1
|
Bonello B, Issitt R, Hughes M, Carr M, Iriart X, Khambadkone S, Giardini A, Kostolny M, Marek J. Long-term outcome after neonatal intervention for congenital critical aortic stenosis. Int J Cardiol 2024; 405:131932. [PMID: 38437954 DOI: 10.1016/j.ijcard.2024.131932] [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] [Received: 11/30/2023] [Revised: 02/08/2024] [Accepted: 03/01/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND This study explored long-term outcome and functional status of patients born with critical aortic stenosis (CAS) following neonatal surgical or catheter interventions. METHODS A 40-year retrospective review of all consecutive patients within a large, single-center referral unit who required neonatal (<30 days) intervention for CAS. Additional detailed evaluation of surviving patients >7 years age was performed, with clinical assessment, objective cardiopulmonary exercise testing and state-of-the-art characterization of myocardial function (advanced echocardiography and cardiac MRI). RESULTS Between 1970 and 2010, ninety-six neonates underwent CAS intervention (mean age 9 ± 7.5 days). Early death occurred in 19 (19.8%) and late death in 10 patients. Overall survival at 10 and 30 years was 70.1% and 68.5%, freedom from reintervention was 41.8% and 32.9% respectively. Among the 25 long-term survivors available for detailed assessment (median age 15.7 ± 6.4 years), 55% exhibited impaired peak oxygen uptake. Mean left ventricle (LV) ejection fraction was 65 ± 11.2%, with a mean LV end-diastolic volume z-score of 0.02 ± 1.4. Mean LV outflow tract Vmax was 2.3 ± 1.02 m/s. CAS patients had reduced LV longitudinal and increased radial strain (p = 0.003, p < 0.001 respectively). Five patients had severe LV diastolic dysfunction associated with endocardial fibroelastosis (EFE) (p = 0.0014). CONCLUSION Despite high early mortality rate, long-term survival of patients with CAS is reasonable at the expense of high reintervention rate. With successful intervention, there remained long-term clinical and subclinical LV myocardial impairment, of which EFE was one marker. Long-term follow-up of all CAS patients is crucial, involving detailed myocardial functional assessment to help elucidate physiology and optimise management.
Collapse
Affiliation(s)
- Beatrice Bonello
- Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK; University College of London, Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Richard Issitt
- Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK; University College of London, Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Marina Hughes
- Norfolk and Norwich University Hospital NHS Trust, Colney Lane, Norwich NR4 7UY, UK.
| | - Michelle Carr
- Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK.
| | - Xavier Iriart
- CHU Bordeaux, Av. du Haut Lévêque, Pessac 33604, France.
| | - Sachin Khambadkone
- Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK; University College of London, Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | | | - Martin Kostolny
- Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK; University College of London, Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Jan Marek
- Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK; University College of London, Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| |
Collapse
|
2
|
Gorecki L, Markova A, Hepnarova V, Zivna N, Junova L, Hrabinova M, Janousek J, Kobrlova T, Prchal L, Jun D, Soukup O, Horn G, Worek F, Marek J, Korabecny J. Uncharged mono- and bisoximes: In search of a zwitterion to countermeasure organophosphorus intoxication. Chem Biol Interact 2024; 394:110941. [PMID: 38493910 DOI: 10.1016/j.cbi.2024.110941] [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: 01/02/2024] [Revised: 02/27/2024] [Accepted: 03/04/2024] [Indexed: 03/19/2024]
Abstract
The current study imposes a new class of organophosphorus (OP)-inhibited cholinesterase reactivators by conceptualizing a family of asymmetric bisoximes with various reactivating scaffolds. Several novel nucleophilic warheads were investigated, putting forward 29 novel reactivating options, by evaluating their nucleophilicity and ability to directly decompose OP compounds. Adopting the so-called zwitterionic strategy, 17 mono-oxime and nine bisoxime reactivators were discovered with major emphasis on the bifunctional-moiety approach. Compounds were compared with clinically used standards and other known experimentally highlighted reactivators. Our results clearly favor the concept of asymmetric bisoximes as leading reactivators in terms of efficacy and versatility. These top-ranked compounds were characterized in detail by reactivation kinetics parameters and evaluated for potential CNS availability. The highlighted molecules 55, 57, and 58 with various reactivating warheads, surpassed the reactivating potency of pralidoxime and several notable uncharged reactivators. The versatility of lead drug candidate 55 was also inspected on OP-inhibited butyrylcholinesterase, revealing a much higher rate compared to existing clinical antidotes.
Collapse
Affiliation(s)
- Lukas Gorecki
- University of Defence, Military Faculty of Medicine, Department of Toxicology and Military Pharmacy, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic; University Hospital Hradec Kralove, Biomedical Research Centre, Sokolska 581, 500 05 Hradec Kralove, Czech Republic.
| | - Aneta Markova
- University Hospital Hradec Kralove, Biomedical Research Centre, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; University Hospital Hradec Kralove, Hospital Pharmacy, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Vendula Hepnarova
- University of Defence, Military Faculty of Medicine, Department of Toxicology and Military Pharmacy, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic; University Hospital Hradec Kralove, Biomedical Research Centre, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Natalie Zivna
- University of Defence, Military Faculty of Medicine, Department of Toxicology and Military Pharmacy, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic; University Hospital Hradec Kralove, Biomedical Research Centre, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Lucie Junova
- University of Defence, Military Faculty of Medicine, Department of Toxicology and Military Pharmacy, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic
| | - Martina Hrabinova
- University of Defence, Military Faculty of Medicine, Department of Toxicology and Military Pharmacy, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic; University Hospital Hradec Kralove, Biomedical Research Centre, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Jiri Janousek
- University Hospital Hradec Kralove, Biomedical Research Centre, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Tereza Kobrlova
- University Hospital Hradec Kralove, Biomedical Research Centre, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Lukas Prchal
- University Hospital Hradec Kralove, Biomedical Research Centre, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Daniel Jun
- University of Defence, Military Faculty of Medicine, Department of Toxicology and Military Pharmacy, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic
| | - Ondrej Soukup
- University of Defence, Military Faculty of Medicine, Department of Toxicology and Military Pharmacy, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic; University Hospital Hradec Kralove, Biomedical Research Centre, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Gabriele Horn
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstrasse 11, 80937 Munich, Germany
| | - Franz Worek
- Bundeswehr Institute of Pharmacology and Toxicology, Neuherbergstrasse 11, 80937 Munich, Germany
| | - Jan Marek
- University Hospital Hradec Kralove, Biomedical Research Centre, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; University of Defence, Military Faculty of Medicine, Department of Epidemiology, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic
| | - Jan Korabecny
- University of Defence, Military Faculty of Medicine, Department of Toxicology and Military Pharmacy, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic; University Hospital Hradec Kralove, Biomedical Research Centre, Sokolska 581, 500 05 Hradec Kralove, Czech Republic.
| |
Collapse
|
3
|
Cantinotti M, Voges I, Miller O, Raimondi F, Grotenhuis H, Bharucha T, Garrido AO, Valsangiacomo E, Roest A, Sunnegårdh J, Salaets T, Brun H, Khraiche D, Jossif A, Schokking M, Sabate-Rotes A, Meyer-Szary J, Deri A, Koopman L, Herberg U, du Marchie Sarvaas G, Leskinen M, Tchana B, Ten Harkel ADJ, Ödemis E, Morrison L, Steimetz M, Laser KT, Doros G, Bellshan-Revell H, Muntean I, Anagostopoulou A, Alpman MS, Hunter L, Ojala T, Bhat M, Olejnik P, Wacker J, Bonello B, Ramcharan T, Greil G, Marek J, DiSalvo G, McMahon CJ. Organisation of paediatric echocardiography laboratories and governance of echocardiography services and training in Europe: current status, disparities and potential solutions. A survey from the Association for European Paediatric and Congenital Cardiology (AEPC) imaging working group - CORRIGENDUM. Cardiol Young 2024:1. [PMID: 38557389 DOI: 10.1017/s1047951124000519] [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: 04/04/2024]
|
4
|
Cantinotti M, Voges I, Miller O, Raimondi F, Grotenhuis H, Bharucha T, Garrido AO, Valsangiacomo E, Roest A, Sunnegårdh J, Salaets T, Brun H, Khraiche D, Jossif A, Schokking M, Sebate-Rotes A, Meyer-Szary J, Deri A, Koopman L, Herberg U, du Marchie Sarvaas G, Leskinen M, Tchana B, Ten Harkel ADJ, Ödemis E, Morrison L, Steimetz M, Laser KT, Doros G, Bellshan-Revell H, Muntean I, Anagostopoulou A, Alpman MS, Hunter L, Ojala T, Bhat M, Olejnik P, Wacker J, Bonello B, Ramcharan T, Greil G, Marek J, DiSalvo G, McMahon CJ. Organisation of paediatric echocardiography laboratories and governance of echocardiography services and training in Europe: current status, disparities, and potential solutions. A survey from the Association for European Paediatric and Congenital Cardiology (AEPC) imaging working group. Cardiol Young 2024:1-9. [PMID: 38439642 DOI: 10.1017/s1047951124000131] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
BACKGROUND There is limited data on the organisation of paediatric echocardiography laboratories in Europe. METHODS A structured and approved questionnaire was circulated across all 95 Association for European Paediatric and Congenital Cardiology affiliated centres. The aims were to evaluate: (1) facilities in paediatric echocardiography laboratories across Europe, (2) accredited laboratories, (3) medical/paramedical staff employed, (4) time for echocardiographic studies and reporting, and (5) training, teaching, quality improvement, and research programs. RESULTS Respondents from forty-three centres (45%) in 22 countries completed the survey. Thirty-six centres (84%) have a dedicated paediatric echocardiography laboratory, only five (12%) of which reported they were European Association of Cardiovascular Imaging accredited. The median number of echocardiography rooms was three (range 1-12), and echocardiography machines was four (range 1-12). Only half of all the centres have dedicated imaging physiologists and/or nursing staff, while the majority (79%) have specialist imaging cardiologist(s). The median (range) duration of time for a new examination was 45 (20-60) minutes, and for repeat examination was 20 (5-30) minutes. More than half of respondents (58%) have dedicated time for reporting. An organised training program was present in most centres (78%), 44% undertake quality assurance, and 79% perform research. Guidelines for performing echocardiography were available in 32 centres (74%). CONCLUSION Facilities, staffing levels, study times, standards in teaching/training, and quality assurance vary widely across paediatric echocardiography laboratories in Europe. Greater support and investment to facilitate improvements in staffing levels, equipment, and governance would potentially improve European paediatric echocardiography laboratories.
Collapse
Affiliation(s)
- Massimiliano Cantinotti
- Fondazione CNR-Regione Toscana G. Monasterio (FTGM), National Research Institute (CNR), Pisa, Italy
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- European Association Cardiovascular Imaging (EACVI), Taskforce on Congenital Heart Disease, Lyon, France
| | - Inga Voges
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- DZHK (German Center for Cardiovascular Research), Partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
- Department for Congenital Cardiology and Pediatric Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Owen Miller
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- Department Paediatric Cardiology, Evelina London Children's Hospital, London, UK
| | - Francesca Raimondi
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- European Association Cardiovascular Imaging (EACVI), Taskforce on Congenital Heart Disease, Lyon, France
- Division of Pediatric Cardiology, Meyer University Hospital, Florence University, Firenze, Italy
| | - Heynric Grotenhuis
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- Department Pediatric Cardiology, Wilhelmina Children's Hospital / UMCU, Utrecht, The Netherlands
| | - Tara Bharucha
- European Association Cardiovascular Imaging (EACVI), Taskforce on Congenital Heart Disease, Lyon, France
- Department of Paediatric Cardiology, University Hospital Southampton, Southampton, UK
| | - Almudena Ortiz Garrido
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- Department Pediatric Cardiology, Hospital Materno Infantil, Malaga, AL, Spain
| | - Emanuela Valsangiacomo
- European Association Cardiovascular Imaging (EACVI), Taskforce on Congenital Heart Disease, Lyon, France
- Department of Paediatric Cardiology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Arno Roest
- Department of Pediatrics, Division of Pediatric Cardiology, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, Netherlands
| | - Jan Sunnegårdh
- Children's Heart Centre, The Queen Silvia Children's Hospital Sahlgrenska University Hospital, Göteborg, Sweden
| | - Thomas Salaets
- Department Paediatric Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Henrik Brun
- Department of Paediatric Cardiology, Oslo University Hospital, Oslo, Norway
| | | | - Antonis Jossif
- Paedi Center for Specialized Pediatrics, Strovolos, Cyprus
| | | | - Anna Sebate-Rotes
- Servicio de Cardiología Pediátrica, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Jaroslaw Meyer-Szary
- Department of Pediatric Cardiology and Congenital Heart Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Antigoni Deri
- Department Paediatric Cardiology, Leeds University, Leeds, UK
| | - Laurens Koopman
- Division of Pediatric Cardiology, Department of Pediatrics, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Ulrike Herberg
- Department or Pediatric Cardiology and Congenital Heart Disease, University of Aachen, Aachen, Germany
| | - Gideon du Marchie Sarvaas
- Department of Pediatric Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Markku Leskinen
- Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
| | - Bertrand Tchana
- Parma University Hospital, Department of Mother and Child Pediatric Cardiology Unit, Parma, Italy
| | - Arend D J Ten Harkel
- Department of Pediatric Cardiology, Willem Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - Ender Ödemis
- Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Louise Morrison
- Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Micheal Steimetz
- Department of Pediatric Cardiology and Intensive Care Medicine (M.S.), University Medical Center, Georg-August-University, Goettingen, Germany
| | - Kai Thorsten Laser
- Department of Congenital Heart Defects, Heart and Diabetes Center, North Rhine Westphalia Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Gabriela Doros
- Victor Babes UMF, IIIrd Pediatric Clinic, Louis Turcanu Emergency Children Hospital, Timisoara, Romania
| | | | - Iolanda Muntean
- Clinic of Paediatric Cardiology, Institute for Cardiovascular Diseases and Transplantation, UMFST "George Emil Palade", Timisoara, Romania
| | | | - Maria Sjoborg Alpman
- Pediatric Cardiology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Lindsey Hunter
- Department Paediatric Cardiology, Evelina London Children's Hospital, London, UK
| | - Tiina Ojala
- Department Pediatric Cardiology, Children's Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Misha Bhat
- Department of Pediatric Cardiology, Children's Heart Center, Skåne University Hospital in Lund, Lund, Sweden
| | - Peter Olejnik
- Pediatric Cardiology Center, Bratislava, Slovakia and Department of Pediatric Cardiology, Faculty of Medicine, National Institute of Cardiovascular Diseases, Comenius University, Bratislava, Slovakia
| | - Julie Wacker
- Pediatric Cardiology Unit, Department of Woman, Child and Adolescent Medicine, Children University Hospital of Geneva, Geneva, Switzerland
| | - Beatrice Bonello
- Department Paediatric Cardiology, Great Ormond Street NHS Trust, London, England
| | | | - Gerald Greil
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- Department of Pediatrics, Division of Pediatric Cardiology, UT Southwestern, Dallas, TX, USA
| | - Jan Marek
- Department Paediatric Cardiology, Great Ormond Street NHS Trust, London, England
| | - Giovanni DiSalvo
- European Association Cardiovascular Imaging (EACVI), Taskforce on Congenital Heart Disease, Lyon, France
- Paediatric Cardiology Unit, Department of Woman's and Child's Health, University Hospital of Padova, University of Padua, Padua, Italy
| | - Colin J McMahon
- Association for European Paediatric and Congenital Cardiology (AEPC), Imaging Work Group Committee
- University School of Medicine, University College Dublin 4, Dublin, Ireland
- Children's Health Ireland and Crumlin, Dublin, Ireland
- School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
5
|
Kapitanov IV, Špulák M, Pour M, Soukup O, Marek J, Jun D, Novak M, Diz de Almeida JSF, França TCC, Gathergood N, Kuča K, Karpichev Y. Sustainable ionic liquids-based molecular platforms for designing acetylcholinesterase reactivators. Chem Biol Interact 2023; 385:110735. [PMID: 37802409 DOI: 10.1016/j.cbi.2023.110735] [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: 07/19/2023] [Revised: 09/09/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023]
Abstract
We report a green chemistry approach for preparation of oxime-functionalized ILs as AChE reactivators: amide/ester linked IL, l-alanine, and l-phenylalanine derived salts bearing pyridinium aldoxime moiety. The reactivation capacities of the novel oximes were evaluated towards AChE inhibited by typical toxic organophosphates, sarin (GB), VX, and paraoxon (PON). The studied compounds are mostly non-toxic up to the highest concentrations screened (2 mM) towards Gram-negative and Gram-positive bacteria cell lines and both filamentous fungi and yeasts in the in vitro screening experiments as well as towards the eukaryotic cell (CHO-K1 cell line). Introduction of the oxime moiety in initially biodegradable structure decreases its ability to biodegradation. The compound 3d was shown to reveal remarkable activity against the AChE inhibited by VX, exceeding conventional reactivators 2-PAM and obidoxime. The regularities on antidotal activity, cell viability, plasma stability, biodegradability as well as molecular docking study of the newly synthesized oximes will be used for further improvement of their structures.
Collapse
Affiliation(s)
- Illia V Kapitanov
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Akadeemia Tee 15, 12618 Tallinn, Estonia
| | - Marcel Špulák
- Department of Organic and Bioorganic Chemistry, Faculty of Pharmacy in Hradec Králové, Charles University, Heyrovského 1203, 500 05 Hradec Kralove, Czech Republic
| | - Milan Pour
- Department of Organic and Bioorganic Chemistry, Faculty of Pharmacy in Hradec Králové, Charles University, Heyrovského 1203, 500 05 Hradec Kralove, Czech Republic
| | - Ondřej Soukup
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defense, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic
| | - Jan Marek
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; Department of Epidemiology, Faculty of Military Health Sciences, University of Defense, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic
| | - Daniel Jun
- Department of Epidemiology, Faculty of Military Health Sciences, University of Defense, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic
| | - Martin Novak
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Joyce S F Diz de Almeida
- Laboratory of Molecular Modeling Applied to the Chemical and Biological Defense (LMCBD), Military Institute of Engineering, Rio de Janeiro, RJ, Brazil
| | - Tanos C C França
- Laboratory of Molecular Modeling Applied to the Chemical and Biological Defense (LMCBD), Military Institute of Engineering, Rio de Janeiro, RJ, Brazil; Department of Chemistry, Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, 500 03 Hradec Kralove, Czech Republic
| | - Nicholas Gathergood
- School of Chemistry, College of Science, University of Lincoln, Lincoln LN6 7TS, UK
| | - Kamil Kuča
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, 500 03 Hradec Kralove, Czech Republic.
| | - Yevgen Karpichev
- Department of Chemistry and Biotechnology, Tallinn University of Technology, Akadeemia Tee 15, 12618 Tallinn, Estonia.
| |
Collapse
|
6
|
Tomek V, Jičínská H, Pavlíček J, Kovanda J, Jehlička P, Klásková E, Mrázek J, Čutka D, Smetanová D, Břešťák M, Vlašín P, Pavlíková M, Chaloupecký V, Janoušek J, Marek J. Pregnancy Termination and Postnatal Major Congenital Heart Defect Prevalence After Introduction of Prenatal Cardiac Screening. JAMA Netw Open 2023; 6:e2334069. [PMID: 37713196 PMCID: PMC10504618 DOI: 10.1001/jamanetworkopen.2023.34069] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/09/2023] [Indexed: 09/16/2023] Open
Abstract
Importance Prenatal cardiac screening of the first and second trimesters has had a major impact on postnatal prevalence of congenital heart defects (CHDs), rates of termination of pregnancy (TOP), and outcomes among children born alive with CHDs. Objective To examine the prenatal and postnatal incidence of major CHDs (ie, necessitating intervention within the first year of life), detection rate trends, rates of TOP, and the association of cardiac screening with postnatal outcomes. Design, Settings, and Participants In this cross-sectional study, 3827 fetuses with antenatally diagnosed major CHDs in the Czech Republic (population 10.7 million) between 1991 and 2021 were prospectively evaluated with known outcomes and associated comorbidities. Prenatal and postnatal prevalence of CHD in an unselected population was assessed by comparison with a retrospective analysis of all children born alive with major CHDs in the same period (5454 children), using national data registry. Data analysis was conducted from January 1991 to December 2021. Main Outcomes and Measures Prenatal detection and postnatal prevalence of major CHDs and rate of TOPs in a setting with a centralized health care system over 31 years. Results A total of 3 300 068 children were born alive during the study period. Major CHD was diagnosed in 3827 fetuses, of whom 1646 (43.0%) were born, 2069 (54.1%) resulted in TOP, and 112 (2.9%) died prenatally. The prenatal detection rate increased from 6.2% in 1991 to 82.8% in 2021 (P < .001). Termination of pregnancy decreased from 70% in 1991 to 43% (P < .001) in 2021. Of 627 fetuses diagnosed in the first trimester (introduced in 2007), 460 were terminated (73.3%). Since 2007, of 2066 fetuses diagnosed in the second trimester, 880 (42.6%) were terminated, resulting in an odds ratio of 3.6 (95% CI, 2.8-4.6; P < .001) for TOP in the first trimester compared with the second trimester. Postnatal prevalence of major CHDs declined from 0.21% to 0.14% (P < .001). The total incidence (combining prenatal detection of terminated fetuses with postnatal prevalence) of major CHD remained at 0.23% during the study period. Conclusions and Relevance In this cross-sectional study, the total incidence of major CHD did not change significantly during the 31-year study period. The prenatal detection of major CHD approached 83% in the current era. Postnatal prevalence of major CHD decreased significantly due to early TOPs and intrauterine deaths. The introduction of first trimester screening resulted in a higher termination rate in the first trimester but did not revert the overall decreasing trend of termination for CHDs in general.
Collapse
Affiliation(s)
- Viktor Tomek
- Children’s Heart Centre, Second Faculty of Medicine, Motol University Hospital, Charles University, Prague, the Czech Republic
| | - Hana Jičínská
- Department of Pediatric Cardiology, The University Hospital Brno, Faculty of Medicine of Masaryk University, Brno, the Czech Republic
| | - Jan Pavlíček
- Department of Pediatrics and Prenatal Cardiology, University Hospital Ostrava, Ostrava, the Czech Republic
| | - Jan Kovanda
- Children’s Heart Centre, Second Faculty of Medicine, Motol University Hospital, Charles University, Prague, the Czech Republic
| | - Petr Jehlička
- Department of Pediatrics, University Hospital in Pilsen, Charles University, Pilsen, the Czech Republic
| | - Eva Klásková
- Department of Pediatrics, Olomouc University Hospital and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, the Czech Republic
| | - Jiří Mrázek
- Department of Pediatrics, Masaryk Hospital, Ústí nad Labem, the Czech Republic
| | - David Čutka
- Centre for Medical Genetics, České Budějovice, the Czech Republic
| | - Dagmar Smetanová
- Gennet, Centre for Fetal Medicine and Reproductive Genetics, Prague, the Czech Republic
| | - Miroslav Břešťák
- Department of Obstetrics and Gynecology of the First Faculty of Medicine, Charles University and General University Hospital, Prague, the Czech Republic
| | | | - Markéta Pavlíková
- Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University, Prague, the Czech Republic
| | - Václav Chaloupecký
- Children’s Heart Centre, Second Faculty of Medicine, Motol University Hospital, Charles University, Prague, the Czech Republic
| | - Jan Janoušek
- Children’s Heart Centre, Second Faculty of Medicine, Motol University Hospital, Charles University, Prague, the Czech Republic
| | - Jan Marek
- Great Ormond Street Hospital for Children and Institute of Cardiovascular Sciences UCL, London, United Kingdom
| |
Collapse
|
7
|
Pecová J, Rohlíková V, Šmoldasová M, Marek J. Clinical Efficacy of Hyaluronic Acid with Iodine in Hard-to-Heal Wounds. Pharmaceutics 2023; 15:2268. [PMID: 37765236 PMCID: PMC10536360 DOI: 10.3390/pharmaceutics15092268] [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: 08/03/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Hard-to-heal wounds do not heal spontaneously and need long-term care provided by specialists. That burdens the patients as well as the healthcare systems. Such wounds arise from several pathologies, which result in venous leg ulcers (VLU), diabetic foot ulcers (DFU), pressure ulcers (PU), or ulcers originating from post-surgical wounds (pSW). Given the complex nature of hard-to-heal wounds, novel treatments are sought to enable wound healing. We tested the clinical efficacy and applicability of fluid comprising hyaluronic acid and iodine complex (HA-I) in the treatment of hard-to-heal wounds. Patients (n = 56) with VLU, DFU, PU, or pSW hospitalised in multiple wound-care centres in the Czech Republic were treated with HA-I. Wound size, classically visible signs of infection, exudation, pain, and wound bed appearance were monitored for 12 weeks. The highest healing rate was in DFU (71.4%), followed by pSW (62.5%), VLU (55.6%), and PU (44.4%). Classical visible signs of infection were resolved within 8 weeks in all types of wounds. Wound bed appearance improved most noticeably in pSW and then in VLU. Exudation was lowered most significantly in DFU and pSW. The highest decrease in pain was in pSW and DFU. The treatment with HA-I successfully led to either complete closure or significant improvement in the wound's healing. Therefore, the complex of hyaluronic acid and iodine is suitable for the treatment of hard-to-heal wounds of various aetiologies.
Collapse
Affiliation(s)
- Jana Pecová
- Medical Faculty, Masaryk University in Brno, 62500 Brno, Czech Republic
| | | | | | - Jan Marek
- Long-Term Care Facility Albertinum Žamberk, 56401 Žamberk, Czech Republic
| |
Collapse
|
8
|
Finger V, Kucera T, Kafkova R, Muckova L, Dolezal R, Kubes J, Novak M, Prchal L, Lakatos L, Andrs M, Hympanova M, Marek J, Kufa M, Spiwok V, Soukup O, Mezeiova E, Janousek J, Nevosadova L, Benkova M, Kitson RRA, Kratky M, Bősze S, Mikusova K, Hartkoorn R, Roh J, Korabecny J. 2,6-Disubstituted 7-(naphthalen-2-ylmethyl)-7H-purines as a new class of potent antitubercular agents inhibiting DprE1. Eur J Med Chem 2023; 258:115611. [PMID: 37421887 DOI: 10.1016/j.ejmech.2023.115611] [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: 05/04/2023] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/10/2023]
Abstract
Phenotypic screening of an in-house library of small molecule purine derivatives against Mycobacterium tuberculosis (Mtb) led to the identification of 2-morpholino-7-(naphthalen-2-ylmethyl)-1,7-dihydro-6H-purin-6-one 10 as a potent antimycobacterial agent with MIC99 of 4 μM. Thorough structure-activity relationship studies revealed the importance of 7-(naphthalen-2-ylmethyl) substitution for antimycobacterial activity, yet opened the possibility of structural modifications at positions 2 and 6 of the purine core. As the result, optimized analogues with 6-amino or ethylamino substitution 56 and 64, respectively, were developed. These compounds showed strong in vitro antimycobacterial activity with MIC of 1 μM against Mtb H37Rv and against several clinically isolated drug-resistant strains, had limited toxicity to mammalian cell lines, medium clearance with respect to phase I metabolic deactivation (27 and 16.8 μL/min/mg), sufficient aqueous solubility (>90 μM) and high plasma stability. Interestingly, investigated purines, including compounds 56 and 64, lacked activity against a panel of Gram-negative and Gram-positive bacterial strains, indicating a specific mycobacterial molecular target. To investigate the mechanism of action, Mtb mutants resistant to hit compound 10 were isolated and their genomes were sequenced. Mutations were found in dprE1 (Rv3790), which encodes decaprenylphosphoryl-β-d-ribose oxidase DprE1, enzyme essential for the biosynthesis of arabinose, a vital component of the mycobacterial cell wall. Inhibition of DprE1 by 2,6-disubstituted 7-(naphthalen-2-ylmethyl)-7H-purines was proved using radiolabelling experiments in Mtb H37Rv in vitro. Finally, structure-binding relationships between selected purines and DprE1 using molecular modeling studies in tandem with molecular dynamic simulations revealed the key structural features for effective drug-target interaction.
Collapse
Affiliation(s)
- Vladimir Finger
- Faculty of Pharmacy in Hradec Králové, Charles University, Akademika, Heyrovskeho 1203, 50005, Hradec Králové, Czech Republic; Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic
| | - Tomas Kucera
- Faculty of Military Health Sciences, University of Defence, Trebesska, 1575, 500 01, Hradec Králové, Czech Republic
| | - Radka Kafkova
- Faculty of Natural Sciences, Department of Biochemistry, Comenius University in Bratislava, Mlynská Dolina, Ilkovičova 6, 842 15, Bratislava, Slovakia
| | - Lubica Muckova
- Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic; Faculty of Military Health Sciences, University of Defence, Trebesska, 1575, 500 01, Hradec Králové, Czech Republic
| | - Rafael Dolezal
- Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic
| | - Jan Kubes
- Faculty of Pharmacy in Hradec Králové, Charles University, Akademika, Heyrovskeho 1203, 50005, Hradec Králové, Czech Republic
| | - Martin Novak
- Faculty of Pharmacy in Hradec Králové, Charles University, Akademika, Heyrovskeho 1203, 50005, Hradec Králové, Czech Republic; Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic
| | - Lukas Prchal
- Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic
| | - Levente Lakatos
- ELKH-ELTE Research Group of Peptide Chemistry, Eötvös Loránd University, Pázmány Péter Sétány 1/A, H-1117, Budapest, Hungary; National Public Health Center, Albert Flórián út 2-6, Budapest, 1097, Hungary
| | - Martin Andrs
- Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic
| | - Michaela Hympanova
- Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic; Faculty of Military Health Sciences, University of Defence, Trebesska, 1575, 500 01, Hradec Králové, Czech Republic
| | - Jan Marek
- Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic; Faculty of Military Health Sciences, University of Defence, Trebesska, 1575, 500 01, Hradec Králové, Czech Republic
| | - Martin Kufa
- Faculty of Pharmacy in Hradec Králové, Charles University, Akademika, Heyrovskeho 1203, 50005, Hradec Králové, Czech Republic; Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic
| | - Vojtech Spiwok
- Department of Biochemistry and Microbiology, University of Chemistry and Technology, Technicka 5, 166 28, Prague, Czech Republic
| | - Ondrej Soukup
- Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic
| | - Eva Mezeiova
- Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic
| | - Jiri Janousek
- Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic
| | - Lenka Nevosadova
- Faculty of Pharmacy in Hradec Králové, Charles University, Akademika, Heyrovskeho 1203, 50005, Hradec Králové, Czech Republic
| | - Marketa Benkova
- Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic
| | - Russell R A Kitson
- Faculty of Pharmacy in Hradec Králové, Charles University, Akademika, Heyrovskeho 1203, 50005, Hradec Králové, Czech Republic
| | - Martin Kratky
- Faculty of Pharmacy in Hradec Králové, Charles University, Akademika, Heyrovskeho 1203, 50005, Hradec Králové, Czech Republic
| | - Szilvia Bősze
- ELKH-ELTE Research Group of Peptide Chemistry, Eötvös Loránd University, Pázmány Péter Sétány 1/A, H-1117, Budapest, Hungary; National Public Health Center, Albert Flórián út 2-6, Budapest, 1097, Hungary
| | - Katarina Mikusova
- Faculty of Natural Sciences, Department of Biochemistry, Comenius University in Bratislava, Mlynská Dolina, Ilkovičova 6, 842 15, Bratislava, Slovakia
| | - Ruben Hartkoorn
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur Lille, U1019-UMR 9017-CIIL-Center for Infection and Immunity of Lille, F-59000, Lille, France
| | - Jaroslav Roh
- Faculty of Pharmacy in Hradec Králové, Charles University, Akademika, Heyrovskeho 1203, 50005, Hradec Králové, Czech Republic.
| | - Jan Korabecny
- Biomedical Research Center, University Hospital Hradec Králové, Sokolska 581, 500 05, Hradec Králové, Czech Republic.
| |
Collapse
|
9
|
Bartsota M, Jowett V, Manuel D, Mortensen K, Wolfenden J, Marek J, Carvalho JS. Double aortic arch: implications of antenatal diagnosis, differential growth of arches during pregnancy, associated abnormalities and postnatal outcome. Ultrasound Obstet Gynecol 2023; 62:69-74. [PMID: 36864493 DOI: 10.1002/uog.26186] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To evaluate the prenatal characteristics of double aortic arch (DAA), assess the relative size of the arches and their growth during pregnancy, describe associated cardiac, extracardiac and chromosomal/genetic abnormalities and review postnatal presentation and clinical outcome. METHODS This was a retrospective cohort study of all fetuses with a confirmed diagnosis of DAA seen in five specialized referral centers in London, UK, between October 2012 and November 2019. Cases were identified from the hospitals' fetal databases. Fetal echocardiographic findings, intracardiac and extracardiac abnormalities, genetic defects, computed tomography (CT) findings and postnatal clinical presentation and outcome were evaluated. RESULTS A total of 79 fetuses with DAA were included. Of those assessed postnatally, 48.6% had an atretic left aortic arch (LAA), while 5.1% had an atretic LAA at the first fetal scan and were misdiagnosed antenatally with right aortic arch (RAA). The LAA was atretic in 55.8% of those who underwent CT. DAA was an isolated abnormality in 91.1% of cases; 8.9% of patients had an additional intracardiac abnormality and 2.5% had both intra- and extracardiac abnormalities. Among the 52 cases that underwent genetic testing, 11.5% had genetic abnormalities and, specifically, the 22q11 microdeletion was identified in 3.8% of patients. At a median follow-up of 993.5 days, 42.5% of patients had developed symptoms of tracheoesophageal compression (5.5% during the first month after birth) and 56.2% had undergone intervention. Statistical analysis using the χ-square test showed no significant relationship between morphology of DAA (patency of both aortic arches vs atretic LAA) and the need for intervention (P = 0.134), development of vascular ring symptoms (P = 0.350) or evidence of airway compression on CT (P = 0.193). CONCLUSIONS Most cases of DAA can be diagnosed easily at midgestation, as typically both arches are patent with a dominant RAA at this stage. However, we found that the LAA had become atretic in approximately half of the cases postnatally, supporting the theory of differential growth of the arches during pregnancy. DAA is usually an isolated abnormality; however, thorough assessment is required to exclude associated intra- and extracardiac anomalies and to determine the need for invasive prenatal genetic testing. Postnatally, early clinical assessment is needed and CT scan should be considered, irrespective of the presence of symptoms. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Collapse
Affiliation(s)
- M Bartsota
- Brompton Centre for Fetal Cardiology, Royal Brompton Hospital, London, UK
| | - V Jowett
- Great Ormond Street Hospital, London, UK
| | - D Manuel
- Brompton Centre for Fetal Cardiology, Royal Brompton Hospital, London, UK
| | | | | | - J Marek
- Great Ormond Street Hospital, London, UK
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - J S Carvalho
- Brompton Centre for Fetal Cardiology, Royal Brompton Hospital, London, UK
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK
- Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| |
Collapse
|
10
|
Lammers AE, Marek J, Diller GP, Haworth SG, Moledina S. Prognostic Value of Transthoracic Echocardiography in Children With Pulmonary Arterial Hypertension. J Am Heart Assoc 2023; 12:e023118. [PMID: 36926945 PMCID: PMC10111552 DOI: 10.1161/jaha.121.023118] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Background Transthoracic echocardiography is part of the regular follow-up protocol at most pediatric pulmonary arterial hypertension (PAH) centers. We aimed to develop a comprehensive and simple echocardiographic risk stratification for children with PAH. Methods and Results We included 63 children with PAH and a biventricular cardiac anatomy without relevant shunt lesions (60% female patients; mean age, 9.0 years; 42 idiopathic PAH and 21 associated PAH) undergoing a standardized transthoracic echocardiographic assessment. The prognostic value of echocardiographic parameters was assessed using Cox proportional hazards survival analysis and recursive partitioning for classification tree methods. Over a median follow-up period of 4.0 years, 17 patients died and 4 underwent lung transplantation. Various echocardiographic parameters were associated with the combined endpoint of death and transplantation on univariate analysis. On further analysis, right atrial area (z score) and left ventricular diastolic eccentricity index (LVEId) emerged as robust and independent predictors of transplant-free survival. Considering mortality alone as an end point, a combination of right atrial area, left ventricular diastolic eccentricity index, and tricuspid annular plane systolic excursion were identified as independent predictors of outcome. Based on these parameters, we propose simple risk scores that can be applied at the bedside without computer assistance. CONCLUSIONS Echocardiographic parameters predict prognosis in children with pulmonary hypertension. A combination of widely available parameters including right atrial area, left ventricular eccentricity index, and tricuspid annular plane systolic excursion emerged as risk stratifiers that await external validation but may assist clinicians determining the prognosis of children with PAH.
Collapse
Affiliation(s)
- Astrid E Lammers
- Paediatric Cardiology and the UK Pulmonary Hypertension Service for Children Great Ormond Street Hospital for Children London United Kingdom
- Paediatric Cardiology and Specialist Clinic for Paediatric Pulmonary Hypertension Muenster University Hospital Muenster Germany
- Adult Congenital Heart Disease Unit Muenster University Hospital Muenster Germany
| | - Jan Marek
- Paediatric Cardiology and the UK Pulmonary Hypertension Service for Children Great Ormond Street Hospital for Children London United Kingdom
- Institute of Cardiovascular Sciences University College London United Kingdom
| | - Gerhard-Paul Diller
- Adult Congenital Heart Disease Unit Muenster University Hospital Muenster Germany
| | - Sheila G Haworth
- Paediatric Cardiology and the UK Pulmonary Hypertension Service for Children Great Ormond Street Hospital for Children London United Kingdom
| | - Shahin Moledina
- Paediatric Cardiology and the UK Pulmonary Hypertension Service for Children Great Ormond Street Hospital for Children London United Kingdom
| |
Collapse
|
11
|
Dusik M, Fingrova Z, Marek J, Dytrych V, Jansa P, Havranek S. The impact of atrial fibrillation and atrial tachycardias on the hemodynamic status of patients with pulmonary hypertension. Physiol Res 2022. [DOI: 10.33549/physiolres.934941] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The impact of atrial fibrillation and atrial tachycardias (AF/AT), and their optimal treatment strategy in PH patients is still being discussed. The goal of this study was to evaluate the effect of AF/AT termination on the hemodynamic parameters in PH patients. We compared patients with pre-capillary pulmonary hypertension (PH group), left ventricular heart failure (LV-HF group), and a Control group. A repeated right heart catheterization was performed during the catheter ablation (CA) procedure. The first measurement was done in arrhythmia, the second after the sinus rhythm (SR) was restored. High frequency atrial stimulation was used to simulate AT in patients without arrhythmia presence at the time of the CA. The variation of pressure parameters in PH patients did not differ significantly from the Controls. There was a significant increase in the right ventricle pressure after the SR restoration in the LV-HF group compared to the Controls and PH group (+4 vs. -2 vs. -3 mmHg, p < 0.05). The cardiac index (CI) variation was not significant when compared between the study groups. An increase of the CI after the SR restoration was found in those patients with AF (+0.31 l/min/m² [IQR 0.18; 0.58]) in contrast to those patients with organized AT/high frequency atrial stimulation (-0.09 l/min/m², [IQR - 0.45; 0.19]). This difference was statistically significant (p < 0.05). The acute hemodynamic response to arrhythmia termination was not significantly different in the PH patients when compared to the Controls. In contrast to AT/high frequency stimulation, the restoration of SR in AF patients leads to an increased CI, irrespective of the presence or absence of PH.
Collapse
Affiliation(s)
| | | | | | | | | | - S Havranek
- 2nd Department of Medicine - Department of Cardiovascular Medicine, General University Hospital in Prague, 1st Faculty of Medicine, Charles University in Prague, Czech Republic.
| |
Collapse
|
12
|
Dusik M, Fingrova Z, Marek J, Dytrych V, Jansa P, Havranek S. The impact of atrial fibrillation and atrial tachycardias on the hemodynamic status of patients with pulmonary hypertension. Europace 2022. [DOI: 10.1093/europace/euac053.623] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Supported by Ministry of Health, Czech Republic – conceptual development of research organization (General University Hospital in Prague – VFN, 00064165)
Introduction
Atrial fibrillation and atrial tachycardias (AF/AT) have been reported as a common condition in patients with pulmonary hypertension (PH). The presence of arrhythmia in patients with PH leads to increased morbidity and mortality. The significance and possibilities of AF/AT treatment in patients with PH is still being discussed. The aim of this study is to evaluate the effect of acute heart rhythm change on hemodynamical parameters in PH patients with AF/AT being treated by catheter ablation.
Methods
We performed an analysis of hemodynamic parameters and their changes in relation to the present heart rhythm. The study group consisted of 11 PH patients with AF/AT (6 males, median age (IQR) 72 (53;76) years) and was compared with a control group of 9 patients with AF/AT without PH or other structural heart disease (5 males, 56 (49;62) years). The data was acquired during the catheter ablation procedure using a Swan-Ganz catheter.
Results
PH patients had higher mean pressures (median; IQR; mmHg) in the right ventricle (31 (24;32) vs. 23 (18;25), p<0.05) and in the pulmonary artery (36 (30;37) vs. 22 (19;25), p<0.05) compared to the control group. Other parameters were comparable. There was a significant decrease of the left atrial pressure in the presence of arrhythmia in the PH group compared to the left atrial pressure change in the control group (p<0.05). The changes of the remaining hemodynamic parameters did not differ significantly between the groups. There was no significant difference in cardiac output in sinus rhythm and AF/AT in both groups. The detailed results are presented in the table below.
Conclusion
The left atrial pressure in PH patients changes significantly according to the actual heart rhythm. The acute impact of AF/AT on the other hemodynamical parameters, including cardiac output, has not been proven.
Collapse
Affiliation(s)
- M Dusik
- First Faculty of Medicine and General Teaching Hospital, Prague, Czechia
| | - Z Fingrova
- First Faculty of Medicine and General Teaching Hospital, Prague, Czechia
| | - J Marek
- First Faculty of Medicine and General Teaching Hospital, Prague, Czechia
| | - V Dytrych
- First Faculty of Medicine and General Teaching Hospital, Prague, Czechia
| | - P Jansa
- First Faculty of Medicine and General Teaching Hospital, Prague, Czechia
| | - S Havranek
- First Faculty of Medicine and General Teaching Hospital, Prague, Czechia
| |
Collapse
|
13
|
Hympanova M, Oliver-Urrutia C, Vojta M, Macháček M, Krupka P, Kukla R, Celko L, Montufar EB, Marek J. Assessment of Streptococcus mutans biofilm formation on calcium phosphate ceramics: The role of crystalline composition and microstructure. Biomater Adv 2022; 135:212750. [PMID: 35929222 DOI: 10.1016/j.bioadv.2022.212750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/14/2022] [Accepted: 03/04/2022] [Indexed: 06/15/2023]
Abstract
Streptococcus mutans is one of the bacteria that initiates the colonization of the pellicle at the tooth surface. It forms a plaque, together with other bacteria, which gradually dissolves the pellicle and leaves the tooth surface unprotected against the acidic oral environment. Calcium phosphate ceramics are excellent synthetic materials for the study of biofilm formation in dentistry because they are comparable to teeth in chemical composition and structure. Calcium phosphates can be processed to achieve a variety of crystalline compounds with biologically relevant ionic substitutions and structures that allow study of the effect of the surface chemistry and the topography independently. In this article, we describe the preparation and characterization of three types of calcium phosphate-based materials as a suitable surface for the formation of the S. mutans biofilm: beta-tricalcium phosphate (β-TCP); sintered hydroxyapatite (SHA); and calcium-deficient hydroxyapatite (CDHA). The densest biofilms were formed on the surfaces of SHA and CDHA, with no significant differences due to the stoichiometry or microstructure. In contrast, β-TCP showed a lower susceptibility to S. mutans biofilm formation, suggesting that the crystalline structure is the controlling parameter. Subsequently, SHA was selected to develop a dental biofilm model that allowed study of S. mutans biofilm susceptibility to chlorhexidine and ethanol.
Collapse
Affiliation(s)
- Michaela Hympanova
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; Department of Epidemiology, Faculty of Military Health Sciences, University of Defence, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic
| | - Carolina Oliver-Urrutia
- Central European Institute of Technology, Brno University of Technology, Purkynova 123, 61200 Brno, Czech Republic
| | - Marek Vojta
- Department of Biology, Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, 500 03 Hradec Kralove, Czech Republic
| | - Miloslav Macháček
- Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Kralove, Charles University, Heyrovskeho 1203, Hradec Kralove 500 05, Czech Republic
| | - Pavel Krupka
- Department of Dentistry, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Rudolf Kukla
- Department of Clinical Microbiology, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Ladislav Celko
- Central European Institute of Technology, Brno University of Technology, Purkynova 123, 61200 Brno, Czech Republic
| | - Edgar B Montufar
- Central European Institute of Technology, Brno University of Technology, Purkynova 123, 61200 Brno, Czech Republic.
| | - Jan Marek
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; Department of Epidemiology, Faculty of Military Health Sciences, University of Defence, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic.
| |
Collapse
|
14
|
Stehlík M, Kisel'ák J, Dinamarca A, Alvarado E, Plaza F, Medina FA, Stehlíková S, Marek J, Venegas B, Gajdoš A, Li Y, Katuščák S, Bražinová A, Zeintl E, Lu Y. REDACS: Regional emergency-driven adaptive cluster sampling for effective COVID-19 management. Stoch Anal Appl 2022; 41:474-508. [PMID: 37982071 PMCID: PMC10655945 DOI: 10.1080/07362994.2022.2033126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/10/2022] [Accepted: 01/17/2022] [Indexed: 11/21/2023]
Abstract
As COVID-19 is spreading, national agencies need to monitor and track several metrics. Since we do not have perfect testing programs on the hand, one needs to develop an advanced sampling strategies for prevalence study, control and management. Here we introduce REDACS: Regional emergency-driven adaptive cluster sampling for effective COVID-19 management and control and justify its usage for COVID-19. We show its advantages over classical massive individual testing sampling plans. We also point out how regional and spatial heterogeneity underlines proper sampling. Fundamental importance of adaptive control parameters from emergency health stations and medical frontline is outlined. Since the Northern hemisphere entered Autumn and Winter season (this paper was originally submitted in November 2020), practical illustration from spatial heterogeneity of Chile (Southern hemisphere, which already experienced COVID-19 winter outbreak peak) is underlying the importance of proper regional heterogeneity of sampling plan. We explain the regional heterogeneity by microbiological backgrounds and link it to behavior of Lyapunov exponents. We also discuss screening by antigen tests from the perspective of "on the fly" biomarker validation, i.e., during the screening.
Collapse
Affiliation(s)
- M Stehlík
- Linz Institute of Technology & Department of Applied Statistics, J. Kepler University in Linz, Linz, Austria
- Instituto de Estadística, Universidad de Valparaíso, Valparaíso, Chile
- Facultad de Ingeniería, Universidad Andrés Bello, Valparaíso, Chile
| | - J Kisel'ák
- Institute of Mathematics, Faculty of Science, P.J.Šafárik University, Košice, Slovakia
| | - A Dinamarca
- Centro de Micro-Bioinnovación, Escuela de Nutrición y Dietética, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso, Chile
| | - E Alvarado
- Instituto de Estadística, Universidad de Valparaíso, Valparaíso, Chile
| | - F Plaza
- Instituto de Estadística, Universidad de Valparaíso, Valparaíso, Chile
- Instituto de Fomento Pesquero, Chile
| | - F A Medina
- Biostatistics Program, School of Public Health, University of Chile, Santiago, Chile
| | - S Stehlíková
- Linz Institute of Technology & Department of Applied Statistics, J. Kepler University in Linz, Linz, Austria
| | - J Marek
- University of Pardubice, Pardubice, Czech Republic
| | - B Venegas
- Departamento de Estomatología, Facultad de Ciencias de la Salud, Universidad de Talca, Chile
| | - A Gajdoš
- Facultad de Ingeniería, Universidad Andrés Bello, Valparaíso, Chile
| | - Y Li
- The University of Iowa, Iowa City, Iowa, USA
| | - S Katuščák
- Emeritus Prof.STU, Senior Konzulting, ESK
| | - A Bražinová
- Institute of Epidemiology, Faculty of Medicine in Bratislava, Comenius University, Slovak Republic
| | - E Zeintl
- Linz Institute of Technology & Department of Applied Statistics, J. Kepler University in Linz, Linz, Austria
| | - Y Lu
- Department of Biomedical Data Science, School of Medicine, Stanford University, Stanford, California, USA
| |
Collapse
|
15
|
Beeman A, Ramaswamy M, Srinivasan Y, Rudrappa S, Christov G, Marek J, Derrick G, Muthialu N. Importance of Acute Anterior Angulation in Double Aortic Arch Needing Attention at Primary Surgery. Front Cardiovasc Med 2022; 8:760523. [PMID: 35141288 PMCID: PMC8818705 DOI: 10.3389/fcvm.2021.760523] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundVascular rings are rare congenital abnormalities of the aortic arch. There are many embryological variants including a double aortic arch. In symptomatic children, division of ring and release of airway structures may be sufficient. Persistence of symptoms can be related to an anterior angle formed between the two arches. The aim of this study is to evaluate the clinical efficacy in improving symptoms and on changing this angle at the primary surgery.MethodsAll children who had surgery for double aortic arch between 2005 and 2020, were studied. Relevant factors were analyzed for persistent symptoms including anatomical substrates and surgical details.ResultsA total of 87 out of 224 children had surgery for a double aortic arch. At presentation, airway symptoms (n = 74/87) were more common than esophageal symptoms (n = 27/87). Early onset symptoms within 1 year were seen in 49 children. In addition to division of one arch, surgical steps also included realigning the anterior left arch, thereby eliminating the acute angle in 36 children (after 2014). After surgery, symptom relief within 12 months following surgery was seen in 64% of children (56 out of 87) but in 27 out of 36 children (75%) with additional surgical modification, as against 29 out of 51 (57%) in those with division of the arch. Symptoms persisted beyond 1 year needing reintervention in eight children.ConclusionAnterior arch angulation plays an important role in double aortic arch by causing a “nutcracker” phenomenon. Repair in double aortic arch should consider this aspect and include modification of surgical steps by realigning the corresponding aortic arch branches and an anterior pexy in selected cases.
Collapse
|
16
|
Milano EG, Kostolny M, Pajaziti E, Marek J, Regan W, Caputo M, Luciani GB, Mortensen KH, Cook AC, Schievano S, Capelli C. Enhanced 3D visualization for planning biventricular repair of double outlet right ventricle: a pilot study on the advantages of virtual reality. Eur Heart J Digit Health 2021; 2:667-675. [PMID: 36713107 PMCID: PMC9707861 DOI: 10.1093/ehjdh/ztab087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/27/2021] [Indexed: 02/01/2023]
Abstract
Aims We aim to determine any additional benefit of virtual reality (VR) experience if compared to conventional cross-sectional imaging and standard three-dimensional (3D) modelling when deciding on surgical strategy in patients with complex double outlet right ventricle (DORV). Methods and results We retrospectively selected 10 consecutive patients with DORV and complex interventricular communications, who underwent biventricular repair. An arterial switch operation (ASO) was part of the repair in three of those. Computed tomography (CT) or cardiac magnetic resonance imaging images were used to reconstruct patient-specific 3D anatomies, which were then presented using different visualization modalities: 3D pdf, 3D printed models, and VR models. Two experienced paediatric cardiac surgeons, blinded to repair performed, reviewed each case evaluating the suitability of repair following assessment of each visualization modalities. In addition, they had to identify those who had ASO as part of the procedure. Answers of the two surgeons were compared to the actual operations performed. There was no mortality during the follow-up (mean = 2.5 years). Two patients required reoperations. After review of CT/cardiac magnetic resonance images, the evaluators identified the surgical strategy in accordance with the actual surgical plan in 75% of the cases. When using 3D pdf this reached only 70%. Accordance improved to 85% after revision of 3D printed models and to 95% after VR. Use of 3D printed models and VR facilitated the identification of patients who required ASO. Conclusion Virtual reality can enhance understanding of suitability for biventricular repair in patients with complex DORV if compared to cross-sectional images and other 3D modelling techniques.
Collapse
Affiliation(s)
- Elena Giulia Milano
- UCL Institute for Cardiovascular Science and Great Ormond Street Hospital, 20c Guilford St, London WC1N 1DZ, UK.,Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, P.le Scuro 10, 37134, Verona, Italy
| | - Martin Kostolny
- UCL Institute for Cardiovascular Science and Great Ormond Street Hospital, 20c Guilford St, London WC1N 1DZ, UK.,Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, WC1N 3JH, London, UK
| | - Endrit Pajaziti
- UCL Institute for Cardiovascular Science and Great Ormond Street Hospital, 20c Guilford St, London WC1N 1DZ, UK
| | - Jan Marek
- UCL Institute for Cardiovascular Science and Great Ormond Street Hospital, 20c Guilford St, London WC1N 1DZ, UK
| | - William Regan
- Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, WC1N 3JH, London, UK.,Department of Congenital Heart Disease, Evelina London Children's Hospital, Westminster Bridge Rd, SE1 7EH, London, UK
| | - Massimo Caputo
- Bristol Heart Institute, Bristol Medical School, Bristol Medical School, University of Bristol, St Michael's Hill, BS2 8DZ, Bristol, UK
| | - Giovanni Battista Luciani
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, P.le Scuro 10, 37134, Verona, Italy
| | - Kristian H Mortensen
- Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, WC1N 3JH, London, UK
| | - Andrew C Cook
- UCL Institute for Cardiovascular Science and Great Ormond Street Hospital, 20c Guilford St, London WC1N 1DZ, UK
| | - Silvia Schievano
- UCL Institute for Cardiovascular Science and Great Ormond Street Hospital, 20c Guilford St, London WC1N 1DZ, UK
| | - Claudio Capelli
- UCL Institute for Cardiovascular Science and Great Ormond Street Hospital, 20c Guilford St, London WC1N 1DZ, UK
| |
Collapse
|
17
|
Markova A, Hympanova M, Matula M, Prchal L, Sleha R, Benkova M, Pulkrabkova L, Soukup O, Krocova Z, Jun D, Marek J. Synthesis and Decontamination Effect on Chemical and Biological Agents of Benzoxonium-Like Salts. Toxics 2021; 9:toxics9090222. [PMID: 34564373 PMCID: PMC8469817 DOI: 10.3390/toxics9090222] [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] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 11/22/2022]
Abstract
Benzoxonium chloride belongs to the group of quaternary ammonium salts, which have been widely used for decades as disinfectants because of their high efficacy, low toxicity, and thermal stability. In this study, we have prepared the C10-C18 set of benzoxonium-like salts to evaluate the effect of their chemical and biological decontamination capabilities. In particular, biocidal activity against a panel of bacterial strains including Staphylococcus aureus in biofilm form was screened. In addition, the most promising compounds were successfully tested against Francisella tularensis as a representative of potential biological warfare agents. From a point of view of chemical warfare protection, the efficiency of BOC-like compounds to degrade the organophosphate simulant fenitrothion was examined. Notwithstanding that no single compound with universal effectiveness was identified, a mixture of only two compounds from this group would be able to satisfactorily cover the proposed decontamination spectrum. In addition, the compounds were evaluated for their cytotoxicity as a basic safety parameter for potential use in practice. In summary, the dual effect on chemical and biological agents of benzoxonium-like salts offer attractive potential as active components of decontamination mixtures in the case of a terrorist threat or chemical or biological accidents.
Collapse
Affiliation(s)
- Aneta Markova
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (A.M.); (M.H.); (L.P.); (M.B.); (L.P.); (O.S.)
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence in Brno, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic; (M.M.); (D.J.)
| | - Michaela Hympanova
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (A.M.); (M.H.); (L.P.); (M.B.); (L.P.); (O.S.)
- Department of Epidemiology, Faculty of Military Health Sciences, University of Defence in Brno, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic;
| | - Marek Matula
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence in Brno, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic; (M.M.); (D.J.)
| | - Lukas Prchal
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (A.M.); (M.H.); (L.P.); (M.B.); (L.P.); (O.S.)
| | - Radek Sleha
- Department of Epidemiology, Faculty of Military Health Sciences, University of Defence in Brno, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic;
| | - Marketa Benkova
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (A.M.); (M.H.); (L.P.); (M.B.); (L.P.); (O.S.)
| | - Lenka Pulkrabkova
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (A.M.); (M.H.); (L.P.); (M.B.); (L.P.); (O.S.)
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence in Brno, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic; (M.M.); (D.J.)
| | - Ondrej Soukup
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (A.M.); (M.H.); (L.P.); (M.B.); (L.P.); (O.S.)
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence in Brno, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic; (M.M.); (D.J.)
| | - Zuzana Krocova
- Department of Molecular Pathology and Biology, Faculty of Military Health Sciences, University of Defence in Brno, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic;
| | - Daniel Jun
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence in Brno, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic; (M.M.); (D.J.)
| | - Jan Marek
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (A.M.); (M.H.); (L.P.); (M.B.); (L.P.); (O.S.)
- Department of Epidemiology, Faculty of Military Health Sciences, University of Defence in Brno, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic;
- Correspondence: ; Tel.: +420-495-833-447
| |
Collapse
|
18
|
Calcagni G, Gagliostro G, Limongelli G, Unolt M, De Luca E, Digilio MC, Baban A, Albanese SB, Ferrero GB, Baldassarre G, Agnoletti G, Banaudi E, Marek J, Kaski JP, Tuo G, Marasini M, Cairello F, Madrigali A, Pacileo G, Russo MG, Milanesi O, Formigari R, Brighenti M, Ragni L, Donti A, Drago F, Dallapiccola B, Tartaglia M, Marino B, Versacci P. Atypical cardiac defects in patients with RASopathies: Updated data on CARNET study. Birth Defects Res 2021; 112:725-731. [PMID: 32558384 DOI: 10.1002/bdr2.1670] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND RASopathies are a set of relatively common autosomal dominant clinically and genetically heterogeneous disorders. Cardiac outcomes in terms of mortality and morbidity for common heart defects (such as pulmonary valve stenosis and hypertrophic cardiomyopathy) have been reported. Nevertheless, also Atypical Cardiac Defects (ACDs) are described. The aim of the present study was to report both prevalence and cardiac outcome of ACDs in patients with RASopathies. METHODS A retrospective, multicentric observational study (CArdiac Rasopathy NETwork-CARNET study) was carried out. Clinical, surgical, and genetic data of the patients who were followed until December 2019 were collected. RESULTS Forty-five patients out of 440 followed in CARNET centers had ACDs. Noonan Syndrome (NS), NS Multiple Lentigines (NSML) and CardioFacioCutaneous Syndrome (CFCS) were present in 36, 5 and 4 patients, respectively. Median age at last follow-up was 20.1 years (range 6.9-47 years). Different ACDs were reported, including mitral and aortic valve dysfunction, ascending and descending aortic arch anomalies, coronary arteries dilation, enlargement of left atrial appendage and isolated pulmonary branches diseases. Five patients (11%) underwent cardiac surgery and one of them underwent a second intervention for mitral valve replacement and severe pericardial effusion. No patients died in our cohort until December 2019. CONCLUSIONS Patients with RASopathies present a distinct CHD spectrum. Present data suggest that also ACDs must be carefully investigated for their possible impact on the clinical outcome. A careful longitudinal follow up until the individuals reach an adult age is recommended.
Collapse
Affiliation(s)
- Giulio Calcagni
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Giulia Gagliostro
- Pediatric Cardiology, Department of Pediatrics, Obstetrics and Gynecology, Sapienza University of Rome, Rome, Italy
| | | | - Marta Unolt
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Enrica De Luca
- Pediatric Cardiology, Department of Pediatrics, Obstetrics and Gynecology, Sapienza University of Rome, Rome, Italy
| | - Maria C Digilio
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Anwar Baban
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Sonia B Albanese
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Giovanni B Ferrero
- Department of Pediatric and Public Health Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Giuseppina Baldassarre
- Department of Pediatric and Public Health Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Gabriella Agnoletti
- Department of Pediatric and Public Health Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Elena Banaudi
- Department of Pediatric and Public Health Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Jan Marek
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London, UK, UCL Institute of Cardiovascular Science, London, UK
| | - Juan P Kaski
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, UK, UCL Institute of Cardiovascular Science, London, UK
| | - Giulia Tuo
- Cardiovascular Department, Giannina Gaslini Institute, Genoa, Italy
| | | | | | - Andrea Madrigali
- Pediatric Cardiology, Department of Pediatrics, Obstetrics and Gynecology, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Pacileo
- Cardiologia SUN, Monaldi Hospital, II University of Naples, Naples, Italy
| | - Maria G Russo
- Cardiologia SUN, Monaldi Hospital, II University of Naples, Naples, Italy
| | - Ornella Milanesi
- Department of Woman and Child's Health, Pediatric Cardiology, University of Padova, Padua, Italy
| | - Roberto Formigari
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy.,Cardiology and Cardiac Surgery, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Maurizio Brighenti
- Cardiology and Cardiac Surgery, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Luca Ragni
- Cardiology and Cardiac Surgery, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Andrea Donti
- Cardiology and Cardiac Surgery, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Fabrizio Drago
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Bruno Dallapiccola
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Bruno Marino
- Pediatric Cardiology, Department of Pediatrics, Obstetrics and Gynecology, Sapienza University of Rome, Rome, Italy
| | - Paolo Versacci
- Pediatric Cardiology, Department of Pediatrics, Obstetrics and Gynecology, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
19
|
Antosova A, Gancar M, Bednarikova Z, Marek J, Zahn D, Dutz S, Gazova Z. Surface-modified magnetite nanoparticles affect lysozyme amyloid fibrillization. Biochim Biophys Acta Gen Subj 2021; 1865:129941. [PMID: 34090976 DOI: 10.1016/j.bbagen.2021.129941] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 05/17/2021] [Accepted: 06/01/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The surface of nanoparticles (NPs) is an important factor affecting the process of poly/peptides' amyloid aggregation. We have investigated the in vitro effect of trisodium citrate (TC), gum arabic (GA) and citric acid (CA) surface-modified magnetite nanoparticles (COAT-MNPs) on hen egg-white lysozyme (HEWL) amyloid fibrillization and mature HEWL fibrils. METHODS Dynamic light scattering (DLS) was used to characterize the physico-chemical properties of studied COAT-MNPs and determine the adsorption potential of their surface towards HEWL. The anti-amyloid properties were studied using thioflavin T (ThT) and tryptophan (Trp) intrinsic fluorescence assays, and atomic force microscopy (AFM). The morphology of amyloid aggregates was analyzed using Gwyddion software. The cytotoxicity of COAT-MNPs was determined utilizing Trypan blue (TB) assay. RESULTS Agents used for surface modification affect the COAT-MNPs physico-chemical properties and modulate their anti-amyloid potential. The results from ThT and intrinsic fluorescence showed that the inhibitory activities result from the more favorable interactions of COAT-MNPs with early pre-amyloid species, presumably reducing nuclei and oligomers formation necessary for amyloid fibrillization. COAT-MNPs also possess destroying potential, which is presumably caused by the interaction with hydrophobic residues of the fibrils, resulting in the interruption of an interface between β-sheets stabilizing the amyloid fibrils. CONCLUSION COAT-MNPs were able to inhibit HEWL fibrillization and destroy mature fibrils with different efficacy depending on their properties, TC-MNPs being the most potent nanoparticles. GENERAL SIGNIFICANCE The study reports findings regarding the general impact of nanoparticles' surface modifications on the amyloid aggregation of proteins.
Collapse
Affiliation(s)
- A Antosova
- Department of Biophysics, Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovakia
| | - M Gancar
- Department of Biophysics, Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovakia
| | - Z Bednarikova
- Department of Biophysics, Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovakia
| | - J Marek
- Department of Biophysics, Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovakia
| | - D Zahn
- Institute of Biomedical Engineering and Informatics (BMTI), Technische Universität Ilmenau, Ilmenau, Germany
| | - S Dutz
- Institute of Biomedical Engineering and Informatics (BMTI), Technische Universität Ilmenau, Ilmenau, Germany
| | - Z Gazova
- Department of Biophysics, Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovakia.
| |
Collapse
|
20
|
Bares M, Bleha M, Votavovä E, Marek J, Vackova E, Zajic J. The reaction of fatty acids and their derivatives with ethylene oxide, V: A kinetic study of the second reaction stage of the reaction of stearic acid with ethylene oxide. TENSIDE SURFACT DET 2021. [DOI: 10.1515/tsd-1979-160605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
21
|
Lee PH, Marek J, Nálevka P. Sleep pattern in the US and 16 European countries during the COVID-19 outbreak using crowdsourced smartphone data. Eur J Public Health 2021; 31:23-30. [PMID: 33169169 PMCID: PMC7717335 DOI: 10.1093/eurpub/ckaa208] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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] [Indexed: 12/20/2022] Open
Abstract
Background To stop the spread of the new coronavirus disease in 2019 (COVID-19), many countries had completely locked down. This lockdown restricted the everyday life of the affected residents and changed their mobility pattern, but its effects on sleep pattern were largely unknown. Methods Here, utilizing one of the largest crowdsourced database (Sleep as Android), we analyzed the sleep pattern of 25 217 users with 1 352 513 sleep records between 1 January and 29 April 2020 in the US and 16 European countries (Germany, UK, Spain, France, Italy, The Netherlands, Belgium, Hungary, Denmark, Finland, Norway, Czech, Sweden, Austria, Poland and Switzerland) with more than 100 records in all days of 2020. Results During the COVID-19 pandemic, the sleeping pattern before and after the country-level lockdown largely differed. The subjects increased their sleep duration by an average of 11.3 to 18.6 min on weekday nights, except Denmark (4.9 min) and Finland (7.1 min). In addition, subjects form all 16 European countries delayed their sleep onset from 10.7 min (Sweden) to 29.6 min (Austria). Conclusion During the COVID-19 pandemic, residents in the US and 16 European countries delayed their bedtime and slept longer than usual.
Collapse
Affiliation(s)
- Paul H Lee
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | | | | |
Collapse
|
22
|
Bonello B, Kostolny M, Marek J. Enhanced Echocardiography Imaging in Reoperation for Complex Congenital Heart Disease in a Child. ACTA ACUST UNITED AC 2020; 5:81-85. [PMID: 33644520 PMCID: PMC7887613 DOI: 10.1016/j.case.2020.11.002] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Evaluation of the mechanism of MR is essential for appropriate repair. 2D and 3D TEE are the gold standard for presurgical MV repair in children. Enhanced echo imaging improves benefits in complex congenital heart disease.
Collapse
Affiliation(s)
- Beatrice Bonello
- Great Ormond Street Hospital for Children, London, United Kingdom
| | - Martin Kostolny
- Great Ormond Street Hospital for Children, London, United Kingdom.,Institute of Cardiovascular Sciences, University College London, London, United Kingdom
| | - Jan Marek
- Great Ormond Street Hospital for Children, London, United Kingdom.,Institute of Cardiovascular Sciences, University College London, London, United Kingdom
| |
Collapse
|
23
|
Bernal Quintero D, Manning N, Wolfenden J, Hughes ML, Marek J. Prenatal diagnosis of double aortic arch in association with an aortopulmonary window. Eur Heart J Cardiovasc Imaging 2020; 20:1180. [PMID: 31005962 DOI: 10.1093/ehjci/jez069] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Diana Bernal Quintero
- Department of Fetal Cardiology, Great Ormond Street Hospital for Children, Great Ormond St, London, UK
| | - Nicky Manning
- Department of Fetal Cardiology, Great Ormond Street Hospital for Children, Great Ormond St, London, UK
| | - Joanne Wolfenden
- Department of Fetal Cardiology, Great Ormond Street Hospital for Children, Great Ormond St, London, UK
| | - Marina L Hughes
- Department of Fetal Cardiology, Great Ormond Street Hospital for Children, Great Ormond St, London, UK
| | - Jan Marek
- Department of Fetal Cardiology, Great Ormond Street Hospital for Children, Great Ormond St, London, UK.,Institute of Cardiovascular Sciences, University College London, London, UK
| |
Collapse
|
24
|
Hympanova M, Terlep S, Markova A, Prchal L, Dogsa I, Pulkrabkova L, Benkova M, Marek J, Stopar D. The Antibacterial Effects of New N-Alkylpyridinium Salts on Planktonic and Biofilm Bacteria. Front Microbiol 2020; 11:573951. [PMID: 33193183 PMCID: PMC7606276 DOI: 10.3389/fmicb.2020.573951] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 06/18/2020] [Accepted: 09/28/2020] [Indexed: 12/03/2022] Open
Abstract
An increasing microbial resistance to known antibiotics raises a demand for new antimicrobials. In this study the antimicrobial properties of a series of new N-Alkylpyridinium quaternary ammonium compounds (QACs) with varying alkyl chain lengths were evaluated for several nosocomial pathogens. The chemical identities of the new QACs were determined by NMR, LC-MS, and HRMS. All the planktonic bacteria tested were susceptible to the new QACs as evaluated by MIC and MBC assays. The antimicrobial effect was most pronounced against Staphylococcus aureus clinical isolates. Live/dead staining CLSM was used to test the effectiveness of the QACs in biofilms. The effectiveness was up to 10-fold lower than in the plankton. When QACs were used as irrigants in Er:YAG – SSP photoacoustic steaming, their effectiveness significantly increased. The combined use of irrigants and photoacoustic streaming increased biofilm removal from the surface and increased the killing rate of the cells remaining on the surface. This may allow for a shorter chemical exposure time and lower dosage of QACs used in applications. The results demonstrate that the new QACs have potential to be applied as antibacterial compounds effective against planktonic and biofilm bacteria as well as irrigants in removal of difficult-to-reach biofilms.
Collapse
Affiliation(s)
- Michaela Hympanova
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czechia.,Department of Epidemiology, Faculty of Military Health Sciences, University of Defence in Brno, Brno, Czechia
| | | | - Aneta Markova
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czechia.,Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence in Brno, Brno, Czechia
| | - Lukáš Prchal
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czechia
| | - Iztok Dogsa
- Department of Microbiology, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Lenka Pulkrabkova
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czechia.,Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence in Brno, Brno, Czechia
| | - Marketa Benkova
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czechia
| | - Jan Marek
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czechia.,Department of Epidemiology, Faculty of Military Health Sciences, University of Defence in Brno, Brno, Czechia
| | - David Stopar
- Department of Microbiology, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
25
|
Neijenhuis RML, Tsang VT, Marek J, Issitt R, Bonello B, Von Klemperer K, Hughes ML. Cone reconstruction for Ebstein anomaly: Late biventricular function and possible remodeling. J Thorac Cardiovasc Surg 2020; 161:1097-1108. [PMID: 33293067 DOI: 10.1016/j.jtcvs.2020.10.124] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Received: 05/31/2020] [Revised: 09/16/2020] [Accepted: 10/09/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To evaluate late-term tricuspid valve competence and biventricular function following cone reconstruction for Ebstein anomaly, and to explore biventricular remodeling. METHODS Consecutive adult and pediatric patients who underwent cone reconstruction from 2009 to 2019 were reviewed for inclusion in this retrospective cardiac magnetic resonance imaging study. Tricuspid valve competence was assessed with tricuspid regurgitation fraction. Biventricular systolic function was assessed by ejection fraction, cardiac index, indexed stroke volume, and indexed aortic and pulmonary artery beat volume. Biventricular remodeling was assessed by planimetered areas (right atrium, functional right ventricle, left heart), and indexed end-diastolic and end-systolic ventricular volumes. Paired t tests or Wilcoxon signed-rank tests were used for analyses. RESULTS Of 58 included patients, 50 underwent cardiac magnetic resonance imaging. Twelve patients had both preoperative and late postoperative cardiac magnetic resonance imaging with a median follow-up of 5.11 years (interquartile range, 3.12-6.07 years). Focusing on these, tricuspid regurgitation fraction decreased (from 69% to 10%; P = .014), right ventricle ejection fraction remained stable, and antegrade pulmonary artery beat volume increased (from 26.7 to 41.6 mL/beat/m2; P = .037). The left ventricle stroke volume (from 30.4 to 44.1 mL/m2; P = .015) and antegrade aortic beat volume (from 28.5 to 41.1 mL/beat/m2; P = .014) also increased, and the left ventricle stroke volume improved progressively with time since surgery (P = .048). Whereas the right atrium area decreased (P = .004), the functional right ventricle and left heart area increased (cm2, P = .021 and P = .004). Right ventricle volumes showed a tendency to normalize and left ventricle indexed end-diastolic volume increased (from 50 to 69 mL/m2; P = .03) over time. CONCLUSIONS Cone valve integrity was sustained. Biventricular function improved progressively during follow-up, and there are positive signs of biventricular remodeling late after cone reconstruction.
Collapse
Affiliation(s)
- Ralph M L Neijenhuis
- Cardiothoracic Unit, Great Ormond Street Hospital for Children, London, United Kingdom
| | - Victor T Tsang
- Cardiothoracic Unit, Great Ormond Street Hospital for Children, London, United Kingdom; Grown-up Congenital Heart Unit, St Bartholomew's Hospital, London, United Kingdom; Institute of Cardiovascular Science, University College London, London, United Kingdom.
| | - Jan Marek
- Institute of Cardiovascular Science, University College London, London, United Kingdom; Department of Cardiology, Great Ormond Street Hospital for Children, London, United Kingdom
| | - Richard Issitt
- Institute of Cardiovascular Science, University College London, London, United Kingdom; Digital Research Environment, Great Ormond Street Hospital for Children, London, United Kingdom; Department of Perfusion, Great Ormond Street Hospital for Children, London, United Kingdom
| | - Beatrice Bonello
- Department of Cardiology, Great Ormond Street Hospital for Children, London, United Kingdom; Centre for Cardiovascular Imaging, Great Ormond Street Hospital for Children, London, United Kingdom
| | | | - Marina L Hughes
- Department of Cardiology, Great Ormond Street Hospital for Children, London, United Kingdom; Centre for Cardiovascular Imaging, Great Ormond Street Hospital for Children, London, United Kingdom
| |
Collapse
|
26
|
Jicinska H, Tax P, Padr R, Jicinsky M, Marek J. Rare congenital umbilical arteriovenous malformation. Eur Heart J Cardiovasc Imaging 2020; 21:1172. [DOI: 10.1093/ehjci/jeaa102] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 04/18/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Hana Jicinska
- Department of Pediatrics, University Hospital Brno; Faculty of Medicine, Masaryk University Brno, Cernopolni 9, 662 63 Brno, Czech Republic
| | - Petr Tax
- Children’s Heart Centre, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, V Uvalu 84, 150 06 Prague, Czech Republic
| | - Radek Padr
- Department of Radiology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague, Czech Republic
| | - Michal Jicinsky
- Children’s Heart Centre, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, V Uvalu 84, 150 06 Prague, Czech Republic
| | - Jan Marek
- Great Ormond Street Hospital for Children and Institute of Cardiovascular Sciences UCL, London, UK
| |
Collapse
|
27
|
Lee PH, Marek J, Nálevka P. Crowdsourced smartphone data reveal altered sleep/wake pattern in quarantined Chinese during the COVID-19 outbreak. Chronobiol Int 2020; 37:1181-1190. [DOI: 10.1080/07420528.2020.1792486] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Paul H. Lee
- School of Nursing, Hong Kong Polytechnic University, Hong Kong
| | - Jan Marek
- Urbandroid Team, Prague, Czech Republic
| | | |
Collapse
|
28
|
Muthialu N, Martens T, Kanakis M, Bezuska L, Nakao M, Derrick G, Marek J, Khambadkone S, Kostolny M, Tsang V. Repair of pulmonary artery sling with tracheal and intracardiac defects. Asian Cardiovasc Thorac Ann 2020; 28:463-469. [PMID: 32659103 DOI: 10.1177/0218492320943342] [Citation(s) in RCA: 4] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pulmonary artery sling is commonly associated with tracheal stenosis and intracardiac anomalies. While surgical repair is standardized, coexistent anomalies often determine outcomes. With the paucity of risk stratification, this study aimed to review our experience and stratify risk factors for the surgical outcome of complex pulmonary artery sling repair in the presence of airway or intracardiac lesions. METHODS Seventy-nine consecutive children with pulmonary artery sling were evaluated retrospectively following surgical repair. Median age at surgery was 5 months (interquartile range 3-9). Surgical approaches included pulmonary artery sling alone (n = 10), pulmonary artery sling with tracheoplasty (n = 41), and pulmonary artery sling with both intracardiac and tracheal surgery (n = 28). RESULTS There were 7 early (8.8%) deaths. Two patients after left pulmonary artery reimplantation needed revision of the anastomosis. The median intensive care and hospital stay were 11 (interquartile range 9.2-24.8) and 17.9 (interquartile range 4.3-19.8) days, and considerably longer when associated tracheal surgery (p = 0.002). Follow-up was complete in 66/69 and 3 (3.8%) children died late: 2.7, 10.2, and 17 months after surgery. Univariate analysis showed abnormal lung and coexisting structural heart disease as risk factors. Multivariate analysis revealed total cardiopulmonary bypass time as an independent predictor of overall mortality. CONCLUSION Complex pulmonary artery sling repair can be performed with a good surgical outcomes even when associated with airway malformations or structural heart diseases. Lung abnormality and longer cardiopulmonary bypass time as a surrogate marker of complex surgery, are possible risk factors.
Collapse
Affiliation(s)
- Nagarajan Muthialu
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - Thomas Martens
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - Meletios Kanakis
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - Laurynas Bezuska
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - Masakazu Nakao
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - Graham Derrick
- Department of Cardiology, Great Ormond Street Hospital, London, UK
| | - Jan Marek
- Department of Cardiology, Great Ormond Street Hospital, London, UK
| | | | - Martin Kostolny
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - Victor Tsang
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| |
Collapse
|
29
|
Benkova M, Soukup O, Marek J. Antimicrobial susceptibility testing: currently used methods and devices and the near future in clinical practice. J Appl Microbiol 2020; 129:806-822. [DOI: 10.1111/jam.14704] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 04/28/2020] [Accepted: 05/11/2020] [Indexed: 12/17/2022]
Affiliation(s)
- M. Benkova
- Department of Epidemiology Faculty of Military Health Sciences University of Defence Hradec Kralove Czech Republic
- Biomedical Research Center University Hospital Hradec Kralove Hradec Kralove Czech Republic
| | - O. Soukup
- Biomedical Research Center University Hospital Hradec Kralove Hradec Kralove Czech Republic
- Department of Toxicology and Military Pharmacy Faculty of Military Health Sciences University of Defence Hradec Kralove Czech Republic
| | - J. Marek
- Department of Epidemiology Faculty of Military Health Sciences University of Defence Hradec Kralove Czech Republic
- Biomedical Research Center University Hospital Hradec Kralove Hradec Kralove Czech Republic
| |
Collapse
|
30
|
Salajkova S, Benkova M, Marek J, Sleha R, Prchal L, Malinak D, Dolezal R, Sepčić K, Gunde-Cimerman N, Kuca K, Soukup O. Wide-Antimicrobial Spectrum of Picolinium Salts. Molecules 2020; 25:E2254. [PMID: 32403238 PMCID: PMC7248777 DOI: 10.3390/molecules25092254] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/05/2020] [Accepted: 05/08/2020] [Indexed: 01/27/2023] Open
Abstract
Nosocomial infections, which greatly increase morbidity among hospitalized patients, together with growing antibiotic resistance still encourage many researchers to search for novel antimicrobial compounds. Picolinium salts with different lengths of alkyl chains (C12, C14, C16) were prepared by Menshutkin-like reaction and evaluated with respect to their biological activity, i.e., lipophilicity and critical micellar concentration. Picolinium salts with C14 and C16 side chains achieved similar or even better results when in terms of antimicrobial efficacy than benzalkoniums; notably, their fungicidal efficiency was substantially more potent. The position of the methyl substituent on the aromatic ring does not seem to affect antimicrobial activity, in contrast to the effect of length of the N-alkyl chain. Concurrently, picolinium salts exhibited satisfactory low cytotoxicity against mammalian cells, i.e., lower than that of benzalkonium compounds, which are considered as safe.
Collapse
Affiliation(s)
- Sarka Salajkova
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (Sa.S.); (M.B.); (J.M.); (L.P.); (D.M.); (R.D.)
- Department of Genome Integrity, Institute of Molecular Genetics of the Czech Academy of Sciences, Videnska 1083, 142 20 Prague, Czech Republic
| | - Marketa Benkova
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (Sa.S.); (M.B.); (J.M.); (L.P.); (D.M.); (R.D.)
- Department of Epidemiology, University of Defence in Brno, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic;
| | - Jan Marek
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (Sa.S.); (M.B.); (J.M.); (L.P.); (D.M.); (R.D.)
- Department of Epidemiology, University of Defence in Brno, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic;
| | - Radek Sleha
- Department of Epidemiology, University of Defence in Brno, Trebesska 1575, 500 05 Hradec Kralove, Czech Republic;
| | - Lukas Prchal
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (Sa.S.); (M.B.); (J.M.); (L.P.); (D.M.); (R.D.)
| | - David Malinak
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (Sa.S.); (M.B.); (J.M.); (L.P.); (D.M.); (R.D.)
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, 500 03 Hradec Kralove, Czech Republic
| | - Rafael Dolezal
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (Sa.S.); (M.B.); (J.M.); (L.P.); (D.M.); (R.D.)
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, 500 03 Hradec Kralove, Czech Republic
| | - Kristina Sepčić
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, 1000 Ljubljana, Slovenia; (K.S.); (N.G.-C.)
| | - Nina Gunde-Cimerman
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, 1000 Ljubljana, Slovenia; (K.S.); (N.G.-C.)
| | - Kamil Kuca
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (Sa.S.); (M.B.); (J.M.); (L.P.); (D.M.); (R.D.)
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Rokitanskeho 62, 500 03 Hradec Kralove, Czech Republic
| | - Ondrej Soukup
- Biomedical Research Center, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic; (Sa.S.); (M.B.); (J.M.); (L.P.); (D.M.); (R.D.)
| |
Collapse
|
31
|
Naqvi N, Babu-Narayan SV, Krupickova S, Muthialu N, Maiya S, Chandershekar P, Cheang MH, Kostolny M, Tsang V, Marek J. Myocardial Function Following Repair of Anomalous Origin of Left Coronary Artery from the Pulmonary Artery in Children. J Am Soc Echocardiogr 2020; 33:622-630. [PMID: 32122741 DOI: 10.1016/j.echo.2019.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/02/2018] [Revised: 11/22/2019] [Accepted: 12/19/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We aimed to assess the change in global and regional myocardial function before and after surgical revascularization and their added value when compared with conventional measures in children with anomalous left coronary artery from the pulmonary artery (ALCAPA). METHODS Advanced echocardiographic assessment was performed pre- and postoperatively in 22 children with ALCAPA (eight male; median surgery age, 0.4 years; interquartile range, 0.21-1.05) and 22 healthy controls. Measurements included global and segmental longitudinal, radial, and circumferential two-dimensional speckle-tracking strain and postsystolic index. RESULTS Global strains were lower in preoperative patients than in controls (longitudinal: -9% vs -21%; P < .001; circumferential: -11% vs -21%; P < .001; radial: 18% vs 60%; P < .001) and improved postoperatively when compared with preoperative findings (longitudinal: -9% pre vs -16% post; P = .002, circumferential:-11% pre vs -17% post; P = .012, radial: 18% pre vs 53% post; P = .001). Preoperatively, patients with normal global systolic function on conventional echocardiography had significantly impaired global longitudinal and radial strain compared with healthy controls. Global mechanical dyssynchrony improved significantly postoperatively (longitudinal postsystolic index 43 pre vs 6 post, P < .001; circumferential 15 pre vs 2 post, P = .001; radial 48 pre vs 5 post, P = .003). Despite overall improvement in most segments, global longitudinal and circumferential and segmental peak strain in some of the segments supplied by the ALCAPA remained postoperatively abnormal. CONCLUSIONS This study shows that myocardial deformation indices were a more sensitive measure of LV dysfunction in patients before and after ALCAPA repair than conventional echocardiographic measures. We believe, therefore, they should be added to routine preoperative and serial postoperative follow-up assessment.
Collapse
Affiliation(s)
- Nitha Naqvi
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London, United Kingdom
| | - Sonya V Babu-Narayan
- Department of Adult Congenital Heart Disease, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Sylvia Krupickova
- Department of Adult Congenital Heart Disease, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College London, London, United Kingdom; Department of Paediatric Cardiology, Royal Brompton Hospital, London, United Kingdom
| | - Nagarajan Muthialu
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London, United Kingdom
| | - Shreesha Maiya
- Department of Paediatric Cardiology, Royal Brompton Hospital, London, United Kingdom
| | - Prathiba Chandershekar
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London, United Kingdom
| | - Mun Hong Cheang
- Institute of Cardiovascular Sciences University College London, London, United Kingdom
| | - Martin Kostolny
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London, United Kingdom
| | - Victor Tsang
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London, United Kingdom; Institute of Cardiovascular Sciences University College London, London, United Kingdom
| | - Jan Marek
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London, United Kingdom; Institute of Cardiovascular Sciences University College London, London, United Kingdom.
| |
Collapse
|
32
|
Šinkorová Z, Filipová A, Vávrová J, Pejchal J, Andrejsová L, Jeličová M, Marek J, Havelek R, Seifrtová M, Řezáčová M, Tichý A. INVESTIGATION OF THE RADIOPROTECTIVE EFFECT OF ORTHOVANADATE IN MICE AFTER TOTAL BODY IRRADIATION. Radiat Prot Dosimetry 2019; 186:149-154. [PMID: 31711201 DOI: 10.1093/rpd/ncz192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 09/10/2019] [Indexed: 06/10/2023]
Abstract
The increasing risk of acute large-scale exposure of ionising irradiation on the population underlines the necessity of developing effective radioprotective and mitigating agents. The aim of this work was to investigate the effect of sodium orthovanadate pre-treatment on mice exposed to high doses of gamma rays (from 5 to 13 Gy). The determination of median lethal dose within 30 days confirmed that orthovanadate applied to total-body-irradiated mice intra-peritoneally has a radioprotective but not a mitigating effect. With orthovanadate pre-treatment, the composition of cellularity in the bone marrow improved substantially and the main lymphocyte populations restored during the first month after irradiation. These findings contribute to 'gap-filling' in radioprotective effects and demonstrate the importance of haematological parameters in radiation-response prediction.
Collapse
Affiliation(s)
- Zuzana Šinkorová
- Department of Radiobiology, University of Defence, 500 01 Hradec Kralove, Czech Republic
| | - Alžběta Filipová
- Department of Radiobiology, University of Defence, 500 01 Hradec Kralove, Czech Republic
| | - Jiřina Vávrová
- Department of Radiobiology, University of Defence, 500 01 Hradec Kralove, Czech Republic
| | - Jaroslav Pejchal
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, 500 01 Hradec Kralove, Czech Republic
| | - Lenka Andrejsová
- Department of Radiobiology, University of Defence, 500 01 Hradec Kralove, Czech Republic
| | - Marcela Jeličová
- Department of Radiobiology, University of Defence, 500 01 Hradec Kralove, Czech Republic
| | - Jan Marek
- Biomedical Research Center, University Hospital, 500 05 Hradec Kralove, Czech Republic
| | - Radim Havelek
- Department of Medical Biochemistry, Faculty of Medicine in Hradec Kralove, Charles University, 500 03 Hradec Kralove, Czech Republic
| | - Martina Seifrtová
- Department of Medical Biochemistry, Faculty of Medicine in Hradec Kralove, Charles University, 500 03 Hradec Kralove, Czech Republic
| | - Martina Řezáčová
- Department of Medical Biochemistry, Faculty of Medicine in Hradec Kralove, Charles University, 500 03 Hradec Kralove, Czech Republic
| | - Aleš Tichý
- Department of Radiobiology, University of Defence, 500 01 Hradec Kralove, Czech Republic
| |
Collapse
|
33
|
Benkova M, Soukup O, Prchal L, Sleha R, Eleršek T, Novak M, Sepčić K, Gunde‐Cimerman N, Dolezal R, Bostik V, Bostik P, Marek J. Synthesis, Antimicrobial Effect and Lipophilicity‐Activity Dependence of Three Series of Dichained
N
‐Alkylammonium Salts. ChemistrySelect 2019. [DOI: 10.1002/slct.201902357] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Marketa Benkova
- Department of EpidemiologyUniversity of Defence in Brno Třebešská 1575, 500 05 Hradec Králové Czech Republic
- University Hospital Hradec Králové Sokolská 581 500 05 Hradec Králové Czech Republic
| | - Ondrej Soukup
- University Hospital Hradec Králové Sokolská 581 500 05 Hradec Králové Czech Republic
| | - Lukas Prchal
- University Hospital Hradec Králové Sokolská 581 500 05 Hradec Králové Czech Republic
| | - Radek Sleha
- Department of EpidemiologyUniversity of Defence in Brno Třebešská 1575, 500 05 Hradec Králové Czech Republic
| | - Tina Eleršek
- Department for Genetic Toxicology and Cancer BiologyNational Institute of Biology Večna pot 111 1111 Ljubljana Slovenia
| | - Martin Novak
- University Hospital Hradec Králové Sokolská 581 500 05 Hradec Králové Czech Republic
| | - Kristina Sepčić
- Department of BiologyUniversity of Ljubljana Jamnikarjeva 101 1000 Ljubljana Slovenia
| | - Nina Gunde‐Cimerman
- Department of BiologyUniversity of Ljubljana Jamnikarjeva 101 1000 Ljubljana Slovenia
| | - Rafael Dolezal
- University Hospital Hradec Králové Sokolská 581 500 05 Hradec Králové Czech Republic
| | - Vanda Bostik
- Department of EpidemiologyUniversity of Defence in Brno Třebešská 1575, 500 05 Hradec Králové Czech Republic
| | - Pavel Bostik
- Department of EpidemiologyUniversity of Defence in Brno Třebešská 1575, 500 05 Hradec Králové Czech Republic
| | - Jan Marek
- Department of EpidemiologyUniversity of Defence in Brno Třebešská 1575, 500 05 Hradec Králové Czech Republic
- University Hospital Hradec Králové Sokolská 581 500 05 Hradec Králové Czech Republic
| |
Collapse
|
34
|
Tichy A, Marek J, Havelek R, Pejchal J, Seifrtova M, Zarybnicka L, Filipova A, Rezacova M, Sinkorova Z. New Light on An Old Friend: Targeting PUMA in Radioprotection and Therapy of Cardiovascular and Neurodegenerative Diseases. Curr Drug Targets 2019; 19:1943-1957. [PMID: 29623837 DOI: 10.2174/1389450119666180406110743] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 11/15/2017] [Revised: 03/27/2018] [Accepted: 04/02/2018] [Indexed: 11/22/2022]
Abstract
This review summarizes recent progress in understanding the role of p53-upregulated mediator of apoptosis (PUMA) in molecular pathways with respect to its potential therapeutic applications. Particular emphasis is given to the PUMA´s role in ionizing radiation-induced signalling as radiotoxicity of normal tissue is mediated mostly via apoptosis. PUMA and its p53-dependent and p53- independent induction are described and potential use as a new target for the development of radioprotective agents is suggested. Further implications, including targeting PUMA to prevent and treat cardiovascular and neurodegenerative diseases, are also discussed together with an overview of other therapeutic applications. Finally, basic chemical structures for the development of novel PUMA modulators such as pifithrine derivatives, kinase inhibitors or modulators of Bcl-2 protein family are described.
Collapse
Affiliation(s)
- Ales Tichy
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence in Brno, 500 01 Hradec Kralove, Czech Republic.,Biomedical Research Center, University Hospital, 500 05 Hradec Kralove, Czech Republic
| | - Jan Marek
- Biomedical Research Center, University Hospital, 500 05 Hradec Kralove, Czech Republic
| | - Radim Havelek
- Department of Medical Biochemistry, Faculty of Medicine in Hradec Kralove, Charles University, 500 03 Hradec Kralove, Czech Republic
| | - Jaroslav Pejchal
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence in Brno, 500 01 Hradec Kralove, Czech Republic
| | - Martina Seifrtova
- Department of Medical Biochemistry, Faculty of Medicine in Hradec Kralove, Charles University, 500 03 Hradec Kralove, Czech Republic
| | - Lenka Zarybnicka
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence in Brno, 500 01 Hradec Kralove, Czech Republic
| | - Alzbeta Filipova
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence in Brno, 500 01 Hradec Kralove, Czech Republic
| | - Martina Rezacova
- Department of Medical Biochemistry, Faculty of Medicine in Hradec Kralove, Charles University, 500 03 Hradec Kralove, Czech Republic
| | - Zuzana Sinkorova
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence in Brno, 500 01 Hradec Kralove, Czech Republic
| |
Collapse
|
35
|
Hughes ML, Bonello B, Choudhary P, Marek J, Tsang V. A simple measure of the extent of Ebstein valve rotation with cardiovascular magnetic resonance gives a practical guide to feasibility of surgical cone reconstruction. J Cardiovasc Magn Reson 2019; 21:34. [PMID: 31242903 PMCID: PMC6595703 DOI: 10.1186/s12968-019-0546-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 05/29/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Once surgical management is indicated, variation of Ebstein valve morphology affects surgical strategy. This study explored practical, easily measureable, cardiovascular magnetic resonance (CMR)-derived attributes that may contribute to the complexity and risk of cone reconstruction. METHODS A retrospective assessment was performed of Ebstein anomaly patients older than 12 years age, with pre-operative CMR, undergoing cone surgical reconstruction by one surgeon. In addition to clinical data, the CMR-derived Ebstein valve rotation angle (EVRA), area ratios of chamber size, indexed functional RV (RVEDVi) and left ventricular (LV) volumes, tricuspid valve regurgitant fraction (TR%) and other valve attributes were related to early surgical outcome; including death, significant residual TR% or breakdown of repair. RESULTS Of 26 operated patients older than 12 years age, since program start, 20 had pre-op CMR and underwent surgery at median (range) age 20 (14-57) years. TR% was improved in all patients. Four of the 20 CMR patients (20%) experienced early surgical dehiscence of the paravalve tissue, with cone-shaped tricuspid valve intact; one of whom died. A larger EVRA correlated with Carpentier category and was significantly related to dehiscence. If EVRA >60o, relative risk of dehiscence was 3.2 (CI 1.3-4.9, p = 0.03). Those with dehiscence had thickened, more tethered anterior leaflet edges (RR 17, CI 3-100, p < 0.01), smaller pre-operative functional RVEDVi; (132 vs 177 mL/m2, p = 0.04), and were older (median 38 vs 19 years, p = 0.01). TR %, chamber area ratios and LV parameters were not different. CONCLUSIONS Comprehensive CMR assessment characterizes patients prior to cone surgical reconstruction of Ebstein anomaly. Pragmatic observation of larger EVRA, smaller RVEDVi and leaflet thickening, suggests risk of repair tension and dehiscence, and may require specific modification of cone surgical technique, such as leaflet augmentation.
Collapse
Affiliation(s)
- Marina L. Hughes
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH UK
- Cardiology Department, Royal Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, CB23 3RE UK
| | - Beatrice Bonello
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH UK
| | - Preeti Choudhary
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH UK
| | - Jan Marek
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH UK
| | - Victor Tsang
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH UK
| |
Collapse
|
36
|
Affiliation(s)
- Elena Giulia Milano
- UCL Institute of Cardiovascular Science & Great Ormond Street Hospital for Children, London, UK (E.G.M., E.P., E.S., A.C., S.S., A.M.T., J.M., C.C.)
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London UK (E.G.M., K.H.M., A.M.T., J.M.)
| | - Endrit Pajaziti
- UCL Institute of Cardiovascular Science & Great Ormond Street Hospital for Children, London, UK (E.G.M., E.P., E.S., A.C., S.S., A.M.T., J.M., C.C.)
| | - Emilie Sauvage
- UCL Institute of Cardiovascular Science & Great Ormond Street Hospital for Children, London, UK (E.G.M., E.P., E.S., A.C., S.S., A.M.T., J.M., C.C.)
| | - Andrew Cook
- UCL Institute of Cardiovascular Science & Great Ormond Street Hospital for Children, London, UK (E.G.M., E.P., E.S., A.C., S.S., A.M.T., J.M., C.C.)
| | - Silvia Schievano
- UCL Institute of Cardiovascular Science & Great Ormond Street Hospital for Children, London, UK (E.G.M., E.P., E.S., A.C., S.S., A.M.T., J.M., C.C.)
| | - Kristian H Mortensen
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London UK (E.G.M., K.H.M., A.M.T., J.M.)
| | - Andrew M Taylor
- UCL Institute of Cardiovascular Science & Great Ormond Street Hospital for Children, London, UK (E.G.M., E.P., E.S., A.C., S.S., A.M.T., J.M., C.C.)
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London UK (E.G.M., K.H.M., A.M.T., J.M.)
| | - Jan Marek
- UCL Institute of Cardiovascular Science & Great Ormond Street Hospital for Children, London, UK (E.G.M., E.P., E.S., A.C., S.S., A.M.T., J.M., C.C.)
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London UK (E.G.M., K.H.M., A.M.T., J.M.)
| | - Martin Kostolny
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK (M.K.)
- Slovak Medical University, Bratislava, Slovakia (M.K.)
| | - Claudio Capelli
- UCL Institute of Cardiovascular Science & Great Ormond Street Hospital for Children, London, UK (E.G.M., E.P., E.S., A.C., S.S., A.M.T., J.M., C.C.)
| |
Collapse
|
37
|
Milano EG, Pajaziti E, Sauvage E, Taylor AM, Marek J, Mortensen K, Cook A, Schievano S, Kostolny M, Capelli C. P358Taking surgery out of reality: a repair of double outlet right ventricle planned by means of virtual reality. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez109.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- E G Milano
- University College London, Institute of Cardiovascular Science, LONDON, United Kingdom of Great Britain & Northern Ireland
| | - E Pajaziti
- University College London, Institute of Cardiovascular Science, LONDON, United Kingdom of Great Britain & Northern Ireland
| | - E Sauvage
- University College London, Institute of Cardiovascular Science, LONDON, United Kingdom of Great Britain & Northern Ireland
| | - A M Taylor
- University College London, Institute of Cardiovascular Science, LONDON, United Kingdom of Great Britain & Northern Ireland
| | - J Marek
- Great Ormond Street Hospital for Children, London, United Kingdom of Great Britain & Northern Ireland
| | - K Mortensen
- Great Ormond Street Hospital for Children, London, United Kingdom of Great Britain & Northern Ireland
| | - A Cook
- University College London, Institute of Cardiovascular Science, LONDON, United Kingdom of Great Britain & Northern Ireland
| | - S Schievano
- University College London, Institute of Cardiovascular Science, LONDON, United Kingdom of Great Britain & Northern Ireland
| | - M Kostolny
- Great Ormond Street Hospital for Children, London, United Kingdom of Great Britain & Northern Ireland
| | - C Capelli
- University College London, Institute of Cardiovascular Science, LONDON, United Kingdom of Great Britain & Northern Ireland
| |
Collapse
|
38
|
Bonello B, Bo I, Mortensen K, Banks RL, Mc Leod IW, Kaski JP, Hsia TY, Marek J. Value of Stress Transesophageal Echocardiography in an Asymptomatic Patient With Single Coronary Artery From Noncoronary Sinus, Intramural Course, and Ostial Stenosis. Circ Cardiovasc Imaging 2019; 12:e008560. [PMID: 30632390 DOI: 10.1161/circimaging.118.008560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Beatrice Bonello
- Great Ormond Street Hospital for Children, London, United Kingdom (B.B., I.B., K.M., R.L.B., I.W.M.L., J.P.K., J.M.)
| | - Ilaria Bo
- Great Ormond Street Hospital for Children, London, United Kingdom (B.B., I.B., K.M., R.L.B., I.W.M.L., J.P.K., J.M.)
| | - Kristian Mortensen
- Great Ormond Street Hospital for Children, London, United Kingdom (B.B., I.B., K.M., R.L.B., I.W.M.L., J.P.K., J.M.)
| | - Rebecca L Banks
- Great Ormond Street Hospital for Children, London, United Kingdom (B.B., I.B., K.M., R.L.B., I.W.M.L., J.P.K., J.M.).,Institute of Cardiovascular Sciences, University College London, United Kingdom (R.L.B., J.P.K., J.M.)
| | - Ian W Mc Leod
- Great Ormond Street Hospital for Children, London, United Kingdom (B.B., I.B., K.M., R.L.B., I.W.M.L., J.P.K., J.M.)
| | - Juan P Kaski
- Great Ormond Street Hospital for Children, London, United Kingdom (B.B., I.B., K.M., R.L.B., I.W.M.L., J.P.K., J.M.).,Institute of Cardiovascular Sciences, University College London, United Kingdom (R.L.B., J.P.K., J.M.)
| | - Tain-Yen Hsia
- Yale New Haven Children's Hospital (T.-Y.H.), New Haven, CT.,Yale University (T.-Y.H.), New Haven, CT
| | - Jan Marek
- Great Ormond Street Hospital for Children, London, United Kingdom (B.B., I.B., K.M., R.L.B., I.W.M.L., J.P.K., J.M.).,Institute of Cardiovascular Sciences, University College London, United Kingdom (R.L.B., J.P.K., J.M.)
| |
Collapse
|
39
|
Marek J, Joskova V, Dolezal R, Soukup O, Benkova M, Fucikova A, Malinak D, Bostikova V, Kuca K. Synthesis, Antimicrobial Effect and Surface Properties of Hydroxymethylsubstituted Pyridinium Salts. LETT DRUG DES DISCOV 2018. [DOI: 10.2174/1570180814666171110142233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Jan Marek
- Department of Epidemiology, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Vera Joskova
- Department of Biological and Medical Sciences, Faculty of Pharmacy, Charles University, Hradec Kralove, Czech Republic
| | - Rafael Dolezal
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Ondrej Soukup
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Marketa Benkova
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Alena Fucikova
- Department of Biology, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - David Malinak
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Vanda Bostikova
- Department of Epidemiology, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| |
Collapse
|
40
|
Carr M, Curtis S, Marek J. EDUCATIONAL SERIES IN CONGENITAL HEART DISEASE: Congenital left-sided heart obstruction. Echo Res Pract 2018; 5:R23-R36. [PMID: 29681546 PMCID: PMC5911774 DOI: 10.1530/erp-18-0016] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 03/16/2018] [Indexed: 11/23/2022] Open
Abstract
Congenital obstruction of the left ventricular outflow tract remains a significant problem and multilevel obstruction can often coexist. Obstruction can take several morphological forms and may involve the subvalvar, valvar or supravalvar portion of the aortic valve complex. Congenital valvar stenosis presenting in the neonatal period represents a spectrum of disorders ranging from the hypoplastic left heart syndrome to almost normal hearts. Treatment options vary dependent on the severity of the left ventricular outflow tract obstruction (LVOTO) and the variable degree of left ventricular hypoplasia as well as the associated lesions such as arch hypoplasia and coarctation.
Collapse
Affiliation(s)
- Michelle Carr
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Stephanie Curtis
- Bristol Heart Institute, University Hospitals Bristol, Bristol, UK
| | - Jan Marek
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,Institute of Cardiovascular Sciences, University College London, London, UK
| |
Collapse
|
41
|
Krupickova S, Muthurangu V, Hughes M, Tann O, Carr M, Christov G, Awat R, Taylor A, Marek J. Echocardiographic arterial measurements in complex congenital diseases before bidirectional Glenn: comparison with cardiovascular magnetic resonance imaging. Eur Heart J Cardiovasc Imaging 2018; 18:332-341. [PMID: 27099275 DOI: 10.1093/ehjci/jew069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 12/23/2015] [Accepted: 03/08/2016] [Indexed: 11/13/2022] Open
Abstract
Aims This study sought to investigate diagnostic accuracy of echocardiographic measures of great vessels in patients before bidirectional cavopulmonary connection (BCPC) compared with cardiovascular magnetic resonance (CMR). Methods and results Seventy-two patients (61% after Norwood operation) undergoing BCPC between 2007 and 2012 were assessed pre-operatively using echocardiography and CMR. Bland-Altman analysis and correlation coefficients were used for comparison of echocardiography and CMR measurements. Sensitivity, specificity, and positive and negative predictive values were calculated to assess the ability of echocardiography to detect vessel stenosis. Twenty-four percent of all vessel measurements could not be made by echocardiography due to poor image quality. Acquisition of unsatisfactory images was higher in non-sedated patients. Although there was a reasonable correlation (0.68-0.90) and low bias (-0.8 to 0.5), there were wide limits of agreement between echocardiography and CMR demonstrating poor agreement. Sensitivity and specificity for pulmonary branches were moderate [sensitivity for right pulmonary artery (RPA) 67%, left pulmonary artery (LPA) 54%, specificity for RPA 65%, LPA 72%] with low levels of accuracy (RPA and LPA 42%). Sensitivity, specificity, and accuracy were better for aorta (82, 86, and 63%, respectively). Conclusion This study demonstrates modest agreement between echocardiographic and CMR measures of vessel diameter and stenosis detection. Approximately a quarter of all vessel segments could not be measured using echocardiography due to poor image quality, which was significantly lower in non-sedated patients. These findings show that echocardiography cannot substitute CMR for reliable identification of great vessel stenoses in complex patients prior to the BCPC, particularly those with Blalock-Taussig shunts.
Collapse
Affiliation(s)
- Sylvia Krupickova
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Vivek Muthurangu
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK.,Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science London, London, UK
| | - Marina Hughes
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Oliver Tann
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Michelle Carr
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Georgi Christov
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Ram Awat
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Andrew Taylor
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK.,Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science London, London, UK
| | - Jan Marek
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK.,Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science London, London, UK
| |
Collapse
|
42
|
Krupickova S, Morgan GJ, Cheang MH, Rigby ML, Franklin RC, Battista A, Spanaki A, Bonello B, Ghez O, Anderson D, Tsang V, Michielon G, Marek J, Fraisse A. Symptomatic partial and transitional atrioventricular septal defect repaired in infancy. Heart 2017; 104:1411-1416. [DOI: 10.1136/heartjnl-2017-312195] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/17/2017] [Accepted: 12/06/2017] [Indexed: 11/03/2022] Open
Abstract
ObjectivesInfants with symptomatic partial and transitional atrioventricular septal defect undergoing early surgical repair are thought to be at greater risk. However, the outcome and risk profile of this cohort of patients are poorly defined. The aim of this study was to investigate the outcome of symptomatic infants undergoing early repair and to identify risk factors which may predict mortality and reoperation.MethodsThis multicentre study recruited 51 patients (24 female) in three tertiary centres between 2000 and 2015. The inclusion criteria were as follows: (1) partial and transitional atrioventricular septal defect, (2) heart failure unresponsive to treatment, (3) biventricular repair during the first year of life.ResultsMedian age at definitive surgery was 179 (range 0–357) days. Sixteen patients (31%) had unfavourable anatomy of the left atrioventricular valve: dysplastic (n=7), double orifice (n=3), severely deficient valve leaflets (n=1), hypoplastic left atrioventricular orifice and/or mural leaflet (n=3), short/poorly defined chords (n=2). There were three inhospital deaths (5.9%) after primary repair. Eleven patients (22%) were reoperated at a median interval of 40 days (4 days to 5.1 years) for severe left atrioventricular valve regurgitation and/or stenosis. One patient required mechanical replacement of the left atrioventricular valve. After median follow-up of 3.8 years (0.1–11.4 years), all patients were in New York Heart Association (NYHA) class I. In multivariable analysis, unfavourable anatomy of the left atrioventricular valve was the only risk factor associated with left atrioventricular valve reoperation.ConclusionsAlthough surgical repair is successful in the majority of the cases, patients with partial and transitional atrioventricular septal defect undergoing surgical repair during infancy experience significant morbidity and mortality. The reoperation rate is high with unfavourable left atrioventricular valve anatomy.
Collapse
|
43
|
Capelli C, Sauvage E, Giusti G, Bosi GM, Ntsinjana H, Carminati M, Derrick G, Marek J, Khambadkone S, Taylor AM, Schievano S. Patient-specific simulations for planning treatment in congenital heart disease. Interface Focus 2017; 8:20170021. [PMID: 29285347 PMCID: PMC5740223 DOI: 10.1098/rsfs.2017.0021] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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] [Indexed: 12/11/2022] Open
Abstract
Patient-specific computational models have been extensively developed over the last decades and applied to investigate a wide range of cardiovascular problems. However, translation of these technologies into clinical applications, such as planning of medical procedures, has been limited to a few single case reports. Hence, the use of patient-specific models is still far from becoming a standard of care in clinical practice. The aim of this study is to describe our experience with a modelling framework that allows patient-specific simulations to be used for prediction of clinical outcomes. A cohort of 12 patients with congenital heart disease who were referred for percutaneous pulmonary valve implantation, stenting of aortic coarctation and surgical repair of double-outlet right ventricle was included in this study. Image data routinely acquired for clinical assessment were post-processed to set up patient-specific models and test device implantation and surgery. Finite-element and computational fluid dynamics analyses were run to assess feasibility of each intervention and provide some guidance. Results showed good agreement between simulations and clinical decision including feasibility, device choice and fluid-dynamic parameters. The promising results of this pilot study support translation of computer simulations as tools for personalization of cardiovascular treatments.
Collapse
Affiliation(s)
- Claudio Capelli
- UCL Institute of Cardiovascular Science, London, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Emilie Sauvage
- UCL Institute of Cardiovascular Science, London, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Giuliano Giusti
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.,Department of Paediatric Cardiology and Adult Congenital Heart Disease, IRCCS-Policlinico San Donato, San Donato, Milanese, Italy
| | - Giorgia M Bosi
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.,UCL Department of Mechanical Engineering, London, UK
| | - Hopewell Ntsinjana
- CH Baragwanath Hospital University of the Witwatersrand, Johannesburg, South Africa
| | - Mario Carminati
- Department of Paediatric Cardiology and Adult Congenital Heart Disease, IRCCS-Policlinico San Donato, San Donato, Milanese, Italy
| | - Graham Derrick
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Jan Marek
- UCL Institute of Cardiovascular Science, London, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Sachin Khambadkone
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Andrew M Taylor
- UCL Institute of Cardiovascular Science, London, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Silvia Schievano
- UCL Institute of Cardiovascular Science, London, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| |
Collapse
|
44
|
Marek J, Malinak D, Dolezal R, Soukup O, Benkova M, Nachtigal P, Vavra P, Kuca K. Novel Series of Quaternary Ammonium Surfactants Based on 2,3-Dihydro- [1,4]dioxino[2,3-b]pyridin-7-ol Ring: Synthesis, Analysis and Antimicrobial Evaluation. LETT ORG CHEM 2017. [DOI: 10.2174/1570178614666171002145959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Jan Marek
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, 700 30 Ostrava, Czech Republic
| | - David Malinak
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Rafael Dolezal
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Ondrej Soukup
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Marketa Benkova
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Petr Nachtigal
- Department of Biological and Medical Sciences, Faculty of Pharmacy, Charles University, Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic
| | - Petr Vavra
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, 700 30 Ostrava, Czech Republic
| | - Kamil Kuca
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| |
Collapse
|
45
|
Calcagni G, Limongelli G, D'Ambrosio A, Gesualdo F, Digilio MC, Baban A, Albanese SB, Versacci P, De Luca E, Ferrero GB, Baldassarre G, Agnoletti G, Banaudi E, Marek J, Kaski JP, Tuo G, Russo MG, Pacileo G, Milanesi O, Messina D, Marasini M, Cairello F, Formigari R, Brighenti M, Dallapiccola B, Tartaglia M, Marino B. Data on cardiac defects, morbidity and mortality in patients affected by RASopathies. CARNET study results. Data Brief 2017. [PMID: 29541661 PMCID: PMC5847490 DOI: 10.1016/j.dib.2017.11.085] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
A comprehensive description of morbidity and mortality in patients affected by mutations in genes encoding for signal transducers of the RAS-MAPK cascade (RASopathies) was performed in our study recently published in the International Journal of Cardiology. Seven European cardiac centres participating to the CArdiac Rasopathy NETwork (CARNET), collaborated in this multicentric, observational, retrospective data analysis and collection. In this study, clinical records of 371 patients with confirmed molecular diagnosis of RASopathy were reviewed. Cardiac defects, crude mortality, survival rate of patients with 1) hypertrophic cardiomyopathy (HCM) and age <2 years or young adults; 2) individuals with Noonan syndrome and pulmonary stenosis carrying PTPN11 mutations; 3) biventricular obstruction and PTPN11 mutations; 4) Costello syndrome or cardiofaciocutaneous syndrome were analysed. Mortality was described as crude mortality, cumulative survival and restricted estimated mean survival. In particular, with this Data In Brief (DIB) paper, the authors aim to report specific statistic highlights of the multivariable regression analysis that was used to assess the impact of mutated genes on number of interventions and overall prognosis.
Collapse
Affiliation(s)
- Giulio Calcagni
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Angelo D'Ambrosio
- Multifactorial Disease and Complex Phenotype Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesco Gesualdo
- Multifactorial Disease and Complex Phenotype Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria Cristina Digilio
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Anwar Baban
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Sonia B Albanese
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Paolo Versacci
- Pediatric Cardiology, Department of Pediatrics, Sapienza University, Rome, Italy
| | - Enrica De Luca
- Pediatric Cardiology, Department of Pediatrics, Sapienza University, Rome, Italy
| | - Giovanni B Ferrero
- Department of Pediatric and Public Health Sciences, Città della Salute e della Scienza, University of Turin, Italy
| | - Giuseppina Baldassarre
- Department of Pediatric and Public Health Sciences, Città della Salute e della Scienza, University of Turin, Italy
| | - Gabriella Agnoletti
- Department of Pediatric and Public Health Sciences, Città della Salute e della Scienza, University of Turin, Italy
| | - Elena Banaudi
- Department of Pediatric and Public Health Sciences, Città della Salute e della Scienza, University of Turin, Italy
| | - Jan Marek
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London, UK.,UCL Institute of Cardiovascular Science, London, UK
| | - Juan P Kaski
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, UK.,UCL Institute of Cardiovascular Science, London, UK
| | - Giulia Tuo
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London, UK.,UCL Institute of Cardiovascular Science, London, UK
| | | | - Giuseppe Pacileo
- Cardiologia SUN, Monaldi Hospital, II University of Naples, Naples, Italy
| | - Ornella Milanesi
- Department of Woman and Child's Health, Pediatric Cardiology, University of Padova, Padua, Italy
| | - Daniela Messina
- Department of Woman and Child's Health, Pediatric Cardiology, University of Padova, Padua, Italy
| | | | | | - Roberto Formigari
- Cardiology and Cardiac Surgery, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Maurizio Brighenti
- Cardiology and Cardiac Surgery, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Bruno Dallapiccola
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Bruno Marino
- Pediatric Cardiology, Department of Pediatrics, Sapienza University, Rome, Italy
| |
Collapse
|
46
|
Moran C, Habeb AM, Kahaly GJ, Kampmann C, Hughes M, Marek J, Rajanayagam O, Kuczynski A, Vargha-Khadem F, Morsy M, Offiah AC, Poole K, Ward K, Lyons G, Halsall D, Berman L, Watson L, Baguley D, Mollon J, Moore AT, Holder GE, Dattani M, Chatterjee K. Homozygous Resistance to Thyroid Hormone β: Can Combined Antithyroid Drug and Triiodothyroacetic Acid Treatment Prevent Cardiac Failure? J Endocr Soc 2017; 1:1203-1212. [PMID: 29264576 PMCID: PMC5686666 DOI: 10.1210/js.2017-00204] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 08/01/2017] [Indexed: 11/20/2022] Open
Abstract
Resistance to thyroid hormone β (RTHβ) due to homozygous THRB defects is exceptionally rare, with only five kindreds reported worldwide. Cardiac dysfunction, which can be life-threatening, is recognized in the disorder. Here we describe the clinical, metabolic, ophthalmic, and cardiac findings in a 9-year-old boy harboring a biallelic THRB mutation (R243Q), along with biochemical, physiologic, and cardiac responses to carbimazole and triiodothyroacetic acid (TRIAC) therapy. The patient exhibits recognized features (goiter, nonsuppressed thyroid-stimulating hormone levels, upper respiratory tract infections, hyperactivity, low body mass index) of heterozygous RTHβ, with additional characteristics (dysmorphic facies, winging of scapulae) and more markedly elevated thyroid hormone levels, associated with the homozygous form of the disorder. Notably, an older sibling with similar clinical features and probable homozygous RTHβ had died of cardiac failure at age 13 years. Features of early dilated cardiomyopathy in our patient prompted combination treatment with carbimazole and TRIAC. Careful titration of therapy limited elevation in TSH levels and associated increase in thyroid volume. Subsequently, sustained reduction in thyroid hormones with normal TSH levels was reflected in lower basal metabolic rate, gain of lean body mass, and improved growth and cardiac function. A combination of antithyroid drug and TRIAC therapy may prevent thyrotoxic cardiomyopathy and its decompensation in homozygous or even heterozygous RTHβ in which life-threatening hyperthyroid features predominate.
Collapse
Affiliation(s)
- Carla Moran
- University of Cambridge Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - Abdelhadi M Habeb
- Department of Paediatrics, Prince Mohammed bin Abdulaziz Hospital for National Guard & Taibah University, Al-Madinah 41511, Kingdom of Saudi Arabia
| | - George J Kahaly
- Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz 55101, Germany
| | - Christoph Kampmann
- Department of Paediatric Cardiology, Johannes Gutenberg University Medical Center, Mainz 55101, Germany
| | - Marina Hughes
- Department of Cardiology, Great Ormond Street Hospital for Children, London WC1N 3JH, United Kingdom
| | - Jan Marek
- Department of Cardiology, Great Ormond Street Hospital for Children, London WC1N 3JH, United Kingdom
| | - Odelia Rajanayagam
- University of Cambridge Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - Adam Kuczynski
- Department of Neuropsychology, Great Ormond Street Hospital for Children, London WC1N 3JH, United Kingdom
| | - Faraneh Vargha-Khadem
- Department of Neuropsychology, Great Ormond Street Hospital for Children, London WC1N 3JH, United Kingdom
| | - Mofeed Morsy
- Department of Paediatrics, Sohag University, Egypt
| | - Amaka C Offiah
- Academic Unit of Child Health, University of Sheffield, Sheffield S10 2TH, United Kingdom
| | - Ken Poole
- Department of Rheumatology, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - Kate Ward
- Nutrition and Bone Health, MRC Elsie Widdowson Laboratory, Cambridge CB1 9NL, United Kingdom
| | - Greta Lyons
- University of Cambridge Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - David Halsall
- Department of Clinical Biochemistry, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - Lol Berman
- Department of Radiology, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - Laura Watson
- University of Cambridge Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - David Baguley
- Department of Audiology, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| | - John Mollon
- Department of Experimental Psychology, University of Cambridge, Cambridge CB2 3EB, United Kingdom
| | - Anthony T Moore
- Moorfields Eye Hospital, London EC1V 2PD, United Kingdom.,Department of Ophthalmology, Great Ormond Street Hospital for Children, London WC1N 3JH, United Kingdom
| | | | - Mehul Dattani
- Department of Endocrinology and Section of Genetics and Epigenetics in Health and Disease, Great Ormond Street Hospital for Children and University College London Institute of Child Health, London WC1N 3JH, United Kingdom
| | - Krishna Chatterjee
- University of Cambridge Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
| |
Collapse
|
47
|
Pavlikova R, Misik J, Cabal J, Marek J, Kuca K. In vitro skin decontamination of paraoxon – wet-type cleansing effect of selected detergents. Cutan Ocul Toxicol 2017; 37:77-83. [DOI: 10.1080/15569527.2017.1354216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ruzena Pavlikova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Jan Misik
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Jiri Cabal
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Jan Marek
- Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
- Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Kamil Kuca
- Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| |
Collapse
|
48
|
Fikrle M, Marek J, Kuchynka P, Palecek T. P5400The utility of simplified apical 4-chamber view evaluation of relative apical sparing of longitudinal strain in diagnosing AL amyloid cardiomyopathy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5400] [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: 11/12/2022] Open
|
49
|
Perdreau E, Tsang V, Hughes ML, Ibrahim M, Kataria S, Janagarajan K, Iriart X, Khambadkone S, Marek J. Change in biventricular function after cone reconstruction of Ebstein’s anomaly: an echocardiographic study. Eur Heart J Cardiovasc Imaging 2017; 19:808-815. [DOI: 10.1093/ehjci/jex186] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 06/23/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- E Perdreau
- Great Ormond Street Hospital for Children, Great Ormond Street, London, UK
- Hôpital du Haut-Lévèque, Bordeaux, France
| | - V Tsang
- Great Ormond Street Hospital for Children, Great Ormond Street, London, UK
- The Bart’s Hospital, London, UK
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - M L Hughes
- Great Ormond Street Hospital for Children, Great Ormond Street, London, UK
| | | | - S Kataria
- Great Ormond Street Hospital for Children, Great Ormond Street, London, UK
| | - K Janagarajan
- Great Ormond Street Hospital for Children, Great Ormond Street, London, UK
| | - X Iriart
- Hôpital du Haut-Lévèque, Bordeaux, France
| | - S Khambadkone
- Great Ormond Street Hospital for Children, Great Ormond Street, London, UK
| | - J Marek
- Great Ormond Street Hospital for Children, Great Ormond Street, London, UK
- Institute of Cardiovascular Sciences, University College London, London, UK
| |
Collapse
|
50
|
Calcagni G, Limongelli G, D'Ambrosio A, Gesualdo F, Digilio MC, Baban A, Albanese SB, Versacci P, De Luca E, Ferrero GB, Baldassarre G, Agnoletti G, Banaudi E, Marek J, Kaski JP, Tuo G, Russo MG, Pacileo G, Milanesi O, Messina D, Marasini M, Cairello F, Formigari R, Brighenti M, Dallapiccola B, Tartaglia M, Marino B. Cardiac defects, morbidity and mortality in patients affected by RASopathies. CARNET study results. Int J Cardiol 2017; 245:92-98. [PMID: 28768581 DOI: 10.1016/j.ijcard.2017.07.068] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [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: 03/31/2017] [Revised: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND RASopathies are developmental disease caused by mutations in genes encoding for signal transducers of the RAS-MAPK cascade. The aim of the present study was to provide a comprehensive description of morbidity and mortality in patients with molecularly confirmed RASopathy. METHODS A multicentric, observational, retrospective study was conducted in seven European cardiac centres participating to the CArdiac Rasopathy NETwork (CARNET). Clinical records of 371 patients with confirmed molecular diagnosis of RASopathy were reviewed. Mortality was described as crude mortality, cumulative survival and restricted estimated mean survival. Multivariable regression analysis was used to assess the impact of mutated genes on number of interventions and overall prognosis. RESULTS Cardiac defects occurred in 80.3% of cases, almost half of them underwent at least one intervention. Overall, crude mortality was 0.29/100 patients-year. Cumulative survival was 98.8%, 98.2%, 97.7%, 94.3%, at 1, 5, 10, and 20years, respectively. Restricted estimated mean survival at 20years follow-up was 19.6years. Ten patients died (2.7% of the entire cohort; 3.4% of patients with cardiac defect). Patients with hypertrophic cardiomyopathy (HCM) and age <2years or young adults, as well as subjects with biventricular obstruction and PTPN11 mutations had a higher risk of cardiac death. CONCLUSIONS The risk of intervention was higher in individuals with Noonan syndrome and pulmonary stenosis carrying PTPN11 mutations. Overall, mortality was relatively low, even though the specific association between HCM, biventricular outflow tract obstructions and PTPN11 mutations appeared to be associated with early mortality, including immediate post-operative events and sudden death.
Collapse
Affiliation(s)
- Giulio Calcagni
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy.
| | | | - Angelo D'Ambrosio
- Multifactorial Disease and Complex Phenotype Research Division, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Francesco Gesualdo
- Multifactorial Disease and Complex Phenotype Research Division, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - M Cristina Digilio
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Anwar Baban
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Sonia B Albanese
- Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Paolo Versacci
- Pediatric Cardiology, Department of Pediatrics, Sapienza University, Rome, Italy
| | - Enrica De Luca
- Pediatric Cardiology, Department of Pediatrics, Sapienza University, Rome, Italy
| | - Giovanni B Ferrero
- Department of Pediatric and Public Health Sciences, Città della Salute e della Scienza, University of Turin, Italy
| | - Giuseppina Baldassarre
- Department of Pediatric and Public Health Sciences, Città della Salute e della Scienza, University of Turin, Italy
| | - Gabriella Agnoletti
- Department of Pediatric and Public Health Sciences, Città della Salute e della Scienza, University of Turin, Italy
| | - Elena Banaudi
- Department of Pediatric and Public Health Sciences, Città della Salute e della Scienza, University of Turin, Italy
| | - Jan Marek
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London, UK; UCL Institute of Cardiovascular Science, London, UK
| | - Juan P Kaski
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, UK; UCL Institute of Cardiovascular Science, London, UK
| | - Giulia Tuo
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children, London, UK; UCL Institute of Cardiovascular Science, London, UK
| | - M Giovanna Russo
- Cardiologia SUN, Monaldi Hospital, II University of Naples, Naples, Italy
| | - Giuseppe Pacileo
- Cardiologia SUN, Monaldi Hospital, II University of Naples, Naples, Italy
| | - Ornella Milanesi
- Department of Woman and Child's Health, Pediatric Cardiology, University of Padova, Padua, Italy
| | - Daniela Messina
- Department of Woman and Child's Health, Pediatric Cardiology, University of Padova, Padua, Italy
| | | | | | - Roberto Formigari
- Cardiology and Cardiac Surgery, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Maurizio Brighenti
- Cardiology and Cardiac Surgery, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Bruno Dallapiccola
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
| | - Bruno Marino
- Pediatric Cardiology, Department of Pediatrics, Sapienza University, Rome, Italy
| |
Collapse
|