TY  - JOUR
AB  - Background: Stanford type B aortic dissection is a rare, life-threatening complex phenotype associated with several modifiable and genetic risk factors. In the current study of a hospital-based, consecutive series of aortic dissection patients we propose a selection based on age and family history of aortic disease for genetic testing and detection of causative gene variants. Methods: In this single center cohort study from 2013 to 2018 patients with acute Stanford type B aortic dissections were consecutively treated and analyzed by next generation sequencing based on selection criteria (age of disease onset ≤45 years and/or positive familial history for aortic disease) to detect genome-wide pathogenic variants in protein-coding sequences and to identify large copy number variants (CNV). Variants in a predefined panel of 30 genes associated with the familial thoracic aortic aneurysm and dissection (TAAD) syndrome were evaluated. Results: From 105 patients nine matched selection criteria for genetic testing. Next-generation sequencing analysis revealed causal variants in FBN1 (fibrillin-1) in three patients: a pathogenic missense variant [c.6661T>C, p.(Cys2221Arg)] and two truncating variants [c.4786C>T, p.(Arg1596Ter)] and [c.6366C>CA, p.(Asp2123GlufsTer5)]. A fourth patient carried a large (>1,000,000 bp) CNV in the long arm of chromosome 10, deleting eleven genes, including the whole ACTA2 (actin alpha 2) gene. The latter two genetic findings have not been reported before. Conclusions: Selection of patients on the basis of young age and familial inheritance of aortic disease favors the identification of disease-causing genetic variants in a clinical cohort of patients with Stanford type B aortic dissection.
AU  - Erhart, P.*
AU  - Gieldon, L.*
AU  - Ante, M.*
AU  - Körfer, D.*
AU  - Strom, T.M.
AU  - Grond-Ginsbach, C.*
AU  - Böckler, D.*
C1  - 60726
C2  - 49516
CY  - Flat-rm C 16f, Kings Wing Plaza 1, No 3 Kwan St, Shatin, Hong Kong 00000, Peoples R China
SP  - 6806-6812
TI  - Acute stanford type B aortic dissection-who benefits from genetic testing?
JO  - J. Thorac. Dis.
VL  - 12
IS  - 11
PB  - Ame Publ Co
PY  - 2020
SN  - 2077-6624
ER  - 

TY  - JOUR
AB  - Background: The Type D Personality (TDP) has been specifically linked to acute myocardial infarction (AMI). However, the impact on prehospital delay of AMI patients is unclear. The aim of this study was to assess the relationship between TDP and pre-hospital delay time (PHT) in a Chinese population.Methods: A total of 256 AMI patients (47 women and 209 men) were taken from the Multicenter Delay in Patients Experiencing AMI in Shanghai (MEDEA FAR-EAST) study. Sociodemographic and psychobehavioral characteristics were assessed by bedside interviews and questionnaires. TDP was evaluated according to the Type D Personality Scale (DS14) subdivided in social inhibition (SI) and negative affectivity (NA). Based on a significant interaction analysis of TDP and sex on PHT, all analyses were stratified by sex.Results: PHT of female patients with TDP were substantially shorter compared to non-TDP female patients (108 vs. 281 min, P=0.029). In male patients, no effect of TDT on PHT was found. Spearman correlation analysis suggests that NA was negatively correlated with PHT (r=-0.358, P=0.014). Further age-adjusted logistic regression analyses showed that female patients with TDP were generally less likely to prehospital delay compared with non-TDP patients (OR =0.28; 95% CI, 0.08-0.98) and had a lower risk of PHT >360 minutes (OR =0.10; 95% CI, 0.01-0.91). However, statistical significance disappeared after adjustment for psychological factors (anxiety, depression, suboptimal wellbeing, cardiac denial and stress event).Conclusions: TDP is associated with less prehospital delay in female patients during AMI-an effect which may be particularly mediated by NA.
AU  - Zhang, Y.*
AU  - Wu, S.*
AU  - Pan, J.*
AU  - Hoschar, S.
AU  - Wang, Z.*
AU  - Tu, R.*
AU  - Ladwig, K.H.*
AU  - Ma, W.*
C1  - 60180
C2  - 49293
CY  - Flat-rm C 16f, Kings Wing Plaza 1, No 3 Kwan St, Shatin, Hong Kong 00000, Peoples R China
SP  - 4680-4689
TI  - The impact of the Type D Personality pattern on prehospital delay in patients suffering from acute myocardial infarction.
JO  - J. Thorac. Dis.
VL  - 12
IS  - 9
PB  - Ame Publ Co
PY  - 2020
SN  - 2077-6624
ER  - 

TY  - JOUR
AB  - Background: Malignant pleural mesothelioma (MPM) is an aggressive malignancy with few long-term survivors. Despite the dismal prognosis, hyperthermic intrathoracic chemoperfusion (HITHOC) was shown to improve survival in a selective group of patients. We analyzed the influence of HITHOC following pleurectomy and decortication on postoperative morbidity and overall survival for patients suffering from localized mesothelioma. Methods: From 2009 until 2013, 71 patients with localized pleural mesothelioma underwent pleurectomy and decortication followed by HITHOC with cisplatin and doxorubicin. We analyzed postoperative morbidity, age, overall survival and influence of macroscopic resection on survival. Results: Median patient age was 70 years (range, 65-73 years). Patients having the sarcomatoid subtype of mesothelioma showed a poor median survival of 9.2 months. In contrast, patients having the epithelioid subtype had a median survival of 17.9 months. Patients following macroscopic complete resection had a significantly better survival with 28.2 months compared to 13.1 months in patients with incomplete resection of the mesothelioma (P<0.0001). HITHOC was performed in all patients after tumor resection using cisplatin and doxorubicin. Conclusions: Taken together, HITHOC following pleurectomy and decortication is supposed to be a safe therapeutic option for selected patients with localized epithelial pleural mesothelioma.
AU  - Klotz, L.V.
AU  - Lindner, M.
AU  - Eichhorn, M.E.*
AU  - Grützner, U.*
AU  - Koch, I.*
AU  - Winter, H.*
AU  - Kauke, T.*
AU  - Duell, T.*
AU  - Hatz, R.
C1  - 56350
C2  - 46994
CY  - Flat-rm C 16f, Kings Wing Plaza 1, No 3 Kwan St, Shatin, Hong Kong 00000, Peoples R China
SP  - 1963-1972
TI  - Pleurectomy/decortication and hyperthermic intrathoracic chemoperfusion using cisplatin and doxorubicin for malignant pleural mesothelioma.
JO  - J. Thorac. Dis.
VL  - 11
IS  - 5
PB  - Ame Publ Co
PY  - 2019
SN  - 2077-6624
ER  -