterns of physical activity pre-, during and post-lockdown measures for COVID-19 pandemic in patients with chronic heart failure (CHF) and cardiac implantable electronic devices (CIED) under remote monitoring (RM), and assessed the physical activity patterns during these periods. Methods The raw data from 95 patients with CHF (age 67,7 ± 15,1 years, 71,5% male) corresponding to 2238 RM transmissions of the Medtronic Carelink™ network platform was obtained. The physical exercise profiles and the impact of the lockdown measures on the physical behaviour during and after the measures were analysed. According to the level of activity duration in the pre-lockdown, lockdown and post-lockdown periods, the patterns of behaviour were identified (non-recoverees, incomplete recoverees, recoverees and full-recoverees). Conclusion RM of CHF patients with CIED using the Carelink™ network is useful for close follow-up and identification of heart failure risk status variations. After relieving the confinement measures there were two groups of patients that did not recover the previous physical activity levels. Physical inactivity in patients with CHF can have a significant impact on outcomes.
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Affiliation(s)
- Pedro Silva Cunha
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central Lisbon Hospital University Centre, Portugal
| | - Sérgio Laranjo
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central Lisbon Hospital University Centre, Portugal.,Cardiovascular Rehabilitation Center, Faculty of Medicine, University of Lisbon, Portugal
| | - André Lourenço
- ISEL, Instituto Superior de Engenharia de Lisboa, Portugal
| | | | - Isabel Cardoso
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central Lisbon Hospital University Centre, Portugal
| | - Guilherme Portugal
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central Lisbon Hospital University Centre, Portugal
| | - Bruno Valente
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central Lisbon Hospital University Centre, Portugal
| | - Ana Sofia Delgado
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central Lisbon Hospital University Centre, Portugal
| | - Rui Cruz Ferreira
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central Lisbon Hospital University Centre, Portugal
| | - Ana Abreu
- Cardiovascular Rehabilitation Center, Faculty of Medicine, University of Lisbon, Portugal
| | - Mário Martins Oliveira
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central Lisbon Hospital University Centre, Portugal.,Cardiovascular Rehabilitation Center, Faculty of Medicine, University of Lisbon, Portugal
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Almeida D, Costa J, Lourenço A. ECG simulator with configurable skin-electrode impedance and artifacts emulation. Biomed Phys Eng Express 2021; 7. [PMID: 34587605 DOI: 10.1088/2057-1976/ac2b4e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/29/2021] [Indexed: 11/11/2022]
Abstract
Electrocardiograms (ECG) recorded from everyday objects, such as wearables, fitness machines or smart steering wheels are becoming increasingly common. Applications are diverse and include health monitoring, athletic performance optimization, identification, authentication, and entertainment. In this study we report the design and implementation of an innovative ECG simulator, providing simulation of signal related artifacts and a dynamically adjustable skin-electrode interface model. The ECG simulator includes a unique combination of features: emulation of time dependent skin-electrode impedance, adjustable differential and common-mode interference, generation of lead-off events and analog front-end output digitalization. The skin-electrode capacitance range is 1 nF-255 nF and the resistance span is 4 kΩ-996 kΩ. System's functionality is demonstrated using a commercially available ECG front-end. The simulated SNR degradation introduced by the ECG simulator is under 0.1 dB. Results show that the skin-electrode interface can have a significant impact in the acquired waveforms. Impedance electrode imbalance, specifically of the resistive component, can generate artifacts which can be misinterpreted has arrhythmias. The proposed device can be useful for hardware and software ECG development and for training physicians and nurses to readily recognize skin-electrode impedance related artifacts.
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Affiliation(s)
- Daniel Almeida
- ISEL-Instituto Superior de Engenharia de Lisboa, Instituto Politécnico de Lisboa, Lisboa, Portugal.,CTS-UNINOVA, Caparica, Portugal.,FCT-UNL, Caparica, Portugal
| | - João Costa
- ISEL-Instituto Superior de Engenharia de Lisboa, Instituto Politécnico de Lisboa, Lisboa, Portugal.,CTS-UNINOVA, Caparica, Portugal
| | - André Lourenço
- ISEL-Instituto Superior de Engenharia de Lisboa, Instituto Politécnico de Lisboa, Lisboa, Portugal.,Instituto de Telecomunicações (IT), Lisboa, Portugal.,CardioID Technologies, Portugal
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Videira RF, Koop AMC, Ottaviani L, Poels EM, Kocken JMM, Dos Remedios C, Mendes-Ferreira P, Van De Kolk KW, Du Marchie Sarvaas GJ, Lourenço A, Llucià-Valldeperas A, Nascimento DS, de Windt LJ, De Man FS, Falcão-Pires I, Berger RMF, da Costa Martins P. The adult heart requires baseline expression of the transcription factor Hand2 to withstand RV pressure overload. Cardiovasc Res 2021; 118:2688-2702. [PMID: 34550326 PMCID: PMC9491876 DOI: 10.1093/cvr/cvab299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Indexed: 11/14/2022] Open
Abstract
AIMS Research on the pathophysiology of right ventricular (RV) failure has, in spite of the associated high mortality and morbidity, lagged behind compared to the left ventricle (LV).Previous work from our lab revealed that the embryonic basic helix-loop-helix transcription factor heart and neural crest derivatives expressed-2 (Hand2) is re-expressed in the adult heart and activates a 'fetal gene program' contributing to pathological cardiac remodeling under conditions of LV pressure overload. As such, ablation of cardiac expression of Hand2 conferred protection to cardiac stress and abrogated the maladaptive effects that were observed upon increased expression levels. In this study, we aimed to understand the contribution of Hand2 to RV remodeling in response to pressure overload induced by pulmonary artery banding (PAB). METHODS AND RESULTS In the present study, Hand2F/F and MCM- Hand2F/F mice were treated with tamoxifen (control and knockout, respectively) and subjected to six weeks of RV pressure overload induced by PAB. Echocardiographic- and MRI-derived hemodynamic parameters as well as molecular remodeling were assessed for all experimental groups and compared to sham-operated controls. Six weeks after PAB, levels of Hand2 expression increased in the control banded animals but, as expected, remained absent in the knockout hearts. Despite the dramatic differences in Hand2 expression, pressure overload resulted in impaired cardiac function independently of the genotype. In fact, Hand2 depletion seems to sensitize the RV to pressure overload as these mice develop more hypertrophy and more severe cardiac dysfunction. Higher expression levels of HAND2 were also observed in RV samples of human hearts from patients with pulmonary hypertension. In turn, the LV of RV-pressure overloaded hearts was also dramatically affected as reflected by changes in shape, decreased LV mass and impaired cardiac function. RNA sequencing revealed a distinct set of genes that are dysregulated in the pressure-overloaded RV, compared to the previously described pressure-overloaded LV. CONCLUSIONS Cardiac-specific depletion of Hand2 is associated with severe cardiac dysfunction in conditions of RV pressure overload. While inhibiting Hand2 expression can prevent cardiac dysfunction in conditions of LV pressure overload, the same does not hold true for conditions of RV pressure overload. This study highlights the need to better understand the molecular mechanisms driving pathological remodeling of the RV in contrast to the LV, in order to better diagnose and treat patients with RV or LV failure. TRANSLATIONAL PERSPECTIVE RV failure associated with pulmonary hypertension reduces long-term survival rate to 55% within 3 years, suggesting that 3 years after diagnosis almost half of the patients will die. To revert these numbers an adequate RV-specific and, therefore, more efficient treatment is needed. Our work suggests that current therapies and potential mechanisms underlying LV failure may not be suitable for RV failure. While Hand2 deletion is favorable in LV response to stress, it is particularly detrimental in the RV under similar conditions, and thus, highlighting potential severe consequences of not differentiating therapeutic targets or treatment for RV or LV failure.
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Affiliation(s)
- R F Videira
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Molecular Genetics, Faculty of Sciences and Engineering, Maastricht University, Maastricht, The Netherlands.,Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Porto, Portuga
| | - A M C Koop
- University of Groningen, University Medical Center Groningen, Department of Pediatrics, Center for Congenital Heart Diseases, Groningen, Netherlands
| | - L Ottaviani
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Molecular Genetics, Faculty of Sciences and Engineering, Maastricht University, Maastricht, The Netherlands
| | - E M Poels
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - J M M Kocken
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Molecular Genetics, Faculty of Sciences and Engineering, Maastricht University, Maastricht, The Netherlands
| | - C Dos Remedios
- University of Sidney, Sidney, and Victor Chang Cardiac Research Institute, Darlinghurst, Australia
| | - P Mendes-Ferreira
- Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Porto, Portuga
| | - K W Van De Kolk
- University Medical Center Groningen, The Central Animal Facility, Groningen, Netherlands.,University Medical Center Groningen, Gronsai (Groningen Small Animal Imaging Facility), Groningen, Netherlands
| | - G J Du Marchie Sarvaas
- University of Groningen, University Medical Center Groningen, Department of Pediatrics, Center for Congenital Heart Diseases, Groningen, Netherlands
| | - A Lourenço
- Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Porto, Portuga
| | - A Llucià-Valldeperas
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Pulmonary Medicine, PHEniX laboratory, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - D S Nascimento
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,INEB-Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal.,ICBAS-Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal
| | - L J de Windt
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Molecular Genetics, Faculty of Sciences and Engineering, Maastricht University, Maastricht, The Netherlands
| | - F S De Man
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Pulmonary Medicine, PHEniX laboratory, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - I Falcão-Pires
- Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Porto, Portuga
| | - R M F Berger
- University of Groningen, University Medical Center Groningen, Department of Pediatrics, Center for Congenital Heart Diseases, Groningen, Netherlands
| | - Paula da Costa Martins
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Molecular Genetics, Faculty of Sciences and Engineering, Maastricht University, Maastricht, The Netherlands.,Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Porto, Portuga
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Velo-Antón G, Lourenço A, Galán P, Nicieza A, Tarroso P. Landscape resistance constrains hybridization across contact zones in a reproductively and morphologically polymorphic salamander. Sci Rep 2021; 11:9259. [PMID: 33927228 PMCID: PMC8085075 DOI: 10.1038/s41598-021-88349-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/07/2021] [Indexed: 02/02/2023] Open
Abstract
Explicitly accounting for phenotypic differentiation together with environmental heterogeneity is crucial to understand the evolutionary dynamics in hybrid zones. Species showing intra-specific variation in phenotypic traits that meet across environmentally heterogeneous regions constitute excellent natural settings to study the role of phenotypic differentiation and environmental factors in shaping the spatial extent and patterns of admixture in hybrid zones. We studied three environmentally distinct contact zones where morphologically and reproductively divergent subspecies of Salamandra salamandra co-occur: the pueriparous S. s. bernardezi that is mostly parapatric to its three larviparous subspecies neighbours. We used a landscape genetics framework to: (i) characterise the spatial location and extent of each contact zone; (ii) assess patterns of introgression and hybridization between subspecies pairs; and (iii) examine the role of environmental heterogeneity in the evolutionary dynamics of hybrid zones. We found high levels of introgression between parity modes, and between distinct phenotypes, thus demonstrating the evolution to pueriparity alone or morphological differentiation do not lead to reproductive isolation between these highly divergent S. salamandra morphotypes. However, we detected substantial variation in patterns of hybridization across contact zones, being lower in the contact zone located on a topographically complex area. We highlight the importance of accounting for spatial environmental heterogeneity when studying evolutionary dynamics of hybrid zones.
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Affiliation(s)
- Guillermo Velo-Antón
- grid.5808.50000 0001 1503 7226CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos da Universidade do Porto, Instituto de Ciências Agrárias de Vairão. R. Padre Armando Quintas, 4485-661 Vairão, Portugal ,grid.6312.60000 0001 2097 6738Universidade de Vigo, Grupo de Ecoloxía Animal, Departamento de Ecoloxía e Bioloxía Animal, Torre Cacti (Lab 97), 36310 Vigo, Spain
| | - André Lourenço
- grid.5808.50000 0001 1503 7226CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos da Universidade do Porto, Instituto de Ciências Agrárias de Vairão. R. Padre Armando Quintas, 4485-661 Vairão, Portugal ,grid.5808.50000 0001 1503 7226Departamento de Biologia da Faculdade de Ciências, Universidade do Porto. Rua Campo Alegre, 4169-007 Porto, Portugal
| | - Pedro Galán
- grid.8073.c0000 0001 2176 8535Grupo de Investigación en Bioloxía Evolutiva (GIBE), Departamento de Bioloxía, Facultade de Ciencias, Universidade da Coruña, Campus da Zapateira, s/n, 15071 A Coruña, Spain
| | - Alfredo Nicieza
- grid.10863.3c0000 0001 2164 6351Departamento de Biologıa de Organismos y Sistemas, Universidad de Oviedo, Oviedo, Spain ,grid.10863.3c0000 0001 2164 6351Unidad Mixta de Investigacion en Biodiversidad (UMIB), CSIC-Universidad de Oviedo-Principado de Asturias, Mieres, Spain
| | - Pedro Tarroso
- grid.5808.50000 0001 1503 7226CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos da Universidade do Porto, Instituto de Ciências Agrárias de Vairão. R. Padre Armando Quintas, 4485-661 Vairão, Portugal
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Figueiredo-Vázquez C, Lourenço A, Velo-Antón G. Riverine barriers to gene flow in a salamander with both aquatic and terrestrial reproduction. Evol Ecol 2021. [DOI: 10.1007/s10682-021-10114-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Viegas FG, Ferreira F, Figueiredo I, Lourenço A. To what extent do sexual hormones influence bipolar disorder? Eur Psychiatry 2021. [PMCID: PMC9480242 DOI: 10.1192/j.eurpsy.2021.1650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction It is known that female reproductive events and hormonal treatments can impact the course of bipolar disorder (BD) in women, some of whom are more vulnerable to the development of mood instability under periods of hormonal fluctuation. The mechanisms involved are, however, largely unknown. The aim of this work is to review the impact of sexual hormones on the course of BD, regarding a clinical case. Objectives To explore the role of sexual hormones in BD. Methods Literature review using Medline database. Results This is a case of a 36-year-old woman with type 1 BD who develops a manic episode after starting oral contraception (OC). This episode remitted with suspension of the pill. Estrogen and progesterone are involved in various aspects of brain function, such as brain development, synaptic plasticity, and modulation of neurotransmitter systems. Studies indicate that there is a relationship between ovarian hormones and intracellular signaling systems involved in the pathophysiology of BD. However, research on OC use in patients with mood disorders is limited. Recent studies state that OC aren’t associated with a worse clinical course and don’t negatively influence BD, while other studies show there is a subgroup of bipolar women that improve with hormonal stability, while others get worse. Conclusions Further studies are needed to determine possible relationships between sexual hormones and BD, and it is essential to identify patients vulnerable to these risks by measuring baseline hormone levels, assessing hormone sensitivity through a history of mood changes during menstrual cycle and a history of previous mental health problems. Disclosure No significant relationships.
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Viegas FG, Figueiredo I, Ferreira F, Lourenço A. Use of botulinum toxin type a in psychiatry - new perspectives and future potential. Eur Psychiatry 2021. [PMCID: PMC9475595 DOI: 10.1192/j.eurpsy.2021.1283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction For almost three decades, botulinum toxin type A (BT-A) has been used for medical purposes. Evidence of the potential use of BT-A is emerging for psychiatric disorders, like unipolar and bipolar depression, borderline personality disorder (BPD), late dyskinesia, amongst others. This may represent a new role of BT-A treatment and could expand the therapeutic arsenal in psychiatry. Objectives The goal is to review current evidence regarding BT-A and psychiatry disorders. Methods Literature review of BT-A use in psychiatric conditions using Medline database. Results There’s evidence supporting the use of BT-A in resistant unipolar depression, with studies showing an 8 and 4 times higher response and remission rates comparing with placebo. Beneficial effects were also found in bipolar depression. Preliminary data suggest that BT-A therapy may also be effective in the treatment of mental disorders characterized by an excess of negative emotions, such as BPD. The underlying mechanism might be the “facial feedback hypothesis”. Hyperhidrosis is a common comorbidity in social anxiety disorder and may itself give rise to depressive or anxiety symptoms. BT-A has proved to be a safe and effective treatment for hyperhidrosis. BT-A can also be safely used for dystonia secondary to the use of psychiatric medication, when there’s an inadequate response to anticholinergic medication. Also, BT-A injections in the salivary glands have been investigated for treating clozapine-induced sialorrhea and studies reported successful reduction in hypersalivation. Conclusions Although more studies are needed to evaluate the potential of BT-A in psychiatry, there is growing evidence of its potential use for some psychiatric conditions.
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Viegas FG, Figueiredo I, Ferreira F, Lourenço A. Mental health conditions in people searching for aesthetic treatments: The importance of early detection. Eur Psychiatry 2021. [PMCID: PMC9475799 DOI: 10.1192/j.eurpsy.2021.1224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction It’s established that aesthetic dysfunctions can be associated with psychiatric conditions. In present times, considering the exponential growth of minimally invasive and accessible techniques, alongside with ideals of beauty present in everyday life through exposure in social media, the importance of early detection of mental illness and its impact on the respective outcome should be emphasized. Objectives To review evidence regarding psychiatric disorders in people searching for aesthetic treatments and their impact on the outcome. Methods Literature review using Medline database. Results Around 50% of individuals seeking aesthetic procedures fulfill the diagnostic criteria for psychiatric disorders. The prevalence of Body Dysmorphic Disorder (BDD) can vary from 5-15%, with some studies showing a prevalence of more than 50%. Patients with heightened BDD symptoms are less satisfied with the outcomes of aesthetic procedures which could result in exacerbation of said symptoms. With regards to eating disorders, evidence suggests the initial satisfaction following aesthetic procedures, when observed, is usually transitory, not leading to long-term changes in self-perception relating to body image, nor improving prognosis or quality of life. There’s also some evidence suggesting that personality disorders may be a predictor of poor satisfaction with the results of aesthetic treatments. Conclusions Awareness should be raised in this matter, since psychiatric conditions are more common in patients seeking aesthetic treatments and early identification can lead to a better prognosis by providing patients with the mental health treatment they need; this could also reduce the probability of dissatisfaction and subsequent aggravation of psychiatric symptoms following aesthetic interventions.
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Alarcón-Ríos L, Nicieza AG, Lourenço A, Velo-Antón G. The evolution of pueriparity maintains multiple paternity in a polymorphic viviparous salamander. Sci Rep 2020; 10:14744. [PMID: 32901062 PMCID: PMC7479106 DOI: 10.1038/s41598-020-71609-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/17/2020] [Indexed: 12/03/2022] Open
Abstract
The reduction in fecundity associated with the evolution of viviparity may have far-reaching implications for the ecology, demography, and evolution of populations. The evolution of a polygamous behaviour (e.g. polyandry) may counteract some of the effects underlying a lower fecundity, such as the reduction in genetic diversity. Comparing patterns of multiple paternity between reproductive modes allows us to understand how viviparity accounts for the trade-off between offspring quality and quantity. We analysed genetic patterns of paternity and offspring genetic diversity across 42 families from two modes of viviparity in a reproductive polymorphic species, Salamandra salamandra. This species shows an ancestral (larviparity: large clutches of free aquatic larvae), and a derived reproductive mode (pueriparity: smaller clutches of larger terrestrial juveniles). Our results confirm the existence of multiple paternity in pueriparous salamanders. Furthermore, we show the evolution of pueriparity maintains, and even increases, the occurrence of multiple paternity and the number of sires compared to larviparity, though we did not find a clear effect on genetic diversity. High incidence of multiple paternity in pueriparous populations might arise as a mechanism to avoid fertilization failures and to ensure reproductive success, and thus has important implications in highly isolated populations with small broods.
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Affiliation(s)
- Lucía Alarcón-Ríos
- Departamento de Biología de Organismos y Sistemas, Área de Ecología, Universidad de Oviedo, C/ Valentín Andrés Álvarez S/N, 33071, Oviedo, Spain.
| | - Alfredo G Nicieza
- Departamento de Biología de Organismos y Sistemas, Área de Ecología, Universidad de Oviedo, C/ Valentín Andrés Álvarez S/N, 33071, Oviedo, Spain.,Unidad Mixta de Investigación en Biodiversidad (UMIB), CSIC-Universidad de Oviedo-Principado de Asturias, Mieres, Spain
| | - André Lourenço
- CIBIO/InBIO, Centro de Investigacão em Biodiversidade e Recursos Genéticos, Instituto de Ciências Agrárias de Vairão , Universidade do Porto, R. Padre Armando Quintas 7, 4485-661, Vairão, Portugal.,Departamento de Biologia da Faculdade de Ciências da, Universidade do Porto, Rua Campo Alegre, 4169-007, Porto, Portugal
| | - Guillermo Velo-Antón
- CIBIO/InBIO, Centro de Investigacão em Biodiversidade e Recursos Genéticos, Instituto de Ciências Agrárias de Vairão , Universidade do Porto, R. Padre Armando Quintas 7, 4485-661, Vairão, Portugal.
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Oliveira JP, Fragão-Marques M, Lourenço A, Falcão-Pires I, Leite-Moreira A. Adverse remodeling in atrial fibrillation following isolated aortic valve replacement surgery. Perfusion 2020; 36:482-490. [PMID: 32838662 DOI: 10.1177/0267659120949210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common arrhythmia with adverse clinical outcomes. Aortic valve replacement (AVR) is one of the most frequently performed cardiac surgeries, although there is scarce evidence on arrhythmic outcomes. We aimed to evaluate AF during the first year post- isolated aortic valve replacement surgery and its clinical, analytical, and echocardiographic predictors. METHODS Severe aortic stenosis patients with no prior atrial fibrillation submitted to isolated aortic valve replacement surgery were included in our study, of which 316 remained in sinus rhythm and 24 developed AF. We performed logistic regression searching for AF predictors and a longitudinal comparison between pre and post-operative echocardiographic data. RESULTS Postoperative AF (POAF), diabetes, and follow-up indexed Left Atrium Diameter (iLAD) were significantly higher in the group of patients developing AF. POAF and iLAD were independent AF predictors at follow-up. No differences between groups were found regarding baseline and follow-up echocardiographic data except for indexed Left Ventricle End-diastolic Diameter (LVED), which failed to decrease after surgery in the AF group. CONCLUSIONS POAF and iLAD independently predicted AF at 1 year following isolated AVR surgery in aortic stenosis patients with no AF history. iLVED did not decrease significantly at follow-up in AF patients, possibly reflecting adverse ventricular remodeling.
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Affiliation(s)
- João Pedro Oliveira
- Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Mariana Fragão-Marques
- Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina, Universidade do Porto, Portugal
| | - André Lourenço
- Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Inês Falcão-Pires
- Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Adelino Leite-Moreira
- Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina, Universidade do Porto, Portugal
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Neves JS, Vale C, von Hafe M, Borges-Canha M, Leite AR, Almeida-Coelho J, Lourenço A, Falcão-Pires I, Carvalho D, Leite-Moreira A. Thyroid hormones and modulation of diastolic function: a promising target for heart failure with preserved ejection fraction. Ther Adv Endocrinol Metab 2020; 11:2042018820958331. [PMID: 33088475 PMCID: PMC7543162 DOI: 10.1177/2042018820958331] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 08/20/2020] [Indexed: 12/16/2022] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome with high mortality for which there is no proven therapy to improve its prognosis. Thyroid dysfunction is common in heart failure (HF) and is associated with worse prognosis. In this review, we discuss the cardiovascular effects of thyroid hormones, the pathophysiology of HFpEF, the prognostic impact of thyroid function, and the potential of thyroid hormones for treatment of HFpEF. Thyroid hormones have a central role in cardiovascular homeostasis, improving cardiac function through genomic and non-genomic mechanisms. Both overt and subclinical hypothyroidism are associated with increased risk of HF. Even when plasmatic thyroid hormones levels are normal, patients with HF may have local cardiac hypothyroidism due to upregulation of type 3 iodothyronine deiodinase. Thyroid hormones improve several pathophysiological mechanisms of HFpEF, including diastolic dysfunction and extra-cardiac abnormalities. Supplementation with thyroid hormones (levothyroxine and/or liothyronine), modulation of deiodinase activity, and heart-specific thyroid receptor agonists are potential therapeutic approaches for the treatment of HFpEF. Further preclinical and clinical studies are needed to clarify the role of thyroid hormones in the treatment of HFpEF.
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Affiliation(s)
- João Sérgio Neves
- Departamento de Cirurgia e Fisiologia, Unidade
de Investigação Cardiovascular, Faculdade de Medicina, Universidade do
Porto, Porto, Portugal
- Department of Endocrinology, Diabetes and
Metabolism, Centro Hospitalar Universitário de São João, Faculdade de
Medicina, Universidade do Porto, Porto, Portugal
| | - Catarina Vale
- Departamento de Cirurgia e Fisiologia, Unidade
de Investigação Cardiovascular, Faculdade de Medicina, Universidade do
Porto, Porto, Portugal
| | - Madalena von Hafe
- Departamento de Cirurgia e Fisiologia, Unidade
de Investigação Cardiovascular, Faculdade de Medicina, Universidade do
Porto, Porto, Portugal
| | - Marta Borges-Canha
- Departamento de Cirurgia e Fisiologia, Unidade
de Investigação Cardiovascular, Faculdade de Medicina, Universidade do
Porto, Porto, Portugal
- Department of Endocrinology, Diabetes and
Metabolism, Centro Hospitalar Universitário de São João, Faculdade de
Medicina, Universidade do Porto, Porto, Portugal
| | - Ana Rita Leite
- Departamento de Cirurgia e Fisiologia, Unidade
de Investigação Cardiovascular, Faculdade de Medicina, Universidade do
Porto, Porto, Portugal
| | - João Almeida-Coelho
- Departamento de Cirurgia e Fisiologia, Unidade
de Investigação Cardiovascular, Faculdade de Medicina, Universidade do
Porto, Porto, Portugal
| | - André Lourenço
- Departamento de Cirurgia e Fisiologia, Unidade
de Investigação Cardiovascular, Faculdade de Medicina, Universidade do
Porto, Porto, Portugal
| | - Inês Falcão-Pires
- Departamento de Cirurgia e Fisiologia, Unidade
de Investigação Cardiovascular, Faculdade de Medicina, Universidade do
Porto, Porto, Portugal
| | - Davide Carvalho
- Department of Endocrinology, Diabetes and
Metabolism, Centro Hospitalar Universitário de São João, Faculdade de
Medicina, Universidade do Porto, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde
da Universidade do Porto, Portugal
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Lourenço A, Gonçalves J, Carvalho F, Wang IJ, Velo‐Antón G. Comparative landscape genetics reveals the evolution of viviparity reduces genetic connectivity in fire salamanders. Mol Ecol 2019; 28:4573-4591. [DOI: 10.1111/mec.15249] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 08/22/2019] [Accepted: 09/16/2019] [Indexed: 01/07/2023]
Affiliation(s)
- André Lourenço
- Departamento de Biologia Faculdade de Ciências Universidade do Porto Porto Portugal
- CIBIO/InBIO Centro de Investigação em Biodiversidade e Recursos Genéticos da Universidade do Porto Instituto de Ciências Agrárias de Vairão Vairão Portugal
| | - João Gonçalves
- CIBIO/InBIO Centro de Investigação em Biodiversidade e Recursos Genéticos da Universidade do Porto Instituto de Ciências Agrárias de Vairão Vairão Portugal
| | - Filipe Carvalho
- CIBIO/InBIO Centro de Investigação em Biodiversidade e Recursos Genéticos da Universidade do Porto Instituto de Ciências Agrárias de Vairão Vairão Portugal
- Department of Zoology and Entomology School of Biological and Environmental Sciences University of Fort Hare Alice South Africa
| | - Ian J. Wang
- Department of Environmental Science, Policy, and Management University of California Berkeley CA USA
| | - Guillermo Velo‐Antón
- CIBIO/InBIO Centro de Investigação em Biodiversidade e Recursos Genéticos da Universidade do Porto Instituto de Ciências Agrárias de Vairão Vairão Portugal
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Neves JS, Leitão L, Baeta Baptista R, Bigotte Vieira M, Magriço R, Viegas Dias C, Oliveira A, Falcão-Pires I, Lourenço A, Carvalho D, Leite-Moreira A. Lower free triiodothyronine levels within the reference range are associated with higher cardiovascular mortality: An analysis of the NHANES. Int J Cardiol 2019; 285:115-120. [PMID: 30879936 DOI: 10.1016/j.ijcard.2019.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 02/09/2019] [Accepted: 03/05/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Thyroid hormones play a central role in cardiovascular homeostasis. Lower free triiodothyronine (FT3) levels have been associated with worse prognosis in several conditions. However, contrary to thyrotropin (TSH) and free thyroxine (FT4), the role of FT3 in morbidity and mortality in the general population remains uncertain. Our objective was to evaluate the association between within the normal range FT3 levels and mortality in the general population. METHODS We evaluated 7116 adults in the National Health and Nutrition Examination Survey (NHANES) 2001-2002, 2007-2008, and 2009-2010 cycles with mortality evaluated as of December 2011. Exclusion criteria were: pregnancy; history of thyroid disease; use of thyroid-related drugs; and TSH, FT4, or FT3 level outside the reference range. RESULTS During a median follow-up of 45 months, 357 participants died. In unadjusted analysis, lower FT3 levels were associated with higher all-cause (HR per 0.1 pg/mL increase in FT3: 0.82 [95% confidence interval, 0.78-0.87]), cardiovascular (HR 0.74 [0.66-0.83]), cancer-related (HR 0.88 [0.80-0.97]) and other cause-related mortality (HR 0.83 [0.77-0.90]). After adjustment with Cox proportional hazard models, lower FT3 levels remained significantly associated with higher cardiovascular mortality (HR 0.83 [0.75-0.93]), but not with all-cause (HR 0.97 [0.92-1.02]), cancer-related (HR 1.02 [0.89-1.17]), or other cause-related mortality (HR 1.00 [0.92-1.10]). CONCLUSIONS Lower levels of FT3 within the reference range may independently predict higher cardiovascular mortality in the general population.
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Affiliation(s)
- João Sérgio Neves
- Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina, Universidade do Porto, Porto, Portugal; Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Lia Leitão
- Neurology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
| | - Rute Baeta Baptista
- Pediatrics Department, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Portugal
| | - Miguel Bigotte Vieira
- Nephrology and Renal Transplantation Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Rita Magriço
- Nephrology Department, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Portugal
| | | | - Ana Oliveira
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Inês Falcão-Pires
- Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - André Lourenço
- Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Davide Carvalho
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Faculdade de Medicina, Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Adelino Leite-Moreira
- Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
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Neves JS, Canha M, Fontes-Carvalho R, von Haffe M, Vale C, Oliveira A, Falcão-Pires I, Lourenço A, Guimarães JT, Azevedo A, Carvalho D, Leite-Moreira A. MON-587 Thyroid Hormones within the Normal Range and Cardiac Function in the General Population: The Epiporto Study. J Endocr Soc 2019. [PMCID: PMC6550766 DOI: 10.1210/js.2019-mon-587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction: Thyroid hormones have a central role in cardiovascular homeostasis. Both hypothyroidism and hyperthyroidism are associated with specific cardiovascular changes. However, the association of thyroid hormone levels within the normal range with cardiac function in general population remains largely unknown. Methods: 835 subjects with ≥45 years from EPIPorto population-based cohort study were analyzed. We excluded participants with TSH, FT4 or FT3 outside the reference range and participants with history of myocardial infarction, coronary revascularization, cardiac surgery, valvular heart disease, history of thyroid disease or treatment with drugs that interfere with thyroid function. All participants were submitted to detailed echocardiographic evaluation. The association of TSH, FT4 and FT3 with heart rate, blood pressure (BP), cardiac structure and cardiac function was evaluated with linear regression models unadjusted and adjusted for sex and age (model 1), and for sex, age, BMI, diabetes and hypertension (model 2). We assessed nonlinear associations using restricted cubic splines (3 knots). Results: The mean age of the population was 61.5±10.5 years, with 61.1% female participants. Eleven percent had diabetes, 47.8% dyslipidemia and 54.8% hypertension. Heart rate was positively associated with FT3 levels (model 2: β=1.78 [0.04 to 3.51], p=0.045). Diastolic BP was positively associated with TSH levels (model 2: β=1.50 [0.10 to 2.89], p=0.035). Regarding left ventricle (LV) structure, there was a nonlinear association of FT4 with posterior wall thickness, with lower thickness in the middle of the reference range. Both LV end-diastolic and end-systolic diameters were inversely associated with TSH (β=-3.62 (-5.89 to -1.35), p=0.002; and β=-2.03 (-3.31 to -0.77), p=0.002 in model 2). FT3 was nonlinearly associated with ejection fraction, with higher ejection fractions near the extremes of the normal range of FT3. Concerning diastolic function, FT3 was positively associated with E', and FT4 was negatively associated with E', although these associations were no longer significant in the adjusted models. Conclusions: Variations of thyroid function within the reference range are associated with heart rate, blood pressure, cardiac structure and cardiac function in the general population. Our results suggest that increasing thyroid function (lower TSH, higher FT4 or higher FT3) is associated with higher heart rate, lower diastolic BP and larger LV cavity volumes. On the other hand, both LV wall thickness and LV ejection fraction are non-linearly associated with thyroid hormones, with greater wall thickness and higher ejection fraction near the extremes of normal range of thyroid hormones concentration.
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Affiliation(s)
- João Sérgio Neves
- Department of Surgery and Physiology, Cardiovascular Research Center, Faculty of Medicine of University of Porto; Department of Endocrinology, Diabetes and Metabolism, São João Hospital Center, Porto, , Portugal
| | - Marta Canha
- Department of Surgery and Physiology, Cardiovascular Research Center, Faculty of Medicine of University of Porto; Department of Endocrinology, Diabetes and Metabolism, São João Hospital Center, Porto, , Portugal
| | - Ricardo Fontes-Carvalho
- Department of Surgery and Physiology, Cardiovascular Research Center, Faculty of Medicine of University of Porto; Department of Cardiology, Centro Hospitalar Gaia/Espinho, Vila Nova de Gaia, Porto, , Portugal
| | - Madalena von Haffe
- Department of Surgery and Physiology, Cardiovascular Research Center, Faculty of Medicine of University of Porto, Porto, , Portugal
| | - Catarina Vale
- Department of Surgery and Physiology, Cardiovascular Research Center, Faculty of Medicine of University of Porto, Porto, , Portugal
| | - Ana Oliveira
- Department of Endocrinology, Diabetes and Metabolism, São João Hospital Center, Porto, , Portugal
| | - Inês Falcão-Pires
- Department of Surgery and Physiology, Cardiovascular Research Center, Faculty of Medicine of University of Porto, Porto, , Portugal
| | - André Lourenço
- Department of Surgery and Physiology, Cardiovascular Research Center, Faculty of Medicine of University of Porto, Porto, , Portugal
| | - João Tiago Guimarães
- Department of Clinical Pathology, São João Hospital Center; Department of Biomedicine, Faculty of Medicine; Epidemiology Research Unit (EPIUnit), Institute of Public Health of the University of Porto (ISPUP), Porto, , Portugal
| | - Ana Azevedo
- Epidemiology Research Unit (EPIUnit), Institute of Public Health of the University of Porto (ISPUP); Department of Clinical Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine, University of Porto, Porto, , Portugal
| | - Davide Carvalho
- Department of Endocrinology, Diabetes and Metabolism, São João Hospital Center; Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, , Portugal
| | - Adelino Leite-Moreira
- Department of Surgery and Physiology, Cardiovascular Research Center, Faculty of Medicine of University of Porto, Porto, , Portugal
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Lourenço A, Raposo V, Martins A. Health innovation: a first contribution to the development of a new practice model for clinical pharmacists in Portuguese primary healthcare. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Lourenço
- Faculty of Economics of the University of Coimbra (FEUC), Portugal
| | - V Raposo
- Centre of Health Studies and Research of the University of Coimbra (CEISUC), Portugal
- Centre for Business and Economics Research (CeBER), Portugal
| | - A Martins
- Faculty of Pharmacy of the University of Lisbon, Portugal
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Borges Canha M, Portela-Cidade JP, Conceição G, Sousa-Mendes C, Leite S, Fontoura D, Moreira-Gonçalves D, Falcão-Pires I, Lourenço A, Leite-Moreira A, Pimentel-Nunes P. Characterization of liver changes in ZSF1 rats, an animal model of metabolic syndrome. Rev Esp Enferm Dig 2018; 109:491-497. [PMID: 28593786 DOI: 10.17235/reed.2017.4575/2016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The non-alcoholic fatty liver disease is the hepatic counterpart of the metabolic syndrome. ZSF1 rats are a metabolic syndrome animal model in which liver changes have not been described yet. AIM The characterization of liver histological and innate immunity changes in ZSF1 rats. METHODS Five groups of rats were included (n = 7 each group): healthy Wistar-Kyoto control rats (Ctrl), hypertensive ZSF1 lean (Ln), ZSF1 obese rats with a normal diet (Ob), ZSF1 obese rates with a high-fat diet (Ob-HFD), and ZSF1 obese rats with low-intensity exercise training (Ob-Ex). The animals were sacrificed at 20 weeks of age, their livers were collected for: a) measurements of the area of steatosis, fibrosis and inflammation (histomorphological analysis); and b) innate immunity (toll-like receptor [TLR] 2, TLR4, peroxisome proliferator-activated receptor γ [PPARγ], toll interacting protein [TOLLIP]) and inflammatory marker (tumor necrosis factor-alpha [TNFα], interleukin 1 [IL-1]) expression analysis by real-time PCR. RESULTS Ob, Ob-HFD and Ob-Ex were significantly heavier than Ln and Ctrl animals. Ob, Ob-HFD and Ob-Ex animals had impaired glucose tolerance and insulin resistance. ZSF1 Ob, Ob-HFD and Ob-Ex presented a higher degree of steatosis (3,5x; p < 0.05) than Ctrl or ZSF1 Ln rats. Steatohepatitis and fibrosis were not observed in any of the groups. No differences in expression were observed between Ctrl, Ln and Ob animals (except for the significantly higher expression of TOLLIP observed in the Ob vs Ln comparison). Ob-HFD and Ob-Ex rats showed increased expression of PPARγ and TOLLIP as compared to other groups. However, both groups also showed increased expression of TLR2 and TLR4. Nevertheless, this did not translate into a differential expression of TNFα or IL-1 in any of the groups. CONCLUSION The ZSF1 model is associated with liver steatosis but not with steatohepatitis or a significantly increased expression of innate immunity or inflammation markers.
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Affiliation(s)
- Marta Borges Canha
- Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Portugal
| | | | - Glória Conceição
- Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto
| | | | - Sara Leite
- Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto
| | - Dulce Fontoura
- Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto
| | | | - Inês Falcão-Pires
- Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto
| | - André Lourenço
- Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto
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Raimundo R, Moreira S, Saraiva F, Cerqueira RJ, Teixeira P, Salgueiro E, Lourenço A, Amorim MJ, Almeida J, Pinho P, Leite-Moreira AF. Early and mid-term haemodynamic performance and clinical outcomes of St. Jude Medical Trifecta™ valve. J Thorac Dis 2018; 10:889-898. [PMID: 29607162 DOI: 10.21037/jtd.2018.01.15] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background New models of aortic bioprostheses have proven excellent early haemodynamic profile, but their mid and long-term performance warrants further systematic assessment. The aim of this study is to report clinical and haemodynamic performance of St. Jude Medical Trifecta bioprosthesis during 5 years of implantation. Methods We performed a single centre, retrospective, observational and descriptive study including all 556 individuals who underwent aortic valve replacement (AVR) with the Trifecta bioprosthesis (between July of 2011 and June of 2016). Survival and re-intervention were censored in February 2017. Postoperative ambulatory echocardiographic data was available for 490 patients. A complete clinical follow-up was available in 463 individuals (mean follow-up time, 27±17 months). Results In our sample the mean age was 73±9 years, 57.6% were male and median European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was 2.9 (interquartile range, 1.6-5.8). There were 301 (54.1%) combined procedures, mostly coronary artery bypass grafting in 170 (30.6%). Overall 30-days mortality was 5.4% (n=30) and cumulative survival at 5-years was 72.3%. There were 23 (4.3%) permanent pacemaker implantations. During follow-up, 5 (0.9%) patients presented non-structural valve dysfunction (NSVD) and 4 (0.8%) underwent reoperation due to prosthesis endocarditis. At the first ambulatory evaluation transvalvular mean gradient and effective orifice area (EOA) were 10.9±4.1 mmHg and 2.0±0.5 cm2, respectively. Severe patient-prosthesis mismatch (PPM) was observed in 5 (1.1%) individuals and moderate in 52 (11.3%). Conclusions In a "real-world" clinical setting, our findings support the good overall mid-term haemodynamic and safety profile of the Trifecta bioprosthesis.
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Affiliation(s)
- Renata Raimundo
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Soraia Moreira
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Francisca Saraiva
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Rui J Cerqueira
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto, Portugal
| | - Pedro Teixeira
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Elson Salgueiro
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto, Portugal
| | - André Lourenço
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Serviço de Anestesiologia, Centro Hospitalar de São João, Porto, Portugal
| | - Mário J Amorim
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto, Portugal
| | - Jorge Almeida
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto, Portugal
| | - Paulo Pinho
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto, Portugal
| | - Adelino F Leite-Moreira
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto, Portugal
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Brito D, Viana T, Sousa D, Lourenço A, Paiva S. A mobile solution to help visually impaired people in public transports and in pedestrian walks. ACTA ACUST UNITED AC 2018. [DOI: 10.2495/sdp-v13-n2-281-293] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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45
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Lourenço A, Vegi P, Faria J, Pinto G, dos Santos M, Sathler P, Saito M, Santana M, Dutra T, Rodrigues C, Monteiro R, Bernardino A, Castro H. Pyrazolyl-Tetrazoles and Imidazolyl-Pyrazoles as Potential Anticoagulants and their Integrated Multiplex Analysis Virtual Screening. J BRAZIL CHEM SOC 2018. [DOI: 10.21577/0103-5053.20180150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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46
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Rodrigues M, Costa R, Brito S, Pissarra A, Lourenço A, Grenho F, Campos L. Ischemic stroke and cancer correlation: A stroke unit experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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47
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J Cerqueira R, Melo R, Moreira S, A Saraiva F, Andrade M, Salgueiro E, Almeida J, J Amorim M, Pinho P, Lourenço A, F Leite-Moreira A. Freedom Solo Versus Trifecta Bioprotheses: Clinical and Hemodynamic Evaluation after Propensity Score Matching. Rev Port Cir Cardiotorac Vasc 2017; 24:121. [PMID: 29701353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Indexed: 06/08/2023]
Abstract
INTRODUCTION To compare stentless Freedom Solo and stented Trifecta aortic bioprostheses regarding hemodynamic profile, left ventricular mass regression, early and late postoperative outcomes and survival. METHODS Longitudinal cohort study of consecutive patients undergoing aortic valve replacement (from 2009 to 2016) with either Freedom Solo or Trifecta at one centre. Local databases and national records were queried. Postoperative echocardiography (3-6 months) was obtained for hemodynamic profile (mean transprosthetic gradient and effective orifice area) and left ventricle mass determination. After propensity score matching (21 covariates), Kaplan-Meier analysis and cumulative incidence analysis were performed for survival and combined outcome of structural valve deterioration and endocarditis, respectively. Hemodynamics and left ventricle mass regression were assessed by a mixed- -effects model including propensity score as a covariate. RESULTS From a total sample of 397 Freedom Solo and 525 Trifecta patients with a median follow-up time of 4.0 (2.2- 6.0) and 2.4 (1.4-3.7) years, respectively, a matched sample of 329 pairs was obtained. Well-balanced matched groups showed no difference in survival (hazard ratio=1.04, 95% confidence interval=0.69-1.56) or cumulative hazards of combined outcome (subhazard ratio=0.54, 95% confidence interval=0.21-1.39). Although Trifecta showed improved hemodynamic profile compared to Freedom Solo, no differences were found in left ventricle mass regression. CONCLUSION Trifecta has a slightly improved hemodynamic profile compared to Freedom Solo but this does not translate into differences in the extent of mass regression, postoperative outcomes or survival, which were good and comparable for both bioprostheses. Long-term follow-up is needed for comparisons with older models of bioprostheses.
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Affiliation(s)
- Rui J Cerqueira
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; Departamento de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto, Portugal
| | - Renata Melo
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Soraia Moreira
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Francisca A Saraiva
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Marta Andrade
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; Departamento de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto, Portugal
| | - Elson Salgueiro
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; Departamento de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto, Portugal
| | - Jorge Almeida
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; Departamento de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto, Portugal
| | - Mário J Amorim
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; Departamento de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto, Portugal
| | - Paulo Pinho
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; Departamento de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto, Portugal
| | - André Lourenço
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; Departamento de Anestesiologia, Centro Hospitalar de São João, Porto, Portugal
| | - Adelino F Leite-Moreira
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; Departamento de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto, Portugal
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A Saraiva F, Girerd N, J Cerqueira R, P Ferreira J, Vilas-Boas N, Pinho P, Barros A, J Amorim M, Lourenço A, F Leite-Moreira A. Survival After Bilateral Internal Mammary Artery In Coronary Artery Bypass Grafting: Are Women at Risk? Rev Port Cir Cardiotorac Vasc 2017; 24:101. [PMID: 29701335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Indexed: 06/08/2023]
Abstract
INTRODUCTION To compare survival and safety of BIMA versus SIMA CABG between males and females at our tertiary care center. METHODS Single-center retrospective cohort including consecutive patients with at least 2 left coronary system (LCS) vessel disease who underwent isolated CABG with at least 1 IMA conduit and a minimum of 2 conduits targeting the LCS between 2004 and 2013. All-cause mortality was the primary outcome, secondary outcomes were in-hospital mortality and reoperation due to sternal wound complications (SWC). Kaplan-Meier analysis after inverse probability weighting using propensity score (IPW) was used to compare BIMA and SIMA CABG amongst genders. Results were confirmed by subgroup analysis. RESULTS BIMA CABG was performed in 39% out of 2424 eligible procedures and in 27% of 460 females. No differences were found in survival after BIMA and SIMA CABG (median and maximum follow-up of 5.5 and 12 years, respectively) but a statistical interaction was observed with gender (P<0.001). Females who underwent BIMA CABG showed higher mortality (weighted HR in females subset: 3.16; 95%CI: 1.56-6.29, P=0.001). BIMA CABG showed a higher incidence of reoperations due to SWC (IPW adjusted model OR: 1.74; 95% CI: 1.16-2.60) that were mostly ascribable to males (weighted OR in males: 3.10; 95%CI: 1.74-5.51, P<0.001). CONCLUSION Females may experience higher mortality after BIMA CABG which should be further explored.
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Affiliation(s)
- Francisca A Saraiva
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto
| | - Nicolas Girerd
- INSERM, Centre d'Investigations Cliniques Plurithématique, Université de Lorraine, CHRU de Nancy
| | - Rui J Cerqueira
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; Departamento de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto
| | - João P Ferreira
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; INSERM, Centre d'Investigations Cliniques Plurithématique, Université de Lorraine, CHRU de Nancy
| | - Noélia Vilas-Boas
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto
| | - Paulo Pinho
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; Departamento de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto
| | - António Barros
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto
| | - Mário J Amorim
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; Departamento de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto
| | - André Lourenço
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; Departamento de Anestesiologia, Centro Hospitalar de São João, Porto
| | - Adelino F Leite-Moreira
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto; Departamento de Cirurgia Cardiotorácica, Centro Hospitalar de São João, Porto
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Gaubert P, Patel RP, Veron G, Goodman SM, Willsch M, Vasconcelos R, Lourenço A, Sigaud M, Justy F, Joshi BD, Fickel J, Wilting A. Phylogeography of the Small Indian Civet and Origin of Introductions to Western Indian Ocean Islands. J Hered 2017; 108:270-279. [PMID: 27940474 DOI: 10.1093/jhered/esw085] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 12/01/2016] [Indexed: 11/14/2022] Open
Abstract
The biogeographic dynamics affecting the Indian subcontinent, East and Southeast Asia during the Plio-Pleistocene has generated complex biodiversity patterns. We assessed the molecular biogeography of the small Indian civet (Viverricula indica) through mitogenome and cytochrome b + control region sequencing of 89 historical and modern samples to (1) establish a time-calibrated phylogeography across the species' native range and (2) test introduction scenarios to western Indian Ocean islands. Bayesian phylogenetic analyses identified 3 geographic lineages (East Asia, sister-group to Southeast Asia and the Indian subcontinent + northern Indochina) diverging 3.2-2.3 million years ago (Mya), with no clear signature of past demographic expansion. Within Southeast Asia, Balinese populations separated from the rest 2.6-1.3 Mya. Western Indian Ocean populations were assigned to the Indian subcontinent + northern Indochina lineage and had the lowest mitochondrial diversity. Approximate Bayesian computation did not distinguish between single versus multiple introduction scenarios. The early diversification of the small Indian civet was likely shaped by humid periods in the Late Pliocene-Early Pleistocene that created evergreen rainforest barriers, generating areas of intra-specific endemism in the Indian subcontinent, East, and Southeast Asia. Later, Pleistocene dispersals through drier conditions in South and Southeast Asia were likely, giving rise to the species' current natural distribution. Our molecular data supported the delineation of only 4 subspecies in V. indica, including an endemic Balinese lineage. Our study also highlighted the influence of prefirst millennium AD introductions to western Indian Ocean islands, with Indian and/or Arab traders probably introducing the species for its civet oil.
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Affiliation(s)
- Philippe Gaubert
- Institut des Sciences de l'Evolution de Montpellier (ISEM)-UM-CNRS-IRD-EPHE, Université de Montpellier, Place Eugène Bataillon-CC 64, Montpellier Cedex 05, France
| | - Riddhi P Patel
- Freie Universität Berlin, Berlin, Germany.,Leibniz Institute for Zoo and Wildlife Research, Berlin, Germany
| | - Géraldine Veron
- Institut de Systématique, Evolution, Biodiversité, UMR 7205 CNRS MNHN UPMC EPHE, Muséum National d'Histoire Naturelle, Sorbonne Universités, Paris, France
| | - Steven M Goodman
- Field Museum of Natural History, Chicago, IL, USA.,Association Vahatra, Antananarivo, Madagascar, East Africa
| | - Maraike Willsch
- Institut des Sciences de l'Evolution de Montpellier (ISEM)-UM-CNRS-IRD-EPHE, Université de Montpellier, Place Eugène Bataillon-CC 64, Montpellier Cedex 05, France.,Museum für Naturkunde, Leibniz Institute for Evolution and Biodiversity Science, Invalidenstr. 43, Berlin, Germany
| | - Raquel Vasconcelos
- Institute of Evolutionary Biology (CSIC-UPF), Passeig Marítim de la Barceloneta, Barcelona, Spain.,CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Laboratório Associado, Universidade do Porto, Vairão, Portugal
| | - André Lourenço
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Laboratório Associado, Universidade do Porto, Vairão, Portugal.,Departamento de Biologia da Faculdade de Ciências da Universidade do Porto, Porto,Portugal
| | - Marie Sigaud
- Cellule Technique Océan Indien, Office National de la Chasse et de la Faune Sauvage (ONCFS), Saint-Denis, France
| | - Fabienne Justy
- Institut des Sciences de l'Evolution de Montpellier (ISEM)-UM-CNRS-IRD-EPHE, Université de Montpellier, Place Eugène Bataillon-CC 64, Montpellier Cedex 05, France
| | | | - Jörns Fickel
- Leibniz Institute for Zoo and Wildlife Research, Berlin, Germany.,Institute of Biochemistry & Biology, Potsdam University, Potsdam-Golm, Germany
| | - Andreas Wilting
- Leibniz Institute for Zoo and Wildlife Research, Berlin, Germany
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Schmidt C, Coelho J, Ferreira R, Paiva N, Falcão-Pires I, Lourenço A, Leite-Moreira A, Oliveira J, Moreira-Gonçalves D. Exercise Improves Diastolic Function In HFpEF By Reducing Intrinsic Cardiomyocyte Stiffness And Fibrosis. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000518934.04521.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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