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ABSTRACT: The transcatheter closure of atrial septal defects provides an alternative to surgery, and various devices, such as the Sideris buttoned device, have been prescribed. Late complications have been rare and have not yet been reported within 2 years of implantation. This report presents a case of delayed migration of a Sideris buttoned device occurring 6 years after successful implantation. In conclusion, this report provides a reminder of the need for careful long-term follow-up of patients receiving transcatheter closure of atrial septal defects, particularly in cases involving the implantation of early-generated devices.
The American Journal of Cardiology 06/2007; 99(10):1479-80. · 3.37 Impact Factor
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Chung-Fang Lai,
Shuting Bai,
Brian A Uthgenannt,
Linda R Halstead,
Patricia McLoughlin,
Beat W Schafer, Po-Hsien Chu,
Ju Chen,
Carol A Otey,
Xu Cao,
Su-Li Cheng
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ABSTRACT: FHL2, a molecule that interacts with many integrins and transcription factors, was found to play an important role in osteoblast differentiation. Overexpression of FHL2 increases the accumulation of osteoblast differentiation markers and matrix mineralization, whereas FHL2 deficiency results in inhibition of osteoblast differentiation and decreased bone formation.
Integrin-matrix interaction plays a critical role in osteoblast function. It has been shown that the cytoplasmic domains of integrin beta subunits mediate signal transduction induced by integrin-matrix interaction. We reasoned that the identification of proteins interacting with beta-cytoplasmic tails followed by analysis of the function of these proteins would enhance our understanding on integrin signaling and the roles of these proteins in osteoblast activities.
Yeast two hybrid assay was used to identify proteins interacting with the cytoplasmic domain of integrin beta5 subunit. The association of these proteins with integrin alphavbeta5 was confirmed by confocal analysis and co-immunoprecipitation. A stable MC3T3-E1 cells line overexpressing Four and Half Lim Protein 2 (FHL2) and mouse osteoblasts deficient in FHL2 were used to study the roles of FHL2 in osteoblast differentiation and bone formation. Matrix protein expression was determined by mRNA analysis and Western blotting. Matrix mineralization was detected by Alizarin red staining. Alkaline phosphatase activity was also measured. muCT was used to determine bone histomorphometry.
FHL2 and actin-binding proteins, palladin and filamin A, were identified as proteins interacting with beta5 cytoplasmic domain. FHL2 co-localized with alphavbeta5 at the focal adhesion sites in association with palladin and filamin A. FHL2 was also present in nuclei. Osteoblasts overexpressing FHL2 exhibited increased adhesion to and migration on matrix proteins. Conversely, FHL2 stimulation of CREB activity was dependent on integrin function because it was inhibited by Gly-Arg-Gly-Asp-Ser (GRGDS) peptide. The expression of osteoblast differentiation markers and Msx2 was upregulated, and bone matrix mineralization was increased in FHL2 overexpressing cells. In contrast, FHL2-deficient bone marrow cells and osteoblasts displayed decreased osteoblast colony formation and differentiation, respectively, compared with wildtype cells. Moreover, FHL2-deficient female mice exhibited greater bone loss than the wildtype littermates after ovariectomy. Thus, FHL2 plays an important role in osteoblast differentiation and bone formation.
Journal of Bone and Mineral Research 02/2006; 21(1):17-28. · 6.37 Impact Factor
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ABSTRACT: Carverdilol has a variable outcome in treating patients with chronic heart failure. This prospective single-center study evaluated the predictors of clinical variables in determining favorable outcomes in treating chronic heart failure patients with carvedilol. The relation between clinical variables and maintenance doses of carvedilol was also determined. Seventy chronic heart failure patients (mean age, 62.2 years, 50 males and 20 females) with a left ventricular ejection fraction < 35% and functional class II-III were enrolled in the study. The patients were clinically followed-up for at least 24 months. Patients were considered to have a favorable outcome if they had no decreases in functional class or quality-of-life score, an increase in left ventricular ejection fraction>5%, were not admitted to hospital due to worsening heart failure, and free of cardiac mortality. Patients with favorable outcomes had a younger age (P = 0.021), higher baseline systolic blood pressure (P = 0.080), better baseline functional class (P = 0.001), and a higher tolerated dose of carvedilol (P = 0.026) than those in the unfavorable group. In this primarily Chinese cohort of chronic heart failure patients, those with favorable outcomes were likely to be young, have a high baseline systolic blood pressure, and good baseline functional class.
Japanese Heart Journal 09/2004; 45(5):823-32. · 0.40 Impact Factor
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ABSTRACT: The requirement for atrial function in developing heart is unknown. To address this question, we have generated mice deficient in atrial myosin light chain 2 (MLC2a), a major structural component of the atrial myofibrillar apparatus. Inactivation of the Mlc2a gene resulted in severely diminished atrial contraction and consequent embryonic lethality at ED10.5-11.5, demonstrating that atrial function is essential for embryogenesis. Our data also address two longstanding questions in cardiovascular development: the connection between function and form during cardiac morphogenesis, and the requirement for cardiac function during vascular development. Diminished atrial function in MLC2a-null embryos resulted in a number of consistent secondary abnormalities in both cardiac morphogenesis and angiogenesis. Our results unequivocally demonstrate that normal cardiac function is directly linked to normal morphogenic development of heart and vasculature. These data have important implications for the etiology of congenital heart disease.
Development 01/2004; 130(24):6111-9. · 6.60 Impact Factor
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ABSTRACT: Hearts of mice lacking Isl1, a LIM homeodomain transcription factor, are completely missing the outflow tract, right ventricle, and much of the atria. isl1 expression and lineage tracing of isl1-expressing progenitors demonstrate that Isl1 is a marker for a distinct population of undifferentiated cardiac progenitors that give rise to the cardiac segments missing in isl1 mutants. Isl1 function is required for these progenitors to contribute to the heart. In isl1 mutants, isl1-expressing progenitors are progressively reduced in number, and FGF and BMP growth factors are downregulated. Our studies define two sets of cardiogenic precursors, one of which expresses and requires Isl1 and the other of which does not. Our results have implications for the development of specific cardiac lineages, left-right asymmetry, cardiac evolution, and isolation of cardiac progenitor cells.
Developmental Cell 01/2004; 5(6):877-89. · 14.03 Impact Factor
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ABSTRACT: The purpose of this study was to evaluate the feasibility of simplifying balloon mitral valvuloplasty through the obviation of left-sided cardiac catheterization using on-line guidance with transesophageal echocardiography in patients with mitral stenosis.
A tertiary care medical center
Patients who were eligible for balloon mitral valvuloplasty were enrolled into the study if they had no evidence of ischemic heart disease. Sixty-six patients (50 women and 16 men) met the criteria. Balloon mitral valvuloplasty was performed through right-sided cardiac catheterization using adjunctive on-line guidance with transesophageal echocardiography. Left-sided catheterization was obviated. Measurement and results: Balloon mitral valvuloplasty was smoothly performed in all patients. Successful dilatation (postprocedural mitral orifice area, > 1.5 cm(2); or increment in mitral orifice area, >or= 50%) was achieved in 50 patients (75.8%). The mean (+/- SD) mitral orifice area increased from 1.08 +/- 0.23 cm(2) to 1.68 +/- 0.39 cm(2) (p = 0.0000). There were no in-hospital deaths, no patients with cardiac tamponade, or complications necessitating an emergency cardiac operation. The mean fluoroscopy time was 7.6 +/- 3.9 min, and the total procedure time was 50.2 +/- 15.0 min.
It is feasible and safe to simplify balloon mitral valvuloplasty by obviating left-sided cardiac catheterization in selected patients with mitral stenosis using adjunctive on-line guidance with transesophageal echocardiography.
Chest 06/2003; 123(6):1957-63. · 5.25 Impact Factor
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ABSTRACT: The purpose of this study was to evaluate the solubility of left atrial thrombi to thrombolytics after failure of long-term anticoagulant therapy in patient with mitral stenosis. One hundred and eighty-one consecutive patients with mitral valve area < or = 1.5 cm(2) and without severe mitral regurgitation were screened with echocardiography; 30 were found to have left atrial thrombi. Follow-up echocardiography performed 7.4 +/- 5.6 months after warfarin therapy revealed that 8/30 of patients had complete dissolution and 3/30 had partial dissolution of the thrombi. Thirteen patients with residual isolated appendageal thrombi underwent balloon mitral commissurotomy and were randomized into four groups at the end of balloon mitral commissurotomy: group A, receiving intra-atrial infusion of heparin and tissue plasminogen activator (t-PA; n = 4); group B, heparin and streptokinase (n = 3); group C, heparin (n = 3); and group D, acting as control (n = 3). It was found that only two patients in the t-PA group had their thrombi either completely or partially dissolved within 48 hr. Thus, this study suggests that t-PA may have the potential of dissolving chronic left atrial thrombi.
Catheterization and Cardiovascular Interventions 09/2002; 56(4):460-5. · 2.29 Impact Factor
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ABSTRACT: Caveolins are important components of caveolae, which have been implicated in vesicular trafficking and signal transduction. To investigate the in vivo significance of Caveolins in mammals, we generated mice deficient in the caveolin-1 (cav-1) gene and have shown that, in the absence of Cav-1, no caveolae structures were observed in several nonmuscle cell types. Although cav-1(-/-) mice are viable, histological examination and echocardiography identified a spectrum of characteristics of dilated cardiomyopathy in the left ventricular chamber of the cav-1-deficient hearts, including an enlarged ventricular chamber diameter, thin posterior wall, and decreased contractility. These animals also have marked right ventricular hypertrophy, suggesting a chronic increase in pulmonary artery pressure. Direct measurement of pulmonary artery pressure and histological analysis revealed that the cav-1(-/-) mice exhibit pulmonary hypertension, which may contribute to the right ventricle hypertrophy. In addition, the loss of Cav-1 leads to a dramatic increase in systemic NO levels. Our studies provided in vivo evidence that cav-1 is essential for the control of systemic NO levels and normal cardiopulmonary function.
Proceedings of the National Academy of Sciences 09/2002; 99(17):11375-80. · 9.68 Impact Factor
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ABSTRACT: A 37-year-old woman had progressive shortness of breath and mitral stenosis was diagnosed. Despite the unusual finding of undegenerated septum primum on echocardiography and angiography, percutaneous transseptal mitral commissurotomy was successfully performed in this patient with rheumatic mitral stenosis under the guidance of online transesophageal echocardiography.
Circulation Journal 04/2002; 66(3):302-4. · 3.77 Impact Factor
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ABSTRACT: Cypher is a member of a recently emerging family of proteins containing a PDZ domain at their NH2 terminus and one or three LIM domains at their COOH terminus. Cypher knockout mice display a severe form of congenital myopathy and die postnatally from functional failure in multiple striated muscles. Examination of striated muscle from the mutants revealed that Cypher is not required for sarcomerogenesis or Z-line assembly, but rather is required for maintenance of the Z-line during muscle function. In vitro studies demonstrated that individual domains within Cypher localize independently to the Z-line via interactions with α-actinin or other Z-line components. These results suggest that Cypher functions as a linker-strut to maintain cytoskeletal structure during contraction.
The Journal of Cell Biology 12/2001; · 10.26 Impact Factor
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Y.-L. Ko,
S.-M. Wang,
Y.-S. Ko, Po-Hsien Chu,
Ming-Sheng Teng,
Nye-Jan Cheng,
Wei-Jan Chen,
Tsu-Shiu Hsu,
Chi-Tai Kuo,
Chen-Wen Chiang,
Ying-Shiung Lee
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ABSTRACT: The homozygous deletion allele (DD) of the angiotensin-I converting enzyme (ACE) gene and the T235 homozygote of the angiotensinogen
(AGT) gene have been reported to be correlated with an increased prevalence of coronary artery disease (CAD) and myocardial
infarction (MI). The importance of the DD genotype and T235 homozygote as genetic risk factors for CAD in Chinese remains
uncertain. This study included 426 patients who underwent coronary angiography and 180 healthy subjects without clinical evidence
of CAD. Coronary angiography identified 268 patients with CAD (CAD group) and 158 patients without CAD. The healthy subjects
and patients without angiographic evidence of CAD constituted the control group. Three polymorphisms were studied: an insertion/deletion
(I/D) polymorphism of the ACE gene and the T174 M and M235T polymorphisms of the AGT gene. No association was found between
any of the three studied polymorphisms and the risk of CAD or MI in Chinese using univariate or multivariate analysis. In
multivariate analysis, the relative risks were 1.20 (95% confidence interval = 0.91–1.61, P = 0.20) for the DD genotype, 1.05 (95% CI = 0.82–1.35, P = 0.69) for the T174 homozygote, and 1.19 (95% CI = 0.91–1.55, P = 0.20) for the T235 homozygote. Similarly, no significant difference was found in the frequencies of the DD genotype and
the T174 and T235 homozygotes between the control group, the CAD group, the non-MI group, and the MI group when analyzed according
to sex, age, or degree of risk. Our data suggest that neither the DD genotype of the ACE I/D polymorphism nor the T174 and
T235 homozygotes of the AGT gene confer significant risk for CAD or MI in Chinese.
Human Genetics 06/1997; 100(2):210-214. · 5.07 Impact Factor
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ABSTRACT: LIM domain-containing proteins play critical roles in vertebrate development and cellular differentiation. Recently, four members of the four and one-half LIM protein (FHL) family have been identified and cloned. One of these, FHL2, is expressed in a restricted manner in the cardiovascular system throughout development into adulthood, suggesting that FHL2 may play an important role in cardiovascular development and function. Here we describe the generation and analysis of mice carrying a null mutation of the FHL2 gene. FHL2-deficient mice are viable and maintain normal cardiac function both before and after acute mechanical stress induced by aortic constriction. These data suggest that FHL2 is not essential for cardiac development and function.
