RESUMO
A greater understanding of the molecular basis of hibernating myocardium may assist in identifying those patients who would most benefit from revascularization. Paired heart biopsies were taken from hypocontractile and normally-contracting myocardium (identified by cardiovascular magnetic resonance) from 6 patients with chronic stable angina scheduled for bypass grafting. Gene expression profiles of hypocontractile and normally-contracting samples were compared using Affymetrix microarrays. The data for patients with confirmed hibernating myocardium were analysed separately and a different, though overlapping, set (up to 380) of genes was identified which may constitute a molecular fingerprint for hibernating myocardium. The expression of B-type natriuretic peptide (BNP) was increased in hypocontractile relative to normally-contracting myocardium. The expression of BNP correlated most closely with the expression of proenkephalin and follistatin 3, which may constitute additional heart failure markers. Our data illustrate differential gene expression in hypocontractile and/hibernating myocardium relative to normally-contracting myocardium within individual human hearts. Changes in expression of these genes, including increased relative expression of natriuretic and other factors, may constitute a molecular signature for hypocontractile and/or hibernating myocardium.
Assuntos
Fator Natriurético Atrial/biossíntese , Encefalinas/biossíntese , Proteínas Relacionadas à Folistatina/biossíntese , Perfilação da Expressão Gênica , Contração Miocárdica , Miocárdio/metabolismo , Peptídeo Natriurético Encefálico/biossíntese , Precursores de Proteínas/biossíntese , Angina Pectoris/fisiopatologia , Fator Natriurético Atrial/genética , Encefalinas/genética , Proteínas Relacionadas à Folistatina/genética , Humanos , Peptídeo Natriurético Encefálico/genética , Precursores de Proteínas/genética , RNA Mensageiro/biossíntese , RNA Mensageiro/genética , Função Ventricular EsquerdaRESUMO
Upper limb deep vein thrombosis (DVT) is a less common phenomenon than lower limb DVT. Repeated trauma secondary to sport- or job-related arm movements and positions has been recognized as the predisposing factor for upper limb DVT. We describe a 38-year-old male computer programmer admitted with swelling and pain in his left upper limb. Venous duplex ultrasound confirmed the presence of axillary vein thrombosis. Coagulation studies for secondary thrombosis were unremarkable. The patient was treated with full anticoagulation using low molecular weight heparin and warfarin. On subsequent follow-up at 3 months, the patient was symptom free and duplex sonography showed no evidence of thrombosis.
Assuntos
Eletrocardiografia , Sistema de Condução Cardíaco/fisiopatologia , Frequência Cardíaca/fisiologia , Síndrome de Wolff-Parkinson-White/diagnóstico , Adolescente , Ablação por Cateter , Diagnóstico Diferencial , Sistema de Condução Cardíaco/cirurgia , Humanos , Masculino , Síndrome de Wolff-Parkinson-White/fisiopatologia , Síndrome de Wolff-Parkinson-White/cirurgiaRESUMO
Schistosomiasis is one of the most widespread parasitic infections in man. Neuroschistosomiasis, referring to schistosomal involvement of the central nervous system, is an uncommon but well recognised complication of schistosomal infection. The duration between time of infection and onset of neurological symptoms typically varies between weeks to months. We describe a case of transverse myelitis secondary to neuroschistosomiasis, presenting more than three years after the time of initial schistosomal infection, diagnosed and treated in the district general hospital setting.