Non-coding RNAs (ncRNAs) are a class of RNA molecules that do not encode proteins. ncRNAs are involved in cell proliferation, apoptosis, differentiation, metabolism, and other physiological processes as well as the pathogenesis of diseases.Cardiac fibrosis is increasingly recognized as a common final pathway in advanced heart diseases. Many studies have shown that the occurrence and development of cardiac fibrosis is closely related to the regulation of ncRNAs. This review will highlight recent updates regarding the involvement of ncRNAs in cardiac fibrosis, and their potential as emerging biomarkers and therapeutic targets.
Rationale:Cardiac inflammatory myofibroblastic tumor (IMT) is a rare primary cardiac tumor which is currently considered as a low-grade neoplasm. The tumor has a predilection in infants and adolescents and primarily occurs as an endocardial-based cavitary mass. However, cardiac IMT that only involves the interventricular septum in middle-aged adults is extremely rarely reported. Considering its infrequency, we report a rare clinical case, with the aim of sharing our experience during the diagnostic procedures.Patient concerns:A 45-year-old, previously healthy female, with no medical history was admitted to the outpatient clinic due to the identification of an abnormal radiographic finding during a routine health examination.Diagnosis:Transthoracic echocardiography (TTE) revealed a 3.5 cm × 4.0 cm × 4.5 cm heterogeneous mass in the interventricular septum. Color Doppler echocardiography detected sparse blood flow signals inside the mass. Magnetic resonance imaging (MRI) confirmed a hyperintense T2-weighted, isointense T1-weighted mass. Three-dimensional (3D) TTE demonstrated a spherical mass in the middle part of the interventricular septum. Postoperative histopathological examinations revealed a mesenchymal tumor composed of scattered spindle myofibroblasts with a myxoid atypia, associated with infiltration of lymphocytes and plasma cells.Interventions:Complete tumor resection was successfully performed via median sternotomy under general anesthesia.Outcomes:After surgery, the patient recovered successfully. The patient was in good general health without any clinical symptoms. The echocardiographic examination at the 12-month follow-up period revealed normal function of the heart, and there was no evidence of tumor recurrence.Lessons:To our knowledge, cardiac IMT only the involving interventricular septum in a middle-aged adult has never been previously reported before. Echocardiography plays a critical role in establishing the primary diagnosis of cardiac IMT and evaluating regular follow-up examinations. Complete surgical resection of the mass is considered the first-line treatment despite the absence of symptoms.
A 5-month-old female was admitted with tachypnea. Cardiac magnetic resonance imaging revealed a 1.5 × 1.3-cm solid mass attached to the free wall of the right ventricular outflow tract (RVOT) beneath the pulmonary valve ( Figure 1). A transesophageal echocardiogram demonstrated a pedunculated mass in the RVOT (Figure 2). At the time of surgery on cardiopulmonary bypass, following a right ventriculotomy in the beating heart, the mass was found to be invading the pulmonary annulus. The mass was completely resected and a bovine pericardial patch was used to reconstruct the pulmonary annulus and close the ventriculotomy (Figure 3). The histology showed presence of spider cells with clear cytoplasm and strands of eosinophilic cytoplasm extending from the nucleus to the cell membrane consistent with the diagnosis of a rhabdomyoma (Figure 4). The patient tolerated the procedure well and a 3-month follow-up echocardiogram showed no recurrent masses or RVOT obstruction and a normal functioning pulmonary valve. FIGURE 1 Sagittal magnetic resonance image showing a tumor mass in the cavity of the right cardiac ventricle (arrow) 62 |
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