New insight into the role of lipid metabolism-related proteins in rheumatic heart valve disease.

PURPOSE: The aim of this study was to determine the expression of lipid metabolism-related proteins in rheumatic heart valve disease (RHVD). METHODS: This retrospective study involved a total of 20 cases of moderate or severe rheumatic mitral valve stenosis and 4 cases of mitral regurgitation due to secondary causes from September 2018 to September 2021. The patients enrolled included 12 males and 12 females who underwent surgical excision of the mitral valve at the cardiac surgery department of Hainan General Hospital. The samples of mitral valve were collected during surgery treatment as the study group, and mitral valves collected from patients with ischemic heart disease were allocated into the control group. Hematoxylin-eosin (HE), oil red staining and immunohistochemical (IHC) staining were conducted to compare the expression of lipid metabolism-related proteins (ATP-binding cassette transporter A1 and acyl-coenzyme A: cholesterol acyltransferase-1), and real-time polymerase chain reaction (RT-PCR) was applied to compare the mRNA levels of ABCA1, ACAT1, and the inflammatory cytokines TNF-α, IL-10, and MCP-1. RESULTS: In general, the rheumatic mitral valve showed leaflet thickening along with border adhesions and visible yellow fats. Oil red O staining also revealed the abovementioned results as well as fat cells. Both ABCA1 and ACAT1 were expressed in the rheumatic mitral valve via IHC, whereas only ACAT1 showed a faint level of expression in the ischemic mitral valve with no expression of ABCA1. In addition, compared with the ischemic mitral valve, RT-PCT showed increased mRNA expression levels of ABCA1, ACAT1, and the inflammatory cytokines TNF-α, IL-10, and MCP-1 (P < 0.05). After dividing the RMs into two groups for RT-PCR, we found that the higher the expression of ABCA1 and ACAT1 was, the lower the relative expression of inflammatory factors. CONCLUSION: This study showed that adipose tissue, adipose cells, and lipid transport-related proteins were expressed strongly in the rheumatic mitral valve, suggesting that adipose tissue formation might be one of the important pathways in the pathology of rheumatic heart disease. In addition, adipose tissue and adipocytes were also involved in the inflammatory process. These data provide new insight into pathological mechanisms in rheumatic heart disease.

microRNA-183 improve myocardial damager via NF-kb pathway: In vitro and in vivo study.

AIM: The aim of this study is to evaluate the effects of microRNA-183 (miRNA-183) in myocardial damager. METHODS: In the cell experiment, the H9C2 cell was divided into three groups: NC group, Model group, and miRNA group. The cell apoptosis and relative proteins' expressions were measured by flow cytometry and Western blot assay. The in vivo study of the rats was divided into three groups: Sham group, Model group, and miRNA group. The pathology, Infarct size, cell apoptosis, and relative protein expressions were evaluated by hematoxylin and eosin staining, nitro blue tetrazolium staining, terminal deoxynucleotidyl transferase dUTP nick-end labeling assay, and immunohistochemistry. RESULTS: Compared with NC groups, the in vitro and in vivo study showed that cell apoptosis rate of miRNA groups was significantly suppressed (P < 0.05). The pathology and infarct size of miRNA group were significantly improved compared with the NC group. Meanwhile, the relative proteins expression (nuclear factor-κB [NF-kb], caspase-3, Bax, and Bcl-2) of miRNA groups were significantly different compared with those of NC groups ( P < 0.05). CONCLUSION: In vitro and in vivo study revealed that miRNA-183 improves myocardial damager through the NF-κb pathway.

Off-Pump Coronary Artery Bypass Using Skeletonized Gastroepiploic Artery, a Pilot Study.

Abstract Background: The problem with using the gastroepiploic artery (GEA)for coronary artery bypass grafting (CABG) is vasospasm. To minimize vasospasm of the GEA, a skeletonized harvesting technique was used for GEA harvesting. We present the initial results of GEA grafting using this technique. Methods: Between September 1, 2002, and December 31, 2002, a total of 25 patients (21 men and 4 women, mean age 65.4 +/- 8.7 years) gave informed consent and underwent elective off-pump CABG using the skeletonized GEA. Skeletonization was completed using an ultrasonic scalpel (Harmonic scalpel, coagulating-scissors; Ethicon Endo-Surgery, Cincinnati, OH, USA). Follow-up data were available until August 31, 2003. Perioperative, early clinical, and follow-up results were analyzed. Results: There were no hospital deaths, perioperative myocardial infarctions, congestive heart failure, strokes, or renal failure. There were no abdominal complications. Follow-up data were available from all patients, with a mean follow-up of 0.8 +/- 0.1 years. There were no cardiac deaths or cardiac events. Conclusion: During our limited follow-up period, the early results of skeletonized GEA grafting were excellent, and cardiac events have been well controlled. Mid-term follow-up study and angiographic study are necessary to confirm our initial clinical outcome data.

Skeletonized gastroepiploic artery for off-pump coronary artery bypass grafting.

BACKGROUND: Skeletonized arterial grafting may reduce the risk of graft spasm and may improve graft patency. Previously we reported a pilot study of skeletonized gastroepiploic artery (GEA) grafting with favorable results. Skeletonized GEA harvesting with an ultrasonic scalpel has now become our routine procedure. In this report, we compare the early clinical outcomes of skeletonized versus pedicled GEA grafting to assess the safety and benefit of use of skeletonized GEA in coronary artery bypass grafting. METHODS: Between July 2002 and October 2003, the GEA was used as a conduit for isolated off-pump coronary artery bypass grafting in 105 patients. Of these, 21 patients (group P) received pedicled GEA and 59 patients (group S) received skeletonized GEA grafts (excluding 25 patients whose results were reported in the pilot study). The perioperative and early follow-up data were prospectively collected and compared. RESULTS: No graft injury was found in either group. The preoperative characteristics were similar in the two groups except that group S had a smaller body surface area (1.64 +/- 0.16 m 2 in group S versus 1.73 +/- 0.16 m 2 in group P, P <.05) and a significant number of patients with diabetes (36/59, 61.0% versus 7/21, 33.3%, P <.05). The number of distal anastomoses was 4.3 < 1.0 versus 3.9 +/- 0.9 ( P = not significant [NS]). An in situ GEA composite graft was constructed in 8 (13.6%) of the patients in group S and none of the patients in group P ( P = NS). There was one hospital death due to infection in group S. Otherwise, there were no cases of low output syndrome or postoperative myocardial infarction in either group. During early postoperative follow-up, no angina recurrence or myocardial infarction was found. CONCLUSION: The GEA can be skeletonized safely with an ultrasonic scalpel. Skeletonization enables a wider variety of choices in the use of GEA grafting.

Synergistic effect of triptolide and tacrolimus on rat cardiac allotransplantation.

Recent studies have shown that triptolide inhibits T cell activation through mechanisms different from those of cyclosporine A and tacrolimus and we postulated that triptolide might have a synergistic effect with tacrolimus to enhance immunosuppression. Using a F344 donor-to-Lewis recipient rat combination, we investigated the immunosuppressive effects of triptolide alone or in combination with tacrolimus on the survival of cardiac allografts. Recipients were treated with placebo, triptolide, tacrolimus, and triptolide in combination with tacrolimus at different doses. The median survival time (MST) was 8 days for placebo; 9.5, 11, 14 and 19 days for triptolide monotherapy at doses of 0.04, 0.08, 0.16, and 0.32 mg/kg/day, respectively, and 11, 13.5, and 52 days for tacrolimus monotherapy at doses of 0.025, 0.05, and 0.1 mg/kg/day, respectively. Tacrolimus 0.025 mg/kg/day combined with triptolide 0.08 and 0.16 mg/kg/day prolonged the MST to 17.5 and 20 days, respectively; while tacrolimus 0.05 mg/kg/day combined with triptolide 0.04, 0.08, and 0.16 mg/kg/day prolonged the MST to 21, 23, and 23 days, respectively. These results suggest that triptolide is a moderately effective immunosuppressive agent. Triptolide combined with a subtherapeutic dose of tacrolimus produced a synergistic effect in prolonging rat cardiac allograft survival.