Coronary Cameral fistula disclosed by echocardiography: a case report of typical findings and literature review.

BACKGROUND: Coronary cameral fistula is a rare cardiovascular anomaly, and usually needs advanced image modalities, such as computerized tomography and/or angiography, to confirm its existence. A few reports in the literature have addressed the role of medical ultrasound in the diagnosis of this disease, without a comprehensive summary of all the valuable echocardiographic features in its diagnosis. CASE PRESENTATION: Hereby, we presented an 80-year-old lady with exertional dyspnea and angina. We diagnosed coronary cameral fistula from the left anterior descending artery into the left ventricle by echocardiography with "intramyocardial vascular channel and the diastolic flow", and "multiple diastolic flow jets into heart chamber from heart wall". We confirmed the diagnosis with coronary angiography later. In the discussion, we make a comprehensive summary to conclude all the echocardiographic findings of this disease into 3 categories. CONCLUSION: We believe the identification of those findings will prompt the early diagnosis of this rare anomaly.

The Protective Role of Autophagy in Matrix Metalloproteinase-Mediated Cell Transmigration and Cell Death in High-Glucose-Treated Endothelial Cells.

Diabetes mellitus may cause vascular endothelial damage via endothelial matrix metalloproteinase-2 (MMP-2). The role of endothelial autophagy in MMP-2-mediated cell injury in response to high-glucose (HG) stimulation was rarely described. In this study, we used HG-treated human umbilical vein endothelial cells (HUVECs) to investigate the effect of autophagy on MMP-2-induced cell transmigration and apoptosis. THP-1 transmigration was detected by the transmigration assay. Light chain 3 (LC3, representing autophagy), MMP-2, and poly (ADP-ribose) polymerase (PARP, representing apoptosis) of HG (33 mM)-treated HUVECs were evaluated by western blot analysis. The MMP-2 activity was also examined by gelatin zymography. We used GM6001 (10 µM, an MMP-2 inhibitor) to investigate the relationship of MMP-2 and THP-1 transmigration. Using 3-methyladenine (3MA, 5 mM, an LC3 inhibitor), we explored the effects of autophagy on MMP-2 expression, THP-1 transmigration, and apoptosis. Our results showed that HG increased LC3-II expression, MMP-2 activity, THP-1 transmigration, and cleaved PARP expression in a time-dependent manner (0-48 h); among them, LC3-II appeared earlier (0-24 h) than the others (24-48 h). GM6001 suppressed MMP-2 activity and ameliorated THP-1 transmigration. 3MA suppressed LC3-II expression and increased MMP-2 expression, THP-1 transmigration, and cleaved PARP expression. From these sequential findings, we demonstrated that autophagy plays a protective role in MMP-2-mediated cell transmigration and cell death in HG-stimulated HUVECs.