Association of arsenic-induced cardiovascular disease susceptibility with genetic polymorphisms

AbstractInorganic arsenic (iAs) exposure has been reported to have an impact on cardiovascular diseases (CVD). However, there is not much known about the cardiac tissue injury of CVD patients in relation to iAs exposure and potential role of single nucleotide polymorphisms (SNPs) of genes related to iAs metabolism, oxidative stress, endothelial dysfunction and inflammation which may play important roles in such CVD cases. In this dual center cross-sectional study, based on the exclusion and inclusion criteria, we have recruited 50 patients out of 270, who came from known arsenic-affected and- unaffected areas of mainly Chittagong, Dhaka and Rajshahi divisions of Bangladesh and underwent open-heart surgery at the selected centers during July 2017 to June 2018. We found that the patients from arsenic affected areas contained significantly higher average iAs concentrations in their urine (6.72 ± 0.54 ppb, P = 0.028), nail (529.29 ± 38.76 ppb, P < 0.05) and cardiac tissue (4.83 ± 0.50 ppb, P < 0.05) samples. Patients’ age, sex, BMI, hypertension and diabetes status adjusted analysis showed that patients from arsenic-affected areas had significantly higher iAs concentration in cardiac tissue (2.854, 95%CI 1.017–8.012, P = 0.046) reflecting higher cardiac tissue injury among them (1.831, 95%CI 1.032–3.249, P = 0.039), which in turn allowed the analysis to assume that the iAs exposure have played a vital role in patients’ disease condition. Adjusted analysis showed significant association between urinary iAs concentration with AA (P = 0.012) and AG (P = 0.034) genotypes and cardiac iAs concentration with AA (P = 0.017) genotype of AS3MT rs10748835. The AG genotype of AS3MT rs10748835 (13.333 95%CI 1.280–138.845, P = 0.013), AA genotype of NOS3 rs3918181 (25.333 95%CI 2.065–310.757, P = 0.002), GG genotype of ICAM1 rs281432 (12.000 95%CI 1.325–108.674, P = 0.010) and AA genotype of SOD2 rs2758331 (13.333 95%CI 1.280–138.845, P = 0.013) were found significantly associated with CVD patients from arsenic-affected areas. Again, adjusted analysis showed significant association of AA genotype of AS3MT rs10748835 with CVD patients from arsenic affected areas. In comparison to the reference genotypes of the selected SNPs, AA of AS3MT 10748835, AG of NOS3 rs3918181 and AC of rs3918188, GG of ICAM1 rs281432, TT of VCAM1 rs3176867, AA of SOD2 rs2758331 and GT of APOE rs405509 significantly increased odds of cardiac tissue injury of CVD patients from arsenic affected areas. The results showed that the selected SNPs played a susceptibility role towards cardiac tissue iAs concentration and injury among CVD patients from iAs affected areas.

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POSTOPERATIVE PERICARDIAL EFFUSION SYNDROME

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2012.6.8 ◽

2012 ◽

pp. 66-71

Author(s):

Quang Thuu Le

Keyword(s):

Pericardial Effusion ◽

Heart Surgery ◽

Open Heart Surgery ◽

Diagnostic Methods ◽

Open Heart ◽

Cross Sectional ◽

Pericardial Drainage ◽

Results Of Treatment ◽

Intraoperative Management ◽

Minimal Problems

Objective: Today, despite many recent improvements in intraoperative management and postoperative care, late pericardial effusions remain an important cause of morbidity after cardiac surgery. Because of widespread use of chronic anticoagulation and increased complexity of operations, the incidence of effusion may be higher. Thus we need to update the information on the symptoms, risk factors, diagnostic methods and treatment of Postoperative pericardial effusion syndrome. Patients and methods: A cross-sectional and prospective study of all patients admitted to hospital because of pericardial effusion after open heart surgery from 1/2010 to 9/2012. Study the clinical characteristics, paraclinicals, evaluate the results of treatment of pericardial effusion after open heart surgery. Results: Symptoms of pericardial effusion are nonspecific. Some patients with pericardial effusion report minimal problems. In the present study, few patients have the classic presentation of tamponade. Echocardiography is the diagnostic accuracy pericardial effusion after open heart surgery. This treatment mainly is pericardial drainage with 100%. Conclusion: Pericardial effusion is a common complication after open-heart surgery, symptoms of pericardial effusion are nonspecific to diagnostic method is echocardiographic surveillance.patients can be treated with internal medicine if has no tamponade and less fliuds. Pericardial drainage is absolute only in patients with pericardial effusion with signs of cardiac tamponade or pericardial many of effusion.

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Evaluation of Complications of Heart Surgery in Children With Congenital Heart Disease at Dena Hospital of Shiraz

Global Journal of Health Science ◽

10.5539/gjhs.v8n5p33 ◽

2015 ◽

Vol 8 (5) ◽

pp. 33 ◽

Cited By ~ 2

Author(s):

Maryam Mirzaei ◽

Samaneh Mirzaei ◽

Elham Sepahvand ◽

Afifeh Rahmanian Koshkaki ◽

Marzieh Kargar Jahromi

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Heart Surgery ◽

Open Heart Surgery ◽

Vascular Complications ◽

Congenital Heart Surgery ◽

Morbidity And Mortality ◽

High Morbidity ◽

Cross Sectional

INTRODUCTION: Today, with progress in the field of congenital heart surgery, different complicated actions are done in children. These actions may be associated with several complications, especially open heart surgery in which the cardiopulmonary bypass (CPB) is used. Serious complications can be caused high morbidity and mortality rates. Present study has been performed to determine the incidence of morbidity and mortality in cardiac surgery in children. METHOD: In a cross-sectional retrospective, records of 203 patients undergoing surgery for congenital heart disease in Dena hospital during 2013-2015 were reviewed for incidence of complications. Data was analyzed by using descriptive and analytical statistics and using SPSS version 18. RESULTS: The mean age of samples was 3/65±4/47 years. The majority of samples (73/8%) were undergoing open surgery. The overall adverse cardiovascular complications were respectively, renal complications (44/3%), lung (40/3%), anemia (35/9%), heart (34/4%), gastrointestinal (17/2%), brain (14/2%), need for re-intubation of the trachea 11/3%), infection (7/8%) required reoperation (5/9%) and vascular complications (1/4%). CONCLUSION: High incidence of complications after congenital heart surgery makes necessary attention to complications and their treatment after surgery. It is necessary to apply the measures and careful monitoring of patients to minimize these effects.

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Complement (C3, C4) and C-reactive Protein Responses to Cardiopulmonary Bypass and Protamine Administration

Anaesthesia and Intensive Care ◽

10.1177/0310057x9302100113 ◽

1993 ◽

Vol 21 (1) ◽

pp. 50-55 ◽

Cited By ~ 8

Author(s):

M. Tulunay ◽

S. Demiralp ◽

S. Tastan ◽

H. Akalin ◽

U. Ozyurda ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Complement System ◽

Complement Activation ◽

Heart Surgery ◽

Tissue Injury ◽

Open Heart Surgery ◽

Complement C3 ◽

C Reactive Protein ◽

Reactive Protein ◽

Protamine Administration

Complement activation has been deemed responsible for the damaging effects of cardiopulmonary bypass (CPB) in patients undergoing open heart surgery. We studied C3, C4 and C-reactive protein (CRP) in 22 patients undergoing CPB. In Group 1 (11 patients), protamine was given intravenously and in Group 2 (11 patients), via the aortic root after CPB. Significant decreases were observed in C3 and C4 during CPB in both groups indicating complement activation primarily by the classic pathway. Protamine did not lead to further activation of the complement system. In both groups, C3 levels gradually returned toward baseline within 24 hours but C4 levels were still lower than baseline 24 hours postoperatively. CPB and protamine administration did not cause any significant changes in CRP levels, but CRP increased abruptly 24 hours after operation. Although activation of complement system during CPB is expected to invoke an acute phase response, we conclude that this period is not long enough to induce an increased production of CRP in response to tissue injury or inflammation.

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Evaluation of Cardiomyocyte Viability after Cardiac Tissue Incubated in Special Culture System

Microscopy and Microanalysis ◽

10.1017/s1431927600035595 ◽

2000 ◽

Vol 6 (S2) ◽

pp. 620-621

Author(s):

C. Wei ◽

J Papadimitriou

Keyword(s):

Culture System ◽

Heart Surgery ◽

Cardiac Tissue ◽

Open Heart Surgery ◽

Culture Conditions ◽

Culture Period ◽

Open Heart ◽

Hypertrophic Response ◽

Signaling Mechanisms ◽

Apoptotic Effect

Cardiac myocytes maintained in cell culture develop hypertrophy both in response to mechanical loading as well as to receptor-mediated signaling mechanisms. However, it has been shown that the hypertrophic response to these stimuli may be modulated through effects of intercellular contact achieved by maintaining cells at different plating densities. We recently developed the new special tissue culture system to culture minced cardiac tissue and to evaluate the apoptotic effect of different agent in cardiomyocytes. After 24 hours culture period, different culture conditions and factors may damage the cardiomyocyte. Therefore, we performed different methods to evaluate the viability of cardiomyocyte in cardiac tissue with 24 hours culture period in our special culture system.Human cardiac atrial tissue was obtained from open-heart surgery (n=6). After cardiac tissue excision, the samples were immediately placed in oxygenated, nominally Ca2+-free Tyrode solution for transport to the laboratory. The time between excision and the beginning of laboratory processing was five to fifteen minutes.

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Management of anticoagulation and its reversal during paediatric cardiopulmonary bypass: a review of current UK practice

Perfusion ◽

10.1177/026765910001500303 ◽

2000 ◽

Vol 15 (3) ◽

pp. 191-201 ◽

Cited By ~ 19

Author(s):

Massimiliano Codispoti ◽

Pankaj S Mankad

Keyword(s):

Cardiopulmonary Bypass ◽

Great Britain ◽

Heart Surgery ◽

Open Heart Surgery ◽

Wide Distribution ◽

Clinical Practices ◽

Cross Sectional ◽

Telephone Interviews ◽

Surgical Units ◽

The Uk

Protocols for management of heparin and protamine administration in patients undergoing open-heart surgery have been developed from experience gained mainly in adult practice. However, it has been demonstrated that there are marked differences between paediatric and adult patients in their response to systemic anticoagulation and its reversal. The aim of this study was to obtain an overview of current practice of management of anticoagulation and its reversal from paediatric cardiac surgical units of Great Britain and Ireland. All centres performing paediatric cardiac surgery agreed to participate in the survey ( n = 16). Telephone interviews were carried out with the chief or a senior perfusionist from all participating institutions, which were based on a structured questionnaire compiled specifically for the purpose. The answers were anonymized. At present, in the UK and Ireland, unfractionated heparin is the anticoagulant of choice in all units, with a slight prevalence of porcine mucosal (9/16, 56.5%) versus bovine lung preparation (7/16, 44.0%). The policy for administration of heparin to the patient is uniform, with a dose of 300 IU/kg. However, there is great variability in the amount of heparin added to the prime and to the volume infused during cardiopulmonary bypass (CPB). Monitoring of anticoagulation is achieved by activated coagulation time alone in all but one centre, with lower limits varying between 400 and 750 s. Use of aprotinin is widely accepted, but clinical indications are highly variable. No centre adopts heparin-bonded or heparin-coated circuitry for CPB. Calculation of initial and additional protamine doses followed a variety of criteria, resulting in a very wide distribution of doses. The data obtained highlighted the lack of uniformity among paediatric cardiac surgical units of Great Britain and Ireland with regard to most of the issues related to the management of anticoagulation and its reversal. The striking heterogeneity of our cross-sectional observations clearly underlines the need for prospective, multicentre studies on a national basis to relate different clinical practices to outcome measures.

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The Relationship Between Performance Indicators and Readmission of Patients With Open Heart Surgery: A Case Study in Iran

Hospital Practices and Research ◽

10.15171/hpr.2019.11 ◽

2019 ◽

Vol 4 (2) ◽

pp. 62-67

Author(s):

Parvin Ebrahimi ◽

Mohammadali Taghi Nattaj Darzi Naghibi ◽

Soudabeh Vatankhah ◽

Ghassem Faghanzadeh Ganji

Keyword(s):

Teaching Hospital ◽

Performance Indicators ◽

Heart Surgery ◽

Open Heart Surgery ◽

Patient Readmission ◽

Open Heart ◽

Cross Sectional ◽

Statistical Population ◽

The North ◽

The Relationship

Background: Open heart surgery is a prevalent therapeutic intervention for cardiovascular diseases. Significant adverse effects occur after heart surgery, one of which is patient readmission to the hospital. Objective: The present study aimed to determine the relationship between performance indicators and the readmission of patients with open heart surgery in a teaching hospital in Iran. Methods: This study was performed using a cross-sectional and descriptive method with a retrospective approach. Data was collected on a data collection form. The statistical population of this study comprised all patients who underwent open heart surgery from mid-September 2015 to mid-September 2016 in a teaching hospital in the north of Iran (n=849). Those patients readmitted to the hospital within 90 days after discharge, based on a review of patient records, were included in the study. Descriptive statistics and Spearman correlation coefficient were used for data analysis by SPSS 20. Results: Among the patients who had open heart surgery in the selected hospital, 12.5% were readmitted within 90 days after discharge. The most important reasons for readmission in this study were infection in surgery place (25.8%), pleural effusion (18.7%), warfarin toxicity (9.8%), and tamponade (8.9%). There were inverse relationships between patient readmission and the two performance indicators of bed occupancy percentage (r = -0.594, P=0.042) and bed turnover rate (r = -0.664, P=0.018). There were no statistically significant relationships between any of the other indicators (length of stay, mortality, and bed turnover interval) and readmission rate (P>0.1). Conclusion: Hospital authorities can use these results for bed management and targeting interventions to reduce costs and readmissions as a measure of hospital quality. However, further research into readmission factors in other hospitals is recommended.

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Relation between pressure and diameter in main pulmonary artery of man

Journal of Applied Physiology ◽

10.1152/jappl.1963.18.3.557 ◽

1963 ◽

Vol 18 (3) ◽

pp. 557-559 ◽

Cited By ~ 63

Author(s):

Joseph C. Greenfield ◽

Douglas M. Griggs

Keyword(s):

Elastic Modulus ◽

Pulmonary Artery ◽

Heart Surgery ◽

Cardiac Cycle ◽

Main Pulmonary Artery ◽

Open Heart Surgery ◽

Mean Value ◽

Cross Sectional ◽

The Mean ◽

Intravascular Pressure

The pressure-diameter relationship in the main pulmonary artery of man was estimated in 11 patients undergoing open-heart surgery. The diameter was measured with a recording caliper sutured to the vessel wall. The lateral intravascular pressure was measured with a 20-gauge needle connected directly to a Statham P23Db strain gauge. In the eight patients with normal pulmonary artery pressure the results indicate: 1) the shapes of the pressure and diameter curves are similar; 2) the mean value for the ratio of change in radius to change in pressure (ΔR/ΔP) x 103 was 8.77 cm/cm H2O (±sd 2.10); 3) the mean value for the pressure-strain elastic modulus (Ep) was 159.0 g/cm2 (±sd 26.0); and 4) the mean change in cross-sectional area during an average cardiac cycle was 22.9% of the diastolic value. In three patients with pulmonary hypertension the value of both ΔR/ΔP and the pressure-strain elastic modulus was lower. Submitted on April 27, 1962

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Neurological Sequelae Following Pediatric Cardiac Interventions

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.5581 ◽

2021 ◽

Vol 9 (B) ◽

pp. 137-143

Author(s):

Hala Agha ◽

Mai Mahmoud Hussien ◽

Marian Y Girgis ◽

Omneya Gamal Eldin Afify ◽

Mervat Haroun

Keyword(s):

Heart Surgery ◽

Open Heart Surgery ◽

Neurological Complications ◽

Cross Sectional Study ◽

Neurological Dysfunction ◽

Open Heart ◽

Cross Sectional ◽

Neurological Sequelae ◽

Electrophysiological Studies ◽

Cardiac Catheterizations

AIM: The aim of the present study was to assess neurological sequelae within 30 days of surgical or cardiac catheter interventions in infants and children. METHOD: In this cross-sectional study, we evaluated all patients who developed neurological problems after cardiac interventions either by surgery or by catheter by clinical evaluation, brain imaging, and electrophysiological studies. RESULTS: Among 1200 procedures were performed; 895 (74.6%) were cardiac catheterizations either diagnostic or intervention, 167 (13.9%) were open-heart surgery, and 138 (11.5%) were closed heart surgery. The overall incidence of post-procedure neurological dysfunction in the studied population was 3.4%. The differences between the three groups were statistically significant (p < 0.0001(. In our series, the neurological complications were in the form of disturbed conscious level in 2/41 (4.9%), impaired motor function in 11/41 (26.8%), impaired mental functions in 6/41(14.6%), hyperreflexia in 27/41 (65.9%), and seizures in 38/41 (92.7%). The most common presentation of seizures was in the form of focal fits 21/41 (51.2%), followed by generalized fits in 15/41(36.6%) and then myoclonic fits 2/41 (4.9%). CONCLUSION: Seizures are the most common complication following cardiac interventions in pediatric age and the highest percentage following open heart surgery.

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Cyclosporine-Induced Apoptosis in Human Cardiomyocytes Through P53-Dependent Pathway

Microscopy and Microanalysis ◽

10.1017/s1431927600035650 ◽

2000 ◽

Vol 6 (S2) ◽

pp. 632-633

Author(s):

M. Kinjo ◽

C. Wei

Keyword(s):

Heart Surgery ◽

Cardiac Tissue ◽

Open Heart Surgery ◽

Related Gene ◽

P53 Expression ◽

Human Cardiomyocytes ◽

Significant Toxicity ◽

Induced Apoptosis ◽

Dependent Pathway ◽

Apoptosis Related Gene

Cyclosporine A (CsA) is the most effective and widely used immunosuppressant drug in heart, lung and kidney transplantation. However, the effect of CsA is limited by the significant toxicity. The mechanism of CsA-induced toxicity is remaining controversial. Cellular apoptosis is being suggested as a possible mediator of CsA toxicity. To date, regarding the effects of CsA on apoptosis and apoptosis-related gene regulation in cardiomyocytes remain unclear. Therefore, the current study was designed to investigate the effect of CsA on apoptosis and apoptosis-related gene p53 expression in human cardiomyocytes. We hypothesized that CsA induces apoptosis in human cardiomyocytes through p53-dependent pathway.Human cardiac atrial tissue was obtained from open-heart surgery (n=5). The cardiac tissue was minced and incubated in the special tissue culture system for 24 hours in the absence or presence of CsA (10-7 M). To detect the DNA fragmentation, in situ terminal deoxymucleotidyl transferase dUTP nick end labeling (TUNEL) was performed.

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Angiotensin II Increases Apoptosis and Caspase-1 Expression in Human Myocardium

Microscopy and Microanalysis ◽

10.1017/s1431927600035649 ◽

2000 ◽

Vol 6 (S2) ◽

pp. 630-631

Author(s):

H. Song ◽

S. W. Downing ◽

C. Wei

Keyword(s):

Angiotensin Ii ◽

Receptor Antagonist ◽

Heart Surgery ◽

Cardiac Tissue ◽

Open Heart Surgery ◽

Cardiomyocyte Apoptosis ◽

Tunel Staining ◽

Caspase 1 ◽

Potent Vasoconstrictor ◽

Human Cardiac Tissue

Angiotensin II (AII) is a potent vasoconstrictor and mitogenic factor. The biological actions of All through AII receptors which include AT-1 and AT-2 receptors. However, the effects of AII on cardiomyocyte apoptosis and caspase expression remain controversial. Therefore, the current study was designed to investigate the actions of AII on human cardiomyocyte apoptosis and caspase-1 expression.Human cardiac tissue was obtained from open-heart surgery (n=6). The cardiac tissue was minced and incubated in the special tissue culture system for 24 hours in the absence or presence of AII (10-7 M). These studies were repeated with losartan (10-6 M, AT-1 receptor antagonist) and PD123319 (PD, 10-6 M, AT-2 receptor antagonist). To detect the DNA fragmentation, TUNEL staining and DNA gel analyses were performed. The caspase-1 expression was determined by immunohistochemical staining (IHCS). An average of 1000 nuclei was analyzed for both TUNEL and caspase-1 IHCS studies.

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