Nicholas J Severs, Emmanuel Dupont, Neil Thomas, Riyaz Kaba, Stephen Rothery, Revti Jain, Katherine Sharpey, Christopher H Fry
Gap junctions, assembled from connexins, form the cell-to-cell pathways for propagation of the precisely orchestrated patterns of current flow that govern the synchronized rhythm of the healthy heart. As in most tissues and organs, multiple connexin types are co-expressed in the heart; the connexins Cx43, Cx40 and Cx45 are found in distinctive combinations and relative quantities in different, functionally specialized subsets of cardiomyocytes. Alterations in connexin expression and gap junction organization, now a well-documented feature of human cardiomyopathies, potentially contribute to the pro-arrhythmic substrate. In the diseased ventricle, the most consistently reported quantitative alteration involves heterogeneous reduction in Cx43 expression and disruption of the normal ordered pattern of Cx43 gap junction distribution. Additional studies suggest that upregulation of Cx40 and Cx45 may also feature in the failing ventricle, the former restricted to ischemic cardiomyopathy and localized to the subendocardial region. By correlating data from studies on the human patient with those from animal and cell models, alterations in connexin expression and gap junction organization have emerged as important factors to be considered in understanding the pro-arrhythmic substrate found in human cardiomyopathies.
{"title":"Alterations in cardiac connexin expression in cardiomyopathies.","authors":"Nicholas J Severs, Emmanuel Dupont, Neil Thomas, Riyaz Kaba, Stephen Rothery, Revti Jain, Katherine Sharpey, Christopher H Fry","doi":"10.1159/000092572","DOIUrl":"https://doi.org/10.1159/000092572","url":null,"abstract":"<p><p>Gap junctions, assembled from connexins, form the cell-to-cell pathways for propagation of the precisely orchestrated patterns of current flow that govern the synchronized rhythm of the healthy heart. As in most tissues and organs, multiple connexin types are co-expressed in the heart; the connexins Cx43, Cx40 and Cx45 are found in distinctive combinations and relative quantities in different, functionally specialized subsets of cardiomyocytes. Alterations in connexin expression and gap junction organization, now a well-documented feature of human cardiomyopathies, potentially contribute to the pro-arrhythmic substrate. In the diseased ventricle, the most consistently reported quantitative alteration involves heterogeneous reduction in Cx43 expression and disruption of the normal ordered pattern of Cx43 gap junction distribution. Additional studies suggest that upregulation of Cx40 and Cx45 may also feature in the failing ventricle, the former restricted to ischemic cardiomyopathy and localized to the subendocardial region. By correlating data from studies on the human patient with those from animal and cell models, alterations in connexin expression and gap junction organization have emerged as important factors to be considered in understanding the pro-arrhythmic substrate found in human cardiomyopathies.</p>","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":"42 ","pages":"228-242"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000092572","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26376460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Endocardial cushion defects: embryology,anatomy and pathophysiology.","authors":"Rubin S Cooper","doi":"10.1159/000079791","DOIUrl":"https://doi.org/10.1159/000079791","url":null,"abstract":"","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":" ","pages":"118-26"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000079791","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40881093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Strategies for management of postcardiotomy cardiogenic shock following valvular heart surgery.","authors":"Deon W Vigilance, Mehmet C Oz","doi":"10.1159/000079794","DOIUrl":"https://doi.org/10.1159/000079794","url":null,"abstract":"","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":" ","pages":"140-9"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000079794","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40881096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leonardo da Vinci's anatomical drawings of quadricuspid, tricuspid, and bicuspid aortic valves underscored the hydraulic superiority of a three leaflet valve with cuspal equality. William Harvey demonstrated that venous valves were designed for unidirectional flow and to prevent reflux from the heart, observations that served as the basis of his immortal de Mortu Cordis. Joseph Rouanet of Paris proposed that heart sounds originated from the closing movements of cardiac valves. The Cardiodynamics of Mitral Insufficiency by Wiggers and Feil was followed three decades later by Paul Wood's An Appreciation of Mitral Stenosis. The Bland/Sweet operation indirectly addressed mitral stenosis by means of a venous shunt. Sir Henry Souttar's early digital repair of mitral stenosis was later reintroduced independently by Harken and Bailey; Doyen, Sellers, and Brock employed surgical valvotomy for pulmonary stenosis, and Bailey employed surgical valvotomy for aortic stenosis. Management of abnormal cardiac valves includes repair (reconstruction), replacement with mechanical or biologic prostheses, and interventional catheterization. The first mechanical valve was inserted extracardiac by Hufnagel into the descending thoracic aorta of patients with severe aortic regurgitation. The Starr caged ball mechanical prosthesis was designed for intracardiac replacement of an abnormal cardiac valve. The peripheral flow ball valve was followed by hydraulically superior and less thrombogenic central flow monoleaflet or bileaflet mechanical valves, and by homograft and heterograft bioprosthetic valves. Improved methods of preparing exogenous bioprostheses and innovative techniques of aortic valve reconstruction are evolving. Cardiac catheterization as a therapeutic intervention is routinely applied to stenotic mitral, aortic and pulmonary valves, and transcatheter replacement of an abnormal pulmonary valve is now a reality.
{"title":"The Howard Gilman Foundation Lecture. Where have we come from and where are we going? Valve management past, present and future.","authors":"Joseph K Perloff","doi":"10.1159/000079778","DOIUrl":"https://doi.org/10.1159/000079778","url":null,"abstract":"<p><p>Leonardo da Vinci's anatomical drawings of quadricuspid, tricuspid, and bicuspid aortic valves underscored the hydraulic superiority of a three leaflet valve with cuspal equality. William Harvey demonstrated that venous valves were designed for unidirectional flow and to prevent reflux from the heart, observations that served as the basis of his immortal de Mortu Cordis. Joseph Rouanet of Paris proposed that heart sounds originated from the closing movements of cardiac valves. The Cardiodynamics of Mitral Insufficiency by Wiggers and Feil was followed three decades later by Paul Wood's An Appreciation of Mitral Stenosis. The Bland/Sweet operation indirectly addressed mitral stenosis by means of a venous shunt. Sir Henry Souttar's early digital repair of mitral stenosis was later reintroduced independently by Harken and Bailey; Doyen, Sellers, and Brock employed surgical valvotomy for pulmonary stenosis, and Bailey employed surgical valvotomy for aortic stenosis. Management of abnormal cardiac valves includes repair (reconstruction), replacement with mechanical or biologic prostheses, and interventional catheterization. The first mechanical valve was inserted extracardiac by Hufnagel into the descending thoracic aorta of patients with severe aortic regurgitation. The Starr caged ball mechanical prosthesis was designed for intracardiac replacement of an abnormal cardiac valve. The peripheral flow ball valve was followed by hydraulically superior and less thrombogenic central flow monoleaflet or bileaflet mechanical valves, and by homograft and heterograft bioprosthetic valves. Improved methods of preparing exogenous bioprostheses and innovative techniques of aortic valve reconstruction are evolving. Cardiac catheterization as a therapeutic intervention is routinely applied to stenotic mitral, aortic and pulmonary valves, and transcatheter replacement of an abnormal pulmonary valve is now a reality.</p>","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000079778","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40881080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perspectives on diseases of the thoracic aorta.","authors":"John A Elefteriades","doi":"10.1159/000079786","DOIUrl":"https://doi.org/10.1159/000079786","url":null,"abstract":"","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":" ","pages":"75-86"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000079786","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40881088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Valve repair versus replacement when aortic regurgitation is caused by aortic root aneurysms: relative advantages and disadvantages and the impact of decision on surgical indications.","authors":"Leonard N Girardi","doi":"10.1159/000079783","DOIUrl":"https://doi.org/10.1159/000079783","url":null,"abstract":"","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":" ","pages":"48-56"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000079783","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40881085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Assessment of myocardial damage in regurgitant valvular disease.","authors":"Jagat Narula","doi":"10.1159/000079784","DOIUrl":"https://doi.org/10.1159/000079784","url":null,"abstract":"","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":" ","pages":"57-61"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000079784","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40881086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clare Hochreiter, Jeffrey S Borer, Andrew Yin, Phyllis G Supino, Edmund M Herrold, Karl Krieger, O Wayne Isom
{"title":"Ventricular arrhythmias in mitral regurgitation: frequency, clinical and prognostic importance, management before and after mitral valve surgery.","authors":"Clare Hochreiter, Jeffrey S Borer, Andrew Yin, Phyllis G Supino, Edmund M Herrold, Karl Krieger, O Wayne Isom","doi":"10.1159/000079789","DOIUrl":"https://doi.org/10.1159/000079789","url":null,"abstract":"","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":" ","pages":"108-11"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000079789","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40881091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeffrey S Borer, Phyllis G Supino, Clare Hochreiter, Edmund M Herrold, Andrew Yin, Karl Krieger, O Wayne Isom
{"title":"Valve surgery in the asymptomatic patient with aortic regurgitation: current indications and the effect of change rates in objective measures.","authors":"Jeffrey S Borer, Phyllis G Supino, Clare Hochreiter, Edmund M Herrold, Andrew Yin, Karl Krieger, O Wayne Isom","doi":"10.1159/000079782","DOIUrl":"https://doi.org/10.1159/000079782","url":null,"abstract":"","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":" ","pages":"36-47"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000079782","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40881084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgery for atrioventricular septal defects.","authors":"Jan M Quaegebeur, Rubin S Cooper","doi":"10.1159/000079792","DOIUrl":"https://doi.org/10.1159/000079792","url":null,"abstract":"","PeriodicalId":50954,"journal":{"name":"Advances in Cardiology","volume":" ","pages":"127-32"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000079792","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40881094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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