RESUMO
BACKGROUND: There are no guidelines on the surgical management for ischemic cardiomyopathy (ICM) patients with severe left ventricular dysfunction. The present study aims to assess the long-term survival of these patients treated with two different surgical techniques, coronary artery bypass grafting (CABG) and heart transplantation (HTx). METHODS: This retrospective study included 218 ICM patients with left ventricular ejection fraction (LVEF) ≤35% who underwent CABG (n = 106) and HTx (n = 112) from 2011 to 2021 in a single center. After propensity adjustment analysis each group consisted of 51 patients. Clinical characteristics were evaluated for all-cause follow-up mortality by the Cox proportional hazards regression model. A risk prediction model was generated from multivariable-adjusted Cox regression analysis and applied to stratify patients with different clinical risks. The long-term survival was estimated by Kaplan-Meier analysis for different surgery groups. RESULTS: Long-term survival was comparable between CABG and HTx groups. After being stratified into different risk subgroups according to risk predictors, the HTx group exhibited superior survival outcomes compared to the CABG group among the high-risk patients (67.8% vs 44.4%, 64.1% vs 38.9%, and 64.1% vs 33.3%, p = 0.047) at 12, 36, and 60 months respectively, while the survival was comparable between HTx and CABG groups among low-risk patients (87.0% vs 97.0%, 82.4% vs 97.0%, and 70.2% vs 91.6%, p = 0.11) at 12, 36, and 60 months respectively in the PSM cohort. CONCLUSION: Long-term survival in ICM patients with severe left ventricular dysfunction who received CABG or HTx was comparable in general. Nonetheless, a favorable outcome of HTx surgery compared to CABG was observed among high-risk patients.
Assuntos
Cardiomiopatias , Transplante de Coração , Isquemia Miocárdica , Disfunção Ventricular Esquerda , Humanos , Estudos Retrospectivos , Volume Sistólico , Resultado do Tratamento , Função Ventricular Esquerda , Seguimentos , Isquemia Miocárdica/etiologia , Isquemia Miocárdica/cirurgia , Ponte de Artéria Coronária/métodos , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/cirurgia , Transplante de Coração/efeitos adversos , Cardiomiopatias/etiologia , Cardiomiopatias/cirurgiaRESUMO
Behçet's disease (BD) is a rarely seen immune disease with multiple systems involvements. Among them, a cardiac manifestation is a severe and rare complication of BD. Here we reported a young man with BD, complicated with a right ventricular thrombus. Surgery was performed successfully to remove the intracardiac thrombus, and a 2-year follow-up failed to find any new symptoms and pathological findings. Our experience provided a better example for diagnosing and early surgical treatment for intracardiac thrombus of BD.
Assuntos
Síndrome de Behçet , Cardiopatias , Trombose , Síndrome de Behçet/complicações , Cardiopatias/diagnóstico por imagem , Cardiopatias/etiologia , Cardiopatias/cirurgia , Humanos , Masculino , Trombose/diagnóstico por imagem , Trombose/etiologia , Trombose/cirurgiaRESUMO
Trichoderma harzianum is a plant-beneficial fungus that secretes small cysteine-rich proteins that induce plant defense responses; however, the molecular mechanism involved in this induction is largely unknown. Here, we report that the class II hydrophobin ThHyd1 acts as an elicitor of induced systemic resistance (ISR) in plants. Immunogold labeling and immunofluorescence revealed ThHyd1 localized on maize (Zea mays) root cell plasma membranes. To identify host plant protein interactors of Hyd1, we screened a maize B73 root cDNA library. ThHyd1 interacted directly with ubiquilin 1-like (UBL). Furthermore, the N-terminal fragment of UBL was primarily responsible for binding with Hyd1 and the eight-cysteine amino acid of Hyd1 participated in the protein-protein interactions. Hyd1 from T. harzianum (Thhyd1) and ubl from maize were co-expressed in Arabidopsis thaliana, they synergistically promoted plant resistance against Botrytis cinerea. RNA-sequencing analysis of global gene expression in maize leaves 24 h after spraying with Curvularia lunata spore suspension showed that Thhyd1-induced systemic resistance was primarily associated with brassinosteroid signaling, likely mediated through BAK1. Jasmonate/ethylene (JA/ET) signaling was also involved to some extent in this response. Our results suggest that the Hyd1-UBL axis might play a key role in inducing systemic resistance as a result of Trichoderma-plant interactions.
Assuntos
Resistência à Doença/imunologia , Proteínas Fúngicas/metabolismo , Doenças das Plantas/imunologia , Proteínas de Plantas/metabolismo , Zea mays/imunologia , Motivos de Aminoácidos , Sequência de Aminoácidos , Clonagem Molecular , Curvularia/fisiologia , Proteínas Fúngicas/química , Proteínas Fúngicas/genética , Regulação da Expressão Gênica de Plantas , Genes Fúngicos , Hypocreales/genética , Filogenia , Folhas de Planta/genética , Proteínas de Plantas/química , Proteínas de Plantas/genética , Raízes de Plantas/metabolismo , Ligação Proteica , Domínios Proteicos , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Saccharomyces cerevisiae/metabolismo , Zea mays/genética , Zea mays/microbiologiaRESUMO
OBJECTIVES: The tolerance to organophosphate pesticide, dichlorvos, is essential for the application of Trichoderma in bioremediation and integrated pest management, although the molecular events associated with the tolerance process have not yet been elucidated. RESULTS: RNA-seq analysis of wild-type Trichoderma atroviride T23 and the hex1-deleted mutant under dichlorvos stress was designed to search for genes involved in the tolerance process. A total of 5382 differentially expressed genes were identified, highlighting the complex transcriptional changes of T. atroviride in response to dichlorvos stress. 137 genes were regulated by dichlorvos and hex1, encoding major facilitator superfamilies, cytochrome P450, glutathione-S-transferase, flavoprotein, Hsp70, Hsp90, etc. Pathway and expression analysis indicated that ABC transporters were affected by the disruption of hex1 gene and might play a vital role in the tolerance process. Expression patterns of seven selected ABC transporter genes were confirmed by qRT-PCR after exposure to dichlorvos for 2, 6 and 24 h. CONCLUSIONS: The present study provides insights into the genetic basis of dichlorvos tolerance in Trichoderma that may be exploited for further development of bioremediation or biocontrol agents.
Assuntos
Transportadores de Cassetes de Ligação de ATP/metabolismo , Diclorvós/farmacologia , Proteínas Fúngicas/metabolismo , Transcriptoma/efeitos dos fármacos , Trichoderma/efeitos dos fármacos , Transportadores de Cassetes de Ligação de ATP/genética , Tolerância a Medicamentos/genética , Tolerância a Medicamentos/fisiologia , Proteínas Fúngicas/genética , Regulação Fúngica da Expressão Gênica/efeitos dos fármacos , Trichoderma/genéticaRESUMO
Calcific aortic valve disease (CAVD) is prevalent in developed nations and has emerged as a pressing global public health concern due to population aging. The precise etiology of this disease remains uncertain, and recent research has primarily focused on examining the role of valvular interstitial cells (VICs) in the development of CAVD. The predominant treatment options currently available involve open surgery and minimally invasive interventional surgery, with no efficacious pharmacological treatment. This article seeks to provide a comprehensive understanding of valvular endothelial cells (VECs) from the aspects of valvular endothelium-derived nitric oxide (NO), valvular endothelial mechanotransduction, valvular endothelial injury, valvular endothelial-mesenchymal transition (EndMT), and valvular neovascularization, which have received less attention, and aims to establish their role and interaction with VICs in CAVD. The ultimate goal is to provide new perspectives for the investigation of non-invasive treatment options for this disease.
Assuntos
Estenose da Valva Aórtica , Valva Aórtica , Calcinose , Células Endoteliais , Humanos , Calcinose/patologia , Valva Aórtica/patologia , Valva Aórtica/metabolismo , Células Endoteliais/patologia , Células Endoteliais/metabolismo , Animais , Estenose da Valva Aórtica/patologia , Óxido Nítrico/metabolismo , Mecanotransdução Celular , Valvopatia Aórtica/metabolismo , Valvopatia Aórtica/patologia , Transição Epitelial-MesenquimalRESUMO
The prevalence of calcific aortic valve disease (CAVD) remains substantial while there is currently no medical therapy available. Forkhead box O1 (FOXO1) is known to be involved in the pathogenesis of cardiovascular diseases, including vascular calcification and atherosclerosis; however, its specific role in calcific aortic valve disease remains to be elucidated. In this study, we identified FOXO1 significantly down-regulated in the aortic valve interstitial cells (VICs) of calcified aortic valves by investigating clinical specimens and GEO database analysis. FOXO1 silencing or inhibition promoted VICs osteogenic differentiation in vitro and aortic valve calcification in Apoe-/- mice, respectively. We identified that FOXO1 facilitated the ubiquitination and degradation of RUNX2, which process was mainly mediated by SMAD-specific E3 ubiquitin ligase 2 (SMURF2). Our discoveries unveil a heretofore unacknowledged mechanism involving the FOXO1/SMURF2/RUNX2 axis in CAVD, thereby proposing the potential therapeutic utility of FOXO1 or SMURF2 as viable strategies to impede the progression of CAVD.
Assuntos
Estenose da Valva Aórtica , Valva Aórtica , Calcinose , Subunidade alfa 1 de Fator de Ligação ao Core , Proteína Forkhead Box O1 , Ubiquitina-Proteína Ligases , Ubiquitinação , Proteína Forkhead Box O1/metabolismo , Proteína Forkhead Box O1/genética , Animais , Valva Aórtica/metabolismo , Valva Aórtica/patologia , Subunidade alfa 1 de Fator de Ligação ao Core/metabolismo , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Camundongos , Humanos , Ubiquitina-Proteína Ligases/metabolismo , Ubiquitina-Proteína Ligases/genética , Calcinose/metabolismo , Calcinose/patologia , Calcinose/genética , Estenose da Valva Aórtica/metabolismo , Estenose da Valva Aórtica/patologia , Estenose da Valva Aórtica/genética , Masculino , Osteogênese/genética , Modelos Animais de Doenças , Diferenciação CelularAssuntos
Neoplasias Cardíacas/diagnóstico , Leiomiomatose/diagnóstico , Artéria Pulmonar/diagnóstico por imagem , Síncope/etiologia , Neoplasias Vasculares/diagnóstico , Procedimentos Cirúrgicos Vasculares/métodos , Veia Cava Inferior , Procedimentos Cirúrgicos Cardíacos , Angiografia por Tomografia Computadorizada , Ecocardiografia , Feminino , Átrios do Coração , Neoplasias Cardíacas/cirurgia , Humanos , Leiomiomatose/complicações , Leiomiomatose/cirurgia , Pessoa de Meia-Idade , Invasividade Neoplásica , Síncope/diagnóstico , Neoplasias Vasculares/complicações , Neoplasias Vasculares/cirurgiaRESUMO
We report a case of hematoma formation in the right coronary artery after spontaneous rupture. A 48-year-old female patient was admitted with a suspected right cardiac mass. Despite diagnostic work-up, the dignity of the mass could not be determined. Due to acute clinical symptoms, explorative surgery was decided and performed. Hereby, the mass was partially incised, and thrombus-like tissue was detected without active bleeding. We described the challenges during the diagnostic process, and the diagnosis was finally made according to a multimodality approach. For further assessment, we reviewed related literature and highlighted the importance of coronary angiography in the preoperative evaluation of such patients. The therapy may vary according to the location and size of such lesions.
RESUMO
Right heart thrombus accompanied by chronic thromboembolic pulmonary hypertension is a rare entity. Right heart thrombus may develop in the peripheral veins or in situ within the right heart chambers. The diagnosis of right heart thrombus is challenging, since its symptoms are typically non-specific and its imaging features resemble those of cardiac masses. Here, we report two cases of right heart thrombus with chronic thromboembolic pulmonary hypertension that presented as right ventricular masses initially. Both patients underwent simultaneous pulmonary endarterectomy and resection of the ventricular thrombi. Thus, when mass-like features are confirmed by imaging, right heart thrombus should be suspected in patients with chronic thromboembolic pulmonary hypertension, and simultaneous right heart thrombus resection is required along with pulmonary endarterectomy.
RESUMO
Structural colors are promising candidates for their antifading and eco-friendly characteristics. However, high cost and complicated processing inevitably hinder their development. Here, we propose a facile full-color structural-color inkjet printing strategy with a single transparent ink from the common polymer materials. This structural color arisen from total internal reflections is prepared by digitally printing the dome-shaped microstructure (microdome) with well-controlled morphology. By controlling the ink volume and substrate wettability, the microdome color can be continuously regulated across whole visible regions. The gamut, saturation, and lightness of the printed structural-color image are precisely adjusted via the programmable arrangement of different microdomes. With the advantages of simple manufacturing and widely available inks, this color printing approach presents great potential in imaging, decoration, sensing, and biocompatible photonics.
RESUMO
In recent years, colchicine has been used to reduce the risk of cardiovascular events; in particular, it has been effectively used for the treatment of atrial fibrillation (AF). We first discovered that colchicine can treat AF in a rat model and that it can reverse the effects of atrial fibrosis. To illustrate the potential therapeutic mechanism of colchicine against AF, we performed comparative transcriptome analyses; our aim was to elucidate the therapeutic effects of colchicine so as to improve treatment and prognoses of AF. Genomics and bioinformatics analyses revealed that the IL-17 signaling pathway, and renin secretion pathway are involved in the mechanism of action of colchicine. Furthermore, there was a significant correlation between overlapping genes in the two groups of differentially expressed genes. The genes encoding Akap4, Pcdha9, Gp2, Cd177, Krt15, Aqp3, Chia, and Bpifb1 were pivotal and possible action sites for the therapeutic mechanisms of colchicine. We conclude that AF involves a multifactorial pathological process. The mechanisms underlying the action of colchicine in the treatment of AF warrant further studies.
Assuntos
Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/genética , Colchicina/uso terapêutico , Perfilação da Expressão Gênica , Animais , Fibrilação Atrial/diagnóstico por imagem , Colchicina/farmacologia , Modelos Animais de Doenças , Regulação para Baixo/efeitos dos fármacos , Regulação para Baixo/genética , Eletrocardiografia , Ontologia Genética , Átrios do Coração/efeitos dos fármacos , Átrios do Coração/patologia , Ratos Sprague-Dawley , Transcriptoma/genética , Regulação para Cima/efeitos dos fármacos , Regulação para Cima/genéticaAssuntos
Apêndice Atrial/diagnóstico por imagem , Aneurisma Cardíaco/diagnóstico por imagem , Apêndice Atrial/cirurgia , Procedimentos Cirúrgicos Cardiovasculares , Técnicas de Apoio para a Decisão , Ecocardiografia , Feminino , Aneurisma Cardíaco/cirurgia , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XAssuntos
Falso Aneurisma/diagnóstico por imagem , Aneurisma da Aorta Torácica/diagnóstico por imagem , Oclusão Coronária/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Traumatismos Torácicos , Idoso , Falso Aneurisma/complicações , Falso Aneurisma/cirurgia , Aneurisma da Aorta Torácica/complicações , Aneurisma da Aorta Torácica/cirurgia , Angiografia Coronária , Oclusão Coronária/complicações , Diagnóstico Diferencial , Humanos , MasculinoRESUMO
Xylanolytic enzymes are widely used in processing industries, e.g., pulp and paper, food, livestock feeds, and textile. Furthermore, certain xylanotic enzymes have demonstrated the capability to improve the resistance and immunity of plants. Screening of high-yield microbial xylanolytic enzyme producers is significant for improving large-scale cost-effective xylanolytic enzyme production. This study provided new evidence of high-level xylanolytic enzyme production by a novel fungus, designated Leptosphaerulina chartarum SJTU59. Under laboratory conditions, L. chartarum SJTU59 produced xylanolytic enzymes of up to 17.566 U/mL (i.e., 878.307 U/g substrate). The enzyme solution was relatively stable over a wide range of pH (pH 3.0 to pH 9.0) and temperature (40°C to 65°C) while showing high resistance to the majority of metal ions tested. Composition analysis of the hydrolytic products of xylan showed sufficient degradation by xylanolytic enzymes from L. chartarum SJTU59, mainly the monosaccharide xylose, and a small amount of xylobiose were enzymatically produced; whereas in the presence of sufficient xylan substrates, mainly xylooligosaccharides, an emerging prebiotic used in food industry, were produced. In addition, the xylanolytic enzyme preparation from L. chartarum SJTU59 could initiate tissue necrosis and oxidative burst in tobacco leaves, which may be related to enhanced plant defense to adversity and disease. L. chartarum SJTU59 possessed a complex xylanolytic enzyme system, from which two novel endo-ß-1,4-xylanases of the glycoside hydrolase (GH) family 10, one novel endo-ß-1,4-xylanase of the GH family 11, and one novel ß-xylosidase of the GH family 43 were obtained via rapid amplification of complementary DNA ends. Given the high yield and stable properties of xylanolytic enzymes produced by L. chartarum SJTU59, future studies will be conducted to characterize the properties of individual xylanolytic enzymes from L. chartarum SJTU59. xylanolytic enzymes-encoding gene(s) of potential use for industrial and agricultural applications will be screened to construct genetically engineered strains.