Approaches to the surgical treatment of cardiovascular diseases and complications in the background COVID-19

2021 ◽  
pp. 30-44
Author(s):  
Valerii Sergeevich Ermakov ◽  
Viacheslav Nikolaevich Kravchuk ◽  
Andrei Evgenievich Skvortsov ◽  
Olga Yaroslavna Porembskaya ◽  
Kirill Vladimirovich Kuznetsov ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Surgical Treatment ◽  
Cardiovascular Diseases ◽  
Foreign Literature ◽  
The Relationship

This article provides an overview of domestic and foreign literature on the relationship between cardiovascular diseases and COVID-19. Various approaches to the management and treatment of this group of patients are considered, such as: postponement of surgical treatment, immediate results of endovascular and cardiac surgery in patients with active COVID-19.

scholarly journals Hsa-miR-494-3p attenuates gene HtrA3 transcription to increase inflammatory response in hypoxia/reoxygenation HK2 Cells

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Qian Gong ◽  
Zhi-ming Shen ◽  
Zhe Sheng ◽  
Shi Jiang ◽  
Sheng-lin Ge
Keyword(s):  
Cardiac Surgery ◽  
Inflammatory Response ◽  
Target Gene ◽  
Kidney Injury ◽  
Human Kidney ◽  
Luciferase Reporter ◽  
The Relationship ◽  
Hk2 Cells ◽  
Dual Luciferase Reporter Assay ◽  
Hypoxia Reoxygenation

AbstractThe occurrence of cardiac surgery-associated acute kidney injury (CSA-AKI) increases hospital stay and mortality. MicroRNAs has a crucial role in AKI. This objective of the current study is to explore the function of hsa-miR-494-3p in inflammatory response in human kidney tubular epithelial (HK2) cells with hypoxia/reoxygenation. According to KDIGO standard, patients after cardiac surgery with cardiopulmonary bypass were divided into two groups: AKI (n = 10) and non-AKI patients (n = 8). HK2 were raised in the normal and hypoxia/reoxygenation circumstances and mainly treated by overexpression ofmiR-494-3p and HtrA3. The relationship between miR-494-3p and HtrA3 was determined by dual-luciferase reporter assay. Our result showed that Hsa-miR-494-3p was elevated in the serum of patients with CSA-AKI, and also induced in hypoxic reoxygenated HK2 cells. Hsa-miR-494-3p also increased a hypoxia-reoxygenation induced inflammatory response in HK2 cells. Moreover, as a target gene of miR-494-3p, overexpression of HtrA3 downregulated the hypoxia-reoxygenation induced inflammatory response in HK2 cells. Overexpression of hsa-miR-494-3p-induced inflammatory response was inhibited by overexpression of HtrA3. Collectively, we identified that hsa-miR-494-3p, a miRNA induced in both circulation of AKI patients and hypoxia-reoxygenation-treated HK2 cells, enhanced renal inflammation by targeting HtrA3, which may suggest a possible role as a new therapeutic target for CSA-AKI.

scholarly journals Preoperative endothelial dysfunction in cutaneous microcirculation is associated with postoperative organ injury after cardiac surgery using extracorporeal circulation: a prospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Stanislas Abrard ◽  
Olivier Fouquet ◽  
Jérémie Riou ◽  
Emmanuel Rineau ◽  
Pierre Abraham ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cohort Study ◽  
Endothelial Dysfunction ◽  
Postoperative Complications ◽  
Sofa Score ◽  
Primary Objective ◽  
Laser Speckle ◽  
Organ Injury ◽  
Contrast Imaging ◽  
The Relationship

Abstract Background Cardiac surgery is known to induce acute endothelial dysfunction, which may be central to the pathophysiology of postoperative complications. Preoperative endothelial dysfunction could also be implicated in the pathophysiology of postoperative complications after cardiac surgery. However, the relationship between preoperative endothelial function and postoperative outcomes remains unknown. The primary objective was to describe the relationship between a preoperative microcirculatory dysfunction identified by iontophoresis of acetylcholine (ACh), and postoperative organ injury in patients scheduled for cardiac surgery using cardiopulmonary bypass (CPB). Methods Sixty patients undergoing elective cardiac surgery using CPB were included in the analysis of a prospective, observational, single-center cohort study conducted from January to April 2019. Preoperative microcirculation was assessed with reactivity tests on the forearm (iontophoresis of ACh and nitroprusside). Skin blood flow was measured by laser speckle contrast imaging. Postoperative organ injury, the primary outcome, was defined as a Sequential Organ Failure Assessment score (SOFA) 48 h after surgery greater than 3. Results Organ injury at 48 h occurred in 29 cases (48.3%). Patients with postoperative organ injury (SOFA score > 3 at 48 h) had a longer time to reach the peak of preoperative iontophoresis of acetylcholine (133 s [104–156] vs 98 s [76–139] than patients without, P = 0.016), whereas endothelium-independent vasodilation to nitroprusside was similar in both groups. Beyond the proposed threshold of 105 s for time to reach the peak of preoperative endothelium-dependent vasodilation, three times more patients presented organ dysfunction at 48 h (76% vs 24% below or equal 105 s). In multivariable model, the time to reach the peak during iontophoresis of acetylcholine was an independent predictor of postoperative organ injury (odds ratio = 4.81, 95% confidence interval [1.16–19.94]; P = 0.030). Conclusions Patients who postoperatively developed organ injury (SOFA score > 3 at 48 h) had preoperatively a longer time to reach the peak of endothelium-dependent vasodilation. Trial registration Clinical-Trials.gov, NCT03631797. Registered 15 August 2018, https://clinicaltrials.gov/ct2/show/NCT03631797

scholarly journals Association between Serum Concentration of Carotenoid and Visceral Fat

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 912
Author(s):  
Mai Matsumoto ◽  
Hiroyuki Suganuma ◽  
Naoki Ozato ◽  
Sunao Shimizu ◽  
Mitsuhiro Katashima ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Visceral Fat ◽  
Fruits And Vegetables ◽  
Beta Carotene ◽  
The Body ◽  
Healthy Individuals ◽  
Health Checkup ◽  
Visceral Fat Area ◽  
The Relationship ◽  
Aomori Prefecture

Consumption of fruits and vegetables rich in carotenoids has been widely reported to prevent cardiovascular diseases. However, the relationship between serum carotenoid concentrations and visceral fat area (VFA), which is considered a better predictor of cardiovascular diseases than the body-mass index (BMI) and waist circumference, remains unclear. Therefore, we examined the relationship in healthy individuals in their 20s or older, stratified by sex and age, to compare the relationship between serum carotenoid concentrations and VFA and BMI. The study was conducted on 805 people, the residents in Hirosaki city, Aomori prefecture, who underwent a health checkup. An inverse relationship between serum carotenoid concentrations and VFA and BMI was observed only in women. In addition, the results were independent of the intake of dietary fiber, which is mainly supplied from vegetables as well as carotenoids. This suggests that consumption of a diet rich in carotenoids (especially lutein and beta-carotene) is associated with lower VFA, which is a good predictor of cardiovascular disease, especially in women. This study is the first to comprehensively evaluate the association between serum carotenoid levels and VFA in healthy individuals.

scholarly journals Association Between Frailty and Gut Microbiota Metabolite TMAO in Older People With Cardiovascular Disease

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 210-211
Author(s):  
Wei He ◽  
Hua Wang ◽  
Jiefu Yang
Keyword(s):  
Older Adults ◽  
Cardiovascular Diseases ◽  
Gut Microbiota ◽  
Linear Trend ◽  
Frailty Index ◽  
Concentration Data ◽  
Dependent Relationship ◽  
The Status ◽  
Cubic Spline Curve ◽  
The Relationship

Abstract The potential for the gut microbiota to affect health has particular relevance for older adults. Recent evidence suggests that microbiota-derived metabolites may modulate aging-related changes in immunity, sarcopenia, and cognitive function, all of which are elements of frailty. Trimethylamine N-oxide (TMAO) produced by the metaorganismal metabolism of choline, has been implicated in disease pathogenesis. However, relatively little geroscience research has been carried out on TMAO，and even less on other gut microbiota metabolites. The purpose of this study was to explore the relationship between frailty and circulating TMAO concentration. Data and fasting blood samples came from a prospective comprehensive geriatric assessment cohort of older adults (age≥65, n=451) with cardiovascular diseases. The frailty index based on the accumulated deficits model (48 variables) was used for evaluating the status of frailty. TMAO levels differed between groups with a significant increase for people with frailty (p＜0.001). Compared with the lowest quartile of TMAO levels, patients in the highest quartile had increased 3.07-fold risk of frailty (OR=3.07, 95%CI, 1.69-2.97). After adjusting for age, gender, BMI, history of diseases, hsCRP, LDLc, TMAO levels remained associated with frailty (OR=2.11, 95%CI, 1.01-4.38). Similarly, a cubic spline curve showed a dose-dependent relationship between the odds ratio for the risk of frailty and circulating TMAO in a linear trend (p = 0.006). This study suggests that circulating TMAO are independently associated with frailty in older adult with cardiovascular diseases. Efforts to further characterize the relationship between gut microbiota metabolite and frailty should be further pursued.

scholarly journals Clinical Significance of the Serotonin Release Assay and Platelet Count Monitoring After Cardiac Surgery

2017 ◽  
Vol 24 (6) ◽  
pp. 944-949 ◽  
Author(s):  
Shinya Motohashi ◽  
Takefumi Matsuo ◽  
Hidenori Inoue ◽  
Makoto Kaneko ◽  
Shunya Shindo
Keyword(s):  
Cardiac Surgery ◽  
Platelet Count ◽  
Clinical Course ◽  
Serotonin Release ◽  
Enzyme Linked Immunosorbent Assay ◽  
Heparin Induced Thrombocytopenia ◽  
Release Assay ◽  
Immunological Assays ◽  
Platelet Count Monitoring ◽  
The Relationship

Heparin-induced thrombocytopenia (HIT) is one of the serious complications in patients who undergo cardiac surgery. However, there remains a major problem in diagnosing HIT because the current immunological assays for detection of HIT antibody have limitations. Furthermore, the clinical course of thrombocytopenia in this surgery makes it increasingly difficult to diagnose HIT. We investigated the relationship between platelet count and HIT antibody in 59 patients who underwent cardiac surgery using cardiopulmonary bypass (CPB). The number of postoperative HIT antibody-positive patients evaluated using enzyme-linked immunosorbent assay kit (polyanion IgG/IgA/IgM complex antibodies/antiplatelet factor 4 enhanced) was 37 (62.7%). In contrast, platelet activation by HIT antibody was evaluated using the serotonin release assay (SRA). More than 20% and 50% release of serotonin was obtained from 12 patients (20.3%) and 8 patients (13.6%), respectively. The levels of d-dimer were significantly different on postoperative day 14 between SRA-positive and SRA-negative groups; however, postoperative thrombus complication was not detected using sonography in the patients with positive serotonin release at all. After being decreased by the operation, their platelet count recovered within 2 weeks in both groups equally. In our study, although the patients were positive in the platelet activating HIT antibody assay, they remained free from thrombosis and their platelet count recovered after early postoperative platelet decrease. Therefore, in addition to the SRA, monitoring of platelet count might be still considered an indispensable factor to facilitate the prediction of HIT thrombosis prior to manifestation in the patients undergoing cardiac surgery using CPB.

scholarly journals The relationship between heart rate variability and inflammatory markers in cardiovascular diseases

2008 ◽  
Vol 33 (10) ◽  
pp. 1305-1312 ◽  
Author(s):  
Alexander Haensel ◽  
Paul J. Mills ◽  
Richard A. Nelesen ◽  
Michael G. Ziegler ◽  
Joel E. Dimsdale
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiovascular Diseases ◽  
Inflammatory Markers ◽  
The Relationship

The relationship between insulin-sensitive obesity and cardiovascular diseases in a Chinese population

2014 ◽  
Vol 172 (2) ◽  
pp. 388-394 ◽  
Author(s):  
Jieli Lu ◽  
Yufang Bi ◽  
Tiange Wang ◽  
Weiqing Wang ◽  
Yiming Mu ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Chinese Population ◽  
The Relationship
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