Treatment of Complex Aorta Diseases by Multilayer Stents

The aim of our study was to evaluate the role of multilayer stents (MLS) in the therapeutic arsenal of complex aortic pathologies for frail patients combining several comorbidities that are initially objected to the conventional surgical treatment. Since March 2012, we conducted a monocentric prospective study on a series of 41 procedures, performed on 41 aortic lesion locations in38 patients treated with multilayer stents. 

The series was divided into four groups. The first group included 21 cases: 20 thoracoabdominal aneurysms and one aneurysm of the entire descending thoracic aorta. The second group included 7 cases of juxta/infra renal aneurysms, the third group included 5 cases of false aneurysms and the fourth group included 8 cases of aortic dissecting hematoma (first subgroup: 6 cases) or extended dissections (second subgroup: 2 cases). Read more>>>>>>>>>>>>

Knockdown of AAMP Impacts on HECV Cell Functions In Vitro and Affects the Expression of VE-Cadherin

The angiogenesis process is vitally important for growth, development and maintenance of a normal physiological state, playing key roles in essential processes such as reproduction, wound healing, and development. Despite this, imbalance of the angiogenic process is observed in a number of disease states. One key example is seen in cancer, where tumour angiogenesis is essential in facilitating advanced tumour growth and increased metastatic potential, a realisation that has led to the development of anti-angiogenic therapies. In 1995, Beckner et al. isolated a 52kDa protein from a human melanoma cell line, termed Angio-Associated Migratory Cell Protein (AAMP), during a search for motility associated cell surface proteins. 

The cytoplasmic and membrane located protein contains two immunoglobulin-like domains, a WD40 repeat and a heparin binding consensus sequence. The WD40 repeat motif is found in a wide range of proteins with diverse roles in signal transduction, transcriptional activation, cytoskeletal regulation and cell cycle control. The homology of AAMP with members of the immune globular super family suggests AAMP may have similar roles to these members, which include recognition and binding, cell-cell interaction and cell signalling. Read more>>>>>>>>>>>>>

Fatal Myocarditis in a Male with Systemic Sclerosis

Cardiac involvements in systemic sclerosis have a poor outcome. We report here a case of 28 year-old-man with history of systemic sclerosis developing a fatal myocarditis. Initially patient has disabling joint manifestation. Systemic sclerosis is diagnosed after progressive development of cutaneous, pulmonary, and gastrointestinal manifestations. One year after systemic sclerosis diagnosis, our patient develops heart failure signs when he is already treated with methotrexate (15 mg/week) and coticosteroids (15 mg/day).

A 28 year-old-man without medical history was complaining of arthralgia, Raynaud’s phenomenon and dysphagia since two years. At presentation, patient had no dyspnea or chest pain. At examination he has a persistent fever and synovitis with joint finger deformities. Sclerotic skin face and sclerodactylia with digital ulcers are apparent. Capillaroscopy show severe organic microangiopathy and foggy aspect without megacapillaries. Thoracic computed tomography confirms interstitial lung disease without forced vital capacity alteration (80%). Gastro-esophageal endoscopy reveals esophagitis. Cardiac echography doesn’t show any abnormality. C-reactive protein is high and creatinin phosphokinase is normal. Antinuclear antibodies are positive (1/800) and anti-centromere are negative. Read more>>>>>>>>>>>>>>>>>

Implication of Endothelin-2 and Oxidative Stress Biomarkers in Essential Hypertension

Hypertension is one of the major risk factors that contribute to cardiovascular and cerebrovascular endpoints. Currently, it is reported that 16.5% of all the deaths worldwide are due to hypertension of which 51% are due to stroke and 45% due to coronary heart disease (CHD) respectively. The molecular basis of Essential Hypertension (EH) is multifactorial, complex and poorly understood and recent interest is directed towards investigating the possible role of vascular hemostasis. The endothelium is recognized as an extremely active source ofvasoactive substances e.g. vasodilators and vasoconstrictors; the balance of which maintains vascular tone. 

Endothelin-2 is a member of the endothelin protein family (ET-1, ET-2 and ET-3) of secretory vasoconstrictive peptides that bind to G-protein-coupled receptors (GPCR), ET-RA and ET-RB. ET-1 is known as one of the most powerful vasoconstrictors in the vasculature. Although, ET-2 is very similar in structure as well as pharmacology to ET-1, studies in knockout mice and in cardiovascular system suggest that ET-2 may have a pathophysiologically distinct role than ET-1, that may be accomplished at the level of gene expression or in their synthesis and therefore, may act as different drug targets. Besides, mediating vasoconstriction, endothelins are shown to regulate growth in several cell types and may also affect differentiation, inflammation and angiogenesis. Read more>>>>>>>>>>>>>

A Rare Case of Catheter Induced Aorto-coronary Dissection

Catheter-induced coronary dissection is rare albeit life threatening complication of coronary angiography and angioplasty. Based on available studies the incidence of coronary dissection involving the aortic root is about 0.02 – 0.07%. Some of the predisposing conditions are hypertension, Marfan syndrome, congenital unicuspid and bicuspid aortic valves.It is more commonly associated with coronary angioplasty than with diagnostic angiography.

RCA angioplasty carries a higher risk for aorto –coronary dissection as compared to left coronary artery angioplasty, the mechanism of which is still not clear. Some of the proposed theory regarding the higher frequency seen in RCA are greater diameter of the left coronary artery than the right, the acute angle between left coronary artery and the ascending aorta compared to nearly right angle for right coronary artery, and more smooth muscles and collagen tissues in left coronary sinus. Read more.................

Myocardial Protective Effect of Exogenous Creatine Phosphate in Children Undergoing Open Heart Surgery

To obtain a bloodless operating field during open-heart surgery, aortic cross-clamping is deliberately introduced leading to a period of myocardial ischemia. As a consequence, an unbalance between demand and supply of cellular high-energy phosphates is created. This results in a rapid fall of creatine phosphate levels, followed by a decrease in the tissue content of ATP. Low levels of ATP are related to the loss of cellular function and the onset of cell injury and death. The precise mechanism of action is, however, still unclear. Most protective measures taken during open-heart surgery aimed at the conservation of cardiac high-energy phosphate pools in the ischemic tissues.

To this end, commonly electro-mechanical activity is abolished rapidly by intracoronary infusion of an ice-cold crystalloid or sanguineous cardioplegic solution immediately after aortic crossclamping. The clinical application of creatine phosphate (PCr) for cardioprotection during heart surgery and myocardial ischaemia is based on the results of a series of pharmacological studies in animal models. Its application as a cardioplegic additive and for intravenous infusion leads to significantly better functional recovery following ischaemia, during the postinfarction period and upon reperfusion. Read more>>>>>>>>>>>

A Non-Contact Method to Assess Contractility on the Langendorff’s Model Based on CCD Imaging

The ex vivo heart perfusion model is a well-accepted preparation, introduced more than a century ago. Nowadays, it is not so much used in the study of heart’s physiological principles, but in supplying corresponding physiological evidence to underlying molecular processes of ischemia, altered myocardial metabolism, new pharmaceutical agents, etc.,. Although it was named after Oscar Langendorff who demonstrated its use in the mammalian heart in 1895, the same model was well established by Elias Cyon in the frog heart as early as 1866.

The chronological reference to the origin of the method is important not only for historical reference reasons, but also, and particularly so, for highlighting the tremendous efforts of the early physiologists to develop suitable recording methods in parallel. Although the continuous pressure monitoring was achieved quite early, almost simultaneously with the genesis of the model, the morphometric assessment of the beating heart, by means of volumetric changes, diastolic and systolic changes, was not possible until much later, during Starling’s era. Read more.................