98%
921
2 minutes
20
Women undergoing cardiac surgery suffer from worse outcomes than their male counterparts. The reasons for this disparity are multifactorial, but the loss of the protective effects of estrogen likely plays a role. Estrogen acts on the CD39/CD73 purine pathway, and loss of estrogen effects may contribute to the increased inflammation seen in post-menopausal women. We aimed to compare CD39/CD73 expression and downstream fibrosis, and inflammation in men and women undergoing cardiac surgery and then used an ovariectomy/high fat diet mouse model to approximate women who present for cardiac surgery to test therapeutics. We found decreased CD39 and CD73 in women compared to men, which was associated with increased fibrosis. Apyrase supplementation (a CD39 mimetic) improved ejection fraction and decreased E/e'. Increased CD73 function (via dipyridamole) decreased fibrosis. This study demonstrates the importance of purinergic dysfunction in cardiovascular disease in women and presents two potential therapeutics to improve cardiac health via manipulation of purine pathways.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994921 | PMC |
http://dx.doi.org/10.1016/j.jmccpl.2025.100294 | DOI Listing |
Eur J Cardiothorac Surg
September 2025
Department of Cardiovascular Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan.
Objectives: Coronary artery bypass grafting (CABG) using bilateral internal thoracic artery (BITA) conduits can achieve good outcomes for multivessel lesions. This study evaluated early angiographic patency and outcomes following off-pump CABG (OPCAB) using only in situ BITA and right gastroepiploic artery (rGEA) grafts.
Methods: This retrospective analysis included patients undergoing OPCAB using only in situ skeletonized BITA and rGEA grafts (July 2007 to March 2019).
JAMA Netw Open
September 2025
School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Importance: The cost-effectiveness of adding early in-bed cycling to usual physiotherapy among adults receiving mechanical ventilation in the intensive care unit (ICU) compared with usual physiotherapy alone is unknown.
Objective: To evaluate the cost-effectiveness of in-bed cycling plus usual physiotherapy compared with usual therapy alone in the Critical Care Cycling to Improve Lower Extremity Strength (CYCLE) randomized clinical trial.
Design, Setting, And Participants: This trial-based economic evaluation with a 90-day time horizon compared early cycling plus usual physiotherapy vs usual physiotherapy alone from a societal perspective.
Multimed Man Cardiothorac Surg
September 2025
Institute of Chest Surgery, Medanta, Gurugram, India
Birt-Hogg-Dubé syndrome (BHDS) is an autosomal dominant inherited disorder caused by mutation in a tumour suppressor gene, FLCN, leading to skin tumours (fibrofolliculomas), renal tumours and pulmonary cysts. Lung involvement is predominantly observed in 70% of the cases of BHDS, manifesting in the form of recurrent primary spontaneous pneumothorax. This video tutorial showcases the surgical management of recurrent right primary spontaneous pneumothorax in a young adult with a history of multiple episodes of bilateral pneumothorax managed by surgical intervention previously.
View Article and Find Full Text PDFMultimed Man Cardiothorac Surg
September 2025
Department of Thoracic Surgery, New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton, UK
Three-dimensional (3D) guided robotic-assisted thoracic surgery is increasingly recognized as the pioneering approach for the most complex of pulmonary resections, offering high-definition 3D visualization, enhanced instrument augmentation and tremor-free tissue articulation. Compared with open thoracotomy, the robotic platform is associated with reduced peri-operative morbidity, shorter hospital admissions and faster patient recovery. However, sublobar resections such as segmentectomies remain anatomically and technically demanding, particularly in the context of resecting multiple segments, as showcased in this right S1 and S2 segmentectomy.
View Article and Find Full Text PDFMultimed Man Cardiothorac Surg
September 2025
Department of Cardiothoracic Surgery, St George’s Hospital, St George's University Hospitals NHS Foundation Trust, London, UK
Three-dimensional (3D) guided robotic-assisted thoracic surgery is increasingly recognized as a leading technique for undertaking the most complex pulmonary resections, providing high-definition 3D visualization, advanced instrument control and tremor-free tissue handling. Compared with open thoracotomy, the robotic platform offers reduced peri-operative complications, shorter hospital stays and faster patient recovery. Nevertheless, sublobar resections, such as segmentectomies, remain both anatomically intricate and technically challenging, particularly when resecting multiple segments, as in this left S1 and S2 segmentectomy.
View Article and Find Full Text PDF