DoRA 2.0 | Database of Research Activity

Epicardial Adipose Tissue in Indigenous and Non-Indigenous Australians: Implications for Cardiometabolic Diseases

2019-01-01T00:00:00Z

Title: Epicardial Adipose Tissue in Indigenous and Non-Indigenous Australians: Implications for Cardiometabolic Diseases Authors: Sun, David F; Kangaharan, Nadarajah; Costello, Benedict; Nicholls, Stephen J; Emdin, Connor A; Tse, Rexson; Gallagher, Celine; Kaur, Amrina; Roberts-Thomson, Kurt C; Mahajan, Rajiv; Lau, Dennis H; Sanders, Prashanthan; Wong, Christopher X Abstract: Background: Obesity is prevalent in Indigenous populations who exhibit significant differences in body fat composition. While excess regional adiposity can be partially inferred from clinical measurements, noninvasive imaging allows for direct quantification of specific fat depots. Epicardial fat is a visceral adipose tissue that has been strongly associated with cardiometabolic disease in other populations. However, this ectopic fat depot has yet to be characterized in Indigenous populations. Methods: We studied 100 individuals matched for ethnicity (Indigenous Australian and Caucasian descent), age, gender, and body mass index. Epicardial and subcutaneous adipose tissue volumes was quantified with computed tomography. Associations of ethnicity and adiposity measures were assessed using linear regression. Results: Indigenous individuals had significantly greater epicardial fat volumes compared to non-Indigenous individuals (95.8±37.5 vs 54.1±27.6cm3, p<0.001). In contrast, subcutaneous fat volumes were comparable in Indigenous compared to non-Indigenous individuals (22.1±15.1 vs 20.3±13.5cm3, p=0.54). Sequential adjustment for age, gender, comorbidities, biochemical parameters, and medication use did not attenuate the association between Indigenous ethnicity and greater epicardial fat volume in multivariable models (B=43.0, p<0.001). Furthermore, this association did not materially change with the inclusion of various adiposity measures, such as body mass index, subcutaneous adipose tissue, or weight. Conclusions: Indigenous individuals have significantly greater epicardial fat, but similar subcutaneous fat volumes, compared to non-Indigenous individuals. This finding extends previous observations on body fat composition differences in these individuals, and supports the possibility that epicardial fat and other visceral adipose depots may be contributing to the greater burden of cardiovascular disease in Indigenous populations.

Stellate ganglionitis in sudden cardiac death: A case report

2021-09-01T00:00:00Z

Title: Stellate ganglionitis in sudden cardiac death: A case report Authors: Duffy, Michael; Garland, Jack; Ondruschka, Benjamin; Paton, Julian F R; Bardsley, Emma N; Wong, Christopher X; Stables, Simon; Tse, Rexson Abstract: Sudden cardiac death (SCD) is the most common natural cause of death. The hypothesized mechanism of death is an arrhythmia precipitated by increased sympathetic outflow. The left stellate ganglion provides sympathetic innervation to the heart and plays a role in arrhythmogensis. We present a SCD with stellate ganglionitis in which the inflammatory cells were characterized. The case was 37-year-old man who died from ischemic and hypertensive heart disease. The left stellate ganglion showed lymphocytic inflammation with features of humoral immune response. This case report provides evidence that stellate ganglionitis can be seen in SCD and raises the possible association between the two.

Elevated Cerebrospinal Fluid Sodium and Chloride Levels in a Saltwater Drowning Death

2019-09-01T00:00:00Z

Title: Elevated Cerebrospinal Fluid Sodium and Chloride Levels in a Saltwater Drowning Death Authors: Garland, Jack; Philcox, Winston; Kesha, Kilak; McCarthy, Sinead; Lam, Leo Chi Sing; Palmiere, Cristian; Hensby-Bennett, Sarah; Stables, Simon; Tse, Rexson Abstract: To ascribe a cause of death from drowning in a body immersed in water can be difficult because of the absence of specific postmortem findings and unreliable ancillary tests. Postmortem vitreous biochemical analysis is documented to be a useful adjunct ancillary test to aid the diagnosis of saltwater drowning. A major confounding factor in using postmortem vitreous is the effect of electrolyte diffusion and water osmosis during immersion. A recent animal study suggested that cerebrospinal fluid (CSF) biochemical analysis, which is unaffected by immersion, may be an alternative. However, to date, there are no human data to support this. We report a saltwater drowning death from presumed suicide in which the postmortem CSF sodium and chloride level was elevated compared with nonimmersion deaths. This case gives evidence to support the potential use of postmortem CSF sodium and chloride level as an adjunct to the diagnosis of saltwater drowning.

Combining Postmortem Cerebrospinal Fluid Biochemistry With Lung-to-Body Ratio to Aid the Diagnosis of Salt Water Drowning

2020-12-01T00:00:00Z

Title: Combining Postmortem Cerebrospinal Fluid Biochemistry With Lung-to-Body Ratio to Aid the Diagnosis of Salt Water Drowning Authors: Garland, Jack; Ondruschka, Benjamin; Palmiere, Cristian; Hu, Mindy; Philcox, Winston; Hensby-Bennett, Sarah; Stables, Simon; Kesha, Kilak; Glenn, Charley; Morrow, Paul; Tse, Rexson Abstract: Diagnosing drowning as a cause of death can pose many challenges for the forensic pathologist and a number of ancillary tests have been proposed to assist in the diagnosis, whether the body was in salt water or fresh water. Although elevated vitreous humor sodium and chloride is a reliable marker, its limitation to prolonged immersion has resulted in the recent investigation of cerebrospinal fluid (CSF) sodium and chloride as alternative matrix in cases of longer or unknown immersion times. This study investigated postmortem CSF from lumbar puncture (CSF_L_Na_Cl) and ventricular aspiration (CSF_Vent_Na_Cl), as well as lung/body (LB) ratio in the diagnosis of salt water drowning and performed comparison and combination testing of methods to improve diagnostic accuracy of the drowning diagnosis. This study found that CSF_L_Na_Cl was the most accurate method (89%) in the given cohort, but that CSF_Vent_Na_Cl and LB combined was the second most accurate method (83%), exceeding CSF_Vent_Na_Cl (77%) and LB (81%) used alone. These findings are useful for stratifying and prioritizing postmortem samples in the investigation of salt water drowning and also have significance for future studies using this methodology to combine and compare the accuracy of different investigations.