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1.
bioRxiv ; 2023 Jan 20.
Article in English | MEDLINE | ID: mdl-36711823

ABSTRACT

Throughout biology, RNA molecules form complex networks of molecular interactions that are central to their function, but remain challenging to investigate. Here, we introduce Oligonucleotide-mediated proximity-interactome MAPping (O-MAP), a straightforward method for elucidating the biomolecules near an RNA of interest, within its native cellular context. O-MAP uses programmable oligonucleotide probes to deliver proximity-biotinylating enzymes to a target RNA, enabling nearby molecules to be enriched by streptavidin pulldown. O-MAP induces exceptionally precise RNA-localized in situ biotinylation, and unlike alternative methods it enables straightforward optimization of its targeting accuracy. Using the 47S pre-ribosomal RNA and long noncoding RNA Xist as models, we develop O-MAP workflows for unbiased discovery of RNA-proximal proteins, transcripts, and genomic loci. This revealed unexpected co-compartmentalization of Xist and other chromatin-regulatory RNAs and enabled systematic characterization of nucleolar-chromatin interactions across multiple cell lines. O-MAP is portable to cultured cells, organoids, and tissues, and to RNAs of various lengths, abundances, and sequence composition. And, O-MAP requires no genetic manipulation and uses exclusively off-the-shelf parts. We therefore anticipate its application to a broad array of RNA phenomena.

3.
JAMA ; 327(23): 2296-2305, 2022 06 21.
Article in English | MEDLINE | ID: mdl-35727277

ABSTRACT

Importance: Ablation of persistent atrial fibrillation (AF) remains a challenge. Left atrial fibrosis plays an important role in the pathophysiology of AF and has been associated with poor procedural outcomes. Objective: To investigate the efficacy and adverse events of targeting atrial fibrosis detected on magnetic resonance imaging (MRI) in reducing atrial arrhythmia recurrence in persistent AF. Design, Setting, and Participants: The Efficacy of Delayed Enhancement-MRI-Guided Fibrosis Ablation vs Conventional Catheter Ablation of Atrial Fibrillation trial was an investigator-initiated, multicenter, randomized clinical trial involving 44 academic and nonacademic centers in 10 countries. A total of 843 patients with symptomatic or asymptomatic persistent AF and undergoing AF ablation were enrolled from July 2016 to January 2020, with follow-up through February 19, 2021. Interventions: Patients with persistent AF were randomly assigned to pulmonary vein isolation (PVI) plus MRI-guided atrial fibrosis ablation (421 patients) or PVI alone (422 patients). Delayed-enhancement MRI was performed in both groups before the ablation procedure to assess baseline atrial fibrosis and at 3 months postablation to assess for ablation scar. Main Outcomes and Measures: The primary end point was time to first atrial arrhythmia recurrence after a 90-day blanking period postablation. The primary safety composite outcome was defined by the occurrence of 1 or more of the following events within 30 days postablation: stroke, PV stenosis, bleeding, heart failure, or death. Results: Among 843 patients who were randomized (mean age 62.7 years; 178 [21.1%] women), 815 (96.9%) completed the 90-day blanking period and contributed to the efficacy analyses. There was no significant difference in atrial arrhythmia recurrence between groups (fibrosis-guided ablation plus PVI patients, 175 [43.0%] vs PVI-only patients, 188 [46.1%]; hazard ratio [HR], 0.95 [95% CI, 0.77-1.17]; P = .63). Patients in the fibrosis-guided ablation plus PVI group experienced a higher rate of safety outcomes (9 [2.2%] vs 0 in PVI group; P = .001). Six patients (1.5%) in the fibrosis-guided ablation plus PVI group had an ischemic stroke compared with none in PVI-only group. Two deaths occurred in the fibrosis-guided ablation plus PVI group, and the first one was possibly related to the procedure. Conclusions and Relevance: Among patients with persistent AF, MRI-guided fibrosis ablation plus PVI, compared with PVI catheter ablation only, resulted in no significant difference in atrial arrhythmia recurrence. Findings do not support the use of MRI-guided fibrosis ablation for the treatment of persistent AF. Trial Registration: ClinicalTrials.gov Identifier: NCT02529319.


Subject(s)
Ablation Techniques , Atrial Fibrillation , Fibrosis , Heart Atria , Magnetic Resonance Imaging , Surgery, Computer-Assisted , Ablation Techniques/adverse effects , Ablation Techniques/methods , Atrial Fibrillation/complications , Atrial Fibrillation/diagnostic imaging , Atrial Fibrillation/surgery , Catheter Ablation/adverse effects , Catheter Ablation/methods , Female , Fibrosis/diagnostic imaging , Fibrosis/surgery , Heart Atria/pathology , Heart Atria/surgery , Humans , Male , Middle Aged , Pulmonary Veins/diagnostic imaging , Pulmonary Veins/surgery , Recurrence , Surgery, Computer-Assisted/adverse effects , Surgery, Computer-Assisted/methods , Treatment Outcome
4.
J Proteome Res ; 21(6): 1382-1391, 2022 06 03.
Article in English | MEDLINE | ID: mdl-35549345

ABSTRACT

Advances in library-based methods for peptide detection from data-independent acquisition (DIA) mass spectrometry have made it possible to detect and quantify tens of thousands of peptides in a single mass spectrometry run. However, many of these methods rely on a comprehensive, high-quality spectral library containing information about the expected retention time and fragmentation patterns of peptides in the sample. Empirical spectral libraries are often generated through data-dependent acquisition and may suffer from biases as a result. Spectral libraries can be generated in silico, but these models are not trained to handle all possible post-translational modifications. Here, we propose a false discovery rate-controlled spectrum-centric search workflow to generate spectral libraries directly from gas-phase fractionated DIA tandem mass spectrometry data. We demonstrate that this strategy is able to detect phosphorylated peptides and can be used to generate a spectral library for accurate peptide detection and quantitation in wide-window DIA data. We compare the results of this search workflow to other library-free approaches and demonstrate that our search is competitive in terms of accuracy and sensitivity. These results demonstrate that the proposed workflow has the capacity to generate spectral libraries while avoiding the limitations of other methods.


Subject(s)
Peptides , Tandem Mass Spectrometry , Peptide Library , Peptides/analysis , Protein Processing, Post-Translational , Proteome/analysis , Tandem Mass Spectrometry/methods , Workflow
5.
Br J Radiol ; 94(1123): 20210048, 2021 Jul 01.
Article in English | MEDLINE | ID: mdl-34111982

ABSTRACT

OBJECTIVES: Magnetic resonance angiography (MRA) has been established as an important imaging method in cardiac ablation procedures. In pulmonary vein (PV) isolation procedures, MRA has the potential to minimize the risk of severe complications, such as atrio-esophageal fistula, by providing detailed information on esophageal position relatively to cardiac structures. However, traditional non-gated, first-pass (FP) MRA approaches have several limitations, such as long breath-holds, non-uniform signal intensity throughout the left atrium (LA), and poor esophageal visualization. The aim of this observational study was to validate a respiratory-navigated, ECG-gated (EC), saturation recovery-prepared MRA technique for simultaneous imaging of LA, LA appendage, PVs, esophagus, and adjacent anatomical structures. METHODS: Before PVI, 106 consecutive patients with a history of AF underwent either conventional FP-MRA (n = 53 patients) or our new EC-MRA (n = 53 patients). Five quality scores (QS) of LA and esophagus visibility were assessed by two experienced readers. The non-parametric Mann-Whitney U-test was used to compare QS between FP-MRA and EC-MRA groups, and linear regression was applied to assess clinical contributors to image quality. RESULTS: EC-MRA demonstrated significantly better image quality than FP-MRA in every quality category. Esophageal visibility using the new MRA technique was markedly better than with the conventional FP-MRA technique (median 3.5 [IQR 1] vs median 1.0, p < 0.001). In contrast to FP-MRA, overall image quality of EC-MRA was not influenced by heart rate. CONCLUSION: Our ECG-gated, respiratory-navigated, saturation recovery-prepared MRA technique provides significantly better image quality and esophageal visibility than the established non-gated, breath-holding FP-MRA. Image quality of EC-MRA technique has the additional advantage of being unaffected by heart rate. ADVANCES IN KNOWLEDGE: Detailed information of cardiac anatomy has the potential to minimize the risk of severe complications and improve success rates in invasive electrophysiological studies. Our novel ECG-gated, respiratory-navigated, saturation recovery-prepared MRA technique provides significantly better image quality of LA and esophageal structures than the traditional first-pass algorithm. This new MRA technique is robust to arrhythmia (tachycardic, irregular heart rates) frequently observed in AF patients.


Subject(s)
Atrial Appendage/diagnostic imaging , Atrial Fibrillation/diagnostic imaging , Esophagus/diagnostic imaging , Heart Atria/diagnostic imaging , Magnetic Resonance Angiography/methods , Pulmonary Veins/diagnostic imaging , Breath Holding , Cardiac-Gated Imaging Techniques , Contrast Media , Female , Humans , Male , Meglumine/analogs & derivatives , Middle Aged , Organometallic Compounds , Respiratory-Gated Imaging Techniques
7.
Cell Rep Methods ; 1(5): 100084, 2021 09 27.
Article in English | MEDLINE | ID: mdl-35474673

ABSTRACT

Oncogenic mutations in KRAS can be recognized by T cells on specific class I human leukocyte antigen (HLA-I) molecules, leading to tumor control. To date, the discovery of T cell targets from KRAS mutations has relied on occasional T cell responses in patient samples or the use of transgenic mice. To overcome these limitations, we have developed a systematic target discovery and validation pipeline. We evaluate the presentation of mutant KRAS peptides on individual HLA-I molecules using targeted mass spectrometry and identify 13 unpublished KRASG12C/D/R/V mutation/HLA-I pairs and nine previously described pairs. We assess immunogenicity, generating T cell responses to nearly all targets. Using cytotoxicity assays, we demonstrate that KRAS-specific T cells and T cell receptors specifically recognize endogenous KRAS mutations. The discovery and validation of T cell targets from KRAS mutations demonstrate the potential for this pipeline to aid the development of immunotherapies for important cancer targets.


Subject(s)
Lung Neoplasms , T-Lymphocytes , Mice , Animals , Humans , Proto-Oncogene Proteins p21(ras)/genetics , Mutation , Receptors, Antigen, T-Cell/genetics , Lung Neoplasms/genetics , Histocompatibility Antigens Class I/genetics
8.
Tissue Eng Part B Rev ; 25(6): 510-525, 2019 12.
Article in English | MEDLINE | ID: mdl-31578930

ABSTRACT

Our goal was to understand the impact of regenerative therapies on the functional capacity of skeletal muscle following volumetric muscle loss (VML) injury. An extensive database search (e.g., PubMed, Cochrane Library, and ClinicalTrials.gov) was conducted up through January 2019 to evaluate the following: "In humans or animals with VML injury, is treatment better than no treatment at recovering functional capacity?" Study eligibility criteria required studies to have both an untreated and at least one treated VML injury group. From 2312 study reports, 44 studies met the inclusion criteria. Quantitative functional capacity data (absolute and/or normalized strength) or proportional measures (histological analysis quantifying viable muscle tissue, mitochondrial function, and/or exhaustive treadmill running) were extracted for use. While both human and animal studies were included in the searches, only animal studies met the eligibility criteria. Using a random-effects model, Hedges' g was used as the effect size (ES) and calculated such that a positive ES indicated treatment efficacy. The overall ES was 0.75 (95% confidence interval: 0.53-0.96; p < 0.0000001), indicating that the treatments, on average, resulted in a significant improvement in functional capacity. From network meta-analyses, it was determined that an acellular biomaterial combined with stem and/or progenitor cells had the greatest treatment effectiveness. The findings indicate that various treatments in animal models of VML improve the functional capacity of muscle compared to leaving the injury untreated; however, the ∼16% beneficial effect is small. Our results suggest that current regenerative therapy paradigms require further maturation to achieve clinically meaningful improvements in the functional capacity of the muscle. Impact Statement Our most salient findings are that (1) various treatment approaches used in animal models of volumetric muscle loss (VML) injury improve functional capacity compared to leaving the injury untreated and (2) an acellular biomaterial in combination with cellular components was the most effective treatment to improve functional capacity following VML injury to date. The nature of our findings has substantial implications for regenerative medicine, biomedical engineering, and rehabilitative techniques currently being evaluated and developed for VML injury repair, and are pivotal to the progression of the regenerative medicine effort aimed at restoring maximal function to traumatized and disabled limbs.


Subject(s)
Muscle, Skeletal/cytology , Muscular Diseases/therapy , Regeneration , Regenerative Medicine , Stem Cells/cytology , Animals , Humans , Muscle, Skeletal/injuries
9.
Immunity ; 51(4): 766-779.e17, 2019 10 15.
Article in English | MEDLINE | ID: mdl-31495665

ABSTRACT

Increasing evidence indicates CD4+ T cells can recognize cancer-specific antigens and control tumor growth. However, it remains difficult to predict the antigens that will be presented by human leukocyte antigen class II molecules (HLA-II), hindering efforts to optimally target them therapeutically. Obstacles include inaccurate peptide-binding prediction and unsolved complexities of the HLA-II pathway. To address these challenges, we developed an improved technology for discovering HLA-II binding motifs and conducted a comprehensive analysis of tumor ligandomes to learn processing rules relevant in the tumor microenvironment. We profiled >40 HLA-II alleles and showed that binding motifs were highly sensitive to HLA-DM, a peptide-loading chaperone. We also revealed that intratumoral HLA-II presentation was dominated by professional antigen-presenting cells (APCs) rather than cancer cells. Integrating these observations, we developed algorithms that accurately predicted APC ligandomes, including peptides from phagocytosed cancer cells. These tools and biological insights will enable improved HLA-II-directed cancer therapies.


Subject(s)
Antigen-Presenting Cells/immunology , CD4-Positive T-Lymphocytes/immunology , Cancer Vaccines/immunology , Epitope Mapping/methods , HLA Antigens/metabolism , Histocompatibility Antigens Class II/genetics , Immunotherapy/methods , Mass Spectrometry/methods , Neoplasms/therapy , Algorithms , Alleles , Antigen Presentation , Antigens, Neoplasm/immunology , Antigens, Neoplasm/metabolism , Datasets as Topic , HLA Antigens/genetics , HLA-D Antigens/metabolism , Humans , Neoplasms/immunology , Protein Binding , Protein Interaction Domains and Motifs/genetics , Software
10.
J Cardiovasc Electrophysiol ; 30(4): 550-556, 2019 04.
Article in English | MEDLINE | ID: mdl-30661270

ABSTRACT

INTRODUCTION: Besides the traditional concept of atrial fibrillation (AF) perpetuating atrial structural remodeling, there is increasing evidence that atrial fibrosis might precede AF, highlighting the need for better characterization of the fibrotic substrate. We aimed to assess atrial fibrosis by use of late gadolinium enhancement magnetic resonance imaging (LGE-MRI) in non-AF individuals and to identify predisposing risk factors. A second aim was to establish a risk score for the prevalence of AF using atrial fibrosis in addition to established clinical variables. METHODS AND RESULTS: Non-AF individuals without structural heart disease (n = 91) and matched AF controls (n = 91) underwent MRI for assessment of LGE. According to the established UTAH classification, atrial LGE ≥20% was considered extensive. Mean left atrial (LA) fibrosis in non-AF and AF individuals were 8.8 ± 6.5% and 12.5 ± 5.8%, respectively. Body mass index (BMI) >30 kg/m 2 and LA volume were predictors of atrial fibrosis. Diastolic function was not significantly different with respect to atrial fibrosis. A novel scoring system for the prevalence of AF (2 points for arterial hypertension and/or left ventricular ejection fraction <55%; 3 points for atrial fibrosis >6%) was derived demonstrating that patients in the intermediate/high-risk group had a significantly increased risk of AF. CONCLUSION: This study reports unexpectedly high atrial fibrosis in non-AF patients without apparent heart disease, highlighting the concept that structural fibrotic alterations may precede AF onset in a significant proportion of individuals. BMI as a predictor of atrial fibrosis suggests that lifestyle and drug intervention, that is, weight reduction, could positively influence fibrosis development. The derived risk score for AF prevalence provides the basis for prospective studies on AF incidence.


Subject(s)
Atrial Fibrillation/epidemiology , Atrial Function, Left , Atrial Remodeling , Contrast Media/administration & dosage , Heart Atria/diagnostic imaging , Magnetic Resonance Imaging , Meglumine/analogs & derivatives , Organometallic Compounds/administration & dosage , Adult , Atrial Fibrillation/diagnosis , Atrial Fibrillation/physiopathology , Case-Control Studies , Female , Fibrosis , Heart Atria/physiopathology , Humans , Male , Meglumine/administration & dosage , Middle Aged , Observer Variation , Predictive Value of Tests , Prevalence , Reproducibility of Results , Risk Assessment , Risk Factors
11.
J Cardiovasc Electrophysiol ; 29(7): 966-972, 2018 07.
Article in English | MEDLINE | ID: mdl-29846999

ABSTRACT

INTRODUCTION: Multiple markers left atrium (LA) remodeling, including LA shape, correlate with outcomes in atrial fibrillation (AF). Catheter ablation is an important treatment of AF, but better tools are needed to determine which patients will benefit. In this study, we use particle-based modeling to quantitatively assess LA shape, and determine to what degree it predicts AF recurrence after catheter ablation. METHODS AND RESULTS: There were 254 patients enrolled in the DECAAF study who underwent cardiac magnetic resonance imaging of the LA prior to AF ablation and were followed for recurrence for up to 475 days. We performed particle-based shape modeling on each patient's LA shape. We selected shape parameters using the LASSO method and factor analysis, and then added them to a Cox regression model, which included multiple clinical parameters and LA fibrosis. We computed Harrell's C-statistic with and without shape in the model. We used the model to stratify patients into recurrence risk classes by both shape and shape and fibrosis combined. Three shape parameters were selected for inclusion. The C-statistic increased from 0.68 to 0.72 when shape was added to the model (P < 0.05). Visualized shapes showed that a more round LA shape with a shorter, more laterally rotated appendage was predictive of recurrence. CONCLUSION: LA shape is an independent predictor of recurrence after AF ablation. When combined with LA fibrosis, shape analysis using PBM may improve patient selection for ablation.


Subject(s)
Atrial Fibrillation/diagnostic imaging , Atrial Fibrillation/surgery , Atrial Remodeling , Catheter Ablation/trends , Heart Atria/diagnostic imaging , Imaging, Three-Dimensional/methods , Aged , Atrial Remodeling/physiology , Female , Follow-Up Studies , Heart Atria/physiopathology , Humans , Male , Middle Aged , Predictive Value of Tests , Prospective Studies , Recurrence
12.
Macromol Rapid Commun ; 39(12): e1800194, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29786164

ABSTRACT

The threat of chemical warfare agents (CWA) compels research into novel self-decontaminating materials (SDM) for the continued safety of first-responders, civilians, and active service personnel. The capacity to actively detoxify, as opposed to merely sequester, offending agents under typical environmental conditions defines the added value of SDMs in comparison to traditional adsorptive materials. Porous polymers, synthesized via the high internal phase emulsion (HIPE) templating, provide a facile fabrication method for materials with permeable open cellular structures that may serve in air filtration applications. PolyHIPEs comprising polydicyclopentadiene (polyDCPD) networks form stable hydroperoxide species following activation in air under ambient conditions. The hydroperoxide-containing polyDCPD materials react quickly with CWA simulants, Demeton-S and 2-chloroethyl ethyl sulfide, forming oxidation products as confirmed via gas chromatography mass spectrometry. The simplicity of the detoxification chemistry paired with the porous foam form factor presents an exciting opportunity for the development of self-decontaminating filter media.


Subject(s)
Chemical Warfare Agents/chemistry , Decontamination , Indenes/chemistry , Polymers/chemistry , Styrenes/chemistry , Chromatography, Liquid , Disulfoton/chemistry , Emulsions/chemistry , Hydrogen Peroxide/chemistry , Mass Spectrometry , Mustard Gas/analogs & derivatives , Mustard Gas/chemistry , Oxidation-Reduction , Porosity , Time Factors
13.
Mater Sci Eng C Mater Biol Appl ; 79: 702-709, 2017 Oct 01.
Article in English | MEDLINE | ID: mdl-28629071

ABSTRACT

There are numerous challenges associated with the acute care of traumatic limb injuries in forward military settings. A lack of immediate medical facilities necessitates that the wound dressing perform multiple tasks including exudate control, infection prevention, and physical protection of the wound for extended periods of time. Here, kaolin was incorporated into recently developed robust polyurethane (PU) hydrogel foams at 1-10wt% in an effort to impart hemostatic character. ATR-IR and gel fraction analysis demonstrated that the facile, one-pot synthesis of the PU hydrogel was unaffected by kaolin loading, as well as the use of a non-toxic catalyst, which significantly improved cytocompatibility of the materials. Kaolin was generally well dispersed throughout the PU matrix, though higher loadings exhibited minor evidence of aggregation. Kaolin-PU composites exhibited burst release of ciprofloxacin over 2h, the initial release rates of which increased with kaolin loading. Kaolin loading imparted excellent hemostatic character to the PU foams at relatively low loading levels (5wt%). This work demonstrates the simple and inexpensive synthesis of robust, hemostatic, and absorptive kaolin-PU foams that have promising potential as multifunctional wound dressing materials.


Subject(s)
Kaolin/chemistry , Bandages , Hemostatics , Polyurethanes
14.
Am J Cardiol ; 118(7): 991-7, 2016 10 01.
Article in English | MEDLINE | ID: mdl-27553101

ABSTRACT

Left ventricular (LV) scar identified by late gadolinium enhanced (LGE) cardiac magnetic resonance (CMR) is associated with adverse outcomes in coronary artery disease and cardiomyopathies. We sought to determine the prognostic significance of LV-LGE in atrial fibrillation (AF). We studied 778 consecutive patients referred for radiofrequency ablation of AF who underwent CMR. Patients with coronary artery disease, previous myocardial infarction, or hypertrophic or dilated cardiomyopathy were excluded. The end points of interest were major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of cardiovascular death, myocardial infarction, and ischemic stroke/transient ischemic attack. Of the 754 patients who met the inclusion criteria, 60% were men with an average age of 64 years. Most (87%) had a normal LV ejection fraction of ≥55%. LV-LGE was found in 46 patients (6%). There were 32 MACCE over the mean follow-up period of 55 months. The MACCE rate was higher for patients with LV-LGE (13.0% vs 3.7%; p = 0.002). In multivariate analysis, CHA2DS2-VASc score (hazard ratio [HR] 1.36, 95% CI 1.05 to 1.76), the presence of LV-LGE (HR 3.21, 95% CI 1.31 to 7.88), and the LV-LGE extent (HR 1.43, 95% CI 1.15 to 1.78) were independent predictors of MACCE. In addition, the presence of LV-LGE was an independent predictor for ischemic stroke/transient ischemic attack (HR 3.61, 95% CI 1.18 to 11.01) after adjusting for CHA2DS2-VASc score. In conclusion, the presence and extent of LV scar identified by LGE-CMR were independent predictors of MACCE in patients with AF.


Subject(s)
Atrial Fibrillation/diagnostic imaging , Cicatrix/diagnostic imaging , Heart Ventricles/diagnostic imaging , Aged , Atrial Fibrillation/epidemiology , Atrial Fibrillation/surgery , Cardiovascular Diseases/mortality , Catheter Ablation , Cicatrix/epidemiology , Contrast Media , Diabetes Mellitus/epidemiology , Dyslipidemias/epidemiology , Female , Follow-Up Studies , Gadolinium , Heart Failure/epidemiology , Humans , Imaging, Three-Dimensional , Ischemic Attack, Transient/epidemiology , Logistic Models , Magnetic Resonance Imaging , Magnetic Resonance Imaging, Cine , Male , Middle Aged , Myocardial Infarction/epidemiology , Odds Ratio , Prognosis , Proportional Hazards Models , Retrospective Studies , Risk Factors , Smoking/epidemiology , Stroke/epidemiology , Time Factors
16.
J Interv Card Electrophysiol ; 47(1): 83-89, 2016 Oct.
Article in English | MEDLINE | ID: mdl-27076060

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) is common in the setting of abnormal ventricular relaxation. We evaluated the association between ventricular relaxation grade and atrial fibrosis and examined the change in left ventricular filling parameters following catheter ablation. METHODS AND RESULTS: AF patients undergoing catheter ablation who had cardiac late gadolinium enhancement MRI (LGE-MRI) and echocardiographic examinations were included in the study. Left atrial (LA) tissue fibrosis and volume were quantified using LGE-MRI. Echocardiograms were performed at baseline and 3 months following catheter ablation to assess left ventricular (LV) filling. Two hundred and ninety three patients (60.8 % male) met the inclusion criteria. In patients in sinus rhythm at baseline (n = 115), ventricular relaxation pattern was identified as normal in 54 patients (47.0 %), impaired in 35 (30.4 %), pseudo-normal in 18 (15.7 %), and restrictive in 8 (7.0 %). Restrictive LV filling was associated with higher LA volume index (61.2 ± 30.5 vs 46.0 ± 18.5 ml/m2; p < 0.01) and LA fibrosis (21.8 ± 10.9 % vs 15.5 ± 9.4 %; p = 0.036) compared to non-restrictive filling. In patients in sinus rhythm on both pre- and post-ablation echocardiograms (n = 104), A waves decreased from 0.70 ± 0.23 at baseline to 0.60 ± 0.20 (p < 0.01) and E/E' decreased from 9.6 ± 4.0 at baseline to 8.6 ± 3.5 (p = 0.03). Thirty-two patients (27.2 %) had an improvement, and 24 patients (23.1 %) had a worsening in diastolic grade. Clinical heart failure and diabetes were associated with worse diastolic grade post-ablation. CONCLUSIONS: Restrictive LV filling is associated with higher LA fibrosis. A change in echocardiographic LV filling pattern was noted in over 50 % of patients post-ablation.


Subject(s)
Atrial Fibrillation/epidemiology , Atrial Fibrillation/surgery , Catheter Ablation/statistics & numerical data , Postoperative Complications/epidemiology , Stroke Volume , Ventricular Dysfunction, Left/epidemiology , Causality , Comorbidity , Disease-Free Survival , Female , Humans , Male , Middle Aged , Prevalence , Risk Factors , Treatment Outcome , Utah/epidemiology , Ventricular Dysfunction, Left/diagnosis
17.
Adv Healthc Mater ; 5(2): 266-75, 2016 Jan 21.
Article in English | MEDLINE | ID: mdl-26632334

ABSTRACT

The outstanding elasticity, excellent resilience at high-frequency, and hydrophilic capacity of natural resilin have motivated investigations of recombinant resilin-based biomaterials as a new class of bio-elastomers in the engineering of mechanically active tissues. Accordingly, here the comprehensive characterization of modular resilin-like polypeptide (RLP) hydrogels is presented and their suitability as a novel biomaterial for in vivo applications is introduced. Oscillatory rheology confirmed that a full suite of the RLPs can be rapidly cross-linked upon addition of the tris(hydroxymethyl phosphine) cross-linker, achieving similar in situ shear storage moduli (20 k ± 3.5 Pa) across various material compositions. Uniaxial stress relaxation tensile testing of hydrated RLP hydrogels under cyclic loading and unloading showed negligible stress reduction and hysteresis, superior reversible extensibility, and high resilience with Young's moduli of 30 ± 7.4 kPa. RLP hydrogels containing MMP-sensitive domains are susceptible to enzymatic degradation by matrix metalloproteinase-1 (MMP-1). Cell culture studies revealed that RLP-based hydrogels supported the attachment and spreading (2D) of human mesenchymal stem cells and did not activate cultured macrophages. Subcutaneous transplantation of RLP hydrogels in a rat model, which to our knowledge is the first such reported in vivo analysis of RLP-based hydrogels, illustrated that these materials do not elicit a significant inflammatory response, suggesting their potential as materials for tissue engineering applications with targets of mechanically demanding tissues such as vocal fold and cardiovascular tissues.


Subject(s)
Elastomers/pharmacology , Insect Proteins/pharmacology , Recombinant Proteins/pharmacology , Regenerative Medicine/methods , Animals , Drosophila , Humans , Hydrogels/pharmacology , Immunohistochemistry , Male , Mesenchymal Stem Cells/cytology , Mesenchymal Stem Cells/drug effects , Mice , RAW 264.7 Cells , Rats, Sprague-Dawley , Subcutaneous Tissue/drug effects , Tensile Strength/drug effects
18.
JACC Clin Electrophysiol ; 2(6): 711-719, 2016 Nov.
Article in English | MEDLINE | ID: mdl-29759749

ABSTRACT

OBJECTIVES: This study hypothesized that left atrial structural remodeling (LA-TR) correlates with exercise capacity (EC) in a cohort of patients with atrial fibrillation (AF). BACKGROUND: Late gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) imaging provides a method of assessing LA-TR in patients with AF. METHODS: A total of 145 patients (32% female, mean age 63.4 ± 11.6 years of age) with AF (66 paroxysmal, 71 persistent, 8 long-standing persistent) presenting for catheter ablation were included in the study. All patients underwent LGE-CMR imaging as well as maximal exercise test using the Bruce protocol prior to catheter ablation of AF. EC was quantified by minutes of exercise and metabolic equivalent (MET) level achieved. LA-TR was quantified from LGE-CMR imaging and classified according to the Utah classification of LA structural remodeling (Utah stage I: <10% LA wall enhancement; Utah II: 10% to <20%; Utah III: 20% to <30%; and Utah IV: >30%). AF recurrence was assessed at 1 year from the date of ablation. RESULTS: The average duration of exercise was 8 ± 3 min, and the mean MET achieved was 9.7 ± 3.2. METs achieved were inversely correlated with LA-TR (R2 = 0.061; p = 0.003). The duration of exercise was also inversely correlated with LA-TR (R2 = 0.071; p = 0.001). Both EC and LA-TR were associated with AF recurrence post ablation in univariate analysis, but only LA-TR and age were independently predictive of recurrence in multivariate analysis (p = 0.001). For every additional minute on the treadmill, subjects were 13% more likely to be free of AF 1 year post ablation (p = 0.047). CONCLUSIONS: EC is inversely associated with LA-TR in patients with AF and is predictive of freedom from AF post-ablation.

19.
Macromol Biosci ; 16(1): 129-38, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26435299

ABSTRACT

A range of chemical strategies have been used for crosslinking recombinant polypeptide hydrogels, although only a few have employed photocrosslinking approaches. Here, we capitalize on the novel insect protein, resilin, and the versatility of click reactions to introduce a resilin-like polypeptide (RLP) that is capable of photoinitiated thiol-ene crosslinking. Lysine residues of the RLP were functionalized with norbornene acid as confirmed via 1H-NMR spectroscopy. The RLPNs were subsequently photocrosslinked with multi-arm PEG thiols in the presence of a photoinitiator to form elastic hybrid hydrogels. The crosslinking reaction and resulting RLP-PEG networks demonstrated cytocompatibility with human mesenchymal stem cells in both 2D cell-adhesion and 3D photoencapsulation studies.


Subject(s)
Biocompatible Materials , Hydrogels/chemistry , Insect Proteins , Peptides/chemistry , Polyethylene Glycols/chemistry , Cell Adhesion , Click Chemistry , Humans , Hydrogels/chemical synthesis , Mesenchymal Stem Cells
20.
Biomacromolecules ; 17(1): 128-40, 2016 Jan 11.
Article in English | MEDLINE | ID: mdl-26646060

ABSTRACT

Hydrogels derived from resilin-like polypeptides (RLPs) have shown outstanding mechanical resilience and cytocompatibility; expanding the versatility of RLP-based materials via conjugation with other polypeptides and polymers would offer great promise in the design of a range of materials. Here, we present an investigation of the biochemical and mechanical properties of hybrid hydrogels composed of a recombinant RLP and a multiarm PEG macromer. These hybrid hydrogels can be rapidly cross-linked through a Michael-type addition reaction between the thiols of cysteine residues on the RLP and vinyl sulfone groups on the multiarm PEG. Oscillatory rheology and tensile testing confirmed the formation of elastomeric hydrogels with mechanical resilience comparable to aortic elastin; hydrogel stiffness was easily modulated through the cross-linking ratio. Macromolecular phase separation of the RLP-PEG hydrogels offers the unique advantage of imparting a heterogeneous microstructure, which can be used to localize cells, through simple mixing and cross-linking. Assessment of degradation of the RLP by matrix metalloproteinases (MMPs) illustrated the specific proteolysis of the polypeptide in both its soluble form and when cross-linked into hydrogels. Finally, the successful encapsulation and viable three-dimensional culture of human mesenchymal stem cells (hMSCs) demonstrated the cytocompatibility of the RLP-PEG gels. Overall, the cytocompatibility, elastomeric mechanical properties, microheterogeneity, and degradability of the RLP-PEG hybrid hydrogels offer a suite of promising properties for the development of cell-instructive, structured tissue engineering scaffolds.


Subject(s)
Hydrogels/chemistry , Insect Proteins/chemistry , Polyethylene Glycols/chemistry , Polymers/chemistry , Tissue Scaffolds/chemistry , Elasticity , Elastin/chemistry , Elastomers , Humans , Hydrogels/administration & dosage , Insect Proteins/administration & dosage , Matrix Metalloproteinases/metabolism , Mesenchymal Stem Cells/drug effects , Peptides/chemistry , Polyethylene Glycols/administration & dosage , Polymers/administration & dosage , Rheology/methods , Tissue Engineering/methods
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