Exosomes: Potential Player in Endothelial Dysfunction in Cardiovascular Disease

Exosomes are spherical bilayer membrane vesicles with an average diameter of 40-100 nm. These particles perform a wide range of biological activities due to their contents, including proteins, nucleic acids, lipids, lncRNA, and miRNA. Exosomes are involved in inflammation induction, oxidative stress and apoptosis, which can be effective in endothelial dysfunction. Due to the induction of mentioned processes in the endothelial cells, the intercellular connections are destroyed, cell permeability increases and finally cell efficiency decreases and functional defects occur. Cardiovascular disease (CVDs) are of consequences of endothelial dysfunction. Thus by identifying the exosome signaling pathways, which induce inflammation, oxidative stress, and apoptosis, endothelial dysfunction and subsequently CVDs can be reduced; exosomes can be used for appropriate target therapy.

The correlation between cardiac magnetic resonance T2* and left ventricular global longitudinal strain in people with β-thalassemia

BACKGROUND

Heart failure is the biggest cause of mortality and morbidity in people with thalassemia, and iron deposition in cardiac tissue impairs cardiovascular function. Therefore, early detection of cardiac involvement is important to improve the prognosis in these individuals.

METHOD

Two- and three-dimensional echocardiography was performed to evaluate left ventricular ejection fraction (LVEF), left ventricular volumes and diameters, and global longitudinal strain (GLS) in 130 individuals with β-thalassemia using the speckle tracking method. Magnetic resonance imaging (MRI) was carried out on both the heart and liver. The participants were divided into 2 groups based on cardiac T2* values (normal and abnormal cardiac iron load), and the correlation between cardiac T2* MRI and GLS was evaluated.

RESULTS

The statistical analysis showed a significant correlation between cardiac T2* MRI and left ventricular global longitudinal strain. There was a significant difference in global longitudinal strain (P < .0001), liver MRI T2*( P < .0001), and left ventricular ejection fraction (P < .001) between the 2 groups. The optimal cutoff value for GLS was -18.5% with sensitivity and specificity 73.0% and 63.0%, respectively (postitive predictive value = 50%, negative predictive value = 82.3%, AUC = 0.742, std. error = 0.046) which predicts T2* value of <20 ms, according to cardiac MRI.

CONCLUSIONS

The participants with cardiac iron overload had a lower GLS than those without one. This suggests that GLS may be a useful method to predict myocardial iron overload particularly in β-thalassemia patients with subclinical cardiac involvement.

Mesoporous TiO2 microbead electrodes for solid state dye-sensitized solar cells

Mesoporous TiO₂ microbead films have been investigated as working electrode for solid state dye sensitized solar cells and 3.5% efficiency was achieved. Low trap density of microbead film leads to high voltage and fast electron transport.

Postinfarction intramyocardial dissection, an interesting case report and systematic review

Intramyocardial dissection (IMD) with ventricular septal rupture (VSR) following myocardial infarction (MI) is a rare subacute form of cardiac rupture. The evidence available in this regard is scarce. We aimed to share our experience and conduct a systematic review of previous cases. We searched the literature and performed a systematic review of previous cases. A total of 37 cases of IMD with VSR were included (1 our original and 36 literature cases). Mean age was 68 ± 8 years and 20 (54.1%) patients were male. Anterior and inferior MI were observed in 14 (37.8%) and 23 (62.2%) cases, respectively. The dissected area was the septum, RV, both septum and RV, or LV apex in 21 (56.8%), 9 (24.3%), 5 (13.5%), and 2 (5.4%), respectively. Apicoseptal and inferoseptal VSR were observed in 15 (40.5%) and 22 (59.5%) cases, respectively. At least one occluded artery was observed in 29 (90.6%) of cases. Reperfusion therapy was done for 15 (40.5%) cases before the VSR occurred. Surgery, percutaneous, and medical therapy were done for 26 (70.3%), 3 (8.1%), and 7 (18.9%) cases, respectively. The mortality rate was significantly higher in the medical versus surgical-treated group (85.7% versus 42.3%, P = .027). There was a trend to higher mortality in the group with dissection of both septum and RV (P = .15). We concluded that echocardiography has a critical role in diagnosing this complication. Surgery is mandatory in IMD with VSR.

Metal-based bracken-like single-sided dye-sensitized solar cells with horizontal separation

One of the drawbacks of typical dye-sensitized solar cells (DSCs) is their high cost and the high electrical resistance of the transparent conducting substrate. In conventional sandwich-type DSCs, only one of the FTO substrates can be replaced by a metal substrate. We investigated an all-metal-electrode single-sided DSC in which interpenetrated bracken-like Cr electrodes were created using photolithography; mesoporous TiO2 and Pt films were deposited on the laterally separated electrodes. Thermal Pt deposition and electrodeposition methods were investigated and it was found that a cyclic electrodeposition method resulted in selective Pt deposition at room temperature with a higher device performance. Cu or ZnO sacrificial layers and TiO2 or TiO2/SiO2 porous layers were used for the spacer layer that keeps the Pt electrode away from the TiO2 mesoporous layer and the optimum results were obtained when a TiO2/SiO2 layer was used. The best device had a current density of 8.47 mA cm(-2), an open circuit voltage of 0.685 V and an efficiency of 2.44%. The results of open circuit voltage decay and electrochemical impedance spectrometry showed the formation of a high-resistivity blocking layer, which was attributed to the Cr oxide formed during thermal treatment. The efficiency may be improved further by developing low-temperature fabrication processes.

The relationship between global longitudinal strain and pulmonary function tests in patients with scleroderma and normal ejection fraction and pulmonary artery pressure: a case-control study

This study examined the relationship between global longitudinal strain (GLS) and pulmonary function tests (PFT) in patients with systemic sclerosis (SS) and normal ejection fraction (EF) and pulmonary artery pressure (PAP) and healthy controls. Sixty patients in two groups underwent extensive screening, including echocardiography, physical examination, the modified Rodnan Skin Score, and pulmonary function tests. Pulmonary interstitial disease was diagnosed by the pulmonary function test and by CT scan in case of indication. GLS score was computed as the mean peak systolic strain for 17 segments. The mean GLS score was - 18.36 ± 2.1 in the case group and - 20.66 ± 1.6 in the control group (P value < 0.001). GLS scores had a significant inverse relationship with the forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) ratio (P value = 0.049) and both FEV and FVC in patients younger than 35 years old (P = 0.046 and 0.049, respectively). GLS scores had no significant relationship with time elapsed since the onset of skin manifestations, and Raynaud phenomenon, Rodnan score, EF, systolic PAP, or the six-minute walk test results. The patients' six-minute walk test had a significant positive relationship with FVC and right ventricular end diastolic diameter (P value = 0.018 and 0.047, respectively). According to our findings, GLS is significantly lower in patients with SS (with normal EF & PAP) than in healthy individuals. It is also related with certain pulmonary function indices including FEV1/FVC. The reduction in GLS is associated with reduced pulmonary function strength.

The Presence of Patent Foramen Ovale in the Superior Type of Sinus Venosus Atrial Septal Defect

Background: The superior type of sinus venosus atrial septal defect (SVASD) is a rare form of the atrial septal defect (ASD) in which the upper part of the atrial septum does not exist. The presence of other cardiac anomalies such as anomalous pulmonary venous connections has been reported in this type of congenital heart disease. This study aimed to assess the presence of the patent foramen ovale (PFO) in patients with the superior type of SVASD.

Methods: This retrospective case-control study on 387 patients, consisting of 187 patients with a definite SVASD and 200 patients with problems other than the ASD, was conducted in Rajaie Cardiovascular Medical and Research Center between February 2005 and July 2014. Seven patients with inadequate data were excluded from the analysis. The presence/absence of the PFO was also evaluated in the case and control groups.

Results: The analyses were performed on 182 male and 198 female patients at a mean age of 39.07±14.41 and 51.01±15.80 years in the case and control groups, respectively. The PFO was significantly more frequent in the patients with the superior type of SVASD than in those without the condition (P<0.001). The persistence of the left superior vena cava was seen in 34 out of 180 patients with SVASD and in 1 out of 200 patients without the condition (18.9% vs 0.5%; P<0.001).

Conclusion: This study was the first to highlight the coexistence of the PFO and the superior type of SVASD. Physiological, genetic, or fetal factors may play an important role in the association between the PFO and the SVASD.

Right ventricular myxoma originating from a papillary muscle: a case report

Very few cases of ventricular myxoma originate from a papillary muscle. Patients with a cardiac myxoma and a history of colorectal carcinoma are also rare. Here, we present a case of an extremely large right ventricular myxoma that originated from the posteromedial papillary muscle in a patient with a history of colorectal carcinoma.

Recombinant human erythropoietin reduces plasminogen activator inhibitor and ameliorates pro-inflammatory responses following trauma

BACKGROUND AND THE PURPOSE OF THE STUDY

sBesides its hematopoietic effects, erythropoietin (EPO) by mobilization of iron and modulation of some inflammatory cytokines has antioxidant and anti-inflammatory properties. The purpose of this study was to evaluate these effects of erythropoietin and its impact on organ function in traumatized patients.

METHODS

Twenty-six ICU-admitted traumatized patients within 24 hrs after trauma were randomly assigned to the EPO (received EPO, 300 units/Kg/day) and Control (not received EPO) groups. The inflammatory biomarkers including Tumor Necrosis Factor alpha (TNF-α), Interleukin 1 (IL-1), Plasminogen Activator Inhibitor 1 (PAI-1) and Nitrotyrosine were recorded at the admission, 3, 6 and 9 days thereafter. Acute Physiology and Chronic Health Evaluation (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were also recorded.

RESULTS

Among 12 patients (EPO group) TNF-α level at the day of 9 (P=0.046), and within EPO group at the days of 3 (P=0.026 ameliorate), 6 (P=0.016), and 9 (P=0.052) were significantly lowered. Level of IL-1 and PAI-1 decreased significantly at days of 3, 6 and 9 post intervention. Also there were significant differences between two groups in the SOFA score during three measured time intervals (the first, third and seventh days).

CONCLUSION

From the results of this study it seems that injection of erythrocyte stimulating agent is well tolerated and inhibits the inflammatory response and oxidative stress following trauma.

Giant congenital left ventricular diverticulum associated with infective endocarditis: A diagnosis made by tissue Doppler echocardiography

Left ventricular (LV) diverticulum is a relatively rare condition, and it is important to differentiate it from pseudoaneurysm. The increasing use of noninvasive imaging modalities can help to demonstrate different types of ventricular outpouching structures. We report a case of congenital LV diverticulum that is much larger than the usual size and is diagnosed with tissue Doppler echocardiography and cardiac magnetic resonance imaging. Although a ventricular diverticulum is mostly asymptomatic, in the case of this particular patient, it has become complicated with infective endocarditis. <Learning objective: Congenital ventricular diverticulum is a rare finding and can be diagnosed with noninvasive imaging modalities such as tissue Doppler echocardiography and cardiac magnetic resonance imaging rather than surgery. Although congenital ventricular diverticulum is asymptomatic in most cases, infective endocarditis is a known complication.>.

Potential Player of Platelet in the Pathogenesis of Cardiotoxicity: Molecular Insight and Future Perspective

Cancer patients may encounter the onset of cardiovascular disease due to tumor advancement or chemotherapy, commonly known as "cardiotoxicity." In this respect, the conventional chemotherapy treatment protocol involves a mixture of different medications. These medications can be detrimental to cardiac tissue, consequently exposing the patient to the possibility of irreversible cardiac injury. The enhancement of oxidative stress and inflammation is an important mechanism of chemotherapeutic agents for developing cardiotoxicity. Regarding their dual pro- and anti-inflammatory functions, platelets can significantly influence the progression or suppression of cardiotoxicity. Therefore, the expression of platelet activatory markers can serve as valuable prognostic indicators for cardiotoxicity. The primary objective of this study is to examine the significance of platelets in cardiotoxicity and explore potential strategies that could effectively target malignant cells while minimizing their cytotoxic impact, such as cardiotoxicity and thrombosis.

Clinical presentation, diagnostic evaluation, and management of undifferentiated/unclassified cardiac sarcoma: A case report and literature review

This case report details a challenging instance of undifferentiated/unclassified cardiac sarcoma in a 28-year-old female, presenting with diverse symptoms like muscle weakness, shortness of breath, and hemoptysis. Diagnostic hurdles led to an initial misdiagnosis of granulomatosis with polyangiitis before discovering a sizable left atrial mass, ultimately diagnosed as high-grade undifferentiated/unclassified sarcoma. Despite initial surgical intervention, the patient's condition worsened, underscoring the complexities in managing such cases involving cardiac sarcomas. This case emphasizes the diagnostic complexities associated with primary cardiac sarcomas, particularly the challenges in achieving accurate diagnoses and formulating effective treatment strategies.

Intravenous thrombolysis in a patient with acute ischemic stroke associated with a ruptured sinus Valsalva aneurysm: The first case report

Sinus Valsalva aneurysms (SVA) are rare asymptomatic cardiac anomalies, which can rupture and cause heart failure, myocardial infarction and also, they can be a potential source for embolic strokes. We report the first case of a patient with acute ischemic stroke associated with a ruptured SVA, who was treated with intravenous thrombolysis (tPA) without further complications.

Prediction of high-Tcsuperconductivity in two corrugated graphene sheets with intercalated CeH9molecules

Recent discoveries involving high-temperature superconductivity in H3S and LaH10have sparked a renewed interest in exploring the potential for superconductivity within hydrides. These superconductors require extremely high-pressure condition (∼100GPa), rendering them virtually impractical for industrial applications. In this study, we verify the occurrence of a low pressure superconductivity phase transition in a system containing two graphene layers with sine form corrugations where CeH9doped molecules are intercalated between the layers. The lowest-order constrained variational method is applied to calculate the thermodynamic and electrical properties of the valence electrons. We examine 9900 different distributions of CeH9molecules separately for finding a second-order phase transition with maximized critical temperature. The novelty of the present work is the prediction of a superconductivity transition atTc=198.61 K for a specific distribution of CeH9molecules with applying no external pressure on the exterior surfaces of the graphene sheets. Notably, this critical temperature is approximately 65 K higher than that observed in cuprate materials (HgBa2Ca2Cu3O8+δ), which are known for their highTcvalues at room pressure. It is interesting that in this particular case, the distribution periodicity of CeH9molecules bears the closest resemblance to the periodicity of the graphene corrugations among all 9900 examined cases. Computing the energy gap of the valence electrons reveals that this critical behavior corresponds to an unconventional superconductivity phase transition exhibiting a high critical current density on the order of∼107A cm-2.

Evaluation of PPAR-α, PPAR-γ, TLR2, TLR4 Gene Expression In Patients with Coronary Artery Disease (CAD): An Experimental Study

Background

Coronary artery disease (CAD) is one of the heart diseases that causes the death of many patients in the world. Many genes and molecular pathways are involved in the regulation of inflammation. However, some genes have a regulatory role and control immune responses. In recent studies, few studies have been done regarding the role of TLRs and PPARs in CAD. Hence, the present study aimed to determine and compare the mRNA expression of PPAR-α and PPAR-γ genes and genes of the innate immune system messenger pathway, including TLR2and TLR4, in CAD patients in comparison to normal individuals.

Methods

This study (case-control) was conducted on 12 patients with coronary arteries and 10 healthy individuals as healthy controls. RNA extraction was performed, cDNA was produced, and then the mRNA expression levels of TLR2, TLR4, PPAR-α, and PPAR-γ genes were examined using Syber green Real-Time PCR. The t-test sample and the related non-parametric tests were used to investigate the relationship between the quantitative variables. The significance level in all tests was considered as less than 0.05.

Results

The results of data analysis showed that the expression level of TLR2 and TLR4 genes was significantly increased in the patient group compared to the controls (P=0.001). However, although PPAR-α and PPAR-γ genes were up-regulated in patients' samples, the comparison of gene expression levels did not significantly differ between the case and control groups.

Conclusion

we found meaningful results to the significant role of 2 and TLR4 in the pathogenesis of CAD and emphasize the hypothesis that TLR2 and TLR4 can be considered therapeutic options.

Evaluating the Role of lncRNAs in the Incidence of Cardiovascular Diseases in Androgenetic Alopecia Patients

Hair loss occurs in patients with Androgenetic Alopecia (AGA). The pattern of hair loss is different between men and women. The main cause of hair loss is increased cell apoptosis and decreased regeneration, proliferation and differentiation processes in hair follicles. Long Non-Coding RNAs (lncRNAs) are one of the most important molecules that regulate the processes of apoptosis, regeneration, proliferation and differentiation in hair follicles. Since studies have shown that lncRNAs can be effective in the development of cardiotoxicity and induction of cardiovascular disease (CVD); so effective lncRNAs in the regulation of regeneration, proliferation, differentiation and apoptosis of hair follicles can be involved in the development of CVD in AGA patients with. Therefore, this study investigated the lncRNAs involved in increasing apoptosis and reducing the processes of regeneration, proliferation and differentiation of hair follicles. The aim of the current study was to evaluate the role of lncRNAs as a risk factor in the incidence of CVD in AGA patients; it will help to design treatment strategies by targeting signaling pathways without any cardiotoxicity complications.

Eosinophilic Granulomatosis With Polyangiitis Presenting With Visual Problems and Subendocardial Fibrosis, A Case Report

This case highlights the atypical presentation of eosinophilic granulomatosis with polyangiitis (EGPA) with neurological and cardiac complications, emphasizing the necessity of early recognition and aggressive treatment to prevent morbidity and mortality.

Three-dimensional speckle tracking echocardiography for evaluation of ventricular function in patients with systemic lupus erythematosus: relationship between duration of lupus erythematosus and left ventricular dysfunction by using global longitudinal strain

BACKGROUND

Cardiovascular diseases are leading causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Cardiac involvement in SLE can often go undetected. Three-dimensional (3D) speckle tracking echocardiography (STE) is a noninvasive imaging technique that can assess the function of the heart's ventricles in an accurate and reproducible way. This makes it an attractive option for detecting early signs of heart disease in SLE patients. By identifying these subclinical cardiac abnormalities, 3D-STE may help reduce the negative impact of cardiovascular diseases in SLE population. Therefore, this study aimed to compare the left ventricular (LV) function between patients with SLE compared to age- and gender-matched controls using two-dimensional (2D) and 3D-STE.

RESULTS

The current study found no significant differences in left ventricle ejection fraction, left ventricle end-diastolic volume, left ventricle end-systolic volume, left ventricle end-diastolic mass, and left ventricle end-systolic mass between the two groups. However, the SLE group exhibited a significantly lower LV global longitudinal strain (GLS) compared to the control group according to all types of echocardiographic assessments, including 3D and 2D long-axis strain, apical 2-chamber, and apical 4-chamber assessments (all P values < 0.05). Furthermore, a good inter-rater reliability and intra-rater reliability were observed regarding the LVGLS measurement with 3D-STE. Additionally, the study identified a significant correlation between LVGLS and SLE duration (r (50) = 0.46, P < 0.001). The use of prednisolone and nephrology disorders was also found to impact LVGLS measurements.

CONCLUSIONS

Despite a normal LVEF in patients with SLE, LVGLS measurements indicated that LV systolic dysfunction was observed more frequently in SLE patients compared to their healthy counterparts. Therefore, advanced 3D-STE techniques may be useful in identifying subtle abnormalities in LV function in SLE patients.