TCT-555 Release of Bioactive Lipids During Percutaneous Coronary, and Peripheral Arterial Interventions in Humans: Lipidomic analysis of Distal Embolic Protection Devices

Abstract

Background: Oxidation of lipoproteins generates multiple bioactive oxidized lipids that affect atherothrombosis and endothelial dysfunction, but direct evidence of their role during therapeutic procedures is lacking. Liberated oxidized lipids may result in no-reflow phenomenon, myocardial infarction and stroke. To assess whether oxidized vasoactive lipids are released downstream from atherosclerotic plaques following percutaneous coronary and peripheral interventions we undertook a lipidomic analysis of material recovered from distal embolic protection devices from different vascular beds. Methods: The presence of specific oxidized lipids was assessed in embolized material captured by distal embolic protection devices during saphenous vein graft, carotid, renal, and superficial femoral artery interventions. Following lipid extraction, specific oxidized phospholipids (OxPL) and cholesterol esters (OxCE) were quantified in 12 filters using liquid chromatography, tandem mass spectrometry. Results: Phosphatidylcholine (PC) containing OxPL, including 1-palmitoyl-2-(5-oxovaleroyl)-sn-glycero-3-phosphocholine (POVPC), C9 aldehyde PC, E2 and F2 isoprostane PC, and hydroperoxy PC were identified in the extracted lipid portion. The major oxidized PC by mass was the C9 aldehyde PC, representing 38% of all oxidized PL. Several species of OxCE, such as aldehyde, hydroperoxide, oxide and epoxy cholesterol ester derivatives from cholesteryl linoleate and cholesteryl arachidonate, were also present. The pattern of OxPL and OxCE within filters correlated well with molecules found in various forms of oxidized LDL and did not differ significantly in different vascular beds. The presence of OxPL was also confirmed using ELISA and immunohistochemistry. Conclusions: This is the first documentation of the presence and direct release of oxidized lipids from atherosclerotic plaques during percutaneous interventions from multiple vascular beds in humans. The release of such oxidized lipids into the microcirculation may mediate some of the adverse clinical outcomes that result during these intravascular interventions.Background: An intra-coronary device becoming ЉstuckЉ is a very uncommon complication that may lead to tragic consequences such as occlusion of the artery and systemic embolism. Methods: Of 14,198 lesions in 13,188 patients who underwent PCI between 1999 and 2011, 40 Љdevice stuckЉ (0.28%) incidents occurred during PCI procedures. The incidence, outcomes and management of these Љdevice stuckЉ occurrences were evaluated. Results: The overall procedural success rate was 97.8% (13,884/14,198). The stuck devices included stents (nϭ20; 50%), wires (nϭ14; 35%), balloons (nϭ4; 10%), intra-vascular ultrasound (nϭ1; 2.5%), and rotablator burrs (nϭ1; 2.5%), respectively. Management of the complication and acute/long-term outcomes are shown in the table. Of 54 instances of Љdevice stuck,Љ 15 (37.5%) were retrieved successfully, and 7 (18%) resulted in rupture and were left in the coronary artery. Thirty-seven patients recovered in the ...

Glucose Uptake and Triacylglycerol Synthesis Are Increased in Barth Syndrome Lymphoblasts

“…Western blot analysis was performed as described [8]. CL mass and species composition were determined as described [9]. DGAT-2 enzyme activity was determined using [1-14 C]oleoyl-CoA as previously described [8].…”