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Adult Monozygotic Twins With Hypertrophic Cardiomyopathy and Identical Disease Expression and Clinical Course.

成人单卵双胎伴肥厚性心肌病和相同疾病的表达和临床过程。

  • 影响因子:2.86
  • DOI:10.1016/j.amjcard.2020.04.020
  • 作者列表:"Maron BJ","Rowin EJ","Arkun K","Rastegar H","Larson AM","Maron MS","Chin MT
  • 发表时间:2020-07-15
Abstract

:A unique clinical circumstance involving middle-aged male identical twins with obstructive hypertrophic cardiomyopathy (HC) is reported. The concordance of morphologic (i.e., phenotype) findings and clinical course between the 2 patients is remarkable, including timing of the onset and progression of heart failure due to left ventricular outflow tract obstruction, frequency of paroxysmal atrial fibrillation and beneficial response to surgical myectomy and Cox-Maze IV procedure (performed 14 days apart). Histopathology of resected ventricular septal muscle showed identical hallmarks of HC including myocyte disorganization, small vessel disease, and myocardial fibrosis. A missense variant of the CRYAB gene was identified as potentially relevant to the pathogenesis of HC in the twins. Taken together, these observations support a powerful genetic determinant for the morphologic and clinical expression of HC, with little or no environmental influence.

摘要

: 报道了一个独特的临床情况,涉及中年男性同卵双胎阻塞性肥厚型心肌病 (HC)。形态学的一致性 (i.e.,表型) 2例患者之间的发现和临床过程是显著的,包括左心室流出道梗阻导致心力衰竭的发作和进展的时间、阵发性心房颤动的频率以及对手术心肌切除术和Cox-Maze IV手术的有益反应 (间隔14天进行)。切除的室间隔肌的组织病理学显示相同的HC特征,包括肌细胞结构紊乱、小血管病和心肌纤维化。CRYAB基因的错义变体被鉴定为与双胞胎中HC的发病机制潜在相关。总之,这些观察结果支持HC的形态学和临床表达的强大遗传决定因素,几乎没有或没有环境影响。

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DOI:10.1002/jcu.22732
作者列表:["Tadic M","Belyavskiy E","Cuspidi C","Pieske B","Haßfeld S"]

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影响因子:2.41
发表时间:2020-06-12
DOI:10.4244/EIJ-D-18-01138
作者列表:["Pellicano M","Di Gioia G","Ciccarelli G","Xaplanteris P","Delrue L","Toth GG","Van Durme F","Heyse A","Wyffels E","Vanderheyden M","Bartunek J","De Bruyne B","Barbato E"]

METHODS:AIMS:Significant platelet activation after long stented coronary segments has been associated with periprocedural microvascular impairment and myonecrosis. In long lesions treated either with an everolimus-eluting bioresorbable vascular scaffold (BVS) or an everolimus-eluting stent (EES), we aimed to investigate (a) procedure-related microvascular impairment, and (b) the relationship of platelet activation with microvascular function and related myonecrosis. METHODS AND RESULTS:Patients (n=66) undergoing elective percutaneous coronary intervention (PCI) in long lesions were randomised 1:1 to either BVS or EES. The primary endpoint was the difference between groups in changes of pressure-derived corrected index of microvascular resistance (cIMR) after PCI. Periprocedural myonecrosis was assessed by high-sensitivity cardiac troponin T (hs-cTnT), platelet reactivity by high-sensitivity adenosine diphosphate (hs-ADP)-induced platelet reactivity with the Multiplate Analyzer. Post-dilatation was more frequent in the BVS group, with consequent longer procedure time. A significant difference was observed between the two groups in the primary endpoint of ΔcIMR (p=0.04). hs-ADP was not different between the groups at different time points. hs-cTnT significantly increased after PCI, without difference between the groups. CONCLUSIONS:In long lesions, BVS implantation is associated with significant acute reduction in IMR as compared with EES, with no significant interaction with platelet reactivity or periprocedural myonecrosis.

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影响因子:1.67
发表时间:2020-01-01
DOI:10.2174/1573403X15666190513105231
作者列表:["Dev M","Sharma M","Rana N"]

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心脏影像技术方向

心脏结构和心脏血流的可视化,用于诊断评估或通过内窥镜、放射性核素成像等技术来指导心脏手术。

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