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Vrtovec B, Poglajen G, Lezaic L, Sever M, Socan A, Domanovic D, Cernelc P, Torre-Amione G, Haddad F, Wu JC. Comparison of transendocardial and intracoronary CD34+ cell transplantation in patients with nonischemic dilated cardiomyopathy. Circulation 2013; 128:S42-9. [PMID: 24030420 DOI: 10.1161/circulationaha.112.000230] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND In an open-label blinded study, we compared intracoronary and transendocardial CD34(+) cell transplantation in patients with nonischemic dilated cardiomyopathy. METHODS AND RESULTS Of the 40 patients with dilated cardiomyopathy, 20 were randomized to receive intracoronary injection and 20 received transendocardial CD34(+) cell delivery. In both groups, CD34(+) cells were mobilized by filgrastim, collected via apheresis, and labeled with technetium-99m radioisotope for single-photon emission computed tomographic imaging. In the intracoronary group, cells were injected intracoronarily in the artery supplying segments of greater perfusion defect on myocardial perfusion scintigraphy. In the transendocardial group, electroanatomic mapping was used to identify viable but dysfunctional myocardium, and transendocardial cell injections were performed. Nuclear single-photon emission computed tomographic imaging for quantification of myocardial retention was performed 18 hours thereafter. At baseline, groups did not differ in age, sex, left ventricular ejection fraction, or N-terminal pro-brain natriuretic peptide levels. The number of CD34(+) cells was also comparable (105 ± 31 × 10(6) in the transendocardial group versus 103 ± 27 × 10(6) in the intracoronary group, P=0.62). At 18 hours after procedure, myocardial retention was higher in the transendocardial group (19.2 ± 4.8%) than in the intracoronary group (4.4 ± 1.2%, P<0.01). At 6 months, left ventricular ejection fraction improved more in the transendocardial group (+8.1 ± 4.3%) than in the intracoronary group (+4.2 ± 2.3%, P=0.03). The same pattern was observed for the 6-minute walk test distance (+125 ± 33 m in the transendocardial group versus +86 ± 13 m in the intracoronary group, P=0.03) and N-terminal pro-brain natriuretic peptide (-628 ± 211 versus -315 ± 133 pg/mL, P=0.04). CONCLUSIONS In patients with dilated cardiomyopathy, transendocardial CD34(+) cell transplantation is associated with higher myocardial retention rates and greater improvement in ventricular function, N-terminal pro-brain natriuretic peptide, and exercise capacity compared with intracoronary route. CLINICAL TRIAL REGISTRATION URL http://www.clinicaltrials.gov. Unique identifier: NCT01350310.
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Affiliation(s)
- Bojan Vrtovec
- Advanced Heart Failure and Transplantation Center (B.V., G.P.), Department of Nuclear Medicine (L.L., A.S.), and Department of Hematology (M.S., P.C.), University Medical Center Ljubljana, Ljubljana, Slovenia; National Blood Transfusion Institute, Ljubljana, Slovenia (D.D.); Methodist DeBakey Heart Center, Houston, TX (G.T.-A.); Stanford Cardiovascular Institute (F.H., J.C.W.) and Department of Medicine, Division of Cardiology (B.V., F.H., J.C.W.), Stanford University School of Medicine, Stanford, CA
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61
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Savinova OV, Liu Y, Aasen GA, Mao K, Weltman NY, Nedich BL, Liang Q, Gerdes AM. Thyroid hormone promotes remodeling of coronary resistance vessels. PLoS One 2011; 6:e25054. [PMID: 21966411 PMCID: PMC3178602 DOI: 10.1371/journal.pone.0025054] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Accepted: 08/23/2011] [Indexed: 12/22/2022] Open
Abstract
Low thyroid hormone (TH) function has been linked to impaired coronary blood flow, reduced density of small arterioles, and heart failure. Nonetheless, little is known about the mechanisms by which THs regulate coronary microvascular remodeling. The current study examined the initial cellular events associated with coronary remodeling induced by triiodothyronine (T3) in hypothyroid rats. Rats with established hypothyroidism, eight weeks after surgical thyroidectomy (TX), were treated with T3 for 36 or 72 hours. The early effects of T3 treatment on coronary microvasculature were examined morphometrically. Gene expression changes in the heart were assessed by quantitative PCR Array. Hypothyroidism resulted in arteriolar atrophy in the left ventricle. T3 treatment rapidly induced small arteriolar muscularization and, within 72 hours, restored arteriolar density to control levels. Total length of the capillary network was not affected by TX or T3 treatment. T3 treatment resulted in the coordinate regulation of Angiopoietin 1 and 2 expression. The response of Angiopoietins was consistent with vessel enlargement. In addition to the well known effects of THs on vasoreactivity, these results suggest that THs may affect function of small resistance arteries by phenotypic remodeling of vascular smooth muscle cells (VSMC).
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Affiliation(s)
- Olga V. Savinova
- Cardiovascular Health Research Center, Sanford Research/University of South Dakota, Sioux Falls, South Dakota, United States of America
| | - Yingheng Liu
- Cardiovascular Health Research Center, Sanford Research/University of South Dakota, Sioux Falls, South Dakota, United States of America
| | - Garth A. Aasen
- Cardiovascular Health Research Center, Sanford Research/University of South Dakota, Sioux Falls, South Dakota, United States of America
| | - Kai Mao
- Cardiovascular Health Research Center, Sanford Research/University of South Dakota, Sioux Falls, South Dakota, United States of America
| | - Nathan Y. Weltman
- Cardiovascular Health Research Center, Sanford Research/University of South Dakota, Sioux Falls, South Dakota, United States of America
| | - Brett L. Nedich
- Cardiovascular Health Research Center, Sanford Research/University of South Dakota, Sioux Falls, South Dakota, United States of America
| | - Qiangrong Liang
- Cardiovascular Health Research Center, Sanford Research/University of South Dakota, Sioux Falls, South Dakota, United States of America
| | - A. Martin Gerdes
- Cardiovascular Health Research Center, Sanford Research/University of South Dakota, Sioux Falls, South Dakota, United States of America
- * E-mail:
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63
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Rasi K, Piuhola J, Czabanka M, Sormunen R, Ilves M, Leskinen H, Rysä J, Kerkelä R, Janmey P, Heljasvaara R, Peuhkurinen K, Vuolteenaho O, Ruskoaho H, Vajkoczy P, Pihlajaniemi T, Eklund L. Collagen XV Is Necessary for Modeling of the Extracellular Matrix and Its Deficiency Predisposes to Cardiomyopathy. Circ Res 2010; 107:1241-52. [DOI: 10.1161/circresaha.110.222133] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Rationale:
The extracellular matrix (ECM) is a major determinant of the structural integrity and functional properties of the myocardium in common pathological conditions, and changes in vasculature contribute to cardiac dysfunction. Collagen (Col) XV is preferentially expressed in the ECM of cardiac muscle and microvessels.
Objective:
We aimed to characterize the ECM, cardiovascular function and responses to elevated cardiovascular load in mice lacking Col XV (
Col15a1
−/−
) to define its functional role in the vasculature and in age- and hypertension-associated myocardial remodeling.
Methods and Results:
Cardiac structure and vasculature were analyzed by light and electron microscopy. Cardiac function, intraarterial blood pressure, microhemodynamics, and gene expression profiles were studied using echocardiography, telemetry, intravital microscopy, and PCR, respectively. Experimental hypertension was induced with angiotensin II or with a nitric oxide synthesis inhibitor. Under basal conditions, lack of Col XV resulted in increased permeability and impaired microvascular hemodynamics, distinct early-onset and age-dependent defects in heart structure and function, a poorly organized fibrillar collagen matrix with marked interstitial deposition of nonfibrillar protein aggregates, increased tissue stiffness, and irregularly organized cardiomyocytes. In response to experimental hypertension,
Col15a1
gene expression was increased in the left ventricle of wild-type mice, and mRNA expression of natriuretic peptides (ANP and BNP) and ECM modeling were abnormal in
Col15a1
−/−
mice.
Conclusions:
Col XV is necessary for ECM organization in the heart, and for the structure and functions of microvessels. Col XV deficiency leads to a complex cardiac phenotype and predisposes the subject to pathological responses under cardiac stress.
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Affiliation(s)
- Karolina Rasi
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Jarkko Piuhola
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Marcus Czabanka
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Raija Sormunen
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Mika Ilves
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Hanna Leskinen
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Jaana Rysä
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Risto Kerkelä
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Paul Janmey
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Ritva Heljasvaara
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Keijo Peuhkurinen
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Olli Vuolteenaho
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Heikki Ruskoaho
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Peter Vajkoczy
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Taina Pihlajaniemi
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
| | - Lauri Eklund
- From the Oulu Center for Cell-Matrix Research, Biocenter Oulu, and Department of Medical Biochemistry and Molecular Biology (K.R., R.H., T.P., L.E.); Biocenter Oulu and Department of Pharmacology and Toxicology (J.P., H.L., J.R., R.K., H.R.); Department of Internal Medicine, Division of Cardiology (J.P.); Biocenter Oulu and Department of Pathology (R.S.); and Department of Physiology (M.I., O.V.), University of Oulu, Finland; Department of Neurosurgery (M.C., P.V.), Charité-Universitätsmedizin
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