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1.
Am J Cardiol ; 172: 115-120, 2022 Jun 01.
Article in English | MEDLINE | ID: covidwho-1838526

ABSTRACT

Previous studies have shown that bovine arch incidence is higher in patients with thoracic aortic aneurysms than in patients without an aneurysm. Although thoracic aortic aneurysm disease is known to be familial in some cases, it remains unknown if bovine arch results from a genetic mutation, thus allowing it to be inherited. Our objective was to determine the heritability of bovine arch from phenotypic pedigrees. We identified 24 probands from an institutional database of 202 living patients with bovine arch who had previously been diagnosed with thoracic aortic aneurysm and who had family members with previous chest computed tomography or magnetic resonance imaging scans. Aortic arch configuration of all first-degree and second-degree relatives was determined from available scans. Heritability of bovine arch was estimated using maximum-likelihood-based variance decomposition methodology implemented by way of the SOLAR package (University of Maryland, Catonsville, Maryland). 43 relatives of 24 probands with bovine arch had preexisting imaging available for review. The prevalence of bovine arch in relatives with chest imaging was 53% (n = 23) and did not differ significantly by gender (male: 64.3%, female: 55.6%, p = 1). The bovine arch was shown to be highly heritable with a heritability estimate (h2) of 0.71 (p = 0.048). In conclusion, the high heritability of bovine arch in our sample population suggests a genetic basis.


Subject(s)
Aneurysm , Aortic Aneurysm, Thoracic , Aneurysm/complications , Aorta, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/epidemiology , Aortic Aneurysm, Thoracic/genetics , Female , Humans , Incidence , Likelihood Functions , Male , Retrospective Studies
2.
Front Immunol ; 12: 780804, 2021.
Article in English | MEDLINE | ID: covidwho-1648493

ABSTRACT

Objectives: Currently, cardiovascular risk associated with COVID-19 has been brought to people's attention, but the mechanism is not clear. The aim of this study is to elucidate the mechanisms based on multiple omics data. Methodology: Weighted gene co-expression network analysis (WGCNA) was used to identify key pathways. Combination analysis with aneurysm and atherosclerosis related pathways, hypoxia induced factor-1 (HIF-1) signaling were identified as key pathways of the increased cardiovascular risk associated with COVID-19. ScMLnet algorithm based on scRNA-seq was used to explore the regulation of HIF-1 pathway by intercellular communication. Proteomic analysis was used to detect the regulatory mechanisms between IL18 and HIF-1 signaling pathway. Pseudo time locus analysis was used to study the regulation of HIF1 signaling pathway in macrophages and vascular smooth muscle cells (VSMC) phenotypic transformation. The Virtual Inference of protein-activity by Enriched Regulon (VIPER) analysis was used to study the activity of regulatory proteins. Epigenetic analysis based on methylation revealed epigenetic changes in PBMC after SARS-CoV-2 infection. Potential therapeutic compounds were explored by using Cmap algorithm. Results: HIF-1 signaling pathway is a common key pathway for aneurysms, atherosclerosis and SARS-CoV-2 infection. Intercellular communication analysis showed that macrophage-derived interleukin-18 (IL-18) activates the HIF-1 signaling pathway through IL18R1. Proteomic analysis showed that IL18/IL18R1 promote NF-κB entry into the nucleus, and activated the HIF-1 signaling pathway. Macrophage-derived IL18 promoted the M1 polarization of macrophages and the syntactic phenotype transformation of VSMCs. MAP2K1 mediates the functional regulation of HIF-1 signaling pathway in various cell types. Epigenetic changes in PBMC after COVID-19 infection are characterized by activation of the type I interferon pathway. MEK inhibitors are the promising compounds for the treatment of HIF-1 overactivation. Conclusions: The IL18/IL18R1/HIF1A axis is expected to be an therapeutic target for cardiovascular protection after SARS-CoV-2 infection. MEK inhibitors may be an choice for cardiovascular protection after SARS-COV-2 infection.


Subject(s)
Aneurysm/etiology , Aneurysm/metabolism , Atherosclerosis/etiology , Atherosclerosis/metabolism , COVID-19/blood , COVID-19/complications , Hypoxia-Inducible Factor 1, alpha Subunit/metabolism , Interleukin-18 Receptor alpha Subunit/metabolism , Interleukin-18/metabolism , SARS-CoV-2 , Signal Transduction , Aneurysm/pathology , Atherosclerosis/pathology , COVID-19/virology , Case-Control Studies , Cells, Cultured , Epigenesis, Genetic , Humans , Interferon Type I/metabolism , Leukocytes, Mononuclear/metabolism , Macrophages/metabolism , Myocytes, Smooth Muscle/metabolism , NF-kappa B/metabolism , Proteomics/methods , RNA-Seq/methods , Risk Factors , Single-Cell Analysis/methods
3.
Ann Vasc Surg ; 79: 127-129, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1458538

ABSTRACT

We describe the story of a 70- year-old Italian male that almost 4 months later respiratory infection by SARS-CoV-2 presented a rapid evolution of a true aneurism of the right posterior tibial artery (PTA).


Subject(s)
Aneurysm/etiology , COVID-19/complications , Tibial Arteries , Aged , Aneurysm/diagnostic imaging , Aneurysm/surgery , COVID-19/diagnosis , Humans , Male , Tibial Arteries/diagnostic imaging , Tibial Arteries/surgery , Treatment Outcome
4.
Ann Vasc Surg ; 63: 461.e1-461.e5, 2020 Feb.
Article in English | MEDLINE | ID: covidwho-1454027

ABSTRACT

A 70-year-old man was scheduled for the robotic resection of a 21×16 × 30 mm thymic nodule incidentally detected by a computed tomography scan (CT) for thoracic trauma after a domestic accident. Positron emission tomography (PET) scan confirmed a low [18F]-FDG uptake (SUVmax = 1,9). During the surgery, the mass showed to be a saccular aneurysm of the left brachiocephalic vein (LBCV). A complete tangential resection of the aneurysm, with the use of EndoGIA stapler (Covidien® Endo GIA™) at its origin, was performed. The patient's recovery was uneventful, and postoperative CT with contrast administration confirmed the patency of the vein.


Subject(s)
Aneurysm/surgery , Brachiocephalic Veins/surgery , Positron-Emission Tomography , Robotic Surgical Procedures , Surgical Stapling , Thymoma/diagnostic imaging , Thymus Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Vascular System Injuries/surgery , Aged , Aneurysm/diagnostic imaging , Brachiocephalic Veins/diagnostic imaging , Diagnosis, Differential , Diagnostic Errors , Humans , Incidental Findings , Male , Predictive Value of Tests , Treatment Outcome , Vascular System Injuries/diagnostic imaging
5.
Curr Rheumatol Rev ; 18(1): 83-87, 2022.
Article in English | MEDLINE | ID: covidwho-1430604

ABSTRACT

BACKGROUND: Behçet's disease (BD) is a complex vasculitis with some vascular manifestations including venous thrombosis, arterial thrombosis/aneurysm/pseudoaneurysm, and co-associated venous thrombosis and arterial lesions. We present two patients with Behçet's disease came with progressive both arterial and venous involvement. CASE PRESENTATION: The first patient was a young man with recurrent oral aphthosis and skin folliculitis and referred with complaint of new abdominal pain and 2 months severe headache. He had not referred to a physician due to COVID-19 pandemic until that time. In addition, he gradually developed a lower extremity edema and eventually was diagnosed with BD complicated with brain sagittal sinus vein thrombosis, abdominal aortic aneurysms and aortitis and deep vein thrombosis (DVT) of femoral vein. The second patient was a young woman with previous history of uveitis, DVT and recurrent oral and genital aphthosis presented with a large inguinal mass due to large iliac artery pseudoaneurysm impending to rupture, and after the operation, due to poor follow-up, developed a new femoral DVT. CONCLUSION: It seems the same inflammatory process is responsible for arterial and venous involvement in patients with BD, so it should be considered that involvement in one side (venous/arterial) can be a risk factor for the other side (venous/arterial) and early immunosuppressive treatment should always be considered to improve the prognosis.


Subject(s)
Aneurysm, False , Aneurysm , Aortitis , Behcet Syndrome , COVID-19 , Thrombosis , Venous Thrombosis , Aneurysm/complications , Aneurysm/surgery , Aneurysm, False/complications , Aortitis/complications , Behcet Syndrome/complications , Behcet Syndrome/diagnosis , COVID-19/complications , Female , Humans , Male , Pandemics , Thrombosis/complications , Venous Thrombosis/complications
6.
Interact Cardiovasc Thorac Surg ; 33(1): 150-152, 2021 06 28.
Article in English | MEDLINE | ID: covidwho-1118995

ABSTRACT

We report a rare case of solitary peripheral pulmonary artery aneurysm in a patient who was evaluated for haemoptysis. Incidentally, his total antibodies were positive for Coronavirus 2019 infection. Patient underwent right lower lobectomy uneventfully. Peripheral pulmonary artery aneurysms arising from segmental or intrapulmonary branches are extremely rare. Untreated, the majority end fatally due to sudden rupture and exsanguination. The purpose of this article is to report our rare case and review the pertinent literature.


Subject(s)
Aneurysm/pathology , Pulmonary Artery/pathology , Adult , Aneurysm/diagnostic imaging , Aneurysm/surgery , Humans , Male , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/surgery , Tomography, X-Ray Computed
8.
Clin Neuroradiol ; 31(3): 653-659, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-723015

ABSTRACT

PURPOSE: Intracerebral hemorrhage (ICH) accounts for up to 20% of all strokes, and there is a high rate of associated morbidity and mortality. Computed tomography (CT) findings, such as a spot sign have been shown to be an independent predictor of poor outcome. We have recently encountered a succession of ICH patients who presented with a peculiar imaging finding, which we term the spot on a string sign. This is a rare imaging finding, and interestingly, all these patients presented to our institution over the last few weeks. METHODS: This was a single high-volume center series of patients who presented to our institution between 1 April and 21 May 2020. All patients underwent initial non-contrast CT brain and subsequent CT angiography (CTA). We also present laboratory and clinical data. Our primary measure was the presence of the spot on a string sign on the CTA. We also report the clinical course of these patients. RESULTS: In this study seven large-volume ICH patients with this imaging sign were identified, with a median age of 48 years (range 30-68 years). All had tested negative for coronavirus disease 19 (COVID-19). CONCLUSION: We have described an unusual imaging finding in a cohort of younger patients with large-volume ICH, all of whom presented in a 2-month period to a high-volume neurovascular unit. The cause of these ICH presentations and associated imaging findings are unclear, but we encourage other clinicians to be aware of and vigilant for this rare phenomenon, especially in younger patients with such a bleeding pattern.


Subject(s)
Aneurysm , COVID-19 , Cerebral Hemorrhage , Adult , Aged , Cerebral Angiography , Cerebral Hemorrhage/diagnostic imaging , Female , Hematoma , Humans , Male , Middle Aged , SARS-CoV-2
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