ANGPTL4 Expression Is Increased in Epicardial Adipose Tissue of Patients with Coronary Artery Disease

Epicardial adipose tissue (EAT) is known to affect atherosclerosis and coronary artery disease (CAD) pathogenesis, persistently releasing pro-inflammatory adipokines that affect the myocardium and coronary arteries. Angiopoietin-like 4 (ANGPTL4) is a protein secreted from adipose tissue and plays a critical role in the progression of atherosclerosis. Here, the expression of ANGPTL4 in EAT was investigated in CAD subjects. Thirty-four consecutive patients (13 patients with significant CAD; 21 patients without CAD) undergoing elective open-heart surgery were recruited. EAT and pericardial fluid were obtained at the time of surgery. mRNA expression and ANGPTL4 and IL-1β levels were evaluated by qRT-PCR and ELISA. The expression of ANGPTL4 (p = 0.0180) and IL-1β (p < 0.0001) in EAT significantly increased in the CAD group compared to that in the non-CAD group and positively correlated (p = 0.004). Multiple regression analysis indicated that CAD is a contributing factor for ANGPTL4 expression in EAT. IL-1β level in the pericardial fluid was significantly increased in patients with CAD (p = 0.020). Moreover, the expression of ANGPTL4 (p = 0.004) and IL-1β (p < 0.001) in EAT was significantly increased in non-obese patients with CAD. In summary, ANGPTL4 expression in EAT was increased in CAD patients

Impact of repeated percutaneous coronary intervention on long-term survival after subsequent coronary artery bypass surgery

<p>Abstract</p> <p>(Background)</p> <p>In the current stent era, aggressive repeated percutaneous coronary intervention (PCI) has become more common. The aim of this study was to investigate the impact of previous repeated PCI on the subsequent coronary artery bypass grafting (CABG).</p> <p>(Methods)</p> <p>Between January 1990 and January 2008, a total of 894 patients underwent first-time isolated elective CABG. Among the 894 patients, 515 patients had had no PCI (group A), 179 patients had had single PCI (Group B), and 200 patients had had multiple PCI (2-15 times, mean 3.6 ± 2.3 times) (group C) before CABG. These groups were compared in terms of early and late clinical results.</p> <p>(Results)</p> <p>Preoperative left ventricular ejection fraction was significantly higher in group A (group A;58 ± 13%, group B;54 ± 12%, and group C;54 ± 12%). Number of bypass grafts was significantly smaller in group C (A:3.3 ± 1.0, B 3.4 ± 0.9, C 3.1 ± 1.0). Although there was no statistically significant difference among the groups, in-hospital mortality in group C was higher than that in group A and B (A:1.6%, B:1.1%, C:3.5%, p = 0.16). Survival analysis by Kaplan-Meier method (mean follow-up: 58 ± 43 methods) revealed that freedom from all-cause death and cardiac death was significantly lower in group C in comparison with group A. Freedom from cardiac event was significantly higher in group C than that in group A. Multivariate analysis identified a number of previous PCI as an independent risk factor for cardiac death.</p> <p>(Conclusions)</p> <p>Repeated PCI increased risk for long-term prognosis of subsequent CABG.</p

ゼラチン スポンジ ノ カンドウミャクナイ チュウニュウ ニ ヨル ブタ マンセイ シンフゼン モデル

京都大学0048新制・論文博士博士(医学)乙第11416号論医博第1845号新制||医||871(附属図書館)UT51-2004-G911(主査)教授 北 徹, 教授 和田 洋巳, 教授 米田 正始学位規則第4条第2項該当Doctor of Medical ScienceKyoto UniversityDA

Predicting time of reoperation based on long-term results of left atrioventricular valve replacement in infants and children

[Abstract] The surgical outcomes of pediatric valve replacements are poor, and these patients require long-term anticoagulation therapy, management and evaluation strictly for serious complications which include late prosthetic valve stenosis and infections. Each facility only deals with a small number of cases, and only a limited number of facilities manage patients who undergo repeated operations as they develop. Because no clear indicators for the timing of repeat valve replacements due to longterm growth have been reported, we examined a new additional indicators. We examined the postoperative courses of 18 patients who underwent left atrioventricular valve replacement during infancy at our hospital from May 1979 to December 2018. Rowlatt\u27s normal mitral annulus diameter was used as an indicator of valve size. There were 2 deaths in the initial operation and 5 late deaths. These were 5 patients underwent repeated valve replacements. Valve thrombi occurred in 2 patients. The avoidance rate of valve-related complications was 71% and 62% at 5 and 10 years, respectively. The avoidance rate of repeat valve replacement due to growth was 95% and 87% at 5 and 10 years, respectively. When valves were replaced,all patients were implanted with a prosthetic valve 2 sizes larger than in the initial operation. In the patients we examined, repeat operations due to growth were performed when the area of the prosthetic valve was less than 70% of Rowlatt\u27s criteria. Although repeat valve replacements are inevitable with growth, it may be possible to predict the timing of repeat interventions