Alex R. Dalal
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View article: A cell and transcriptome atlas of human arterial vasculature
A cell and transcriptome atlas of human arterial vasculature Open
Arterial segments show differing disease propensities, yet mechanisms remain unknown. We compiled a transcriptomic and spatial atlas of healthy human arterial cells across multiple segments to understand these differences. Arteries demonst…
View article: Epigenomic landscape of single vascular cells reflects developmental origin and disease risk loci
Epigenomic landscape of single vascular cells reflects developmental origin and disease risk loci Open
Vascular sites have distinct susceptibility to atherosclerosis and aneurysm, yet the epigenomic and transcriptomic underpinning of vascular site-specific disease risk is largely unknown. Here, we performed single-cell chromatin accessibili…
View article: Rapid manufacturing of angiogenic cellular collagen patches for ischemic cardiomyopathy
Rapid manufacturing of angiogenic cellular collagen patches for ischemic cardiomyopathy Open
Background One in ten Americans carry a lifetime risk of ischemic heart failure, the most severe form of ischemic heart disease. Carrying a nearly 50% five‑year mortality rate, no interventional therapy exists to treat the underlying cause…
View article: Loeys-Dietz syndrome subtypes exhibit distinct clinical behavior and aortic cellular transcriptomic profiles
Loeys-Dietz syndrome subtypes exhibit distinct clinical behavior and aortic cellular transcriptomic profiles Open
Loeys-Dietz syndrome subtypes may demonstrate variable clinical outcomes after aortic root replacement. Distinct gene dysregulation patterns suggest varying smooth muscle cell-extracellular matrix interactions may participate in clinical v…
View article: A cell and transcriptome atlas of human arterial vasculature
A cell and transcriptome atlas of human arterial vasculature Open
Summary Contiguous arterial segments show different propensities for different vascular pathologies, yet mechanisms explaining these fundamental differences remain unknown. We sought to build a transcriptomic, cellular, and spatial atlas o…
View article: Almanac — Retrieval-Augmented Language Models for Clinical Medicine
Almanac — Retrieval-Augmented Language Models for Clinical Medicine Open
Our results show the potential for LLMs with access to domain-specific corpora to be effective in clinical decision-making. The findings also underscore the importance of carefully testing LLMs before deployment to mitigate their shortcomi…
View article: Comprehensive Integration of Multiple Single-Cell Transcriptomic Data Sets Defines Distinct Cell Populations and Their Phenotypic Changes in Murine Atherosclerosis
Comprehensive Integration of Multiple Single-Cell Transcriptomic Data Sets Defines Distinct Cell Populations and Their Phenotypic Changes in Murine Atherosclerosis Open
BACKGROUND: The application of single-cell transcriptomic (single-cell RNA sequencing) analysis to the study of atherosclerosis has provided unique insights into the molecular and genetic mechanisms that mediate disease risk and pathophysi…
View article: Smooth Muscle Cell Klf4 Expression Is Not Required for Phenotype Modulation or Aneurysm Formation in Marfan Syndrome Mice—Brief Report
Smooth Muscle Cell Klf4 Expression Is Not Required for Phenotype Modulation or Aneurysm Formation in Marfan Syndrome Mice—Brief Report Open
Background: Smooth muscle cell (SMC) phenotypic reprogramming toward a mixed synthetic-proteolytic state is a central feature of aortic root aneurysm in Marfan syndrome (MFS). Previous work identified Klf4 as a potential mediator of SMC pl…
View article: Lineage-Specific Induced Pluripotent Stem Cell–Derived Smooth Muscle Cell Modeling Predicts Integrin Alpha-V Antagonism Reduces Aortic Root Aneurysm Formation in Marfan Syndrome Mice
Lineage-Specific Induced Pluripotent Stem Cell–Derived Smooth Muscle Cell Modeling Predicts Integrin Alpha-V Antagonism Reduces Aortic Root Aneurysm Formation in Marfan Syndrome Mice Open
Background: The role of increased smooth muscle cell (SMC) integrin αv signaling in Marfan syndrome (MFS) aortic aneurysm remains unclear. Herein, we examine the mechanism and potential efficacy of integrin αv blockade as a therapeutic str…
View article: Outcomes of Reoperative Aortic Root Replacement After Previous Acute Type A Dissection Repair
Outcomes of Reoperative Aortic Root Replacement After Previous Acute Type A Dissection Repair Open
Limited aortic root repair for acute type A dissection is associated with greater risk of proximal reoperations compared to full aortic root replacement. Surgical outcomes for patients undergoing reoperative root replacement after previous…
View article: Outcomes after concomitant arch replacement at the time of aortic root surgery
Outcomes after concomitant arch replacement at the time of aortic root surgery Open
Hemiarch and total arch replacement are safe to perform at the time of aortic root intervention, with no significant differences in survival or stroke rates, but increased ventilator and blood product use.
View article: Blood transfusion in aortic root surgery impairs midterm survival
Blood transfusion in aortic root surgery impairs midterm survival Open
Aortic root replacement frequently requires RBC transfusion during and after the operation, but even after matching for observed preoperative and operative characteristics, RBC transfusion is associated with more frequent postoperative com…
View article: Embryologic Origin Influences Smooth Muscle Cell Phenotypic Modulation Signatures in Murine Marfan Syndrome Aortic Aneurysm
Embryologic Origin Influences Smooth Muscle Cell Phenotypic Modulation Signatures in Murine Marfan Syndrome Aortic Aneurysm Open
Background: Aortic root smooth muscle cells (SMC) develop from both the second heart field (SHF) and neural crest. Disparate responses to disease-causing Fbn1 variants by these lineages are proposed to promote focal aortic root aneurysm fo…
View article: The epigenomic landscape of single vascular cells reflects developmental origin and identifies disease risk loci
The epigenomic landscape of single vascular cells reflects developmental origin and identifies disease risk loci Open
Vascular sites have distinct susceptibility to atherosclerosis and aneurysm, yet the biological underpinning of vascular site-specific disease risk is largely unknown. Vascular tissues have different developmental origins that may influenc…
View article: Type A Aortic Dissection With Concurrent Aortic Valve Endocarditis, Subarachnoid Hemorrhage, and Disseminated Intravascular Coagulation
Type A Aortic Dissection With Concurrent Aortic Valve Endocarditis, Subarachnoid Hemorrhage, and Disseminated Intravascular Coagulation Open
We describe surgical repair of a Stanford Type A aortic dissection with concurrent aortic valve Streptococcus equi endocarditis in the setting of subarachnoid hemorrhage and disseminated intravascular coagulation. Multidisciplinary collabo…
View article: Relative strain is a novel predictor of aneurysmal degeneration of the thoracic aorta: An ex vivo mechanical study
Relative strain is a novel predictor of aneurysmal degeneration of the thoracic aorta: An ex vivo mechanical study Open
Aortic aneurysm surveillance and prophylactic surgical recommendations are based on computed tomographic angiogram aortic dimensions and growth rate measurements. However, aortic catastrophes may occur at small sizes, confounding current r…
View article: Quantitative proteomics reveal lineage-specific protein profiles in iPSC-derived Marfan syndrome smooth muscle cells
Quantitative proteomics reveal lineage-specific protein profiles in iPSC-derived Marfan syndrome smooth muscle cells Open
Marfan syndrome (MFS) is a connective tissue disorder caused by mutations in the FBN1 gene that produces wide disease phenotypic variability. The lack of ample genotype–phenotype correlation hinders translational study development aimed at…
View article: Long-term miR-29b suppression reduces aneurysm formation in a Marfan mouse model
Long-term miR-29b suppression reduces aneurysm formation in a Marfan mouse model Open
Aortic root aneurysm formation and subsequent dissection and/or rupture remain the leading cause of death in patients with Marfan syndrome. Our laboratory has reported that miR-29b participates in aortic root/ascending aorta extracellular …