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Wei QT, Liu BY, Ji HY, Lan YF, Tang WH, Zhou J, Zhong XY, Lian CL, Huang QZ, Wang CY, Xu YM, Guo HB. Exosome-mediated transfer of MIF confers temozolomide resistance by regulating TIMP3/PI3K/AKT axis in gliomas. Mol Ther Oncolytics 2021; 22:114-128. [PMID: 34514093 PMCID: PMC8413833 DOI: 10.1016/j.omto.2021.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 03/09/2021] [Accepted: 08/12/2021] [Indexed: 01/08/2023]
Abstract
Temozolomide (TMZ) resistance is an important cause of clinical treatment failure and poor prognosis in gliomas. Increasing evidence indicates that cancer-derived exosomes contribute to chemoresistance; however, the specific contribution of glioma-derived exosomes remains unclear. The aim of this study was to explore the role and underlying mechanisms of exosomal macrophage migration inhibitory factor (MIF) on TMZ resistance in gliomas. We first demonstrated that MIF was upregulated in the exosomes of TMZ-resistant cells, engendering the transfer of TMZ resistance to sensitive cells. Our results indicated that exosomal MIF conferred TMZ resistance to sensitive cells through the enhancement of cell proliferation and the repression of cell apoptosis upon TMZ exposure. MIF knockdown enhanced TMZ sensitivity in resistant glioma cells by upregulating Metalloproteinase Inhibitor 3 (TIMP3) and subsequently suppressing the PI3K/AKT signaling pathway. Additionally, exosomal MIF promoted tumor growth and TMZ resistance of glioma cells in vivo, while IOS-1 (MIF inhibitor) promotes glioma TMZ sensitive in vivo. Taken together, our study demonstrated that exosome-mediated transfer of MIF enhanced TMZ resistance in glioma through downregulating TIMP3 and further activating the PI3K/AKT signaling pathway, highlighting a prognostic biomarker and promising therapeutic target for TMZ treatment in gliomas.
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Affiliation(s)
- Q T Wei
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China.,Department of Neurosurgery, The First Affiliated Hospital of Shantou University, Shantou 515041, Guangdong, China
| | - B Y Liu
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - H Y Ji
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China.,Department of Neurosurgery, The First Affiliated Hospital of Shantou University, Shantou 515041, Guangdong, China
| | - Y F Lan
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - W H Tang
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - J Zhou
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - X Y Zhong
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - C L Lian
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - Q Z Huang
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - C Y Wang
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - Y M Xu
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University, Shantou 515041, Guangdong, China
| | - H B Guo
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
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Cong QQ, Wang Y, Liu J, Lan YF, Guo ZK, Yang JG, Li XD, Tian YP. Evaluation of Potato virus X mild mutants for cross protection against severe infection in China. Virol J 2019; 16:36. [PMID: 30894176 PMCID: PMC6425663 DOI: 10.1186/s12985-019-1143-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 11/09/2018] [Accepted: 03/12/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Cross protection is a promising alternative to control plant viral diseases. One critical factor limiting the application of cross protection is the availability of attenuated mutants or mild strains. Potato virus X (PVX) infects many crops and induces huge economic losses to agricultural production. However, researches on the variability and mechanism of PVX virulence are scarce. METHODS The mutants were obtained by introducing mutations into the RNA dependent RNA polymerase (RdRp) gene of PVX via site-directed mutagenesis. Attenuated mutants were screen according to their symptoms in Nicotiana benthamiana plants. The protection efficacy against severe infection were evaluated with interval of 5, 10 and 15 days. RESULTS Among the 40 mutants obtained, four mutants carrying substitutions of either Glu46, Asn863, Asn968 or Glu1001 to Ala in PVX RdRp showed drastically attenuated symptom, accompanying with reduced accumulation levels of coat protein, plus- and minus-sense RNAs. When the interval between protective and challenging inoculations was 15 days, mutant E1001A (with substitution of Glu1001 to Ala in RdRp) provided complete protection against severe infection in both Nicotiana benthamiana and tomato, while E46A (Glu46 mutated to Ala) provided incomplete protection. To reduce the risk of reverse mutation, we constructed mutant dM which carries double mutations of both Glu46 and Glu1001 to Ala in RdRp. The mutant dM could provide effective protection against severe PVX infection. CONCLUSION Mutations of Glu46, Asn863, Asn968 or Glu1001 to Ala in PVX RdRp significantly reduced the viral symptoms. Mutants E1001A and E46A could provide effective protection against wild type PVX in both Nicotiana benthamiana and tomato. These results provide theoretical and practical bases for the control of PVX via cross protection.
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Affiliation(s)
- Q. Q. Cong
- Shandong Province Key Laboratory of Agricultural Microbiology, Department of Plant Pathology, College of Plant Protection, Shandong Agricultural University, Tai’an, Shandong 271018 People’s Republic of China
- Key Laboratory of Tobacco Pest Monitoring Controlling & Integrated Management, Qingdao, 266101 China
- Tai’an Academy of Agricultural Sciences, Tai’an, 271000 Shandong China
| | - Y. Wang
- Shandong Province Key Laboratory of Agricultural Microbiology, Department of Plant Pathology, College of Plant Protection, Shandong Agricultural University, Tai’an, Shandong 271018 People’s Republic of China
| | - J. Liu
- Shandong Province Key Laboratory of Agricultural Microbiology, Department of Plant Pathology, College of Plant Protection, Shandong Agricultural University, Tai’an, Shandong 271018 People’s Republic of China
| | - Y. F. Lan
- Tai’an Academy of Agricultural Sciences, Tai’an, 271000 Shandong China
| | - Z. K. Guo
- Heilongjiang Academy of Agricultural Sciences, Mudanjiang, 157011 Heilongjiang China
| | - J. G. Yang
- Key Laboratory of Tobacco Pest Monitoring Controlling & Integrated Management, Qingdao, 266101 China
| | - X.-D. Li
- Shandong Province Key Laboratory of Agricultural Microbiology, Department of Plant Pathology, College of Plant Protection, Shandong Agricultural University, Tai’an, Shandong 271018 People’s Republic of China
| | - Y. P. Tian
- Shandong Province Key Laboratory of Agricultural Microbiology, Department of Plant Pathology, College of Plant Protection, Shandong Agricultural University, Tai’an, Shandong 271018 People’s Republic of China
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Li K, Zhang LH, Zhang H, Luo HQ, Lan YF, Shahzad M, Wang XQ, Mehmood K, Li JK. Prevalence, associated risk factors, and phylogenetic analysis of Echinococcus granulosus isolated from freerange Tibetan pigs in Tibet, China. Trop Biomed 2017; 34:903-910. [PMID: 33592960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The current study was performed to investigate the prevalence, associated risk factors exploration and phylogenetic analysis of Echinococcus granulosus (E. granulosus) genotypes isolated from Tibetan pigs. A total 373 Tibetan pigs were examined during 2014 and 2015, and the variables potentially associated with E. granulosus infection were explored with a multivariable logistic regression model. E. granulosus cysts (n=37) were collected from Tibetan pigs (lungs or livers). Fragments amplification of mitochondrial (mt) DNA of cox1 (shorter and longer) and atp6 were employed. The genotype of E. granulosus were identified by sequence and phylogenetic analysis. Results showed the prevalence of E. granulosus in Tibetan pigs was 9.9%. The prevalence of E. granulosus in male and female Tibetan pigs was 6.8% and 13.3%, with a significant difference in the two genders (P<0.05). In different seasons, the infection rate of E. granulosus in Tibetan pigs were ranged from 5.8% to 12.3%. E. granulosus infection rates in different growing stages of Tibetan pigs were ranged from 4.4% to 15.9%, with a statistical difference in the three stages (P<0.01). The prevalence of E. granulosus in Tibetan pigs were 7.9% in 2014 and 13.0% in 2015. Genders and growing stages were demonstrated to be risk factors to influence the prevalence significantly through multivariable logistic regression model. All the three fragments were successfully amplified from each of the 37 cysts. E. granulosus genotypes of G4 and G6 were identified by comparing with reference sequences of E. genotypes available at NCBI database and phylogenetic analysis by using MEGA software.
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Affiliation(s)
- K Li
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - L H Zhang
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - H Zhang
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - H Q Luo
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - Y F Lan
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - M Shahzad
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
- University College of Veterinary and Animal Sciences, The Islamia University of Bahawalpur, Bahawalpur, 631000, Pakistan
| | - X Q Wang
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
- DeQing Animal Husbandary and Veterinary Bureau, Huzhou, 313299, People's Republic of China
| | - K Mehmood
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
- University College of Veterinary and Animal Sciences, The Islamia University of Bahawalpur, Bahawalpur, 631000, Pakistan
| | - J K Li
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
- Laboratory of Detection and Monitoring of Highland Animal Disease, Tibet Agriculture and Animal Husbandry College, Linzhi 860000 Tibet, People's Republic of China
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Luo HQ, Zhang H, Li K, Lan YF, Shahzad M, Wang XQ, Khalid M, Mujeeb R, Huang SC, Li JK, Yangzom QB. Molecular characterization of ascaris from Tibetan pigs by three mitochondrial markers of nad1, cox1 and cox2. Trop Biomed 2017; 34:576-582. [PMID: 33592926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Ascaris is a helminthic parasite, which infects a wide range of host species causing ascariasis, a predominant disease worldwide. This parasite causes significant economic losses to the pig industry. The current study was designed to determine the Ascaris nematode by the genetic characterization of three mitochondrial (mt) genes namely NADH dehydrogenase subunit 1 (nad1), cytochrome oxidase subunit 1 (cox1) and cytochrome oxidase subunit 2 (cox2). A high infection rate of Ascaris nematode has been found in Tibetan pigs at the slaughter houses in Tibet Autonomous Region of China. The nad1, cox1 and cox2 genes sequences collected from adult Ascaris individuals were amplified by polymerase chain reaction. The cloned-amplicons and the positive products were sequenced and phylogenetic analysis was performed. The results indicated that the Ascaris infecting the Tibetan pigs were Ascaris suum (A. suum). This is the first report on the isolation, identification and genetic characterization of three mitochondrial genomes (nad1, cox1, and cox2) of A. suum originated from Tibetan pigs at high altitudes in Tibet.
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Affiliation(s)
- H Q Luo
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, PR China
- College of Animal Science, Wenzhou Vocational College of Science and Technology, Wenzhou 325006, PR China
| | - H Zhang
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, PR China
| | - K Li
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, PR China
| | - Y F Lan
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, PR China
| | - M Shahzad
- University College of Veterinary and Animal Sciences, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - X Q Wang
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, PR China
| | - M Khalid
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, PR China
| | - R Mujeeb
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, PR China
| | - S C Huang
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, PR China
| | - J K Li
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, PR China
- Laboratory of Detection and Monitoring of Highland Animal Disease, XiZang Agriculture and Animal Husbandry College, Linzhi 860000 Tibet, PR China
| | - Q B Yangzom
- Laboratory of Detection and Monitoring of Highland Animal Disease, XiZang Agriculture and Animal Husbandry College, Linzhi 860000 Tibet, PR China
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Luo HQ, Li K, Zhang H, Lan YF, Peng JP, Shahzad M, Wang JX. Seroprevalence of bluetongue virus infection in goats in the central China. Trop Biomed 2017; 34:80-83. [PMID: 33592984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Seroprevalence of Bluetongue virus (BTV) in goats from Hubei was investigated by a commercial competitive enzyme-linked immunosorbent assay kits. Blood samples (n= 1157) were collected during the year 2014 and 2015. The results showed that 13.31% (CI 95% 11.4%-15.4%) serum samples were positive for BTV antibodies in goats in Hubei. The prevalence of BTV antibodies in each region ranged from 1.32% to 27.70%, and differences among the regions were statistically significant (p < 0.01). The prevalence of BTV in male and female goats was 14.23% (95% CI: 11.3, 17.6) and 12.58% (95% CI: 10.1, 15.4), respectively, no significant difference in genders (p > 0.05). In different seasons, the seroprevalence were 8.94% (95% CI: 5.6, 13.3) in spring; 18.31% (95% CI: 14.5, 22.7) in summer; 23.08% (95% CI: 17.0, 30.2) in autumn and 6.98% (95% CI: 4.6, 10.0) in winter, respectively with a significant difference of the prevalence in the different seasons (p < 0.01).
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Affiliation(s)
- H Q Luo
- College of Animal Sciences, Wenzhou Vocational College of Science and Technology, Wenzhou 325006, People's Republic of China
| | - K Li
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - H Zhang
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - Y F Lan
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, People's Republic of China
| | - J P Peng
- China Agricultural University, College of Veterinary Medicine, Beijing 100083, People's Republic of China
| | - M Shahzad
- University College of Veterinary and Animal Sciences, The Islamia University of Bahawalpur, 63100 Pakistan
| | - J X Wang
- College of Animal Science, Yangtze University, Jingzhou 434023, People's Republic of China
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Abstract
Cucumber mosaic virus (CMV) isolates are currently divided into two main groups, I and II according to their genomic sequences. The group I is further divided into two subgroups IA and IB. We performed a phylogenetic analysis of the genome regions containing 1a, 2a, 2b, coat protein (CP), and movement protein (MP) genes of 5 CMV isolates from China and other 28 CMV isolates available in the GenBank. The results indicated that CMV isolates could be genetically divided into three groups I, II, and III according to the genes encoding MP, CP, 1a, and 2a proteins and to the 2 groups according to the gene 2b. Group I could be further divided into two subgroups (IA and IB) according to the genes encoding CP, MP, 2a, and 2b proteins and to the three subgroups (IA, IB, and IC) according to the gene encoding 1a protein. Four of 5 examined Chinese CMV isolates belonged to the subgroup IB, while the remaining isolate was a natural inter-subgroup reassortant. We found that the 2b gene of CMV was under positive selection, while the other genes were under negative selection. No evidence of the selection associated with a host adaptation or geographic distribution was found.
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Affiliation(s)
- Y Y Liu
- Department of Plant Pathology, College of Plant Protection, Shandong Agricultural University, Shandong, PR China
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Abstract
The effect of valvular and subvalvular morphologic features and balloon size/mitral anulus size ratio on results of valvuloplasty were prospectively studied in 38 consecutive patients undergoing mitral valvuloplasty. The severity of valvular and subvalvular disease was graded echocardiographically from grade I to IV (mild to severe) for immobility, thickening, calcification of mitral leaflets and subvalvular thickening and fusion, yielding a maximal total score of 16. The diastolic mitral anulus diameter was measured in the apical four chamber view. After valvuloplasty, the mitral valve area increased from 0.9 +/- 0.3 to 2.2 +/- 0.5 cm2 (p less than 0.001) with increasing mitral regurgitation in 12 (32%) of the 38 patients. Multiple stepwise analysis revealed that the ratio of balloon size and annular size and the severity of subvalvular disease are two independent factors that correlated significantly with the mitral valve area after valvuloplasty (multiple r = 0.65, p less than 0.0002). One of 34 patients with mild subvalvular disease of grade III or less had an unsatisfactory increase in mitral valve area to less than or equal to 1.5 cm2, whereas 3 of 4 patients with severe (grade IV) subvalvular disease had a valve area less than or equal to 1.5 cm2 (p less than 0.002) after valvuloplasty. The increase in mitral regurgitation after valvuloplasty correlated significantly with the ratio of balloon to mitral anulus size and the severity of subvalvular disease (multiple r = 0.53, p less than 0.003). (ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C G Chen
- Fujian Medical College, Fuzhou, People's Republic of China
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Abstract
Percutaneous balloon valvotomy by means of a new sequential single- and and double-balloon dilatation procedure was performed in 23 patients (aged 13 to 53 years) with severe rheumatic mitral stenosis. The dilatation procedure was initially performed with a small balloon to primarily dilate the stenotic valve for easier passage of a second balloon catheter and to make the procedure tolerable for severely ill patients; the procedure was then followed by two balloons to further increase the mitral valve area (MVA) for effective dilatation of the stenotic mitral orifice. The dilatation was successful in all patients; the mitral valve pressure gradient decreased from 19 +/ 6 to 5 +/ 2 mm Hg, the cardiac output increased from 4.0 +/ 0.5 to 5.2 +/ 0.6 L/min, and the MVA increased from 0.8 +/ 0.2 to 1.9 +/ 0.4 cm2 (p less than 0.01 each). The MVA after dilatation was relative to the effective balloon dilatation diameter selected (r = 0.57; p less 0.01). A small atrial septal defect was observed in 3 of 23 patients immediately after the dilatation procedure. Mild mitral regurgitation was produced in 3 of 23 patients by the dilatation. We conclude that the sequential single- and double-balloon dilatation procedure can effectively increase the MVA and improve hemodynamics in severe mitral stenosis and that the larger effective balloon diameter of 24.8 mm or more (12 +/ 18 mm of two balloons) is necessary for effective dilatation.
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Affiliation(s)
- C G Chen
- Cardiovasclar Center, Fujian Medical College, People's Republic of China
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