| 1. |
- Aburawi, Elhadi H., et al.
(författare)
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Epigenetics of conotruncal congenital heart disease : Protocol for a systematic review and meta-analysis
- 2024
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 19:4
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Conotruncal congenital heart defects (CTD) are a subset of congenital heart diseases (CHD) that involve structural anomalies of the right, left, or both cardiac outflow tracts. CHD is caused by multifactorial inheritance and changes in the genes or chromosomes. Recently, CHD was found to be due to epigenetic alterations, which are a combination of genetic and other environmental factors. Epigenetics is the study of how a gene's function changes as a result of environmental and behavioral influences. These causative factors can indirectly cause CHD by altering the DNA through epigenetic modifications. This is a protocol for a systematic review and meta-analysis that aims to explore whether the strength of association between various epigenetic changes and CTD types varies by race. Furthermore, to determine and compare the changes in gene expression of each mutation.METHODS: Our protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) guidelines. A comprehensive pre-search has been developed in PubMed and PubMed's Medical Subject Headings (MeSH). The final search will be performed in June 2023 in PubMed, Embase, Scopus, Web of Science, Cochrane Library, CIANHL, and PsycInfo, without restrictions on publication years. The Covidence systematic review software will be used for blinded screening and selection. Conflicts will be resolved by a third, independent reviewer. The risk of bias in selected studies will be assessed using the National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The data to be extracted will cover basic information on the included studies, study sample size, number of patients with various types of epigenetic changes, number of patients with various CTD types, measures of association and their 95% confidence interval between each epigenetic change and each CTD. The protocol has been registered with the International Prospero Register of Systematic Review (PROSPERO) [CRD42023377597].DISCUSSION: To the best of our knowledge, this protocol outlines the first systematic review and meta-analysis of the epigenetics of CTD. There is a growing body of evidence on epigenetics and its indirect involvement in disease by altering the DNA through epigenetic modifications in the genes associated with the causative factors for CHD. We will conduct a comprehensive and systematic search for literature in the above-mentioned seven core biomedical databases. It is very important to identify population-specific risk factors for CHD, which will have significant creative, custom-made, and effective prevention programs for the future generation.
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| 2. |
- Aburawi, Elhadi, et al.
(författare)
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A transthoracic Doppler echocardiography study of C-reactive protein and coronary microcirculation in children after open heart surgery.
- 2007
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Ingår i: Cardiology in the Young. - 1467-1107. ; 17:5, s. 472-477
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Tidskriftsartikel (refereegranskat)abstract
- Background Systemic inflammation has been suggested to underlie in part the elevated risk of arrhythmias and myocardial dysfunction during the first weeks after cardiac surgery. Recent transthoracic Doppler studies from our centre indicated increased basal coronary arterial flow in children 5 days after cardiopulmonary bypass surgery. In these children, we investigated whether the inflammatory mediator, C-reactive protein, could influence this association. Methods The peak flow velocity, velocity time-integral in diastole and systole, and basal blood flow in the proximal part of the left anterior descending artery, were assessed by transthoracic Doppler echocardiography 1 day before, and 5 days after, cardiac surgery in 17 children with ventricular and atrioventricular septal defects whose mean age at surgery was 6 months. Levels of C-reactive protein in the plasma were measured at both time-points. Results Prior to surgery, all children had levels of C-reactive protein under the limit for detection, that is less than 0.8 milligrams per litre. The levels of the protein had increased significantly by the second day, when the median value was 25, and the range from 20 to 142 milligrams per litre. They remained elevated on the fifth day after surgery, when the median was 11, and the range from 3 to 20 milligrams per litre. On the fifth day, the percentage increase in velocity time integral corrected for left ventricular mass was significantly lower in those patients with C-reactive protein greater than or equal to 10 milligrams per litre than in the remaining patients. Also, both the velocity time integral and the velocity of diastolic peak flow correlated inversely with log C-reactive protein, r being equal to −0.54 and p less than 0.02 and r equal to −0.74 and p less than 0.01, respectively, particularly among those patients in whom clamping of the aorta lasted for more than 1 hour, r for this statistic being equal to −0.8. Conclusion The postsurgical increase in the velocity of coronary arterial flow in children is inversely associated with rising levels of C-reactive protein. The duration of the aortic cross-clamping during surgery strengthens the association between levels of C-reactive protein and the microcirculatory changes.
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| 3. |
- Aburawi, Elhadi, et al.
(författare)
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Acute respiratory viral infections aggravate arterial endothelial dysfunction in children with type 1 diabetes.
- 2004
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Ingår i: Diabetes Care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 27:11, s. 2733-2735
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Tidskriftsartikel (refereegranskat)abstract
- Despite improvements in therapy for children with type 1 diabetes, the prevalence of cardiovascular morbidity in adulthood due to accelerated atherosclerosis remains significant (1). Similar to other cardiovascular risk factors, the diabetic state facilitates arterial endothelial injury, a primary event in the pathogenesis of atherosclerosis (2). Although several pediatric studies have reported an association of diabetes with arterial endothelial dysfunction (3,4), pathogenic animal studies have suggested that even though this disease predisposes to endothelial dysfunction and atherosclerosis, it might not be sufficient to cause them (5). Notably, type 1 diabetes increases the propensity for both chronic and acute infections in part by weakening the immune mechanisms (6). The risk is particularly increased for respiratory tract infections, but other infections have also been associated with diabetes (7). Furthermore, diabetic patients are at greater risk for infection-related mortality (8), and the excess risk appears to be linked to cardiovascular diseases (9). In the present study, we investigated whether viral respiratory tract infections in children with type 1 diabetes might impose an additional burden on the arterial endothelial function.
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| 4. |
- Aburawi, Elhadi, et al.
(författare)
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Coronary artery stenosis in asymptomatic child after arterial switch operation: detection by transthoracic colour-flow doppler echocardiography.
- 2008
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Ingår i: Acta Pædiatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 97:3, s. 376-378
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Tidskriftsartikel (refereegranskat)abstract
- Arterial switch operation (ASO) has become the definitive anatomical correction for transposition of great arteries (TGA). Left coronary artery (LCA) ostial stenosis was detected by transthoracic Doppler echocardiography (TTDE) as a flame like colour flow diastolic signal and coronary flow reserve (CFR) was low, 1.3. It was treated successfully by a drug-eluted stent. These findings could be diagnostic for coronary ostial stenosis. Conclusion: Coronary artery stenosis can be detected with colour Doppler echocardiography. Assessment of CFR provides information of the physiological significance of the coronary stenosis.
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| 5. |
- Aburawi, Elhadi, et al.
(författare)
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Coronary Blood Flow by Transthoracic Echocardiography in Children with Endomyocardial Fibrosis.
- 2009
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Ingår i: Pediatric Cardiology. - : Springer Science and Business Media LLC. - 0172-0643 .- 1432-1971. ; 30, s. 371-373
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Tidskriftsartikel (refereegranskat)abstract
- We report herein the coronary flow (CF) pattern determined by transthoracic Doppler echocardiography (TTDE) in two children with biventricular endomyocardial fibrosis (EMF). Endomyocardial biopsy showed various degrees of cardiac fibrosis in both patients as well as signs of chronic inflammation in one of the patients. TTDE showed a significant increase in CF in both the left anterior descending coronary artery and the posterior descending coronary artery compared with age-matched healthy controls. The diastolic flow in patients with EMF appeared to terminate earlier than in controls. The mechanisms and the potential significance of these novel findings are discussed.
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| 6. |
- Aburawi, Elhadi, et al.
(författare)
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Coronary flow before and after surgical versus device closure of atrial septal defect.
- 2009
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 135, s. 14-20
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cardiopulmonary bypass (CPB) affects coronary flow after the operation. Surgical as compared to device closure of atrial septal defect (ASD) serves as a good model to clarify the effects of surgery with CPB on coronary flow. METHODS: Coronary flow parameters were determined by transthoracic Doppler echocardiography before and after ASD closure. Thirteen children underwent surgery on CPB and fourteen children had device closure of their ASD under interventional cardiac catheterisation. Fourteen age-matched healthy controls were studied. RESULTS: Left ventricular fractional shortening increased and cardiac output increased after the device closure but there were no significant changes after the surgery. After the surgery the mean diameter of left anterior descending coronary artery increased from 1.7+/-0.6 to 2.1 +/-0.4 mm (p=0.03), the peak flow velocity in diastole (PFVd) from 48+/-10 to 70+/-12 cm/s (p=0.0001) and basal blood flow (BF) from 62+/-18 to 105+/-35 ml/min (p=0.0001). Flow parameters in the right coronary artery increased similarly. In contrast, all coronary flow parameters decreased substantially after catheter interventions, but still remained significantly elevated as compared with controls. CONCLUSIONS: Surgery with cardiopulmonary bypass but not the device closure affects coronary flow beyond the pure effects of anatomical correction. Cardiac output increases after the device closure. The reported decrease of coronary flow reserve is obviously due to increased basal coronary flow.
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| 7. |
- Aburawi, Elhadi, et al.
(författare)
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Coronary flow dynamics in children after repair of Tetralogy of Fallot.
- 2014
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 172:1, s. 122-126
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Tidskriftsartikel (refereegranskat)abstract
- To assess the possible effect of a stiff right ventricle on the coronary flow (CF) in patients with post-operative Tetralogy of Fallot (TOF).
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| 8. |
- Aburawi, Elhadi, et al.
(författare)
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Coronary Flow in Neonates with Impaired Intrauterine Growth.
- 2012
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Ingår i: Journal of the American Society of Echocardiography. - : Elsevier BV. - 1097-6795 .- 0894-7317. ; 25:3, s. 313-318
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Subclinical myocardial injury has been reported in newborns with fetal weights < 2 SDs for gestational age. Intrauterine growth restriction might affect cardiac function and coronary flow (CF). METHODS: Seventeen newborns with intrauterine growth restriction and 15 age-matched healthy controls were enrolled in the study. Blood flow in the umbilical artery and maternal uterine artery was assessed using Doppler velocimetry. Cardiac function and left anterior descending coronary artery CF were measured using transthoracic Doppler echocardiography at 1 week of age. RESULTS: The mean growth deviation of the newborns from normal was -2.5 ± 0.2 SDs. Percentage left ventricular shortening fraction was 39 ± 4.3% in patients and 42 ± 4.1% in controls (P = .40), and the mean left ventricular mass index was 86.6 g/m(2) in patients and 73.7 g/m(2) in controls (P < .01). The mean left anterior descending coronary artery diameter was 0.99 ± 0.1 mm in patients and 0.8 ± 0.1 mm in controls (P = .002). The left anterior descending coronary artery flow velocity-time integral was correlated with left ventricular mass index (r = 0.31, P = .007) and with mitral peak E/A ratio (r = 0.74, P = .01). Intrauterine growth restriction was associated with increased peak flow velocity in diastole (34.5 ± 4 vs 19 ± 6 cm/sec in controls, P = .0001), as well as increased CF (37 ± 7.3 vs 8.2 ± 3.0 mL/min in controls, P = .001). CONCLUSIONS: CF is significantly increased in neonates with impaired intrauterine growth. Left ventricular mass index is increased, but systolic and diastolic function remains normal. The clinical significance of increased CF is unclear, but it might lead to decreased CF reserve.
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| 9. |
- Aburawi, Elhadi, et al.
(författare)
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Early changes in myocardial repolarization and coronary perfusion after cardiopulmonary bypass surgery for ASD repair in children
- 2013
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: In adults, impaired myocardial repolarization and increased risk of arrhythmia are known consequences of open heart surgery. Little is known, however, about post-operative consequences of cardiopulmonary bypass surgery in children. The aim of this study was to assess ventricular repolarization and coronary perfusion after bypass surgery for atrial septal defect (ASD) repair in children. Methods: Twelve patients with ASD were assessed one day before and 5-6 days after ASD repair. Myocardial repolarization (corrected QT interval, QTc, QT dispersion, QTd, and PQ interval) was determined on 12-lead electrocardiograms. Coronary flow in proximal left anterior descending artery (peak flow velocity in diastole, PFVd) was assessed by transthoracic Doppler echocardiography. Results: Ten of the 12 (83%) children had normal myocardial repolarization before and after surgery. After surgery, QTc increased 1-9% in 5 (42%) patients, decreased 2-11% in 5 (42%) patients and did not change in 2 (16%) patients. Post-op QTc positively correlated with bypass time (R=0.686, p=0.014) and changes in PFVd (R=0.741, p=0.006). After surgery, QTd increased 33-67% in 4 (33%) patients, decreased 25-50% in 6 patients (50%) and did not change in 2 (16%) patients. After surgery, PQ interval increased 5-30% in 4 (33%) patients, decreased 4-29% in 6 (50%) patients and did not change in 1 (8%) patient. Post-op PQ positively correlated with bypass time (R=0.636, p=0.027). As previously reported, PFVd significantly increased after surgery (p<0.001). Conclusions: Changes in QTc, PQ and PFVd are common in young children undergoing surgery for ASD repair. Post-op QTc significantly correlates with bypass time, suggesting prolonged cardiopulmonary bypass may impair ventricular repolarization. Post-op QTc significantly correlates with PFVd changes, suggesting increased coronary flow may also impair ventricular repolarization. The clinical significance and reversibility of these alternations require further investigations.
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| 10. |
- Aburawi, Elhadi, et al.
(författare)
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Effects of Balloon Valvuloplasty on Coronary Blood Flow in Neonates With Critical Pulmonary Valve Stenosis Assessed With Transthoracic Doppler Echocardiography.
- 2009
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Ingår i: Journal of the American Society of Echocardiography. - : Elsevier BV. - 1097-6795 .- 0894-7317. ; 22, s. 165-169
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Treating pulmonary valve stenosis with balloon valvuloplasty (BV) is a good model to study the effect of right ventricular (RV) pressures on coronary flow. METHODS: Transthoracic Doppler echocardiography was used to register coronary flow in 10 age-matched healthy controls and 7 neonates before and 1 day after BV. RESULTS: Left ventricular fractional shortening and cardiac output increased significantly after BV. Right coronary artery diameter decreased from 1.2 +/- 0.2 to 1.1 +/- 0.1 mm (P < .02). Posterior descending coronary artery flow parameters decreased significantly, with blood flow decreasing from 8.4 to 5.7 +/- 1.9 mL/s (P < .003). RV end-diastolic pressure and RV systolic pressure explained almost totally the variation in coronary flow (r(2) = 0.87). CONCLUSIONS: RV end-diastolic pressure and RV systolic pressure determined coronary flow in neonates with critical pulmonary valve stenosis. Cardiac output and left ventricular fractional shortening increased after pulmonary valve BV.
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