2
|
Zhou W, Teklu M, Bui V, Manyak GA, Kapoor P, Dey AK, Sorokin AV, Patel N, Teague HL, Playford MP, Erb-Alvarez J, Rodante JA, Keel A, Shanbhag SM, Hsu LY, Bluemke DA, Chen MY, Carlsson M, Mehta NN. The relationship between systemic inflammation and increased left ventricular mass is partly mediated by noncalcified coronary artery disease burden in psoriasis. Am J Prev Cardiol 2021; 7:100211. [PMID: 34611643 PMCID: PMC8387288 DOI: 10.1016/j.ajpc.2021.100211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 12/12/2022] Open
Abstract
Objective Increased left ventricular (LV) mass is an important precursor to heart failure. Inflammation plays an important role in increasing LV mass. However, the contribution of subclinical coronary artery disease (CAD) to the inflammation-LV mass relationship is unknown. In subjects with psoriasis, a chronic inflammatory skin disease, we evaluated if systemic inflammation assessed by plasma glycoprotein A (GlycA) associated with LV mass measured on coronary CT angiography (CCTA). Additionally, we analyzed whether this relationship was mediated by early CAD assessed as noncalcified coronary burden (NCB). Methods We performed an observational longitudinal study of 213 subjects with psoriasis free of known cardiovascular disease, 189 of whom were followed over one year. All participants had GlycA measurements by nuclear magnetic resonance spectroscopy and LV mass and NCB quantified by CCTA. Results The cohort had a mean age of 50.3 (±12.9) years and 59% were male. There was moderate psoriasis severity and low cardiovascular risk. LV mass increased by GlycA tertiles [1st tertile:24.6 g/m2.7(3.8), 2nd tertile:25.5 g/m2.7(3.8), 3rd tertile:27.7 g/m2.7(5.5), p<0.001]. Both GlycA (β=0.24, p = 0.001) and NCB (β=0.50, p<0.001) associated with LV mass in models adjusted for age, sex, hypertension, hypertension therapy, lipid therapy, biologic therapy for psoriasis, waist:hip ratio, psoriasis disease duration and severity. In multivariable-adjusted mediation analyses, NCB accounted for 32% of the GlycA-LV mass relationship. Finally, over one year, change in NCB independently associated with change in LV mass (β=0.25, p = 0.002). Conclusions Both systemic inflammation and coronary artery NCB were associated with LV mass beyond cardiovascular risk factors in psoriasis. Furthermore, a substantial proportion of the inflammatory-LV mass relationship was mediated by NCB. These findings underscore the possible contribution of early coronary artery disease to the relationship between systemic inflammation and LV mass.
Collapse
Affiliation(s)
- Wunan Zhou
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Meron Teklu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Vy Bui
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Grigory A Manyak
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Promita Kapoor
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Amit K Dey
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Alexander V Sorokin
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Nidhi Patel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Heather L Teague
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Martin P Playford
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Julie Erb-Alvarez
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Justin A Rodante
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Andrew Keel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Sujata M Shanbhag
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Li-Yueh Hsu
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - David A Bluemke
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Marcus Y Chen
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Marcus Carlsson
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Nehal N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| |
Collapse
|
3
|
Ramos G, Bulnes J, Lindefjeld D, Herrera S, Gabrielli L. Coronary Ostia Localization by 3-Dimensional Transesophageal Echocardiography in a Patient With Quadricuspid Aortic Valve. JACC Case Rep 2021; 3:928-931. [PMID: 34317657 PMCID: PMC8311275 DOI: 10.1016/j.jaccas.2021.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/05/2021] [Accepted: 04/12/2021] [Indexed: 11/25/2022]
Abstract
Quadricuspid aortic valve is rare and requires surgery when symptomatic severe regurgitation/stenosis is present. Associated anomalous coronary ostia location demands accurate diagnosis to avoid intraoperative complications, and several imaging techniques have been used, with drawbacks of low sensitivity, radiation and contrast exposure. We report a pre-operative assessment using 3-dimensional echocardiography. (Level of Difficulty: Intermediate.)
Collapse
Key Words
- 3-dimensional imaging
- 3D, 3-dimensional
- AR, aortic regurgitation
- AV, aortic valve
- CCTA, cardiac computed tomography angiography
- CMR, cardiac magnetic resonance
- CO, coronary ostia/ostium
- COA, coronary ostia/ostium anomaly
- LV, left ventricular
- QAV, quadricuspid aortic valve
- TEE, transesophageal echocardiography
- TTE, transthoracic echocardiography
- aortic valve
- congenital heart defect
- coronary vessel anomaly
- echocardiography
Collapse
Affiliation(s)
- Germán Ramos
- Department of Cardiology, Fundación Arturo López Pérez, Santiago, Chile
- Echocardiography Laboratory, Hospital Dr. Sótero del Río, Santiago, Chile
- Department of Cardiology, Hospital Dr. Sótero del Río, Santiago, Chile
- Address for correspondence: Dr. Germán Ramos, Department of Cardiology, Hospital Dr. Sótero del Río, 3459 Concha y Toro Avenue, Puente Alto, Santiago 8207257, Chile.
| | - Juan Bulnes
- Division of Cardiovascular Diseases, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Sebastián Herrera
- Echocardiography Laboratory, Hospital Dr. Sótero del Río, Santiago, Chile
- Department of Cardiology, Hospital Dr. Sótero del Río, Santiago, Chile
| | - Luigi Gabrielli
- Division of Cardiovascular Diseases, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases (ACCDiS), Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|
4
|
Imaizumi T, Takata K, Ike A, Idemoto Y, Shiga Y, Sugihara M, Matsunaga A, Miura SI. A Continuous Murmur as the Only Clinical Sign for Complex Coronary Artery Fistulas Diagnosis. JACC Case Rep 2021; 3:740-744. [PMID: 34317617 PMCID: PMC8311187 DOI: 10.1016/j.jaccas.2021.03.007] [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] [Received: 05/27/2020] [Revised: 02/08/2021] [Accepted: 03/12/2021] [Indexed: 11/24/2022]
Abstract
An asymptomatic patient presented at our hospital exhibiting a Brugada electrocardiography pattern with coronary artery fistulas. Coronary artery fistula is a congenital or acquired rare abnormal condition with increased symptoms and complications over time. In the absence of the therapeutic consensus, we discuss the association and management for this condition. (Level of Difficulty: Advanced.).
Collapse
Key Words
- BA, bronchial artery
- BrP, Brugada phenocopy
- BrS, Brugada syndrome
- CAF, coronary artery fistula
- CAG, coronary angiography
- CBF, coronary artery–to–bronchial artery fistula
- CCTA, cardiac computed tomography angiography
- ECG, electrocardiography
- IE, infectious endocarditis
- LAD, left anterior descending artery
- LMT, left main trunk
- PT, pulmonary trunk
- TTE, transthoracic echocardiography
- coronary vessel anomaly
- electrocardiogram
- murmur
Collapse
Affiliation(s)
- Tomoki Imaizumi
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
| | - Kohei Takata
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
- Department of Laboratory Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Amane Ike
- Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, Chikushino, Japan
| | - Yoshiaki Idemoto
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
| | - Yuhei Shiga
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
| | - Makoto Sugihara
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
| | - Akira Matsunaga
- Department of Laboratory Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Shin-ichiro Miura
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
- Department of Cardiology, Fukuoka University Nishijin Hospital, Fukuoka, Japan
| |
Collapse
|