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Results of the First 10 Cases of Coronary Bypass Surgery in Senegal

World Journal of cardiovascular Surgery 2024年第4期14卷 45-60页

作者： Papa Amath Diagne Jean Claude Ndiogou Dione Papa Ousmane Ba Momar Sokhna Diop El Hadji Boubacar Ba Momar Dioum Marième Soda Mbaye Moussa Seck Diop Mory Camara Abdou Lahad Mbengue Abdou Aziz Thiaw Abdoul Khoudoss Diallo Moussa Mareme Samba Dialtabé Ibrahima Guéssé Ba Anta Mbaye Sall Papa Salmaneba Amadou Gabriel Ciss department of cardiovascular and Thoracic Surgery FANN National University Hospital Dakar Senegal

This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. cardiovascular risk factors were mainly myocardial infarction (MI) (60%), hypertension (50%), obesity (40%) and diabetes (30%), with at least two risk factors per patient. Angina was the main symptom (80%). The average time from presentation to surgery was 8 months. The mean Euroscore 2 was 2.92 ± 1.65 [1.33 - 6.60]. Coronary angiography revealed an average of 2 lesions per patient, with 3-vessel involvement in 70% of cases: the Interventricular artery (IVA) (100%), the right coronary artery (90%) and the circumflex artery (70%). On echocardiography, the mean Left ventricular ejection fraction (LVEF) was 59% [33% - 76%]. All patients underwent median sternotomy with bypass grafting. The average duration of the cardiopulmonary bypass was 150 min [46 - 275 min];that of aortic clamping, 120 min [43 - 232 min]. The grafts used were internal thoracic artery (ITA) in 100% of cases (80% on the left and 20% on the right), and the great saphenous vein (GSV) in 60% of cases (50% on the left and 10 on the right). Double bypass was performed in 60% of cases, single bypass in 30% and triple bypass in 10%. The bypasses were performed on the IVA (100%), the middle lateral of the circumflex (30%) and the bisector (20%). The average time to extubation was 11 hours and the length of stay in the intensive care unit was 7 days [03 - 17 days]. One patient had a reoperation on Day 0 post-op. The average hospital stay was 13 days [06 - 27 days]. Complications occurred in nine of the patients (90%), with a predominance of infectious and neurological complications. Overall operative mortality was 3%, all in intensive care.

关键词： Coronary Bypass Surgery Coronary Lesions Cardiac Surgery Senegal

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Large-Scale Surface Modification of Decellularized Matrix with Erythrocyte Membrane for Promoting In Situ Regeneration of Heart Valve

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Engineering 2024年第10期41卷 216-230页

作者： Yuqi Liu Pengning Fan Yin Xu Junwei Zhang Li Xu Jinsheng Li Shijie Wang Fei Li Si Chen Jiawei Shi Weihua Qiao Nianguo Dong department of cardiovascular Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China

In situ regeneration is a promising strategy for constructing tissue engineering heart valves(TEHVs).Currently,the decellularized heart valve(DHV)is extensively employed as a TEHV ***,DHV exhibits limited blood compatibility and notable difficulties in endothelialization,resulting in thrombosis and graft *** red blood cell membrane(RBCM)exhibits excellent biocompatibility and prolonged circulation stability and is extensively applied in the camouflage of nanoparticles for drug delivery;however,there is no report on its application for large-scale modification of decellularized extracellular matrix(ECM).For the first time,we utilized a layer-by-layer assembling strategy to immobilize RBCM on the surface of DHV and construct an innovative TEHV *** findings demonstrated that the scaffold significantly improved the hemocompatibility of DHV by effectively preventing plasma protein adsorption,activated platelet adhesion,and erythrocyte aggregation,and induced macrophage polarization toward the M2 phenotype in ***,RBCM modification significantly enhanced the mechanical properties and enzymatic stability of *** rat models of subcutaneous embedding and abdominal aorta implantation showed that the scaffold regulated the polarization of macrophages into the anti-inflammatory and pro-modeling M2 phenotype and promoted endothelialization and ECM remodeling in the early stage without thrombosis and *** novel TEHV exhibits excellent performance and can overcome the limitations of commonly used clinical prostheses.

关键词： In situ tissue engineering heart valves Red blood cell membrane Endothelialization Hemocompatibility Immunomodulation

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Transient induction of actin cytoskeletal remodeling associated with dedifferentiation,proliferation,and redifferentiation stimulates cardiac regeneration

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Acta Pharmaceutica Sinica B 2024年第6期14卷 2537-2553页

作者： Wenbin Fu Qiao Liao Yu Shi Wujian Liu Hongmei Ren Chunmei Xu Chunyu Zeng department of Cardiology Daping Hospitalthe Third Military Medical University(Army Medical University)Chongqing 400042China Key Laboratory of Geriatric cardiovascular and Cerebrovascular Disease Research Ministry of Education of ChinaChongqing 400042China Chongqing Key Laboratory for Hypertension Research Chongqing Cardiovascular Clinical Research CenterChongqing Institute of CardiologyChongqing 400042China State Key Laboratory of Trauma Burns and Combined InjuryDaping Hospitalthe Third Military Medical UniversityChongqing 400042China cardiovascular Research Center Chongqing CollegeUniversity of Chinese Academy of SciencesChongqing 400042China State Key Laboratory of Trauma and Chemical Poisoning Chongqing 400042China

The formation of new and functional cardiomyocytes requires a 3-step process:dedifferentiation,proliferation,and redifferentiation,but the critical genes required for efficient dedifferentiation,proliferation,and redifferentiation remain *** our study,a circular trajectory using single-nucleus RNA sequencing of the pericentriolar material 1 positive(PCM1^(+))cardiomyocyte nuclei from hearts 1 and 3 days after surgery-induced myocardial infarction(MI)on postnatal Day 1 was reconstructed and demonstrated that actin remodeling contributed to the dedifferentiation,proliferation,and redifferentiation of cardiomyocytes after *** identified four top actin-remodeling regulators,namely Tmsb4x,Tmsb10,Dmd,and Ctnna3,which we collectively referred to as *** expressed changes of 2D2P,using a polycistronic non-integrating lentivirus driven by Tnnt2(cardiac-specific troponin T)promoters(Tnnt2-2D2P-NIL),efficiently induced transiently proliferative activation and actin remodeling in postnatal Day 7 cardiomyocytes and adult ***,the intramyocardial delivery of Tnnt2-2D2P-NIL resulted in a sustained improvement in cardiac function without ventricular dilatation,thickened septum,or fatal arrhythmia for at least 4 *** conclusion,this study highlights the importance of actin remodeling in cardiac regeneration and provides a foundation for new gene-cocktail-therapy approaches to improve cardiac repair and treat heart failure using a novel transient and cardiomyocyte-specific viral construct.

关键词： Single cell analysis Actin remodeling Tmsb4x Tmsb10 Dmd Ctnna3 Myocardial infarction Cardiomyocytes proliferation Cardiac regeneration Genetic therapy

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Pressure-responsive pH-triggered layer-by-layer coating of paclitaxel-eluting balloon catheters for instant high-dose drug delivery for percutaneous coronary artery intervention

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Nano Research 2024年第10期17卷 9141-9151页

作者： Jeong Yu Lee Shonit Nair Sharma Sung-Yu Hong Young-Guk Ko Yangsoo Jang Minjae Do Michael Christopher Stark Qiwen Peng Benjamin Allen Mossburg Bo Chan Seo Yuhan Lee department of Materials Science and Engineering Korea Advanced Institute of Science and TechnologyDaejeon 305-701Republic of Korea department of Anesthesiology Perioperativeand Pain MedicineCenter for Accelerated Medical Innovation&Center for NanomedicineBrigham and Women’s HospitalHarvard Medical SchoolBostonMA 02115USA department of Biological Engineering Massachusetts Institute of TechnologyCambridgeMA 02139USA cardiovascular Product Evaluation Center Yonsei University College of MedicineSeoul 120-752Republic of Korea Division of Cardiology Department of Internal MedicineSeverance Cardiovascular HospitalYonsei University College of MedicineSeoul 120-752Republic of Korea

cardiovascular diseases remain the leading cause of mortality worldwide,with percutaneous coronary interventions(PCI)using drug-eluting stents(DES)as the standard treatment for coronary artery *** advancements in DES technology,challenges such as restenosis and stent thrombosis still necessitate further interventions and carry considerable risks,highlighting an urgent need for a novel therapeutic approach with lower restenosis rates and reduced reintervention *** balloons(DEBs)coated with anti-proliferative agents offer a novel method of local drug delivery for reducing restenosis by directly administering drugs to the lesion ***,efficient delivery of drugs within the brief procedural window while minimizing drug loss during maneuvering to the target site remains a ***,we developed a pressure-responsive and pH-triggered,paclitaxel(PTX)coated DEB catheter for rapid and high-dose delivery of paclitaxel to the lesion sites,overcoming the limitations of drug dispersion and inefficiencies associated with conventional *** the charge reversion of albumin around its isoelectric point,paclitaxel-loaded human serum albumin nanoparticles(PTX-HSA-NPs)and heparin were coated using a layer-by-layer deposition method at pH *** exposure to physiological pH(i.e.,7.4),the coating is rapidly released from the balloon *** with a protective shellac coating,the DEB achieved controlled release of high-dose paclitaxel to the arterial tissue in vivo(up to 400μg per gram tissue),exceeding current DEBs in the *** results suggest the pH-responsive,multi-layer coated DEB’s potential for superior procedural outcomes,addressing a critical unmet need in PCI.

关键词： drug-eluting balloon layer-by-layer coating coronary artery disease paclitaxel

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Triglyceride-glucose index predicts the prognosis of patients with acute myocardial infarction

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South China Journal of Cardiology 2024年第1期25卷 11-20,43页

作者：伦梓恒何洁欣付明易诗欣张莹 department of cardiovascular Medicine Guangdong Cardiovascular InstituteGuangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhou 510180GuangdongChina

Background Research has indicated that the triglyceride-glucose(Ty G)index is associated with the development and prognosis of cardiovascular ***,there is still uncertainty regarding whether the Ty G index can predict adverse cardiovascular events in patients with acute myocardial infarction(AMI).The present study aimed to explore the prognostic value of the Ty G index in patients with *** AMI patients who underwent emergency percutaneous coronary intervention(PCI)in Guangdong General Hospital from February 2021 to June 2022 were *** study population was grouped based on the median Ty G *** end point of the study was major adverse cardiovascular events(MACEs),defined as all-cause mortality,cardiogenic shock,recurrent myocardial infarction,acute attack of heart failure,repeat revascularization induced by cardiac ischemia,and urgent visit due to aggravation of chest *** Ty G index was calculated as follows:LN[fasting triglycerides(mg/d L)×fasting blood glucose(mg/d L)x1/2].Results A total of 196 patients were *** the multivariate logistic regression analysis,Ty G index[odds ratio(OR):0.99,95%confidence interval(CI):0.45-2.16,P=0.98]was not significantly correlated with the occurrence of MACEs in AMI patients during *** a total of 178 patients were followed up for an average of 12.66±5.35 *** the multivariate Cox proportional hazards model,Ty G index[hazard ratio(HR):1.91,95%CI:1.02-3.6,P<0.05]were independent predictor of adverse events during follow-up,and the area under the receiver operating characteristic(ROC)curve(AUC)was0.63(0.53-0.73,P<0.05).Conclusions Ty G index can independently predict the prognosis of AMI patients during the follow-up period.[S Chin J Cardiol 2024;25(1):11-20]

关键词： Triglyceride glucose index Acute myocardial infarction Prognosis

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Cardiac Piezo1 Exacerbates Lethal Ventricular Arrhythmogenesis by Linking Mechanical Stress with Ca^(2+) Handling After Myocardial Infarction

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Research 2024年第1期2023卷 583-594页

作者： Sheng-an Su Yuhao Zhang Wudi Li Yutao Xi Yunrui Lu Jian Shen Yuankun Ma Yaping Wang Yimin Shen Lan Xie Hong Ma Yao Xie Meixiang Xiang department of Cardiology Cardiovascular Key Laboratory of Zhejiang ProvinceThe Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310009China department of Endocrinology The Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310009China Texas Heart Institute HoustonTX 77030USA

Ventricular arrhythmogenesis is a key cause of sudden cardiac death following myocardial infarction(MI).Accumulating data show that ischemia,sympathetic activation,and inflammation contribute to ***,the role and mechanisms of abnormal mechanical stress in ventricular arrhythmia following MI remain *** aimed to examine the impact of increased mechanical stress and identify the role of the key sensor Piezo1 in ventricular arrhythmogenesis in *** with increased ventricular pressure,Piezo1,as a newly recognized mechano-sensitive cation channel,was the most up-regulated mechanosensor in the myocardium of patients with advanced heart ***1 was mainly located at the intercalated discs and T-tubules of cardiomyocytes,which are responsible for intracellular calcium homeostasis and intercellular communication.

关键词： ventricular homeostasis Ventricular

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Early Prosthetic Valve Endocarditis with Mycobacterium Tuberculosis after Mitral Valve Replacement: A Case Report

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World Journal of cardiovascular Surgery 2024年第3期14卷 33-40页

作者： Papa Amath Diagne Mory Camara Papa Ousmane Ba Momar Sokhna Diop Moussa Samba Abdou Lahad Mbengue Jean Claude Ndiogou Dione Myriam Bizrane Marième Soda Mbaye Moussa Seck Diop Toudiani Malam Kaka Papa Salmane Ba Papa Adama Dieng Amadou Gabriel Ciss Assane Ndiaye cardiovascular and Thoracic Surgery department FANN National University Hospital Dakar Senegal

Background: Tuberculous endocarditis is a rare but serious complication of heart valve replacement surgery. We report the case of a 24-year-old patient, who presented with tuberculous endocarditis after mechanical mitral valve replacement, with a favorable clinical course following anti-tuberculosis treatment. Case Presentation: We report a 24-year-old male patient, admitted to the cardiac surgery department of the Fann Hospital (Dakar, Senegal), for the management of severe mixed (rheumatic and endocarditic) mitral insufficiency with associated tricuspid insufficiency. He had a history of recurrent angina and polyarthralgia in childhood, was hospitalized several times for refractory global cardiac decompensation, and for a suspected infective endocarditis a month before his admission. On admission, the clinical examination revealed signs suggestive of mitral and tricuspid insufficiency. Transthoracic echocardiography revealed severe post-endocarditic mitral insufficiency with A3 amputation, highly mobile 15 mm vegetations on the free edge of the large valve, moderate tricuspid insufficiency, and severe pulmonary artery hypertension. Mechanical mitral valve replacement and tricuspid valve annuloplasty using autologous pericardial strip were performed via median sternotomy. After ten days, the patient presented with global cardiac decompensation associated with a clinico-biological infectious syndrome, and tans-oesophageal echography revealed an abscess at the sinotubular junction, communicating with the aorta. A thoraco-abdomino-pelvic CT scan was done, which revealed a bilateral alveolar-interstitial syndrome with mediastinal lymphadenopathy. Anti-tuberculosis treatment with RHZE was initiated for 06 months. The clinical course was favorable. Conclusion: Tuberculous endocarditis in prostheses is a serious complication of heart valve replacement surgery, which may evolve favorably under medical treatment.

关键词： Tuberculous Endocarditis Prosthetic Valve Endocarditis Mycobacterium Tuberculosis

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Sex and racial disparities in non-alcoholic fatty liver disease-related cardiovascular events: National inpatient sample analysis (2019)

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World Journal of Cardiology 2024年第3期16卷 137-148页

作者： Rupak Desai Ali Tariq Alvi Advait Vasavada Yashwitha Sai Pulakurthi Bhavin Patel Adil Sarvar Mohammed Shreyans Doshi Ikechukwu Ogbu Independent Researcher AtlantaGA 30079United States department of Internal Medicine HCA Florida Westside HospitalPlantationFL 33324United States department of Internal Medicine M.P.Shah Medical CollJamnagar 361008India department of Internal Medicine Saint Michael Medical CenterNewarkNJ 07102United States department of Internal Medicine Trinity Health Oakland HospitalPontiacMI 48341United States department of Internal Medicine Central Michigan University College of MedicineSaginawMI 48602United States department of Internal Medicine UCF College of Medicine HCA GME ConsortiumGainesvilleFL 32605United States department of Internal Medicine Mountainview HospitalLas VegasNV 89108United States

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)increases cardiovascular disease(CVD)risk irrespective of other risk ***,large-scale cardiovascular sex and race differences are poorly *** To investigate the relationship between NAFLD and major cardiovascular and cerebrovascular events(MACCE)in subgroups using a nationally representative united States inpatient *** We examined National Inpatient Sample(2019)to identify adult hospitalizations with NAFLD by age,sex,and race using ICD-10-CM *** and demographic characteristics,comorbidities,and MACCE-related mortality,acute myocardial infarction(AMI),cardiac arrest,and stroke were compared in NAFLD cohorts by sex and *** regression analyses were adjusted for sociodemographic characteristics,hospitalization features,and *** We examined 409130 hospitalizations[median 55(IQR 43-66)years]with *** was more common in females(1.2%),Hispanics(2%),and Native Americans(1.9%)than *** often reported non-elective admissions,Medicare enrolment,the median age of 55(IQR 42-67),and poor *** had higher obesity and uncomplicated diabetes but lower hypertension,hyperlipidemia,and complicated diabetes than *** had a median age of 48(IQR 37-60),were Medicaid enrollees,and had non-elective *** had greater diabetes and obesity rates than whites but lower hypertension and ***,all-cause mortality,AMI,cardiac arrest,and stroke were all greater in elderly individuals(P<0.001).MACCE,AMI,and cardiac arrest were more common in men(P<0.001).Native Americans(aOR 1.64)and Asian Pacific Islanders(aOR 1.18)had higher all-cause death risks than *** Increasing age and male sex link NAFLD with adverse MACCE outcomes;Native Americans and Asian Pacific Islanders face higher mortality,highlighting a need for tailored interventions and care.

关键词： Non-alcoholic fatty liver disease cardiovascular disease Major cardiovascular and cerebrovascular events Sex/gender disparities Mortality

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Genetically predicted waist circumference and risk of atrial fibrillation

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Chinese Medical Journal 2024年第1期137卷 82-86页

作者： Wenting Wang Jiang-shan Tan Jingyang Wang Wei Xu Liting Bai Yu Jin Peng Gao Peiyao Zhang Yixuan Li Yanmin Yang Jinping Liu department of Cardiopulmonary Bypass State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China department of Anaesthesiology Second Affiliated HospitalHainan Medical CollegeHaikouHainan 570311China State Key Laboratory of cardiovascular Disease Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

Introduction:Observational studies have revealed an association between waist circumference(WC)and atrial fibrillation(AF).However,it is difficult to infer a causal relationship from observational studies because the observed associations could be confounded by unknown risk ***,the causal role of WC in AF is *** study was designed to investigate the causal association between WC and AF using a two-sample Mendelian randomization(MR)***:In our two-sample MR analysis,the genetic variation used as an instrumental variable for MR was acquired from a genome-wide association study(GWAS)of WC(42 single nucleotide polymorphisms with a genetic significance of P<5×10^(-8)).The data of WC(from the Genetic Investigation of ANthropometric Traits consortium,containing 232,101 participants)and the data of AF(from the European Bioinformatics Institute database,containing 55,114 AF cases and 482,295 controls)were used to assess the causal role of WC on *** different approaches(inverse variance weighted[IVW],MR-Egger,and weighted median regression)were used to ensure that our results more ***:All three MR analyses provided evidence of a positive causal association between high WC and *** WC was suggested to increase the risk of AF based on the IVW method(odds ratio[OR]=1.43,95%confidence interval[CI],1.30-1.58,P=2.51×10^(-13)).The results of MR-Egger and weighted median regression exhibited similar trends(MR-Egger OR=1.40[95%CI,1.08-1.81],P=1.61×10^(-2);weighted median OR=1.39[95%CI,1.21-1.61],P=1.62×10^(-6)).MR-Egger intercepts and funnel plots showed no directional pleiotropic effects between high WC and ***:Our findings suggest that greater WC is associated with an increased risk of *** measures to reduce WC may help prevent the occurrence of AF.

关键词： Genetically predicted Waist circumference Atrial fibrillation Mendelian randomization

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Impact of depression on in-hospital outcomes for adults with type 2 myocardial infarction:A united States population-based analysis

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World Journal of Cardiology 2024年第7期16卷 412-421页

作者： Sivaram Neppala Himaja Dutt Chigurupati Shaylika Chauhan Mrunal Teja Chinthapalli Rupak Desai department of Internal Medicine University of Texas at San AntonioSan AntonioTX 78249United States department of Internal Medicine New York Medical College at Saint Michael’s Medical CenterNewarkNJ 07102United States department of Internal Medicine Geisinger Health SystemWikes-BarrePA 18702United States department of Internal Medicine Mayo ClinicRochesterMN 55905United States Independent Researcher AtlantaGA 30079United States

BACKGROUND Type 2 myocardial infarction(T2MI)is an ischemic myocardial injury in the context of oxygen supply/demand mismatch in the absence of a primary coronary ***,though there is a rising prevalence of depression and its potential association with type 1 myocardial infarction(T1MI),data remains nonexistent to evaluate the asso-ciation with *** To identify the prevalence and risk of T2MI in adults with depression and its impact on the in-hospital *** We queried the National Inpatient Sample(2019)to identify T2MI hospitalizations using Internal Classification of Diseases-10 codes in hospitalized adults(≥18 years).In addition,we compared sociodemographic and comorbidities in the T2MI cohort with vs without comorbid ***,we used multivariate regression analysis to study the odds of T2MI hospitalizations with vs without depression and in-hospital outcomes(all-cause mortality,cardiogenic shock,cardiac arrest,and stroke),adjusting for *** significance was RESULTS There were 331145 adult T2MI hospitalizations after excluding T1MI(median age:73 years,52.8%male,69.9%white);41405(12.5%)had depression,the remainder;289740 did not have *** analysis revealed lower odds of T2MI in patients with depression vs without[adjusted odds ratio(aOR)=0.88,95%confidence interval(CI):0.86-0.90,P=0.001].There was the equal prevalence of prior MI with any revascularization and a similar prevalence of peripheral vascular disease in the cohorts with depression vs without *** is a greater prevalence of stroke in patients with depression(10.1%)vs those without(8.6%).There was a slightly higher prevalence of hyperlipidemia in patients with depression vs without depression(56.5%vs 48.9%),as well as obesity(21.3%vs 17.9%).There was generally equal prevalence of hypertension and type 2 diabetes mellitus in both *** was no significant difference in elective and non-elective admissions frequency b

关键词： Type 2 myocardial infarction Depression Major adverse cardiovascular events Mortality Stroke Cardiac arrest Outcomes

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