RESUMEN
Attempts to create quantum degenerate gases without evaporative cooling have been pursued since the early days of laser cooling, with the consensus that polarization gradient cooling (PGC, also known as "optical molasses") alone cannot reach condensation. In the present work, we report that simple PGC can generate a small Bose-Einstein condensate (BEC) inside a corrugated micrometer-sized optical dipole trap. The experimental parameters enabling BEC creation were found by machine learning, which increased the atom number by a factor of 5 and decreased the temperature by a factor of 2.5, corresponding to almost 2 orders of magnitude gain in phase space density. When the trapping light is slightly misaligned through a microscopic objective lens, a BEC of â¼250 ^{87}Rb atoms is formed inside a local dimple within 40 ms of PGC after MOT loading.
RESUMEN
Quantum scrambling describes the spreading of information into many degrees of freedom in quantum systems, such that the information is no longer accessible locally but becomes distributed throughout the system. This idea can explain how quantum systems become classical and acquire a finite temperature, or how in black holes the information about the matter falling in is seemingly erased. We probe the exponential scrambling of a multiparticle system near a bistable point in phase space and utilize it for entanglement-enhanced metrology. A time-reversal protocol is used to observe a simultaneous exponential growth of both the metrological gain and the out-of-time-order correlator, thereby experimentally verifying the relation between quantum metrology and quantum information scrambling. Our results show that rapid scrambling dynamics capable of exponentially fast entanglement generation are useful for practical metrology, resulting in a 6.8(4)-decibel gain beyond the standard quantum limit.
RESUMEN
State-of-the-art atomic clocks are based on the precise detection of the energy difference between two atomic levels, which is measured in terms of the quantum phase accumulated over a given time interval1-4. The stability of optical-lattice clocks (OLCs) is limited both by the interrupted interrogation of the atomic system by the local-oscillator laser (Dick noise5) and by the standard quantum limit (SQL) that arises from the quantum noise associated with discrete measurement outcomes. Although schemes for removing the Dick noise have been recently proposed and implemented4,6-8, performance beyond the SQL by engineering quantum correlations (entanglement) between atoms9-20 has been demonstrated only in proof-of-principle experiments with microwave clocks of limited stability. The generation of entanglement on an optical-clock transition and operation of an OLC beyond the SQL represent important goals in quantum metrology, but have not yet been demonstrated experimentally16. Here we report the creation of a many-atom entangled state on an OLC transition, and use it to demonstrate a Ramsey sequence with an Allan deviation below the SQL after subtraction of the local-oscillator noise. We achieve a metrological gain of [Formula: see text] decibels over the SQL by using an ensemble consisting of a few hundred ytterbium-171 atoms, corresponding to a reduction of the averaging time by a factor of 2.8 ± 0.3. Our results are currently limited by the phase noise of the local oscillator and Dick noise, but demonstrate the possible performance improvement in state-of-the-art OLCs1-4 through the use of entanglement. This will enable further advances in timekeeping precision and accuracy, with many scientific and technological applications, including precision tests of the fundamental laws of physics21-23, geodesy24-26 and gravitational-wave detection27.
RESUMEN
Free radical driven lipid peroxidation is a chain reaction which can lead to oxidative degradation of biological membranes. Propagation vs. termination rates of peroxidation in biological membranes are determined by a variety of factors including fatty acyl chain composition, presence of antioxidants, as well as biophysical properties of mono- or bilayers. Sphingomyelins (SMs), a class of sphingophospholipids, were previously described to inhibit lipid oxidation most probably via the formation of H-bond network within membranes. To address the "antioxidant" potential of SMs, we performed LC-MS/MS analysis of model SM/glycerophosphatidylcholine (PC) liposomes with different SM fraction after induction of radical driven lipid peroxidation. Increasing SM fraction led to a strong suppression of lipid peroxidation. Electrochemical oxidation of non-liposomal SMs eliminated the observed effect, indicating the importance of membrane structure for inhibition of peroxidation propagation. High resolution MS analysis of lipid peroxidation products (LPPs) observed in in vitro oxidized SM/PC liposomes allowed to identify and relatively quantify SM- and PC-derived LPPs. Moreover, mapping quantified LPPs to the known pathways of lipid peroxidation allowed to demonstrate significant decrease in mono-hydroxy(epoxy) LPPs relative to mono-keto derivatives in SM-rich liposomes. The results presented here illustrate an important property of SMs in biological membranes, acting as "biophysical antioxidant". Furthermore, a ratio between mono-keto/mono-hydroxy(epoxy) oxidized species can be used as a marker of lipid peroxidation propagation in the presence of different antioxidants.
Asunto(s)
Cromatografía Liquida , Peroxidación de Lípido/efectos de los fármacos , Esfingomielinas/química , Esfingomielinas/farmacología , Espectrometría de Masas en Tándem , Antioxidantes/química , Antioxidantes/farmacología , Electroquímica , Radicales Libres/química , Liposomas/química , Oxidación-Reducción/efectos de los fármacos , Estrés Oxidativo/efectos de los fármacosRESUMEN
Hepatocellular carcinoma and cholangiocarcinoma are the most common primary malignant liver tumors. Since the liver plays a key role in lipid metabolism, the study of serum phospholipid (PL) profiles may provide a better understanding of alterations in hepatic lipid metabolism. In this study, we used a high-resolution HILIC-LC-MS lipidomic approach to establish the serum phospholipidome profile of patients with liver cancer before (T0) and after tumor resection (T1) and a control group (CT) of healthy individuals. After the analysis of PL profiles, we observed that the phospholipidome of patients with liver cancer was significantly modified after the tumor resection procedure. We observed an upregulation of some phosphatidylcholine (PtdCho) species, namely, PtdCho(36:6), PtdCho(42:6), PtdCho(38:5), PtdCho(36:5), PtdCho(38:6) and choline plasmalogens (PlsCho), and/or 1-O-alkyl-2-acyl-glycerophosphocholine (PakCho) in patients with liver cancer at T0 compared to the CT group, and a downregulation after tumor resection (T1) when compared to T0. These results show that LC-MS can detect different serum PL profiles in patients with liver cancer, before and after tumor resection, by defining a specific PL fingerprint that was used to determine the effect of tumor and tumor resection on lipid metabolism.
Asunto(s)
Procedimientos Quirúrgicos del Sistema Digestivo/efectos adversos , Lipidómica/métodos , Neoplasias Hepáticas/cirugía , Fosfolípidos/sangre , Anciano , Animales , Estudios de Casos y Controles , Cromatografía Liquida , Femenino , Humanos , Neoplasias Hepáticas/sangre , Masculino , Espectrometría de Masas , Persona de Mediana Edad , Fosfatidilcolinas/sangre , Plasmalógenos/sangreRESUMEN
We introduce a Magnetic Particle Imaging Susceptometer (MPIS) that uses a high-sensitivity atomic magnetometer (AM) for recording the spatial distribution of fluid-suspended magnetic nanoparticles. We have evaluated the MPIS performance by one-dimensional scans of structured nanoparticle phantoms, demonstrating, in particular, resolutions of ≈2.5 mm prior to deconvolution and << 1 mm after deconvolution. Our instrument conceptually follows the general principle of Magnetic Particle Imaging (MPI) for encoding spatial distributions into magnetic flux density variations. Conversely to previously demonstrated MPI methods, MPIS works in time-space by recording time series of the sample's magnetic response including all Fourier components. The device deploys a specifically designed system of coils, a low-frequency excitation scheme, and a simple source localization algorithm. The difference of the AM's frequency response with respect to the conventional receive coil detection allows us to work at much lower driving frequencies. We demonstrate operation at frequencies on the order of 100 Hz, enabling the beneficial use of larger nanoparticles. The spatial distribution encoded into the particles' susceptibility needs a much lower excitation field amplitude compared to conventional MPI scanners. These two features make MPIS least harmful for biological samples and subjects compared to conventional MPI scanners. We also address performance characteristics and other possible applications of MPIS.
Asunto(s)
Diagnóstico por Imagen/métodos , Nanopartículas de Magnetita/química , Magnetometría/métodos , Algoritmos , Diseño de Equipo , Fantasmas de ImagenRESUMEN
Obesity is a public health problem and a risk factor for pathologies such type 2 diabetes mellitus, cardiovascular diseases, and nonalcoholic fatty liver disease. Given these clinical implications, there is a growing interest to understand the pathophysiological mechanism of obesity. Changes in lipid metabolism have been associated with obesity and obesity-related complications. However, changes in the lipid profile of obese children have been overlooked. In the present work, we analyzed the serum phospholipidome of overweight and obese children by HILIC-MS/MS and GC-MS. Using this approach, we have identified 165 lipid species belonging to the classes PC, PE, PS, PG, PI, LPC, and SM. The phospholipidome of overweight (OW) and obese (OB) children was significantly different from normal-weight children (control). Main differences were observed in the PI class that was less abundant in OW and OB children and some PS, PE, SM, and PC lipid species are upregulated in obese and overweight children. Although further studies are needed to clarify some association between phospholipid alterations and metabolic changes, our results highlight the alteration that occurs in the serum phospholipid profile in obesity in children.
Asunto(s)
Lipidómica , Sobrepeso/sangre , Obesidad Infantil/sangre , Fosfolípidos/sangre , Adolescente , Niño , Femenino , Cromatografía de Gases y Espectrometría de Masas , Humanos , Metabolismo de los Lípidos/genética , Masculino , Sobrepeso/genética , Sobrepeso/patología , Obesidad Infantil/genética , Obesidad Infantil/patología , Fosfolípidos/genéticaRESUMEN
Spin squeezing can improve atomic precision measurements beyond the standard quantum limit (SQL), and unitary spin squeezing is essential for improving atomic clocks. We report substantial and nearly unitary spin squeezing in ^{171}Yb, an optical lattice clock atom. The collective nuclear spin of â¼10^{3} atoms is squeezed by cavity feedback, using light detuned from the system's resonances to attain unitarity. The observed precision gain over the SQL is limited by state readout to 6.5(4) dB, while the generated states offer a gain of 12.9(6) dB, limited by the curvature of the Bloch sphere. Using a squeezed state within 30% of unitarity, we demonstrate an interferometer that improves the averaging time over the SQL by a factor of 3.7(2). In the future, the squeezing can be simply transferred onto the optical-clock transition of ^{171}Yb.
RESUMEN
This manuscript described a dynamic simulation of uranyl nitrate crystallization in a linear crystallizer. Furthermore, a mathematical model of the crystallizer supply system was developed with a related control algorithm; the model contained two piston feeders. The results showed the crystallization process's sensitivity to the solution level in the crystallizer. An expression for calculating the performance of the crystallizer was proposed. That expression allowed us to understand that the accuracy of the liquid phase level (to avoid the crystallizer's performance decreasing by more than 5%) should be in the range of ±4% of the crystallization section height. For this, we developed a control algorithm for the supply system to support operability. This algorithm allowed us to maintain a specified level of mother solution in the crystallization area and provided an asynchronous operation mode for the piston batchers. Furthermore, this paper described how the developed mathematical model and the proposed control system, i.e., the envisaged recommendations, can be used to optimize the process during the design and adjustment of equipment.
RESUMEN
Oxidized LDL (oxLDL) has been shown to play a crucial role in the onset and development of cardiovascular disorders. The study of oxLDL, as an initiator of inflammatory cascades, led to the discovery of a variety of oxidized phospholipids (oxPLs) responsible for pro-inflammatory actions. Oxidized 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphocholine (PAPC) is frequently used by the scientific community as a representative oxPL mixture to study the biological effects of oxidized lipids, due to the high abundance of PAPC in human tissues and the biological activities of oxidized arachidonic acids derivatives. Most studies focusing on oxPAPC effects rely on in-house prepared mixtures of oxidized species obtained by exposing PAPC to air oxidation. Here, we described a multi-laboratory evaluation of the compounds in oxPAPC by LC-MS/MS, focusing on the identification and relative quantification of the lipid peroxidation products (LPPs) formed. PAPC was air-oxidized in four laboratories using the same protocol for 0, 48, and 72â¯h. It was possible to identify 55 different LPPs with unique elemental composition and characterize different structural isomeric species within these. The study showed good intra-sample reproducibility and similar qualitative patterns of oxidation, as the most abundant LPPs were essentially the same between the four laboratories. However, there were substantial differences in the extent of oxidation, i.e. the amount of LPPs relative to unmodified PAPC, at specific time points. This shows the importance of characterizing air-oxidized PAPC preparations before using them for testing biological effects of oxidized lipids, and may explain some variability of effects reported in the literature.
Asunto(s)
Aire/análisis , Ensayos de Aptitud de Laboratorios/normas , Fosfatidilcolinas/aislamiento & purificación , Terminología como Asunto , Cromatografía de Fase Inversa , Europa (Continente) , Humanos , Peroxidación de Lípido , Variaciones Dependientes del Observador , Fosfatidilcolinas/química , Fosfatidilcolinas/clasificación , Análisis de Componente Principal , Reproducibilidad de los Resultados , Soluciones , Espectrometría de Masas en TándemRESUMEN
The aminophospholipids (APL), phosphatidylethanolamine (PE) and phosphatidylserine (PS) are widely present in cell membranes and lipoproteins. Glucose and reactive oxygen species (ROS), such as the hydroxyl radical (â¢OH), can react with APL leading to an array of oxidised, glycated and glycoxidised derivatives. Modified APL have been implicated in inflammatory diseases and diabetes, and were identified as signalling molecules regulating cell death. However, the biological relevance of these molecules has not been completely established, since they are present in very low amounts, and new sensitive methodologies are needed to detect them in biological systems. Few studies have focused on the characterisation of APL modifications using liquid chromatography-tandem mass spectrometry (LC-MS/MS), mainly using C5 or C18 reversed phase (RP) columns. In the present study, we propose a new analytical approach for the characterisation of complex mixtures of oxidised, glycated and glycoxidised PE and PS. This LC approach was based on a reversed-phase C30 column combined with high-resolution MS, and higher energy C-trap dissociation (HCD) MS/MS. C30 RP-LC separated short and long fatty acyl oxidation products, along with glycoxidised APL bearing oxidative modifications on the glucose moiety and the fatty acyl chains. Functional isomers (e.g. hydroxy-hydroperoxy-APL and tri-hydroxy-APL) and positional isomers (e.g. 9-hydroxy-APL and 13-hydroxy-APL) were also discriminated by the method. HCD fragmentation patterns allowed unequivocal structural characterisation of the modified APL, and are translatable into targeted MS/MS fingerprinting of the modified derivatives in biological samples.
Asunto(s)
Glucosa/química , Glicerofosfatos/análisis , Lisofosfolípidos/análisis , Fosfatidiletanolaminas/análisis , Fosfatidilserinas/análisis , Cromatografía de Fase Inversa/métodos , Glicerofosfatos/química , Glicosilación , Humanos , Lisofosfolípidos/química , Oxidación-Reducción , Fosfatidiletanolaminas/química , Fosfatidilserinas/química , Soluciones , Espectrometría de Masas en TándemRESUMEN
Recent evidence suggests that phosphatidylserine (PS) and its oxidized species drive the clearance of apoptotic cells by macrophages with putative immune response modulation. However, it is not clear whether PS and oxidized PS differentially modulate at molecular level the functional responses of macrophages. Therefore, we proposed in this work to explore this question by evaluating the influence of PS oxidation products on the macrophages inflammatory status. Thus, we determined the effects of oxidized 1-palmitoyl-2-linoleoyl-phosphatidylserine (oxPLPS) and PLPS on RAW 264.7 macrophages production of the pro-inflammatory mediator nitric oxide (NO) and on the levels of the inducible NO synthase (Nos2) and Il1ß mRNA. The ability of PLPS and oxPLPS to modulate the lipopolysaccharide (LPS)-triggered macrophage activation was also analyzed. Finally, the effects of PLPS species over canonical inflammation-associated signaling pathways, such as nuclear factor (NF)-κB and mitogen-activated protein kinases (MAPKs) were also disclosed. The results obtained showed that both PLPS and oxPLPS species are deprived of intrinsic pro-inflammatory activity. Exquisitely, only oxPS were found to significantly inhibit NO production and iNos and IL1ß genes transcription induced by LPS. At a molecular level, these effects were partially due to attenuation of LPS-induced c-Jun-N-terminal kinase (JNK) phosphorylation and p65 NF-κB nuclear translocation. Overall our data suggest that oxPLPS, but not native PLPS, mitigates pro-inflammatory signaling in macrophages, contributing to containment of inflammation during apoptotic cell engulfment.
Asunto(s)
Proteínas Quinasas JNK Activadas por Mitógenos/metabolismo , Lipopolisacáridos/farmacología , Sistema de Señalización de MAP Quinasas/efectos de los fármacos , Macrófagos/efectos de los fármacos , FN-kappa B/metabolismo , Fosfatidilserinas/farmacología , Animales , Apoptosis/efectos de los fármacos , Inflamación/metabolismo , Interleucina-1beta/genética , Macrófagos/metabolismo , Ratones , Óxido Nítrico/antagonistas & inhibidores , Óxido Nítrico/metabolismo , Óxido Nítrico Sintasa de Tipo II/genética , Óxido Nítrico Sintasa de Tipo II/metabolismo , Oxidación-Reducción , Fosfatidilserinas/química , Células RAW 264.7 , ARN Mensajero/genética , Transcripción Genética/efectos de los fármacosRESUMEN
The biological functions of modified aminophospholipids (APL) have become a topic of interest during the last two decades, and distinct roles have been found for these biomolecules in both physiological and pathological contexts. Modifications of APL include oxidation, glycation, and adduction to electrophilic aldehydes, altogether contributing to a high structural variability of modified APL. An outstanding technique used in this challenging field is mass spectrometry (MS). MS has been widely used to unveil modified APL of biological interest, mainly when associated with soft ionization methods (electrospray and matrix-assisted laser desorption ionization) and coupled with separation techniques as liquid chromatography. This review summarizes the biological roles and the chemical mechanisms underlying APL modifications, and comprehensively reviews the current MS-based knowledge that has been gathered until now for their analysis. The interpretation of the MS data obtained by in vitro-identification studies is explained in detail. The perspective of an analytical detection of modified APL in clinical samples is explored, highlighting the fundamental role of MS in unveiling APL modifications and their relevance in pathophysiology.
Asunto(s)
Espectrometría de Masas/métodos , Fosfolípidos/química , Aldehídos/química , Aminación , Animales , Glicosilación , Humanos , Oxidación-ReducciónRESUMEN
Epidemiological studies show increasing prevalence rates of cognitive decline and hearing loss with age, particularly after the age of 65 years. These conditions are reported to be associated, although conclusive evidence of causality and implications is lacking. Nevertheless, audiological and cognitive assessment among elderly people is a key target for comprehensive and multidisciplinary evaluation of the subject's frailty status. To evaluate the use of tools for identifying older adults at risk of hearing loss and cognitive decline and to compare skills and abilities in terms of hearing and cognitive performances between older adults and young subjects, we performed a prospective cross-sectional study using supraliminal auditory tests. The relationship between cognitive assessment results and audiometric results was investigated, and reference ranges for different ages or stages of disease were determined. Patients older than 65 years with different degrees of hearing function were enrolled. Each subject underwent an extensive audiological assessment, including tonal and speech audiometry, Italian Matrix Sentence Test, and speech audiometry with logatomes in quiet. Cognitive function was screened and then verified by experienced clinicians using the Montreal Cognitive Assessment Score, the Geriatric Depression Scale, and further investigations in some. One hundred twenty-three subjects were finally enrolled during 2016-2019: 103 were >65 years of age and 20 were younger participants (as controls). Cognitive functions showed a correlation with the audiological results in post-lingual hearing-impaired patients, in particular in those affected by slight to moderate hearing loss and aged more than 70 years. Audiological testing can thus be useful in clinical assessment and identification of patients at risk of cognitive impairment. The study was limited by its sample size (CI 95%; CL 10%), strict dependence on language, and hearing threshold. Further investigations should be conducted to confirm the reported results and to verify similar screening models.
RESUMEN
Aminophospholipids (APL), phosphatidylethanolamine (PE) and phosphatidylserine (PS), can be oxidized upon oxidative stress. Oxidized PE and PS have been detected in clinical samples of different pathologies and may act as modulators of the inflammatory response. However, few studies have focused on the effects of oxidized APL (ox-APL) esterified with arachidonic acid, even though a considerable number of studies have assessed the modulation of the immune system by oxidized 1-palmitoyl-2-arachidonoyl-sn-3-glycerophosphocholine (OxPAPC). In the present study, we have used flow cytometry to evaluate the ability of oxidized PAPE (OxPAPE) and PAPS (OxPAPS) to promote or suppress an inflammatory phenotype on monocytes subsets and myeloid dendritic cells (mDCs). The results indicate that OxPAPE increases the frequency of all monocyte subpopulations expressing TNF-α, which promotes an inflammatory response. However, immune cell stimulation with OxPAPE in the presence of LPS results in a decrease of TNF-α expressed by classical monocytes. Incubation with OxPAPS and LPS induces a decrease in TNF-α produced by monocytes, and a significant decrease in IL-1ß expressed by monocytes and mDCs, indicating that OxPAPS reduces the LPS-induced pro-inflammatory expression in these populations. These results show the importance of OxPAPE and OxPAPS as modulators of the inflammatory response and demonstrate their possible contribution to the onset and resolution of human diseases related to oxidative stress and inflammation.
Asunto(s)
Fosfolípidos/metabolismo , Citocinas/metabolismo , Humanos , Inflamación/inmunología , Monocitos/metabolismo , Oxidación-Reducción , Fosfolípidos/sangreRESUMEN
Endothelial dysfunction has been widely associated with oxidative stress, glucotoxicity and lipotoxicity and underlies the development of cardiovascular diseases (CVDs), atherosclerosis and diabetes. In such pathological conditions, lipids are emerging as mediators of signalling pathways evoking key cellular responses as expression of proinflammatory genes, proliferation and apoptosis. Hence, the assessment of lipid profiles in endothelial cells (EC) can provide valuable information on the molecular alterations underlying CVDs, atherosclerosis and diabetes. We performed a lipidomic approach based on hydrophilic interaction liquid chromatography-tandem mass spectrometry (HILIC-MS/MS) for the analysis of the phospholipidome of bovine aortic EC (BAEC) exposed to oxidative (H2O2), glycative (glucose), or lipoxidative (4-hydroxynonenal, HNE) stress. The phospholipid (PL) profile was evaluated for the classes PC, PE, PS, PG, PI, SM, LPC and CL. H2O2 induced a more acute adaptation of the PL profile than glucose or HNE. Unsaturated PL molecular species were up-regulated after 24 h incubation with H2O2, while an opposite trend was observed in glucose- and HNE-treated cells. This study compared, for the first time, the adaptation of the phospholipidome of BAEC upon different induced biochemical stresses. Although further biological studies will be necessary, our results unveil specific lipid signatures in response to characteristic types of stress.
Asunto(s)
Células Endoteliales/metabolismo , Fosfolípidos/metabolismo , Animales , Enfermedades Cardiovasculares/metabolismo , Bovinos , Cromatografía Liquida , Células Endoteliales de la Vena Umbilical Humana , Humanos , Peróxido de Hidrógeno/metabolismo , Interacciones Hidrofóbicas e Hidrofílicas , Lipoproteínas LDL/metabolismo , Estrés Oxidativo , Espectrometría de Masa por Ionización de Electrospray , Espectrometría de Masas en TándemRESUMEN
Vinyl sulfones are used for drug design of irreversible inhibitors of cysteine proteases since they are able to alkylate cysteine thiols inside the catalytic pocket of this class of enzymes. Some authors have reported the lack of reactivity towards glutathione as sufficient evidence of the selectivity of such a mechanism. Herein, we demonstrate that some simple molecules containing a vinyl sulfone moiety are not thiol-specific alkylants since they react with some albumin nucleophiles including side chains of Cys34 and His146. Such side-reactions are not desirable for any drug candidate since they limit serum stability, bioavailability and they possibly trigger toxicity mechanisms. In silico predictions, indicate that the compounds tested share similar structural features with reported inhibitors of cysteine proteases, as well as similar poses around the main albumin nucleophiles. Altogether, the data suggest that albumin is better than glutathione for the setup of early in vitro tests probing the selectivity of cysteine protease inhibitors.
Asunto(s)
Inhibidores de Cisteína Proteinasa/farmacología , Sondas Moleculares/química , Albúmina Sérica/química , Sulfonas/química , Secuencia de AminoácidosRESUMEN
OBJECTIVES: Aortic valvuloplasty could represent an alternative to valve replacement resulting in optimal haemodynamic conditions, avoiding anticoagulation and allowing, in young people, normal aortic annulus growth. We analysed our results of aortic valve repair for incompetence due to leaflets and root pathology. METHODS: From January 2003 to January 2013, 235 patients affected by aortic valve regurgitation, pure or associated with aortic dilatation, were treated with a combination of the principal leaflet repair techniques and, when necessary, sparing procedures. Of these patients, 218 were considered eligible in this study. All of them were submitted to pre- and postoperative transthoracic echocardiography and pre- and post-repair transoesophageal echocardiography. Follow-up was achieved with periodic echocardiograms and clinical evaluations. RESULTS: Eight patients (3.40%) died before discharge. Median clinical and echocardiographic follow-up for all patients was 2.94 (1.41-5.41) years. Mean cross-clamping time was 101.94 ± 40.22 min and mean hospital stay was 10 ± 6.69 days. Kaplan-Meier freedom from aortic regurgitation >2 and freedom from aortic valve replacement were, respectively, 92.9 ± 2.8 and 94.5 ± 2.5% at 9.24 years: 6 patients (2.75%) were reoperated on with aortic valve replacement for severe aortic regurgitation. We also observed a good effect of aortic surgery on the left ventricle: the end-diastolic volume decreased from 137.89 ± 50.23 ml in the preop to 105.17 ± 31.19 ml at follow-up. CONCLUSIONS: Aortic valve leaflet repair seems to be a good and feasible option for selected patients, both alone or associated with an aortic sparing technique concerning long-term results.