Publications
Below you can find a list of our published research.
Below you can find a list of our published research.
36 results
The Thoracic and cardiovascular surgeon, 12 2 2024 Sex Differences in the Histopathology of Acute Type A Aortic Dissections. Grewal N, Dolmaci OB, Klautz RJ, Poelmann RE
Background: Although sex-related differences in cardiovascular surgery outcomes have increasingly garnered attention in the past decades, knowledge about sex disparities in the pathophysiology of acute type A aortic dissections (ATAADs) remains sparse. In this study, we evaluate the histopathologic and atherosclerotic lesions in female and male ATAAD patients. Methods: A total of 68 patients were studied: 51 ATAAD patients (mean age: 62.5 ± 10.8 years; 49% women) and 17 control patients (mean... Abstract
Cited 1 times since 2023 (2 per year) source: EuropePMC
International journal of molecular sciences, Volume 24, Issue 21, 27 4 2023, Pages 15640 Evidence Accumulates: Patients with Ascending Aneurysms Are Strongly Protected from Atherosclerotic Disease. Waldron C, Zafar MA, Ziganshin BA, Weininger G, Grewal N, Elefteriades JA
Ascending thoracic aortic aneurysms may be fatal upon rupture or dissection and remain a leading cause of death in the developed world. Understanding the pathophysiology of the development of ascending thoracic aortic aneurysms may help reduce the morbidity and mortality of this disease. In this review, we will discuss our current understanding of the protective relationship between ascending thoracic aortic aneurysms and the development of atherosclerosis, including decreased carotid intima-med... Abstract
BMC cardiovascular disorders, Volume 23, Issue 1, 19 3 2023, Pages 363 Thoracic aortic atherosclerosis in patients with a bicuspid aortic valve; a case-control study. Dolmaci OB, Klautz RJM, Poelmann RE, Lindeman JHN, Sprengers R, Kroft L, Grewal N
Introduction: Bicuspid aortic valve (BAV) patients have an increased risk to develop thoracic aortic complications. Little is known about the prevalence and severity of atherosclerosis in the BAV ascending aortic wall. This study evaluates and compares the prevalence of thoracic aortic atherosclerosis in BAV and tricuspid aortic valve (TAV) patients. Methods: Atherosclerosis was objectified using three diagnostic modalities in two separate BAV patient cohorts (with and without an aortic dilatati... Abstract
Cited 2 times since 2023 (2.4 per year) source: EuropePMC
Pathology, research and practice, Volume 248, 28 4 2023, Pages 154620 Intrinsic histological and morphological abnormalities of the pediatric thoracic aorta in bicuspid aortic valve patients are predictive for future aortopathy. Grewal N, Klautz RJM, Poelmann RE
Background: Patients with a bicuspid aortic valve (BAV) have an increased risk to develop aortic complications. Many studies are pointing towards a possible embryonic explanation for the development of both a bicuspid aortic valve as well as a defective ascending aortic wall in these patients. The fetal and newborn ascending aortic wall has however scarcely been studied in bicuspid aortic valve patients. We hypothesize that early histopathological defects might already be visible in the fetal an... Abstract
Indian journal of thoracic and cardiovascular surgery, Volume 39, Issue Suppl 2, 5 1 2023, Pages 233-238 Is the intimal thickness a key contributor to thoracic aortopathy? Grewal N, Poelmann R
Background: An aortic dissection is the most devastating complication of thoracic aortic disease. Several non- and syndromic conditions such as a bicuspid aortic valve (BAV) and Marfan syndrome (MFS) have a severely increased risk to develop a thoracic aortic aneurysm and dissection. To date, the medial layer has been extensively studied in search of the pathogenetic mechanisms leading to aortic complications. Objective: We aim to determine whether intimal layer pathology is characteristic in al... Abstract
Indian journal of thoracic and cardiovascular surgery, Volume 39, Issue Suppl 2, 25 4 2023, Pages 270-279 The role of transforming growth factor beta in bicuspid aortic valve aortopathy. Grewal N, Dolmaci O, Klautz A, Legue J, Driessen A, Klautz R, Poelmann R
A bicuspid aortic valve (BAV) is the most prevalent congenital cardiac deformity, which is associated with an increased risk to develop a thoracic aortic aneurysm and/or an aortic dissection as compared to persons with a tricuspid aortic valve. Due to the high prevalence of a BAV in the general population and the associated life-long increased risk for adverse vascular events, BAV disease places a considerable burden on the public health. The aim of the present review is to discuss the role of t... Abstract
Frontiers in cardiovascular medicine, Volume 10, 28 4 2023, Pages 1127685 Adventitial adaptive immune cells are associated with ascending aortic dilatation in patients with a bicuspid aortic valve. Staal AHJ, Cortenbach KRG, Gorris MAJ, van der Woude LL, Srinivas M, Heijmen RH, Geuzebroek GSC, Grewal N, Hebeda KM, de Vries IJM, DeRuiter MC, van Kimmenade RRJ
Background: Bicuspid aortic valve (BAV) is associated with ascending aorta aneurysms and dissections. Presently, genetic factors and pathological flow patterns are considered responsible for aneurysm formation in BAV while the exact role of inflammatory processes remains unknown. Methods: In order to objectify inflammation, we employ a highly sensitive, quantitative immunohistochemistry approach. Whole slides of dissected, dilated and non-dilated ascending aortas from BAV patients were quantitat... Abstract
Frontiers in cardiovascular medicine, Volume 10, 9 2 2023, Pages 1018167 Thoracic aortopathy in Marfan syndrome overlaps with mechanisms seen in bicuspid aortic valve disease. Grewal N, Dolmaci O, Jansen E, Klautz R, Driessen A, Poelmann RE
Background: Thoracic aortopathy is a serious complication which is more often seen in patients with Marfan syndrome (MFS) and patients with a bicuspid aortic valve (BAV) than in individuals with a tricuspid aortic valve (TAV). The identification of common pathological mechanisms leading to aortic complications in non-syndromic and syndromic diseases would significantly improve the field of personalized medicine. Objective: This study sought to compare thoracic aortopathy between MFS, BAV, and TA... Abstract
Frontiers in cardiovascular medicine, Volume 10, 2 1 2023, Pages 1097201 Commentary: Transforming growth factor serum concentrations in patients with proven non-syndromic aortopathy. Grewal N, Klautz R, Poelmann RE
Cited 1 times since 2023 (0.8 per year) source: EuropePMC
Frontiers in cardiovascular medicine, Volume 9, 12 2 2023, Pages 1036522 Risk for acquired coronary artery disease in genetic vs. congenital thoracic aortopathy. Dolmaci OB, Ayyildiz T, Poelmann RE, Driessen AHG, Koolbergen DR, Klautz RJM, Lindeman JHN, Grewal N
Objective: Patients with Marfan syndrome (MFS) and patients with a bicuspid aortic valve (BAV) have a significantly increased risk to develop thoracic aortopathy. Both conditions share many pathophysiological mechanisms leading to aortic complications. Bicuspidy is known to have a low risk for acquired coronary artery sclerosis. The aim of this study is to determine the risk of coronary sclerosis in MFS patients. Methods: Marfan syndrome patients with an aortic root dilatation, which were surgic... Abstract
Cited 3 times since 2023 (2.3 per year) source: EuropePMC
Frontiers in cardiovascular medicine, Volume 9, 9 2 2023, Pages 1032755 Are acute type A aortic dissections atherosclerotic? Grewal N, Dolmaci O, Jansen E, Klautz R, Driessen A, Lindeman J, Poelmann RE
Background: Type A aortic dissections (TAAD) are devastating aortic complications. Patients with Marfan syndrome, a bicuspid aortic valve or a thoracic aortic aneurysm have an increased risk to develop a TAAD. These predisposing conditions are characterized by a histologically thin intimal layer and hardly any atherosclerosis. Little is known about the susceptibility for atherosclerosis in patients with a type A aortic dissection. Objective: We aim to systematically describe atherosclerotic lesi... Abstract
Cited 2 times since 2022 (1.5 per year) source: EuropePMC
Journal of clinical medicine, Volume 12, Issue 1, 29 5 2022, Pages 272 Are Thoracic Aortic Aneurysm Patients at Increased Risk for Cardiovascular Diseases? Dolmaci OB, El Mathari S, Driessen AHG, Klautz RJM, Poelmann RE, Lindeman JHN, Grewal N
Objectives: Abdominal aortic aneurysms are associated with a sharply increased cardiovascular risk. Cardiovascular risk management is therefore recommended in prevailing guidelines for abdominal aneurysm patients. It has been hypothesized that associated risk relates to loss of aortic compliance. If this hypothesis is correct, observations for abdominal aneurysms would also apply to thoracic aortic aneurysms. The objective of this study is to test whether thoracic aneurysms are also associated w... Abstract
Indian journal of thoracic and cardiovascular surgery, Volume 39, Issue 2, 1 1 2022, Pages 209-210 Letter to the editor: The motivators and barriers to a career in cardiothoracic surgery: a cross-sectional study among surgical residents in India. Grewal N, Eberl S
Cited 1 times since 2022 (0.7 per year) source: EuropePMC
Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology, Volume 63, 18 3 2022, Pages 107498 Can transforming growth factor beta and downstream signalers distinguish bicuspid aortic valve patients susceptible for future aortic complications? Grewal N, Klautz R, Poelmann RE
Patients with a bicuspid aortic valve have an extreme high risk to develop a thoracic aortic aneurysm and dissection (TAAD). TAADs form a leading cause of death worldwide, with the majority of deaths being preventable if individuals at risk are identified and properly managed. Risk stratification for TAADs in bicuspidy is so far solely based on the aortic diameter. Exclusive use of aortic wall dimension, as in the current guidelines, is however not sufficient in selecting patients vulnerable for... Abstract
Cited 2 times since 2022 (1.4 per year) source: EuropePMC
Journal of cardiac surgery, Volume 37, Issue 12, 6 1 2022, Pages 4207-4208 Can general histopathology distinguish bicuspid aortopathy? Grewal N, Driessen A, Klautz RJM, Poelmann RE
Cited 6 times since 2022 (3.8 per year) source: EuropePMC
Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology, Volume 62, 23 4 2022, Pages 107478 Structural abnormalities in the non-dilated ascending aortic wall of bicuspid aortic valve patients. Grewal N, Girdauskas E, Idhrees M, Velayudhan B, Klautz R, Driessen A, Poelmann RE
Background: A bicuspid aortic valve (BAV) is the most common congenital cardiac malformation. The development of the aortic valve is closely related to the development of the ascending aorta, associated with structural differences in the bicuspid aorta. Here we describe the non-dilated ascending aortic wall in bicuspid aortic valve patients. Methods: BAV (n=41) and tricuspid aortic valve (TAV) (n=18) non-dilated ascending aortic wall samples were studied. We investigated the following features o... Abstract
Cited 12 times since 2022 (6.6 per year) source: EuropePMC
Annals of cardiothoracic surgery, Volume 11, Issue 4, 1 1 2022, Pages 380-388 Normal and abnormal development of the aortic valve and ascending aortic wall: a comprehensive overview of the embryology and pathology of the bicuspid aortic valve. Grewal N, Gittenberger-de Groot AC, Lindeman JH, Klautz A, Driessen A, Klautz RJM, Poelmann RE
A bicuspid aortic valve (BAV) is the most prevalent congenital cardiac anomaly, in which the valve has only two leaflets, instead of the normal three. Patients with a BAV have an increased risk of aneurysm formation and the development of an aortic dissection. Vascular smooth muscle cells in both the non- and dilated aortic wall are characterized by a maturation defect in all BAV patients, as compared to patients with a tricuspid aortic valve, which can contribute to inherent developmental susce... Abstract
Cited 1 times since 2022 (0.5 per year) source: EuropePMC
Journal of cardiothoracic surgery, Volume 17, Issue 1, 7 1 2022, Pages 108 Accuracy of point-of-care coagulation testing during cardiopulmonary bypass in a patient post COVID-19 infection. Grewal N, Yousef D, Palmen M, Klautz R, Eikenboom J, Wink J
Introduction: Extracorporeal circulation (ECC) in cardiac surgery is performed under systemic heparinization. Adequacy of heparin therapy and anticoagulation during ECC is assessed by activated clotting time (ACT), although there are concerns regarding the reliability of this measure. The ACT can be affected by factors other than heparin anticoagulation. A novel factor that should be considered is the influence of a COVID-19 infection. More than half of the hospitalized COVID-19 patients develop... Abstract
Cited 1 times since 2021 (0.4 per year) source: EuropePMC
Indian heart journal, Volume 74, Issue 1, 2 1 2021, Pages 76-78 Acute aortic syndromes in India: The need for a nationwide program to increase awareness. Shetty V, Shetty D, Grewal N
Acute aortic dissection is a rare, but potentially life-threatening and time-critical condition that is frequently misdiagnosed. Therefore, its prompt and proper diagnosis is vital to increase a patient's chance of survival and to prevent grievous complications. Raising awareness and educating the general population and healthcare professionals about an aortic dissection is mandatory, for early diagnosis and improving the chances of survival. Abstract
Cited 5 times since 2021 (2 per year) source: EuropePMC
Journal of cardiovascular development and disease, Volume 8, Issue 10, 15 3 2021, Pages 132 Ventricular Septation and Outflow Tract Development in Crocodilians Result in Two Aortas with Bicuspid Semilunar Valves. Poelmann RE, Gittenberger-de Groot AC, Goerdajal C, Grewal N, De Bakker MAG, Richardson MK
Background: The outflow tract of crocodilians resembles that of birds and mammals as ventricular septation is complete. The arterial anatomy, however, presents with a pulmonary trunk originating from the right ventricular cavum, and two aortas originating from either the right or left ventricular cavity. Mixing of blood in crocodilians cannot occur at the ventricular level as in other reptiles but instead takes place at the aortic root level by a shunt, the foramen of Panizza, the opening of whi... Abstract