Dilated-Hypokinetic Evolution of Hypertrophic Cardiomyopathy Prevalence, Incidence, Risk Factors, and Prognostic Implications in Pediatric and Adult Patients

ObjectivesThis study sought to investigate the incidence, risk factors, and prognosis of dilated-hypokinetic evolution in a large cohort of patients with hypertrophic cardiomyopathy (HCM) followed up at a cardiology center serving both the pediatric and the adult population.BackgroundThe available data on this evolution of HCM mainly regards prevalence (rather than incidence) in adults, with very little being known about the pediatric population.MethodsA total of 222 consecutive HCM patients (65% men, 19% ≤18 years old) were prospectively evaluated for a mean follow-up of 11 ± 9 years.ResultsA diagnosis of dilated-hypokinetic HCM was made in 12 patients at first evaluation (11 without previous septal myectomy surgery; prevalence, 4.9%). Twelve of the 210 patients with classic HCM at first evaluation underwent dilated-hypokinetic evolution (incidence, 5.3/1,000 patient-years). Patients with prevalent/incident dilated-hypokinetic evolution were younger at first evaluation (32 ± 14 years vs. 41 ± 21 years, p = 0.04) and more often had a family history of HCM (61% vs. 26%, p = 0.002) or sudden death (43% vs. 19%, p = 0.01) with respect to patients who maintained classic HCM. Moreover, they showed greater interventricular septum (23 ± 3 mm vs. 19 ± 6 mm, p = 0.004) and posterior wall (15 ± 3 mm vs. 13 ± 4 mm, p = 0.006) thickness. Cardiovascular death-free survival was lower among patients with dilated-hypokinetic HCM (p < 0.04). Cox proportional hazards regression analysis identified left ventricular wall thickness (hazard ratio [HR] = 1.07; 95% confidence interval [CI], 1.01 to 1.14; p = 0.03) and end-diastolic diameter (HR = 1.08; 95% CI 1.04 to 1.11; p = 0.0001) as independent predictors of cardiovascular death.ConclusionsDilated-hypokinetic evolution is rare but not exceptional in HCM. Young age at diagnosis, family history of HCM, and greater wall thickness are incremental risk factors for dilated-hypokinetic HCM, which carries an ominous prognosis

Biomarkers of effect of three pesticides on a human breast cell line

Agrochemicals, including acaricides, insecticides, herbicides and fungicides, are used on plant production against insects, weeds, fungi and rodents; however, the pesticide exposure can represent a risk for human health, mainly linked to neurological, respiratory and reproductive diseases. In children, the pesticides exposure can be associated with premature sexual maturation, including the premature thelarche, defined as breast development in girls below the age of eight years without other signs of sexual development. Indeed, several pesticides are considered as endocrine disrupting chemicals since they can interfere with the dysregulation of sexual, thyroid and neuro-endocrine hormones, acting via nuclear receptors. The present study aims to evaluate a panel of nuclear receptors as biomarkers of effect of three widely used pesticides such as glyphosate, imidacloprid and chlorpyrifos on a human breast cell line (MCF-7), representing the target organ of the idiopathic premature thelarche. Cytotoxic effects of the three pesticides were evaluated by the MTS and CyQuant assays at 48 and 72 hours(h), using five 10-fold dilutions spanning real exposure concentrations (100 pM –1μM). Proliferation was not affected whereas a dose-dependent decrease of metabolic activity was observed at 72h in all three pesticides, being statistically significant in imidacloprid treated cells. Three concentrations, including the real exposure level occurring in children, were selected for each pesticide to evaluate the gene expression of the estrogen receptor α (ERα), the estrogen receptor β (ERβ), the androgen receptor (AR), the aryl hydrocarbon receptor (AhR) and the progesterone receptor (PgR), by Real Time PCR (qPCR). Preliminary results will be shown. The project (RF-2016-02364628) is funded by the Italian Ministry of Health

PESTICIDE EXPOSURE AND PREMATURE IDIOPATHIC THELARCHE IN GIRLS: THE PEACH PROJECT

This abstract book contains the abstracts presented at the 94th National Congress of the Italian Society for Experimental Biology, Torino, Italy, 6-9 April 2022

PESTICIDE EXPOSURE AND PREMATURE IDIOPATHIC THELARCHE IN GIRLS: THE PEACH PROJECT

This abstract book contains the abstracts presented at the 94th National Congress of the Italian Society for Experimental Biology, Torino, Italy, 6-9 April 2022