Spotlight on the July 13 Issue

Natural History of Afferent Baroreflex Failure in Adults

This retrospective study reviewed clinical and laboratory data in patients diagnosed with afferent baroreflex failure (ABF). Neck radiation and surgeries were the most common etiologies, and all-cause mortality over a 20-year period was 39.4%. The authors concluded that ABF should be suspected in patients with history of neck cancer who present with labile hypertension and orthostatic hypotension.

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Large Mitochondrial DNA Deletions in HIV Sensory Neuropathy

The authors of this study examined the skin biopsy of 67 people with HIV and found an association between the extent of mitochondrial DNA (mtDNA) deletions and the presence of sensory neuropathy. This correlation suggests but does not prove that mtDNA deletions may play a role in the pathogenesis of peripheral neuropathies and that strategies to improve the mtDNA repair process may have therapeutic implications.

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Effect of Patent Foramen Ovale Closure After Stroke on Circulatory Biomarkers

To understand how patent foramen ovale (PFO) closure influences circulatory biomarkers, the authors sampled cardiac atrial and venous blood of patients before and after PFO closure. Homocysteine was the most significantly decreased factor in intracardiac plasma after complete PFO closure; it was reduced immediately and led to long-term reduction in peripheral blood. The results suggested that homocysteine could act as a biomarker to monitor residual shunting after closure.

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From editorialist O'Suilleabhain: “A greater value of this important report is in opening a new area of research into the role of pulmonary homeostasis into the nexus of PFO and stroke, and potentially migraine and dementia.”

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