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Dissection of right coronary artery and occlusion of left anterior descending artery after aortic valve replacement
Abstracts / Atherosclerosis 241 (2015) e149ee229
H. Small*, S. Griffin, M. Indahl, S. Totten, E. Beattie, D. Graham. BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, Glasgow, United Kingdom
* Corresponding author. Aim: During normal pregnancy the blood supply to the uterus increases to meet the needs of the developing foetus. This increase in blood supply is achieved through circumferential structural enlargement (remodelling) of the uterine blood vessels. In some women, the vessels supplying the uterus do not remodel sufficiently during pregnancy, and this has been linked to high risk pregnancy conditions such as preeclampsia, reduced foetal growth and gestational hypertension. We have recently demonstrated abnormal uterine artery remodelling during pregnancy in the SHRSP rat compared to the normotensive WKY rat. The aim of this project was to investigate the impact of high blood pressure on abnormal uterine artery remodelling in time mated SHRSP and WKY rats. Method: We carried out a pharmacological intervention study in the SHRSP using the clinically relevant anti-hypertensive agent, nifedipine (25 mg/kg/day). Blood pressure was measured throughout pregnancy by radiotelemetry and uterine artery blood flow was measured by echo Doppler. At gestational day 18, uterine vascular structure and function were analysed by wire and pressure myography respectively. Result: Our results demonstrate a significant reduction in systolic blood pressure by nifedipine treatment (p<0.01) in the SHRSP during pregnancy. However, there were no significant improvements in abnormal uterine artery structure or function, blood flow or arterial stiffness in the treated group. Furthermore, litter size was also reduced in the untreated and nifedipine treated SHRSP compared to the normotensive WKY. Conclusion: We conclude from our findings that the abnormal uterine artery remodelling in the SHRSP is independent of hypertension. EAS-0522. DISSECTION OF RIGHT CORONARY ARTERY AND OCCLUSION OF LEFT ANTERIOR DESCENDING ARTERY AFTER AORTIC VALVE REPLACEMENT S. Mitsos*, S. Attaran, A.C. De Souza. Cardiac Surgery, Royal Brompton Hospital NHS Foundation Trust, London, United Kingdom
* Corresponding author. Coronary arteries stenosis is an infrequent but potentially serious complication after aortic valve replacement (AVR). We present a patient with unobstructed coronary arteries pre-operatively, who underwent a routine aortic valve replacement and developed dissection of right coronary artery (RCA) on the third postoperative day as well as the occlusion of left anterior descending (LAD) artery one month post surgery. Patient treated with aortocoronary bypass and with angioplasty and stenting respectively. The patients who develop myocardial ischemia-type chest pain, ST elevation or tachyarrhythmias, in the postoperative phase following valve surgery, should be investigated thoroughly to exclude occlusion of coronary artery as the cause of myocardial dysfunction. Coronary angiogram is warranted in the event of typical exertional angina, even after angiographic exclusion of coronary artery stenosis prior to AVR. Surgeons should be aware of this potential complication so that early recognition and rapid intervention can be instituted. The treatment has been early coronary artery bypass grafting or with balloon angioplasty and stenting. EAS-0592. NEWLY DIAGNOSED DIABETES BY SCREENING IS RELATED TO MORE EXTENSIVE CORONARY ARTERY DISEASE IN PATIENTS WITH ACUTE CORONARY SYNDROMES
e221
Aim: Patients with Acute Coronary Syndrome (ACS) often have undiagnosed glucose metabolism disorders which negatively affects their prognosis. The aim of this study was to evaluate whether derangement of glucose metabolism was related to the extent of Coronary Artery Disease (CAD). Methods: ACS patients with no previous diagnosis of type 2 diabetes mellitus (DM2) were consecutively studied in a single center university hospital setting. Prediabetes and DM2 were diagnosed by fasting plasma glucose (FPG), HbA1c and standard oral glucose tolerance test performed 24 days after hospital admission and repeated 3 months after discharge. The extent of CAD was evaluated by Gensini score which grades severity and location of lesions as well as the cumulative effect of multiple lesions. Results: Among 171 patients (77% male, average age ¼ 63.3), 47% had normal glucose metabolism (NGM), 41% were diagnosed with prediabetes and 12% with DM2. The median Gensini score was 30.0 (16.0 e 48.8). The median Gensini score was 26.0, 28.5 and 37.0 for patients with NGM, prediabetes and DM2, respectively (p¼0.07). Conclusions: ACS patients with no previously known metabolic derangement that are found to have DM2 by screening have more extensive CAD than patients with NGM. This underscores the importance of screening for metabolic derangements among patients hospitalized for ACS. EAS-0605. EXPOSURE OF MHIPPOE-14 CELLS TO OLIGOMYCIN AS A TOOL FOR IN VITRO APPROACHES TO BRAIN ISCHAEMIA-RELATED PRO- AND EPIPHENOMENA: TIME-DEPENDENT CELLULAR RESPONSE PROFILING A. Zarros 1, *, R.T. Cameron 1, A. Bimpis 2, G.S. Baillie 1. 1 Gardiner Lab, Institute of Cardiovascular and Medical Sciences, Glasgow, United Kingdom; 2 Department of Trauma and Orthopaedics, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
* Corresponding author. Aim: To assess the effect of oligomycin (Figure 1.a) as a tool for the induction of “chemical hypoxia” on an immortalized embryonic murine hippocampal cell-line (mHippoE-14) via the use of xCELLigence technology (that monitors real-time cellular proliferation and cellular events without the incorporation of labels), in the presence and absence of foetal bovine serum (FBS). Methods: xCELLigence monitored mHippoE-14 cells that were seeded at a density of 7.5 x 103 cells/well in 96-well plates and were allowed to grow for 24 h prior to being exposed to oligomycin (1 ug/mL) in the presence and absence of FBS. Parallel phase-contrast microscopy morphological studies were conducted. Results: FBS-deprivation led mHippoE-14 cells into a “pathopoietic phase”. Within this phase, oligomycin exerted a stable and statisticallysignificant decrease of the cellular index (Figure 1.b; green line) that was associated with both morphological and numerical changes in the exposed neuronal populations; the latter could allow for the use of oligomycin in the in vitro simulation of pro- and epiphenomena related to neuronal ischaemic injury. Conclusions: The highly-reproducible xCELLigence data generated by the exposure of mHippoE-14 to oligomycin have provided us with a number of important observations of technical interest that could allow for a more reliable implementation of the specific cell-line in the in vitro neuropathopoiesis attempts aiming to simulate ischaemic brain injury and related drug-screening assessment.
S. Hafthorsson 1, *, T.A. Bjarnason 2, E.S. Oskarsdottir 1, L.B. Kristinsdottir 1, I. Olafsson 3, T.G. Gudnason 2, G. Thorgeirsson 2, K. Andersen 2. 1 Department of Health Sciences, University of Iceland, Reykjavik, Iceland; 2 Department of Cardiology, Landspitali e The National University Hospital of Iceland, Reykjavik, Iceland; 3 Department of Clinical Biochemistry, Landspitali e The National University Hospital of Iceland, Reykjavik, Iceland
* Corresponding author. Ă
H. Small*, S. Griffin, M. Indahl, S. Totten, E. Beattie, D. Graham. BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, Glasgow, United Kingdom
* Corresponding author. Aim: During normal pregnancy the blood supply to the uterus increases to meet the needs of the developing foetus. This increase in blood supply is achieved through circumferential structural enlargement (remodelling) of the uterine blood vessels. In some women, the vessels supplying the uterus do not remodel sufficiently during pregnancy, and this has been linked to high risk pregnancy conditions such as preeclampsia, reduced foetal growth and gestational hypertension. We have recently demonstrated abnormal uterine artery remodelling during pregnancy in the SHRSP rat compared to the normotensive WKY rat. The aim of this project was to investigate the impact of high blood pressure on abnormal uterine artery remodelling in time mated SHRSP and WKY rats. Method: We carried out a pharmacological intervention study in the SHRSP using the clinically relevant anti-hypertensive agent, nifedipine (25 mg/kg/day). Blood pressure was measured throughout pregnancy by radiotelemetry and uterine artery blood flow was measured by echo Doppler. At gestational day 18, uterine vascular structure and function were analysed by wire and pressure myography respectively. Result: Our results demonstrate a significant reduction in systolic blood pressure by nifedipine treatment (p<0.01) in the SHRSP during pregnancy. However, there were no significant improvements in abnormal uterine artery structure or function, blood flow or arterial stiffness in the treated group. Furthermore, litter size was also reduced in the untreated and nifedipine treated SHRSP compared to the normotensive WKY. Conclusion: We conclude from our findings that the abnormal uterine artery remodelling in the SHRSP is independent of hypertension. EAS-0522. DISSECTION OF RIGHT CORONARY ARTERY AND OCCLUSION OF LEFT ANTERIOR DESCENDING ARTERY AFTER AORTIC VALVE REPLACEMENT S. Mitsos*, S. Attaran, A.C. De Souza. Cardiac Surgery, Royal Brompton Hospital NHS Foundation Trust, London, United Kingdom
* Corresponding author. Coronary arteries stenosis is an infrequent but potentially serious complication after aortic valve replacement (AVR). We present a patient with unobstructed coronary arteries pre-operatively, who underwent a routine aortic valve replacement and developed dissection of right coronary artery (RCA) on the third postoperative day as well as the occlusion of left anterior descending (LAD) artery one month post surgery. Patient treated with aortocoronary bypass and with angioplasty and stenting respectively. The patients who develop myocardial ischemia-type chest pain, ST elevation or tachyarrhythmias, in the postoperative phase following valve surgery, should be investigated thoroughly to exclude occlusion of coronary artery as the cause of myocardial dysfunction. Coronary angiogram is warranted in the event of typical exertional angina, even after angiographic exclusion of coronary artery stenosis prior to AVR. Surgeons should be aware of this potential complication so that early recognition and rapid intervention can be instituted. The treatment has been early coronary artery bypass grafting or with balloon angioplasty and stenting. EAS-0592. NEWLY DIAGNOSED DIABETES BY SCREENING IS RELATED TO MORE EXTENSIVE CORONARY ARTERY DISEASE IN PATIENTS WITH ACUTE CORONARY SYNDROMES
e221
Aim: Patients with Acute Coronary Syndrome (ACS) often have undiagnosed glucose metabolism disorders which negatively affects their prognosis. The aim of this study was to evaluate whether derangement of glucose metabolism was related to the extent of Coronary Artery Disease (CAD). Methods: ACS patients with no previous diagnosis of type 2 diabetes mellitus (DM2) were consecutively studied in a single center university hospital setting. Prediabetes and DM2 were diagnosed by fasting plasma glucose (FPG), HbA1c and standard oral glucose tolerance test performed 24 days after hospital admission and repeated 3 months after discharge. The extent of CAD was evaluated by Gensini score which grades severity and location of lesions as well as the cumulative effect of multiple lesions. Results: Among 171 patients (77% male, average age ¼ 63.3), 47% had normal glucose metabolism (NGM), 41% were diagnosed with prediabetes and 12% with DM2. The median Gensini score was 30.0 (16.0 e 48.8). The median Gensini score was 26.0, 28.5 and 37.0 for patients with NGM, prediabetes and DM2, respectively (p¼0.07). Conclusions: ACS patients with no previously known metabolic derangement that are found to have DM2 by screening have more extensive CAD than patients with NGM. This underscores the importance of screening for metabolic derangements among patients hospitalized for ACS. EAS-0605. EXPOSURE OF MHIPPOE-14 CELLS TO OLIGOMYCIN AS A TOOL FOR IN VITRO APPROACHES TO BRAIN ISCHAEMIA-RELATED PRO- AND EPIPHENOMENA: TIME-DEPENDENT CELLULAR RESPONSE PROFILING A. Zarros 1, *, R.T. Cameron 1, A. Bimpis 2, G.S. Baillie 1. 1 Gardiner Lab, Institute of Cardiovascular and Medical Sciences, Glasgow, United Kingdom; 2 Department of Trauma and Orthopaedics, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
* Corresponding author. Aim: To assess the effect of oligomycin (Figure 1.a) as a tool for the induction of “chemical hypoxia” on an immortalized embryonic murine hippocampal cell-line (mHippoE-14) via the use of xCELLigence technology (that monitors real-time cellular proliferation and cellular events without the incorporation of labels), in the presence and absence of foetal bovine serum (FBS). Methods: xCELLigence monitored mHippoE-14 cells that were seeded at a density of 7.5 x 103 cells/well in 96-well plates and were allowed to grow for 24 h prior to being exposed to oligomycin (1 ug/mL) in the presence and absence of FBS. Parallel phase-contrast microscopy morphological studies were conducted. Results: FBS-deprivation led mHippoE-14 cells into a “pathopoietic phase”. Within this phase, oligomycin exerted a stable and statisticallysignificant decrease of the cellular index (Figure 1.b; green line) that was associated with both morphological and numerical changes in the exposed neuronal populations; the latter could allow for the use of oligomycin in the in vitro simulation of pro- and epiphenomena related to neuronal ischaemic injury. Conclusions: The highly-reproducible xCELLigence data generated by the exposure of mHippoE-14 to oligomycin have provided us with a number of important observations of technical interest that could allow for a more reliable implementation of the specific cell-line in the in vitro neuropathopoiesis attempts aiming to simulate ischaemic brain injury and related drug-screening assessment.
S. Hafthorsson 1, *, T.A. Bjarnason 2, E.S. Oskarsdottir 1, L.B. Kristinsdottir 1, I. Olafsson 3, T.G. Gudnason 2, G. Thorgeirsson 2, K. Andersen 2. 1 Department of Health Sciences, University of Iceland, Reykjavik, Iceland; 2 Department of Cardiology, Landspitali e The National University Hospital of Iceland, Reykjavik, Iceland; 3 Department of Clinical Biochemistry, Landspitali e The National University Hospital of Iceland, Reykjavik, Iceland
* Corresponding author. Ă