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1.
Nitric Oxide ; 149: 41-48, 2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38880198

RESUMEN

BACKGROUND: Inhaled nitric oxide (iNO) showed to improve oxygenation at low doses by reducing intrapulmonary shunt and to display antiviral properties at high doses. To assess the safety and potential benefits, we designed an exploratory clinical trial comparing low-dose with intermittent high-dose iNO to only intermittent high-dose iNO in hypoxemic COVID-19 patients. METHODS: In this single-center interventional non-inferiority randomized trial (ClinicalTrials.gov, NCT04476992), twenty oxygen-dependent COVID-19 patients were randomly assigned to the high-dose (200 ppm for 30 min) + continuous low-dose (20 ppm) iNO group (iNO200/20) or the high-dose iNO group (iNO200). Methemoglobinemia (MetHb) assessed 48 h after iNO initiation was the primary endpoint. Reverse-transcription polymerase chain reaction for SARS-CoV-2, inflammatory markers during hospitalization, and heart ultrasounds during the iNO200 treatments were evaluated. RESULTS: MetHb difference between iNO groups remained within the non-inferiority limit of 3 %, indicating comparable treatments despite being statistically different (p-value<0.01). Both groups presented similar SpO2/FiO2 ratio at 48 h (iNO200 vs. iNO200/20 341[334-356] vs. 359 [331-380], respectively, p-value = 0.436). Both groups showed the same time to SARS-CoV-2 negativization, hospital length of stay, and recovery time. iNO-treated patients showed quicker SARS-CoV-2 negativization compared to a similar group of non-iNO patients (HR 2.57, 95%CI 1.04-6.33). During the 228 treatments, iNO200 and iNO200/20 groups were comparable for safety, hemodynamic stability, and respiratory function improvement. CONCLUSIONS: iNO200/20 and iNO200 are equally safe in non-intubated patients with COVID-19-induced respiratory failure with regards to MetHb and NO2. Larger studies should investigate whether iNO200/20 leads to better outcomes compared to non-iNO treated patients.

2.
Biomedicines ; 12(6)2024 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-38927505

RESUMEN

This study aims to determine the effectiveness of administering 80 ppm nitric oxide in reducing kidney injury, mitochondrial dysfunction and regulated cell death in kidneys during experimental perfusion. Twenty-four sheep were randomized into four groups: two groups received 80 ppm NO conditioning with 90 min of cardiopulmonary bypass (CPB + NO) or 90 min of CPB and hypothermic circulatory arrest (CPB + CA + NO), while two groups received sham protocols (CPB and CPB + CA). Kidney injury was assessed using laboratory (neutrophil gelatinase-associated lipocalin, an acute kidney injury biomarker) and morphological methods (morphometric histological changes in kidney biopsy specimens). A kidney biopsy was performed 60 min after weaning from mechanical perfusion. NO did not increase the concentrations of inhaled NO2 and methemoglobin significantly. The NO-conditioning groups showed less severe kidney injury and mitochondrial dysfunction, with statistical significance in the CPB + NO group and reduced tumor necrosis factor-α expression as a trigger of apoptosis and necroptosis in renal tissue in the CPB + CA + NO group compared to the CPB + CA group. The severity of mitochondrial dysfunction in renal tissue was insignificantly lower in the NO-conditioning groups. We conclude that NO administration is safe and effective at reducing kidney injury, mitochondrial dysfunction and regulated cell death in kidneys during experimental CPB.

3.
Biomedicines ; 12(4)2024 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-38672075

RESUMEN

Performing cardiac surgery under cardiopulmonary bypass (CPB) and circulatory arrest (CA) provokes the development of complications caused by tissue metabolism, microcirculatory disorders, and endogenous nitric oxide (NO) deficiency. This study aimed to investigate the potential mechanisms for systemic organoprotective effects of exogenous NO during CPB and CA based on the assessment of dynamic changes in glycocalyx degradation markers, deformation properties of erythrocytes, and tissue metabolism in the experiment. A single-center prospective randomized controlled study was conducted on sheep, n = 24, comprising four groups of six in each. In two groups, NO was delivered at a dose of 80 ppm during CPB ("CPB + NO" group) or CPB and CA ("CPB + CA + NO"). In the "CPB" and "CPB + CA" groups, NO supply was not carried out. NO therapy prevented the deterioration of erythrocyte deformability. It was associated with improved tissue metabolism, lower lactate levels, and higher ATP levels in myocardial and lung tissues. The degree of glycocalyx degradation and endothelial dysfunction, assessed by the concentration of heparan sulfate proteoglycan and asymmetric dimethylarginine, did not change when exogenous NO was supplied. Intraoperative delivery of NO provides systemic organoprotection, which results in reducing the damaging effects of CPB on erythrocyte deformability and maintaining normal functioning of tissue metabolism.

4.
Heliyon ; 10(1): e23538, 2024 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-38170063

RESUMEN

Background: It remains difficult to understand the association between the local mechanical properties of ascending thoracic aorta aneurysm (asTAA), its tissue, and its cellular and molecular changes. The purpose of our study was to investigate the relationship between biomechanical properties, histopathological findings, and tissue biomarkers of asTAA. Methods: Intraoperative asTAA samples from 30 patients were studied. All samples were examined histologically and underwent a tensile test. We determined the tensile strength (σв, MPa), the strain (ε, mm/mm˟%), and the area under the strength-strain curve (S) along with the concentrations of tissue matrix metalloproteinases (MMP-1 et al.) and their inhibitors, their interleukins (IL) -6 -10, and their tumor necrosis factor (TNF) -α. Results: It was found that 43.3 % of asTAA patients had atherosclerosis, 3.3 % had aortitis, and 53.3 % of patients had connective tissue dysplasia. Differences in the studied parameters between these subgroups were not found. Age correlated with ε (r = -0.49) and S (r = -0.54). ε was also associated with media fibrosis degree (r = -0.5), collagen/elastin ratio (r = -0.61), and IL-10 (r = 0.52). IL-10 correlated with collagen/elastin ratio (r = -0.58), TNF-α (r = 0.77), and MMP-1 (r = 0.71). Conclusion: Tissue IL-10 has a protective effect on the elastic structures of the aortic wall and is positively associated with the activity of MMP-1 and pro-inflammatory cytokines. IL-6 is associated with media fibrosis degree, and negatively affects strength-strain parameters of asTAA samples.

5.
Rev. bras. cir. cardiovasc ; 39(1): e20220179, 2024. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1521671

RESUMEN

ABSTRACT Introduction: According to recent data, thoracic aortic surgery has reduced morbidity and mortality including ascending aortic aneurysm treatment; however, women are at increased postoperative risk of adverse outcomes. Objective: Our aim was to evaluate early and late outcomes in male and female patients who underwent pre-emptive ascending aortic replacement (AAR). Methods: From January 2013 to September 2021, 91 patients (56 [61.5%] men and 35 [38.5%] women) underwent AAR for small (ranged from 5.0 to 5.5 cm) non-syndromic aneurysms. A propensity score-based adjustment of the groups was performed. We compared clinical outcomes between males and females. Results: Preoperative normalized aortic diameters were significantly larger in females (2.9 [2.7; 3.2] cm/m2) than in males (2.5 [2.3; 2.6] cm/m2, P<0.001), without differences in absolute values (51 [49; 53] mm vs. 52 [50; 53] mm, P=0.356). There were no significant differences in neurological, cardiac, pulmonary, and renal complications in both groups before and after matching. In-hospital mortality was 1 (1.8%) and 2 (5.7%) (P=0.307) in male and female patients in unmatched groups and 1 (2.9%) and 2 (5.7%) (P=0.553) in matched groups, respectively. Univariate logistic regression analysis revealed that the only risk factor for in-hospital mortality was age (odds ratio 1.117, 95% confidence interval 1.003-1.244; P=0.04). The overall survival rate was 83.5±0.06% in men and 94.3±0.04% in women at 36 months (P=0.404). Conclusion: Ascending aortic surgery for aneurysms ranged from 5.0 to 5.5 cm seems to have tolerable early and late outcomes in men and women.

6.
J Am Soc Mass Spectrom ; 34(12): 2764-2774, 2023 Dec 06.
Artículo en Inglés | MEDLINE | ID: mdl-37886896

RESUMEN

Modern time-of-flight mass spectrometer instruments exhibit excellent mass accuracy in the parts per billion range. At this level, mass calibration methods should consider potential distortions in the basic calibration. Factors which can cause distortions are to be under control. We have analytically modeled and numerically verified the influence of the main causes of mass calibration distortions, including the uncompensated dependence of flight time on the starting position, spatial gradient of the accelerating field, and overshooting at the rising edge of the accelerating pulse. Additionally, the relativity correction has been taken into account.

7.
Braz J Cardiovasc Surg ; 39(1): e20220179, 2023 10 27.
Artículo en Inglés | MEDLINE | ID: mdl-37889231

RESUMEN

INTRODUCTION: According to recent data, thoracic aortic surgery has reduced morbidity and mortality including ascending aortic aneurysm treatment; however, women are at increased postoperative risk of adverse outcomes. OBJECTIVE: Our aim was to evaluate early and late outcomes in male and female patients who underwent pre-emptive ascending aortic replacement (AAR). METHODS: From January 2013 to September 2021, 91 patients (56 [61.5%] men and 35 [38.5%] women) underwent AAR for small (ranged from 5.0 to 5.5 cm) non-syndromic aneurysms. A propensity score-based adjustment of the groups was performed. We compared clinical outcomes between males and females. RESULTS: Preoperative normalized aortic diameters were significantly larger in females (2.9 [2.7; 3.2] cm/m2) than in males (2.5 [2.3; 2.6] cm/m2, P<0.001), without differences in absolute values (51 [49; 53] mm vs. 52 [50; 53] mm, P=0.356). There were no significant differences in neurological, cardiac, pulmonary, and renal complications in both groups before and after matching. In-hospital mortality was 1 (1.8%) and 2 (5.7%) (P=0.307) in male and female patients in unmatched groups and 1 (2.9%) and 2 (5.7%) (P=0.553) in matched groups, respectively. Univariate logistic regression analysis revealed that the only risk factor for in-hospital mortality was age (odds ratio 1.117, 95% confidence interval 1.003-1.244; P=0.04). The overall survival rate was 83.5±0.06% in men and 94.3±0.04% in women at 36 months (P=0.404). CONCLUSION: Ascending aortic surgery for aneurysms ranged from 5.0 to 5.5 cm seems to have tolerable early and late outcomes in men and women.


Asunto(s)
Aneurisma de la Aorta , Humanos , Masculino , Femenino , Resultado del Tratamiento , Estudios Retrospectivos , Aneurisma de la Aorta/cirugía , Factores de Riesgo , Aorta/cirugía , Complicaciones Posoperatorias
8.
Kardiologiia ; 63(6): 45-51, 2023 Jun 30.
Artículo en Ruso, Inglés | MEDLINE | ID: mdl-37470733

RESUMEN

Aim      To evaluate quality of life (QoL), general survival, and development of complications in patents one year after surgical aortic valve (AV) replacement with a MedInzh-BIO xenopericardial carcass prosthesis.Material and methods  Degenerative AV disease is one of the most common cardiovascular diseases that gives place only to ischemic heart disease. Surgical correction of the AV defect should be aimed not only at hemodynamic outcomes but also at improvement of QoL. This study included 91 patients (48 women and 43 men), who were implanted with a MedInzh-BIO biological xenopericardial prosthesis in aortic position from January 2017 through March 2020. Mean age of patients was 69.96±4.4 years. QoL was evaluated with a standard SF-36 questionnaire. Also, survival and complications were analyzed one year after surgery.Results Data analysis before and one year after surgery showed a significant improvement of QoL. Postoperative one-year survival was 95.4 %, and major valve-associated complications were absent in 94.5% of cases. During one year, four patients died after 1, 6, 8, and 10 months of follow-up, respectively.Conclusion      The improvement of QoL following the AV replacement with a novel xenopericardial carcass prosthesis with the "easy change" system indicates the clinical and functional effectiveness of the used method. The results of the study demonstrated improvements of both the physical health component and the subjective emotional assessment. Postoperative one-year survival was 95.4 %, and major valve-associated complications were absent in 94.5% of cases.


Asunto(s)
Estenosis de la Válvula Aórtica , Implantación de Prótesis de Válvulas Cardíacas , Prótesis Valvulares Cardíacas , Masculino , Humanos , Femenino , Anciano , Calidad de Vida/psicología , Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Implantación de Prótesis de Válvulas Cardíacas/métodos , Válvula Aórtica/cirugía , Estenosis de la Válvula Aórtica/cirugía , Constricción Patológica , Resultado del Tratamiento , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía
9.
J Pers Med ; 13(5)2023 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-37240954

RESUMEN

BACKGROUND: The frozen elephant trunk technique has become popular and led to an expansion of indications for surgery. Various hybrid grafts for the frozen elephant trunk are used, sometimes with significantly different features. The objective of this study was to compare early- and mid-term outcomes after the frozen elephant trunk for aortic dissection using different hybrid grafts. METHODS: The prospective study included 45 patients with acute/chronic aortic dissections. The patients were randomized into two groups. Group 1 patients (n = 19) were implanted with a hybrid graft E-vita open plus (E-vita OP). Group 2 (n = 26) included patients who received a MedEng graft. The inclusion criteria were type A and type B acute and chronic aortic dissection. The exclusion criteria were as follows: hyperacute aortic dissection (less than 24 h), organ malperfusion, oncology, severe heart failure, stroke, and acute myocardial infarction. The primary endpoint was early- and mid-term mortality. The secondary endpoints were postoperative complications (stroke and spinal cord ischemia, myocardial infarction, respiratory failure, acute renal injury, and re-operation for bleeding). RESULTS: The rate of stroke and spinal cord ischemia in the E-vita OP vs. MedEng groups was 11% vs. 4% (p = 0.565) and 11% vs. 0% (p = 0.173), respectively. The respiratory failure rate was comparable in both groups (p > 0.999). Acute kidney injury requiring hemodialysis and the need for re-sternotomy in the MedEng group vs. E-vita OP group was 31% vs. 16% (p = 0.309) and 15% vs. none (p = 0.126), respectively. Early mortality in the MedEng and E-vita OP groups did not differ (8% vs. 0, p = 0.501). The mid-term survival in the analyzed groups was 79% vs. 61%, (p = 0.079), respectively. CONCLUSIONS: No statistically significant differences were observed between patients receiving frozen elephant trunk with the hybrid MedEng and E-vita OP grafts in regard to early mortality and morbidity. Mid-term survival was also non-significant between analyzed groups with a trend toward more favorable mortality in the MedEng group.

10.
Int J Angiol ; 32(2): 140-142, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37207013

RESUMEN

We describe a case report of a 63-year-old man who presented with chronic left-hand weakness and the absence of a pulse in the left arm. Thoracoabdominal computed tomography (CT) revealed an extensive thoracic aortic mural thrombus. Initial anticoagulation therapy did not provide a positive result, so the patient was referred for surgery. Hybrid aortic arch surgery using the frozen elephant trunk technique was performed with excellent early outcomes. A CT performed in the early postoperative period showed that the thrombus was completely excluded from the aortic lumen by the hybrid graft. No thrombus dislodgment was detected. No thrombus recurrence was observed during 19 months of follow-up.

11.
J Am Soc Mass Spectrom ; 34(2): 264-272, 2023 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-36603847

RESUMEN

A novel mass spectrometry system is described here comprising a quadrupole-multireflecting time-of-flight design. The new multireflecting time-of-flight analyzer has an effective path length of 48 m and employs planar, gridless ion mirrors providing fourth-order energy focusing resulting in resolving power over 200 000 fwhm and sub-ppm mass accuracy. We show how these attributes are maintained with relatively fast acquisition speeds, setting the system apart from other high resolution mass spectrometers. We have integrated this new system into both liquid chromatography-mass spectrometry and mass spectrometry imaging workflows to demonstrate how the instrument characteristics are of benefit to these applications.

12.
Perfusion ; 38(4): 681-683, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-35099311

RESUMEN

Hypothermic circulatory arrest is commonly used during aortic arch surgery. However, it is associated with high risk of visceral organ and lower limb ischemia. There may be advantages to reduction duration of hypothermic circulatory arrest to prevent ischemic complications. We present a case of partial aortic arch replacement without use of hypothermic circulatory arrest.


Asunto(s)
Aneurisma de la Aorta Torácica , Paro Cardíaco , Humanos , Aorta Torácica/cirugía , Paro Cardíaco Inducido , Perfusión , Paro Circulatorio Inducido por Hipotermia Profunda , Circulación Cerebrovascular , Aneurisma de la Aorta Torácica/cirugía , Resultado del Tratamiento
13.
J Imaging ; 8(10)2022 Oct 14.
Artículo en Inglés | MEDLINE | ID: mdl-36286374

RESUMEN

Ascending thoracic aortic aneurysm is a life-threatening disease, which is difficult to detect prior to the occurrence of a catastrophe. Epidemiology patterns of ascending thoracic aortic dilations/aneurysms remain understudied, whereas the risk assessment of it may be improved. The electronic databases PubMed/Medline 1966-2022, Web of Science 1975-2022, Scopus 1975-2022, and RSCI 1994-2022 were searched. The current guidelines recommend a purely aortic diameter-based assessment of the thoracic aortic aneurysm risk, but over 80% of the ascending aorta dissections occur at a size that is lower than the recommended threshold of 55 mm. Moreover, a 55 mm diameter criterion could exclude a vast majority (up to 99%) of the patients from preventive surgery. The authors review several visualization-based and alternative approaches which are proposed to better predict the risk of dissection in patients with borderline dilated thoracic aorta. The imaging-based assessments of the biomechanical aortic properties, the Young's elastic modulus, the Windkessel function, compliance, distensibility, wall shear stress, pulse wave velocity, and some other parameters have been proposed to improve the risk assessment in patients with ascending thoracic aortic aneurysm. While the authors do not argue for shifting the diameter threshold to the left, they emphasize the need for more personalized solutions that integrate the imaging data with the patient's genotypes and phenotypes in this heterogeneous pathology.

14.
Gene ; 844: 146820, 2022 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-35987510

RESUMEN

ß1-adrenergic receptors (ß1-AR) directly affect on intracardiac hemodynamic and the ability of the heart to tolerate physical activity by regulating its inotropic and chronotropic functions. Severe hypersympathicotonia, specific to coronary artery disease (CAD) and chronic heart failure (HF), leads to impaired functioning of ß1-AR. The aim of this research was to assess the expression level of the ß1-AR ADRB1 gene in the myocardium, to evaluate the ß-adrenergic reactivity of the membrane (ß-ARM) of erythrocytes, and to analyze the association of these parameters with myocardial contractile dysfunction in patients with a myocardial infarction (MI) in the past and without it. The study included 126 patients with chronic CAD. Among the patients, 55.6 % had a history of MI at least 6 months ago. The expression of the ADRB1 gene was assessed using real-time polymerase chain reaction. With this purpose, we isolated RNA from the right atrial appendage, which was excised when a heart-lung machine was connected during a planned coronary bypass surgery. ß-ARM was evaluated in 57 patients. This method is based on the fact of inhibition of hemolysis of erythrocytes, placed in a hyposmotic medium, in the presence of a ß-blocker. Within the whole sample of patients, the expression of the ADRB1 gene is comparable in different functional classes of HF. There was no linear correlation between the expression of the ADRB1 gene and left ventricle ejection fraction (LVEF). In patients with a history of MI, the expression of the ADRB1 gene was elevated when compared to a group of patients without MI (p = 0.017). Patients with a history of MI had higher values of ß-ARM than those without MI (p = 0.017). The reverse correlation between ß-ARM and LVEF (r = -0,570, p = 0,002) was revealed in the group of patients without MI but not in the group of patients with a history of MI (r = -0,137, p = 0,479). In the sample of patients with chronic CAD, in the myocardium of subjects with a history of MI, the relative expression of ADRB1 gene was higher compared to the group of patients without MI. In patients with different functional classes (FC) of HF and with different ejection fraction, both with MI and without it, ADRB1 gene expression was comparable. In the group of patients with a history of MI, an increase in ß-ARM was observed, i.e. decrease in the number or sensitivity of ß-AR. Among patients without MI, an inverse correlation was found between ß-ARM and LVEF.


Asunto(s)
Cardiomiopatías , Infarto del Miocardio , Adrenérgicos , Antagonistas Adrenérgicos beta , Humanos , Infarto del Miocardio/genética , Miocardio , Receptores Adrenérgicos beta 1/genética , Volumen Sistólico
15.
Int J Mol Sci ; 23(15)2022 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-35897812

RESUMEN

The high mortality rate caused by atherosclerosis makes it necessary to constantly search for new and better treatments. In previous reports, chemically modified carbon-coated iron nanoparticles (Fe@C NPs) have been demonstrated a high biocompatibility and promising anti-plaque properties. To further investigate these effects, the interaction of these nanoparticles with the adipose tissue of Wistar rats (in vivo) and human atherosclerotic plaques (ex vivo) was studied. For the in vivo study, cobalt-chromium (CoCr) alloy tubes, which are used for coronary stent manufacturing, were prepared with a coating of polylactic acid (PLA) which contained either modified or non-modified Fe@C NPs in a 5% by weight concentration. The tubes were implanted into an area of subcutaneous fat in Wistar rats, where changes in the histological structure and functional properties of the surrounding tissue were observed in the case of coatings modified with Fe@C NPs. For the ex vivo study, freshly explanted human atherosclerotic plaques were treated in the physiological solution with doses of modified Fe@C NPs, with mass equal to 5% or 25% relative to the plaques. This treatment resulted in the release of cholesterol-like compounds from the surface of the plaques into the solution, thus proving a pronounced destructive effect on the plaque structure. Chemically modified Fe@C NPs, when used as an anti-atherosclerosis agent, were able to activate the activity of macrophages, which could lead to the destruction of atherosclerotic plaques structures. These findings could prove the fabrication of next-generation vascular stents with built-in anti-atherosclerotic agents.


Asunto(s)
Aterosclerosis , Nanopartículas , Placa Aterosclerótica , Tejido Adiposo/patología , Animales , Aterosclerosis/tratamiento farmacológico , Aterosclerosis/patología , Carbono/farmacología , Carbono/uso terapéutico , Humanos , Hierro/uso terapéutico , Nanopartículas/química , Placa Aterosclerótica/tratamiento farmacológico , Placa Aterosclerótica/patología , Ratas , Ratas Wistar
16.
J Pers Med ; 12(4)2022 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-35455753

RESUMEN

The complications of thoracic aortic disease include aortic dissection and aneurysm. The risks are frequently compounded by many cardiovascular comorbidities, which makes the process of clinical decision making complicated. The purpose of this study is to develop risk predictive models for patients after thoracic aneurysm surgeries, using integrated data from different medical institutions. Seven risk features were formulated for prediction. The CatBoost classifier performed best and provided an ROC AUC of 0.94-0.98 and an F-score of 0.95-0.98. The obtained results are widely in line with the current literature. The obtained findings provide additional support for clinical decision making, guiding a patient care team prior to surgical treatment, and promoting a safe postoperative period.

17.
J Thorac Cardiovasc Surg ; 163(4): 1393-1403.e9, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-32718702

RESUMEN

OBJECTIVE: Acute kidney injury (AKI) is a serious complication of cardiac surgery with cardiopulmonary bypass (CPB). The aim of this study was to evaluate the effects of nitric oxide (NO) supplementation to the CPB circuit on the development of cardiac surgery-associated AKI. METHODS: This prospective randomized controlled study included 96 patients with moderate risk of renal complications who underwent elective cardiac surgery with CPB. The study protocol was registered at ClinicalTrials.gov (identifier NCT03527381). Patients were randomly allocated to either NO supplementation to the CPB bypass circuit (NO treatment group; n = 48) or usual care (control group; n = 48). In the NO treatment group, 40-ppm NO was administered during the entire CPB period. The primary outcome was the incidence of AKI. RESULTS: NO treatment was associated with a significant decrease in AKI incidence (10 cases [20.8%] vs 20 cases [41.6%] in the control group; relative risk, 0.5; 95% confidence interval, 0.26-0.95; P = .023) and a higher median urine output during CPB (2.6 mL/kg/h [interquartile range (IQR), 2.1-5.08 mL/kg/h] vs 1.7 mL/kg/h [IQR, 0.80-2.50 mL/kg/h]; P = .0002). The median urinary neutrophil gelatinase-associated lipocalin level at 4 hours after surgery was significantly lower in the NO treatment group (1.12 ng/mL [IQR, 0.75-5.8 ng/mL] vs 4.62 ng/mL [IQR, 2.02-34.55 ng/mL]; P = .005). In the NO treatment group, concentrations of NO metabolites were significantly increased at 5 minutes postclamping, at 5 minutes after declamping, and at the end of the operation. Concentrations of proinflammatory and anti-inflammatory mediators and free plasma hemoglobin did not differ significantly between the 2 groups. CONCLUSIONS: NO administration in patients at moderate risk of renal complications undergoing elective cardiac surgery with CPB was associated with a lower incidence of AKI.


Asunto(s)
Lesión Renal Aguda/prevención & control , Puente Cardiopulmonar , Óxido Nítrico/administración & dosificación , Complicaciones Posoperatorias/prevención & control , Anciano , Femenino , Hemoglobinas/análisis , Humanos , Lipocalina 2/orina , Masculino , Persona de Mediana Edad , Nitratos/sangre , Dióxido de Nitrógeno/sangre , Estudios Prospectivos
18.
J Cardiovasc Surg (Torino) ; 63(2): 195-201, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34792310

RESUMEN

BACKGROUND: The clinical significance of the false lumen (FL) thrombosis after the thoracic aortic surgery consists in the correlation with aortic remodeling. The aim of the study was to analyze the incidence of the FL thrombosis of the thoracoabdominal aorta after the frozen elephant trunk (FET) procedure in acute and chronic aortic dissection. METHODS: A total of 57 consecutive patients with type A and B aortic dissection (AD) underwent the FET procedure between March 2012 and December 2020 were included in a retrospective study. All of the patients were divided in two groups: acute (N.=18) and chronic (N.=39) AD. Early and 2-year outcomes were evaluated in both groups. Computed tomography scans were obtained along the entire aorta for the aortic status assessment. RESULTS: There were no statistically significant differences in early mortality and postoperative outcomes in both groups. The 2-year survival rate in acute and chronic AD was 74.7±10% vs. 71.4±7% (P=0.573), respectively. In the follow-up, the FL thrombosis rate, changes of the true lumen and total aortic diameters did not differ significantly between the analyzed groups of patients. The freedom from negative aortic remodeling was 62.2±26% in acute AD versus 76.2±11% in chronic AD (P=0.853). One (5.6%) and 4 (10.3%) distal aortic reinterventions were performed in acute and chronic AD, respectively. CONCLUSIONS: False lumen thrombosis rate after the FET procedure did not differ significantly in acute and chronic AD.


Asunto(s)
Aneurisma de la Aorta Torácica , Disección Aórtica , Implantación de Prótesis Vascular , Trombosis , Disección Aórtica/complicaciones , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/cirugía , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Aneurisma de la Aorta Torácica/complicaciones , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/cirugía , Prótesis Vascular/efectos adversos , Humanos , Estudios Retrospectivos , Trombosis/diagnóstico por imagen , Trombosis/etiología , Trombosis/cirugía , Resultado del Tratamiento
19.
Data Brief ; 39: 107656, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34917707

RESUMEN

Understanding the mechanisms underlying the connection between somatic mosaicism and cardiovascular disease is likely essential for the future of personalized medicine. This article is aimed at providing data on somatic mosaicism in human carotid atherosclerosis. An advanced carotid atherosclerotic plaque and white blood cells were collected simultaneously from each patient (eight Slavic males, aged 67 ± 3.8 years [mean ± SD]) to assess the spectrum of germline and somatic genetic variants. Exome sequencing of DNA from the samples was performed with the SureSelect Clinical Research Exome Enrichment Kit (Agilent Technologies) and HiSeq 1500 (Illumina). The dataset contains germline and somatic single-nucleotide variants and small indels identified in the advanced carotid atherosclerotic plaque and white blood cells of each patient. This dataset does not include copy number variants owing to a lack of suitable tools for reliable calculation of copy numbers from exome sequencing data on cancer-unrelated samples. The dataset should help to understand somatic mosaicism in cardiovascular diseases and to identify copy number variants by means of more appropriate newer tools in the future.

20.
Stud Health Technol Inform ; 285: 88-93, 2021 Oct 27.
Artículo en Inglés | MEDLINE | ID: mdl-34734856

RESUMEN

This article describes the results of feature extraction from unstructured medical records and prediction of postoperative complications for patients with thoracic aortic aneurysm operations using machine learning algorithms. The datasets from two different medical centers were integrated. Seventy-two features were extracted from Russian unstructured medical records. We formulated 8 target features: Mortality, Temporary neurological deficit (TND), Permanent neurological deficit (PND), Prolonged (> 7 days) lung ventilation (LV), Renal replacement therapy (RRT), Bleeding, Myocardial infarction (MI), Multiple organ failure (MOF). XGBoost showed the best performance for most target variables (F-measure 0.74-0.95) which is comparable to recent results in cardiovascular postoperative risks prediction.


Asunto(s)
Aneurisma de la Aorta Torácica , Aprendizaje Automático , Complicaciones Posoperatorias , Algoritmos , Aneurisma de la Aorta Torácica/cirugía , Humanos , Complicaciones Posoperatorias/epidemiología , Periodo Posoperatorio , Factores de Riesgo , Federación de Rusia
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