Plasma Hydrogen Sulfide Production Capacity is Positively Associated with Post-Operative Survival in Patients Undergoing Surgical Revascularization

ABSTRACTObjectiveHydrogen sulfide (H2S) is a gaseous signaling molecule and redox factor important for cardiovascular function. Deficiencies in its production or bioavailability are implicated in atherosclerotic disease. However, it is unknown if circulating H2S levels differ between vasculopaths and healthy individuals, and if so, whether H2S measurements can be used to predict surgical outcomes. Here, we examine: 1) Plasma H2S levels in patients undergoing vascular surgery and compare these to healthy controls, and 2) Associations between H2S levels and mortality in surgical revascularization patients.Approach & ResultsPatients undergoing carotid endarterectomy, open lower extremity revascularization or leg amputation were enrolled. Peripheral blood was also collected from a matched cohort of 20 patients without peripheral or coronary artery disease. Plasma H2S production capacity and sulfide concentration were measured using the lead acetate and monobromobimane methods, respectively. Plasma H2S production capacity and plasma sulfide concentrations were reduced in patients with PAD (p<0.001, p=0.013 respectively). Patients that underwent surgical revascularization were divided into high versus low H2S production capacity groups by median split. Patients in the low H2S production group had increased probability of mortality (p=0.003). This association was robust to correction for potentially confounding variables using Cox proportional hazard models.ConclusionsCirculating H2S levels were lower in patients with atherosclerotic disease. Patients undergoing surgical revascularization with lower H2S production capacity, but not sulfide concentrations, had increased probability of mortality within 36 months post-surgery. This work provides insight on the role H2S plays as a diagnostic and potential therapeutic for cardiovascular disease.HIGHLIGHTSVascular disease patients have higher plasma hydrogen sulfide levels than controls without vascular disease as measured by two distinct methods, the lead acetate hydrogen sulfide release method and the HPLC-based monobromobimane method.Only the lead acetate hydrogen sulfide release method robustly predicts survival after vascular surgery intervention over 35 months of follow up.The lead acetate release method measures non-enzymatic hydrogen sulfide release from plasma which requires iron and is catalyzed by vitamin B6.

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Late-life intermittent fasting decreases aging-related frailty and increases renal hydrogen sulfide production in a sexually dimorphic manner

GeroScience ◽

10.1007/s11357-021-00330-4 ◽

2021 ◽

Author(s):

Yoko O. Henderson ◽

Nazmin Bithi ◽

Christopher Link ◽

Jie Yang ◽

Rebecca Schugar ◽

...

Keyword(s):

Hydrogen Sulfide ◽

Dietary Intervention ◽

Caloric Intake ◽

Production Capacity ◽

Late Life ◽

Model Organisms ◽

Intermittent Fasting ◽

Sexually Dimorphic ◽

Average Life Expectancy ◽

Multiple Components

AbstractGlobal average life expectancy continues to rise. As aging increases the likelihood of frailty, which encompasses metabolic, musculoskeletal, and cognitive deficits, there is a need for effective anti-aging treatments. It is well established in model organisms that dietary restriction (DR), such as caloric restriction or protein restriction, enhances health and lifespan. However, DR is not widely implemented in the clinic due to patient compliance and its lack of mechanistic underpinnings. Thus, the present study tested the effects of a somewhat more clinically applicable and adoptable DR regimen, every-other-day (EOD) intermittent fasting, on frailty in 20-month-old male and female C57BL/6 mice. Frailty was determined by a series of metabolic, musculoskeletal, and cognitive tasks performed prior to and toward the end of the 2.5-month dietary intervention. Late-life EOD fasting attenuated overall energy intake, hypothalamic inflammatory gene expression, and frailty in males. However, it failed to reduce overall caloric intake and had a little positive effect in females. Given that the selected benefits of DR are dependent on augmented production of the gasotransmitter hydrogen sulfide (H2S) and that renal H2S production declines with age, we tested the effects of EOD fasting on renal H2S production capacity and its connection to frailty in males. EOD fasting boosted renal H2S production, which positively correlated with improvements in multiple components of frailty tasks. Therefore, late-life initiated EOD fasting is sufficient to reduce aging-related frailty, at least in males, and suggests that renal H2S production capacity may modulate the effects of late-life EOD fasting on frailty.

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Cholinesterase activity in serum during general anesthesia in patients with or without vascular disease

Scientific Reports ◽

10.1038/s41598-021-96251-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yitzhak Brzezinski-Sinai ◽

Ester Zwang ◽

Elena Plotnikova ◽

Ester Halizov ◽

Itzhak Shapira ◽

...

Keyword(s):

Vascular Surgery ◽

General Anesthesia ◽

Vascular Disease ◽

Cholinesterase Activity ◽

Serum Cholinesterase ◽

Hemodynamic Support ◽

System A ◽

Lower Baseline ◽

Increased Risk ◽

A Prospective Study

AbstractMaintaining hemodynamic stability during the induction and maintenance of anesthesia is one of the challenges of the anesthesiologist. Patients with vascular disease are at increased risk of instability due to imbalance between the sympathetic and parasympathetic parts of the autonomic nervous system, a balance accessible by serum cholinesterase activity. We aim to characterize the dynamics of cholinesterase activity in patients undergoing general anesthesia (GA) and surgery. This was a prospective study of 57 patients undergoing ambulatory or vascular surgery under GA. Cholinesterase activity was measured before the induction of anesthesia, after 15 min and at the end of surgery by calculating the capacity of serum acetylcholinesterase (AChE) and butyrylcholinesterase to hydrolyze AcetylThioCholine. Data on atherosclerotic disease, anesthesia management were analyzed. Both AChE and total cholinergic status (CS) decreased significantly after GA induction at 15 min and even more so by the end of surgery. Vascular surgery patients had lower baseline cholinesterase activity compared to ambulatory surgery patients. Patients requiring intraoperative administration of phenylephrine for hemodynamic support (21.1%) had a significantly lower level of AChE and CS compared to untreated patients. Our findings serve as a mirror to the sympathetic/parasympathetic imbalance during GA, with a marked decrease in the parasympathetic tone. The data of a subgroup analysis show a correlation between low cholinesterase activity and an increase in the need for hemodynamic support.

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Vascular surgery

Oxford Assess and Progress: Clinical Surgery ◽

10.1093/oso/9780199696420.003.0025 ◽

2014 ◽

Author(s):

Oliver Old

Keyword(s):

Vascular Surgery ◽

Vascular Disease ◽

Systemic Disease ◽

Antiplatelet Agents ◽

Sudden Onset ◽

Venous Hypertension ◽

Limb Ischaemia ◽

Diagnostic Features ◽

Vascular Emergencies ◽

Careful Distinction

As the patient in clinic describes the cramp-like pain that he gets in his calf when he walks, a pain that disappears on resting but which is exacerbated by walking up hills and necessitates him stopping to look in shop windows when out and about, you will be thinking about questioning him for risk factors for vascular disease. Atherosclerosis is a systemic disease. Identification and early treatment of diabetes, hypercholesterolaemia, hypertension, and provision of antiplatelet agents and smoking cessation therapy will confer important cardio- and cerebroprotective benefits. Acute vascular emergencies requiring an urgent response include the patient with sudden onset, limb-threatening ischaemia; the collapsed patient with a ruptured aortic aneurysm; and the patient in whom haemorrhage or ischaemia comprises part of the picture of complex trauma. Rapid, but thorough examination, appropriate resuscitation, and judicious use of diagnostic imaging will help to underpin urgent management and interventions necessary to obtain the best outcomes for these patients. Despite increasing reliance on minimally invasive diagnostic modalities including duplex Doppler ultrasound, magnetic resonance angiography, and computed tomography angiography, principles of history taking and good clinical examination remain of paramount importance. Observation to detect nuances of ischaemic trophic changes and skin colour, as well as more overt signs of necrosis, gangrene, and ulceration, complements palpation of pulses, detection of subtle changes in skin temperature, delayed capillary refill, and presence of sensory neuropathy. A positive Buerger’s test, with pallor of the foot and venous guttering on leg elevation, and rubor (redness), due to reactive hyperaemia on dependency, may help clinch the diagnosis of critical limb ischaemia when other diagnostic features are equivocal. Careful distinction between features of arterial insufficiency, venous hypertension, and diabetic neuropathy may help to determine aetiology of a recalcitrant lower limb ulcer and the consequent course of management. In the UK, vascular surgery has recently become an independent surgical specialty. This chapter will test your understanding of signs and symptoms of vascular disease and will hopefully stimulate your understanding of priorities for investigation and management of the range of conditions comprising this exciting sphere of surgery.

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Peroneal artery entrapment syndrome (PRAES): a rare cause of ischaemic toes

BMJ Case Reports ◽

10.1136/bcr-2018-227353 ◽

2019 ◽

Vol 12 (1) ◽

pp. bcr-2018-227353

Author(s):

Alfred Bingchao Tan ◽

Wesley Stuart ◽

Giles Roditi

Keyword(s):

Vascular Surgery ◽

Vascular Disease ◽

Interosseous Membrane ◽

Peroneal Artery ◽

Entrapment Syndrome ◽

Atherosclerotic Stenosis ◽

Contrast Enhanced ◽

Mr Angiogram

A 75-year-old man presenting with intermittent discolouration of his left toes was referred to vascular surgery with suspicion of embolic vascular disease. A contrast-enhanced MR angiogram was performed which revealed bilateral dominant peroneal arteries (PRAs). There was evidence of short atherosclerotic stenosis directly at the point where the left PRA passes through the tibiofibular interosseous membrane which we postulate to be the source of the emboli. We present what is believed to be the first reported case of PRA entrapment complicated by distal toe emboli.

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Modification of the Carbon Disulfide Evolution Method for Dithiocarbamate Residues

Journal of AOAC INTERNATIONAL ◽

10.1093/jaoac/52.1.162 ◽

1969 ◽

Vol 52 (1) ◽

pp. 162-167 ◽

Cited By ~ 3

Author(s):

George E Keppel

Keyword(s):

Hydrogen Sulfide ◽

Hydrochloric Acid ◽

Carbon Disulfide ◽

Lead Acetate ◽

Stannous Chloride ◽

Acetate Solution ◽

Colorimetric Measurement ◽

Fungicide Residues ◽

Mineral Acids ◽

Lead Acetate Solution

Abstract A study was made of the analytical method for dithiocarbamate fungicide residues based on decomposition by hot mineral acids to the amine and carbon disulfide and colorimetric measurement of the carbon disulfide. Increased recoveries are obtained by the following modifications: adding a reducing agent (stannous chloride) to the sample before treatment with hot acid; svibstituting diluted sodium hydroxide for lead acetate solution to remove hydrogen sulfide and other interferences; and using boiling diluted hydrochloric acid. With these modifications, recoveries of N,N-dimethyldithiocarbamates from crops ranged from 85.3 to 103.8% (average 94.7%). Ethylenebisdithiocarbamates, with the exception of zineb (range 89.1–96.8%, average 92.0%), gave appreciably lower recoveries, indicating further study is necessary.

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Test Method for Analysis of Hydrogen Sulfide in Gaseous Fuels (Lead Acetate Reaction Rate Method)

10.1520/d4084-06 ◽

2006 ◽

Author(s):

Keyword(s):

Hydrogen Sulfide ◽

Lead Acetate ◽

Reaction Rate ◽

Test Method ◽

Gaseous Fuels ◽

Rate Method

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Spot Test Reaction for the Detection of Elemental Sulfur

Rubber Chemistry and Technology ◽

10.5254/1.3542581 ◽

1956 ◽

Vol 29 (3) ◽

pp. 1117-1118 ◽

Cited By ~ 1

Author(s):

Fritz Feigl ◽

Cecile Stark

Keyword(s):

Hydrogen Sulfide ◽

Lead Acetate ◽

Elemental Sulfur ◽

Test Tube ◽

Spot Test ◽

Sensitive Test ◽

Test Reaction ◽

Commercial Products ◽

Inorganic Substances ◽

Free Sulfur

Abstract Hydrogen sulfide is formed when free sulfur is heated with fused benzoin. This is the basis of a new and sensitive test for free sulfur in mixtures with organic or inorganic substances. The heating is done in a test-tube, whose mouth carries lead acetate paper. The limit of identification is 0.5µ. Selenium does not interfere. Tests of a wide variety of commercial products gave satisfactory results.

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Transient Duodenal Erosions in Association with Superior Mesenteric Ischemia

Canadian Journal of Gastroenterology ◽

10.1155/1989/104013 ◽

1989 ◽

Vol 3 (1) ◽

pp. 29-33

Author(s):

D.G. MacIntosh ◽

D.J. Leddin

Keyword(s):

Mesenteric Artery ◽

Inferior Mesenteric Artery ◽

Mesenteric Ischemia ◽

Upper Endoscopy ◽

Revascularization Procedure ◽

Surgical Revascularization ◽

Right Hepatic Artery ◽

Post Surgery ◽

Repeat Endoscopy ◽

Aphthous Ulcers

A 41 -year-old male was seen with complaints of periumbilical pain and weight loss Physical examination, radiological and colonoscopic examinations were unremarkable upper endoscopy revealed aphthous ulcers of the antrum and duodenum at repeat endoscopy two weeks later the erosions had spontaneously healed. Mesenteric angiography revealed occlusion of the superior mesenteric artery and an aberrant right hepatic artery arising distal to the superior mesenteric stenosis A surgical revascularization procedure was performed at which time occlusion of the inferior mesenteric artery was documented. The patient is now 18 months post surgery and entirely asymptomatic.

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