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1.
Cerebrovasc Dis ; 53(2): 224-232, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39250893

RESUMEN

Research on the pathophysiological mechanism of carotid artery dissection and its clinical translation is limited due to the lack of effective animal models to simulate the occurrence of this condition. Assuming that intimal injury is an important factor in the formation of carotid dissection, we established a novel method for inducing carotid dissection models by scraping the carotid intima using a fine needle. Scraping the carotid intima with fine needles can induce the rapid formation of carotid dissection. Magnetic resonance imaging and hematoxylin-eosin staining suggest the presence of false lumens and mural hematomas in the vessels. Our model-induction technique, inspired by iatrogenic catheter-induced artery dissections (carotid, coronary, aortic), significantly mimics the pathological process of clinical carotid dissection. The results suggest that mechanical injury may be a significant cause of carotid dissection and that intimal injury is a major factor in the formation of arterial dissections. This approach will provide assistance in the understanding of medically induced arterial dissection.


Asunto(s)
Modelos Animales de Enfermedad , Túnica Íntima , Animales , Túnica Íntima/patología , Túnica Íntima/lesiones , Masculino , Arterias Carótidas/patología , Arterias Carótidas/diagnóstico por imagen , Disección de la Arteria Carótida Interna/diagnóstico por imagen , Disección de la Arteria Carótida Interna/etiología , Disección de la Arteria Carótida Interna/patología , Traumatismos de las Arterias Carótidas/patología , Traumatismos de las Arterias Carótidas/diagnóstico por imagen , Traumatismos de las Arterias Carótidas/etiología , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/patología , Disección Aórtica/etiología
2.
Diving Hyperb Med ; 54(3): 188-195, 2024 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-39288923

RESUMEN

Introduction: Aortic dissections and dissections of cervical, cerebral, and coronary arteries have been previously reported in scuba divers. These incidents may be the consequence of a variety of physiological effects. We review the reported cases of arterial dissection in scuba divers and discuss potential contributing factors related to immersion and diving. Methods: Medline, CINAHL Plus, and SPORTDiscus were searched for published reports of arterial dissection and the Australasian Diving Safety Foundation fatality database was searched for additional cases from Australia. Identified cases were recorded and scrutinised for possible contributing factors. Results: Nineteen cases of arterial dissection, both fatal and non-fatal, were identified. These included cervical or intracranial artery dissection (n = 14), aortic dissection (n = 4), and coronary artery dissection (n = 1). There were 14 male and five female victims; mean age 44 years (SD 14, range 18-65). Contributing factors may include a combination of vasoconstriction and blood redistribution, untreated hypertension, increased pulse pressure, abnormal neck movement or positioning, constrictive and burdensome equipment, exercise, increased gas density and circuit resistance with concomitant elevated work of breathing, atheroma, and possibly the mammalian dive response. Conclusions: Dissecting aneurysms of the aorta or cervical, cerebral, and coronary arteries should be considered as a potential complication of scuba diving. The development of aneurysms associated with scuba diving is likely multifactorial in pathogenesis. Detailed reporting is important in the evaluation of cases. The potential role of the mammalian dive response as a contributing factor requires further evaluation.


Asunto(s)
Disección Aórtica , Buceo , Humanos , Buceo/efectos adversos , Buceo/fisiología , Masculino , Femenino , Adulto , Disección Aórtica/etiología , Disección Aórtica/fisiopatología , Persona de Mediana Edad , Anciano , Adolescente , Adulto Joven , Inmersión/efectos adversos , Inmersión/fisiopatología , Hipertensión/etiología , Disección de los Vasos Sanguíneos
3.
Ann Cardiol Angeiol (Paris) ; 73(4): 101794, 2024 Sep.
Artículo en Francés | MEDLINE | ID: mdl-39121667

RESUMEN

Iatrogenic coronary dissections are rare but potentially serious. Their management is complex, particularly if the dissection occurs without an angioplasty guide in the arterial lumen. In this context, angiography alone is insufficient, and endocoronary imaging is essential (using optical coherence or IVUS) to guide angioplasty when necessary (guide in the true lumen, coverage of the tear). We report here the case of an iatrogenic dissection of the right coronary artery treated with OFDI guiding.


Asunto(s)
Enfermedad Iatrogénica , Humanos , Tomografía de Coherencia Óptica , Vasos Coronarios/lesiones , Vasos Coronarios/diagnóstico por imagen , Angiografía Coronaria/efectos adversos , Masculino , Ultrasonografía Intervencional , Persona de Mediana Edad , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/etiología , Disección Aórtica/cirugía , Angioplastia Coronaria con Balón/efectos adversos , Anciano , Femenino
4.
Undersea Hyperb Med ; 51(2): 185-187, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38985154

RESUMEN

A 60-year-old man with hypertension and dyslipidemia complained of chest pain upon ascending from a maximum depth of 27 meters while diving. After reaching the shore, his chest pain persisted, and he called an ambulance. When a physician checked him on the doctor's helicopter, his electrocardiogram (ECG) was normal, and there were no bubbles in his inferior vena cava or heart on a portable ultrasound examination. The physician still suspected that he had acute coronary syndrome instead of decompression illness; therefore, he was transported to our hospital. After arrival at the hospital, standard cardiac echography showed a flap in the ascending aorta. Immediate enhanced computed tomography revealed Stanford type A aortic dissection. The patient obtained a survival outcome after emergency surgery. To our knowledge, this is the first reported case of aortic dissection potentially associated with scuba diving. It highlights the importance of considering aortic dissection in patients with sudden-onset chest pain during physical activity. In addition, this serves as a reminder that symptoms during scuba diving are not always related to decompression. This report also suggests the usefulness of on-site ultrasound for the differential diagnosis of decompression sickness from endogenous diseases that induce chest pain. Further clinical studies of this management approach are warranted.


Asunto(s)
Disección Aórtica , Dolor en el Pecho , Enfermedad de Descompresión , Buceo , Humanos , Buceo/efectos adversos , Masculino , Persona de Mediana Edad , Disección Aórtica/etiología , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/complicaciones , Disección Aórtica/cirugía , Dolor en el Pecho/etiología , Enfermedad de Descompresión/etiología , Enfermedad de Descompresión/terapia , Enfermedad de Descompresión/complicaciones , Enfermedad de Descompresión/diagnóstico por imagen , Enfermedad de Descompresión/diagnóstico , Enfermedad Aguda , Aneurisma de la Aorta/diagnóstico por imagen , Aneurisma de la Aorta/etiología , Aneurisma de la Aorta/complicaciones , Aneurisma de la Aorta/cirugía , Diagnóstico Diferencial
5.
Braz J Cardiovasc Surg ; 39(5): e20230252, 2024 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-39038234

RESUMEN

Cannulation strategies in aortic arch surgeries are a matter of immense discussion. Majority of time deep hypothermic circulatory arrest (DHCA) is the way out, but it does come with its set of demerits. Here we demonstrate a case with aortic arch dissection dealt with dual cannulation strategy in axillary and femoral artery without need for DHCA and ensuring complete neuroprotection of brain and spinal cord without hinderance of time factor. Inception of new ideas like this may decrease the need for DHCA and hence its drawbacks, thus decreasing the morbidity and mortality associated.


Asunto(s)
Disección Aórtica , Trasplante de Corazón , Humanos , Disección Aórtica/cirugía , Disección Aórtica/etiología , Trasplante de Corazón/efectos adversos , Masculino , Aneurisma de la Aorta Torácica/cirugía , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Paro Circulatorio Inducido por Hipotermia Profunda , Persona de Mediana Edad , Arteria Femoral/cirugía , Complicaciones Posoperatorias
6.
Int J Mol Sci ; 25(13)2024 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-39000474

RESUMEN

Marfan syndrome (MFS) is a rare congenital disorder of the connective tissue, leading to thoracic aortic aneurysms (TAA) and dissection, among other complications. Currently, the most efficient strategy to prevent life-threatening dissection is preventive surgery. Periodic imaging applying complex techniques is required to monitor TAA progression and to guide the timing of surgical intervention. Thus, there is an acute demand for non-invasive biomarkers for diagnosis and prognosis, as well as for innovative therapeutic targets of MFS. Unraveling the intricate pathomolecular mechanisms underlying the syndrome is vital to address these needs. High-throughput platforms are particularly well-suited for this purpose, as they enable the integration of different datasets, such as transcriptomic and epigenetic profiles. In this narrative review, we summarize relevant studies investigating changes in both the coding and non-coding transcriptome and epigenome in MFS-induced TAA. The collective findings highlight the implicated pathways, such as TGF-ß signaling, extracellular matrix structure, inflammation, and mitochondrial dysfunction. Potential candidates as biomarkers, such as miR-200c, as well as therapeutic targets emerged, like Tfam, associated with mitochondrial respiration, or miR-632, stimulating endothelial-to-mesenchymal transition. While these discoveries are promising, rigorous and extensive validation in large patient cohorts is indispensable to confirm their clinical relevance and therapeutic potential.


Asunto(s)
Aneurisma de la Aorta Torácica , Síndrome de Marfan , Transcriptoma , Síndrome de Marfan/genética , Síndrome de Marfan/metabolismo , Humanos , Aneurisma de la Aorta Torácica/genética , Aneurisma de la Aorta Torácica/metabolismo , Aneurisma de la Aorta Torácica/etiología , Biomarcadores , Animales , Disección Aórtica/genética , Disección Aórtica/etiología , Disección Aórtica/metabolismo , MicroARNs/genética , MicroARNs/metabolismo
7.
Atherosclerosis ; 395: 118519, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38944894

RESUMEN

BACKGROUND AND AIMS: The role of aortic mineralization in the pathogenesis of acute type B aortic dissection (TBAD) is unclear. Whether thoracic aortic calcification (TAC) and circulating alkaline phosphatase (ALP) activity are associated with acute TBAD risk remains elusive. METHODS: Observational and Mendelian randomization (MR) studies were conducted sequentially. Using propensity score matching (1:1) by age and sex, patients with acute TBAD (n = 125) were compared with control patients (n = 125). Qualitative (score) and quantitative (volume) analyses of the TAC burden on different thoracic aortic segments were conducted using non-enhanced computed tomography. Univariate and multivariate analyses were used to identify significant independent risk factors for TBAD and TAC burden, respectively. MR was finally used to determine the causal relationship between elevated ALP activity and TBAD risk. RESULTS: The qualitative and quantitative analyses revealed that TAC burden was significantly higher in the TBAD group, except for in the ascending aortic segment (both p < 0.05). Preoperative circulating ALP was significantly elevated in the TBAD group (p < 0.001). The elevated TAC burden score on the descending thoracic aortic segment (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.31-8.37) and increased ALP activity (OR 1.03, 95% CI 1.01-1.06) was independently associated with TBAD risk. Interestingly, ALP was significantly positively associated with TAC burden, and MR analyses confirmed that ALP genetically predicted TBAD risk. CONCLUSIONS: Elevated ALP may trigger TBAD risk via the increased volume of TAC. Aortic mineralization may not protect the aorta itself.


Asunto(s)
Fosfatasa Alcalina , Aneurisma de la Aorta Torácica , Disección Aórtica , Análisis de la Aleatorización Mendeliana , Calcificación Vascular , Humanos , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/etiología , Masculino , Femenino , Persona de Mediana Edad , Factores de Riesgo , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/genética , Calcificación Vascular/diagnóstico por imagen , Fosfatasa Alcalina/sangre , Anciano , Enfermedad Aguda , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/patología , Medición de Riesgo , Estudios de Casos y Controles , Biomarcadores/sangre , Aortografía/métodos , Predisposición Genética a la Enfermedad , Angiografía por Tomografía Computarizada
8.
Methodist Debakey Cardiovasc J ; 20(1): 45-48, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38855041

RESUMEN

Left ventricular assist devices (LVAD) are frequently used in the management of end-stage heart failure, especially given the limited availability of donor hearts. The latest HeartMate 3 LVAD delivers non-physiological continuous flow (CF), although the impact on the aorta is not well established. We highlight a case of aortic aneurysm formation complicated by dissection formation that necessitated high-risk re-operative surgery in a patient post CF-LVAD.


Asunto(s)
Aneurisma de la Aorta , Disección Aórtica , Implantación de Prótesis Vascular , Insuficiencia Cardíaca , Corazón Auxiliar , Humanos , Disección Aórtica/cirugía , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/etiología , Disección Aórtica/fisiopatología , Resultado del Tratamiento , Implantación de Prótesis Vascular/instrumentación , Implantación de Prótesis Vascular/efectos adversos , Aneurisma de la Aorta/cirugía , Aneurisma de la Aorta/diagnóstico por imagen , Aneurisma de la Aorta/etiología , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/terapia , Insuficiencia Cardíaca/cirugía , Masculino , Función Ventricular Izquierda , Reoperación , Persona de Mediana Edad , Aortografía , Angiografía por Tomografía Computarizada , Diseño de Prótesis
9.
Mol Med ; 30(1): 90, 2024 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-38886644

RESUMEN

BACKGROUND: Aortic dissection (AD) is a macrovascular disease which is pathologically characterized by aortic media degeneration.This experiment aims to explore how iron deficiency (ID) affects the function of vascular smooth muscle cell (VSMC) and participates in the occurrence and development of AD by regulating gene expression. METHODS: The relationship between iron and AD was proved by Western-blot (WB) and immunostaining experiments in human and animals. Transcriptomic sequencing explored the transcription factors that were altered downstream. WB, flow cytometry and immunofluorescence were used to demonstrate whether ID affected HIF1 expression through oxygen transport. HIF1 signaling pathway and phenotypic transformation indexes were detected in cell experiments. The use of the specific HIF1 inhibitor PX478 further demonstrated that ID worked by regulating HIF1. RESULTS: The survival period of ID mice was significantly shortened and the pathological staining results were the worst. Transcriptomic sequencing indicated that HIF1 was closely related to ID and the experimental results indicated that ID might regulate HIF1 expression by affecting oxygen balance. HIF1 activation regulates the phenotypic transformation of VSMC and participates in the occurrence and development of AD in vivo and in vitro.PX478, the inhibition of HIF1, can improve ID-induced AD exacerbation.


Asunto(s)
Disección Aórtica , Músculo Liso Vascular , Miocitos del Músculo Liso , Oxígeno , Transducción de Señal , Animales , Humanos , Masculino , Ratones , Disección Aórtica/metabolismo , Disección Aórtica/etiología , Disección Aórtica/genética , Disección Aórtica/patología , Modelos Animales de Enfermedad , Regulación de la Expresión Génica , Factor 1 Inducible por Hipoxia/metabolismo , Factor 1 Inducible por Hipoxia/genética , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Subunidad alfa del Factor 1 Inducible por Hipoxia/genética , Deficiencias de Hierro , Músculo Liso Vascular/metabolismo , Músculo Liso Vascular/patología , Miocitos del Músculo Liso/metabolismo , Oxígeno/metabolismo , Fenotipo
10.
Prague Med Rep ; 125(2): 130-137, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38761045

RESUMEN

We report a case of a 44-year-old woman surgically treated for tetralogy of Fallot who experienced an acute and extensive Stanford A type aortic dissection despite the meticulous follow-up. While aortic dilatation is prevalent in individuals with repaired tetralogy of Fallot, aortic dissection represents a rare consequence, that when it appears, is progressive and usually detected during the check-up visits. In the case reported, the dissection was unexpected and severe, and the patient's clinical state worsened suddenly, leading to death after a few days. Constant awareness for aortic aneurysms is essential in the Fallot tetralogy population, nevertheless, several causes may contribute to the acute worsening of the clinical condition until the patient's death.


Asunto(s)
Disección Aórtica , Tetralogía de Fallot , Humanos , Tetralogía de Fallot/cirugía , Tetralogía de Fallot/complicaciones , Tetralogía de Fallot/diagnóstico , Adulto , Femenino , Disección Aórtica/etiología , Disección Aórtica/cirugía , Disección Aórtica/diagnóstico , Resultado Fatal , Aneurisma de la Aorta Torácica/etiología , Aneurisma de la Aorta Torácica/cirugía , Aneurisma de la Aorta Torácica/diagnóstico
11.
Kyobu Geka ; 77(5): 357-360, 2024 May.
Artículo en Japonés | MEDLINE | ID: mdl-38720604

RESUMEN

A 52-year-old woman with Marfan syndrome developed Stanford type B aortic dissection and was treated with thoracic endovascular aortic repair. However, 29 months later, she presented with retrograde Stanford type A aortic dissection. We successfully performed aortic arch replacement with the frozen elephant trunk technique and valve-sparing aortic root replacement. The advantages of the frozen elephant trunk technique are that the distal anastomosis can be created without stent-graft resection and the cardiac arrest time is shortened. Therefore, the frozen elephant trunk technique was considered valuable and safe in this potentially lethal situation.


Asunto(s)
Aneurisma de la Aorta Torácica , Disección Aórtica , Síndrome de Marfan , Femenino , Humanos , Persona de Mediana Edad , Aorta Torácica/cirugía , Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/cirugía , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/etiología , Disección Aórtica/cirugía , Disección Aórtica/etiología , Disección Aórtica/diagnóstico por imagen , Implantación de Prótesis Vascular , Reparación Endovascular de Aneurismas , Síndrome de Marfan/complicaciones , Síndrome de Marfan/cirugía
12.
J Am Coll Cardiol ; 84(1): 130-136, 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38754705

RESUMEN

Iatrogenic aortic dissection is a rare but life-threatening complication of coronary artery bypass surgery. We report a case with incidentally detected iatrogenic aortic dissection related to aorta cross-clamping that was successfully managed with watchful follow-up. The decision making was based on 3-dimensional holographic and fluid dynamic analysis guidance.


Asunto(s)
Disección Aórtica , Puente de Arteria Coronaria , Holografía , Enfermedad Iatrogénica , Imagenología Tridimensional , Humanos , Disección Aórtica/etiología , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/cirugía , Holografía/métodos , Puente de Arteria Coronaria/efectos adversos , Masculino , Tomografía Computarizada por Rayos X , Anciano , Hidrodinámica , Aneurisma de la Aorta Torácica/cirugía , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/diagnóstico , Femenino
13.
Front Endocrinol (Lausanne) ; 15: 1405517, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38803481

RESUMEN

Objective: Some evidence suggests a reduced prevalence of type 2 diabetes mellitus (T2DM) in patients with aortic dissection (AD), a catastrophic cardiovascular illness, compared to general population. However, the conclusions were inconsistent, and the causal relationship between T2DM and AD remains unclear. Methods: In this study, we aimed to explore the causal relationship between T2DM and AD using bidirectional Mendelian randomization (MR) analysis. Mediation MR analysis was conducted to explore and quantify the possible mediation effects of 1400 metabolites in T2DM and AD. Results: The results of 26 datasets showed no causal relationship between T2DM and AD (P>0.05). Only one dataset (ebi-a-GCST90006934) showed that T2DM was a protective factor for AD (I9-AORTDIS) (OR=0.815, 95%CI: 0.692-0.960, P=0.014), and did not show horizontal pleiotropy (P=0.808) and heterogeneity (P=0.525). Vanillic acid glycine plays a mediator in the causal relationship between T2DM and AD. The mediator effect for vanillic acid glycine levels was -0.023 (95%CI: -0.066-0.021). Conclusion: From the perspective of MR analysis, there might not be a causal relationship between T2DM and AD, and T2DM might not be a protective factor for AD. If a causal relationship does exist between T2DM and AD, with T2DM serving as a protective factor, vanillic acid glycine may act as a mediator and enhance such a protective effect.


Asunto(s)
Disección Aórtica , Diabetes Mellitus Tipo 2 , Análisis de Mediación , Análisis de la Aleatorización Mendeliana , Humanos , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Disección Aórtica/genética , Disección Aórtica/epidemiología , Disección Aórtica/etiología
14.
Am J Cardiol ; 222: 108-112, 2024 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-38750948

RESUMEN

Acute aortic dissection (AAD) is a rare and potentially fatal complication associated with transcatheter aortic valve replacement (TAVR). Owing to the paucity of existing institutional data, we sought to assess the incidence of postimplant AAD in patients who underwent TAVR at a single institution. All patients who underwent TAVR from 2013 to 2022 were retrospectively reviewed to identify those who possessed clinical or radiologic evidence of AAD after TAVR. Follow-up and survival data were retrieved for all included patients. A total of 4,317 patients underwent TAVR, of whom 9 (0.2%) sustained an AAD. These patients had a mean age of 80 years (range 53 to 92), mean Society of Thoracic Surgeons 30-day mortality risk of 5.7% (2.4% to 16.7%), and mean effective aortic valve area of 0.8 cm2 (0.4 to 1.5 cm2). Preoperative maximum aortic diameter was 3.9 cm (2.6 to 4 cm). Of these 9 patients, 6 (67%) showed evidence of Stanford type A dissection, whereas 3 (33%) were diagnosed with Stanford type B dissection. The most common causes of dissection were posterior annular rupture by the transcatheter valve (THV) (44%) and THV embolization or "pop-out" into the ascending aorta (22%). A total of 6 patients (66.7%), comprising 5 type A (55.6%) and 1 type B (11.1%) aortic dissections, died within 30 days of AAD. The median time to follow-up in those surviving TAVR with intraoperative AAD was 1,042 days (range: 648 to 2,666). Surviving patients were managed through thoracic endovascular aortic repair and medical management. In conclusion, in this highly selected cohort of patients, our experience indicates that AAD after TAVR is a rare but often lethal intraprocedural sequela of THV implantation, especially in cases of type A aortic dissection.


Asunto(s)
Disección Aórtica , Estenosis de la Válvula Aórtica , Complicaciones Posoperatorias , Reemplazo de la Válvula Aórtica Transcatéter , Humanos , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Masculino , Disección Aórtica/etiología , Disección Aórtica/cirugía , Femenino , Anciano , Anciano de 80 o más Años , Estudios Retrospectivos , Complicaciones Posoperatorias/epidemiología , Persona de Mediana Edad , Estenosis de la Válvula Aórtica/cirugía , Enfermedad Aguda , Incidencia , Estudios de Seguimiento , Aneurisma de la Aorta Torácica/cirugía , Aneurisma de la Aorta Torácica/diagnóstico , Factores de Riesgo
15.
Cardiovasc Diabetol ; 23(1): 159, 2024 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-38715052

RESUMEN

BACKGROUND: In observational and experimental studies, diabetes has been reported as a protective factor for aortic dissection. 3-Hydroxybutyrate, a key constituent of ketone bodies, has been found to favor improvements in cardiovascular disease. However, whether the protective effect of diabetes on aortic dissection is mediated by 3-hydroxybutyrate is unclear. We aimed to investigate the causal effects of diabetes on the risk of aortic dissection and the mediating role of 3-hydroxybutyrate in them through two-step Mendelian randomization. MATERIALS AND METHODS: We performed a two-step Mendelian randomization to investigate the causal connections between diabetes, 3-hydroxybutyrate, and aortic dissection and calculate the mediating effect of 3-hydroxybutyrate. Publicly accessible data for Type 1 diabetes, Type 2 diabetes, dissection of aorta and 3-hydroxybutyrate were obtained from genome-wide association studies. The association between Type 1 diabetes and dissection of aorta, the association between Type 2 diabetes and dissection of aorta, and mediation effect of 3-hydroxybutyrate were carried out separately. RESULTS: The IVW method showed that Type 1 diabetes was negatively associated with the risk of aortic dissection (OR 0.912, 95% CI 0.836-0.995), The weighted median, simple mode and weighted mode method showed consistent results. The mediated proportion of 3-hydroxybutyrate on the relationship between Type 1 diabetes and dissection of aorta was 24.80% (95% CI 5.12-44.47%). The IVW method showed that Type 2 diabetes was negatively associated with the risk of aortic dissection (OR 0.763, 95% CI 0.607-0.960), The weighted median, simple mode and weighted mode method showed consistent results. 3-Hydroxybutyrate does not have causal mediation effect on the relationship between Type 2 diabetes and dissection of aorta. CONCLUSION: Mendelian randomization study revealed diabetes as a protective factor for dissection of aorta. The protective effect of type 1 diabetes on aortic dissection was partially mediated by 3-hydroxybutyrate, but type 2 diabetes was not 3-hydroxybutyrate mediated.


Asunto(s)
Ácido 3-Hidroxibutírico , Aneurisma de la Aorta , Disección Aórtica , Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Análisis de la Aleatorización Mendeliana , Humanos , Disección Aórtica/genética , Disección Aórtica/epidemiología , Disección Aórtica/etiología , Ácido 3-Hidroxibutírico/sangre , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiología , Factores de Riesgo , Aneurisma de la Aorta/genética , Aneurisma de la Aorta/epidemiología , Aneurisma de la Aorta/etiología , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/epidemiología , Medición de Riesgo , Factores Protectores , Fenotipo , Biomarcadores/sangre , Análisis de Mediación
16.
BMJ Case Rep ; 17(4)2024 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-38684352

RESUMEN

A man in his 20s with no medical illness sustained a blunt chest injury with pneumothorax and lung contusion after involving in a motorbike accident. Five days postadmission, he subsequently had myocardial infarction with cardiac arrest, in which coronary angiogram and intravascular ultrasound showed diffused multivessel coronary artery dissection.


Asunto(s)
Angiografía Coronaria , Infarto del Miocardio , Traumatismos Torácicos , Heridas no Penetrantes , Humanos , Masculino , Heridas no Penetrantes/complicaciones , Traumatismos Torácicos/complicaciones , Infarto del Miocardio/etiología , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/lesiones , Accidentes de Tránsito , Adulto , Disección Aórtica/etiología , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/complicaciones , Ultrasonografía Intervencional
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