6 research outputs found

    Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

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    The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

    RMN cardíaca en pacientes con cardiopatía chagásica referidos a Fundación Cardioinfantil – Instituto de Cardiología 2013-2016

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    INTRODUCCIÓN: La resonancia magnética cardíaca constituye una herramienta diagnóstica que nos permite detectar de manera no invasiva la presencia, localización y distribución heterogénea del proceso inflamatorio y fibrosis miocárdica en pacientes con cardiopatía chagásica. METODOLOGIA: Estudio descriptivo, retrospectivo, que recolectó los hallazgos en RMN cardíaca de pacientes con cardiopatía chagásica remitidos a Fundación Cardioinfantil–IC entre 2013 y 2016. RESULTADOS: Se recolectó una muestra de 29 pacientes, 75% hombres, con una mediana para la edad de 60 (57-64) años. Todos los pacientes tenían alguna manifestación de cardiopatía chagásica. El 72% de los pacientes presentó algún tipo de arritmia ventricular. La FEVI promedio por RMN fue de 37% (DE 16), la presencia de aneurismas fue del 58% y la presencia de realce tardío del 86%. El segmento más frecuentemente comprometido fue el inferolateral basal, siendo el patrón transmural el más frecuente. Entre el 70% y 100% de los pacientes, de acuerdo a la severidad de la arritmia ventricular, tenían algún grado de realce tardío. El 90% de los pacientes con FEVI<35% presentaban algún grado de fibrosis y el 70% algún tipo de arritmia ventricular. DISCUSIÓN Y CONCLUSIONES: En nuestro estudio la presencia de realce tardío y arritmias ventriculares se presentó en un porcentaje elevado de pacientes. La presencia de relace tardío por RMN cardíaca puede convertirse en una variable adicional a estandarizar en el score de riesgo de muerte de estos pacientes por su asociación ya establecida con el desarrollo de arritmias ventriculares en otras cardíopatías. Se requiere de la realización de estudios específicos en esta población.INTRODUCTION: Cardiac magnetic resonance is a diagnostic tool that allows us to detect non-invasively the presence, location and heterogeneous distribution of the inflammatory process and myocardial fibrosis in patients with Chagas cardiomyopathy. METHODS: A retrospective, descriptive study that collected the findings in cardiac MRI from patients with Chagas cardiomyopathy referred to the Cardioinfantil-IC Foundation between 2013 and 2016. RESULTS: A sample of 29 patients, 75% male, with a median age of 60 (57-64) years were collected. All patients had some manifestation of chagasic heart disease. Seventy-two percent of the patients had ventricular arrhythmia. The mean LVEF by MRI was 37% (SD 16), the presence of aneurysms was 58% and the presence of late enhancement was 86%. The most frequently compromised segment was the basal inferolateral, being the transmural pattern the most frequent. Between 70% and 100% of the patients, according to the severity of the ventricular arrhythmia, had some degree of late enhancement. 90% of patients with LVEF <35% had some degree of fibrosis and 70% had some type of ventricular arrhythmia. DISCUSSION AND CONCLUSIONS: In our study, the presence of late enhancement and ventricular arrhythmias occurred in a high percentage of patients. The presence of a late relationship by cardiac MRI may become an additional variable to standardize in the risk score of death of these patients because of its association with the development of ventricular arrhythmias in other cardiac diseases. Specific studies are required in this population

    RMN cardíaca en pacientes con cardiopatía chagásica referidos a Fundación Cardioinfantil – Instituto de Cardiología 2013-2016

    No full text
    INTRODUCCIÓN: La resonancia magnética cardíaca constituye una herramienta diagnóstica que nos permite detectar de manera no invasiva la presencia, localización y distribución heterogénea del proceso inflamatorio y fibrosis miocárdica en pacientes con cardiopatía chagásica. METODOLOGIA: Estudio descriptivo, retrospectivo, que recolectó los hallazgos en RMN cardíaca de pacientes con cardiopatía chagásica remitidos a Fundación Cardioinfantil–IC entre 2013 y 2016. RESULTADOS: Se recolectó una muestra de 29 pacientes, 75% hombres, con una mediana para la edad de 60 (57-64) años. Todos los pacientes tenían alguna manifestación de cardiopatía chagásica. El 72% de los pacientes presentó algún tipo de arritmia ventricular. La FEVI promedio por RMN fue de 37% (DE 16), la presencia de aneurismas fue del 58% y la presencia de realce tardío del 86%. El segmento más frecuentemente comprometido fue el inferolateral basal, siendo el patrón transmural el más frecuente. Entre el 70% y 100% de los pacientes, de acuerdo a la severidad de la arritmia ventricular, tenían algún grado de realce tardío. El 90% de los pacientes con FEVI<35% presentaban algún grado de fibrosis y el 70% algún tipo de arritmia ventricular. DISCUSIÓN Y CONCLUSIONES: En nuestro estudio la presencia de realce tardío y arritmias ventriculares se presentó en un porcentaje elevado de pacientes. La presencia de relace tardío por RMN cardíaca puede convertirse en una variable adicional a estandarizar en el score de riesgo de muerte de estos pacientes por su asociación ya establecida con el desarrollo de arritmias ventriculares en otras cardíopatías. Se requiere de la realización de estudios específicos en esta población.INTRODUCTION: Cardiac magnetic resonance is a diagnostic tool that allows us to detect non-invasively the presence, location and heterogeneous distribution of the inflammatory process and myocardial fibrosis in patients with Chagas cardiomyopathy. METHODS: A retrospective, descriptive study that collected the findings in cardiac MRI from patients with Chagas cardiomyopathy referred to the Cardioinfantil-IC Foundation between 2013 and 2016. RESULTS: A sample of 29 patients, 75% male, with a median age of 60 (57-64) years were collected. All patients had some manifestation of chagasic heart disease. Seventy-two percent of the patients had ventricular arrhythmia. The mean LVEF by MRI was 37% (SD 16), the presence of aneurysms was 58% and the presence of late enhancement was 86%. The most frequently compromised segment was the basal inferolateral, being the transmural pattern the most frequent. Between 70% and 100% of the patients, according to the severity of the ventricular arrhythmia, had some degree of late enhancement. 90% of patients with LVEF <35% had some degree of fibrosis and 70% had some type of ventricular arrhythmia. DISCUSSION AND CONCLUSIONS: In our study, the presence of late enhancement and ventricular arrhythmias occurred in a high percentage of patients. The presence of a late relationship by cardiac MRI may become an additional variable to standardize in the risk score of death of these patients because of its association with the development of ventricular arrhythmias in other cardiac diseases. Specific studies are required in this population

    Amiloidosis Renal: Reporte de un Caso y Revisión de Tema

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    Se designa con el nombre de amiloidosis a un grupo de enfermedades poco frecuentes, que se caracterizan por el depósito extracelular de un material proteico fibrilar denominado amiloide. La afectación renal en la amiloidosis sistémica es frecuente, por lo que se le asocia un pronóstico desfavorable, al ser la falla renal la segunda causa de muerte en los pacientes que la presentan. El objetivo de este trabajo consistió en presentar el caso de un hombre de 55 años, hipertenso de novo, con cuadro clinico de 7 meses de evolución de edema progresivo asociado a disnea, oliguria y hematuria, documentándose síndrome nefrótico en paraclínicos. El reporte histopatológico reveló acumulación de material eosinofílico rojo congo positiva a nivel glomerular, e inmunofluoresencia positiva para cadenas livianas en patrón mesangial, compatible con amiloidosis renal. La amiloidosis sigue siendo un desafío para los clínicos, en cuanto a su diagnóstico y tratamiento, y el pronóstico empeora a medida que se comprometen más órganos. La principal causa de muerte de los pacientes con amiloidosis obedece a trastornos cardiacos, siendo la segunda causa la falla renal.ABSTRACTA group of rare diseases are called amyloidosis. It is characterized by extracellular fibrillar protein material named amyloid deposit. Renal involvement in systemic amyloidosis is often, giving an unfavorable prognostic, being this one the second death cause in these kind of patients. It aims to show a 55 years old man, hypertensive with a clinical history of 7 months with a progressive edema associated with dyspnea, oliguria and hematuria, reporting nephrotic syndrome in paraclinical patients. The histopathological report reveals accumulation of Congo red coloured material positive in glomerular level and positive iimmune-fluorescence for light chains in mesangial pattern associated with renal Amyloidosis. Amyloidosis is still a challenge for clinical patients. based on its diagnosis and treatment. The prognosis is even worst as more organs are committed. It should be considered that the main cause of death of an amyloidosis patient is cardiac disorders, being renal failure the second cause of death

    Novel genes and sex differences in COVID-19 severity.

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    Here we describe the results of a genome-wide study conducted in 11 939 COVID-19 positive cases with an extensive clinical information that were recruited from 34 hospitals across Spain (SCOURGE consortium). In sex-disaggregated genome-wide association studies for COVID-19 hospitalization, genome-wide significance (p < 5x10-8) was crossed for variants in 3p21.31 and 21q22.11 loci only among males (p = 1.3x10-22 and p = 8.1x10-12, respectively), and for variants in 9q21.32 near TLE1 only among females (p = 4.4x10-8). In a second phase, results were combined with an independent Spanish cohort (1598 COVID-19 cases and 1068 population controls), revealing in the overall analysis two novel risk loci in 9p13.3 and 19q13.12, with fine-mapping prioritized variants functionally associated with AQP3 (p = 2.7x10-8) and ARHGAP33 (p = 1.3x10-8), respectively. The meta-analysis of both phases with four European studies stratified by sex from the Host Genetics Initiative confirmed the association of the 3p21.31 and 21q22.11 loci predominantly in males and replicated a recently reported variant in 11p13 (ELF5, p = 4.1x10-8). Six of the COVID-19 HGI discovered loci were replicated and an HGI-based genetic risk score predicted the severity strata in SCOURGE. We also found more SNP-heritability and larger heritability differences by age (<60 or ≥ 60 years) among males than among females. Parallel genome-wide screening of inbreeding depression in SCOURGE also showed an effect of homozygosity in COVID-19 hospitalization and severity and this effect was stronger among older males. In summary, new candidate genes for COVID-19 severity and evidence supporting genetic disparities among sexes are provided
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