Hellenic Journal of Cardiology最新文献

Objective: The anatomic considerations of transcatheter aortic valve implantation (TAVI) have an important role for the procedure planning; however, sex-specific data are lacking.

Methods: All eligible cases undergoing evaluation for TAVI procedure in the period from November 2019 to July 2023 at the University Hospital of Split were included. Cardiac computed tomography was analyzed to derive the measures of left ventricular outflow tract (LVOT), aortic root, ascending aorta, and ilio-femoral arteries. A sex-based comparison was conducted using the descriptive statistics.

Results: There were 140 female (43.8%) and 180 male patients (56.2%). Female patients had smaller dimensions of aortic annulus (area 391.9 vs. 491.5 mm², p < 0.001), LVOT (area 373.3 vs. 481.8 mm², p < 0.001), and ascending aorta (maximal diameter 32.7 vs. 34.5 mm, p < 0.001), as well as ilio-femoral arteries bilaterally (p < 0.001). There was no significant difference in the proportion of ilio-femoral unfeasibility for transfemoral TAVI procedure, as measured by diameter of ilio-femoral arteries <5.0 mm (9.0% in males vs. 6.1% in females, p = 0.441) and <5.5 mm (24.7% in males vs. 16.7% in females, p = 0.156). Female patients were more likely to receive the smallest valve across different valve platforms (p < 0.001). There were sex-specific differences in the availability of conventional valve sizes across different platforms (p < 0.001). Female patients had significantly higher periprocedural mortality (7.9% vs. 1.7%, p = 0.030), whereas there were no differences in other clinical outcomes and no association of periprocedural mortality with anatomic measures.

Conclusion: Female patients showed smaller absolute dimensions of LVOT, aortic root, and ilio-femoral arteries than male patients. There were no differences in the prevalence of ilio-femoral unfeasibility for the transfemoral TAVI procedure; however, there were sex-specific differences in the availability of conventional valve sizes across different platforms. Female patients exhibited a higher periprocedural mortality, with no difference in other clinical outcomes.

Objective: Thoracic aortic aneurysm (TAA) represents an aortic pathology that is caused by the deranged integrity of the three layers of the aortic wall and is related to severe morbidity and mortality. Consequently, it is crucial to identify the biomarkers implicated in the pathogenesis and biology of TAA. The aim of the current computational study was to assess the differential gene expression profile of the gap junction proteins (GJPs) in patients with TAA to identify novel potential biomarkers for the diagnosis and treatment of this disease.

Methods: We implemented bioinformatics methodology to construct the gene network of the GJPs family, evaluate their expression in pathologic aortic tissue excised from patients with TAA, and compare it with healthy controls. We also investigated the related biological functions and miRNA families.

Results: We extracted raw data related to the transcriptomic profile of selected genes from a microarray dataset, incorporating 43 TAA and 43 healthy control samples. A total of 17 GJPs were evaluated. Eight GJPs (47%) were downregulated in TAA (GJA3, GJA9, GJA10, GJB1 GJC2, GJD2, GJD3, and GJD4). We also demonstrated the important correlations among the differentially expressed genes (DEGs). Four GJPs (GJA3, GJA9, GJC2, and GJD3) were associated with fair discrimination and calibration traits in predicting TAA presentation. Finally, we performed gene set enrichment analysis (GSEA) and identified the major biological functions and miRNA families (hsa-miR-5001-3p, hsa-miR-942-5p, hsa-miR-7113-3p, hsa-miR-6867-3p, and hsa-miR-4685-3p) associated with the DEGs.

Conclusion: These outcomes support the important role of certain gap junction proteins in the pathogenesis of TAA.

Objective: To investigate the modifying role of obesity in the association between abnormal glucose metabolism and atrial fibrillation (AF) risk in older individuals.

Methods: From April 2007 to November 2011, 11,663 participants aged ≥60 years were enrolled in the Shandong area. Glucose metabolic status was determined using fasting plasma glucose and hemoglobin A1c levels, and obesity was determined using body mass index (BMI), waist-to-hip ratio (WHR), and visceral fat area (VFA). Obesity-associated metabolic activities were assessed using the adiponectin-to-leptin ratio (ALR), galectin-3, and triglyceride-glucose index (TyG). New-onset AF was diagnosed by ICD-10.

Results: During an average of 11.1 years of follow-up, 1343 participants developed AF. AF risks were higher in those with prediabetes, uncontrolled diabetes, and well-controlled diabetes than with normoglycemia. The hazard ratios were decreased by 14.79%, 40.29%, and 25.23% in those with prediabetes; 31.44%, 53.56%, and 41.90% in those with uncontrolled diabetes; and 21.16%, 42.38%, and 27.59% in those with well-controlled diabetes after adjusting for BMI, WHR, and VFA, respectively. The population-attributable risk percentages of general obesity, central obesity, and high VFA for new-onset AF were 10.43%, 34.78%, and 31.30%, respectively. ALR, galectin-3, and TyG significantly mediated the association of BMI, WHR, and VFA with AF risk (all P_adj. < 0.001).

Conclusion: Obesity mediates the association between abnormal glucose metabolism and AF risk in older individuals. WHR is a more effective modifier than BMI and VFA for moderating the association. ALR, TyG, and galectin-3 mediate the moderating effect of obesity on the association between abnormal glucose metabolism and AF risk.