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Fatin Malek Rivan N, Murukesu RR, Shahar S, Fadilah Rajab N, Subramaniam P, Choon Ooi T, Zul Amin Kamaruddin M, Singh DKA. Synergistic effects of cognitive frailty and comorbidities on disability: a community-based longitudinal study. BMC Geriatr 2024; 24:448. [PMID: 38778287 PMCID: PMC11112824 DOI: 10.1186/s12877-024-05057-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE In this study, we aimed to assess the synergistic effects of cognitive frailty (CF) and comorbidity on disability among older adults. METHODS Out of the 1318 participants from the Malaysian Towards Useful Aging (TUA) study, only 400 were included in the five-year follow-up analysis. A comprehensive interview-based questionnaire covering socio-demographic information, health status, biochemical indices, cognitive and physical function, and psychosocial factors was administered. Binary logistic regression analysis was employed to estimate the independent and combined odd ratios (ORs). Measures such as the relative excess risk due to interaction (RERI), the attributable proportion of risk due to the interaction, and the synergy index were used to assess the interaction between CF and comorbidity. RESULTS Participants with CF (24.1%) were more likely to report disability compared to those without CF (10.3%). Synergistic effects impacting disability were observed between CF and osteoarthritis (OA) (OR: 6.675, 95% CI: 1.057-42.158; RERI: 1.501, 95% CI: 1.400-1.570), CF and heart diseases (HD) (OR: 3.480, 95% CI: 1.378-8.786; RERI: 0.875, 95% CI: 0.831-0.919), CF and depressive symptoms (OR: 3.443, 95% CI: 1.065-11.126; RERI: 0.806, 95% CI: 0.753-0.859), and between CF and diabetes mellitus (DM) (OR: 2.904, 95% Confidence Interval (CI): 1.487-5.671; RERI: 0.607, 95% CI: 0.577-0.637). CONCLUSION These findings highlight the synergism between the co-existence of CF and comorbidity, including OA, HD, DM, and depressive symptoms, on disability in older adults. Screening, assessing, and managing comorbidities, especially OA, HD, DM and depressive symptoms, when managing older adults with CF are crucial for reducing the risk of or preventing the development of disability.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Resshaya Roobini Murukesu
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
- TUM School of Medicine & Health, Department of Health and Sport Sciences, Technical University of Munich, Munich, Germany
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Science Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Ponnusamy Subramaniam
- Health Psychology Programme and Centre of Rehabilitation Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Theng Choon Ooi
- Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Mohd Zul Amin Kamaruddin
- Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia.
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Sandek A, Gertler C, Valentova M, Jauert N, Wallbach M, Doehner W, von Haehling S, Anker SD, Fielitz J, Volk HD. Increased Expression of Proinflammatory Genes in Peripheral Blood Cells Is Associated with Cardiac Cachexia in Patients with Heart Failure with Reduced Ejection Fraction. J Clin Med 2024; 13:733. [PMID: 38337428 PMCID: PMC10856330 DOI: 10.3390/jcm13030733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Background: Cardiac cachexia (CC) in chronic heart failure with reduced ejection fraction (HFrEF) is characterized by catabolism and inflammation predicting poor prognosis. Levels of responsible transcription factors like signal transducer and activator of transcription (STAT)1, STAT3, suppressor of cytokine signaling (SOCS)1 and SOCS3 in peripheral blood cells (PBC) are underinvestigated in CC. Expression of mediators was related to patients' functional status, body composition (BC) and metabolic gene expression in skeletal muscle (SM). Methods: Gene expression was quantified by qRT-PCR in three cohorts: non-cachectic patients (ncCHF, n = 19, LVEF 31 ± 7%, BMI 30.2 ± 5.0 kg/m2), cachectic patients (cCHF; n = 18, LVEF 27 ± 7%, BMI 24.3 ± 2.5 kg/m2) and controls (n = 17, LVEF 70 ± 7%, BMI 27.6 ± 4.6 kg/m2). BC was assessed by dual-energy X-ray absorptiometry. Blood inflammatory markers were measured. We quantified solute carrier family 2 member 4 (SLC2A4) and protein degradation by expressions of proteasome 20S subunit beta 2 and calpain-1 catalytic subunit in SM biopsies. Results: TNF and IL-10 expression was higher in cCHF than in ncCHF and controls (all p < 0.004). cCHF had a lower fat mass index (FMI) and lower fat-free mass index (FFMI) compared to ncCHF and controls (p < 0.05). STAT1 and STAT3 expression was higher in cCHF vs. ncCHF or controls (1.1 [1.6] vs. 0.8 [0.9] vs. 0.9 [1.1] RU and 4.6 [5.5] vs. 2.5 [4.8] vs. 3.0 [4.2] RU, all ANOVA-p < 0.05). The same applied for SOCS1 and SOCS3 expression (1.1 [1.5] vs. 0.4 [0.4] vs. 0.4 [0.5] and 0.9 [3.3] vs. 0.4 [1.1] vs. 0.8 [0.9] RU, all ANOVA-p < 0.04). In cCHF, higher TNF and STAT1 expression was associated with lower FMI (r = 0.5, p = 0.053 and p < 0.05) but not with lower FFMI (p > 0.4). In ncCHF, neither cytokine nor STAT/SOCS expression was associated with BC (all p > 0.3). SLC2A4 was upregulated in SM of cCHF vs. ncCHF (p < 0.03). Conclusions: Increased STAT1, STAT3, SOCS1 and SOCS3 expression suggests their involvement in CC. In cCHF, higher TNF and STAT-1 expression in PBC were associated with lower FMI. Increased SLC2A4 in cachectic SM biopsies indicates altered glucose metabolism.
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Affiliation(s)
- Anja Sandek
- Department of Cardiology and Pneumology, University Medical Center Göttingen, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, 37075 Göttingen, Germany
| | - Christoph Gertler
- Department of Cardiology and Pneumology, University Medical Center Göttingen, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, 37075 Göttingen, Germany
| | - Miroslava Valentova
- Department of Cardiology and Pneumology, University Medical Center Göttingen, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, 37075 Göttingen, Germany
| | - Nadja Jauert
- Centre for Stroke Research Berlin, Charité-University Medicine Berlin, Corporate Member of Free University Berlin and Humboldt-University Berlin, 10117 Berlin, Germany
- Division of Physiology, Department of Human Medicine, MSB Medical School Berlin, Rüdesheimerstr 50, 14197 Berlin, Germany
| | - Manuel Wallbach
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, 37075 Göttingen, Germany
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Wolfram Doehner
- Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, German Heart Center Charité, Charité-University Medicine Berlin, Corporate Member of Free University Berlin and Humboldt-University Berlin, 13353 Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, 13353 Berlin, Germany
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University Medical Center Göttingen, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, 37075 Göttingen, Germany
| | - Stefan D Anker
- Department of Internal Medicine and Cardiology, Campus Virchow-Klinikum, German Heart Center Charité, Charité-University Medicine Berlin, Corporate Member of Free University Berlin and Humboldt-University Berlin, 13353 Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, 13353 Berlin, Germany
- BIH Center for Regenerative Therapies (BCRT), Charité-University Medicine Berlin, Corporate Member of Free University Berlin and Humboldt-University Berlin, 10117 Berlin, Germany
| | - Jens Fielitz
- Department of Internal Medicine B, Cardiology, University Medicine Greifswald, 17475 Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany
| | - Hans-Dieter Volk
- BIH Center for Regenerative Therapies (BCRT), Charité-University Medicine Berlin, Corporate Member of Free University Berlin and Humboldt-University Berlin, 10117 Berlin, Germany
- Department of Medical Immunology, Charité-University Medicine Berlin, Corporate Member of Free University Berlin and Humboldt-University Berlin, 10117 Berlin, Germany
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Hyun J, Lee SY, Ryu B, Jeon YJ. A Combination Study of Pre- and Clinical Trial: Seaweed Consumption Reduces Aging-Associated Muscle Loss! Aging Dis 2023:AD.2023.0927. [PMID: 38029400 DOI: 10.14336/ad.2023.0927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/26/2023] [Indexed: 12/01/2023] Open
Abstract
Seaweed consumption in Asian food cultures may benefit longevity and age-related conditions like sarcopenia with aging. However, sarcopenia lacks a definitive treatment, and pharmaceutical options have limitations in efficacy and safety. Recent studies on aging female mice found that Ishige okamurae (IO), a brown algae, and its active compound diphloroethohydroxycarmalol improved sarcopenia. Further research is needed to understand the effects of seaweed consumption on sarcopenia in humans. This clinical trial divided participants into a test group (receiving 500 mg/kg IO supplementation, mean±SD; age 62.73±7.18 years, n=40) and a control group (age 63.10±7.06 years, n=40). Hazard analysis assessed vital signs and muscle strength improvement during the trial. Additionally, 12-month-old mice were oral-fed IO at different doses (50, 100, 200 mg/kg) for 6-weeks. Aging and muscle-wasting related markers were evaluated, including grip strength, body weight and compositions, serum-parameters, and molecular-changes. The clinical trial found no significant changes in toxicity-parameters between the groups (p<0.05) after 12-weeks of IO supplementation. The IO group exhibited a remarkable increase in lower-limb quadriceps muscle-strength compared to the control (p=0.002). Furthermore, IO treatment improved age-related decline in quadriceps strength in the subgroup; under 61-years-old (p=0.004), without significant differences in foot-dominancy between groups (p=0.171). In 12-month-old male mice, IO administration improved age-related deficiencies in grip strength (p>0.0001) and testosterone (p=0.0001). Muscular regeneration parameters, such as lean-mass (p>0.0001), inhibition of proteolysis (measured by changes in myogenin and atrogin-1 protein expressions), cross-sectional myofiber area (p>0.0001), number of satellite cells (p=0.0001), and increased mitochondrial oxidative phosphorylation complexes in muscle tissue indicative of mitochondrial biogenesis, were also improved by IO administration. This trial is the first to explore the positive association between consuming brown-algae IO and age-related decreases in muscle strength. IO treatment helps maintain muscle mass and delays muscle wasting during aging, suggesting it as a potent nutritional strategy to protect against aging-associated sarcopenia.
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Affiliation(s)
- Jimin Hyun
- Department of Marine Life Sciences, Jeju National University, Jeju, Republic of Korea
| | - Sang Yeoup Lee
- Integrated Research Institute for Natural Ingredients and Functional Foods, Department of Family Medicine, Biomedical Research Institute, and Integrated Research Institute for Natural Ingredients and Functional Foods, Pusan National University Yangsan Hospital, Republic of Korea
- Department of Medical Education, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Bomi Ryu
- Department of Food Science & Nutrition, Pukyong National University, Busan, Republic of Korea
| | - You-Jin Jeon
- Department of Marine Life Sciences, Jeju National University, Jeju, Republic of Korea
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Charbonneau EJ, Grover P, Johns JS, McDowell SM, Stillo JV. Baseline Characteristics and Outcomes for People With and Without COVID-19 Diagnoses Receiving Inpatient Rehabilitation Care Across the US in 2020-2021. Arch Rehabil Res Clin Transl 2023; 5:100281. [PMID: 37744204 PMCID: PMC10517355 DOI: 10.1016/j.arrct.2023.100281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
Objective To assess sociodemographic, medical complexity, and outcomes of persons receiving care at inpatient rehabilitation facilities (IRFs) with and without a diagnosis of COVID-19. Design A retrospective cohort study using electronic medical record (EMR) data from 138 IRFs across 34 states and Puerto Rico. Setting N/A. Participants IRF EMR data for 212,663 patients discharged between 04/01/2020 and 05/31/2021 (N=212,663), of which 16,199 (COVID-19 group) had a primary or secondary COVID-19 diagnosis based upon ICD codes set (ICD-10 codes U07.1, B94.8, Z86.19, Z86.16). Main Outcome Measures Four categories: (a) sociodemographic, (b) medical complexity, (c) process, that is, standard IRF processes, and clinical outcomes (collected routinely as part of administrative reporting), and (d) functional outcomes. Patients with missing functional data associated with short/incomplete stays (n=623) were excluded from analysis of functional outcomes category only. Standard descriptive analysis techniques were employed for comparing categorical and continuous variables between groups. Results Statistically significant differences were noted between the COVID-19 group and non-COVID groups for race (26.0% vs 19.7% non-minority, P<.001), Case Mix Index (1.49 vs 1.46, P<.001), Center for Medicare and Medicaid Services 60% rule qualification (79.0% vs 73.4%, P<.001), time to onset (24.3 vs 18.0 days, P<.001), length of stay (14.2 vs 12.9 days, P<.001), and discharge disposition (to community: 75.3% vs 81%, P<.001; to acute care facility: 15.6% vs 10.8%, P<.001). The COVID-19 group had higher frequency of respiratory and cardiovascular disease, diabetes, encephalopathy, morbid obesity, and critical illness neuropathy and myopathy. Clinically insignificant differences were noted for age, sex, depression, and cognitive assessment. Ability to participate and functional outcomes were comparable between the groups. Conclusion There are significant differences between the COVID-19 and non-COVID group in some sociodemographic, medical complexity, process and clinical outcomes, but not in functional outcomes. The ability to participate in the IRF-required intensity of therapy services along with attainment of comparable levels of functional outcomes supports the benefit of IRFs for persons with COVID-19.
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Affiliation(s)
| | - Prateek Grover
- Encompass Health Corp, Birmingham, AL
- Washington University School of Medicine, St Louis, MO
| | - Jeffery S. Johns
- Encompass Health Corp, Birmingham, AL
- Vanderbilt University Medical Center, Nashville, TN
| | - Susan M. McDowell
- Encompass Health Corp, Birmingham, AL
- University of Kentucky, Lexington, KY
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Dos Santos EM, Moreira ASB, Huguenin GVB, Tibiriça E, De Lorenzo A. Effects of Whey Protein Isolate on Body Composition, Muscle Mass, and Strength of Chronic Heart Failure Patients: A Randomized Clinical Trial. Nutrients 2023; 15:nu15102320. [PMID: 37242203 DOI: 10.3390/nu15102320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 05/28/2023] Open
Abstract
Heart failure (HF) is associated with a reduction of skeletal muscle mass. Whey protein isolate (WPI) has been beneficial in increasing muscle mass and strength, in addition to improving body composition. The goal of this research was to evaluate the effect of WPI on the body composition, muscle mass, and strength of chronic HF patients. For this purpose, twenty-five patients of both genders with predominantly NYHA I functional class and a median age of 65.5 (60.5-71.0) years were used to conduct a randomized, single-blind, placebo-controlled clinical trial and received 30 g per day of WPI for 12 weeks. Anthropometric measurements, body composition analysis, and biochemical exams were performed at the beginning and end of the study. An increase in skeletal muscle mass was observed in the intervention group after 12 weeks. A reduction in waist circumference, body fat percentage, and an increase in skeletal muscle index was observed when compared to the placebo group. No significant effect on muscle strength was observed after 12 weeks of intervention. These data demonstrate that WPI consumption contributed to the increase of skeletal muscle mass, strength, and reduction of body fat in HF patients.
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Affiliation(s)
- Elisa M Dos Santos
- Institute of Heart Edson Saad, Federal University of Rio de Janeiro, Rio de Janeiro 21941-913, RJ, Brazil
- Department of Clinical Research, National Institute of Cardiology, Rio de Janeiro 22240-006, RJ, Brazil
| | - Annie S B Moreira
- Department of Clinical Research, National Institute of Cardiology, Rio de Janeiro 22240-006, RJ, Brazil
| | - Grazielle V B Huguenin
- Departamento de Nutrição e Dietética, Faculdade de Nutrição Emília de Jesus Ferreiro, Federal Fluminense University, Niterói 24020-140, RJ, Brazil
| | - Eduardo Tibiriça
- Department of Clinical Research, National Institute of Cardiology, Rio de Janeiro 22240-006, RJ, Brazil
| | - Andrea De Lorenzo
- Institute of Heart Edson Saad, Federal University of Rio de Janeiro, Rio de Janeiro 21941-913, RJ, Brazil
- Department of Clinical Research, National Institute of Cardiology, Rio de Janeiro 22240-006, RJ, Brazil
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Esteban-Fernández A, Villar-Taibo R, Alejo M, Arroyo D, Bonilla Palomas JL, Cachero M, Joaquin C, Méndez Bailón M, Pérez-Rivera JÁ, Romero-Vigara JC, Somoza G. Diagnosis and Management of Malnutrition in Patients with Heart Failure. J Clin Med 2023; 12:3320. [PMID: 37176761 PMCID: PMC10179706 DOI: 10.3390/jcm12093320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 04/30/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
Heart failure is a disease with an increasingly greater prevalence due to the aging population, the development of new drugs, and the organization of healthcare processes. Malnutrition has been identified as a poor prognostic factor in these patients, very often linked to frailty or to other comorbidities, meaning that early diagnosis and treatment are essential. This paper reviews some important aspects of the pathophysiology, detection, and management of malnutrition in patients with heart failure.
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Affiliation(s)
- Alberto Esteban-Fernández
- Cardiology Department, Severo Ochoa University Hospital, Calle Orellana s/n, 28911 Madrid, Spain
- Faculty of Health Sciences, Valencian International University, 46002 Valencia, Spain
| | - Rocío Villar-Taibo
- Endocrinology Department, Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain;
| | - Mirian Alejo
- Endocrinology Department, Hospital El Bierzo, 24404 Ponferrada, Spain;
| | - David Arroyo
- Nephrology Department, Gregorio Marañón General University Hospital, 28007 Madrid, Spain;
| | | | - Montserrat Cachero
- Endocrinology Department, Germans Trias i Pujol Hospital, 08916 Badalona, Spain; (M.C.); (C.J.)
| | - Clara Joaquin
- Endocrinology Department, Germans Trias i Pujol Hospital, 08916 Badalona, Spain; (M.C.); (C.J.)
| | - Manuel Méndez Bailón
- Internal Medicine Department, San Carlos Clinical University Hospital, 28034 Madrid, Spain;
| | - José Ángel Pérez-Rivera
- Cardiology Department, Burgos University Hospital, 09006 Burgos, Spain;
- Faculty of Health Sciences, Isabel I University, 09003 Burgos, Spain
| | | | - Gema Somoza
- Geriatric Department, Gregorio Marañón University Hospital, 28007 Madrid, Spain;
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Yuneldi RF, Airin CM, Saragih HTS, Sarmin S, Astuti P, Alimon AR. Growth, pectoralis muscle performance, and testis of pelung cockerels (Gallus gallus gallus [Linnaeus, 1758]) supplemented with blood clam shell powder (Anadara granosa [Linnaeus, 1758]). Vet World 2023; 16:474-482. [PMID: 37041827 PMCID: PMC10082742 DOI: 10.14202/vetworld.2023.474-482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/27/2023] [Indexed: 03/19/2023] Open
Abstract
Background and Aim: Pelung cockerels (Gallus gallus gallusGallus gallus gallus [Linnaeus, 1758]) are different from other native cockerels in that they have a long and unique voice, in addition to their tall, large, and sturdy body with a relatively heavy body weight (BW). The sound quality of pelung cockerels is affected by the structure of the syrinx and their large and strong chest muscles. The performance of the chest muscles, and subsequently its voice, is influenced by the hormone testosterone. The shell of blood clams (Anadara granosa Linnaeus, 1758), a saltwater bivalve is known to contain a natural aromatase blocker (NAB) capable of blocking the aromatase enzyme from converting testosterone to estradiol. This generates consistently high levels of testosterone. This study aimed to determine the effect of blood clam shell powder (BCSP) as an NAB on the growth, pectoralis muscle performance, and testes of pelung cockerels.
Materials and Methods: The study design was a completely randomized design, with 16 pelung cockerels aged 40–56 weeks divided into four treatment groups: T0 (control); T1 (BCSP [A. granosa] 0.9 mg/kg BW); T2 (zinc sulfate [ZnSO4] 0.9 mg/kg BW); and T3 (testosterone 3 mg/day). The animals were acclimatized for 7 days and then given dietary treatments for 56 days. The measurement of the comb, wattle, and chest circumference (CC) of pelung cockerels was performed on days 0, 14, 28, 42, and 56. At the end of the treatment, the pelung cockerels were sacrificed and the data of the pectoralis muscle weight (PMW), testis weight (TW), and area of the pectoralis muscle (APM) were measured. Samples of pectoralis muscle and testes were taken and fixed in 10% neutral buffer formalin for histology. The proliferating cell nuclear antigen (PCNA) was identified by immunohistochemical staining. To measure fascicle area (FA), myofiber area (MA), and enumerate, the fascicle myofibers (NM) histology preparations were stained with hematoxylin and eosin (H and E). Testicular preparations were stained with H and E to measure the diameter of the seminiferous tubules (DST) using ImageJ software.
Results: The growth performance on day 56 showed significantly (p < 0.05) higher differences of CC in T1 compared to T2 and T0, in T1 and T3 compared to T0, and in T3 and T2 compared to T0. Pectoralis muscle results, that is, FA, NM, MA, and PCNA-positive cells, showed that cockerels on treatment T3 had significantly higher results than other treatments, T1 was significantly different from T2 and T0, and T2 was significantly different from T0. In addition, the TW and DST measurement of cockerels on treatment T3 were significantly reduced (p < 0.05) than the other treatment groups.
Conclusion: The oral administration of BCSP in the role of a NAB at a dose of 0.9 mg/kg BW for 56 days improved the growth performance and pectoralis muscle, especially the CC, FA, NM, MA, and PCNA-positive cells parameters, but did not affect the PMW, APM, and testis of pelung cockerels. The administration of testosterone at 3 mg/day for 56 days contributed to the decrease in TW and DST, as well as atrophy of the seminiferous tubules of pelung cockerels.
Keywords: growth performance, muscle, natural aromatase blocker, pelung, testis.
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Affiliation(s)
- Rizki Fitrawan Yuneldi
- Post-Doctoral Program, Faculty of Veterinary Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Claude Mona Airin
- Department of Physiology, Faculty of Veterinary Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Hendry T. S. Saragih
- Laboratory of Animal Development Structure, Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Sarmin Sarmin
- Department of Physiology, Faculty of Veterinary Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Pudji Astuti
- Department of Physiology, Faculty of Veterinary Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Abdul Razak Alimon
- Department of Animal Science, Faculty of Agriculture, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Liu H, Huang Y, Zhuo W, Wan R, Hong K. U-shaped association between body mass index and ejection fraction in intensive care unit patients with heart failure. ESC Heart Fail 2023; 10:377-384. [PMID: 36251539 PMCID: PMC9871715 DOI: 10.1002/ehf2.14198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/07/2022] [Accepted: 10/02/2022] [Indexed: 01/29/2023] Open
Abstract
AIMS There are limited data about the relationship between body mass index (BMI) and left ventricular ejection fraction (EF) in patients with heart failure (HF). The study aims to assess the correlation between BMI and left ventricular EF under HF conditions. METHODS AND RESULTS We derived the data from the Dryad Digital Repository for analysis, and the information of the original patients was obtained from the MIMIC-III database by the data uploader. We performed smooth curve and two piecewise linear regression analyses to evaluate the association between BMI and EF in HF patients. A total of 962 participants were included in this study, with age of 73.7 ± 13.5 years, and 475 participants were male (49.4%). The results of the smooth curve supported a U-shaped relationship between BMI and EF, and the inflection point was found to be a BMI of 23.3 kg/m2 in these HF patients. After adjusting for potential confounders, we found that EF decreased with increasing BMI up to the inflection point (β = -0.7, 95% CI -1.3 to -0.1, P = 0.028), whereas beyond the turning point, the relationship between EF and BMI showed a positive correlation (β = 0.2, 95% CI 0.1-0.3 P < 0.001). Importantly, ischaemic heart disease (interaction P = 0.0499) and hyperlipidaemia (interaction P = 0.0162) affected the association between BMI and EF in the lower BMI group (BMI < 23.3 kg/m2 ), although only diabetes mellitus (interaction P = 0.0255) altered the association between BMI and EF in the higher BMI group (BMI ≥ 23.3 kg/m2 ). CONCLUSIONS In addition to higher BMI, we also found that lower BMI is related to higher EF in intensive care unit patients with HF, supporting a U-shaped association between BMI and EF.
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Affiliation(s)
- Hualong Liu
- Department of Cardiovascular MedicineThe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Ying Huang
- Department of Cardiovascular MedicineThe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Wen Zhuo
- Department of Cardiovascular MedicineThe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Rong Wan
- Jiangxi Key Laboratory of Molecular MedicineThe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Kui Hong
- Department of Cardiovascular MedicineThe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
- Jiangxi Key Laboratory of Molecular MedicineThe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
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9
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The complex pathophysiology of cardiac cachexia: A review of current pathophysiology and implications for clinical practice. Am J Med Sci 2023; 365:9-18. [PMID: 36055378 DOI: 10.1016/j.amjms.2022.08.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 04/09/2022] [Accepted: 08/24/2022] [Indexed: 01/04/2023]
Abstract
Cardiac cachexia is a muscle wasting process that often develops in those with chronic heart failure resulting in weight loss, low levels of physical activity, reduced quality of life, and is associated with a poor prognosis. The pathology of cardiac cachexia is complex with new evidence emerging that implicates several body systems. This review describes the pathophysiology associated with cardiac cachexia and addresses: 1) hormonal changes- neurohormonal abnormalities and metabolic hormone imbalance; 2) mechanisms of muscle wasting in cardiac cachexia, and the integral mechanisms between changed hormones due to cardiac cachexia and muscle wasting processes, and 3) associated abnormalities of gastrointestinal system that contribute to cardiac cachexia. These pleiotropic mechanisms demonstrate the intricate interplay between the affected systems and account for why cardiac cachexia is difficult to manage clinically. This review summarises current pathophysiology of cardiac cachexia and highlights symptoms of cardiac cachexia, implications for clinical practice and research gaps.
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10
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Machado Magalhães de Souza W, Vieira MC, Marino Correa Nascimento P, Manoel Serra S, Kaufman R, Pedrosa RC, Miranda H, Reis MS. Association Between Upper Limb Strength Through 1-Repetition Maximum Test and V'O 2peak in Heart Failure. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:845-850. [PMID: 34904926 DOI: 10.1080/02701367.2021.1926897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/03/2021] [Indexed: 06/14/2023]
Abstract
Purpose: This study aimed to evaluate whether there is a correlation between the maximum strength of upper limb when performing a multijoint exercise and peak oxygen uptake (V'O2peak) in Chronic Heart Failure (CHF) subjects. Method: This cross-sectional study involved CHF subjects with a left ventricular ejection fraction (LVEF) less than 50%, who underwent a cardiopulmonary exercise test (CPET) on a treadmill and 1-repetition maximum (1-RM) test for upper limb strength using a bench press exercise. Results: The sample consisted of 16 individuals aged 54 ± 12 years with a LVEF of 37 ± 7%. The V'O2peak was 14.98 ± 5.4 ml·min-1·kg-1 and mean maximum load in the 1-RM test was 38 ± 16 kg. There was strong correlation of V'O2peak with the load in the 1-RM test (r = 0.70; p = .037; r2 = 0.48). Conclusion: There is a strong correlation between the load in 1-RM test for upper limb with V'O2peak in CHF individuals. It is a safe, inexpensive and reproducible way to assess the muscle strength in this population.
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Affiliation(s)
| | | | | | | | | | - Roberto Coury Pedrosa
- Clementino Fraga Filho University Hospital, Cardiology Institute Edson Saad, Federal University of Rio de Janeiro
| | | | - Michel Silva Reis
- Federal University of Rio de Janeiro
- Clementino Fraga Filho University Hospital, Cardiology Institute Edson Saad, Federal University of Rio de Janeiro
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11
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Sato R, Vatic M, da Fonseca GWP, von Haehling S. Sarcopenia and Frailty in Heart Failure: Is There a Biomarker Signature? Curr Heart Fail Rep 2022; 19:400-411. [PMID: 36261756 DOI: 10.1007/s11897-022-00575-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 10/24/2022]
Abstract
PURPOSE OF REVIEW Sarcopenia and frailty are common in patients with heart failure (HF) and are strongly associated with prognosis. This review aims to examine promising biomarkers that can guide physicians in identifying sarcopenia and frailty in HF. RECENT FINDINGS Traditional biomarkers including C-reactive protein, aminotransaminase, myostatin, and urinary creatinine as well as novel biomarkers including microRNAs, suppression of tumorigenicity 2 (ST2), galectin-3, and procollagen type III N-terminal peptide may help in predicting the development of sarcopenia and frailty in HF patients. Among those biomarkers, aminotransferase, urinary creatinine, and ST2 predicted the prognosis in HF patients with sarcopenia and frailty. This review outlines the current knowledge of biomarkers that are considered promising for diagnosing sarcopenia and frailty in HF. The listed biomarkers might support the diagnosis, prognosis, and therapeutic decisions for sarcopenia and frailty in HF patients.
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Affiliation(s)
- Ryosuke Sato
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075, Gottingen, Germany
| | - Mirela Vatic
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075, Gottingen, Germany
| | | | - Stephan von Haehling
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Gottingen, Germany.
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12
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Li S, Zheng Y, Huang Y, He W, Liu X, Zhu W. Association of body mass index and prognosis in patients with HFpEF: A dose-response meta-analysis. Int J Cardiol 2022; 361:40-46. [PMID: 35568057 DOI: 10.1016/j.ijcard.2022.05.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although agreements regarding the negative effects of obesity on the development of heart failure with preserved ejection fraction (HFpEF) have been reached, the relationship between body mass index (BMI) and adverse outcomes in HFpEF patients are still debatable. Therefore, we conducted the dose-response meta-analysis to investigate this relationship. METHODS We searched the PubMed and Embase databases up to February 2022 for studies that evaluated the association between BMI and prognostic outcomes in patients with HFpEF. A cubic spline random-effects model was used to fit the potential dose-response curve. The effect estimates were expressed as adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS A total of 11 studies involving 69,273 patients with HFpEF were included. The summary HR for all-cause mortality was 0.90 (95% CI, 0.84-0.95) per 5 units increase in BMI, but the association was U-shaped (Pnonlinear < 0.01) with the nadir of risk at a BMI of 32-34 kg/m2. The summary HR for HF hospitalization was 1.12 (95% CI, 1.05-1.19) with a significant positive linear association (Pnonlinear = 0.54). CONCLUSIONS For patients with HFpEF, there was a positive linear association of BMI with HF hospitalization, while a U-shaped relationship between BMI and all-cause mortality was observed with the lowest event rate at a BMI of 32-34 kg/m2.
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Affiliation(s)
- Siyuan Li
- The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
| | - Yuxiang Zheng
- The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
| | - Yuwen Huang
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
| | - Wenfeng He
- Department of Medical Geneticsthe, Jiangxi Key Laboratory of Molecular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
| | - Xiao Liu
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510030, China.
| | - Wengen Zhu
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China.
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13
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Yamamoto S, Yamasaki S, Higuchi S, Kamiya K, Saito H, Saito K, Ogasahara Y, Maekawa E, Konishi M, Kitai T, Iwata K, Jujo K, Wada H, Kasai T, Nagamatsu H, Ozawa T, Izawa K, Aizawa N, Makino A, Oka K, Momomura SI, Kagiyama N, Matsue Y. Prevalence and prognostic impact of cognitive frailty in elderly patients with heart failure: sub-analysis of FRAGILE-HF. ESC Heart Fail 2022; 9:1574-1583. [PMID: 35182038 PMCID: PMC9065815 DOI: 10.1002/ehf2.13844] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/12/2022] [Accepted: 02/04/2022] [Indexed: 11/12/2022] Open
Abstract
Aims Although evidence suggests that cognitive decline and physical frailty in elderly patients with heart failure (HF) are associated with prognosis, the impact of concurrent physical frailty and cognitive impairment, that is, cognitive frailty, on prognosis has yet to be fully investigated. The current study sought to investigate the prevalence and prognostic impact of cognitive frailty in elderly patients with HF. Methods and results This study is a sub‐analysis of FRAGILE‐HF, a prospective multicentre observational study involving patients aged ≥65 years hospitalized for HF. The Fried criteria and Mini‐Cog were used to diagnose physical frailty and cognitive impairment, respectively. The association between cognitive frailty and the combined endpoint of mortality and HF rehospitalization within 1 year was then evaluated. Among the 1332 patients identified, 1215 who could be assessed using Mini‐Cog and the Fried criteria were included in this study. Among those included, 279 patients (23.0%) had cognitive frailty. During the follow‐up 1 year after discharge, 398 combined events were observed. Moreover, cognitive frailty was determined to be associated with a higher incidence of combined events (log‐rank: P = 0.0146). This association was retained even after adjusting for other prognostic factors (hazard ratio: 1.55, 95% confidence interval: 1.13–2.13). Furthermore, a sensitivity analysis using grip strength, short physical performance battery, and gait speed to determine physical frailty instead of the Fried criteria showed similar results. Conclusions This cohort study found that 23% of elderly patients with HF had cognitive frailty, which was associated with a 1.55‐fold greater risk for combined events within 1 year compared with patients without cognitive frailty.
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Affiliation(s)
- Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Saeko Yamasaki
- Department of Cardiovascular Medicine, National Hospital Organization Matsumoto Medical Center, Matsumoto, Japan
| | - Satoko Higuchi
- Department of Cardiovascular Medicine, Shinshu University School of Medicine Matsumoto, Matsumoto, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Hiroshi Saito
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Department of Rehabilitation, Kameda Medical Center, Kamogawa, Japan
| | - Kazuya Saito
- Department of Rehabilitation, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Yuki Ogasahara
- Department of Nursing, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masaaki Konishi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.,Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kentaro Iwata
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kentaro Jujo
- Department of Cardiology, Nishiarai Heart Center Hospital, Tokyo, Japan
| | - Hiroshi Wada
- Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirofumi Nagamatsu
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Tetsuya Ozawa
- Department of Rehabilitation, Odawara Municipal Hospital, Odawara, Japan
| | - Katsuya Izawa
- Department of Rehabilitation, Kasukabe Chuo General Hospital, Kasukabe, Japan
| | - Naoki Aizawa
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Okinawa, Japan
| | - Akihiro Makino
- Rehabilitation Center, Kitasato University Medical Center, Kitamoto, Japan
| | - Kazuhiro Oka
- Department of Rehabilitation, Saitama Citizens Medical Center, Saitama, Japan
| | | | - Nobuyuki Kagiyama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan.,Department of Digital Health and Telemedicine R&D, Juntendo University, Tokyo, Japan
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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14
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Taylor AG, Ignaszewski AI, Bredin SSD, Hill JS, Shellington EM, Warburton DER. High Intensity Interval Training Leads to Similar Inflammatory Activation as Seen With Traditional Training in Chronic Heart Failure. Front Cardiovasc Med 2022; 8:752531. [PMID: 35211515 PMCID: PMC8860824 DOI: 10.3389/fcvm.2021.752531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 12/21/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Inflammatory activation has been associated with the severity and progression of chronic heart failure (CHF). Although cardiac rehabilitation is an important therapy, acute bouts of exercise may lead to increases in pro-inflammatory cytokines with exercise intensity mediating these changes. OBJECTIVE To evaluate the acute inflammatory response in patients living with CHF during a randomized trial following Steady State (SS) or High Intensity Interval (HIIT) training. METHODS Patients living with CHF (n = 14) were stratified (for body mass and aerobic power) and randomized into SS and HIIT cycle exercise. The HIIT exercise training involved 2 min work:recovery phases at 90:40% heart rate reserve. The SS exercise training involved continuous exercise at 65% of heart rate reserve (matched total work). Acute inflammatory markers were evaluated (via ELISA) at baseline, immediately following the bout, and at 6, 24, and 48 h post-exercise. RESULTS There was limited differences in the changes in inflammatory biomarkers across time between the HIIT and SS groups. Both groups experienced a significant (p < 0.05) change in Interleukin-6 immediately post-exercise. CONCLUSIONS A single bout of HIIT or SS does not result in excessive inflammatory activation in CHF patients. Acute HIIT and SS result in similar changes in inflammatory markers. These findings have important implications for exercise training and rehabilitation programs in persons living with CHF.
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Affiliation(s)
- Arlana G. Taylor
- Cardiovascular Physiology and Rehabilitation Laboratory, University of British Columbia, Vancouver, BC, Canada
- Healthy Heart Program, St. Paul's Hospital, Vancouver, BC, Canada
| | | | - Shannon S. D. Bredin
- Indigenous Health and Physical Activity Program, University of British Columbia, Vancouver, BC, Canada
- Laboratory for Knowledge Mobilization, University of British Columbia, Vancouver, BC, Canada
| | - John S. Hill
- University of British Columbia James Hogg Research Centre, Institute of Heart and Lung Health, Vancouver, BC, Canada
| | - Erin M. Shellington
- Indigenous Health and Physical Activity Program, University of British Columbia, Vancouver, BC, Canada
- Laboratory for Knowledge Mobilization, University of British Columbia, Vancouver, BC, Canada
| | - Darren E. R. Warburton
- Cardiovascular Physiology and Rehabilitation Laboratory, University of British Columbia, Vancouver, BC, Canada
- Indigenous Health and Physical Activity Program, University of British Columbia, Vancouver, BC, Canada
- Experimental Medicine Program, University of British Columbia, Vancouver, BC, Canada
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15
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Kanda D, Ikeda Y, Takumi T, Tokushige A, Sonoda T, Arikawa R, Anzaki K, Kosedo I, Ohishi M. Impact of nutritional status on prognosis in acute myocardial infarction patients undergoing percutaneous coronary intervention. BMC Cardiovasc Disord 2022; 22:3. [PMID: 34996387 PMCID: PMC8742435 DOI: 10.1186/s12872-021-02448-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/28/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Malnutrition affects the prognosis of cardiovascular disease. Acute myocardial infarction (AMI) has been a major cause of death around the world. Thus, we investigated the impact of malnutrition as defined by Geriatric Nutritional Risk Index (GNRI) on mortality in AMI patients. METHODS In 268 consecutive AMI patients who underwent percutaneous coronary intervention (PCI), associations between all-cause death and baseline characteristics including malnutrition (GNRI < 92.0) and Global Registry of Acute Coronary Events (GRACE) risk score were assessed. RESULTS Thirty-three patients died after PCI. Mortality was higher in the 51 malnourished patients than in the 217 non-malnourished patients, both within 1 month after PCI (p < 0.001) and beyond 1 month after PCI (p = 0.017). Multivariate Cox proportional hazards regression modelling using age, left ventricular ejection fraction and GRACE risk score showed malnutrition correlated significantly with all-cause death within 1 month after PCI (hazard ratio [HR] 7.04; 95% confidence interval [CI] 2.30-21.51; p < 0.001) and beyond 1 month after PCI (HR 3.10; 95% CI 1.70-8.96; p = 0.037). There were no significant differences in area under the receiver-operating characteristic (ROC) curve between GRACE risk score and GNRI for predicting all-cause death within 1 month after PCI (0.90 vs. 0.81; p = 0.074) or beyond 1 month after PCI (0.69 vs. 0.71; p = 0.87). Calibration plots comparing actual and predicted mortality confirmed that GNRI (p = 0.006) was more predictive of outcome than GRACE risk score (p = 0.85) beyond 1 month after PCI. Furthermore, comparison of p-value for interaction of malnutrition and GRACE risk score for all-cause death within 1 month after PCI, beyond 1 month after PCI, and the full follow-up period after PCI were p = 0.62, p = 0.64 and p = 0.38, respectively. CONCLUSIONS GNRI may have a potential for predicting the mortality in AMI patients especially in beyond 1 month after PCI, separate from GRACE risk score. Assessment of nutritional status may help stratify the risk of AMI mortality.
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Affiliation(s)
- Daisuke Kanda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan.
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Takuro Takumi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Akihiro Tokushige
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Takeshi Sonoda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Ryo Arikawa
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Kazuhiro Anzaki
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Ippei Kosedo
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima, 890-8520, Japan
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16
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Souza WMMD, Nascimento PMC, Vieira MC. Importance of Muscle Strength in Chronic Heart Failure. Strength Cond J 2021. [DOI: 10.1519/ssc.0000000000000683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Yuneldi RF, Astuti P, Saragih HTS, Airin CM. Anadara granosa shell powder improves the metabolism, testosterone level, and sound frequency of Pelung chickens. Vet World 2021; 14:1564-1571. [PMID: 34316204 PMCID: PMC8304415 DOI: 10.14202/vetworld.2021.1564-1571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/29/2021] [Indexed: 11/21/2022] Open
Abstract
Background and Aim: Pelung chickens make unique, pleasant, and rhythmic sounds in addition to having strong muscle mass. Performance is controlled by testosterone. A natural aromatase blocker is an agent capable of blocking the aromatase enzyme, which consequently prevents testosterone from being changed into estradiol. Such a condition results in consistently high testosterone levels. The aim of this study was to determine the effect of the administration of the shell powder of Anadara granosa on the testosterone level, frequency and quality of sounds, and metabolism of Pelung chickens within set parameters of thyroid hormone levels, the triiodothyronine (T3)/thyroxine (T4) ratio, and weight gain. Materials and Methods: This study used four Pelung chickens aged 14 months. Control data consisted of data before treatment (day 0). Shell powder of A. granosa was administered for 56 days. Body weight (BW) was measured, and blood samples were drawn. In addition, the sounds from Pelung chickens were recorded once every 2 weeks on days 14, 28, 42, and 56. The blood samples were analyzed using the enzyme immunoassay method to determine testosterone, T3, and T4 levels. The sounds of Pelung chickens were recorded using the Hagemon touch method and analyzed using the Audacity application. Results: The results showed a significant difference (p<0.05) in the levels of testosterone, BW, and sound frequency after the administration of A. granosa shell powder, but the administration did not have a significant effect on the levels of T4 and T3 hormones (thyroid hormone), T3/T4 ratio, or sound duration. The testosterone content and BW of Pelung chickens increased from day 14 to day 56, whereas T3 was indicative of the same profile as the T4 hormone. However, T3 and T4 levels and the T3/T4 ratio decreased and increased, respectively. The sound frequency of Pelung chickens increased from day 0 to day 14, although sound duration decreased. Conclusion: The administration of A. granosa shell powder at 0.9 mg/kg BW orally could improve the metabolism, testosterone level, BW, and sound frequency of Pelung chickens.
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Affiliation(s)
- Rizki Fitrawan Yuneldi
- Veterinary Science Postgraduate Study Program, Faculty of Veterinary Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Pudji Astuti
- Department of Physiology, Faculty of Veterinary Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Hendry T S Saragih
- Laboratory of Animal Development Structure, Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Claude Mona Airin
- Department of Physiology, Faculty of Veterinary Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
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18
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Abstract
PURPOSE OF REVIEW Heart failure (HF) is a structural or functional cardiac abnormality which leads to failure of the heart to deliver oxygen commensurately with the requirements of the tissues and it may progress to a generalized wasting of skeletal muscle, fat tissue, and bone tissue (cardiac cachexia). Clinically, dyspnea, fatigue, and exercise intolerance are some typical signs and symptoms that characterize HF patients. This review focused on the phenotypic characteristics of HF-induced skeletal myopathy as well as the mechanisms of muscle wasting due to HF and highlighted possible therapeutic strategies for skeletal muscle wasting in HF. RECENT FINDINGS The impaired exercise capacity of those patients is not attributed to the reduced blood flow in the exercising muscles, but rather to abnormal metabolic responses, myocyte apoptosis and atrophy of skeletal muscle. Specifically, the development of skeletal muscle wasting in chronic HF is characterized by structural, metabolic, and functional abnormalities in skeletal muscle and may be a result not only of reduced physical activity, but also of metabolic or hormonal derangements that favour catabolism over anabolism. In particular, abnormal energy metabolism, mitochondrial dysfunction, transition of myofibers from type I to type II, muscle atrophy, and reduction in muscular strength are included in skeletal muscle abnormalities which play a central role in the decreased exercise capacity of HF patients. Skeletal muscle alterations and exercise intolerance observed in HF are reversible by exercise training, since it is the only demonstrated intervention able to improve skeletal muscle metabolism, growth factor activity, and functional capacity and to reverse peripheral abnormalities.
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19
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Abstract
Exercise training is recommended for patients with heart failure by major societies' guidelines. It improves exercise capacity and quality of life, reduces symptoms of depression, can improve survival, and reduce the risk for hospitalizations. Exercise-based cardiac rehabilitation can be offered with different modalities, such as continuous or interval aerobic training, resistance, and inspiratory muscle training. The intervention must follow an accurate evaluation of the patient's cardiovascular conditions and functional capacity. Despite the multiple benefits of exercise training, there is a lack of adherence to exercise-based programs, due to socioeconomic factors, patients' characteristics, and lack of referral.
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20
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Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review. Healthcare (Basel) 2021; 9:healthcare9010097. [PMID: 33477800 PMCID: PMC7832337 DOI: 10.3390/healthcare9010097] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/03/2021] [Accepted: 01/11/2021] [Indexed: 12/19/2022] Open
Abstract
Anabolic-androgenic steroids (AASs) are a large group of molecules including endogenously produced androgens, such as testosterone, as well as synthetically manufactured derivatives. AAS use is widespread due to their ability to improve muscle growth for aesthetic purposes and athletes’ performance, minimizing androgenic effects. AAS use is very popular and 1–3% of US inhabitants have been estimated to be AAS users. However, AASs have side effects, involving all organs, tissues and body functions, especially long-term toxicity involving the cardiovascular system and the reproductive system, thereby, their abuse is considered a public health issue. The aim of the proposed review is to highlight the most recent evidence regarding the mechanisms of action of AASs and their unwanted effects on organs and lifestyle, as well as suggesting that AAS misuse and abuse lead to adverse effects in all body tissues and organs. Oxidative stress, apoptosis, and protein synthesis alteration are common mechanisms involved in AAS-related damage in the whole body. The cardiovascular system and the reproductive system are the most frequently involved apparatuses. Epidemiology as well as the molecular and pathological mechanisms involved in the neuropsychiatric side-effects of AAS abuse are still unclear, further research is needed in this field. In addition, diagnostically reliable tests for AAS abuse should be standardized. In this regard, to prevent the use of AASs, public health measures in all settings are crucial. These measures consist of improved knowledge among healthcare workers, proper doping screening tests, educational interventions, and updated legislation.
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21
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Zacharski M, Tomaszek A, Kiczak L, Ugorski M, Bania J, Pasławska U, Rybinska I, Jankowska EA, Janiszewski A, Ponikowski P. Catabolic/Anabolic Imbalance Is Accompanied by Changes of Left Ventricular Steroid Nuclear Receptor Expression in Tachycardia-Induced Systolic Heart Failure in Male Pigs. J Card Fail 2021; 27:682-692. [PMID: 33450412 DOI: 10.1016/j.cardfail.2020.12.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 12/13/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Steroid hormones play an important role in heart failure (HF) pathogenesis, and clinical data have revealed disordered steroidogenesis in male patients with HF. However, there is still a lack of studies on steroid hormones and their receptors during HF progression. Therefore, a porcine model of tachycardia-induced cardiomyopathy corresponding to HF was used to assess steroid hormone concentrations in serum and their nuclear receptor levels in heart tissue during the consecutive stages of HF. METHODS AND RESULTS Male pigs underwent right ventricular pacing and developed a clinical picture of mild, moderate, or severe HF. Serum concentrations of dehydroepiandrosterone, testosterone, dihydrotestosterone, estradiol, aldosterone, and cortisol were assessed by enzyme-linked immunosorbent assay. Androgen receptor, estrogen receptor alpha, mineralocorticoid receptor, and glucocorticoid receptor messenger RNA levels in the left ventricle were determined by qPCR.The androgen level decreased in moderate and severe HF animals, while the corticosteroid level increased. The estradiol concentration remained stable. The quantitative real-time polymerase chain reaction revealed the downregulation of androgen receptor in consecutive stages of HF and increased expression of mineralocorticoid receptor messenger RNA under these conditions. CONCLUSIONS In the HF pig model, deteriorated catabolic/anabolic balance, manifested by upregulation of aldosterone and cortisol and downregulation of androgen signaling on the ligand level, was augmented by changes in steroid hormone receptor expression in the heart tissue.
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Affiliation(s)
- Maciej Zacharski
- Regional Specialist Hospital in Wroclaw - Research and Development Centre, Wroclaw, Poland; Department of Biochemistry and Molecular Biology, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland.
| | - Alicja Tomaszek
- Regional Specialist Hospital in Wroclaw - Research and Development Centre, Wroclaw, Poland; Department of Pathology, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Liliana Kiczak
- Regional Specialist Hospital in Wroclaw - Research and Development Centre, Wroclaw, Poland; Department of Biochemistry and Molecular Biology, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Maciej Ugorski
- Department of Biochemistry and Molecular Biology, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Jacek Bania
- Regional Specialist Hospital in Wroclaw - Research and Development Centre, Wroclaw, Poland; Department of Food Hygiene and Consumer Health Protection, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Urszula Pasławska
- Regional Specialist Hospital in Wroclaw - Research and Development Centre, Wroclaw, Poland; Department of Diagnostics and Clinical Science, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University Toruń, Poland; Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Ilona Rybinska
- Regional Specialist Hospital in Wroclaw - Research and Development Centre, Wroclaw, Poland; Molecular Targeting Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Italy
| | - Ewa Anita Jankowska
- Regional Specialist Hospital in Wroclaw - Research and Development Centre, Wroclaw, Poland; Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; Centre for Heart Diseases, University Hospital, Wroclaw, Poland
| | - Adrian Janiszewski
- Regional Specialist Hospital in Wroclaw - Research and Development Centre, Wroclaw, Poland; Department of Internal Disease and Veterinary Diagnosis, Faculty of Veterinary Medicine and Animal Sciences, Poznań University of Life Sciences, Poznań, Poland
| | - Piotr Ponikowski
- Regional Specialist Hospital in Wroclaw - Research and Development Centre, Wroclaw, Poland; Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; Centre for Heart Diseases, University Hospital, Wroclaw, Poland
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22
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Tkaczyszyn M, Drozd M, Węgrzynowska-Teodorczyk K, Bojarczuk J, Majda J, Banasiak W, Ponikowski P, Jankowska EA. Iron status, catabolic/anabolic balance, and skeletal muscle performance in men with heart failure with reduced ejection fraction. Cardiol J 2020; 28:391-401. [PMID: 33140393 DOI: 10.5603/cj.a2020.0138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/26/2020] [Accepted: 10/13/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Metabolic derangements related to tissue energetics constitute an important pathophysiological feature of heart failure. We investigated whether iron deficiency and catabolic/anabolic imbalance contribute to decreased skeletal muscle performance in men with heart failure with reduced ejection fraction (HFrEF), and whether these pathologies are related to each other. METHODS We comprehensively examined 23 men with stable HFrEF (median age [interquartile range]: 63 [59-66] years; left ventricular ejection fraction: 28 [25-35]%; New York Heart Association class I/II/III: 17/43/39%). We analyzed clinical characteristics, iron status, hormones, strength and fatigability of forearm flexors and quadriceps (surface electromyography), and exercise capacity (6-minute walking test). RESULTS None of the patients had anemia whereas 8 were iron-deficient. Flexor carpi radialis fatigability correlated with lower reticulocyte hemoglobin content (CHR, p < 0.05), and there was a trend towards greater fatigability in patients with higher body mass index and lower serum ferritin (both p < 0.1). Flexor carpi ulnaris fatigability correlated with lower serum iron and CHR (both p < 0.05). Vastus medialis fatigability was related to lower free and bioavailable testosterone (FT and BT, respectively, both p < 0.05), and 6-minute walking test distance was shorter in patients with higher cortisol/FT and cortisol/BT ratio (both p < 0.05). Lower ferritin and transferrin saturation correlated with lower percentage of FT and BT. Men with HFrEF and iron deficiency had higher total testosterone, but lower percentage of FT and BT. CONCLUSIONS Iron deficiency correlates with lower bioactive testosterone in men with HFrEF. These two pathologies can both contribute to decreased skeletal muscle performance in such patients.
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23
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Inspiratory muscle dysfunction and restrictive lung function impairment in congenital heart disease: Association with immune inflammatory response and exercise intolerance. Int J Cardiol 2020; 318:45-51. [DOI: 10.1016/j.ijcard.2020.06.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/06/2020] [Accepted: 06/26/2020] [Indexed: 11/23/2022]
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24
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Pugliese NR, Fabiani I, Santini C, Rovai I, Pedrinelli R, Natali A, Dini FL. Value of combined cardiopulmonary and echocardiography stress test to characterize the haemodynamic and metabolic responses of patients with heart failure and mid-range ejection fraction. Eur Heart J Cardiovasc Imaging 2020; 20:828-836. [PMID: 30753369 DOI: 10.1093/ehjci/jez014] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/11/2019] [Accepted: 01/21/2019] [Indexed: 12/19/2022] Open
Abstract
AIMS To characterize heart failure (HF) with mid-range ejection fraction (HFmrEF), combining cardiopulmonary exercise test, and exercise stress echocardiography. METHODS AND RESULTS We studied 169 consecutive subjects (age 62.3 ± 11 years; 74% male): 30 healthy controls, 45 patients with HF and preserved EF (HFpEF), 40 HFmrEF, and 54 with HF and reduced EF (HFrEF). Left ventricular (LV) stroke volume (SV), EF, elastance, global longitudinal strain, E/E', oxygen consumption (VO2), and arterial-venous oxygen content difference (AVO2diff) were measured in all exercise stages. HFmrEF revealed baseline features intermediate between HFrEF and HFpEF, except for B-type natriuretic peptide levels, which was similar to HFpEF and significantly lower than HFrEF. Peak VO2 was not significantly different between HF groups. HFrEF exhibited a significantly lower peak SV as compared to either HFpEF or HFmrEF (74.3 ± 21.8 mL vs. 88.0 ± 17.4 mL and 96.5 ± 25.1 mL; P < 0.01), whereas peak heart rate was not significantly different between HF groups. A significantly reduced AVO2diff at peak exercise was apparent in HFpEF and HFmrEF (15.2 ± 3.3 mL/dL and 13.3 ± 4.2 mL/dL) vs. HFrEF (17.±6.6 mL/dL; P < 0.01), whereas no significant difference was reported between HFpEF and HFmrEF. Multivariate analysis in the overall population and all groups revealed peak parameters as independent predictors of peak VO2 (R2 = 0.90, P < 0.0001); AVO2diff showed the largest standardized regression coefficient. CONCLUSION In HFpEF and HFmrEF, effort intolerance is predominantly due to peripheral factors (AVO2diff), whereas in HFrEF peak VO2 is restricted by low increases in SV. Individual therapy according to which component of VO2 is more impaired is advisable.
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Affiliation(s)
- Nicola Riccardo Pugliese
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Via Paradisa, 2, Pisa, Italy.,Cardiac, Thoracic and Vascular Department, University of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Iacopo Fabiani
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Via Paradisa, 2, Pisa, Italy.,Cardiac, Thoracic and Vascular Department, University of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Claudia Santini
- Cardiac, Thoracic and Vascular Department, University of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Ilaria Rovai
- Cardiac, Thoracic and Vascular Department, University of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Roberto Pedrinelli
- Cardiac, Thoracic and Vascular Department, University of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Andrea Natali
- Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa, 2, Pisa, Italy
| | - Frank L Dini
- Cardiac, Thoracic and Vascular Department, University of Pisa, Via Paradisa, 2, Pisa, Italy
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25
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HS-1793 protects C2C12 cells from oxidative stress via mitochondrial function regulation. Mol Cell Toxicol 2020. [DOI: 10.1007/s13273-020-00090-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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26
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Sarcopenia, sarcopenic overweight/obesity and risk of cardiovascular disease and cardiac arrhythmia: A cross-sectional study. Clin Nutr 2020; 40:571-580. [PMID: 32593523 DOI: 10.1016/j.clnu.2020.06.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/31/2020] [Accepted: 06/01/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Sarcopenia is an age-dependent skeletal muscle disorder that is common in patients with heart failure. The current study aimed to investigate the associations of sarcopenia with carotid atherosclerosis, cardiovascular disease and cardiac arrhythmia in a middle-aged and elderly population without clinical heart failure. METHODS A total of 2432 participants (992 men and 1440 women) from Shanghai Changfeng Study were included for analysis. The degree of sarcopenia was measured using height-adjusted appendicular skeletal muscle mass (ASM/height2). Carotid plaques were detected by carotid artery ultrasonography, and myocardial ischemia, infarction and cardiac arrhythmia were diagnosed based on electrocardiogram, past history and clinical manifestations. RESULTS Sarcopenia was associated with higher prevalence of carotid atherosclerosis (26.4% vs 20.4%, P = 0.027), myocardial infarction (4.0% vs 1.1%, P = 0.001), and premature ventricular contraction (4.0% vs 2.0%, P = 0.034) in the participants with normal body weight, and higher prevalence of carotid atherosclerosis (45.0% vs 31.2%, P = 0.016), myocardial infarction (10.0% vs 4.3%, P = 0.020) and atrial fibrillation (7.5% vs 1.3%, P < 0.001) in those with overweight/obese status. After adjustment for age, gender, cigarette smoking, alcohol drinking, menopausal status in women and other metabolic and inflammatory confounding factors, sarcopenia was independently associated with the risk of myocardial infarction in the whole population, and the risk of atrial fibrillation in the overweight/obese participants (all P < 0.05). Compared with nonsarcopenic lean participants, the risk of myocardial infarction was gradually increased in sarcopenic lean (OR 3.08 [1.28-7.45], P = 0.012) and sarcopenic overweight/obese participants (OR 4.07 [1.31-12.62], P = 0.015). For the atrial fibrillation, the participants with either sarcopenia or overweight/obesity alone showed no higher risk. However, concomitant sarcopenia and overweight/obesity was associated with approximately 5-fold risk of atrial fibrillation (OR 5.68 [1.34-24.12], P = 0.019) after multiple adjustment. CONCLUSION Sarcopenia is associated with myocardial infarction and atrial fibrillation in middle-aged and elderly adults without clinical heart failure.
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27
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Tran D, D'Ambrosio P, Verrall CE, Attard C, Briody J, D'Souza M, Fiatarone Singh M, Ayer J, d'Udekem Y, Twigg S, Davis GM, Celermajer DS, Cordina R. Body Composition in Young Adults Living With a Fontan Circulation: The Myopenic Profile. J Am Heart Assoc 2020; 9:e015639. [PMID: 32290749 PMCID: PMC7428525 DOI: 10.1161/jaha.119.015639] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background We sought to characterize body composition abnormalities in young patients living with a Fontan circulation and explore potential pathophysiologic associations. Methods and Results Twenty‐eight patients with a Fontan circulation were prospectively recruited in this cross‐sectional study. Participants underwent cardiopulmonary exercise testing, dual‐energy X‐ray absorptiometry, echocardiography, and biochemical assessment. Mean age was 26±7 years. Skeletal muscle mass, estimated by appendicular lean mass index Z score, was reduced compared with reference data (−1.49±1.10, P<0.001). Percentage body fat Z score overall was within normal range (0.23±1.26, P=0.35), although 46% had elevated adiposity. Those with reduced skeletal muscle mass (appendicular lean mass index Z score of −1 or lower) had lower percent predicted oxygen pulse (55±15 versus 76±16%, P=0.002). Overall agreement between body mass index and dual‐energy X‐ray absorptiometry to assess adiposity was fair only (weighted [linear] κ coefficient: 0.53; 95% CI, 0.34–0.73) and slight in the setting of muscle mass deficiency (weighted κ coefficient: 0.32; 95% CI, 0.13–0.50). Appendicular lean mass was independently associated with absolute peak VO2 (β=70.6 mL/min, P=0.001). Appendicular lean mass index Z score was inversely associated with hemoglobin (r=−0.4, P=0.04), and the degree of muscle deficit was associated with ventricular systolic impairment. Conclusions Young patients with a Fontan circulation have a body composition characterized by reduced skeletal muscle mass, which is associated with peak exercise capacity. Increased adiposity is common despite a normal body mass index. Low skeletal muscle mass is associated with systolic dysfunction and compensatory erythrocytosis.
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Affiliation(s)
- Derek Tran
- Sydney School of Health Sciences The University of Sydney Camperdown New South Wales Australia.,Sydney Medical School The University of Sydney Camperdown New South Wales Australia.,Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia
| | - Paolo D'Ambrosio
- Sydney Medical School The University of Sydney Camperdown New South Wales Australia.,Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia
| | - Charlotte E Verrall
- Heart Centre for Children The Children's Hospital at Westmead New South Wales Australia
| | - Chantal Attard
- Haematology Research Group Murdoch Children's Research Institute Parkville Victoria Australia
| | - Julie Briody
- Department of Nuclear Medicine The Children's Hospital at Westmead New South Wales Australia
| | - Mario D'Souza
- Sydney Medical School The University of Sydney Camperdown New South Wales Australia
| | - Maria Fiatarone Singh
- Sydney School of Health Sciences The University of Sydney Camperdown New South Wales Australia.,Sydney Medical School The University of Sydney Camperdown New South Wales Australia
| | - Julian Ayer
- Sydney Medical School The University of Sydney Camperdown New South Wales Australia.,Heart Centre for Children The Children's Hospital at Westmead New South Wales Australia
| | - Yves d'Udekem
- Department of Paediatrics Faculty of Medicine The University of Melbourne Parkville Victoria Australia.,Department of Cardiac Surgery Royal Children's Hospital Melbourne Parkville Victoria Australia
| | - Stephen Twigg
- Sydney Medical School The University of Sydney Camperdown New South Wales Australia.,Department of Endocrinology Royal Prince Alfred Hospital Camperdown New South Wales Australia
| | - Glen M Davis
- Sydney School of Health Sciences The University of Sydney Camperdown New South Wales Australia
| | - David S Celermajer
- Sydney Medical School The University of Sydney Camperdown New South Wales Australia.,Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia
| | - Rachael Cordina
- Sydney Medical School The University of Sydney Camperdown New South Wales Australia.,Department of Cardiology Royal Prince Alfred Hospital Camperdown New South Wales Australia
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28
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De Spiegeleer A, Elewaut D, Van Den Noortgate N, Janssens Y, Debunne N, Van Langenhove S, Govindarajan S, De Spiegeleer B, Wynendaele E. Quorum sensing molecules as a novel microbial factor impacting muscle cells. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165646. [DOI: 10.1016/j.bbadis.2019.165646] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 12/15/2019] [Indexed: 02/07/2023]
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29
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Abstract
Modifications of lean mass are a frequent critical determinant in the pathophysiology and progression of heart failure (HF). Sarcopenia may be considered one of the most important causes of low physical performance and reduced cardiorespiratory fitness in older patients with HF. Sarcopenia is frequently misdiagnosed as cachexia. However, muscle wasting in HF has different pathogenetic features in sarcopenic and cachectic conditions. HF may induce sarcopenia through common pathogenetic pathways such as hormonal changes, malnutrition, and physical inactivity; mechanisms that influence each other. In the opposite way, sarcopenia may favor HF development by different mechanisms, including pathological ergoreflex. Paradoxically, sarcopenia is not associated with a sarcopenic cardiac muscle, but the cardiac muscle shows a hypertrophy which seems to be “not-functional.” First-line agents for the treatment of HF, physical activity and nutritional interventions, may offer a therapeutic advantage in sarcopenic patients irrespective of HF. Thus, sarcopenia is highly prevalent in patients with HF, contributing to its poor prognosis, and both conditions could benefit from common treatment strategies based on pharmacological, physical activity, and nutritional approaches.
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30
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Abstract
Sarcopaenia is defined as reduced skeletal muscle mass associated with either a decline in muscle strength or low physical performance. It has been shown to affect 17.5% of people worldwide, with a prevalence of 20% or higher in patients with heart failure (HF). Sarcopaenia has severe impact on mortality, physical capacity, and quality of life. Even though several mechanisms, such as autonomic imbalance, reduced muscle blood flow, increased inflammation, hormonal alterations, increased apoptosis, and autophagy have been proposed to fuel the pathogenesis of sarcopaenia, additional studies assessing the interaction of these conditions need to be conducted to elucidate how the presence of sarcopaenia can exacerbate the progression of HF and vice-versa. Resistance training combined with nutritional protein intake seems to be effective in the treatment of sarcopaenia, although current pharmacotherapies have not been extensively studied with this endpoint in mind. In conclusion, sarcopaenia is interwoven with HF and leads to worse exercise capacity in these patients. The mechanisms associated with this bilateral relationship between sarcopaenia and HF are still to be elucidated, leading to effective treatment, not only for the heart, but also for the skeletal muscle.
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Affiliation(s)
- Guilherme Wesley Peixoto da Fonseca
- Cardiovascular Rehabilitation and Exercise Physiology Unit, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44 - Cerqueira Cesar, 05403-900 São Paulo, Brazil.,Department of Cardiology and Pneumology, University Medicine Göttingen (UMG), Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University Medicine Göttingen (UMG), Robert-Koch-Straße 40, 37075 Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany
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31
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Groennebaek T, Sieljacks P, Nielsen R, Pryds K, Jespersen NR, Wang J, Carlsen CR, Schmidt MR, de Paoli FV, Miller BF, Vissing K, Bøtker HE. Effect of Blood Flow Restricted Resistance Exercise and Remote Ischemic Conditioning on Functional Capacity and Myocellular Adaptations in Patients With Heart Failure. Circ Heart Fail 2019; 12:e006427. [PMID: 31830830 DOI: 10.1161/circheartfailure.119.006427] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Patients with congestive heart failure (CHF) have impaired functional capacity and inferior quality of life. The clinical manifestations are associated with structural and functional impairments in skeletal muscle, emphasizing a need for feasible rehabilitation strategies beyond optimal anticongestive medical treatment. We investigated whether low-load blood flow restricted resistance exercise (BFRRE) or remote ischemic conditioning (RIC) could improve functional capacity and quality of life in patients with CHF and stimulate skeletal muscle myofibrillar and mitochondrial adaptations. METHODS We randomized 36 patients with CHF to BFRRE, RIC, or nontreatment control. BFRRE and RIC were performed 3× per week for 6 weeks. Before and after intervention, muscle biopsies, tests of functional capacity, and quality of life assessments were performed. Deuterium oxide was administered throughout the intervention to measure cumulative RNA and subfraction protein synthesis. Changes in muscle fiber morphology and mitochondrial respiratory function were also assessed. RESULTS BFRRE improved 6-minute walk test by 39.0 m (CI, 7.0-71.1, P=0.019) compared with control. BFRRE increased maximum isometric strength by 29.7 Nm (CI, 10.8-48.6, P=0.003) compared with control. BFRRE improved quality of life by 5.4 points (CI, -0.04 to 10.9; P=0.052) compared with control. BFRRE increased mitochondrial function by 19.1 pmol/s per milligram (CI, 7.3-30.8; P=0.002) compared with control. RIC did not produce similar changes. CONCLUSIONS Our results demonstrate that BFRRE, but not RIC, improves functional capacity, quality of life, and muscle mitochondrial function. Our findings have clinical implications for rehabilitation of patients with CHF and provide new insights on the myopathy accompanying CHF. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT03380663.
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Affiliation(s)
- Thomas Groennebaek
- Section for Sports Science, Department of Public Health, Aarhus University, Aarhus, Denmark (T.G., P.S., J.W., C.R.C., K.V.)
| | - Peter Sieljacks
- Section for Sports Science, Department of Public Health, Aarhus University, Aarhus, Denmark (T.G., P.S., J.W., C.R.C., K.V.)
| | - Roni Nielsen
- Department of Cardiology (R.N., K.P., N.R.J., M.R.S., H.E.B.), Aarhus University Hospital, Denmark
| | - Kasper Pryds
- Department of Cardiology (R.N., K.P., N.R.J., M.R.S., H.E.B.), Aarhus University Hospital, Denmark
| | - Nichlas R Jespersen
- Department of Cardiology (R.N., K.P., N.R.J., M.R.S., H.E.B.), Aarhus University Hospital, Denmark
| | - Jakob Wang
- Section for Sports Science, Department of Public Health, Aarhus University, Aarhus, Denmark (T.G., P.S., J.W., C.R.C., K.V.)
| | - Caroline R Carlsen
- Section for Sports Science, Department of Public Health, Aarhus University, Aarhus, Denmark (T.G., P.S., J.W., C.R.C., K.V.)
| | - Michael R Schmidt
- Department of Cardiology (R.N., K.P., N.R.J., M.R.S., H.E.B.), Aarhus University Hospital, Denmark
| | - Frank V de Paoli
- Department of Biomedicine (F.V.d.P.), Aarhus University Hospital, Denmark.,Department of Cardiothoracic and Vascular Surgery (F.V.d.P.), Aarhus University Hospital, Denmark
| | - Benjamin F Miller
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City (B.F.M.)
| | - Kristian Vissing
- Section for Sports Science, Department of Public Health, Aarhus University, Aarhus, Denmark (T.G., P.S., J.W., C.R.C., K.V.)
| | - Hans Erik Bøtker
- Department of Cardiology (R.N., K.P., N.R.J., M.R.S., H.E.B.), Aarhus University Hospital, Denmark
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De Spiegeleer A, Elewaut D, Van Den Noortgate N, Janssens Y, Debunne N, Van Langenhove S, Govindarajan S, De Spiegeleer B, Wynendaele E. WITHDRAWN: This article has been withdrawn. Biochim Biophys Acta Mol Basis Dis 2019:165585. [PMID: 31678164 DOI: 10.1016/j.bbadis.2019.165585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 09/11/2019] [Accepted: 09/22/2019] [Indexed: 11/21/2022]
Abstract
This article has been withdrawn at the request of the author for administrative reasons. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Affiliation(s)
- Anton De Spiegeleer
- Department of Geriatrics, Faculty of Medicine and Health Sciences, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium; Drug Quality and Registration (DruQuaR) group, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium; Unit for Molecular Immunology and Inflammation, VIB-Center for Inflammation Research, Technologiepark 71, 9052, Zwijnaarde, Ghent, Belgium
| | - Dirk Elewaut
- Unit for Molecular Immunology and Inflammation, VIB-Center for Inflammation Research, Technologiepark 71, 9052, Zwijnaarde, Ghent, Belgium; Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Nele Van Den Noortgate
- Department of Geriatrics, Faculty of Medicine and Health Sciences, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Yorick Janssens
- Drug Quality and Registration (DruQuaR) group, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - Nathan Debunne
- Drug Quality and Registration (DruQuaR) group, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - Selien Van Langenhove
- Drug Quality and Registration (DruQuaR) group, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - Srinath Govindarajan
- Unit for Molecular Immunology and Inflammation, VIB-Center for Inflammation Research, Technologiepark 71, 9052, Zwijnaarde, Ghent, Belgium; Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Bart De Spiegeleer
- Drug Quality and Registration (DruQuaR) group, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - Evelien Wynendaele
- Drug Quality and Registration (DruQuaR) group, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium.
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Refsgaard Holm M, Christensen H, Rasmussen J, Johansen ML, Schou M, Faber J, Kistorp C. Fibroblast growth factor 21 in patients with cardiac cachexia: a possible role of chronic inflammation. ESC Heart Fail 2019; 6:983-991. [PMID: 31429530 PMCID: PMC6816069 DOI: 10.1002/ehf2.12502] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 06/18/2019] [Accepted: 07/01/2019] [Indexed: 12/12/2022] Open
Abstract
Aims Cardiac cachexia is a wasting syndrome characterized by chronic inflammation and high mortality. Fibroblast growth factor 21 (FGF‐21) and monocyte chemoattractant protein 1 (MCP‐1) are associated with cardiovascular disease and systemic inflammation. We investigated FGF‐21 and MCP‐1 in relations to cardiac function, inflammation, and wasting in patients with heart failure with reduced ejection fraction (HFrEF) and cardiac cachexia. Methods and results Plasma FGF‐21 and MCP‐1 were measured in a cross‐sectional study among the three study groups: 19 patients with HFrEF with cardiac cachexia, 19 patients with HFrEF without cachexia, and 19 patients with ischaemic heart disease and preserved ejection fraction. Patients with HFrEF and cardiac cachexia displayed higher FGF‐21 levels median (inter quantile range) 381 (232–577) pg/mL than patients with HFrEF without cachexia 224 (179–309) pg/mL and ischaemic heart disease patients 221 (156–308) pg/mL (P = 0.0496). No difference in MCP‐1 levels were found among the groups (P = 0.345). In a multivariable regression analysis, FGF‐21 (logarithm 2) was independently associated with interleukin 6 (logarithm 2) (P = 0.015) and lower muscle mass (P = 0.043), while no relation with N‐terminal pro‐hormone brain natriuretic peptide was observed. Conclusions Fibroblast growth factor 21 (FGF‐21) levels were elevated in patients with HFrEF and cardiac cachexia, which could be mediated by increased inflammation and muscle wasting rather than impaired cardiac function.
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Affiliation(s)
- Maria Refsgaard Holm
- Centre of Endocrinology and Metabolism, Department of Internal Medicine, Copenhagen University Hospitals, Herlev and Gentofte, Herlev Ringvej 75, 2730, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Heidi Christensen
- Centre of Endocrinology and Metabolism, Department of Internal Medicine, Copenhagen University Hospitals, Herlev and Gentofte, Herlev Ringvej 75, 2730, Herlev, Denmark
| | - Jon Rasmussen
- Centre of Endocrinology and Metabolism, Department of Internal Medicine, Copenhagen University Hospitals, Herlev and Gentofte, Herlev Ringvej 75, 2730, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marie Louise Johansen
- Centre of Endocrinology and Metabolism, Department of Internal Medicine, Copenhagen University Hospitals, Herlev and Gentofte, Herlev Ringvej 75, 2730, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Morten Schou
- Department of Cardiology, Copenhagen University Hospitals, Herlev and Gentofte, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Faber
- Centre of Endocrinology and Metabolism, Department of Internal Medicine, Copenhagen University Hospitals, Herlev and Gentofte, Herlev Ringvej 75, 2730, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Caroline Kistorp
- Department of Endocrinology, Copenhagen University Hospitals, Rigshospitalet, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Sheean P, Gonzalez MC, Prado CM, McKeever L, Hall AM, Braunschweig CA. American Society for Parenteral and Enteral Nutrition Clinical Guidelines: The Validity of Body Composition Assessment in Clinical Populations. JPEN J Parenter Enteral Nutr 2019; 44:12-43. [DOI: 10.1002/jpen.1669] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Patricia Sheean
- Marcella Niehoff School of Nursing Department of Health Promotion Loyola University Chicago Maywood Illinois USA
| | - M. Cristina Gonzalez
- Postgraduate Program in Health and Behavior Catholic University of Pelotas Pelotas Rio Grande do Sul Brazil
| | - Carla M. Prado
- Human Nutrition Research Unit Department of Agricultural Food and Nutritional Science Division of Human Nutrition, University of Alberta Edmonton Alberta Canada
| | - Liam McKeever
- Department of Kinesiology and Nutrition University of Illinois Chicago Illinois USA
| | - Amber M. Hall
- University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Carol A. Braunschweig
- Department of Kinesiology and Nutrition and Division of Epidemiology and Biostatistics University of Illinois at Chicago Chicago Illinois USA
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Yin J, Lu X, Qian Z, Xu W, Zhou X. New insights into the pathogenesis and treatment of sarcopenia in chronic heart failure. Am J Cancer Res 2019; 9:4019-4029. [PMID: 31281529 PMCID: PMC6592172 DOI: 10.7150/thno.33000] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/10/2019] [Indexed: 12/13/2022] Open
Abstract
Sarcopenia is an age-related geriatric syndrome that is characterized by a progressive loss of muscle mass, strength and function. Chronic heart failure (CHF), the final stage of various cardiovascular diseases, may be closely correlated with the occurrence of sarcopenia. Accumulating evidence has demonstrated that CHF can promote the development of sarcopenia through multiple pathophysiological mechanisms, including malnutrition, inflammation, hormonal changes, oxidative stress, autophagy, and apoptosis. Additionally, CHF can aggravate the adverse outcomes associated with sarcopenia, including falls, osteoporosis, frailty, cachexia, hospitalization, and mortality. Sarcopenia and CHF are mutually interacting clinical syndromes. Patients with these two syndromes seem to endure a double burden, with no particularly effective way to hinder their progression. However, the combination of physical exercise, nutritional supplements, and drug therapy may counteract the development of these maladies. In this review, we will summarize the latest progress in the pathogenesis and treatment of sarcopenia in patients with CHF.
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Tsuji M, Amiya E, Hatano M, Nitta D, Maki H, Bujo C, Saito A, Hosoya Y, Minatsuki S, Hara T, Nemoto M, Kagami Y, Endo M, Kimura M, Kinoshita O, Nawata K, Morita H, Ono M, Komuro I. Abdominal skeletal muscle mass as a predictor of mortality in Japanese patients undergoing left ventricular assist device implantation. ESC Heart Fail 2019; 6:526-535. [PMID: 30929311 PMCID: PMC6487708 DOI: 10.1002/ehf2.12429] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 02/15/2019] [Indexed: 12/25/2022] Open
Abstract
Aims We assessed preoperative muscle wasting in patients undergoing left ventricular assist device (LVAD) implantations using abdominal skeletal muscle images on computed tomography (CT) and explored the associations between the preoperative muscle wasting and clinical outcomes after LVAD implantation. Methods and results We retrospectively examined the records of 111 patients who underwent continuous‐flow LVAD implantations as bridge‐to‐transplant therapy from January 2010 to December 2016 at our institution. After 33 patients were excluded, the study cohort consisted of 78 individuals. CT images used to calculate the skeletal muscle index (SMI) at the third lumbar vertebra level were obtained before the LVAD implantation procedures. Patients were classified as having muscle wasting if their SMI fell into the lowest gender‐based tertile. The median SMI for the study patients was 37.6 cm2/m2. The SMI cut‐off values for the lowest tertiles were 36.7 cm2/m2 for men and 28.2 cm2/m2 for women, resulting in 26 patients (33.3%) with muscle wasting in this study. During the mean follow‐up of 738 ± 379 days, there were 10 deaths (12.8% mortality). Seven of the 26 patients with muscle wasting (26.9%) died, and 3 of the 52 patients without muscle wasting (5.8%) died. The times to all‐cause mortality were significantly different between patients with and without muscle wasting (P = 0.0094). Muscle wasting was found to be associated with mortality in univariate and multivariate Cox analyses (hazard ratio: 4.32; 95% CI: 1.19–20.2). Conclusions Preoperative muscle wasting was associated with a higher mortality in patients with LVAD. Assessment of the abdominal skeletal muscle area on CT prior to LVAD implantation can help predict mortality.
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Affiliation(s)
- Masaki Tsuji
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Therapeutic Strategy for Heart Failure, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Daisuke Nitta
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hisataka Maki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Chie Bujo
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Akihito Saito
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yumiko Hosoya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shun Minatsuki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toru Hara
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mariko Nemoto
- Department of Organ Transplantation, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yukie Kagami
- Department of Organ Transplantation, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Miyoko Endo
- Department of Organ Transplantation, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mitsutoshi Kimura
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Osamu Kinoshita
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kan Nawata
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
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Abstract
Hyperkalaemia causes significant burden, and even mild hyperkalaemia has been independently associated with increased morbidity and mortality. Patients with chronic disease states, such as heart failure, hypertension, chronic kidney disease and diabetes mellitus, are increasingly susceptible to the development of hyperkalaemia. Options for management of hyperkalaemia had mainly been limited to short-term, temporizing methods with focus on rapid achievement of normokalaemia. Until recently, there was a lack of safe, efficacious and well-tolerated therapies for long-term management. Two novel potassium binders, patiromer and sodium zirconium cyclosilicate, have recently been approved by the US Food and Drug Administration for the management of hyperkalaemia. This review discusses these potassium binders with focus largely on the clinical implications of these agents in patients with chronic cardiovascular conditions.
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Affiliation(s)
- Shilpa Vijayakumar
- Department of Medicine, Stony Brook University, 101 Nicolls Road, Stony Brook, NY, USA
| | - Javed Butler
- Department of Medicine, University of Mississippi, 2500 North State Street, Jackson, MS, USA
| | - Stefan D Anker
- Department of Cardiology (CVK); and Berlin-Brandenburg Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin; Charité Universitätsmedizin Berlin, Germany; and
- Department of Cardiology, Universityätsmedizin Göttingen (UMG), Göttingen, Germany
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Song T, Manoharan P, Millay DP, Koch SE, Rubinstein J, Heiny JA, Sadayappan S. Dilated cardiomyopathy-mediated heart failure induces a unique skeletal muscle myopathy with inflammation. Skelet Muscle 2019; 9:4. [PMID: 30678732 PMCID: PMC6345027 DOI: 10.1186/s13395-019-0189-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/10/2019] [Indexed: 02/02/2023] Open
Abstract
Background Skeletal muscle myopathy and exercise intolerance are diagnostic hallmarks of heart failure (HF). However, the molecular adaptations of skeletal muscles during dilated cardiomyopathy (DCM)-mediated HF are not completely understood. Methods Skeletal muscle structure and function were compared in wild-type (WT) and cardiac myosin binding protein-C null mice (t/t), which develop DCM-induced HF. Cardiac function was examined by echocardiography. Exercise tolerance was measured using a graded maximum treadmill running test. Hindlimb muscle function was assessed in vivo from measurements of plantar flexor strength. Inflammatory status was evaluated from the expression of inflammatory markers and the presence of specific immune cell types in gastrocnemius muscles. Muscle regenerative capacityat days 3, 7, and 14 after eccentric contraction-induced injury was determined from the number of phenotypically new and adult fibers in the gastrocnemius, and functional recovery of plantar flexion torque. Results t/t mice developed DCM-induced HF in association with profound exercise intolerance, consistent with previous reports. Compared to WT, t/t mouse hearts show significant hypertrophy of the atria and ventricles and reduced fractional shortening, both systolic and diastolic. In parallel, the skeletal muscles of t/t mice exhibit weakness and myopathy. Compared to WT, plantar flexor muscles of t/t null mice produce less peak isometric plantar torque (Po), develop torque more slowly (+ dF/dt), and relax more slowly (− dF/dt, longer half-relaxation times,1/2RT). Gastrocnemius muscles of t/t mice have a greater number of fibers with smaller diameters and central nuclei. Oxidative fibers, both type I and type IIa, show significantly smaller cross-sectional areas and more central nuclei. These fiber phenotypes suggest ongoing repair and regeneration under homeostatic conditions. In addition, the ability of muscles to recover and regenerate after acute injury is impaired in t/t mice. Conclusions Our studies concluded that DCM-induced HF induces a unique skeletal myopathy characterized by decreased muscle strength, atrophy of oxidative fiber types, ongoing inflammation and damage under homeostasis, and impaired regeneration after acute muscle injury. Furthermore, this unique myopathy in DCM-induced HF likely contributes to and exacerbates exercise intolerance. Therefore, efforts to develop therapeutic interventions to treat skeletal myopathy during DCM-induced HF should be considered. Electronic supplementary material The online version of this article (10.1186/s13395-019-0189-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Taejeong Song
- Heart Lung Vascular Institute, Division of Cardiology, University of Cincinnati, Cincinnati, OH, 45267, USA
| | - Palanikumar Manoharan
- Department of Molecular Genetics, Biochemistry, and Microbiology, University of Cincinnati, Cincinnati, OH, 45267, USA
| | - Douglas P Millay
- Division of Molecular Cardiovascular Biology, Cincinnati Children's Hospital Medical Center, 240 Albert Sabin Way, Cincinnati, OH, 45229, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
| | - Sheryl E Koch
- Heart Lung Vascular Institute, Division of Cardiology, University of Cincinnati, Cincinnati, OH, 45267, USA
| | - Jack Rubinstein
- Heart Lung Vascular Institute, Division of Cardiology, University of Cincinnati, Cincinnati, OH, 45267, USA
| | - Judith A Heiny
- Department of Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, OH, 45267, USA
| | - Sakthivel Sadayappan
- Heart Lung Vascular Institute, Division of Cardiology, University of Cincinnati, Cincinnati, OH, 45267, USA. .,Department of Internal Medicine, Heart, Lung and Vascular Institute, Division of Cardiovascular Health and Sciences, College of Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH, 45267-0575, USA.
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[Prevention of frailty and cognitive impairment in elderly patients with heart failure]. Nihon Ronen Igakkai Zasshi 2019; 56:107-114. [PMID: 31092774 DOI: 10.3143/geriatrics.56.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Dos Santos EM, de Moraes R, Tibiriça EV, Huguenin GVB, Moreira ASB, De Lorenzo AR. Whey protein supplementation for the preservation of mass and muscular strength of patients with heart failure: study protocol for a randomized controlled trial. Trials 2018; 19:431. [PMID: 30089525 PMCID: PMC6083622 DOI: 10.1186/s13063-018-2811-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 07/17/2018] [Indexed: 02/06/2023] Open
Abstract
Background Heart failure (HF) is an important public health problem, considered a new epidemic with high morbidity and mortality. The progression of HF often determines weight reduction, muscle mass loss, and reduced physical ability. Whey protein supplementation may increase the effects of exercise on strength and muscle mass, in addition to promoting improved endothelial function, body composition and quality of life. However, studies are needed to evaluate its benefits in patients with HF. Methods/design This is a double-blind, randomized, placebo-controlled clinical trial in which patients with HF will be randomly allocated to two groups to receive supplementation with whey protein or placebo, associated with supervised exercise, for 12 weeks. The frequency of exercise will be three times a week. The study variables will be evaluated at baseline and 12 weeks. The main outcome will be maintenance of muscle mass and strength. Microvascular reactivity, quality of life, and inflammatory parameters will be evaluated as secondary outcomes. Discussion HF is associated with severe loss of muscle mass and strength, directly contributing to exercise intolerance and inability to maintain daily life activities, becoming a strong predictor of reduced quality of life and mortality. The results of this study will add to the evidence base for providing new dietary recommendations. Trial registration ClinicalTrials.gov, ID: NCT03142399. Registered on 29 May 2016. Effect of Whey Protein’ Supplementation and Exercise in Patients with Heart Failure (PROT-HF). Electronic supplementary material The online version of this article (10.1186/s13063-018-2811-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elisa Maia Dos Santos
- Institute of the Heart Edson Saad, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil. .,Department of Clinical Research, National Institute of Cardiology (INC), Rua das Laranjeiras, 374, 5o andar - Laranjeiras, Rio de Janeiro, RJ, CEP: 22240-006, Brazil.
| | | | - Eduardo Vera Tibiriça
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute (IOC), Rio de Janeiro, RJ, Brazil
| | - Grazielle Vilas Bôas Huguenin
- Universidade Federal Fluminense (UFF), Niterói, Brazil.,National Institute of Cardiology (INC), Rio de Janeiro, RJ, Brazil
| | - Annie Seixas Belo Moreira
- State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Department of Clinical Research, National Institute of Cardiology (INC), Rua das Laranjeiras, 374, 5o andar - Laranjeiras, Rio de Janeiro, RJ, CEP: 22240-006, Brazil
| | - Andrea Rocha De Lorenzo
- Institute of the Heart Edson Saad, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Department of Clinical Research, National Institute of Cardiology (INC), Rua das Laranjeiras, 374, 5o andar - Laranjeiras, Rio de Janeiro, RJ, CEP: 22240-006, Brazil
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Iliopoulos F, Mazis N. Exercise training in heart failure patients: effects on skeletal muscle abnormalities and sympathetic nervous activity—a literature review. SPORT SCIENCES FOR HEALTH 2018. [DOI: 10.1007/s11332-018-0442-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Cao Q, Zhang J, Gao L, Zhang Y, Dai M, Bao M. Dickkopf‑3 upregulation mediates the cardioprotective effects of curcumin on chronic heart failure. Mol Med Rep 2018; 17:7249-7257. [PMID: 29568962 PMCID: PMC5928680 DOI: 10.3892/mmr.2018.8783] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 02/28/2018] [Indexed: 01/20/2023] Open
Abstract
Curcumin, isolated from rhizome of turmeric, has been widely studied as a potential therapeutic drug for cancer. However, protective effects of curcumin on chronic heart failure (CHF) have not been fully studied. In the present study, the effects of curcumin on CHF and the underlying mechanisms were investigated. A total of 40 rabbits were randomized into 4 groups: Control rabbits fed with placebo (Con) or curcumin (Con‑cur), CHF rabbits fed with placebo (CHF) or curcumin (CHF‑cur). CHF was induced by volume and pressure overload. The effects of curcumin on cardiac function and left ventricular (LV) structure were assessed by echocardiography and histology. The effects of curcumin on CHF molecular biomarkers were detected by dihydroethidium and immunohistochemical staining. The effects of curcumin on Dickkopf‑related protein 3 (DKK‑3), p38 mitogen‑activated protein kinase (p38), c‑Jun N‑terminal kinase (JNK) and apoptosis signal‑regulating kinase 1 (ASK1) were assessed by immunohistochemical staining and western blot analysis. Cardiac dysfunction and LV remodeling were successfully produced by ten weeks volume overload and eight weeks pressure overload in the CHF group. Compared with the Con group, the CHF group demonstrated higher levels of CHF molecular biomarkers, a lower level of DKK‑3 expression and alterations of p38, JNK and ASK1 protein expression. Curcumin alleviated all those abnormalities markedly in the CHF‑cur group. In summary, curcumin may exert cardioprotective effects by up‑regulating DKK‑3, which in turn may inhibit p38 and JNK signaling pathways in an ASK1‑dependent way. The present study demonstrated that Dickkopf‑3 upregulation mediates the cardioprotective effects of curcumin on chronic heart failure for the first time.
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Affiliation(s)
- Quan Cao
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Junxia Zhang
- Department of Endocrinology, Wuhan General Hospital of the Chinese People's Liberation Army, Wuhan, Hubei 430070, P.R. China
| | - Ling Gao
- Department of Endocrinology and Metabolism, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Yijie Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Mingyan Dai
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Mingwei Bao
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
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Saitoh M, Ebner N, von Haehling S, Anker SD, Springer J. Therapeutic considerations of sarcopenia in heart failure patients. Expert Rev Cardiovasc Ther 2018; 16:133-142. [PMID: 29308681 DOI: 10.1080/14779072.2018.1424542] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Sarcopenia is a common feature, and affects 20-47% of patients with heart failure (HF). Sarcopenia is also an independent predictor of impaired functional capacity, even after adjusting for clinical relevant variables, which is associated with adverse outcome in patients with HF. Areas covered: Several different pathophysiological pathways are involved in sarcopenic processes including altered nutrient intake and absorption, hormonal factor, inflammatory processes, oxidative stress, cellular proteolysis, and unhealthy lifestyle. Nutritional therapy, physical activity and/or exercise training have been associated with improved muscle mass or physical performance in HF. Few studies reported beneficial effects for muscle mass and physical performance, in those who received angiotensin-converting enzyme (ACE) inhibitors, or/and beta-blocker. In addition, testosterone, selective androgen receptor modulators, ghrelin agonist and myostatin inhibitors are currently under study as possible future therapeutic options. Expert commentary: Regular and adequate level of physical activity and/or exercise training, and sufficient nutritional intake or special nutritional supplementation may represent the best strategy for prevention or delay of sarcopenia and worsening physical performance in patients with HF. Maximal tolerated dosages of standard therapies for HF such as ACE-inhibitors or beta-blockers are first-line strategy, however it is difficult to recommend other pharmacological agents as part of routine treatment of sarcopenia.
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Affiliation(s)
- Masakazu Saitoh
- a Department of Cardiology and Pneumology , University Medical Center Göttingen , Göttingen , Germany
| | - Nicole Ebner
- a Department of Cardiology and Pneumology , University Medical Center Göttingen , Göttingen , Germany
| | - Stephan von Haehling
- a Department of Cardiology and Pneumology , University Medical Center Göttingen , Göttingen , Germany
| | - Stefan D Anker
- a Department of Cardiology and Pneumology , University Medical Center Göttingen , Göttingen , Germany.,b Division of Cardiology and Metabolism - Heart Failure, Cachexia & Sarcopenia, Department of Cardiology (CVK) , Berlin , Germany.,c Berlin-Brandenburg Center for Regenerative Therapies (BCRT) , Berlin , Germany.,d Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK) , Berlin , Germany.,e Charité Universitätsmedizin , Berlin , Germany
| | - Jochen Springer
- a Department of Cardiology and Pneumology , University Medical Center Göttingen , Göttingen , Germany
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Muscular Atrophy in Cardiovascular Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1088:369-391. [DOI: 10.1007/978-981-13-1435-3_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Loncar G, Bozic B, Neskovic AN, Cvetinovic N, Lainscak M, Prodanovic N, Dungen HD, von Haehling S, Radojicic Z, Trippel T, Putnikovic B, Markovic-Nikolic N, Popovic V. Androgen status in non-diabetic elderly men with heart failure. Aging Male 2017; 20:215-224. [PMID: 28696825 DOI: 10.1080/13685538.2017.1350155] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE We aimed at evaluating androgen status (serum testosterone [TT] and estimated free testosterone [eFT]) and its determinants in non-diabetic elderly men with heart failure (HF). Additionally, we investigated its associations with body composition and long-term survival. METHODS Seventy three non-diabetic men with HF and 20 healthy men aged over 55 years were studied. Echocardiography, 6-min walk test, grip strength, body composition measurement by DEXA method were performed. TT, sex hormone binding globulin, NT-proBNP, and adipokines (adiponectin and leptin) were measured. All-cause mortality was evaluated at six years of follow-up. RESULTS Androgen status (TT, eFT) was similar in elderly men with HF compared to healthy controls (4.79 ± 1.65 vs. 4.45 ± 1.68 ng/ml and 0.409 ± 0.277 vs. 0.350 ± 0.204 nmol/l, respectively). In HF patients, TT was positively associated with NT-proBNP (r= 0.371, p = 0.001) and adiponectin levels (r = 0.349, p = 0.002), while inverse association was noted with fat mass (r = -0.413, p < 0.001). TT and eFT were independently determined by age, total fat mass and adiponectin levels in elderly men with HF (p < 0.05 for all). Androgen status was not predictor for all-cause mortality at six years of follow-up. CONCLUSIONS In non-diabetic men with HF, androgen status is not altered and is not predictive of long-term outcome.
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Affiliation(s)
- Goran Loncar
- a Department of Cardiology , Zvezdara University Medical Center , Belgrade , Serbia
- b Faculty of Medicine , University of Belgrade , Belgrade , Serbia
| | - Biljana Bozic
- c Institute for Medical Research , Military Medical Academy , Belgrade , Serbia
- d Institute for Physiology and Biochemistry , University of Belgrade , Belgrade , Serbia
| | - Aleksandar N Neskovic
- b Faculty of Medicine , University of Belgrade , Belgrade , Serbia
- e Department of Cardiology , University Hospital Zemun , Belgrade , Serbia
| | - Natasa Cvetinovic
- a Department of Cardiology , Zvezdara University Medical Center , Belgrade , Serbia
| | - Mitja Lainscak
- f Departments of Cardiology, Research and Education , General Hospital Celje , Celje , Slovenia
- g Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia
| | - Nenad Prodanovic
- h Clinic for Rheumatology and Clinical Immunology , Military Medical Academy , Belgrade , Serbia
| | - Hans-Dirk Dungen
- i Department of Cardiology, Campus Virchow , Charité Universitätsmedizin Berlin , Berlin , Germany
| | - Stephan von Haehling
- j Innovative Clinical Trials, Department of Cardiology and Pneumology , University of Medicine Göttingen , Germany
- k Applied Cachexia Research, Department of Cardiology , Charité-University Medical School, Campus Virchow-Klinikum Berlin , Germany
| | - Zoran Radojicic
- l Institute for Statistics, Faculty of Organizational Sciences , University of Belgrade , Belgrade , Serbia
| | - Tobias Trippel
- i Department of Cardiology, Campus Virchow , Charité Universitätsmedizin Berlin , Berlin , Germany
| | - Biljana Putnikovic
- b Faculty of Medicine , University of Belgrade , Belgrade , Serbia
- e Department of Cardiology , University Hospital Zemun , Belgrade , Serbia
| | - Natasa Markovic-Nikolic
- a Department of Cardiology , Zvezdara University Medical Center , Belgrade , Serbia
- b Faculty of Medicine , University of Belgrade , Belgrade , Serbia
| | - Vera Popovic
- b Faculty of Medicine , University of Belgrade , Belgrade , Serbia
- m Institute of Endocrinology , Clinical Center of Serbia , Belgrade , Serbia
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von Haehling S, Ebner N, Anker SD. Oodles of opportunities: the Journal of Cachexia, Sarcopenia and Muscle in 2017. J Cachexia Sarcopenia Muscle 2017; 8:675-680. [PMID: 29076661 PMCID: PMC5659063 DOI: 10.1002/jcsm.12247] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 08/31/2017] [Indexed: 12/12/2022] Open
Affiliation(s)
- Stephan von Haehling
- Department of Cardiology and PneumologyUniversity of Göttingen Medical CenterGöttingenGermany
| | - Nicole Ebner
- Department of Cardiology and PneumologyUniversity of Göttingen Medical CenterGöttingenGermany
| | - Stefan D. Anker
- Division of Cardiology and Metabolism—Heart Failure, Cachexia & Sarcopenia, Department of Cardiology (CVK); and Berlin‐Brandenburg Center for Regenerative Therapies (BCRT); Deutsches Zentrum für Herz‐Kreislauf‐Forschung (DZHK) BerlinCharité Universitätsmedizin BerlinBerlinGermany
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48
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Coats AJS, Forman DE, Haykowsky M, Kitzman DW, McNeil A, Campbell TS, Arena R. Physical function and exercise training in older patients with heart failure. Nat Rev Cardiol 2017; 14:550-559. [PMID: 28518178 PMCID: PMC7245611 DOI: 10.1038/nrcardio.2017.70] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Heart failure (HF) is a common end point for numerous cardiovascular conditions, including coronary artery disease, valvular disease, and hypertension. HF predominantly affects older individuals (aged ≥70 years), particularly those living in developed countries. The pathophysiological sequelae of HF progression have a substantial negative effect on physical function. Diminished physical function in older patients with HF, which is the result of combined disease-related and age-related effects, has important implications on health. A large body of research spanning several decades has demonstrated the safety and efficacy of regular physical activity in improving outcomes among the HF population, regardless of age, sex, or ethnicity. However, patients with HF, especially those who are older, are less likely to engage in regular exercise training compared with the general population. To improve initiation of regular exercise training and subsequent long-term compliance, there is a need to rethink the dialogue between clinicians and patients. This Review discusses the need to improve physical function and exercise habits in patients with HF, focusing on the older population.
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Affiliation(s)
- Andrew J Stewart Coats
- Monash University, Clayton Campus, Melbourne, Victoria 3800, Australia
- University of Warwick, Kirby Corner Road, Coventry CV4 8UW, UK
| | - Daniel E Forman
- Section of Geriatric Cardiology, University of Pittsburgh Medical Center, VA Pittsburgh Healthcare System, 259 Mt Nebo Pointe Drive, Pittsburgh, Pennsylvania 15213, USA
| | - Mark Haykowsky
- College of Nursing and Health Innovation, University of Texas at Arlington, 411 South Nedderman Drive, Arlington, Texas 76019, USA
| | - Dalane W Kitzman
- Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, North Carolina 27157, USA
| | - Amy McNeil
- Department of Physical Therapy, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 West Taylor Street, Chicago, Illinois 60612, USA
| | - Tavis S Campbell
- Department of Psychology, University of Calgary, 2500 University Drive North West, Calgary, Alberta T2N 1N4, Canada
| | - Ross Arena
- Department of Physical Therapy, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 West Taylor Street, Chicago, Illinois 60612, USA
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49
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Hajahmadi M, Shemshadi S, Khalilipur E, Amin A, Taghavi S, Maleki M, Malek H, Naderi N. Muscle wasting in young patients with dilated cardiomyopathy. J Cachexia Sarcopenia Muscle 2017; 8:542-548. [PMID: 28251827 PMCID: PMC5566643 DOI: 10.1002/jcsm.12193] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 11/01/2016] [Accepted: 01/21/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Muscle wasting can be accelerated by chronic diseases such as heart failure and is one of the major causes of disability, morbidity, and mortality in this population. We aimed to investigate the incidence of muscle wasting and its associated factors in dilated cardiomyopathy patients younger than 55 years of age. METHODS Between April 2014 and December 2015, all symptomatic patients with a diagnosis of non-ischaemic dilated cardiomyopathy who were referred to heart failure clinic were included in our study. Dual energy X-ray absorptiometry was used to evaluate body composition and identify muscle wasting. Muscle mass was calculated as the ratio of an individual's total lean mass of legs and arms (also called appendicular skeletal muscle) to their squared height (kg/m2 ). The muscle mass values of less than 5.45 kg/m2 for women and 7.26 kg/m2 for men were considered low. RESULTS A total of 55 patients (32 male) were included. The mean (standard deviation) of age was 37.3 (10.1) years, and the mean of left ventricular ejection fraction was 21.4%. Most of the patients were in the New York Heart Association classes of II and II-III. Twenty-six patients (47.3%) met criteria for muscle wasting. Patients with muscle wasting had lower left ventricular ejection fraction, lower 6-min walk distance, and higher New York Heart Association function class and hospitalization rate. CONCLUSIONS We concluded that muscle wasting might be present in younger patients with heart failure, particularly in those who are in worse clinical condition.
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Affiliation(s)
- Marjan Hajahmadi
- Department of Cardiology, Hazrat Rasoul Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sara Shemshadi
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ehsan Khalilipur
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Amin
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sepideh Taghavi
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Maleki
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hadi Malek
- Department of Nuclear Medicine, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nasim Naderi
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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50
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Integration of miRNA and mRNA expression profiles reveals microRNA-regulated networks during muscle wasting in cardiac cachexia. Sci Rep 2017; 7:6998. [PMID: 28765595 PMCID: PMC5539204 DOI: 10.1038/s41598-017-07236-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 06/28/2017] [Indexed: 12/28/2022] Open
Abstract
Cardiac cachexia (CC) is a common complication of heart failure (HF) associated with muscle wasting and poor patient prognosis. Although different mechanisms have been proposed to explain muscle wasting during CC, its pathogenesis is still not understood. Here, we described an integrative analysis between miRNA and mRNA expression profiles of muscle wasting during CC. Global gene expression profiling identified 1,281 genes and 19 miRNAs differentially expressed in muscle wasting during CC. Several of these deregulated genes are known or putative targets of the altered miRNAs, including miR-29a-3p, miR-29b-3p, miR-210-5p, miR-214, and miR-489. Gene ontology analysis on integrative mRNA/miRNA expression profiling data revealed miRNA interactions affecting genes that regulate extra-cellular matrix (ECM) organization, proteasome protein degradation, citric acid cycle and respiratory electron transport. We further identified 11 miRNAs, including miR-29a-3p and miR-29b-3p, which target 21 transcripts encoding the collagen proteins related to ECM organization. Integrative miRNA and mRNA global expression data allowed us to identify miRNA target genes involved in skeletal muscle wasting in CC. Our functional experiments in C2C12 cells confirmed that miR-29b down-regulates collagen genes and contributes to muscle cell atrophy. Collectively, our results suggest that key ECM-associated miRNAs and their target genes may contribute to CC in HF.
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