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Article ; Online: Case report: angiosarcoma of the pulmonary artery diagnosed as pulmonary artery emboli.

Korça, Edina / Kanaan, Jad / Benke, Kálmán / Veres, Gábor / Michaelsen, Jens / Szabó, Gábor

2022 Volume 17, Issue 1, Page(s) 288

Abstract: Background: Angiosarcomas are the most common malignant tumors of the heart and great vessels. Late onset and unspecific symptoms are reasons why a diagnosis is made rather late at a time when most tumors have already metastasized. We report a rare case ...

Abstract	Background: Angiosarcomas are the most common malignant tumors of the heart and great vessels. Late onset and unspecific symptoms are reasons why a diagnosis is made rather late at a time when most tumors have already metastasized. We report a rare case of an angiosarcoma presenting as pulmonary artery emboli. Case presentation: A 66-year-old patient was initially admitted to the hospital with a STEMI. Days later a successful reanimation due to ventricular fibrillation followed. An emboli of the pulmonary artery was diagnosed as the cause and after a lysis therapy the patient was discharged. A few weeks later the patient suffered an episode of absolute arrhythmia. TTE as well as CT-Scan showed an emboli of the pulmonary artery and a pericardial effusion with compression to the right ventricle. Intraoperative findings, showed an infiltrating tumor of the pulmonary artery, the pulmonary valve, the RVOT, the LA and LV. A resection of the tumor from the pulmonary artery, valve and RVOT was carried out. A new pulmonary valve was implanted with the reconstruction of the RVOT and pulmonary artery. Due to LV infiltration, only a palliative surgical approach was possible. Despite an uncomplicated postoperative course, the patient died at home two months later. Conclusion: Although a rarity, a tumor of the pulmonary artery should be taken into consideration as a differential diagnosis to pulmonary artery emboli. Development of better diagnostic tools (specific tumor markers) and more effective chemotherapeutic agents is necessary to improve the prognosis of these patients.
MeSH term(s)	Humans ; Aged ; Pulmonary Artery/diagnostic imaging ; Pulmonary Artery/surgery ; Hemangiosarcoma/complications ; Hemangiosarcoma/diagnosis ; Hemangiosarcoma/surgery ; Pulmonary Embolism/diagnosis ; Pulmonary Embolism/surgery ; Pulmonary Valve ; Lung Neoplasms
Language	English
Publishing date	2022-11-16
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2227224-0
ISSN	1749-8090 ; 1749-8090
ISSN (online)	1749-8090
ISSN	1749-8090
DOI	10.1186/s13019-022-02036-w
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Article ; Online: Long-Term Outcomes Stratified by Age in Patients with a Mechanical versus Biological Mitral Valve Replacement.

Veres, Gábor / Benke, Kálmán / Stengl, Roland / Weber, Petra / Marina, Ereva / Szabó, Gábor / Karck, Matthias

Journal of cardiovascular development and disease

2022 Volume 9, Issue 10

Abstract: Objectives: Balancing anticoagulation and reoperation risks determines prostheses choice (mechanical/biological) for mitral valve replacement. We aimed to re-evaluate the outcomes after biological versus mechanical mitral valve replacement. Methods: We ... ...

Abstract	Objectives: Balancing anticoagulation and reoperation risks determines prostheses choice (mechanical/biological) for mitral valve replacement. We aimed to re-evaluate the outcomes after biological versus mechanical mitral valve replacement. Methods: We compared long-term benefits and risks of mechanical and biological prostheses in 2056 patients (52% men, 48% women; 65.4 ± 12.1 years) who underwent mitral valve replacements between 1993−2017, in a retrospective single-centre study. Data sources included prospective institutional database, social registry, general practitioner data and follow-up questionnaire. Patients were stratified by age: < = 39 y (n = 82), 40−49 y (n = 164), 50−59 y (n = 335), 60−69 y (n = 593), 70−79 y (n = 743) and > = 80 y (n = 139). Long-term outcomes (mortality, reoperations, bleeding) were analysed. Results: Altogether, 1308 mechanical (53% men, 47% women; 61.5 ± 11.7 years) and 748 biological (50% men, 50% women; 72.3 ± 9.6 years) valves were implanted. The reason for valve replacement was stenosis in 162, insufficiency in 823 and combined in 323 cases for mechanical, while it was 46, 567 and 135 for biological valves, respectively. Overall cumulative survival was higher with mechanical prosthesis (mean: 139 ± 4 vs. 102 ± 5 months, 10 y: 55% vs. 33%, p < 0.0001). Subgroup analysis revealed higher survival among patients receiving mechanical prosthesis up to 60 years (< = 39 y p = 0.047, 40−49 y p < 0.0001, 50−59 y p = 0.001). In patients 60−69 years, overall survival did not differ; however, in survivors beyond 8 years, mechanical prosthesis showed improved survival (p = 0.014). While between 70−79 years survival was nearly identical, for above 80 years, patients had a higher survival with biological prosthesis (p = 0.014). Conclusion: The present data demonstrated a higher survival of mechanical prosthesis in a wide range of patients after mitral valve replacement.
Language	English
Publishing date	2022-10-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2777082-5
ISSN	2308-3425 ; 2308-3425
ISSN (online)	2308-3425
ISSN	2308-3425
DOI	10.3390/jcdd9100339
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Article: Zinc-aspirin preconditioning reduces endothelial damage of arterial grafts in a rodent model of revascularization.

Benke, Kálmán / Stengl, Roland / Stark, Klára Aliz / Bai, Yang / Radovits, Tamás / Loganathan, Sivakkanan / Korkmaz-Icöz, Sevil / Csonka, Máté / Karck, Matthias / Szabó, Gábor / Veres, Gábor

Frontiers in cardiovascular medicine

2024 Volume 10, Page(s) 1288128

Abstract: Introduction: Coronary artery bypass grafting (CABG) is the most common cardiac surgical procedure. The prognosis of revascularization via CABG is determined by the patency of the used grafts, for which an intact endothelium is essential. The degree of ... ...

Abstract	Introduction: Coronary artery bypass grafting (CABG) is the most common cardiac surgical procedure. The prognosis of revascularization via CABG is determined by the patency of the used grafts, for which an intact endothelium is essential. The degree of ischemia-reperfusion injury (IRI), which occurs during the harvest and implantation of the grafts, is an important determinant of graft patency. Preconditioning with aspirin, a nonsteroidal anti-inflammatory drug has been shown to reduce the functional and molecular damage of arterial grafts in a rodent model. Studies have found that the zinc-aspirin complex may be able to exert an even better protective effect in pathological cardiovascular conditions. Thus, our aim was to characterize the protective effect of zinc-aspirin complex on free arterial grafts in a rodent model of revascularization. Methods: Donor Lewis rats were treated with either zinc-aspirin, aspirin, or placebo ( Results: The endothelium dependent maximal vasorelaxation was improved (non-transplanted control group: 82% ± 3%, transplanted control group: 14% ± 2%, aspirin group: 31% ± 4%, zinc-aspirin group: 52% ± 4%), the nitro-oxidative stress and cell apoptosis decreased, and significant endothelial protection was shown in the groups preconditioned with aspirin or zinc-aspirin. However, zinc-aspirin proved to be more effective in the reduction of IRI, than aspirin alone. Discussion: Preconditioning with zinc-aspirin could be a promising way to protect the function and structural integrity of free arterial grafts, thus improving the outcomes of CABG.
Language	English
Publishing date	2024-01-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2023.1288128
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Article ; Online: The Perioperative Period of Heart Transplantation Is Affected by Thyroid Hormone Status.

Szécsi, Balázs / Sinkó, Richárd / Vereb, Alexandra / Khochanskiy, Dmitry / Benke, Kálmán / Radovits, Tamás / Lakatos, Bálint / Kőszegi, Andrea / Losoncz, Eszter / Kugler, Szilvia / Szabó, Márk / Merkely, Béla / Székely, Andrea / Gereben, Balázs

Thyroid : official journal of the American Thyroid Association

2024

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2024-05-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	1086044-7
ISSN	1557-9077 ; 1050-7256
ISSN (online)	1557-9077
ISSN	1050-7256
DOI	10.1089/thy.2023.0628
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Zs.MO 106: Show issues

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Article ; Online: Poor Preoperative Nutritional Status, but Not Hormone Levels, Are Associated With Mortality After Cardiac Surgery.

Tóth, Krisztina / Szabó, András / Menyhárd, Júlia / Benke, Kálmán / Radovits, Tamás / Pólos, Miklós / Merkely, Béla / Gál, János / Székely, Andrea

Journal of cardiothoracic and vascular anesthesia

2022 Volume 36, Issue 8 Pt B, Page(s) 3074–3083

Abstract: Objectives: The authors' aim was to examine the preoperative hormone and nutritional status in patients undergoing elective cardiac surgery.: Design and settings: The authors' research was a single-center, prospective, observational study ( ... ...

Abstract	Objectives: The authors' aim was to examine the preoperative hormone and nutritional status in patients undergoing elective cardiac surgery. Design and settings: The authors' research was a single-center, prospective, observational study (ClinicalTrials.gov: NCT03736499). Participants & interventions: The authors examined 252 patients who underwent elective cardiac surgery. Preoperative thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), prolactin, and testosterone levels were collected and analyzed after the surgery. The Geriatric Nutritional Risk Index (GNRI), Controlling Nutritional Status (CONUT), and Prognostic Nutritional Index (PNI) were all calculated as a sum and groups. Frailty was calculated based on the modified Frailty Index-11. The primary outcome was overall mortality. Measurements and main results: The mean age of the patients was 64.23 years (standard deviation: 11.07 years). Thirty-three patients (13.01%) died during the median follow-up time of 20.48 months (interquartile range: 18.90-22.98 months). Thyroid hormones were examined as continuous variables and also in 3 groups based on low, normal, and high hormone levels. Continuous TSH (p = 0.230), continuous fT3 (p = 0.492), and continuous fT4 (p = 0.657) were not significantly associated with total mortality. After adjustment for the European System for Cardiac Operative Risk Evaluation II and postoperative complications, the following nutritional scores were associated with total mortality: GNRI < 91 (adjusted hazard ratio [AHR]: 4.384; 95% confidence interval [CI]: 1.866-10.303, p = 0.001), the higher CONUT group (AHR: 1.736; 95% CI: 1.736-2.866, p = 0.031), and a PNI < 48 points (AHR: 3.465; 95% CI: 1.735-6.918, p < 0.001). The modified Frailty Index-11 was not associated with mortality. Conclusions: Before cardiac surgery, nutritional status should be assessed because the findings may help to decrease mortality. The hormone levels were not associated with mortality.
MeSH term(s)	Aged ; Cardiac Surgical Procedures/adverse effects ; Frailty ; Humans ; Malnutrition ; Middle Aged ; Nutritional Status ; Prognosis ; Prospective Studies ; Retrospective Studies ; Thyroid Hormones ; Thyrotropin
Chemical Substances	Thyroid Hormones ; Thyrotropin (9002-71-5)
Language	English
Publishing date	2022-04-29
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	1067317-9
ISSN	1532-8422 ; 1053-0770
ISSN (online)	1532-8422
ISSN	1053-0770
DOI	10.1053/j.jvca.2022.04.035
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Article: Aspirin Reduces Ischemia-Reperfusion Injury Induced Endothelial Cell Damage of Arterial Grafts in a Rodent Model

Veres, Gábor / Benke, Kálmán / Stengl, Roland / Bai, Yang / Stark, Klára Aliz / Sayour, Alex Ali / Radovits, Tamás / Loganathan, Sivakkanan / Korkmaz-Icöz, Sevil / Karck, Matthias / Szabó, Gábor

Antioxidants. 2022 Jan. 18, v. 11, no. 2

2022

Abstract: Long-term graft patency determines the prognosis of revascularization after coronary artery bypass grafting (CABG). Ischemia-reperfusion (I/R) injury of the graft suffered during harvesting and after implantation might influence graft patency. Aspirin, a ...

Abstract	Long-term graft patency determines the prognosis of revascularization after coronary artery bypass grafting (CABG). Ischemia-reperfusion (I/R) injury of the graft suffered during harvesting and after implantation might influence graft patency. Aspirin, a nonsteroidal anti-inflammatory drug improves the long-term patency of vein grafts. Whether aspirin has the same effect on arterial grafts is questionable. We aimed to characterize the beneficial effects of aspirin on arterial bypass grafts in a rodent revascularization model. We gave Lewis rats oral pretreatment of either aspirin (n = 8) or saline (n = 8) for 5 days, then aortic arches were explanted and stored in cold preservation solution. The third group (n = 8) was a non-ischemia-reperfusion control. Afterwards the aortic arches were implanted into the abdominal aorta of recipient rats followed by 2 h of reperfusion. Endothelium-dependent vasorelaxation was examined with organ bath experiments. Immunohistochemical staining were carried out. Endothelium-dependent maximal vasorelaxation improved, nitro-oxidative stress and cell apoptosis decreased, and significant endothelial protection was shown in the aspirin preconditioned group, compared to the transplanted control group. Significantly improved endothelial function and reduced I/R injury induced structural damage were observed in free arterial grafts after oral administration of aspirin. Aspirin preconditioning before elective CABG might be beneficial on free arterial graft patency.
Keywords	animal models ; aorta ; apoptosis ; aspirin ; cold ; coronary vessels ; endothelial cells ; immunohistochemistry ; nonsteroidal anti-inflammatory agents ; oral administration ; prognosis ; vasodilation
Language	English
Dates of publication	2022-0118
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2704216-9
ISSN	2076-3921
ISSN	2076-3921
DOI	10.3390/antiox11020177
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Nanoscale Structural Comparison of Fibrillin-1 Microfibrils Isolated from Marfan and Non-Marfan Syndrome Human Aorta.

Șulea, Cristina M / Mártonfalvi, Zsolt / Csányi, Csilla / Haluszka, Dóra / Pólos, Miklós / Ágg, Bence / Stengl, Roland / Benke, Kálmán / Szabolcs, Zoltán / Kellermayer, Miklós S Z

International journal of molecular sciences

2023 Volume 24, Issue 8

Abstract: Fibrillin-1 microfibrils are essential elements of the extracellular matrix serving as a scaffold for the deposition of elastin and endowing connective tissues with tensile strength and elasticity. Mutations in the fibrillin-1 gene (FBN1) are linked to ... ...

Abstract	Fibrillin-1 microfibrils are essential elements of the extracellular matrix serving as a scaffold for the deposition of elastin and endowing connective tissues with tensile strength and elasticity. Mutations in the fibrillin-1 gene (FBN1) are linked to Marfan syndrome (MFS), a systemic connective tissue disorder that, besides other heterogeneous symptoms, usually manifests in life-threatening aortic complications. The aortic involvement may be explained by a dysregulation of microfibrillar function and, conceivably, alterations in the microfibrils' supramolecular structure. Here, we present a nanoscale structural characterization of fibrillin-1 microfibrils isolated from two human aortic samples with different FBN1 gene mutations by using atomic force microscopy, and their comparison with microfibrillar assemblies purified from four non-MFS human aortic samples. Fibrillin-1 microfibrils displayed a characteristic "beads-on-a-string" appearance. The microfibrillar assemblies were investigated for bead geometry (height, length, and width), interbead region height, and periodicity. MFS fibrillin-1 microfibrils had a slightly higher mean bead height, but the bead length and width, as well as the interbead height, were significantly smaller in the MFS group. The mean periodicity varied around 50-52 nm among samples. The data suggest an overall thinner and presumably more frail structure for the MFS fibrillin-1 microfibrils, which may play a role in the development of MFS-related aortic symptomatology.
MeSH term(s)	Humans ; Fibrillin-1/genetics ; Fibrillins ; Microfibrils ; Microfilament Proteins/genetics ; Microfilament Proteins/chemistry ; Marfan Syndrome/genetics ; Aorta ; Fibrillin-2
Chemical Substances	Fibrillin-1 ; Fibrillins ; Microfilament Proteins ; Fibrillin-2
Language	English
Publishing date	2023-04-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms24087561
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Article ; Online: Pressure overload-induced systolic heart failure is associated with characteristic myocardial microRNA expression signature and post-transcriptional gene regulation in male rats.

Ruppert, Mihály / Korkmaz-Icöz, Sevil / Benczik, Bettina / Ágg, Bence / Nagy, Dávid / Bálint, Tímea / Sayour, Alex Ali / Oláh, Attila / Barta, Bálint András / Benke, Kálmán / Ferdinandy, Péter / Karck, Matthias / Merkely, Béla / Radovits, Tamás / Szabó, Gábor

Scientific reports

2023 Volume 13, Issue 1, Page(s) 16122

Abstract: Although systolic function characteristically shows gradual impairment in pressure overload (PO)-evoked left ventricular (LV) hypertrophy (LVH), rapid progression to congestive heart failure (HF) occurs in distinct cases. The molecular mechanisms for the ...

Abstract	Although systolic function characteristically shows gradual impairment in pressure overload (PO)-evoked left ventricular (LV) hypertrophy (LVH), rapid progression to congestive heart failure (HF) occurs in distinct cases. The molecular mechanisms for the differences in maladaptation are unknown. Here, we examined microRNA (miRNA) expression and miRNA-driven posttranscriptional gene regulation in the two forms of PO-induced LVH (with/without systolic HF). PO was induced by aortic banding (AB) in male Sprague-Dawley rats. Sham-operated animals were controls. The majority of AB animals demonstrated concentric LVH and slightly decreased systolic function (termed as AB
MeSH term(s)	Male ; Rats ; Animals ; Heart Failure, Systolic/genetics ; Rats, Sprague-Dawley ; Gene Expression Regulation ; Hypertrophy, Left Ventricular ; MicroRNAs/genetics ; RNA, Messenger ; Weight Gain ; Fragile X Mental Retardation Protein
Chemical Substances	MicroRNAs ; RNA, Messenger ; Fmr1 protein, rat ; Fragile X Mental Retardation Protein (139135-51-6)
Language	English
Publishing date	2023-09-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-43171-1
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Article: Comprehensive frailty assessment with multidimensional frailty domains as a predictor of mortality among vascular and cardiac surgical patients.

Szabó, András / Szabó, Dominika / Tóth, Krisztina / Szécsi, Balázs / Szentgróti, Rita / Nagy, Ádám / Eke, Csaba / Sándor, Ágnes / Benke, Kálmán / Merkely, Béla / Gál, János / Székely, Andrea

Physiology international

2023 Volume 110, Issue 2, Page(s) 191–210

Abstract: Purpose: The frailty concept has become a fundamental part of daily clinical practice. In this study our purpose was to create a risk estimation method with a comprehensive aspect of patients' preoperative frailty.: Patients and methods: In our ... ...

Abstract	Purpose: The frailty concept has become a fundamental part of daily clinical practice. In this study our purpose was to create a risk estimation method with a comprehensive aspect of patients' preoperative frailty. Patients and methods: In our prospective, observational study, patients were enrolled between September 2014 and August 2017 in the Department of Cardiac Surgery and Department of Vascular Surgery at Semmelweis University, Budapest, Hungary. A comprehensive frailty score was built from four main domains: biological, functional-nutritional, cognitive-psychological and sociological. Each domain contained numerous indicators. In addition, the EUROSCORE for cardiac patients and the Vascular POSSUM for vascular patients were calculated and adjusted for mortality. Results: Data from 228 participants were included for statistical analysis. A total of 161 patients underwent vascular surgery, and 67 underwent cardiac surgery. The preoperatively estimated mortality was not significantly different (median: 2.700, IQR (interquartile range): 2.000-4.900 vs. 3.000, IQR: 1.140-6.000, P = 0.266). The comprehensive frailty index was significantly different (0.400 (0.358-0.467) vs. 0.348 (0.303-0.460), P = 0.001). In deceased patients had elevated comprehensive frailty index (0.371 (0.316-0.445) vs. 0.423 (0.365-0.500), P < 0.001). In the multivariate Cox model an increased risk for mortality in quartiles 2, 3 and 4 compared with quartile 1 as a reference was found (AHR (95% CI): 1.974 (0.982-3.969), 2.306 (1.155-4.603), and 3.058 (1.556-6.010), respectively). Conclusion: The comprehensive frailty index developed in this study could be an important predictor of long-term mortality after vascular or cardiac surgery. Accurate frailty estimation could make the traditional risk scoring systems more accurate and reliable.
MeSH term(s)	Humans ; Aged ; Frailty/etiology ; Frail Elderly ; Prospective Studies ; Geriatric Assessment/methods ; Postoperative Complications/etiology ; Cardiac Surgical Procedures/adverse effects ; Risk Factors ; Risk Assessment
Language	English
Publishing date	2023-05-03
Publishing country	Hungary
Document type	Observational Study ; Journal Article
ZDB-ID	2896288-6
ISSN	2498-602X
ISSN	2498-602X
DOI	10.1556/2060.2023.00195
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Article: Hormonal changes in the first 24 postoperative hours after cardiac surgical procedures.

Szécsi, Balázs / Tóth, Krisztina / Szabó, András / Eke, Csaba / Szentgróti, Rita / Dohán, Orsolya / Benke, Kálmán / Radovits, Tamás / Pólos, Miklós / Merkely, Béla / Gál, János / Székely, Andrea

Physiology international

2023 Volume 110, Issue 3, Page(s) 251–266

Abstract: Background: Hormone level changes after heart surgeries are a widely observed phenomenon due to neurohormonal feedback mechanisms that may affect postoperative morbidity and mortality. The current study aimed to analyze the changes in thyroid and sex ... ...

Abstract	Background: Hormone level changes after heart surgeries are a widely observed phenomenon due to neurohormonal feedback mechanisms that may affect postoperative morbidity and mortality. The current study aimed to analyze the changes in thyroid and sex hormones in the first 24 postoperative hours after heart surgery. Methods: This prospective, observational study (registered on ClinicalTrials.gov: NCT03736499; 09/11/2018) included 49 patients who underwent elective cardiac surgical procedures at a tertiary heart center between March 2019 and December 2019. Thyroid hormones, including thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4), and sex hormones, including prolactin (PRL) and total testosterone, were measured preoperatively and at 24 h postoperatively. Results: Significant decreases in serum TSH (P < 0.001), T3 (P < 0.001) and total testosterone (P < 0.001) levels were noted, whereas T4 (P = 0.554) and PRL (P = 0.616) did not significantly change. Intensive care unit (ICU) hours (P < 0.001), mechanical ventilation (P < 0.001) and Vasoactive-Inotropic Score (VIS) (P = 0.006) were associated with postoperative T3 level. ICU hours were associated with postoperative T4 level (P = 0.028). Postoperative and delta testosterone levels were in connection with lengths of stay in ICU (P = 0.032, P = 0.010 respectively). Model for End-Stage Liver Disease (MELD) scores were associated with thyroid hormone levels and serum testosterone. Conclusions: T3 may represent a marker of nonthyroidal illness syndrome and testosterone may reflect hepatic dysfunction. In addition, PRL may act as a stress hormone in female patients.
MeSH term(s)	Humans ; Female ; Prospective Studies ; End Stage Liver Disease ; Severity of Illness Index ; Thyroid Hormones ; Thyrotropin ; Cardiac Surgical Procedures/adverse effects ; Testosterone
Chemical Substances	Thyroid Hormones ; Thyrotropin (9002-71-5) ; Testosterone (3XMK78S47O)
Language	English
Publishing date	2023-08-04
Publishing country	Hungary
Document type	Observational Study ; Journal Article
ZDB-ID	2896288-6
ISSN	2498-602X
ISSN	2498-602X
DOI	10.1556/2060.2023.00219
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