scholarly journals ACUTE AORTIC DISSECTION IN A POSTMENOPAUSAL FEMALE IN THE SETTING OF PARENTERAL TESTOSTERONE, ESTRADIOL, AND PROGESTERONE THERAPY

2019 ◽  
Vol 5 (5) ◽  
pp. e287-e289
Author(s):  
Michael Zeihen ◽  
Daniel Mattox ◽  
Timothy Sanborn ◽  
Michael Kreager ◽  
Raaid Museitif ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Thoracic Aorta ◽  
Acute Aortic Dissection ◽  
Aortic Disease ◽  
Review Of The Literature ◽  
Free Standing ◽  
Testosterone Therapy ◽  
Laboratory Findings ◽  
Off Label ◽  
Postmenopausal Female

Objective: The FDA has not approved the use of testosterone in women. However, parenteral testosterone is being used off-label in free standing clinics throughout America. The recent multi-ethnic study of atherosclerosis (MESA) population study showed that postmenopausal women with a higher testosterone/estradiol ratio had a higher incident of cardiovascular disease. This is a case of a postmenopausal woman who dissected her thoracic aorta after 8 months of parenteral testosterone. Methods: The clinical examination, radiographic, and laboratory findings of a patient are presented along with a review of the literature. Results: A heathy postmenopausal women, whose only risk factor was parenteral testosterone, developed a dissection of her entire thoracic aorta. Conclusion: The MESA study and other conflicting publications on cardiovascular events in transgender patients receiving exogenous androgens indicates the need for further investigation to determine the safety of testosterone therapy for women and its possible role in contributing to aortic disease.

Aortic Stenosis, Aortic Regurgitation and Arterial Hypertension

2019 ◽  
Vol 17 (2) ◽  
pp. 180-190 ◽  
Author(s):  
V. Katsi ◽  
G. Georgiopoulos ◽  
D. Oikonomou ◽  
C. Aggeli ◽  
C. Grassos ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Regurgitation ◽  
Antihypertensive Agents ◽  
Renin Angiotensin System ◽  
Aortic Disease ◽  
Review Of The Literature ◽  
Angiotensin System ◽  
The Impact ◽  
Worse Prognosis

Background: Hypertension (HT) is an important risk factor for cardiovascular disease and might precipitate pathology of the aortic valve. </P><P> Objective: To investigate the association of HT with aortic dysfunction (including both aortic regurgitation and stenosis) and the impact of antihypertensive treatment on the natural course of underlying aortic disease. </P><P> Methods: We performed a systematic review of the literature for all relevant articles assessing the correlation between HT and phenotype of aortic disease. </P><P> Results: Co-existence of HT with aortic stenosis and aortic regurgitation is highly prevalent in hypertensive patients and predicts a worse prognosis. Certain antihypertensive agents may improve haemodynamic parameters (aortic jet velocity, aortic regurgitation volume) and remodeling of the left ventricle, but there is no strong evidence of benefit regarding clinical outcomes. Renin-angiotensin system inhibitors, among other vasodilators, are well-tolerated in aortic stenosis. </P><P> Conclusion: Several lines of evidence support a detrimental association between HT and aortic valve disease. Therefore, HT should be promptly treated in aortic valvulopathy. Despite conventional wisdom, specific vasodilators can be used with caution in aortic stenosis.

scholarly journals Radial self-navigated native magnetic resonance angiography in comparison to navigator-gated contrast-enhanced MRA of the entire thoracic aorta in an aortic patient collective

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Martina Correa Londono ◽  
Nino Trussardi ◽  
Verena C. Obmann ◽  
Davide Piccini ◽  
Michael Ith ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Image Quality ◽  
Magnetic Resonance Angiography ◽  
Thoracic Aorta ◽  
Aortic Root ◽  
Aortic Disease ◽  
Ascending Aorta ◽  
Scan Time ◽  
Contrast Enhanced

Abstract Background The native balanced steady state with free precession (bSSFP) magnetic resonance angiography (MRA) technique has been shown to provide high diagnostic image quality for thoracic aortic disease. This study compares a 3D radial respiratory self-navigated native MRA (native-SN-MRA) based on a bSSFP sequence with conventional Cartesian, 3D, contrast-enhanced MRA (CE-MRA) with navigator-gated respiration control for image quality of the entire thoracic aorta. Methods Thirty-one aortic native-SN-MRA were compared retrospectively (63.9 ± 10.3 years) to 61 CE-MRA (63.1 ± 11.7 years) serving as a reference standard. Image quality was evaluated at the aortic root/ascending aorta, aortic arch and descending aorta. Scan time was recorded. In 10 patients with both MRA sequences, aortic pathologies were evaluated and normal and pathologic aortic diameters were measured. The influence of artifacts on image quality was analyzed. Results Compared to the overall image quality of CE-MRA, the overall image quality of native-SN-MRA was superior for all segments analyzed (aortic root/ascending, p < 0.001; arch, p < 0.001, and descending, p = 0.005). Regarding artifacts, the image quality of native-SN-MRA remained superior at the aortic root/ascending aorta and aortic arch before and after correction for confounders of surgical material (i.e., susceptibility-related artifacts) (p = 0.008 both) suggesting a benefit in terms of motion artifacts. Native-SN-MRA showed a trend towards superior intraindividual image quality, but without statistical significance. Intraindividually, the sensitivity and specificity for the detection of aortic disease were 100% for native-SN-MRA. Aortic diameters did not show a significant difference (p = 0.899). The scan time of the native-SN-MRA was significantly reduced, with a mean of 05:56 ± 01:32 min vs. 08:51 ± 02:57 min in the CE-MRA (p < 0.001). Conclusions Superior image quality of the entire thoracic aorta, also regarding artifacts, can be achieved with native-SN-MRA, especially in motion prone segments, in addition to a shorter acquisition time.

COVID-19 and aortic disease: a practical systematic review of the literature on management and outcomes

2021 ◽  
Author(s):  
Daniele BISSACCO ◽  
Chiara LOMAZZI ◽  
Gianluca BUONGIOVANNI ◽  
Agnese MAGNI ◽  
Maurizio DOMANIN ◽  
...  
Keyword(s):  
Systematic Review ◽  
Aortic Disease ◽  
Review Of The Literature

scholarly journals Sex differences in thoracic aortic disease: A review of the literature and a call to action

2020 ◽  
Vol 160 (3) ◽  
pp. 656-660
Author(s):  
Jennifer Chung ◽  
Thais Coutinho ◽  
Michael W.A. Chu ◽  
Maral Ouzounian
Keyword(s):  
Sex Differences ◽  
Aortic Disease ◽  
Review Of The Literature ◽  
Thoracic Aortic Disease ◽  
Call To Action

The effect of multistrain probiotic supplementation in two doses on iron metabolism in obese postmenopausal women: a randomized trial

2019 ◽  
Vol 10 (8) ◽  
pp. 5228-5238 ◽  
Author(s):  
Katarzyna Skrypnik ◽  
Paweł Bogdański ◽  
Magdalena Sobieska ◽  
Joanna Suliburska
Keyword(s):  
Randomized Trial ◽  
Postmenopausal Women ◽  
Iron Metabolism ◽  
Probiotic Supplementation ◽  
Female Patients ◽  
Postmenopausal Female

Multistrain probiotic supplementation may influence iron metabolism in obese postmenopausal female patients.

scholarly journals Successful free flap salvage surgery with off-label use of Alteplase: A case report, review of the literature and our free flap salvage algorithm

2020 ◽  
Vol 75 ◽  
pp. 398-402
Author(s):  
Fatima Barhoum ◽  
Klaus Tschaikowsky ◽  
Michael Koch ◽  
Markus Kapsreiter ◽  
Matti Sievert ◽  
...  
Keyword(s):  
Case Report ◽  
Free Flap ◽  
Salvage Surgery ◽  
Off Label Use ◽  
Review Of The Literature ◽  
Off Label ◽  
Label Use

scholarly journals Exogenous Testosterone Does Not Influence 11-Oxygenated C19 Steroid Concentrations in Healthy Postmenopausal Women

2019 ◽  
Vol 3 (3) ◽  
pp. 670-677 ◽  
Author(s):  
Susan R Davis ◽  
Adina F Turcu ◽  
Penelope J Robinson ◽  
Robin J Bell
Keyword(s):  
Postmenopausal Women ◽  
Correlation Coefficient ◽  
Rank Correlation ◽  
Serum Testosterone Level ◽  
Controlled Clinical Trial ◽  
Spearman Rank Correlation ◽  
Testosterone Therapy ◽  
Spearman Rank ◽  
The Impact ◽  
Spearman Rank Correlation Coefficient

Abstract Context 11β-Hydroxyandrostenedione (11OHA4), 11β-hydroxytestosterone (11OHT), and their respective peripheral derivatives, 11-ketoandrostenedione (11KA4) and 11-ketotesosterone (11KT), have been implicated in androgen-related physiopathology. Little is known of these steroids in postmenopausal women or whether exogenous testosterone therapy influences their levels. Objective The impact of exogenous testosterone on serum levels of 11-oxygenated steroids was determined in healthy postmenopausal women. Participants and Methods Levels of 19-carbon (C19) steroids were measured by liquid chromatography–tandem mass spectrometry in serum obtained at baseline and at 12 and 26 weeks from 73 healthy postmenopausal women, aged 55 to 65 years, who participated in a randomized, double-blind, placebo-controlled clinical trial assessing the effects of transdermal testosterone on cognitive performance. Results Of the 11-oxygenated androgens, 11OHA4 was the most abundant (median, 6.46 nmol/L; range, 1.51 to 23.82 nmol/L), with concentrations several fold greater than its precursor androstenedione (median, 1.38 nmol/L; range, 0.52 to 2.92 nmol/L). Baseline median (range) testosterone and 11KT levels were similar [0.56 (0.23 to 1.48) nmol/L; 0.85 (0.25 to 2.86) nmol/L, respectively). 11OHT was closely correlated with 11KT (Spearman rank correlation coefficient, 0.79; P &lt; 0.001) and 11OHA4 correlated with 11KA4 (Spearman rank correlation coefficient, 0.73; P &lt; 0.001). Testosterone therapy resulted in an increase in serum testosterone level, whereas all 11-oxygenated androgens remained unchanged throughout the 26 weeks of treatment. Conclusion After menopause, the adrenal production of 11-oxygenated derivatives of androstenedione and testosterone contributes importantly to the total circulating androgen pool. Exogenous testosterone does not influence the circulating levels 11-oxygenated C19 steroids.

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