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Circulation 22건

  1. [해외논문]   Correction to: Ventricular Tachycardia Ablation in Patients With Implantable Cardioverter Defibrillators Should No Longer Be a Therapy of Last Resort  


    Circulation v.137 no.23 ,pp. e842 - e842 , 2018 , 0009-7322 ,

    초록

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  2. [해외논문]   Medical Nutrition Education, Training, and Competencies to Advance Guideline-Based Diet Counseling by Physicians: A Science Advisory From the American Heart Association   SCI SCIE

    Aspry, Karen E. , Van Horn, Linda , Carson, Jo Ann S. , Wylie-Rosett, Judith , Kushner, Robert F. , Lichtenstein, Alice H. , Devries, Stephen , Freeman, Andrew M. , Crawford, Allison , Kris-Etherton, Penny
    Circulation v.137 no.23 ,pp. e821 - e841 , 2018 , 0009-7322 ,

    초록

    Growing scientific evidence of the benefits of heart-healthy dietary patterns and of the massive public health and economic burdens attributed to obesity and poor diet quality have triggered national calls to increase diet counseling in outpatients with atherosclerotic cardiovascular disease or risk factors. However, despite evidence that physicians are willing to undertake this task and are viewed as credible sources of diet information, they engage patients in diet counseling at less than desirable rates and cite insufficient knowledge and training as barriers. These data align with evidence of large and persistent gaps in medical nutrition education and training in the United States. Now, major reforms in undergraduate and graduate medical education designed to incorporate advances in the science of learning and to better prepare physicians for 21st century healthcare delivery are providing a new impetus and novel ways to expand medical nutrition education and training. This science advisory reviews gaps in undergraduate and graduate medical education in nutrition in the United States, summarizes reforms that support and facilitate more robust nutrition education and training, and outlines new opportunities for accomplishing this goal via multidimensional curricula, pedagogies, technologies, and competency-based assessments. Real-world examples of efforts to improve undergraduate and graduate medical education in nutrition by integrating formal learning with practical, experiential, inquiry-driven, interprofessional, and population health management activities are provided. The authors conclude that enhancing physician education and training in nutrition, as well as increasing collaborative nutrition care delivery by 21st century health systems, will reduce the health and economic burdens from atherosclerotic cardiovascular disease to a degree not previously realized.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  3. [해외논문]   Rediscovering the Orbit of Percutaneous Coronary Intervention After ORBITA   SCI SCIE

    Bhatt, Deepak L. (Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA (D.L.B.). ) , Gersh, Bernard J. (Mayo Clinic, Rochester, MN (B.J.G.). ) , Steg, Ph. Gabriel (French Alliance for Cardiovascular Trials, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Université) , Harrington, Robert A. (Paris-Diderot, Institut National de la Santé) , Windecker, Stephan (et de la Recherche Médicale U-1148, Paris, France (G.S.). )
    Circulation v.137 no.23 ,pp. 2427 - 2429 , 2018 , 0009-7322 ,

    초록

    Growing scientific evidence of the benefits of heart-healthy dietary patterns and of the massive public health and economic burdens attributed to obesity and poor diet quality have triggered national calls to increase diet counseling in outpatients with atherosclerotic cardiovascular disease or risk factors. However, despite evidence that physicians are willing to undertake this task and are viewed as credible sources of diet information, they engage patients in diet counseling at less than desirable rates and cite insufficient knowledge and training as barriers. These data align with evidence of large and persistent gaps in medical nutrition education and training in the United States. Now, major reforms in undergraduate and graduate medical education designed to incorporate advances in the science of learning and to better prepare physicians for 21st century healthcare delivery are providing a new impetus and novel ways to expand medical nutrition education and training. This science advisory reviews gaps in undergraduate and graduate medical education in nutrition in the United States, summarizes reforms that support and facilitate more robust nutrition education and training, and outlines new opportunities for accomplishing this goal via multidimensional curricula, pedagogies, technologies, and competency-based assessments. Real-world examples of efforts to improve undergraduate and graduate medical education in nutrition by integrating formal learning with practical, experiential, inquiry-driven, interprofessional, and population health management activities are provided. The authors conclude that enhancing physician education and training in nutrition, as well as increasing collaborative nutrition care delivery by 21st century health systems, will reduce the health and economic burdens from atherosclerotic cardiovascular disease to a degree not previously realized.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  4. [해외논문]   Therapeutic Attenuation of Cardiac Remodeling After Acute Myocardial Infarction : A Conversation With Marc A. Pfeffer, MD, PhD   SCI SCIE

    Pfeffer, Marc A. , Rutherford, John D.
    Circulation v.137 no.23 ,pp. 2430 - 2434 , 2018 , 0009-7322 ,

    초록

    Growing scientific evidence of the benefits of heart-healthy dietary patterns and of the massive public health and economic burdens attributed to obesity and poor diet quality have triggered national calls to increase diet counseling in outpatients with atherosclerotic cardiovascular disease or risk factors. However, despite evidence that physicians are willing to undertake this task and are viewed as credible sources of diet information, they engage patients in diet counseling at less than desirable rates and cite insufficient knowledge and training as barriers. These data align with evidence of large and persistent gaps in medical nutrition education and training in the United States. Now, major reforms in undergraduate and graduate medical education designed to incorporate advances in the science of learning and to better prepare physicians for 21st century healthcare delivery are providing a new impetus and novel ways to expand medical nutrition education and training. This science advisory reviews gaps in undergraduate and graduate medical education in nutrition in the United States, summarizes reforms that support and facilitate more robust nutrition education and training, and outlines new opportunities for accomplishing this goal via multidimensional curricula, pedagogies, technologies, and competency-based assessments. Real-world examples of efforts to improve undergraduate and graduate medical education in nutrition by integrating formal learning with practical, experiential, inquiry-driven, interprofessional, and population health management activities are provided. The authors conclude that enhancing physician education and training in nutrition, as well as increasing collaborative nutrition care delivery by 21st century health systems, will reduce the health and economic burdens from atherosclerotic cardiovascular disease to a degree not previously realized.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  5. [해외논문]   Comparison of Reduced-Dose Prasugrel and Standard-Dose Clopidogrel in Elderly Patients With Acute Coronary Syndromes Undergoing Early Percutaneous Revascularization   SCI SCIE

    Savonitto, Stefano (Ospedale Manzoni, Lecco, Italy (S.S., L.A.F., L.P.). ) , Ferri, Luca A. (Ospedale Manzoni, Lecco, Italy (S.S., L.A.F., L.P.). ) , Piatti, Luigi (Ospedale Manzoni, Lecco, Italy (S.S., L.A.F., L.P.). ) , Grosseto, Daniele (Ospedale Infermi, Rimini, Italy (D.G., G.P.). ) , Piovaccari, Giancarlo (Ospedale Infermi, Rimini, Italy (D.G., G.P.). ) , Morici, Nuccia (Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy (N. Morici, I.B.). ) , Bossi, Irene (Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milano, Italy (N. Morici, I.B.). ) , Sganzerla, Paolo (Ospedale Treviglio-Caravaggio, Treviglio, Italy (P.S.). ) , Tortorella, Giovanni (Istituto di Ricerca e Cura a Carattere Scientifico Arcispedale S. Maria Nuova, Reggio Emilia, Italy (G.T.). ) , Cacucci, Michele (Ospedale Maggiore, Crema, Italy (M.C.). ) , Ferrario, Maurizio (IRCCS Fondazione Policlinico S. Matteo, Pavia, Italy (M.F.). ) , Murena, Ernesto (Ospedale S. Maria delle Grazie, Pozzuoli, Italy (E.M., G.S.). ) , Sibilio, Girolamo (Ospedale S. Maria delle Grazie, Pozzuoli, Italy (E.M., G.S.). ) , Tondi, Stefano (Ospedale Baggiovara, Modena, Italy (S.T.). ) , Toso, Anna (Ospedale S. Stefano, Prato, Italy (A.T.). ) , Bongioanni, Sergio (Ospedale Mauriziano, Tori) , Ravera, Amelia , Corrada, Elena , Mariani, Matteo , Di Ascenzo, Leonardo , Petronio, A. Sonia , Cavallini, Claudio , Vitrella, Giancarlo , Rogacka, Renata , Antonicelli, Roberto , Cesana, Bruno M. , De Luca, Leonardo , Ottani, Filippo , De Luca, Giuseppe , Piscione, Federico , Moffa, Nadia , De Servi, Stefano , Bolognese, Leonardo , Bovenzi, Francesco , Steffenino, Giuseppe , Santilli, Ignazio , Bassanelli, Giorgio , Sacco, Alice , Canziani, Federico , Ferri, Marco , Lo Jacono, Emilia , Canosi, Umberto , Fornaro, Giuseppe , Leoncini, Mario , Rosa Conte, Maria , Farina, Rosario , Stefanin, Catia , Di Pede, Francesco , Chella, Piersilvio , Chiara Nardoni, M. , Tamburrini, Paola , Trimarco, Br
    Circulation v.137 no.23 ,pp. 2435 - 2445 , 2018 , 0009-7322 ,

    초록

    Background: Elderly patients are at elevated risk of both ischemic and bleeding complications after an acute coronary syndrome and display higher on-clopidogrel platelet reactivity compared with younger patients. Prasugrel 5 mg provides more predictable platelet inhibition compared with clopidogrel in the elderly, suggesting the possibility of reducing ischemic events without increasing bleeding. Methods: In a multicenter, randomized, open-label, blinded end point trial, we compared a once-daily maintenance dose of prasugrel 5 mg with the standard clopidogrel 75 mg in patients >74 years of age with acute coronary syndrome undergoing percutaneous coronary intervention. The primary end point was the composite of mortality, myocardial infarction, disabling stroke, and rehospitalization for cardiovascular causes or bleeding within 1 year. The study was designed to demonstrate superiority of prasugrel 5 mg over clopidogrel 75 mg. Results: Enrollment was interrupted, according to prespecified criteria, after a planned interim analysis, when 1443 patients (40% women; mean age, 80 years) had been enrolled with a median follow-up of 12 months, because of futility for efficacy. The primary end point occurred in 121 patients (17%) with prasugrel and 121 (16.6%) with clopidogrel (hazard ratio, 1.007; 95% confidence interval, 0.78–1.30; P = 0.955). Definite/probable stent thrombosis rates were 0.7% with prasugrel versus 1.9% with clopidogrel (odds ratio, 0.36; 95% confidence interval, 0.13–1.00; P = 0.06). Bleeding Academic Research Consortium types 2 and greater rates were 4.1% with prasugrel versus 2.7% with clopidogrel (odds ratio, 1.52; 95% confidence interval, 0.85–3.16; P = 0.18). Conclusions: The present study in elderly patients with acute coronary syndromes showed no difference in the primary end point between reduced-dose prasugrel and standard-dose clopidogrel. However, the study should be interpreted in light of the premature termination of the trial. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01777503.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  6. [해외논문]   Prasugrel in the Elderly   SCI SCIE

    Bangalore, Sripal (New York University School of Medicine, New York.)
    Circulation v.137 no.23 ,pp. 2446 - 2449 , 2018 , 0009-7322 ,

    초록

    Background: Elderly patients are at elevated risk of both ischemic and bleeding complications after an acute coronary syndrome and display higher on-clopidogrel platelet reactivity compared with younger patients. Prasugrel 5 mg provides more predictable platelet inhibition compared with clopidogrel in the elderly, suggesting the possibility of reducing ischemic events without increasing bleeding. Methods: In a multicenter, randomized, open-label, blinded end point trial, we compared a once-daily maintenance dose of prasugrel 5 mg with the standard clopidogrel 75 mg in patients >74 years of age with acute coronary syndrome undergoing percutaneous coronary intervention. The primary end point was the composite of mortality, myocardial infarction, disabling stroke, and rehospitalization for cardiovascular causes or bleeding within 1 year. The study was designed to demonstrate superiority of prasugrel 5 mg over clopidogrel 75 mg. Results: Enrollment was interrupted, according to prespecified criteria, after a planned interim analysis, when 1443 patients (40% women; mean age, 80 years) had been enrolled with a median follow-up of 12 months, because of futility for efficacy. The primary end point occurred in 121 patients (17%) with prasugrel and 121 (16.6%) with clopidogrel (hazard ratio, 1.007; 95% confidence interval, 0.78–1.30; P = 0.955). Definite/probable stent thrombosis rates were 0.7% with prasugrel versus 1.9% with clopidogrel (odds ratio, 0.36; 95% confidence interval, 0.13–1.00; P = 0.06). Bleeding Academic Research Consortium types 2 and greater rates were 4.1% with prasugrel versus 2.7% with clopidogrel (odds ratio, 1.52; 95% confidence interval, 0.85–3.16; P = 0.18). Conclusions: The present study in elderly patients with acute coronary syndromes showed no difference in the primary end point between reduced-dose prasugrel and standard-dose clopidogrel. However, the study should be interpreted in light of the premature termination of the trial. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01777503.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  7. [해외논문]   Pharmacodynamic Effects of Switching From Ticagrelor to Clopidogrel in Patients With Coronary Artery Disease : Results of the SWAP-4 Study   SCI SCIE

    Franchi, Francesco (University of Florida College of Medicine–Jacksonville. ) , Rollini, Fabiana (University of Florida College of Medicine–Jacksonville. ) , Rivas Rios, Jose (University of Florida College of Medicine–Jacksonville. ) , Rivas, Andrea (University of Florida College of Medicine–Jacksonville. ) , Agarwal, Malhar (University of Florida College of Medicine–Jacksonville. ) , Kureti, Megha (University of Florida College of Medicine–Jacksonville. ) , Nagaraju, Deepa (University of Florida College of Medicine–Jacksonville. ) , Wali, Mustafa (University of Florida College of Medicine–Jacksonville. ) , Shaikh, Zubair (University of Florida College of Medicine–Jacksonville. ) , Briceno, Maryuri (University of Florida College of Medicine–Jacksonville. ) , Nawaz, Ahmed (University of Florida College of Medicine–Jacksonville. ) , Moon, Jae Youn (University of Florida College of Medicine–Jacksonville. ) , Been, Latonya (University of Florida College of Medicine–Jacksonville. ) , Suryadevara, Siva (University of Florida College of Medicine–Jacksonville. ) , Soffer, Daniel (University of Florida College of Medicine–Jacksonville. ) , Zenni, Martin M. (University of Florida Col) , Bass, Theodore A. , Angiolillo, Dominick J.
    Circulation v.137 no.23 ,pp. 2450 - 2462 , 2018 , 0009-7322 ,

    초록

    Background: Switching between different classes of P2Y 12 inhibitors, including de-escalation from ticagrelor to clopidogrel, commonly occurs in clinical practice. However, the pharmacodynamic profiles of this strategy have been poorly explored. Methods: This was a prospective, randomized, open-label study conducted in patients on maintenance dosing (MD) of aspirin (81 mg/d) and clopidogrel (75 mg/d). After a 7-day run-in with ticagrelor (180 mg loading dose [LD] followed by 90 mg twice daily MD), patients (n=80) were randomized into 1 of 4 groups: group A, clopidogrel 600 mg LD 24 hours after the last MD of ticagrelor (C-600 mg-24h); group B, clopidogrel 600 mg LD 12 hours after the last MD of ticagrelor (C-600 mg-12h); group C, clopidogrel 75 mg/d MD 24 hours after the last MD of ticagrelor (C-75 mg-24h); and group D, ticagrelor 90 mg twice daily MD (T-90 mg twice daily). MD of the randomized treatment was maintained for 10±3 days. Pharmacodynamic assessments were performed at baseline, after run-in, and at 2, 24, 48, and 72 hours and 10 days with P2Y 12 reaction units by VerifyNow; platelet reactivity index was assessed by vasodilator-stimulated phosphoprotein; and maximal platelet aggregation was determined by light transmittance aggregometry. Results: T-90 mg twice daily led to lower platelet reactivity than any clopidogrel regimen using all assays at all time points. P2Y 12 reaction unit levels were similar between the C-600 mg-24h (group A) and the C-75 mg-24h (group C) ( P = 0.29), including at 48 hours (primary end point; least mean difference, −6.9; 95% confidence interval, −38.1 to 24.3; P = 0.66). P2Y 12 reaction unit levels were lower with C-600 mg-12h (group B) than with C-75 mg-24h (group C; P = 0.024). Maximal platelet aggregation over time was lower with both C-600 mg-24h (group A; P = 0.041) and C-600 mg-12h (group B; P = 0.028) compared with C-75 mg-24h (group C). Platelet reactivity index profiles paralleled those observed with P2Y 12 reaction units. There were no pharmacodynamic differences for all tests between C-600 mg-24h (group A) and C-600 mg-12h (group B). In group C (C-75 mg-24h), platelet reactivity increased compared with baseline as early as 24 hours, reaching statistical significance at 48 and 72 hours and up to 10 days. These pharmacodynamic findings were delayed and blunted in magnitude with the administration of an LD, regardless of the timing of administration. Conclusions: De-escalation from ticagrelor to clopidogrel therapy is associated with an increase in platelet reactivity. The use of an LD before the initiation of an MD regimen of clopidogrel mitigates these observations, although this is not affected by the timing of its administration after ticagrelor discontinuation. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02287909.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

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  8. [해외논문]   Ventricular Fibrillation Conversion Testing After Implantation of a Subcutaneous Implantable Cardioverter Defibrillator : Report From the National Cardiovascular Data Registry   SCI SCIE

    Friedman, Daniel J. (Division of Cardiology, Duke University Hospital, Durham, NC (D.J.F., S.M.A.-K.). ) , Parzynski, Craig S. (Yale University School of Medicine, New Haven, CT (C.S.P., J.G.A., J.V.F., J.P.C.). ) , Heist, E. Kevin (Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston (E.K.H.). ) , Russo, Andrea M. (Cooper Medical School of Rowan University, Camden, NJ (A.M.R.). ) , Akar, Joseph G. (Yale University School of Medicine, New Haven, CT (C.S.P., J.G.A., J.V.F., J.P.C.). ) , Freeman, James V. (Yale University School of Medicine, New Haven, CT (C.S.P., J.G.A., J.V.F., J.P.C.). ) , Curtis, Jeptha P. (Yale University School of Medicine, New Haven, CT (C.S.P., J.G.A., J.V.F., J.P.C.). ) , Al-Khatib, Sana M. (Division of Cardiology, Duke University Hospital, Durham, NC (D.J.F., S.M.A.-K.).)
    Circulation v.137 no.23 ,pp. 2463 - 2477 , 2018 , 0009-7322 ,

    초록

    Background: Compared with transvenous implantable cardioverter defibrillators (ICDs), subcutaneous (S)-ICDs require a higher energy for effective defibrillation. Although ventricular fibrillation conversion testing (CT) is recommended after S-ICD implantation to ensure an adequate margin between the defibrillation threshold and maximum device output (80J), prior work found that adherence to this recommendation is declining. Methods: We studied first-time recipients of S-ICDs (between September 28, 2012, and April 1, 2016) in the National Cardiovascular Database Registry ICD Registry to determine predictors of use of CT, predictors of an insufficient safety margin (ISM, defined as ventricular fibrillation conversion energy >65J) during testing, and inhospital outcomes associated with use of CT. Multivariable logistic regression analysis was used to predict use of CT and ISM. Inverse probability weighted logistic regression analysis was used to examine the association between use of CT and inhospital adverse events including death. Results: CT testing was performed in 70.7% (n=5624) of 7960 patients with S-ICDs. Although deferral of CT was associated with several patient characteristics (including increased body mass index, increased body surface area, severely reduced ejection fraction, dialysis dependence, warfarin use, anemia, and hypertrophic cardiomyopathy), the facility effect was comparatively more important (area under the curve for patient level versus generalized linear mixed model: 0.619 versus 0.877). An ISM occurred in 6.9% (n=336) of 4864 patients without a prior ICD and was more common among white patients and those with ventricular pacing on the preimplant ECG, higher preimplant blood pressure, larger body surface area, higher body mass index, and lower ejection fraction. A risk score was able to identify patients at low (<5%), medium (5% to 10%), and high risk (>10%) for ISM. CT testing was not associated with a composite of inhospital complications including death. Conclusions: Use of CT testing after S-ICD implantation was driven by facility preference to a greater extent than patient factors and was not associated with a composite of inhospital complications or death. ISM was relatively uncommon and is associated with several widely available patient characteristics. These data may inform ICD system selection and a targeted approach to CT.

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  9. [해외논문]   CD301b/MGL2+ Mononuclear Phagocytes Orchestrate Autoimmune Cardiac Valve Inflammation and Fibrosis   SCI SCIE

    Meier, Lee A. (Center for Immunology (L.A.M., J.L.A., B.J.E., H.M.C., M.I.G.-T., B.A.B.) ) , Auger, Jennifer L. (Center for Immunology (L.A.M., J.L.A., B.J.E., H.M.C., M.I.G.-T., B.A.B.) ) , Engelson, Brianna J. (Center for Immunology (L.A.M., J.L.A., B.J.E., H.M.C., M.I.G.-T., B.A.B.) ) , Cowan, Hannah M. (Center for Immunology (L.A.M., J.L.A., B.J.E., H.M.C., M.I.G.-T., B.A.B.) ) , Breed, Elise R. (Department of Laboratory Medicine and Pathology (E.R.B.) ) , Gonzalez-Torres, Mayra I. (Center for Immunology (L.A.M., J.L.A., B.J.E., H.M.C., M.I.G.-T., B.A.B.) ) , Boyer, Joshua D. (Department of Medicine, University of California, San Diego (J.D.B.). ) , Verma, Mayank (Department of Integrative Biology and Physiology (M.V.) ) , Marath, Aubyn (CardioStart International, Tampa, FL (A.M.). ) , Binstadt, Bryce A. (Center for Immunology (L.A.M., J.L.A., B.J.E., H.M.C., M.I.G.-T., B.A.B.))
    Circulation v.137 no.23 ,pp. 2478 - 2493 , 2018 , 0009-7322 ,

    초록

    Background: Valvular heart disease is common and affects the mitral valve (MV) most frequently. Despite the prevalence of MV disease (MVD), the cellular and molecular pathways that initiate and perpetuate it are not well understood. Methods: K/B.g7 T-cell receptor transgenic mice spontaneously develop systemic autoantibody-associated autoimmunity, leading to fully penetrant fibroinflammatory MVD and arthritis. We used multiparameter flow cytometry, intracellular cytokine staining, and immunofluorescent staining to characterize the cells in inflamed K/B.g7 MVs. We used genetic approaches to study the contribution of mononuclear phagocytes (MNPs) to MVD in this model. Specifically, we generated K/B.g7 mice in which either CX3CR1 or CD301b/macrophage galactose N -acetylgalactosamine–specific lectin 2 (MGL2)–expressing MNPs were ablated. Using K/B.g7 mice expressing Cx3Cr1 -Cre, we conditionally deleted critical inflammatory molecules from MNPs, including the Fc-receptor signal-transducing tyrosine kinase Syk and the cell adhesion molecule very late antigen–4. We performed complementary studies using monoclonal antibodies to block key inflammatory molecules. We generated bone marrow chimeric mice to define the origin of the inflammatory cells present in the MV and to determine which valve cells respond to the proinflammatory cytokine tumor necrosis factor (TNF). Finally, we examined specimens from patients with rheumatic heart disease to correlate our findings to human pathology. Results: MNPs comprised the vast majority of MV-infiltrating cells; these MNPs expressed CX3CR1 and CD301b/MGL2. Analogous cells were present in human rheumatic heart disease valves. K/B.g7 mice lacking CX3CR1 or in which CD301b/MGL2-expressing MNPs were ablated were protected from MVD. The valve-infiltrating CD301b/MGL2 + MNPs expressed tissue-reparative molecules including arginase-1 and resistin-like molecule α. These MNPs also expressed the proinflammatory cytokines TNF and interleukin-6, and antibody blockade of these cytokines prevented MVD. Deleting Syk from CX3CR1-expressing MNPs reduced their TNF and interleukin-6 production and also prevented MVD. TNF acted through TNF receptor–1 expressed on valve-resident cells to increase the expression of vascular cell adhesion molecule–1. Conditionally deleting the vascular cell adhesion molecule-1 ligand very late antigen–4 from CX3CR1-expressing MNPs prevented MVD. Conclusions: CD301b/MGL2 + MNPs are key drivers of autoimmune MVD in K/B.g7 mice and are also present in human rheumatic heart disease. We define key inflammatory molecules that drive MVD in this model, including Syk, TNF, interleukin-6, very late antigen–4, and vascular cell adhesion molecule–1.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  10. [해외논문]   Myeloid Cells Remodel the Mitral Valve   SCI SCIE

    Cremer, Sebastian (Center for Systems Biology (S.C., M.N.) ) , Nahrendorf, Matthias (Center for Systems Biology (S.C., M.N.))
    Circulation v.137 no.23 ,pp. 2494 - 2496 , 2018 , 0009-7322 ,

    초록

    Background: Valvular heart disease is common and affects the mitral valve (MV) most frequently. Despite the prevalence of MV disease (MVD), the cellular and molecular pathways that initiate and perpetuate it are not well understood. Methods: K/B.g7 T-cell receptor transgenic mice spontaneously develop systemic autoantibody-associated autoimmunity, leading to fully penetrant fibroinflammatory MVD and arthritis. We used multiparameter flow cytometry, intracellular cytokine staining, and immunofluorescent staining to characterize the cells in inflamed K/B.g7 MVs. We used genetic approaches to study the contribution of mononuclear phagocytes (MNPs) to MVD in this model. Specifically, we generated K/B.g7 mice in which either CX3CR1 or CD301b/macrophage galactose N -acetylgalactosamine–specific lectin 2 (MGL2)–expressing MNPs were ablated. Using K/B.g7 mice expressing Cx3Cr1 -Cre, we conditionally deleted critical inflammatory molecules from MNPs, including the Fc-receptor signal-transducing tyrosine kinase Syk and the cell adhesion molecule very late antigen–4. We performed complementary studies using monoclonal antibodies to block key inflammatory molecules. We generated bone marrow chimeric mice to define the origin of the inflammatory cells present in the MV and to determine which valve cells respond to the proinflammatory cytokine tumor necrosis factor (TNF). Finally, we examined specimens from patients with rheumatic heart disease to correlate our findings to human pathology. Results: MNPs comprised the vast majority of MV-infiltrating cells; these MNPs expressed CX3CR1 and CD301b/MGL2. Analogous cells were present in human rheumatic heart disease valves. K/B.g7 mice lacking CX3CR1 or in which CD301b/MGL2-expressing MNPs were ablated were protected from MVD. The valve-infiltrating CD301b/MGL2 + MNPs expressed tissue-reparative molecules including arginase-1 and resistin-like molecule α. These MNPs also expressed the proinflammatory cytokines TNF and interleukin-6, and antibody blockade of these cytokines prevented MVD. Deleting Syk from CX3CR1-expressing MNPs reduced their TNF and interleukin-6 production and also prevented MVD. TNF acted through TNF receptor–1 expressed on valve-resident cells to increase the expression of vascular cell adhesion molecule–1. Conditionally deleting the vascular cell adhesion molecule-1 ligand very late antigen–4 from CX3CR1-expressing MNPs prevented MVD. Conclusions: CD301b/MGL2 + MNPs are key drivers of autoimmune MVD in K/B.g7 mice and are also present in human rheumatic heart disease. We define key inflammatory molecules that drive MVD in this model, including Syk, TNF, interleukin-6, very late antigen–4, and vascular cell adhesion molecule–1.

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    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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