John P Veinot

John P Veinot
University of Ottawa · Department of Pathology and Laboratory Medicine

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280
Publications
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Introduction
Skills and Expertise

Publications

Publications (280)
Article
Giant cell arteritis (GCA) is a systemic vasculitis of medium and large sized blood vessels. The incidence is greater in women as compared to men (3:1) and most often occurs in the elderly. The most common symptoms are unilateral headaches, visual disturbances and scalp tenderness. If untreated, GCA may result in irreversible blindness. Prompt trea...
Chapter
Knowledge of cardiac anatomy forms the backbone of clinical cardiovascular medicine. Clinical examination of the patient, surgical intervention and imaging techniques, and examination of cardiac tissues are meaningless without an appreciation of basic anatomy. This chapter reviews the gross, light microscopic, and ultrastructural anatomy of cardiov...
Article
Background and Purpose Unstable carotid plaques are a common cause of ischemic strokes. Identifying markers that reflect/contribute to plaque instability has become a prominent focus in cardiovascular research. The adipokines, resistin and chemerin, and ChemR23 (chemerin receptor), may play a role in carotid atherosclerosis, making them potential c...
Article
We report a case of a 75-year-old female post orthotopic heart transplantation, who presented to the emergency department with a six-week history of shortness of breath, hand tremor and ultimately delirium. She had lobular breast carcinoma more than 5 years prior to her heart transplant, treated by lumpectomy followed by anthracycline based chemoth...
Article
We present two patients who underwent cardiac surgery followed by post-operative low cardiac output, diastolic dysfunction and resistance to inotropic support. Despite aggressive medical management, both patients died. At autopsy, the hearts were enlarged and showed previously undiagnosed myocardial and vascular amyloidosis. Occult cardiac amyloido...
Article
Full-text available
Objective: Atherosclerosis and its thrombotic complications are major causes of morbidity and mortality worldwide. Plaque stability assessment is considered to be important for both clinical and fundamental applications. The current gold standard method to investigate plaque stability is performed by histological assessment of plaque features usin...
Article
Lysosomal storage disorders (LSD) comprise a group of diseases caused by a deficiency of lysosomal enzymes, membrane transporters or other proteins involved in lysosomal biology. Lysosomal storage disorders result from an accumulation of specific substrates, due to the inability to break them down. The diseases are classified according to the type...
Data
Supplementary material: SUPPLEMENTARY FIGURE 1: Representative M-mode images with the short-axis view of the echocardiographic analysis of the left ventricular. SUPPLEMENTARY FIGURE 2: (A) The expression values of GRX2 (also known as GLRX2) in 27 tissue types was plotted using GTEx Analysis Release v6 (dbGaP accession number: phs000424.v6.p1). Expr...
Article
Full-text available
Glutaredoxin 2 (GRX2), a mitochondrial glutathione-dependent oxidoreductase, is central to glutathione homeostasis and mitochondrial redox, which is crucial in highly metabolic tissues like the heart. Previous research showed that absence of Grx2, leads to impaired mitochondrial complex I function, hypertension and cardiac hypertrophy in mice but t...
Article
Background: Idiopathic aortitis became recognized relatively recently, and the body of knowledge concerning this condition is scarce. We aimed to determine the frequency of idiopathic aortitis in aortic specimens, the clinical, laboratory and radiologic characteristics at diagnosis and during follow-up, and the approach to investigation, treatment...
Conference Paper
Introduction: Sex differences in plaque morphology and composition exist; men develop more unstable plaques than women. Yet, stroke kills more women than men. Despite these differences, no sex-specific guidelines for carotid disease management exist. Thus, markers that reflect sex-specific morphological features in the plaque should be explored for...
Article
Full-text available
Background and purpose: Adiponectin, the most abundantly secreted anti-inflammatory adipokine, protects against all stages of atherosclerotic plaque formation by acting on its receptors, AdipoR1 (adiponectin receptor 1) and AdipoR2 (adiponectin receptor 2). Through binding of AdipoR1, adiponectin leads to the activation of the AMPK (adenosine mono...
Article
The Nkx2.5 gene encodes a transcription factor that plays a critical role in heart development. In humans, heterozygous mutations in NKX2.5 result in congenital heart defects (CHDs). However, the molecular mechanisms by which these mutations cause the disease remain unknown. NKX2.5-R142C is a mutation that was reported to be associated with atrial...
Article
We report on a 45 year-old man with rapidly progressive cardiac amyloidosis, requiring heart transplantation within two years of symptomatic onset. Hematologic testing and initial tissue biopsies confirmed amyloid infiltration but were inconclusive for the amyloidogenic protein source. Mass spectroscopy and transthyretin (TTR) sequencing were requi...
Article
Stroke is associated with vulnerable carotid artery plaques showing specific histopathologic features, namely a lipid-rich necrotic core, intraplaque hemorrhage, ulceration, and thin fibrous cap. While ultrasound and computed tomography (CT) can identify carotid plaques and determine the extent of stenosis, magnetic resonance imaging (MRI) provides...
Chapter
Knowledge of cardiac anatomy forms the backbone of clinical cardiovascular medicine. Clinical examination of the patient, surgical intervention and imaging techniques, and examination of cardiac tissues are meaningless without an appreciation of basic anatomy. This chapter reviews the gross, light microscopic and ultrastructural anatomy of cardiova...
Article
Objective: The rupture of unstable carotid atherosclerotic plaques is one of the main causes of cerebrovascular ischemic events. There is need for circulating markers that can predict plaque instability and risk of stroke. Proinflammatory chemerin, leptin, and resistin, along with anti-inflammatory adiponectin, are adipokines with direct influence...
Article
Background: Carotid plaque echodensity and texture features predict cerebrovascular symptomatology. Our purpose was to determine the association of echodensity and textural features obtained from a digital image analysis (DIA) program with histologic features of plaque instability as well as to identify the specific morphologic characteristics of...
Chapter
Infective endocarditis (IE) may give rise to numerous extracardiac, cardiac and valvular findings including infected thrombi (vegetations), sequelae of local tissue destruction, and systemic manifestations including vasculitis, emboli and ischemic events. This is an appropriate term as the causal organisms may be bacterial, fungal, rickettsial, or...
Article
Surgical aortic specimens are usually examined in Pathology Departments as a result of treatment of aneurysms or dissections. A number of diseases, genetic syndromes (Marfan syndrome, Loeys-Dietz syndrome, etc.), and vasculopathic aging processes involved in vascular injury can cause both distinct and non-specific histopathologic changes with degen...
Chapter
Endomyocardial biopsy is a commonly performed useful procedure utilized for the evaluation of cardiac tissues. Biopsy is most often used to monitor transplant rejection, but it has many other applications including the evaluation of myocarditis, cardiomyopathy, drug toxicity, tumors, arrhythmia, and secondary involvement of the heart by systemic di...
Article
Cerebral Metastasis Presenting after Complete Primary Resection of Atrial Myxoma: Case Report - Volume 42 Issue 6 - Ian Côté, John Sinclair, John Woulfe, Rafael Glikstein, John Veinot
Article
Historical development of percutaneous coronary intervention (PCI) from percutaneous coronary transluminal angioplasty (PCTA) is outlined, along with the progression in the development of coronary artery stents—from the earliest bare-metal stents to drug-eluting stents to the current leading edge of bioresorbable and polymer-free stents. The early,...
Article
Full-text available
Inflammatory diseases of the aorta include routine atherosclerosis, aortitis, periaortitis, and atherosclerosis with excessive inflammatory responses, such as inflammatory atherosclerotic aneurysms. The nomenclature and histologic features of these disorders are reviewed and discussed. In addition, diagnostic criteria are provided to distinguish be...
Article
Background: Obstructive Sleep Apnea (OSA) results in intermittent hypoxia leading to atrial remodeling, which, among other things, facilitates development of atrial fibrillation. While much data exists on the macrostructural changes in cardiac physiology induced by OSA, there is a lack of studies looking for histologic changes in human atrial tissu...
Article
Background: Obstructive Sleep Apnea (OSA) results in intermittent hypoxia leading to atrial remodeling, which, among other things, facilitates development of atrial fibrillation. While much data exists on the macrostructural changes in cardiac physiology induced by OSA, there is a lack of studies looking for histologic changes in human atrial tissu...
Conference Paper
Adiponectin, an adipose tissue secreted protein, possesses anti-atherosclerotic properties. Its effects are partly mediated through its action on monocytes, via receptors, AdipoR1 and AdipoR2. Circulating monocytes play a crucial role both in plaque initiation and in the progression of atherosclerosis. The aim of this ongoing study is to investigat...
Article
Full-text available
To investigate the association of cholesterol efflux capacity with carotid atherosclerosis and cerebrovascular disease. Patients with high-grade carotid stenosis (n=154) were recruited from Vascular Surgery clinics and 9 healthy controls from the McGill University Health Network, Montreal, Canada. Cerebrovascular symptomatology history was obtained...
Article
The Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology created a task force to write a consensus document on when and how endomyocardial biopsy is of help for clinicians in the diagnosis and treatment of patients with heart failure, arrhythmias, and cardiac masses. Endomyocardial biopsy is the gold standa...
Article
Introduction Evidence shows that low plasma levels of adiponectin, a vasculoprotective adipokine, are associated with coronary artery disease and carotid-intima media thickness. The current study investigated for the first time the association between adiponectin and carotid plaque instability, namely the association between circulating adiponectin...
Article
A young woman thought to have seronegative rheumatoid arthritis developed Stevens-Johnson syndrome after treatment with sulfasalazine; this resolved with prednisone. Later she was found to be HLA-B27-positive in keeping with a spondyloarthropathy. Soon afterward, she developed clinical myopericarditis and cardiogenic shock that responded initially...
Article
Full-text available
Mutations of the ACTA2 gene, which encodes the smooth muscle cell-specific isoform of α-actin protein, have recently been found to be among the most common genetic abnormalities observed in patients with familial thoracic aortic aneurysms/dissection (TAAD). Other reported vascular manifestations caused by these mutations include premature coronary...
Article
Material properties needed for accurate stress analysis of the human aorta are still incompletely known, especially as many reports have ignored the presence of residual stresses in the aortic wall. To contribute new material regarding these issues, we carried out measurements and pressurization testing on ascending, thoracic and abdominal aortic s...
Article
Anatomy of the native cardiac valves, reasons for surgical excision and examination, and a summary of the gross examination and documentation are presented. Aortic stenosis, aortic valve regurgitation, tricuspid and pulmonary valve pathology, mitral stenosis, and mitral insufficiency are each presented with an overview, focused anatomy, and discuss...
Article
We review the clinical and pathological features of the various types of amyloid that involve the heart, the diagnostic utility of endomyocardial biopsy, and the experience of patient survival and disease recurrence following cardiac transplant for amyloidosis. Patient outcome is dependent on arresting the cause of amyloid as well as controlling th...
Article
While systemic embolic events occur with relative frequency in infective endocarditis (IE), coronary embolization remains an uncommon cause of ST elevation myocardial infarction. Herein we report a case of ventricular fibrillation and anterior ST elevation myocardial infarction occurring in a patient initially presenting with septic shock. Angiogra...
Article
Full-text available
The Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology have produced this position paper concerning the current role of endomyocardial biopsy (EMB) for the diagnosis of cardiac diseases and its contribution to patient management, focusing on pathological issues, with these aims: • Determining appropriate...
Article
Primary neoplasms of the heart are rare. Benign entities in adult populations include myxoma, fibroma, lipoma, hamartoma of mature myocytes, and vascular hamartoma. The most common pediatric cardiac neoplasm is the rhabdomyoma. We report a 22-year-old female with a primary left ventricle tumor composed of multiple mature mesenchymal tissues, includ...
Article
Culture-negative endocarditis is most often the result of prior antimicrobial therapy. Tropheryma whipplei is the etiologic agent of Whipple's disease, which is typically characterized by diarrhea, weight loss, and intra-abdominal lymphadenopathy. We present the case of a 48-year-old male with Whipple's endocarditis of the aortic valve who did not...
Article
We present a patient with recurrent constrictive physiology resulting from exuberant post-operative fibrosis after complete pericardiectomy. The patient underwent a repeat stripping procedure. At surgery, there was an extensive fibrotic and calcified rind around the heart. The recurrence of constriction physiology after complete pericardiectomy in...
Article
With the advent of molecular subclassification of diseases, much consideration should be given to the proper processing of cardiovascular surgical pathology specimens to maximize patient care. Such specimens include endomyocardial biopsies, cardiac myectomy specimens, cardiac apical core segments, resected cardiac valves, pericardial biopsies, rese...
Article
The right ventricle (RV) has not received as much attention as the left ventricle partly due to the fact that primary diseases of the RV are uncommon. Another reason may be the complexity of RV anatomy, which has a distinct inflow and outflow tract. The RV is associated with a tricuspid atrioventricular valve with septal chordal attachments and dis...
Article
Like all visceral organs, the heart ages. The fibrous skeleton of the heart becomes sclerotic and calcifies, the valve closing margins thicken, the aorta dilates and tilts rightward on the interventricular septum making the latter seem prominent, the ventricles decrease in size, the left atrium enlarges, valves calcify and/or become myxomatous and...
Article
The heart is located in the chest between the lungs and in front of the esophagus (Fig. 1.1). It has four chambers – two atria and two ventricles (Fig. 1.2). The right atrium receives blood from the head and neck via the superior vena cava, while the blood from the body and lower limbs enters the right atrium via the inferior vena cava. The blood p...
Article
The pathologist and cardiologist in routine practice do not commonly encounter tumors of the heart and great vessels. Prior to the 1960s, cardiac tumors were rarely diagnosed before the death of the patient and could only be examined at autopsy. The development of cardiac surgery has allowed resection of these tumors.
Article
Stroke is the third leading cause of death after heart disease and cancer. Its prevalence increases with age, affecting about 5% of people over 65 years of age. Stroke is frequently associated with severe long-term disability. There are multiple causes of stroke, and determination of the etiology of stroke is important for the acute management and...
Article
The tricuspid valve has three leaflets, the anterior, the septal and the posterior (Fig. 5.1). The anterior leaflet is the largest of the three. As with all cardiac valves there is a free edge and a line of closure, located on the atrial side of the tricuspid valve. There are three commissures separating each leaflet. Each leaflet has chordae tendo...
Article
In systemic diseases, such as connective tissue diseases and metabolic syndromes, involvement of multiple organs is the general rule. Yet cardiac involvement in many systemic diseases is not well recognized, as the dominant manifestations frequently reside in other organ systems. Cardiac involvement is very common with many systemic diseases and ma...
Chapter
The development of prosthetic heart valves has been a major advance in the treatment of patients with valvular heart disease. There have been ongoing improvements in valve design so that the performance and durability of the currently available heart valves far surpasses early generation valve prostheses. Despite the major improvements in prostheti...
Chapter
Heart failure has become an increasingly important medical problem. It is one of the major reasons for hospitalization and is associated with increased mortality. The prevalence of heart failure is expected to rise with the aging of the population. About half of the patients with heart failure have preserved left ventricular systolic function, and...
Chapter
Technological advancements in cardiology have been proceeding at a rapid pace over the past two decades. Many surgical procedures can now be performed using a percutaneous approach. Echocardiography plays an important role in these procedures for selecting the appropriate patients, monitoring the procedure to avoid complications, assessing the resu...
Chapter
To understand mitral valve dysfunction the anatomy of the valve must be understood. The mitral valve is an atrioventricular valve with leaflets and chordae that attach to papillary muscles. There are two leaflets: the anterior and the posterior (Fig. 4.1). On either side of the leaflets there are commissures. The mitral valve has no septal chordal...
Chapter
The pericardium surrounds the heart as the heart becomes enveloped in the developing pericardial sac during embryogenesis. There are two layers – the visceral pericardium, which is part of the epicardium and the parietal pericardium, which is a strong fibrous sac (Fig. 10.1) [1, 2]. Both are lined by mesothelial cells which have a secretory functio...
Chapter
Endocarditis, as a pathological entity, has been traditionally classified into infective endocarditis (IE), verrucous endocarditis, and nonbacterial thrombotic endocarditis (NBTE). Infective endocarditis can be subdivided into culture negative or culture positive endocarditis. NBTE has been associated with connective tissue diseases, chronic inflam...
Chapter
Native cardiac valves may be involved by dysfunctional states, stenosis and regurgitation, or by vegetations, infective or non-infective. Valves that are surgically excised are examined for a number of reasons: (a) to document the indications for surgery, (b) to correlate pathology with pre-operative clinical diagnosis, hemodynamics, and imaging fi...
Chapter
Many patients with congenital heart disease survive into adulthood. In some cases, this is due to the mild nature of the disease, while in others, it is the result of palliative or curative procedures performed during ­childhood. In this chapter, we shall provide an overview of our approach in the echocardiographic assessment of patients with suspe...
Chapter
The aorta is an elastic artery that takes origin from the left ventricle. Embryologically the aorta and the pulmonary trunk derive from the truncus arteriosus in the fetus. The smooth muscle cells in variable areas of the aorta derive from different cells of origin. The ascending aorta smooth muscle cells are neural crest derived, whereas the cells...
Article
Endomyocardial biopsy is a commonly performed useful procedure utilized for the evaluation of cardiac tissue. Biopsy may be used to monitor transplant rejection, but it has many other applications including the evaluation of myocarditis, cardiomyopathy, chest pain, arrhythmia, and secondary involvement by systemic diseases. Drug toxicity may be eva...
Chapter
Cardiomyopathies are cardiac disorders characterized by predominant myocardial dysfunction – expressed as diastolic or systolic ventricular dysfunction. Before the advent of molecular biology, cardiomyopathies were considered heart muscle disease of unknown etiology. The most recently accepted definition of a cardiomyopathy is a heterogeneous group...
Chapter
Ischemic heart disease is the most common cause of death in developed countries and its prevalence is increasing in developing countries. Not all ischemic heart disease is related to atherosclerosis, although the great majority is due to coronary artery atherosclerosis (Table 7.1). Plaques may become complicated whether they are mildly or severely...
Article
Atrial fibrillation (AF) is the most common sustained arrhythmia observed in otherwise healthy individuals. Most lone AF cases are nonfamilial, leading to the assumption that a primary genetic origin is unlikely. In this study, we provide data supporting a novel paradigm that atrial tissue-specific genetic defects may be associated with sporadic ca...
Article
Cardiovascular disease is of continuing importance as the result of a growing burden of risk factors in both developing and developed countries and the increasing number of elderly people worldwide. The recruitment and training of a new generation of Cardiovascular Pathologists is crucial to sustaining clinical excellence and to advancing our knowl...
Article
Clinical efficacy of cardiac cell therapy may be compromised by its target population, patients with endothelial dysfunction. In vivo inhibition by endothelial dysfunction has been demonstrated for protein angiogenesis but remains unclear for cell therapy. We examined whether hypercholesterolemia inhibits vasculogenic effects of transplanted human...
Article
This is a case report of a 30-year-old man who presented with acute right-sided pleuritic chest pain. A chest roentgenogram performed in the emergency room shows a large, well-circumscribed transparent lesion obscuring the right heart border. Further imaging revealed a large pericardial cyst. The patient was taken to surgery as a result of clinical...
Article
Mechanical aortic prosthesis dysfunction can result from thrombosis or pannus formation. Pannus formation usually restricts systolic excursion of the occluding disk, resulting in progressive stenosis of the aortic prosthesis. Intermittent dysfunction of a mechanical aortic prosthesis is usually ascribed to thrombus formation. We describe an unusual...