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[en] Haemostatic devices can be categorised according to their mechanism of action into three main types; namely pressure devices, topical haemostatic pads and vascular closure devices (VCD). Of these three categories, it is the development of VCDs that revolutionised management of endovascular procedures. Currently available VCDs fall into three major classes, those that use a collagen plug, those that use clips and those that perform suture closure at the arteriotomy site. This article provides a comprehensive review of the all three classes with examples of commercially available devices.
[en] Cine CT is a new technology that allows for acquisition of high resolution tomographic images of cardiac structures allowing for precise measurements of global and regional cardiac function. This technology can be used in determining vein bypass graft patency and may be helpful in determining the flow reserve of bypass grafts and specific regions of the left ventricular myocardium. It is likely that information of this nature will be helpful in the care of patients with heart disease, and cine CT may find a place in the diagnostic evaluation of patients with cardiac disease. 11 refs.; 5 figs
[en] Some studies have been showed that electromechanical delay, which may pose an increased tendency to atrial fibrillation, may prolong in patients with various clinical conditions. In addition, the electromechanical delay in patients with secundum type atrial septal defect (ASD) compared to healthy people have been reported previously. Therefore, in the present study, we prospectively evaluated the mid-term and long-term effects of the transcatheter closure of secundum type ASD on the lateral atrial conduction time (PA), septal PA, tricuspid PA, left and right intra-atrial electromechanical delay (ILeft-EMD and IRight-EMD, respectively) and inter-atrial electromechanical delay (IA-EMD) measured by means of Doppler echocardiography. Our prospective study included a total of 45 secundum type ASD patients who undergone percutaneous transcatheter closure from December 2012 to April 2015. All patients underwent transthoracic echocardiography (TTE) before the closure, at sixth and twelfth months after the closure. In comparison of the EMD sixth months after the device closure, there were statistically significant decrease in lateral PA, septal PA, tricuspid PA, ILeft-EMD, IRight-EMD and IA-EMD compared to pre-device closure values. Twelfth months after the device closure, we also observed statistically significant decrease in lateral PA, septal PA, tricuspid PA, ILeft-EMD, IRight-EMD and IA-EMD compared to 6-month post-device closure values. In the present study, we observed that the atrial EMD improves after device closure and continues to improve after twelfth month following post-device closure.
[en] The medical imaging market comprises several billion tests per year worldwide, and at least one-third of these are cardiovascular procedures. Keeping in mind that each test represents a cost, often a risk, and a diagnostic hypothesis, we must agree that every unnecessary and unjustifiable test is one test too many. Small individual costs, risks, and waste multiplied by billions of examinations per year become an important population, societal and environmental burden. (author)
[en] Highlights: • β-catenin mediates TGF-β–induced osteoblastic differentiation of human AVICs. • Metformin ameliorates osteoblastic differentiation of AVICs by activating AMPKα. • Smad2/3 and JNK signaling mediates TGF-β1–induced activation of β-catenin in AVICs. • Metformin mitigates TGF-β1–induced β-catenin signaling by inhibiting Smad2/3 and JNK. Osteoblastic differentiation of aortic valve interstitial cells (AVICs) is the central process in the development of calcific aortic valve disease (CAVD). Metformin is a widely used first-line antidiabetic drug, and recently, pleiotropic benefits of metformin beyond hypoglycemia have been reported in the cardiovascular system. Here, we examined the effect of metformin on the osteoblastic differentiation of human AVICs. Our results showed that metformin ameliorated TGF-β1–induced production of osteogenic proteins Runx2 and osteopontin as well as calcium deposition in the cultured human AVICs. Experiments using AICAR, Compound C and AMPKα siRNA showed that the beneficial effect of metformin on TGF-β1–induced osteoblastic differentiation of human AVICs was mediated by AMPKα. Moreover, metformin inhibited the TGF-β1–induced activation of β-catenin, and β-catenin siRNA blocked TGF-β1–induced osteoblastic differentiation of AVICs. Smad2/3 and JNK were phosphorylated to promote the TGF-β1–induced activation of β-catenin and osteoblastic differentiation of AVICs, and metformin also alleviated TGF-β1–induced activation of Smad2/3 and JNK. In conclusion, our results suggest a beneficial effect of metformin based on the prevention of osteoblastic differentiation of human AVICs via inhibition of β-catenin, which indicates the therapeutic potential of metformin for CAVD.