Publicaciones: agosto 2024

A dual colorimetric-electrochemical microfluidic paper-based analytical device for point-of-care testing of ischemic strokes

Dortez S, Pacheco M, Gasull T, Crevillen AG, Escarpa A. Lab Chip. 2024 Aug 9. doi: 10.1039/d4lc00398e. Online ahead of print. PMID: 39118539
Abstract: A novel microfluidic paper-based analytical device with dual colorimetric and electrochemical detection (dual μPAD) was developed for the assessment of transferrin saturation (TSAT) in samples from ischemic stroke patients. TSAT was calculated from the ratio between transferrin-bound iron, which was colorimetrically measured, and the total iron-binding capacity, which was electrochemically measured. To this end, a μPAD was smartly designed, which integrated both colorimetric and electrochemical detection reservoirs, communicating via a microchannel acting as a chemical reactor, and with preloading/storing capabilities (reagent-free device). This approach allowed the dual and simultaneous determination of both parameters, providing an improvement in the reliability of the results due to an independent signal principle and processing. The μPADs were validated by analyzing a certified reference material, showing excellent accuracy (Er ≤ 5%) and precision (RSD ≤ 2%). Then they were applied to the analysis of diagnosed serum samples from ischemic stroke patients. The results were compared to those provided by a free-interference method (urea-PAGE). Impressively, both methods exhibited a good correlation (r = 0.96, p < 0.05) and no significant differences were found between them (slope 1.0 ± 0.1 and the intercept 1 ± 4, p < 0.05), demonstrating the excellent accuracy of our approach during the analysis of complex samples from ischemic stroke patients, using just 90 μL of clinical samples and taking less than 90 min in comparison with the 18 hours required by the urea-PAGE approach. The developed fully integrated colorimetric-electrochemical μPAD is a promising ready to use reagent-free device for the point-of-care testing of TSAT, which can be used to assist physicians in the fast diagnosis and prognosis of ischemic strokes, where the decision-time is crucial for the patient’s survival.
Funding: This work has been financially supported by the TRANSNANOAVANSENS program from the Community of Madrid (P2018/NMT-4349) (A. E.), by the grant PID2020-118154GB-I00 funded by MCIN/AEI/10.13039/501100011033 (A. E.), by the NEURO-CHIP-CM program from the Community of Madrid (Y2020/NMT6312) (A. E.), by the RICORS RD21/0006/0024 (NextGeneration EU funding) and 2021SGR00925 (Agencia de gestio d’Ajuts Universitaris i de Recerca de Catalunya) (T. G.), and by the Spanish Ministry of Economy and Competitiveness (CTQ2017-86441-C2-1-R, FPI fellowship (S. D.)).

Atrial Imaging and Cardiac Rhythm in Cryptogenic Embolic Stroke: The ARIES Study

Rigual R,Castrejón-Castrejón S, Fernández-Gassó L et al. J Am Heart Assoc. 2024 Sep 3;13(17):e036236. doi: 10.1161/JAHA.124.036236. Epub 2024 Aug 29. PMID: 39206739.

https://pubmed.ncbi.nlm.nih.gov/39206739/

Abstract: BACKGROUND: Unknown cardioembolic sources are frequent causes of cryptogenic stroke. We analyzed the risk of atrial fibrillation (AF) or high burden of ectopic atrial activity (HBEA) in patients with cryptogenic stroke, assessing atrial function and 1- year outcomes. METHODS AND RESULTS: The ARIES (Atrial Imaging and Cardiac Rhythm in Cryptogenic Embolic Stroke) study is an observational study including patients with cryptogenic stroke. We analyzed the frequency of AF and HBEA (>3000 atrial ectopic beats/day or >2 bursts or atrial tachycardia between 3 beats and ≤30 seconds) in two 30- day Holter- ECGs, comparing advanced echocardiography signs of left atrial (LA) dysfunction according to rhythm: AF, HBEA, and normal sinus rhythm. We also evaluated 1- year stroke recurrence and mortality. The study included 109 patients; 35 (32.1%) patients had AF, 27 (24.8%) HBEA, and 47 (43.1%) normal sinus rhythm. Compared with those with normal sinus rhythm, patients with AF presented higher 2- dimensional and 3- dimensional LA indexed volumes (38.8±11.2 versus 27.3±11.8 mL/m2, and 50.6±17.2 versus 34.0±15.4 mL/m2, respectively, P<0.001), lower 3- dimensional LA ejection fraction (50±14.6 versus 62.7±11.8, P=0.001), LA reservoir strain (22.0±8.6 versus 30.4±10.5, P<0.001), and LA contraction strain (10.5±8.18 versus 17.1±7.5, P<0.001), remaining significant in multivariate analysis. Patients with HBEA showed higher LA indexed volumes and lower LA reservoir strain than patients with normal sinus rhythm only in univariate analysis. There were no differences in ischemic recurrence or mortality among the groups. CONCLUSIONS: Patients with cryptogenic stroke showed a high incidence of AF and HBEA. AF is strongly related to LA volume, LA function, and LA reservoir and contraction strain, whereas HBEA showed milder structural changes. Advanced LA echocardiography could help patient selection for long- term ECG monitoring in suspected cardiac sources.

Funding: This project has been supported by a grant from the Stroke Project of the Cerebrovascular Diseases Study Group of the Spanish Society of Neurology, funded by Daiichi- Sankyo. This work was also supported by RICORS (Redes de Investigación Cooperativa Orientadas a Resultados en Salud) network under grant RD21/0006/0012.