The Relationship of Mitral Annular Calcification and Aortic Valve Sclerosis to Endothelial Dysfunction.

BACKGROUND: Calcific aortic valve disease (CAVD) and mitral annular calcification (MAC) are associated with various cardiovascular diseases and may influence systemic vascular pathologies. However, their relationship with endothelial dysfunction and carotid intima-media thickness (CIMT) remains poorly elucidated. This research aims to explore the associations between MAC, aortic valve sclerosis (AVS), and markers of vascular dysfunction, specifically CIMT and endothelial function. METHODS: This prospective observational study included 200 patients undergoing routine echocardiographic evaluation at the National Heart Institute between May 2022 and April 2023. Patients were stratified into four groups namely isolated MAC (38 patients), isolated AVS (72 patients), combined MAC and AVS (50 patients), and a control group without MAC or AVS (40 patients). All participants underwent comprehensive cardiovascular evaluation, including transthoracic echocardiography (TTE) and carotid duplex ultrasonography. Endothelial function was determined by measuring reactive hyperemia-induced alterations in brachial artery diameter. RESULTS: The mean age of participants was 60.6±8.4 years, with a predominance of male subjects (64%). No significant differences were noted in baseline demographic and clinical characteristics across the groups. Patients with isolated AVS, isolated MAC, and both conditions demonstrated increased CIMT compared to controls, with significant differences noted in the combined MAC and AVS group compared to controls (p-value=0.031). Endothelial dysfunction was observed in 14.8% of the AVS group and 21.1% in the combined group, but no significant differences existed when compared to controls. The study also revealed that patients with AVS are more likely to exhibit increased CIMT (p-value=0.008). CONCLUSIONS: Both MAC and AVS are connected to increased CIMT, suggesting a link with systemic atherosclerotic processes. Although the existence of endothelial dysfunction was not significantly higher in patients with valvular calcifications, the findings support the need for further research into the cardiovascular implications of CAVD and MAC.

Amniotic stem cells repair ureteric defect: a study to evaluate the feasibility of amniotic membrane as a graft in surgical reconstruction.

BACKGROUND: Amniotic membrane is considered a promising procedure as a graft in the field of ophthalmology and skin reconstruction. It has been shown to decrease inflammation, fibrosis, elicit no host immune reaction and also has antibiotic actions. AIM: Recently, the amnion has been shown to contain cells capable of plasticity. Therefore, we felt its application could be extended to include surgical reconstruction. METHODS: We used ureteric reconstruction to study the feasibility of the amnion as a graft in these situations. We induced different degrees of injury in the ureter of dogs and reconstructed the defect with amniotic membrane. In addition, we also studied the effects of supplying the graft with a source of blood supply. RESULTS: The subjects were sacrificed after 6 weeks and histopathological examination showed impressive repair of the defect. CONCLUSION: The post reconstruction complications seen with present grafts were not seen with amniotic membrane. Therefore, amniotic membrane has produced noteworthy results and its potential should be further evaluated in order to be used as a cheap, readily available source of graft for the various surgical reconstruction procedures.