Cardiovascular syphilis treated with transcatheter aortic valve replacement.

Cardiovascular syphilis presented with concomitant aortic regurgitation (AR) and left coronary ostial stenosis is rare, usually treated with on-pump aortic valve replacement and coronary artery bypass graft. We report a critical case of AR and left coronary ostial stenosis due to cardiovascular syphilis treated with emergent salvage transcatheter aortic valve replacement and percutaneous coronary intervention.

Intraoperative Fenestration of Frozen Elephant Trunk (FET) and Total Arch Replacement for Aortic Dissection in Aberrant Subclavian Artery.

BACKGROUND: Total arch replacement (TAR) and the frozen elephant trunk (FET) routinely are performed to treat aortic dissection. When aortic dissection combines with the aberrant right subclavian artery (aRSA), routine TAR+FET will occlude the ostium of aRSA. But there is no consensus regarding the optimal surgical strategy to revascularize the aRSA. We seek an uncomplicated and less time-intensive way to reconstruct the aRSA. METHODS: From July 2020 to April 2022, six patients with aortic dissection and aRSA underwent TAR+FET and intraoperative fenestration on the descending trunk. The mean age of the patients was 51.7 (SD 16.2; range 30.0-72.0). TAR+FET was performed via a median sternotomy and under cardiopulmonary bypass (CPB) and moderate hypothermic circulatory arrest (HCA). A fenestra of descending trunk was made intraoperative. RESULTS: There was no operative death in hospital and follow up. The average aortic cross-clamp time, SACP time, and lower body circulatory arrest time was 138.8 (SD 22.5; range 103.0-156.0) min and 28.3 (SD 3.9; range 25.0-35.0) min. Bleeding, neurological deficit, visceral ischemia, injury to the spinal cord, or organ dysfunction was not observed. Follow-up CTA showed the blood flow of aRSA was patent in all patients. CONCLUSION: TAR+FET and intraoperative fenestration on the descending trunk is an efficacious approach. It also reduces the difficulty of reconstruction the aRSA in aortic dissection patients.

Cardiac Papillary Fibroelastoma Result in Acute Left Main Coronary Artery Disease: A Case Report.

BACKGROUND: Cardiac papillary fibroelastoma is a rare, benign primary cardiac tumor that remains asymptomatic. Severe complications have been reported in some cases. The only effective therapy is surgical excision. CASE PRESENTATION: Here, we report a case of cardiac papillary fibroelastoma with the initial symptom of chest pain and a first diagnosis of acute left main coronary artery disease. This patient eventually underwent tumor excision surgery and recovered well. CONCLUSION: For patients with symptomatic cardiac papillary fibroelastoma, we provide a series of comprehensive data from before, during, and after surgery. This might be helpful for the future diagnosis and treatment of these tumors.

Predicting Value of Growth Differentiation Factor 15 and Its Correlations With Atrial Fibrillation.

AIMS: Despite several clinical risk factors for atrial fibrillation (AF), some newly identified biomarkers may also potentially serve as risk factors for AF. However, none of these factors so far have been adopted in clinical practice. Recently, a number of studies with an attempt to identify the role of growth differentiation factor 15 (GDF-15) in AF have obtained ambiguous results. We try to identify the predicting role of GDF-15 in AF and AF-related complications with meta-analysis or systematic analysis. METHODS AND RESULTS: We enrolled 10 studies, looking at the predicting role of GDF-15 in non-valvular AF using meta-analysis, summarized its role in AF-related major complications, and discussed whether it was dependable to forecast postoperative AF. It turned out that GDF-15 is an independent factor to predict occurrence of AF, while it remains obscure to directly demonstrate its relationship with postoperative AF. For AF patients on anti-platelet treatment, GDF-15 plays a critical role in predicting major bleeding, cardiovascular death and overall death, and improves the current predicting model. CONCLUSIONS: Circulating GDF-15 greatly associates with AF and AF-related complications. It should be applied clinically.

Microtubule Assists Actomyosin to Regulate Cell Nuclear Mechanics and Chromatin Accessibility.

Cellular behaviors and functions can be regulated by mechanical cues from microenvironments, which are transmitted to nucleus through the physical connections of cytoskeletons in the cells. How these physical connections determine transcriptional activity were not clearly known. The actomyosin, which generates intracellular traction force, has been recognized to control the nuclear morphology. Here, we have revealed that microtubule, the stiffest cytoskeleton, is also involved in the process of nuclear morphology alteration. The microtubule negatively regulates the actomyosin-induced nuclear invaginations but not the nuclear wrinkles. Moreover, these nuclear shape changes are proven to mediate the chromatin remodeling, which essentially mediates cell gene expression and phenotype determination. The actomyosin disruption leads to the loss of chromatin accessibility, which can be partly recovered by microtubule interference through nuclear shape control. This finding answers the question of how mechanical cues regulate chromatin accessibility and cell behaviors. It also provides new insights into cell mechanotransduction and nuclear mechanics.

The association between caffeine intake and risk of kidney stones: A population-based study.

Background: Although many studies have proven the beneficial effects of caffeine on human health, the association between caffeine intake and the risk of kidney stones is limited in large epidemiologic studies. Objectives: We aimed to investigate the association between caffeine intake and the risk of kidney stones. Methods: A total of 30,716 participants (with weight numbers of 204, 189, and 886) with a history of kidney stone were included in this analysis. All data were survey-weighted, and corresponding logistic regression models were performed to examine the associations between caffeine intake and the risk of kidney stones. Results: In a fully adjusted model, a per-quartile increase in caffeine intake was associated with a 5.32% decreased risk of kidney stones. In the subgroup analysis, the multivariate-adjusted odds ratios (95% confidence intervals) of the risk of kidney stones for per-quartile increments in caffeine intake were 0.9650 (0.9643, 0.9656) for men, 0.9320 (0.9313, 0.9327) for women, 0.9384 (0.9378, 0.9389) for white race individuals, 1.0281 (1.0270, 1.0292) for nonwhite race individuals, 0.9460 (0.9455, 0.9465) for overweight/obese individuals, and 0.9314 (0.9303, 0.9324) for non-overweight individuals, 0.9100 (0.9094, 0.9105) for caffeine from coffee, and 1.0021 (1.0013, 1.0029) for caffeine from non-coffee sources. Conclusion: Caffeine intake was negatively associated with the risk of kidney stones. In subgroup analyses, the negative association of caffeine with kidney stone risk was only found in white individuals. In addition, the decreased risk was found higher in women and non-overweight individuals. Especially for women, white individuals and non-overweight individuals. The protective effect of caffeine intake from coffee on stone formation was more significant than that of caffeine from non-coffee sources.

Behcet's disease involved the root of aorta in the treatment with modified Bentall procedure: a case report.

BACKGROUND: Behcet's disease (BD) is a multisystemic vasculitis of unknown etiology, the incidence of cardiovascular system involvement is rare, about1-5% (Sakane et al., N Engl J Med 341:1284-91, 1999). BD combined with aortic pseudoaneurysm and aortic valve regurgitation is usually need surgical treatment, but there is controversy about which surgical method to choose. CASE PRESENTATION: We report a case of BD combined with severe aortic valve regurgitation and two giant pseudoaneurysms of the aortic sinus. The patient underwent modified Bentall procedure (MBP) and use oral immunosuppressive as well as corticosteroid strictly, after 8 months follow-up, the patient recovered well. CONCLUSION: For patient with aortic valve regurgitation and ascend aortic pseudoaneurysm caused by BD, we recommend modified Bentall procedure when rheumatism in a stable period. Corticosteroids and immunosuppressive drugs should be used before and after surgery.