No abstract

SUMMARYAntibodies recognizing anionic phosphoiipids have bren described in systemic iupus erythemalosus (SLE) and other autoimmune diseases. Recent studies have shown that some of these antibodies may recognize a cardiolipin-binding protein (apolipoprotein H) rather than phosphoiipids. A similar possibility is conceivable for other cardiolipin-binding proieins that are targets of auioaniibodies. In this study we have addressed whether this might be the case for histones, a set of highly cationic and widely distributed proteins that react in a well known auloantibody system. Our results indicate that: (i) histones bind to anionic phosphoiipids (cardioiipin and phosphatidylserine) with high avidity, but not to zwitterionic phosphoiipids (phosphatidylcholine); (ii) monoclonal and polyclona! antihistone antibodies recognize histones bound to cardioiipin; (iii) the addition of histones to serum samples containing antihistone antibodies often enhances their anticardiolipin reactivity. In addition, we have found that antihistone-producing hybridomas derived from MKL-tpr mice may show anticardiolipin activity due to the presence of histones in the cell culture supernatants with the resultant formation of immune complexes. Taken together, the results suggest a potential role for histones in the anticardiolipin activity detected in sera containing antihistone antibodies. These histone phospholipid interactions should be taken into account when evaluating the pathogenic effects of antihistone antibodies or other autoantibodies reacting with nuclear components (e.g. nucleosomes) containing histones.

Aortic intramural hematoma (AIH) is an entity within the acute aortic syndrome. Combination of a priori probability, clinical history, laboratory blood test and imaging techniques are the basis for diagnosis of AIH. This review is focused on all aspects related to diagnosis of patients with AIH, from clinical to imaging and analytical.

Reference values and differences of LVTM and LVTM% in various cardiac conditions are given for the first time. Quantification of these parameters with CMR may be clinically useful in the differential diagnosis between left ventricular noncompaction and other cardiac diseases. Exclusion of LVT from myocardium alters left ventricular morphological and functional parameters, which have significant clinical importance.

Thoracic aortic dissection is a life-threatening disease with a high mortality rate and an elevated incidence of early and long-term complications. Advances in surgical treatment of ascending (Stanford type A) aortic dissection have helped improve patient survival, but follow-up imaging is critically important for the identification of postsurgical complications. Gadolinium-enhanced three-dimensional (3D) magnetic resonance (MR) angiography, along with multisection computed tomography, is the technique of choice for this purpose. For accurate assessment of 3D MR angiograms, it is important to know what surgical procedure was performed and to be familiar with the appearance of the normal postsurgical anatomy. A thorough understanding of potential postsurgical complications also is essential. Some complications (eg, formation of a periprosthetic hematoma or pseudoaneurysm, stenosis in a graft anastomosis) may derive from the prosthesis. Complications also may occur in the remnant of the native aorta, where persistent dissection distal to the prosthesis is common and may result in false channel thrombosis or aneurysmatic dilatation with collapse of the true lumen. Residual dissection that involves the supra-aortic trunks or the visceral aortic branches may produce neurologic effects or renal and mesenteric ischemia, respectively.