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Sökning: WFRF:(Liuba P.)

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1.
  • Sjöberg, P., et al. (författare)
  • Ventricular kinetic energy in young fontan patients
  • 2016
  • Ingår i: Cardiology in the Young. - 1467-1107. ; 26:Suppl 1, s. 64-64
  • Konferensbidrag (refereegranskat)abstract
    • Introduction: Four-dimensional (4D) flow magnetic resonance imaging (MRI) enables kinetic energy (KE) quantification of intraventricular blood flow. In this study we aimed to quantify the KE in in patients with univentricular heart and to assess the change in the KE after different types of interventions. Methods: 4D flow MRI was acquired in patients with Fontan circulation (n=12; median age 12, range 3-29 years) and in healthy volunteers (n =8; median age 26, range 23-36 years). MRI was repeated after transcatheter embolization of significant aortopulmonary collaterals (APC; n = 1), after stenting of left pulmonary artery (n=1) and after surgical replacement of hepatic flow tunnel with a Y graft due to significant central pulmonary artery stenosis with secondary formation of arteriovenous (AV) fistulas in the right lung (n= 1). Intraventricular KE was calculated throughout the cardiac cycle and indexed to stroke volume (SV). Results: The systole/diastole ratio of KE in Fontan patients was similar to the ratio of the controls' left ventricle (LV) or right ventricle (RV) depending on the ventricular morphology (Coheńs kappa =1.0). Peak systolic KE/SV did not differ in patients compared to the LV in controls (0.016 ± 0.006 mJ/ml vs 0.020 ±0.004 mJ/ml, p= 0.09). Peak diastolic KE/SV in Fontan patients was lower than in the LV of the control group (0.028 ±0.010 vs 0.057± 0.011 mJ/ml, p
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3.
  • I. FERNLUND, EVA, et al. (författare)
  • MYBPC3 hypertrophic cardiomyopathy can be detected by using advanced ECG in children and young adults
  • 2016
  • Ingår i: Journal of Electrocardiology. - : Elsevier BV. - 0022-0736 .- 1532-8430. ; 49:3, s. 392-400
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction The conventional ECG is commonly used to screen for hypertrophic cardiomyopathy (HCM), but up to 25% of adults and possibly larger percentages of children with HCM have no distinctive abnormalities on the conventional ECG, whereas 5 to 15% of healthy young athletes do. Recently, a 5-min resting advanced 12-lead ECG test ("A-ECG score") showed superiority to pooled criteria from the strictly conventional ECG in correctly identifying adult HCM. The purpose of this study was to evaluate whether in children and young adults, A-ECG scoring could detect echocardiographic HCM associated with the MYBPC3 genetic mutation with greater sensitivity than conventional ECG criteria and distinguish healthy young controls and athletes from persons with MYBPC3 HCM with greater specificity. Methods Five-minute 12-lead ECGs were obtained from 15 young patients (mean age 13.2 years, range 0-30 years) with MYBPC3 mutation and phenotypic HCM. The conventional and A-ECG results of these patients were compared to those of 198 healthy children and young adults (mean age 13.2, range 1 month-30 years) with unremarkable echocardiograms, and to those of 36 young endurance-trained athletes, 20 of whom had athletic (physiologic) left ventricular hypertrophy. Results Compared with commonly used, age-specific pooled criteria from the conventional ECG, a retrospectively generated A-ECG score incorporating results from just 2 derived vectorcardiographic parameters (spatial QRS-T angle and the change in the vectorcardiographic QRS azimuth angle from the second to the third eighth of the QRS interval) increased the sensitivity of ECG for identifying MYBPC3 HCM from 46% to 87% (p <0.05). Use of the same score also demonstrated superior specificity in a set of 198 healthy controls (94% vs. 87% for conventional ECG criteria; p <0.01) including in a subset of 36 healthy, young endurance-trained athletes (100% vs. 69% for conventional ECG criteria, p <0.001). Conclusions In children and young adults, a 2-parameter 12-lead A-ECG score is retrospectively significantly more sensitive and specific than pooled, age-specific conventional ECG criteria for detecting MYBPC3-HCM and in distinguishing such patients from healthy controls, including endurance-trained athletes.
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4.
  • Liuba, P., et al. (författare)
  • Matrix Metalloproteinase-8 Activity is Increased in Type 1 Diabetes Children with High-Risk Diabetes HLA and Systemic Inflammation
  • 2012
  • Ingår i: Cardiology in the Young. - 1467-1107. ; 22:S1, s. 115-116
  • Konferensbidrag (refereegranskat)abstract
    • Background: Matrix metalloproteinases (MMPs) and myeloperoxidase (MPO) are colocalized to lipid-laden macrophages, and play a central role in initiation and propagation of chronic vascular diseases including atherosclerosis. Prior cross-sectional studies from our centre on children and adolescents with type 1 diabetes suggested possible propensity conferred by diabetes-risk HLA DQ2/8, particularly in an inflammatory milieu, to peripheral vascular dysfunction, an important precursor of atherosclerosis. In the same population, we aimed to assess whether this putative interplay between DQ2/8 and inflammation also reflects into increased activity of MMP and MPO. Methods: Blood pressure, inflammatory, lipid, HbA1c, cyclic guanilate monophospate (cGMP), along with degree of exposure to secondhand tobacco smoke (STS) were determined in 74 children and adolescents with type 1 diabetes at baseline and 1 year later. MMP-8 and MPO levels were measured only at the 2nd time-point. Results: In univariate regression, baseline BMI, HbA1c, CRP(log), and TC/HDL were all predictors of 1-year MMP-2 (p,.05 for all), while exposure to STS, BMI, cGMP, and TC/ HDL predicted levels of MPO (p,.05 for all). The rise in serum MMP-8 was most increased in those with both DQ2/8 and CRP .1 mg/l (p=0.01), but no such difference was noted with regard to MPO. Conclusion: In young patients with type 1 diabetes, increased activities of MMP and MPO appear to relate mainly to dyslipidemia, but inflammation, particularly in those with diabetes-risk HLA, and exposure to tobacco smoke could be important stimuli as well.
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5.
  • Ahlström, L., et al. (författare)
  • Surgical age and morbidity after arterial switch of transposition of the great arteries
  • 2014
  • Ingår i: Cardiology in the Young. - 1467-1107. ; 24:S1, s. 151-152
  • Konferensbidrag (refereegranskat)abstract
    • Background: Although transposition of the great arteries (TGA) accounts for less than 5% of congenital heart disease, the clinical course is often dramatic with need for early diagnosis and careful preoperative care as well as advanced surgical correction and postoperative support. Since 1993, Lund is one of the two tertiary referral centers for pediatric cardiac surgery in Sweden, with nearly 400 surgical procedures each year. Methods: A single-institution 12-year retrospective survey of 127 neonates and infants (median for birth weight, gestational week, and age at surgery: 3.5 kg, 39 weeks, and 4 days, respectively) with TGA corrected via arterial switch operation (ASO). Postoperative morbidity and mortality during the hospital stay were reviewed. Patients with double outlet right ventricle and chromosome abnormalities were excluded. “Major postoperative morbidity” (MPM) was defined as presence of 1 or more of the following: prolonged mechanical ventilation (MV), delayed sternum closure, reoperation, CPAP/NIV after extubation, and ECMO. Patients were grouped based on distance between Lund and referral clinic as follows: “local”- within 200 km radius (n=67), and “external” >200 km (n=60). Results: There was only 1 death, born preterm (gestational week 34) with a body weight 7 days, n=25) surgical age had impact on MPM (p>0.4). Among those without fetal diagnosis of TGA, neither age at surgery (p=0.8) nor MPO (p=0.5) differed between “local” and “external” groups. Conclusion: ASO can be performed safely in full term neonates and in infants with TGA regardless of surgical age. This finding, along with the similar postoperative outcome regardless the distance between Lund and the referral clinic lend further support to the concept of centralization of pediatric cardiac surgery.
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6.
  • Belkin, Liuba, et al. (författare)
  • When Bad is Good (and Good is Bad):Examining the Ironic Antecedents and Consequences of Bad Behavior
  • 2023
  • Ingår i: Academy of Management Annual Meeting Proceedings. - New York : Academy of Management. - 2151-6561 .- 0065-0668.
  • Konferensbidrag (refereegranskat)abstract
    • It is a common assumption that organizations should avoid “bad” behaviors, as such behaviors have very few positive outcomes or they are likely motivated by undesirable antecedents. In this symposium, we question this prevailing wisdom, in several ways. We suggest that bad behaviors may both inspire positive outcomes (task performance) and be motivated by seemingly “positive” or innocuous antecedents (gratitude, psychological distance). Additionally, we find that engaging in “bad” behaviors (expressing anger) may have positive relational consequences. Together this symposium explores a series of counterintuitive findings that help explain why bad may be good, and good bad in ways that helps illuminate unexpected behavioral mechanism in workplace relationships.
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7.
  • Charitakis, Emmanouil, et al. (författare)
  • Comparing efficacy and safety in catheter ablation strategies for atrial fibrillation: a network meta-analysis
  • 2022
  • Ingår i: BMC Medicine. - : BMC. - 1741-7015. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: There is no consensus on the most efficient catheter ablation (CA) strategy for patients with atrial fibrillation (AF). The objective of this study was to compare the efficacy and safety of different CA strategies for AF ablation through network meta-analysis (NMA). Methods: A systematic search of PubMed, Web of Science, and CENTRAL was performed up to October 5th, 2020. Randomized controlled trials (RCT) comparing different CA approaches were included. Efficacy was defined as arrhythmia recurrence after CA and safety as any reported complication related to the procedure during a minimum follow-up time of 6 months. Results: In total, 67 RCTs (n = 9871) comparing 19 different CA strategies were included. The risk of recurrence was significantly decreased compared to pulmonary vein isolation (PVI) alone for PVI with renal denervation (RR: 0.60, CI: 0.38-0.94), PVI with ganglia-plexi ablation (RR: 0.62, CI: 0.41-0.94), PVI with additional ablation lines (RR: 0.8, CI: 0.68-0.95) and PVI in combination with bi-atrial modification (RR: 0.32, CI: 0.11-0.88). Strategies including PVI appeared superior to non-PVI strategies such as electrogram-based approaches. No significant differences in safety were observed. Conclusions: This NMA showed that PVI in combination with additional CA strategies, such as autonomic modulation and additional lines, seem to increase the efficacy of PVI alone. These strategies can be considered in treating patients with AF, since, additionally, no differences in safety were observed. This study provides decision-makers with comprehensive and comparative evidence about the efficacy and safety of different CA strategies.
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  • Charitakis, Emmanouil, et al. (författare)
  • Comparing Efficacy and Safety in Catheter Ablation Strategies for Paroxysmal Atrial Fibrillation : A Network Meta-Analysis of Randomized Controlled Trials
  • 2022
  • Ingår i: Diagnostics. - : MDPI. - 2075-4418. ; 12:2
  • Forskningsöversikt (refereegranskat)abstract
    • Although catheter ablation (CA) is an established treatment for paroxysmal atrial fibrillation (PAF), there is no consensus regarding the most efficient CA strategy. The objective of this network meta-analysis (NMA) was to compare the efficacy and safety of different CA strategies for PAF. A systematic search was performed in PubMed, Web of Science, and CENTRAL until the final search date, 5 October 2020. Randomised controlled trials (RCT) comparing different CA strategies and methods for pulmonary vein isolation (PVI) were included. Efficacy was defined as lack of arrhythmia recurrence after CA and safety as any reported complication related to the procedure during a minimum follow-up time of six months. In total, 43 RCTs comparing 11 different CA strategies involving 6701 patients were included. The risk of recurrence was significantly decreased in comparison with PVI with radiofrequency only for the following treatments: PVI with adjuvant ablation (RR: 0.79, CI: 0.65-0.97) and PVI with sympathetic modulation (RR: 0.64, CI: 0.46-0.88). However, PVI with radiofrequency was superior to non-PVI strategies (RR: 1.65, CI: 1.2-2.26). No statistically significant difference was found in safety between different CA strategies. Concerning different PVI strategies, no difference was observed either in efficacy or in safety between tested strategies. This NMA suggests that different PVI strategies are generally similar in terms of efficacy, while PVI with additional ablation or sympathetic modulation may be more effective than PVI alone. This study provides decision-makers with insights into the efficacy and safety of different CA strategies.
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9.
  • Eriksson, Peter J, 1959, et al. (författare)
  • Transcatheter Intervention for Coarctation of the Aorta A Nordic Population-Based Registry With Long-Term Follow-Up
  • 2023
  • Ingår i: Jacc-Cardiovascular Interventions. - : Elsevier BV. - 1936-8798 .- 1876-7605. ; 16:4, s. 444-453
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND Coarctation of the aorta (CoA), a congenital narrowing of the proximal descending thoracic aorta, is a relatively common form of congenital heart disease. Untreated significant CoA has a major impact on morbidity and mortality. In the past 3 decades, transcatheter intervention (TCI) for CoA has evolved as an alternative to surgery.OBJECTIVES The authors report on all TCIs for CoA performed from 2000 to 2016 in 4 countries covering 25 million inhabitants, with a mean follow-up duration of 6.9 years.METHODS During the study period, 683 interventions were performed on 542 patients.RESULTS The procedural success rate was 88%, with 9% considered partly successful. Complications at the intervention site occurred in 3.5% of interventions and at the access site in 3.5%. There was no in-hospital mortality. During follow-up, TCI for CoA reduced the presence of hypertension significantly from 73% to 34%, but despite this, many patients remained hypertensive and in need of continuous antihypertensive treatment. Moreover, 8% to 9% of patients needed aortic and/or aortic valve surgery during follow-up.CONCLUSIONS TCI for CoA can be performed with a low risk for complications. Lifetime follow-up after TCI for CoA seems warranted. (J Am Coll Cardiol Intv 2023;16:444-453) & COPY; 2023 by the American College of Cardiology Foundation.
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  • I. Fernlund, Eva, et al. (författare)
  • Serum Biomarkers of Myocardial Remodeling and Coronary Dysfunction in Early Stages of Hypertrophic Cardiomyopathy in the Young
  • 2017
  • Ingår i: Pediatric Cardiology. - : Springer Science and Business Media LLC. - 0172-0643 .- 1432-1971. ; 38:4, s. 853-863
  • Tidskriftsartikel (refereegranskat)abstract
    • Hypertrophic cardiomyopathy (HCM) remains the leading cause of sudden cardiac death in the young. Early markers for HCM are important to identify individuals at risk. The aim of this study was to investigate novel serum biomarkers reflecting myocardial remodeling, microfibrosis, and vascular endotheliopathy in the early stages of familial HCM in young patients. Twenty-three HCM patients, 16 HCM-risk individuals, and 66 controls (median 15 years) underwent echocardiography and serum analysis for cathepsin S, endostatin, myostatin, type I collagen degradation marker (ICTP), matrix metalloproteinase (MMP)-9, vascular endothelial growth factor receptor (VEGFR)-1, and vascular and intercellular adhesion molecules (VCAM, ICAM). In a subset of the population, global myocardial perfusion was performed by magnetic resonance imaging. Cathepsin S (p = 0.0009), endostatin (p < 0.0001), MMP-9 (p = 0.008), and VCAM (p = 0.04) were increased in the HCM group and correlated to left ventricular mass index and mitral E/e′ (p < 0.01). In the HCM-risk group, myostatin was decreased (p = 0.004), whereas ICAM was increased (p = 0.002). Global perfusion was decreased in the HCM group (p < 0.05) versus controls. Endostatin and mitral E/e′ correlated inversely to myocardial perfusion (p ≤ 0.05). This is the first study demonstrating adverse changes in biomarkers reflecting myocardial matrix remodeling, microfibrosis, and vascular endotheliopathy in early stage of hypertrophic cardiomyopathy in the young.
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12.
  • Jacobs, Jeffrey P., et al. (författare)
  • Combining Congenital Heart Surgical and Interventional Cardiology Outcome Data in a Single Database : The Development of a Patient-Centered Collaboration of the European Congenital Heart Surgeons Association (ECHSA) and the Association for European Paediatric and Congenital Cardiology (AEPC)
  • 2023
  • Ingår i: World Journal for Pediatric and Congenital Heart Surgery. - 2150-1351. ; 14:4, s. 464-473
  • Tidskriftsartikel (refereegranskat)abstract
    • The European Congenital Heart Surgeons Association (ECHSA) Congenital Database (CD) is the second largest clinical pediatric and congenital cardiac surgical database in the world and the largest in Europe, where various smaller national or regional databases exist. Despite the dramatic increase in interventional cardiology procedures over recent years, only scattered national or regional databases of such procedures exist in Europe. Most importantly, no congenital cardiac database exists in the world that seamlessly combines both surgical and interventional cardiology data on an international level; therefore, the outcomes of surgical and interventional procedures performed on the same or similar patients cannot easily be tracked, assessed, and analyzed. In order to fill this important gap in our capability to gather and analyze information on our common patients, ECHSA and The Association for European Paediatric and Congenital Cardiology (AEPC) have embarked on a collaborative effort to expand the ECHSA-CD with a new module designed to capture data about interventional cardiology procedures. The purpose of this manuscript is to describe the concept, the structure, and the function of the new AEPC Interventional Cardiology Part of the ECHSA-CD, as well as the potentially valuable synergies provided by the shared interventional and surgical analyses of outcomes of patients. The new AEPC Interventional Cardiology Part of the ECHSA-CD will allow centers to have access to robust surgical and transcatheter outcome data from their own center, as well as robust national and international aggregate outcome data for benchmarking. Each contributing center or department will have access to their own data, as well as aggregate data from the AEPC Interventional Cardiology Part of the ECHSA-CD. The new AEPC Interventional Cardiology Part of the ECHSA-CD will allow cardiology centers to have access to aggregate cardiology data, just as surgical centers already have access to aggregate surgical data. Comparison of surgical and catheter interventional outcomes could potentially strengthen decision processes. A study of the wealth of information collected in the database could potentially also contribute toward improved early and late survival, as well as enhanced quality of life of patients with pediatric and/or congenital heart disease treated with surgery and interventional cardiac catheterization across Europe and the world.
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13.
  • Jacobs, Jeffrey P., et al. (författare)
  • Combining Congenital Heart Surgical and Interventional Cardiology Outcome Data in a Single Database : The Development of a Patient-Centered Collaboration of the European Congenital Heart Surgeons Association (ECHSA) and the Association for European Paediatric and Congenital Cardiology (AEPC)
  • 2023
  • Ingår i: Cardiology in the Young. - 1047-9511. ; 33:7, s. 1043-1059
  • Tidskriftsartikel (refereegranskat)abstract
    • The European Congenital Heart Surgeons Association (ECHSA) Congenital Database (CD) is the second largest clinical pediatric and congenital cardiac surgical database in the world and the largest in Europe, where various smaller national or regional databases exist. Despite the dramatic increase in interventional cardiology procedures over recent years, only scattered national or regional databases of such procedures exist in Europe. Most importantly, no congenital cardiac database exists in the world that seamlessly combines both surgical and interventional cardiology data on an international level; therefore, the outcomes of surgical and interventional procedures performed on the same or similar patients cannot easily be tracked, assessed, and analyzed. In order to fill this important gap in our capability to gather and analyze information on our common patients, ECHSA and The Association for European Paediatric and Congenital Cardiology (AEPC) have embarked on a collaborative effort to expand the ECHSA-CD with a new module designed to capture data about interventional cardiology procedures. The purpose of this manuscript is to describe the concept, the structure, and the function of the new AEPC Interventional Cardiology Part of the ECHSA-CD, as well as the potentially valuable synergies provided by the shared interventional and surgical analyses of outcomes of patients. The new AEPC Interventional Cardiology Part of the ECHSA-CD will allow centers to have access to robust surgical and transcatheter outcome data from their own center, as well as robust national and international aggregate outcome data for benchmarking. Each contributing center or department will have access to their own data, as well as aggregate data from the AEPC Interventional Cardiology Part of the ECHSA-CD. The new AEPC Interventional Cardiology Part of the ECHSA-CD will allow cardiology centers to have access to aggregate cardiology data, just as surgical centers already have access to aggregate surgical data. Comparison of surgical and catheter interventional outcomes could potentially strengthen decision processes. A study of the wealth of information collected in the database could potentially also contribute toward improved early and late survival, as well as enhanced quality of life of patients with pediatric and/or congenital heart disease treated with surgery and interventional cardiac catheterization across Europe and the world.
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15.
  • Liuba, Ioan, et al. (författare)
  • Scar progression in patients with nonischemic cardiomyopathy and ventricular arrhythmias
  • 2014
  • Ingår i: Heart Rhythm. - : Elsevier. - 1547-5271 .- 1556-3871. ; 11:5, s. 755-762
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND Disease progression in patients with nonischemic cardiomyopathy (NICM) is poorly understood. OBJECTIVE To assess left ventricular(LV) scar progression and dilatation by using endocardial electroanatomic mapping. METHODS We studied 13 patients with NICM and recurrent ventricular tachycardia. Two detailed sinus rhythm endocardial voltage maps(265 +/- 122 points/map) were obtained after a mean of 32 months(range 9-77 months). The scar area, defined by low bipolar (BI; less than 1.5 mV) and unipolar(UNI; less than 8.3 mV) endocardial voltage, and the LV volume were measured and compared. A scar difference of greater than 6% of the LV surface and an increase in LV volume of greater than= 20 mL were considered beyond measurement error. RESULTS Six (46%) patients had an increase in scar area beyond boundaries of prior ablation. Five patients had an increase in UNI and 1 patient had an increase in both BI and UNI areas. The increase in BI area represented 16% and the increase in UNI area represented 6.5%-46.2% of the LV surface. A significant decrease in LV ejection fraction was found only in patients with scar progression (from 39% +/- 8%:p = .0003) (LV volume increase ranging between 9% and 23%) was noted in 3 patients, all of whom had scar progression. CONCLUSIONS Progressive scarring with an increase in the area of UNI and less commonly BI electrogram abnormality is seen in 46% of the patients with NICM and ventricular tachycardia and is associated with LV dilatation and decrease in LV ejection fraction. The prominent UNI abnormality suggests predominantly midmyo-cardial or epicardial scarring.
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  • Liuba, P., et al. (författare)
  • Coronary flow and reactivity, but not arrhythmia vulnerability, are affected by cardioplegia during cardiopulmonary bypass surgery of piglets
  • 2011
  • Ingår i: Cardiology in the Young. - 1467-1107. ; 21:S1, s. 70-70
  • Konferensbidrag (refereegranskat)abstract
    • Introduction: Cardiopulmonary bypass (CPB) surgery remains associated with significant cardiovascular morbidity in both pediatric and adult patients but the mechanisms are not fully clarified. Abnormalities in coronary flow and function have beensuggested to play an important role. A few prior studies suggested protective effects on coronary and myocardial function by short intravenous (i.v.) infusion of cyclosporine A prior to CPB surgery. Methods: Barrier-bred piglets (10-12 kg, n=20) were subjected to CPB with (n=10) or without (n=10) antegrade administration for 20 minutes of cardioplegic solution. Prior to surgery, half of animals from each group received 10-minute i.v. infusion of 100 mg/kg cyclosporine A. Left anterior descending coronary flow velocity responses to adenosine, serotonin, and atrial pacing, as well as left ventricular function and postsurgical vulnerability to atrial fibrillation (Afib) were assessed by intracoronary Doppler, epicardial echocardiography, and in vivo electrophysiological study, respectively. Results: Coronary peak flow velocity (cPFV) rose significantly after surgery, especially in cardioplegia group (p0.4). There was no difference in systolic myocardial function between groups at any timepoint. Conclusions: Cardioplegia during CPB surgery of piglets was associated with profound abnormalities in coronary vasomotor tone and receptor-related flow regulation, whereas arrhythmia vulnerability appeared to be comparable with that in non-cardioplegia group. In this study, intracoronary pretreatment with cyclosporine had no observable protective effect on coronary circulation or arrhythmia vulnerability after CPB surgery.
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18.
  • Liuba, Petru, et al. (författare)
  • Endothelial dysfunction after repeated Chlamydia pneumoniae infection in apolipoprotein E-knockout mice
  • 2000
  • Ingår i: Circulation. - 1524-4539. ; 102:9, s. 1039-1044
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Arterial relaxation is largely regulated by endothelial nitric oxide (NO). Its diminished activity has been associated with incipient atherosclerosis. We investigated the endothelium-dependent relaxation of aorta in apolipoprotein E-knockout (apoE-KO) mice exposed to single or repeated Chlamydia pneumoniae inoculation. METHODS AND RESULTS: Forty-eight apoE-KO mice, 8 weeks old, were inoculated intranasally with C pneumoniae (n=24) or saline (n=24) every 2 weeks over a 6-week period. Twenty mice (10 infected and 10 controls) were killed at 2 weeks and 6 weeks, respectively, after the first inoculation. The smooth muscle tone of aortic rings was measured in vitro at both time points. The norepinephrine-precontracted thoracic aortic rings were successively exposed to methacholine in the absence and presence of N:(G)-nitro-L-arginine methyl ester (L-NAME) and diclofenac. The methacholine-induced relaxation was attenuated in the infected mice at 6 weeks in both the absence and presence of L-NAME (P:<0.05 and P:<0.01, respectively). When administered together with L-NAME, diclofenac enhanced the relaxation of the L-NAME-pretreated aortas in infected mice at 2 weeks (P:<0.05) but not in noninfected mice. The relaxation response from infected mice tended to differ in the same manner at 6 weeks (P:<0.1). No intimal thickening was detected at either time point. CONCLUSIONS: C pneumoniae impairs arterial endothelial function, and the NO pathway is principally involved. Cyclooxygenase-dependent vasoconstricting products may also account for the infection-induced impaired relaxation. These findings further support the role of C pneumoniae infection in atherosclerosis development.
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20.
  • Odermarsky, M., et al. (författare)
  • Human Leucocyte Antigen, Infections and Systemic Inflammatory Biomarkers in Early Atherosclerosis in Children and Adolescents with Type 1 Diabetes
  • 2015
  • Ingår i: Cardiology in the Young. - 1467-1107. ; 25:Suppl. 1, s. 33-33
  • Konferensbidrag (refereegranskat)abstract
    • Background: This prospective study focuses on factors associated with arterial damage in children with type 1 diabetes (T1D). Materials and Methods: Eighty children and adolescents with T1D (mean age 15, range: 8-20 yrs; mean diabetes duration 7, range: 0.5 to 19 years) were investigated twice, approximately 2 years apart, for carotid artery intima-media thickness (cIMT) and compliance (CAC), flow-mediated dilatation (FMD) of the brachial artery, and plasma levels of matrix metalloproteinase (MMP)-8. HLA genotypes were determined in dried spots of peripheral blood by polymerase chain reaction followed by hybridization assay. The number of respiratory tract infections (RTI) during the past year was obtained by a questionnaire in 56 patients. Results: cIMT progression (% change of cIMT from baseline) correlated inversely with the % changes of both CAC (p = 0.04, r=−0.3, n=62) and FMD (p=0.03, r=−0.3, n=67). RTI frequency correlated significantly with cIMT progression irre- spective of age, diabetes duration, BMI, and HbA1c (p=0.03, r=0.3, in multivariate analysis). When patients were divided in relation to DQ2/8 genotype and RTI, the association of DQ2/8 with cIMT progression remained significant in patients with over three infections/year (p = 0.04, r = 0.3). During follow-up, the group of DQ2/8 patients with CRP > 1 mg/l showed significantly higher levels of plasma MMP-8 than the non-DQ2/8 group. Conclusions: Diabetes-risk genotype DQ2/8 and inflammation con- tribute to vascular changes in children and adolescents with T1D.
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