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PubMedDate not supplied

[Periarteritis nodosa with heart valve disease disclosed by occlusion of the central artery of the retina].

We report a case of periarteritis nodosa revealed by blindness due to occlusion of the central retinal artery. The disease appeared after a serous otitis and was accompanied by thrombocytosis. Its outcome was favourable under corticosteroid therapy, but it was complicated by aortic valve regurgitation. Lesions of fibrinoid necrosis were found on the aortic cusps removed during surgical replacement. It seems highly probable that the ocular and valvular lesions were specific, although this cannot be directly demonstrated. The case presented here is exceptional, and the relevant literature is reviewed.

Aortic Valve↗
PubMed1991

[Plastic correction of aortic stenosis in two- and three heart valve diseases].

Plastic correction of aortic stenosis with simultaneous intervention on the mitral and, in some cases, on the tricuspid valve was performed on 50 patients whose ages ranged from 25 to 53 years (average age 43.2 years); 15 were in NYHA functional class III and 35 in class IV. There were 38 females and 12 males. Correction of the aortic stenosis was achieved by open valvulotomy and additional plane resection of the cusps, suture plastic was conducted whenever necessary. In 6 cases calcinates were removed form the cusps simultaneously. Mitral valve prosthetics was undertaken in 42 patients, and open mitral commissurotomy in 8 patients. In 17 patients aortic and mitral stenoses were attended by defect of the tricuspid valve which called for plastic correction. Among the 50 patients who underwent operation 8 (16.0%) died. there were no fatal outcomes among patients related to the NYHA functional class III. In 41 cases the result of aortic stenosis correction was satisfactory, which was confirmed by clinical and echocardiographic data. After the operation, opening of the aortic valve cusps during echocardiography in the M-regimen increased, on average, from 12 +/- 2.0 to 18 +/- 2.6 mm. According to doppler-echocardiogram, the gradient on the aortic valve reduced, on average, from 45 +/- 5.0 to 26.5 +/- 4.0 mm. Only in one female patient aortic incompetence started progressing after the operation and called for prosthetics 6 months later.

Adult↗
PubMed2002

Serotonin mechanisms in heart valve disease II: the 5-HT2 receptor and its signaling pathway in aortic valve interstitial cells.

Serotonin [5-hydroxytryptamine (5-HT)]-mediated cardiac valvular disease has been commonly observed in patients with carcinoid tumors. Previous research by others using reverse transcriptase-polymerase chain reaction demonstrated that aortic valve cells expressed predominantly 5-HT(2A/2B) receptors (5-HT(2A)R). Related investigations by our group using sheep aortic valve interstitial cell (SAVIC) cultures demonstrated that 5-HT both up-regulates transforming growth factor (TGF)-beta1 expression and activity, and also results in increased phospholipase C (PLC) activity. Thus, the present study investigated the hypothesis that the 5-HT signaling pathway in SAVICs involves 5-HT(2)Rs with associated G-protein signal transduction. The objectives were to functionally characterize in SAVIC cultures the native serotonin receptor subtypes using specific agonists and antagonists, and to delineate the serotonin-signaling pathway. 5-HT administration caused a marked stimulation of PLC activity. SAVIC studies of specific agents that target the 5-HT(2)R subtypes indicate that this response seemed to be mediated predominantly by 5-HT(2A)Rs. Furthermore, the sheep 5-HT(2A)R was identified by reverse transcriptase-polymerase chain reaction with sequence confirmation including comparisons to pig and human 5-HT(2A)R. Extracellular signal-regulated kinase (Erk 1/2) is a signaling molecule downstream from the 5-HT(2A)R. Both a protein kinase C inhibitor, GF109203X, and a Src inhibitor, PP1, attenuated 5-HT-stimulated Erk 1/2 activation. However, a 5-HT(2A)R antagonist, MDL 100907, inhibited 5-HT up-regulation of PLC and TGF-beta1, while having far less pronounced effects on Erk 1/2. In conclusion, these studies of the signal transduction activity of SAVICs in response to 5-HT have demonstrated that the 5-HT(2A)Rs are the most functionally active of the 5-HT(2)Rs in this cell type. Furthermore, 5-HT(2A)Rs are also involved in 5-HT up-regulation of active TGF-beta. 5-HT also mediated strong Erk 1/2 signaling via the MAP-kinase pathway, which was only in part because of 5-HT(2A)R activity. Thus, major 5-HT Erk 1/2 signaling beyond that controlled by 5-HT(2)Rs must involve other serotonin receptor types and/or secondary signaling events.

Animals↗
PubMedDate not supplied

[DIASTOLIC MURMURS].

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Heart Diseases↗