@J_Rosales_MD

@J_Rosales_MD

Most recents (8)

@WorldStrokeEd

#WeekendLecture
#GeneticsAndStroke

#Genetics is involved in several #stroke related conditions, such as small vessel disease #SVD, aneurysms, dissections, cavernomas, and intracranial #hemorrhages

Check this 🧵!
Prepared by @J_Rosales_MD
Edited by @interneurona

#Weekendlecture

#Genetic & #SVD
🧬🧠

✅1,5% of cerebral #SVD are #monogenic disorders
✅AR, AD or X-linked
☝🏼Absence of family history doesn't rule out diagnosis because of
👉de novo mutation
👉reduced expression or
👉incomplete penetrance
✅ahajournals.org/doi/10.1161/ST…

#Weekendlecture

#Genetic & #SVD

When to #suspect?🕵️‍♀️

✅early onset stroke without vascular RFs
✅systemic features and neuroimaging of an specific monogenic disorder
✅consanguinity
✅negative work up for other causes of SVD

👉ahajournals.org/doi/10.1161/ST…

Read 15 tweets

Vipin M. Vashishtha

@vipintukur

We know that the two Ad-vector based vaccines, #AstraZeneca & #JNJ lead to clot-related complications like cerebral venous sinus thrombosis. We also know these events are referred to as ‘Vaccine induced Thrombotic Thrombocytopenia’ (VITT). But what lead to these complications? 1/

Now a new explanation for VITT seen with vector vaccines. “Vaccine-Induced #Covid19 Mimicry” Syndrome: Splice reactions within the #SARSCoV2 Spike ORF result in ‘Spike protein variants’ that may cause thromboembolic events in patients immunized with vector-based vaccines 2/

These soluble Spike #variants may initiate severe side effects when binding to #ACE2-expressing #endothelial cells in blood vessels 3/

Read 27 tweets

CVR Tomasz Guzik

@CVR_TomaszGuzik

Endothelial-derived microvesicles play a pathogenic role in vascular #inflammation, causing #endothelial barrier dysfunction by impairing adherens junctions and activating #neutrophils

More here: bit.ly/3g1FpH7
#Cardiotwitter #CardiovascularResearch

#Tweetorial below!

#Microvesicles (MV) are formed from the outward blebbing of the plasma membrane and carry a diverse cargo that regulate multiple processes.

During #inflammation these are produced by activated endothelial cells and released into the #circulation. TEM image of plasma MVs: (2/8)

In this study the authors investigated whether endothelial-derived MVs (EC-MVs) contribute to #vascular dysfunction during inflammation.

The authors used an animal model of #sepsis (CLP) and found that this increased EC-MV production (3/8)

Read 8 tweets

Lumos Biotech

@lumosbio

THREAD from the new #bradykinin research (pre-print) from 🇳🇱:

"We propose that the severity of the disease and many deaths are due to a local vascular problem due to activation of B1 receptors on #endothelial cells in the lungs."

#COVID19 #kinins

preprints.org/manuscript/202…

➡️"the B1 receptor on endothelial cells is upregulated by proinflammatory #cytokines

➡️ Without #ACE2 acting as a guardian to inactivate the ligands of B1, the lung environment is prone for local vascular leakage leading to #angioedema"

...

#bradykinin #COVID19

➡️"... and might explain the typical #CTscans and the feeling of people that they drown.

➡️In some pt., this is followed by a clinical worsening of disease around day 9 due to the formation antibodies directed against the spike (S)-antigen of #SARSCoV2 that binds to #ACE2"

Read 12 tweets

Juan García Gavín

@DrJuanGavin

Dermatologist are seeing more and more #skin symptoms related to #COVID19 . Acral lesions (i.e. hands and feet) are particularly frequent, specially in #children and #youngadult with no or few COVID symptoms. After seeing many cases, here is my vision: #Thread 👇

I think that these kind of lesions can be classified in four types. 1. Chilblain-like lesions, which are the most described, usually affecting many fingers / toes, either symmetrically or not. Pruritic and/or painful.

2. Insect-bite like lesions, that may also appear in the palm and the soles. Very #itchy and persistent (more than 2 weeks in some cases)

Read 10 tweets

Parham Eshtehardi MD

@CoronaryDoc

@JACCJournals

Sub-study of WISE @JACCJournals by @ahmedalbadrimd @lesleejshaw:

In women with signs & symptoms of ischemia
✅ low CFR (microvascular dysfunction) ➡️ ⬆️ major CV events
✅ endothelial dysfunction ➡️ ⬆️ angina hospitalization
onlinejacc.org/content/73/6/6…
@emorywomenheart @venkmurthy

In this relatively large & very well-done study, 4 indices of coronary dz were invasively measured:

✅ CFR (adenosine): non-endo dependent CMD

✅ CBF (ACh): endo dependent CMD

✅ Nitro Δ CSA: non-endo dependent epicardial dz

✅ ACh Δ CSA: endo depedent epicardial dz

@ahmedalbadrimd

Findings:
1️⃣ low CFR associated with ⬆️ MACE

2️⃣ low CBF not associated with MACE

3️⃣ impaired ACh dilatation assocaited with ⬆️ angina hospitalization

4️⃣ impaired NTG dilatation not associated with MACE
@ahmedalbadrimd @lesleejshaw @gina_lundberg @CedarsSinai @Michel_CorbanMD

Read 4 tweets

Parham Eshtehardi MD

@CoronaryDoc

@CoronaryDoc

What’s Your “Shear Stress”?

Want to Know More?

Relax & Read ⤵️ #Tweetorial by @CoronaryDoc + @arnavkumar

⚡️Coronary Wall Shear Stress in 12 Tweets ⚡️

1/12
Main Readings:
1) interventions.onlinejacc.org/content/early/…
2) ow.ly/XmD130mc9X8
3) link.springer.com/article/10.100…
#ACCImaging @ACCCardioEd

2/12
Wall shear stress (#WSS) is the frictional force of blood exerted tangential to endothelial surface of vessel wall & expressed in variety of units (1Pa=1N/m2=10 dynes/cm2)

It is derived from
• luminal geometry
• flow rate
• blood viscosity
• near wall velocity values

3/12
In vivo WSS calculations are derived from computational fluid dynamic (#CFD) simulations created from reconstructed 3D vessel geometries (from biplane angio/IVUS/OCT/CT/MR) combined with patient-specific pulsatile inlet/outlet velocity values (Doppler wire or other methods)

Read 12 tweets

Parham Eshtehardi MD

@CoronaryDoc