RESUMEN
The pathogenesis of pulmonary hypertension has not been elucidated. We investigated the role of a circular ribonucleic acid, circDiaph3, in the proliferation and migration of pulmonary artery smooth muscle cells during pulmonary hypertension. CircDiaph3 overexpression in blood samples of patients with pulmonary hypertension was analyzed by real-time quantitative polymerase chain reaction. Subsequently, a rat model of pulmonary arterial hypertension was established under hypoxic conditions. Pulmonary artery smooth muscle cells were harvested from the rat model for subsequent experiments with small interfering ribonucleic acid-mediated knockdown of circDiaph3. In cell model, we found that PI3K, AKT, mTOR and insulin-like growth factor 1 signaling pathway (IGF1R) and smooth muscle cell marker genes (α-SMA, Vcam1) were significantly downregulated. The overexpression of Igf1r in pulmonary artery smooth muscle cells rescued the downregulated smooth muscle cell genes, IGF1R signaling pathway proteins, increased smooth muscle cell proliferation, and reduced apoptosis. CircDiaph3 regulates the PI3K/AKT/mTOR signaling pathway via IGF1R to inhibit apoptosis and promote proliferation of smooth muscle cells. Additionally, adenovirus-mediated in vivo inhibition of circDiaph3 was carried out in rats with pulmonary arterial hypertension, followed by harvesting of their pulmonary artery smooth muscle cells for subsequent experiments. Excessive proliferation of smooth muscle cells in the pulmonary artery has narrowed the pulmonary artery lumen, thereby causing pulmonary hypertension, and our results suggest that circDiaph3 has important value in the treatment of pulmonary hypertension. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-023-03739-0.
RESUMEN
Right coronary artery-left ventricular (RCA-LV) fistula with associated giant right coronary artery aneurysm (CAA) is an extremely rare cardiac condition. This case study presents a patient with a large left ventricle (LV) and a giant right CAA with a maximal inner diameter of approximately 56.6 mm and an inner diameter of approximately 22 mm at its communication with the left ventricle. The patient underwent surgical management, involving suturing of the proximal end of the CAA and coronary artery bypass grafting (CABG). RCA-LV fistula with a giant right CAA may involve serious complications, such as thrombosis, rupture, and heart failure. Therefore, it is necessary to establish effective management strategies for this condition. Although this case is not unique, it serves as an illustrative example of the implementation of a classic surgical treatment method.
Asunto(s)
Anomalías Múltiples , Procedimientos Quirúrgicos Cardíacos/métodos , Aneurisma Coronario/congénito , Vasos Coronarios , Ventrículos Cardíacos , Fístula Vascular/congénito , Aneurisma Coronario/diagnóstico , Aneurisma Coronario/cirugía , Angiografía Coronaria/métodos , Humanos , Imagenología Tridimensional/métodos , Masculino , Persona de Mediana Edad , Tomografía Computarizada Multidetector/métodos , Fístula Vascular/diagnóstico , Fístula Vascular/cirugíaRESUMEN
RATIONALE: Cardiac lymphangioma is a rare disease. Until now, there have been only a few cases of cardiac lymphangioma reported in the literature. PATIENT CONCERNS: We report the case of a 57-year-old female patient with cardiac lymphangioma from atrial septum. DIAGNOSIS: Color Doppler echocardiography was performed, which revealed a tumor occupying a large amount of space in the left and right atrium. INTERVENTIONS: The patient underwent thoracoscopic cardiac tumor resection under general anesthesia according to the procedure used for benign tumors. OUTCOMES: The patient recovered completely and was discharged home. Follow-up color Doppler echocardiography scans obtained from 6 months to 2 years after the operation showed no recurrent mass. LESSONS: Once the tumor is detected, surgical treatment should be implemented as soon as possible.