Apolipoprotein E gene polymorphism and the risk of left ventricular dysfunction among Egyptian β-thalassemia major

In Egypt, β-thalassemia is the most common hereditary hemolytic anemia. Cardiac dysfunction, secondary to iron overload with formation of oxygen free radicals, is the most common cause of death in β-thalassemia patients. This study was designed to determine whether the allelic genotype of apolipoprotein E (Apo E), which exhibits antioxidant properties, could represent a genetic risk factor for the development of left ventricular (LV) dysfunction in β-thalassemia major. Fifty Egyptian β-thalassemia major patients were subjected to echocardiography to assess LV function. Apo E genotyping by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) was done for all patients in addition to 50 age and sex matched healthy control subjects. Patients were classified into three groups. Group I and II were clinically asymptomatic. Group II subjects had evidence of LV dilatation, while Group III patients had clinical and echocardiographic findings of LV failure. Apo E4 allele was significantly higher among Group II and III than in controls. In conclusion, Apo E4 allele can be considered as a genetic risk factor for LV dysfunctions in β-thalassemic patients. It could be used as predictive indicator for additional risk of LV failure, particularly in asymptomatic patients with LV dilatation, requiring a closer follow-up, to prevent further disease progression.     

3q26.31–q29 duplication and 9q34.3 microdeletion associated with omphalocele,ventricular septal defect,abnormal first-trimester maternal serum screening and increased nuchal translucency: Prenatal diagnosis and aCGH characterization

We present prenatal diagnosis and array comparative genomic hybridization characterization of 3q26.31–q29 duplication and 9q34.3 microdeletion in a fetus with omphalocele, ventricular septal defect, increased nuchal translucency, abnormal first-trimester maternal screening and facial dysmorphism with distinct features of the 3q duplication syndrome and Kleefstra syndrome. The 26.61-Mb duplication of 3q26.31–q29 encompasses EPHB3, CLDN1 and CLDN16, and the 972-kb deletion of 9q34.3 encompasses EHMT1. We review the literature of partial trisomy 3q associated with omphalocele and discuss the genotype–phenotype correlation in this case.     

Erfahrungsbericht über die Haltung und deutsche Erstzucht der Borneo-Flussschildkröte (Orlitia borneensis Gray, 1873) im Zoo Dresden

Dresden Zoo bred successfully the Malaysian giant turtle (Orlitia borneensis) in summer 2012. This was the first successful breeding of this species in Germany.Little is known about biology and behaviour of this large river turtle and keeping and especially breeding of this endangered species in captivity is a rarity. In order to create optimal breeding conditions Dresden Zoo rebuilt an enclosure for the turtles in 2010. An area with soil and sand was built for the expected egg deposition. After arranged matings one female dug a nest on this area and buried her eggs. Nine eggs were secured and transferred into an incubator in a box filled with a 1:1 mixture of vermiculite and water. The average temperature was 29 °C. After problems with the temperature regulation the damaged incubator had to be replaced. Because of an estimated incubation period of 3–4 months, one egg was opened on day 127 of incubation. A live hatchling with a big yolk sac was fetched. Because of the non-reabsorbed yolk sac the hatchling was further incubated. On day 154 of incubation all eggs were manually opened and the hatchlings were fetched. All of these hatchlings showed a non-reabsorbed yolk sac and were incubated onwards in a box with wet paper towel until the yolk sac was completely reabsorbed. After that the hatchlings were housed solitarily in a box with water of approximately 4 cm height and a small land area. Two days after housing food was offered for the first time. All hatchlings accepted the offered food consisting of herbal as well as of animal products and later turtle pellets and self-made turtle jelly.Though little is known about breeding this species, the breeding success of Dresden Zoo demonstrates a possible approach to this topic. But there are still things to optimize. For example the manual hatching is something that should be avoided in future. Fertilization and hatching rate of 100% are promising and up to date eight out of nine hatchlings are still alive.     

NT-pro BNP与LAVI对原发性高血压患者左心室舒张功能的评价

目的:应用左房容积指数(LAVI)与血清N末端脑钠肽原(NT-pro BNP)水平的变化情况评价原发性高血压(EH)患者左心室舒张功能。方法:选择2013年5月-2015年5月在我院接受治疗的原发性高血压患者100例。根据左房舒张功能将患者分为A组(E/A1,且Em/Am1)、B组(E/A1,且Em/Am1)、C组(E/A1,且Em/Am1)及D组(E/A2,且Em/Am1),。另选取同期在我院接受体检的健康志愿者100例作为对照组。观察并比较各组LAVI及NT-pro BNP水平,分析LAVI与及NT-pro BNP与原发性高血压患者左心室舒张功能的相关性关系。结果:原发性高血压患者E/A、LAVI及NT-pro BNP水平均显著高于对照组,而Em/Am则低于对照组,差异具有统计学意义(P0.05);原发性高血压患者中,LAVI及NT-pro BNP水平随E/A升高而递增,随Em/Am升高而递减,其中D组LAVI及NT-pro BNP水平显著高于其他三组,差异均具有统计学意义(P0.05)。根据Pearson相关性分析可知结果显示,原发性高血压患者LAVI与NT-pro BNP呈正相关关系(P0.05),但与E/A及Em/Am无明显相关关系(P0.05)。LAVI的截断值为29.040,NT-pro BNP为2.065时评价左室舒张功能存在异常的敏感度及特异度均较高(P0.05)。结论:LAVI及NT-pro BNP可较好地评价EH患者左室舒张功能情况,且:LAVI及NT-pro BNP二者之间联系紧密与原发性高血压存在一定的相关性,两者均能较为准确的评价原发性高血压患者的左心室舒张功能,值得在临床给予推广应用。     

The influence of right ventricular stimulation on acute response to cardiac resynchronisation therapy

Background

The contribution of right ventricular (RV) stimulation to cardiac resynchronisation therapy (CRT) remains controversial. RV stimulation might be associated with adverse haemodynamic effects, dependent on intrinsic right bundle branch conduction, presence of scar, RV function and other factors which may partly explain non-response to CRT. This study investigates to what degree RV stimulation modulates response to biventricular (BiV) stimulation in CRT candidates and which baseline factors, assessed by cardiac magnetic resonance imaging, determine this modulation.

Methods and results

Forty-one patients (24 (59 %) males, 67 ± 10 years, QRS 153 ± 22 ms, 21 (51 %) ischaemic cardiomyopathy, left ventricular (LV) ejection fraction 25 ± 7 %), who successfully underwent temporary stimulation with pacing leads in the RV apex (RV_apex) and left ventricular posterolateral (PL) wall were included. Stroke work, assessed by a conductance catheter, was used to assess acute haemodynamic response during baseline conditions and RV_apex, PL (LV) and PL+RV_apex (BiV) stimulation.Compared with baseline, stroke work improved similarly during LV and BiV stimulation (∆+ 51 ± 42 % and ∆+ 48 ± 47 %, both p < 0.001), but individual response showed substantial differences between LV and BiV stimulation. Multivariate analysis revealed that RV ejection fraction (β = 1.01, p = 0.02) was an independent predictor for stroke work response during LV stimulation, but not for BiV stimulation. Other parameters, including atrioventricular delay and scar presence and localisation, did not predict stroke work response in CRT.

Conclusion

The haemodynamic effect of addition of RV_apex stimulation to LV stimulation differs widely among patients receiving CRT. Poor RV function is associated with poor response to LV but not BiV stimulation.

Electronic supplementary material

The online version of this article (doi:10.1007/s12471-015-0770-x) contains supplementary material, which is available to authorized users.     

Proper autophagy is indispensable for angiogenesis during chick embryo development

People have known that autophagy plays a very important role in many physiological and pathological events. But the role of autophagy on embryonic angiogenesis still remains obscure. In this study, we demonstrated that Atg7, Atg8 and Beclin1 were expressed in the plexus vessels of angiogenesis at chick yolk sac membrane and chorioallantoic membrane. Interfering in autophagy with autophagy inducer or inhibitor could restrict the angiogenesis in vivo, which might be driven by the disorder of angiogenesis-related gene expressions, and also lead to embryonic hemorrhage, which was due to imperfection cell junctions in endothelial cells including abnormal expressions of tight junction, adheren junction and desmosome genes. Using HUVECs, we revealed that cell viability and migration ability changed with the alteration of cell autophagy exposed to RAPA or 3-MA. Interestingly, tube formation assay showed that HUVECs ability of tube formation altered with the change of Atg5, Atg7 and Atg8 manipulated by the transfection of their corresponding siRNA or plasmids. Moreover, the lost cell polarity labeled by F-actin and the absenced β-catenin in RAPA-treated and 3-MA-treated cell membrane implied intracellular cytoskeleton alteration was induced by the activation and depression of autophagy. Taken together, our current experimental data reveal that autophagy is really involved in regulating angiogenesis during embryo development.     

急性心肌梗死高龄患者心肌灌注水平影响左室重构

为了探讨高龄急性心肌梗死(acute myocardial infarction, AMI)患者心脏超声特点,分析左室重构(left ventricle remodel, LVR)与心肌灌注水平的相关性,本研究选取2016年2月至2017年10月在广西医科大学第一附属医院治疗的高龄AMI患者104例,根据患者年龄分为A组49例(60~79岁)和B组55例(≥80岁),比较两组心脏超声指标,采用声学造影积分指数(contrast score index, CSI)评估两组术后心肌灌注水平。结果表明,B组后下壁心肌梗死比例为27.27%,明显高于A组(p<0.05);B组和A组前壁、下壁、前壁+下壁心肌梗死比例差异无统计学意义(p>0.05);B组左心室射血分数(left ventricular ejection fraction, LVEF)为(45.29±12.14)%,明显低于A组(p<0.05),左心房内径和左心室内径分别为(46.10径和左心室) mm和(57.29径和左心室内) mm,明显高于A组(p<0.05);B组经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后6个月CSI为(0.68±0.20),明显低于A组(p<0.05);B组术后左心房内径和左心室内径分别为(50.01±8.10) mm和(64.10±7.02) mm,明显高于A组(p<0.05);左心室内径与CSI呈负相关(r=-0.312, p<0.05)。综上表明,≥80岁患者与60~79岁患者心脏超声特点有所差异,年龄超过80岁的患者心功能以及PCI术后心肌灌注水平较差;心肌灌注水平与左室重构有一定相关性。     

Evolution of ASPM coding variation in apes and associations with brain structure in chimpanzees

Studying genetic mechanisms underlying primate brain morphology can provide insight into the evolution of human brain structure and cognition. In humans, loss‐of‐function mutations in the gene coding for ASPM (Abnormal Spindle Microtubule Assembly) have been associated with primary microcephaly, which is defined by a significantly reduced brain volume, intellectual disability and delayed development. However, less is known about the effects of common ASPM variation in humans and other primates. In this study, we characterized the degree of coding variation at ASPM in a large sample of chimpanzees (N = 241), and examined potential associations between genotype and various measures of brain morphology. We identified and genotyped five non‐synonymous polymorphisms in exons 3 (V588G), 18 (Q2772K, K2796E, C2811Y) and 27 (I3427V). Using T1‐weighted magnetic resonance imaging of brains, we measured total brain volume, cerebral gray and white matter volume, cerebral ventricular volume, and cortical surface area in the same chimpanzees. We found a potential association between ASPM V588G genotype and cerebral ventricular volume but not with the other measures. Additionally, we found that chimpanzee, bonobo, and human lineages each independently show a signature of accelerated ASPM protein evolution. Overall, our results suggest the potential effects of ASPM variation on cerebral cortical development, and emphasize the need for further functional studies. These results are the first evidence suggesting ASPM variation might play a role in shaping natural variation in brain structure in nonhuman primates.