ABSTRACT Aim This study investigated the major factors contributing to the missed diagnosis of total anomalous pulmonary venous connection (TAPVC) in fetal echocardiography. Methods We retrospectively analyzed the prenatal ultrasonic images of 32 fetuses with missed diagnoses of TAPVC, compared them with autopsy and postnatal surgical records, and summarized the most likely reasons leading to the missed diagnoses. Results We studied a total of 157 fetuses with TAPVC, 32 (20.3%) of whom were missed in prenatal echocardiography. The main factors for the missed diagnoses of TAPVC in the 32 fetuses were anatomic variants leading to the formation of a false pulmonary venous horn‐like structure, the combination of TAPVC with other intracardiac anomalies, difficulty or inability to show the course and abouchement of TAPVC on conventional color Doppler flow imaging (CDFI), and excessive color flow gain, with a rate of approximately 53.1% (17/32). A decreased left atrial size and augmentation of the PLAS index may be indicators of false pulmonary venous horn‐like structure. Conclusion False pulmonary venous horn‐like structures due to anatomic variants are a major factor in the missed diagnosis of fetal TAPVC. The presence of pulmonary venous horn‐like structure in a four‐chamber view does not completely exclude TAPVC.
The aims of this study were to assess the vortex characteristics of left ventricle (LV) in fetuses with coarctation of the aorta (CoA) using high-frame rate ultrasound with blood speckle-tracking (BST) and explore its relationships with cardiac function and morphology parameters.
Objective To evaluate the vascular impedance of the pulmonary arteries in fetuses with tetralogy of Fallot (TOF) by Doppler echocardiography. Methods A total of 42 fetuses with TOF (TOF group) and 84 gestational age‐matched normal fetuses (control group) were prospectively collected from the Second Xiangya Hospital of Central South University from August 2022 to January 2023. The severity of TOF was classified into mild TOF ( z score ≥−2), moderate TOF (−4 < z score < −2), or severe TOF ( z score ≤−4) according to the z score value of the pulmonary annulus diameter. The pulsatility index (PI) of the main pulmonary artery (MPA), distal left pulmonary artery (DLPA), and distal right pulmonary artery (DRPA) were measured by pulsed‐wave Doppler. The differences in clinical data and echocardiographic parameters between TOF group, control group, and TOF subgroups were compared. Results Compared with the control group, MPA‐PI increased significantly, whereas DLPA‐PI and DRPA‐PI decreased in TOF group (all P < .001). There were no significant differences in MPA‐PI and DRPA‐PI among mild TOF, moderate TOF, and severe TOF (all P > .05). However, DLPA‐PI decreased significantly in severe TOF compared with mild TOF ( P < .05). Conclusion Fetuses with TOF presented increased vascular impedance in the pulmonary trunk and decreased impedance in distal pulmonary artery branches. Further large and follow‐up studies are needed to demonstrate the associations between those changed vascular impedances and the development of PA in patients with TOF.
Purpose: This study evaluated the elastic characteristics of the pulmonary trunk and distal branches in fetuses diagnosed with tetralogy of Fallot (TOF) using Doppler echocardiography.Methods: Data on 42 fetuses diagnosed with TOF and 84 gestational age–matched normal fetuses were prospectively collected from the Second Xiangya Hospital of Central South University between August 2022 and January 2023. The severity of TOF was classified into three categories based on the z-score of the pulmonary annulus diameter: mild (z-score ≥-2), moderate (-4<z-score<-2), and severe (z-score ≤-4). Pulmonary artery stiffness (PAS) in the main pulmonary artery (MPA), distal left pulmonary artery (DLPA), and distal right pulmonary artery (DRPA) was measured using pulsed-wave Doppler imaging. Differences in clinical data and echocardiographic parameters were compared between the TOF group and the normal group, as well as among TOF subgroups.Results: Compared with the normal group, the MPA-PAS in fetuses with TOF was significantly higher, while the DLPA-PAS and DRPA-PAS were notably lower (all P<0.05). The MPA-PAS of fetuses with severe TOF was higher than that of those with mild and moderate TOF (all P<0.05). However, there were no significant differences in the DLPA-PAS or DRPA-PAS among fetuses with mild, moderate, and severe TOF (all P>0.05).Conclusion: Fetuses diagnosed with TOF exhibited increased vascular stiffness in the MPA and reduced stiffness in the distal pulmonary artery (PA). Larger-scale follow-up studies are required to elucidate the relationships between these changes in vascular stiffness and PA development in patients with TOF.
Purpose. Myocardial ischemia-reperfusion (MIR) injury is a common stimulus for cardiac diseases like cardiac arrhythmias and heart failure and may cause high mortality rates. Salviae miltiorrhizae liguspyragine hydrochloride and glucose injection (SGI) has been widely used to treat myocardial and cerebral infarctions in China even though its pharmacological mechanisms are not completely clear. Methods. The protective effect and mechanism of SGI on MIR injury and heart failure were investigated through the H9c2 cell model induced by hypoxia/reoxygenation (H/R) and rapamycin, zebrafish model induced by H/R and isoprenaline, and rat MIR model. Results. SGI significantly reduced the infarct size and alleviated the impairment of cardiac functions in the MIR rat model and H/R zebrafish model and promoted cell viability of cardiomyocyte-like H9c2 cells under H/R condition. Consistently, SGI significantly downregulated the serum level of biomarkers for cardiac damage and attenuated the oxidative damage in the MIR and H/R models. We also found that SGI could downregulate the increased autophagy level in those MIR and H/R models since autophagy can contribute to the injurious effects of ischemia-reperfusion in the heart, suggesting that SGI may alleviate MIR injury via regulating the autophagy pathway. In addition, we demonstrated that SGI also played a protective role in the isoproterenol-induced zebrafish heart failure model, and SGI significantly downregulated the increased autophagy and SP1/GATA4 pathways. Conclusion. SGI may exert anti-MIR and heart failure by inhibiting activated autophagy and the SP1/GATA4 pathway.
Abstract Background and objective Itch, an unpleasant sensation prompting the urge to scratch, and pain, aimed at detecting potential harm through acute withdrawal or protective behaviors, are increasingly recognized as interconnected phenomena. The co-occurrence of itch and pain symptoms in various diseases impairs therapeutic efficacy and the quality of life. In this study, we investigated the potential antipruritic and analgesic effects of sophocarpine (SC), an active compound of Sophorae Flavesentis Radix , in a murine model of inflammatory itch and pain, and sought to elucidate the underlying mechanisms. Method The anti-pruritic and analgesic effects of three doses of SC (60 mg/kg, 30 mg/kg, 10 mg/kg) were tested by analyzing the scratching and wiping behaviors in squaric acid dibutylester (SABDE)-induced allergic contact dermatitis (ACD) mouse model accompany by itch and pain, respectively. Psoriasis area and severity index (PASI) score was used to test the anti-inflammatory effect of SC. The underlying mechanisms were studied by real-time quantitative polymerase chain reaction (RT-qPCR) and western blotting. Additionally, the anti-pruritic and analgesic effects of SC were further tested in mice with intradermal injection of allyl-isothiocyanate (AITC), a TRPA1 agonist, or capsaicin (CAP), a TRPV1 agonist, respectively. The relationships between SC, AITC, CAP and TRPV1, TRPA1 were simulated by molecular docking. Results SC treatment significantly decreased scratching bouts and wipes, as well as the PASI score. Administration of SC reduced the mRNA and protein expression of both TRPA1 and TRPV1. Moreover, pretreatment of SC decreased scratching bouts and wipes induced by AITC as well as by CAP. Molecular docking revealed potential competitive binding between SC and AITC on TRPA1, and SC and CAP on TRPV1. Conclusion We demonstrated that SC has strong anti-pruritic and analgesic effects by targeting the TRPA1 and TRPV1 ion channels, and is a potential competitive inhibitor of TRPA1 and TRPV1. These findings suggest that SC has significant therapeutic potential in the therapy of diseases with inflammatory itch and pain.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)
