Proprotein convertase subtilisin/kexin type 9 levels and aortic valve calcification: A prospective, cross sectional study

♦ Objective To analyze the late cardiovascular outcome of end-stage renal disease (ESRD) in children. ♦ Design A nation-wide long-term follow-up study. Determinants of outcomes and causes of death were retrospectively assessed. Patients underwent assessment of overall health state, B- and M-mode ultrasound of the carotid arteries, and echocardiography for cross-sectional analysis. ♦ Results We analyzed the medical course of all 249 adult Dutch patients with ESRD onset between 1972 and 1992 at age 0 – 14 years, and who were born before 1979. Of the 187 living patients, 140 participated in the cross-sectional part of the study. The standardized mortality rate was 31.0. Overall 5-, 10-, and 20-year survival after ESRD onset was 87%, 82%, and 78%, respectively. Cardiovascular disease accounted for most deaths (41%). In the whole group, left ventricular hypertrophy (LVH), aortic valve calcification, and arterial wall stiffening were highly prevalent. LVH was associated with hypertension at time of assessment. Aortic valve calcification was strongly associated with a long total duration of peritoneal dialysis (β = 0.33, p < 0.001). Arterial wall pathology was not associated with current treatment modality. ♦ Conclusions As in adults, cardiovascular disease is the most important cause of death in children with ESRD. Stricter reduction of volume overload, prevention of high serum calcium–phosphate product, and more vigorous treatment of hypertension are important targets to improve cardiovascular survival in children with ESRD.

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Malnutrition as a risk factor for cardiac valve calcification in patients under maintenance dialysis: a cross-sectional study

International Urology and Nephrology ◽

10.1007/s11255-020-02590-z ◽

2020 ◽

Vol 52 (11) ◽

pp. 2205-2212

Author(s):

Petrini Plytzanopoulou ◽

Marios Papasotiriou ◽

Panayiotis Politis ◽

Christophoros Parissis ◽

Pinelopi Paraskevopoulou ◽

...

Keyword(s):

Risk Factor ◽

Cross Sectional Study ◽

Cardiac Valve ◽

Sectional Study ◽

Cross Sectional ◽

Valve Calcification ◽

Cardiac Valve Calcification ◽

Maintenance Dialysis

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Epicardial pacing wires after cardiac surgery: an Irish cross-sectional study

British Journal of Nursing ◽

10.12968/bjon.2020.29.8.476 ◽

2020 ◽

Vol 29 (8) ◽

pp. 476-480

Author(s):

Niamh Kiely ◽

Frances O'Brien ◽

Mary Mooney

Keyword(s):

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Aortic Valve ◽

Best Practice ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Delayed Discharge ◽

Epicardial Pacing ◽

Delayed Removal

Background: Temporary epicardial pacing wires are inserted after cardiac surgery. However, there are no international guidelines on which to base best practice regarding wire insertion or removal. Methods: Data were collected on patients following cardiopulmonary bypass and analysed in terms of use, duration of use and complications of pacing wires after surgery. Results: Wires were inserted in 164 of the 167 patients. Most (74%) did not require pacing. Patients were categorised into those who had aortic valve replacement (AVR) (n=42) and those who did not (n=122). Of the AVR group, 26% (n=11) were pacemaker dependent after surgery and 10% (n=4) required permanent pacemakers. Most pacing wires were removed by day 4. The only noted complication was delayed discharge. Conclusion: Unused pacing wires are normally removed on day 4, but for 77 (47%) of patients they remained in place longer. Forty patients (24%) had delayed wire removal because of a policy of wire removal during business hours only. Of these 40 patients, 27 (17% of the 77 with delayed removal) had delayed discharge as a result of our wire removal policy.

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Quality of life after aortic valve repair is similar to Ross patients and superior to mechanical valve replacement: a cross-sectional study

BMC Cardiovascular Disorders ◽

10.1186/s12872-016-0236-0 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 16

Author(s):

Pavel Zacek ◽

T. Holubec ◽

M. Vobornik ◽

J. Dominik ◽

J. Takkenberg ◽

...

Keyword(s):

Quality Of Life ◽

Aortic Valve ◽

Valve Replacement ◽

Mechanical Valve ◽

Cross Sectional Study ◽

Aortic Valve Repair ◽

Sectional Study ◽

Valve Repair ◽

Cross Sectional

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Variations in TM6SF2, PCSK9 and PCSK7 genes and risk of hepatic steatosis after liver transplantation: a cross-sectional study

BMC Gastroenterology ◽

10.1186/s12876-021-02041-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ahad Eshraghian ◽

Elham Moasser ◽

Negar Azarpira ◽

Mohammad Reza Fattahi ◽

Saman Nikeghbalian ◽

...

Keyword(s):

Liver Transplantation ◽

Liver Transplant ◽

Hepatic Steatosis ◽

Cross Sectional Study ◽

Genetic Variations ◽

Transplant Recipients ◽

Sectional Study ◽

Proprotein Convertase ◽

Cross Sectional ◽

Liver Transplant Recipients

Abstract Background Genetic abnormalities might have important role in pathogenesis of hepatic steatosis after liver transplantation. We aimed to investigate association between genetic variations in transmembrane 6 superfamily member 2 (TM6SF2) rs58542926, proprotein convertase subtilisin/kexin type 9 (PCSK9) rs505151 and proprotein convertase subtilisin/kexin type 7 (PCSK7) rs2277287 with hepatic steatosis in liver transplant recipients. Methods In a cross-sectional study, adult (> 18 years) liver transplant recipients who were referred for their routine post-transplant follow-up between June 2018 and September 2018 were included in the study. Hepatic steatosis in transplant recipients was assessed by controlled attenuation parameter (CAP). Polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) was used to study TM6SF2 rs58542926, PCSK7 rs2277287 and PCSK9 rs505151 genotypes. Results 107 liver transplant recipients were included. There was no association between different genotypes of PCSK9 rs505151 and PCSK7 rs2277287 with hepatic steatosis in liver transplant recipients (P value > 0.05). The presence of TT genotype of TM6SF2 rs58542926 was higher in patients with hepatic steatosis measured by CAP after liver transplantation. In patients with moderate and severe hepatic steatosis (grade 2 and 3 steatosis), AG + GG genotypes of PCSK9 rs505151 were more prevalent than AA genotype (OR 8.667; 95% CI 1.841–40.879; P value = 0.004) compared to patients with mild steatosis (grade 1). In multivariate regression model, AG + GG genotypes of PCSK9 rs505151 were associated with moderate and severe steatosis in liver transplant recipients (OR 5.747; 95% CI 1.086–30.303; P value = 0.040). Conclusions Genetic variations in TM6SF2 rs58542926 and PCSK9 rs505151 might be associated with hepatic steatosis in liver transplant recipients.

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Institutional infrastructural preconditions and current perioperative anaesthesia practice in patients undergoing transfemoral transcatheter aortic valve implantation: a cross-sectional study in German heart centres

BMJ Open ◽

10.1136/bmjopen-2020-045330 ◽

2021 ◽

Vol 11 (8) ◽

pp. e045330

Author(s):

Benjamin Löser ◽

Annika Haas ◽

Amelie Zitzmann ◽

Andre Dankert ◽

Sascha Treskatsch ◽

...

Keyword(s):

Aortic Valve ◽

Transcatheter Aortic Valve Implantation ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Consensus Recommendations ◽

Transcatheter Aortic Valve ◽

Aortic Valve Implantation ◽

Anaesthesia Care ◽

Valve Implantation

ObjectivesTransfemoral transcatheter aortic valve implantation (TF-TAVI) is an established therapy for patients with symptomatic aortic stenosis, which requires periprocedural anaesthesia care. In 2015, the German Federal Joint Committee released a directive on minimally invasive heart valve interventions which defines institutional infrastructural requirements in German heart centres. But still generally accepted expert consensus recommendations or national or international guidelines regarding periprocedural anaesthesia management for TF-TAVI are lacking. This nationwide cross-sectional study had two major objectives: first to assess the concordance with existing national regulations regarding infrastructural requirements and second to evaluate the status quo of periprocedural anaesthesia management for patients undergoing TF-TAVI in German heart centres.DesignMulticentre cross-sectional online study to evaluate the periprocedural anaesthesia management.SettingIn this nationwide cross-sectional study, electronic questionnaires were sent out to anaesthesia departments at TF-TAVI-performing centres in Germany in March 2019.Participants78 anaesthesia departments of German heart centres.Results54 (69.2%) centres returned the questionnaire of which 94.4% stated to hold regular Heart Team meetings, 75.9% to have ready-to-use heart-lung machines available on-site, 77.8% to have cardiac surgeons and 66.7% to have perfusionists routinely attending throughout TF-TAVI procedures. Regarding periprocedural anaesthesia management, 41 (75.9%) of the participating centres reported to predominantly use ‘monitored anaesthesia care’ and 13 (24.1%) to favour general anaesthesia. 49 (90.7%) centres stated to use institutional standard operating procedures for anaesthesia. Five-lead ECG, central venous lines, capnometry and intraprocedural echocardiography were reported to be routine measures in 85.2%, 83.3%, 77.8% and 51.9% of the surveyed heart centres.ConclusionsThe concordance with national regulations, anaesthesia management and in-house standards for TF-TAVI vary broadly among German heart centres. According to the opinion of the authors, international expert consensus recommendations and/or guidelines would be helpful to standardise peri interventional anaesthesia care.

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Dialysis Amyloid Deposition in the Aortic Valve and Its Association with Aortic Stenosis

Blood Purification ◽

10.1159/000381938 ◽

2015 ◽

Vol 40 (2) ◽

pp. 146-154 ◽

Cited By ~ 2

Author(s):

Noriaki Kurita ◽

Akiko Fujii ◽

Nagaaki Kotera ◽

Mototsugu Tanaka ◽

Shinji Tanaka ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Stenosis ◽

Congo Red ◽

Polarized Light ◽

Cross Sectional Study ◽

Sectional Study ◽

Dialysis Patients ◽

Cross Sectional ◽

The Relationship ◽

Large Deposits

Background: The relationship between dialysis amyloid (DA) deposition in the aortic valve (AV) and aortic stenosis (AS) is unknown. Methods: This was a cross-sectional study. AV specimens of dialysis patients (median vintage: 8.8 years) consecutively collected from cardiac surgeries (n = 56) or autopsies (n = 13) were examined by a board-certified pathologist blinded to clinical data. DAs were considered to be present if deposits were stained both by Congo red with apple-green birefringence under polarized light and by anti-β2-microblobulin antibody. Degree of deposition was graded as follows: Amyloid (-), no deposit; Amyloid (1+), occasional small deposits; Amyloid (2+), multiple small to large deposits or a single large deposit. Calcification was defined as a calcified deposit with a diameter >1 mm in the specimen. Severe AS (sAS) was defined as a mean gradient >50 mm Hg by echocardiogram. We examined the proportion of DAs and the association between DAs and the sAS. Results: DAs were present in 71% (n = 49) of specimens and primarily co-localized with calcification. Non-dialysis related amyloid was found in one specimen. After excluding this specimen, sAS was associated with ‘Amyloid (1+) and Calcification >1 mm' and ‘Amyloid (2+) and Calcification >1 mm' (vs. ‘Amyloid (-) and Calcification ≤1 mm', odds ratios (ORs): 13.5 and 34.2, respectively). Furthermore, after adjustment for covariates, sAS was found to be associated with ‘Amyloid (2+) and Calcification >1 mm' (OR: 24.3). Conclusions: DA deposition in the AV was prevalent among dialysis patients. DA deposition with accompanying calcification might contribute to the severity of AS.

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Cross-sectional study of aortic valve calcification and cardiovascular risk factors in older Danish men

Heart ◽

10.1136/heartjnl-2021-319023 ◽

2021 ◽

pp. heartjnl-2021-319023

Author(s):

Lida Khurrami ◽

Jacob Eifer Møller ◽

Jes Sanddal Lindholt ◽

Grazina Urbonaviciene ◽

Flemming Hald Steffensen ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Cardiovascular Risk ◽

Aortic Valve ◽

Cardiovascular Risk Factors ◽

Large Population ◽

Aortic Valve Calcification ◽

Cross Sectional ◽

Valve Calcification ◽

Link Type

ObjectiveAortic valve calcification (AVC) and coronary artery calcification (CAC) are predictors of cardiovascular disease (CVD), presumably sharing risk factors. Our objectives were to determine the prevalence and extent of AVC in a large population of men aged 60–74 years and to assess the association between AVC and cardiovascular risk factors including CAC and biomarkers.MethodsParticipants from the DANish CArdioVAscular Screening and intervention trial (DANCAVAS) with AVC and CAC scores and without previous valve replacement were included in the study. Calcification scores were calculated on non-contrast CT scans. Cardiovascular risk factors were self-reported, measured or both, and further explored using descriptive and regression analysis for AVC association.Results14 073 men aged 60–74 years were included. The AVC scores ranged from 0 to 9067 AU, with a median AVC of 6 AU (IQR 0–82). In 8156 individuals (58.0%), the AVC score was >0 and 215 (1.5%) had an AVC score ≥1200. In the regression analysis, all cardiovascular risk factors were associated with AVC; however, after inclusion of CAC ≥400, only age (ratio of expected counts (REC) 1.07 (95% CI 1.06 to 1.09)), hypertension (REC 1.24 (95% CI 1.09 to 1.41)), obesity (REC 1.34 (95% CI 1.20 to 1.50)), known CVD (REC 1.16 (95% CI 1.03 to 1.31)) and serum phosphate (REC 2.25 (95% CI 1.66 to 3.10) remained significantly associated, while smoking, diabetes, hyperlipidaemia, estimated glomerular filtration rate and serum calcium were not.ConclusionsAVC was prevalent in the general population of men aged 60–74 years and was significantly associated with all modifiable cardiovascular risk factors, but only selectively after adjustment for CAC ≥400 AU.Trial registration numberNCT03946410 and ISRCTN12157806.

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