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A major portion of spinal cord injury (SCI) cases occur in the cervical region, where essential components of the respiratory neural circuitry are located. Phrenic motor neurons (PhMNs) housed at cervical spinal cord level C3-C5 directly innervate the diaphragm, and SCI-induced damage to these cells severely impairs respiratory function. In this study, we tested a biomaterial-based approach aimed at preserving this critical phrenic motor circuitry after cervical SCI by locally delivering hepatocyte growth factor (HGF). HGF is a potent mitogen that promotes survival, proliferation, migration, repair, and regeneration of a number of different cell and tissue types in response to injury. We developed a hydrogel-based HGF delivery system that can be injected into the intrathecal space for local delivery of high levels of HGF without damaging the spinal cord. Implantation of HGF hydrogel after unilateral C5 contusion-type SCI in rats preserved diaphragm function, as assessed by in vivo recordings of both compound muscle action potentials and inspiratory electromyography amplitudes. HGF hydrogel also preserved PhMN innervation of the diaphragm, as assessed by both retrograde PhMN tracing and detailed neuromuscular junction morphological analysis. Furthermore, HGF hydrogel significantly decreased lesion size and degeneration of cervical motor neuron cell bodies, as well as reduced levels surrounding the injury site of scar-associated chondroitin sulfate proteoglycan molecules that limit axon growth capacity. Our findings demonstrate that local biomaterial-based delivery of HGF hydrogel to injured cervical spinal cord is an effective strategy for preserving respiratory circuitry and diaphragm function.
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Despite gossip research's predominant focus on gossipers and gossip targets, existing theoretical views and the limited yet important empirical studies converge to suggest that gossip benefits its recipients. Our research builds on conservation of resources theory to shift this consensus by examining the negative effects of supervisor-directed gossip on recipients. We theorize that hearing negative supervisor-directed gossip triggers both cognition- and affect-focused rumination, which consume resources, and we develop a research question around the moderating role of hearing positive supervisor-directed gossip. Furthermore, we propose that the aforementioned effects have cascading implications for recipients' work behaviors the following day. In a 15-day experience sampling investigation of 122 workers, we found that on days when employees hear negative gossip about the supervisor, they are more likely to engage in cognition- and affect-focused rumination, and hearing positive supervisor-directed gossip strengthens these positive relationships. In addition, we found that cognition- and affect-focused rumination lead to poor sleep quality and diminished next-morning vitality, which in turn results in reduced work engagement and supervisor-directed organizational citizenship behavior. We conclude by discussing the implications and future directions of our work. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Emprego , Ruminação Cognitiva , Qualidade do Sono , Humanos , Adulto , Feminino , Masculino , Ruminação Cognitiva/fisiologia , Emprego/psicologia , Engajamento no Trabalho , Relações InterpessoaisRESUMO
Rechargeable magnesium-ion batteries (MIBs) hold significant promise as an alternative to conventional lithium-ion technology driven by their natural abundance and low-cost, high-energy density, and safety features. Spinel oxides, including MgCrVO4, have emerged as a prospective cathode material for MIBs due to their promising combination of capacity, operating potential, and cation mobility. However, the structural evolution, phase stability, and processes of Mg mobility in MgCrVO4 during electrochemical cycling are poorly understood. In this study, we synthesized a single-phase, solid solution of spinel oxide MgCrVO4 and employed operando X-ray diffraction to couple physical properties with structural changes during cycling. Our results revealed a two-phase reaction mechanism coupled with a solid-solution-like reaction, highlighting the complicated transformation between two distinct phases in the MgCrVO4 lattice during Mg (de)intercalation. Rietveld refinement of the operando data provided valuable insights into the mechanism of the Cr/V-based spinel oxide, shedding light on the transition between the two phases and their roles in Mg-ion (de)intercalation. This study contributes to a deeper understanding of the structural dynamics in multivalent cathode materials and sets the stage for the development of advanced Mg-ion cathodes with enhanced performance and stability.
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Choriocarcinoma is an exceptionally aggressive trophoblastic cell tumor that that typically originates in gonadal tissues, with rare occurrences outside the gonads, including the mediastinum, retroperitoneum, and intracranial sites. However, it rarely occurs in the stomach. Herein, we presented a case of primary gastric choriocarcinoma in a 27-year-old female patient who found multiple liver masses detected during physical examination, accompanied by remarkably elevated human chorionic gonadotropin levels. The 18F-FDG PET/CT scan suggested ring-shaped intense uptake masses located in the gastric sinus and liver, and no significance in the pelvic region. Final histopathology indicated primary choriocarcinoma of the stomach. This case illustrates that 18F-FDG PET/CT is an essential imaging technique for the clinical diagnosis and stage of primary choriocarcinoma.
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Background: Patients with gynecologic cancers experience side effects of chemotherapy cardiotoxicity. We aimed to quantify cardiac magnetic resonance (CMR) markers of myocardial fibrosis in patients with gynecologic cancer and low cardiovascular risk who undergo chemotherapy. Methods: This study is part of a registered clinical research. CMR T1 mapping was performed in patients with gynecologic cancer and low cardiovascular risk undergoing chemotherapy. The results were compared with those of age-matched healthy control subjects. Results: 68 patients (median age = 50 years) and 30 control subjects were included. The median number of chemotherapy cycles of patients was 9.0 (interquartile range [IQR] 3.3-17.0). Extracellular volume fraction (ECV) (27.2% ± 2.7% vs. 24.5% ± 1.7%, P < 0.001) and global longitudinal strain (-16.2% ± 2.8% vs. -17.4% ± 2.0%, P = 0.040) were higher in patients compared with controls. Patients with higher chemotherapy cycles (>6 cycles) (n=41) had significantly lower intracellular mass indexed (ICMi) compared with both patients with lower chemotherapy cycles (≤6 cycles) (n=27) (median 27.44 g/m2 [IQR 24.03-31.15 g/m2] vs. median 34.30 g/m2 [IQR 29.93-39.79 g/m2]; P = 0.002) and the control group (median 27.44 g/m2 [IQR 24.03-31.15 g/m2] vs. median 32.79 g/m2 [IQR 27.74-35.76 g/m2]; P = 0.002). Patients with two or more chemotherapy regimens had significantly lower ICMi compared with both patients with one chemotherapy regimen (27.45 ± 5.16 g/m2 vs. 33.32 ± 6.42 g/m2; P < 0.001) and the control group (27.45 ± 5.16 g/m2 vs. 33.02 ± 5.52 g/m2; P < 0.001). The number of chemotherapy cycles was associated with an increase in the ECV (Standard regression coefficient [ß] = 0.383, P = 0.014) and a decrease in the ICMi (ß = -0.349, P = 0.009). Conclusion: Patients with gynecologic cancer and low cardiovascular risk who undergo chemotherapy have diffuse extracellular volume expansion, which is obvious with the increase of chemotherapy cycles. Myocyte loss may be part of the mechanism in patients with a higher chemotherapy load. Clinical trial registration: http://www.chictr.org.cn, identifier ChiCTR-DDD-17013450.
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In order to investigate the mechanism of glucagon regulation of gluconeogenesis, primary hepatocytes of the Japanese flounder (Paralichthys olivaceus) were incubated with synthesized glucagon, and methods based on inhibitors and gene overexpression were employed. The results indicated that glucagon promoted glucose production and increased the mRNA levels of glucagon receptor (gcgr), guanine nucleotide-binding protein Gs α subunit (gnas), adenylate cyclase 2 (adcy2), protein kinase A (pka), cAMP response element-binding protein 1 (creb1), peroxisome proliferator-activated receptor-γ coactivator 1α (pgc-1α), phosphoenolpyruvate carboxykinase 1 (pck1), and glucose-6-phosphatase (g6pc) in the hepatocytes. An inhibitor of GCGR decreased the mRNA expression of gcgr, gnas, adcy2, pka, creb1, pgc-1α, pck1, g6pc, the protein expression of phosphorylated CREB and PGC-1α, and glucose production. The overexpression of gcgr caused the opposite results. An inhibitor of PKA decreased the mRNA expression of pgc-1α, pck1, g6pc, the protein expression of phosphorylated-CREB, and glucose production in hepatocytes. A CREB-targeted inhibitor significantly decreased the stimulation by glucagon of the mRNA expression of creb1, pgc-1α, and gluconeogenic genes, and glucose production decreased accordingly. After incubating the hepatocytes with an inhibitor of PGC-1α, the glucagon-activated mRNA expression of pck1 and g6pc was significantly down-regulated. Together, these results demonstrate that glucagon promotes gluconeogenesis through the GCGR/PKA/CREB/PGC-1α pathway in the Japanese flounder.
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Linguado , Gluconeogênese , Animais , Gluconeogênese/genética , Glucagon/metabolismo , Linguado/genética , Receptores de Glucagon/metabolismo , Hepatócitos/metabolismo , Glucose/metabolismo , Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , RNA Mensageiro/metabolismoRESUMO
BACKGROUND: Obesity is highly prevalent in patients with hypertrophic cardiomyopathy (HCM) and believed to influence its phenotype. PURPOSE: To explore the effects of obesity on left ventricular (LV) remodeling and long-term clinical course in Chinese patients with HCM. STUDY TYPE: Longitudinal. POPULATION: A total of 247 patients with HCM classified according to body mass index (BMI) (normal weight: BMI = 18.0-22.9 kg/m2 [N = 90]; overweight: BMI = 23.0-24.9 kg/m2 [N = 58]; and obese: BMI ≥ 25 kg/m2 [N = 99]). FIELD STRENGTH/SEQUENCE: 3.0 T/Balanced steady-state free precession sequence and phase-sensitive inversion recovery late gadolinium enhancement (LGE) sequence. ASSESSMENT: LV function and geometry were measured. LV peak strain analysis was performed. The presence and percentage of LGE in the LV were recorded. The endpoints including heart failure, sudden cardiac death, and overall composite outcome were assessed during a median follow-up of 4.1 years (interquartile range, 3.0-6.2 years). STATISTICAL TESTS: One-way analysis of variance, Kruskal-Wallis test, or chi-square test; Pearson correlation coefficient (r); multivariable linear regression analysis; Kaplan-Meier survival analysis; and Cox proportional hazards model analysis were conducted. A two-tailed P-value < 0.05 was considered statistically significant. RESULTS: Obese patients exhibited a significant progressive increase in LV mass compared with normal-weight patients. The magnitude of all LV strain indices gradually and significantly decreased as BMI increased, whereas LV ejection fraction was not significantly different among BMI groups (P = 0.364). Multivariable linear regression analysis showed that obesity had a significant association with impaired strain indices as well as with indexed LV mass. Multivariable Cox model analysis retained obesity as an independent marker for future endpoints, and conveyed a > 3-fold increase in risk compared with patients with normal weight (hazard ratio, 3.04; 95% confidence interval, 1.07-6.57). DATA CONCLUSION: Obesity is an important environmental modifier that is associated with adverse LV remodeling and is independently associated with future clinical outcomes in Chinese patients with HCM. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 2.
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Cardiomiopatia Hipertrófica , Meios de Contraste , Humanos , Remodelação Ventricular , População do Leste Asiático , Imagem Cinética por Ressonância Magnética , Gadolínio , Cardiomiopatia Hipertrófica/complicações , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Imageamento por Ressonância Magnética , Obesidade/complicações , Obesidade/diagnóstico por imagem , Função Ventricular Esquerda , Valor Preditivo dos TestesRESUMO
PURPOSE: This study aimed to describe a modified technique for primary unilateral incomplete cleft lip repair together with postoperative outcomes assessment. STUDY DESIGN: A Retrospective study. PARTICIPANTS AND SETTING: Photos of 64 consecutive patients with nonsyndromic primary unilateral incomplete cleft lip were reviewed. Of the 64 participants for the study sample, 32 patients had received Millard rotational advancement technique (RA), while the other 32 had modified rotational advancement technique (MRA) with preserving the nasal sill intact. It was conducted at a university-affiliated tertiary hospital between 2013 and 2021. MAIN MEASURES: The lip measures were represented by lip height and width, vermillion height, midline-philtrum angle, and angle of Cupid's bow peaks. The nasal measures involved columella length and angle, nostril height and width, and ala width. Both descriptive and comparative data analyses were calculated. RESULTS: Symmetrical lip height, lip width, philtrum angle, Cupid's bow, as well columellar length, and alar width were obtained following the MRA technique. No significant difference was found between the MRA and RA groups concerning the preoperative lip height, Cupid's bow angle, columellar length and angle. However, the postoperative lip height, width and columellar length were greater in MRA group than RA group (P= .001, 0.004 and 0.002, respectively). On the other hand, the MRA group had significantly smaller columellar and Cupid's bow peaks angles than RA group (0.53±0.36 vs 1.21±0.91 and 1.34±1.84 vs 3.14 ± 2.97, respectively). CONCLUSIONS: The MRA technique has obtained satisfactory lip and nasal outcomes in terms of lip height, lip width, philtrum angle, Cupid's bow, columellar length, and alar width while keeping the nasal sill intact.
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Fenda Labial , Humanos , Fenda Labial/cirurgia , Estudos Retrospectivos , Lábio/cirurgia , Nariz/cirurgiaRESUMO
Objective: Myocardial edema is an early manifestation of chemotherapy-related myocardial injury. In this study, we used cardiac magnetic resonance (CMR) T2 mapping to assess myocardial edema and its changes during chemotherapy for gynecologic malignancies. Methods: We enrolled 73 patients receiving chemotherapy for gynecologic malignancies, whose the latest cycle was within one month before the beginning of this study, and 41 healthy volunteers. All participants underwent CMR imaging. Of the 73 patients, 35 completed CMR follow-up after a median interval of 6 (3.3 to 9.6) months. The CMR sequences included cardiac cine, T2 mapping, and late gadolinium enhancement. Results: Myocardial T2 was elevated in patients who were treated with chemotherapy compared with healthy volunteers [41ms (40ms to 43ms) vs. 41ms (39ms to 41ms), P = 0.030]. During follow-up, myocardial T2 rose further [40ms (39ms to 42ms) vs. 42.70 ± 2.92ms, P < 0.001]. Multivariate analysis showed that the number of chemotherapy cycles was associated with myocardial T2 elevation (ß = 0.204, P = 0.029). After adjustment for other confounders, myocardial T2 elevation was independently associated with a decrease in left ventricular mass (ß = -0.186; P = 0.024). Conclusion: In patients with gynecologic malignancies, myocardial edema developed with chemotherapy cycles increase, and was associated with left ventricular mass decrease. T2 mapping allows the assessment of myocardial edema and monitoring of its change during chemotherapy.
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Background and Objectives: According to recent guidelines, myocardial contrast echocardiography (MCE) is recommended for detecting residual myocardial viability (MV). However, the long-term prognostic value of MV as assessed by MCE in identifying major adverse cardiac events (MACE) after acute myocardial infarction (AMI) remains undefined. Materials and Methods: We searched multiple databases, including PubMed, EMBASE, and Web of Science for studies on the prognostic value of MCE for clinical outcomes in AMI patients. The primary endpoints were MACEs during follow-up. Six studies that evaluated a total of 536 patients with a mean follow-up of 36.8 months were reviewed. Results: The pooled sensitivity and specificity of MCE for predicting MACEs were 0.80 and 0.78, respectively, and the summary operating receiver characteristics achieved an area under the curve of 0.84. The pooled relative risks demonstrated that the MV evaluated by MCE after AMI was correlated with a high risk for total cardiac events (pooled relative risk: 2.07; 95% confidence interval: 1.28-3.37) and cardiac death (pooled relative risk: 2.48; 95% confidence interval: 1.03-5.96). MV evaluated by MCE was a highly independent predictor of total cardiac events (pooled hazard ratio: 2.09, 95% confidence interval: 1.14-3.81) in patients after AMI. Conclusions: Residual MV evaluated by MCE may be an effective long-term prognostic tool for predicting MACE in patients after AMI that can provide moderate predictive accuracy. The assessment of MV by MCE may become an alternative technique with the potential to rapidly provide important information for improving long-term risk stratification in patients after AMI, at the bedside in clinical practice, especially for patients who cannot tolerate prolonged examinations. The PROSPERO registration number is CRD42020167565.
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Ecocardiografia , Infarto do Miocárdio , Humanos , Prognóstico , Ecocardiografia/métodos , Infarto do Miocárdio/diagnóstico por imagem , Miocárdio , Coração , Valor Preditivo dos TestesRESUMO
The present study was conducted to investigate the dietary replacement of fish meal with poultry by-product meal (PBM) on the growth performance, immunity, antioxidant properties, and intestinal health of red swamp crayfish (Procambarus clarkia). A diet containing 20% fish meal (FM) and complex plant ingredients as the main protein resources was set as the FM group (crude protein 32%, crude lipid 6%). Four diets replacing 25%, 50%, 75%, and 100% fish meal of the FM diet with PBM were set as the PBM25, PBM50, PBM75, and PBM100 groups, respectively. Compared to the FM group, the PBM100 diet significantly decreased growth performance and feed utilization of crayfish, while markedly increasing the activity of serum aspartate aminotransferase. The immune response was depressed in crayfish fed the PBM100 diet as the activities of serum lysozyme and phenoloxidase, gene expression of anti-lipopolysaccharide factors (alf), cyclophilin A (cypa), crustin, and hemocyanin-1 (hep-1) in hepatopancreas were remarkably decreased. The activities of antioxidases and expression of antioxidant-relevant genes in the hepatopancreas were not influenced by PBM inclusion. Crayfish fed different diets exhibited no obvious symptoms of enteritis, but the PBM100 diet destructed intestinal morphology by significantly decreasing the average length of longitudinal ridges. The α-diversity and overall community structure were not significantly influenced but variations were found in the relative abundance of some genera by PBM inclusion. In summary, CAP could successfully replace 75% dietary FM in a basal diet containing 20% fish meal, while higher CAP level compromised growth performance, immunity, and intestinal histology of crayfish.
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Astacoidea , Clarkia , Animais , Ração Animal/análise , Antioxidantes/farmacologia , Aves Domésticas , Imunidade Inata , Dieta/veterinária , PeixesRESUMO
Reversible electrochemical magnesium plating/stripping processes are important for the development of high-energy-density Mg batteries based on Mg anodes. Ether glyme solutions such as monoglyme (G1), diglyme (G2), and triglyme (G3) with the MgTFSI2 salt are one of the conventional and commonly used electrolytes that can obtain the reversible behavior of Mg electrodes. However, the electrolyte cathodic efficiency is argued to be limited due to the enormous parasitic reductive decomposition and passivation, which is governed by impurities. In this work, a systematic identification of the impurities in these systems and their effect on the Mg deposition-dissolution processes is reported. The mitigation methods generally used for eliminating impurities are evaluated, and their beneficial effects on the improved reactivity are also discussed. By comparing the performances, we proposed a necessary conditioning protocol that can be easy to handle and much safer toward the practical application of MgTFSI2/glyme electrolytes containing impurities.
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Occurrences and characteristics of atmospheric microplastics(MPs) have been widely studied by previous studies, while the mitigation of airborne MPs pollution was not well understood. In this study, atmospheric samples of MPs were collected in pairs on the rooftop and under trees composed of representative afforested species Ficus microcarpa in Chengdu, Southwest China, to explore whether trees could intercept MPs. Results showed that the daily life of human beings and textile industries of urban areas were sources of airborne MPs as revealed by chemical compositions and air trajectories. The trees with the high coverage degree (88%) and large three-dimensional spaces formed by leaves did have the ability to intercept high-density MPs with small sizes under the force of gravity. The intercepting rate was about 16.3%, 12,593 n/m2 of fibers and 347.69 kg of MPs could be intercepted by urban forests for one year. However, threshold values of rainfall intensity (12 mm/d) and rainfall amounts (14 mm) were found to limit the intercepting mechanism, and intercepting effects decrease with the increase of rainfall amounts (r =-0.71). This work provides quantitative evidence that elucidated urban forests may act as receptors of airborne MPs, thus improving the air quality and human health.
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Microplásticos , Poluentes Químicos da Água , Monitoramento Ambiental , Poluição Ambiental , Florestas , Humanos , Plásticos , Árvores , Poluentes Químicos da Água/análiseRESUMO
OBJECTIVES: Cancer chemotherapy potentially increases the risk of myocardial ischemia. This study assessed myocardial microvascular function by cardiac magnetic resonance (CMR) first-pass perfusion in patients treated with chemotherapy for gynecologic malignancies. METHODS: A total of 81 patients treated with chemotherapy for gynecologic malignancies and 39 healthy volunteers were prospectively enrolled and underwent CMR imaging. Among the patients, 32 completed CMR follow-up, with a median interval of 6 months. The CMR sequences comprised cardiac cine, rest first-pass perfusion, and late gadolinium enhancement. RESULTS: There were no significant differences in the baseline characteristics between the patients and normal controls (all p > 0.05). Compared with the normal controls, the patients had a lower myocardial perfusion index (PI) (13.62 ± 2.01% vs. 12% (11 to 14%), p = 0.001) but demonstrated no significant variation with an increase in the number of chemotherapy cycles at follow-up (11.79 ± 2.36% vs. 11.19 ± 2.19%, p = 0.234). In multivariate analysis with adjustments for clinical confounders, a decrease in the PI was independently associated with chemotherapy treatment (ß = - 0.362, p = 0.002) but had no correlation with the number of chemotherapy cycles (r = - 0.177, p = 0.053). CONCLUSION: Myocardial microvascular dysfunction was associated with chemotherapy treatment in patients with gynecologic malignancies, and can be assessed and monitored by rest CMR first-pass perfusion. KEY POINTS: ⢠Chemotherapy was associated with but did not aggravate myocardial microvascular dysfunction in patients with gynecologic malignancies. ⢠Rest CMR first-pass perfusion is an ideal modality for assessing and monitoring alterations in myocardial microcirculation during chemotherapy treatment.
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Cardiomiopatias , Neoplasias dos Genitais Femininos , Imagem de Perfusão do Miocárdio , Meios de Contraste , Circulação Coronária , Feminino , Gadolínio , Neoplasias dos Genitais Femininos/tratamento farmacológico , Humanos , Imagem Cinética por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Imagem de Perfusão do Miocárdio/métodos , Perfusão , Valor Preditivo dos TestesRESUMO
BACKGROUND: Mitral regurgitation (MR) is a comorbidity of myocardial infarction (MI), which may promote the incidence of adverse cardiovascular clinical events. However, it is not yet completely understood how MR in MI patients is associated with impaired myocardial deformation. PURPOSE: To determine the damaging myocardium effects of MR in MI patients in terms of the global peak strain (PS) and left ventricular (LV) function, and evaluate the independent risk factors impacting LV deformation after MI. STUDY TYPE: Retrospective. POPULATION: One hundred eighty-six MI patients (17.7% female) and 84 normal control subjects (27.4% female). FIELD STRENGTH/SEQUENCE: 3.0T; late gadolinium enhancement sequence, balanced steady-state free precession. ASSESSMENT: LV function and LV global PS (global radial peak strain [GRPS]; global circumferential peak strain [GCPS]; and global longitudinal peak strain [GLPS]) were compared among normal controls, MI without MR (MR-) and MI with MR (MR+, mild, moderate, severe) patients. STATISTICAL TESTS: One-way analysis of variance (ANOVA) test, Mann-Whitney U test, Kruskal-Wallis test, and multiple linear regressions were used. A P value <0.05 indicated statistically significant difference (two-tailed). RESULTS: The MI (MR+) patients showed significantly lower LV global PS than both MI (MR-) and control groups in three directions (GRPS 16.66 ± 7.43%; GCPS -11.27 ± 4.27%; GLPS -7.75 ± 3.44%), and significantly higher LV end-systolic (128.85 [87.91, 188.01] mL) and end-diastolic volumes (210.29 [164.07, 264.00] mL) and significantly lower LV ejection fraction (38.23 ± 13.02%). Multiple regression analysis demonstrated that MR was independently associated with LV GCPS (ß = -0.268) and GLPS (ß = -0.320). LV infarct size was an independent indicator of LV GRPS (ß = -0.215) and GCPS (ß = -0.222). LV end-diastolic volume was an independent indicator of LV GRPS (ß = -0.518), GCPS (ß = -0.503), and GLPS (ß = -0.331). DATA CONCLUSION: MR may further exacerbate the reduction of LV global peak strains and function. The MR, infarct size, and LV end-diastolic volume can be used as independent association indicators for LV global PS in MI (MR+) patients. LEVEL OF EVIDENCE: 4 Technical Efficacy Stage: 2 TOC Category: Chest.
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Insuficiência da Valva Mitral , Infarto do Miocárdio , Disfunção Ventricular Esquerda , Meios de Contraste , Feminino , Gadolínio , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Insuficiência da Valva Mitral/diagnóstico por imagem , Infarto do Miocárdio/complicações , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/patologia , Estudos Retrospectivos , Volume Sistólico , Disfunção Ventricular Esquerda/etiologia , Função Ventricular EsquerdaRESUMO
Myocardial fibrosis predisposes the development of main adverse cardiovascular events (MACEs) in various cardiac disorders. Native T1 derived from cardiac magnetic resonance allows the quantitative assessment of myocardial fibrosis without the use of contrast media. However, the prognostic value of native T1 in risk stratification remains uncertain. We searched MEDLINE®, Embase, and the Cochrane Library for cohort studies up to July 31, 2021, that reported prognostic data for native T1 in various cardiac disorders; the studies enrolling patients with myocardial iron or amyloid deposition, edema, and inflammation were excluded. A random effects meta-analysis was conducted. Heterogeneity was assessed using I2 statistic. Nineteen studies with 5,380 patients were included in this meta-analysis. Patients with MACEs had higher native T1 than those without [weighted mean difference: 27.35 (15.55-39.16), I2 = 23.2%]. The increase of native T1 per 1 ms [pooled adjusted hazard ratio (HR): 1.02 (1.00-1.03), I2 = 41.8%] and per ≥ 10 ms [pooled adjusted HR: 1.11 (1.07-1.16), I2 = 28.6%] was both associated with the development of MACEs; the categorical variable derived from native T1 also has the predicative value for MACEs [pooled adjusted HR: 5.97 (3.69-9.68), I2 = 0.0%].Myocardial native T1 potentially serves as a prognostic biomarker in patients with various cardiac disorders. Different variable definitions of native T1 have different positively predictive value for outcome; the categorical variable derived from native T1 may be more helpful in identifying high-risk patients.
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Cardiomiopatias , Doenças Cardiovasculares , Cardiomiopatias/patologia , Meios de Contraste , Fibrose , Humanos , Imagem Cinética por Ressonância Magnética , Miocárdio/patologia , Valor Preditivo dos Testes , PrognósticoRESUMO
OBJECTIVE: This meta-analysis assessed the associations of myocardial fibrosis detected by late gadolinium-enhanced (LGE)-MRI with the risk of major adverse cardiac and cerebrovascular events (MACCEs) and major adverse cardiac events (MACEs) in patients with diabetes. DESIGN: Systematic review and meta-analysis reported in accordance with the guidelines of the Meta-analysis of Observational Studies in Epidemiology statement. DATA SOURCES: We searched the Medline, Embase and Cochrane by Ovid databases for studies published up to 27 August 2021. ELIGIBILITY CRITERIA: Prospective or respective cohort studies were included if they reported the HR and 95% CIs for MACCEs/MACEs in patients with either type 1 or 2 diabetes and LGE-MRI-detected myocardial fibrosis compared with patients without LGE-MRI-detected myocardial fibrosis and if the articles were published in the English language. DATA EXTRACTION AND SYNTHESIS: Two review authors independently extracted data and assessed the quality of the included studies. Pooled HRs and 95% CIs were analysed using a random effects model. Heterogeneity was assessed using forest plots and I2 statistics. RESULTS: Eight studies with 1121 patients with type 1 or type 2 diabetes were included in this meta-analysis, and the follow-up ranged from 17 to 70 months. The presence of myocardial fibrosis detected by LGE-MRI was associated with an increased risk for MACCEs (HR: 2.58; 95% CI 1.42 to 4.71; p=0.002) and MACEs (HR: 5.28; 95% CI 3.20 to 8.70; p<0.001) in patients with diabetes. Subgroup analysis revealed that ischaemic fibrosis detected by LGE was associated with MACCEs (HR 3.80, 95% CI 2.38 to 6.07; p<0.001) in patients with diabetes. CONCLUSIONS: This study demonstrated that ischaemic myocardial fibrosis detected by LGE-MRI was associated with an increased risk of MACCEs/MACEs in patients with diabetes and may be an imaging biomarker for risk stratification. Whether LGE-MRI provides incremental prognostic information with respect to MACCEs/MACEs over risk stratification by conventional cardiovascular risk factors requires further study.
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Diabetes Mellitus Tipo 2 , Gadolínio , Meios de Contraste , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/patologia , Fibrose , Humanos , Idioma , Imageamento por Ressonância Magnética , Imagem Cinética por Ressonância Magnética/métodos , Miocárdio/patologia , Valor Preditivo dos Testes , Prognóstico , Estudos ProspectivosRESUMO
Background: Myocardial injury may be caused by myocardial ischemia-reperfusion (IR), and salvaging such an injury is still a great challenge in clinical practice. This study comprehensively characterized the physiopathologic changes of myocardial injury after IR to explore the underlying mechanism in the early reperfusion phase with particular emphasis on early myocardial inflammation. Methods and Results: The experimental IR model was obtained by the left anterior descending artery's transient ligation of C57BL/6 mice. T2W signals of all mice showed increased signal at different IR stages. It was positively correlated with inflammatory cytokines and cells. T2W imaging by 7.0 T MRI surprisingly detected signal enhancement, but histopathology and flow cytometry did not reveal any inflammatory cells infiltration within 3 h after IR. Cardiomyocyte swelling and increased vascular permeability were observed by WGA staining and ultrastructural analysis, respectively. The 3 h IR group showed that the cardiomyocytes were severely affected with disintegrating myofilaments and mitochondria. Both VEGF and phosphorylated Src protein were markedly expressed in the 3 h IR group in comparison with the sham group, and TUNEL staining displayed little positive cells. Cleaved caspase-3 apoptin also has similar expression levels with that of the sham group. Resident macrophages had notably become M1 phenotype. The T2W signal was still elevated, and we observed that collagen deposition occurred from 1 to 7 days. Conclusions: The inflammation response during the first week after reperfusion injury gradually increase 3 h later, but the main manifestation before that was edema. This study indicated that the first 3 h may be crucial to the early rescue process for reperfusion-induced myocardial injury due to inflammatory cell infiltration absence and apoptosis.
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Traumatismo por Reperfusão Miocárdica , Camundongos , Animais , Traumatismo por Reperfusão Miocárdica/metabolismo , Camundongos Endogâmicos C57BL , Miocárdio/patologia , Miócitos Cardíacos/metabolismo , Inflamação/metabolismoRESUMO
BACKGROUND: The pathophysiological changes in the remote myocardium after acute myocardial infarction (MI) remains less understood. PURPOSE: To assess the inflammation in the remote myocardium post-MI and its association with left ventricular (LV) remodeling using T2 mapping. STUDY TYPE: Prospective. ANIMAL MODEL AND SUBJECTS: Twelve pigs at 3-day post-MI, 6 pigs at 3-month post-MI, 6 healthy pigs; 54 patients at 3-day and 3-month post-MI, 31 healthy volunteers; FIELD STRENGTH/SEQUENCE: A 3 T MRI/ steady-state free-precession sequence for T2 mapping (animals: 0, 30, and 55 msec; human: 0, 25, and 55 msec), phase-sensitive inversion recovery gradient echo for late gadolinium enhancement (LGE), balanced steady free-precession sequence for cine. ASSESSMENT: Infarcted myocardium was defined on LGE, remote T2 was measured on T2 maps. LV remodeling was evaluated as LV end-diastolic volume change index between two scans using cine. CD68 staining was conducted to detect monocyte/macrophage. STATISTICAL TESTS: Student-t test and one-way ANOVA were used to compare remote T2 with normal controls. The association of remote T2 with LV remodeling was assessed using linear regression. P values of <0.05 were used to denote statistical significance. RESULTS: Compared with healthy pigs, remote T2 significantly increased from 3 days to 3 months post-MI (31.43 ± 0.67 vs. 33.53 ± 1.15 vs. 36.43 ± 1.07 msec). CD68 staining demonstrated the inflammation in remote myocardium post-MI but not in healthy pigs. Significant remote myocardial alterations in T2 were also observed in human group (40.51 ± 1.79 vs. 41.94 ± 1.14 vs. 42.52 ± 1.71 msec). In patients, the 3-month remote T2 (ß = 0.432) and remote T2 variation between two scans (ß = 0.554) were both independently associated with LV remodeling. CONCLUSION: T2 mapping could characterize the abnormalities in the remote myocardium post-MI, which was potentially caused by the inflammatory response. Moreover, variations in remote T2 were associated with LV remodeling. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 3.
Assuntos
Infarto do Miocárdio , Remodelação Ventricular , Animais , Meios de Contraste , Gadolínio , Humanos , Inflamação/diagnóstico por imagem , Imagem Cinética por Ressonância Magnética , Infarto do Miocárdio/diagnóstico por imagem , Miocárdio , Projetos Piloto , Estudos Prospectivos , SuínosRESUMO
OBJECTIVES: This study aimed to explore the associations between soluble epoxide hydrolase 2 gene (EPHX2) variants and non-syndromic cleft lip with or without cleft palate (NSCL/P) in Chinese Han population. METHODS: We recruited 159 NSCL/P cases from Chinese Han population and carried out targeted resequencing using the whole genome sequencing data of 542 healthy Chinese individuals from Novegene internal database as controls. We classified EPHX2 variants as common or rare according to their minor allele frequency and performed an association analysis for common variations and a burden analysis for rare variations. RESULTS: The lowest P-value in NSCL/P was observed at rs57699806 (P=0.000 13, OR=2.849 and 95% CI: 1.691-4.800), followed by rs4732723 (P=0.006 50, OR=0.662 and 95%CI: 0.491-0.892), rs7829267 (P=0.009 20, OR=1.496 and 95%CI: 1.117-2.005), rs721619 (P=0.011 00, OR=1.474 and 95%CI: 1.098-1.980), and rs7816586 (P=0.040 00, OR=1.310 and 95%CI: 1.015-1.691). The odds ratios suggested the C allele at rs4732723 as a protective factor for NSCL/P and the reference alleles at other single nucleotide polymorphisms (SNPs) as the risk factors for NSCL/P. Burden analysis showed no statistical significance (P>0.05). CONCLUSIONS: Through targeted resequencing, this study identified five SNPs named rs57699806, rs4732723, rs7829267, rs721619, and rs7816586 around the region of EPHX2 gene associated with NSCL/P in Chinese Han population. Four SNPs of rs57699806, rs4732723, rs7829267, and rs7816586 were first identified.