Article
Pathology
Thomas Strecker, Felix Wiesmueller, Sabine Rudnik-Schoeneborn, Juliane Hoyer, Andre Reis, Michael Weyand, Abbas Agaimy
Summary: Aortic dissection is a life-threatening cardiovascular disease, and understanding the genetic causes, such as mutations of the ACTA2 gene, is crucial for identifying at-risk individuals and providing appropriate management and surveillance strategies.
Editorial Material
Medicine, General & Internal
Gordana Krljanac, Svetlana Apostolovic, Zlatko Mehmedbegovic, Olga Nedeljkovic-Arsenovic, Ruzica Maksimovic, Ivan Ilic, Aleksandra Djokovic, Lidija Savic, Ratko Lasica, Milika Asanin
Summary: Spontaneous coronary artery dissection (SCAD) is a possible cause of acute myocardial infarction (AMI) and sudden cardiac death. The clinical presentation of SCAD can vary, but the most common symptom is elevated cardiac biomarkers accompanied by chest discomfort. SCAD has a different pathological etiology compared to Type 1 AMI, affecting the size of the infarct. Management of SCAD typically begins in the catheterization laboratory, where a diagnosis is established and appropriate treatment is initiated. Additional imaging methods may be necessary for a fast and accurate management process.
Review
Health Care Sciences & Services
Eduardo Bossone, Andreina Carbone, Kim A. Eagle
Summary: Cardiovascular disease (CVD) is the leading cause of death and morbidity worldwide, and there are differences in the epidemiology and management of CVD between male and female patients. In the case of acute aortic dissection (AAD), women are typically older than men at the time of diagnosis and have a less abrupt onset of pain, leading to delayed presentation to the emergency department. Women also have a higher prevalence of hypertension and chronic obstructive pulmonary disease. In type A AAD, women are more prone to pleural effusion and coronary artery compromise, but experience fewer neurological and malperfusion symptoms. They undergo surgical treatment less frequently and have higher in-hospital mortality rates. In contrast, there are no significant differences in in-hospital mortality between genders in type B AAD. Further studies are needed to develop gender-specific strategies for preventive, diagnostic, and therapeutic approaches to AAD.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Review
Genetics & Heredity
Paolo Gelosa, Laura Castiglioni, Joanna Rzemieniec, Majeda Muluhie, Marina Camera, Luigi Sironi
Summary: Myocardial infarction is the leading cause of death among ischemic heart diseases, often accompanied by non-cardiovascular comorbidities, including brain disorders. Although there is evidence of a causal relationship between MI and stroke, the precise underlying mechanisms are still not fully understood. The challenge remains in reducing the risk of stroke in patients with MI.
JOURNAL OF MOLECULAR MEDICINE-JMM
(2022)
Article
Medicine, General & Internal
Xiaoli Wang, Xi Liu, E. Liao, Ning Ge, Yaping Hu
Summary: This study investigates the characteristics, diagnosis and treatment plan, and maternal and infant outcomes of pregnancy complicated with aortic dissection. Two pregnant women with persistent back pain were diagnosed with aortic dissection and underwent surgical interventions. Good maternal and infant outcomes were achieved through early identification and treatment.
Editorial Material
Cardiac & Cardiovascular Systems
Kaushalendra Rathore, Milena M. Wilke, Bharat Khialani
Summary: The patient developed inferolateral myocardial infarction after successful aortic root replacement surgery, with a small contrast leak around the left button seen on coronary angiogram. Intravascular ultrasound played a major role in diagnosing left main coronary artery compression due to intramural hematoma, and a drug-eluting stent was deployed for treatment.
JOURNAL OF CARDIAC SURGERY
(2021)
Article
Medicine, General & Internal
Thierry Carrel, Thoralf M. Sundt, Yskert von Kodolitsch, Martin Czerny
Summary: Despite advancements in the prevention, diagnosis, and treatment of acute aortic dissection, it remains a complex cardiovascular event with high mortality and morbidity rates. Recent research has improved our understanding of the disease's pathophysiology and led to reevaluations of existing classifications. There is a shift towards a unified naming system based on morphology and function. The location and extent of the initial tear, as well as the affected aortic segments, determine the appropriate management approach - emergency surgery, endovascular intervention, or medical treatment. Ongoing scientific evidence continues to shape the management and follow-up of acute aortic dissection, the most severe form of acute aortic syndrome.
Article
Cardiac & Cardiovascular Systems
Simone Gasser, Lukas Stastny, Markus Kofler, Christoph Krapf, Nikolaos Bonaros, Michael Grimm, Julia Dumfarth
Summary: The study found that female patients with acute aortic dissection type A were older and had a more aggressive and complicated preoperative course. They also had impaired neurological outcomes and lower survival rates.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)
Review
Cardiac & Cardiovascular Systems
Daniela Crousillat, Joan Briller, Niti Aggarwal, Leslie Cho, Thais Coutinho, Colleen Harrington, Eric Isselbacher, Kathryn Lindley, Maral Ouzounian, Ourania Preventza, Jyoti Sharma, Ranya Sweis, Melissa Russo, Nandita Scott, Nupoor Narula
Summary: Despite being more common in men, women with thoracic aortic aneurysm and dissection (TAAD) receive lower rates of treatment and surgical intervention, leading to worse outcomes. Additionally, an increasing number of women with TAAD desire pregnancy, which poses an increased risk of aortic complications. Understanding the sex-specific differences in TAAD holds the potential to enhance care delivery, reduce treatment disparities, and optimize outcomes for women with TAAD.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Surgery
Pascal Delsart, Clemence Vanlerberghe, Francis Juthier, Jonathan Sobocinski, Olivia Domanski, Benjamin Longere, Nadine Hanna, Pauline Arnaud, Luisa Marsili
Summary: Heterozygous variants in the ACTA2 gene can cause HTAD, with thoracic aortic aneurysm and dissection as main phenotypes, and detection rates varying between 1.5-21%. A consensus statement for screening and management of patients with pathogenic ACTA2 variants has been published by the European reference network for rare vascular diseases (VASCERN). However, the extremely variable clinical courses of ACTA2 patients within and between families pose challenges for effective prevention strategies.
ANNALS OF VASCULAR SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Ibrahim Sultan, Edgar Aranda-Michel, Valentino Bianco, Arman Kilic, Andreas Habertheuer, James A. Brown, Forozan Navid, Thomas G. Gleason
Summary: In this study, a total of 161 patients underwent total arch replacement for acute TAAD, with 50 patients undergoing concomitant carotid artery replacement. The baseline characteristics were similar between the two cohorts, but the carotid replacement group had higher rates of preoperative cerebral malperfusion and stroke. There was no significant difference in short-term or long-term mortality, as well as postoperative stroke, between the carotid replacement and conventional total arch replacement groups.
ANNALS OF THORACIC SURGERY
(2021)
Editorial Material
Medicine, General & Internal
Jane A. Leopold, Darren B. Taichman
Summary: In patients with acute myocardial infarction complicated by cardiogenic shock, the mortality rate after coronary-artery revascularization procedures is around 50%. Mechanical circulatory support, such as extracorporeal life support with venoarterial extracorporeal membrane oxygenation, can improve perfusion and workload for patients with persistent hemodynamic compromise and organ hypoperfusion.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Obstetrics & Gynecology
Zhigang Wang, Hongyan Sun, Chi Zhang, Lichong Lu, Lifang Zhang, Dongjin Wang
Summary: This study evaluated the efficacy and safety of performing cesarean section surgery before aortic repair after acute type A aortic dissection during pregnancy. The results indicated that aortic repair can be safely performed in the third-trimester.
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Hongliang Zhao, Chengxiang Li, Zhenxiao Jin, Weixun Duan, Lei Shang, Yingjuan Chang, Jingji Xu, Jialiang Ren, Shushen Lin, Yan Wang, Li Zhu, Gang Wang, Xin Chen, Chao He, Minwen Zheng
Summary: A nomogram, based on simple imaging and clinical variables collected on admission, showed good discrimination and calibration abilities in predicting preoperative AIS for ATAAD patients.
EUROPEAN RADIOLOGY
(2023)
Editorial Material
Medicine, General & Internal
Jayson R. Baman, S. Chris Malaisrie
Summary: This article describes aortic dissection, a condition characterized by a tear in the aorta, and discusses its diagnosis and treatment.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Surgery
Sherene Shalhub, Peter H. Byers, Kelli L. Hicks, Dawn M. Coleman, Frank M. Davis, Giovanni De Caridi, K. Nicole Weaver, Erin M. Miller, Marc L. Schermerhorn, Katie Shean, Gustavo Oderich, Mauricio Ribeiro, Cole Nishikawa, Kristofer Charlton-Ouw, Christian-Alexander Behrendt, E. Sebastian Debus, Yskert von Kodolitsch, Devin Zarkowsky, Richard J. Powell, Melanie Pepin, Dianna M. Milewicz, Ellen S. Regalado, Peter F. Lawrence, Karen Woo
JOURNAL OF VASCULAR SURGERY
(2020)
Article
Genetics & Heredity
Amelie Pinard, Stephanie Guey, Dongchuan Guo, Alana C. Cecchi, Natasha Kharas, Stephanie Wallace, Ellen S. Regalado, Ellen M. Hostetler, Anjail Z. Sharrief, Francoise Bergametti, Manoelle Kossorotoff, Dominique Herve, Markus Kraemer, Michael J. Bamshad, Deborah A. Nickerson, Edward R. Smith, Elisabeth Tournier-Lasserve, Dianna M. Milewicz
GENETICS IN MEDICINE
(2020)
Article
Cardiac & Cardiovascular Systems
David Ben-Nun, L. Maximilian Buja, Francisco Fuentes
CARDIOVASCULAR PATHOLOGY
(2020)
Article
Clinical Neurology
Arne Lauer, Samantha L. Speroni, Jay B. Patel, Ellen Regalado, Myoung Choi, Edward Smith, Jayashree Kalpathy-Kramer, Paul Caruso, Dianna M. Milewicz, Patricia L. Musolino
Summary: Patients with ACTA2 Arg179 pathogenic variants exhibit characteristic patterns of acute white matter ischemic injury and progressive internal carotid artery stenosis. Longitudinal analysis shows stable white matter hyperintensities but increasing cystic-like lesions in patients older than 1.2 years. 80% of patients experience progressive narrowing of the terminal internal carotid artery, which correlates with the number of critical stenoses in cerebral arteries and arterial ischemic infarctions.
Article
Cardiac & Cardiovascular Systems
Shahzeb Qaisar, Leon D. Brodsky, Rolf F. Barth, Carl Leier, Louis Maximilian Buja, Vedat Yildiz, Xiaokui Mo, Patricia Allenby, Stephen Moore, Iouri Ivanov, Wei Chen, Diana Thomas, Ashly Cordero Rivera, Denise Gamble, Ramon Hartage, George Mao, Jesse Sheldon, David Sinclair, Jennifer Vazzano, Bradley Zehr, Ashley Patton, Sergey Brodsky
Summary: This study aimed to investigate the relationship between obesity and aortic atherosclerosis (AA), finding that wall shear stress (WSS) was inversely correlated with AA but not a determinant of the obesity paradox. History of hypertension, diabetes, and age were significant factors for developing AA.
CARDIOVASCULAR PATHOLOGY
(2021)
Letter
Cardiac & Cardiovascular Systems
Louis Maximilian Buja
CARDIOVASCULAR PATHOLOGY
(2021)
Editorial Material
Cardiac & Cardiovascular Systems
Louis Maximilian Buja, Bihong Zhao, Michelle McDonald, Giulia Ottaviani, Dwayne A. Wolf
CARDIOVASCULAR PATHOLOGY
(2021)
Editorial Material
Cardiac & Cardiovascular Systems
Louis Maximilian Buja, James R. Stone
CARDIOVASCULAR PATHOLOGY
(2021)
Article
Genetics & Heredity
Andrea M. Murad, Hannah L. Hill, Yu Wang, Michael Ghannam, Min-Lee Yang, Norma L. Pugh, Federico M. Asch, Whitney Hornsby, Anisa Driscoll, Jennifer McNamara, Cristen J. Willer, Ellen S. Regalado, Dianna M. Milewicz, Kim A. Eagle, Santhi K. Ganesh
Summary: Spontaneous coronary artery dissection (SCAD) is a potential cause of myocardial infarction and sudden death, and it is related to genetic vascular and connective tissue disorders (TAD). The prevalence of SCAD is low in TAD patients, but the identified pathogenic gene variants are consistent with prior clinical reports on SCAD.
AMERICAN JOURNAL OF MEDICAL GENETICS PART A
(2022)
Article
Cardiac & Cardiovascular Systems
Uttam Savariya, Maria M. Patarroyo Aponte, Sriram Nathan, Bihong Zhao, Rajko Radovancevic, Ismael A. Salas de Armas, Biswajit Kar, Igor D. Gregoric, L. Maximilian Buja
Summary: This report presents the clinicopathological features of two cases of hypertrophic cardiomyopathy (HCM) that underwent orthotopic heart transplantation (OHT) due to complex clinical courses. The cases highlight the variable disease progression of HCM and the clinical challenges in patient management.
CARDIOVASCULAR PATHOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Louis Maximilian Buja
Summary: This article discusses the intersection of the author's interests in science, medicine, pathology, and oenology, focusing on viticulture and wine production, as well as the qualities and health benefits of wine consumption. The evidence for the special effects of red wine consumption, particularly in the context of the Mediterranean diet and lifestyle, is analyzed. The article concludes by suggesting that wine promotes civility and social engagement.
CARDIOVASCULAR PATHOLOGY
(2022)
Article
Cell & Tissue Engineering
Maria da Graca Cabreira, Xiaohong Wang, Andre Critsinelis, Mekedlawit Setegne, Parisa Lotfi, Ying-Wooi Wan, Gabriela Barrios, Zhuyong Mei, Adrian P. Gee, Louis Maximilian Buja, Emerson Perin
Summary: This study compares the effects of different oxygen concentrations on the growth and metabolism of multipotent mesenchymal stromal cells (MSCs). The results show that MSCs cultured in a 5% oxygen environment exhibit better proliferation and self-renewal ability, supported by non-oxidative glycolysis-based energy metabolism. The cytoprotection mechanisms and triggers of cell stress also differ between different oxygen conditions.
Article
Cardiac & Cardiovascular Systems
Ellen S. Regalado, Shaine A. Morris, Alan C. Braverman, Ellen M. Hostetler, Julie De Backer, Ruosha Li, Reed E. Pyeritz, Anji T. Yetman, Elena Cervi, Sherene Shalhub, Richmond Jeremy, Scott LeMaire, Maral Ouzounian, Arturo Evangelista, Catherine Boileau, Guillaume Jondeau, Dianna M. Milewicz
Summary: This study compares the risk of first aortic events among 7 genes for heritable thoracic aortic disease (HTAD) and variant types within each gene. The findings highlight significant differences in aortic event risk based on specific genes and variants, supporting personalized aortic surveillance and clinical management.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2022)
Letter
Cardiac & Cardiovascular Systems
Louis Maximilian Buja
CARDIOVASCULAR PATHOLOGY
(2023)
Article
Medicine, Research & Experimental
Suravi Majumder, Abhijnan Chattopadhyay, Jamie M. Wright, Pujun Guan, L. Maximilian Buja, Callie S. Kwartler, Dianna M. Milewicz
Summary: Microcephalic osteodysplastic primordial dwarfism type II (MOPDII) is a syndrome with complications like premature coronary artery disease (CAD). In this study, it was found that patients with MOPDII who died of CAD showed extensive atherosclerosis in their coronary arteries. Mice with smooth muscle cell-specific (SMC-specific) deficiency of pericentrin (PCNT) also had increased atherosclerotic plaque burden compared to the control mice. The activation of cellular stress and upregulation of cholesterol biosynthesis were identified as the mechanisms behind this phenomenon. Treatment with a HMG-CoA reductase inhibitor reduced plaque burden, indicating a potential therapeutic strategy for reducing CAD in MOPDII patients.