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Nordén ES, Veras I, Yadav P, Løken K, Dishington H, Thorstensen C, Sjaastad I, Rasmussen H. Clinical efficacy of buprenorphine after oral dosing in rats undergoing major surgery. Lab Anim 2024; 58:34-43. [PMID: 37669442 PMCID: PMC10919059 DOI: 10.1177/00236772231178417] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/09/2023] [Indexed: 09/07/2023]
Abstract
Serum corticosterone, serum buprenorphine, body weight change, consumption of food and water and behaviour-based pain assessment were measured in catheterised and non-catheterised male Wistar rats undergoing myocardial infarct (MI) surgery under general anaesthesia following buprenorphine dosing by subcutaneous (Bup-SC, 0.05 mg/kg) and oral (Bup-O, 0.4 mg/kg) routes. Buprenorphine was dosed subcutaneously at half an hour before and 8, 16 and 24 hours after surgery (Bup-SC), orally at one hour before surgery (Bup-O1) or at one hour before and 12 hours after surgery (Bup-O2) in catheterised rats and at one hour before and 24 hours after surgery (Bup-O24) in non-catheterised rats. Serum corticosterone, body weight changes and food and water consumption were not significantly different between treatments in catheterised rats. Bup-SC resulted in rapidly decreasing serum concentrations below the clinically effective concentrations (1 ng/mL) already at two hours after the first dose. Bup-O provided significantly higher and slowly decreasing serum concentrations, at or above clinically effective concentrations, for 24 hours (Bup-O1) and 42 hours (Bup-O2) after surgery. In non-catheterised rats, body weight development and food consumption were significantly higher in Bup-O24 rats compared to Bup-SC rats. The results indicate that a SC buprenorphine dose of 0.05 mg/kg every eight hours provides long periods of serum concentrations below clinically effective levels, and that a higher dose and/or more frequent dosage are required to provide stable serum concentrations at or above clinically effective levels. A single oral buprenorphine dose of 0.4 mg/kg provides clinically effective and stable serum concentrations for 24 hours in rats after MI surgery.
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Affiliation(s)
- Einar Sjaastad Nordén
- Institute for Experimental Medical Research, Oslo University Hospital, Norway
- K. G. Jebsen Centre for Cardiac Research, University of Oslo, Norway
| | - Ioanni Veras
- Department of Molecular Medicine, University of Oslo, Norway
| | - Prakash Yadav
- Department of Comparative Medicine, Oslo University Hospital, Norway
| | - Kari Løken
- Department of Comparative Medicine, Oslo University Hospital, Norway
| | - Hilde Dishington
- Institute for Experimental Medical Research, Oslo University Hospital, Norway
- K. G. Jebsen Centre for Cardiac Research, University of Oslo, Norway
| | | | - Ivar Sjaastad
- Institute for Experimental Medical Research, Oslo University Hospital, Norway
- K. G. Jebsen Centre for Cardiac Research, University of Oslo, Norway
| | - Henrik Rasmussen
- Department of Comparative Medicine, Oslo University Hospital, Norway
- Institute of Clinical Medicine, University of Oslo, Norway
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2
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Kalenikova EI, Gorodetskaya EA, Povarova OV, Medvedev OS. Prospects of Intravenous Coenzyme Q10 Administration in Emergency Ischemic Conditions. Life (Basel) 2024; 14:134. [PMID: 38255749 PMCID: PMC10817270 DOI: 10.3390/life14010134] [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: 12/12/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 01/24/2024] Open
Abstract
Coenzyme CoQ10 (CoQ10) is an endogenous lipid-soluble antioxidant that effectively protects lipids, proteins, and DNA from oxidation due to its ability to undergo redox transitions between oxidized and reduced forms. Various oxidative stress-associated infectious and somatic diseases have been observed to disrupt the balance of CoQ10 concentration in tissues. As a high molecular weight polar lipophilic compound, CoQ10 exhibits very limited oral bioavailability, which restrains its therapeutic potential. Nevertheless, numerous studies have confirmed the clinical efficacy of CoQ10 therapy through oral administration of high doses over extended time periods. Experimental studies have demonstrated that in emergency situations, intravenous administration of both oxidized and reduced-form CoQ10 leads to a rapid increase in its concentration in organ tissues, offering protection for organ tissues in ischemic conditions. This suggests that the cardio- and neuroprotective efficacy of intravenously administered CoQ10 forms could present new opportunities in treating acute ischemic conditions. Based on these findings, the review provides reasoning supporting further research and implementation of CoQ10 dosage forms for intravenous administration in emergency situations into clinical practice.
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Affiliation(s)
- Elena I. Kalenikova
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia; (E.I.K.); (E.A.G.); (O.S.M.)
| | - Evgeniya A. Gorodetskaya
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia; (E.I.K.); (E.A.G.); (O.S.M.)
| | - Oxana V. Povarova
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia; (E.I.K.); (E.A.G.); (O.S.M.)
| | - Oleg S. Medvedev
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia; (E.I.K.); (E.A.G.); (O.S.M.)
- National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation, Laboratory of Experimental Pharmacology, 121552 Moscow, Russia
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3
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Sahoglu SG, Kazci YE, Karadogan B, Aydin MS, Nebol A, Turhan MU, Ozturk G, Cagavi E. High-resolution mapping of sensory fibers at the healthy and post- myocardial infarct whole transgenic hearts. J Neurosci Res 2023; 101:338-353. [PMID: 36517461 DOI: 10.1002/jnr.25150] [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: 07/07/2022] [Revised: 10/15/2022] [Accepted: 11/19/2022] [Indexed: 12/23/2022]
Abstract
The sensory nervous system is critical to maintain cardiac function. As opposed to efferent innervation, less is known about cardiac afferents. For this, we mapped the VGLUT2-expressing cardiac afferent fibers of spinal and vagal origin by using the VGLUT2::tdTomato double transgenic mouse as an approach to visualize the whole hearts both at the dorsal and ventral sides. For comparison, we colabeled mixed-sex transgenic hearts with either TUJ1 protein for global cardiac innervation or tyrosine hydroxylase for the sympathetic network at the healthy state or following ischemic injury. Interestingly, the nerve density for global and VGLUT2-expressing afferents was found significantly higher on the dorsal side compared to the ventral side. From the global nerve innervation detected by TUJ1 immunoreactivity, VGLUT2 afferent innervation was detected to be 15-25% of the total network. The detailed characterization of both the atria and the ventricles revealed a remarkable diversity of spinal afferent nerve ending morphologies of flower sprays, intramuscular endings, and end-net branches that innervate distinct anatomical parts of the heart. Using this integrative approach in a chronic myocardial infarct model, we showed a significant increase in hyperinnervation in the form of axonal sprouts for cardiac afferents at the infarct border zone, as well as denervation at distal sites of the ischemic area. The functional and physiological consequences of the abnormal sensory innervation remodeling post-ischemic injury should be further evaluated in future studies regarding their potential contribution to cardiac dysfunction.
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Affiliation(s)
- Sevilay Goktas Sahoglu
- Regenerative and Restorative Medical Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Turkey.,Neuroscience Program, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey.,Department of Medical Biology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Yusuf Enes Kazci
- Regenerative and Restorative Medical Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Turkey.,Neuroscience Program, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey.,Department of Medical Biology, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Behnaz Karadogan
- Regenerative and Restorative Medical Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Turkey
| | - Mehmet Serif Aydin
- Regenerative and Restorative Medical Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Turkey
| | - Aylin Nebol
- Regenerative and Restorative Medical Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Turkey.,Department of Medical Biology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.,Medical Biology and Genetics Program, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Mehmet Ugurcan Turhan
- Department of Cardiovascular Surgery, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Gurkan Ozturk
- Regenerative and Restorative Medical Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Turkey.,Department of Physiology, International School of Medicine, Istanbul Medipol University, İstanbul, Turkey
| | - Esra Cagavi
- Regenerative and Restorative Medical Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Turkey.,Department of Medical Biology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.,Department of Medical Biology, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey.,Medical Biology and Genetics Program, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
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Gökduman A, Yel I, Vogl TJ, Dimitrova M, Grünewald LD, Koch V, Alizadeh LS, Brendlin AS, Othman AE, Martin SS, D'Angelo T, Blandino A, Mazziotti S, Booz C. Diagnosis of an Acute Anterior Wall Infarction in Dual-Energy CT. Diagnostics (Basel) 2023; 13. [PMID: 36832249 DOI: 10.3390/diagnostics13040761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/19/2023] Open
Abstract
Due to its high morbidity and mortality, myocardial infarction is the leading cause of death worldwide. Against this background, rapid diagnosis is of immense importance. Especially in case of an atypical course, the correct diagnosis may be delayed and thus lead to increased mortality rates. In this report, we present a complex case of acute coronary syndrome. A triple-rule-out CT examination was performed in dual-energy CT (DECT) mode. While pulmonary artery embolism and aortic dissection could be ruled out with conventional CT series, the presence of anterior wall infarction was only detectable on DECT reconstructions. Subsequently, adequate and rapid therapy was then initiated leading to survival of the patient.
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Beetler DJ, Bruno KA, Di Florio DN, Douglass EJ, Shrestha S, Tschöpe C, Cunningham MW, Krejčí J, Bienertová-Vašků J, Pankuweit S, McNamara DM, Jeon ES, van Linthout S, Blauwet LA, Cooper LT, Fairweather D. Sex and age differences in sST2 in cardiovascular disease. Front Cardiovasc Med 2023; 9:1073814. [PMID: 36741845 PMCID: PMC9889877 DOI: 10.3389/fcvm.2022.1073814] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/23/2022] [Indexed: 01/19/2023] Open
Abstract
Aims The goal of this study was to determine whether sex and age differences exist for soluble ST2 (sST2) for several cardiovascular diseases (CVDs). Methods We examined sST2 levels using an ELISA kit for myocarditis (n = 303), cardiomyopathy (n = 293), coronary artery disease (CAD) (n = 239), myocardial infarct (MI) (n = 159), and congestive heart failure (CHF) (n = 286) and compared them to controls that did not have CVDs (n = 234). Results Myocarditis occurred in this study in relatively young patients around age 40 while the other CVDs occurred more often in older individuals around age 60. We observed a sex difference in sST2 by age only in myocarditis patients (men aged 38, women 46, p = 0.0002), but not for other CVDs. Sera sST2 levels were significantly elevated compared to age-matched controls for all CVDs: myocarditis (p ≤ 0.0001), cardiomyopathy (p = 0.0009), CAD (p = 0.03), MI (p = 0.034), and CHF (p < 0.0001) driven by elevated sST2 levels in females for all CVDs except myocarditis, which was elevated in both females (p = 0.002) and males (p ≤ 0.0001). Sex differences in sST2 levels were found for myocarditis and cardiomyopathy but no other CVDs and were higher in males (myocarditis p = 0.0035; cardiomyopathy p = 0.0047). sST2 levels were higher in women with myocarditis over 50 years of age compared to men (p = 0.0004) or women under 50 years of age (p = 0.015). In cardiomyopathy and MI patients, men over 50 had significantly higher levels of sST2 than women (p = 0.012 and p = 0.043, respectively) but sex and age differences were not detected in other CVDs. However, women with cardiomyopathy that experienced early menopause had higher sST2 levels than those who underwent menopause at a natural age range (p = 0.02). Conclusion We found that sex and age differences in sera sST2 exist for myocarditis, cardiomyopathy, and MI, but were not observed in other CVDs including CAD and CHF. These initial findings in patients with self-reported CVDs indicate that more research is needed into sex and age differences in sST2 levels in individual CVDs.
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Affiliation(s)
- Danielle J. Beetler
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States,Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States,Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Jacksonville, FL, United States
| | - Katelyn A. Bruno
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States,Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, United States
| | - Damian N. Di Florio
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States,Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States,Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Jacksonville, FL, United States
| | - Erika J. Douglass
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Swikriti Shrestha
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States,Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Jacksonville, FL, United States,Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, United States
| | - Carsten Tschöpe
- Berlin Institute of Health (BIH) at Charité – Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany,German Centre for Cardiovascular Research, Berlin, Germany,Department of Cardiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Madeleine W. Cunningham
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jan Krejčí
- First Department of Internal Medicine and Cardioangiology, St. Anne’s University Hospital, Brno, Czechia,Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Julie Bienertová-Vašků
- Incubator of Kinanthropology Research, Faculty of Sports, Masaryk University, Brno, Czechia,Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Sabine Pankuweit
- Department Internal Medicine-Cardiology, Philipps-University of Marburg, Marburg, Germany
| | - Dennis M. McNamara
- Division of Cardiology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States,University of Pittsburgh Medical Center (UPMC), Heart and Vascular Institute, Pittsburgh, PA, United States
| | - Eun-Seok Jeon
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sophie van Linthout
- Berlin Institute of Health (BIH) at Charité – Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany,German Centre for Cardiovascular Research, Berlin, Germany
| | | | - Leslie T. Cooper
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - DeLisa Fairweather
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States,Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States,Department of Environmental Health Sciences and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States,*Correspondence: DeLisa Fairweather,
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6
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Mrázová J, Kopčeková J. Evaluation of cardiovascular diseases risk factors in a group of men hospitalized after myocardial infarction. Rocz Panstw Zakl Hig 2022; 73:485-493. [PMID: 36547225 DOI: 10.32394/rpzh.2022.0233] [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] [Indexed: 12/24/2022] Open
Abstract
Background Cardiovascular diseases (CVD) due to their large expansion and high mortality represent a serious problem for society. Ischemic heart disease and myocardial infarction is the leading cause of death and morbidity in both men and women in Europe, although is lower in women than in men. Objective To evaluate the occurrence of cardiovascular risk factors and the impact of selected dietary habits on lipid profile and body mass index in adult men hospitalized after myocardial infarction in the Cardiocenter Nitra in 2010-2020. Material and Methods This study was focused on a group of adult men (n = 193) in the age range of 25 to 85 years. Patients were selected using the method of random selection from the database of those hospitalized in the Cardiocenter Nitra in 2010-2020. We evaluated to influence of risk factors of cardiovascular diseases on lipid profile and BMI of men. The questionnaire for the detection of dietary habits and life style of respondents was used. It was applied individually by interviewer and was compiled by the Institute of Nutrition and Genomics. Data collection was carried out simultaneously with a somatometric and biochemical examination of the respondents ensured by the Cardiocenter Nitra. The following parameters were tested: total cholesterol (T-C), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C) and triacylglycerols (TAG) and glucose (GLU) by automatic biochemical analyzer BioMajesty® JCA-BM6010/C. We used statistical analysis of Statistica Cz version 10 and one-way ANOVA, followed by Tukey's post hoc test. Results The most important risk factor is clearly the lifestyle of the respondents. Only 11% of the respondents had an optimal BMI, 51% were classified as overweight and up to 38% had a BMI higher than 30 kg.m-2. Improper dietary habits and lack of physical activity contributed to the development of hypertension and hypercholesterolaemia in the majority of respondents. Statistically significant changes in HDL-cholesterol scores were found to be associated with respondents'BMI (p< 0.01). Conclusions Studied men after the myocardial infarction should attach particular importance to their diet and lifestyle, which significantly affect BMI, blood lipid parameters and the inflammatory process as risk factors responsible for the etiopathogenesis of cardiovascular diseases.
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Affiliation(s)
- Jana Mrázová
- Slovak University of Agriculture in Nitra, Faculty of Agrobiology and Food Resources, Institute of Nutrition and Genomics, Nitra, Slovakia
| | - Jana Kopčeková
- Slovak University of Agriculture in Nitra, Faculty of Agrobiology and Food Resources, Institute of Nutrition and Genomics, Nitra, Slovakia
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Chong CZ, Tan BYQ, Sia CH, Khaing T, Litt Yeo LL. Simultaneous cardiocerebral infarctions: a five-year retrospective case series reviewing natural history. Singapore Med J 2022; 63:686-690. [PMID: 33866711 DOI: 10.11622/smedj.2021043] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Introduction Concurrent cardiocerebral infarction (CCI), a rare condition defined as simultaneous occlusions in the cerebrovascular and coronary vessels, has high mortality but very limited literature on optimum treatment methods. A better understanding of the natural history and effect of treatment would improve patient outcomes. Methods Using our prospective stroke database from 2014 to 2018, ten consecutive patients with CCI were identified (incidence = 0.29%). We recorded patient demographics, cardiovascular risk factors, cardiac and cerebral occlusions, circumstances of admission and management of each patient. Patient notes and imaging findings were reviewed to determine the underlying cause of CCI. Results Median National Institute of Health Stroke Scale score was 15 (range 4-27). Mean patient age was 59 years and 90% were men. Two patients were treated with intravenous tissue plasminogen activator (IV tPA) only and three underwent endovascular treatment in both the cerebral and coronary vessels sequentially. One patient underwent percutaneous coronary intervention (PCI) only and two underwent PCI after IV tPA therapy. Two patients were conservatively treated due to poor premorbid status. At the three-month follow-up, five patients had excellent functional outcomes (modified Rankin Scale 0-1) while three died. Conclusion CCI is a rare but devastating clinical scenario, with high incidence of morbidity and mortality. Treatment strategy can impact patient outcome, and further research is warranted on the ideal acute and post-reperfusion treatments for CCI. In this series, IV tPA at stroke doses appeared to be the preferred initial step for its treatment, with subsequent coronary or cerebral endovascular therapy, if necessary.
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Affiliation(s)
- Cheryl Zhiya Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Ching-Hui Sia
- Yong Loo Lin School of Medicine, National University of Singapore; Department of Cardiology, National University Heart Centre, Singapore
| | - Thet Khaing
- Department of Cardiology, National University Heart Centre, Singapore
| | - Leonard Leong Litt Yeo
- Yong Loo Lin School of Medicine, National University of Singapore; Division of Neurology, Department of Medicine, National University Health System, Singapore
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Shi H, El Kazzi M, Liu Y, Gao A, Schroder AL, Vuong S, Young PA, Rayner BS, Vreden C, King NJC, Witting PK. Multiplex analysis of mass imaging data: Application to the pathology of experimental myocardial infarction. Acta Physiol (Oxf) 2022; 235:e13790. [PMID: 35080155 PMCID: PMC9286669 DOI: 10.1111/apha.13790] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 10/18/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 12/28/2022]
Abstract
Aim Imaging mass cytometry (IMC) affords simultaneous immune‐labelling/imaging of multiple antigens in the same tissue. Methods utilizing multiplex data beyond co‐registration are lacking. This study developed and applied an innovative spatial analysis workflow for multiplex imaging data to IMC data determined from cardiac tissues and revealed the mechanism(s) of neutrophil‐mediated post‐myocardial‐infarction damage. Methods IMC produced multiplex images with various redox/inflammatory markers. The cardiac peri‐infarct zone (PIZ) was determined to be up to 240 µm from the infarct border based on the presence of neutrophils. The tissue region beyond the infarct was defined as the remote area (RA). ImageJ was used to quantify the immunoreactivity. Functional assessments included infarct size, cell necro/apoptosis, total thiol assay and echocardiogram. Results Expression of damage markers decreased in order from the infarct area to PIZ and then RA, reflecting the neutrophil density in the regions. Concentrically spaced “shoreline contour analysis” around the cardiac infarct extending into the PIZ showed that immunoreactivity for damage markers decreased linearly with increasing distance from the infarct, concomitant with a decreasing neutrophil‐myeloperoxidase (MPO) gradient from the infarct to the PIZ. Stratifying by concentric bands around individual MPO+‐signal identified that the immunoreactivity of haem‐oxygenase‐1 (HO‐1) and phosphorylated‐p38 mitogen‐activated protein kinase (pP38) peaked near neutrophils. Furthermore, spatial dependence between neutrophils and markers of cardiac cellular damage was confirmed by nearest‐neighbour distance analysis. Post‐infarction tissue exhibited declined functional parameters that were associated with neutrophil migration from the infarct to PIZ. Conclusion This image‐based quantitative protocol revealed the spatial association and provided potential molecular pathways responsible for neutrophil‐mediated damage post‐infarction.
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Affiliation(s)
- Han Shi
- Redox Biology Group Discipline of Pathology Faculty of Medicine and Health Charles Perkins Centre The University of Sydney Sydney New South Wales Australia
| | - Mary El Kazzi
- Redox Biology Group Discipline of Pathology Faculty of Medicine and Health Charles Perkins Centre The University of Sydney Sydney New South Wales Australia
| | - Yuyang Liu
- Redox Biology Group Discipline of Pathology Faculty of Medicine and Health Charles Perkins Centre The University of Sydney Sydney New South Wales Australia
| | - Antony Gao
- Redox Biology Group Discipline of Pathology Faculty of Medicine and Health Charles Perkins Centre The University of Sydney Sydney New South Wales Australia
| | - Angie L. Schroder
- Redox Biology Group Discipline of Pathology Faculty of Medicine and Health Charles Perkins Centre The University of Sydney Sydney New South Wales Australia
| | - Sally Vuong
- The Heart Research Institute Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
| | - Pamela A. Young
- Australian Centre for Microscopy & Microanalysis Charles Perkins Centre The University of Sydney Sydney New South Wales Australia
| | - Benjamin S. Rayner
- The Heart Research Institute Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
| | - Caryn Vreden
- Immunopathology Group Discipline of Pathology Faculty of Medicine and Health Charles Perkins Centre The University of Sydney Sydney New South Wales Australia
- Sydney Cytometry Facility and Ramaciotti Facility for Human Systems Biology The University of Sydney Sydney New South Wales Australia
| | - Nicholas J. C. King
- Immunopathology Group Discipline of Pathology Faculty of Medicine and Health Charles Perkins Centre The University of Sydney Sydney New South Wales Australia
- Sydney Cytometry Facility and Ramaciotti Facility for Human Systems Biology The University of Sydney Sydney New South Wales Australia
- Marie Bashir Institute for Infectious Disease and Biosecurity The University of Sydney Sydney New South Wales Australia
- The University of Sydney Nano Institute The University of Sydney Sydney New South Wales Australia
| | - Paul K. Witting
- Redox Biology Group Discipline of Pathology Faculty of Medicine and Health Charles Perkins Centre The University of Sydney Sydney New South Wales Australia
- The University of Sydney Nano Institute The University of Sydney Sydney New South Wales Australia
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Wang L, Zhang J. Layer-By-Layer Fabrication of Thicker and Larger Human Cardiac Muscle Patches for Cardiac Repair in Mice. Front Cardiovasc Med 2022; 8:800667. [PMID: 35071364 PMCID: PMC8770979 DOI: 10.3389/fcvm.2021.800667] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 10/23/2021] [Accepted: 12/13/2021] [Indexed: 02/06/2023] Open
Abstract
The engineered myocardial tissues produced via most manufacturing techniques are typically just a few dozen micrometers thick, which is too thin for therapeutic applications in patients. Here, we used a modified layer-by-layer (LBL) fabrication protocol to generate thick human cardiac muscle patches (hCMPs) with thicknesses of ~3.75 mm. The LBL-hCMPs were composed of a layer of endothelial cells (ECs) sandwiched between two layers of cardiomyocytes (CMs): both cell populations were differentiated from the same human induced pluripotent stem cell line (hiPSCs) and suspended in a fibrin matrix, and the individual layers were sutured together, leaving channels that allowed the culture medium to access the internal cell layer. The LBL-hCMPs were cultured on a dynamic culture platform with electrical stimulation, and when compared to Control-hCMPs consisting of the same total number of hiPSC-ECs and -CMs suspended in a single layer of fibrin, hiPSC-CMs in the LBL-hCMPs were qualitatively more mature with significantly longer sarcomeres and expressed significantly higher levels of mRNA transcripts for proteins that participate in cardiomyocyte contractile activity and calcium handing. Apoptotic cells were also less common in LBL- than in Control-hCMPs. The thickness of fabricated LBL-hCMP gradually decreased to 0.8 mm by day 28 in dynamic culture. When the hCMP constructs were compared in a mouse model of myocardial infarction, the LBL-hCMPs were associated with significantly better measurements of engraftment, cardiac function, infarct size, hypertrophy, and vascularity. Collectively these observations indicate that our modified LBL fabrication protocol produced thicker hCMPs with no decline in cell viability, and that LBL-hCMPs were more potent than Control-hCMPs for promoting myocardial repair in mice.
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Affiliation(s)
- Lu Wang
- Department of Biomedical Engineering, School of Medicine, School of Engineering, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jianyi Zhang
- Department of Biomedical Engineering, School of Medicine, School of Engineering, University of Alabama at Birmingham, Birmingham, AL, United States.,Division of Cardiovascular Disease, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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10
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Pittenger MF, Eghtesad S, Sanchez PG, Liu X, Wu Z, Chen L, Griffith BP. MSC Pretreatment for Improved Transplantation Viability Results in Improved Ventricular Function in Infarcted Hearts. Int J Mol Sci 2022; 23:694. [PMID: 35054878 PMCID: PMC8775864 DOI: 10.3390/ijms23020694] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 12/22/2022] Open
Abstract
Many clinical studies utilizing MSCs (mesenchymal stem cells, mesenchymal stromal cells, or multipotential stromal cells) are underway in multiple clinical settings; however, the ideal approach to prepare these cells in vitro and to deliver them to injury sites in vivo with maximal effectiveness remains a challenge. Here, pretreating MSCs with agents that block the apoptotic pathways were compared with untreated MSCs. The treatment effects were evaluated in the myocardial infarct setting following direct injection, and physiological parameters were examined at 4 weeks post-infarct in a rat permanent ligation model. The prosurvival treated MSCs were detected in the hearts in greater abundance at 1 week and 4 weeks than the untreated MSCs. The untreated MSCs improved ejection fraction in infarcted hearts from 61% to 77% and the prosurvival treated MSCs further improved ejection fraction to 83% of normal. The untreated MSCs improved fractional shortening in the infarcted heart from 52% to 68%, and the prosurvival treated MSCs further improved fractional shortening to 77% of normal. Further improvements in survival of the MSC dose seems possible. Thus, pretreating MSCs for improved in vivo survival has implications for MSC-based cardiac therapies and in other indications where improved cell survival may improve effectiveness.
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Affiliation(s)
- Mark F. Pittenger
- Department of Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.E.); (P.G.S.); (X.L.); (Z.W.)
| | - Saman Eghtesad
- Department of Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.E.); (P.G.S.); (X.L.); (Z.W.)
- Department of Biochemistry, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
| | - Pablo G. Sanchez
- Department of Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.E.); (P.G.S.); (X.L.); (Z.W.)
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15260, USA
| | - Xiaoyan Liu
- Department of Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.E.); (P.G.S.); (X.L.); (Z.W.)
| | - Zhongjun Wu
- Department of Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.E.); (P.G.S.); (X.L.); (Z.W.)
| | - Ling Chen
- Departments of Physiology and Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA;
| | - Bartley P. Griffith
- Department of Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.E.); (P.G.S.); (X.L.); (Z.W.)
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11
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Abstract
INTRODUCTION Patients with severe epilepsy are at increased risk of cardiovascular disease and arrhythmias. Although antiseizure medications (ASMs) may have indirect protective effects against cardiovascular events by reducing seizure frequency and hence sudden death in epilepsy, some of them exert cardiotoxic effects. AREAS COVERED Patients with epilepsy, mainly those with severe forms, are at higher risk of cardiac disease because their heart can have structural alterations and electrical instability as a consequence of repeated seizures. Some ASMs have direct protective effects through anti-inflammatory, antioxidant, hypotensive, and lipid-reducing properties. Antiseizure medications can also have toxic cardiac effects including both long-term consequences, such as the increased risk of atherogenesis and subsequent cardiovascular disease due to the influence on lipid profile and pro-inflammatory milieu, and immediate effects as the increased risk of potentially fatal arrhythmias due to the influence on ion channels. Sodium channel blocking ASMs may also affect cardiac sodium channels and this effect is particularly observed in subjects with genetic mutations in cardiac ion channels. Fenfluramine cause valvulopathies in obese subjects and this effect need to be evaluated in epilepsy patients. EXPERT OPINION For the selection of treatment, cardiotoxic effects of ASMs should be considered; cardiac monitoring of treatment is advisable.
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Affiliation(s)
- Gaetano Zaccara
- Department of Eidemiology, Regional Health Agency of Tuscany, Firenze, Italy
| | - Simona Lattanzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Francesco Brigo
- Department of Neurology, Hospital of Merano (Sabes-asdaa), Merano-Meran, Italy
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12
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Schussler O, Falcoz PE, Chachques JC, Alifano M, Lecarpentier Y. Possible Treatment of Myocardial Infarct Based on Tissue Engineering Using a Cellularized Solid Collagen Scaffold Functionalized with Arg-Glyc-Asp (RGD) Peptide. Int J Mol Sci 2021; 22:12563. [PMID: 34830447 DOI: 10.3390/ijms222212563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/23/2021] [Accepted: 11/15/2021] [Indexed: 12/13/2022] Open
Abstract
Currently, the clinical impact of cell therapy after a myocardial infarction (MI) is limited by low cell engraftment due to low cell retention, cell death in inflammatory and poor angiogenic infarcted areas, secondary migration. Cells interact with their microenvironment through integrin mechanoreceptors that control their survival/apoptosis/differentiation/migration and proliferation. The association of cells with a three-dimensional material may be a way to improve interactions with their integrins, and thus outcomes, especially if preparations are epicardially applied. In this review, we will focus on the rationale for using collagen as a polymer backbone for tissue engineering of a contractile tissue. Contractilities are reported for natural but not synthetic polymers and for naturals only for: collagen/gelatin/decellularized-tissue/fibrin/Matrigel™ and for different material states: hydrogels/gels/solids. To achieve a thick/long-term contractile tissue and for cell transfer, solid porous compliant scaffolds are superior to hydrogels or gels. Classical methods to produce solid scaffolds: electrospinning/freeze-drying/3D-printing/solvent-casting and methods to reinforce and/or maintain scaffold properties by reticulations are reported. We also highlight the possibility of improving integrin interaction between cells and their associated collagen by its functionalizing with the RGD-peptide. Using a contractile patch that can be applied epicardially may be a way of improving ventricular remodeling and limiting secondary cell migration.
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13
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Lan NSR, Nguyen LT, Vasikaran SD, Wilson C, Jonsson J, Rankin JM, Bell DA. Short- and long-term biological variation of cardiac troponin I in healthy individuals, and patients with end-stage renal failure requiring haemodialysis or cardiomyopathy. Clin Chem Lab Med 2021; 58:1941-1949. [PMID: 32598297 DOI: 10.1515/cclm-2020-0046] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/20/2020] [Indexed: 11/15/2022]
Abstract
Objectives High-sensitivity (hs) cardiac troponin (cTn) assays can quantitate small fluctuations in cTn concentration. Determining biological variation allows calculation of reference change values (RCV), to define significant changes. We assessed the short- and long-term biological variation of cardiac troponin I (cTnI) in healthy individuals and patients with renal failure requiring haemodialysis or cardiomyopathy. Methods Plasma samples were collected hourly for 4 h and weekly for seven further weeks from 20 healthy individuals, 9 renal failure patients and 20 cardiomyopathy patients. Pre- and post-haemodialysis samples were collected weekly for 7 weeks. Samples were analysed using a hs-cTnI assay (Abbott Alinity ci-series). Within-subject biological variation (CVI), analytical variation (CVA) and between-subject biological variation (CVG) was used to calculate RCVs and index of individuality (II). Results For healthy individuals, CVI, CVA, CVG, RCV and II values were 8.8, 14.0, 43.1, 45.8% and 0.38 respectively for short-term, and 41.4, 14.0, 25.8, 121.0% and 1.69 for long-term. For renal failure patients, these were 2.6, 5.8, 50.5, 17.6% and 0.30 respectively for short-term, and 19.1, 5.8, 11.2, 55.2% and 1.78 for long-term. For cardiomyopathy patients, these were 4.2, 10.0, 65.9, 30.0% and 0.16 respectively for short-term, and 17.5, 10.0, 63.1, 55.8% and 0.32 for long-term. Mean cTnI concentration was lower post-haemodialysis (15.2 vs. 17.8 ng/L, p < 0.0001), with a 16.9% mean relative change. Conclusions The biological variation of cTnI is similar between end-stage renal failure and cardiomyopathy patients, but proportionately greater in well-selected healthy individuals with very low baseline cTnI concentrations.
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Affiliation(s)
- Nick S R Lan
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia.,Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Lan T Nguyen
- Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Samuel D Vasikaran
- Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Fiona Stanley Hospital, Perth, Western Australia, Australia.,Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Catherine Wilson
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Jacqueline Jonsson
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - James M Rankin
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Damon A Bell
- Medical School, The University of Western Australia, Perth, Western Australia, Australia.,Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Fiona Stanley Hospital, Perth, Western Australia, Australia.,Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital, Perth, Western Australia, Australia.,Department of Cardiology, Lipid Disorders Clinic, Royal Perth Hospital, Perth, Western Australia, Australia.,Department of Clinical Biochemistry, Clinipath Pathology, Perth, Western Australia, Australia
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14
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Artemiou P, Gasparovic I, Bezak B, Hudec V, Glonek I, Hulman M. Mortality and risk factors after a surgical repair of postinfarction ventricular septal defect. ACTA ACUST UNITED AC 2021; 122:555-558. [PMID: 34282620 DOI: 10.4149/bll_2021_088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to present our experience in the treatment of post-myocardial infarction ventricular septal defect and examine the various risk factors. METHODS This is a retrospective study. From January 2010 to December 2018, 20 patients underwent an urgent /emergency surgical repair of post-myocardial infarction ventricular septal defect. RESULTS The mortality in our group of patients was 45 %. Non-survivors compared to the survivors were all in cardiogenic shock (p=0.0098), had an emergency/salvage operation (p=0.0055), preoperative mechanical ventilation (p=0.0081), shorter time between intraaortic balloon pressure insertion and surgery (p=0.0115), shorter median time between ventricular septal defect and surgery, postoperative renal replacement therapy (p=0.0498), and more patients had a residual effect (p=0.0022). In multivariate analysis, preoperative mechanical ventilation (p=0.0001), postoperative renal replacement therapy (p=0.0021) and residual defect (p=0.0000027) were shown to be strong predictors for hospital mortality. CONCLUSION This analysis showed that post-myocardial infarction ventricular septal defect repair is a devastating complication and preoperative mechanical ventilation, postoperative renal replacement therapy and residual defect were identified to be the predictors of mortality. Initial stabilization of the patients, when it is possible, and a delayed repair, may improve the outcome of these patients (Tab. 3, Ref. 17).
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15
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Fischer M, Zacherl MJ, Weckbach L, Paintmayer L, Weinberger T, Stark K, Massberg S, Bartenstein P, Lehner S, Schulz C, Todica A. Cardiac 18F-FDG Positron Emission Tomography: An Accurate Tool to Monitor In vivo Metabolic and Functional Alterations in Murine Myocardial Infarction. Front Cardiovasc Med 2021; 8:656742. [PMID: 34113662 PMCID: PMC8185215 DOI: 10.3389/fcvm.2021.656742] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/04/2021] [Indexed: 12/28/2022] Open
Abstract
Cardiac monitoring after murine myocardial infarction, using serial non-invasive cardiac 18F-FDG positron emissions tomography (PET) represents a suitable and accurate tool for in vivo studies. Cardiac PET imaging enables tracking metabolic alterations, heart function parameters and provides correlations of the infarct size to histology. ECG-gated 18F-FDG PET scans using a dedicated small-animal PET scanner were performed in mice at baseline, 3, 14, and 30 days after myocardial infarct (MI) by permanent ligation of the left anterior descending (LAD) artery. The percentage of the injected dose per gram (%ID/g) in the heart, left ventricular metabolic volume (LVMV), myocardial defect, and left ventricular function parameters: end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and the ejection fraction (EF%) were estimated. PET assessment of the defect positively correlates with post-infarct histology at 3 and 30 days. Infarcted murine hearts show an immediate decrease in LVMV and an increase in %ID/g early after infarction, diminishing in the remodeling process. This study of serial cardiac PET scans provides insight for murine myocardial infarction models by novel infarct surrogate parameters. It depicts that serial PET imaging is a valid, accurate, and multimodal non-invasive assessment.
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Affiliation(s)
- Maximilian Fischer
- Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Mathias J Zacherl
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
| | - Ludwig Weckbach
- Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Lisa Paintmayer
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
| | - Tobias Weinberger
- Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Konstantin Stark
- Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Steffen Massberg
- Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
| | - Sebastian Lehner
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany.,Ambulatory Healthcare Center Dr. Neumaier & Colleagues, Radiology, Nuclear Medicine, Radiation Therapy, Regensburg, Germany
| | - Christian Schulz
- Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Andrei Todica
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
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16
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Prakash V, Jaker S, Burgan A, Jacques A, Fluck D, Sharma P, Fry CH, Han TS. The smoking-dyslipidaemia dyad: A potent synergistic risk for atherosclerotic coronary artery disease. JRSM Cardiovasc Dis 2021; 10:2048004020980945. [PMID: 33796280 PMCID: PMC7968041 DOI: 10.1177/2048004020980945] [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: 09/16/2020] [Revised: 11/09/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Smoking and dyslipidaemia are known individual risk factors of coronary artery disease (CAD). The present study examined the combined risk of smoking and dyslipidaemia on coronary atherosclerosis. METHODS Coronary artery calcium (CAC), measured by cardiac CT, was used to assess the extent of CAD, which was related to smoking and dyslipidaemia using logistic regression, adjusted for age, sex, hypertension, BMI and family history of ischaemic heart disease. RESULTS Seventy-one patients (46 men, 25 women: median age of 53.7yrs; IQR = 47.0-59.5) were recruited. The mean log10 CAC score in never-smokers without dyslipidaemia (reference group) was 0.37 (SD = 0.73), while the value in those with a history of smoking was 0.44 ± 0.48 (mean difference: 0.07, 95%CI:-0.67 to 0.81, p = 0.844), dyslipidaemia was 1.07 ± 1.08 (mean difference: 0.71, 95%CI: 0.24 to 1.17, p = 0.003), and both risk factors was 1.82 ± 0.64 (mean difference: 1.45, 95%CI:0.88 to 2.02, p < 0.001). For individuals in the reference group, the proportions with none, one and multiple vessel disease were 80.6%, 16.1% and 3.2%; for those with a history of smoking or with dyslipidaemia were 50.0%, 25.0% and 25.0%; and for those with both risk factors were 8.3%, 25.0% and 66.7%. Patients with a history of both risk factors had greater adjusted risks of having one- vessel disease - OR = 14.3 (95%CI = 2.1-98.2) or multiple vessel disease: OR = 51.8 (95%CI = 4.2-609.6). CONCLUSIONS Smoking and dyslipidaemia together are associated with high coronary artery calcification and CAD, independent of other major risk factors.
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Affiliation(s)
- Vineet Prakash
- Department of Radiology, Ashford & St Peter’s Foundation Trust, Chertsey, UK
- Diagnostic Imaging, Royal Surrey County Hospital, Guildford, UK
| | - Sams Jaker
- Department of Radiology, Ashford & St Peter’s Foundation Trust, Chertsey, UK
| | - Amjad Burgan
- Department of Radiology, Ashford & St Peter’s Foundation Trust, Chertsey, UK
| | - Adam Jacques
- Department of Cardiology, Ashford & St Peter’s Foundation Trust, Chertsey, UK
| | - David Fluck
- Department of Cardiology, Ashford & St Peter’s Foundation Trust, Chertsey, UK
| | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London, Egham, UK
| | - Christopher H Fry
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - Thang S Han
- Institute of Cardiovascular Research, Royal Holloway University of London, Egham, UK
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17
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Dickow J, Suzuki A, Henz BD, Madhavan M, Lehmann HI, Wang S, Parker KD, Monahan KH, Rettmann ME, Curley MG, Packer DL. Characterization of Lesions Created by a Heated, Saline Irrigated Needle-Tip Catheter in the Normal and Infarcted Canine Heart. Circ Arrhythm Electrophysiol 2020; 13:e009090. [PMID: 33198498 DOI: 10.1161/circep.120.009090] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Inability to eliminate intramural arrhythmogenic substrate may lead to recurrent ventricular tachycardia after catheter ablation. The aim of the present study was to evaluate intramural and full thickness lesion formation using a heated saline-enhanced radiofrequency (SERF) needle-tip catheter, compared with a conventional ablation catheter in normal and infarcted myocardium. METHODS Twenty-two adult mongrel dogs (30-40 kg, 15 normal and 7 myocardial infarct group) were studied. Lesions were created using the SERF catheter (40 W/50 °C) or a standard contact force (CF) catheter in both groups. RESULTS Comparing SERF to CF ablation, the SERF catheter produced larger lesion volumes than the standard CF catheter-even with >20 g of CF-in both normal (983.1±905.8 versus 461.9±178.3 mm3; P=0.023) and infarcted left ventricular myocardium (1052.3±543.0 versus 340.3±160.5 mm3; P=0.001). SERF catheter lesions were more often transmural than standard CF lesions with >20 g of CF in both groups (59.1% versus 7.7%; P<0.001 and 60.0% versus 12.5%; P=0.017, respectively). Using the SERF catheter, mean depth of ablated lesions reached 90% of the left ventricular wall in both normal and infarcted myocardium. CONCLUSIONS The SERF catheter created more transmural and larger ablative lesions in both normal and infarcted canine myocardium. SERF ablation is a promising new approach for endocardial intramural and full thickness ablation of ventricular tachycardia substrate that is not accessible with current techniques.
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Affiliation(s)
- Jannis Dickow
- Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN (J.D., A.S., B.D.H., M.M., H.I.L., S.W., K.D.P., K.H.M., M.E.R., D.L.P.)
| | - Atsushi Suzuki
- Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN (J.D., A.S., B.D.H., M.M., H.I.L., S.W., K.D.P., K.H.M., M.E.R., D.L.P.)
| | - Benhur D Henz
- Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN (J.D., A.S., B.D.H., M.M., H.I.L., S.W., K.D.P., K.H.M., M.E.R., D.L.P.)
| | - Malini Madhavan
- Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN (J.D., A.S., B.D.H., M.M., H.I.L., S.W., K.D.P., K.H.M., M.E.R., D.L.P.)
| | - H Immo Lehmann
- Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN (J.D., A.S., B.D.H., M.M., H.I.L., S.W., K.D.P., K.H.M., M.E.R., D.L.P.)
| | - Songyun Wang
- Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN (J.D., A.S., B.D.H., M.M., H.I.L., S.W., K.D.P., K.H.M., M.E.R., D.L.P.)
| | - Kay D Parker
- Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN (J.D., A.S., B.D.H., M.M., H.I.L., S.W., K.D.P., K.H.M., M.E.R., D.L.P.)
| | - Kristi H Monahan
- Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN (J.D., A.S., B.D.H., M.M., H.I.L., S.W., K.D.P., K.H.M., M.E.R., D.L.P.)
| | - Maryam E Rettmann
- Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN (J.D., A.S., B.D.H., M.M., H.I.L., S.W., K.D.P., K.H.M., M.E.R., D.L.P.)
| | | | - Douglas L Packer
- Translational Interventional Electrophysiology Laboratory, Mayo Clinic, Rochester, MN (J.D., A.S., B.D.H., M.M., H.I.L., S.W., K.D.P., K.H.M., M.E.R., D.L.P.)
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18
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Kesidou D, da Costa Martins PA, de Windt LJ, Brittan M, Beqqali A, Baker AH. Extracellular Vesicle miRNAs in the Promotion of Cardiac Neovascularisation. Front Physiol 2020; 11:579892. [PMID: 33101061 PMCID: PMC7546892 DOI: 10.3389/fphys.2020.579892] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/25/2020] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality worldwide claiming almost 17. 9 million deaths annually. A primary cause is atherosclerosis within the coronary arteries, which restricts blood flow to the heart muscle resulting in myocardial infarction (MI) and cardiac cell death. Despite substantial progress in the management of coronary heart disease (CHD), there is still a significant number of patients developing chronic heart failure post-MI. Recent research has been focused on promoting neovascularisation post-MI with the ultimate goal being to reduce the extent of injury and improve function in the failing myocardium. Cardiac cell transplantation studies in pre-clinical models have shown improvement in cardiac function; nonetheless, poor retention of the cells has indicated a paracrine mechanism for the observed improvement. Cell communication in a paracrine manner is controlled by various mechanisms, including extracellular vesicles (EVs). EVs have emerged as novel regulators of intercellular communication, by transferring molecules able to influence molecular pathways in the recipient cell. Several studies have demonstrated the ability of EVs to stimulate angiogenesis by transferring microRNA (miRNA, miR) molecules to endothelial cells (ECs). In this review, we describe the process of neovascularisation and current developments in modulating neovascularisation in the heart using miRNAs and EV-bound miRNAs. Furthermore, we critically evaluate methods used in cell culture, EV isolation and administration.
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Affiliation(s)
- Despoina Kesidou
- Centre for Cardiovascular Science, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Paula A. da Costa Martins
- Department of Molecular Genetics, Faculty of Science and Engineering, Maastricht University, Maastricht, Netherlands
- Faculty of Health, Medicine and Life Sciences, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
| | - Leon J. de Windt
- Department of Molecular Genetics, Faculty of Science and Engineering, Maastricht University, Maastricht, Netherlands
| | - Mairi Brittan
- Centre for Cardiovascular Science, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Abdelaziz Beqqali
- Centre for Cardiovascular Science, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew Howard Baker
- Centre for Cardiovascular Science, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
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19
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Wafa D, Koch N, Kovács J, Kerék M, Proia RL, Tigyi GJ, Benyó Z, Miklós Z. Opposing Roles of S1P 3 Receptors in Myocardial Function. Cells 2020; 9:cells9081770. [PMID: 32722120 PMCID: PMC7466142 DOI: 10.3390/cells9081770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/15/2020] [Revised: 06/12/2020] [Accepted: 07/22/2020] [Indexed: 01/09/2023] Open
Abstract
Sphingosine-1-phosphate (S1P) is a lysophospholipid mediator with diverse biological function mediated by S1P1–5 receptors. Whereas S1P was shown to protect the heart against ischemia/reperfusion (I/R) injury, other studies highlighted its vasoconstrictor effects. We aimed to separate the beneficial and potentially deleterious cardiac effects of S1P during I/R and identify the signaling pathways involved. Wild type (WT), S1P2-KO and S1P3-KO Langendorff-perfused murine hearts were exposed to intravascular S1P, I/R, or both. S1P induced a 45% decrease of coronary flow (CF) in WT-hearts. The presence of S1P-chaperon albumin did not modify this effect. CF reduction diminished in S1P3-KO but not in S1P2-KO hearts, indicating that in our model S1P3 mediates coronary vasoconstriction. In I/R experiments, S1P3 deficiency had no influence on postischemic CF but diminished functional recovery and increased infarct size, indicating a cardioprotective effect of S1P3. Preischemic S1P exposure resulted in a substantial reduction of postischemic CF and cardiac performance and increased the infarcted area. Although S1P3 deficiency increased postischemic CF, this failed to improve cardiac performance. These results indicate a dual role of S1P3 involving a direct protective action on the myocardium and a cardiosuppressive effect due to coronary vasoconstriction. In acute coronary syndrome when S1P may be released abundantly, intravascular and myocardial S1P production might have competing influences on myocardial function via activation of S1P3 receptors.
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Affiliation(s)
- Dina Wafa
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (N.K.); (J.K.); (M.K.); (G.J.T.); (Z.B.)
- Correspondence: (D.W.); (Z.M.)
| | - Nóra Koch
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (N.K.); (J.K.); (M.K.); (G.J.T.); (Z.B.)
| | - Janka Kovács
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (N.K.); (J.K.); (M.K.); (G.J.T.); (Z.B.)
| | - Margit Kerék
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (N.K.); (J.K.); (M.K.); (G.J.T.); (Z.B.)
| | - Richard L. Proia
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institues of Health, Bethesda, MD 20892, USA;
| | - Gábor J. Tigyi
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (N.K.); (J.K.); (M.K.); (G.J.T.); (Z.B.)
- Department of Physiology, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Zoltán Benyó
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (N.K.); (J.K.); (M.K.); (G.J.T.); (Z.B.)
| | - Zsuzsanna Miklós
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (N.K.); (J.K.); (M.K.); (G.J.T.); (Z.B.)
- Correspondence: (D.W.); (Z.M.)
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Valls-Lacalle L, Consegal M, Ruiz-Meana M, Benito B, Inserte J, Barba I, Ferreira-González I, Rodríguez-Sinovas A. Connexin 43 Deficiency Is Associated with Reduced Myocardial Scar Size and Attenuated TGFβ1 Signaling after Transient Coronary Occlusion in Conditional Knock-Out Mice. Biomolecules 2020; 10:E651. [PMID: 32340244 DOI: 10.3390/biom10040651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/15/2020] [Accepted: 04/20/2020] [Indexed: 12/20/2022] Open
Abstract
Previous studies demonstrated a reduction in myocardial scar size in heterozygous Cx43+/- mice subjected to permanent coronary occlusion. However, patients presenting with ST segment elevation myocardial infarction often undergo rapid coronary revascularization leading to prompt restoration of coronary flow. Therefore, we aimed to assess changes in scar size and left ventricular remodeling following transient myocardial ischemia (45 min) followed by 14 days of reperfusion using Cx43fl/fl (controls) and Cx43Cre-ER(T)/fl inducible knock-out (Cx43 content: 50%) mice treated with vehicle or 4-hydroxytamoxifen (4-OHT) to induce a Cre-ER(T)-mediated global deletion of the Cx43 floxed allele. The scar area (picrosirius red), measured 14 days after transient coronary occlusion, was similarly reduced in both vehicle and 4-OHT-treated Cx43Cre-ER(T)/fl mice, compared to Cx43fl/fl animals, having normal Cx43 levels (15.78% ± 3.42% and 16.54% ± 2.31% vs. 25.40% ± 3.14% and 22.43% ± 3.88% in vehicle and 4-OHT-treated mice, respectively, p = 0.027). Left ventricular dilatation was significantly attenuated in both Cx43-deficient groups (p = 0.037 for left ventricular end-diastolic diameter). These protective effects were correlated with an attenuated enhancement in pro-transforming growth factor beta 1 (TGFβ1) expression after reperfusion. In conclusion, our data demonstrate that Cx43 deficiency induces a protective effect on scar formation after transient coronary occlusion in mice, an effect associated with reduced left ventricular remodeling and attenuated enhancement in pro-TGFβ1 expression.
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21
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Ferraro B, Leoni G, Hinkel R, Ormanns S, Paulin N, Ortega-Gomez A, Viola JR, de Jong R, Bongiovanni D, Bozoglu T, Maas SL, D'Amico M, Kessler T, Zeller T, Hristov M, Reutelingsperger C, Sager HB, Döring Y, Nahrendorf M, Kupatt C, Soehnlein O. Pro-Angiogenic Macrophage Phenotype to Promote Myocardial Repair. J Am Coll Cardiol 2020; 73:2990-3002. [PMID: 31196457 DOI: 10.1016/j.jacc.2019.03.503] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 03/12/2019] [Accepted: 03/19/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Heart failure following myocardial infarction (MI) remains one of the major causes of death worldwide, and its treatment is a crucial challenge of cardiovascular medicine. An attractive therapeutic strategy is to stimulate endogenous mechanisms of myocardial regeneration. OBJECTIVES This study evaluates the potential therapeutic treatment with annexin A1 (AnxA1) to induce cardiac repair after MI. METHODS AnxA1 knockout (AnxA1-/-) and wild-type mice underwent MI induced by ligation of the left anterior descending coronary artery. Cardiac functionality was assessed by longitudinal echocardiographic measurements. Histological, fluorescence-activated cell sorting, dot blot analysis, and in vitro/ex vivo studies were used to assess the myocardial neovascularization, macrophage content, and activity in response to AnxA1. RESULTS AnxA1-/- mice showed a reduced cardiac functionality and an expansion of proinflammatory macrophages in the ischemic area. Cardiac macrophages from AnxA1-/- mice exhibited a dramatically reduced ability to release the proangiogenic mediator vascular endothelial growth factor (VEGF)-A. However, AnxA1 treatment enhanced VEGF-A release from cardiac macrophages, and its delivery in vivo markedly improved cardiac performance. The positive effect of AnxA1 treatment on cardiac performance was abolished in wild-type mice transplanted with bone marrow derived from Cx3cr1creERT2Vegfflox/flox or in mice depleted of macrophages. Similarly, cardioprotective effects of AnxA1 were obtained in pigs in which full-length AnxA1 was overexpressed by use of a cardiotropic adeno-associated virus. CONCLUSIONS AnxA1 has a direct action on cardiac macrophage polarization toward a pro-angiogenic, reparative phenotype. AnxA1 stimulated cardiac macrophages to release high amounts of VEGF-A, thus inducing neovascularization and cardiac repair.
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Affiliation(s)
- Bartolo Ferraro
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität Munich, Munich, Germany; Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), partner site Munich Heart Alliance, Munich, Germany
| | - Giovanna Leoni
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität Munich, Munich, Germany; Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), partner site Munich Heart Alliance, Munich, Germany
| | - Rabea Hinkel
- Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), partner site Munich Heart Alliance, Munich, Germany; Medizinische Klinik I, TU Munich, Germany; Deutsches Primatenzentrum GmbH, Leibniz-Institut für Primatenforschung, Department of Laboratory Animal Science, Göttingen, Germany
| | - Steffen Ormanns
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Nicole Paulin
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität Munich, Munich, Germany; Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), partner site Munich Heart Alliance, Munich, Germany
| | - Almudena Ortega-Gomez
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität Munich, Munich, Germany; Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), partner site Munich Heart Alliance, Munich, Germany
| | - Joana R Viola
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität Munich, Munich, Germany; Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), partner site Munich Heart Alliance, Munich, Germany
| | - Renske de Jong
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Dario Bongiovanni
- Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), partner site Munich Heart Alliance, Munich, Germany; Medizinische Klinik I, TU Munich, Germany
| | | | - Sanne L Maas
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität Munich, Munich, Germany; Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), partner site Munich Heart Alliance, Munich, Germany
| | - Michele D'Amico
- Department of Experimental Medicine, University of Campania, Campania, Italy
| | - Thorsten Kessler
- Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), partner site Munich Heart Alliance, Munich, Germany; Department of Cardiology, German Heart Center Munich, Munich, Germany
| | - Tanja Zeller
- DZHK, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany; Clinic for Cardiology, University Heart Center, Hamburg, Germany
| | - Michael Hristov
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Chris Reutelingsperger
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, University Maastricht, Maastricht, the Netherlands
| | - Hendrik B Sager
- Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), partner site Munich Heart Alliance, Munich, Germany; Department of Cardiology, German Heart Center Munich, Munich, Germany
| | - Yvonne Döring
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität Munich, Munich, Germany; Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), partner site Munich Heart Alliance, Munich, Germany
| | - Matthias Nahrendorf
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christian Kupatt
- Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), partner site Munich Heart Alliance, Munich, Germany; Medizinische Klinik I, TU Munich, Germany
| | - Oliver Soehnlein
- Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-Universität Munich, Munich, Germany; Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), partner site Munich Heart Alliance, Munich, Germany; Department of Physiology and Pharmacology (FyFa) and Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
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22
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Bloise N, Rountree I, Polucha C, Montagna G, Visai L, Coulombe KLK, Munarin F. Engineering Immunomodulatory Biomaterials for Regenerating the Infarcted Myocardium. Front Bioeng Biotechnol 2020; 8:292. [PMID: 32318563 PMCID: PMC7154131 DOI: 10.3389/fbioe.2020.00292] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 12/19/2019] [Accepted: 03/19/2020] [Indexed: 12/13/2022] Open
Abstract
Coronary artery disease is a severe ischemic condition characterized by the reduction of blood flow in the arteries of the heart that results in the dysfunction and death of cardiac tissue. Despite research over several decades on how to reduce long-term complications and promote angiogenesis in the infarct, the medical field has yet to define effective treatments for inducing revascularization in the ischemic tissue. With this work, we have developed functional biomaterials for the controlled release of immunomodulatory cytokines to direct immune cell fate for controlling wound healing in the ischemic myocardium. The reparative effects of colony-stimulating factor (CSF-1), and anti-inflammatory interleukins 4/6/13 (IL4/6/13) have been evaluated in vitro and in a predictive in vivo model of ischemia (the skin flap model) to optimize a new immunomodulatory biomaterial that we use for treating infarcted rat hearts. Alginate hydrogels have been produced by internal gelation with calcium carbonate (CaCO3) as carriers for the immunomodulatory cues, and their stability, degradation, rheological properties and release kinetics have been evaluated in vitro. CD14 positive human peripheral blood monocytes treated with the immunomodulatory biomaterials show polarization into pro-healing macrophage phenotypes. Unloaded and CSF-1/IL4 loaded alginate gel formulations have been implanted in skin flap ischemic wounds to test the safety and efficacy of the delivery system in vivo. Faster wound healing is observed with the new therapeutic treatment, compared to the wounds treated with the unloaded controls at day 14. The optimized therapy has been evaluated in a rat model of myocardial infarct (ischemia/reperfusion). Macrophage polarization toward healing phenotypes and global cardiac function measured with echocardiography and immunohistochemistry at 4 and 15 days demonstrate the therapeutic potential of the proposed immunomodulatory treatment in a clinically relevant infarct model.
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Affiliation(s)
- Nora Bloise
- Department of Molecular Medicine, Center for Health Technologies (CHT), INSTM UdR of Pavia, University of Pavia, Pavia, Italy.,Department of Occupational Medicine, Toxicology and Environmental Risks, ICS Maugeri, IRCCS, Pavia, Italy
| | - Isobel Rountree
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, RI, United States
| | - Collin Polucha
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, RI, United States
| | - Giulia Montagna
- Department of Molecular Medicine, Center for Health Technologies (CHT), INSTM UdR of Pavia, University of Pavia, Pavia, Italy.,Department of Electrical, Computer and Biomedical Engineering, Centre for Health Technologies (CHT), University of Pavia, Pavia, Italy
| | - Livia Visai
- Department of Molecular Medicine, Center for Health Technologies (CHT), INSTM UdR of Pavia, University of Pavia, Pavia, Italy.,Department of Occupational Medicine, Toxicology and Environmental Risks, ICS Maugeri, IRCCS, Pavia, Italy
| | - Kareen L K Coulombe
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, RI, United States
| | - Fabiola Munarin
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, RI, United States
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23
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Giannarelli C, Wong CK. Crosstalk Between Inflammatory Cells to Promote Cardioprotective Angiogenesis. J Am Coll Cardiol 2020; 73:3003-3005. [PMID: 31196458 DOI: 10.1016/j.jacc.2019.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 04/17/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Chiara Giannarelli
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, New York; Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Genetics and Genomic Sciences, The Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Christine K Wong
- Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, New York
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24
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Huded CP, Kapadia SR, Ballout JA, Krishnaswamy A, Ellis SG, Raymond R, Cho L, Simpfendorfer C, Bajzer C, Martin J, Nair R, Lincoff AM, Kravitz K, Menon V, Hantz S, Khot UN. Association of adoption of transradial access for percutaneous coronary intervention in ST elevation myocardial infarction with door-to-balloon time. Catheter Cardiovasc Interv 2020; 96:E165-E173. [PMID: 32105411 PMCID: PMC7496393 DOI: 10.1002/ccd.28785] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/14/2019] [Accepted: 02/10/2020] [Indexed: 11/19/2022]
Abstract
Objectives We aimed to study adoption of transradial primary percutaneous coronary intervention (TR‐PPCI) for ST elevation myocardial infarction (STEMI) (“radial first” approach) and its association with door‐to‐balloon time (D2BT). Background TR‐PPCI for STEMI is underutilized in the United States due to concerns about prolonging D2BT. Whether operators and hospitals adopting a radial first approach in STEMI incur prolonged D2BT is unknown. Methods In 1,272 consecutive cases of STEMI with PPCI at our hospital from January 1, 2011, to December 31, 2016, we studied TR‐PPCI adoption and its association with D2BT including a propensity matched analysis of similar risk TR‐PPCI and trans‐femoral primary PCI (TF‐PPCI) patients. Results With major increases in hospital‐level TR‐PPCI (hospital TR‐PPCI rate: 2.6% in 2011 to 79.4% in 2016, p‐trend<.001) and operator‐level TR‐PPCI (mean operator TR‐PPCI rate: 2.9% in 2011 to 81.1% in 2016, p‐trend = .005), median hospital level D2BT decreased from 102 min [81, 142] in 2011 to 84 min [60, 105] in 2016 (p‐trend<.001). TF crossover (10.3%; n = 57) was not associated with unadjusted D2BT (TR‐PPCI success 91 min [72, 112] vs. TF crossover 99 min [70, 115], p = .432) or D2BT adjusted for study year and presenting location (7.2% longer D2BT with TF crossover, 95% CI: −4.0% to +18.5%, p = .208). Among 273 propensity‐matched pairs, unadjusted D2BT (TR‐PPCI 98 [78, 117] min vs. TF‐PPCI 101 [76, 132] min, p = .304), and D2BT adjusted for study year and presenting location (5.0% shorter D2BT with TR‐PPCI, 95% CI: −12.4% to +2.4%, p = .188) were similar. Conclusions TR‐PPCI can be successfully implemented without compromising D2BT performance.
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Affiliation(s)
- Chetan P Huded
- Heart and Vascular Institute Center for Healthcare Delivery Innovation, Cleveland Clinic, Cleveland, Ohio.,Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Samir R Kapadia
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jad A Ballout
- Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Stephen G Ellis
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Russell Raymond
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Leslie Cho
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Chris Bajzer
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Joseph Martin
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Ravi Nair
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | | | | | - Venu Menon
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Scott Hantz
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Umesh N Khot
- Heart and Vascular Institute Center for Healthcare Delivery Innovation, Cleveland Clinic, Cleveland, Ohio.,Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
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25
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Lai XL, Liu HX, Hu X, Tian JF, Shang JJ, Li X, Zhou Q, Xing WL. Acute Myocardial Infarction in Chinese Medicine Hospitals in China from 2006 to 2013: An Analysis of 2311 Patients from Hospital Data. Chin J Integr Med 2020; 27:323-329. [PMID: 32107728 DOI: 10.1007/s11655-020-3189-1] [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] [Subscribe] [Scholar Register] [Accepted: 10/18/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess the trends in characteristics, treatments, and outcomes of acute myocardial infarction (AMI) patients in tertiary Chinese medicine (CM) hospitals in China between 2006 and 2013. METHODS This retrospective study was based on two nationwide epidemiological surveys of AMI in tertiary CM hospitals during 2 years (2006 and 2013). Patients admitted to the hospital for AMI were enrolled. Hospital records were used as the data source. Case data were derived regarding baseline characteristics, treatments, and outcomes of patients to assess changes from 2006 to 2013. Logistic regression was used to analyze the relationship between prognosis, general influencing factors of disease, and various treatment measures. RESULTS Totally 26 tertiary CM hospitals in 2006 and 29 tertiary CM hospitals in 2013 (18 were repetitive) were surveyed. A total of 2,311 patients with AMI were enrolled (1,094 cases in 2006 and 1,217 cases in 2013). From 2006 to 2013, the mean age did not significantly change, but the proportion of patients younger than 65 years increased. The prevalence of risk factors such as hypertension, diabetes, and hyperlipidemia also increased. Significant increases were observed in primary percutaneous coronary intervention [20.48% (2006) vs. 24.90% (2013)] and revascularization [36.11% (2006) vs. 52.42% (2013)]. In-hospital mortality decreased from 11.15% in 2006 to 10.60% in 2013. A mortality logistic regression analysis identified reperfusion therapy [odds ratio (OR), 0.222; 95% confidence interval (CI), 0.106-0.464], Chinese patent medicines (OR, 0.394; 95% CI, 0.213-0.727), and CM decoctions (OR, 0.196; 95% CI, 0.109-0.353) as protective factors. CONCLUSION Reperfusion and revascularization capabilities of tertiary CM hospitals have improved significantly, but in-hospital mortality has not significantly decreased. Efforts are needed to improve medical awareness of AMI and expand the use of CM to reduce in-hospital mortality in China.
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Affiliation(s)
- Xiao-Lei Lai
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Hong-Xu Liu
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.
| | - Xin Hu
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Jing-Feng Tian
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Ju-Ju Shang
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Xiang Li
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Qi Zhou
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Wen-Long Xing
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
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26
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Korenczuk CE, Barocas VH, Richardson WJ. Effects of Collagen Heterogeneity on Myocardial Infarct Mechanics in a Multiscale Fiber Network Model. J Biomech Eng 2019; 141:091015. [PMID: 31141605 PMCID: PMC6807994 DOI: 10.1115/1.4043865] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 03/04/2019] [Revised: 05/23/2019] [Indexed: 01/14/2023]
Abstract
The scar that forms after a myocardial infarction is often characterized by a highly disordered architecture but generally exhibits some degree of collagen fiber orientation, with a resulting mechanical anisotropy. When viewed in finer detail, however, the heterogeneity of the sample is clear, with different subregions exhibiting different fiber orientations. In this work, we used a multiscale finite element model to explore the consequences of the heterogeneity in terms of mechanical behavior. To do so, we used previously obtained fiber alignment maps of rat myocardial scar slices (n = 15) to generate scar-specific finite element meshes that were populated with fiber models based on the local alignment state. These models were then compared to isotropic models with the same sample shape and fiber density, and to homogeneous models with the same sample shape, fiber density, and average fiber alignment as the scar-specific models. All simulations involved equibiaxial extension of the sample with free motion in the third dimension. We found that heterogeneity led to a lower degree of mechanical anisotropy and a higher level of local stress concentration than the corresponding homogeneous model, and also that fibers failed in the heterogeneous model at much lower macroscopic strains than in the isotropic and homogeneous models. Taken together, these results suggest that scar heterogeneity may impair myocardial mechanical function both in terms of anisotropy and strength, and that individual variations in scar heterogeneity could be an important consideration for understanding scar remodeling and designing therapeutic interventions for patients after myocardial infarction.
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Affiliation(s)
- Christopher E Korenczuk
- Department of Biomedical Engineering,University of Minnesota,7-105 Nils Hasselmo Hall,312 Church Street SE,Minneapolis, MN 55455e-mail:
| | - Victor H Barocas
- Department of Biomedical Engineering,University of Minnesota,7-105 Nils Hasselmo Hall,312 Church Street SE,Minneapolis, MN 55455e-mail:
| | - William J Richardson
- Department of Bioengineering,Clemson University,401-3 Rhodes Engineering Research Center,118 Engineering Service Drive,Clemson, SC 29631e-mail:
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27
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Ključević N, Boban D, Milat AM, Jurić D, Mudnić I, Boban M, Grković I. Expression of Leukocytes Following Myocardial Infarction in Rats is Modulated by Moderate White Wine Consumption. Nutrients 2019; 11:E1890. [PMID: 31416120 DOI: 10.3390/nu11081890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/08/2019] [Accepted: 08/10/2019] [Indexed: 01/18/2023] Open
Abstract
How moderate white wine consumption modulates inflammatory cells infiltration of the ischemic myocardium following permanent coronary ligation was the key question addressed in this study. Male Sprague-Dawley rats were given either a combination of different white wines or water only for 28 days. Three peri-infarct/border zones and a control/nonischemic zone were analysed to determine the expression of myeloperoxidase (MPO) and cluster of differentiation 68 (CD68). Smaller expressions for both MPO and CD68 were found in all three peri-infarct zones of wine drinking animals (p < 0.001). There was no difference in the expression of leukocyte markers between animals drinking standard and polyphenol-rich white wine, although for CD68, a nonsignificant attenuation was noticed. In sham animals, a subepicardial MPO/CD68 immunoreactive "inflammatory ring" is described. Standard white wine consumption caused attenuation of the expression of MPO but not of CD68 in these animals. We conclude that white wine consumption positively modulates peri-infarct inflammatory infiltration.
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Lee CC, Chua GWY, Zheng H, Soon YY, Foo LL, Thiagarajan A, Yap SP, Siow TR, Ng WL, Chua KLM, Yip C, Chia BSH, Ng YY, Master Z, Tan PW, Tan YI, Leong YF, Loria JFE, Vellayappan B, Koh WY, Leong CN, Tey JCS, Tham IWK, Fong KW. Are heart doses associated with survival in patients with non-small cell lung cancer who received post-operative thoracic radiotherapy?: A national population-based study. Medicine (Baltimore) 2019; 98:e17020. [PMID: 31464961 PMCID: PMC6736475 DOI: 10.1097/md.0000000000017020] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The aim of this retrospective national cohort study is to assess the association between various radiation heart dosimetric parameters (RHDPs), acute myocardial infarct (AMI) and overall survival (OS) outcomes in non-small cell lung cancer (NSCLC) patients treated with post-operative thoracic radiotherapy (PORT) using contemporary radiation techniques.We identified patients with stage I to III NSCLC treated with PORT at the 2 national cancer institutions from 2007 to 2014. We linked their electronic medical records to the national AMI and death registries. Univariable Cox regression was performed to assess the association between various RHDPs, AMI, and OS.We included 43 eligible patients with median follow-up of 36.6 months. Median age was 64 years. Majority of the patients had pathological stage III disease (72%). Median prescription dose was 60Gy. Median mean heart dose (MHD) was 9.4Gy. There were no AMI events. The 5-year OS was 34%. Univariable Cox regression showed that age was significantly associated with OS (hazard ratio, 1.06; 95% confidence interval, 1.01 to 1.10; P = .008). Radiation heart doses, including MHD, volume of heart receiving at least 5, 25, 30, 40, 50Gy and dose to 30% of heart volume, were not significantly associated with OS.There is insufficient evidence to conclude that RHDPs are associated with OS for patients with NSCLC treated with PORT in this study. Studies with larger sample size and longer term follow-up are needed to assess AMI outcome.
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Affiliation(s)
- Chia Ching Lee
- Department of Radiation Oncology, National University Cancer Institute, Singapore, National University Hospital
| | | | - Huili Zheng
- National Registry of Disease Office, Research & Surveillance Division, Health Promotion Board, Singapore
| | - Yu Yang Soon
- Department of Radiation Oncology, National University Cancer Institute, Singapore, National University Hospital
| | - Ling Li Foo
- National Registry of Disease Office, Research & Surveillance Division, Health Promotion Board, Singapore
| | | | - Swee Peng Yap
- Department of Radiation Oncology, National Cancer Centre
| | - Tian Rui Siow
- Department of Radiation Oncology, National Cancer Centre
| | - Wee Loon Ng
- Department of Radiation Oncology, National Cancer Centre
| | | | - Connie Yip
- Department of Radiation Oncology, National Cancer Centre
| | | | - Yan Yee Ng
- Department of Radiation Oncology, National Cancer Centre
| | - Zubin Master
- Department of Radiation Oncology, National Cancer Centre
| | - Poh Wee Tan
- Department of Radiation Oncology, National University Cancer Institute, Singapore, National University Hospital
| | - Yun Inn Tan
- Department of Radiation Oncology, National University Cancer Institute, Singapore, National University Hospital
| | - Yuh Fun Leong
- Department of Radiation Oncology, National University Cancer Institute, Singapore, National University Hospital
| | - Joan Faith Evacula Loria
- Department of Radiation Oncology, National University Cancer Institute, Singapore, National University Hospital
| | - Balamurugan Vellayappan
- Department of Radiation Oncology, National University Cancer Institute, Singapore, National University Hospital
| | - Wee Yao Koh
- Department of Radiation Oncology, National University Cancer Institute, Singapore, National University Hospital
| | - Cheng Nang Leong
- Department of Radiation Oncology, National University Cancer Institute, Singapore, National University Hospital
| | - Jeremy Chee Seong Tey
- Department of Radiation Oncology, National University Cancer Institute, Singapore, National University Hospital
| | - Ivan Weng Keong Tham
- Department of Radiation Oncology, National University Cancer Institute, Singapore, National University Hospital
| | - Kam Weng Fong
- Department of Radiation Oncology, National Cancer Centre
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29
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Batt AM, Al-Hajeri AS, Delport S, Jenkins SM, Norman SE, Cummins FH. Implementation of an ST-Segment Elevation Myocardial Infarction Bypass Protocol in the Northern United Arab Emirates. Heart Views 2019; 19:121-127. [PMID: 31057704 PMCID: PMC6487298 DOI: 10.4103/heartviews.heartviews_81_17] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: The aim was to evaluate the translation of an ST-segment elevation myocardial infarction (STEMI) bypass protocol to the outcomes of patients with acute coronary syndrome in the Emirate of Ras al-Khaimah in the United Arab Emirates (UAE). Methods: A prospective cohort study was conducted, which included all patients who had a prehospital 12-lead electrocardiogram (ECG) performed by ambulance crews. Analysis of those who were identified as having STEMI and who subsequently underwent percutaneous coronary intervention (PCI) was performed. Results: A total of 152 patients had a 12-lead ECG performed during the pilot study period (February 24, 2016–August 31, 2016) with 118 included for analysis. Mean patient age was 52 years. There were 87 male (74%) and 31 female (26%) patients. Twenty-nine patients suffered a STEMI, and data were available for 11 who underwent PCI. There was no mortality, and no major adverse cardiac events were reported. The median door-to-balloon (D2B) time was 73 min (range 48–124), and 81% of patients had a D2B time < 90 min. Discharge data were available for six patients: All were discharged home with no impediments to rehabilitation. Conclusion: This pilot study has demonstrated agreement with the existing literature surrounding prehospital ECG and PCI activation in an unstudied STEMI population and in a novel clinical setting. It has demonstrated a D2B time of < 90 min in over 80% of STEMI patients, and a faster mean D2B time than self-presentations (mean 77 min vs. 113 min), with no associated mortality or major adverse cardiac events.
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Affiliation(s)
- Alan M Batt
- National Ambulance, Abu Dhabi, UAE.,CQ University, Rockhampton, Australia.,Fanshawe College, Ontario, Canada.,Retrieval, Emergency and Disaster Medicine Research and Development Unit, University Hospital Limerick, Ireland, UK
| | | | - Shannon Delport
- National Ambulance, Abu Dhabi, UAE.,CQ University, Rockhampton, Australia
| | | | | | - Fergal H Cummins
- National Ambulance, Abu Dhabi, UAE.,Retrieval, Emergency and Disaster Medicine Research and Development Unit, University Hospital Limerick, Ireland, UK.,Charles Sturt University, Bathurst, Australia.,Graduate Entry Medical School, University of Limerick, Ireland
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30
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Abstract
Many reports of marijuana-associated myocardial infarct (MI) are limited by incomplete evaluation of the toxicologic exposure, a lack of definitive anatomic findings, and the potential for comorbid coronary atherosclerosis inherent in an adult population. We report a 16-year-old adolescent boy who presented with chest pain after smoking marijuana and was found to have acute MI. Electrocardiogram showed diffuse ST-segment elevations. Exhaustive toxicologic testing confirmed the presence of Δ-9-tetrahydrocannabinol metabolite and ruled out other drugs of abuse. Echocardiography demonstrated moderate global left ventricular systolic dysfunction. Coronary angiography demonstrated no focal coronary lesions or obstruction. Right ventricular septal endomyocardial samples biopsied 36 hours after the onset of pain showed a subendocardial acute MI with a sparse neutrophilic infiltrate. One month after the event, magnetic resonance imaging showed a severely dilated left ventricle and moderately to severely depressed global systolic function. Late gadolinium enhancement consistent with myocardial fibrosis was seen in nearly all myocardial segments. Our unusually well-documented findings strengthen the potential association between marijuana and MI. Furthermore, we demonstrate a disease distribution supporting a process that affects the coronary circulation globally, likely at the distal, small-vessel level.
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Affiliation(s)
- Michael S Toce
- 1 Harvard Medical Toxicology Program, Boston Children's Hospital, Boston, Massachusetts.,2 Division of Emergency Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Michael Farias
- 3 Department of Cardiology, The Heart Center, Arnold Palmer Hospital for Children, Orlando, Florida
| | - Andrew J Powell
- 4 Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts
| | - Kevin P Daly
- 4 Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts
| | - Sara O Vargas
- 5 Department of Pathology, Boston Children's Hospital, Boston, Massachusetts
| | - Michele M Burns
- 1 Harvard Medical Toxicology Program, Boston Children's Hospital, Boston, Massachusetts.,2 Division of Emergency Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
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31
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Singh M, Khan K, Fisch E, Frey C, Mathias K, Jneid H, Musher DM, Barshes NR. Acute Cardiac Events in Patients With Severe Limb Infection. INT J LOW EXTR WOUND 2018; 17:261-267. [PMID: 30461325 DOI: 10.1177/1534734618810944] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Recent studies have shown an association between infections, such as influenza, pneumonia, or bacteremia, and acute cardiac events. We studied the association between foot infection and myocardial infarction, arrhythmia, and/or congestive heart failure. We analyzed the records of 318 consecutive episodes of deep soft tissue infection, gangrene, and/or osteomyelitis in 274 patients referred to a vascular surgery service at a tertiary center. We identified 24 acute cardiac events in 21 of 318 (6.6%) episodes of foot infection or foot gangrene. These 24 events included 11 new myocardial infarctions (3.5%), 8 episodes of new onset or worsening congestive heart failure (2.5%), and 5 new arrhythmias (1.6%). Tachycardia and systemic inflammatory response syndrome were associated with acute cardiac events ( P < .05 for each). The 1-year survival of patients with acute cardiac events was 50.4%, significantly lower than the 91.7% 1-year survival of patients without acute cardiac events ( P < .0015). Acute cardiac complications are not uncommon among patients presenting with severe foot infection and are associated with a high 1-year mortality. Primary care physicians, cardiologists, and vascular and orthopedic surgeons must keep a high index of suspicion for the occurrence of an acute cardiac event.
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Affiliation(s)
| | | | - Evan Fisch
- 2 Baylor College of Medicine, Houston, TX, USA
| | | | | | - Hani Jneid
- 2 Baylor College of Medicine, Houston, TX, USA.,3 Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Daniel M Musher
- 2 Baylor College of Medicine, Houston, TX, USA.,3 Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Neal R Barshes
- 2 Baylor College of Medicine, Houston, TX, USA.,3 Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
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32
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Rong SL, Wang XL, Wang YC, Wu H, Zhou XD, Wang ZK, Wang YC, Xue CS, Li B, Gao DL. Anti-inflammatory activities of hepatocyte growth factor in post-ischemic heart failure. Acta Pharmacol Sin 2018; 39:1613-21. [PMID: 29795355 DOI: 10.1038/aps.2018.14] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 02/28/2018] [Indexed: 02/06/2023] Open
Abstract
Hepatocyte growth factor (HGF) alleviates acute and chronic inflammation in experimental inflammatory bowel disease, glomerulonephritis, and airway inflammation. However, the anti-inflammatory effects of HGF on myocardial infarction are not defined. The current study assessed the anti-inflammatory effects of HGF in post-ischemic heart failure. The left anterior descending coronary artery was ligated in rats, and adenovirus containing human HGF (Ad-HGF) or control virus (Ad-GFP) was administered intramyocardially. The quantity of proinflammatory cytokines secreted by cardiomyocytes, such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and IL-1β, was evaluated. Cardiac function and LV remodeling were assessed using echocardiography and collagen deposition, respectively. Left ventricular fractional shortening (LVFS) and left ventricular ejection fraction (LVEF) four weeks after injection were significantly increased in Ad-HGF-treated animals compared to the Ad-GFP group. HGF gene therapy improved ventricular geometry with a significantly decreased left ventricular end-diastolic diameter (LVEDD) and markedly reduced myocardial collagen deposition. Treatment with Ad-HGF significantly decreased the mRNA levels of TNF-α, IL-6, and IL-1β in the non-infarcted region four weeks after injection. Changes of the TNF-α, IL-6, and IL-1β levels in the non-infarcted region positively correlated with the LVEDD 4 weeks after infarction. Treatment of acute myocardial infarction (AMI) with Ad-HGF in the early stage of MI reduced the pro-inflammatory cytokine levels and preserved cardiac function. These findings indicated that Ad-HGF gene therapy alleviated ventricular remodeling after infarction by reducing inflammation.
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33
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Kanda P, Alarcon EI, Yeuchyk T, Parent S, de Kemp RA, Variola F, Courtman D, Stewart DJ, Davis DR. Deterministic Encapsulation of Human Cardiac Stem Cells in Variable Composition Nanoporous Gel Cocoons To Enhance Therapeutic Repair of Injured Myocardium. ACS Nano 2018; 12:4338-4350. [PMID: 29660269 DOI: 10.1021/acsnano.7b08881] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Although cocooning explant-derived cardiac stem cells (EDCs) in protective nanoporous gels (NPGs) prior to intramyocardial injection boosts long-term cell retention, the number of EDCs that finally engraft is trivial and unlikely to account for salutary effects on myocardial function and scar size. As such, we investigated the effect of varying the NPG content within capsules to alter the physical properties of cocoons without influencing cocoon dimensions. Increasing NPG concentration enhanced cell migration and viability while improving cell-mediated repair of injured myocardium. Given that the latter occurred with NPG content having no detectable effect on the long-term engraftment of transplanted cells, we found that changing the physical properties of cocoons prompted explant-derived cardiac stem cells to produce greater amounts of cytokines, nanovesicles, and microRNAs that boosted the generation of new blood vessels and new cardiomyocytes. Thus, by altering the physical properties of cocoons by varying NPG content, the paracrine signature of encapsulated cells can be enhanced to promote greater endogenous repair of injured myocardium.
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Affiliation(s)
- Pushpinder Kanda
- University of Ottawa Heart Institute, Division of Cardiology, Department of Medicine , University of Ottawa , Ottawa , Canada K1Y4W7
| | - Emilio I Alarcon
- Division of Cardiac Surgery, Department of Surgery, University of Ottawa Heart Institute , University of Ottawa , Ottawa , Canada K1Y4W7
- Department of Biochemistry, Microbiology, and Immunology, Faculty of Medicine , University of Ottawa , Ottawa , Canada K1H8M5
| | - Tanya Yeuchyk
- University of Ottawa Heart Institute, Division of Cardiology, Department of Medicine , University of Ottawa , Ottawa , Canada K1Y4W7
| | - Sandrine Parent
- University of Ottawa Heart Institute, Division of Cardiology, Department of Medicine , University of Ottawa , Ottawa , Canada K1Y4W7
| | - Robert A de Kemp
- University of Ottawa Heart Institute, Division of Cardiology, Department of Medicine , University of Ottawa , Ottawa , Canada K1Y4W7
| | - Fabio Variola
- Department of Mechanical Engineering , University of Ottawa , Ottawa , Canada K1N6N5
- Department of Cellular and Molecular Medicine , University of Ottawa , Ottawa , Canada K1H8M5
| | - David Courtman
- Regenerative Medicine Program , Ottawa Hospital Research Institute , Ottawa , Canada K1H8L6
| | - Duncan J Stewart
- University of Ottawa Heart Institute, Division of Cardiology, Department of Medicine , University of Ottawa , Ottawa , Canada K1Y4W7
- Department of Cellular and Molecular Medicine , University of Ottawa , Ottawa , Canada K1H8M5
- Regenerative Medicine Program , Ottawa Hospital Research Institute , Ottawa , Canada K1H8L6
| | - Darryl R Davis
- University of Ottawa Heart Institute, Division of Cardiology, Department of Medicine , University of Ottawa , Ottawa , Canada K1Y4W7
- Department of Cellular and Molecular Medicine , University of Ottawa , Ottawa , Canada K1H8M5
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34
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Sin WC, Kwong JM, Wong TCL, Kwong C, Chan C, Siu CW. PostOperative ST-segment elevation: not a blocked coronary artery, then what? Clin Case Rep 2018; 6:631-633. [PMID: 29636929 PMCID: PMC5889249 DOI: 10.1002/ccr3.1116] [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: 03/08/2016] [Revised: 11/04/2016] [Accepted: 02/13/2017] [Indexed: 11/11/2022] Open
Abstract
ST‐segment elevation is well known for its diagnostic value for transmural myocardial infarction due to acute thrombotic occlusion of a coronary artery, and often requires emergency reperfusion therapy. However, ST segment is by no means pathognomonic for acute coronary events. Here, we report a case of ST‐segment elevation after hepatectomy secondary to an unusual etiology.
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Affiliation(s)
- Wai-Ching Sin
- Department of Adult Intensive Care Queen Mary Hospital Hong Kong China
| | - Joy Melody Kwong
- Department of Adult Intensive Care Queen Mary Hospital Hong Kong China
| | - Tiffany Cho-Lam Wong
- Department of Surgery Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong China
| | - Charlotte Kwong
- Department of Diagnostic Radiology Queen Mary Hospital Hong Kong China
| | - Carmen Chan
- Division of Cardiology Department of Medicine Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong China
| | - Chung-Wah Siu
- Division of Cardiology Department of Medicine Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong China
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35
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Mendonca Costa C, Plank G, Rinaldi CA, Niederer SA, Bishop MJ. Modeling the Electrophysiological Properties of the Infarct Border Zone. Front Physiol 2018; 9:356. [PMID: 29686626 PMCID: PMC5900020 DOI: 10.3389/fphys.2018.00356] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [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: 12/06/2017] [Accepted: 03/22/2018] [Indexed: 12/28/2022] Open
Abstract
Ventricular arrhythmias (VA) in patients with myocardial infarction (MI) are thought to be associated with structural and electrophysiological remodeling within the infarct border zone (BZ). Personalized computational models have been used to investigate the potential role of the infarct BZ in arrhythmogenesis, which still remains incompletely understood. Most recent models have relied on experimental data to assign BZ properties. However, experimental measurements vary significantly resulting in different computational representations of this region. Here, we review experimental data available in the literature to determine the most prominent properties of the infarct BZ. Computational models are then used to investigate the effect of different representations of the BZ on activation and repolarization properties, which may be associated with VA. Experimental data obtained from several animal species and patients with infarct show that BZ properties vary significantly depending on disease's stage, with the early disease stage dominated by ionic remodeling and the chronic stage by structural remodeling. In addition, our simulations show that ionic remodeling in the BZ leads to large repolarization gradients in the vicinity of the scar, which may have a significant impact on arrhythmia simulations, while structural remodeling plays a secondary role. We conclude that it is imperative to faithfully represent the properties of regions of infarction within computational models specific to the disease stage under investigation in order to conduct in silico mechanistic investigations.
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Affiliation(s)
- Caroline Mendonca Costa
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Gernot Plank
- Department of Biophysics, Medical University of Graz, Graz, Austria
| | | | - Steven A Niederer
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Martin J Bishop
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
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36
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Suinesiaputra A, Ablin P, Albà X, Alessandrini M, Allen J, Bai W, Çimen S, Claes P, Cowan BR, D’hooge J, Duchateau N, Ehrhardt J, Frangi AF, Gooya A, Grau V, Lekadir K, Lu A, Mukhopadhyay A, Oksuz I, Parajuli N, Pennec X, Pereañez M, Pinto C, Piras P, Rohé MM, Rueckert D, Säring D, Sermesant M, Siddiqi K, Tabassian M, Teresi L, Tsaftaris SA, Wilms M, Young AA, Zhang X, Medrano-Gracia P. Statistical shape modeling of the left ventricle: myocardial infarct classification challenge. IEEE J Biomed Health Inform 2018; 22:503-515. [PMID: 28103561 PMCID: PMC5857476 DOI: 10.1109/jbhi.2017.2652449] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [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] [Indexed: 01/20/2023]
Abstract
Statistical shape modeling is a powerful tool for visualizing and quantifying geometric and functional patterns of the heart. After myocardial infarction (MI), the left ventricle typically remodels in response to physiological challenges. Several methods have been proposed in the literature to describe statistical shape changes. Which method best characterizes left ventricular remodeling after MI is an open research question. A better descriptor of remodeling is expected to provide a more accurate evaluation of disease status in MI patients. We therefore designed a challenge to test shape characterization in MI given a set of three-dimensional left ventricular surface points. The training set comprised 100 MI patients, and 100 asymptomatic volunteers (AV). The challenge was initiated in 2015 at the Statistical Atlases and Computational Models of the Heart workshop, in conjunction with the MICCAI conference. The training set with labels was provided to participants, who were asked to submit the likelihood of MI from a different (validation) set of 200 cases (100 AV and 100 MI). Sensitivity, specificity, accuracy and area under the receiver operating characteristic curve were used as the outcome measures. The goals of this challenge were to (1) establish a common dataset for evaluating statistical shape modeling algorithms in MI, and (2) test whether statistical shape modeling provides additional information characterizing MI patients over standard clinical measures. Eleven groups with a wide variety of classification and feature extraction approaches participated in this challenge. All methods achieved excellent classification results with accuracy ranges from 0.83 to 0.98. The areas under the receiver operating characteristic curves were all above 0.90. Four methods showed significantly higher performance than standard clinical measures. The dataset and software for evaluation are available from the Cardiac Atlas Project website1.
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Affiliation(s)
- Avan Suinesiaputra
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Pierre Ablin
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Xènia Albà
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Martino Alessandrini
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Jack Allen
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Wenjia Bai
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Serkan Çimen
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Peter Claes
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Brett R. Cowan
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Jan D’hooge
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Nicolas Duchateau
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Jan Ehrhardt
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Alejandro F. Frangi
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Ali Gooya
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Vicente Grau
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Karim Lekadir
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Allen Lu
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Anirban Mukhopadhyay
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Ilkay Oksuz
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Nripesh Parajuli
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Xavier Pennec
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Marco Pereañez
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Catarina Pinto
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Paolo Piras
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Marc-Michel Rohé
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Daniel Rueckert
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Dennis Säring
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Maxime Sermesant
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Kaleem Siddiqi
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Mahdi Tabassian
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Luciano Teresi
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Sotirios A. Tsaftaris
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Matthias Wilms
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Alistair A. Young
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Xingyu Zhang
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
| | - Pau Medrano-Gracia
- AS, XZ, BRC, AAY and PM-G are with the Department of Anatomy and Medical Imaging, Auckland, New Zealand. WB and DR are with Biomedical Image Analysis Group, Department of Computing, Imperial College London, UK. AM is with Zuse Institute Berlin, Germany. IO and SAT are with IMT Institute for Advanced Studies Lucca, Italy. SAT is also with the University of Edinburgh, UK. JA and VG are with the Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford. PA and KS are with School of Computer Science and Centre for Intelligent Machines, McGill University. KL, MP, and XA are with Department of Information and Communication Technologies, Universitat Pompeu Fabra Barcelona, Spain. SÇ, AG, CP and AFF are with the Center for Computational Imaging and Simulation Technologies in Biomedicine, University of Sheffield, UK. PP is with Department Structural Engineering & Geotechnics, Sapienza, Università di Roma, Italy. LT is with Dept. Mathematics & Physics, Roma Tre University, Italy. MT, MA and JD are with the Department of Cardiovascular Sciences, KU Leuven, Belgium. PC is with the Department of Electrical Engineering-ESAT, KU Leuven, Belgium. MT and MA are also with the Department of Electrical, Electronic and Information Engineering, University of Bologna, Italy. JE and MW are with the Institute of Medical Informatics, University of Lübeck, Lübeck, Germany. DS is with the University of Applied Sciences Wedel, Wedel, Germany. NP and AL are with the Department of Electrical Engineering and Biomedical Engineering, Yale University, New Haven, CT, USA. M-MR, ND, MS and XP are with the Inria Sophia-Antipolis, Asclepios Research Group, France
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Lu YM, Jiao B, Lee J, Zhang L, Yu ZB. Simulated microgravity increases myocardial susceptibility to ischemia-reperfusion injury via a deficiency of AMP-activated protein kinase. Can J Physiol Pharmacol 2016; 95:59-71. [PMID: 27831744 DOI: 10.1139/cjpp-2015-0456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 01/06/2023]
Abstract
Gravitation is an important factor in maintaining cardiac contractility. Our study investigated whether simulated microgravity increases myocardial susceptibility to ischemia-reperfusion (IR) injury. Using the Langendorff-perfused heart model with 300 beats/min pacing, 4-week tail suspension (SUS) and control (CON) male Sprague-Dawley rats (n = 10 rats/group) were subjected to 60 min of left anterior descending coronary artery (LAD) occlusion followed by 120 min of reperfusion. Left ventricular end-systolic pressure (LVESP), left ventricular end-diastolic pressure (LVEDP), creatine kinase (CK) and lactate dehydrogenase (LDH) activity, and infarct size were assessed. Data demonstrated that there were significantly increased LVEDP, CK, LDH, and infarct size in SUS compared with CON (P < 0.05), accompanied by decreased LVESP (P < 0.05). Furthermore, TUNEL-positive cardiomyocytes were higher in SUS than that in CON (P < 0.01), and AMP-activated protein kinase (AMPK) phosphorylation and Bcl-2/Bax in SUS were less compared with CON (P < 0.05). Similarly, isolated hearts pre-treated with A-769662 exhibited better recovery of cardiac function, increased AMPK phosphorylation, and reduced necrosis and apoptosis. Furthermore, AMPKα protein showed a significant suppression in 4-week hindlimb unweighting rats. These results suggest that AMPK deficiency increases myocardial susceptibility to IR injury in rats subjected to simulated microgravity.
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Affiliation(s)
- Yuan-Ming Lu
- a Department of Aerospace Physiology, Fourth Military Medical University, Key Laboratory of Aerospace Medicine, Ministry of China, Xi'an, 710032, China
| | - Bo Jiao
- a Department of Aerospace Physiology, Fourth Military Medical University, Key Laboratory of Aerospace Medicine, Ministry of China, Xi'an, 710032, China
| | - Jun Lee
- b Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Lin Zhang
- a Department of Aerospace Physiology, Fourth Military Medical University, Key Laboratory of Aerospace Medicine, Ministry of China, Xi'an, 710032, China
| | - Zhi-Bin Yu
- a Department of Aerospace Physiology, Fourth Military Medical University, Key Laboratory of Aerospace Medicine, Ministry of China, Xi'an, 710032, China
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38
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Saeed M, Bajwa HZ, Do L, Hetts SW, Wilson MW. Multi-detector CT and MRI of microembolized myocardial infarct: monitoring of left ventricular function, perfusion, and myocardial viability in a swine model. Acta Radiol 2016; 57:215-24. [PMID: 25735621 DOI: 10.1177/0284185115574737] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 08/05/2014] [Accepted: 01/31/2015] [Indexed: 01/15/2023]
Abstract
BACKGROUND Patients with acute myocardial infarct (MI) show additional damage after coronary interventions. PURPOSE To longitudinally quantify structural and functional changes in the left ventricle (LV) subjected to microembolized MI using multidisciplinary computed tomography (MDCT) and independent reference methods. MATERIAL AND METHODS Swine (n = 20) served as controls (group I) or were subjected to a combination of coronary occlusion, microembolization, and reperfusion and imaged at 3 days (group II) or 3 days and 5 weeks (group III). LV volumes, perfusion, and MI mass were quantified on cine, perfusion, and delayed contrast enhancement (DE) MDCT. MRI, cardiac injury biomarkers, histochemical and histopathologic stains were used as independent references. RESULTS MDCT showed a reduction in ejection fraction and increased end systolic volume (31 ± 2% and 82 ± 3 mL, respectively) of group III compared with I (48 ± 2% and 57 ± 1 mL, respectively). It also demonstrated perfusion deficits in microembolized MI and peri-infarcts. DE-MDCT delineated microvascular obstruction (MVO) zones embedded in acute microembolized MI and microinfarct specks resulting from persistent MVO by deposited microemboli in microvessels of peri-infarct zone. Bland-Altman test showed close agreements between the extents of microembolized MI measured on DE-MDCT, DE-MRI, and histochemical TTC staining, but not between these modalities and microscopy. MI resorption was evident between 3 days and 5 weeks (13.4 ± 0.5 g and 9.8 ± 0.5 g, P < 0.017) and histologic examination revealed incomplete healing. Injury biomarkers were increased after intervention. CONCLUSION MDCT can longitudinally quantify regional perfusion deficits, LV dysfunction, and resorption of microembolized MI. MDCT or MRI can be used alternatively after coronary interventions in cases of contraindications for one modality or the other.
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Affiliation(s)
- Maythem Saeed
- Department of Radiology and Biomedical Imaging, School of Medicine, University of California San Francisco, California, USA
| | - Hisham Z Bajwa
- Department of Radiology and Biomedical Imaging, School of Medicine, University of California San Francisco, California, USA
| | - Loi Do
- Department of Radiology and Biomedical Imaging, School of Medicine, University of California San Francisco, California, USA
| | - Steven W Hetts
- Department of Radiology and Biomedical Imaging, School of Medicine, University of California San Francisco, California, USA
| | - Mark W Wilson
- Department of Radiology and Biomedical Imaging, School of Medicine, University of California San Francisco, California, USA
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39
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Ferrando-Castagnetto F, Ricca-Mallada R, Vidal A, Martínez F, Ferrando R. [Left ventricular dyssynchrony in prolonged septal stimulation]. Medicina (B Aires) 2016; 76:321-325. [PMID: 27723623] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Pacemaker stimulation is associated with unpredictable severe cardiac events. We evaluated left ventricular mechanical dyssynchrony (LVMD) during prolonged septal right ventricular pacing. We performed 99mTc-MIBI gated-SPECT and phase analysis in 6 patients with pacemakers implanted at least one year before scintigraphy due to advanced atrioventricular block. Using V-Sync of Emory Cardiac Toolbox we obtained phase bandwidth (PBW) and standard deviation (PSD) from rest phase histogram. Clinical variables, QRS duration, rate and mode of pacing in septal right ventricle wall, chamber diameters, presence and extension of myocardial scar and ischemia and rest LVEF were recorded. Prolonged septal endocardial pacing is associated with marked LVMD, even when systolic function was preserved. More severe dyssynchrony was found in patients with impaired LVEF, higher left ventricle diameters, extensive infarct or severe ischemia than in patients with preserved LVEF (PBW: 177.3o vs. 88.3o; PSD: 53.1o vs. 33.8o). In the patients with ischemic heart disease and pacemaker, gated-SPECT phase analysis is a valid and potentially useful technique to evaluate LMVD associated with myocardial scar and to decide the upgrading to biventricular pacing mode.
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Affiliation(s)
- Federico Ferrando-Castagnetto
- 1Departamento de Cardiología, Centro Cardiovascular Universitario, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay, E-mail:
| | - Roberto Ricca-Mallada
- 1Departamento de Cardiología, Centro Cardiovascular Universitario, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Alejandro Vidal
- Departamento de Cardiología, Centro Cardiovascular Universitario, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Fabián Martínez
- Departamento de Cardiología, Centro Cardiovascular Universitario, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Rodolfo Ferrando
- Servicio de Medicina Nuclear, Centro Asistencial del Sindicato Médico, Montevideo, Uruguay
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40
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Lenkey Z, Varga-Szemes A, Simor T, van der Geest RJ, Kirschner R, Toth L, Bodnar T, Brott BC, Elgavish A, Elgavish GA. Age-independent myocardial infarct quantification by signal intensity percent infarct mapping in swine. J Magn Reson Imaging 2015; 43:911-20. [PMID: 26354594 DOI: 10.1002/jmri.25046] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 08/25/2015] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To test whether signal intensity percent infarct mapping (SI-PIM) accurately determines the size of myocardial infarct (MI) regardless of infarct age. MATERIALS AND METHODS Forty-five swine with reperfused MI underwent 1.5T late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) after bolus injection of 0.2 mmol/kg Gd(DTPA) on days 2-62 following MI. Animals were classified into acute, healing, and healed groups by pathology. Infarct volume (IV) and infarct fraction (IF) were determined by two readers, using binary techniques (including 2-5 standard deviations [SD] above the remote, and full-width at half-maximum) and the SI-PIM method. Triphenyl-tetrazolium-chloride staining (TTC) was performed as reference. Bias (percent under/overestimation of IV relative to TTC) of each quantification method was calculated. Bland-Altman analysis was done to test the accuracy of the quantification methods, while intraclass correlation coefficient (ICC) analysis was done to assess intra- and interobserver agreement. RESULTS Bias of the MRI quantification methods do not depend on the age of the MI. Full-width at half-maximum (FWHM) and SI-PIM gave the best estimate of MI volume determined by the reference TTC (P-values for the FWHM and SI-PIM methods were 0.183, 0.26, 0.95, and 0.073, 0.091, 0.73 in Group 1, Group 2, and Group 3, respectively), while using any of the binary thresholds of 2-4 SDs above the remote myocardium showed significant overestimation. The 5 SD method, however, provided similar IV compared to TTC and was shown to be independent of the size and age of MI. ICC analysis showed excellent inter- and intraobserver agreement between the readers. CONCLUSION Our results indicate that the SI-PIM method can accurately determine MI volume regardless of the pathological stage of MI. Once tested, it may prove to be useful for the clinic.
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Affiliation(s)
- Zsofia Lenkey
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Elgavish Paramagnetics Inc, Birmingham, Alabama, USA.,Medical School, University of Pecs, Hungary
| | - Akos Varga-Szemes
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Elgavish Paramagnetics Inc, Birmingham, Alabama, USA
| | - Tamas Simor
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Elgavish Paramagnetics Inc, Birmingham, Alabama, USA.,Medical School, University of Pecs, Hungary
| | - Rob J van der Geest
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert Kirschner
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Elgavish Paramagnetics Inc, Birmingham, Alabama, USA
| | - Levente Toth
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Elgavish Paramagnetics Inc, Birmingham, Alabama, USA
| | - Tamas Bodnar
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Elgavish Paramagnetics Inc, Birmingham, Alabama, USA
| | - Brigitta C Brott
- Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ada Elgavish
- Elgavish Paramagnetics Inc, Birmingham, Alabama, USA.,Department of Medicine, Division of Clinical Immunology & Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gabriel A Elgavish
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Elgavish Paramagnetics Inc, Birmingham, Alabama, USA
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Abstract
Atherosclerosis is the leading cause of death in the United States and worldwide, yet more men die from atherosclerosis than women, and at a younger age. Women, on the other hand, mainly develop atherosclerosis following menopause, and particularly if they have one or more autoimmune diseases, suggesting that the immune mechanisms that increase disease in men are different from those in women. The key processes in the pathogenesis of atherosclerosis are vascular inflammation, lipid accumulation, intimal thickening and fibrosis, remodeling, and plaque rupture or erosion leading to myocardial infarction and ischemia. Evidence indicates that sex hormones alter the immune response during atherosclerosis, resulting in different disease phenotypes according to sex. Women, for example, respond to infection and damage with increased antibody and autoantibody responses, while men have elevated innate immune activation. This review describes current knowledge regarding sex differences in the inflammatory immune response during atherosclerosis. Understanding sex differences is critical for improving individualized medicine.
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Affiliation(s)
- DeLisa Fairweather
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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42
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Sharma S, Mishra R, Walker BL, Deshmukh S, Zampino M, Patel J, Anamalai M, Simpson D, Singh IS, Kaushal S, Kaushal S. Celastrol, an oral heat shock activator, ameliorates multiple animal disease models of cell death. Cell Stress Chaperones 2015; 20:185-201. [PMID: 25300203 PMCID: PMC4255245 DOI: 10.1007/s12192-014-0536-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 08/05/2014] [Accepted: 08/08/2014] [Indexed: 12/11/2022] Open
Abstract
Protein homeostatic regulators have been shown to ameliorate single, loss-of-function protein diseases but not to treat broader animal disease models that may involve cell death. Diseases often trigger protein homeostatic instability that disrupts the delicate balance of normal cellular viability. Furthermore, protein homeostatic regulators have been delivered invasively and not with simple oral administration. Here, we report the potent homeostatic abilities of celastrol to promote cell survival, decrease inflammation, and maintain cellular homeostasis in three different disease models of apoptosis and inflammation involving hepatocytes and cardiomyocytes. We show that celastrol significantly recovers the left ventricular function and myocardial remodeling following models of acute myocardial infarction and doxorubicin-induced cardiomyopathy by diminishing infarct size, apoptosis, and inflammation. Celastrol prevents acute liver dysfunction and promotes hepatocyte survival after toxic doses of thioacetamide. Finally, we show that heat shock response (HSR) is necessary and sufficient for the recovery abilities of celastrol. Our observations may have dramatic clinical implications to ameliorate entire disease processes even after cellular injury initiation by using an orally delivered HSR activator.
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Affiliation(s)
- Sudhish Sharma
- />Division of Cardiac Surgery, University of Maryland Medical Center, 110 S. Paca Street, 7th Floor, Baltimore, MD 21201 USA
| | - Rachana Mishra
- />Division of Cardiac Surgery, University of Maryland Medical Center, 110 S. Paca Street, 7th Floor, Baltimore, MD 21201 USA
| | - Brandon L. Walker
- />Division of Cardiac Surgery, University of Maryland Medical Center, 110 S. Paca Street, 7th Floor, Baltimore, MD 21201 USA
| | - Savitha Deshmukh
- />Division of Cardiac Surgery, University of Maryland Medical Center, 110 S. Paca Street, 7th Floor, Baltimore, MD 21201 USA
| | - Manuela Zampino
- />Division of Cardiac Surgery, University of Maryland Medical Center, 110 S. Paca Street, 7th Floor, Baltimore, MD 21201 USA
| | - Jay Patel
- />Division of Cardiac Surgery, University of Maryland Medical Center, 110 S. Paca Street, 7th Floor, Baltimore, MD 21201 USA
| | - Mani Anamalai
- />Division of Cardiac Surgery, University of Maryland Medical Center, 110 S. Paca Street, 7th Floor, Baltimore, MD 21201 USA
| | - David Simpson
- />Division of Cardiac Surgery, University of Maryland Medical Center, 110 S. Paca Street, 7th Floor, Baltimore, MD 21201 USA
| | - Ishwar S. Singh
- />Division of Cardiac Surgery, University of Maryland Medical Center, 110 S. Paca Street, 7th Floor, Baltimore, MD 21201 USA
| | - Shalesh Kaushal
- />Retina Specialty Institute, 6717 North 11th Place Suite C, Gainesville, FL 32605 USA
| | - Sunjay Kaushal
- />Division of Cardiac Surgery, University of Maryland Medical Center, 110 S. Paca Street, 7th Floor, Baltimore, MD 21201 USA
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43
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Udholm S, Laugesen S, Agger P, Hønge J, Smerup M, Udholm N, Bøtker HE, Bøttcher M. Delayed uptake and washout of contrast in non-viable infarcted myocardium shown with dynamic computed tomography. Cardiovasc Diagn Ther 2014; 4:350-6. [PMID: 25414821 DOI: 10.3978/j.issn.2223-3652.2014.09.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 09/12/2014] [Indexed: 01/27/2023]
Abstract
BACKGROUND Assessment of ischemic but potentially viable myocardium plays an important role in the planning of coronary revascularization. Until now SPECT, PET, and MRI have been used to identify viable myocardium. Computed tomography (CT) is increasingly used to diagnose coronary atherosclerosis. OBJECTIVE To evaluate the feasibility of CT enhancement as a viability marker by investigating myocardial contrast distribution over time in pigs with experimentally induced antero-septal myocardial infarctions. METHODS Twelve pigs were subjected to 60 min of balloon occlusion of the left anterior descending artery, followed by removal of the balloon and reperfusion. Four pigs died due to refractory ventricular fibrillation. After 6 weeks, dynamic cardiac CT was performed assessing both wall motion and contrast attenuation. Measurements of attenuation values in Hounsfield units (HU) in the infarct zone and the normal lateral wall were performed at 20 s, and 1, 3, 5, 8 and 12 min after contrast injection. RESULTS We found highly significant differences in attenuation values between the two zones at all-time points except t =1 min (ANOVA P=0.85). The normal myocardium showed higher uptake- and washout-rates of contrast than the infarct zone (84±15 vs. 58±8 at 20 s, P=0.0001 and 27±12 vs. 81±13 at 12 min, P=0.0001). Specifically, the ratio between early (20 s) and late (12 min) uptake is a valid marker of viable myocardium. In all animals this ration was above one in the normal zone and below one in the infarct zone. CONCLUSIONS Delayed infarct related uptake and washout of contrast shows promise for future clinical application of CT in a combined assessment of coronary atherosclerosis and myocardial viability.
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Affiliation(s)
- Sebastian Udholm
- 1 Department of Cardiothoracic & Vascular Surgery T, 2 Department of Cardiology, Cardiac Imaging Center, Aarhus University Hospital, DK-8200 Aarhus N, Denmark ; 3 Cardiac Imaging Center, Hospital Unit West, Denmark
| | - Sofie Laugesen
- 1 Department of Cardiothoracic & Vascular Surgery T, 2 Department of Cardiology, Cardiac Imaging Center, Aarhus University Hospital, DK-8200 Aarhus N, Denmark ; 3 Cardiac Imaging Center, Hospital Unit West, Denmark
| | - Peter Agger
- 1 Department of Cardiothoracic & Vascular Surgery T, 2 Department of Cardiology, Cardiac Imaging Center, Aarhus University Hospital, DK-8200 Aarhus N, Denmark ; 3 Cardiac Imaging Center, Hospital Unit West, Denmark
| | - Jesper Hønge
- 1 Department of Cardiothoracic & Vascular Surgery T, 2 Department of Cardiology, Cardiac Imaging Center, Aarhus University Hospital, DK-8200 Aarhus N, Denmark ; 3 Cardiac Imaging Center, Hospital Unit West, Denmark
| | - Morten Smerup
- 1 Department of Cardiothoracic & Vascular Surgery T, 2 Department of Cardiology, Cardiac Imaging Center, Aarhus University Hospital, DK-8200 Aarhus N, Denmark ; 3 Cardiac Imaging Center, Hospital Unit West, Denmark
| | - Nichlas Udholm
- 1 Department of Cardiothoracic & Vascular Surgery T, 2 Department of Cardiology, Cardiac Imaging Center, Aarhus University Hospital, DK-8200 Aarhus N, Denmark ; 3 Cardiac Imaging Center, Hospital Unit West, Denmark
| | - Hans Erik Bøtker
- 1 Department of Cardiothoracic & Vascular Surgery T, 2 Department of Cardiology, Cardiac Imaging Center, Aarhus University Hospital, DK-8200 Aarhus N, Denmark ; 3 Cardiac Imaging Center, Hospital Unit West, Denmark
| | - Morten Bøttcher
- 1 Department of Cardiothoracic & Vascular Surgery T, 2 Department of Cardiology, Cardiac Imaging Center, Aarhus University Hospital, DK-8200 Aarhus N, Denmark ; 3 Cardiac Imaging Center, Hospital Unit West, Denmark
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44
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Regalado ES, Guo DC, Estrera AL, Buja LM, Milewicz DM. Acute aortic dissections with pregnancy in women with ACTA2 mutations. Am J Med Genet A 2013; 164A:106-12. [PMID: 24243736 DOI: 10.1002/ajmg.a.36208] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [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: 05/23/2013] [Accepted: 08/08/2013] [Indexed: 11/08/2022]
Abstract
Mutations in ACTA2 predispose to thoracic aortic aneurysms and dissection as well as coronary artery and cerebrovascular disease. Here we examined the risk of aortic dissections, stroke and myocardial infarct with pregnancy in women with ACTA2 mutations. Of the 53 women who had a total of 137 pregnancies, eight had aortic dissections in the third trimester or the postpartum period (6% of pregnancies). One woman also had a myocardial infarct that occurred during pregnancy that was independent of her aortic dissection. Compared to the population-based frequency of peripartum aortic dissections of 0.6%, the rate of peripartum aortic dissections in women with ACTA2 mutations is much higher (8 out of 39; 20%). Six of these dissections initiated in the ascending aorta (Stanford type A), three were fatal. Three women had ascending aortic dissections at diameters less that 5.0 cm (range 3.8-4.7 cm). Aortic pathology showed mild to moderate medial degeneration of the aorta in three women. Of note, five of the women had hypertension either during or before the pregnancy. In summary, the majority of women with ACTA2 mutations did not have aortic or other vascular complications with pregnancy. However, these findings show that pregnancy is associated with significant risk for aortic dissection in women with ACTA2 mutations. Women with ACTA2 mutations who are planning to get pregnant should be counseled about this risk of aortic dissection, and proper clinical management should be initiated to reduce this risk.
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Affiliation(s)
- Ellen S Regalado
- Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas
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45
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Crooijmans HJA, Ruder TD, Zech WD, Somaini S, Scheffler K, Thali MJ, Bieri O. Cardiovascular magnetization transfer ratio imaging compared with histology: a postmortem study. J Magn Reson Imaging 2013; 40:915-9. [PMID: 24227690 DOI: 10.1002/jmri.24460] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 09/08/2013] [Indexed: 11/06/2022] Open
Abstract
Cardiovascular magnetization transfer ratio (MTR) imaging by steady state free precession is a promising imaging method to assess microstructural changes within the myocardium. Hence, MTR imaging was correlated to histological analysis. Three postmortem cases were selected based on a suspicion of myocardial infarction. MTR and T2 -weighted (T2w ) imaging was performed, followed by autopsy and histological analysis. All tissue abnormalities, identified by autopsy or histology, were retrospectively selected on visually matched MTR and T2w images, and corresponding MTR values compared with normal appearing tissue. Regions of elevated MTR (up to approximately 20%, as compared to normal tissue), appearing hypo-intense in T2w -images, revealed the presence of fibrous tissue in microscopic histological analysis. Macroscopic observation (autopsy) described scar tissue only in one case. Regions of reduced MTR (up to approximately 20%) corresponded either to (i) the presence of edema, appearing hyperintense in T2w -images and confirmed by autopsy, or to (ii) inflammatory granulocyte infiltration at a microscopic level, appearing as hypo-intense T2w -signal, but not observed by autopsy. Findings from cardiovascular MTR imaging corresponded to histology results. In contrast to T2w -imaging, MTR imaging discriminated between normal myocardium, scar tissue and regions of acute myocardial infarction in all three cases.
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Affiliation(s)
- Hendrikus J A Crooijmans
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland
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46
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Haneef K, Lila N, Benadda S, Legrand F, Carpentier A, Chachques JC. Development of bioartificial myocardium by electrostimulation of 3D collagen scaffolds seeded with stem cells. Heart Int 2012. [PMID: 23185681 PMCID: PMC3504306 DOI: 10.4081/hi.2012.e14] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [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: 12/25/2022] Open
Abstract
Electrostimulation (ES) can be defined as a safe physical method to induce stem cell differentiation. The aim of this study is to evaluate the effectiveness of ES on bone marrow mesenchymal stem cells (BMSCs) seeded in collagen scaffolds in terms of proliferation and differentiation into cardiomyocytes. BMSCs were isolated from Wistar rats and seeded into 3D collagen type 1 templates measuring 25 × 25 × 6 mm. Bipolar in vitro ES was performed during 21 days. Electrical impedance and cell proliferation were measured. Expression of cardiac markers was assessed by immunocytochemistry. Viscoelasticity of collagen matrix was evaluated. Electrical impedance assessments showed a low resistance of 234±41 Ohms which indicates good electrical conductivity of collagen matrix. Cell proliferation at 570 nm as significantly increased in ES groups after seven day (ES 0.129±0.03 vs non-stimulated control matrix 0.06±0.01, P=0.002) and after 21 days, (ES 0.22±0.04 vs control 0.13±0.01, P=0.01). Immunocytoche mistry of BMSCs after 21 days ES showed positive staining of cardiac markers, troponin I, connexin 43, sarcomeric alpha-actinin, slow myosin, fast myosin and desmin. Staining for BMSCs marker CD29 after 21 days was negative. Electrostimulation of cell-seeded collagen matrix changed stem cell morphology and biochemical characteristics, increasing the expression of cardiac markers. Thus, MSC-derived differentiated cells by electrostimulation grafted in biological scaffolds might result in a convenient tissue engineering source for myocardial diseases.
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Affiliation(s)
- Kanwal Haneef
- University Paris Descartes, Pompidou Hospital, Laboratory of Biosurgical Research (LRB), Paris
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47
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Mäki MT, Koskenvuo JW, Ukkonen H, Saraste A, Tuunanen H, Pietilä M, Nesterov SV, Aalto V, Airaksinen KEJ, Pärkkä JP, Lautamäki R, Kervinen K, Miettinen JA, Mäkikallio TH, Niemelä M, Säily M, Koistinen P, Savolainen ER, Ylitalo K, Huikuri HV, Knuuti J. Cardiac Function, Perfusion, Metabolism, and Innervation following Autologous Stem Cell Therapy for Acute ST-Elevation Myocardial Infarction. A FINCELL-INSIGHT Sub-Study with PET and MRI. Front Physiol 2012; 3:6. [PMID: 22363288 PMCID: PMC3277266 DOI: 10.3389/fphys.2012.00006] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 01/10/2012] [Indexed: 01/04/2023] Open
Abstract
Purpose: Beneficial mechanisms of bone marrow cell (BMC) therapy for acute ST-segment elevation myocardial infarct (STEMI) are largely unknown in humans. Therefore, we evaluated the feasibility of serial positron emission tomography (PET) and MRI studies to provide insight into the effects of BMCs on the healing process of ischemic myocardial damage. Methods: Nineteen patients with successful primary reteplase thrombolysis (mean 2.4 h after symptoms) for STEMI were randomized for BMC therapy (2.9 × 106 CD34+ cells) or placebo after bone marrow aspiration in a double-blind, multi-center study. Three days post-MI, coronary angioplasty, and paclitaxel eluting stent implantation preceded either BMC or placebo therapy. Cardiac PET and MRI studies were performed 7–12 days after therapies and repeated after 6 months, and images were analyzed at a central core laboratory. Results: In BMC-treated patients, there was a decrease in [11C]-HED defect size (−4.9 ± 4.0 vs. −1.6 ± 2.2%, p = 0.08) and an increase in [18F]-FDG uptake in the infarct area at risk (0.06 ± 0.09 vs. −0.05 ± 0.16, p = 0.07) compared to controls, as well as less left ventricular dilatation (−4.4 ± 13.3 vs. 8.0 ± 16.7 mL/m2, p = 0.12) at 6 months follow-up. However, BMC treatment was inferior to placebo in terms of changes in rest perfusion in the area at risk (−0.09 ± 0.17 vs. 0.10 ± 0.17, p = 0.03) and infarct size (0.4 ± 4.2 vs. −5.1 ± 5.9 g, p = 0.047), and no effect was observed on ejection fraction (p = 0.37). Conclusion: After the acute phase of STEMI, BMC therapy showed only minor trends of long-term benefit in patients with rapid successful thrombolysis. There was a trend of more decrease in innervation defect size and enhanced glucose metabolism in the infarct-related myocardium and also a trend of less ventricular dilatation in the BMC-treated group compared to placebo. However, no consistently better outcome was observed in the BMC-treated group compared to placebo.
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Affiliation(s)
- Maija T Mäki
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital Turku, Finland
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48
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Smedema JP, Freeman V, Brink J. Aneurysm of the left aortic sinus causing acute myocardial infarction. Ann Pediatr Cardiol 2011; 4:189-91. [PMID: 21976885 PMCID: PMC3180983 DOI: 10.4103/0974-2069.84671] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This report describes the findings and management of a young male who presented with an acute ST-segment elevation myocardial infarction due to compression of the circumflex coronary artery by a large aneurysm of left sinus of Valsalva.
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49
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Tao Z, Zhao Z, Lee CC. 5'- Adenosine monophosphate induced hypothermia reduces early stage myocardial ischemia/reperfusion injury in a mouse model. Am J Transl Res 2011; 3:351-61. [PMID: 21904655 PMCID: PMC3158737] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Accepted: 07/12/2011] [Indexed: 05/31/2023]
Abstract
Early intervention using hypothermia treatment has been shown to reduce early inflammation, apoptosis and infarct size in animal models of cardiac ischemia/reperfusion. We have shown that 5'-adenosine monophosphate (5'-AMP) can induce a reversible deep hypothermia in mammals. We hypothesize that 5'-AMP-induced hypothermia (AIH) may reduce ischemic/reperfusion damage following myocardial infarct. C57BL/6J male mice were subjected to myocardial ischemia by ligating the left anterior descending coronary artery (LAD) followed by reperfusion. Compared to euthermic controls, mice given AIH treatment exhibited significant inhibition of neutrophil infiltration and a reduction in matrix metallopeptidase 9 (MMP-9) expressions in the infarcted myocardium. A decrease in terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL)-positive nuclei in the left ventricle myocardium were also observed. The overall infarct size of the heart was significantly smaller in AIH treated mice. Myocardial ischemia in mice given 5'-AMP without hypothermia had similar ischemia/reperfusion injuries as the euthermic control. Thus, the AIH cardio-protective effects were primarily hypothermia based.
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Affiliation(s)
- Zhenyin Tao
- Department of Biochemistry and Molecular Biology, Medical School of The University of Texas Health Science Center at Houston Houston TX 77225, USA
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50
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Abstract
The muscle lost after a myocardial infarction is replaced with noncontractile scar tissue, often initiating heart failure. Whole-organ cardiac transplantation is the only currently available clinical means of replacing the lost muscle, but this option is limited by the inadequate supply of donor hearts. Thus, cell-based cardiac repair has attracted considerable interest as an alternative means of ameliorating cardiac injury. Because of their tremendous capacity for expansion and unquestioned cardiac potential, pluripotent human embryonic stem cells (hESCs) represent an attractive candidate cell source for obtaining cardiomyocytes and other useful mesenchymal cell types for such therapies. Human embryonic stem cell-derived cardiomyocytes exhibit a committed cardiac phenotype and robust proliferative capacity, and recent testing in rodent infarct models indicates that they can partially remuscularize injured hearts and improve contractile function. Although the latter successes give good reason for optimism, considerable challenges remain in the successful application of hESCs to cardiac repair, including the need for preparations of high cardiac purity, improved methods of delivery, and approaches to overcome immune rejection and other causes of graft cell death. This review will describe the phenotype of hESC-derived cardiomyocytes and preclinical experience with these cells and will consider strategies to overcoming the aforementioned challenges.
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Affiliation(s)
- Wei-Zhong Zhu
- Department of Pathology, University of Washington, Seattle, WA 98109
| | - Kip Hauch
- Department of Bioengineering, University of Washington, Seattle, WA 98109
| | - Chunhui Xu
- Geron Corporation, 230 Constitution Drive, Menlo Park, CA 94025
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