ABSTRACT
Olanzapine (OLZ), a widely used second-generation antipsychotic drug, is known to cause metabolic side effects, including diabetes and obesity. Interestingly, OLZ-induced metabolic side effects have been demonstrated to be more profound in females in human studies and animal models. Metformin (MET) is often used as a medication for the metabolic side effects of OLZ. However, the mechanisms underlying OLZ-induced metabolic disturbances and their treatment remain unclear. Recent evidence has suggested that hypothalamic inflammation is a key component of the pathophysiology of metabolic disorders. On this background, we conducted this study with the following three objectives: 1) to investigate whether OLZ can independently induce hypothalamic microgliosis; 2) to examine whether there are sex-dependent differences in OLZ-induced hypothalamic microgliosis; and 3) to examine whether MET affects hypothalamic microgliosis. We found that administration of OLZ for 5 days induced systemic glucose intolerance and hypothalamic microgliosis and inflammation. Of note, both hypothalamic microglial activation and systemic glucose intolerance were far more evident in female mice than in male mice. The administration of MET attenuated hypothalamic microglial activation and prevented OLZ-induced systemic glucose intolerance and hypothalamic leptin resistance. Minocycline, a tetracycline derivative that prevents microgliosis, showed similar results when centrally injected. Our findings reveal that OLZ induces metabolic disorders by causing hypothalamic inflammation and that this inflammation is alleviated by MET administration.
ABSTRACT
Antipsychotics have been widely accepted as a treatment of choice for psychiatric illnesses such as schizophrenia. While atypical antipsychotics such as aripiprazole are not associated with obesity and diabetes, olanzapine is still widely used based on the anticipation that it is more effective in treating severe schizophrenia than aripiprazole, despite its metabolic side effects. To address metabolic problems, metformin is widely prescribed. Hypothalamic proopiomelanocortin (POMC) neurons have been identified as the main regulator of metabolism and energy expenditure. Although the relation between POMC neurons and metabolic disorders is well established, little is known about the effects of olanzapine and metformin on hypothalamic POMC neurons. In the present study, we investigated the effect of olanzapine and metformin on the hypothalamic POMC neurons in female mice. Olanzapine administration for 5 days significantly decreased Pomc mRNA expression, POMC neuron numbers, POMC projections, and induced leptin resistance before the onset of obesity. It was also observed that coadministration of metformin with olanzapine not only increased POMC neuron numbers and projections but also improved the leptin response of POMC neurons in the olanzapine-treated female mice. These findings suggest that olanzapine-induced hypothalamic POMC neuron abnormality and leptin resistance, which can be ameliorated by metformin administration, are the possible causes of subsequent hyperphagia. [BMB Reports 2022; 55(6): 293-298].
Subject(s)
Antipsychotic Agents , Metformin , Animals , Antipsychotic Agents/metabolism , Antipsychotic Agents/pharmacology , Aripiprazole/metabolism , Aripiprazole/pharmacology , Female , Hypothalamus/metabolism , Leptin/metabolism , Metformin/metabolism , Metformin/pharmacology , Mice , Neurons/metabolism , Obesity/drug therapy , Obesity/metabolism , Olanzapine/metabolism , Olanzapine/pharmacology , Pro-Opiomelanocortin/genetics , Pro-Opiomelanocortin/metabolism , Pro-Opiomelanocortin/pharmacologyABSTRACT
Apple stem grooving virus (ASGV; genus Capillovirus) is an economically important virus. It has an approx. 6.5 kb, monopartite, linear, positive-sense, single-stranded RNA genome. The present study includes identification of 24 isolates-13 isolates from apple (Pyrus malus L.) and 11 isolates from pear (Pyrus communis L.)-from different agricultural fields in South Korea. The coat protein (CP) gene of the corresponding 23 isolates were amplified, sequenced, and analyzed. The CP sequences showed phylogenetic separation based on their host species, and not on the geography, indicating host adaptation. Further analysis showed that the ASGV isolated in this study followed host adaptation influenced and preferred by the host codon-usage.
ABSTRACT
The Sweet potato chlorotic fleck virus (SPCFV), of the genus Carlavirus (family Betaflexiviridae), was first detected as one of several viruses infecting sweet potatoes (Ipomea batatas L.) in Korea. Out of 154 sweet potato samples collected in 2012 that were showing virus-like symptoms, 47 (31%) were infected with SPCFV, along with other viruses. The complete genome sequences of four SPCFV isolates were determined and analyzed using previously reported genome sequences. The complete genomes were found to contain 9,104-9,108 nucleotides, excluding the poly-A tail, containing six putative open reading frames (ORFs). Further, the SPCFV Korean isolates were divided into two groups (Group I and Group II) by phylogenetic analysis based on the complete nucleotide sequences; Group I and Group II had low nucleotide sequence identities of about 73%. For the first time, we determined the complete genome sequence for the Group II SPCFV isolates. The amino acid sequence identity in coat proteins (CP) between the two groups was over 90%, whereas the amino acid sequence identity in other proteins was less than 80%. In addition, SPCFV Korean isolates had a low amino acid sequence identity (61% CPs and 47% in the nucleotide- binding protein [NaBp] region) to that of Melon yellowing-associated virus (MYaV), a typical Carlavirus.
ABSTRACT
Sweet potato is a vegetatively propagated crop that is produced for both growth in Korean fields and for export out of the country. The viruses that are present in introduced sweet potatoes can spread both domestically and to foreign countries. Determining the time and path of virus movement could help curtail its spread and prevent future dispersal of related viruses. Determining the consequences of past virus and sweet potato dispersal could provide insight into the ecological and economic risks associated with other sweet potato-infecting viral invasions. We therefore applied Bayesian phylogeographic inferences and recombination analyses of the available Sweepovirus sequences (including 25 Korean Sweepovirus genomes) and reconstructed a plausible history of Sweepovirus diversification and movement across the globe. The Mediterranean basin and Central America were found to be the launchpad of global Sweepovirus dispersal. Currently, China and Brazil are acting as convergence regions for Sweepoviruses. Recently reported Korean Sweepovirus isolates were introduced from China in a recent phase and the regions around China and Brazil continue to act as centers of Sweepovirus diversity and sites of ongoing Sweepovirus evolution. The evidence indicates that the region is an epidemiological hotspot, which suggests that novel Sweepovirus variants might be found.
Subject(s)
Begomovirus/genetics , Genome, Viral , Ipomoea batatas/virology , Begomovirus/isolation & purification , Crop Production , Phylogeny , Phylogeography , Plant Diseases/genetics , Recombination, Genetic , Republic of Korea , Spatial AnalysisABSTRACT
A nationwide survey was performed to investigate the current incidence of viral diseases in Korean sweet potatoes for germplasm and growing fields from 2011 to 2014. A total of 83.8% of the germplasm in Korea was infected with viruses in 2011. Commercial cultivars that were used to supply growing fields were infected at a rate of 62.1% in 2012. Among surveyed viruses, the incidence of five Potyvirus species that infect sweet potato decreased between 2012 and 2013, and then increased again in 2014. Representatively, the incidence of Sweet potato feathery mottle virus (SPFMV) was 87.0% in 2012, 20.7% in 2013 and then increased to 35.3% in 2014. Unlike RNA viruses, DNA viruses were shown to decrease continuously. The incidence of Sweet potato leaf curl virus (SPLCV) was 5.5% in 2003, 59.5% in 2011, and 47.4% in 2012. It then decreased continuously year by year to 33.2% in 2013, and then 25.6% in 2014. While the infection rate of each virus species showed a tendency to decline, the virus infection status was more variable in 2013 and 2014. Nevertheless, the high rate of single infections and mixed infection combinations were more variable than the survey results from 2012. As shown in the results from 2013, the most prevalent virus infection was a single infection at 27.6%, with the highest rate of infection belonging to sweet potato symptomless virus-1 (SPSMV-1) (12.9%). Compared to 2013, infection combinations were more varied in 2014, with a total of 122 kinds of mixed infection.
ABSTRACT
Broad bean wilt virus 2 (BBWV2), which belongs to the genus Fabavirus, is a destructive pathogen of many economically important horticultural and ornamental crops. In this study, we constructed infectious full-length cDNA clones of two distinct isolates of BBWV2 under control of the cauliflower mosaic virus 35S promoter. BBWV2-PAP1 isolated from paprika (Capsicum annuum var. gulosum) induces severe disease symptoms in various pepper varieties, whereas BBWV2-RP1 isolated from red pepper (Capsicum annuum L.) causes mild symptoms. Agrobacterium-mediated inoculation of the infectious cDNA clones of BBWV2-PAP1 and RP1 resulted in the same symptoms as the original virus isolates. The infectious cDNA clones of BBWV2-PAP1 and RP1 were used to examine the symptoms induced by pseudorecombinants between the two isolates to localize in which of the two genomic RNAs are the symptom severity determinants in BBWV2. The pseudorecombinant of RP1-RNA1 and PAP1-RNA2 induced severe symptoms, similar to those caused by the parental isolate PAP1, whereas the pseudorecombinant of PAP1-RNA1 and RP1-RNA2 induced mild symptoms, similar to those caused by the parental isolate RP1. Our results suggest that BBWV2 RNA2 contains a symptom determinant(s) capable of enhancing symptom severity.
Subject(s)
Fabavirus/genetics , Fabavirus/pathogenicity , Plant Diseases/virology , RNA, Viral/genetics , Capsicum/virology , Fabavirus/physiology , Pancreatitis-Associated Proteins , RNA, Viral/metabolism , Nicotiana/virology , VirulenceABSTRACT
Sweet potatoes (Ipomea batatas L.) are grown extensively, in tropical and temperate regions, and are important food crops worldwide. In Korea, potyviruses, including Sweet potato feathery mottle virus (SPFMV), Sweet potato virus C (SPVC), Sweet potato virus G (SPVG), Sweet potato virus 2 (SPV2), and Sweet potato latent virus (SPLV), have been detected in sweet potato fields at a high (~95%) incidence. In the present work, complete genome sequences of 18 isolates, representing the five potyviruses mentioned above, were compared with previously reported genome sequences. The complete genomes consisted of 10,081 to 10,830 nucleotides, excluding the poly-A tails. Their genomic organizations were typical of the Potyvirus genus, including one target open reading frame coding for a putative polyprotein. Based on phylogenetic analyses and sequence comparisons, the Korean SPFMV isolates belonged to the strains RC and O with >98% nucleotide sequence identity. Korean SPVC isolates had 99% identity to the Japanese isolate SPVC-Bungo and 70% identity to the SPFMV isolates. The Korean SPVG isolates showed 99% identity to the three previously reported SPVG isolates. Korean SPV2 isolates had 97% identity to the SPV2 GWB-2 isolate from the USA. Korean SPLV isolates had a relatively low (88%) nucleotide sequence identity with the Taiwanese SPLV-TW isolates, and they were phylogenetically distantly related to SPFMV isolates. Recombination analysis revealed that possible recombination events occurred in the P1, HC-Pro and NIa-NIb regions of SPFMV and SPLV isolates and these regions were identified as hotspots for recombination in the sweet potato potyviruses.
ABSTRACT
The complete genome sequence of a new virus isolated from a bellflower (Campanula takesimana) plant was determined. The genome of this virus is composed of monopartite single-stranded RNA of 11,649 nucleotides in length. BLAST searches of protein databases showed that the encoded polyprotein has a maximum amino acid sequence identity of 42% (with 99% coverage) to the polyprotein of the isolate Orissa of rice tungro spherical virus (RTSV; genus Waikavirus). Phylogenetic analysis strongly supports that the identified virus is a member of a new species of the genus Waikavirus. The name bellflower vein chlorosis virus (BVCV) is proposed for this new virus.
Subject(s)
Campanulaceae/virology , Genome, Viral , Plant Diseases/virology , Waikavirus/genetics , Waikavirus/isolation & purification , Base Sequence , Molecular Sequence Data , Open Reading Frames , Phylogeny , Waikavirus/classificationABSTRACT
Tomato yellow leaf curl virus (TYLCV), a member of the genus Begomovirus, has a single-stranded DNA genome. TYLCV can induce severe disease symptoms on tomato plants, but other hosts plants such as cucurbits and peppers are asymptomatic. A full-length DNA clone of a Korean TYLCV isolate was constructed by rolling-circle amplification from TYLCV-infected tomatoes in Korea. To assess relative susceptibility of sweet pepper varieties to TYLCV, 19 cultivars were inoculated with cloned TYLCV by agro-inoculation. All TYLCV-infected sweet peppers were asymptomatic, even though Southern hybridization and polymerase chain reaction analysis showed TYLCV genomic DNA accumulation in roots, stems, and newly produced shoots. Southern hybridization indicated that TYLCV replicated and moved systemically from agro-inoculated apical shoot tips to roots or newly produced shoots of sweet peppers. Whitefly-mediated inoculation experiments showed that TYLCV can be transmitted to tomatoes from TYLCV-infected sweet peppers. Taken together, these results indicate that sweet pepper can be a reservoir for TYLCV in nature.
Subject(s)
Begomovirus/growth & development , Capsicum/virology , Animals , Begomovirus/genetics , Begomovirus/isolation & purification , Blotting, Southern , Cloning, Molecular , DNA, Viral/chemistry , DNA, Viral/genetics , Hemiptera/virology , Insect Vectors , Korea , Solanum lycopersicum/virology , Molecular Sequence Data , Plant Roots/virology , Plant Shoots/virology , Plant Stems/virology , Sequence Analysis, DNAABSTRACT
After the first identification of tomato yellow leaf curl virus (TYLCV) in the southern part of Korea in 2008, TYLCV has rapidly spread to tomato farms in most regions of Korea. From 2008 to 2010, a survey of natural weed hosts that could be reservoirs of TYLCV was performed in major tomato production areas of Korea. About 530 samples were collected and identified as belonging to 25 species from 11 families. PCR and Southern hybridization were used to detect TYLCV in samples, and replicating forms of TYLCV DNA were detected in three species (Achyranthes bidentata, Lamium amplexicaule, and Veronica persica) by Southern hybridization. TYLCV transmission mediated by Bemisia tabaci from TYLCV-infected tomato plants to L. amplexicaule was confirmed, and TYLCV-infected L. amplexicaule showed symptoms such as yellowing, stunting, and leaf curling. TYLCV from infected L. amplexicaule was also transmitted to healthy tomato and L. amplexicaule plants by B. tabaci. The rate of infection of L. amplexicaule by TYLCV was similar to that of tomato. This report is the first to show that L. amplexicaule is a reservoir weed host for TYLCV.
Subject(s)
Begomovirus/isolation & purification , Lamiaceae/virology , Plant Diseases/virology , Solanum lycopersicum/virology , Animals , Begomovirus/genetics , Begomovirus/physiology , Blotting, Southern , DNA, Viral/genetics , DNA, Viral/isolation & purification , Hemiptera/virology , Korea , Virus ReplicationABSTRACT
Loop-mediated isothermal amplification (LAMP) is an established nucleic acid amplification method offering rapid, sensitive, and convenient diagnosis of infectious diseases. Chrysanthemum chlorotic mottle viroid (CChMVd) causes one of the most serious viral diseases in chrysanthemum in Korea. A sensitive LAMP assay was developed for rapidly detecting CChMVd infection. The assay was based on a set of four primers matching the specific region of the CChMVd genome. The CChMVd LAMP primer sets were designed using the sequences from nonsymptomatic and symptomatic CChMVd isolates in Korea. The efficiency and specificity of this method were optimized using Bst DNA polymerase, which allowed for increased viroid detection sensitivity. The reaction was carried out at 65 °C for 90 min, and was improved by adding SYBR Green I dye to the inside of the reaction tube lid prior to amplification. The results indicate that this LAMP method will be useful for chrysanthemum viroid disease monitoring and detecting CChMVd infectious disease.
Subject(s)
Chrysanthemum/virology , Nucleic Acid Amplification Techniques/methods , Plant Diseases/virology , Viroids/isolation & purification , Virology/methods , DNA Primers/genetics , Korea , Sensitivity and Specificity , Temperature , Time Factors , Viroids/geneticsABSTRACT
BACKGROUND: Inflammation is frequently associated with the development of atrial fibrillation (AF). This study was performed to investigate whether the high sensitivity C-reactive protein (hsCRP) present during acute inflammation could predict early AF and its relationship to left atrial (LA) enlargement in acute myocardial infarction (AMI). METHODS AND RESULTS: In 401 consecutive AMI patients, AF predictors were compared between those with and without early AF. Early AF was defined as AF developing within 24 h after AMI. In order to identify the difference in the AF predictors according to LA enlargement, patients were subgrouped according to an LA volume index (LAVI) of <32 cm(3)/m(2) (group 1, n=321) and ≥32 cm(3)/m(2) (group 2, n=80). Thirty-three (8.2%) patients developed early AF including 17 (5.3%) and 16 (20%) patients in groups 1 and 2, respectively. The independent predictors of AF were multivessel involvement (OR=2.51, p=0.03), LAVI≥32 cm(3)/m(2) (OR=2.47, p=0.03), higher hsCRP (OR=2.24, p=0.05), and old age (OR=1.06, p=0.01) in all patients. In the subgroups divided by the LAVI, higher hsCRP was a predictor of early AF only in group 1 (OR=4.56, p=0.004). CONCLUSIONS: Our results suggest that multivessel involvement, enlarged LA, higher hsCRP, and old age are predictors of early AF after AMI. However, hsCRP could be strongly related to early AF only in AMI patients with less dilated LA.
Subject(s)
Atrial Fibrillation/blood , Atrial Fibrillation/pathology , Myocardial Infarction/blood , Myocardial Infarction/pathology , Aged , Aged, 80 and over , Atrial Fibrillation/etiology , Atrial Function, Left/physiology , C-Reactive Protein/metabolism , Female , Heart Atria/pathology , Humans , Inflammation/blood , Inflammation/pathology , Male , Middle Aged , Myocardial Infarction/complications , Prospective Studies , Time FactorsABSTRACT
Tomato yellow leaf curl virus (TYLCV) is a member of the genus Begomovirus of the family Geminiviridae, members of which are characterized by closed circular single-stranded DNA genomes of 2.7-2.8 kb in length, and include viruses transmitted by the Bemisia tabaci whitefly. No reports of TYLCV in Korea are available prior to 2008, after which TYLCV spread rapidly to most regions of the southern Korean peninsula (Gyeongsang-Do, Jeolla-Do and Jeju-Do). Fifty full sequences of TYLCV were analyzed in this study, and the AC1, AV1, IR, and full sequences were analyzed via the muscle program and bayesian analysis. Phylogenetic analysis demonstrated that the Korea TYLCVs were divided into two subgroups. The TYLCV Korea 1 group (Masan) originated from TYLCV Japan (Miyazaki) and the TYLCV Korea 2 group (Jeju/Jeonju) from TYLCV Japan (Tosa/Haruno). A B. tabaci phylogenetic tree was constructed with 16S rRNA and mitochondria cytochrome oxidase I (MtCOI) sequences using the muscle program and MEGA 4.0 in the neighbor-joining algorithm. The sequence data of 16S rRNA revealed that Korea B. tabaci was closely aligned to B. tabaci isolated in Iran and Nigeria. The Q type of B. tabaci, which was originally identified as a viruliferous insect in 2008, was initially isolated in Korea as a non-viruliferous insect in 2005. Therefore, we suggest that two TYLCV Japan isolates were introduced to Korea via different routes, and then transmitted by native B. tabaci.
Subject(s)
Hemiptera/virology , Plant Diseases/virology , Solanum lycopersicum/virology , Viral Proteins/genetics , Animals , Base Sequence , DNA Barcoding, Taxonomic , DNA, Single-Stranded/genetics , DNA, Viral/genetics , Electron Transport Complex IV/genetics , Insect Vectors/genetics , Mitochondria/genetics , Molecular Sequence Data , RNA, Ribosomal, 16S/genetics , Republic of Korea , Sequence Analysis, DNA , Sequence Homology, Nucleic Acid , Virus Diseases/virologyABSTRACT
PURPOSE: The aim of this study is to identify the extent of initial malapposition using optical coherence tomography (OCT) in ST-elevation myocardial infarctions (STEMI) treated with different types of drug-eluting stents (DES). MATERIALS AND METHODS: Twenty four STEMI patients that underwent primary percutaneous coronary intervention (PCI) were enrolled. The OCT and intravascular ultrasound (IVUS) were performed within 72 hours after the primary PCI. Distances between the endo-luminal surface of the strut reflection and the vessel wall and the extent of malapposition were measured and analyzed. RESULTS: Sirolimus-eluting stents (SES), paclitaxel-eluting stents (PES) and zotarolimus-eluting stents (ZES) were deployed in 7 patients (29%), 7 patients (29%) and 10 patients (42%). In total, 4951 struts in 620 mm single-stent segments were analyzed (1463 struts in SES, 1522 in PES, and 1966 in ZES). In strut analysis by OCT, the incidence of malapposition was 17 % (860/4951) and in stent analysis by IVUS, malapposition rate was 21% (5/24). The malapposition rate of strut level using OCT in 5 patients who had malapposition in IVUS was significantly higher than the 19 of those who had not (32 +/- 5% vs. 12 +/- 6%, p = 0.001). In addition, the frequency of malapposition was also significantly different (28% in SES, 11% in PES, 10% in ZES, p = 0.001). The use of SES was an independent predictor of malapposed struts. CONCLUSION: The incidence of malapposition using OCT was quite prevalent in STEMI after primary PCI with DES implantation and SES has especially higher rates of malapposition compared to other DESs.
Subject(s)
Drug-Eluting Stents , Myocardial Infarction/therapy , Tomography, Optical Coherence/methods , Aged , Angioplasty, Balloon, Coronary/methods , Female , Humans , Male , Middle Aged , Myocardial Infarction/pathology , Paclitaxel/therapeutic use , Sirolimus/analogs & derivatives , Sirolimus/therapeutic useABSTRACT
OBJECTIVES: This study sought to determine the efficacy of high-dose atorvastatin in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). BACKGROUND: Previous randomized trials have demonstrated that statin pre-treatment reduced major adverse cardiac events (MACEs) in patients with stable angina pectoris and acute coronary syndrome. However, no randomized studies have been carried out with STEMI patients in a primary PCI setting. METHODS: A total 171 patients with STEMI were randomized to 80-mg atorvastatin (n = 86) or 10-mg atorvastatin (n = 85) arms for pre-treatment before PCI. All patients were prescribed clopidogrel (600 mg) before PCI. After PCI, both groups were treated with atorvastatin (10 mg). The primary end point was 30-day incidence of MACE including death, nonfatal MI, and target vessel revascularization. Secondary end points included corrected thrombolysis in myocardial infarction frame count, myocardial blush grade, and ST-segment resolution at 90 min after PCI. RESULTS: MACE occurred in 5 (5.8%) and 9 (10.6%) patients in the 80-mg and 10-mg atorvastatin pre-treatment arms, respectively (p = 0.26). Corrected thrombolysis in myocardial infarction frame count was lower in the 80-mg atorvastatin arm (26.9 +/- 12.3 vs. 34.1 +/- 19.0, p = 0.01). Myocardial blush grade and ST-segment resolution were also higher in the 80-mg atorvastatin arm (2.2 +/- 0.8 vs. 1.9 +/- 0.8, p = 0.02 and 61.8 +/- 26.2 vs. 50.6 +/- 25.8%, p = 0.01). CONCLUSIONS: High-dose atorvastatin pre-treatment before PCI did not show a significant reduction of MACEs compared with low-dose atorvastatin but did show improved immediate coronary flow after primary PCI. High-dose atorvastatin may produce an optimal result for STEMI patients undergoing PCI by improving microvascular myocardial perfusion. (Efficacy of High-Dose AtorvaSTATIN Loading Before Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction [STATIN STEMI]; NCT00808717).
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Circulation/drug effects , Heptanoic Acids/administration & dosage , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Myocardial Infarction/therapy , Pyrroles/administration & dosage , Aged , Angioplasty, Balloon, Coronary/adverse effects , Angioplasty, Balloon, Coronary/mortality , Atorvastatin , Chi-Square Distribution , Clopidogrel , Coronary Angiography , Disease-Free Survival , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Kaplan-Meier Estimate , Korea , Male , Middle Aged , Myocardial Infarction/diagnosis , Myocardial Infarction/drug therapy , Myocardial Infarction/mortality , Myocardial Infarction/physiopathology , Platelet Aggregation Inhibitors/therapeutic use , Prospective Studies , Recurrence , Ticlopidine/analogs & derivatives , Ticlopidine/therapeutic use , Time Factors , Treatment OutcomeABSTRACT
BACKGROUND: The objective of this study was to investigate atrial myocardial properties through two-dimensional (2D) myocardial imaging in patients with atrial fibrillation (AF) and its predictive role for recurrence after catheter ablation. METHODS AND RESULTS: Echocardiographic examinations were performed in 40 patients with paroxysmal AF before catheter ablation and 40 age- and gender-matched healthy control subjects. Using a software package, bidimensional acquisitions were analyzed to measure longitudinal strain and strain rate for the left atrium (LA). Systolic strain and strain rate in all eight segments, and its average values, were significantly reduced in AF patients compared to controls. During 9 months of follow-up after catheter ablation for AF, 11 of 40 AF patients had AF recurrence. AF recurrence was associated with gender, LA volume index, and average values of systolic strain and strain rate. By multivariate analysis, only average strain was an independent predictor of AF recurrence (OR = 0.88, 95% CI 0.79-0.98, p = 0.018). CONCLUSIONS: Lower systolic strain of LA was strongly associated with recurrence after catheter ablation. Thus, diverse adjunctive ablation strategies should be considered to reduce recurrence in patients with lower systolic strain.
Subject(s)
Atrial Fibrillation/diagnostic imaging , Atrial Fibrillation/surgery , Catheter Ablation/methods , Echocardiography/methods , Elasticity Imaging Techniques/methods , Heart Atria/diagnostic imaging , Elastic Modulus , Female , Humans , Male , Middle Aged , Prognosis , Reproducibility of Results , Sensitivity and Specificity , Treatment OutcomeABSTRACT
PURPOSE: To assess mid- to long-term clinical results of stent-graft repair in patients with type B aortic dissection. METHODS: Retrospective analysis was done on 72 patients (47 men; mean age 55+/-12 years) who were diagnosed with chronic type B aortic dissection and underwent stent-graft repair from June 1994 to December 2007. Two types of stent-grafts were employed. Prior to 2000, a custom-designed stent-graft composed of self-expanding Z-type stainless steel stents covered with woven polytetrafluoroethylene material was used. Thereafter, a separate-type (modular) manufactured stent-graft was used, consisting of proximal and distal nitinol stents with an unsupported Dacron tube graft in between; the unsupported graft was stented after deployment. RESULTS: Procedural success (completion of the stent-graft deployment at the target area without device failure) was obtained in 97% (70/72). The 2 failures were due to stent migration and tortuous anatomy, respectively. There were persistent type I endoleaks in 6 cases for a clinical success (entry tear exclusion) of 88% (64/72). There was no immediate postprocedural mortality or paraplegia. There was unintended partial left subclavian artery occlusion in 1 case, as well as postprocedural transient renal failure in 1 patient and 2 access-site pseudoaneurysms. Median follow-up was 43 months (range 5-97, mean 64.4+/-38.8) in 61 patients (3 patients lost to follow-up). Five patients died, 1 of probable aortic rupture in the setting of residual type I endoleak. Overall clinical success (no death, conversion, or endoleak) was achieved in 84% (47/56); of these, 35 (74%) showed complete resolution of the thoracic false lumen, while the other 12 (26%) had a decrease in false lumen diameter. CONCLUSIONS: Intermediate to long-term results of stent-graft implantation in patients with chronic type B aortic dissection seem acceptable and may justify the use of this minimally invasive approach as first line therapy in these patients.
Subject(s)
Aortic Aneurysm, Thoracic/surgery , Aortic Dissection/surgery , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis , Stents , Adult , Aged , Aortic Dissection/mortality , Aortic Aneurysm, Thoracic/mortality , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/mortality , Chronic Disease , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Polyethylene Terephthalates , Polytetrafluoroethylene , Prosthesis Design , Retrospective Studies , Time Factors , Treatment OutcomeABSTRACT
BACKGROUND: Increased aortic stiffness is a independent risk factor of cardiovascular disease in patients with hypertension. Acute changes of the heart rate (HR) have been reported not to affect the aortic stiffness in pacing. However, it is unknown whether acute changes in HR caused by sympathomimetics can affect the aortic stiffness in patients with hypertension. We investigated the effect of acute changes in HR produced by isoproterenol on the aortic stiffness in 17 hypertensive patientss (mean age: 59 +/- 9 years). METHODS: All vasoactive drugs were discontinued at least 3 days before the study. The carotid-to-femoral pulse wave velocity (PWV) was measured by the foot-to-foot method. The pulse waves were recorded at the baseline and at every increase of HR by 5 to 10 bpm with a gradual increase of the dose of isoproterenol. The blood pressures and HR were measured simultaneously. For the analysis, HR, PWV, compliance (C), and compliance index (Ci) were converted as percent changes (delta) from the baseline values. Percent changes of the parameters of the aortic stiffness, i.e., deltaPWV, deltaC, and deltaCi, were grouped by every 10% increase in deltaHR. RESULTS: There was no significant difference among groups in deltaPWV, deltaC and deltaCi (p > 0.05 for each of the group). The regression analysis showed no significant correlation of deltaHR with deltaPWV and deltaC (r = 0.18, 0.13 respectively, p > 0.05 for each). deltaCi had a poor correlation with deltaHR (r = 0.22, p < 0.05). However, only 4.6% of deltaCi could be referred to deltaHR (r2 = 0.046). CONCLUSION: Aortic stiffness was not affected by acute changes in HR produced by isoproterenol which suggests that it is not necessary to consider acute changes in HR when measuring aortic PWV.