Ischemic Group Research Articles

The gut microbial metabolite phenylacetylglutamine increases susceptibility to atrial fibrillation after myocardial infarction through ferroptosis and NLRP3 inflammasome.

Myocardial infarction (MI) is an important risk factor for the development of atrial fibrillation (AF), and the gut microbial metabolite phenylacetylglutamine (PAGln) is strongly associated with the prognosis of MI patients. However, whether PAGln is involved in the regulation of AF after MI is currently unknown. Therefore, the present study aimed to explore the effect of PAGln on the susceptibility to AF after MI.MI model was constructed by surgically ligating the left anterior descending branch of the coronary artery. PAGln was administered by intraperitoneal injection for 7 consecutive days starting after surgery and then investigated by histopathologic, molecular biological, and electrophysiologic studies.Myocardial ischemia resulted in intestinal barrier dysfunction and significantly increased circulating levels of PAGln. Compared with the myocardial ischemia group, administration of PAGln significantly exacerbated atrial fibrosis and atrial electrical remodeling in mice after myocardial ischemia, as evidenced by shortening of the ERP (at varying pacing cycle lengths of 40, 60, 80, and 100), ion channel remodeling (Nav1.5, Cav1.2, and Kv1.5), and decreased expression of CX40, which led to an increase in the susceptibility to AF (54.5% vs. 90.9%, P < 0.05). In addition, administration of PAGln further exacerbated MI-induced intestinal barrier dysfunction compared with the MI group. Mechanistically, PAGln may affect atrial remodeling and AF susceptibility after MI by modulating ferroptosis and NLRP3 inflammasome.The present study preliminarily reveals that the gut microbial metabolite PAGln exacerbates post-MI AF remodeling and AF susceptibility, possibly through ferroptosis and activation of NLRP3 inflammasome.

Identification of the optimal thresholds for the hypoperfusion intensity ratio in moyamoya disease.

The authors' objective was to retrospectively compare two methods for defining the hypoperfusion intensity ratio (HIR) in moyamoya disease (MMD) by using hypoperfused volumes calculated from time to maximum of the residue function (Tmax) thresholds of 10 seconds/4 seconds and 10 seconds/6 seconds. All hemispheres were categorized into normal, ischemic, and hemorrhagic groups. Hypoperfused volumes were calculated using Tmax thresholds of 10 seconds, 6 seconds, and 4 seconds. HIR was computed as Tmax > 10 seconds/Tmax > 4 seconds (HIR10/4) and Tmax > 10 seconds/Tmax > 6 seconds (HIR10/6). Angiographic collaterals were assessed using CT perfusion (CTP)-sourced images (CTP-sis). The 3-month clinical follow-up included primary outcomes (survival or death) and secondary outcomes (modified Rankin Scale [mRS] and Katz activities of daily living [ADL] scale scores). Multivariate logistic regression and correlation analyses were conducted. Thirty patients (54 hemispheres) were included. Patients with poor primary outcomes exhibited higher rates of hypertension (p = 0.015), larger hypoperfused volumes, and elevated HIR10/4 and HIR10/6 (p < 0.001). The regression model with HIR10/4 outperformed that with HIR10/6 for predicting primary outcomes (Z = 2.02, p = 0.044). Both HIR10/4 and HIR10/6 correlated with mRS and ADL scores (p < 0.05). Although there was no correlation between HIR and CTP-sis when all hemispheres were included, a significant association was found between HIR10/4 and CTP-sis when hemispheres with hemorrhagic lesions were excluded (p = 0.013). HIR10/4 exhibited a superior predictive value for primary outcomes in MMD compared to HIR10/6. Additionally, HIR10/4 showed a significant association with angiographic collaterals, particularly in ischemic MMD cases. This study suggested that HIR defined as Tmax > 10 seconds/Tmax > 4 seconds may be more suitable than Tmax > 10 seconds/Tmax > 6 seconds in MMD.

Therapeutic effect of Berberis vulgaris fruit extract on histopathological changes and oxidative stress markers of ovarian ischemia and reperfusion injury in rats

AimThis study aimed to investigate the possible protective effect of berberine, the active compound of Berberis vulgaris plant extract, which has anti-inflammatory and antioxidant properties, in an ovarian ischemia–reperfusion model by utilizing molecular, biochemical, and histopathological methods. MethodsIn this experimental study, 42 adolescent female Sprague Dawley rats (6 weeks old) were divided into 7 equal groups. Under anesthesia, ischemia was induced by ligating the bilateral adnexal tissues, and after 3 h of ischemia, reperfusion was achieved by removing the adnexal ligation. Berberis vulgaris extract was administered by oral gavage 1 h after ischemia for the ischemia groups and 1 h before reperfusion for the ischemia + reperfusion groups. After 3 h of reperfusion, the experiment was terminated. ResultsThe administration of Berberis vulgaris extract decreased the hemorrhagic areas, reduced the number of TUNEL-positive cells, and decreased CYC1 immunoreactivity levels in histopathological analysis compared to the groups subjected to ischemia or ischemia + reperfusion without the plant extract. CAT, SOD, and GSH increased due to Berberis vulgaris administration while MDA levels decreased. Berberis vulgaris also downregulated TNF-α levels compared to the ischemia and ischemia + reperfusion groups. ConclusionBerberis vulgaris extract may have a protective effect against ovarian ischemia–reperfusion injury. Further molecular studies are needed to clarify this protective effect.

Silymarin administration after cerebral ischemia improves survival of obese mice by increasing cortical BDNF and IGF1 levels.

Obesity is associated with a systemic inflammatory state that contributes to neuroinflammation and increases the risk of stroke at an early age. Stroke is the third leading cause of death worldwide and the leading cause of permanent disability. This work aimed to assess whether obesity-induced neuroinflammation can be a prognostic stroke factor that can be improved with oral administration of silymarin, an anti-inflammatory and neuroprotective drug. Male C57/Bl6 mice were used to establish an obesity model through a high-fat diet (HFD) for 12 weeks. Cerebral ischemia was performed with photothrombosis in the left motor cortex at the end of the diet. Following the induction of ischemia, silymarin (100 mg/kg) was administered orally for 14 days. Levels of pro-inflammatory (IL1β, TNFα, and MCP1) and anti-inflammatory markers (IL4, IL10), neurotrophic factors (IGF1, BDNF), and CX3CL1 were assessed in the cortex and striatum using ELISA. Mice on the HFD gained significantly more weight than control subjects and exhibited altered glucose metabolism, which was improved after silymarin treatment. The survival rate was significantly lower in HFD mice (52.2%) compared to control mice (86%). Silymarin treatment improved survival in both ischemic groups (non-diet control: 95.7%, HFD: 78.3%). Silymarin raised cortical TNFα, IL4, IL10, IGF1, BDNF, and CX3CL1 levels in the HFD group with stroke, while the striatum did not present relevant differences. Our findings suggest that silymarin improves glucose metabolism, possibly impacting post-stroke survival in obese mice. The increased levels of neurotrophic factors BDNF and IGF1, along with microglial regulatory factor CX3CL1, may contribute to the improved survival observed. These results indicate that silymarin could be a potential therapeutic option for managing neuroinflammation and enhancing post-stroke outcomes in obese individuals.

Efficacy of Omega-5 NanoPSO Treatment in the Hippocampus, Through Antioxidant Mechanisms, After an Ischemia/Reperfusion Injury, in Murine Model.

Stroke is the third cause of death worldwide and a health problem, and current therapy continues to be very poor. It promotes an alteration associated with excitotoxicity, oxidative stress, and inflammatory processes, exacerbating the damage in the brain. Although cortical areas are the most affected by stroke, the hippocampus can be impacted in the long term through the pathways it connects with these areas, which are associated further with motor alterations; this encourages the search for new therapeutic approaches. Omega-5, being an antioxidant, participates in regulating oxidative stress. A recently designed nanoemulsified compound coupled with pomegranate seed oil (NanoPSO) maintains bioavailability in the body for longer. Omega-5 NanoPSO is more effective in different models of neurodegenerative diseases and metabolic disorders. Therefore, it is important to analyze the effect of omega-5 NanoPSO on ischemic damage through changes in the hippocampus, oxidative mechanisms, and behavioral outcomes. Male Wistar rats were used in five groups; three groups were subjected to an ischemic event through bilateral occlusion of the carotid arteries. An ischemia group received omega-5 NanoPSO after injury, and another group received omega-5 NanoPSO performed two weeks before the ischemic event and three weeks after the surgical process. The control and sham groups did not show changes in the hippocampus and behavior. In the ischemia group, neuronal loss, oxidative stress, and a higher expression of astrocytes were maintained in the hippocampal region, and behavior was modified. In the post and pre-treatment group with omega-5 NanoPSO, we observed reduced damage, glial proliferation, and oxidative stress. It increased neuron survival in the hippocampal region and improved the locomotion. These results highlight its promise for use in clinical settings to treat patients suffering from ischemic brain injury.

Perfusate Biomarkers of DCD Cardiac Graft Quality Identified With Proteomics: Studies in an Isolated Rat Heart Model.

Heart transplantation with donation after circulatory death (DCD) enhances cardiac graft availability, but exposes hearts to potentially damaging conditions, such as warm ischemia. Normothermic machine perfusion (NMP), used for graft transportation, allows biomarker determination in perfusate. Using our isolated, rat heart model of DCD, we evaluated potent. Isolated, perfused adult male Wistar rat hearts (n = 5/group) underwent different warm ischemic durations to simulate DCD, followed by reperfusion to simulate NMP. Perfusate samples were collected after 10 min reperfusion, and proteins were analyzed using mass spectrometry. Cardiac recovery was evaluated after 60 min reperfusion. The relationship between perfusate proteins and cardiac recovery was investigated. Cardiac recovery decreased with increasing ischemic duration. Principal component analysis of perfusate proteins demonstrated segregation by ischemic group. Several proteins demonstrated an On-Off pattern, and correlated with key outcome measurements. Other proteins were released by all hearts and were confirmed as predictors of cardiac recovery, for example, heat shock protein 70 and valosin-containing protein (area under the curve [AUC] = 0.962-0.968, respectively; P < 0.05 for all). Additionally, proteins such as glycogen phosphorylase, muscle associated (AUC = 0.9632; P < 0.05) showed potential as novel biomarkers for evaluating cardiac graft quality, unlike lactate release after 10 min of reperfusion (AUC = 0.60). Multiple perfusate proteins, such as heat shock protein 70, valosin-containing protein, or glycogen phosphorylase, muscle associated, released during early reperfusion are promising as biomarkers for assessing graft quality during NMP. Perfusate proteins, as biomarkers, offer the possibility of both rapid immune detection and out-of-hospital implementation, and may provide valuable information about graft quality, especially when profiled with serial sampling during NMP.

Analysis of nerve excitability in the dentate gyrus of the hippocampus in cerebral ischaemia-reperfusion mice

Ischemic stroke often leads to cognitive dysfunction, which delays the recovery process of patients. However, its pathogenesis is not yet clear. In this study, the cerebral ischemia-reperfusion model was built as the experimental object, and the hippocampal dentate gyrus (DG) was the target brain area. TTC staining was used to evaluate the degree of cerebral infarction, and nerve cell membrane potentials and local field potentials (LFPs) signals were collected to explore the mechanism of cognitive impairment in ischemia-reperfusion mice. The results showed that the infarcted area on the right side of the brain of the mice in the model group was white. The resting membrane potential, the number of action potential discharges, the post-hyperpolarization potential and the maximum ascending slope of the hippocampal DG nerve cells in the model mice were significantly lower than those in the control group ( P < 0.01); the peak time, half-wave width, threshold and maximum descending slope of the action potential were significantly higher than those in the control group ( P < 0.01). The time-frequency energy values of LFPs signals in the θ and γ bands of mice in the ischemia and reperfusion groups were significantly reduced ( P < 0.01), and the time-frequency energy values in the reperfusion group were increased compared with the ischemia group ( P < 0.01). The signal complexity of LFPs in the ischemia and reperfusion group was significantly reduced ( P < 0.05), and the signal complexity in the reperfusion group was increased compared with the ischemia group ( P < 0.05). In summary, cerebral ischemia-reperfusion reduced the excitability of nerve cells in the DG area of the mouse hippocampus; cerebral ischemia reduced the discharge activity and signal complexity of nerve cells, and the electrophysiological indicators recovered after reperfusion, but it failed to reach the healthy state during the experiment period.

Effect of Treatment of Neuropathic and Ischemic Diabetic Foot Ulcers with the Use of Local Ozone Therapy Procedures-An Observational Single Center Study.

Background: Diabetes ranks high among worldwide global health problems, and diabetic foot ulcer syndrome (DFU) is considered as one of its most serious complications. The purpose of this study was to evaluate the impact of local ozone therapy procedures on the wound healing process in patients with two DFU types: neuropathic and ischemic. Material and Methods: In the retrospective study reported here, the treatment outcomes of 90 patients were analyzed: 44 males (48.8%) and 46 females (51.2%), in the age range between 38 and 87 years of age, with neuropathic (group 1) and ischemic (group 2) diabetic foot ulcers treated by means of local ozone therapy. The assessment of therapeutic effects in both groups of patients included an analysis of the rate of ulcer healing using planimetry and an analysis of the intensity of pain associated with ulcers performed using the VAS scale. Results: After the application of ozone therapy procedures, a statistically significant decrease in the surface area of the ulcers was obtained in both groups of patients, respectively: in group 1 from 7 (6-7.5) cm2 to 3 (2-3.5) cm2 and in group 2 from 7.5 (6.5-8) cm2 to 5 (4.5-5.5) cm2 (p < 0.001), with a complete healing of ulcers not observed in any patients from groups 1 and 2. After treatment, the surface area of the assessed ulcers was smaller in the neuropathic group. The intensity of pain experienced after treatment also decreased with statistical significance in both groups (p < 0.001). Conclusions: Short-term local ozone therapy was effective in promoting wound healing and alleviating pain in patients with DFUs of both neuropathic and ischemic etiology. The effectiveness of therapy in the neuropathic type of DFUs was significantly higher than in the ischemic type, in which patients had a higher incidence of risk factors and more advanced lesions, characterized by a larger initial ulcer area and greater intensity of pain.

Effect of Photobiomodulation on an Experimental Model ofLower Limb Ischemia.

Photobiomodulation (PBM) has been shown to be promising for the promotion of angiogenesis. The present study investigated the effects of PBM on vascularization in an animal model of peripheral artery disease. Wistar rats were divided into three groups. The control group received no procedures. The ischemia group was submitted to ligation of the femoral artery of the hindleg. The ischemia + PBM group was submitted to ligation of the femoral artery followed by PBM (660 and 808 nm, 100 mW, 4 J) over the site. Animals with ischemia treated with PBM exhibited comparable results to the control group with regards to the diameter of the α-SMA+ vessels, cross-sectional area of muscle fibers, percentage of collagen and serum concentration of IL-17A, as well as similarities in terms of vertical mobility, temperature of the hindleg, number of acts of grooming, and percentage of movement, indicating a condition like that of limbs unaffected by ischemia.

Analysis of the Association between Telomere Length and Neurological Disability in Stroke Types.

Background and Objectives: The association between neurological disability, prognosis, and telomere length (TL) in patients with stroke has been investigated in various ways. However, analysis of the type of stroke and ischemic stroke subgroups is limited. In this study, we aimed to determine the association between TL and neurological disability according to stroke type. Materials and Methods: This prospective study included patients with stroke who visited a single-center emergency department (ED) between January 2022 and December 2023. The association between TL and neurological disabilities, using the Modified Rankin Scale (mRS) and National Institutes of Health Stroke Scale (NIHSS), was evaluated according to the patient's stroke type and subgroup of ischemic stroke. Multivariate analysis was performed to determine the association between neurological disabilities in patients with ischemic stroke and the subgroups. Results: A total of 271 patients with stroke were enrolled. The NIHSS score was found to be higher at the time of ED visit (adjusted odds ratio [OR], 5.23; 95% confidence interval [CI], 1.59-17.2, p < 0.01) and 1 day later (adjusted OR, 7.78; 95% CI, 1.97-30.70, p < 0.01) in the ischemic stroke group with a short TL. In the other determined etiology (OD) or undetermined etiology (UD) group, the NIHSS was higher in the short TL group at the ED visit (adjusted OR, 7.89; 95% CI, 1.32-47.25, p = 0.02) and 1 day after (adjusted OR, 7.02; 95% CI, 1.14-43.47, p = 0.04). Conclusions: TL is associated with neurological disability in early ischemic stroke and is prominent in the UD and OD subgroups.

8709 FABP4+ Bone Marrow Endothelial Cells Support Hematopoietic Stem Cell Niches And Osteogenesis In Response To Vascular Insufficiency

Abstract Disclosure: Y. Kim: None. M. Song: None. H. Sun: None. S. Cho: None. Background: Numerous non-communicable and aging-related diseases are linked to systemic vascular insufficiency. The consequences of vascular insufficiency in bone marrow extend to compromising osteogenesis and hematopoiesis, with a more pronounced impact on aging individuals compared to younger counterparts affected by these conditions. Recent advances in scRNA-seq have shed light on the cellular taxonomy in bone marrow; however, a comprehensive understanding of cellular complexity requires further elucidation, and there are limitations in delineating impaired osteogenesis and hematopoiesis resulting from vascular insufficiency. In this study, we employed a combined approach of scRNA-seq and intensive ex vivo investigations to elucidate the regeneration process of bone marrow microenvironment following vascular insufficiency. Method Female C57BL/6 mice at different ages (6-wkks and 14 weeks) were subjected to sham (sham group) or right femoral artery ligation surgery (ischemia group). Reperfusion duration was quantified by color laser doppler. Osteogenesis was assessed by H&amp;E staining, DXA and microCT scan. Flow cytometry was employed to count the number of type H endothelial cell (THEC, Endomucinhi). Bone marrow regeneration capacity was examined in vitro by treating with conditioned medium (CM) of THEC and in vivo via THEC injection. scRNA-seq was performed on the bone marrow of both sham and ischemia group 7 days post-ischemia. Result In young mice, reperfusion occurred within 7 days and osteogenesis was not different between sham and ischemia group. However, in old mice, reperfusion extended to 6 weeks, and accompanied by a reduction in osteogenesis, which did not recover until 12 weeks post-ischemia compared to sham group. The percentage of THEC increased after ischemia in young mice from 1.01% to 3.12 % (n=10, p&amp;lt;0.05), while those were comparable between sham and ischemia group in old mice (from 0.66% to 1.02%, n = 10, p=0.56). in MC3T3-E1 preosteoblast cell line, treatment with THEC-CM upregulated gene expressions associated with bone formation such as Alpl, Bglap, and Col1a1. In vivo THEC injection in old mice following ischemia surgery resulted in a reduction in reperfusion duration and an improvement in osteogenesis. scRNA-seq of bone marrow identified a significant increase of bone marrow stromal cells (BMSCs) and Cxcl12-abundant reticular (CAR) cells 7-days post-ischemia, which provides favorable microenvironment for dormant hematopoietic stem cells (HSCs). The number of FABP4+ THEC synchronized with the increase in BMSCs and CARs. In addition, FABP4+ THEC expressed Col1a1 and Col1a2, associated with osteogenesis, along with Cxcl12 and Foxc1, linked to HSC niches. Conclusion: FABP4+ THECs contribute to favorable microenvironment for HSCs and play a pivotal role in angiogenesis-osteogenesis coupling following vascular insufficiency. Presentation: 6/1/2024

The clinical value of noninvasive left ventricular myocardial work in the diagnosis of myocardial ischemia in coronary heart disease: a comparative study with coronary flow reserve fraction.

The prompt and precise identification of hemodynamically significant coronary artery lesions remains an ongoing challenge. This study investigated the diagnostic value of non-invasive global left ventricular myocardial work indices by echocardiography in functional status of coronary artery disease (CAD) patients with myocardial ischemia using fractional flow reserve (FFR) as the gold standard. A total of 77 consecutive patients with clinically suspected CAD were prospectively enrolled. All participants sequentially underwent echocardiography, invasive coronary angiography (ICA) and FFR measurement. According to the results of ICA, patients were divided into myocardial ischemia group (FFR ≤ 0.8, n = 27) and non-myocardial ischemia group (FFR > 0.8, n = 50). Myocardial work indices including global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE), global positive work (GPW), global negative work (GNW), global systolic constructive work (GSCW) and global systolic wasted work (GSWW) were obtained by using the non-invasive left ventricular pressure strain loop (PSL) technique. Compared with the non-myocardial ischemia group, GWI, GCW, GPW and GSCW were significantly decreased in the myocardial ischemia group at either the 18-segment level or the 12-segment level (P < 0.001). At the 18-segment level, GWI < 1783.6 mmHg%, GCW < 1945.4 mmHg%, GPW < 1788.7 mmHg% and GSCW < 1916.5 mmHg% were optimal cut-off value to detect myocardial ischemia with an FFR ≤ 0.8. Global left ventricular myocardial work indices by echocardiography exhibited a good diagnostic value in patients with CAD and may have a good clinical significance for the screening of suspected myocardial ischemia.

Neutrophil extracellular traps and citrullinated fibrinogen contribute to injury in a porcine model of limb ischemia and reperfusion.

Ischemia/reperfusion injury (IRI) is a complex pathological process, triggered by the restoration of blood flow following an interrupted blood supply. While restoring the blood flow is the only option to salvage the ischemic tissue, reperfusion after a prolonged period of ischemia initiates IRI, triggering a cascade of inflammatory responses ultimately leading to neutrophil recruitment to the inflamed tissue, where they release neutrophil extracellular traps (NETs). NETs are web-like structures of decondensed chromatin and neutrophilic proteins, including peptidyl-arginine deiminase 2 and 4 (PAD2, PAD4), that, once outside, can citrullinate plasma proteins, irreversibly changing their conformation and potentially their function. While the involvement of NETs in IRI is known mainly from rodent models, we aimed to determine the effect of NET formation and especially PADs-mediated extracellular protein citrullination in a porcine model of limb IRI. We conducted our study on amputated pig forelimbs exposed to 1h or 9h of ischemia and then reperfused in vivo for 12h. Limb weight, edema formation, compartmental pressure were measured, and skeletal muscle was analyzed by immunofluorescence (TUNEL assay and dystrophin staining) to evaluate tissue damage. Fibrin tissue deposition, complement deposition and NETs were investigated by immunofluorescence. Citrullinated plasma proteins were immunoprecipitated and citrullinated fibrinogen was identified in the plasma by Western blot and in the tissue by immunofluorescence and Western blot. Our data consolidate the involvement of NETs in a porcine model of limb IRI, correlating their contribution to damage extension with the duration of the ischemic time. We found a massive infiltration of NETs in the group subjected to 9h ischemia compared to the 1h and citrullinated fibrinogen levels, in plasma and tissue, were higher in 9h ischemia group. We propose fibrinogen citrullination as one of the mechanisms contributing to the worsening of IRI. NETs and protein citrullination represent a potential therapeutic target, but approaches are still a matter of debate. Here we introduce the idea of therapeutic approaches against citrullination to specifically inhibit PADs extracellularly, avoiding the downstream effects of hypercitrullination and keeping PADs' and NETs' intracellular regulatory functions.

Abstract P130: Predictive value of the MCG-based Nomogram model for the anatomical and functional evaluation of coronary artery lesions

Objective: Optical coherence tomography (OCT) is an intravascular imaging technology that can provide cross-sectional images of coronary arteries, which can more accurately assess the condition of coronary artery lesions and the degree of vascular stenosis. It is an important method for the anatomical evaluation of coronary artery lesions. Radionuclide myocardial perfusion imaging (MPI) is a commonly used non-invasive method for functional evaluation of myocardial ischemia in clinical practice. The clinical application of these two methods is greatly limited due to operational risk and high cost. This study aimed to explore the potential predictive value of the MCG-based Nomogram model for the anatomical and functional evaluation of coronary artery lesions. Methods: We reviewed the patients who were hospitalized in the cardiovascular department of our hospital from October 2021 to July 2023 for MCG test. A total of 137 patients were included in the OCT subgroup, including 48 patients in the severe coronary artery stenosis group (inclusion criteria: OCT showed coronary artery area stenosis ≥70.0%) and 89 patients in the control group (inclusion criteria: OCT showed coronary artery area stenosis &lt;50.0% or CCTA showed no coronary artery stenosis). A total of 46 patients were included in the MPI subgroup, including 10 patients in the severe myocardial ischemia group (inclusion criteria: MPI showed abnormal perfusion scores of at least one ventricular segment ≥3 points) and 36 patients in the control group (inclusion criteria: MPI showed abnormal perfusion scores of all ventricular segments ≤2 points). The Nomogram model was used to predict the results of patients in the two subgroups, and the results were compared with the OCT and MPI results. The sensitivity, specificity and Youden index were calculated. Results: The Nomogram model based on MCG had a sensitivity of 70.8%, a specificity of 85.4%, and a Youden index of 0.562 for predicting OCT results. The sensitivity, specificity and Youden index of Nomogram model for predicting MPI results were 70.0%, 72.2% and 0.422, respectively. Conclusions: The MCG-based Nomogram model has good prediction accuracy for the anatomical and functional evaluation of coronary artery lesions, which has potential application value.

The value and accuracy of intracoronary electrocardiogram in the diagnosis of myocardial ischemia in coronary heart disease.

Although intracoronary electrocardiography (IC-ECG) offers direct electrophysiological insights into myocardial ischemia caused by insufficient coronary blood supply, compared to common diagnostic methods like electrocardiography (ECG), it lacks widespread adoption and robust clinical research. To analyze the value and accuracy of intracoronary electrocardiogram in myocardial ischemia diagnosis in coronary heart disease patients. Three hundred patients treated at our hospital were included in the study. Patients were categorized into non-ischemic group A (Fraction Flow Reserve [FFR] > 0.8) and ischemic group B (FFR < 0.75) based on FFR examination results. Both groups underwent IC-ECG examination. The ischemic group received percutaneous coronary intervention (PCI) treatment followed by another FFR examination, dividing them into non-ischemic subgroup B1 (FFR > 0.8) and ischemic subgroup B2 (FFR < 0.75). Both subgroups underwent IC-ECG examination. Receiver operating curves were constructed using FFR to assess the clinical utility of different IC-ECG parameters. Group A patients showed a significant decrease in ST-segment shift at J-point, ST-segment integral, T-peak, T-wave integral, and T-peak to end-time, while the Corrected Q-T interval (QTc-time) was significantly higher in the B group (p< 0.05). The parameters, including ST-segment shift at J-point, ST-segment integral, T-wave integral, T-peak, T-peak to end-time, and QTc-time, were found to have clinical significance in predicting the occurrence of myocardial ischemia (p< 0.05). Intracoronary electrocardiogram QT interval dispersion and Q-T peak (QTp) interval dispersion have a high diagnostic accuracy for myocardial ischemia in coronary heart disease.

Intraluminal administration of indocyanine green as a method of intraoperative diagnostic of staple line leak during sleeve gastrectomy in an experiment.

Background: Bariatric surgery is an actively developing branch of surgery. At the same time, thanks to the use of modern hardware methods for disconnecting and stitching tissue, the number of postoperative complications have significantly decreased. However, staple line failure is still quiet high and the cause of severe postoperative complications. Traditional methods for intraoperative diagnosis of leakage are provocative tests: tests with methylene blue and air. One of the promising methods of intraoperative control in surgery is the use of indocyanine green (ICG) test . Aims: The purpose of the study is to assess the diagnostic value of intraoperative using fluorescent imaging with indocyanine green (ICG) in case of staple line leak during sleeve gastrectomy (SG) by modeling in pig models various causes of staple line failure using morphological studies. Methods: The study was carried out on 20 pigs, each of which underwent SG. The animals were divided into few groups: a control group standard SG (n=4), a group of SG with mechanical failure of staple line(n=12), and a group of SG with local ischemia of staple line (n=4). To assess a staple line leak methylene blue and indocynin green was injected into the stomach. The appearance of the methylene blue or visualization of indocyanine green fluorescence was assessed on the staple line. In the ischemia group ICG was administered intravenously. On the 7th day after surgery, the histological material for morphology examination was collected. Results: In the group of SG with mechanical failure of staple line (n=11) positive ISG test was in 10 cases and positive methylene blue test was in 2 cases. In 90% of cases, ICG leakage corresponded to the localization of modeling ischemia zone, while methylene blue leakage was noted in only 20% of cases. Conclusions: The intraluminal administration of indocyanine green in cases of "mechanical" failure of staple line during sleeve gastrectomy is more informative compared to the standart methylene blue test. ICG angiography data fully corresponds to the localization of modeling ischemia zone.

The protective effect of Cloprostenol on ischemia/reperfusion injury in rat ovary: Histopathologic and immunohistochemically evaluation: An experimental study

ObjectıvesThis study investigates whether Cloprostenol, a synthetic prostaglandin analog, could protect against ischemia/reperfusion (IR) injury in rat ovaries. MethodsAdult female rats were divided into four groups: Sham groups, ischemia (IS) groups, ischemia/reperfusion (IR) groups, and Cloprostenol-treated (CT) groups. The IR injury model was established by clamping the ovarian pedicle for a specified period, followed by reperfusion. The CT group received a pre-treatment of Cloprostenol before inducing ischemia. Ovarian tissues were collected for histological, and immunohistochemical examination. ResultsThe IS group exhibited severe morphological damage to ovarian tissues, including disrupted tissue architecture and increased apoptosis (p < 0.001). In contrast, the CT group displayed significantly improved ovarian histology, with notable preservation of ovarian tissue and reduced apoptotic activity (p < 0.01). Immunohistochemical analysis revealed that the levels of 8-Hydroxy-2-deoxyguanosine (8-OHdG), Caspase 3, Cyclooxygenase 2 (COX-2), and Interleukin 1 beta (IL-1β) staining, which were elevated in the IS and IR groups, were significantly diminished in the CT group (p < 0.05). ConclusıonCloprostenol administration before IR injury in rat ovaries demonstrated a remarkable protective effect by improving histological damage and reducing DNA damage inflammation. These results highlight the therapeutic potential of Cloprostenol in safeguarding ovarian health against IR.

A Novel Biomarker in Experimental Cerebral Ischemia: Junctional Adhesion Molecule-A

Objectives: To investigate the role of blood brain barrier biomarkers for the detection of experimental cerebral ischemia in rats. Methods: Forty adult male Wistar albino rats with a mean age of 4–6 months and an average weight of 350–400 g were used in the study. The rats were divided into five ischemia groups (control, 1.5 h of ischemia, 4.5 h of ischemia, 6 h of ischemia, and 24 h of ischemia). Cerebral ischemia was achieved by unilateral ligating of CCA and ECA at the same time. After surgical preparation and awaiting for appropriate ischemia time we collected blood and brain tissue samples. Then we investigated serum occludin, claudin-5 and JAM-A levels from blood samples and the apoptotic index and percentages of pycnotic nucleus from brain tissues histologically. The obtained data were analyzed using IBM SPSS Statistics software package version 18 and the Jamovi software package. Results: Serum JAM-A level showed a statistically significant difference in all ischemia groups compared with the control group (p

CLINICAL APPLICATION STUDY OF 3D-ASL PERFUSION IMAGING AND MAGNETIC RESONANCE DIFFUSION IMAGING IN TRANSIENT ISCHEMIC ATTACK.

Objective: This study aimed to explore the clinical application of three-dimensional arterial spin labeling (3D-ASL) and diffusion-weighted magnetic resonance imaging (DWI) in transient ischemic attacks. Methods: Forty patients with transient cerebral ischemia in our hospital were selected and included from July 2020 to March 2022. All subjects were detected by DWI and 3D-ASL technology. The positive rate, relative cerebral blood flow (rCBF), and the receiver operating characteristic curve of the two methods in the diagnosis of transient cerebral ischemia were compared; the objective was to compare the relationship between the frequency of transient ischemic attack and hypoperfusion, and vascular stenosis. Results: The 3D-ASL examination showed two cases of hypoperfusion in the healthy control group (5.00), and the magnetic resonance imaging examination showed four cases of vascular stenosis in the healthy control group (10.00). The rCBF ratio in the cerebral ischemia group was significantly lower than that in the cerebral ischemia group, which was significantly lower than that in the healthy control group ( P < 0.05). The area under the curve (AUC) of 3D-ASL in the diagnosis of transient cerebral ischemia was 0.800, and the AUC of DWI in the diagnosis of transient cerebral ischemia was 0.725. The AUC of the combination of the two methods in transient cerebral ischemia was 0.850. There was a significant difference in the attack frequency of patients with transient cerebral ischemia with different perfusion ( P < 0.05). There was a significant difference in attack frequency between patients with transient ischemic attack and patients without vascular stenosis ( P < 0.05). Conclusion: 3D-ASL and DWI technology have higher diagnostic efficiency for transient cerebral ischemia.

An Investigative Study of Prothrombin Time, Activated Partial Thromboplastin Time and Antithrombin Levels in Patients with Ischaemic Stroke

Background: The haemostatic system maintains a balance between prothrombotic and antithrombotic components in the body. The role of this system in ischaemic stroke is not certain. Objective: Prothrombin time (PT) and Activated Partial Thromboplastin Time(APTT) are widely used screening tests to assess the haemostatic cascade. We sought to evaluate the relevance of these test and antithrombin (AT) levels in patients with ischaemic stroke. Methods: AT, platelet count, PT and APTT tests were carried out for 65 patients with ischaemic stroke and 65 controls with no history of stroke. Results: The mean age of stroke subjects was 60.4 ± 12.3yrs. PT and APTT in the test and control groups were similar and Antithrombin levels did not show significant difference. But there was a significant association between functional AT deficiency and diabetes mellitus in the ischaemic stroke group. A significant negative correlation existed between functional AT activity and prothrombin and between AT Ag levels and APTT Conclusion: There was no difference in the Antithrombin levels, PT and APTT values in patients with ischaemic stroke and those without a history of stroke and carrying out these tests routinely to assess hypercoagulable states in ischaemic stroke patients may not have any diagnostic value in our population.