Predominant Involvement of the Aortic Root in a Patient with Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis: Congestive Heart Failure due to Subacute Severe Aortic Regurgitation and Reversible Conduction Disturbance

Yatomi, Atsusuke; Mori, Shigeo; Kawauchi, Hirotaka; Shono, Ayu; Shimoyama, Shinsuke; Tanaka, Hidekazu; Okano, T.; Inoue, Takeshi; Jimbo, Naoe; Morinobu, Akio; Hirata, Ken‐ichi

doi:10.2169/internalmedicine.3831-19

Cited by 2 publications

(4 citation statements)

References 14 publications

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“…ANCA, as a specific antibody of proteinase-3 and MPO, is closely related to HF. In recent years, many cases have reported ANCA antibody-induced HFrEF, severe aortic regurgitation and mitral regurgitation, and a severe insufficiency of the aortic valve [ 111 , 112 ]. One 20-year population-based cohort analysis recruited 58 patients diagnosed with ANCA-associated vasculitis (AAV); the risk of cardiovascular events (coronary artery disease, HF, and atrial fibrillation) was more than three times higher and the risk of cerebrovascular accident was eight times higher in AAV patients than in matched subjects [ 113 ].…”

Section: Netosis In Diseases Inducing Hfmentioning

confidence: 99%

NETosis as a Pathogenic Factor for Heart Failure

Ling

2021

Oxidative Medicine and Cellular Longevity

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Heart failure threatens the lives of patients and reduces their quality of life. Heart failure, especially heart failure with preserved ejection fraction, is closely related to systemic and local cardiac persistent chronic low-grade aseptic inflammation, microvascular damage characterized by endothelial dysfunction, oxidative stress, myocardial remodeling, and fibrosis. However, the initiation and development of persistent chronic low-grade aseptic inflammation is unexplored. Oxidative stress-mediated neutrophil extracellular traps (NETs) are the main immune defense mechanism against external bacterial infections. Furthermore, NETs play important roles in noninfectious diseases. After the onset of myocardial infarction, atrial fibrillation, or myocarditis, neutrophils infiltrate the damaged tissue and aggravate inflammation. In tissue injury, damage-related molecular patterns (DAMPs) may induce pattern recognition receptors (PRRs) to cause NETs, but whether NETs are directly involved in the pathogenesis and development of heart failure and the mechanism is still unclear. In this review, we analyzed the markers of heart failure and heart failure-related diseases and comorbidities, such as mitochondrial DNA, high mobility box group box 1, fibronectin extra domain A, and galectin-3, to explore their role in inducing NETs and to investigate the mechanism of PRRs, such as Toll-like receptors, receptor for advanced glycation end products, cGAS-STING, and C-X-C motif chemokine receptor 2, in activating NETosis. Furthermore, we discussed oxidative stress, especially the possibility that imbalance of thiol redox and MPO-derived HOCl promotes the production of 2-chlorofatty acid and induces NETosis, and analyzed the possibility of NETs triggering coronary microvascular thrombosis. In some heart diseases, the deletion or blocking of neutrophil-specific myeloperoxidase and peptidylarginine deiminase 4 has shown effectiveness. According to the results of current pharmacological studies, MPO and PAD4 inhibitors are effective at least for myocardial infarction, atherosclerosis, and certain autoimmune diseases, whose deterioration can lead to heart failure. This is essential for understanding NETosis as a therapeutic factor of heart failure and the related new pathophysiology and therapeutics of heart failure.

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Section: Netosis In Diseases Inducing Hfmentioning

confidence: 99%

NETosis as a Pathogenic Factor for Heart Failure

Ling

2021

Oxidative Medicine and Cellular Longevity

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“…Corticosteroid therapy was initiated before cardiac surgery. 48 The second case was suspected to have a quadricuspid aortic valve during intracardiac echocardiography. Cardiac computed tomography revealed it was just a normal trileaflet aortic valve visualized with an oblique section of the aortic root.…”

Section: Normative 3-dimensional Aortic Valvar Measurementsmentioning

confidence: 99%

“…This fibrous tissue extends inferiorly to form the roof of the inferoseptal recess, which overlaps with the superiorly directed apex of the inferior pyramidal space Corticosteroid therapy was initiated before cardiac surgery. 48 The second case was suspected to have a quadricuspid aortic valve during intracardiac echocardiography. Cardiac computed tomography revealed it was just a normal trileaflet aortic valve visualized with an oblique section of the aortic root.…”

Section: Variation In the Central Fibrous Body Related To The Aortic ...mentioning

confidence: 99%

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Understanding the Aortic Root Using Computed Tomographic Assessment: A Potential Pathway to Improved Customized Surgical Repair

Tretter

Izawa

Spicer

et al. 2021

Circ: Cardiovascular Imaging

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There is continued interest in surgical repair of both the congenitally malformed aortic valve, and the valve with acquired dysfunction. Aortic valvar repair based on a geometric approach has demonstrated improved durability and outcomes. Such an approach requires a thorough comprehension of the complex 3-dimensional anatomy of both the normal and congenitally malformed aortic root. In this review, we provide an understanding of this anatomy based on the features that can accurately be revealed by contrast-enhanced computed tomographic imaging. We highlight the complimentary role that such imaging, with multiplanar reformatting and 3-dimensional reconstructions, can play in selection of patients, and subsequent presurgical planning for valvar repair. The technique compliments other established techniques for perioperative imaging, with echocardiography maintaining its central role in assessment, and enhances direct surgical evaluation. This additive morphological and functional information holds the potential for improving selection of patients, surgical planning, subsequent surgical repair, and hopefully the subsequent outcomes.

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Predominant Involvement of the Aortic Root in a Patient with Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis: Congestive Heart Failure due to Subacute Severe Aortic Regurgitation and Reversible Conduction Disturbance

Cited by 2 publications

References 14 publications

NETosis as a Pathogenic Factor for Heart Failure

NETosis as a Pathogenic Factor for Heart Failure

Understanding the Aortic Root Using Computed Tomographic Assessment: A Potential Pathway to Improved Customized Surgical Repair

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