Nanomedicine in diagnostics and therapy of cardiovascular diseases: beyond atherosclerotic plaque imaging

2013 ◽  
Vol 2 (4) ◽  
pp. 449-472 ◽  
Author(s):  
Iwona Cicha ◽  
Stefan Lyer ◽  
Christoph Alexiou ◽  
Christoph D. Garlichs
Keyword(s):  
Cardiovascular Diseases ◽  
Heart Surgery ◽  
Vascular Tissue ◽  
Open Heart Surgery ◽  
Clinical Manifestations ◽  
Current Therapy ◽  
Systemic Delivery ◽  
Stent Restenosis ◽  
Modified Lipoproteins ◽  
Inflammatory Processes

AbstractAtherosclerosis results from the accumulation of the modified lipoproteins within the artery walls, which triggers complex vascular inflammatory processes. Although the pharmacologic agents for the treatment of clinical manifestations of atherosclerosis are available, their systemic delivery has serious disadvantages, such as considerable side effects or low efficacy at tolerated doses. Moreover, the treatment of atherosclerosis using the interventional techniques bears further shortcomings: the implanted stents require a lengthy antiplatelet therapy and carry the risk of in-stent restenosis. In the surgical approach to atherosclerosis, apart from the overall risk of open heart surgery, the lack of adequate venous material for bypasses constitutes a common problem. The nanotechnology has the potential to overcome the disadvantages of the current therapy of atherosclerosis, e.g., by the formation of nanosized assemblies for the earlier detection of atherosclerotic lesions and for cell-specific delivery of therapeutics. Replacing the current systemic pharmacological approach by a locally targeted treatment of plaques can substantially minimize the adverse effects, by lowering the drug cytotoxicity and reducing the required dosage. Moreover, a new generation of nanotechnological approaches to the revascularization procedures is now emerging, e.g., vascular tissue engineering utilizing the magnetic nanoparticles or the design of stents with the reduced risk of thrombosis and restenosis. This review discusses the possible applications of the nanomedical approaches in the treatment of cardiovascular diseases.

Association between Proliferative Scars and In-Stent Restenosis

2007 ◽  
Vol 11 (6) ◽  
pp. 206-210 ◽  
Author(s):  
Cagdas Ozdol ◽  
Sibel Turhan ◽  
Cansin Tulunay ◽  
A. Timucin Altin ◽  
Yusuf Atmaca ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Healing Process ◽  
Open Heart Surgery ◽  
Median Sternotomy ◽  
Multivariate Logistic Regression Analysis ◽  
Coronary Stenting ◽  
Wound Healing Process ◽  
Angiographic Restenosis ◽  
Stent Restenosis ◽  
In Stent Restenosis

Background: Keloid and hypertrophic scars are two types of proliferative scars at sites of cutaneous injury that form as a result of an abnormal wound-healing process. Proliferative scar formation after skin injury and restenosis after coronary stenting have common features. The aim of this study was to investigate the association of proliferative scars with coronary stent restenosis. Methods: Patients with previous open heart surgery with median sternotomy who had coronary stenting after the surgery and were admitted for control angiography were included in the study. The patients were divided into two groups according to the presence or absence of proliferative scars. The primary end point was the incidence of angiographic restenosis in patient groups. Results: The study group consisted of 80 patients (64 men; mean age 64 ± 9 years). Twenty-three patients (29%) have a proliferative scar. In general, two groups were comparable with regard to baseline lipid profiles, demographics, and cardiovascular risk factors. Restenosis was significantly more prevalent in patients with proliferative scars than with controls ( p = .04). By multivariate logistic regression analysis, stent length (odds ratio [OR] 1.12, p = .005), diabetes (OR 3.3, p = .03), and proliferative scar (OR 4.2, p = .02) independently predicted in-stent restenosis. Conclusion: The findings of this study suggest that patients with proliferative scars may have a higher risk of in-stent restenosis.

scholarly journals The Anesthesia & Anesthetists of the First Open Heart Surgery of Bangladesh

2021 ◽  
Vol 36 (1) ◽  
pp. 55-60
Author(s):  
Suman Nazmul Hosain ◽  
Farzana Amin ◽  
Shahnaz Ferdous
Keyword(s):  
College Student ◽  
Cardiovascular Diseases ◽  
Human Resources ◽  
Heart Surgery ◽  
Septal Defect ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Success Story ◽  
Direct Closure ◽  
Over Time

Although a few closed heart operations were performed in the late 1960s, well organized approach to open heart surgery began in Bangladesh only after establishment of Institute of Cardiovascular Diseases (ICVD) in 1978. A Japanese team of surgeons, anesthetists, nurses and technicians provided extensive support in capacity building of the local human resources. Ultimately the first open heart surgery of Bangladesh, the direct closure of Atrial Septal Defect of an 18 year old college student, was performed on 18th September 1981. It was great news of that time. People came to know about the success story of the ICVD director then Colonel M Abdul Malik, a renowned cardiologist cum team leader and the Bangladeshi surgeon duo Dr M Nabi Alam Khan and Dr S R Khan. But somehow the anesthetists, an important part of the team were out of focus and have been forgotten over time. Led by Prof Khalilur Rahman, the anesthetist team of the day included Dr Nurul Islam, Dr Abdul Hadi, Dr Delowar Hossain, Dr A Y F Ellahi Chowdhury and Dr Monir Hossain. This article is an attempt to remind their contribution and expressing respect and gratitude to the anesthetists of that pioneering team. Bangladesh Heart Journal 2021; 36(1) : 55-60

scholarly journals Clinical Manifestations in Atrial Myxoma

2004 ◽  
Vol 43 (152) ◽  
pp. 88-90
Author(s):  
U K Shrestha ◽  
B Koirala ◽  
BMS Shrestha ◽  
R Shrestha ◽  
P R Joshi ◽  
...  
Keyword(s):  
Left Atrial ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Clinical Manifestations ◽  
Venous Hypertension ◽  
Atrial Myxoma ◽  
Open Heart ◽  
Primary Tumors ◽  
Successful Removal ◽  
Regular Open

In Nepal, we started regular open-heart surgery since February 1997. Primary tumors of the heart are rareand the commonest is myxoma. Left atrium is the commonest site of occurrence. There is diagnostic difficultyin this most frequent benign tumor of the heart.We present 5 cases of left atrial myxomas who presented with different clinical features. Among them 4cases were diagnosed preoperatively by transthoracic echocardiography.The youngest was 32 years whereas the oldest was 58 years (mean 49.8 years) and 4 of them were female.Among them, one presented with right unilobar pulmonary venous hypertension; another mimicking mitralstenosis with large left atrial clot; with embolization to brain with motor the third aphasia and the remainingtwo had only constitutional symptoms. All of them were discharged with successful removal of tumor andare surviving at present with no features of recurrence.There are no pathognomic features of atrial myxoma. All suspected cases must be subjected forechocardiography. With the advent of open-heart surgery, extirpation of tumors with good outcome hasbeen a regular service in our hospital.Key Words: Atrial myxoma, Transthoracic Echocardiography, Embolization, Recurrence.

scholarly journals COVID-19 in Neonates, A Case Series Study From Tertiary Neonatal Centers in Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sedigheh Rafiei Tabatabaei ◽  
Minoo Fallahi ◽  
Abbas Boskabadi ◽  
Naeeme Taslimi Taleghani ◽  
Fatemeh Pajouhandeh ◽  
...  
Keyword(s):  
Respiratory Symptoms ◽  
Neonatal Intensive Care ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Clinical Manifestations ◽  
Case Series ◽  
Reactive Protein ◽  
Radiologic Findings ◽  
Case Series Study ◽  
Novel Coronavirus

Introduction: The Novel coronavirus, sars-cov-2, is responsible for the recent pandemic. Although it mostly affects adults, children of all ages, including neonates, can become ill with Covid-19, as well. The real prevalence rate of coronavirus disease 2019 (COVID-19) in children is unknown. However, the severity of symptoms in children and neonates is less than in adults. Regarding the new presentation of this disease, the current study has reported a case series of COVID-19 in neonates. Case Presentation: In this article, 10 neonates with COVID- 19 admitted to our neonatal intensive care units are reported. All reported neonates had general suspicious symptoms of COVID- 19 with positive results for SARS-CoV-2 assessed by polymerase chain reaction (PCR) from the nasopharynx area or nose of the patients. All neonates, except for two of them, were term neonates. One case had open-heart surgery for congenital heart disease (transposition of the great arteries (TGA)). The patients aged 22 days on admission. The most frequent symptom was fever. Severe respiratory symptoms were reported in two cases. Also, abnormal radiologic findings in the chest x-ray were detected in two cases. Regarding the lack of significant respiratory symptoms in most of the patients, the lung computed tomography (CT) scan was taken just from one neonate. Leukopenia (WBC < 5000/mm3) was detected in one case, with no lymphopenia in all neonates. The positive C-reactive protein test was not found in all cases. No patient was treated by special anti-viral agents for COVID-19, and usual antibiotic treatment for neonatal sepsis was administered for all cases. All patients, except for one, survived with no significant sequela of the disease. Conclusions: This study demonstrated that clinical manifestations, as well as laboratory and radiologic findings of COVID-19, are milder in neonates than in the older ages. Hence, it can be argued that the prognosis of COVID-19 in the neonatal period is generally good.

Investigation of anxiety, depression and perceived caregiving burden in parents of pediatric patients undergoing open heart surgery and being followed up in intensive care

2021 ◽  
Author(s):  
Abdullah Arif Yılmaz ◽  
Mehmet Fatih Üstündağ ◽  
Yasemin Yavuz ◽  
Fatma Ukil Işıldak ◽  
Ömer Faruk Şavluk ◽  
...  
Keyword(s):  
Intensive Care ◽  
Trait Anxiety ◽  
Congenital Heart ◽  
Maternal Education ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Open Heart Surgery ◽  
Clinical Manifestations ◽  
Pediatric Cardiovascular Surgery ◽  
The Mean

Objectives: This study aims to investigate the relationship between anxiety levels and perceived caregiver burden in mothers of children who had undergone Congenital Heart Disease Surgery (CHDS) and who were followed up in the intensive care unit with the surgical type and clinical variables applied. Patients and Methods: The study was conducted with the mothers of both patient groups who underwent Palliative Surgery (PS) (n:32) or Corrective (Biventricular) Repair (CR) (n:35) in the Pediatric Cardiovascular Surgery clinic of Istanbul Koşuyolu High Specialty Educational and Research Hospital. Sociodemographic-Clinical Data Form, Beck Depression Inventory (BDI), Standardized Mini-Mental Test, State-Trait Anxiety Inventory (STAI TX I-II), and Zarit Burden Interview (ZBI) were applied to the parents. Results: The rate of interventional birth was higher in the PS group whereas there was no difference between the PS and CR groups in terms of age, gender, birth weights, and presence of additional diseases (p: 0.001). There was no difference between maternal education levels and pregnancy duration. This difference was not significant even though the mean age of the mothers in the CR group was higher compared to the PS group. The mean STAI-S scores of the PS group (State Anxiety) were lower than the CR group, and the STAI-T scores of the PS group (Trait Anxiety) were higher. The ZBI scores were significantly higher in the PS group (p: 0.03) Conclusion: Congenital heart diseases and surgical interventions, as a result, are a major source of distress for affected families. Mothers are mainly affected by this situation. Changes in the mental status of the caregiver may have serious adverse effects on the operated child at every stage of the disease. Caregiving in parents is perceived as a burden and increased anxiety leads to different psychiatric clinical manifestations. Therefore, it is recommended that parents of children who have undergone congenital cardiac surgery receive routine psychiatric support from the early stages of the disease.

Use of thyroid hormones in the treatment of cardiovascular diseases: literature review

2020 ◽  
Vol 66 (3) ◽  
pp. 6-14
Author(s):  
Daniil V. Borisov ◽  
Diliara N. Gubaeva ◽  
Evgeniy A. Praskurnichiy
Keyword(s):  
Cardiovascular Diseases ◽  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Hormone Therapy ◽  
Large Scale ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Physiological Mechanism ◽  
Treatment Method ◽  
Research Field

Cardiovascular diseases remain the leading cause of death all over the world. Thyroid hormones play a significant role in the regulation of cardiac function. According to a number of researches, patients with cardiovascular diseases usually have a decrease in the concentration of thyroid hormones in the blood serum, which may be associated with a poor prognosis. Today it still remains unclear whether the change in the bioavailability of thyroid hormones in the myocardium is a favorable physiological mechanism or a replication of an adaptation disorder. Experimental researches suggest that thyroid hormone therapy may be applied in clinical cardiology. This review describes the results of researches examining the use of thyroid hormones in patients with cardiovascular diseases, as well as experiment data on animal models. The available data on the use of thyroid hormones in patients with acute myocardial infarction and heart failure allow us to suggest that normalization of thyroid hormone levels is a safe and potentially effective treatment method in the group of patients with cardiovascular disease. At the same time, the data on the use of thyroid hormones in patients who have undergone an open-heart surgery or heart transplantation are limited. However, at present, it is difficult to draw unambiguous conclusions about the benefits, as well as about the possible risk of using thyroid hormones in the described conditions. Large-scale clinical researches are required to confirm the safety and evaluate the effectiveness of such therapy. Moreover, it is necessary to set parameters for evaluating the safety and effectiveness and understand which hormone (thyroxine or triiodothyronine), what dosage and at what stage of the disease should be applied. Until we do not have answers for these questions, thyroid hormone therapy in patients with cardiovascular diseases should remain within the research field.

scholarly journals Successful treatment of infective endocarditis caused by Listeria monocytogenes in a patient after previous open-heart surgery (clinical case)

2019 ◽  
Vol 21 (4) ◽  
pp. 366-368
Author(s):  
Gufron A. Shamsiev ◽  
F.A. Khammud ◽  
F.I. Zakirov ◽  
Dmitriy A. Popov ◽  
R.A. Lazarev ◽  
...  
Keyword(s):  
Heart Disease ◽  
Listeria Monocytogenes ◽  
Infective Endocarditis ◽  
Successful Treatment ◽  
Rare Case ◽  
Clinical Case ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Clinical Manifestations ◽  
Open Heart

Listeriosis has a variety of clinical manifestations from febrile gastroenteritis to bacteremia, sepsis, meningoencephalitis and infective endocarditis with valvular heart disease. In this report, we present a rare case of successful treatment of infective endocarditis of the mitral valve due to Listeria monocytogenes after previous open-heart surgery.

scholarly journals Ventricular tachycardia: beginning and ending fate of a benign invasive cardiac lipoma

2020 ◽  
Vol 90 (3) ◽  
Author(s):  
Olga Vriz ◽  
Mawada M. Ahmed ◽  
Suleiman Kharabsheha ◽  
Mohammed Aladmawi ◽  
Bandar Alamro ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Clinical Manifestations ◽  
Distal Segment ◽  
Electrical Storm ◽  
Appropriate Shocks ◽  
Anatomical Relationship ◽  
Cardiac Lipoma ◽  
Heart Tumors

Cardiac lipomas are rare benign heart tumors. Their clinical manifestations primarily depend on their dimension and location. We describe a case of a 14-year-old boy complaining of palpitations. ECG showed non-sustained ventricular tachycardia (NSVT). Echocardiography and cardiac MRI showed a large apical mass suggestive of a cardiac lipoma. The patient underwent open-heart surgery which detected a pericardial mass, partially attached to the myocardium, and crossed by the distal segment of LAD. This critical anatomical relationship prevents its complete resection. The biopsy confirmed mature fat tissue. Postoperatively, Propranolol was started for NSVT episodes. After 8 months, he presented with VT recurrence. A subcutaneous ICD (S-ICD) was implanted. Two months later, he was admitted for an electrical storm with six appropriate shocks. Since then, amiodarone was added. Lipomas are not always benign and their surgery might be very difficult and unhelpful. A multidisciplinary team is crucial for their diagnosis and management.

scholarly journals Transcriptome and Molecular Endocrinology Aspects of Epicardial Adipose Tissue in Cardiovascular Diseases: A Systematic Review and Meta-Analysis of Observational Studies

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Zhila Maghbooli ◽  
Arash Hossein-nezhad
Keyword(s):  
Systematic Review ◽  
Adipose Tissue ◽  
Cardiovascular Diseases ◽  
Heart Surgery ◽  
Assessment Tool ◽  
Epicardial Adipose Tissue ◽  
Open Heart Surgery ◽  
Specific Gene ◽  
Science Literature ◽  
Hub Genes

The objective of this study was to perform a systematic review of published literature on differentially expressed genes (DEGs) in human epicardial adipose tissue (EAT) to identify molecules associated with CVDs. A systematic literature search was conducted in PubMed, SCOPUS, and ISI Web of Science literature databases for papers published before October 2014 that addressed EAT genes and cardiovascular diseases (CVDs). We included original papers that had performed gene expressions in EAT of patients undergoing open-heart surgery. The Reporting Recommendations for Tumor Marker Prognostic Studies (PRIMARK) assessment tool was also used for methodological quality assessment. From the 180 papers identified by our initial search strategy, 40 studies met the inclusion criteria and presented DEGs in EAT samples from patients with and without CVDs. The included studies reported 42 DEGs identified through comparison of EAT-specific gene expression in patients with and without CVDs. Among the 42 DEGs, genes involved in regulating apoptosis had higher enrichment scores. Notably, interleukin-6 (IL-6) and tumor protein p53 (TP53) were the main hub genes in the network. The results suggest that regulation of apoptosis in EAT is critical for CVD development. Moreover, IL-6 and TP53 as hub genes could serve as biomarkers and therapeutic targets for CVDs.

Inflammageing in the cardiovascular system: mechanisms, emerging targets, and novel therapeutic strategies

2020 ◽  
Vol 134 (17) ◽  
pp. 2243-2262
Author(s):  
Danlin Liu ◽  
Gavin Richardson ◽  
Fehmi M. Benli ◽  
Catherine Park ◽  
João V. de Souza ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Cardiovascular System ◽  
Nlrp3 Inflammasome ◽  
Molecular Mechanisms ◽  
Molecular Targets ◽  
Therapeutic Interventions ◽  
Low Grade ◽  
Cardiovascular Research ◽  
Inflammatory Processes ◽  
Ach Receptors

Abstract In the elderly population, pathological inflammation has been associated with ageing-associated diseases. The term ‘inflammageing’, which was used for the first time by Franceschi and co-workers in 2000, is associated with the chronic, low-grade, subclinical inflammatory processes coupled to biological ageing. The source of these inflammatory processes is debated. The senescence-associated secretory phenotype (SASP) has been proposed as the main origin of inflammageing. The SASP is characterised by the release of inflammatory cytokines, elevated activation of the NLRP3 inflammasome, altered regulation of acetylcholine (ACh) nicotinic receptors, and abnormal NAD+ metabolism. Therefore, SASP may be ‘druggable’ by small molecule therapeutics targeting those emerging molecular targets. It has been shown that inflammageing is a hallmark of various cardiovascular diseases, including atherosclerosis, hypertension, and adverse cardiac remodelling. Therefore, the pathomechanism involving SASP activation via the NLRP3 inflammasome; modulation of NLRP3 via α7 nicotinic ACh receptors; and modulation by senolytics targeting other proteins have gained a lot of interest within cardiovascular research and drug development communities. In this review, which offers a unique view from both clinical and preclinical target-based drug discovery perspectives, we have focused on cardiovascular inflammageing and its molecular mechanisms. We have outlined the mechanistic links between inflammageing, SASP, interleukin (IL)-1β, NLRP3 inflammasome, nicotinic ACh receptors, and molecular targets of senolytic drugs in the context of cardiovascular diseases. We have addressed the ‘druggability’ of NLRP3 and nicotinic α7 receptors by small molecules, as these proteins represent novel and exciting targets for therapeutic interventions targeting inflammageing in the cardiovascular system and beyond.

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