Structural features localizing the ferroptosis inhibitor GIF-2197-r to lysosomes

We previously reported that N,N-dimethylaniline derivatives are potent ferroptosis inhibitors. Among them, the novel aminoindan derivative GIF-2197-r (the racemate of GIF-2115 (R-form) and GIF-2196 (S-form)) is effective at a concentration of 0.01 μM due to its localization to lysosomes and ferrous ion coordination capacity. The current study demonstrates that the aliphatic tertiary amine moiety of GIF-2197-r is responsible for lysosomal localization. Although N,N-dimethylaniline derivatives cannot form chelate structures with Fe2+, density functional theory computation demonstrates that they can form stable monodentate complexes with a hydrated ferrous ion, likely due to the highly electron-rich nature of the (dialkylamino)phenyl ring. Furthermore, the results suggest that the aliphatic tertiary amine moiety contributes to stabilizing the complexation. These findings could prove useful for developing improved lysosomotropic ferroptosis inhibitors for neurodegenerative diseases.

Activation of Lactate Receptor Positively Regulates Skeletal Muscle Mass in Mice

G protein-coupled receptor 81 (GPR81), a selective receptor for lactate, expresses in skeletal muscle cells, but the physiological role of GPR81 in skeletal muscle has not been fully elucidated. As it has been reported that the lactate administration induces muscle hypertrophy, the stimulation of GPR81 has been suggested to mediate muscle hypertrophy. To clarify the contribution of GPR81 activation in skeletal muscle hypertrophy, in the present study, we investigated the effect of GPR81 agonist administration on skeletal muscle mass in mice. Male C57BL/6J mice were randomly divided into control group and GPR81 agonist-administered group that received oral administration of the specific GPR81 agonist 3-Chloro-5-hydroxybenzoic acid (CHBA). In both fast-twitch plantaris and slow-twitch soleus muscles of mice, the protein expression of GPR81 was observed. Oral administration of CHBA to mice significantly increased absolute muscle weight and muscle weight relative to body weight in the two muscles. Moreover, both absolute and relative muscle protein content in the two muscles were significantly increased by CHBA administration. CHBA administration also significantly upregulated the phosphorylation level of p42/44 extracellular signal-regulated kinase-1/2 (ERK1/2) and p90 ribosomal S6 kinase (p90RSK). These observations suggest that activation of GRP81 stimulates increased the mass of two types of skeletal muscle in mice in vivo. Lactate receptor GPR81 may positively affect skeletal muscle mass through activation of ERK pathway.

The effect of γ phosphate modified deoxynucleotide substrates on PCR activity and fidelity

Controlling PCR fidelity is an important issue for molecular biology and high-fidelity PCR is essential for gene cloning. In general, fidelity control is achieved by protein engineering of polymerases. In contrast, only a few studies have reported controlling fidelity using chemically modified nucleotide substrates. In this report, we synthesized nucleotide substrates possessing a modification on Pγ and evaluated the effect of this modification on PCR fidelity. One of the substrates, nucleotide tetraphosphate, caused a modest decrease in Taq DNA polymerase activity and the effect on PCR fidelity was dependent on the type of mutation. The use of deoxyadenosine tetraphosphate enhanced the A:T→G:C mutation dramatically, which is common when using Taq polymerase. Conversely, deoxyguanosine tetraphosphate (dG4P) suppressed this mutation but increased the G:C→A:T mutation during PCR. Using an excess amount of dG4P suppressed both mutations successfully and total fidelity was improved.

Enantioselective aromatic Claisen rearrangement of allyl 2-naphthyl ethers catalyzed by π-Cu(ii) complexes

The first catalytic enantioselective aromatic Claisen rearrangement of allyl 2-naphthyl ethers using 5-10 mol% of π-copper(ii) complexes is reported. A Cu(OTf)₂ complex with an l-α-homoalanine amide ligand gave (S)-products in up to 92% ee. Conversely, a Cu(OSO₂C₄F₉)₂ complex with an l-tert-leucine amide ligand gave (R)-products in up to 76% ee. Density-functional-theory (DFT) calculations suggest that these Claisen rearrangements proceed stepwise via tight-ion-pair intermediates, and that (S)- and (R)-products are enantioselectively obtained via the staggered transition states for the cleavage of the C-O bond, which is the rate-determining step.

Alzheimer PHF-tau aggregates do not spread tau pathology to the brain via the Retino-tectal projection after intraocular injection in mouse models

Neurofibrillary tangles (NFT), a neuronal lesion found in Alzheimer's disease (AD), are composed of fibrillary aggregates of modified forms of tau proteins. The propagation of NFT follows neuroanatomical pathways suggesting that synaptically connected neurons could transmit tau pathology by the recruitment of normal tau in a prion-like manner. Moreover, the intracerebral injection of pathological tau from AD brains induces the seeding of normal tau in mouse brain. Creutzfeldt-Jacob disease has been transmitted after ocular transplants of cornea or sclera and the scrapie agent can spread across the retino-tectal pathway after intraocular injection of scrapie mouse brain homogenates. In AD, a tau pathology has been detected in the retina. To investigate the potential risk of tau pathology transmission during eye surgery using AD tissue material, we have analysed the development of tau pathology in the visual pathway of mice models expressing murine tau, wild-type or mutant human tau after intraocular injection of pathological tau proteins from AD brains. Although these pathological tau proteins were internalized in retinal ganglion cells, they did not induce aggregation of endogenous tau nor propagation of a tau pathology in the retino-tectal pathway after a 6-month incubation period. These results suggest that retinal ganglion cells exhibit a resistance to develop a tau pathology, and that eye surgery is not a major iatrogenic risk of transmission of tau pathology, contrary to what has been observed for transmission of infectious prions in prion diseases.

One-Pot O2-Oxidation and the Horner-Wadsworth-Emmons Reaction of Primary Alcohols for the Synthesis of (Z)-α,β-Unsaturated Esters

We developed one-pot oxidation/olefination procedures of primary alcohols giving Z-α,β-unsaturated esters 3. TEMPO-(CuCl or CuBr₂)-(2,2'-bipyridine) (1:1:1) catalyzed O₂ oxidation of primary alcohols in the presence of Z-selective Horner-Wadsworth-Emmons reagent 1b and K₃PO₄ or NaH gave 3 with Z/E = 84:16 to 96:4 in high yields. A stepwise reaction was also developed. After TEMPO-CuBr₂-(2,2'-bipyridine)-K₃PO₄ (1:1:1:1) catalyzed O₂ oxidation of alcohols in MeCN, the resulting mixture was treated with a THF solution of 1b and t-BuOK at -78 °C to 0 °C, giving 3 with higher selectivity (Z/E = 91:9 to 99:1).

Synthesis of Truncated Carbocyclic Nucleosides Using 5'-Deoxy-5'-Heteroarylsulfonylnucleosides

This article describes the detailed protocol for the synthesis of "truncated" carbocyclic nucleosides with a cyclopentene core and without a 4'-hydroxymethyl group. The synthesis was performed using 5'-deoxy-5'-heteroarylsulfonylnucleosides, which were prepared by the 5'-O-mesylation of the appropriately protected nucleosides, followed by a nucleophilic substitution with heteroarylthiols and the oxidation of the resulting 5'-S-heteroaryl-5'-thionucleosides. The treatment of the 5'-deoxy-5'-heteroarylsulfonylnucleosides with 1,8-diazabicyclo[5.4.0]undec-7-ene affords the truncated carbocyclic nucleosides, presumably via a domino reaction involving the α-deprotonation of the heteroarylsulfone, elimination of the nucleobase, formation of an α,β-unsaturated sulfone, Michael addition of the nucleobase to the α,β-unsaturated sulfone, and an intramolecular Julia-Kocienski reaction. This protocol would be useful for the short-step synthesis of biologically active carbocyclic nucleosides. © 2022 Wiley Periodicals LLC. Basic Protocol 1: Preparation of 5'-deoxy-5'-heteroarylsulfonylnucleosides Basic Protocol 2: Synthesis of truncated carbocyclic nucleosides.

Diastereoselective Addition of Prochiral Nucleophilic Alkenes to α-Chiral N-Sulfonyl Imines

The Lewis-acid-promoted addition of prochiral E- and Z-allyl nucleophiles to chiral α-alkoxy N-tosyl imines is described. Alkene geometry is selectively transferred to the newly formed carbon-carbon bond, resulting in stereochemical control of C1, C2, and C3 of the resulting 2-alkoxy-3-N-tosyl-4-alkyl-5-hexene products. A computational analysis to elucidate the high selectivity is also presented. This methodology was employed in the synthesis of two naturally occurring isomers of clausenamide.

Serendipitous One-Step Synthesis of Cyclopentene Derivatives from 5'-Deoxy-5'-heteroarylsulfonylnucleosides as Nucleoside-Derived Julia-Kocienski Reagents

A serendipitous one-step transformation of 5'-deoxy-5'-heteroarylsulfonylnucleosides into cyclopentene derivatives is reported. This unique transformation likely proceeds via a domino reaction initiated by α-deprotonation of the heteroaryl sulfone and subsequent elimination reaction to generate a nucleobase and an α,β-unsaturated sulfone that contains a formyl group. The Michael addition of the nucleobase to the α,β-unsaturated sulfone and the subsequent intramolecular Julia-Kocienski reaction eventually generate the cyclopentene ring. Heteroarylthio and acylthio groups can be incorporated into the cyclopentene core in place of the nucleobase by conducting this reaction in the presence of a heteroarylthiol and a thiocarboxylic acid, respectively. cis,cis-Trisubstituted cyclopentene derivatives are obtained as a single stereoisomer from ribonucleoside-derived Julia-Kocienski sulfones.

Synthesis of xanthosine 2-phosphate diesters via phosphitylation of the carbonyl group

O²-Phosphodiesterification of xanthosine has been achieved by a one-pot procedure consisting of the phosphitylation of the 2-carbonyl group of appropriately protected xanthosine derivatives using phosphoramidites and N-(cyanomethyl)dimethylammonium triflate (CMMT), oxidation of the resulting xanthosine 2-phosphite triesters, and deprotection. In addition, a study on the hydrolytic stability of a fully deprotected xanthosine 2-phosphate diester has revealed that it is more stable at higher pH.

Temporal course of vascular response after fluoropolymer paclitaxel-eluting stent implantation for femoropopliteal artery lesions

Background

Limited data is available regarding the vascular response after fluoropolymer paclitaxel-eluting stent (FP-PES) implantation. We sought to assess the vascular response at 6- and 12-month after FP-PES implantation for femoropopliteal artery lesions using serial optical coherence tomography (OCT) examination.

Methods and results

From the IMPERIAL trial, this study evaluated 10 de novo femoropopliteal lesions treated with FP-PES. The primary study endpoint was neointimal tissue coverage at 6- and 12-month follow-up as assessed by serial OCT examination. The incidence of peri-strut low-intensity area (PLIA) and extra-stent lumen (ESL) was also assessed. A total of 203 matched cross-sectional images were evaluated at 6- and 12-month (5,615 and 5,763 struts, respectively). From 6 to 12 months, the mean neointimal thickness tended to increase from 198 μm to 233 μm with a significant reduction in the incidence of malapposed struts (0.59% vs. 0.28%, p=0.039). Conversely, uncovered struts and PLIA were more frequently observed at 12 months (4.4% vs. 7.8%, p=0.01; 12.7% vs. 21.0%, p<0.001, respectively). The ESL area significantly increased over time without any difference in its incidence (0.24±0.32 mm2 vs. 0.38±0.36 mm2, p=0.009).

Conclusions

Neointimal proliferation was markedly inhibited from 6 to 12 months after FP-PES implantation, whereas the incidence of uncovered struts and PLIA significantly increased over time with the enlargement of ESL.

Funding Acknowledgement

Type of funding sources: None.

Genetic characterization of melon accessions in the U.S. National Plant Germplasm System and construction of a melon core collection

Melon (C. melo L.) is an economically important vegetable crop cultivated worldwide. The melon collection in the U.S. National Plant Germplasm System (NPGS) is a valuable resource to conserve natural genetic diversity and provide novel traits for melon breeding. Here we use the genotyping-by-sequencing (GBS) technology to characterize 2083 melon accessions in the NPGS collected from major melon production areas as well as regions where primitive melons exist. Population structure and genetic diversity analyses suggested that C. melo ssp. melo was firstly introduced from the centers of origin, Indian and Pakistan, to Central and West Asia, and then brought to Europe and Americas. C. melo ssp. melo from East Asia was likely derived from C. melo ssp. agrestis in India and Pakistan and displayed a distinct genetic background compared to the rest of ssp. melo accessions from other geographic regions. We developed a core collection of 383 accessions capturing more than 98% of genetic variation in the germplasm, providing a publicly accessible collection for future research and genomics-assisted breeding of melon. Thirty-five morphological characters investigated in the core collection indicated high variability of these characters across accessions in the collection. Genome-wide association studies using the core collection panel identified potentially associated genome regions related to fruit quality and other horticultural traits. This study provides insights into melon origin and domestication, and the constructed core collection and identified genome loci potentially associated with important traits provide valuable resources for future melon research and breeding.

Stereoselective Installation of Five Contiguous Stereogenic Centers in a Double Aldol-Tishchenko Cascade and Evaluation of the Key Transition State through DFT Calculation

The stereoselective formation of 5 contiguous chiral centers in a single pot reaction is demonstrated using an aldol, aldol–Tishchenko reaction of N-tert-butyl sulfinimines. One diastereoisomer (from 32 possibilities) predominates, and a series of cyclic and acyclic 3-amino-1,5-diol derivatives are synthesized in good yields (up to 80%) and excellent diastereoselectivities (up to >98:2 dr). Investigations support two reversible aldol steps, and multiple intermediates which are funnelled through a remarkably selective, irreversible, Tishchenko reduction, in a Curtin–Hammett phenomenon. DFT calculations using a disolvated (THF) model reveal the factors controlling stereoselectivity in the final irreversible Tishchenko step.

A systematic review of patient-reported outcome measures used to assess sleep in postpartum women using Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines

STUDY OBJECTIVES

We performed a systematic review to identify the best patient-reported outcome measure (PROM) of postpartum sleep in women.

METHODS

We searched 4 databases for validated PROMs used to assess postpartum sleep. Studies were considered if they evaluated at least 1 psychometric measurement property of a PROM. An overall rating was assigned for each psychometric measurement property of each PROM based upon COSMIN criteria. A modified GRADE approach was used to assess the level of evidence and recommendations were then made for each PROM.

RESULTS

We identified 15 validation studies of 8 PROMs, in 9,070 postpartum women. An adequate number of sleep domains was assessed by 5 PROMs: Bergen Insomnia Scale (BIS), Pittsburgh Sleep Quality Index (PSQI), General Sleep Disturbance Scale (GSDS), Athens Insomnia Scale (AIS) and the Sleep Symptom Checklist (SSC). BIS and GSDS were the only PROMs to demonstrate adequate content validity and at least a low level of evidence of sufficient internal consistency, resulting in Class A recommendations. The BIS was the only PROM, which is easily accessible and free to use for non-commercial research, that achieved a Class A recommendation.

CONCLUSION

The BIS is the best currently available PROM of postpartum sleep. However, this PROM fails to assess several important domains such as sleep duration (and efficiency), chronotype, sleep-disordered breathing and medication usage. Future studies should focus on evaluating the psychometric measurement properties of BIS in the North American setting and in different cultural groups, or to develop a more specific PROM of postpartum sleep.

One-Pot Preparation of (E)-α,β-Unsaturated Aldehydes by a Julia-Kocienski Reaction of 2,2-Dimethoxyethyl PT Sulfone Followed by Acid Hydrolysis

(E)-α,β-Unsaturated aldehydes were synthesized by the Julia-Kocienski reaction of 2,2-dimethoxyethyl 1-phenyl-1H-tetrazol-5-yl (PT) sulfone 3 with various aldehydes, followed by acid hydrolysis. The reaction could be carried out in one pot, and various (E)-α,β-unsaturated aldehydes were obtained in a short time and with high yields.

Mechanism and Origins of Stereoselectivity of the Aldol-Tishchenko Reaction of Sulfinimines

Density functional theory computations have elucidated the mechanism and origins of stereoselectivity in McGlacken’s aldol-Tishchenko reaction for the diastereoselective synthesis of 1,3-amino alcohols using Ellman’s t-butylsulfinimines as chiral auxiliaries. Variations of stereochemical outcome are dependent on the nature of the ketone starting materials used, and the aspects leading to these differences have been rationalized. The intramolecular hydride transfer step is the rate- and stereochemistry-determining step, and all prior steps are reversible.

Stereoselective Synthesis of Ribofuranoid exo-Glycals by One-Pot Julia Olefination Using Ribofuranosyl Sulfones

One-pot Julia olefination using ribofuranosyl sulfones is described. The α-anomers of the ribofuranosyl sulfones were synthesized with complete α-selectivity via the glycosylation of heteroarylthiols using ribofuranosyl iodides as glycosyl donors and the subsequent oxidation of the resulting heteroaryl 1-thioribofuranosides with magnesium monoperphthalate (MMPP). The Julia olefination of the α-ribofuranosyl sulfones with aldehydes proceeded smoothly in one pot to afford the thermodynamically less stable (E)-exo-glycals with modest-to-excellent stereoselectivity (up to E/Z = 94:6) under the optimized conditions. The E selectivity was especially high for aromatic aldehydes. In contrast, the (Z)-exo-glycal was obtained as the main product with low stereoselectivity when the corresponding β-ribofuranosyl sulfone was used (E/Z = 41:59). The remarkable impact of the anomeric configuration of the ribofuranosyl sulfones on the stereoselectivity of the Julia olefination has been rationalized using density functional theory (DFT) calculations. The protected ribose moiety of the resulting exo-glycals induced completely α-selective cyclopropanation on the exocyclic carbon-carbon double bond via the Simmons-Smith-Furukawa reaction. The 2-cyanoethyl group was found to be useful for the protection of the exo-glycals, as it could be removed without affecting the exocyclic C═C bond.

Impact of tapered-shaped left ventricular outflow tract on permanent pacemaker implantation after the third-generation balloon-expandable valve implantation

Background

In the era of transcatheter aortic valve implantation (TAVI) for patients with lower surgical risk, conduction disturbances requiring permanent pacemaker implantation (PPI) after TAVI remain a serious concern. The association between tapered-shaped left ventricular outflow tract (LVOT) and PPI after TAVI has not been elucidated.

Purposes

This study sought to identify predictors for PPI after TAVI with the third-generation balloon-expandable valve, with focus on LVOT morphology.

Methods

Of 272 consecutive patients treated with the third-generation balloon-expandable valve, 256 patients without previous PPI or bicuspid valve were retrospectively analyzed.

Results

PPI was implanted after TAVI in 20 (7.8%) patients. Patients requiring PPI had smaller LVOT area (356.3 mm2 vs. 399.4 mm2, p=0.011). Moreover, receiver-operating characteristic (ROC) statistics showed that LVOT area /annulus area possessed significantly higher predictive ability than LVOT area (area under the curve: 0.91 [95% confidence interval [CI]: 0.84 to 0.95] vs. 0.67 [95% CI: 0.57 to 0.77], p<0.001). Multivariable analysis revealed LVOT area /annulus area (odds ratio [OR]: 1.93 [95% CI: 1.38–2.71]; p<0.001 per % of decreasing), the difference between membranous septum length and implantation depth (ΔMSID) (OR: 6.82 [95% CI 2.39–19.48]; p<0.001 per mm of decreasing) and pre-existing complete right bundle branch block (CRBBB) (OR: 32.38 [95% CI 2.30–455.63]; p=0.002) as independent predictors of PPI. Further analysis using ROC statistics revealed LVOT area / annulus area of 88.5% and ΔMSID of 1.8 mm as the optimal cutoff points for prediction of PPI after the third-generation balloon-expandable valve implantation, with high negative predictive values of 98.1% and 99.0%, respectively. Figure shows the PPI rates stratified by the number of following predictors: LVOT area /annulus area <88.5%, ΔMSID <1.8 mm and pre-existing CRBBB. Patients with 2 or more predictors had significantly higher PPI rates than those with 1 or less predictor (67% [18 of 27 patients] vs. 1% [2 of 229 patients], p<0.001).

Conclusions

LVOT area /annulus area, ΔMSID and pre-existing CRBBB were identified as powerful independent predictors for PPI after TAVI. Higher valve implantation is important to prevent excessive PPI especially for patients with pre-procedural tapered-shaped LVOT, short membranous septum or pre-existing CRBBB.

PPI rates stratified by predictors

Funding Acknowledgement

Type of funding source: None

Impact of SYNTAX score 2 on 7-year clinical outcomes in patients treated with cobalt-chromium everolimus-eluting stent

Background

Impact of SYNTAX score II (SSII) on long-term clinical outcomes after cobalt-chromium everolimus-eluting stent (CoCr-EES) implantation remains unclear.

Methods

Between February 2010 and May 2011, 1064 consecutive patients with 1440 lesions were treated only with CoCr-EES implantation. Of these, the SSII was calculated in 1013 patients with 1345 lesions. Patients were divided into the tertile group: Tertiles for SSII (low SSII [12–28.9], n=334; intermediate SSII [29–39.1], n=339; and high SSII [39.2–80.8], n=340). We assessed the cumulative 7-year incidences of major adverse cardiac events (MACE), defined as a composite of cardiac death, myocardial infarction, definite stent thrombosis, and clinically driven target lesion revascularization (CDTLR) based on SSII groupings.

Results

Cumulative 7-year incidence of MACE was significantly higher in the high SSII group than in the other groups (34.1% vs. 18.6% vs. 17.2%, p<0.001). The cumulative incidence of cardiac death, myocardial infarction and stent thrombosis were significantly higher in the high SSII group than in the other groups (22.1% vs. 2.0% vs. 5.3%, p<0.001; 6.6% vs. 4.9% vs. 1.7%, p=0.01; 2.9% vs. 1.7% vs. 0.3%, p=0.03, respectively). The cumulative incidence of CDTLR was similar between the groups (15.2% vs. 12.8% vs. 15.7%, p=0.57). High SSII group (hazard ratio [HR] 2.18 [vs. low SS], 95% confidence intervals [CI]: 1.56–3.06, p<0.001) and diabetes mellitus (HR 1.37, 95% CI: 1.04–1.81, p=0.03) were predictors of 7-year MACE.

Conclusions

SSII has significantly impact on 7 years clinical outcomes after CoCr-EES implantation.

Cumulative incidence of MACE

Funding Acknowledgement

Type of funding source: None

Different clinical features between left atrial and left atrial appendage thrombus: an insight into more than 16,000 transesophageal echography database

Background

Thrombosis localization inside the left atrium (LA) is very frequently in the left atrial appendage (LAA). Some cases show atrial thrombus outside LAA, whose characteristics have not well elucidated.

Purpose

To reveal the different clinical background between thrombus inside LAA and outside LAA in a large transesophageal echo (TEE) database.

Methods

We searched the TEE database over 8 years of our center to identify patients in whom LA thrombus was pointed out. After initial TEE imaging, LA thrombus was confirmed with repeated TEE by echocardiography specialist or other modality, such as CT images.

Results

In a consecutive 16,142 TEE cases, LA thrombus was suspected in 162 cases (1%), finally 38 cases were identified as LA thrombus. They were divided into two groups; LAA only group and outside LAA group. Atrial fibrillation was concomitant in 34 patients (89%). History of stroke was significantly higher in LAA group (46.2% vs 8.3%, p=0.03) and malignant tumor was significantly higher in outside LAA group (23.1% vs 58.3%, p=0.035). LA thrombus was the first symptom in 3 cases of outside LAA group, following by malignant tumor was newly detected. Oral anticoagulation was prescribed in 23 cases (61%) at TEE study, mostly treated with warfarin, and median 123 days later thrombus dissolution was confirmed in 21 cases (55%). During mean follow up of 893 days, 4 patients experienced ischemic stroke, but two of them were due to self-interruption.

Conclusion

Outside LAA thrombus is minor but more concomitant with malignant tumor. Physician must be aware that screening of cancer is important if outside LAA thrombus is detected.

Funding Acknowledgement

Type of funding source: None

Serum Lipoprotein(a) levels on clinical outcomes after endovascular therapy

Background

While lipoprotein (a) (Lp(a)) is an independent predictor of atherosclerotic diseases involving the coronary and cerebrovascular arteries, its prognostic value in patients with peripheral artery disease (PAD) remains still unclear.

Objective

The aim of study is to determine the role of Lp(a) levels after endovascular therapy (EVT).

Methods

This study was prospective observational study. From September 2016 to April 2019, 676 the patients (873 limbs) who underwent EVT for de-novo PAD were enrolled. We divided into Lp(a) levels ≥40 mg/dl (high Lp(a) group; n=129) and <40 mg/dl (low Lp(a) group; n=547). Outcome measures were major adverse cardiovascular events (MACE; all-cause death, myocardial infarction and stroke), and major adverse limb events (MALE; repeat revascularization for limb and major amputation) at 1 year. Major amputation defined as above forefoot amputation due to vascular cause.

Results

The mean follow-up period was 14.3±8.9 months. Serum Lp(a) levels before EVT were 27.2 (10.0–36.0 mg/dl). High Lp (a) group was significantly older, higher prevalence of history of stroke, chronic kidney disease, and multi-vessel lesions. Cumulative incidence of MACE at 1 year was not significantly between two groups (p=0.53, log-rank test), whereas cumulative incidence of MALE at 1 year was significantly higher in high Lp (a) group (p=0.04, log-rank test). However, after adjusting for prespecified risk factors, high Lp (a) group was not independent predictor in MALE at 1 year.

Conclusion

High Lp (a) might not be associated with cardiovascular events and limb prognosis after EVT for PAD in early phase.

Funding Acknowledgement

Type of funding source: None

High-risk plaque burdens myocardial flow reserve in intermediate coronary artery disease: hybrid analysis of 13N-ammonia PET and coronary CT angiography

Background

13N-ammonia PET (NH3-PET) can detect myocardial perfusion abnormalities in patients with coronary artery disease (CAD) and also obtain diagnostic quantitative values of absolute myocardial blood flow and myocardial flow reserve (MFR). Low MFR (MFR<2.0) is an independent prognostic factor for major adverse cardiac event in patients with ischemic and non-ischemic heart disease. A feature of low attenuation plaque (LAP) on coronary CT angiography (CCTA) has been known as high-risk plaque (HRP) for acute coronary syndrome even if there is no significant coronary stenosis. The presence of HRP potentially adversely affects MFR, but the hypothesis has not been elucidated.

Purpose

We aimed to investigate the affect of LAP to MFR in intermediate CAD.

Methods

One hundred five patients (age 67±9 years, 65% male) with CAD underwent NH3-PET and CCTA within 6 months between April 2015 and March 2019 were enrolled. Based on the results of CCTA, mild and moderate stenosis were defined as 1% to 49% and 50% to 69% stenosis. Ischemic territories for major three vessels were identified by stress/rest NH3-PET images. Finally, 194 coronary arteries with mild to moderate stenosis corresponding to non-ischemic territory were analyzed in this study. LAP was defined as plaques containing CT value less than 90HU. Partially calcified plaques were included in LAP. Entirely calcification plaque without LAP was defined as calcified plaque. MFR for major three vessels were calculated from dynamic scan at stress/rest NH3-PET.

Results

CCTA showed 80 coronary arteries with LAP (41%), 104 coronary arteries with calcified plaque (54%), 102 vessels with mild stenosis (53%), and 92 vessels with moderate stenosis (47%). MFRs for coronary arteries with LAP were significantly lower than those without LAP (2.1±0.6 vs 2.5±0.6, p<0.0001). The significant difference in MFR between with and without LAP was observed in both mild and moderate stenosis (mild: 2.0±0.6 vs 2.5±0.6, p=0.0015, moderate: 2.1±0.6 vs 2.5±0.6, p<0.0001). In contrast, coronary arteries with calcified plaque had significantly higher MFR than those without (2.5±0.6 vs 2.1±0.6, p<0.0001).

In 58 coronary arteries with MFR<2.0, 71% (41/58) had LAP and 24% (14/58) had calcified plaque. In 136 coronary arteries with MFR≥2.0, 29% (39/136) had LAP and 66% (90/136) had calcified plaque. LAP was significantly more frequent in the former and calcified plaque was significantly more frequent in the latter.

Conclusion

The presence of LAP burdens MFR in mild to moderate CAD. On the other hand, calcified plaque alone had no adverse effect on MFR. LAP is an important sign in CAD risk assessment even without significant coronary stenosis.

MFR and stress MPI

Funding Acknowledgement

Type of funding source: None

Stereoselective Synthesis of Trisubstituted (Z)-Alkenes from Ketones via the Julia-Kocienski Olefination Using 1-Methyl- and 1-tert-Butyl-1H-tetrazol-5-yl Alkyl Sulfones

1-Methyl-1H-tetrazol-5-yl (MT) alkyl sulfones 1b, 3b, and 7b react with various unsymmetrical ketones in the presence of LiHMDS in THF at low temperature to give trisubstituted (Z)-alkenes in good yields stereoselectively (Z/E = 91:9 to 99:1). For sterically less demanding ketones, olefination using t-Bu reagents 1d and 3d generated (Z)-alkenes with higher stereoselectivity (93:7-99:1).

Methylenation for Aldehydes and Ketones Using 1-Methylbenzimidazol-2-yl Methyl Sulfone

The methylenation reagent 1-methylbenzimidazol-2-yl methyl sulfone 2 reacts with various aldehydes and ketones in the presence of t-BuOK (room temperature, 1 h) in dimethylformamide to give the corresponding terminal alkenes generally in high yields. For sensitive substrates, the reaction is better carried out at low temperature using sodium hexamethyldisilazide in 1,2-dimethoxyethane. The byproduct is easily removed from the products, and the reaction conditions are mild and practical. Reagent 2 can be easily prepared from commercially available 2-mercaptobenzimidazole 5 in 95% yield without any expensive reagents.

Cucurbit Genomics Database (CuGenDB): a central portal for comparative and functional genomics of cucurbit crops

The Cucurbitaceae family (cucurbit) includes several economically important crops, such as melon, cucumber, watermelon, pumpkin, squash and gourds. During the past several years, genomic and genetic data have been rapidly accumulated for cucurbits. To store, mine, analyze, integrate and disseminate these large-scale datasets and to provide a central portal for the cucurbit research and breeding community, we have developed the Cucurbit Genomics Database (CuGenDB; http://cucurbitgenomics.org) using the Tripal toolkit. The database currently contains all available genome and expressed sequence tag (EST) sequences, genetic maps, and transcriptome profiles for cucurbit species, as well as sequence annotations, biochemical pathways and comparative genomic analysis results such as synteny blocks and homologous gene pairs between different cucurbit species. A set of analysis and visualization tools and user-friendly query interfaces have been implemented in the database to facilitate the usage of these large-scale data by the community. In particular, two new tools have been developed in the database, a ‘SyntenyViewer’ to view genome synteny between different cucurbit species and an ‘RNA-Seq’ module to analyze and visualize gene expression profiles. Both tools have been packed as Tripal extension modules that can be adopted in other genomics databases developed using the Tripal system.

P2716Correlation between computed tomography derived ischemia index and conventional fractional flow reserve

Background

Computed tomography (CT) derived ischemia index is a novel tool to determine the significance of coronary artery disease, however, its ability to identify myocardial ischemia has not been examined.

Methods

From Jan. 2013 to Dec. 2015, 14,000 patients underwent ECG-gated CT coronary angiography for suspected coronary artery disease. From Jan. 2013 to Jan. 2016, 483 patients (589 vessels) underwent conventional FFR to assess myocardial ischemia. Among those, FFR was assessed in 148 patients (167 vessels) within 30 days after CT coronary angiography. We further excluded 24 patients with prior stenting or bypass grafting, 3 patients with multiple MDCT or FFR, and 6 patients with insufficient datasets. Finally, we included 117 patients (127 vessels) to assess the correlation between CT derived ischemia index and conventional FFR.

CT derived ischemia index was calculated as follows: left ventricular volume distally to the coronary artery lumen (cm3)/coronary artery lumen area (mm2). Left ventricular volume was automatically determined using Advantage Workstation and divided according to the nearest coronary artery tree. Center of coronary arteries were manually traced and contours of coronary artery lumen were automatically depicted. CT derived ischemia index was calculated at approximately every 0.625mm point of coronary artery. Moving median of consecutive 5 points (approximately 3.125mm) were used to remove outliers. Maximum value of CT derived ischemia index per coronary artery segment was calculated to determine the significance of coronary artery disease.

Results

Mean age was 71.3±10.5 years and 63.8% of patients were male. Coronary angiography was performed to assess conventional FFR at the median of 13 days (IQR 7 to 18 days) after CT. Majority of the target vessel was left anterior descending artery (71.7%), followed by right coronary artery (14.2%), left circumflex artery (13.4%) and left main coronary artery (0.8%). According to the quantitative coronary angiography, minimum lumen diameter was 1.47±0.32mm with percent diameter stenosis of 48.3±10.4%. Median FFR value was 0.83 (IQR 0.76 to 0.88) and positive test for myocardial ischemia (FFR <0.80) was observed in 42 vessels (33.1%). Maximum CT derived ischemia index per segment ranged from 1.825 to 57.296 (median 8.333, IQR 4.911 to 14.484). There was a negative correlation between CT derived ischemia index and FFR (r=−0.319, 95% confidence interval −0.467 to −0.153, P<0.001). Receiver operating characteristic analysis indicated CT derived ischemia index of 9.962 has 76.2% sensitivity and 70.6% specificity for the presence of FFR<0.80 (AUC 0.73, 95% CI 0.64 to 0.82).

Conclusions

A novel tool of CT derived ischemia index has a significant negative correlation with conventional FFR in lesions with mild to moderate stenosis. Larger multicenter prospective studies are needed to fully determine the impact of CT derived ischemia index.

P6355The behavior of atrial fibrillation in patients with heart failure hospitalization

Background

Relationship between atrial fibrillation (AF) and heart failure (HF) is often compared with proverbial question of which came first, the chicken or the egg. Some patients showing AF at the HF admission result in restoration of sinus rhythm (SR) at discharge. It is not well elucidated that the restoration into SR during hospitalization can render the preventive effect for rehospitalization.

Purpose

To investigate the impact of restoration into SR during hospitalization for readmission rate of the HF patients showing AF.

Methods

We enrolled consecutive 640 HF patients hospitalized from January 2015 to December 2015. Patients data were retrospectively investigated from medical record. Patients showing atrial fibrillation on admission but unrecognized ever were defined as “incident AF”; patients with AF diagnosed before admission were defined as “prevalent AF”. Primary endpoint was a composite of death from cardiovascular disease or hospitalization for worsening heart failure. Secondary endpoints were death from cardiovascular disease, unplanned hospitalization related to heart failure, and any hospitalization.

Results

During mean follow up of 19 months, 139 patients (22%) were categorized as incident AF and 145 patients (23%) were categorized as prevalent AF. Among 239 patients showing AF on admission, 44 patients were discharged in SR (39 patients in incident AF and 5 patients in prevalent AF). Among incident AF patients, the primary composite end point occurred in significantly fewer in those who discharged in SR (19% vs. 42% at 1-year; 23% vs. 53% at 2-year follow-up, p=0.005). To compare the risk factors related to readmission due to HF with the cox proportional-hazards model, AF only during hospitalization [Hazard Ratio (HR)=0.37, p<0.01] and prevalent AF (HR=1.67, p=0.04) was significantly associated. There was no significant difference depending on LVEF.

Conclusion

Newly diagnosed AF with restoration to SR during hospitalization was a good marker to forecast future prognosis.

P6544A real world study of high frequency atrial anti-tachycardia pacing in new algorithm for atrial arrhythmia

Background

Advanced pacemakers feature atrial antitachycardia pacing (aATP) therapies for terminating atrial arrhythmia. Previous studies showed the efficacy of combined atrial preventive pacing and aATP in patients with pacemakers. The independent effect of aATP and the impact for patients outside the clinical trials has not been well elucidated.

Methods

In a single center, prospective, all-comers trial, we enrolled 567 patients implanted cardiac devices with Reactive ATP function. History of permanent atrial fibrillation (AF) was not included. After device interrogation of the AF burden and the longest AF duration in the last 6 months, aATP was programmed as a bit more aggressive setting than MINERVA trial (time interval was set as every 2 hours). As for newly implanted devices, aATP was activated after at least 3 months run-in period. Primary and secondary outcomes were the longest AF duration and cumulative percentage of progression into permanent AF, respectively.

Results

Of 541 eligible patients, aged 75.3±10.7 years, 356 pacemaker, 82 ICD and 103 CRT patients, the longest single episode of AF lasted ≤6 min in 439 patients (81.1%), >6 min to 6 h in 43 (8.0%), >6–24 h in 33 (6.1%), and >24 h in 26 (4.8%) at the enrollment. During mean follow-up of 1.9 years, the longest AF episode lasted >24 h in 49 patients (9.1%) and 14 patients (2.6%) progressed into permanent AF. According with baseline longest single episode of AF, patients with AF ≤6 min developed an episode >24 h in 0.8% at 1 year and 3.2% at 2 years follow up; patients with AF >6 min to 6 h developed an episode >24 h in none at 1 year and 7% at 2 years follow up; and patients with AF >6–24 h developed an episode >24 h in 19% at 1 year and 42% at 2 years follow up, respectively. In a subgroup analysis of in 192 patients with at least 1 aATP, 46 patients with high efficacy (>44%) did not developed an episode >24 h. Only one patient developed into permanent AF without aATP therapy. On multivariate analysis, neither ICD nor CRT was independent risk factor for developing the longest AF episode >24 h.

Conclusions

The independent use of aATP without atrial preventive pacing was effective for preventing AF progression in a real world cohort. Even without the previous AF episodes, aATP could prevent AF development, especially in patients showing high aATP efficacy. Future research is required to enhance the aATP success rate.

Systemic Immunologic Consequences of Chronic Periodontitis

Chronic periodontitis (ChP) is a prevalent inflammatory disease affecting 46% of the US population. ChP produces a profound local inflammatory response to dysbiotic oral microbiota that leads to destruction of alveolar bone and tooth loss. ChP is also associated with systemic illnesses, including cardiovascular diseases, malignancies, and adverse pregnancy outcomes. However, the mechanisms underlying these adverse health outcomes are poorly understood. In this prospective cohort study, we used a highly multiplex mass cytometry immunoassay to perform an in-depth analysis of the systemic consequences of ChP in patients before (n = 28) and after (n = 16) periodontal treatment. A high-dimensional analysis of intracellular signaling networks revealed immune system-wide dysfunctions differentiating patients with ChP from healthy controls. Notably, we observed exaggerated proinflammatory responses to Porphyromonas gingivalis-derived lipopolysaccharide in circulating neutrophils and monocytes from patients with ChP. Simultaneously, natural killer cell responses to inflammatory cytokines were attenuated. Importantly, the immune alterations associated with ChP were no longer detectable 3 wk after periodontal treatment. Our findings demarcate systemic and cell-specific immune dysfunctions in patients with ChP, which can be temporarily reversed by the local treatment of ChP. Future studies in larger cohorts are needed to test the boundaries of generalizability of our results.

Introgression of a Novel Ug99-Effective Stem Rust Resistance Gene into Wheat and Development of Dasypyrum villosum Chromosome-Specific Markers via Genotyping-by-Sequencing (GBS)

Dasypyrum villosum is a wild relative of common wheat (Triticum aestivum L.) with resistance to Puccinia graminis f. tritici, the causal agent of stem rust, including the highly virulent race TTKSK (Ug99). In order to transfer resistance, T. durum-D. villosum amphiploids were initially developed and used as a bridge to create wheat-D. villosum introgression lines. Conserved ortholog set (COS) markers were used to identify D. villosum chromosome introgression lines, which were then subjected to seedling P. graminis f. tritici resistance screening with race TTKSK. A COS marker-verified line carrying chromosome 2V with TTKSK resistance was further characterized by combined genomic in situ and fluorescent in situ analyses to confirm a monosomic substitution line MS2V(2D) (20″ + 1' 2V[2D]). This is the first report of stem rust resistance on 2V, which was temporarily designated as SrTA10276-2V. To facilitate the use of this gene in wheat improvement, a complete set of previously developed wheat-D. villosum disomic addition lines was subjected to genotyping-by-sequencing analysis to develop D. villosum chromosome-specific markers. On average, 350 markers per chromosome were identified. These markers can be used to develop diagnostic markers for D. villosum-derived genes of interest in wheat improvement.

Cucurbit Genomics Database (CuGenDB): a central portal for comparative and functional genomics of cucurbit crops

The Cucurbitaceae family (cucurbit) includes several economically important crops, such as melon, cucumber, watermelon, pumpkin, squash and gourds. During the past several years, genomic and genetic data have been rapidly accumulated for cucurbits. To store, mine, analyze, integrate and disseminate these large-scale datasets and to provide a central portal for the cucurbit research and breeding community, we have developed the Cucurbit Genomics Database (CuGenDB; http://cucurbitgenomics.org) using the Tripal toolkit. The database currently contains all available genome and expressed sequence tag (EST) sequences, genetic maps, and transcriptome profiles for cucurbit species, as well as sequence annotations, biochemical pathways and comparative genomic analysis results such as synteny blocks and homologous gene pairs between different cucurbit species. A set of analysis and visualization tools and user-friendly query interfaces have been implemented in the database to facilitate the usage of these large-scale data by the community. In particular, two new tools have been developed in the database, a 'SyntenyViewer' to view genome synteny between different cucurbit species and an 'RNA-Seq' module to analyze and visualize gene expression profiles. Both tools have been packed as Tripal extension modules that can be adopted in other genomics databases developed using the Tripal system.