Thu.Feb 15, 2024

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ECG Blog #417 — AFib with Aberrancy?

Ken Grauer, MD

The ECG in Figure-1 was obtained from a previously healthy middle-aged man — who presented to the ED ( E mergency D epartment ) for shortness of breath. QUESTIONS: How would YOU interpret the ECG shown in Figure-1 ? Given the irregular irregularity of beats #4-through 17 — Is this a run of AFib ( A trial Fib rillation ) with aberrant conduction? Figure-1: The initial ECG in today's case.

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CTRP4/interleukin-6 receptor signaling ameliorates autoimmune encephalomyelitis by suppressing Th17 cell differentiation

Journal of Clinical Investigation - Cardiology

C1q/TNF-related protein 4 (CTRP4) is generally thought to be released extracellularly and plays a critical role in energy metabolism and protecting against sepsis. However, its physiological functions in autoimmune diseases have not been thoroughly explored. In this study, we demonstrate that Th17 cell–associated experimental autoimmune encephalomyelitis was greatly exacerbated in Ctrp4–/– mice compared with WT mice due to increased Th17 cell infiltration.

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AI tools better at predicting heart transplant rejection than standard clinical method, finds study

Medical Xpress - Cardiology

More than 4,500 heart transplants were performed in the U.S. in 2023. While the lifesaving operation improves the quality of life and longevity for most recipients, organ rejection remains a risk, with acute rejection occurring in up to 32% of recipients within the first year.

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Piezo1 agonist restores meningeal lymphatic vessels, drainage, and brain-CSF perfusion in craniosynostosis and aged mice

Journal of Clinical Investigation - Cardiology

Skull development coincides with the onset of cerebrospinal fluid (CSF) circulation, brain-CSF perfusion, and meningeal lymphangiogenesis, processes essential for brain waste clearance. How these processes are affected by craniofacial disorders such as craniosynostosis are poorly understood. We report that raised intracranial pressure and diminished CSF flow in craniosynostosis mouse models associate with pathological changes to meningeal lymphatic vessels that affect their sprouting, expansion,

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Diabetes Dialogue: Tirzepatide in Type 1 Diabetes, with Viral Shah, MD

HCPLive

Viral Shah, MD, of Indiana University, joins Diabetes Dialogue to discuss a recent proof-of-concept study examining use of tirzepatide in type 1 diabetes.

Diabetes 125
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Dynamic metabolism of endothelial triglycerides protects against atherosclerosis in mice

Journal of Clinical Investigation - Cardiology

Blood vessels are continually exposed to circulating lipids, and elevation of ApoB-containing lipoproteins causes atherosclerosis. Lipoprotein metabolism is highly regulated by lipolysis, largely at the level of the capillary endothelium lining metabolically active tissues. How large blood vessels, the site of atherosclerotic vascular disease, regulate the flux of fatty acids (FAs) into triglyceride-rich (TG-rich) lipid droplets (LDs) is not known.

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Hot Flashes, Migraine Tied to Higher Risk of Stroke, Heart Disease

Med Page Today

(MedPage Today) -- History of migraine combined with persistent hot flashes was associated with higher risks for cardiovascular disease and stroke, according to an analysis of women in the Coronary Artery Risk Development in Young Adults (CARDIA.

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Top 50 cardiovascular hospitals, per Fortune, PINC

Becker's Hospital Review - Cardiology

Fortune and PINC AI named the top cardiovascular hospitals, including teaching hospitals with and without cardiovascular residency programs, and community hospitals.

Hospital 116
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Microbiota-dependent indole production stimulates the development of collagen-induced arthritis in mice

Journal of Clinical Investigation - Cardiology

Altered tryptophan catabolism has been identified in inflammatory diseases like rheumatoid arthritis (RA) and spondyloarthritis (SpA), but the causal mechanisms linking tryptophan metabolites to disease are unknown. Using the collagen-induced arthritis (CIA) model, we identified alterations in tryptophan metabolism, and specifically indole, that correlated with disease.

Diet 111
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Marla Dubinsky, MD: Using Off-Label Treatments to Address the Unmet Need in Pediatric IBD

HCPLive

Marla Dubinsky, MD, discusses the use of off-label upadacitinib in pediatric IBD patients and the importance of this research due to delays in pediatric drug approvals.

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ZODIAC Clinical Trial Led by UT Health Science Center Professor Likely to Make Major Impact on Stroke Care

DAIC

Dr. Anne Alexandrov. Image courtesy of the UT Health Science Center milla1cf Thu, 02/15/2024 - 13:16 February 15, 2024 — Research findings in a clinical trial led by a professor at the University of Tennessee Health Science Center ’s College of Nursing are likely to dramatically change care and improve outcomes for patients suffering from acute stroke.

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Abrocitinib Effective for Eczema Patients with Inadequate Response to Upadacitinib, Dupilumab

HCPLive

This research also included results from a sub-analysis of non-responders with hand eczema to dupilumab and upadacitinib.

Research 128
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Canary Completes First-in-Human Trial of Cardiac Auscultation Monitoring Sensor

DAIC

milla1cf Thu, 02/15/2024 - 13:10 February 15, 2024 — Canary Medical , a medical data company focused on the development and commercialization of its patented implantable sensor technology and complementary data and analytics ecosystem, today announced the completion of the first-in-human limited feasibility trial of their Cardiac Auscultation (Acoustic) monitoring sensor device.

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Clinician Quiz: AAO Guidelines for Inherited Retinal Degenerations

HCPLive

Test your knowledge with this clinician quiz! In this quiz, we test your knowledge on clinical assessment recommendations for patients with inherited retinal diseases based on 2022 guidelines from the American Academy of Ophthalmology.

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Heterozygous mutations in the C-terminal domain of COPA underlie a complex autoin?ammatory syndrome

Journal of Clinical Investigation - Cardiology

Mutations in the N-terminal WD40 domain of coatomer protein complex subunit α (COPA) cause a type I interferonopathy, typically characterized by alveolar hemorrhage, arthritis, and nephritis. We described 3 heterozygous mutations in the C-terminal domain (CTD) of COPA (p.C1013S, p.R1058C, and p.R1142X) in 6 children from 3 unrelated families with a similar syndrome of autoinflammation and autoimmunity.

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Magnetically operated robot can move through arteries to treat stroke patients

Medical Xpress - Cardiology

A team of roboticists at Multi-Scale Robotics Lab, ETH Zurich, working with several hospitals in Switzerland, has developed a magnetically operated robot that could potentially be used to treat people after a stroke. Their paper is published in the journal Science Robotics.

Stroke 98
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S1PR1 inhibition induces proapoptotic signaling in T cells and limits humoral responses within lymph nodes

Journal of Clinical Investigation - Cardiology

Effective immunity requires a large, diverse naive T cell repertoire circulating among lymphoid organs in search of antigen. Sphingosine 1-phosphate (S1P) and its receptor S1PR1 contribute by both directing T cell migration and supporting T cell survival. Here, we addressed how S1P enables T cell survival and the implications for patients treated with S1PR1 antagonists.

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First Patient Randomized in AskBio Phase II Gene Therapy Trial for Congestive Heart Failure Treatment

DAIC

Bayer AG and Asklepios BioPharmaceutical, Inc. (AskBio), a subsidiary of Bayer AG, have announced that the first patient has been randomized in GenePHIT (Gene PHosphatase Inhibition Therapy), a Phase II trial of AB-1002, also known as NAN-101, for the treatment of congestive heart failure (CHF). Image courtesy: AskBio christine.book Thu, 02/15/2024 - 13:39 February 15, 2024 — Bayer AG and Asklepios BioPharmaceutical, Inc. ( AskBio ), a gene therapy company wholly owned and independently operated

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The interaction of Synapsin 2a and Synaptogyrin-3 regulates fear extinction in mice

Journal of Clinical Investigation - Cardiology

The mechanisms behind a lack of efficient fear extinction in some individuals are unclear. Here, by employing a principal components analysis–based approach, we differentiated the mice into extinction-resistant and susceptible groups. We determined that elevated synapsin 2a (Syn2a) in the infralimbic cortex (IL) to basolateral amygdala (BLA) circuit disrupted presynaptic orchestration, leading to an excitatory/inhibitory imbalance in the BLA region and causing extinction resistance.

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Q&A: Healthy gums, healthy heart; what's the connection?

Medical Xpress - Cardiology

Healthy gums are imperative to a healthy mouth, but what about your cardiovascular health? In honor of Heart Month, Dr. Frank Nichols, professor of periodontics at the UConn School of Dental Medicine, unravels the underlying connection between gum health and heart health.

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KCTD1/KCTD15 complexes control ectodermal and neural crest cell functions, and their impairment causes aplasia cutis

Journal of Clinical Investigation - Cardiology

Aplasia cutis congenita (ACC) is a congenital epidermal defect of the midline scalp and has been proposed to be due to a primary keratinocyte abnormality. Why it forms mainly at this anatomic site has remained a long-standing enigma. KCTD1 mutations cause ACC, ectodermal abnormalities, and kidney fibrosis, whereas KCTD15 mutations cause ACC and cardiac outflow tract abnormalities.

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The effect of colchicine on cholesterol crystal formation, expansion and morphology: a potential mechanism in atherosclerosis

Frontiers in Cardiovascular Medicine

Background Inflammation is pivotal to the progression of atherosclerosis. Cholesterol crystals (CCs) that grow and enlarge within the plaque core can cause plaque rupture and trigger inflammation as they deposit into the atherosclerotic bed. Thus, agents that affect CC formation, expansion, and morphology may reduce cardiovascular (CV) risk independent of lipid-lowering and anti-inflammatory therapy.

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A metabolic signature for NADSYN1-dependent congenital NAD deficiency disorder

Journal of Clinical Investigation - Cardiology

Nicotinamide adenine dinucleotide (NAD) is essential for embryonic development. To date, biallelic loss-of-function variants in 3 genes encoding nonredundant enzymes of the NAD de novo synthesis pathway — KYNU, HAAO, and NADSYN1 — have been identified in humans with congenital malformations defined as congenital NAD deficiency disorder (CNDD). Here, we identified 13 further individuals with biallelic NADSYN1 variants predicted to be damaging, and phenotypes ranging from multiple severe malformat

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The effect of surgery started at different time point during the day on the clinical outcomes of mitral valve surgery

Frontiers in Cardiovascular Medicine

Background The clinical prognosis of mitral valve surgery at morning, afternoon, and evening is not yet clear. The aim of the study is to investigate the impact of different time periods of surgery in the morning, afternoon and evening on the short-term and long-term results of mitral valve surgery. Methods From January 2018 to December 2020, 947 patients with mitral valve surgery in our department were selected.

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Proteogenomic analysis reveals cytoplasmic sequestration of RUNX1 by the acute myeloid leukemia–initiating CBFB::MYH11 oncofusion protein

Journal of Clinical Investigation - Cardiology

Several canonical translocations produce oncofusion genes that can initiate acute myeloid leukemia (AML). Although each translocation is associated with unique features, the mechanisms responsible remain unclear. While proteins interacting with each oncofusion are known to be relevant for how they act, these interactions have not yet been systematically defined.

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Evaluation of Large Ischemic Cores to Predict Outcomes of Thrombectomy: A Proposal of a Novel Treatment Phase

Stroke: Vascular and Interventional Neurology

Stroke: Vascular and Interventional Neurology, Ahead of Print. BACKGROUNDEndovascular treatment of large ischemic cores is challenging. The severity of ischemic stress is assessed using the apparent diffusion coefficient (ADC). We aimed to evaluate the ADC in patients with a low Alberta Stroke Program Early CT [Computed Tomography] Score using diffusion‐weighted imaging and whether it correlates with clinical outcomes.METHODSThis study included consecutive patients with acute large ischemic stro

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Lipid droplets in the endothelium: The missing link between metabolic syndrome and cardiovascular disease?

Journal of Clinical Investigation - Cardiology

The physiology of lipid droplets (LDs) has been most extensively characterized in adipocytes, but LDs also accumulate in endothelial cells lining blood vessels in response to changing levels of triglycerides. In recent issues of the JCI, two independent papers highlight a direct role of endothelial LDs in the genesis of hypertension and atherosclerosis in rodent models.

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Targeting the microenvironment rather than a specific cell type could be the key to healing injured hearts

Medical Xpress - Cardiology

A new study published in Nature Cardiovascular Research has unveiled a remarkable discovery that may have far-reaching implications for the treatment of heart disease.

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Interferon-? receptor antisense oligonucleotides reduce neuroinflammation and neuropathology in a mouse model of cerebral interferonopathy

Journal of Clinical Investigation - Cardiology

Chronic and elevated levels of the antiviral cytokine IFN-α in the brain are neurotoxic. This is best observed in patients with genetic cerebral interferonopathies such as Aicardi-Goutières syndrome. Cerebral interferonopathies typically manifest in early childhood and lead to debilitating disease and premature death. There is no cure for these diseases with existing treatments largely aimed at managing symptoms.

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Prenatal diagnosis and clinical management of cardiac rhabdomyoma: a single-center study

Frontiers in Cardiovascular Medicine

Objective The study aims to assess the ultrasonic features of fetal cardiac rhabdomyoma (CR), track the perinatal outcome and postnatal disease progression, investigate the clinical utility of ultrasound, MRI and tuberous sclerosis complex (TSC) gene analysis in CR evaluation, and offer evidence for determing of fetal CR prognosis. Methods We conducted a retrospective analysis of prenatal ultrasound-diagnosed fetal CR cases in our hospital from June 2011 to June 2022, tracked the perinatal outco

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An engineered immunomodulatory IgG1 Fc suppresses autoimmune inflammation through pathways shared with i.v. immunoglobulin

Journal of Clinical Investigation - Cardiology

Immunoglobulin G (IgG) antibodies in the form of high-dose intravenous immunoglobulin (IVIG) exert immunomodulatory activity and are used in this capacity to treat inflammatory and autoimmune diseases. Reductionist approaches have revealed that terminal sialylation of the single asparagine-linked (N-linked) glycan at position 297 of the IgG1 Fc bestows antiinflammatory activity, which can be recapitulated by introduction of an F241A point mutation in the IgG1 Fc (FcF241A).

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Artificial intelligence applied in cardiovascular disease: a bibliometric and visual analysis

Frontiers in Cardiovascular Medicine

Background With the rapid development of technology, artificial intelligence (AI) has been widely used in the diagnosis and prognosis prediction of a variety of diseases, including cardiovascular disease. Facts have proved that AI has broad application prospects in rapid and accurate diagnosis. Objective This study mainly summarizes the research on the application of AI in the field of cardiovascular disease through bibliometric analysis and explores possible future research hotpots.

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ACSS2 gene variants determine kidney disease risk by controlling de novo lipogenesis in kidney tubules

Journal of Clinical Investigation - Cardiology

Worldwide, over 800 million people are affected by kidney disease, yet its pathogenesis remains elusive, hindering the development of novel therapeutics. In this study, we used kidney-specific expression of quantitative traits and single-nucleus open chromatin analysis to show that genetic variants linked to kidney dysfunction on chromosome 20 target the acyl-CoA synthetase short-chain family 2 (ACSS2).

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Evolution of Adjuvant, Neoadjuvant Therapy with Jonathan Spicer, MD, PhD

HCPLive

This segment of Lungcast features a discussion with Spicer about the timing of lung cancer treatment, as well as evolution of adjuvant and neoadjuvant therapies.

Cancer 64
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A human obesity-associated MC4R mutation with defective Gq/11? signaling leads to hyperphagia in mice

Journal of Clinical Investigation - Cardiology

Melanocortin 4 receptor (MC4R) mutations are the most common cause of human monogenic obesity and are associated with hyperphagia and increased linear growth. While MC4R is known to activate Gsα/cAMP signaling, a substantial proportion of obesity-associated MC4R mutations do not affect MC4R/Gsα signaling. To further explore the role of specific MC4R signaling pathways in the regulation of energy balance, we examined the signaling properties of one such mutant, MC4R (F51L), as well as the metabol

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Triggering Memories Through Scent Instead of Words Can Help Alleviate Depression

HCPLive

A new study found engaging the amygdala can help with memory recall for individuals with depression—and familiar scents helped more than word cues. Memories with odor cues were more arousing and vivid.

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Status check: next-generation sequencing for infectious-disease diagnostics

Journal of Clinical Investigation - Cardiology

Next-generation sequencing (NGS) applications for the diagnostics of infectious diseases has demonstrated great potential with three distinct approaches: whole-genome sequencing (WGS), targeted NGS (tNGS), and metagenomic NGS (mNGS, also known as clinical metagenomics). These approaches provide several advantages over traditional microbiologic methods, though challenges still exist.

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