Chronic cerebral hypoperfusion (CCH) is a high-risk factor of Alzheimer's disease (AD). MicroRNAs (miRNAs) are ideal mediators of hypoxic stress responses to facilitate cellular adaptation to long-term hypoxia. MiR-124 is a kind of nervous system-specific miRNAs, and one of its target genes is β-site amyloid precursor protein cleaving enzyme 1 (BACE1). In the present study, miR-124 was found to be inhibited all the time from early to late stage of cerebral hypoxia accompanying with the upregulation of BACE1 protein and overproduction of amyloid-β (Aβ) in the hippocampus from cerebral hypoperfusion rat models. Meanwhile, Aβ could further enhance the expression of BACE1 protein due to the inhibition of miR-124. Thus, miR-124 was the key factor in this hypoxia/Aβ-miR-124-BACE1-Aβ cycle. The activation of EPAC-Rap1 pathway was involved in the inhibition of miR-124 in hippocampus under hypoxia or Aβ insult. Our data suggest that, as an endogenous regulator of BACE1 protein, miR-124 may play a role in AD onset induced by CCH.

No abstract

No abstract

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp atent foramen ovale (PFO) is an anatomical variant of the interatrial septum with an overall prevalence of 27% in autopsy studies. 1 PFO has been associated with cryptogenic stroke and migraine headaches, 2-4 and increasingly recognized as a source of paradoxical embolism. A high prevalence of PFO has been reported in approximately 50% of patients with cryptogenic transient ischemic attack (TIA) or ischemic stroke, 2 suggesting an association between the presence of PFO, with or without atrial septal aneurysm (ASA), and thromboembolic events (TE). 5 The optimal management for the prevention of a paradoxical embolic event in these patients remains controversial. Medical therapies with anticoagulants or antiplatelet agents, surgical PFO closure and percutaneous transcatheter closure of the PFO have been proposed as therapeutic options. 6 The results of several randomized clinical trials, randomized controlled trials and reports of single-center experience have indicated that transcatheter PFO closure is a potential option for patients with PFO and thromboembolic phenomena, in that it avoids the morbidity associated with surgical closure or lifelong anticoagulation therapy. 4,7-10 Despite the good short-term results of transcatheter PFO closure in these patients, however, the long-term data are limited, especially in Chinese patients. The aim of the present study was therefore to assess the long-term clinical outcome in PFO patients with paradoxical embolism who underwent transcatheter PFO closure in a single center. Methods PatientsBetween January 2005 and May 2010, 192 patients who were referred for transcatheter closure of a PFO following 1 or more presumed paradoxical systemic events were included in the present study. A TE was considered to be due to a paradoxical embolism when the following criteria were met: presence of PFO with spontaneous or provocable right-to-left shunt during transthoracic echocardiography (TTE)/trans-

This prospective study provides a feasible method to prove that transthoracic echocardiography can visualize clearly and identify accurately the exact site of each pulmonary vein. The information should be helpful to study various pulmonary venous diseases.

Objective To compare the acute hemodynamic effects of aerosolized iloprost and inhaled nitric oxide (NO) in adult congenital heart disease (CHD) patients with severe pulmonary arterial hypertension (PAH). Methods One hundred and eighty five adult CHDs with severe PAH were nonrandomized into two groups (iloprost, n=127; NO, n=58). Various hemodynamic parameters were measured before and after iloprost or NO inhalation. Results Iloprost and NO inhalation resulted in significant reductions in pulmonary arterial pressure (from 110.6±21.8 mmHg to 105.5±22.3 mmHg, p<0.05; from 113.1±18.7 mmHg to 107.2±19.9 mmHg, p<0.05, respectively) and pulmonary vascular resistance (PVR) (from 13.4±8.3 Wood units to 9.6±6.4 Wood units, p< 0.01; from 13.7±7.1 Wood units to 9.3±4.9 Wood units, p<0.01, respectively) and increases in pulmonary blood flow (from 6.7±3.3 L/min to 9.4±5.8 L/min, p<0.05; from 6.6±3.1 L/min to 9.6±5.9 L/min, p<0.01, respectively) and the Qp/Qs ratio (from 1.5±0.8 to 2.1±1.4, p<0.01; from 1.5±0.8 to 2.0±1.3, p<0.01, respectively). When the effects of inhaled iloprost and NO were compared, similar reductions in pulmonary arterial pressure and pulmonary vascular resistance were observed. Aerosolized iloprost and inhaled nitric oxide (iNO) were generally well tolerated and no patient experienced any side effects during inhalation. Conclusion Aerosolized iloprost can be effectively and safely used and might be an alternative to NO for testing pulmonary vascular reactivity and treating severe PAH in adult CHD patients.

No abstract

A 52-year-old man presented with moderate-effort dyspnea for 2 years, cardiomegaly on the chest radiograph, and atrial fibrillation on the ECG. The transthoracic echocardiography image was unclear because of obesity. Transesophageal echocardiography showed both atrial and right ventricular enlargement (Figure 1) and normal pulmonary venous return. An intact interatrial septum was found on the 4-chamber view of the transverse plane. A defect of the partial coronary sinus was found on the near longitudinal plane, and a significant left-to-right shunt was demonstrated by color Doppler flow imaging (Figure 1). With further rotation of the transducer, an intact interatrial septum and a defect beyond the realm of the atrial septum were obtained simultaneously in the same view (Figure 2). Diameter of the coronary sinus defect was 2.3 cm. The left superior vena cava was not confirmed by injection of agitated salt into the left median cubital vein. A coronary sinus defect may also be suggested by the catheter passing the coronary sinus through the left atrium and pulmonary vein. Selection angiography of the coronary sinus confirmed the communication between the coronary sinus and left atrium. Pulmonary artery pressure was 60/18 (mean 34) mm Hg. Pulmonary-to-systemic blood flow ratio was 1.68. The pulmonary vascular resistance was 3.2 Wood units. The patient was referred for surgical repair of the lesion. DisclosuresNone.