Nerve growth factor (Ngf) gene-driven semaphorin 3a (Sema3a) expression exacerbates thoracic aortic aneurysm dissection in mice.

Thoracic aortic aneurysm and dissection (TAAD) is a life-threatening disease and currently there is no pharmacological therapy. Sympathetic nerve overactivity plays an important role in the development of TAAD. Sympathetic innervation is mainly controlled by nerve growth factor (NGF, a key neural chemoattractant) and semaphoring 3A (Sema3A, a key neural chemorepellent), while the roles of these two factors in aortic sympathetic innervation and especially TAAD are unknown. We hypothesized that genetically manipulating the NGF/Sema3A ratio by the Ngf -driven Sema3a expression approach may reduce aortic sympathetic nerve innervation and mitigate TAAD progression. A mouse strain of Ngf gene-driven Sema3a expression (namely NgfSema3a/Sema3a mouse) was established by inserting the 2A-Sema3A expression frame to the Ngf terminating codon using CRISPR/Cas9 technology. TAAD was induced by ß-aminopropionitrile monofumarate (BAPN) both in NgfSema3a/Sema3a mice and wild type (WT) littermates. Contrary to our expectation, the BAPN-induced TAAD was severer in NgfSema3a/Sema3a mice than in wild-type (WT) mice. In addition, NgfSema3a/Sema3a mice showed higher aortic sympathetic innervation, inflammation and extracellular matrix degradation than the WT mice after BAPN treatment. The aortic vascular smooth muscle cells isolated from NgfSema3a/Sema3a mice and pretreated with BAPN in vivo for two weeks showed stronger capabilities of proliferation and migration than that from the WT mice. We conclude that the strategy of Ngf -driven Sema3a expression cannot suppress but worsens the BAPN-induced TAAD. By investigating the aortic phenotype of NgfSema3a/Sema3a mouse strain, we unexpectedly find a path to exacerbate BAPN-induced TAAD which might be useful in future TAAD studies.

Successful leadless pacemaker implantation in a patient with dextroversion of the heart: A case report.

BACKGROUND: Dextroversion is defined as the presence of dextrocardia with situs solitus, dextro-loop ventricles, and normally related great arteries. Dextrocardia can pose technical challenges when interventional treatments are required. However, the challenges posed by dextroversion can be amplified due to the disruption of typical anatomical relationships, the unpredictable positioning and boundaries of cardiac structures resulting from the shift, and the pathological processes influencing rotation. CASE SUMMARY: A 73-year-old woman with cardiac dextroversion suffered from a recurrence of atrial fibrillation after her radiofrequency catheter ablation and Despite the cessation of antiarrhythmic medications, there were episodes of sinus pauses and symptomatic bradycardia, with heart rates dropping as low as 28 beats per minute. CONCLUSION: Dextroversion makes the implantation of leadless pacemakers more challenging, and appropriate adjustments in fluoroscope angles may be crucial for intracardiac operations. Additionally, when advancing delivery systems, attention should be paid to rotational direction during valve-crossing procedures; changes in the perspective of posture angle between normal cardiac position and dextroversion can serve as references.

Removal of a pulmonary artery foreign body during pulse ablation in a patient with atrial fibrillation: A case report.

BACKGROUND: Foreign bodies in the pulmonary circulation have been documented in the literature and are typically caused by interventional procedures. However, reports of pulmonary artery foreign bodies during femoral vein puncture are rare, and there is no description of this complication from the guidewire surface flows into the pulmonary artery during a pulse ablation in a patient with atrial fibrillation. CASE SUMMARY: We described a case in which a linear foreign body suddenly appeared on fluoroscopy image during pulsed ablation of atrial fibrillation. Multiposition angiography showed that the foreign body was currently lodged in the pulmonary artery but was hemodynamically stable. We then chose to use an interventional approach to remove the foreign body from the pulmonary artery. This foreign body was subsequently confirmed to be from the hydrophilic coating of the guidewire surface. This may be related to the difficulties encountered during the puncture of the femoral vein. This is a rare and serious complication of femoral vein puncture. Therefore, we reported this case in order to avoid a similar situation. CONCLUSION: Mismatches between interventional devices from different manufacturers used for femoral venipuncture may result in pulmonary artery foreign bodies.

FOXO3a-dependent PARKIN negatively regulates cardiac hypertrophy by restoring mitophagy.

BACKGROUND: Sustained cardiac hypertrophy often develops maladaptive myocardial remodeling, and eventually progresses to heart failure and sudden death. Therefore, maladaptive hypertrophy is considered as a critical therapeutic target for many heart diseases. Mitophagy, a crucial mechanism in mitochondria quality control and cellular homeostasis, has been implicated in diverse cardiac disorders such as myocardial infarction, diabetic cardiomyopathy, cardiac hypertrophy and heart failure. However, what role mitophagy plays in heart diseases remains an enigma. PARKIN functions as an E3 ubiquitin protein ligase and mediates mitophagy cascades. It is still unclear whether PARKIN participates in the regulation of cardiac hypertrophy. RESULTS: PARKIN was downregulated in cardiomyocytes and hearts under hypertrophic stress. Enforced expression of PARKIN inhibited Ang II-induced cardiomyocyte hypertrophy. Compared to wide-type mice with Ang II-induced cardiac hypertrophy, Parkin transgenic mice subjected to Ang II administration showed attenuated cardiac hypertrophy and improved cardiac function. In addition, mitophagy machinery was impaired in response to Ang II, which was rescued by overexpression of PARKIN. PARKIN exerted the anti-hypertrophy effect through restoring mitophagy. In further exploring the underlying mechanisms, we found that PARKIN was transcriptionally activated by FOXO3a. FOXO3a promoted mitophagy and suppressed cardiac hypertrophy by targeting Parkin. CONCLUSIONS: The present study reveals a novel cardiac hypertrophy regulating model composed of FOXO3a, PARKIN and mitophagy program. Modulation of their levels may provide a new approach for preventing cardiac hypertrophy and heart failure.

Percutaneous transhepatic access for catheter ablation of a patient with heterotaxy syndrome complicated with atrial fibrillation: A case report.

BACKGROUND: Atrial fibrillation (AF) is one of the most common arrhythmias, and radiofrequency catheter ablation is the most effective treatment strategy. The inferior vena cava (IVC) is a common approach for radiofrequency ablation of AF. However, this approach may not be applied to some cases such as chronic venous occlusions, surgical ligation of the IVC, and heterotaxy syndrome (HS). CASE SUMMARY: A 68-year-old man with HS suffered from severely symptomatic persistent AF for 9 years, and we successfully ablated by percutaneous transhepatic access. CONCLUSION: In patients without femoral vein access, the use of the hepatic vein for pulmonary vein isolation is a viable alternative for invasive electrophysiology procedures.

[Correlative analysis on metatarsalgia and the X-ray measurement indexes under weight-bearing and non-weight-bearing of hallux valgus].

OBJECTIVE: To study changes in the radiographic appearance during weight-bearing and non-weigh-bearing in hallux valgus, and to analyse the correlation between the elasticity of plantar soft tissue of hallux valgus and the pain under the metatarsal head. METHODS: From May 2012 to October 2012, 240 feet of 120 patients with hallux valgus were enrolled in the study. The degrees of the pian under the metatarsal head of all the patients were observed. AP and lateral X-ray films of feet were taken on the condition of weight-bearing and non-weight-bearing. So the hallux valgus angle (HVA), the inter-metatarsal angle between the first and second metatarsals (IM1-2), the inter-metatarsal angle between the first and fifth metatarsals (IM1-5), top angle of the medial longitudinal arch (TAOTMLA),and anterior angle of the medial longitudinal arch (AAOTMLA) were measured on the X-ray films. The differences of HVA, IM1-2, IM1-5, TAOTMLA and AAOTMLA between two groups were compared, and the correlation between the changes of IM1-2, IM 1-5, TAOTMLA, AAOTMLA and the degree of the pain under the metatarsal head were analysed. RESULTS: One hundred and forty-eight feet had the pain under the metatarsal head. The IM1-2, IM1-5 and TAOTMLA increased on weight-bearing position compared with those on non-weight-bearing position, but the HVA and AAOTMLA decreased on weight-bearing position compared with those on non-weight-bearing position. There was a moderate relationship between the changes of IM 1-2,IM1-5 and the degree of the hallux valgus deformity, as well as the relationship between the different of IM1-5 and the degree of the pian under the metatarsal head. CONCLUSION: The degree of the collapse of the arch of foot with hallux valgus becomes serious with its deformity increasing. The pain under the metatarsal head of hallux valgus increases with the increased changes of IM 1-2,IM 1-5 and TAOTMLA. Analysis of the X-ray observation indexes of hallux valgus on weight-bearing position and non-weight-bearing position has important significance in evaluating the degree of the collapse of the arch of foot with hallux valgus,preventing and curing the the pain under the metatarsal head.