Strong desmin immunoreactivity in the myocardial sleeves around pulmonary veins, superior caval vein and coronary sinus supports the presumed arrhythmogenicity of these regions.

Myocardial sleeve around human pulmonary veins plays a critical role in the pathomechanism of atrial fibrillation. Besides the well-known arrhythmogenicity of these veins, there is evidence that myocardial extensions into caval veins and coronary sinus may exhibit similar features. However, studies investigating histologic properties of these structures are limited. We aimed to investigate the immunoreactivity of myocardial sleeves for intermediate filament desmin, which was reported to be more abundant in Purkinje fibers than in ventricular working cardiomyocytes. Sections of 16 human (15 adult and 1 fetal) hearts were investigated. Specimens of atrial and ventricular myocardium, sinoatrial and atrioventricular nodes, pulmonary veins, superior caval vein and coronary sinus were stained with anti-desmin monoclonal antibody. Intensity of desmin immunoreactivity in different areas was quantified by the ImageJ program. Strong desmin labeling was detected at the pacemaker and conduction system as well as in the myocardial sleeves around pulmonary veins, superior caval vein, and coronary sinus of adult hearts irrespective of sex, age, and medical history. In the fetal heart, prominent desmin labeling was observed at the sinoatrial nodal region and in the myocardial extensions around the superior caval vein. Contrarily, atrial and ventricular working myocardium exhibited low desmin immunoreactivity in both adults and fetuses. These differences were confirmed by immunohistochemical quantitative analysis. In conclusion, this study indicates that desmin is abundant in the conduction system and venous myocardial sleeves of human hearts.

Proteome alterations in human autopsy tissues in relation to time after death.

Protein expression is a primary area of interest for routine histological diagnostics and tissue-based research projects, but the limitations of its post-mortem applicability remain largely unclear. On the other hand, tissue specimens obtained during autopsies can provide unique insight into advanced disease states, especially in cancer research. Therefore, we aimed to identify the maximum post-mortem interval (PMI) which is still suitable for characterizing protein expression patterns, to explore organ-specific differences in protein degradation, and to investigate whether certain proteins follow specific degradation kinetics. Therefore, the proteome of human tissue samples obtained during routine autopsies of deceased patients with accurate PMI (6, 12, 18, 24, 48, 72, 96 h) and without specific diseases that significantly affect tissue preservation, from lungs, kidneys and livers, was analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). For the kidney and liver, significant protein degradation became apparent at 48 h. For the lung, the proteome composition was rather static for up to 48 h and substantial protein degradation was detected only at 72 h suggesting that degradation kinetics appear to be organ specific. More detailed analyses suggested that proteins with similar post-mortem kinetics are not primarily shared in their biological functions. The overrepresentation of protein families with analogous structural motifs in the kidney indicates that structural features may be a common factor in determining similar postmortem stability. Our study demonstrates that a longer post-mortem period may have a significant impact on proteome composition, but sampling within 24 h may be appropriate, as degradation is within acceptable limits even in organs with faster autolysis.

Mitral and Tricuspid Annular Abnormalities in Hypereosinophilic Syndrome-Insights from the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study.

Background: Hypereosinophilic syndrome (HES) is a peripheral eosinophilia characterized by elevated absolute eosinophil cell count ( > 1.500 cells/ µ L) and consequent tissue and end-organ damage. Our aim was to evaluate the mitral annular (MA) and/or tricuspid annular (TA) parameters of patients with HES and to determine whether there are any changes in these parameters compared to healthy individuals. Methods: 17 patients with HES were involved in our study, 2 cases were excluded due to suboptimal image quality (mean age of the evaluated patients: 61.7 ± 11.2 years, 10 males). Their data were compared with those of 24 healthy subjects (mean age: 55.2 ± 7.9 years, 12 males) in the control group. Complete echocardiographic examinations were performed including two-dimensional (2D) Doppler echocardiography and three-dimensional echocardiography (3DE) to assess the MA and the TA. Results: Comparing the echocardiographic parameters of the HES patients with those of the healthy volunteers, the following changes were seen: the interventricular septum was significantly thickened in HES patients, no other significant changes were detected between the examined patient groups. End-diastolic and end-systolic MA diameters, areas and perimeters were increased and MA fractional area change and MA fractional shortening were decreased in HES patients. From TA morphological parameters, only end-diastolic TA area and end-systolic TA perimeter were significantly increased in HES patients. Functional TA parameters showed no significant alterations in the HES group. In patients with HES, no correlations could be detected between 2D and 3D echocardiographic data with the examined laboratory findings. Conclusions: The extent of the dilation of the MA is more pronounced than that of the TA in HES. MA functional impairment is present in HES.

Real 3D Visualization of the Circumflex Artery Surrounding the Mitral Annulus.

BACKGROUND: The circumflex coronary artery is located close to the mitral annulus. Consequently, it is not immune to iatrogenic damage during mitral valve procedures. Our objective was to visualize the circumflex artery from a surgeon's point of view, emphasizing its proximity. Furthermore, comparing it to coronary angiograms might support preoperative planning. METHODS: Ten adult human hearts preserved in 4% formaldehyde solution were investigated (left coronary artery injected with contrast agent). After performing coronary angiographies from LAO (left anterior oblique) 40/cranial 20, RAO (right anterior oblique) 10/cranial 40, and true lateral projections, anatomical preparations were performed. Images were captured throughout the full course of the circumflex coronary artery from multiple angles. Finally, the mean distances were measured in every 5 mm between the investigated artery and the annulus of the mitral valve. RESULTS: Three-dimensional model of the circumflex coronary artery and its surroundings was successfully achieved from a left atrial surgical viewpoint. The main branches were identified on the coronary angiograms. The closest distance was measured under the region of the left auricle (2.02 ± 0.69 mm; 1-3.1 mm). Afterward, the circumflex artery was observed to make a loop away from the annular region. CONCLUSION: Our observations show correlation with previous anatomical studies and case reports addressing iatrogenic lesions on the circumflex coronary artery. Based on all these, we could determine a "danger zone" on the vessel. The simultaneous evaluation of the anatomical preparations and the angiograms might improve the acknowledgment of this vulnerable region serving to avoid any damage to the coronary artery.

Characterization of Kisspeptin Neurons in the Human Rostral Hypothalamus.

BACKGROUND: Kisspeptin (KP) neurons in the rostral periventricular region of the 3rd ventricle (RP3V) of female rodents mediate positive estrogen feedback to gonadotropin-releasing hormone neurons and, thus, play a fundamental role in the mid-cycle luteinizing hormone (LH) surge. The RP3V is sexually dimorphic, and male rodents with lower KP cell numbers are unable to mount estrogen-induced LH surges. OBJECTIVE: To find and characterize the homologous KP neurons in the human brain, we studied formalin-fixed post-mortem hypothalami. METHODS: Immunohistochemical techniques were used. RESULTS: The distribution of KP neurons in the rostral hypothalamus overlapped with distinct subdivisions of the paraventricular nucleus. The cell numbers decreased after menopause, indicating that estrogens positively regulate KP gene expression in the rostral hypothalamus in humans, similarly to several other species. Young adult women and men had similar cell numbers, as opposed to rodents reported to have more KP neurons in the RP3V of females. Human KP neurons differed from the homologous rodent cells as well, in that they were devoid of enkephalins, galanin and tyrosine hydroxylase. Further, they did not contain known KP neuron markers of the human infundibular nucleus, neurokinin B, substance P and cocaine- and amphetamine-regulated transcript, while they received afferent input from these KP neurons. CONCLUSIONS: The identification and positive estrogenic regulation of KP neurons in the human rostral hypothalamus challenge the long-held view that positive estrogen feedback may be restricted to the mediobasal part of the hypothalamus in primates and point to the need of further anatomical, molecular and functional studies of rostral hypothalamic KP neurons.

Right ventricular longitudinal shortening and right atrial volumes are not associated in healthy adults-detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study.

Background: There is a close relationship between volumes of the right atrium (RA) and dimensions and derived functional sphincter-like features of the tricuspid annulus (TA). However, its relation to longitudinal TA motion is not clear, which can even be considered to be a characteristic of the longitudinal shortening of the right ventricle (RV) and represented by TA plane systolic excursion (TAPSE). Therefore, the aim of this cohort study was to perform a detailed analysis of the relationship of three-dimensional speckle-tracking echocardiography (3DSTE)-derived RA volumes and RV longitudinal shortening in healthy individuals. These parameters were also examined in case of average values and larger/smaller than mean values. Methods: The present study comprised 93 healthy adults (mean age: 27.7±6.3 years, 46 men), who participated in a complete medical investigation including two-dimensional, TAPSE, Doppler and 3DSTE-derived RA volumetric echocardiographic assessments. Results: RA volumes, stroke volumes and emptying fractions were not related to TAPSE. In case of low, mean and high TAPSE, maximum [50.4±22.4 vs. 49.5±15.5 vs. 49.0±15.8 mL, P= not significant (ns)], preatrial contraction (36.9±16.8 vs. 34.5±10.4 vs. 35.6±10.5 mL, P= ns) and minimum (28.7±13.6 vs. 27.2±9.4 vs. 26.6±9.3 mL, P= ns) RA volumes did not differ. Higher RA volumes showed no associations with TAPSE either. Conclusions: 3DSTE-derived RA volumes and M-mode echocardiography-derived TAPSE representing RV longitudinal shortening are not associated in healthy adults. None of the RA volumes showed correlations with TAPSE.

Three-Dimensional Speckle-Tracking Echocardiography-Derived Tricuspid Annular Properties in Acromegaly-Results from the MAGYAR-Path Study.

INTRODUCTION: Acromegaly is an endocrine pathology characterized by the overproduction of human growth hormone. The present study aimed to analyze three-dimensional speckle-tracking echocardiography (3DSTE)-derived tricuspid annular (TA) properties in detail in patients with acromegaly and to compare the findings to those of matched healthy controls. METHODS: The present study consisted of 29 patients with acromegaly (mean age: 55.9 ± 14.5 years, 21 males), of which 13 had an active disease. The control population comprised 57 healthy subjects (mean age: 53.2 ± 8.4 years, 38 males). RESULTS: In the presence of acromegaly, left atrial and end-diastolic left ventricular (LV) sizes were dilated, and LV ejection fraction was increased, which was accompanied by thickened interventricular septum and LV posterior wall as compared with matched healthy controls. The presence of grade 1 mitral (MR) and tricuspid (TR) regurgitations were more frequent in acromegaly than in controls, regardless of disease activity. Higher than grade 1 MR/TR was uncommon in acromegaly. The 3DSTE-derived all end-diastolic (2.47 ± 0.27 cm vs. 2.23 ± 0.27 cm; 8.73 ± 1.77 cm2 vs. 6.67 ± 1.40 cm2; 11.56 ± 1.34 cm vs. 10.20 ± 1.10 cm, p < 0.001 for all) and end-systolic (1.97 ± 0.27 cm vs. 1.77 ± 0.28 cm; 6.24 ± 1.61 cm2 vs. 5.01 ± 1.42 cm2; 9.80 ± 1.35 cm vs. 8.72 ± 1.10 cm, p < 0.001 for all) TA diameters, areas, and perimeters proved to be dilated, while TA functional parameters including TA fractional area change (28.77 ± 9.80% vs. 27.64 ± 15.34%, p = 0.720) and fractional shortening (20.60 ± 9.08% vs. 20.51 ± 8.81%, p = 0.822) were normal in acromegaly regardless of whether acromegaly was active or not. RA volumes respecting the cardiac cycle were dilated in acromegaly as compared with those of healthy controls regardless of disease activity and were associated with respective changes in TA dimensions. CONCLUSIONS: In the presented acromegaly patients, significant TA dilation with preserved function could be detected regardless of disease activity. RA volumes and TA dimensions are correlated in acromegaly.

Characterization of dUTPase expression in mouse postnatal development and adult neurogenesis.

The enzyme dUTPase has an essential role in maintaining genomic integrity. In mouse, nuclear and mitochondrial isoforms of the enzyme have been described. Here we present the isoform-specific mRNA expression levels in different murine organs during development using RT-qPCR. In this study, we analyzed organs of 14.5-day embryos and of postnatal 2-, 4-, 10-week- and 13-month-old mice. We demonstrate organ-, sex- and developmental stage-specific differences in the mRNA expression levels of both isoforms. We found high mRNA expression level of the nuclear isoform in the embryo brain, and the expression level remained relatively high in the adult brain as well. This was surprising, since dUTPase is known to play an important role in proliferating cells, and mass production of neural cells is completed by adulthood. Thus, we investigated the pattern of the dUTPase protein expression specifically in the adult brain with immunostaining and found that dUTPase is present in the germinative zones, the subventricular and the subgranular zones, where neurogenesis occurs and in the rostral migratory stream where neuroblasts migrate to the olfactory bulb. These novel findings suggest that dUTPase may have a role in cell differentiation and indicate that accurate dTTP biosynthesis can be vital, especially in neurogenesis.

Autopsy findings in cancer patients infected with SARS-CoV-2 show a milder presentation of COVID-19 compared to non-cancer patients.

COVID-19, caused by SARS-CoV-2, manifests with differing severity across distinct patient subgroups, with outcomes influenced by underlying comorbidities such as cancer, which may cause functional and compositional alterations of the immune system during tumor progression. We aimed to investigate the association of SARS-CoV-2 infection and its complications with cancer in a large autopsy series and the role of COVID-19 in the fatal sequence leading to death. A total of 2641 adult autopsies were investigated, 539 of these were positive for SARS-CoV-2. Among the total number of patients analyzed, 829 had active cancer. Overall, the cohort included 100 patients who simultaneously had cancer and SARS-CoV-2 infection. The course of COVID-19 was less severe in cancer patients, including a significantly lower incidence of viral and bacterial pneumonia, occurring more frequently as a contributory disease or coexisting morbidity, or as SARS-CoV-2 positivity without viral disease. SARS-CoV-2 positivity was more frequent among non-metastatic than metastatic cancer cases, and in specific tumor types including hematologic malignancies. COVID-19 was more frequently found to be directly involved in the fatal sequence in patients undergoing active anticancer therapy, but less frequently in perioperative status, suggesting that the underlying malignancy and consequent surgery are more important factors leading to death perioperatively than viral disease. The course of COVID-19 in cancer patients was milder and balanced during the pandemic. This may be due to relative immunosuppressed status, and the fact that even early/mild viral infections can easily upset their condition, leading to death from their underlying cancer or its complications.

A GnRH neuronal population in the olfactory bulb translates socially relevant odors into reproductive behavior in male mice.

Hypothalamic gonadotropin-releasing hormone (GnRH) neurons regulate fertility and integrate hormonal status with environmental cues to ensure reproductive success. Here we show that GnRH neurons in the olfactory bulb (GnRHOB) of adult mice can mediate social recognition. Specifically, we show that GnRHOB neurons extend neurites into the vomeronasal organ and olfactory epithelium and project to the median eminence. GnRHOB neurons in males express vomeronasal and olfactory receptors, are activated by female odors and mediate gonadotropin release in response to female urine. Male preference for female odors required the presence and activation of GnRHOB neurons, was impaired after genetic inhibition or ablation of these cells and relied on GnRH signaling in the posterodorsal medial amygdala. GnRH receptor expression in amygdala kisspeptin neurons appear to be required for GnRHOB neurons' actions on male mounting behavior. Taken together, these results establish GnRHOB neurons as regulating fertility, sex recognition and mating in male mice.

The Relationship between Tricuspid Annular Longitudinal and Sphincter-like Features of Its Function in Healthy Adults: Insights from the MAGYAR-Healthy Study.

INTRODUCTION: The tricuspid valve is an atrioventricular valve located on the right side of the heart, which consists of the fibrous tricuspid annulus (TA), three valvular leaflets and a supporting apparatus, the papillary muscles and the tendinous chords. The TA is an oval-shaped three-dimensional (3D) fibrous structure with a complex spatial movement during the cardiac cycle. Three-dimensional echocardiography (3DE) could help during "en-face" assessment of TA dimensions and related functional properties featuring its "sphincter-like" function. TA plane systolic excursion (TAPSE) is a displacement of the lateral edge of the TA toward the apex in systole measured in apical long-axis using M-mode echocardiography (MME). The aim of this study was to determine potential relationships between TA size and its "sphincter-like" and "longitudinal" functions in healthy adults with no functional tricuspid regurgitation. METHODS: The present study consisted of 119 healthy patients (age: 34.6 ± 11.5 years, 70 men) who underwent routine echocardiography with M-mode-derived TAPSE measurement and 3DE. Two subgroups of healthy subjects were compared with each other. A total of 29 subjects with TAPSE between 17 and 21 mm were compared with 90 cases with TAPSE ≥ 22 mm. RESULTS: Subjects with TAPSE of 17-21 mm had tendentiously dilated TA dimensions compared with subjects with TAPSE ≥ 22 mm. Significant differences could be detected in the end-systolic TA area (5.85 ± 1.90 cm2 vs. 3.70 ± 1.22 cm2, p < 0.05), leading to impaired TAFAC (24.8 ± 9.0% vs. 35.1 ± 9.1%, p < 0.05) in subjects with lower TAPSE (17-21 mm) compared with subjects with TAPSE ≥ 22 mm. TAPSE did not show correlations with any TA size or "sphincter-like" functional parameters as determined using 3DE. CONCLUSIONS: Three-dimensional echocardiography is capable of measuring TA dimensions and functional "sphincter-like" properties, which are associated with MME-derived TAPSE, suggesting a sensitive and harmonic TA function in healthy adults without functional tricuspid regurgitation.

Normal reference values of tricuspid annular dimensions and functional properties in healthy adults using three-dimensional speckle-tracking echocardiography (insights from the MAGYAR-Healthy Study).

Background: Three-dimensional speckle-tracking echocardiography (3DSTE) is a relatively new non-invasive imaging modality with ability for simultaneous chamber quantifications and determination of valvular dimensions. The aim of the present retrospective cohort study was to determine normal reference values of 3DSTE-derived tricuspid annular (TA) dimensions and functional properties and to evaluate their age- and gender dependency. Methods: The present study comprised 156 healthy adult subjects, from which 28 cases were excluded due to inferior image quality, therefore the remaining group consisted of 128 cases with the mean age of 35.4±12.5 years (72 males). The subject population was further divided into the following categories: 18-29 years (n=57; mean age: 25.2±2.8 years, 51 males), 30-39 years (n=29; mean age: 34.1±2.5 years, 31 males), 40-49 years (n=17; mean age: 44.1±3.2 years, 11 males) and ≥50 years of age (n=25, mean age: 59.2±6.4 years, 14 males). Results: End-diastolic TA diameter (2.2±0.3 vs. 2.5±0.3 cm, P<0.05), area (7.1±1.3 vs. 8.1±1.7 cm2, P<0.05) and perimeter (10.3±0.9 vs. 11.0±1.2 cm, P<0.05) were lower in females than in males in the 18-29 year-old group and TA area (6.1±0.8 vs. 8.0±1.2 cm2, P<0.05) and TA perimeter (9.7±0.8 vs. 11.0±0.9 cm, P<0.05) were lower in females than in males in the 40-49 year-old group. End-systolic TA diameter were lower in females than in males in the 18-29 year-old group (1.8±0.2 vs. 1.9±0.3 cm, P<0.05) and TA area (4.7±0.3 vs. 6.3±1.2 cm2, P<0.05) and TA perimeter (8.6±0.4 vs. 9.5±0.9 cm, P<0.05) were lower in females than in males in the 40-49 year-old group. TA fractional area change was found to be reduced in the 40-49 year-old group as compared to the 30-39 year-old group (21.7%±8.7% vs. 29.2%±10.0%, P<0.05). Conclusions: 3DSTE is a novel method for non-invasive assessment of TA dimensions and functional properties. Results highlight the importance of age- and gender-specific reference values in case of TA diameter, area and perimeter and calculated functional features respecting the cardiac cycle.

[Multimodality imaging of adult patients with surgically corrected tetralogy of Fallot. Results from the CSONGRAD Registry] / A mutétileg korrigált Fallot-tetralógiával élo felnott betegek multimodális képalkotó vizsgálata. Eredmények a CSONGRAD Regiszterbol

INTRODUCTION: There is an increasing ratio of surviving patients with congenital heart disease including tetralogy of Fallot. OBJECTIVE: The aim of the present study was a comparative assessment of echocardiographic and cardiac magnetic resonance imaging-derived findings in patients with tetralogy of Fallot following early total reconstruction versus early palliation/late correction. METHODS: The study comprised 17 patients with tetralogy of Fallot (mean age: 28.6 ± 10.4 years; 10 males). Early total reconstruction was performed in 10 cases (mean age: 25.0 ± 8.0 years; 8 males), while early palliation/late construction was done in 7 subjects (mean age: 33.7 ± 11.8 years; 2 males). Complete two-dimensional Doppler echocardiography and cardiac resonance imaging were performed in all patients. RESULTS: During long-term follow-up, lower left ventricular end-systolic (40.50 ± 10.55 ml/m2 vs. 58.14 ± 19.07 ml/m2, p = 0.013) and end-diastolic volume indices (86.60 ± 12.62 ml/m2 vs. 116.70 ± 23.70 ml/m2, p = 0.002) and stroke volume index (46.00 ± 6.77 ml/m2 vs. 58.43 ± 7.11 ml/m2, p = 0.001) could be detected, which were associated with higher echocardiographic left ventricular ejection fraction (69.75 ± 6.80% vs. 61.67 ± 8.80%, p = 0.038) in patients with tetralogy of Fallot following early total reconstruction as compared to that of subjects late after early palliation/late correction. In regard with the right heart, larger right ventricular muscle mass (72.33 ± 21.03 g/m2 vs. 51.33 ± 22.33 g/m2, p = 0.044) could be seen in patients with tetralogy of Fallot following early total reconstruction. CONCLUSION: Beneficial left ventricular morphological and functional parameters, but more pronounced right ventricular hypertrophy could be detected in patients with tetralogy of Fallot following early total reconstruction as compared to that of subjects late after early palliation/late correction. Orv Hetil. 2023; 164(5): 186-194.

Tricuspid annular and right atrial volume changes are associated in healthy adults-insights from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study.

Introduction: The tricuspid valve and its annulus (TA) and the right atrium (RA) play a significant role in regulating blood flow in the right heart. However, their effect on each other is not fully understood even in normal circumstances. Three-dimensional (3D) speckle-tracking echocardiography (3DSTE) is able to simultaneously assess TA and RA at the same time in a non-invasive way. The present study aimed to examine associations between tricuspid annular (TA) dimensions and right atrial (RA) volumes in healthy adults by 3DSTE. Methods: The present study comprised 144 healthy subjects (mean age: 34.4 ± 12.6 years, 72 males), who participated in this study on a voluntary basis for screening between 2011 and 2015. In all subjects, electrocardiography, two-dimensional Doppler echocardiography and 3DSTE have been performed. Results: With increasing end-systolic maximum RA volume, all end-systolic and end-diastolic TA dimensions showed simultaneous increase, but in various degrees resulting in (non-significant) reduction of TA functional properties. Similarly, with increasing diastolic pre-atrial contraction and minimum RA volumes, TA dimensions increased simultaneously (except end-diastolic TA diameter), but in various degrees resulting in reduced TA fractional shortening and fractional area change. With increasing RA dimensions, end-systolic and end-diastolic TA dimensions showed simultaneous increase, but in different, sometimes not significant degrees. While RA stroke volumes showed increasing pattern with TA dilation, RA emptying fractions have not changed substantially. Conclusions: 3DSTE is suitable for non-invasive assessment of TA dimensions and RA volumes at the same time using the same 3D echocardiographic dataset. Significant associations between TA size and RA volumes exist in healthy circumstances. Strong associations in case of dilation of TA in the presence of higher RA volumes could partly explain functional tricuspid regurgitation later developing in subjects in sinus rhythm.

Discovery of two new isoforms of the human DUT gene.

In human cells two dUTPase isoforms have been described: one nuclear (DUT-N) and one mitochondrial (DUT-M), with cognate localization signals. In contrast, here we identified two additional isoforms; DUT-3 without any localization signal and DUT-4 with the same nuclear localization signal as DUT-N. Based on an RT-qPCR method for simultaneous isoform-specific quantification we analysed the relative expression patterns in 20 human cell lines of highly different origins. We found that the DUT-N isoform is expressed by far at the highest level, followed by the DUT-M and the DUT-3 isoform. A strong correlation between expression levels of DUT-M and DUT-3 suggests that these two isoforms may share the same promoter. We analysed the effect of serum starvation on the expression of dUTPase isoforms compared to non-treated cells and found that the mRNA levels of DUT-N decreased in A-549 and MDA-MB-231 cells, but not in HeLa cells. Surprisingly, upon serum starvation DUT-M and DUT-3 showed a significant increase in the expression, while the expression level of the DUT-4 isoform did not show any changes. Taken together our results indicate that the cellular dUTPase supply may also be provided in the cytoplasm and starvation stress induced expression changes are cell line dependent.

Tricuspid Annular Abnormalities in Isolated Left Ventricular Non-compaction-Insights From the Three-dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study.

Introduction: Prominent trabecular left ventricular (LV) meshwork and deep intertrabecular LV recesses are featuring LV non-compaction (LVNC). The aim of this study was to evaluate tricuspid annular (TA) morphological and functional abnormalities by three-dimensional speckle-tracking echocardiography (3DSTE) in patients with LVNC without right ventricular (RV) involvement. Materials and Methods: This study consisted of 21 patients with isolated LVNC, from which 6 cases were excluded due to inferior image quality. The remaining patient group consisted of 15 subjects with a mean age of 52.1 ± 11.4 years (9 males). LVNC was defined according to the Jenni's criteria. Their results were compared to 21 age- and gender-matched healthy controls (mean age: 52.4 ± 3.9 years, 14 males). Complete routine 2-dimensional Doppler echocardiographic examination was performed in all the patients with isolated LVNC and healthy controls. End-systolic and end-diastolic TA dimensions were assessed on selected planes derived from full-volume 3D echocardiographic datasets during 3DSTE. Results: Patients with isolated LVNC showed significantly dilated end-systolic and end-diastolic TA diameter and area, which were accompanied with preserved TA functional properties and associated with right atrial (RA) volumes. TA plane systolic excursion (TAPSE) showed mild correlations with TA fractional area change (TAFAC) and TA fractional shortening (TAFS). No correlations could be demonstrated between TAPSE and TA morphological features. Extent of LVNC did not correlate with any echocardiographic parameters. Conclusion: TA is dilated with preserved sphincter-like function in patients with isolated LVNC. Longitudinal (TAPSE) and sphincter-like (TAFAC and TAFS) TA movements correlate with each other. TA dilation is associated with an increased RA volumes respecting cardiac cycle.

The tricuspid annulus in amyloidosis with cardiac involvement: Detailed analysis from the three-dimensional speckle tracking echocardiographic MAGYAR-Path Study.

Introduction: Amyloidosis is a rare condition due to extracellular deposition of excessive amount of protein in parenchymal tissues including the heart. The present study aimed to test whether cardiac amyloidosis (CA) is associated with morphological and functional abnormalities of the tricuspid annulus (TA). For this aim, the results of patients having CA were compared to age- and gender-matched healthy controls by three-dimensional speckle-tracking echocardiography (3DSTE). Moreover, differences in TA parameters between light-chain CA (AL-CA) and transthyretin CA (TTR-CA) were studies as well. Materials and Methods: The study comprised 27 CA patients (mean age: 62.7 ±â€¯9.1 years, 21 males), their results were compared to those of 20 age- and gender-matched healthy volunteers (59.3 ±â€¯3.8 years, 13 males). Complete two-dimensional Doppler echocardiography and 3DSTE were performed in all CA patients and controls. Results: Dilated end-diastolic and end-systolic TA diameter, area and perimeter could be detected in all CA patients and in the AL-CA and TTR-CA subgroups, as well. Although only a few TTR-CA patients were involved, morphologic TA parameters proved to be tendentiously higher as compared to those of AL-CA patients. Functional parameters of TA were found to be reduced in CA patients, which were more deteriorated in AL-CA patients. Conclusions: Dilated TA is associated with its functional deterioration in CA.

Screening for Myocardial Injury after Mild SARS-CoV-2 Infection with Advanced Transthoracic Echocardiography Modalities.

Although the clinical manifestations of SARS-CoV-2 viral infection affect mainly the respiratory system, cardiac complications are common and are associated with increased morbidity and mortality. While echocardiographic alterations indicating myocardial involvement are widely reported in patients hospitalized for acute COVID-19 infection, much fewer data available in non-hospitalized, mildly symptomatic COVID-19 patients. In our work, we aimed to investigate subclinical cardiac alterations characterized by parameters provided by advanced echocardiographic techniques following mild SARS-CoV-2 viral infection. A total of 86 patients (30 males, age: 39.5 ± 13.0 yrs) were assessed 59 ± 33 days after mild SARS-CoV-2 viral infection (requiring no hospital or <5 days in-hospital treatment) by advanced echocardiographic examination including 2-dimensional (2D) speckle tracking echocardiography and non-invasive myocardial work analysis, and were compared to an age-and sex-matched control group. Altogether, variables from eleven echocardiographic categories representing morphological or functional echocardiographic parameters showed statistical difference between the post-COVID patient group and the control group. The magnitude of change was subtle or mild in the case of these parameters, ranging from 1−11.7% of relative change. Among the parameters, global longitudinal strain [−20.3 (−21.1−−19.0) vs. −19.1 (−20.4−−17.6) %; p = 0.0007], global myocardial work index [1975 (1789−2105) vs. 1829 (1656−2057) Hgmm%; p = 0.007] and right ventricular free wall strain values (−26.6 ± 3.80 vs. −23.8 ± 4.0%; p = 0.0003) showed the most significant differences between the two groups. Subclinical cardiac alterations are present following even mild SARS-CoV-2 viral infection. These more subtle alterations are difficult to detect by routine echocardiography. Extended protocols, involving speckle-tracking echocardiography, non-invasive measurement of cardiac hemodynamics, and possibly myocardial work are necessary for detection and adequate follow-up.

Tricuspid annular abnormalities following different surgical strategies in adults with corrected tetralogy of Fallot (Results from the CSONGRAD Registry and MAGYAR-Path Study).

BACKGROUND: Although there is an increasing number of patients with corrected tetralogy of Fallot (cTOF), who reach adulthood due to recent successful surgical procedures, some of them suffers from late complications, including functional tricuspid regurgitation (FTR). The purpose of the present study was to examine tricuspid annular (TA) abnormalities in adult cTOF patients and their relationship right atrial (RA) volumes respecting the cardiac cycle assessed by three-dimensional speckle-tracking echocardiography (3DSTE). Moreover, the effect of different surgical procedures on TA morphologic and functional parameters was examined as well. METHODS: The study comprised 24 cTOF patients (32.8±13.5 years, 9 males) in which early palliative surgery and late total correction were performed in 12 cases (pcTOF), while early total reconstruction was performed in 12 subjects (etrTOF). Their results were compared to those of 33 matched healthy adults (36.7±7.2 years, 15 males). RESULTS: Dilated end-systolic and end-diastolic TA morphologic parameters and their body surface area-indexed counterpart could be detected in cTOF patients as compared to that of controls. TA fractional area change and TA fractional shortening proved to be reduced in cTOF patients as well as in etrTOF and pcTOF patients compared to controls. None of the TA morphologic and functional parameters showed any differences between etrTOF and pcTOF patients. Increased maximum, preatrial contraction and minimum RA volumes could be detected in cTOF patients compared to controls, which correlated with TA dimensions. CONCLUSIONS: TA is dilated with reduced function in adult patients with cTOF. TA dilation is related to RA volumes. etrTOF and pcTOF patients have similar TA dimensions and TA functional properties. KEYWORDS: Fallot; tricuspid annulus; three-dimensional (3D); speckle-tracking; echocardiography.

Tricuspid annular abnormalities in repaired dextro-transposition of the great arteries following Senning and Mustard procedures (Insights from the CSONGRAD Registry and MAGYAR-Path Study).

BACKGROUND: In dextro-transposition of the great arteries (dTGA), the aorta and the pulmonary artery are transposed in position, when aorta arises from the right ventricle and pulmonary artery arises from the left ventricle. The present study was designed to assess three-dimensional speckle-tracking echocardiography-derived tricuspid annular (TA) abnormalities in adult patients with dTGA late after atrial switch operations. It was also examined whether differences in TA morphology and function exist between Senning- and Mustard-procedures. METHODS: The study consisted of 14 adult dTGA patients (mean age: 29.9±8.3 years, 6 males), who underwent Mustard-procedure (n=7) at the age of 1.57±0.53 years or Senning-procedure (n=7) at the age of 1.42±0.53 years. Their results were compared to 28 age- and gender-matched healthy subjects (30.3±4.9 years, 14 males). RESULTS: Dilated end-systolic and end-diastolic TA diameters, areas and perimeters could be detected in dTGA patients as compared to those of controls. TA functional properties calculated from TA diameter (TAFS) and area (TAFAC) data proved to be deteriorated in dTGA patients. No differences could be detected either in TA dimensions, or in TA functional properties between Senning- and Mustard-operated dTGA patients. TA plane systolic excursion (TAPSE) was reduced, which did not correlate with TAFAC and TAFS in dTGA patients. CONCLUSIONS: In dTGA, dilated end-systolic and end-diastolic TA is accompanied with deteriorated TA functional properties regardless of which atrial switch procedure was performed. Correlations between TAPSE representing longitudinal movement of the TA and TAFAC and TAFS representing sphincter-like movement of the TA disappeared, which could partially explain accompanying tricuspid functional regurgitations. KEYWORDS: Tricuspid annulus; function; three-dimensional echocardiography; speckle-tracking; transposition of the great arteries.