Publications
2089 results found
Aikawa E, Blaser MC, Singh SA, et al., 2024, Challenges and Opportunities in Valvular Heart Disease: From Molecular Mechanisms to the Community., Arterioscler Thromb Vasc Biol, Vol: 44, Pages: 763-767
Afifi A, Mahgoub A, Yacoub M, 2024, Toward Excellence in Managing Transposition of the Great Arteries in the Community., Ann Thorac Surg, Vol: 117, Pages: 549-550
Yacoub MH, Afifi A, Hosny H, et al., 2024, Structural aortic wall abnormalities following the Nikaidoh operation, which could be reversible and include a healing process., Glob Cardiol Sci Pract, Vol: 2024, ISSN: 2305-7823
The Nikaidoh operation continues to be used for patients with transposition of the great arteries, ventricular septal defect and left ventricular outflow tract obstruction. We recently reported structural and functional changes in the aortic root during the follow-up of a patient who underwent the Nikaidoh operation. These changes necessitated re-operation. The pathophysiology of these changes and their potential for reversibility have not yet been studied. In this communication, we describe the extensive structural changes in the aortic wall of the same patient.
Elshabrawy HA, Moustafa HA, Yacoub MH, et al., 2024, Hydrogel advancements in vascular tissue regeneration: a comprehensive review and future prospects, Emergent Materials, ISSN: 2522-5731
Vascular tissue regeneration has gained a lot of interest, especially in addressing the challenges associated with vascular-related diseases and injuries. Hydrogels have shown great promise in the field of vascular tissue regeneration because of their special features, which include biocompatibility and mechanical characteristics that may be adjusted, as well as their likeness to the natural extracellular matrix. The fabrication techniques for vascular scaffolds have been the subject of much investigation due to the effectiveness of scaffold-based tissue engineering in producing new blood vessel tissues. The creation of vascular scaffolds has been greatly aided by recent developments in 3D printing, which presents an encouraging concept for the vascularization of tissues. This review covers the various cutting-edge hydrogel formulations, fabrication techniques, and strategies for the development of functional and biocompatible vascular scaffolds. The review also reveals these novel hydrogel-based techniques’ possible uses, difficulties, and possibilities for the future of vascular tissue regeneration.
Medali T, Couchie D, Mougenot N, et al., 2024, Thioredoxin-1 and its mimetic peptide improve systolic cardiac function and remodeling after myocardial infarction., FASEB J, Vol: 38
Myocardial infarction (MI) is characterized by a significant loss of cardiomyocytes (CMs), and it is suggested that reactive oxygen species (ROS) are involved in cell cycle arrest, leading to impaired CM renewal. Thioredoxin-1 (Trx-1) scavenges ROS and may play a role in restoring CM renewal. However, the truncated form of Trx-1, Trx-80, can compromise its efficacy by exerting antagonistic effects. Therefore, a Trx-1 mimetic peptide called CB3 was tested as an alternative way to restore CMs. This study aimed to investigate the effects of Trx-1, Trx-80, and CB3 on mice with experimental MI and study the underlying mechanism of CB3 on CMs. Mouse cardiac parameters were quantified by echocardiography, and infarction size and fibrosis determined using Trichrome and Picro-Sirius Red staining. The study found that Trx-1 and CB3 improved mouse cardiac function, reduced the size of cardiac infarct and fibrosis, and decreased the expression of cardiac inflammatory markers. Furthermore, CB3 polarized macrophages into M2 phenotype, reduced apoptosis and oxidative stress after MI, and increased CM proliferation in cell culture and in vivo. CB3 effectively protected against myocardial infarction and could represent a new class of compounds for treating MI.
Yacoub MH, Notenboom ML, Melina G, et al., 2024, Surgical Heritage: You Had to Be There, Ross: The Comeback Kid., Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, Vol: 27, Pages: 37-41, ISSN: 1092-9126
Half a century after the first pulmonary autograft operation (Ross operation), performed in 1967 by Donald Ross in central London, there is a very strong conviction that the Ross operation is the best available valve substitute today, not only for children, but also for younger and older adults. The Ross operation has stimulated a lot of science to do with tissue-engineering and biology of heart valves, which is a promising avenue for the future. For one of us (M.Y.), it has certainly been a privilege to be associated with the comeback of the Ross operation.
Allouba M, Walsh R, Afify A, et al., 2023, Ethnicity, consanguinity, and genetic architecture of hypertrophic cardiomyopathy, European Heart Journal, Vol: 44, Pages: 5146-5158, ISSN: 0195-668X
AIMS: Hypertrophic cardiomyopathy (HCM) is characterized by phenotypic heterogeneity that is partly explained by the diversity of genetic variants contributing to disease. Accurate interpretation of these variants constitutes a major challenge for diagnosis and implementing precision medicine, especially in understudied populations. The aim is to define the genetic architecture of HCM in North African cohorts with high consanguinity using ancestry-matched cases and controls. METHODS AND RESULTS: Prospective Egyptian patients (n = 514) and controls (n = 400) underwent clinical phenotyping and genetic testing. Rare variants in 13 validated HCM genes were classified according to standard clinical guidelines and compared with a prospective HCM cohort of majority European ancestry (n = 684). A higher prevalence of homozygous variants was observed in Egyptian patients (4.1% vs. 0.1%, P = 2 × 10-7), with variants in the minor HCM genes MYL2, MYL3, and CSRP3 more likely to present in homozygosity than the major genes, suggesting these variants are less penetrant in heterozygosity. Biallelic variants in the recessive HCM gene TRIM63 were detected in 2.1% of patients (five-fold greater than European patients), highlighting the importance of recessive inheritance in consanguineous populations. Finally, rare variants in Egyptian HCM patients were less likely to be classified as (likely) pathogenic compared with Europeans (40.8% vs. 61.6%, P = 1.6 × 10-5) due to the underrepresentation of Middle Eastern populations in current reference resources. This proportion increased to 53.3% after incorporating methods that leverage new ancestry-matched controls presented here. CONCLUSION: Studying consanguineous populations reveals novel insights with relevance to genetic testing and our understanding of the genetic architecture of HCM.
Yacoub MH, Tseng Y-T, Kluin J, et al., 2023, Valvulogenesis of a living, innervated pulmonary root induced by an acellular scaffold, Communications Biology, Vol: 6, ISSN: 2399-3642
Heart valve disease is a major cause of mortality and morbidity worldwide with no effective medical therapy and no ideal valve substitute emulating the extremely sophisticated functions of a living heart valve. These functions influence survival and quality of life. This has stimulated extensive attempts at tissue engineering "living" heart valves. These attempts utilised combinations of allogeneic/ autologous cells and biological scaffolds with practical, regulatory, and ethical issues. In situ regeneration depends on scaffolds that attract, house and instruct cells and promote connective tissue formation. We describe a surgical, tissue-engineered, anatomically precise, novel off-the-shelf, acellular, synthetic scaffold inducing a rapid process of morphogenesis involving relevant cell types, extracellular matrix, regulatory elements including nerves and humoral components. This process relies on specific material characteristics, design and "morphodynamism".
Francis N, Hosny M, Yacoub MH, et al., 2023, Asymmetry of flow in aortic root and its application in hypertrophic obstructive cardiomyopathy., J Appl Physiol (1985), Vol: 135, Pages: 840-848
The aortic root (AR) performs sophisticated functions regulating the blood dynamics during the cardiac cycle. Such complex function depends on the nature of flow in the AR. Here, we investigate the potential of new quantitative parameters of flow asymmetry that could have clinical implications. We developed a MATLAB program to study the AR hemodynamics in each sinus of Valsalva using two-dimensional (2-D) cardiac magnetic resonance imaging during systole and particularly at peak systolic flow in 13 healthy volunteers and compared with 10 patients with hypertrophic obstructive cardiomyopathy (HOCM). We show that the effective area of the aortic jet in healthy volunteers is significantly higher at peak systolic flow and on average during systole. The flow asymmetry index, indicating how the jet is skewed away from the left coronary sinus (LCS), is small in healthy volunteers and much larger in HOCM at peak systole. The average of this index over systole is significantly more different between cohorts. Looking in more detail at the flow in the sinuses during systole, we show that the AR jet in healthy volunteers is more symmetrical, affecting the three sinuses almost equally, unlike the asymmetric AR jet in patients with HOCM that has decreased flow rate in the LCS and increased fractional area of backward flow in the LCS. The percentage of backward flow in the sinuses of Valsalva calculated over systole is a potential indicator of perturbed AR hemodynamics and the distribution of vortical flow and could be used as a measure of flow asymmetry.NEW & NOTEWORTHY The aortic root is a vital organ responsible for performing sophisticated functions to regulate the blood flow dynamics during the cardiac cycle. Such synchronized complex performance affects and is affected by the flow symmetry and type of flow reaching the aorta. Here, we report flow asymmetry in the aortic root which could have clinical implications, and we investigate the potential of various quantitative
Kotit S, Yacoub MH, 2023, The Aswan Rheumatic heart disease reGIstry: rationale and preliminary results of the ARGI database, FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol: 10, ISSN: 2297-055X
Pang KT, Ghim M, Sarathchandra P, et al., 2023, Shear-mediated ALK5 expression regulates endothelial activation, BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS, Vol: 642, Pages: 90-96, ISSN: 0006-291X
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Romeih S, Elkafrawy F, Shaaban M, et al., 2023, Validation of cardiac index measured by four-dimensional cardiac magnetic resonance flow against the invasively measured cardiac index in patients with pulmonary hypertension, Pulmonary Circulation, Vol: 13, ISSN: 2045-8932
The purpose of this study was to validate cardiac index (CI) measured noninvasively by four-dimensional (4D) and two-dimensional (2D) cardiovascular magnetic resonance (CMR) flows against the invasively measured CI by right heart catheterization (RHC) in patients with pulmonary hypertension (PH). Thirty patients with PH (mean age: 32 ± 10 years) were included. 4D and 2D flow measured CI within 24 h from RHC measured CI invasively. Qualitative analysis of 4D pulmonary flow (vortex presence and eccentricity of flow) was performed. All patients had helical right-sided flow with vortex formation; the mean vortex diameter was 29 ± 7 mm, occupying 69% of the main pulmonary artery (MPA) lumen. MPA was dilated (42 ± 9 mm). Mean CI measured by 4D flow CMR was closer to mean CI measured invasively (indirect Fick method CI = 2.1 ± 0.8 L/min/m2 vs. PA 4D flow = 2.3 ± 0.7 L/min/m2 “bias 0.22 ± 0.25 L/min, p = 0.001,” and Ao 4D flow = 2.3 ± 0.7 L/min/m2 “bias 0.2 ± 0.28 L/min, p = 0.001”), while 2D flow had a higher mean CI (PA 2D flow = 2.5 ± 0.7 L/min/m2 “bias 0.45 ± 0.7 L/min, p = 0.001” and Ao 2D flow = 2.5 ± 0.8 L/min/m2 “bias 0.45 ± 0.67 L/min, p = 0.001”). The correlation coefficients among the different comparisons of CI showed: a low correlation between the 2D flow-indirect Fick method (Ao r2 = 0.37, PA r2 = 0.32) and a high correlation between the 4D flow-indirect Fick method (Ao r2 = 0.86, PA r2 = 0.89). There is an excellent agreement between CI measured by 4D flow and CI measured invasively. 4D flow, a noninvasive imaging technique, could accurately measure CI better than the conventional 2D flow in patients with PH.
Soppa G, Bilkhu R, Jahangiri M, et al., 2023, Valve Sparing Aortic Root Procedure: Yacoub’s Procedure, Essentials of Operative Cardiac Surgery, Second Edition, Pages: 177-186, ISBN: 9783031145568
Aortic root replacement is performed for pathology of the aortic root, including aneurysm, dissection, connective tissue disease and in some cases, endocarditis of the aortic valve. Valve-sparing aortic root replacement (VSRR) is performed for aortic aneurysm when the aortic valve leaflets are normal and the aortic valve annulus is not dilated. The remodelling technique of aortic root replacement was originally described by Yacoub and colleagues and has the advantage of preserving the physiological properties of the aortic root. In this chapter, we describe our operative technique of VSRR using the remodelling technique.
Zabielska-Kaczorowska MA, Wierzbicka B, Kalmes A, et al., 2022, Beneficial Effects of RNS60 in Cardiac Ischemic Injury, CURRENT ISSUES IN MOLECULAR BIOLOGY, Vol: 44, Pages: 4877-4887, ISSN: 1467-3037
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Jedrzejewska A, Braczko A, Kawecka A, et al., 2022, Novel Targets for a Combination of Mechanical Unloading with Pharmacotherapy in Advanced Heart Failure, INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, Vol: 23
Da'as SI, Hasan W, Salem R, et al., 2022, Transcriptome Profile Identifies Actin as an Essential Regulator of Cardiac Myosin Binding Protein C3 Hypertrophic Cardiomyopathy in a Zebrafish Model., Int J Mol Sci, Vol: 23
Variants in cardiac myosin-binding protein C (cMyBP-C) are the leading cause of inherited hypertrophic cardiomyopathy (HCM), demonstrating the key role that cMyBP-C plays in the heart's contractile machinery. To investigate the c-MYBPC3 HCM-related cardiac impairment, we generated a zebrafish mypbc3-knockout model. These knockout zebrafish displayed significant morphological heart alterations related to a significant decrease in ventricular and atrial diameters at systolic and diastolic states at the larval stages. Immunofluorescence staining revealed significant hyperplasia in the mutant's total cardiac and ventricular cardiomyocytes. Although cardiac contractility was similar to the wild-type control, the ejection fraction was significantly increased in the mypbc3 mutants. At later stages of larval development, the mutants demonstrated an early cardiac phenotype of myocardium remodeling, concurrent cardiomyocyte hyperplasia, and increased ejection fraction as critical processes in HCM initiation to counteract the increased ventricular myocardial wall stress. The examination of zebrafish adults showed a thickened ventricular cardiac wall with reduced heart rate, swimming speed, and endurance ability in both the mypbc3 heterozygous and homozygous groups. Furthermore, heart transcriptome profiling showed a significant downregulation of the actin-filament-based process, indicating an impaired actin cytoskeleton organization as the main dysregulating factor associated with the early ventricular cardiac hypertrophy in the zebrafish mypbc3 HCM model.
Halawa S, Pullamsetti SS, Bangham CRM, et al., 2022, Potential long-term effects of SARS-CoV-2 infection on the pulmonary vasculature: a global perspective, Nature Reviews Cardiology, Vol: 19, Pages: 314-331, ISSN: 1759-5010
The lungs are the primary target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with severe hypoxia being the cause of death in the most critical cases. Coronavirus disease 2019 (COVID-19) is extremely heterogeneous in terms of severity, clinical phenotype and, importantly, global distribution. Although the majority of affected patients recover from the acute infection, many continue to suffer from late sequelae affecting various organs, including the lungs. The role of the pulmonary vascular system during the acute and chronic stages of COVID-19 has not been adequately studied. A thorough understanding of the origins and dynamic behaviour of the SARS-CoV-2 virus and the potential causes of heterogeneity in COVID-19 is essential for anticipating and treating the disease, in both the acute and the chronic stages, including the development of chronic pulmonary hypertension. Both COVID-19 and chronic pulmonary hypertension have assumed global dimensions, with potential complex interactions. In this Review, we present an update on the origins and behaviour of the SARS-CoV-2 virus and discuss the potential causes of the heterogeneity of COVID-19. In addition, we summarize the pathobiology of COVID-19, with an emphasis on the role of the pulmonary vasculature, both in the acute stage and in terms of the potential for developing chronic pulmonary hypertension. We hope that the information presented in this Review will help in the development of strategies for the prevention and treatment of the continuing COVID-19 pandemic.
Halawa S, Latif N, Tseng Y-T, et al., 2022, Profiling genome-wide DNA methylation patterns in human aortic and mitral valves, Frontiers in Cardiovascular Medicine, Vol: 9, ISSN: 2297-055X
Cardiac valves exhibit highly complex structures and specialized functions that include dynamic interactions between cells, extracellular matrix (ECM) and their hemodynamic environment. Valvular gene expression is tightly regulated by a variety of mechanisms including epigenetic factors such as histone modifications, RNA-based mechanisms and DNA methylation. To date, methylation fingerprints of non-diseased human aortic and mitral valves have not been studied. In this work we analyzed the differential methylation profiles of 12 non-diseased aortic and mitral valve tissue samples (in matched pairs). Analysis of methylation data [reduced representation bisulfite sequencing (RRBS)] of 16,101 promoters genome-wide revealed 584 differentially methylated (DM) promoters, of which 13 were reported in endothelial mesenchymal trans-differentiation (EMT), 37 in aortic and mitral valve disease and 7 in ECM remodeling. Both functional classification as well as network analysis showed that the genes associated with the DM promoters were enriched for WNT-, Cadherin-, Endothelin-, PDGF-, HIF-1 and VEGF- signaling implicated in valvular physiology and pathophysiology. Additional enrichment was detected for TGFB-, NOTCH- and Integrin- signaling involved in EMT as well as ECM remodeling. This data provides the first insight into differential regulation of human aortic and mitral valve tissue and identifies candidate genes linked to DM promoters. Our work will improve the understanding of valve biology, valve tissue engineering approaches and contributes to the identification of relevant drug targets.
Vizza CD, Lang IM, Badagliacca R, et al., 2022, Aggressive Afterload Lowering to Improve the Right Ventricle A New Target for Medical Therapy in Pulmonary Arterial Hypertension?, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 205, Pages: 751-760, ISSN: 1073-449X
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- Citations: 15
Latif N, Sarathchandra P, Mccormack A, et al., 2022, Atypical expression of smooth muscle markers and co-activators and their regulation in rheumatic aortic and calcified bicuspid valves, Frontiers in Cardiovascular Medicine, Vol: 9, Pages: 1-13, ISSN: 2297-055X
Objective: We have previously reported that human calcified aortic cusps have abundantexpression of smooth muscle (SM) markers and co-activators. We hypothesised that cells inbicuspid aortic valve (BAV) cusps and those affected by rheumatic heart valve (RHV)disease may follow a similar phenotypic transition into smooth muscle cells, a process thatcould be regulated by transforming growth factors (TGFs).Aims: Cusps from 8 patients with BAV and 7 patients with RHV were analysed for ealy andlate SM markers and regulators of SM gene expression by immunocytochemistry andcompared to healthy aortic valves from 12 unused heart valve donors. The ability of TGFs toinduce these markers in valve endothelial cells (VECs) on two substrates was assessed.Results: 7 out of 8 BAVs and all the RHVs showed an increased and atypical expression ofearly and late SM markers α-SMA, calponin, SM22 and SM-myosin. The SM marker coactivators were aberrantly expressed in 6 of the BAV and 6 of the RHV, in a similar regionalpattern to the expression of SM markers. Additionally, regions of VECs, and endothelial cellslining the vessels within the cusps were found to be positive for SM markers and coactivators in 3 BAV and 6 RHV. Both BAVs and RHVs were significantly thickened andHIF1α expression was prominent in 4 BAVs and 1 RHV. The ability of TGFβs to induce theexpression of SM markers and myocardin was greater in VECs cultured on fibronectin thanon gelatin. Fibronectin was shown to be upregulated in BAVs and RHVs, within the cusps aswell as in the basement membrane.Conclusion: BAVs and RHVs expressed increased numbers of SM marker-positive VICsand VECs. Concomittantly, these cells expressed MRTF-A and myocardin, key regulators ofSM gene expression. TGFβ1 was able to preferentially upregulate SM markers andmyocardin in VECs on fibronectin, and fibronectin was found to be upregulated in BAVs andRHVs. These findings suggest a role of VEC as a source of cells that express SM cel
El-Mehalmey WA, Latif N, Ibrahim AH, et al., 2022, Nine days extended release of adenosine from biocompatible MOFs under biologically relevant conditions, Biomaterials Science, Vol: 10, Pages: 1342-1351, ISSN: 2047-4830
Adenosine is a small molecule directly involved in maintaining homeostasis under pathological and stressful conditions. Due to its rapid metabolism, delivery vehicles capable of exhibiting extended release of adenosine are of paramount interest. Herein, we demonstrate a superior long-term (9 days) release profile of adenosine from biocompatible MOFs in a physiologically relevant environment. The key to the biocompatibility of MOFs is their stability under biologically relevant conditions. This study additionally highlights the interplay between the chemical stability of prototypal MOFs, assessed under physiological conditions, and their cytotoxicity profiles. Cytotoxicity of the prototypal Zn-based MOF (ZIF-8) and three Zr-based MOFs (UiO-66, UiO-66-NH2, and MOF-801) on six cell types was assessed. The cell types selected were valve interstitial cells (VICs), valve endothelial cells (VECs), adipose tissue-derived stem cells (ADSCs), and cell lines U937, THP1, and HeLa. Zr-based MOFs demonstrated a wide tolerance range in the cell culture cytotoxicity assays, demonstrating cell viability up to a very high dose of ∼1000 μg mL−1, as compared to ZIF-8 which showed notable cytotoxicity in as little as ∼100 μg mL−1 dose. This study demonstrates, for the first time, the utilization of biocompatible MOFs for adenosine delivery as well as establishes a direct link between structural instability in the cell culture medium and the observed cytotoxicity of the studied MOFs.
Yacoub MH, 2022, The Ross Operation and the Long Windy Road to the Clinic, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 79, Pages: 816-818, ISSN: 0735-1097
Yacoub MH, Hosny H, Afifi A, et al., 2022, Novel concepts and early results of repairing common arterial trunk, EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, Vol: 61, Pages: 562-571, ISSN: 1010-7940
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Vikhorev P, Vikhoreva N, Yeung W, et al., 2022, Titin-truncating mutations associated with dilated cardiomyopathy alter length-dependent activation and its modulation via phosphorylation, Cardiovascular Research, Vol: 118, Pages: 241-253, ISSN: 0008-6363
Aims Dilated cardiomyopathy (DCM) is associated with mutations in many genes encoding sarcomere proteins. Truncating mutations in the titin gene TTN are the most frequent. Proteomic and functional characterizations are required to elucidate the origin of the disease and the pathogenic mechanisms of TTN-truncating variants.Methods and results We isolated myofibrils from DCM hearts carrying truncating TTN mutations and measured the Ca2+ sensitivity of force and its length dependence. Simultaneous measurement of force and adenosine triphosphate (ATP) consumption in skinned cardiomyocytes was also performed. Phosphorylation levels of troponin I (TnI) and myosin binding protein-C (MyBP-C) were manipulated using protein kinase A and λ phosphatase. mRNA sequencing was employed to overview gene expression profiles. We found that Ca2+ sensitivity of myofibrils carrying TTN mutations was significantly higher than in myofibrils from donor hearts. The length dependence of the Ca2+ sensitivity was absent in DCM myofibrils with TTN-truncating variants. No significant difference was found in the expression level of TTN mRNA between the DCM and donor groups. TTN exon usage and splicing were also similar. However, we identified down-regulation of genes encoding Z-disk proteins, while the atrial-specific regulatory myosin light chain gene, MYL7, was up-regulated in DCM patients with TTN-truncating variants.Conclusion Titin-truncating mutations lead to decreased length-dependent activation and increased elasticity of myofibrils. Phosphorylation levels of TnI and MyBP-C seen in the left ventricles are essential for the length-dependent changes in Ca2+ sensitivity in healthy donors, but they are reduced in DCM patients with TTN-truncating variants. A decrease in expression of Z-disk proteins may explain the observed decrease in myofibril passive stiffness and length-dependent activation.
Emmons-Bell S, Johnson C, Boon-Dooley A, et al., 2022, Prevalence, incidence, and survival of pulmonary arterial hypertension: A systematic review for the global burden of disease 2020 study, Pulmonary Circulation, Vol: 12, ISSN: 2045-8932
Pulmonary arterial hypertension (PAH) is characterized by increased resistance in the pulmonary arterioles as a result of remodeled blood vessels. We sought all available epidemiologic data on population-based prevalence, incidence, and 1-year survival of PAH as part of the Global Burden of Disease Study. We performed a systematic review searching Global Index Medicus (GIM) for keywords related to PAH between 1980 and 2021 and identified population-representative sources of prevalence, incidence, and mortality for clinically diagnosed PAH. Of 6772 articles identified we found 65 with population-level data: 17 for prevalence, 17 for incidence, and 58 reporting case fatality. Reported prevalence ranged from 0.37 cases/100,000 persons in a referral center of French children to 15 cases/100,000 persons in an Australian study. Reported incidence ranged from 0.008 cases/100,000 person-years in Finland, to 1.4 cases/100,000 person-years in a retrospective chart review at a clinic in Utah, United States. Reported 1-year survival ranged from 67% to 99%. All studies with sex-specific estimates of prevalence or incidence reported higher levels in females than males. Studies varied in their size, study design, diagnostic criteria, and sampling procedures. Reported PAH prevalence, incidence, and mortality varied by location and study. Prevalence ranged from 0.4 to 1.4 per 100,000 persons. Harmonization of methods for PAH registries would improve efforts at disease surveillance. Results of this search contribute to ongoing efforts to quantify the global burden of PAH.
Ali AM, Dena ASA, Yacoub MH, et al., 2022, Drag-minimizing spore/pollen-mimicking microparticles for enhanced pulmonary drug delivery: CFD and experimental studies, JOURNAL OF DRUG DELIVERY SCIENCE AND TECHNOLOGY, Vol: 67, ISSN: 1773-2247
Latif N, Tseng Y-T, Yacoub MH, 2021, Starry Night by Van Gogh and morphogenesis of a tissue engineered heart valve., Global Cardiology Science & Practice, Vol: 2021, Pages: 1-2, ISSN: 2305-7823
Pelliccia F, Seggewiss H, Cecchi F, et al., 2021, Septal Ablation Versus Surgical Myomectomy for Hypertrophic Obstructive Cardiomyopathy, CURRENT CARDIOLOGY REPORTS, Vol: 23, ISSN: 1523-3782
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Chester AH, McCormack A, Miller EJ, et al., 2021, Coronary vasodilation mediated by T cells expressing choline acetyltransferase, AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY, Vol: 321, Pages: H933-H939, ISSN: 0363-6135
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Torii R, Yacoub MH, 2021, CT-based fractional flow reserve: development and expanded application., Glob Cardiol Sci Pract, Vol: 2021, ISSN: 2305-7823
Computations of fractional flow reserve, based on CT coronary angiography and computational fluid dynamics (CT-based FFR) to assess the severity of coronary artery stenosis, was introduced around a decade ago and is now one of the most successful applications of computational fluid dynamic modelling in clinical practice. Although the mathematical modelling framework behind this approach and the clinical operational model vary, its clinical efficacy has been demonstrated well in general. In this review, technical elements behind CT-based FFR computation are summarised with some key assumptions and challenges. Examples of these challenges include the complexity of the model (such as blood viscosity and vessel wall compliance modelling), whose impact has been debated in the research. Efforts made to address the practical challenge of processing time are also reviewed. Then, further application areas-myocardial bridge, renal stenosis and lower limb stenosis-are discussed along with specific challenges expected in these areas.
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