Alterações estruturais cardíaca e aórticana menopausa cirúrgica associada à hipertensão renovascular em ratos

A menopausa e a hipertensão podem alterar o remodelamento cardiovascular, porém pouco se sabe sobre sua associação no remodelamento ventricular esquerdo e na aorta. As ratas foram separadas em quatro grupos com seis animais cada: grupo Sham, OVX (ratas ooforectomizadas), 2K1C (ratas com dois rins, um clipe), e grupo 2K1C+OVX com período experimental de 11 semanas. O ventrículo esquerdo (VE) e a aorta torácica foram removidos e analisados (microscopia de luz, imuno-histoquímica e estereologia). A citologia vaginal mostrou que os animais dos grupos Sham e 2K1C ciclaram normalmente, entretanto, os animais dos grupos OVX e OVK+2K1C permaneceram na fase do diestro ou proestro. Comparado ao grupo Sham, a pressão arterial aumentou 12% no grupo OVX e 35% maior nos grupos 2K1C e OVX+2K1C. A relação massa do VE/comprimento da tíbia e a área seccional média de cardiomiócitos aumentaram em todos os grupos com exceção do grupo Sham. A vascularização intramiocárdica foi reduzida cerca de 30% em relação ao grupo Sham, não havendo diferença significativa entre os grupos OVX, 2K1C e OVX+2K1C. O tecido conjuntivo cardíaco teve um aumento superior a 45% nos grupos 2K1C e OVX+2K1C comparados ao grupo Sham, sem diferença entre o os animais do grupo Sham e OVX. O número de núcleos de cardiomiócitos do VE foi gradualmente menor nos grupos OVX, 2K1C e OVX+2K1C, sem diferença entre os dois últimos grupos. Imuno-histoquímica positiva para receptor AT1 da Ang II nas células musculares lisas da túnica média da aorta foi observado em todos os grupos. Estes resultados indicam que a ooforectomia e a hipertensão renovascular agem aumentando a pressão arterial independentemente, com conseqüente remodelamento cardíaco adverso, com estímulo maior da hipertensão renovascular que da menopausa induzida cirurgicamente.

Alterações estruturais cardíaca e aórtica na menopausa cirúrgica associada à hipertensão renovascular em ratos

A menopausa e a hipertensão podem alterar o remodelamento cardiovascular, porém pouco se sabe sobre sua associação no remodelamento ventricular esquerdo e na aorta. As ratas foram separadas em quatro grupos com seis animais cada: grupo Sham, OVX (ratas ooforectomizadas), 2K1C (ratas com dois rins, um clipe), e grupo 2K1C+OVX com período experimental de 11 semanas. O ventrículo esquerdo (VE) e a aorta torácica foram removidos e analisados (microscopia de luz, imuno-histoquímica e estereologia). A citologia vaginal mostrou que os animais dos grupos Sham e 2K1C ciclaram normalmente, entretanto, os animais dos grupos OVX e OVK+2K1C permaneceram na fase do diestro ou proestro. Comparado ao grupo Sham, a pressão arterial aumentou 12% no grupo OVX e 35% maior nos grupos 2K1C e OVX+2K1C. A relação massa do VE/comprimento da tíbia e a área seccional média de cardiomiócitos aumentaram em todos os grupos com exceção do grupo Sham. A vascularização intramiocárdica foi reduzida cerca de 30% em relação ao grupo Sham, não havendo diferença significativa entre os grupos OVX, 2K1C e OVX+2K1C. O tecido conjuntivo cardíaco teve um aumento superior a 45% nos grupos 2K1C e OVX+2K1C comparados ao grupo Sham, sem diferença entre o os animais do grupo Sham e OVX. O número de núcleos de cardiomiócitos do VE foi gradualmente menor nos grupos OVX, 2K1C e OVX+2K1C, sem diferença entre os dois últimos grupos. Imuno-histoquímica positiva para receptor AT1 da Ang II nas células musculares lisas da túnica média da aorta foi observado em todos os grupos. Estes resultados indicam que a ooforectomia e a hipertensão renovascular agem aumentando a pressão arterial independentemente, com conseqüente remodelamento cardíaco adverso, com estímulo maior da hipertensão renovascular que da menopausa induzida cirurgicamente.

An extended computational model of the circulatory system for designing ventricular assist devices.

An extended computational model of the circulatory system has been developed to predict blood flow in the presence of ventricular assist devices (VADs). A novel VAD, placed in the descending aorta, intended to offload the left ventricle (LV) and augment renal perfusion is being studied. For this application, a better understanding of the global hemodynamic response of the VAD, in essence an electrically driven pump, and the cardiovascular system is necessary. To meet this need, a model has been established as a nonlinear, lumped-parameter electrical analog, and simulated results under different states [healthy, congestive heart failure (CHF), and postinsertion of VAD] are presented. The systemic circulation is separated into five compartments and the descending aorta is composed of three components to accurately yield the system response of each section before and after the insertion of the VAD. Delays in valve closing time and blood inertia in the aorta were introduced to deliver a more realistic model. Pump governing equations and optimization are based on fundamental theories of turbomachines and can serve as a practical initial design point for rotary blood pumps. The model's results closely mimic established parameters for the circulatory system and confirm the feasibility of the intra-aortic VAD concept. This computational model can be linked with models of the pump motor to provide a valuable tool for innovative VAD design.

The myogenic automatism of the systemic heart of Octopus vulgaris (Cephalopoda: Coleoidea): evidence for localized stretch sensitivity and pacing activity

The localization of the stretch sensitivity and myogenic automatism in the systemic heart of Octopus vulgaris has been studied on an isolated preparation in which the ventricle was zoned by ligatures. Each region has been submitted to two different levels of internal hydrostatic pressure (1 and 2 kPa). Only the two atrio-ventricular regions were able to contract regularly when submitted to internal pressure, with a frequency dependent from the pressure value, while the ventricle-aortic region was insensitive to the stretching by internal pressure. This result supports the hypothesis that the automatism in this heart is localized. Electrocardiogram recordings from different areas of an isolated and perfused preparation of the systemic heart ventricle are also reported, which suggest that the electrical activity of the ventricle originates in two narrow areas near the atrio-ventricular valves.

非晶状体βγ晶状体蛋白与三叶因子蛋白复合物诱导兔胸主动脉环内皮依赖的持续收缩效应

脊椎动物中,非晶状体βγ-晶状体蛋白广泛分布于各种组织,但是功能知之甚少.三叶因子在创伤修复与肿瘤发生中具有重要作用,其分子作用机制尚不清楚.非晶状体βγ晶状体蛋白与三叶因子蛋白复合物(βγ-CAT)是一个从大蹼铃蟾皮肤分泌物中分离的一类全新的蛋白复合物.研究表明,βγ-CAT能够诱导离体的兔胸主动脉产生快速而持续的收缩,结合药理学抑制剂,细胞培养,激光共聚焦显微镜和免疫荧光原位组化,从细胞和分子水平对其作用机制进行研究.结果表明:.βγ-CAT诱导兔胸主动脉产生的收缩效应为剂量依赖(2-35 nmol/L)和内皮依赖(P＜0.01).在βγ-CAT(25nmol/L)处理的主动脉环的内皮细胞层检测到肿瘤坏死因子-α的释放.同时,βγ-CAT能够诱导原代培养的兔胸主动脉内皮细胞(RAEC)快速释放肿瘤坏死因子-α,βγ-CAT(25nmol/L)分别处理5和30min,RAEC释放的肿瘤坏死因子-α的浓度分别为(34.17±5.10)pg/mL和(98.01±4.67)pg/mL(P＜0.01).表明肿瘤坏死因子-α在βγ-CAT诱导兔胸丰动脉产生的收缩效应中发挥重要作用.为进一步深入研究非晶状体βγ晶状体蛋白与三叶因子的生理功能提供了新的思路和线索.

A phospholipase A1 platelet activator from the wasp venom of Vespa magnifica (Smith)

Wasp is an impor tant venomous animal that can induce human fatalities. Aortic thrombosis and cerebral infarction are major clinical symptoms after massive wasp stings but the reason leading to the envenomation manifestation is still not known. In this paper, a toxin protein is purified and characterized by Sephadex G-75 gel filtration, CM-Sephadex C-25 cationic exchange and fast protein liquid chromatography (FPLC) from the venom of the wasp, Vespa magnifica (Smith). This protein, named magnifin, contains phospholipase-like activity and induces platelet aggregation. The cDNA encoding magnifin is cloned from the venom sac cDNA library of the wasp. The predicted protein was deduced from the cDNA with a sequence composed of 337 amino acid residues. Magnifin is very similar to other phospholipase A(1) (PLA(1)), especially to other wasp allergen PLA(1). Magnifin can activate platelet aggregation and induce thrombosis in vivo. The current results proved that PLA(1) in wasp venom could be contributable to aortic thrombosis after massive wasp stings. (c) 2007 Elsevier Ltd. All rights reserved.

Determination of bioaccumulation and microscopic survey of LAS pollutant effect on the liver, kidney and gill tissues of Rutilus frisii kutum in Caspian sea

Linear alkylbenzene sulfonate (LAS) are widely used in detergent industry. Due to contaminants entering the water, and the effects of their accumulation in fish, LAS, has a great importance in environmental pollution. In the present study, accumulation of LAS and its histological effects on gill tissue, liver and kidney of Caspian kutum (Rutilus frisii kutum) were studied. Caspian kutum is the most important and most valuable teleosts of the Caspian Sea. Due to releasing Caspian Kutum in rivers and Anzali Lagoon and unlimited entry of wastewater to the aquatic ecosystem, research on the impact of LAS on Caspian kutum is important. In the present study, fish exposed to sublethal concentrations of LAS (0.58, 1.16 and 2.32 mg/l) for 192 hours. Control treatments with three replicates at 0, 24, 48, 72, 96 and 192 hours were done. For assessments of the histological effects of LAS, tissue sections prepared and by using Hematoxylin - Eosin were stained, then the prepared sections, examined by light microscopy. For determination of the bio accumulation of LAS, the soxhlet extraction and solid phase extraction was performed to determine the amount of LAS using HPLC with fluorescence detector. According to results average of bioconcentration factor and LAS concentrations in fish had reached stable levels after approximately 72 h and thus represented steady state BCF values in this species. The value of steady-state bio-concentration factor of total LAS was 33.96 L.Kg- 1 and for each of the homologous C10-n-LAS, C11-n-LAS, C12-n-LAS and C13-n- LAS were 3.84, 6.15, 8.58 and 15.57 L.Kg-1 respectively. According to the results obtained in gills exposed to LAS, histopathological alteration include hypertrophy, lifting of lamella epithelium, edema, clubbing of lamellae hyperplasia, lamellar fusion and aneurysm were seen. In liver tissue exposed to three concentrations of LAS, congestion and dilation of sinusoids, irregular-shaped nuclei and degeneration in the hepatocyte, vacuolar degeneration and necrosis were observed. In kidney exposed to three concentrations of LAS, reduction of the interstitial haematopoietic tissue, degeneration in the epithelial cells of renal tubule, tubular degeneration, necrosis, shrinkage and luminal occlusion were observed. According to the results the most alteration due to exposure to LAS was seen in the gill tissue. None of the control samples showed histological effects of LAS.

鲨鱼软骨抗血管生成多肽的分离纯化及其生物活性

以血管生成为靶点的抗肿瘤策略是抗肿瘤领域的研究热点，目前已经发现许多天然和化学合成的抗血管生成药物。鲨鱼软骨作为抗新生血管生成因子的重要来源的研究已有20多年的历史，很多研究显示鲨鱼软骨提取物有抗血管生成活性。但鲨鱼软骨活性多肽的完整分子结构一直未见报道；鲨鱼软骨活性多肽干扰血管生成通路的信号途径尚不明确。 本文应用盐酸胍抽提、丙酮分级沉淀、超滤、凝胶层析等分离技术，从青鲨（Prionace glauca）软骨中分离纯化并鉴定了一种新的具有抗新生血管生成活性的多肽。经SDS-PAGE和N-末端氨基酸序列分析显示，该多肽分子量为15500 Da，采用蛋白数据库分析表明该多肽是一种新发现的鲨鱼软骨多肽（Polypeptide from Prionace glauca，PG155）。 体外实验显示，PG155抑制内皮细胞生长因子（vascular endothelial growth factor，VEGF）介导的人脐静脉内皮细胞（human umbilical vein endothelial cell ，HUVEC）迁移和管腔形成，并呈剂量依赖关系。200 μg/ml PG155对牛主动脉内皮细胞（Bovine Aortic Endothelial Cells，BAECs）和HUVECs及以下癌细胞，包括人肝癌细胞（human hepatoma Bel-7402 cells，Bel-7402）、 口腔上皮癌细胞（human oral epidermoid carcinoma KB cells ，KB）、人结肠癌细胞（human colon cancer HCT-18 cells，HCT-18）和人乳腺癌细胞（human breast MCF7 cancer cells ，MCF7）的增殖均无抑制作用，说明PG155无细胞毒作用。20 μg/ml PG155显著抑制HUVEC的迁移和管腔形成；40-80 μg/ml PG155 对VEGF 介导的HUVEC的迁移和管腔形成几乎完全抑制。 体内实验显示，PG155显著抑制斑马鱼胚胎模型新生血管生成，并呈剂量依赖关系。形态学观察表明PG155显著抑制斑马鱼胚胎肠下静脉（subintestinal vessels， SIVs）的生长，随着浓度的升高SIVs的生长可受到完全抑制。碱性磷酸酶染色分析显示，在一定浓度范围内，PG155随着浓度的升高对斑马鱼胚胎整体血管生成抑制作用依次增强。160 μg/ml PG155会引起斑马鱼胚胎心脏功能障碍。 由海洋生物中发现新的肿瘤新生血管生成抑制剂国内外的报道较少，我们的工作表明鲨鱼软骨可作为血管生成抑制剂的重要来源，鲨鱼软骨活性多肽PG155由于具有极低的细胞毒作用，并能抑制VEGF介导的血管生成过程，有希望成为一类新型抗肿瘤药物。

Centenarians and their hearts: a prospective registry with comprehensive geriatric assessment, electrocardiogram, echocardiography, and follow-up

Background Data on the cardiac characteristics of centenarians are scarce. Our aim was to describe electrocardiogram (ECG) and echocardiography in a cohort of centenarians and to correlate them with clinical data. Methods We used prospective multicenter registry of 118 centenarians (28 men) with a mean age of 101.5 ± 1.7 years. Electrocardiogram was performed in 103 subjects (87.3%) and echocardiography in 100 (84.7%). All subjects underwent a follow-up for at least 6 months. Results Centenarians with abnormal ECG were less frequently females (72% vs 93%), had higher rates of previous consumption of tobacco (14% vs 0) and alcohol (24% vs 12%), and scored lower in the perception of health status (6.8 ± 2.0 vs 8.3 ± 6.8). Centenarians with significant abnormalities in echocardiography were less frequently able to walk 6 m (33% vs 54%). Atrial fibrillation/flutter was found in 27 subjects (26%). Mean left ventricular (LV) ejection fraction was 60.0 ± 10.5%. Moderate or severe aortic valve stenosis was found in 16%, mitral valve regurgitation in 15%, and aortic valve regurgitation in 13%. Diastolic dysfunction was assessed in 79 subjects and was present in 55 (69.6%). Katz index and LV dilation were independently associated with the ability to walk 6 m. Age, Charlson and Katz indexes, and the presence of significant abnormalities in echocardiography were associated with mortality. Conclusions Centenarians have frequent ECG alterations and abnormalities in echocardiography. More than one fifth has atrial fibrillation, and most have diastolic dysfunction. Left ventricular dilation was associated with the ability to walk 6 m. Significant abnormalities in echocardiography were associated with mortality.

Genome-wide association study for subclinical atherosclerosis in major arterial territories in the NHLBI's Framingham Heart Study

INTRODUCTION:Subclinical atherosclerosis (SCA) measures in multiple arterial beds are heritable phenotypes that are associated with increased incidence of cardiovascular disease. We conducted a genome-wide association study (GWAS) for SCA measurements in the community-based Framingham Heart Study.METHODS:Over 100,000 single nucleotide polymorphisms (SNPs) were genotyped (Human 100K GeneChip, Affymetrix) in 1345 subjects from 310 families. We calculated sex-specific age-adjusted and multivariable-adjusted residuals in subjects tested for quantitative SCA phenotypes, including ankle-brachial index, coronary artery calcification and abdominal aortic calcification using multi-detector computed tomography, and carotid intimal medial thickness (IMT) using carotid ultrasonography. We evaluated associations of these phenotypes with 70,987 autosomal SNPs with minor allele frequency [greater than or equal to] 0.10, call rate [greater than or equal to] 80%, and Hardy-Weinberg p-value [greater than or equal to] 0.001 in samples ranging from 673 to 984 subjects, using linear regression with generalized estimating equations (GEE) methodology and family-based association testing (FBAT). Variance components LOD scores were also calculated.RESULTS:There was no association result meeting criteria for genome-wide significance, but our methods identified 11 SNPs with p < 10-5 by GEE and five SNPs with p < 10-5 by FBAT for multivariable-adjusted phenotypes. Among the associated variants were SNPs in or near genes that may be considered candidates for further study, such as rs1376877 (GEE p < 0.000001, located in ABI2) for maximum internal carotid artery IMT and rs4814615 (FBAT p = 0.000003, located in PCSK2) for maximum common carotid artery IMT. Modest significant associations were noted with various SCA phenotypes for variants in previously reported atherosclerosis candidate genes, including NOS3 and ESR1. Associations were also noted of a region on chromosome 9p21 with CAC phenotypes that confirm associations with coronary heart disease and CAC in two recently reported genome-wide association studies. In linkage analyses, several regions of genome-wide linkage were noted, confirming previously reported linkage of internal carotid artery IMT on chromosome 12. All GEE, FBAT and linkage results are provided as an open-access results resource at http://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?id=phs000007.CONCLUSION:The results from this GWAS generate hypotheses regarding several SNPs that may be associated with SCA phenotypes in multiple arterial beds. Given the number of tests conducted, subsequent independent replication in a staged approach is essential to identify genetic variants that may be implicated in atherosclerosis.

Allylation of intraerythrocytic hemoglobin by raw garlic extracts.

Recent studies have shown that deoxygenated human red blood cells (RBCs) converted garlic-derived polysulfides into hydrogen sulfide, which in turn produced vasorelaxation in aortic ring preparations. The vasoactivity was proposed to occur via glucose- and thiol-dependent acellular reactions. In the present study, we investigated the interaction of garlic extracts with human deoxygenated RBCs and its effect on intracellular hemoglobin molecules. The results showed that garlic extract covalently modified intraerythrocytic deoxygenated hemoglobin. The modification identified consisted of an addition of 71 atomic mass units, suggesting allylation of the cysteine residues. Consistently, purified human deoxyhemoglobin reacted with chemically pure diallyl disulfide, showing the same modification as garlic extracts. Tandem mass spectrometry analysis demonstrated that garlic extract and diallyl disulfide modified hemoglobin's beta-chain at cysteine-93 (beta-93C) or cysteine-112 (beta-112C). These results indicate that garlic-derived organic disulfides as well as pure diallyl disulfide must permeate the RBC membrane and modified deoxyhemoglobin at beta-93C or beta-112C. Although the physiological role of the reported garlic extract-induced allyl modification on human hemoglobin warrants further study, the results indicate that constituents of natural products, such as those from garlic extract, modify intracellular proteins.

Level of beta-adrenergic receptor kinase 1 inhibition determines degree of cardiac dysfunction after chronic pressure overload-induced heart failure.

BACKGROUND: Heart failure is characterized by abnormalities in beta-adrenergic receptor (betaAR) signaling, including increased level of myocardial betaAR kinase 1 (betaARK1). Our previous studies have shown that inhibition of betaARK1 with the use of the Gbetagamma sequestering peptide of betaARK1 (betaARKct) can prevent cardiac dysfunction in models of heart failure. Because inhibition of betaARK activity is pivotal for amelioration of cardiac dysfunction, we investigated whether the level of betaARK1 inhibition correlates with the degree of heart failure. METHODS AND RESULTS: Transgenic (TG) mice with varying degrees of cardiac-specific expression of betaARKct peptide underwent transverse aortic constriction (TAC) for 12 weeks. Cardiac function was assessed by serial echocardiography in conscious mice, and the level of myocardial betaARKct protein was quantified at termination of the study. TG mice showed a positive linear relationship between the level of betaARKct protein expression and fractional shortening at 12 weeks after TAC. TG mice with low betaARKct expression developed severe heart failure, whereas mice with high betaARKct expression showed significantly less cardiac deterioration than wild-type (WT) mice. Importantly, mice with a high level of betaARKct expression had preserved isoproterenol-stimulated adenylyl cyclase activity and normal betaAR densities in the cardiac membranes. In contrast, mice with low expression of the transgene had marked abnormalities in betaAR function, similar to the WT mice. CONCLUSIONS: These data show that the level of betaARK1 inhibition determines the degree to which cardiac function can be preserved in response to pressure overload and has important therapeutic implications when betaARK1 inhibition is considered as a molecular target.

Beta-arrestins regulate atherosclerosis and neointimal hyperplasia by controlling smooth muscle cell proliferation and migration.

Atherosclerosis and arterial injury-induced neointimal hyperplasia involve medial smooth muscle cell (SMC) proliferation and migration into the arterial intima. Because many 7-transmembrane and growth factor receptors promote atherosclerosis, we hypothesized that the multifunctional adaptor proteins beta-arrestin1 and -2 might regulate this pathological process. Deficiency of beta-arrestin2 in ldlr(-/-) mice reduced aortic atherosclerosis by 40% and decreased the prevalence of atheroma SMCs by 35%, suggesting that beta-arrestin2 promotes atherosclerosis through effects on SMCs. To test this potential atherogenic mechanism more specifically, we performed carotid endothelial denudation in congenic wild-type, beta-arrestin1(-/-), and beta-arrestin2(-/-) mice. Neointimal hyperplasia was enhanced in beta-arrestin1(-/-) mice, and diminished in beta-arrestin2(-/-) mice. Neointimal cells expressed SMC markers and did not derive from bone marrow progenitors, as demonstrated by bone marrow transplantation with green fluorescent protein-transgenic cells. Moreover, the reduction in neointimal hyperplasia seen in beta-arrestin2(-/-) mice was not altered by transplantation with either wild-type or beta-arrestin2(-/-) bone marrow cells. After carotid injury, medial SMC extracellular signal-regulated kinase activation and proliferation were increased in beta-arrestin1(-/-) and decreased in beta-arrestin2(-/-) mice. Concordantly, thymidine incorporation and extracellular signal-regulated kinase activation and migration evoked by 7-transmembrane receptors were greater than wild type in beta-arrestin1(-/-) SMCs and less in beta-arrestin2(-/-) SMCs. Proliferation was less than wild type in beta-arrestin2(-/-) SMCs but not in beta-arrestin2(-/-) endothelial cells. We conclude that beta-arrestin2 aggravates atherosclerosis through mechanisms involving SMC proliferation and migration and that these SMC activities are regulated reciprocally by beta-arrestin2 and beta-arrestin1. These findings identify inhibition of beta-arrestin2 as a novel therapeutic strategy for combating atherosclerosis and arterial restenosis after angioplasty.

A Tissue-Engineered Microvascular System to Evaluate Vascular Progenitor Cells for Angiogenic Therapies

The ability of tissue engineered constructs to replace diseased or damaged organs is limited without the incorporation of a functional vascular system. To design microvasculature that recapitulates the vascular niche functions for each tissue in the body, we investigated the following hypotheses: (1) cocultures of human umbilical cord blood-derived endothelial progenitor cells (hCB-EPCs) with mural cells can produce the microenvironmental cues necessary to support physiological microvessel formation in vitro; (2) poly(ethylene glycol) (PEG) hydrogel systems can support 3D microvessel formation by hCB-EPCs in coculture with mural cells; (3) mesenchymal cells, derived from either umbilical cord blood (MPCs) or bone marrow (MSCs), can serve as mural cells upon coculture with hCB-EPCs. Coculture ratios between 0.2 (16,000 cells/cm2) and 0.6 (48,000 cells/cm2) of hCB-EPCs plated upon 3.3 µg/ml of fibronectin-coated tissue culture plastic with (80,000 cells/cm2) of human aortic smooth muscle cells (SMCs), results in robust microvessel structures observable for several weeks in vitro. Endothelial basal media (EBM-2, Lonza) with 9% v/v fetal bovine serum (FBS) could support viability of both hCB-EPCs and SMCs. Coculture spatial arrangement of hCB-EPCs and SMCs significantly affected network formation with mixed systems showing greater connectivity and increased solution levels of angiogenic cytokines than lamellar systems. We extended this model into a 3D system by encapsulation of a 1 to 1 ratio of hCB-EPC and SMCs (30,000 cells/µl) within hydrogels of PEG-conjugated RGDS adhesive peptide (3.5 mM) and PEG-conjugated protease sensitive peptide (6 mM). Robust hCB-EPC microvessels formed within the gel with invasion up to 150 µm depths and parameters of total tubule length (12 mm/mm2), branch points (127/mm2), and average tubule thickness (27 µm). 3D hCB-EPC microvessels showed quiescence of hCB-EPCs (<1% proliferating cells), lumen formation, expression of EC proteins connexin 32 and VE-cadherin, eNOS, basement membrane formation by collagen IV and laminin, and perivascular investment of PDGFR-β+/α-SMA+ cells. MPCs present in <15% of isolations displayed >98% expression for mural markers PDGFR-β, α-SMA, NG2 and supported hCB-EPC by day 14 of coculture with total tubule lengths near 12 mm/mm2. hCB-EPCs cocultured with MSCs underwent cell loss by day 10 with a 4-fold reduction in CD31/PECAM+ cells, in comparison to controls of hCB-EPCs in SMC coculture. Changing the coculture media to endothelial growth media (EBM-2 + 2% v/v FBS + EGM-2 supplement containing VEGF, FGF-2, EGF, hydrocortisone, IGF-1, ascorbic acid, and heparin), promoted stable hCB-EPC network formation in MSC cocultures over 2 weeks in vitro, with total segment length per image area of 9 mm/mm2. Taken together, these findings demonstrate a tissue engineered system that can be utilized to evaluate vascular progenitor cells for angiogenic therapies.

Two Cases of Late Shone Syndrome With Pulmonary Hypertension: Heart-Lung Transplant or Valve Surgery?

Two cases of Shone syndrome with severe mitral and aortic valve problems and pulmonary hypertension were referred for heart-lung transplantation. Severely elevated pulmonary vascular resistance (PVR) was confirmed as was severe periprosthetic mitral and aortic regurgitation. Based on the severity of the valve lesions in both patients, surgery was decided upon and undertaken. Both experienced early pulmonary hypertensive crises, one more than the other, that gradually subsided, followed by excellent recovery and reversal of pulmonary hypertension and PVR. These cases illustrate Braunwald's concept that pulmonary hypertension secondary to left-sided valve disease is reversible.