scholarly journals "Bonded by one chain, related to one purpose": what is primary in the development of thrombotic complications in COVID-19 — mechanisms of inflammation or endothelium damage?

2021 ◽  
Vol 40 (3) ◽  
pp. 45-49
Author(s):  
Dmitriy V. Cherkashin
Keyword(s):  
Heart Failure ◽  
Structural Changes ◽  
Clinical Importance ◽  
Endothelial Damage ◽  
Spike Protein ◽  
Significant Morbidity ◽  
Profound Impact ◽  
Thrombotic Complications ◽  
Coronavirus Infection ◽  
Endothelium Damage

The ongoing COVID-19 pandemic has caused significant morbidity and mortality worldwide, as well as a profound impact on society. Among the nosologies that increase the risk of a severe course of COVID-19, coronary heart disease, chronic heart failure, cardiomyopathy. The main complications caused by coronavirus infection include thrombotic ones. Spike protein SARS-CoV-2 can interact directly with platelets and fibrin, causing blood hypercoagulation and obstructing blood flow. The presence of the spike protein in circulation leads to structural changes in fibrin, complement 3 and prothrombin, which can contribute to hypercoagulability in COVID-19 positive patients and cause a significant violation of fibrinolysis. Endothelial damage and systemic inflammation, being interrelated triggers of coagulopathy characteristic of COVID-19, trigger a cascade of reactions resulting in thrombotic complications against the background of endothelial dysfunction and hyperinflammation, which may be of clinical importance in the treatment of hypercoagulability in patients with COVID-19 (bibliography: 14 refs).

Histopathological analysis of incompetent great saphenous veins after mechanochemical ablation treatment – An ex-vivo experiment

Vascular ◽  
2021 ◽  
pp. 170853812110076
Author(s):  
Bo Yang ◽  
Qiang-Qiang Nie ◽  
Xue-Qiang Fan ◽  
Jian-Bin Zhang ◽  
Peng Liu
Keyword(s):  
Ex Vivo ◽  
Endothelial Damage ◽  
Statistical Result ◽  
Histopathological Analysis ◽  
Saphenous Veins ◽  
Mechanochemical Ablation ◽  
Group A ◽  
Endothelium Damage ◽  
Group B ◽  
Group D

Background The endovascular technique of mechanochemical ablation (MOCA) has become popular in treating patients with saphenous reflux. We reported the histopathological findings in human ex-vivo incompetent great saphenous veins following treatment with saline, polidocanol, mechanical ablation and MOCA using ClariVein device. Methods Twenty-four vein GSV specimens were obtained via traditional surgery and treated with four methods: Group A: 0.9% normal saline (NS); Group B: 3% polidocanol; Group C: mechanical ablation + 0.9% NS; Group D: mechanical ablation + 3% polidocanol (MOCA). Hematoxylin and eosin (HE), Masson’s trichrome and immunohistochemical staining were performed on each specimen and integrated optical densities were measured with vWF and a-SMA stains and statistically evaluated. vWF staining was used to assess endothelial damage and a a-SMA staining was used to assess media injury. Results HE and Masson’s trichrome staining of Groups C and D revealed severe damage to the endothelium and media compared to Groups A and B. The statistical result of vWF staining showed the damage of endothelium was significantly increased by Group D compared to Groups A, B and C. The statistical result of a-SMA staining showed the damage of media was significantly increased by Groups C and D compared to Groups A and B. Conclusions The mechanism of MOCA was caused by both endothelium damage and media tearing. The damage of endothelium was significantly increased by MOCA when compared with mechanical ablation alone.

Abstract P170: Nicorandil Inhibits Gáq-Induced Chronic Heart Failure in Transgenic Mice

2011 ◽  
Vol 109 (suppl_1) ◽  
Author(s):  
Masamichi Hirose ◽  
Yasuchika Takeishi ◽  
Hisashi Shimojo ◽  
Toshihide Kashihara ◽  
Tsutomu Nakada ◽  
...  
Keyword(s):  
Heart Failure ◽  
Transgenic Mice ◽  
Structural Changes ◽  
Interstitial Fibrosis ◽  
Left Ventricular ◽  
Acute Administration ◽  
Sulfonylurea Receptor ◽  
Inhibitory Effects ◽  
Premature Ventricular Contractions ◽  
Beneficial Effects

Introduction: Beneficial effects of nicorandil on the treatment of hypertensive heart failure (HF) and ischemic heart disease have been suggested. However, whether nicorandil has inhibitory effects on HF and ventricular arrhythmias caused by the activation of G protein alpha q (Gαq) -coupled receptor (GPCR) signaling pathway still remains unknown. We examined effects of chronic and acute administration of nicorandil on the development of HF and ventricular action potential (VAP) in transgenic mice with transient cardiac expression of activated Gαq (Gαq-TG), respectively. Method and Results: Nicorandil (6 mg/kg/day) or vehicle was chronically administered in Gαq-TG mice for 24 weeks from 8 weeks of age, and then ventricular function, and electrical and structural changes were investigated in the hearts. Chronic nicorandil administration improved the reduction of left ventricular fractional shortening (p < 0.001) in Gαq-TG hearts. During 10 min of electrocardiogram recording, premature ventricular contractions (more than 20 beats/min) were observed in 7 of 10 vehicle-treated Gαq-TG but in none of 10 nicorandil-treated Gαq-TG hearts (p < 0.01). QT interval was significantly shorter in nicorandil-treated Gαq-TG than in vehicle-treated Gαq-TG hearts (p < 0.05). Chronic nicorandil administration improved the increased ventricular interstitial fibrosis (p < 0.05) but not cardiac hypertrophy in Gαq-TG left ventricles. Real time RT-PCR revealed that mRNA expression levels of s sulfonylurea receptor 2B (SUR-2B) were decreased in vehicle-treatd Gαq-TG but not in nicorandil-treated Gαq-TG. In addition, chronic nicorandil increased endotherial nitric oxide syntheses gene expression in Gαq-TG hearts (p < 0.05). Acute nicorandil administration (1 microM) significantly shortened the prolonged VAP duration and reduced the number of PVCs in vehicle treated Gαq-TG hearts. Conclusions: These findings suggest that nicorandil inhibits ventricular electrical and structural remodeling and arrhythmias through the shortening of VAP duration and the increased expression of SUR-2B and eNOS in a mouse model of HF.

scholarly journals Propéptido natriurético tipo B N-terminal en adultos mayores ecuatorianos

2020 ◽  
Vol 4 (1) ◽  
pp. 9
Author(s):  
Rubí Eliana Bermello Zamora ◽  
Yury Jordano Sanclemente Núñez ◽  
Ivón Howland Álvarez
Keyword(s):  
Heart Failure ◽  
Healthcare Expenditure ◽  
Clinical Manifestations ◽  
Clinical Importance ◽  
The Elderly ◽  
Comprehensive Health Care ◽  
Palabras Clave ◽  
Insuficiencia Cardiaca ◽  
Comprehensive Health ◽  
Severity Of The Disease

  La insuficiencia cardiaca (IC) es un trastorno progresivo y letal que constituye la primera causa de ingreso hospitalario en las personas mayores de 65 años. Se ha demostrado la utilidad del NT-proBNP para su diagnóstico; sin embargo, los valores de estos marcadores difieren según las características de los pacientes y la severidad de la enfermedad. El objetivo de este estudio consistió en determinar la utilidad de la medición de NT-proBNP para diagnosticar el riesgo de padecer IC en adultos mayores. Se realizaron análisis de NT-proBNP, creatinina, urea, hemoglobina, glucosa y sodio en 47 muestras sanguíneas de pacientes de un centro gerontológico de Manabí en el periodo octubre a diciembre 2017. Se analizaron los valores y la posible asociación a otras enfermedades. Se compararon los valores de variables demográficas, analíticas y clínicas. Se analizaron las manifestaciones clínicas y antecedentes patológicos personales asociados al riesgo de IC. El valor NT-proBNP se asoció con la presencia de anemia, creatinina mayor de 2 mg/dL e hiponatremia. La edad media de los pacientes fue de 79 años, de predominio masculino, con comorbilidad asociada y cierto grado de dependencia, aunque la edad no fue un factor que influyó en la probabilidad de tener elevación en el valor plasmático de NT-proBNP y por lo tanto del riesgo latente de padecer o no IC. El valor de NT-proBNP mostró ser un analito complementario de gran importancia clínica para la evaluación y el cuidado integral de salud del anciano.   Palabras clave: NT-proBNP, insuficiencia cardiaca, adultos mayores.   Abstract Heart failure (HF) is a progressive and lethal disorder that constitutes the first cause of hospital admission in people over 65 years of age and represents just over 2% of national healthcare expenditure. The usefulness of NT-proBNP for its diagnosis has been demonstrated, however, the values of these markers differ according to the characteristics of the patients and the severity of the disease. The objective of this study is to determine the NT-proBNP usefullness to diagnose risk of HF in older adults. NT-proBNP, creatinine, urea, hemoglobin, glucose and sodium were analyzed in 47 blood samples of patients from the gerontological center from October to December 2017. The values and the possible association to other diseases were analyzed. The values of demographic, analytical and clinical variables were compared. The clinical manifestations and personal pathological background associated with the risk of HF were analyzed. The NT-proBNP value was associated with the presence of anemia, creatinine greater than 2 mg/dL and hyponatremia. The average age of the patients was 79 years, predominantly male, with associated comorbidity and a certain degree of dependence, although age was not a factor that influenced the probability of having an elevated plasma NT-proBNP value and therefore both of the latent risk of suffering or not IC. The value of NT-proBNP was shown to be a complementary analyte of great clinical importance for the evaluation and comprehensive health care of the elderly.   Keywords: NT-proBNP, heart failure, elderly.

scholarly journals A case of severe acute respiratory syndrome coronavirus 2 with acute thrombotic cerebral infarction and generalized thrombosis

2021 ◽  
pp. 405-408
Author(s):  
Sylvia Nikolaeva Genova ◽  
Nikolaeva Genova ◽  
Mina Miroslavova Pencheva ◽  
Alexander Georgiev Ivanov
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Cerebral Infarction ◽  
Viral Pneumonia ◽  
Autopsy Case ◽  
Full Spectrum ◽  
Histological Changes ◽  
Large Size ◽  
Thrombotic Complications ◽  
Coronavirus Infection ◽  
The Brain

The full spectrum of coronavirus disease 2019 (COVID-19) has not been fully described yet. COVID-19 is associated with a high risk of thrombotic complications such as venous thromboembolism and cerebrovascular disease. Here, we report an autopsy case of a 55-year-old woman diagnosed with severe viral pneumonia complicated by acute cerebral infarction and venous and arterial thrombosis in different organs. The patient died due to severe acute respiratory syndrome coronavirus 2. Macroscopically and histologically, in addition to viral pneumonia and diffuse hemorrhages, fibrin clots were found in arteries and venous vessels of medium and large size in the brain, lungs, and pancreas. Propagation of cerebrovascular thrombosis has led to extensive cerebral infarction. The dating of this infarction, according to the macroscopical findings and the histological changes, was between 24 and 48 h before death. This case confirms the hypothesis on the risk of generalized arterial and venous thromboses in coronavirus infection.

scholarly journals Influence of COVID-19 on creative industries

2021 ◽  
Vol 21 (1) ◽  
pp. 48-54
Author(s):  
Yulia O. Glushkova ◽  
◽  
Anastasia V. Vasina ◽  
Keyword(s):  
Theoretical Analysis ◽  
Economic Activity ◽  
Information Technologies ◽  
Structural Changes ◽  
Business Processes ◽  
Creative Industries ◽  
Creative Economy ◽  
Social Efficiency ◽  
Coronavirus Infection ◽  
The Impact

Introduction. This study analyzes the impact of the new COVID-19 coronavirus infection on the creative industries in the Russian Federation, as well as finding solutions to support this area in the context of the pandemic. Theoretical analysis. Since the latest imperatives of the current world processes dictate the need for structural changes in the state economic activity, the actual principle of the economic activity organization can be called the creative industries concept development, which include industries related to the creation of a certain cultural or creative product, IT-sphere, fashion and design, advertising and marketing products, as well as folk art and craft. Due to the relevance of the creative industries development, modern research on the theory of creative economy development pays great attention to the study of the specifics of this activity and ways to improve it. The article provides a theoretical analysis of the crisis in the creative industries, as well as a detailed analysis of the opportunities and threats of the crisis. Empirical analysis. Based on the analysis of the activities of companies in the creative industries, the authors of the article identify opportunities for the development of companies in the creative sphere in terms of economic and social efficiency. New trends in the transformation of business processes in various fields (theatre, film industry, music, exhibition and Museum activities) are considered. Results. Based on the analysis, it is concluded that the urgent tasks in the situation of forced quarantine measures are the timely transformation of creative industries with the use of information technologies, the transition to online areas of interaction with consumers, as well as state support for creative industries most affected by the crisis.

Abstract 14309: A Novel Fibroblast Activation Inhibitor, NM922, Attenuates Maladaptive Fibrotic Remodeling to Preserve Cardiac Function Following the Onset of Heart Failure

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jessica M Bradley ◽  
Craig M Ziblich ◽  
Kazi N Islam ◽  
Amanda M Rushing ◽  
David J Polhemus ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Function ◽  
Structural Changes ◽  
Volume Fraction ◽  
Left Ventricular ◽  
Normal Fibroblast ◽  
Wall Thickening ◽  
Cellular Mechanisms ◽  
Collagen Formation ◽  
Failing Heart

Background: Cardiac fibroblasts are critical mediators of fibrotic remodeling in the failing heart. These maladaptive structural changes can worsen cardiac function accelerating the progression to decompensated heart failure (HF). We investigated the effects of a novel inhibitor of the conversion of normal fibroblast to the myofibroblast phenotype in the setting of pressure overload induced HF. Methods: Male C57BL/6J mice (10 wks) were subjected to transverse aortic constriction (TAC; 27 g needle) and NM922 (NovoMedix, LLC50 mg/kg/d i.p.) or VEH (DMSO + HS-15) was administered daily starting at 6 wks post TAC. Echocardiography was assessed at baseline and for 16 wks post TAC. At the 16 wk endpoint, mice were sacrificed and hearts were collected for biochemical and molecular assessment. Results: NM922 significantly attenuated TAC-induced left ventricular (LV) dilation at 16 wks post TAC (LVEDD: 3.5 ± 0.1 vs. 4.5 ± 0.2 mm, p < 0.01; LVESD: 2.5 ± 0.2 vs. 3.8 ± 0.3 mm, p < 0.01) compared to VEH. NM922 treated mice displayed reduced wall thickening (LVPWd: 1.0 ± 0.03 vs. 1.2 ± 0.05 mm; p < 0.05) at 10 wks post TAC compared to VEH. LV ejection fraction (LVEF) was preserved in NM922 treated mice at 8-16 wks post TAC compared to VEH (*p < 0.05; **p < 0.001) compared to VEH. Treatment with NM922 resulted in reductions in heart (8.5 ± 0.5 vs. 12.0 ± 0.9 mg/mm; p < 0.01) and lung (8.2 ± 0.3 vs. 11.5 ± 0.6 mg/mm; p < 0.0001) weights compared to VEH. Picrosirius Red staining revealed that NM922 reduced cardiac interstitial collagen volume fraction by 50% (p < 0.05 vs. VEH). Circulating BNP levels trended toward lower (p = 0.08) in the NM922 mice when compared to VEH. Conclusion: Chronic treatment with NM922 following the onset of cardiac hypertrophy and HF resulted in attenuated myocardial collagen formation and adverse remodeling with preservation of LVEF. Future studies are aimed at further elucidation of the molecular and cellular mechanisms by which this novel agent protects the failing heart.

Hemorrhagic complications of а novel coronavirus infection: actual clinical problem.

2021 ◽  
Author(s):  
И.Б. Симарова ◽  
С.Н. Переходов ◽  
А.Ю. Буланов
Keyword(s):  
Case Reports ◽  
Clinical Problem ◽  
Clear Understanding ◽  
The Novel ◽  
Hemorrhagic Events ◽  
Thrombotic Complications ◽  
Predictive Role ◽  
Coronavirus Infection ◽  
Novel Coronavirus ◽  
Therapeutic Doses

Гиперкоагуляционный характер коагулопатии, ассоциированной с новой коронавирусной инфекцией COVID-19, и высокий риск связанных с этим тромботических осложнений — хорошо известный факт на сегодняшний день. Тем не менее в литературе имеются описания и геморрагических событий у больных COVID. В обзоре приведен анализ публикаций, описывающих кровотечения при коронавирусной инфекции; общая частота их в среднем составляет 4–8%. Превалируют желудочно-кишечные кровотечения, существенную часть составляют межмышечные гематомы и кровоизлияния в кожу и слизистые. Показана предиктивная роль применения антикоагулянтов в терапевтических дозах и гипофибриногенемии. Отмечено отсутствие четкого понимания патофизиологических механизмов. Hypercoagulable character of coagulopathy associated with the novel coronavirus infection COVID-19, and the high risk of associated thrombotic complications is a well-known fact. However, there are also case reports of hemorrhagic events in COVID patients in the literature. The review summarizes the publications describing bleedings in coronavirus infection; their overall frequency is on average 4–8%. Gastrointestinal bleeding are prevalent, intermuscular hematomas and hemorrhages in the skin and mucous membranes are frequent. The predictive role of anticoagulants use in therapeutic doses and hypofibrinogenemia is shown. The absence of clear understanding of the pathophysiological mechanisms is noted.

Abstract 12732: Risk of Heart Failure After Contemporary Radiotherapy for Breast Cancer in the Community

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Hirofumi Saiki ◽  
Randi R Finley ◽  
Christopher G Scott ◽  
Elizabeth S Yan ◽  
Ivy A Petersen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Conditional Logistic Regression ◽  
Continuous Variable ◽  
Endothelial Damage ◽  
Myocardial Inflammation ◽  
Reduced Ejection Fraction ◽  
Breast Cancer Radiotherapy

Background: Contemporary breast cancer radiotherapy (RT) results in variable cardiac radiation exposure. While cardiomyocytes are radio-resistant, radiation induces coronary microvascular endothelial damage and inflammation which may ultimately lead to myocardial inflammation, ischemia and fibrosis and put patients at risk for heart failure (HF) and particularly, HF with preserved ejection fraction (HFpEF). Methods: Community based (Olmsted County, MN), HF case-control study of contemporary (1999-2014) breast cancer RT patients with CT-based RT planning for precise mean cardiac radiation dose (MCRD) calculation. HF cases (n=66) and controls (n=129) were matched (1:2) for age at RT, HF risk factors, tumor side and chemotherapy use. Matched controls and cases had identical follow-up (index interval). Proportion of HF and clinical characteristics in categories of MCRD were reported (table) and conditional logistic regression was used to estimate the HF odds ratio (OR) associated with MCRD as a continuous variable. Results: Of the 66 HF cases, 46 (70%) had HFpEF and 20 (30%) had HF with reduced ejection fraction (HFrEF). The proportion of patients with HF (any) or HFpEF increased and proportion with HFrEF tended to increase with increasing MCRD. The prevalence of HF risk factors (hypertension, diabetes, coronary disease) at time of RT did not vary by MCRD while left sided tumor, cancer stage and adriamycin use increased with increasing MCRD. The OR per 1 unit increase in log MCRD was 3.71 (1.98, 6.94) for total HF (p<0.001), 4.91 (1.93, 9.09) for HFpEF (p<0.001) and 2.78 (0.91, 8.47) for HFrEF (p=0.07). The mean index interval was 5.0±3.2 years. Conclusion: Cardiac radiation incident to contemporary breast RT increases the risk of HF, and particularly HFpEF over a short post-RT interval. These data may guide use of proton beam therapy in breast cancer. These data also provide support for the role of coronary microvascular compromise in the pathophysiology of HFpEF.

Sign in / Sign up

Export Citation Format

Share Document