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Microvascular disease confers additional risk to COVID-19 infection.
Bale BF, Doneen AL, Vigerust DJ
(2020) Med Hypotheses 144: 109999
MeSH Terms: Adult, Aging, COVID-19, Cardiovascular Diseases, Child, Diabetes Mellitus, Disease Susceptibility, Humans, Hydrogen Peroxide, Hypertension, Hypochlorous Acid, Immunity, Innate, Lung, Microcirculation, Microvessels, Neutrophils, Pandemics, Peroxidase, Risk Factors, United States
Show Abstract · Added June 25, 2020
The majority of fatalities thus far in the COVID-19 pandemic have been attributed to pneumonia. As expected, the fatality rate reported in China is higher in people with chronic pulmonary disease (6.3%) and those who have cancer (5.6%). According to the American College of Cardiology Clinical Bulletin "COVID-19 Clinical Guidance for the CV Care Team", there is a significantly higher fatality rate in people who are elderly (8.0% 70-79 years; 14.8% ≥80 years), diabetic (7.3%), hypertensive (6.0%), or have known cardiovascular disease (CVD) (10.5%). We propose a biological reason for the higher mortality risk in these populations that is apparent. We further present a set of pathophysiological reasons for the heightened danger that could lead to therapies for enhanced management and prevention.
Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.
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20 MeSH Terms
Cardiac Events Associated With Chimeric Antigen Receptor T-Cells (CAR-T): A VigiBase Perspective.
Salem JE, Ederhy S, Lebrun-Vignes B, Moslehi JJ
(2020) J Am Coll Cardiol 75: 2521-2523
MeSH Terms: Adult, Cardiovascular Diseases, Humans, Receptors, Chimeric Antigen, T-Lymphocytes
Added May 29, 2020
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5 MeSH Terms
Deep Learning for Automatic Calcium Scoring in CT: Validation Using Multiple Cardiac CT and Chest CT Protocols.
van Velzen SGM, Lessmann N, Velthuis BK, Bank IEM, van den Bongard DHJG, Leiner T, de Jong PA, Veldhuis WB, Correa A, Terry JG, Carr JJ, Viergever MA, Verkooijen HM, Išgum I
(2020) Radiology 295: 66-79
MeSH Terms: Aged, Clinical Protocols, Coronary Artery Disease, Deep Learning, Female, Heart, Humans, Male, Middle Aged, Retrospective Studies, Thorax, Tomography, X-Ray Computed, Vascular Calcification
Show Abstract · Added February 24, 2020
Background Although several deep learning (DL) calcium scoring methods have achieved excellent performance for specific CT protocols, their performance in a range of CT examination types is unknown. Purpose To evaluate the performance of a DL method for automatic calcium scoring across a wide range of CT examination types and to investigate whether the method can adapt to different types of CT examinations when representative images are added to the existing training data set. Materials and Methods The study included 7240 participants who underwent various types of nonenhanced CT examinations that included the heart: coronary artery calcium (CAC) scoring CT, diagnostic CT of the chest, PET attenuation correction CT, radiation therapy treatment planning CT, CAC screening CT, and low-dose CT of the chest. CAC and thoracic aorta calcification (TAC) were quantified using a convolutional neural network trained with 1181 low-dose chest CT examinations (baseline), a small set of examinations of the respective type supplemented to the baseline (data specific), and a combination of examinations of all available types (combined). Supplemental training sets contained 199-568 CT images depending on the calcium burden of each population. The DL algorithm performance was evaluated with intraclass correlation coefficients (ICCs) between DL and manual (Agatston) CAC and (volume) TAC scoring and with linearly weighted κ values for cardiovascular risk categories (Agatston score; cardiovascular disease risk categories: 0, 1-10, 11-100, 101-400, >400). Results At baseline, the DL algorithm yielded ICCs of 0.79-0.97 for CAC and 0.66-0.98 for TAC across the range of different types of CT examinations. ICCs improved to 0.84-0.99 (CAC) and 0.92-0.99 (TAC) for CT protocol-specific training and to 0.85-0.99 (CAC) and 0.96-0.99 (TAC) for combined training. For assignment of cardiovascular disease risk category, the κ value for all test CT scans was 0.90 (95% confidence interval [CI]: 0.89, 0.91) for the baseline training. It increased to 0.92 (95% CI: 0.91, 0.93) for both data-specific and combined training. Conclusion A deep learning calcium scoring algorithm for quantification of coronary and thoracic calcium was robust, despite substantial differences in CT protocol and variations in subject population. Augmenting the algorithm training with CT protocol-specific images further improved algorithm performance. © RSNA, 2020 See also the editorial by Vannier in this issue.
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13 MeSH Terms
Adult Aortotracheal Fistula as Sequela of Double Aortic Arch Repair in Infancy: A Case Report.
Rees AB, Rodney JP, Gilbert MR, Kaiser CA, Gelbard AH
(2020) Ann Otol Rhinol Laryngol 129: 649-652
MeSH Terms: Aortic Aneurysm, Thoracic, Aortic Diseases, DiGeorge Syndrome, Fistula, Humans, Male, Middle Aged, Postoperative Complications, Thoracic Surgical Procedures, Tomography, X-Ray Computed, Tracheal Diseases, Tracheomalacia, Tracheostomy, Vascular Grafting, Vascular Ring
Show Abstract · Added July 30, 2020
INTRODUCTION - Double aortic arch is a rare congenital malformation of the aortic arch that most frequently presents in childhood. Early surgical intervention typically yields excellent outcomes.
OBJECTIVES - To describe aortotracheal fistula as a rare, yet serious complication of vascular ring and subsequent aortic aneurysm in an adult patient.
METHODS - Clinical history, as well as radiographic and endoscopic imaging were obtained to describe the development, diagnosis, and clinical course of this patient's aortotracheal fistula. Additionally, follow up data was obtained to document the healing of this fistula after surgical repair.
RESULTS - We describe a case of a 46-year-old male with DiGeorge Syndrome and a double aortic arch, repaired in childhood, which developed into an aortotracheal fistula after tracheostomy placement as an adult.
CONCLUSIONS - This case demonstrates that dangerous complications of a double aortic arch can persist into adulthood, even after surgical repair in infancy. Each patient's unique anatomy must be considered when thinking about airway management and prevention of complications of this rare congenital anomaly.
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Cardiovascular Effects of Androgen Deprivation Therapy in Prostate Cancer: Contemporary Meta-Analyses.
Hu JR, Duncan MS, Morgans AK, Brown JD, Meijers WC, Freiberg MS, Salem JE, Beckman JA, Moslehi JJ
(2020) Arterioscler Thromb Vasc Biol 40: e55-e64
MeSH Terms: Androgen Antagonists, Antineoplastic Agents, Hormonal, Cardiotoxicity, Cardiovascular Diseases, Cardiovascular System, Humans, Male, Prostatic Neoplasms, Risk Assessment, Risk Factors, Treatment Outcome
Show Abstract · Added May 29, 2020
Androgen deprivation therapy is a cornerstone of prostate cancer treatment. Pharmacological androgen deprivation includes gonadotropin-releasing hormone agonism and antagonism, androgen receptor inhibition, and CYP17 (cytochrome P450 17A1) inhibition. Studies in the past decade have raised concerns about the potential for androgen deprivation therapy to increase the risk of adverse cardiovascular events such as myocardial infarction, stroke, and cardiovascular mortality, possibly by exacerbating cardiovascular risk factors. In this review, we summarize existing data on the cardiovascular effects of androgen deprivation therapy. Among the therapies, abiraterone stands out for increasing risk of cardiac events in meta-analyses of both randomized controlled trials and observational studies. We find a divergence between observational studies, which show consistent positive associations between androgen deprivation therapy use and cardiovascular disease, and randomized controlled trials, which do not show these associations reproducibly.
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11 MeSH Terms
Reverse Cardio-Oncology: Cancer Development in Patients With Cardiovascular Disease.
Aboumsallem JP, Moslehi J, de Boer RA
(2020) J Am Heart Assoc 9: e013754
MeSH Terms: Cardiology, Cardiovascular Diseases, Humans, Incidence, Inflammation, Inflammation Mediators, Medical Oncology, Neoplasms, Prevalence, Prognosis, Risk Assessment, Risk Factors, Signal Transduction, Specialization, Tumor Hypoxia, Tumor Microenvironment
Added May 29, 2020
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16 MeSH Terms
Cardio-Immuno-Oncology.
Zaha VG, Meijers WC, Moslehi J
(2020) Circulation 141: 87-89
MeSH Terms: Cardiovascular Diseases, Cell- and Tissue-Based Therapy, Cytokines, Humans, Immune System, Immunotherapy, Neoplasms, Prognosis
Added January 15, 2020
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8 MeSH Terms
Transendothelial Insulin Transport is Impaired in Skeletal Muscle Capillaries of Obese Male Mice.
Williams IM, McClatchey PM, Bracy DP, Bonner JS, Valenzuela FA, Wasserman DH
(2020) Obesity (Silver Spring) 28: 303-314
MeSH Terms: Animals, Capillaries, Endothelium, Vascular, Insulin, Male, Mice, Mice, Obese, Muscle, Skeletal, Obesity
Show Abstract · Added March 30, 2020
OBJECTIVE - The continuous endothelium of skeletal muscle (SkM) capillaries regulates insulin's access to skeletal myocytes. Whether impaired transendothelial insulin transport (EIT) contributes to SkM insulin resistance (IR), however, is unknown.
METHODS - Male and female C57/Bl6 mice were fed either chow or a high-fat diet for 16 weeks. Intravital microscopy was used to measure EIT in SkM capillaries, electron microscopy to assess endothelial ultrastructure, and glucose tracers to measure indices of glucose metabolism.
RESULTS - Diet-induced obesity (DIO) male mice were found to have a ~15% reduction in EIT compared with lean mice. Impaired EIT was associated with a 45% reduction in endothelial vesicles. Despite impaired EIT, hyperinsulinemia sustained delivery of insulin to the interstitial space in DIO male mice. Even with sustained interstitial insulin delivery, DIO male mice still showed SkM IR indicating severe myocellular IR in this model. Interestingly, there was no difference in EIT, endothelial ultrastructure, or SkM insulin sensitivity between lean female mice and female mice fed a high-fat diet.
CONCLUSIONS - These results suggest that, in male mice, obesity results in ultrastructural alterations to the capillary endothelium that delay EIT. Nonetheless, the myocyte appears to exceed the endothelium as a contributor to SkM IR in DIO male mice.
© 2020 The Authors. Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).
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9 MeSH Terms
Tyrosine Kinase Inhibitors in Leukemia and Cardiovascular Events: From Mechanism to Patient Care.
Manouchehri A, Kanu E, Mauro MJ, Aday AW, Lindner JR, Moslehi J
(2020) Arterioscler Thromb Vasc Biol 40: 301-308
MeSH Terms: Cardiovascular Diseases, Humans, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Patient Care, Protein Kinase Inhibitors, Protein-Tyrosine Kinases
Show Abstract · Added January 15, 2020
Targeted oncology therapies have revolutionized cancer treatment over the last decade and have resulted in improved prognosis for many patients. This advance has emanated from elucidation of pathways responsible for tumorigenesis followed by targeting of these pathways by specific molecules. Cardiovascular care has become an increasingly critical aspect of patient care in part because patients live longer, but also due to potential associated toxicities from these therapies. Because of the targeted nature of cancer therapies, cardiac and vascular side effects may additionally provide insights into the basic biology of vascular disease. We herein provide the example of tyrosine kinase inhibitors utilized in chronic myelogenous leukemia to illustrate this medical transformation. We describe the vascular considerations for the clinical care of chronic myelogenous leukemia patients as well as the emerging literature on mechanisms of toxicities of the individual tyrosine kinase inhibitors. We additionally postulate that basic insights into toxicities of novel cancer therapies may serve as a new platform for investigation in vascular biology and a new translational research opportunity in vascular medicine.
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6 MeSH Terms
Posterior circulation strokes in children: Fearsome or not?
Jordan LC, Jacobs BS
(2020) Neurology 94: 149-150
MeSH Terms: Cerebrovascular Circulation, Child, Humans, Stroke
Added March 24, 2020
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MeSH Terms