Description of Naviculavanseea sp. nov. (Naviculales, Naviculaceae), a new species of diatom from the highly alkaline Lake Van (Republic of Türkiye) with complete characterisation of its organellar genomes and multigene phylogeny

The current article describes Naviculavanseeasp. nov., a new species of diatom from Lake Van, a highly alkaline lake in Eastern Anatolia (Türkiye). The description is based on light and scanning electron microscopy performed on two monoclonal cultures. The complete nuclear rRNA clusters and plastid genomes have been sequenced for these two strains and the complete mitogenome for one of them. The plastome of both strains shows the probable loss of a functional ycf35 gene. They also exhibit two IB4 group I introns in their rrl, each encoding for a putative LAGLIDADG homing endonuclease, with the first L1917 IB4 intron reported amongst diatoms. The Maximum Likelihood phylogeny inferred from a concatenated alignment of 18S, rbcL and psbC distinguishes N.vanseea sp. nov. from the morphologically similar species Naviculacincta and Naviculamicrodigitoradiata.

Description of five new Luticola D.G.Mann (Bacillariophyta, Diadesmidaceae) species from Indonesia with comments on the morphological boundaries of the genus

During a survey of the Indonesian diatoms, five Luticola D.G.Mann taxa that could not be identified, based on the available literature were discovered. Based on light microscopy, scanning electron microscope observations and comparisons with similar taxa, all of them are described as new species. All taxa were found on mosses growing on tree trunks and concrete on the islands of Banda Besar and Seram and from spring on Java Island. Luticolainsularissp. nov. is most similar to L.aequatorialis and L.simplex, but it can easily be distinguished from both taxa, based on the lower striae density, the narrower valves and the well-developed silica ridges on the valve face/mantle junction. Luticolabandanensissp. nov. resembles L.frequentissima, but they can be easily distinguished, based on their valve widths and the direction of the grooves located on the distal and proximal raphe endings. Luticolaellipticasp. nov. is most similar to L.sparsipunctata, L.tenuis and L.bryophila. Amongst all the species compared, L.ellipticasp. nov. is the only one with a highly asymmetrical central area, with the isolated pore located on the wider side. Luticolamalukuanasp. nov. shares similarities with L.dismutica and L.areolata, but it has a notably higher stria density. From L.areolata, it can also be separated by the morphology of striae and the lack of ghost areolae in the central area. Luticolapoliporeasp. nov. is unique in the whole genus due to the presence of multiple isolated pores.

Distribution and morphology of the diatom genus Olifantiella Riaux-Gobin & Compère in Indonesian and Australian waters, including the description of O.gondwanensis sp. nov

Samples from coastal tropical waters of Central Sulawesi, Bangka Island and Bawean Island in Indonesia and from the Great Barrier Reef at Fitzroy Island in Queensland, Australia were analysed for species composition of diatom assemblages with a focus on Olifantiella. Whereas samples from Fitzroy Island littoral in Australia retrieved only one species of Olifantiella, in Poso Bay, Indonesia, we observed at least six species. All established taxa were documented with light (LM) and scanning electron microscope (SEM) and principal component analysis (PCA) analysis was used to compare the species, based on the basic valve parameters of length, width, length to width ratio and striae density. A new species of the genus Olifantiella, O.gondwanensis is described from Australia. In addition, we showed the distinct nature of O.pilosellavar.rhizophorae permitting to species status. Particular attention is placed on girdle bands in this genus.

Prey preference in a kleptoplastic dinoflagellate is linked to photosynthetic performance

Dinoflagellates of the family Kryptoperidiniaceae, known as "dinotoms", possess diatom-derived endosymbionts and contain individuals at three successive evolutionary stages: a transiently maintained kleptoplastic stage; a stage containing multiple permanently maintained diatom endosymbionts; and a further permanent stage containing a single diatom endosymbiont. Kleptoplastic dinotoms were discovered only recently, in Durinskia capensis; until now it has not been investigated kleptoplastic behavior and the metabolic and genetic integration of host and prey. Here, we show D. capensis is able to use various diatom species as kleptoplastids and exhibits different photosynthetic capacities depending on the diatom species. This is in contrast with the prey diatoms in their free-living stage, as there are no differences in their photosynthetic capacities. Complete photosynthesis including both the light reactions and the Calvin cycle remain active only when D. capensis feeds on its habitual associate, the "essential" diatom Nitzschia captiva. The organelles of another edible diatom, N. inconspicua, are preserved intact after ingestion by D. capensis and expresses the psbC gene of the photosynthetic light reaction, while RuBisCO gene expression is lost. Our results indicate that edible but non-essential, "supplemental" diatoms are used by D. capensis for producing ATP and NADPH, but not for carbon fixation. D. capensis has established a species-specifically designed metabolic system allowing carbon fixation to be performed only by its essential diatoms. The ability of D. capensis to ingest supplemental diatoms as kleptoplastids may be a flexible ecological strategy, to use these diatoms as "emergency supplies" while no essential diatoms are available.

Craspedostaurosnazmii sp. nov., a new diatom species (Bacillariophyta) from the Turkish Coast of the Black Sea

Craspedostauros E.J. Cox is a diatom genus comprising 17 taxa reported from various regions of the world. While many species of Craspedostauros are epibiontic, the taxa have variable ecological preferences. In this study we formally describe Craspedostaurosnazmiisp. nov., an epilithic species discovered along the Turkish Black Sea Coast, based on light and scanning electron microscopy. Craspedostaurosnazmiisp. nov. is characterized by valves that are lanceolate to narrowly lanceolate, slightly constricted near the apices with uniseriate, parallel throughout the whole valve, transapical striae and and the presence of an apical silica flap. The areolae are distributed over the valve face and the mantle. The differences and similarities between C.nazmiisp. nov. and established species of Craspedostauros are discussed. Based on shape and morphometrics, the most similar species is Craspedostauroscapensis, but it is easily distinguished from C.nazmiisp. nov. by its lack of an apical silica flap.

A novel effective bio-originated methylene blue adsorbent: the porous biosilica from three marine diatom strains of Nanofrustulum spp. (Bacillariophyta)

In the present paper, for the first time the ability of the porous biosilica originated from three marine diatom strains of 'Nanofrustulum spp.' viz. N. wachnickianum (SZCZCH193), N. shiloi (SZCZM1342), N. cf. shiloi (SZCZP1809), to eliminate MB from aqueous solutions was investigated. The highest biomass was achieved under silicate enrichment for N. wachnickianum and N. shiloi (0.98 g L-1 DW and 0.93 g L-1 DW respectively), and under 15 °C for N. cf. shiloi (2.2 g L-1 DW). The siliceous skeletons of the strains were purified with hydrogen peroxide and characterized by SEM, EDS, the N2 adsorption/desorption, XRD, TGA, and ATR-FTIR. The porous biosilica (20 mg DW) obtained from the strains i.e. SZCZCH193, SZCZM1342, SZCZP1809, showed efficiency in 77.6%, 96.8%, and 98.1% of 14 mg L-1 MB removal under pH 7 for 180 min, and the maximum adsorption capacity was calculated as 8.39, 19.02, and 15.17 mg g-1, respectively. Additionally, it was possible to increase the MB removal efficiency in alkaline (pH = 11) conditions up to 99.08% for SZCZP1809 after 120 min. Modelling revealed that the adsorption of MB follows Pseudo-first order, Bangham's pore diffusion and Sips isotherm models.

Removal of the Basic and Diazo Dyes from Aqueous Solution by the Frustules of Halamphora cf. salinicola (Bacillariophyta)

Industrial wastes with hazardous dyes serve as a major source of water pollution, which is considered to have an enormous impact on public health. In this study, an eco-friendly adsorbent, the porous siliceous frustules extracted from the diatom species Halamphora cf. salinicola, grown under laboratory conditions, has been identified. The porous architecture and negative surface charge under a pH of 7, provided by the various functional groups via Si-O, N-H, and O-H on these surfaces, revealed by SEM, the N₂ adsorption/desorption isotherm, Zeta-potential measurement, and ATR-FTIR, respectively, made the frustules an efficient mean of removal of the diazo and basic dyes from the aqueous solutions, 74.9%, 94.02%, and 99.81% against Congo Red (CR), Crystal Violet (CV), and Malachite Green (MG), respectively. The maximum adsorption capacities were calculated from isotherms, as follows: 13.04 mg g^-1, 41.97 mg g^-1, and 33.19 mg g^-1 against CR, CV, and MG, respectively. Kinetic and isotherm models showed a higher correlation to Pore diffusion and Sips models for CR, and Pseudo-Second Order and Freundlich models for CV and MG. Therefore, the cleaned frustules of the thermal spring-originated diatom strain Halamphora cf. salinicola could be used as a novel adsorbent of a biological origin against anionic and basic dyes.

Xenobennettella coralliensis a new monoraphid diatom genus characterized by the alveolate sternum valve with cavum, observed from coral reef habitats

During a survey of benthic diatoms from the coral reefs of the Indian Ocean (Scattered Islands) and Pacific Ocean (Tuamotu Archipelago), an interesting monoraphid diatom was observed and examined by light microscopy and various electron microscopy methods including Focus Ion Beam milling. Our thorough analysis revealed the similarity of this diatom to Bennettella R.W.Holmes, which we reference in the name: Xenobennettella Witkowski & Riaux-Gobin gen. nov., with Xenobennettella coralliensis Witkowski & Riaux-Gobin sp. nov. as the generitype. The type habitat for this new species is the sublittoral coral reef of Juan de Nova in the Mozambique Channel. The sternum valve of the new genus is characterized by an alveolate ultrastructure with the rim of the alveola opening along the valve margin, resembling the sternum valve of Bennettella. Internally, Xenobennettella differs from the latter by possessing a cavum (horseshoe-shaped chamber) on one side of the valve, in a central axial position. The raphe valve of Xenobennettella has small, marginal, apically elongate chambers, which are internally delineated by transapical ribs that are very similar to Bennettella. However, the raphe in the new genus is different from the latter, resembling some Cocconeis and Planothidium with internal raphe endings bent in the opposite direction, while resembling some Planothidium taxa externally by ending on the apical part of the mantle. This contrasts to Bennettella, which has a unique raphe system, with external raphe endings below the apices, a prominent axial structure and a transapically expanded central area. Likewise, the external surface of Bennettella is different from that of the new genus with a complex mantle structure and biseriate striae. In Xenobennettella, the valve mantle of the raphe valve is simple and perforated by areola. The transapical striae occur in the valve margin and the axial area is ornamented along its course with a single row of densely packed areola on both sides. The characteristics of the raphe valve and alveolate sternum valve place the new genus among the Achnanthidiaceae.

Non-invasive characterization of pancoronary inflammation by computed tomography angiography in patients with recent spontaneous coronary dissection

Background

Spontaneous coronary artery dissection (SCAD) is a non-atherosclerotic cause of myocardial infarction of unclear aethiology. Histopathological analyses have identified increased coronary inflammation in patients with SCAD [1]. Recently the peri-coronary adipose tissue attenuation (PCAT) derived from standard computed tomography angiography (CTA) has been established as a reproducible method for measuring vascular inflammation which enhances risk stratification in patients with coronary atherosclerosis [2].

Purpose

To characterize the pancoronary and vessel-specific inflammation by means of CTA-derived PCAT in patients with recent SCAD compared with individuals without prior SCAD.

Methods

Patients with confirmed SCAD referred to a tertiary center between 2017 and 2021 who underwent CTA as a routine cardiac evaluation were included in this retrospective study. Subjects were matched 1:1 with individuals with no prior SCAD who underwent CTA within the same timespan, using the same scanner and imaging protocol, with coronary arteries free of obstructive disease and similar clinical characteristics (Table 1). PCAT was analyzed on end-diastolic CTA reconstructions with a semi-automated software using standard methodology (Figure 1A) [3]. Proximal 40 mm of all major coronary vessels >2 mm in diameter as well as the SCAD-related vessel were included. The primary outcome was pancoronary PCAT defined as mean PCAT in the right (RCA), left anterior descending (LAD) and circumflex (LCX) artery. Secondary outcome was vessel-specific PCAT defined as PCAT in RCA and averaged PCAT in LAD and LCX (PCAT LCA).

Results

The final cohort comprised 35 patients with recent SCAD (median 6.1 mo. [4.0–16.8] since SCAD, 94.3% female) and 35 patients in the non-SCAD group. Pancoronary PCAT was higher in patients with SCAD compared with non-SCAD group (−80.1 [IQR: −74.5, −84.6] vs. −83.4 HU [−78.7, −88.0], P=0.008) suggestive of increased coronary inflammation. Vessel-specific PCAT was higher for the RCA (−80.7 [−70.4, −86.9] vs. −85.3 [−80.4, −90.6] HU, P<0.001) and borderline higher for the LCA (−79.2 [−73.9, −83.2] vs. −83.4 [−78.0, −88.3] HU, P=0.056) in patients with SCAD compared with non-SCAD respectively (Figure 1B). In patients with SCAD, PCAT in previously dissected vessel was not significantly different from averaged PCAT in unaffected vessels (−78.4 [−73.7, −89.0] vs. −80.9 [−74.9, −83.3], P=0.77; Figure 1C). While PCAT numerically decreased with time since SCAD, the association was not statistically significant when patients were stratified into tertiles according to time from SCAD (Figure 1D).

Conclusions

Patients with recent SCAD have higher pericoronary adipose tissue attenuation compared with non-SCAD patients suggesting increased perivascular inflammatory activity. This association is not restricted to the dissected vessel, nor reflected in routine serum inflammatory analysis and persists over time.

Funding Acknowledgement

Type of funding sources: None.

Photonic Nano-/Microstructured Diatom Based Biosilica in Metal Modification and Removal-A Review

The siliceous exoskeletal shells of diatoms, commonly known as frustules, have drawn attention because of their photoluminescence property and high volume to surface area. Photonic biosilica can also enhance the plasmonic sensitivity of nanoparticles. Because of this, researchers have studied the effectiveness of various metal particles after combining with biosilica. Additionally, naturally occurring diatom-based biosilica has excellent adsorption and absorption capabilities, which have already been exploited for wastewater treatment. Moreover, the nanoporous, ultra-hydrophilic frustules can easily accumulate more molecules on their surfaces. As a consequence, it becomes easier to conjugate noble metals with silica, making them more stable and effective. The main focus of this review is to agglomerate the utility of biocompatible diatom frustules, which is a no-cost natural resource of biosilica, in metal modification and removal.

The sub-fossil diatom distribution in the Beibu Gulf (northwest South China Sea) and related environmental interpretation

Located in northwestern South China Sea (SCS), the Beibu Gulf constitutes an environmentally sensitive region shaped by land-ocean-atmosphere interactions in Asia between the western Pacific and eastern Indian Oceans. This study aims to provide a comprehensive view of the sub-fossil diatom biogeography, distribution pattern and oceanographic environmental controls with support of multivariate methods based on Beibu Gulf core-top samples. Cluster analysis of diatom assemblages divides the distribution pattern into four subclusters. Sea surface salinity (SSS), temperature (SST), trophic state (chlorophyll a concentration in this study) and water depth constrain the diatom distribution pattern through canonical redundancy analysis although only partly support an interpretation of the relationship between these various variables. Chlorophyll a has a strong correlation to diatom distribution, and responds to Paralia sulcata occurrence, while SSS and SST also have significant influence and indicate warm water invasion from the open SCS. Water depth is a subordinate factor in terms of Beibu Gulf diatom distribution. The ca. 25 m water-depth marks the upper extent of Paralia sulcata dominance in the northern Beibu Gulf. A strong mixing area with a complex diatom distribution exists below this water depth in the middle of Beibu Gulf. Coastal currents from north of SCS invade Beibu Gulf through Qiongzhou Strait and south of Hainan Island, as recorded by higher percentages of Paralia sulcata and Cyclotella striata at these sites. Our results provide a selection of evaluation method for a marine ecological red-line definition for sustainable development. This study highlights the perspective relationships between the spatial distribution of sub-fossil diatom assemblages in surface sediments and oceanographic variables, which could serve as a model for paleoenvironmental and paleoclimatic reconstruction in future marginal sea geoscience research for the Beibu Gulf, northwestern SCS.

What Was Old Is New Again: The Pennate Diatom Haslea ostrearia (Gaillon) Simonsen in the Multi-Omic Age

The marine pennate diatom Haslea ostrearia has long been known for its characteristic blue pigment marennine, which is responsible for the greening of invertebrate gills, a natural phenomenon of great importance for the oyster industry. For two centuries, this taxon was considered unique; however, the recent description of a new blue Haslea species revealed unsuspected biodiversity. Marennine-like pigments are natural blue dyes that display various biological activities—e.g., antibacterial, antioxidant and antiproliferative—with a great potential for applications in the food, feed, cosmetic and health industries. Regarding fundamental prospects, researchers use model organisms as standards to study cellular and physiological processes in other organisms, and there is a growing and crucial need for more, new and unconventional model organisms to better correspond to the diversity of the tree of life. The present work, thus, advocates for establishing H. ostrearia as a new model organism by presenting its pros and cons—i.e., the interesting aspects of this peculiar diatom (representative of benthic-epiphytic phytoplankton, with original behavior and chemodiversity, controlled sexual reproduction, fundamental and applied-oriented importance, reference genome, and transcriptome will soon be available); it will also present the difficulties encountered before this becomes a reality as it is for other diatom models (the genetics of the species in its infancy, the transformation feasibility to be explored, the routine methods needed to cryopreserve strains of interest).

Dermoscopy of Gottron's papules and other inflammatory dermatoses involving the dorsa of the hands

BACKGROUND

Several inflammatory dermatoses, including dermatomyositis (DM), may present as erythematous papules or plaques on the dorsal aspects of the hands over the joints. Limited skin involvement in these entities may pose a diagnostic challenge. (Video)dermoscopy is being utilized more frequently to aid in differential diagnosis of inflammatory skin conditions.

OBJECTIVE

To describe the dermoscopic findings in Gottron's papules and compare with dermoscopic features of other dermatoses involving the dorsal aspects of the hands.

METHODS

Videodermoscopic images from patients presenting with erythematous papules or plaques on the dorsal surface of the hands were retrospectively analyzed for the presence of standardized dermoscopic parameters.

RESULTS

Dermoscopic images from patients with DM (n=12), psoriasis (n=19), chronic dermatitis (n=16), mycosis fungoides (n=7), lichen planus (n=5) and pityriasis rubra pilaris (n=3) were included. Gottron's papules were characterized by pleomorphic vessels (dotted vessels accompanied by thick or thin linear vessels with branches or linear curved vessels) in 66.7% of cases, arranged in unspecified pattern (91.7%), and accompanied by white or pink structureless areas (75.0%). Psoriatic plaques were characterized by dotted vessels arranged in a uniform pattern (94.7%). Vessels arranged in a ring pattern were nearly exclusively observed in psoriasis, while yellow structureless areas and erosions were more frequently present in chronic dermatitis. White lines, corresponding to Wickham striae, were specific for lichen planus.

CONCLUSIONS

Videodermoscopy might be of value in differentiating Gottron's papules from other dermatoses involving dorsa of the hands.

Assessment of marine benthic diatom communities: insights from a combined morphological-metabarcoding approach in Mediterranean shallow coastal waters

We investigated the advantages and disadvantages of light microscope (LM)-based identifications and DNA metabarcoding, based on a 312-bp rbcL marker, for examining benthic diatom communities from Mediterranean shallow coastal environments. For this, we used biofilm samples collected from different substrata in the Ebro delta bays. We show that 1) Ebro delta bays harbour high-diversity diatom communities [LM identified 249 taxa] and 2) DNA metabarcoding effectively reflects this diversity at genus- but not species level, because of the incompleteness of the DNA reference library. Nevertheless, DNA metabarcoding offers new opportunities for detecting small, delicate and rare diatom species missed by LM and diatoms that lack silica frustules. The primers used, though designed for diatoms, successfully amplified rarely reported members of other stramenopile groups. Combining LM and DNA approaches offers stronger support for ecological studies of benthic microalgal communities in shallow coastal environments than using either approach on its own.

Diatom Mediated Production of Fluorescent Flower Shaped Silver-Silica Nanohybrid

Fabrication of flower-like nanostructures are gaining attention because of their high surface/volume ratio and extensive adsorption capacity. In the present investigation, flower-shaped, autofluorescent silver-silica (Ag-SiO₂) hybrid nanoparticles have been fabricated exploiting diatoms as a source of nanosilica. Two different species of Gedaniella including G. flavovirens and G. mutabilis showed their efficacy in synthesizing fluorescent Ag-SiO₂ nanoflowers (NFs) and nanospheres (NSs) against 9 mM silver nitrate solution, respectively. The biogenic nanoconjugate (Ag-SiO₂) was characterized by Uv-vis spectroscopy, energy dispersive X-ray spectroscopy (EDS), scanning (SEM) and transmission (TEM) electron microscopy. Production of Ag-SiO₂ hybrid nanoparticle was confirmed by observing both Ag and Si signals from a single nanoparticle in an EDS study. The broad and single absorption band at ~420 nm in Uv-vis spectroscopy confirmed proper miscibility and production of hybrid nanoparticles. The Ag-SiO₂ nanohybrids revealed autofluorescent property under the blue light region (excitation ~450–490 nm). SEM images of particles synthesized by G. flavovirens revealed the production of microscopic flower shaped Ag-SiO₂ particles with several layers of petals. A TEM study confirmed that the synthesized Ag-SiO₂ NFs are variable in size with 100–500 nm in diameter. Decolorization of methylene blue after exposure to Ag-SiO₂ particles confirmed catalytic activity of synthesized nanostructures. This eco-friendly method provides a new dimension in nanobiotechnology for biogenesis of such hierarchical nanostructure in a cost-effective way.

Nitzschia anatoliensis sp. nov., a cryptic diatom species from the highly alkaline Van Lake (Turkey)

In this article we describe Nitzschia anatoliensis Górecka, Gastineau & Solak sp. nov., an example of a diatom species inhabiting extreme habitats. The new species has been isolated and successfully grown from the highly alkaline Van Lake in East Turkey. The description is based on morphology (light and scanning electron microscopy), the sequencing of its organellar genomes and several molecular phylogenies. This species could easily be overlooked because of its extreme similarity to Nitzschia aurariae but molecular phylogenies indicate that they are only distantly related. Furthermore, molecular data suggest that N. anatoliensis may occur in several alkaline lakes of Asia Minor and Siberia, but was previously misidentified as Nitzschia communis. It also revealed the very close genetic proximity between N. anatoliensis and the endosymbiont of the dinotom Kryptoperidinium foliaceum, providing additional clues on what might have been the original species of diatoms to enter symbiosis.

Marine and brackish Luticola D.G.Mann (Bacillariophyta) species from the Java Sea and South China Sea coasts with the description of three new species

In this study, samples were collected from the Java Sea coasts, from the South China Sea in Hainan Island coasts and Quảng Yên region and Rú Chá mangrove near Hue in Central Vietnam. In studied samples a total of eight Luticola species have been observed. Three of the taxa studied are described herein as species new to science - Luticolaorientalis sp. nov., L.cribriareolata sp. nov. and L.halongiana sp. nov. Under light microscopy (LM) L.orientalis sp. nov. and L.cribriareolata sp. nov. are similar with rhombic-lanceolate to rhombic/ elliptic-lanceolate to elliptic valve shapes and narrowly rounded apices. Both species can be easily distinguished by stria density (higher density in L.orientalis). Under SEML.cribriareolata is characterized by cribrate areola occlusions, a character thus far observed only in three established species. The remaining species of the whole genus known thus far are characterized by hymenate areola. Similar morphology Luticola species have been observed from tropical mangrove forests from Madagascar but they all can be easily distinguished based on the lack of grooves in the central area. The third species - L.halongiana sp. nov. has rhombic-elliptic to rhombic-lanceolate valves with broadly rounded to slightly protracted apices in larger specimens. This species has a relatively broad central area. Also unique among brackish-water Luticola is the small, rounded stigma positioned almost midway between the valve center and valve margin. In the habitats from which the new species are described we also identified five established Luticola taxa including, L.belawanensis, L.celebesica, L.inserata, L.seposita and L.tropica. For those species we provide detailed SEM characteristics of valve ultrastructure, as well as the range of environmental conditions and geographic distribution within the study area.

Mitochondrial and Plastid Genomes of the Monoraphid Diatom Schizostauron trachyderma

We provide for the first time the complete plastid and mitochondrial genomes of a monoraphid diatom: Schizostauron trachyderma. The mitogenome is 41,957 bp in size and displays two group II introns in the cox1 gene. The 187,029 bp plastid genome features the typical quadripartite architecture of diatom genomes. It contains a group II intron in the petB gene that overlaps the large single-copy and the inverted repeat region. There is also a group IB4 intron encoding a putative LAGLIDADG homing endonuclease in the rnl gene. The multigene phylogenies conducted provide more evidence of the proximity between S. trachyderma and fistula-bearing species of biraphid diatoms.

Duration of dual antiplatelet therapy and long-term outcomes following drug-eluting balloon or drug-eluting stents for treatment of in-stent restenosis (DAPT-Dragon Registry)

Objectives

The aim of the DAPT-DRAGON registry was to asses long-term outcomes and the length of dual antiplatelet therapy (DAPT) in patients treated with percutaneous coronary intervention (PCI) due to drug-eluting stent in stent restenosis (DES-ISR) with drug-eluting balloons (DEB) or thin-DES.

Background

Data regarding the duration of DAPT in patients with DES-ISR treated with PCI is still undergoing research and observation, and the adequate duration of DAPT in this group of patients is not unambiguously sanctioned.

Methods

Overall, 1,367 consecutive patients with DES-ISR who underwent PCI with DEB or DES, were entered into the multi-center DAPT-DRAGON Registry (Fig. 1). The mean age was 66.7±9 years (70.5% males). The median follow-up was 3.3 years. There were 34.1% patients with chronic coronary syndrome, 35.2% with unstable angina, 2.9% with ST segment elevation myocardial infarction and 27.7% with non-ST segment elevation myocardial infarction (MI). We assessed selected study endpoints according to the duration of DAPT (≤3 vs. >3 months and ≤6 vs. >6 months), before and after propensity score matching (PSM): stroke, target lesion revascularization (TLR), target vessel revascularization (TVR), MI, death and device-oriented composite endpoints (DOCE).

Results

Among predictors of increased DOCE rate before PSM, we demonstrated: PCI with DEB vs. DES (p<0.001), recurrent ISR (p=0.002), treatment with glycoprotein IIb/IIIa inhibitor during PCI (p<0.001), lower left ventricle ejection fraction (p=0.004) and extent of stenosis (p<0.001). Pairwise contrast analysis considering type of PCI (thin-DES vs. DEB) and duration of DAPT (≤6 vs. >6 months) before PSM revealed superiority of thin-DES+DAPT >6 months vs. DEB+DAPT >6 months for DOCE (p<0.001), TVR (p=0.02) and TLR (p=0.01). After PSM analysis, the length of DAPT (≤3 vs. >3 months) had no significant influence on assessed long-term outcomes, while the percentage of stroke free survival was significantly lower in the group of patients with DAPT ≤6 months vs. >6 months (p=0.01; Fig. 2).

Conclusions

Long-term treatment with DAPT (>6 months) in patients with DES-ISR with DES implantation is related to better long-term outcomes in terms of lower rate of DOCE, TVR and TLR compared to PCI with DEB. DAPT >6 months is related to a greater rate of strokes, independently of the type of treatment (thin-DES and DEB) compared to DAPT ≤6 months.

Funding Acknowledgement

Type of funding sources: None. Figure 1Figure 2

Gender distribution in patients treated with rotablation – analysis of 5,177 percutaneous coronary interventions based on a large national registry from between 2014 and 2020

Background

Patients undergoing percutaneous coronary intervention (PCI) procedures using rotational atherectomy (RA) are a special group of patients characterised by the presence of massive calcifications in the coronary arteries. Due to a significant increase regarding the frequency of these procedures in recent years and the distinctiveness of this narrow group of patients among all patients undergoing PCIs, we have characterised the group according to gender.

Aims

The aim of analysis was to assess the gender percentage share in following years and differences between both groups of Polish patients undergoing PCI with rotational RA between 2014 and 2020.

Methods

Based on the Polish National Registry of Percutaneous Coronary Interventions (ORPKI), we analysed 751,113 patients treated with PCI between 2014 and 2020. Then, we extracted 5,177 (0.7%) treated with PCI and RA, 3,552 of them (68.6%) were males. Selected indices among the two groups were compared using the t-test for continuous variables, the χ2 test or the likelihood-ratio test for nominal variables where appropriate. To compare means of samples in the following years, one-way ANOVA test was used.

Results

The results of the study indicate an upward RA tendency in successive years (p<0.001). Moreover, this tendency and its increase was greater between the years 2016–2019 (Fig. 1). Almost twice as many RA procedures pertain to men, while the percentage share did not undergo a significant change in following years (Fig. 2). The mean age was 72±9 years in the overall group. In the total group, there were 2,873 patients (55.49%) with chronic coronary syndrome, 1,033 (19.95%) with unstable angina, 654 (12.63%) with non-ST segment elevation myocardial infarction (NSTEMI) and 494 (9.54%) with ST segment elevation myocardial infarction (STEMI).

Females were significantly older in comparison to males [75.2±8.3 vs. 70.5±9.2, p<0.001], more often diabetics [613 (37.72%) vs. 1,068 (30.07%), p<0.001], less often smokers [173 (10.6%) vs. 635 (17.9%), p<0.001] and were significantly more often treated due to acute coronary syndrome [780 (48.8%) vs. 1,401 (40.5%), p<0.001]. Considering periprocedural complications among females, there were more cardiac arrests [13 (0.8%) vs. 10 (0.28%), p=0.01] and deaths [11 (0.68%) vs. 6 (0.17%), p=0.006] when compared to males.

Conclusion

The percentage of RA among overall PCIs has been still growing in recent years in Poland. The majority of patients treated with RA are men. Gender distribution did not change significantly among patients treated with PCI and RA during the analysed period of time.

Funding Acknowledgement

Type of funding sources: None.

Hybrid telerehabilitation in patients with hypertrophic cardiomyopathy without left ventricular outflow tract obstruction and preserved left ventricular ejection fraction-the randomised clinical trial

Background

Hypertrophic cardiomyopathy (HCM) is the most common hereditary heart disease, and its diagnosis is often associated with limited physical activity. Little is known about cardiac rehabilitation programs for patients with HCM. Therefore the novel hybrid cardiac telerehabilitation (HCTR) model consisting of hospital-based rehabilitation and home-based telemonitored rehabilitation might be an option to improve physical capacity in patients with HCM.

Purpose

To evaluate the safety, effectiveness and adherence to HCTR in patients with HCM without the left ventricle (LV) outflow tract obstruction and preserved LV ejection fraction.

Methods

The study group comprised 60 patients with HCM (51.1±13.3 years; NYHA II-III; LV ejection fraction 66.1±6.9%). Patients were randomised (1:1) to either HCTR program (hospital-based rehabilitation [1 month] based on cycloergometer training and home-based telemonitored rehabilitation [2 months] based on Nordic walking, five times a week, at 40–70% of maximal estimated heart rate) - training group (TG), or to a control group (CG). All patients had implantable cardioverter-defibrillator. In order to perform home-based telemonitored rehabilitation, a special device was used which enabled patients to: (1) do Nordic walking training according to a preprogrammed plan, (2) record and send electrocardiograms (ECGs) via mobile phone network to the monitoring centre. The moments of automatic ECGs registration were pre-set and coordinated with exercise training. The effectiveness of HCTR was assessed by changes - delta (Δ) in duration (t) of the workload, peak oxygen consumption (pVO2) in cardiopulmonary exercise test, 6-minute walking test distance (6-MWT) as a result of comparing t (s), pVO2 (ml/kg/min), 6-MWT (m) from the beginning and the end of the program.

Results

Safety of HCTR. Neither death nor other serious adverse events occurred during HCTR. We did not observe any ICDs intervention during the HCTR.

Effectiveness of HCTR: Within-group analysis: t, pVO2, 6-MWT increased significantly in TG: t 657±183 vs 766±181 (p<0.001), pVO2 19.2±5.0 vs 20.6±4.9 (p=0.007), 6-MWT 445±88 vs 551±77 (p<0.001). In the untrained CG, the unfavourable results were observed: 695±198 vs 717±187 (p=0.114), pVO2 21.2±5.1 vs 21.1±5.6 (p=0.723), 6-MWT 512±83 vs 536±84 (p=0.061).

Between-group analysis: The differences between TG and CG were statistically significant: in Δt (p<0.001); ΔpVO2 (p=0.012); Δ6-MWT (p<0.001).

Adherence to HCTR: In TG 28 patients (93%) completed the HCTR program. Two patients did no undergo HCTR because of personal issues.

Conclusion

Hybrid cardiac telerehabilitation in patients with HCM without the left ventricle (LV) outflow tract obstruction and preserved LV ejection fraction is safe and effective. The adherence to HCTR is high.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Statutory work in The Cardinal Stefan Wyszyński National Institute of Cardiology in Warsaw, Poland

Intravascular ultrasound for valve frame expansion and orifice area measurement as well as paravalvular leak assessment during transcatheter aortic valve replacement

Introduction

Valve frame expansion (measured outer valve frame area/nominal valve dimension), but not oversizing (nominal valve dimension/annulus area, %) determines pattern of restored blood flow after transcatheter aortic valve replacement (TAVR). There is no online measure of frame expansion, and error in current echocardiographic assessment of effective orifice area (EOA) and paravalvular leak (PVL) are common.

Purpose

To evaluate large imaging field intravascular ultrasound (IVUS) during TAVR for measuring valve geometry [frame expansion, minimal geometric orifice area (min GOA), and mechanism of PVL] with transthoracic echo and angio-CT serving for comparative measures, along with the nominal EOA as established by Hahn et al.

Methods

After successful TAVR either a 10MHz Vision PV 0.035" (60mm imaging field) or 20MHz Vision PV 0.018" (24mm imaging field plus Chr omaFlo) IVUS catheter (Philips) was slowly pulled from the left ventricle outflow (LVOT) to the aorta with continuous imaging of the aortic root.

Results

There were 16 pts (80.8±7.1 yrs, 8 female) treated for de novo aortic stenosis (n=15) or failed bioprosthesis (n=1), 7 of whom were treated with balloon-expandable TAVR. PV 0.35" catheters were used in 8 pts (including valve-in-valve) and allowed complete geometry assessment of 26.6±2.7mm nominal prosthesis Ø (Figure 1A) whereas PV 0.018" allowed complete geometry assessment in only 4 of 8 pts with nominal prosthesis Ø of 26.1±2.8mm (Figure 1B). Actual % valve inflow expansion (IVUS outer frame/valve nominal dimension) was significantly smaller than % valve oversizing (80%±19% vs 125±19%, p=0.005). Min GOA was substantially bigger than corresponding nominal EOA and EOA calculated using the post-procedural LVOT diameter (272±84mm2 vs 174±25mm2 vs 181±59mm2, p=0.001 correspondingly). However, min GOA was similar to EOA calculated using baseline LVOT area (272±84mm2 vs 230±90mm2; r=0.713, p=0.009). IVUS and angio-CT measurements of outer prosthesis frame area were similar for inflow, coaptation site, and outflow (460±143mm2 vs 454±134mm2 and 455±134mm2 vs 447±114mm2 and 722±174mm2 vs 725±180; p≤0.001 for all paired correlations). Inflow expansion (IVUS outer frame/baseline CT annulus area) tended to be smaller among valves with ≥mild vs no PVL (95±14% vs 107±11%, p=0.156), with clear ChromaFlo signal seen in the space between the aortic annulus wall and outer-valve frame surface (Figure 1C).

Conclusions

Large imaging field IVUS during TAVR allows for peri-procedural assessment of actual valve geometry that differs substantially from nominal. IVUS offers online tomographic perspective and highest accuracy in anatomy evaluation corresponding with valve function.

Funding Acknowledgement

Type of funding sources: None. Figure 1

Multigene phylogenetic data place monoraphid diatoms Schizostauron and Astartiella along with other fistula-bearing genera in the Stauroneidaceae1

Presented here are new insights into the marine monoraphid diatom genera Schizostauron and Astartiella, based on molecular and morphological data, including descriptions of new species. Although no unambiguous morphological synapomorphies between the two genera are currently recognized, they are closely related by DNA sequence data. Heterovalvate frustules of Schizostauron are characterized by a bifid stauros on the raphe-bearing valve and intricate areolate occlusions on the sternum valve. In Astartiella, the raphe-bearing valve is characterized by a process resembling a fistula by morphology, while the sternum valve presents a particular striation pattern. Observations by light and electron microscopy were made, along with a molecular phylogenetic analysis using a three-gene (SSU, rbcL, and psbC) concatenated dataset. Three new Schizostauron species are described (S. kajotkei, S. rawaii, S. papilliareae), and two new combinations proposed (S. citronella and S. trachyderma) for species that were previously included either in Achnanthes and Cocconeis, respectively. Likewise, six new species of Astartiella (A. almalikii, A. bornmanii, A. chunlianlii, A. marksii, A. persica, and A. wangii) are described. Molecular results exclude Schizostauron and Astartiella from three clades of exclusively monoraphid diatoms, the Achnanthaceae, Cocconeidaceae, and Achnanthidiaceae, instead placing them in the Stauroneidaceae. Morphological features of Schizostauron and Astartiella, such as the stauros, fistula, and coaxial internal proximal raphe endings, are found in other genera in this clade, whereas the only common feature with monoraphid diatoms as whole group is the heterovalvy of frustules.

Reducing Efficiency of Fucoxanthin in Diatom Mediated Biofabrication of Gold Nanoparticles

In the present investigation, fucoxanthin—one of the major pigments in diatoms—has been extracted from Nanofrustulum shiloi SZCZM1342, and its reducing efficiency in the biogenesis of gold nanoparticles (GNPs) was checked. Fucoxanthin extracted from golden-brown cells of N. shiloi was compared to the healthy, growing biomass of N. shiloi and standard fucoxanthin after separate exposure to 25 mg L⁻¹ aqueous hydrogen tetrachloroaurate solutions at room temperature. Isolated and standard fucoxanthin were found to be able to reduce gold ions within 12 h whereas, the whole biomass turned pink in color after 72 h of reaction. The synthesized particles were characterized by UV-vis spectroscopy, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). UV–vis spectroscopy of purple-colored suspensions showed the absorption band at approximately 520–545 nm, indicating a strong positive signal for GNP synthesis. The SEM study revealed the deposition of GNPs on siliceous frustules of metal-treated diatom cells. The TEM analysis confirmed the GNPs synthesized by whole biomass are triangular, spherical and hexagonal in nature, whereas the particles produced by extracted and standard fucoxanthin are all spherical in nature. This study demonstrates the involvement of fucoxanthin in the reduction of gold ions and subsequent production of gold nanospheres.

Extreme Enlargement of the Inverted Repeat Region in the Plastid Genomes of Diatoms from the Genus Climaconeis

We sequenced the plastid genomes of three diatoms from the genus Climaconeis, including two strains formerly designated as Climaconeis scalaris. At 208,097 and 216,580 bp, the plastid genomes of the latter strains are the largest ever sequenced among diatoms and their increased size is explained by the massive expansion of the inverted repeat region. Important rearrangements of gene order were identified among the two populations of Climaconeis cf. scalaris. The other sequenced Climaconeis chloroplast genome is 1.5 times smaller compared with those of the Climaconeis cf. scalaris strains and it features an usual quadripartite structure. The extensive structural changes reported here for the genus Climaconeis are compared with those previously observed for other algae and plants displaying large plastid genomes.

Diatom Genus Hyalosira (Rhabdonematales emend.) and Resolution of its Polyphyly in Grammatophoraceae and Rhabdonemataceae with a New Genus, Placosira, and Five New Hyalosira Species

Hyalosira gene sequences are divided into two clades within different families. We examined authentic material of Hyalosira (isotype material of H. obtusangula, synonymous with H. delicatula) and voucher specimens of published sequences, and pooled our observations of Hyalosira-like taxa from benthic and epizoic habitats in several parts of the globe. The two molecular clades corresponded to two morphological groups, with Hyalosira obtusangula associated with Grammatophoraceae. We emend the description and provide lectotypification for Hyalosira and propose Placosira to encompass the taxa in the other clade, associated with Rhabdonemataceae. We propose that Hyalosira has uniseriate to triseriate striae, sometimes different on valve face and mantle. Copulae in most species had shallow septa, though in one they were moderately deep. All species had girdle bands bearing two rows of areolae separated by a midrib. We name five new species of Hyalosira. Morphologies of taxa in the Placosira clade were superficially similar to Hyalosira but differed in having areolae with ricae, a single row of areolae on the girdle bands, and tubular rimoportulae on the valve-face-mantle junction. Hyalosira hustedtiana Patrick should revert to its original position in Striatella until the appropriate genus can be determined. We emend Rhabdonematales to encompass Rhabdonemataceae, Grammatophoraceae and Tabellariaceae.

Haslea silbo, A Novel Cosmopolitan Species of Blue Diatoms

Specimens of a new species of blue diatoms from the genus Haslea Simonsen were discovered in geographically distant sampling sites, first in the Canary Archipelago, then North Carolina, Gulf of Naples, the Croatian South Adriatic Sea, and Turkish coast of the Eastern Mediterranean Sea. An exhaustive characterization of these specimens, using a combined morphological and genomic approach led to the conclusion that they belong to a single new to science cosmopolitan species, Haslea silbo sp. nov. A preliminary characterization of its blue pigment shows similarities to marennine produced by Haslea ostrearia, as evidenced by UV-visible spectrophotometry and Raman spectrometry. Life cycle stages including auxosporulation were also observed, providing data on the cardinal points of this species. For the two most geographically distant populations (North Carolina and East Mediterranean), complete mitochondrial and plastid genomes were sequenced. The mitogenomes of both strains share a rare atp6 pseudogene, but the number, nature, and positions of the group II introns inside its cox1 gene differ between the two populations. There are also two pairs of genes fused in single ORFs. The plastid genomes are characterized by large regions of recombination with plasmid DNA, which are in both cases located between the ycf35 and psbA genes, but whose content differs between the strains. The two sequenced strains hosts three plasmids coding for putative serine recombinase protein whose sequences are compared, and four out of six of these plasmids were highly conserved.

Three new Luticola D.G.Mann (Bacillariophyta) species from Rapa Nui (Easter Island) found in terrestrial diatom assemblages dominated by widely distributed taxa

Background

Rapa Nui (Easter Island = Isla de Pasqua) is of volcanic origin, best known for about 900 man-made stone statues known as moai. It is one of the most isolated inhabited islands on Earth and studies on the diatoms of Rapa Nui are very few.

Methods

Light (LM) and electron microscopic (SEM) observations of a single sample collected from Rapa Nui are presented. The samples (mix of soil and organic detritus) were collected from ground of cave entrance.

Results

The samples were characterized by low diatom diversity and strongly dominated by terrestrial (soil) forms. Among the taxa present in the material studied were cosmopolitan forms of the genera Humidophila, Nitzschia, Angusticopula, Orthoseira, Tryblionella and Luticola. Whereas most of taxa of the enumerated genera were identifiable, only one among four Luticola species distinguished in the samples studied was identified. This taxon was L. ectorii, a cosmopolitan species known previously from South America (Brazil) and Asia (China). The three remaining species could not be assigned to any established species. Therefore, based on external and internal morphological features from light and scanning electron microscopic analysis, we describe here three species new to science, including: L. georgzizkae, L. rapanuiensis and L. moaiorum. All three taxa new to science are compared to established Luticola species and their significance for the global distribution of the genus is discussed.

Metadata standards and practical guidelines for specimen and DNA curation when building barcode reference libraries for aquatic life

DNA barcoding and metabarcoding is increasingly used to effectively and precisely assess and monitor biodiversity in aquatic ecosystems. As these methods rely on data availability and quality of barcode reference libraries, it is important to develop and follow best practices to ensure optimal quality and traceability of the metadata associated with the reference barcodes used for identification. Sufficient metadata, as well as vouchers, corresponding to each reference barcode must be available to ensure reliable barcode library curation and, thereby, provide trustworthy baselines for downstream molecular species identification. This document (1) specifies the data and metadata required to ensure the relevance, the accessibility and traceability of DNA barcodes and (2) specifies the recommendations for DNA harvesting and for the storage of both voucher specimens/samples and barcode data.

A gene-rich and compact chloroplast genome of the green alga Nephroselmis pyriformis (N.Carter) Ettl 1982 from the shores of Mersin (Eastern Mediterranean Sea)

We report the complete chloroplast genome of the MED1 strain of Nephroselmis pyriformis from the Eastern Mediterranean Sea. At 111,026 bp, this genome is smaller and more compact than those of Nephroselmis olivacea and Nephroselmis astigmatica, and in contrast to the latter taxa, its inverted repeat contains no complete protein-coding genes. It encodes 3 rRNAs, 33 tRNAs and 94 proteins. Maximum likelihood analysis of a concatenated set of chloroplast genes from green algae belonging to deep-diverging lineages positioned the three Nephroselmis species in a strongly supported clade in which N. pyriformis is sister to N. astigmatica.

trans-3-Methylglutaconyl CoA isomerization-dependent protein acylation

3-methylglutaconic (3MGC) aciduria is associated with a growing number of discrete inborn errors of metabolism. Herein, an antibody-based approach to detection/quantitation of 3MGC acid has been pursued. When trans-3MGC acid conjugated keyhole limpet hemocyanin (KLH) was inoculated into rabbits a strong immune response was elicited. Western blot analysis provided evidence that immune serum, but not pre-immune serum, recognized 3MGC-conjugated bovine serum albumin (BSA). In competition ELISAs using isolated immune IgG, the limit of detection for free trans-3MGC acid was compared to that for cis-3MGC acid and four structurally related short-chain dicarboxylic acids. Surprisingly, cis-3MGC acid yielded a much lower limit of detection (∼0.1 mg/ml) than trans-3MGC acid (∼1.0 mg/ml) while all other dicarboxylic acids tested were poor competitors. The data suggest trans-3MGC- isomerized during, or after, conjugation to KLH such that the immunogen was actually comprised of KLH harboring a mixture of cis- and trans-3MGC haptens. To investigate this unexpected isomerization reaction, trans-3MGC CoA was prepared and incubated at 37 °C in the presence of BSA. Evidence was obtained that non-enzymatic isomerization of trans-3MGC CoA to cis-3MGC CoA precedes intramolecular catalysis to form cis-3MGC anhydride plus CoASH. Anhydride-dependent acylation of BSA generated 3MGCylated BSA, as detected by anti-3MGC immunoblot. The results presented provide an explanation for the unanticipated detection of 3MGCylated proteins in a murine model of primary 3MGC aciduria. Furthermore, non-enzymatic hydrolysis of cis-3MGC anhydride represents a potential source of cis-3MGC acid found in urine of subjects with 3MGC aciduria.

Calcified mitro-aortic continuity and mitral regurgitation in patients undergoing transcatheter aortic valve replacement

Introduction

Calcified aortic stenosis (AS) and mitral annular calcification (MAC) have similar etiology and pathophysiological mechanisms. Half of all patients undergoing transcatheter aortic valve implantation (TAVI) have MAC. Several studies assessed the role of mitral regurgitation (MR) following TAVI but only few examined influence of MAC on its changes after TAVI. MAC frequently coexists with the calcification of mitro-aortic continuity (CMAC).

Purpose

Presence of CMAC may influence the results of TAVI, especially in the case of deeper implantation, protruding to let ventricular outflow tract (LVOT). In the present study we aimed at qualitative and semi-quantitative analysis of calcifications of the mitral complex – MAC and CMAC in multi-slice computed tomography (MSCT) in patients qualified to TAVI, in order to assess their impact on the occurrence and dynamics of MR following aortic valve implantation.

Methods

MAC was assessed quantitatively (Calcium Score) and semi-quantitative scale in depending on the degree of annular involvement. CMAC was evaluated in semi-quantitatively scale in depending on length of calcifications in the largest dimension. Subsequently patients were classified in a dichotomous manner as having non-severe or severe MAC and CMAC. All patients underwent transthoracic echocardiographic examinations prior to the procedure and after TAVI. Changes of MR severity following TAVI were defined as no change, improvement or worsening by at least one degree.

Results

The study group consisted of 94 patients. Fifty six (59.6%) out of 94 patients had MAC and 21 patients (22.3%) had severe MAC. Patients with MAC had higher mean aortic gradients (54.07±13,62 mmHg vs 46.79±14.42 mmHg, p=0.02) and smaller left ventricular diastolic diameter (46.09±6.86 mm vs 51.19±8.42 mm, p=0.002). Almost half of the patients - 46 (48.9%) had CMAC and 12 patients (12.8%) had severe CMAC. Patients with CMAC had higher Calcium Score Aortic Valve (3773.67±1734.02 Hounsfield Units (HU) vs 2875.1±1352.76 HU, p=0.006) and smaller AVA (0.59±0.16 cm2 vs 0.66±0.20 cm2, p=0.052). Before TAVI 35.1% of patients had more than mild MR. MR improved by at least one grade following TAVI in 17 (18.1%) patients and worsened by at least one grade in 7 (7.5%) patients. In multivariable logistic regression analysis MR worsening was associated with higher CMAC [OR 1.092, 95% CI: 1.006–1.185, p=0.035].

Conclusions

The study demonstrated CMAC is prevalent in patients undergoing TAVI. CMAC was associated with MR worsening. This is a novel finding, which may be particular importance in patients with severe AS and coexisting MR in whom arguments for and against surgical repair of concomitant mitral insufficiency are considered, as opposed to isolated aortic valve procedure.

Funding Acknowledgement

Type of funding source: None

Infarct-related artery and long-term mortality following recurrent ST-elevation myocardial infarction; insights from a Polish nationwide registry

Background

Recurrent ST-elevation myocardial infarction (rSTEMI) occurs either as an acute thrombotic event in the same (target-vessel, TV-STEMI) or different vessel (non-target, nonTV-STEMI) compared with the first infarction. Little is known about the frequency of rSTEMI in the era of primary percutaneous coronary intervention (PCI) and about the impact of the infarct-related artery (IRA) on long-term prognosis.

Purpose

We hypothesized that long-term mortality after rSTEMI varies according to IRA (either same or different compared with first STEMI).

Methods

We retrospectively analysed data from the Polish Registry of Acute Coronary Syndromes (PL-ACS) and identified survivors of first STEMI treated with PCI who experienced rSTEMI and were discharged home. We divided rSTEMI into TV-STEMI and nonTV-STEMI group. We compared baseline clinical, angiographic and procedural characteristics and utilized propensity score matching to adjust for baseline differences. 1-, 3- and 5-year all-cause mortality was obtained from the Polish National Health Fund. Categorical variables were presented as counts and percentages and compared using Chi2 test. Continuous variables were presented as medians and interquartile ranges and compared using Mann-Whitney test. The registry was approved by local Ethics Committee and meets the conditions of the Declaration of Helsinki

Results

Between January 2003 and August 2019 a total of 3517 patients (mean age 62.9 years, 75% male) had rSTEMI, of whom 1941 (55%) had TV- and 1576 (45%) had nonTV-STEMI after 615 (77, 1683) days since first infarction (Figure 1). Patients with nonTV-STEMI had higher BMI (27.2 vs 26.8 kg/m2, p=0.03), more hypertension (76.9 vs. 73.5%, p=0.02) and atrial fibrillation (4.7 vs. 3.3%, p=0.04), but had lower left ventricular ejection fraction (43 [35,50] vs. 45 [38,50], p<0.001) compared with TV-STEMI. On coronary angiography nonTV-STEMI had more frequently TIMI flow ≥1 (44.9 vs. 28.0%, p<0.001), multivessel disease (51.8 vs. 41.1%, p=0.003), culprit lesion located in circumflex artery (15.2 vs. 4.8, p<0.001) and more frequently underwent stenting (88.4 vs. 76.1%, p<0.001) compared with TV-STEMI. There was no difference in unadjusted 1-, 3- and 5-year mortality between nonTV-STEMI and TV-STEMI group (14.9 vs. 14.7%, p=0.9; 23.4 vs. 24.2%, p=0.64 and 29.6 vs. 32.9%, p=0.1 respectively). The propensity-score matching of 825 patients with TV- and 826 patients with nonTV STEMI suppressed all baseline differences, but adjusted mortality remained similar between study groups (Figure 1).

Conclusion

While patients with recurrent nonTV-STEMI have different clinical and angiographic characteristics compared with TV-STEMI, the long-term mortality in these groups is similar.

Figure 1

Funding Acknowledgement

Type of funding source: None

Managed care improves prognosis in acute myocardial infarction survivors. Data from the MAnaged Care for Acute Myocardial Infarction Survivors (MACAMIS) Programme

Background

Mortality following acute myocardial infarction (MI) remains high despite progress in pharmacotherapy and interventional treatment. In 2017 a nation-wide system of managed care for MI survivors comprising a continuum of acute treatment of MI, staged revascularization, cardiac rehabilitation, cardiac electrotherapy and cardiac ambulatory care within one year following MI was implemented in Poland. The managed care programme (MCP) includes also the quality of care assessment based on clinical measures (e.g. cardiovascular risk factors control) as well as on the rate of minor and major cardiovascular events. The goal of the analysis was to assess the overall mortality of MI survivors participating and not participating in the MCP.

Methods

The database of survivors of acute MI discharged from hospital from October 1, 2017 to December 31, 2018 was analyzed. Patients who died within 10 days after discharge were excluded from the analysis. The primary end-point was defined as death from any cause. Propensity-Score Matching (PSM) using nearest neighbor matching was used to form comparable groups of patients participating and not participating in the MCP. The Cox proportional hazard regression analysis was used to assess the relation between MCP and the overall mortality.

Results

MCP was implemented in the first stage in 48 hospitals spread around the country (about 34% of all hospitals treating acute MI patients in Poland). Out of 87739 analyzed patients (age: 68.1±11.9 years; 55581 men and 32158 women) 34064 were hospitalized in hospitals with MCP implemented. Altogether 10404 patients (11.9% of the whole cohort; 30.5% of those hospitalized in hospitals with MCP implemented) participated in MCP. They were matched with 10404 patients not participating in the MCP. During 324.8±140.5 days of follow-up 7413 patients died. One-year mortality was lower in patients participating in the MCP both when we analyzed the whole cohort (4.4% vs. 9.5%; p<0.001) as well as when we limited the analysis to the PSM groups (4.4% vs. 6.5%; p<0.001, figure 1). MCP was related to the overall mortality in univariate (HR 0.43 [0.39–0.48]) as well as in multivariate analysis (0.64 [0.57–0.71]) in the whole cohort as well as in the PSM cohort (HR 0.63 [0.56–0.72] and 0.64 [0.56–0.72] for the univariate and multivariate analysis respectively). When we limited the analysis to hospitals in which MCP was implemented one-year mortality was 4.3% vs. 6.3% (p<0.001) whereas univariate HR was 0.51 (0.44–0.60) and multivariate HR 0.52 (0.44–0.61).

Conclusion

The implemented in Poland nation-wide system of managed care for MI survivors is related to improved survival. Therefore, the Ministry of Health plans to implement the programme in all cardiac centers in Poland.

Funding Acknowledgement

Type of funding source: None

Impact of annular and cusps calcification on occurrence of paravalvular leak after transcatheter aortic valve replacement with intra- versus supra-annular devices

Introduction

Severe annular and valve cusps calcification is frequent among patients treated with transcatheter aortic valve replacement (TAVR). Severe annular calcification increases the risk of paravalvular leak (PVL) and was associated with worse outcomes. Whether it is accompanied by an independent effect of calcifications localized on cusps and whether the impact of cusps/annular calcification depends on supra vs intra-annular valve design is unknown.

Purpose

To assess the impact of cusps/annular calcifications on occurrence of moderate PVL after successful TAVR with devices of either intra- or supra-annular design.

Methods

282 consecutive patients (80.3±7.6 yrs, 63% female) with baseline 384-slice CT scan were successfully treated with TAVR between Jul 2012 and Oct 2017, either with intra-annular or supra-annular devices. Severe annular calcification (clear protrusion) and severe cusps calcification (Rosenhek 4 score) were identified using a Syngo Via.

Results

138 (48.9%) patients were treated with intra-annular and 144 (51.15) with supra-annular devices. Whereas severe annular calcification was similar (23.9% vs 20.1%), there was more severe cusps calcification among intra-annular valves (52.9% vs 41.7%, p=0.073). Intra-annular devices were used less frequently among bicuspid aortic valves, were also of smaller diameter, less frequently deployed after pre-dilation, and less frequently post-dilated. Post-procedure mean aortic gradient tended to be higher among intra-annular devices. Moderate PVL was less frequent among intra- vs supra-annular valves (14.5% vs 34.0%, p<0.001). However, PVL occurrence was higher (30.3%) among those (33/138, 23.9%) treated with an intra-annular valve who had severe annular calcification vs 9.5% in pts treated with an intra-annular TAVR who did not have severe annular calcification (p=0.008) unlike in patients treated with a supra-annular valve who had a high frequency of PVL with or without severe annular calcium (37.9% vs 33.0%). After excluding patients with severe annular calcium (n=62, 22%), moderate PVL was similar between those with vs without severe cusp calcification whether treated with intra- or supra-annular valves (11.8% vs 7.4% and 29.3% vs 35.1%, respectively). Combined VARC-2 safety endpoints plus 2-yr mortality occurrence were lower for intra- vs supra-annular devices (30.4% vs 43.8%, p=0.026).

Conclusions

Moderate PVL after intra-annular TAVR device deployment occurs in 30% of patients with protruding annular calcification. Severe cusps calcification unaccompanied by annular calcium was not associated with PVL occurrence. Higher frequency of moderate PVL (34%) seen after supra-annular valve deployment appears to be related to other parameters rather than presence of severe annular or cusps calcification.

Funding Acknowledgement

Type of funding source: None

Ripe for reassessment: A synthesis of available molecular data for the speciose diatom family Bacillariaceae

The Bacillariaceae is a very species-rich family of raphid diatoms and includes the large and taxonomically difficult genus Nitzschia, whose species are often small-celled and finely structured and have few discrete morphological characters visible in the light microscope. The classification of Nitzschia is still mostly based on one developed in the second half of the 19th century by Grunow, who separated the genus into a series of sections largely on cell shape and symmetry, the position of the raphe, transverse extension of the fibulae, and folding of the valve. We assembled and analysed single-gene and concatenated alignments of nSSU, nLSU, rbcL, psbC and cox1 to test Grunow's and subsequent classifications and to examine selected morphological characters for their potential to help define monophyletic groups. The maximum likelihood trees were equivocal as to monophyly of the family itself but showed good support for each of eight main clades of Bacillariaceae, three of which corresponded more or less to existing genera (Hantzschia, Cylindrotheca and Bacillaria). The other five main clades and some subclades comprised groups of Nitzschia species or assemblies of Nitzschia species with other genera (Pseudo-nitzschia, Fragilariopsis, Neodenticula, Tryblionella, Psammodictyon). Relationships between most of the eight main clades were not resolved robustly but all analyses recovered Nitzschia as non-monophyletic. The Grunowian classification of Nitzschia into sections was not supported, though in some respects (e.g. treatment of sigmoid species) it is better than subsequent reclassifications. Several of the main clades and subclades are cryptic (lacking morphological synapomorphies) and homoplasy is common in both light microscopical and ultrastructural characters (to the extent that organisms initially assigned to the same species sometimes prove to belong to a different main clade). Nevertheless, some characters, including the structure of the raphe canal and girdle, seem to be sufficiently conservative evolutionarily to give a provisional estimate of relationships if molecular data are unavailable. No new formal classifications are proposed but various options are explored and research needs identified.

The Taxonomy and Diversity of Proschkinia (Bacillariophyta), A Common But Enigmatic Genus from Marine Coasts

Detailed morphological documentation is provided for established Proschkinia taxa, including the generitype, P. bulnheimii, and P. complanata, P. complanatula, P. complanatoides and P. hyalosirella, and six new species. All established taxa are characterized from original material from historical collections. The new species described in this paper (P. luticola, P. staurospeciosa, P. impar, P. modesta, P. fistulispectabilis, and P. rosowskii) were isolated from the Western Pacific (Yellow Sea coast of Korea) and the Atlantic (Scottish and Texas coasts). Thorough documentation of the frustule, valve and protoplast architecture revealed the combination of characters diagnostic of the genus Proschkinia: a single-lobed chloroplast; a broad girdle composed of U-shaped, perforated bands; the position of the conopeate raphe-sternum relative to the external and internal valve surface; and the presence of an occluded process through the valve, termed the "fistula". Seven strains of Proschkinia were grown in culture and five of these were sequenced for nuclear ribosomal SSU and plastid-encoded rbcL. Phylogenetic analysis recovered a clade of Proschkinia with Fistulifera, another fistula-bearing diatom genus, and together these were sister to a clade formed of the Stauroneidaceae; in turn, all of these were sister to a clade composed of Parlibellus and two monoraphid genera Astartiella and Schizostauron. Despite morphological similarities between Proschkinia and the Naviculaceae, these two taxa are distant in our analysis. We document the variation in the morphology of Proschkinia, including significant variability in the fistula, suggesting that fistula ultrastructure might be one of the key features for species identification within the genus.

Biodiversity of carapace epibiont diatoms in loggerhead sea turtles (Caretta caretta Linnaeus 1758) in the Aegean Sea Turkish coast

Background

The Aegean Sea coast of Turkey hosts one of the most important nesting grounds for loggerhead sea turtles (Caretta caretta) in the Mediterranean Sea. Previous studies have revealed that the sea turtle carapace provides favourable conditions for various epibiontic organisms. Epibionts occurring on the carapace have been examined from different locations in the oceans.

Methods

This is the first time such a high number (39) of samples collected from nesting turtles during such a long time period (extending from 2011 to 2018) has been used for the study of the diatom component of the microbiome on the turtle carapaces. A total of 33 samples were investigated in terms of light microscopy (LM) and scanning electron microscopy (SEM). Six unprocessed biofilm fragments were subject to SEM observations.

Results

A total of 457 epizoic diatom taxa belonging to 86 genera were identified. Epizoic forms, e.g., Achnanthes spp., Chelonicola spp. or Tripterion spp. (also identified by SEM observations of the undisturbed pieces of the microbiome) dominated in terms of relative abundance, but the highest numbers of taxa were ubiquitously represented by Navicula (79), Nitzschia (45), Amphora (40), Cocconeis (32), Diploneis (25) and Mastogloia (23). Navicula perminuta and Delphineis australis were the most frequent taxa, present in 65% of the samples, both with an average relative abundance of 10%. The results of our study revealed that diatoms are an essential component of the loggerhead sea turtles’ microbiome, in terms of high biodiversity and abundance. Although strict epibionts provide a signature of the turtle microbiome, the carapace as a solid substrate attracts numerous benthic diatom species which are considered opportunistic forms and can be found in the surrounding benthic habitats of the vast ocean littoral space.

"Outsourcing" Diatoms in Fabrication of Metal-Doped 3D Biosilica

Diatoms have an ability that is unique among the unicellular photoautotrophic organisms to synthesize an intricately ornamented siliceous (biosilica) exoskeleton with an ordered, hierarchical, three-dimensional structure on a micro- to nanoscale. The unique morphological, structural, mechanical, transport, photonic, and optoelectronic properties of diatomaceous biosilica make it a desirable material for modern technologies. This review presents a summary and discussion of published research on the metabolic insertion of chemical elements with specific functional activity into diatomaceous biosilica. Included in the review is research on innovation in methods of synthesis of a new generation of functional siliceous materials, where the synthesis process is "outsourced" to intelligent microorganisms, referred to here as microtechnologists, by providing them with appropriate conditions and reagents.

Morphology, phylogeny, and molecular dating in Plagiogrammaceae family focused on Plagiogramma-Dimeregramma complex (Urneidophycidae, Bacillariophyceae)

Although previous phylogenetic analyses suggested that the araphid diatom family Plagiogrammaceae is monophyletic, there is still not a clear understanding of relationships among the genera, and the taxonomy of several genera--Dimeregramma and Plagiogramma--remains questionable in light of paraphyly for both genera using molecular and morphological data. We have expanded the available DNA for molecular work for dozens of plagiogrammacean clones and analyzed 29 morphological characters from plagiogrammarian taxa and closely related genera, to increase understanding of the evolutionary history and systematics of the family and re-evaluate the current taxonomical classification of plagiogrammacean genera. The addition of more taxa and more data confirm the results from previous molecular phylogenies: most plagiogrammacean genera are monophyletic, except for Dimeregramma and Plagiogramma. Interestingly, the morphological analysis resolves only Talaroneis and Glyphodesmis as monophyletic. Given these results, we feel there is limited support for retaining Dimeregramma and Plagiogramma as distinct genera, and formally propose amending Plagiogramma and transferring six Dimeregramma species. As the Plagiogrammaceae is also one of the first-diverging clades of pennate diatoms, we also used these molecular data to estimate the age of the family, based on multiple calibration points derived from fossil taxa within or close to the Plagiogrammaceae. The results indicated that the Plagiogrammaceae evolved more than 114 million year ago and its diversification appears to correspond to a time of climate cooling. Additionally, we described a new monotypic genus (Coccinelloidea) with one new species C. gracilis, and five new species within established genera, e.g. Plagiogramma marginalis, Plagiogramma harenae, Plagiogramma porcipellis, Neofragilaria montgomeryii and Psammogramma anacarae.

Exploring Diversity, Taxonomy and Phylogeny of Diatoms (Bacillariophyta) from Marine Habitats. Novel Taxa with Internal Costae

In many marine littoral and sublittoral benthic habitats, we find small diatoms with few features resolvable with light microscopy (LM) other than internal costae across their valves. While classically those internal costae have defined their identification and classification, the use of electron microscopy and of molecular data have started to reveal the true diversity of unrelated forms and genera (e.g., Anaulus, Eunotogramma, Hustedtiella, or Plagiogramma) which possess these structures. Here we describe the new genus Ambo, in an attempt to clarify some of the polyphyly of taxa with internal costa by formally transferring Anaulus balticus, Anaulus simonsenii, and Plagiogramma tenuissimum as well as Ambo gallaeciae, described here. Related to this, we attempt to document and characterize the genus Anaulus itself, which was formally described by Ehrenberg with an illustration. A search by LM of mica designated by Ehrenberg as the holotype of Anaulus scalaris, the generitype of Anaulus, failed to recover a specimen which adequately describes the genus to the exclusion of other genera with internal costa. We also present morphological and molecular data for Anaulus creticus and suggest a new genus-Ceratanaulus-to reflect the distinct morphological and molecular characters we documented.

P925 An analysis of the impact of etiology vs. impact of hemodynamic variables on the right ventricular free wall deformation in patients with pulmonary hypertension

Purpose

Pulmonary hypertension (PH) is a deadly disease leading to right ventricular (RV) failure. The aim of this study was to establish whether aetiology of PH has a greater impact on RV longitudinal deformation than cardiac catherization parameters.

Methods

We retrospectively analyzed echocardiographic studies and cardiac catherization parameters of 25 patients with pulmonary hypertension : 13 pts with precapillary PH associated with atrial/ventricular septum defect and 12 pts with postcapillary PH due to dilated cardiomyopathy. We measured regional strain and regional systolic and diastolic strain rates (SR) in right ventricular free wall in basal, mid and apical segments.

Results

Aside from TAPSE, echocardiographic parameters indicate no difference. Even though mean pulmonary arterial pressure and pulmonary vascular residence significantly higher in patients with precapillary PH, strain was significantly decreased in patients with postcapillary PH. Statistically significant differences were observed between pre- and postcapillary PH patients" strain in apical and mid myocardial segments. Early diastolic strain rate (SR) in apical RV segment in precapillary PH patients was significantly higher than in patients with postcapillary PH. In other myocardial segments there were no differences between systolic, early diastolic and late diastolic SR.

Conclusion

Our study suggests that RV free wall strain in patients with PH moderately correlate with aetiology of PH. We did not find correlation between higher RA pressure or PVR and worsening of RV function in PH of different aetiologies.

Precapillary PH Postcapillary PH p value PA mean pressure (mmHG) 75,2 ± 17,7 42,0 ± 7,3 <0,05 PWR (WU) 15,8 ± 6,7 4,7 ± 2,6 <0,05 RV wall thickenss (mm) 11,0 ± 2,5 5,5 ± 1,0 NS RVIT (mm) 42,7 ± 10,4 42,8 ± 8,1 NS TAPSE (mm) 19,2 ± 4,2 15,6 ± 4,9 <0,05 S" 10,8 ± 2,0 9,4 ± 2,1 NS basal segment strain -16 ± 7 -17 ± 5 NS mid segment strain -18 ± 8 -15 ± 4 <0,05 apical segment strain -19 ± 8 -14 ± 4 <0,05

Complete chloroplast genome of the tiny marine diatom Nanofrustulum shiloi (Bacillariophyta) from the Adriatic Sea

We report the chloroplast genome sequence of Nanofrustulum shiloi, a tiny araphid pennate diatom collected from the Adriatic Sea. The 160,994-bp N. shiloi genome displays a quadripartite structure and its gene repertoire resembles those of other diatom chloroplast genomes. Besides the genes located in the inverted repeat, psbY is duplicated. A gene-poor region in the large single-copy region contains multiple ORFs sharing sequence similarities with plasmids and chloroplast ORFs found in other diatom species. The genome features a single intron, a group II intron in petB. Phylogenomic analysis identified N. shiloi at a basal position within the araphid 2 clade.

P3738Clinical outcomes after early vs new generation TAVR device deployment

Background

Whether newer generation devices influence early and long-term outcomes post-TAVR in a real life setting is unknown.

Aim

To assess impact of an early vs a new generation transcatheter heart valves (THV) on clinical outcomes (30-day and -years) in a real life scenario.

Methods

Out of 445 consecutive pts treated between 8/2009 and 10/2017 within the single-center, prospective TAVR Registry, there were 432 [median 83.0 years of age, 63.4% female] with device success (97.1%) as per VARC-2. Early generation THV included: CoreValve; Edwards SAPIEN or SAPIEN XT. Newer generation devices included: Evolut-R/-Pro; Acurate neo; Engager, SAPIEN 3; or Lotus Edge Aortic Valve System.

Results

Median follow-up was 29.3 (15.8–53.1) months with 100% 1-year follow-up. Early generation devices were deployed in 60.6% (n=262) and new devices in 39.4% (n=170). Pts treated with newer devices had more peripheral arterial disease (PAD) and more frequent PCI history (17.1% vs 8.8%, p=0.015, and 35.3% vs 26.7%, p=0.068 respectively); other demographic and clinical data were alike. Baseline aortic valve area and LV ejection fraction were similar between early and newer devices. Pre-dilation was less frequent with newer devices (41.8% vs 70.6%, p<0.001), whereas THV size, contrast volume, fluoroscopy time, radiation dose, and post-procedure aortic valve gradients were similar. Moderate PVL assessed early post-TAVR was recognized with same frequency between earlier vs newer devices (28.2% vs 28.6%). An VARC-2 safety endpoint was recognized more often among pts treated with early vs new devices (30.5% vs 21.8%, p=0.028, respectively), with more frequent: 30-day death (3.8% vs 1.8%, p=0.177), life-threatening or disabling bleeding (8.4% vs 5.3%, p=0.181), major vascular complications (20.2% vs 15.3%, p=0.121), and new permanent pacemaker implantation (22.9% vs 10.0%, p=0.001) with early devices, but similar frequencies of stroke and acute kidney injury (1.9% vs 1.8% and 3.8% vs 5.9%, respectively). The 1-year mortality rates were similar (13.4% vs 13.5%, respectively), with similar estimated midterm (1–2 years) prognosis, but worse estimated very long-term follow-up for newer THV devices (fig 1).

Figure 1

Conclusions

Newer TAVR devices with smaller delivery system size, although deployed in pts with more PAD and PCI history, are associated with less frequent occurrence of an VARC-2 safety endpoint and less frequent permanent pacemaker implantation. The 1-year and midterm (1–2 years) prognosis are similar for early and newer devices, whereas the longer follow-up could have been influenced by intrinsic pt characteristics (more frequent PAD and history of PCI).