Luminal Diameter Research Articles

Association of radiocephalic arteriovenous anatomical markers with post-angioplasty blood flow volume.

Doppler ultrasound (DUS) blood volume flow (VF) calculation is the most reliable method for demonstrating the success of endovascular treatment of dysfunctional radiocephalic arteriovenous fistula (AVF). Due to the difficulty of this method for the interventionalist, VF-correlated markers are required during the procedure. To investigate the relationship between intraprocedural anatomical markers (AMs) and changes in VF induced by percutaneous transluminal angioplasty (PTA). The study included 56 patients with dysfunctional radiocephalic AVF who underwent PTA between September 2020 and 2022. The VF of all patients was measured using DUS before and 1 h after PTA. AMs were determined from 10 images, five before and five after balloon angioplasty. The mean post-PTA VF was 637 ± 277 mL/min compared to baseline (151 ± 107 mL/min). Before and after balloon angioplasty, vein diameter (VD), artery diameter (AD), stenosis minimum luminal diameter (MLD), stenosis percentage (SP), and VF values were statistically significant (P = 0.001). Spearman's correlation analysis showed a positive strong linear relationship between VF and MLD (rs = 0.850, P <0.001), and a negative strong linear relationship between VF and SP (rs = 0.815). Receiver operating characteristic curve analysis showed that the sensitivity and specificity for VF ≥400 mL/min at cutoffs of SP <50% and MLD >2.5 mm were 81% and 82%, and 81% and 90%, respectively. Among the AMs readily available during PTA, first MLD and then SP provided satisfactory results in predicting VF.

A Variant Dorsalis Pedis Artery and Its Relationship with the Deep Fibular Nerve

During a cadaveric dissection session, a distinctive neurovascular pattern was identified in the left leg of a 66-year-old female cadaver. The Anterior Tibial Artery (ATA), while maintaining a normal origin and luminal diameter, exhibited a shortened course, terminating in the upper third of the leg. In the lower third of the leg, the Fibular Artery (FA), known as the peroneal artery, traversed through the interosseous membrane to the anterior compartment, persisting as the Dorsalis Pedis Artery (DPA). The Deep Fibular Nerve (DFN), displaying a usual course in the upper two-thirds of the leg, crossed the variant DPA posteriorly and divided into two terminal branches on its posterolateral side. The medial terminal branch proceeded to cross the artery anteriorly within the anterior tarsal tunnel. This distinctive relationship between the DFN and the variant DPA renders the nerve susceptible to compression and may result in “anterior tarsal tunnel syndrome”.

Comparison of Carotid Ultrasound Parameters in Patients with Rheumatoid Arthritis and Control Subjects: A Cross-sectional Study

Introduction: Rheumatoid Arthritis (RA) is considered one of the risk factors for Cardiovascular Disease (CVD). Carotid ultrasound is used to assess the extent of subclinical atherosclerosis in patients with RA. Very few studies have evaluated all carotid ultrasound findings, such as Carotid Intima-media Thickness (CIMT), carotid diameters like Luminal Diameter (LD) and Interadventitial Diameter (IAD), and plaque characteristics in patients with RA. Aim: To assess and compare the various carotid parameters in RA patients with controls and also to evaluate their association with age and duration of onset of the disease. Materials and Methods: A single-centre cross-sectional study was conducted at the Department of Radiology, GCS Medical College and Hospital, Ahmedabad, Gujarat, India, involving 40 patients with RA (Group-RA) and 40 controls (Group-C). Patients were further divided into three age subgroups. Carotid ultrasound parameters like CIMT, LD, IAD, and plaque were evaluated in both groups. Continuous variables were analysed using the t-test, and categorical data were analysed using the Chi-squared test. A p-value of &lt; 0.05 was considered statistically significant. Results: Age- and sex-matched controls were included with 28 females and 12 males in both the study groups. The mean LD and IAD were significantly higher in the RA group than in controls (Mean LD- 5.88±0.97 mm vs 5.26±1.08 mm with p=0.009; Mean IAD- 6.85±0.89 mm vs 6.30±0.87 mm with p=0.006). The mean CIMT was higher in the RA group but not statistically significant (0.57±0.13 mm vs 0.54±0.12 mm with p=0.256). Further subgroup analysis showed that all carotid parameters were statistically significant in the 31-60 years age group as compared to 18-30 years and 61-80 years subgroups. The effect of the duration of the disease (&gt;5 years) on the carotid parameters was also significantly higher in the 30-60 age group (p&lt;0.001). Conclusion: The present study showed that various carotid ultrasound parameters can be used as a screening tool in the follow-up of RA patients to detect early changes in atherosclerosis, with LD and IAD having superior predictive capability. The study further showed that carotid ultrasound parameters have a better predictive value in the 31-60 years age group.

Artificial intelligence-based diagnostic imaging system with virtual enteroscopy and virtual unfolded views to evaluate small bowel lesions in Crohn's disease.

Since even subtle mucosal changes may be depicted using virtual endoscopy created by the three-dimensional reconstruction of MDCT images, we developed a novel diagnostic imaging system that integrates and displays virtual enteroscopy, curved planar reconstruction, and a virtual unfolded view, the width of which changes with increases/decreases in the inner luminal diameter. The system is also equipped with artificial intelligence that superimposes and displays depressed areas, generates an automatic small bowel centerline that connects fragmented small bowel regions, and performs electronic cleansing. We retrospectively evaluated the diagnostic performance of this system for small bowel lesions in Crohn's disease, which were divided into two groups: endoscopically-observable and endoscopically-unobservable. Lesion detection rates for stenoses, longitudinal ulcers with a cobblestone appearance, and scars were excellent in both groups. This system, when used in combination with endoscopy, shows slight mucosal changes in areas in which an endoscope cannot reach due to strictures, thereby extending the range of observation of the small bowel. This system is a useful diagnostic modality that has the capacity to assess mucosal healing and provide extraluminal information.

Transcatheter dilation and stenting of the modified blalock-taussig shunt in cyanotic heart diseases: points to consider. A single-center experience.

Our study focuses on the technique and results of interventional dilation and stenting of the modified Blalock-Taussig shunt (MBTS) performed in our center, providing a comprehensive review of our practice over the past 4 years. 42 catheter interventions on MBTS performed on 32 patients between January 2020 and May 2024 included 11 balloon dilatations and 31 stenting procedures. They were analyzed retrospectively. We documented early and late complications, the need for in-shunt reintervention or surgical revision, in-stent thrombotic events, and sudden death. The median age, weight, body surface area, and procedural radiation time at the time of the intervention were 100 days (15-870 days), 5 kg (2.6-12 kg), 0.3 m2 (0.19-0.54 m2), and 12 min (7-28 min). Four interventions were performed as an emergency in three patients, of which three were performed with ECMO support. The interventions were semi-emergent for severe hypoxia in 22 patients and elective for mild desaturation in the rest. All interventions were successfully performed without any intervention-related complications or death. Eighty-two percent of the shunt dilations led to saturation improvement. Of the 31 shunt stentings performed in 26 patients, saturation improvement was documented in 97% of the cases. The late complication with stent thrombosis was documented in one patient. In two patients, sudden death and cardiac decompensation with the need for resuscitation were documented. MBTS interventions are effective in emergent and semi-emergent situations with severe hypoxia. While serial balloon dilatations improved the luminal diameter in clipped MBTS, most patients needed stenting as a definitive procedure. In some cases, enlargement of the shunt via stenting may be an alternative to the surgical shunt revision to accommodate the shunt size and weight and delay the subsequent operation when there are contraindications. Dual antiplatelet therapy is strongly recommended to reduce thrombotic events, especially in shunts with more than one stent and those that need reinterventions.

Lymphocytic myenteric ganglionitis associated with equine herpesvirus infection: A cause of chronic intestinal pseudo‐obstruction and recurrent colic in an adult horse

SummaryThis report describes a rare case of chronic intestinal pseudo‐obstruction (CIPO) in a 12‐year‐old Quarter Horse gelding, caused by lymphocytic myenteric ganglionitis (MG) associated with equine herpesvirus 1 (EHV‐1) and equine herpesvirus 5 (EHV‐5) infection. The horse presented with recurrent colic and weight loss over 1.5 years. Repetitive transrectal examinations consistently revealed small colon impaction and enlargement. During postmortem examination alternating segments of enlarged and reduced luminal diameter were observed throughout the entire intestinal tract. MG with lymphocytic infiltrates and neuronal degeneration of the large intestine were found on histopathological analysis. Additionally, polymerase chain reaction (PCR) analysis confirmed the presence of EHV‐1 and EHV‐5 DNA in affected intestinal tissues. Further research is needed to understand the pathophysiology of MG and its association with herpesviruses. Early recognition and diagnosis of MG‐associated CIPO may improve treatment approaches and outcomes for future cases.

Aortic remodeling following hybrid arch repair with zone 0 to 5 thoracic endovascular aortic repairs for complex arch and descending thoracic aortic pathologies

ObjectiveFor high-risk patients with aortic arch pathology, hybrid aortic arch repair with simultaneous or staged thoracic endovascular repair of the descending aorta may be a viable alternative to open repair. However, data on postintervention aortic remodeling remain limited. We report the short-term outcomes of remodeling of the thoracoabdominal aorta after hybrid arch repair + thoracic endovascular repair. MethodsAll patients undergoing hybrid arch repair with planned zones 0 to 5 thoracic endovascular repair from January 2020 to March 2022 were retrospectively reviewed. Computed tomography angiography scans preoperatively, after hybrid aortic arch repair, and on long-term follow-up were analyzed for thoracoabdominal aorta remodeling. Mean change in aortic true luminal diameter and full luminal diameter was calculated at every level, and paired-samples t test was used to compare means. ResultsOf 39 patients, 38 had follow-up data at a mean duration of 14.9 months. There were a total of 3 (7.7%) deaths, 0 (0.0%) strokes, and 0 (0.0%) paralysis. For the 35 patients undergoing thoracic endovascular repair for aortic dissection, at follow-up, there was a significant increase in the mean true luminal diameter at each level (P < .05), except at the aortic bifurcation and common iliac arteries. The largest increase in mean true luminal diameter (P < .01) was observed at the level of the left inferior pulmonary vein (mean difference +13.22 mm, 95% CI, 10.38-16.07), tracheal carina (mean difference +13.06 mm, 95% CI, 10.05-16.07), and inferior left atrium (mean difference +11.19 mm, 95% CI, 7.84-14.53). ConclusionsHybrid arch repair with zones 0 to 5 leads to improved true lumen augmentation in zones 0 to 8 with complete false lumen thrombosis down to zone 5 at short-term follow-up. Zones 9 to 11, if involved, may require adjunctive treatment strategies for total aortic remodeling and complete false lumen obliteration.

Ivermectin prevents stress-induced testicular damage in juvenile rats

Ivermectin is a popular antiparasitic drug used in veterinary and human medicine. Studies by our group have shown that therapeutic doses of ivermectin induce some brain and behavioral impairments, especially in the reproductive sphere. So far, the studies were focused in adulthood. Considering that juveniles are more susceptible to drugs during developmental stages and both farm/domestic animals and humans have been medicated with ivermectin in youth, it is necessary to evaluate the possible harm effects in youth. The stress variable is also important, as it potentially influences the effects produced by ivermectin. Therefore, the objective of this study was to evaluate morphofunctional and hormonal reproductive aspects of juvenile rats exposed to ivermectin and/or stressed. Prepubertal male rats were treated with 0.2 or 1.0 mg/kg of ivermectin (a therapeutic dose and a higher dose, respectively). Rats were also submitted to a restraint stress session. The testis morphology and histology were analyzed and plasma testosterone levels were measured. The two doses of ivermectin did not induce a biologically relevant effect on testis and testosterone levels of rats. However, restraint stress impaired macroscopic and microscopic morphometric and stereological parameters, as well as the histology of the testis: it increased the relative testis weight, the tubular diameter, the tubular luminal diameter, and the tubular cellular index, and injured the interstitial area. Previous treatment of juvenile rats with ivermectin prevented most of the stress-induced testes injuries. In conclusion, in addition to be a remarkable antiparasitic agent, ivermectin prevented stress-induced testes injuries in juvenile rats.

Ultrasound-Responsive Micelle-Encapsulated Mesenchymal Stem Cell-Derived EVs for the Treatment of Lower Limb Microcirculation Disease.

Lower limb microcirculatory ischemic disease is a vascular disorder primarily characterized by limb pain, gangrene, and potential amputation. It can be caused by various factors, such as hyperglycemia, atherosclerosis, and infection. Due to the extremely narrow luminal diameter in lower limb microcirculatory ischemic lesions, both surgical and medical interventions face challenges in achieving satisfactory therapeutic outcomes within the microvessels. Extracellular vesicles derived from mesenchymal stem cells (MSCs-EVs) exhibit promising potential in the treatment of microcirculation ischemic lesions due to their small size and ability to promote angiogenesis. After undergoing substantial losses during the process of EVs transportation, only a minimal fraction of EVs can effectively reach the site of microcirculatory lesions, thereby compromising the therapeutic efficacy for microcirculatory disorders. Herein, an ultrasound-responsive system utilizing 2-(dimethylamino)ethyl methacrylate-b-2-tetrahydropyranyl methacrylate (DMAEMA-b-THPMA) micelles to encapsulate MSCs-EVs has been successfully constructed, with the aim of achieving localized and targeted release of EVs at the site of microcirculatory lesions. The reversible addition-fragmentation chain transfer (RAFT) polymerization method facilitates the successful synthesis of diblock copolymers comprising monomer 2-(dimethylamino)ethyl methacrylate (DMAEMA) and monomer 2-tetrahydropyranyl methacrylate (THPMA). The DMAEMA-b-THPMA micelles exhibit a nanoscale structure, reliable biocompatibility, ultrasound responsiveness, and conspicuous protection of EVs. Furthermore, the implementation of low-energy-density ultrasound can enhance angiogenesis by upregulating the levels of the vascular endothelial growth factor (VEGF). In in vivo experiments, the ultrasound-responsive system of the DMAEMA-b-THPMA micelles and MSCs-EVs synergistically enhances therapeutic efficacy by promoting angiogenesis, improving vascular permeability, and optimizing vascular. In conclusion, this work demonstrates bioapplication of an ultrasound-responsive micellar nanosystem loaded with EVs for the treatment of lower limb microcirculatory ischemic disorders.

Pericyte loss initiates microvascular dysfunction in the development of diastolic dysfunction.

Microvascular dysfunction has been proposed to drive heart failure with preserved ejection fraction (HFpEF), but the initiating molecular and cellular events are largely unknown. Our objective was to determine when microvascular alterations in HFpEF begin, how they contribute to disease progression, and how pericyte dysfunction plays a role herein. Microvascular dysfunction, characterized by inflammatory activation, loss of junctional barrier function, and altered pericyte-endothelial crosstalk, was assessed with respect to the development of cardiac dysfunction, in the Zucker fatty and spontaneously hypertensive (ZSF1) obese rat model of HFpEF at three time points: 6, 14, and 21 weeks of age. Pericyte loss was the earliest and strongest microvascular change, occurring before prominent echocardiographic signs of diastolic dysfunction were present. Pericytes were shown to be less proliferative and had a disrupted morphology at 14 weeks in the obese ZSF1 animals, who also exhibited an increased capillary luminal diameter and disrupted endothelial junctions. Microvascular dysfunction was also studied in a mouse model of chronic reduction in capillary pericyte coverage (PDGF-Bret/ret), which spontaneously developed many aspects of diastolic dysfunction. Pericytes exposed to oxidative stress in vitro showed downregulation of cell cycle-associated pathways and induced a pro-inflammatory state in endothelial cells upon co-culture. We propose pericytes are important for maintaining endothelial cell function, where loss of pericytes enhances the reactivity of endothelial cells to inflammatory signals and promotes microvascular dysfunction, thereby accelerating the development of HFpEF.

Anatomical, histological, and histochemical alterations in portio vaginalis uteri with an evaluation of the vaginal artery vascularity during the luteal and early pregnant stages in domestic buffaloes (Bubalus bubalis)

The portio-vaginalis uteri (PVU) and its mucus secretion have shown an essential role in conception. A significant endeavour to improve buffaloes' reproductive efficiency is the investigation of their basic reproductive pattern, which provides a reference for applications in breeding and pregnancy. The present study aimed to evaluate the anatomical and histological alterations in PVU regarding to the vaginal artery (VA) hemodynamic at luteal and early pregnant stages in buffalos. Egyptian live buffaloes (n = 16) and fresh genitals (n = 25) of mature buffalo were used. Different luteal and early pregnant stages were macroscopically identified with the shape and mucosal colouration with discharges of the PVU. Histological examination showed a significant difference in area % of alcian blue and periodic acid Schiff positive granules which considered an indication for presence of acidic and neutral mucins respectively in the epithelial cells of PVU mucosa which increased in pregnant stage than in other luteal stages. VA assessment demonstrated an increase in luminal diameter and thickness of tunica muscularis in pregnant stage than other stages (P < 0.05). Middle uterine (MUA) and VA arteries peak velocity point (PSV mm/sec) were elevated (P < 0.05) in pregnant stage, with a marked reduction in both resistance and pulsatility indices (RI and PI), and ratio of systolic /diastolic (S/D). Positive correlation was detected between VA. PSV and, MUA. PSV (r = 0.87), but a negative relation was detected with VA. S/D (r = -0.77), VA.PI (r = -0.89), VA. RI (r = -0.97), MUA. S/D (r = -0.94), MUA. PI (r = -0.85), and MUA. RI (r = -0.88). Doppler indices were negatively corrected with the VA. PSV (r = -0.68). It was concluded that there was a significant alterations in histological features of the cervical PVU at different physiological stages (luteal and early pregnant) in buffalos in relation to the MUA and VA hemodynamic pattern and that hypotheses can be established regarding the female cyclicity that affected by both arteries hemodynamics change.

Visualization of choroidal vasculature in pigmented mouse eyes from experimental models of AMD

A variety of techniques exist to investigate retinal and choroidal vascular changes in experimental mouse models of human ocular diseases. While all have specific advantages, a method for evaluating the choroidal vasculature in pigmented mouse eyes has been more challenging especially for whole mount visualization and morphometric analysis. Here we report a simple, reliable technique involving bleaching pigment prior to immunostaining the vasculature in whole mounts of pigmented mouse choroids. Eyes from healthy adult pigmented C57BL/6J mice were used to establish the methodology. The retina and anterior segment were separated from the choroid. The choroid with retinal pigment epithelial cells (RPE) and sclera was soaked in 1% ethylenediaminetetraacetic acid (EDTA) to remove the RPE. Tissues were fixed in 2% paraformaldehyde (PFA) in phosphate-buffered saline (PBS). Choroids were subjected to melanin bleaching with 10% hydrogen peroxide (H2O2) at 55 °C for 90 min, washed in PBS and then immunostained with anti-podocalyxin antibody to label vascular endothelium followed by Cy3-AffiniPure donkey anti-goat IgG at 4 °C overnight. Images of immunostained bleached choroids were captured using a Zeiss 710 confocal microscope. In addition to control eyes, this method was used to analyze the choroids from subretinal sodium iodate (NaIO3) RPE atrophy and laser-induced choroidal neovascularization (CNV) mouse models. The H2O2 pretreatment effectively bleached the melanin, resulting in a transparent choroid. Immunolabeling with podocalyxin antibody following bleaching provided excellent visualization of choroidal vasculature in the flat perspective. In control choroids, the choriocapillaris (CC) displayed different anatomical patterns in peripapillary (PP), mid peripheral (MP) and far peripheral (FP) choroid. Morphometric analysis of the vascular area (VA) revealed that the CC was most dense in the PP region (87.4 ± 4.3% VA) and least dense in FP (79.9 ± 6.7% VA). CC diameters also varied depending on location from 11.4 ± 1.97 mm in PP to 15.1 ± 3.15 mm in FP. In the NaIO3-injected eyes, CC density was significantly reduced in the RPE atrophic regions (50.7 ± 5.8% VA in PP and 45.8 ± 6.17% VA in MP) compared to the far peripheral non-atrophic regions (82.8 ± 3.8% VA). CC diameters were significantly reduced in atrophic regions (6.35 ± 1.02 mm in PP and 6.5 ± 1.2 mm in MP) compared to non-atrophic regions (14.16 ± 2.12 mm). In the laser-induced CNV model, CNV area was 0.26 ± 0.09 mm2 and luminal diameters of CNV vessels were 4.7 ± 0.9 mm. Immunostaining on bleached choroids with anti-podocalyxin antibody provides a simple and reliable tool for visualizing normal and pathologic choroidal vasculature in pigmented mouse eyes for quantitative morphometric analysis. This method will be beneficial for examining and evaluating the effects of various treatment modalities on the choroidal vasculature in mouse models of ocular diseases such as age-related macular degeneration, and degenerative genetic diseases.

B-Flow/Spatiotemporal Image Correlation M-Mode and Contrast-Enhanced/Microbubble Ultrasonography Quantification of Spiral Artery Distensibility and Placental Intervillous Perfusion in the First Trimester in a Primate Model of Impaired Spiral Artery Remodeling.

During early human pregnancy, placental trophoblasts remodel spiral arteries into distensible low-resistance vessels to promote placental perfusion. We have established a model of impaired spiral artery remodeling (SAR) by elevating estradiol levels in the first trimester of baboon pregnancy. In the present study, B-flow/spatiotemporal image correlation (STIC) M-mode ultrasonography, a non-Doppler technology for sharp rendering of vessel dimensions, was used to determine whether spiral artery distensibility was altered in SAR-suppressed baboons. Contrast-enhanced ultrasound/microbubble imaging was also performed to determine whether it detected changes in placenta intervillous space perfusion in SAR-suppressed baboons. The two imaging procedures were performed in the first trimester in baboons not treated or treated with estradiol to suppress SAR. Spiral artery distensibility, that is, luminal diameter at systole minus diameter at diastole, and volume flow as quantified by B-flow/STIC M-mode were 26% (p=0.03) and 55% (p=0.059) lower, respectively, in SAR-suppressed baboons. However, placental intervillous space flow rate and video intensity plateau levels reflecting blood perfusion, quantified by contrast-enhanced ultrasound/microbubble imaging, were unaltered in SAR-suppressed baboons. The results indicate that B-flow/STIC M-mode ultrasonography provides a non-invasive method to detect reduced distensibility and, thus, function of spiral arteries across the cardiac cycle in the first trimester in a primate model of impaired SAR. This study represents a first step in determining whether B-flow/STIC M-mode detects a similar defect in SAR early in adverse human pregnancy. This would provide an avenue to develop therapeutic modalities to prevent the devastating consequences of impaired SAR.

Dementia and Stroke Risk Associated with Brain Artery Luminal Diameters

AbstractBackgroundIt is unclear whether brain artery diameters measured on conventional T2‐weighted brain MRI images relate to dementia and stroke outcomes across distinct populations. We aimed this study to evaluate the association of T2‐weighted brain artery luminal diameters with dementia and stroke in three distinct population‐based studies.MethodsThree longitudinal population‐based studies with 8420 adults &gt;40 years old (Northern Manhattan Study [NOMAS] from the United States, and the Rotterdam Study [RS], from the Netherlands, and Three‐City, from France) with brain MRI scans obtained between 1999 and 2015. The median follow‐up time for clinical events ranged between 7 and 12.5 years. We tested our hypothesis in each cohort separately due to local data‐sharing regulations. The exposure variable was brain carotid and basilar artery luminal diameters measured on MRI axial T2‐weighted scans. Multivariable hazard ratios (HRs) and their 95% confidence intervals (CI) expressed the risk of dementia and stroke (primary outcomes) associated with the lowest (&lt;5th) and highest (&gt;95th) percentiles of the rank‐normalized brain artery diameters compared to a reference group defined as the diameters distributed between the 5th and 95th percentiles. Secondary outcomes included total and vascular mortality, and fatal and nonfatal cardiovascular and coronary end points.ResultsAmong the three cohorts (mean age ranged from 65 to 73 y, ≥57% women), 335 participants developed dementia and 331 strokes. Compared with the reference group, participants with arterial diameters &gt;95th percentile had a higher risk of dementia (HR range 1.15‐4.50) and any stroke (HR range 1.29‐2.03). For secondary outcomes, participants with arterial diameters &gt;95th percentile had a consistent higher risk of coronary outcomes, vascular mortality and a composite of any vascular events. The results were less supportive of a higher risk of events among participants with arterial diameters &lt;5th percentile except for vascular mortality.ConclusionsIndividuals with dilated brain arteries are at higher risk of dementia and vascular events. Our findings were consistency across distinct populations in spite of using a non‐enhanced, conventional T2‐weighted MRI sequence. Understanding the underlying physiopathology of the reported associations, particularly with dementia and stroke, might reveal novel vascular contributions to dementia

Supraphysiological doses of nandrolone decanoate disrupts spermatogenesis but did not interfere on embryo rate.

The aim of this study was to investigate the effects of 10 mg/kg/week of nandrolone decanoate (DECA - Deca Durabolin®) on body composition, hormonal levels, spermatic parameters, redox status, and morphometric parameters of testicle and epididymis; furthermore, the fertility capacity of Wistar rats was measured thought in vitro fertilization (IVF). The animals (n = 16) were divided into two groups: control group (CTRL, n = 8), which received only vehicle composed by peanut oil and 10% of the benzoic alcohol and nandrolone decanoate group (DECA, n = 8), which received intramuscular injections of DECA for 8 weeks, both groups were treated for 8 weeks. The results demonstrate significative decrease in visceral fat, testosterone levels, and thiol content on epididymis, reduction on normal sperm parameters, and deleterious effect on testicles and epididymis tissue morphology showing reduction of germ height and luminal diameter on the DECA group. Thus, it can be concluded that high doses of nandrolone decanoate impairs male reproductive parameters.

Reconfiguration and loss of peritubular capillaries in chronic kidney disease

Functional and structural alterations of peritubular capillaries (PTCs) are a major determinant of chronic kidney disease (CKD). Using a software-based algorithm for semiautomatic segmentation and morphometric quantification, this study analyzes alterations of PTC shape associated with chronic tubulointerstitial injury in three mouse models and in human biopsies. In normal kidney tissue PTC shape was predominantly elongated, whereas the majority of PTCs associated with chronic tubulointerstitial injury had a rounder shape. This was reflected by significantly reduced PTC luminal area, perimeter and diameters as well as by significantly increased circularity and roundness. These morphological alterations were consistent in all mouse models and human kidney biopsies. The mean circularity of PTCs correlated significantly with categorized glomerular filtration rates and the degree of interstitial fibrosis and tubular atrophy (IFTA) and classified the presence of CKD or IFTA. 3D reconstruction of renal capillaries revealed not only a significant reduction, but more importantly a substantial simplification and reconfiguration of the renal microvasculature in mice with chronic tubulointerstitial injury. Computational modelling predicted that round PTCs can deliver oxygen more homogeneously to the surrounding tissue. Our findings indicate that alterations of PTC shape represent a common and uniform reaction to chronic tubulointerstitial injury independent of the underlying kidney disease.

Efficacy of Intravascular Lithotripsy (IVL) in peripheral lesions with severe calcification and its use in TAVI procedure: A systematic review and meta-analysis

Abstract Background Heavily calcified peripheral artery lesions increase the risk of vascular complications, constituting a severe challenge for the operator. Intravascular Lithotripsy (IVL) technology disrupts subendothelial calcification by using localized pulsative sonic pressure waves and is a promising technique for patients with severe calcification in peripheral arteries. Purpose Our aim was to systematically review and summarize available data regarding the safety and efficacy of IVL in preparing severely calcified plaques in peripheral arteries and its use in Transcatheter Aortic Valve Implantation (TAVI). Methods This study was conducted according to the PRISMA guidelines. We systematically searched PubMed, SCOPUS, and Cochrane databases from their inception to February 23, 2023, for studies assessing the characteristics and outcomes of patients undergoing IVL in peripheral vasculature. The diameter of the vessel lumen before and after IVL was estimated. The occurrence peri-procedural complications were assessed using a random-effects model. Results 20 studies with a total of 1,223 patients with heavily calcified peripheral lesions were analyzed. The mean age of the cohort was 73.8 ± 8.9 years. Successful IVL delivery achieved in 100% (95% CI: 100%-100%, I2=0%), with an increase in the luminal diameter (SMD: 4.66, 95% CI: 3.41-5.92, I2=90.8%) and reduction in diameter stenosis (SMD: -4.15, 95% CI: -4.75 to -3.55, I2=92.8%), and a described low rate of complications. There was not observed any dissection in 97% (95% CI: 91%-100%, I2=81.4%), while dissections of any type (A, B, C, or D) were observed in 6% (95% CI: 2%-10%, I2=85.3%) of the patients. Several rare cases of abrupt closure, no-reflow phenomenon, perforation, thrombus formation, and distal embolization were recorded. Finally, the subgroup analysis of patients who underwent a TAVI with IVL assistance presented successful implantation in 100% (95% CI: 100%-100%, I2=0%) of the cases, with only 4% (95% CI: 0%-12%, I2=68.96%) presented dissections of any sort. Conclusions IVL seems to be an effective and safe technique for preparing severely calcified lesions in peripheral vessels during TAVI interventions. These results support the use of IVL for amelioration of overall outcome in high vascular risk TAVI settings.

Biomarkers for identification of high-risk coronary plaques in patients with suspected coronary artery disease

Abstract Background Patients with atherosclerotic plaques containing high-risk features have an increased likelihood of events and a worse prognosis. Whether elevated levels of biomarkers of ischemia e.g. TnI and inflammation e.g. high sensitive C-reactive protein (hsCRP) are associated with the presence of high-risk coronary atherosclerotic plaques (HRP) evaluated on coronary computed tomography angiography (CCTA) is not well described. Objectives To assess the association between 1) TnI and 2) hsCRP and quantified coronary plaque burden, luminal diameter stenosis and HRP in symptomatic patients with low/intermediate pre-test probability of obstructive coronary artery disease (CAD) referred to CCTA evaluation. Methods On enrolled patients (n=1,615), CCTA were analysed using a semiautomatic software for coronary artery plaque characterization. Patients with high (&amp;gt;6 ng/L) and low (&amp;lt;3 ng/L) TnI as well as high (&amp;gt;2 mg/L) and low (&amp;lt;1 mg/L) hsCRP were identified. Associations of high levels of TnI and hsCRP compared to low levels were investigated for the following: high plaque burden (defined as having total plaque volume above the 75th percentile on CCTA), presence of significant stenosis (defined as ≥50% luminal diameter stenosis on CCTA), and presence of HRP (defined as having a plaque with at least two risk features on CCTA). Results TnI and hsCRP were both positively correlated with total plaque burden (TnI rs=0.14, p&amp;lt;0.001; hsCRP rs=0.08, p&amp;lt;0.001). In multivariate logistic regression analyses, high TnI was when compared to low TnI associated with presence of stenosis (OR 1.43, 95% confidence interval (CI) 1.03-1.99, p=0.034), the presence of HRP (OR 1.79, 95% CI: 1.17– 2.74, p=0.008) and further the subtypes of HRP including low attenuation plaque (OR 1.93, 95% CI: 1.24–3.00, p=0.003) and positive remodelling (OR 1.51, 95% CI: 1.07–2.13, p=0.018). For high hsCRP levels, only the presence of stenosis and the HRP-subtype napkin ring sign correlated significantly. Conclusion In patients with suspected CAD TnI and hsCRP are associated with the presence of HRP features. These findings suggest that inflammatory and particularly ischemic biomarkers might improve early risk stratification and potentially also affect patient management.

Abstract 11389: Circulating Aldosterone is an Independent Risk Marker for Left Main Coronary Artery Disease

Background: Elevated plasma aldosterone concentrations reflect remodeling of the vascular wall and increased cardiovascular risk, whereas data from the left main coronary artery (LMCA) are lacking. Patients with stenosis of the LMCA present difficult challenges. Therefore, the aim of this study was to investigate the relationship between plasma aldosterone concentrations and LMCA in patients with hypertension. Methods: We recruited hypertensive patients with LMCA with assessed plasma aldosterone concentrations before disease onset from the hospital between 2018 and 2022 and set them as the case group. Simultaneously, an age- and gender-matched cohort with plasma aldosterone concentration measurements but without LMCA was selected as the control group using a ratio of 1:3. Multivariable logistic regression analysis was used to assess the relationship of plasma aldosterone concentrations with LMCA. Angiographically significant LMCA stenosis is defined as luminal diameter stenosis ≥ 50%. Results: A total of 608 hypertensive patients were identified in this study, including 152 cases and 456 controls. The mean age of the patients was 60.8 ± 17.5 years, and 389 (64.0%) were men. Compared with the control group, the case group exhibited significantly higher plasma aldosterone concentrations (15.38 versus 9.68 ng/dL, P =0.009). In logistic regression analysis, higher plasma aldosterone concentrations showed 2.73-fold higher odds (95% confidence interval [CI], 1.35-3.68, P =0.003) for the presence of LMCA, which was significant in the adjusted model (odds ratio, 2.02 [95% CI, 1.18-2.97], P =0.008). In a stratified analysis, males with coronary artery disease and women of all ages showed a relationship between the two. The link between the two was unaffected by sensitivity analysis that excluded those who were exposed to interfering substances during the measurement of plasma aldosterone concentration and those who had primary aldosteronism. Conclusions: This study indicated that higher plasma aldosterone levels were associated with an increased risk of LMCA in patients with hypertension, even in the absence of primary aldosteronism. Interventional studies are needed to elucidate the health effect of treatments to lower aldosterone levels.

PSVII-6 Effect of Summer Months on Testicular Histoarchitecture and Spermatogenesis in Dezhou Donkey: a Histological Study

Abstract This study aims to illustrate testicular histoarchitecture and progression of spermatogenesis in Dezhou donkeys during summer months. For experiment, 8 male Dezhou donkeys having body weight 260 + 20 kg and aged 2 years were analyzed using microscopy and Jonhson’s score. Based on acrosomal system, Dezhou donkey spermatogenesis comprised of XII stages. Various types of spermatogonia: A1, A2, A3, B1 and B2 were observed along with undifferentiated spermatogonia (Aund; Figure 1, 2, 3 and 4). Testicular histoarchitecture during spermatogenesis, seminiferous tubules diameter (ST), ST height (µm), Luminal tubulaR diameter (µm), Number of ST/field, Number of germ cells along with normal Jonhson’s score illustrated that stages of spermatogenesis and testicular histoarchitecture of adult Dezhou donkeys are not affected during summer months (Table 1).