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Ali Alaraj - One of the best experts on this subject based on the ideXlab platform.
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Cerebral Arteriovenous Malformation draining vein stenosis is associated with atherosclerotic risk factors
Journal of NeuroInterventional Surgery, 2018Co-Authors: Nasya Mendozaelias, Sophia F. Shakur, Fady T. Charbel, Ali AlarajAbstract:Objective The pathogenesis of venous outflow stenosis associated with Cerebral Arteriovenous Malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and atherosclerotic risk factors. Materials and methods All patients with an AVM seen at our institution between 1990 and 2016 were retrospectively reviewed. Patients 50 years, sex, race, hypertension, type 2 diabetes mellitus, hyperlipidemia, coronary artery disease, chronic kidney disease stage III, and cigarette smoking. The relationship between venous stenosis and atherosclerotic risk factors was assessed using univariate and multivariate analyses. Results 278 patients were included (mean age 41 years, 55% men). Venous stenosis was present in 87 patients (31% of the cohort). The presence of venous stenosis was significantly associated with age >50 years (P=0.05), hypertension (P=0.05), diabetes (P=0.02), and hyperlipidemia (P=0.001). Multivariate analysis showed that hyperlipidemia (P=0.05) was predictive of draining vein stenosis. Conclusions Venous stenosis is associated with several atherosclerotic risk factors, suggesting that Cerebral AVM venous outflow stenosis occurs by a degenerative process. Additional studies can show whether these modifiable risk factors may be targeted to prevent draining vein stenosis and AVM rupture.
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effect of age on Cerebral Arteriovenous Malformation draining vein stenosis
World Neurosurgery, 2018Co-Authors: Sophia F. Shakur, Fady T. Charbel, Denise Brunozzi, Rahim Ismail, Dilip K Pandey, Ali AlarajAbstract:Objective The pathogenesis of venous intimal hyperplasia and venous outflow stenosis associated with Cerebral Arteriovenous Malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and age. Methods All patients with an AVM seen at our institution between 1990 and 2016 who underwent a diagnostic Cerebral angiogram were retrospectively reviewed. Draining vein stenosis was measured from angiograms before any treatment. The relationship between venous stenosis and age was assessed. Results We included 281 patients (mean age 39 years, age range 3–83 years, 55% male). Venous stenosis measuring ≥50% was present in 59 patients (21% of cohort). Peak age at presentation was 25–29 years, whereas peak frequency of venous stenosis ≥50% was 50–54 years. Venous stenosis was present in a significantly higher proportion of patients ≥50 years versus Conclusions Clinically significant Cerebral AVM draining vein stenosis appears to be associated with older age, suggesting that venous stenosis is a progressive disease that occurs by the same process that leads to intimal hyperplasia. These results should be confirmed with a population-based longitudinal study.
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e 086 effect of age on Cerebral Arteriovenous Malformation draining vein stenosis
Journal of NeuroInterventional Surgery, 2017Co-Authors: Sophia F. Shakur, Fady T. Charbel, Denise Brunozzi, Rahim Ismail, Ali AlarajAbstract:Introduction The pathogenesis of venous intimal hyperplasia and venous outflow stenosis associated with Cerebral Arteriovenous Malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and age. Methods All patients with an AVM seen at our institution between 1990–2016 who underwent a diagnostic Cerebral angiogram were retrospectively reviewed (n=281). Draining vein stenosis was measured from angiograms prior to any treatment. Relationship between venous stenosis, age, and age class (5 year increments) was assessed using linear regression analysis. Results 281 patients were included (mean age 39 years, age range 3-83 years, 55% male). Venous stenosis measuring ≥ 50% was present in 59 patients (21% of cohort). Higher percentage stenosis correlated significantly with older age class (R=+0.12, P=0.05) (Figure). Higher percentage stenosis also tended to be associated with older age (R=+0.11, P=0.07) (figure 1). Conclusion Higher percentage venous stenosis is associated with older age class, suggesting that venous stenosis is a progressive disease that occurs by the same process that leads to intimal hyperplasia. Disclosures: S. Shakur: None. D. Brunozzi: None. R. Ismail: None. F. Charbel: None. A. Alaraj: None.
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Cerebral Arteriovenous Malformation Flow Is Associated With Venous Intimal Hyperplasia.
Stroke, 2017Co-Authors: Sophia F. Shakur, Ahmed E. Hussein, Sepideh Amin-hanjani, Tibor Valyi-nagy, Fady T. Charbel, Ali AlarajAbstract:Background and Purpose—The pathogenesis of venous intimal hyperplasia and venous outflow stenosis associated with Cerebral Arteriovenous Malformation (AVM) draining veins is poorly understood. We s...
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relationship of pulsatility and resistance indices to Cerebral Arteriovenous Malformation angioarchitectural features and hemorrhage
Journal of Clinical Neuroscience, 2016Co-Authors: Sophia F. Shakur, Fady T. Charbel, Sepideh Aminhanjani, Hassan Mostafa, Victor A Aletich, Ali AlarajAbstract:Abstract The role that hemodynamics plays in the pathophysiology of Cerebral Arteriovenous Malformation (AVM) hemorrhage remains unclear. Here, we examine the relationship of pulsatility and resistance indices to AVM angioarchitectural features and hemorrhage. Records of patients with Cerebral AVMs evaluated at our institution between 2007–2014 and with flows obtained before treatment using quantitative magnetic resonance angiography (QMRA) were retrospectively reviewed. Flow volume rate and flow velocity were measured in primary arterial feeders and compared to their contralateral counterparts. Pulsatility index (PI) = [(systolic flow velocity − diastolic flow velocity)/mean flow velocity] and resistance index (RI) = [(systolic flow velocity − diastolic flow velocity)/systolic flow velocity] were calculated for each feeder and compared to the normal contralateral vessel. Relationships between PI, RI and AVM clinical and angioarchitectural features were assessed using linear regression. Seventy-two patients with a total of 101 feeder arteries were included. PI and RI were significantly lower in AVM arterial feeders compared to normal vessels, thereby resulting in significantly higher flow volume rates and flow velocities in feeder vessels. There was no significant association of PI and RI with hemorrhagic presentation, exclusive deep venous drainage, venous stenosis, single draining vein, or deep location. In conclusion, PI and RI can be measured using QMRA and are lower in AVM arterial feeders compared to normal vessels. Although we found no significant correlation between PI, RI, and AVM angioarchitectural characteristics thought to be associated with increased hemorrhage risk, future studies with larger sample sizes may better elucidate this relationship.
Sophia F. Shakur - One of the best experts on this subject based on the ideXlab platform.
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Cerebral Arteriovenous Malformation draining vein stenosis is associated with atherosclerotic risk factors
Journal of NeuroInterventional Surgery, 2018Co-Authors: Nasya Mendozaelias, Sophia F. Shakur, Fady T. Charbel, Ali AlarajAbstract:Objective The pathogenesis of venous outflow stenosis associated with Cerebral Arteriovenous Malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and atherosclerotic risk factors. Materials and methods All patients with an AVM seen at our institution between 1990 and 2016 were retrospectively reviewed. Patients 50 years, sex, race, hypertension, type 2 diabetes mellitus, hyperlipidemia, coronary artery disease, chronic kidney disease stage III, and cigarette smoking. The relationship between venous stenosis and atherosclerotic risk factors was assessed using univariate and multivariate analyses. Results 278 patients were included (mean age 41 years, 55% men). Venous stenosis was present in 87 patients (31% of the cohort). The presence of venous stenosis was significantly associated with age >50 years (P=0.05), hypertension (P=0.05), diabetes (P=0.02), and hyperlipidemia (P=0.001). Multivariate analysis showed that hyperlipidemia (P=0.05) was predictive of draining vein stenosis. Conclusions Venous stenosis is associated with several atherosclerotic risk factors, suggesting that Cerebral AVM venous outflow stenosis occurs by a degenerative process. Additional studies can show whether these modifiable risk factors may be targeted to prevent draining vein stenosis and AVM rupture.
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effect of age on Cerebral Arteriovenous Malformation draining vein stenosis
World Neurosurgery, 2018Co-Authors: Sophia F. Shakur, Fady T. Charbel, Denise Brunozzi, Rahim Ismail, Dilip K Pandey, Ali AlarajAbstract:Objective The pathogenesis of venous intimal hyperplasia and venous outflow stenosis associated with Cerebral Arteriovenous Malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and age. Methods All patients with an AVM seen at our institution between 1990 and 2016 who underwent a diagnostic Cerebral angiogram were retrospectively reviewed. Draining vein stenosis was measured from angiograms before any treatment. The relationship between venous stenosis and age was assessed. Results We included 281 patients (mean age 39 years, age range 3–83 years, 55% male). Venous stenosis measuring ≥50% was present in 59 patients (21% of cohort). Peak age at presentation was 25–29 years, whereas peak frequency of venous stenosis ≥50% was 50–54 years. Venous stenosis was present in a significantly higher proportion of patients ≥50 years versus Conclusions Clinically significant Cerebral AVM draining vein stenosis appears to be associated with older age, suggesting that venous stenosis is a progressive disease that occurs by the same process that leads to intimal hyperplasia. These results should be confirmed with a population-based longitudinal study.
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e 086 effect of age on Cerebral Arteriovenous Malformation draining vein stenosis
Journal of NeuroInterventional Surgery, 2017Co-Authors: Sophia F. Shakur, Fady T. Charbel, Denise Brunozzi, Rahim Ismail, Ali AlarajAbstract:Introduction The pathogenesis of venous intimal hyperplasia and venous outflow stenosis associated with Cerebral Arteriovenous Malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and age. Methods All patients with an AVM seen at our institution between 1990–2016 who underwent a diagnostic Cerebral angiogram were retrospectively reviewed (n=281). Draining vein stenosis was measured from angiograms prior to any treatment. Relationship between venous stenosis, age, and age class (5 year increments) was assessed using linear regression analysis. Results 281 patients were included (mean age 39 years, age range 3-83 years, 55% male). Venous stenosis measuring ≥ 50% was present in 59 patients (21% of cohort). Higher percentage stenosis correlated significantly with older age class (R=+0.12, P=0.05) (Figure). Higher percentage stenosis also tended to be associated with older age (R=+0.11, P=0.07) (figure 1). Conclusion Higher percentage venous stenosis is associated with older age class, suggesting that venous stenosis is a progressive disease that occurs by the same process that leads to intimal hyperplasia. Disclosures: S. Shakur: None. D. Brunozzi: None. R. Ismail: None. F. Charbel: None. A. Alaraj: None.
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Cerebral Arteriovenous Malformation Flow Is Associated With Venous Intimal Hyperplasia.
Stroke, 2017Co-Authors: Sophia F. Shakur, Ahmed E. Hussein, Sepideh Amin-hanjani, Tibor Valyi-nagy, Fady T. Charbel, Ali AlarajAbstract:Background and Purpose—The pathogenesis of venous intimal hyperplasia and venous outflow stenosis associated with Cerebral Arteriovenous Malformation (AVM) draining veins is poorly understood. We s...
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relationship of pulsatility and resistance indices to Cerebral Arteriovenous Malformation angioarchitectural features and hemorrhage
Journal of Clinical Neuroscience, 2016Co-Authors: Sophia F. Shakur, Fady T. Charbel, Sepideh Aminhanjani, Hassan Mostafa, Victor A Aletich, Ali AlarajAbstract:Abstract The role that hemodynamics plays in the pathophysiology of Cerebral Arteriovenous Malformation (AVM) hemorrhage remains unclear. Here, we examine the relationship of pulsatility and resistance indices to AVM angioarchitectural features and hemorrhage. Records of patients with Cerebral AVMs evaluated at our institution between 2007–2014 and with flows obtained before treatment using quantitative magnetic resonance angiography (QMRA) were retrospectively reviewed. Flow volume rate and flow velocity were measured in primary arterial feeders and compared to their contralateral counterparts. Pulsatility index (PI) = [(systolic flow velocity − diastolic flow velocity)/mean flow velocity] and resistance index (RI) = [(systolic flow velocity − diastolic flow velocity)/systolic flow velocity] were calculated for each feeder and compared to the normal contralateral vessel. Relationships between PI, RI and AVM clinical and angioarchitectural features were assessed using linear regression. Seventy-two patients with a total of 101 feeder arteries were included. PI and RI were significantly lower in AVM arterial feeders compared to normal vessels, thereby resulting in significantly higher flow volume rates and flow velocities in feeder vessels. There was no significant association of PI and RI with hemorrhagic presentation, exclusive deep venous drainage, venous stenosis, single draining vein, or deep location. In conclusion, PI and RI can be measured using QMRA and are lower in AVM arterial feeders compared to normal vessels. Although we found no significant correlation between PI, RI, and AVM angioarchitectural characteristics thought to be associated with increased hemorrhage risk, future studies with larger sample sizes may better elucidate this relationship.
Fady T. Charbel - One of the best experts on this subject based on the ideXlab platform.
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Cerebral Arteriovenous Malformation draining vein stenosis is associated with atherosclerotic risk factors
Journal of NeuroInterventional Surgery, 2018Co-Authors: Nasya Mendozaelias, Sophia F. Shakur, Fady T. Charbel, Ali AlarajAbstract:Objective The pathogenesis of venous outflow stenosis associated with Cerebral Arteriovenous Malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and atherosclerotic risk factors. Materials and methods All patients with an AVM seen at our institution between 1990 and 2016 were retrospectively reviewed. Patients 50 years, sex, race, hypertension, type 2 diabetes mellitus, hyperlipidemia, coronary artery disease, chronic kidney disease stage III, and cigarette smoking. The relationship between venous stenosis and atherosclerotic risk factors was assessed using univariate and multivariate analyses. Results 278 patients were included (mean age 41 years, 55% men). Venous stenosis was present in 87 patients (31% of the cohort). The presence of venous stenosis was significantly associated with age >50 years (P=0.05), hypertension (P=0.05), diabetes (P=0.02), and hyperlipidemia (P=0.001). Multivariate analysis showed that hyperlipidemia (P=0.05) was predictive of draining vein stenosis. Conclusions Venous stenosis is associated with several atherosclerotic risk factors, suggesting that Cerebral AVM venous outflow stenosis occurs by a degenerative process. Additional studies can show whether these modifiable risk factors may be targeted to prevent draining vein stenosis and AVM rupture.
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effect of age on Cerebral Arteriovenous Malformation draining vein stenosis
World Neurosurgery, 2018Co-Authors: Sophia F. Shakur, Fady T. Charbel, Denise Brunozzi, Rahim Ismail, Dilip K Pandey, Ali AlarajAbstract:Objective The pathogenesis of venous intimal hyperplasia and venous outflow stenosis associated with Cerebral Arteriovenous Malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and age. Methods All patients with an AVM seen at our institution between 1990 and 2016 who underwent a diagnostic Cerebral angiogram were retrospectively reviewed. Draining vein stenosis was measured from angiograms before any treatment. The relationship between venous stenosis and age was assessed. Results We included 281 patients (mean age 39 years, age range 3–83 years, 55% male). Venous stenosis measuring ≥50% was present in 59 patients (21% of cohort). Peak age at presentation was 25–29 years, whereas peak frequency of venous stenosis ≥50% was 50–54 years. Venous stenosis was present in a significantly higher proportion of patients ≥50 years versus Conclusions Clinically significant Cerebral AVM draining vein stenosis appears to be associated with older age, suggesting that venous stenosis is a progressive disease that occurs by the same process that leads to intimal hyperplasia. These results should be confirmed with a population-based longitudinal study.
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e 086 effect of age on Cerebral Arteriovenous Malformation draining vein stenosis
Journal of NeuroInterventional Surgery, 2017Co-Authors: Sophia F. Shakur, Fady T. Charbel, Denise Brunozzi, Rahim Ismail, Ali AlarajAbstract:Introduction The pathogenesis of venous intimal hyperplasia and venous outflow stenosis associated with Cerebral Arteriovenous Malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and age. Methods All patients with an AVM seen at our institution between 1990–2016 who underwent a diagnostic Cerebral angiogram were retrospectively reviewed (n=281). Draining vein stenosis was measured from angiograms prior to any treatment. Relationship between venous stenosis, age, and age class (5 year increments) was assessed using linear regression analysis. Results 281 patients were included (mean age 39 years, age range 3-83 years, 55% male). Venous stenosis measuring ≥ 50% was present in 59 patients (21% of cohort). Higher percentage stenosis correlated significantly with older age class (R=+0.12, P=0.05) (Figure). Higher percentage stenosis also tended to be associated with older age (R=+0.11, P=0.07) (figure 1). Conclusion Higher percentage venous stenosis is associated with older age class, suggesting that venous stenosis is a progressive disease that occurs by the same process that leads to intimal hyperplasia. Disclosures: S. Shakur: None. D. Brunozzi: None. R. Ismail: None. F. Charbel: None. A. Alaraj: None.
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Cerebral Arteriovenous Malformation Flow Is Associated With Venous Intimal Hyperplasia.
Stroke, 2017Co-Authors: Sophia F. Shakur, Ahmed E. Hussein, Sepideh Amin-hanjani, Tibor Valyi-nagy, Fady T. Charbel, Ali AlarajAbstract:Background and Purpose—The pathogenesis of venous intimal hyperplasia and venous outflow stenosis associated with Cerebral Arteriovenous Malformation (AVM) draining veins is poorly understood. We s...
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relationship of pulsatility and resistance indices to Cerebral Arteriovenous Malformation angioarchitectural features and hemorrhage
Journal of Clinical Neuroscience, 2016Co-Authors: Sophia F. Shakur, Fady T. Charbel, Sepideh Aminhanjani, Hassan Mostafa, Victor A Aletich, Ali AlarajAbstract:Abstract The role that hemodynamics plays in the pathophysiology of Cerebral Arteriovenous Malformation (AVM) hemorrhage remains unclear. Here, we examine the relationship of pulsatility and resistance indices to AVM angioarchitectural features and hemorrhage. Records of patients with Cerebral AVMs evaluated at our institution between 2007–2014 and with flows obtained before treatment using quantitative magnetic resonance angiography (QMRA) were retrospectively reviewed. Flow volume rate and flow velocity were measured in primary arterial feeders and compared to their contralateral counterparts. Pulsatility index (PI) = [(systolic flow velocity − diastolic flow velocity)/mean flow velocity] and resistance index (RI) = [(systolic flow velocity − diastolic flow velocity)/systolic flow velocity] were calculated for each feeder and compared to the normal contralateral vessel. Relationships between PI, RI and AVM clinical and angioarchitectural features were assessed using linear regression. Seventy-two patients with a total of 101 feeder arteries were included. PI and RI were significantly lower in AVM arterial feeders compared to normal vessels, thereby resulting in significantly higher flow volume rates and flow velocities in feeder vessels. There was no significant association of PI and RI with hemorrhagic presentation, exclusive deep venous drainage, venous stenosis, single draining vein, or deep location. In conclusion, PI and RI can be measured using QMRA and are lower in AVM arterial feeders compared to normal vessels. Although we found no significant correlation between PI, RI, and AVM angioarchitectural characteristics thought to be associated with increased hemorrhage risk, future studies with larger sample sizes may better elucidate this relationship.
Varina Boerwinkle - One of the best experts on this subject based on the ideXlab platform.
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Multimodal Assessment of Cerebral Autoregulation and Autonomic Function After Pediatric Cerebral Arteriovenous Malformation Rupture
Neurocritical Care, 2020Co-Authors: Brian Appavu, Stephen Foldes, Brian T. Burrows, Austin Jacobson, Todd Abruzzo, Varina Boerwinkle, Anthony Willyerd, Tara Mangum, Vishal Gunnala, Iris MarkuAbstract:Background Management after Cerebral Arteriovenous Malformation (AVM) rupture aims toward preventing hemorrhagic expansion while maintaining Cerebral perfusion to avoid secondary injury. We investigated associations of model-based indices of Cerebral autoregulation (CA) and autonomic function (AF) with outcomes after pediatric Cerebral AVM rupture. Methods Multimodal neurologic monitoring data from the initial 3 days after Cerebral AVM rupture were retrospectively analyzed in children (
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multimodal assessment of Cerebral autoregulation and autonomic function after pediatric Cerebral Arteriovenous Malformation rupture
Neurocritical Care, 2020Co-Authors: Brian Appavu, Stephen Foldes, Brian T. Burrows, Austin Jacobson, Todd Abruzzo, Varina BoerwinkleAbstract:BACKGROUND Management after Cerebral Arteriovenous Malformation (AVM) rupture aims toward preventing hemorrhagic expansion while maintaining Cerebral perfusion to avoid secondary injury. We investigated associations of model-based indices of Cerebral autoregulation (CA) and autonomic function (AF) with outcomes after pediatric Cerebral AVM rupture. METHODS Multimodal neurologic monitoring data from the initial 3 days after Cerebral AVM rupture were retrospectively analyzed in children (< 18 years). AF indices included standard deviation of heart rate (HRsd), root-mean-square of successive differences in heart rate (HRrmssd), low-high frequency ratio (LHF), and baroreflex sensitivity (BRS). CA indices include pressure reactivity index (PRx), wavelet pressure reactivity indices (wPRx and wPRx-thr), pulse amplitude index (PAx), and correlation coefficient between intracranial pressure pulse amplitude and Cerebral perfusion pressure (RAC). Percent time of Cerebral perfusion pressure (CPP) below lower limits of autoregulation (LLA) was also computed for each CA index. Primary outcomes were determined using Pediatric Glasgow Outcome Score Extended-Pediatrics (GOSE-PEDs) at 12 months and acquired epilepsy. Association of biomarkers with outcomes was investigated using linear regression, Wilcoxon signed-rank, or Chi-square. RESULTS Fourteen children were analyzed. Lower AF indices were associated with poor outcomes (BRS [p = 0.04], HRsd [p = 0.04], and HRrmssd [p = 0.00]; and acquired epilepsy (LHF [p = 0.027]). Higher CA indices were associated with poor outcomes (PRx [p = 0.00], wPRx [p = 0.00], and wPRx-thr [p = 0.01]), and acquired epilepsy (PRx [p = 0.02] and wPRx [p = 0.00]). Increased time below LLA was associated with poor outcome (percent time below LLA based on PRx [p = 0.00], PAx [p = 0.04], wPRx-thr [p = 0.03], and RAC [p = 0.01]; and acquired epilepsy (PRx [p = 0.00], PAx [p = 0.00], wPRx-thr [p = 0.03], and RAC [p = 0.01]). CONCLUSIONS After pediatric Cerebral AVM rupture, poor outcomes are associated with AF and CA when applying various neurophysiologic model-based indices. Prospective work is needed to assess these indices of CA and AF in clinical decision support.
Jizong Zhao - One of the best experts on this subject based on the ideXlab platform.
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n6 methyladenosine methyltransferase mettl3 affects the phenotype of Cerebral Arteriovenous Malformation via modulating notch signaling pathway
Journal of Biomedical Science, 2020Co-Authors: Linjian Wang, Yimeng Xue, Ran Huo, Zihan Yan, Jia Wang, Qian Zhang, Yong Cao, Jizong ZhaoAbstract:Cerebral Arteriovenous Malformation (AVM) is a serious life-threatening congenital cerebrovascular disease. Specific anatomical features, such as nidus size, location, and venous drainage, have been validated to affect treatment outcomes. Until recently, molecular biomarkers and corresponding molecular mechanism related to anatomical features and treatment outcomes remain unknown. RNA N6-methyladenosine (m6A) Methyltransferase METTL3 was identified as a differentially expressed gene in groups with different lesion sizes by analyzing the transcriptome sequencing (RNA-seq) data. Tube formation and wound healing assays were performed to investigate the effect of METTL3 on angiogenesis. In addition, Methylated RNA Immunoprecipitation Sequencing technology (MeRIP-seq) was performed to screen downstream targets of METTL3 in endothelial cells and to fully clarify the specific underlying molecular mechanisms affecting the phenotype of Cerebral AVM. In the current study, we found that the expression level of METTL3 was reduced in the larger pathological tissues of Cerebral AVMs. Moreover, knockdown of METTL3 significantly affected angiogenesis of the human endothelial cells. Mechanistically, down-regulation of METTL3 reduced the level of heterodimeric Notch E3 ubiquitin ligase formed by DTX1 and DTX3L, thereby continuously activating the Notch signaling pathway. Ultimately, the up-regulated downstream genes of Notch signaling pathway dramatically affected the angiogenesis of endothelial cells. In addition, we demonstrated that blocking Notch pathway with DAPT could restore the phenotype of METTL3 deficient endothelial cells. Our findings revealed the mechanism by which m6A modification regulated the angiogenesis and might provide potential biomarkers to predict the outcome of treatment, as well as provide suitable pharmacological targets for preventing the formation and progression of Cerebral AVM.
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risk of Cerebral Arteriovenous Malformation rupture during pregnancy and puerperium
Neurology, 2014Co-Authors: Shuo Wang, Shuai Kang, Xun Ye, Yuanli Zhao, Dong Zhang, Rong Wang, Jizong ZhaoAbstract:Objective: To determine whether the risk of Arteriovenous Malformation (AVM) rupture is increased during pregnancy and puerperium. Methods: Participants included 979 female patients with intracranial AVM admitted to Beijing Tiantan Hospital between 1960 and 2010. Two neurosurgery residents reviewed medical records for each case. Of them, 393 patients with ruptured AVM between 18 and 40 years of age were used for case-crossover analysis. Number of children born and clinical information during pregnancy and puerperium were retrieved to identify whether AVM rupture occurred during this period. Results: Of the 979 women, 797 hemorrhages occurred during 25,578 patient-years of follow-up, yielding an annual hemorrhage rate of 3.11%. The annual AVM hemorrhage rate in patients aged 18 to 40 years (n = 579) was 2.78%, lower than the rate in other age groups (odds ratio = 0.75, 95% confidence interval 0.65–0.86, p Conclusions: No increased risk of hemorrhage was found in patients with Cerebral AVM during pregnancy and the puerperium. We therefore would not advise against pregnancy in women with intracranial AVM.