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Cipriani C, Pascarella S, Errante F, Menicacci B, Magnelli L, Mocali A, Rovero P, Giovannelli L. Serpin A1 and the modulation of type I collagen turnover: Effect of the C-terminal peptide 409-418 (SA1-III) in human dermal fibroblasts. Cell Biol Int 2018; 42:1340-1348. [PMID: 29908000 DOI: 10.1002/cbin.11018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/10/2018] [Indexed: 11/09/2022]
Abstract
The pharmacological modulation of collagen turnover is a strategy potentially useful in different skin conditions. The serine protease inhibitor Serpin A1 and portions of its C-terminal region have been investigated as collagen modulators. To clarify the mechanisms by which the C-terminal 409-418 peptide SA1-III increases extracellular type I collagen levels, to compare its activities range with that of the originator molecule Serpin A1, and to evaluate its efficacy in primary cultures from adult and aged human subjects. The different forms of type I collagen were analyzed by means of western blot in cell lysates and cell-conditioned media of primary human dermal fibroblasts obtained from subjects of different ages. Gelatin zymography was used to investigate the degrading enzymes. Cell viability and in vitro wound healing tests were used to evaluate cell proliferation. The SA1-III peptide increased extracellular collagen levels by reducing degradation, with no effect on cellular biosynthesis or cell proliferation mechanisms. A reduced level of MMP-2 and MMP-9 was also found in cell media upon peptide treatment. No peptide effect was detected on inflammatory mediators gene expression in resting and LPS-stimulated fibroblasts, or in the wound healing test. The SA1-III peptide is a good collagen modulator candidate, protecting collagen against degradation without detectable actions on biosynthesis, acting at reasonably low concentrations, and non-interfering with cell proliferation. It is effective in primary fibroblasts from young and aged subjects. These effects can prove useful in pathological and physiological skin conditions in which collagen degradation is excessive compared to the synthetic capacity.
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Affiliation(s)
- Caterina Cipriani
- NEUROFARBA Department, Pharmacology and Toxicology Section, University of Florence, Viale G. Pieraccini 6, Florence, 50134, Italy
| | - Simona Pascarella
- NEUROFARBA Department, Pharmaceutical and Nutraceutical Section, Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, Florence, Italy
| | - Fosca Errante
- NEUROFARBA Department, Pharmaceutical and Nutraceutical Section, Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, Florence, Italy.,Espikem S.r.l., Florence, Italy
| | - Beatrice Menicacci
- Department of Experimental and Clinical Biomedical Science, Section of Experimental Pathology and Oncology, University of Florence, Florence, Italy
| | - Lucia Magnelli
- Department of Experimental and Clinical Biomedical Science, Section of Experimental Pathology and Oncology, University of Florence, Florence, Italy
| | - Alessandra Mocali
- Department of Experimental and Clinical Biomedical Science, Section of Experimental Pathology and Oncology, University of Florence, Florence, Italy
| | - Paolo Rovero
- NEUROFARBA Department, Pharmaceutical and Nutraceutical Section, Interdepartmental Laboratory of Peptide and Protein Chemistry and Biology, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, Florence, Italy
| | - Lisa Giovannelli
- NEUROFARBA Department, Pharmacology and Toxicology Section, University of Florence, Viale G. Pieraccini 6, Florence, 50134, Italy
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52
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Abstract
Collagen and hyaluronan are the most abundant components of the extracellular matrix (ECM) and their overexpression in tumors is linked to increased tumor growth and metastasis. These ECM components contribute to a protective tumor microenvironment by supporting a high interstitial fluid pressure and creating a tortuous setting for the convection and diffusion of chemotherapeutic small molecules, antibodies, and nanoparticles in the tumor interstitial space. This review focuses on the research efforts to deplete extracellular collagen with collagenases to normalize the tumor microenvironment. Although collagen synthesis inhibitors are in clinical development, the use of collagenases is contentious and clinically untested in cancer patients. Pretreatment of murine tumors with collagenases increased drug uptake and diffusion 2-10-fold. This modest improvement resulted in decreased tumor growth, but the benefits of collagenase treatment are confounded by risks of toxicity from collagen breakdown in healthy tissues. In this review, we evaluate the published in vitro and in vivo benefits and limitations of collagenase treatment to improve drug delivery.
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Affiliation(s)
- Aaron Dolor
- Pharmaceutical Sciences and Pharmacogenomics Graduate Program, University of California, San Francisco, California. Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, 94143
| | - Francis C. Szoka
- Pharmaceutical Sciences and Pharmacogenomics Graduate Program, University of California, San Francisco, California. Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, 94143
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53
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Toro-Salazar OH, Lee JH, Zellars KN, Perreault PE, Mason KC, Wang Z, Hor KN, Gillan E, Zeiss CJ, Gatti DM, Davey BT, Kutty S, Liang BT, Spinale FG. Use of integrated imaging and serum biomarker profiles to identify subclinical dysfunction in pediatric cancer patients treated with anthracyclines. CARDIO-ONCOLOGY (LONDON, ENGLAND) 2018; 4:4. [PMID: 29900007 PMCID: PMC5995570 DOI: 10.1186/s40959-018-0030-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 03/14/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Anthracycline induced cardiomyopathy is a major cause of mortality and morbidity among pediatric cancer survivors. It has been postulated that oxidative stress induction and inflammation may play a role in the pathogenesis of this process. Accordingly, the present study performed an assessment of biomarker profiles and functional imaging parameters focused upon potential early determinants of anthracycline induced cardiomyopathy. METHODS Patients (10-22 years) were prospectively enrolled between January 2013 and November 2014. Thirteen subjects completed the study and underwent serial cardiac magnetic resonance imaging and plasma biomarker profiling performed 24-48 h after the first anthracycline dose and at set dose intervals. In addition, we collected plasma samples from 62 healthy controls to examine normal plasma biomarker profiles. RESULTS Left ventricular ejection fraction (LVEF) decreased from 64.3 ± 6.2 at the first visit to 57.5 ± 3.3 (p = 0.004) 1 year after chemotherapy. A decline in longitudinal strain magnitude occurred at lower cumulative doses. A differential inflammatory/matrix signature emerged in anthracycline induced cardiomyopathy patients compared to normal including increased interleukin-8 and MMP levels. With longer periods of anthracycline dosing, MMP-7, a marker of macrophage proteolytic activation, increased by 165 ± 54% whereas interleukin-10 an anti-inflammatory marker decreased by 75 ± 13% (both p < 0.05). MMP7 correlated with time dependent changes in EF. CONCLUSIONS Asymptomatic pediatric patients exposed to anthracycline therapy develop abnormal strain parameters at lower cumulative doses when compared to changes in EF. A differential biomarker signature containing both inflammatory and matrix domains occur early in anthracycline treatment. Dynamic changes in these domains occur with increased anthracycline doses and progression to anthracycline induced cardiomyopathy. These findings provide potential prognostic and mechanistic insights into the natural history of anthracycline induced cardiomyopathy. TRIAL REGISTRATION NUMBER NCT03211520 Date of Registration February 13, 2017, retrospectively registered.
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Affiliation(s)
- Olga H. Toro-Salazar
- Connecticut Children’s Medical Center, 282 Washington Street, Hartford, CT 06106 USA
- Pat and Jim Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, CT USA
| | - Ji Hyun Lee
- Connecticut Children’s Medical Center, 282 Washington Street, Hartford, CT 06106 USA
| | - Kia N. Zellars
- University of South Carolina School of Medicine, Columbia, SC USA
| | | | - Kathryn C. Mason
- University of South Carolina School of Medicine, Columbia, SC USA
| | - Zhu Wang
- Connecticut Children’s Medical Center, 282 Washington Street, Hartford, CT 06106 USA
| | - Kan N. Hor
- Nationwide Children’s Hospital, Columbus, OH USA
| | - Eileen Gillan
- Connecticut Children’s Medical Center, 282 Washington Street, Hartford, CT 06106 USA
| | | | | | - Brooke T. Davey
- Connecticut Children’s Medical Center, 282 Washington Street, Hartford, CT 06106 USA
| | | | - Bruce T. Liang
- Pat and Jim Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, CT USA
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54
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Ravassa S, Trippel T, Bach D, Bachran D, González A, López B, Wachter R, Hasenfuss G, Delles C, Dominiczak AF, Pieske B, Díez J, Edelmann F. Biomarker-based phenotyping of myocardial fibrosis identifies patients with heart failure with preserved ejection fraction resistant to the beneficial effects of spironolactone: results from the Aldo-DHF trial. Eur J Heart Fail 2018; 20:1290-1299. [PMID: 29709099 DOI: 10.1002/ejhf.1194] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 02/19/2018] [Accepted: 03/12/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Myocardial fibrosis is characterized by excessive cross-linking and deposition of collagen type I and is involved in left ventricular stiffening and left ventricular diastolic dysfunction (LVDD). We investigated whether the effect of spironolactone on LVDD in patients with heart failure with preserved ejection fraction (HFpEF) depends on its effects on collagen cross-linking and/or deposition. METHODS AND RESULTS We investigated 381 HFpEF patients from the multicentre, randomized, placebo-controlled Aldo-DHF trial with measures of the E:e' ratio. The ratio of serum carboxy-terminal telopeptide of collagen type I to serum matrix metalloproteinase-1 (CITP:MMP-1, an inverse index of myocardial collagen cross-linking) and serum carboxy-terminal propeptide of procollagen type I (PICP, a direct index of myocardial collagen deposition) were determined at baseline and after 1-year treatment with spironolactone 25 mg once daily or placebo. Patients were classified by CITP:MMP-1 and PICP tertiles at baseline. While CITP:MMP-1 tertiles at baseline interacted (P < 0.05) with spironolactone effect on E:e', PICP tertiles did not. In fact, while spironolactone treatment did not modify E:e' in patients with lower CITP:MMP-1 levels, this ratio was significantly reduced in the remaining spironolactone-treated patients. In addition, PICP was unchanged in patients with lower CITP:MMP-1 levels but was reduced in the remaining spironolactone-treated patients. CONCLUSIONS A biochemical phenotype of high collagen cross-linking identifies HFpEF patients resistant to the beneficial effects of spironolactone on LVDD. It is suggested that excessive collagen cross-linking, which stabilizes collagen type I fibres, diminishes the ability of spironolactone to reduce collagen deposition in these patients.
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Affiliation(s)
- Susana Ravassa
- University of Navarra, CIMA, Program of Cardiovascular Diseases, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain, CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Tobias Trippel
- Institute for Internal Medicine and Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Doris Bach
- Institute for Internal Medicine and Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Diana Bachran
- Institute for Internal Medicine and Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Arantxa González
- University of Navarra, CIMA, Program of Cardiovascular Diseases, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain, CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Begoña López
- University of Navarra, CIMA, Program of Cardiovascular Diseases, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain, CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Rolf Wachter
- Department of Cardiology and Pneumology, University of Göttingen Medical Centre Göttingen, Göttingen, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Göttingen, Göttingen, Germany
| | - Gerd Hasenfuss
- Department of Cardiology and Pneumology, University of Göttingen Medical Centre Göttingen, Göttingen, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Göttingen, Göttingen, Germany
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Anna F Dominiczak
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Burkert Pieske
- Institute for Internal Medicine and Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,Deutsches Herzzentrum Berlin (DHZB), Department of Cardiology, Berlin, Germany
| | - Javier Díez
- University of Navarra, CIMA, Program of Cardiovascular Diseases, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain, CIBERCV, Carlos III Institute of Health, Madrid, Spain.,University of Navarra Clinic, Departments of Cardiology and Cardiac Surgery, and Nephrology, Pamplona, Spain
| | - Frank Edelmann
- Institute for Internal Medicine and Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.,Department of Cardiology and Pneumology, University of Göttingen Medical Centre Göttingen, Göttingen, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Göttingen, Göttingen, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
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55
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Kim SK, McCurley AT, DuPont JJ, Aronovitz M, Moss ME, Stillman IE, Karumanchi SA, Christou DD, Jaffe IZ. Smooth Muscle Cell-Mineralocorticoid Receptor as a Mediator of Cardiovascular Stiffness With Aging. Hypertension 2018; 71:609-621. [PMID: 29463624 PMCID: PMC5843545 DOI: 10.1161/hypertensionaha.117.10437] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 10/26/2017] [Accepted: 01/24/2018] [Indexed: 12/22/2022]
Abstract
Stiffening of the vasculature with aging is a strong predictor of adverse cardiovascular events, independent of all other risk factors including blood pressure, yet no therapies target this process. MRs (mineralocorticoid receptors) in smooth muscle cells (SMCs) have been implicated in the regulation of vascular fibrosis but have not been explored in vascular aging. Comparing SMC-MR-deleted male mice to MR-intact littermates at 3, 12, and 18 months of age, we demonstrated that aging-associated vascular stiffening and fibrosis are mitigated by MR deletion in SMCs. Progression of cardiac stiffness and fibrosis and the decline in exercise capacity with aging were also mitigated by MR deletion in SMC. Vascular gene expression profiling analysis revealed that MR deletion in SMC is associated with recruitment of a distinct antifibrotic vascular gene expression program with aging. Moreover, long-term pharmacological inhibition of MR in aged mice prevented the progression of vascular fibrosis and stiffness and induced a similar antifibrotic vascular gene program. Finally, in a small trial in elderly male humans, short-term MR antagonism produced an antifibrotic signature of circulating biomarkers similar to that observed in the vasculature of SMC-MR-deleted mice. These findings suggest that SMC-MR contributes to vascular stiffening with aging and is a potential therapeutic target to prevent the progression of aging-associated vascular fibrosis and stiffness.
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MESH Headings
- Aged
- Animals
- Cellular Senescence/drug effects
- Cellular Senescence/physiology
- Disease Progression
- Exercise Tolerance/physiology
- Fibrosis/metabolism
- Fibrosis/pathology
- Fibrosis/prevention & control
- Gene Expression/drug effects
- Gene Expression Profiling
- Humans
- Male
- Mice
- Mineralocorticoid Receptor Antagonists/metabolism
- Mineralocorticoid Receptor Antagonists/pharmacology
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/metabolism
- Receptors, Mineralocorticoid/genetics
- Receptors, Mineralocorticoid/metabolism
- Spironolactone/metabolism
- Spironolactone/pharmacology
- Treatment Outcome
- Vascular Stiffness/drug effects
- Vascular Stiffness/physiology
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Affiliation(s)
- Seung Kyum Kim
- From the Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA (S.K.K., A.T.M., J.J.D., M.A., M.E.M., I.Z.J.); Departments of Pathology (I.E.S.) and Medicine and Obstetrics and Gynecology (S.A.K.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; and Department of Applied Physiology and Kinesiology, University of Florida, Gainesville (D.D.C.)
| | - Amy T McCurley
- From the Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA (S.K.K., A.T.M., J.J.D., M.A., M.E.M., I.Z.J.); Departments of Pathology (I.E.S.) and Medicine and Obstetrics and Gynecology (S.A.K.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; and Department of Applied Physiology and Kinesiology, University of Florida, Gainesville (D.D.C.)
| | - Jennifer J DuPont
- From the Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA (S.K.K., A.T.M., J.J.D., M.A., M.E.M., I.Z.J.); Departments of Pathology (I.E.S.) and Medicine and Obstetrics and Gynecology (S.A.K.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; and Department of Applied Physiology and Kinesiology, University of Florida, Gainesville (D.D.C.)
| | - Mark Aronovitz
- From the Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA (S.K.K., A.T.M., J.J.D., M.A., M.E.M., I.Z.J.); Departments of Pathology (I.E.S.) and Medicine and Obstetrics and Gynecology (S.A.K.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; and Department of Applied Physiology and Kinesiology, University of Florida, Gainesville (D.D.C.)
| | - M Elizabeth Moss
- From the Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA (S.K.K., A.T.M., J.J.D., M.A., M.E.M., I.Z.J.); Departments of Pathology (I.E.S.) and Medicine and Obstetrics and Gynecology (S.A.K.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; and Department of Applied Physiology and Kinesiology, University of Florida, Gainesville (D.D.C.)
| | - Isaac E Stillman
- From the Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA (S.K.K., A.T.M., J.J.D., M.A., M.E.M., I.Z.J.); Departments of Pathology (I.E.S.) and Medicine and Obstetrics and Gynecology (S.A.K.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; and Department of Applied Physiology and Kinesiology, University of Florida, Gainesville (D.D.C.)
| | - S Ananth Karumanchi
- From the Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA (S.K.K., A.T.M., J.J.D., M.A., M.E.M., I.Z.J.); Departments of Pathology (I.E.S.) and Medicine and Obstetrics and Gynecology (S.A.K.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; and Department of Applied Physiology and Kinesiology, University of Florida, Gainesville (D.D.C.)
| | - Demetra D Christou
- From the Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA (S.K.K., A.T.M., J.J.D., M.A., M.E.M., I.Z.J.); Departments of Pathology (I.E.S.) and Medicine and Obstetrics and Gynecology (S.A.K.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; and Department of Applied Physiology and Kinesiology, University of Florida, Gainesville (D.D.C.)
| | - Iris Z Jaffe
- From the Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA (S.K.K., A.T.M., J.J.D., M.A., M.E.M., I.Z.J.); Departments of Pathology (I.E.S.) and Medicine and Obstetrics and Gynecology (S.A.K.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; and Department of Applied Physiology and Kinesiology, University of Florida, Gainesville (D.D.C.).
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56
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Duprez DA, Gross MD, Kizer JR, Ix JH, Hundley WG, Jacobs DR. Predictive Value of Collagen Biomarkers for Heart Failure With and Without Preserved Ejection Fraction: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Heart Assoc 2018; 7:JAHA.117.007885. [PMID: 29475876 PMCID: PMC5866330 DOI: 10.1161/jaha.117.007885] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Collagen biomarkers may correlate with incident heart failure (HF) and its subtypes. We hypothesized that circulating procollagen type III N-terminal propeptide (PIIINP) and collagen type I carboxy-terminal telopeptide (ICTP) predict incident HF. METHODS AND RESULTS We used a stratified sampling design in a multiethnic sample of 3187 subjects, initially aged 45 to 84 years and free of cardiovascular disease. We assayed baseline serum PIIINP and ICTP concentrations using radioimmunoassay. Incident HF was adjudicated, distinguishing reduced ejection fraction (HFrEF; EF <45%) from preserved EF (HFpEF; EF ≥45%). The incidence density for HFpEF and HFrEF was computed using Poisson regression per SD for each of PIIINP and ICTP, adjusting in model 1 for age, race, sex, and renal function or in model 2 for these variables plus blood pressure and medication. Mean (SD) ICTP was 3.38±1.77 μg/L, and mean (SD) PIIINP was 5.48±2.04 μg/L. Among the HF cases, 96 were HFrEF and 107 were HFpEF. Neither ICTP nor PIIINP significantly predicted incident HFrEF. The incidence density for HFpEF per 100 people observed for 13 years was 1.65 for low PIIINP (lower 6 octiles) versus 3.00 for higher PIIINP (P=0.002) in model 1 and correspondingly 1.45 versus 2.59 (P=0.003) in model 2. For low ICTP (lower 7 octiles) versus higher ICTP (octile 8), incidence densities were 1.79 versus 3.64 (P=0.002) in model 1 and 1.58 versus 3.12 (P=0.002) in model 2. CONCLUSIONS High levels of circulating ICTP and PIIINP as collagen biomarkers appear to be associated with incident HFpEF, but not HFrEF.
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Affiliation(s)
- Daniel A Duprez
- Cardiovascular Division, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Myron D Gross
- Laboratory Medicine, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Jorge R Kizer
- Division of Cardiology, Department of Medicine, and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Joachim H Ix
- Nephrology Division, University of California, San Diego, CA
| | | | - David R Jacobs
- School of Public Health, University of Minnesota, Minneapolis, MN
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57
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Meel R, Nethononda R, Libhaber E, Dix-Peek T, Peters F, Essop M. Assessment of myocardial fibrosis by late gadolinium enhancement imaging and biomarkers of collagen metabolism in chronic rheumatic mitral regurgitation. Cardiovasc J Afr 2018; 29:150-154. [PMID: 29443354 PMCID: PMC6107724 DOI: 10.5830/cvja-2018-002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 12/19/2017] [Indexed: 12/31/2022] Open
Abstract
Background In chronic rheumatic mitral regurgitation (CRMR), involvement of the myocardium in the rheumatic process has been controversial. Therefore, we sought to study the presence of fibrosis using late gadolinium enhancement cardiac magnetic resonance imaging (LGE–CMR) and biomarkers of collagen turnover in CRMR. Methods Twenty–two patients with CRMR underwent CMR and echocardiography. Serum concentrations of matrix metalloproteinase– 1 (MMP–1), tissue inhibitor of MMP–1 (TIMP– 1), MMP–1–to–TIMP–1 ratio, procollagen III N–terminal pro–peptide (PIIINP) and procollagen type IC peptide (PIP) were measured. Results Four patients had fibrosis on LGE–CMR. PIP and PIIINP concentrations were similar to those of the controls, however MMP–1 concentration was increased compared to that of the controls (log MMP–1 3.5 ± 0.7 vs 2.7 ± 0.9, p = 0.02). There was increased MMP–1 activity as the MMP–1–to– TIMP–1 ratio was higher in CRMR patients compared to the controls (–1.2 ± 0.6 vs –2.1 ± 0.89, p = 0.002). Conclusion Myocardial fibrosis was rare in CRMR patients. CRMR is likely a disease characterised by the predominance of collagen degradation rather than increased synthesis and myocardial fibrosis.
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Affiliation(s)
- Ruchika Meel
- Division of Cardiology, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa.
| | - Richard Nethononda
- Division of Cardiology, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - Elena Libhaber
- Division of Cardiology, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - Therese Dix-Peek
- Division of Cardiology, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - Ferande Peters
- Division of Cardiology, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - Mohammed Essop
- Division of Cardiology, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa
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58
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Pinkert MA, Hortensius RA, Ogle BM, Eliceiri KW. Imaging the Cardiac Extracellular Matrix. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1098:21-44. [PMID: 30238364 DOI: 10.1007/978-3-319-97421-7_2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cardiovascular disease is the global leading cause of death. One route to address this problem is using biomedical imaging to measure the molecules and structures that surround cardiac cells. This cellular microenvironment, known as the cardiac extracellular matrix, changes in composition and organization during most cardiac diseases and in response to many cardiac treatments. Measuring these changes with biomedical imaging can aid in understanding, diagnosing, and treating heart disease. This chapter supports those efforts by reviewing representative methods for imaging the cardiac extracellular matrix. It first describes the major biological targets of ECM imaging, including the primary imaging target of fibrillar collagen. Then it discusses the imaging methods, describing their current capabilities and limitations. It categorizes the imaging methods into two main categories: organ-scale noninvasive methods and cellular-scale invasive methods. Noninvasive methods can be used on patients, but only a few are clinically available, and others require further development to be used in the clinic. Invasive methods are the most established and can measure a variety of properties, but they cannot be used on live patients. Finally, the chapter concludes with a perspective on future directions and applications of biomedical imaging technologies.
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Affiliation(s)
- Michael A Pinkert
- Laboratory for Optical and Computational Instrumentation and Department of Medical Physics, University of Wisconsin at Madison, Madison, WI, USA.,Morgridge Institute for Research, Madison, WI, USA
| | - Rebecca A Hortensius
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Brenda M Ogle
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Kevin W Eliceiri
- Laboratory for Optical and Computational Instrumentation and Department of Medical Physics, University of Wisconsin at Madison, Madison, WI, USA. .,Morgridge Institute for Research, Madison, WI, USA.
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59
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Ho JE, Shi L, Day SM, Colan SD, Russell MW, Towbin JA, Sherrid MV, Canter CE, Jefferies JL, Murphy A, Taylor M, Mestroni L, Cirino AL, Sleeper LA, Jarolim P, Lopez B, Gonzalez A, Diez J, Orav EJ, Ho CY. Biomarkers of cardiovascular stress and fibrosis in preclinical hypertrophic cardiomyopathy. Open Heart 2017; 4:e000615. [PMID: 29177058 PMCID: PMC5687543 DOI: 10.1136/openhrt-2017-000615] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/09/2017] [Accepted: 06/13/2017] [Indexed: 11/04/2022] Open
Abstract
Objective Sarcomeric gene mutation carriers without overt left ventricular hypertrophy (G+/LVH-) can harbour subclinical changes in cardiovascular structure and function that precede the development of hypertrophic cardiomyopathy (HCM). We sought to investigate if circulating biomarkers of cardiovascular stress and collagen metabolism among G+/LVH- individuals, measured at rest and following exercise provocation, yield further insights into the underlying biology of HCM. Methods We studied 76 individuals with overt HCM, 50 G+/LVH- individuals and 41 genotype-negative related controls enrolled in a cross-sectional, multicentre observational study (HCMNet). Biomarkers of cardiac stress (N-terminal pro-B-type natriuretic peptide, NT-proBNP; high-sensitivity troponin I, hsTnI; soluble ST2) and fibrosis (carboxy-terminal propeptide of procollagen type I; C-terminal telopeptide of type I collagen; galectin-3; periostin) were measured. Results Individuals with overt HCM had elevated NT-proBNP and hsTnI compared with G+/LVH- subjects and controls at rest, along with an exaggerated increase in NT-proBNP and hsTnI in response to exercise. We found no detectable differences in resting or exercise-provoked biomarker profiles of cardiovascular stress and fibrosis among G+/LVH- individuals compared with healthy controls despite subtle echocardiographic differences in cardiac structure and function. Conclusion Dynamic exercise testing exaggerated resting differences in natriuretic peptides and troponin elevations among individuals with overt HCM. In contrast, we found no differences in biomarker profiles of cardiovascular stress and fibrosis among G+/LVH- individuals compared with controls even after maximal exercise provocation. Our findings highlight the need for continued investigation into early phenotypes of sarcomeric gene mutations and the evolution of HCM.
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Affiliation(s)
- Jennifer E Ho
- Division of Cardiology, Department of Medicine, Cardiovascular Research Center, Massachusetts General Hospital, Ann Arbor, Michigan, USA
| | - Ling Shi
- New England Research Institutes, Watertown, Massachusetts, USA
| | - Sharlene M Day
- Departments of Internal Medicine and Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Steven D Colan
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Mark W Russell
- Departments of Internal Medicine and Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Jeffrey A Towbin
- The Heart Institute and Pediatric Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Mark V Sherrid
- Division of Cardiology, Department of Medicine, New York University Langone Medical Center, New York, New York, USA
| | - Charles E Canter
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA
| | - John Lynn Jefferies
- The Heart Institute and Pediatric Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Anne Murphy
- Division of Pediatric Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matthew Taylor
- Department of Medicine, University of Colorado Denver CU-Cardiovascular Institute, Aurora, Colorado, USA
| | - Luisa Mestroni
- Department of Medicine, University of Colorado Denver CU-Cardiovascular Institute, Aurora, Colorado, USA
| | - Allison L Cirino
- Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Lynn A Sleeper
- New England Research Institutes, Watertown, Massachusetts, USA
| | - Peter Jarolim
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - Begoña Lopez
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain
| | - Arantxa Gonzalez
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain
| | - Javier Diez
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain.,Department for Cardiology and Cardiac Surgery, University Clinic, University of Navarra, Pamplona, Spain
| | - E John Orav
- Department of Biostatistics, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Carolyn Y Ho
- Division of Cardiology, Department of Medicine, Cardiovascular Research Center, Massachusetts General Hospital, Ann Arbor, Michigan, USA
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Amar S, Smith L, Fields GB. Matrix metalloproteinase collagenolysis in health and disease. BIOCHIMICA ET BIOPHYSICA ACTA. MOLECULAR CELL RESEARCH 2017; 1864:1940-1951. [PMID: 28456643 PMCID: PMC5605394 DOI: 10.1016/j.bbamcr.2017.04.015] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 04/20/2017] [Accepted: 04/24/2017] [Indexed: 01/08/2023]
Abstract
The proteolytic processing of collagen (collagenolysis) is critical in development and homeostasis, but also contributes to numerous pathologies. Mammalian interstitial collagenolytic enzymes include members of the matrix metalloproteinase (MMP) family and cathepsin K. While MMPs have long been recognized for their ability to catalyze the hydrolysis of collagen, the roles of individual MMPs in physiological and pathological collagenolysis are less defined. The use of knockout and mutant animal models, which reflect human diseases, has revealed distinct collagenolytic roles for MT1-MMP and MMP-13. A better understanding of temporal and spatial collagen processing, along with the knowledge of the specific MMP involved, will ultimately lead to more effective treatments for cancer, arthritis, cardiovascular conditions, and infectious diseases. This article is part of a Special Issue entitled: Matrix Metalloproteinases edited by Rafael Fridman.
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Affiliation(s)
- Sabrina Amar
- Department of Chemistry & Biochemistry, Florida Atlantic University, Jupiter, FL 33458, USA.
| | - Lyndsay Smith
- Department of Chemistry & Biochemistry, Florida Atlantic University, Jupiter, FL 33458, USA.
| | - Gregg B Fields
- Department of Chemistry & Biochemistry, Florida Atlantic University, Jupiter, FL 33458, USA; Department of Chemistry, The Scripps Research Institute/Scripps Florida, Jupiter, FL 33458, USA.
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Yoshihisa A, Sato Y, Yokokawa T, Sato T, Suzuki S, Oikawa M, Kobayashi A, Yamaki T, Kunii H, Nakazato K, Saitoh S, Takeishi Y. Liver fibrosis score predicts mortality in heart failure patients with preserved ejection fraction. ESC Heart Fail 2017; 5:262-270. [PMID: 28967709 PMCID: PMC5880657 DOI: 10.1002/ehf2.12222] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 07/27/2017] [Accepted: 08/17/2017] [Indexed: 02/06/2023] Open
Abstract
AIMS Heart failure with preserved ejection fraction (HFpEF) has several pathophysiological aspects, including stiffness and/or congestion of multiple organs. Poor prognosis is expected in heart failure patients with liver stiffness, which has recently been assessed by non-alcoholic fatty liver disease fibrosis score (NFS; based on aspartate aminotransferase to alanine aminotransferase ratio, platelet counts, and albumin). We aimed to investigate the impact of NFS on prognosis of HFpEF patients, with consideration for the peripheral collagen markers such as procollagen type III peptide (PIIIP), type IV collagen 7S, and hyaluronic acid. METHODS AND RESULTS We performed a prospective observational study. Consecutive 492 hospitalized HFpEF patients were divided into four groups based on their NFS: first-fourth quartiles (n = 123). The fourth quartile group had the highest levels of PIIIP, type IV collagen 7S, hyaluronic acid, and B-type natriuretic peptide (P<0.001 each). In addition, there were significant positive correlations between PIIIP, type IV collagen 7S, hyaluronic acid, B-type natriuretic peptide, and NFS (P < 0.001 each). In the follow-up period (mean 1107 days), 93 deaths occurred. All-cause mortality increased in all four quartiles (8.1%, 12.2%, 23.6%, and 31.7%, P < 0.001). In the multivariable Cox proportional hazard analysis, NFS was an independent predictor of all-cause mortality in the HFpEF patients. CONCLUSIONS NFS, a novel indicator of liver fibrosis, correlates with circulating systemic markers of fibrosis and congestion and is associated with higher all-cause mortality in HFpEF patients. NFS can be calculated simply and may be a useful tool to assess liver stiffness and prognosis in HFpEF patients.
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Affiliation(s)
- Akiomi Yoshihisa
- Department of Cardiovascular MedicineFukushima Medical University1 HikarigaokaFukushima960‐1295Japan
| | - Yu Sato
- Department of Cardiovascular MedicineFukushima Medical University1 HikarigaokaFukushima960‐1295Japan
| | - Tetsuro Yokokawa
- Department of Cardiovascular MedicineFukushima Medical University1 HikarigaokaFukushima960‐1295Japan
| | - Takamasa Sato
- Department of Cardiovascular MedicineFukushima Medical University1 HikarigaokaFukushima960‐1295Japan
| | - Satoshi Suzuki
- Department of Cardiovascular MedicineFukushima Medical University1 HikarigaokaFukushima960‐1295Japan
| | - Masayoshi Oikawa
- Department of Cardiovascular MedicineFukushima Medical University1 HikarigaokaFukushima960‐1295Japan
| | - Atsushi Kobayashi
- Department of Cardiovascular MedicineFukushima Medical University1 HikarigaokaFukushima960‐1295Japan
| | - Takayoshi Yamaki
- Department of Cardiovascular MedicineFukushima Medical University1 HikarigaokaFukushima960‐1295Japan
| | - Hiroyuki Kunii
- Department of Cardiovascular MedicineFukushima Medical University1 HikarigaokaFukushima960‐1295Japan
| | - Kazuhiko Nakazato
- Department of Cardiovascular MedicineFukushima Medical University1 HikarigaokaFukushima960‐1295Japan
| | - Shu‐ichi Saitoh
- Department of Cardiovascular MedicineFukushima Medical University1 HikarigaokaFukushima960‐1295Japan
| | - Yasuchika Takeishi
- Department of Cardiovascular MedicineFukushima Medical University1 HikarigaokaFukushima960‐1295Japan
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Trippel TD, Van Linthout S, Westermann D, Lindhorst R, Sandek A, Ernst S, Bobenko A, Kasner M, Spillmann F, González A, López B, Ravassa S, Pieske B, Paulus WJ, Díez J, Edelmann F, Tschöpe C. Investigating a biomarker-driven approach to target collagen turnover in diabetic heart failure with preserved ejection fraction patients. Effect of torasemide versus furosemide on serum C-terminal propeptide of procollagen type I (DROP-PIP trial). Eur J Heart Fail 2017; 20:460-470. [PMID: 28891228 DOI: 10.1002/ejhf.960] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 12/28/2022] Open
Abstract
AIM Heart failure with preserved ejection fraction (HFpEF) is associated with myocardial remodelling including severe pro-fibrotic changes contributing to an increase in left ventricular stiffness and diastolic dysfunction. Serum C-terminal propeptide of procollagen type I (PIP) strongly correlates with the turnover of extracellular cardiac matrix proteins and fibrosis. Torasemide, but not furosemide, was described to reduce collagen type I synthesis in clinically unstable patients with heart failure with reduced ejection fraction. We evaluated whether its effect translated to HFpEF patients with type 2 diabetes mellitus (T2DM) and abnormal basal PIP levels. METHODS AND RESULTS We performed a relatively small, single-centre, randomised, double-blind, two-arm parallel-group, active controlled clinical trial in 35 HFpEF patients with T2DM to determine the effects of a 9-month treatment with torasemide vs. furosemide on changes of serum PIP levels. Patients with increased PIP levels (≥110 ng/mL), or evidence of structural changes with a left atrial volume index (LAVI) >29 mL/m2 and abnormal PIP levels (≥70 ng/mL), were eligible to participate. Fifteen patients were female (42%), mean age was 69 years, body mass index was 34.7 kg/m2 , 83% were in New York Heart Association class II/III. Echocardiographic characteristics showed a mean left ventricular ejection fraction of >60%, a left ventricular mass index >120 g/m2 , an E/e' ratio of 14, and a LAVI of 40 mL/m2 with a NT-proBNP of 174 ng/L and a 6-minute walk distance of 421 m. Mean per cent change in PIP was 2.63 ± 5.68% (±SEM) in torasemide vs. 2.74 ± 6.49% in furosemide (P = 0.9898) treated patients. Torasemide was not superior to furosemide in improving functional capacity, diastolic function, quality of life, or neuroendocrine activation. CONCLUSION In this hypothesis-generating, mechanistic trial in stable HFpEF patients with T2DM, neither long-term administration of torasemide nor furosemide was associated with a significant effect on myocardial fibrosis, as assessed by serum PIP. Further studies are urgently needed in this field. More specific diuretic and anti-fibrotic treatment strategies in T2DM and/or HFpEF are warranted.
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Affiliation(s)
- Tobias Daniel Trippel
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Sophie Van Linthout
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Berlin-Brandenburg Centre for Regenerative Therapies, Berlin, Germany
| | - Dirk Westermann
- Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Ruhdja Lindhorst
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Anja Sandek
- Department of Cardiology and Pneumology, University Medical Centre Göttingen, Göttingen, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | | | - Anna Bobenko
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Mario Kasner
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Cardiology, Department of Medicine (CBF), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Frank Spillmann
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Arantxa González
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, IdiSNA, Navarra Institute for Health Research, CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Begoña López
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, IdiSNA, Navarra Institute for Health Research, CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Susana Ravassa
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, IdiSNA, Navarra Institute for Health Research, CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Burkert Pieske
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Walter J Paulus
- Department of Physiology, Institute of Cardiovascular Research VU, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Javier Díez
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, IdiSNA, Navarra Institute for Health Research, CIBERCV, Carlos III Institute of Health, Madrid, Spain.,Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, University of Navarra, Pamplona, Spain
| | - Frank Edelmann
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Carsten Tschöpe
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Berlin-Brandenburg Centre for Regenerative Therapies, Berlin, Germany
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Dias Bastos PA, Vlahou A, Leite-Moreira A, Santos LL, Ferreira R, Vitorino R. Deciphering the disease-related molecular networks using urine proteomics. Trends Analyt Chem 2017. [DOI: 10.1016/j.trac.2017.07.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Collagen turnover biomarkers and systemic right ventricle remodeling in adults with previous atrial switch procedure for transposition of the great arteries. PLoS One 2017; 12:e0180629. [PMID: 28767656 PMCID: PMC5540554 DOI: 10.1371/journal.pone.0180629] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 06/18/2017] [Indexed: 12/31/2022] Open
Abstract
Background Myocardial fibrosis is a potential pathophysiological mechanism leading to systemic right ventricular (SRV) deterioration. We hypothesize that circulating levels of collagen deposition markers are elevated in patients with SRV remodeling and this elevation may have a predictive value. Methods We prospectively evaluated 56 patients with D-TGA after the atrial switch procedure (mean age 25.6 ± 4.8, range 18–37 years; 67% males). Serum levels of procollagen type III amino-terminal propeptide (PIIINP), collagen type I carboxy-terminal telopeptide (CITP), procollagen type I N-terminal propeptide (PINP), matrix metalloproteinase (MMP 1, MMP 9) and a tissue inhibitor of matrix metalloproteinase (TIMP 1) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) were measured and compared with healthy controls. The relationship between these serum markers, echocardiographic and cardiac magnetic resonance parameters and the outcome at a follow-up of 61 months (range, 24–85 months) was determined. Results Compared with the healthy control group, the study group had significantly higher levels of TIMP1, PIIINP, CITP, PINP and NT-pro-BNP (p<0.05, each). The levels of PIIINP and CITP were significantly higher among patients with an SRV mass index above the mean value. The level of PIIINP was significantly higher among patients with an SRV EDV index above the mean value. CITP was significantly elevated in SRV late gadolinium enhanced (LGE) positive patients, compared to patients without SRV LGE. MMP9 and TIMP1 predicted an adverse clinical outcome on univariate Cox proportional hazard survival analysis in addition to well proven predictors of outcome (SRV EF and NYHA). Conclusions We demonstrated a pattern of altered collagen turnover adversely related with the indices of SRV remodeling and an adverse clinical outcome in patients with SRV.
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Karetnikova VN, Kashtalap VV, Kosareva SN, Barbarash OL. [Myocardial fibrosis: Current aspects of the problem]. TERAPEVT ARKH 2017. [PMID: 28635904 DOI: 10.17116/terarkh201789188-93] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Fibrosis is one of the main components in the progression of most cardiovascular diseases, including coronary heart disease, by causing structural changes in the myocardium and vascular wall. The quantitative and qualitative characteristics of fibrosis of the myocardium are responsible for decreasing its elastic properties, developing diastolic dysfunction, impairing myocardial contractility, developing systolic dysfunction and cardiac arrhythmias, and worsening coronary blood flow in patients with heart failure of different etiologies. The important aspect of studying fibrosis is not only its interpretation as a model of the typical pathological process, but also its consideration as a systemic lesion of various organs and tissues. At the same time, the identification of myocardial fibrosis biomarkers that are available for their determination in circulating blood is of particular interest. Since there was evidence for the role of fibrosis in developing dysfunction of various organs and ensuring the systematicity of most diseases, especially at their development stages, the process of fibrosis came to be regarded as a promising therapeutic target. It is relevant to further investigate myocardial fibrosis, which is aimed at increasing the efficiency of its diagnosis and predicting its course and pathogenetically sound therapy.
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Affiliation(s)
- V N Karetnikova
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - V V Kashtalap
- Kemerovo State Medical Academy, Ministry of Health of Russia, Kemerovo, Russia
| | - S N Kosareva
- Kemerovo State Medical Academy, Ministry of Health of Russia, Kemerovo, Russia; Kemerovo Cardiology Dispensary, Kemerovo, Russia
| | - O L Barbarash
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia; Kemerovo State Medical Academy, Ministry of Health of Russia, Kemerovo, Russia
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Usefulness of Collagen Carboxy-Terminal Propeptide and Telopeptide to Predict Disturbances of Long-Term Mortality in Patients ≥60 Years With Heart Failure and Reduced Ejection Fraction. Am J Cardiol 2017; 119:2042-2048. [PMID: 28464988 DOI: 10.1016/j.amjcard.2017.03.036] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/10/2017] [Accepted: 03/10/2017] [Indexed: 11/21/2022]
Abstract
Disturbances of collagen metabolism may alter the myocardial collagen network and contribute to cardiac remodeling and prognosis in heart failure (HF). Collagen type I synthesis and degradation can be assessed indirectly by the circulating biomarkers carboxy-terminal propeptide (PICP) and carboxy-terminal telopeptide (CITP), respectively. We examined the associations between PICP and CITP and long-term mortality in patients with HF. The Optimizing Congestive Heart Failure Outpatient Clinic (OPTIMAL) project studied patients aged ≥60 years with New York Heart Association class II to IV and HF with reduced ejection fraction (EF) hospitalized with acute HF during 1996 to 1999. On entry, mean age was 75 years, blood pressure 134/80 mm Hg, EF 34%, brain natriuretic peptide 312 pg/ml; 55% had atrial fibrillation. Dates of mortality were collected from administrative databases and medical records up until 2008. Follow-up was 9 to 13 years in all 132 patients, and mean survival was 5.5 ± 4.0 years. Baseline PICP tended to be higher, CITP was higher, and the PICP:CITP ratio was lower in the 102 deceased, compared with the 30 patients alive. Multivariable Cox regression analyses including 2 established risk factor models performed for all-cause (n = 101) and cardiovascular mortality (n = 61) show PICP and CITP to be independent predictors for all-cause and cardiovascular mortality. In conclusion, disturbances of collagen type I metabolism have independent prognostic implications for long-term all-cause and cardiovascular mortality in patients with HF with reduced EF. The results suggest excessive degradation to be the predominant disturbance associated with untoward prognosis and adds information on possible target mechanisms for future therapy.
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Nagao K, Tamura A, Morimoto T, Shimamura K, Yukawa H, Ito H, Hayashi F, Makita T, Takemura G, Sato Y, Inada T, Kimura T, Tanaka M. Liver fibrogenesis marker, 7S domain of collagen type IV in patients with acutely decompensated heart failure: Correlates, prognostic value and time course. Int J Cardiol 2017; 236:483-487. [DOI: 10.1016/j.ijcard.2017.01.089] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 01/10/2017] [Indexed: 12/01/2022]
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Redfors B, Furer A, Lindman BR, Burkhoff D, Marquis-Gravel G, Francese DP, Ben-Yehuda O, Pibarot P, Gillam LD, Leon MB, Généreux P. Biomarkers in Aortic Stenosis: A Systematic Review. STRUCTURAL HEART-THE JOURNAL OF THE HEART TEAM 2017. [DOI: 10.1080/24748706.2017.1329959] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Björn Redfors
- Cardiovascular Research Foundation, New York, NY, USA
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ariel Furer
- Cardiovascular Research Foundation, New York, NY, USA
| | | | - Daniel Burkhoff
- Cardiovascular Research Foundation, New York, NY, USA
- NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
| | | | | | - Ori Ben-Yehuda
- Cardiovascular Research Foundation, New York, NY, USA
- NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
| | - Philippe Pibarot
- Pulmonary Hypertension and Vascular Biology Research Group, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Québec, Canada
| | - Linda D. Gillam
- Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ, USA
| | - Martin B. Leon
- Cardiovascular Research Foundation, New York, NY, USA
- NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
| | - Philippe Généreux
- Cardiovascular Research Foundation, New York, NY, USA
- Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
- Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ, USA
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Duprez DA, Gross MD, Sanchez OA, Kizer JR, Ix JH, Lima J, Tracy RP, Jacobs DR. Collagen Turnover Markers in Relation to Future Cardiovascular and Noncardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis. Clin Chem 2017; 63:1237-1247. [PMID: 28515098 DOI: 10.1373/clinchem.2016.270520] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 03/31/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND Sustained remodeling of extracellular matrix can compromise organs and tissues. Procollagen type III N-terminal propeptide (PIIINP) and collagen type I carboxy-terminal telopeptide (ICTP) reflect collagen synthesis and degradation. We studied their predictive value for future death and disease. METHODS A total of 3068 men and women in the Multi-Ethnic Study of Atherosclerosis who were free of cardiovascular disease (CVD) and in generally good health had a baseline blood sample taken for ICTP and PIIINP. Median follow-up was 13.0 years. Among 4 primary outcomes, CVD events (n = 697) were adjudicated, death (n = 571) was by death certificate, and chronic inflammatory-related severe hospitalization and death (ChrIRD, n = 726) and total cancer (n = 327) were classified using International Classification of Diseases codes. We used Poisson regression to study baseline ICTP and PIIINP relative to these outcomes. RESULTS Mean (SD) PIIINP was 5.47 (1.95) μg/L and ICTP was 3.37 (1.70) μg/L. PIIINP and ICTP were highly correlated with each other and with estimated glomerular filtration rate (eGFR). Adjustment for age and eGFR attenuated relative risks, remaining 20%-30% per SD of both PIIINP and ICTP in prediction for total death and ChrIRD, and of PIIINP for cancer, with little additional attenuation by adjusting for risk factors and inflammatory biomarkers. CVD outcome was generally unrelated to PIIINP but became marginally inversely related to ICTP in the most adjusted model. CONCLUSIONS The collagen biomarkers PIIINP and ICTP, in part through pathophysiologically parallel associations with renal function, predicted ChrIRD and total death. Moreover, PIIINP predicted future cancer. These collagen markers may help differentiate healthy from unhealthy aging.
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Affiliation(s)
| | | | - Otto A Sanchez
- Nephrology Division, School of Medicine, University of Minnesota, Minneapolis, MN
| | - Jorge R Kizer
- Division of Cardiology, Department of Medicine, and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Joachim H Ix
- Nephrology Division, University of California San Diego, San Diego, CA
| | - Joao Lima
- Cardiovascular Division, John Hopkins University, Baltimore, MD
| | - Russell P Tracy
- Department of Pathology & Laboratory Medicine and Department of Biochemistry, University of Vermont College of Medicine, Colchester, VT
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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Oren O, Goldberg S. Heart Failure with Preserved Ejection Fraction: Diagnosis and Management. Am J Med 2017; 130:510-516. [PMID: 28163048 DOI: 10.1016/j.amjmed.2016.12.031] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 12/20/2022]
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a prevalent condition with substantial individual and societal burden. In this article, we review the current status of understanding of HFpEF, focusing on the challenges and uncertainties regarding diagnosis and treatment. We then propose a scientific roadmap to facilitate research that may translate into improved clinical outcomes.
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Affiliation(s)
- Ohad Oren
- Department of Internal Medicine, Pennsylvania Hospital of the University of Pennsylvania, Philadelphia.
| | - Sheldon Goldberg
- Department of Internal Medicine, Pennsylvania Hospital of the University of Pennsylvania, Philadelphia
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71
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Ho CY, McMurray JJV, Cirino AL, Colan SD, Day SM, Desai AS, Lipshultz SE, MacRae CA, Shi L, Solomon SD, Orav EJ, Braunwald E. The Design of the Valsartan for Attenuating Disease Evolution in Early Sarcomeric Hypertrophic Cardiomyopathy (VANISH) Trial. Am Heart J 2017; 187:145-155. [PMID: 28454798 PMCID: PMC5586211 DOI: 10.1016/j.ahj.2017.02.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 02/08/2017] [Indexed: 01/10/2023]
Abstract
Hypertrophic cardiomyopathy (HCM) is often caused by sarcomere gene mutations, resulting in left ventricular hypertrophy (LVH), myocardial fibrosis, and increased risk of sudden cardiac death and heart failure. Studies in mouse models of sarcomeric HCM demonstrated that early treatment with an angiotensin receptor blocker (ARB) reduced development of LVH and fibrosis. In contrast, prior human studies using ARBs for HCM have targeted heterogeneous adult cohorts with well-established disease. The VANISH trial is testing the safety and feasibility of disease-modifying therapy with an ARB in genotyped HCM patients with early disease. METHODS A randomized, placebo-controlled, double-blind clinical trial is being conducted in sarcomere mutation carriers, 8 to 45 years old, with HCM and no/minimal symptoms, or those with early phenotypic manifestations but no LVH. Participants are randomly assigned to receive valsartan 80 to 320 mg daily (depending on age and weight) or placebo. The primary endpoint is a composite of 9 z-scores in domains representing myocardial injury/hemodynamic stress, cardiac morphology, and function. Total z-scores reflecting change from baseline to final visits will be compared between treatment groups. Secondary endpoints will assess the impact of treatment on mutation carriers without LVH, and analyze the influence of age, sex, and genotype. CONCLUSIONS The VANISH trial is testing a new strategy of disease modification for treating sarcomere mutation carriers with early HCM, and those at risk for its development. In addition, further insight into disease mechanisms, response to therapy, and phenotypic evolution will be gained.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ling Shi
- New England Research Institutes, Watertown, MA, USA
| | | | - E John Orav
- Brigham and Women's Hospital, Boston, MA, USA
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Takawale A, Zhang P, Patel VB, Wang X, Oudit G, Kassiri Z. Tissue Inhibitor of Matrix Metalloproteinase-1 Promotes Myocardial Fibrosis by Mediating CD63-Integrin β1 Interaction. Hypertension 2017; 69:1092-1103. [PMID: 28373589 DOI: 10.1161/hypertensionaha.117.09045] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 01/17/2017] [Accepted: 03/03/2017] [Indexed: 12/28/2022]
Abstract
Myocardial fibrosis is excess accumulation of the extracellular matrix fibrillar collagens. Fibrosis is a key feature of various cardiomyopathies and compromises cardiac systolic and diastolic performance. TIMP1 (tissue inhibitor of metalloproteinase-1) is consistently upregulated in myocardial fibrosis and is used as a marker of fibrosis. However, it remains to be determined whether TIMP1 promotes tissue fibrosis by inhibiting extracellular matrix degradation by matrix metalloproteinases or via an matrix metalloproteinase-independent pathway. We examined the function of TIMP1 in myocardial fibrosis using Timp1-deficient mice and 2 in vivo models of myocardial fibrosis (angiotensin II infusion and cardiac pressure overload), in vitro analysis of adult cardiac fibroblasts, and fibrotic myocardium from patients with dilated cardiomyopathy (DCM). Timp1 deficiency significantly reduced myocardial fibrosis in both in vivo models of cardiomyopathy. We identified a novel mechanism for TIMP1 action whereby, independent from its matrix metalloproteinase-inhibitory function, it mediates an association between CD63 (cell surface receptor for TIMP1) and integrin β1 on cardiac fibroblasts, initiates activation and nuclear translocation of Smad2/3 and β-catenin, leading to de novo collagen synthesis. This mechanism was consistently observed in vivo, in cultured cardiac fibroblasts, and in human fibrotic myocardium. In addition, after long-term pressure overload, Timp1 deficiency persistently reduced myocardial fibrosis and ameliorated diastolic dysfunction. This study defines a novel matrix metalloproteinase-independent function of TIMP1 in promoting myocardial fibrosis. As such targeting TIMP1 could prove to be a valuable approach in developing antifibrosis therapies.
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Affiliation(s)
- Abhijit Takawale
- From the Department of Physiology (A.T., P.Z., X.W., G.O., Z.K.), Department of Medicine/Division of Cardiology (V.B.P., G.O.), and Cardiovascular Research Center, Mazankowski Alberta Heart Institute (A.T., P.Z., V.B.P., X.W., G.O., Z.K.), University of Alberta, Edmonton, Canada
| | - Pu Zhang
- From the Department of Physiology (A.T., P.Z., X.W., G.O., Z.K.), Department of Medicine/Division of Cardiology (V.B.P., G.O.), and Cardiovascular Research Center, Mazankowski Alberta Heart Institute (A.T., P.Z., V.B.P., X.W., G.O., Z.K.), University of Alberta, Edmonton, Canada
| | - Vaibhav B Patel
- From the Department of Physiology (A.T., P.Z., X.W., G.O., Z.K.), Department of Medicine/Division of Cardiology (V.B.P., G.O.), and Cardiovascular Research Center, Mazankowski Alberta Heart Institute (A.T., P.Z., V.B.P., X.W., G.O., Z.K.), University of Alberta, Edmonton, Canada
| | - Xiuhua Wang
- From the Department of Physiology (A.T., P.Z., X.W., G.O., Z.K.), Department of Medicine/Division of Cardiology (V.B.P., G.O.), and Cardiovascular Research Center, Mazankowski Alberta Heart Institute (A.T., P.Z., V.B.P., X.W., G.O., Z.K.), University of Alberta, Edmonton, Canada
| | - Gavin Oudit
- From the Department of Physiology (A.T., P.Z., X.W., G.O., Z.K.), Department of Medicine/Division of Cardiology (V.B.P., G.O.), and Cardiovascular Research Center, Mazankowski Alberta Heart Institute (A.T., P.Z., V.B.P., X.W., G.O., Z.K.), University of Alberta, Edmonton, Canada
| | - Zamaneh Kassiri
- From the Department of Physiology (A.T., P.Z., X.W., G.O., Z.K.), Department of Medicine/Division of Cardiology (V.B.P., G.O.), and Cardiovascular Research Center, Mazankowski Alberta Heart Institute (A.T., P.Z., V.B.P., X.W., G.O., Z.K.), University of Alberta, Edmonton, Canada.
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73
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Hu X, Bai T, Xu Z, Liu Q, Zheng Y, Cai L. Pathophysiological Fundamentals of Diabetic Cardiomyopathy. Compr Physiol 2017; 7:693-711. [PMID: 28333387 DOI: 10.1002/cphy.c160021] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Diabetic cardiomyopathy (DCM) was first recognized more than four decades ago and occurred independent of cardiovascular diseases or hypertension in both type 1 and type 2 diabetic patients. The exact mechanisms underlying this disease remain incompletely understood. Several pathophysiological bases responsible for DCM have been proposed, including the presence of hyperglycemia, nonenzymatic glycosylation of large molecules (e.g., proteins), energy metabolic disturbance, mitochondrial damage and dysfunction, impaired calcium handling, reactive oxygen species formation, inflammation, cardiac cell death, and cardiac hypertrophy and fibrosis, leading to impairment of cardiac contractile functions. Increasing evidence also indicates the phenomenon called "metabolic memory" for diabetes-induced cardiovascular complications, for which epigenetic modulation seemed to play an important role, suggesting that the aforementioned pathogenic bases may be regulated by epigenetic modification. Therefore, this review aims at briefly summarizing the current understanding of the pathophysiological bases for DCM. Although how epigenetic mechanisms play a role remains incompletely understood now, extensive clinical and experimental studies have implicated its importance in regulating the cardiac responses to diabetes, which are believed to shed insight into understanding of the pathophysiological and epigenetic mechanisms for the development of DCM and its possible prevention and/or therapy. © 2017 American Physiological Society. Compr Physiol 7:693-711, 2017.
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Affiliation(s)
- Xinyue Hu
- Center of Cardiovascular Diseases, the First Hospital of Jilin University, Changchun, China.,Pediatric Research Institute at the Department of Pediatrics of the University of Louisville, Louisville, Kentucky, USA
| | - Tao Bai
- Center of Cardiovascular Diseases, the First Hospital of Jilin University, Changchun, China.,Pediatric Research Institute at the Department of Pediatrics of the University of Louisville, Louisville, Kentucky, USA
| | - Zheng Xu
- Center of Cardiovascular Diseases, the First Hospital of Jilin University, Changchun, China.,Pediatric Research Institute at the Department of Pediatrics of the University of Louisville, Louisville, Kentucky, USA
| | - Qiuju Liu
- Department of Hematological Disorders the First Hospital of Jilin University, Changchun, China
| | - Yang Zheng
- Center of Cardiovascular Diseases, the First Hospital of Jilin University, Changchun, China
| | - Lu Cai
- Pediatric Research Institute at the Department of Pediatrics of the University of Louisville, Louisville, Kentucky, USA.,Wendy Novak Diabetes Care Center, University of Louisville, Louisville, Kentucky, USA
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Ross GR, Bajwa T, Edwards S, Emelyanova L, Rizvi F, Holmuhamedov EL, Werner P, Downey FX, Tajik AJ, Jahangir A. Enhanced store-operated Ca 2+ influx and ORAI1 expression in ventricular fibroblasts from human failing heart. Biol Open 2017; 6:326-332. [PMID: 28126709 PMCID: PMC5374400 DOI: 10.1242/bio.022632] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Excessive cardiac fibrosis, characterized by increased collagen-rich extracellular matrix (ECM) deposition, is a major predisposing factor for mechanical and electrical dysfunction in heart failure (HF). The human ventricular fibroblast (hVF) remodeling mechanisms that cause excessive collagen deposition in HF are unclear, although reports suggest a role for intracellular free Ca2+ in fibrosis. Therefore, we determined the association of differences in cellular Ca2+ dynamics and collagen secretion/deposition between hVFs from failing and normal (control) hearts. Histology of left ventricle sections (Masson trichrome) confirmed excessive fibrosis in HF versus normal. In vitro, hVFs from HF showed increased secretion/deposition of soluble collagen in 48 h of culture compared with control [85.9±7.4 µg/106 cells vs 58.5±8.8 µg/106 cells, P<0.05; (Sircol™ assay)]. However, collagen gene expressions (COL1A1 and COL1A2; RT-PCR) were not different. Ca2+ imaging (fluo-3) of isolated hVFs showed no difference in the thapsigargin-induced intracellular Ca2+ release capacity (control 16±1.4% vs HF 17±1.1%); however, Ca2+ influx via store-operated Ca2+ entry/Ca2+ release-activated channels (SOCE/CRAC) was significantly (P≤0.05) greater in HF-hVFs (47±3%) compared with non-failing (35±5%). Immunoblotting for ICRAC channel components showed increased ORAI1 expression in HF-hVFs compared with normal without any difference in STIM1 expression. The Pearson's correlation coefficient for co-localization of STIM1/ORAI1 was significantly (P<0.01) greater in HF (0.5±0.01) than control (0.4±0.01) hVFs. The increase in collagen secretion of HF versus control hVFs was eliminated by incubation of hVFs with YM58483 (10 µM), a selective ICRAC inhibitor, for 48 h (66.78±5.87 µg/106 cells vs 55.81±7.09 µg/106 cells, P=0.27). In conclusion, hVFs from HF have increased collagen secretion capacity versus non-failing hearts and this is related to increase in Ca2+ entry via SOCE and enhanced expression of ORAI, the pore-forming subunit. Therapeutic inhibition of SOCE may reduce the progression of cardiac fibrosis/HF. Summary: The excessive collagen secretory phenotype found in failing human hearts is associated with ventricular fibroblast remodeling, caused by an elevated influx of intracellular calcium via SOC channels.
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Affiliation(s)
- Gracious R Ross
- Center for Integrative Research on Cardiovascular Aging, Aurora Research Institute, Aurora Health Care, Milwaukee, WI 53215, USA
| | - Tanvir Bajwa
- Center for Integrative Research on Cardiovascular Aging, Aurora Research Institute, Aurora Health Care, Milwaukee, WI 53215, USA
| | - Stacie Edwards
- Center for Integrative Research on Cardiovascular Aging, Aurora Research Institute, Aurora Health Care, Milwaukee, WI 53215, USA
| | - Larisa Emelyanova
- Center for Integrative Research on Cardiovascular Aging, Aurora Research Institute, Aurora Health Care, Milwaukee, WI 53215, USA
| | - Farhan Rizvi
- Center for Integrative Research on Cardiovascular Aging, Aurora Research Institute, Aurora Health Care, Milwaukee, WI 53215, USA
| | - Ekhson L Holmuhamedov
- Center for Integrative Research on Cardiovascular Aging, Aurora Research Institute, Aurora Health Care, Milwaukee, WI 53215, USA
| | - Paul Werner
- Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, WI 53215, USA
| | - Francis X Downey
- Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, WI 53215, USA
| | - A Jamil Tajik
- Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, WI 53215, USA
| | - Arshad Jahangir
- Center for Integrative Research on Cardiovascular Aging, Aurora Research Institute, Aurora Health Care, Milwaukee, WI 53215, USA .,Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, WI 53215, USA
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75
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Beaumont J, López B, Ravassa S, Hermida N, San José G, Gallego I, Valencia F, Gómez-Doblas JJ, de Teresa E, Díez J, González A. MicroRNA-19b is a potential biomarker of increased myocardial collagen cross-linking in patients with aortic stenosis and heart failure. Sci Rep 2017; 7:40696. [PMID: 28091585 PMCID: PMC5238428 DOI: 10.1038/srep40696] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/08/2016] [Indexed: 01/07/2023] Open
Abstract
This study analyzed the potential associations of 7 myocardial fibrosis-related microRNAs with the quality of the collagen network (e.g., the degree of collagen fibril cross-linking or CCL) and the enzyme lysyl oxidase (LOX) responsible for CCL in 28 patients with severe aortic stenosis (AS) of whom 46% had a diagnosis of chronic heart failure (HF). MicroRNA expression was analyzed in myocardial and blood samples. From the studied microRNAs only miR-19b presented a direct correlation (p < 0.05) between serum and myocardium. Compared to controls both myocardial and serum miR-19b were reduced (p < 0.01) in AS patients. In addition, miR-19b was reduced in the myocardium (p < 0.01) and serum (p < 0.05) of patients with HF compared to patients without HF. Myocardial and serum miR-19b were inversely correlated (p < 0.05) with LOX, CCL and LV stiffness in AS patients. In in vitro studies miR-19b inhibition increased (p < 0.05) connective tissue growth factor protein and LOX protein expression in human fibroblasts. In conclusion, decreased miR-19b may be involved in myocardial LOX up-regulation and excessive CCL, and consequently increased LV stiffness in AS patients, namely in those with HF. Serum miR-19b can be a biomarker of these alterations of the myocardial collagen network in AS patients, particularly in patients with HF.
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Affiliation(s)
- Javier Beaumont
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Begoña López
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Susana Ravassa
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Nerea Hermida
- Institute of Experimental and Clinical Research, University of Louvain (UCL) Medical School, B-1200 Brussels, Belgium
| | - Gorka San José
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Idoia Gallego
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Félix Valencia
- Division of Cardiology, Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | | | - Eduardo de Teresa
- Division of Cardiology, Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | - Javier Díez
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain.,Department of Cardiology and Cardiovascular Surgery, University of Navarra Clinic, 31008 Pamplona, Spain
| | - Arantxa González
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
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76
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Atorvastatin Improves Ventricular Remodeling after Myocardial Infarction by Interfering with Collagen Metabolism. PLoS One 2016; 11:e0166845. [PMID: 27880844 PMCID: PMC5120826 DOI: 10.1371/journal.pone.0166845] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 11/05/2016] [Indexed: 12/27/2022] Open
Abstract
Purpose Therapeutic strategies that modulate ventricular remodeling can be useful after acute myocardial infarction (MI). In particular, statins may exert effects on molecular pathways involved in collagen metabolism. The aim of this study was to determine whether treatment with atorvastatin for 4 weeks would lead to changes in collagen metabolism and ventricular remodeling in a rat model of MI. Methods Male Wistar rats were used in this study. MI was induced in rats by ligation of the left anterior descending coronary artery (LAD). Animals were randomized into three groups, according to treatment: sham surgery without LAD ligation (sham group, n = 14), LAD ligation followed by 10mg atorvastatin/kg/day for 4 weeks (atorvastatin group, n = 24), or LAD ligation followed by saline solution for 4 weeks (control group, n = 27). After 4 weeks, hemodynamic characteristics were obtained by a pressure-volume catheter. Hearts were removed, and the left ventricles were subjected to histologic analysis of the extents of fibrosis and collagen deposition, as well as the myocyte cross-sectional area. Expression levels of mediators involved in collagen metabolism and inflammation were also assessed. Results End-diastolic volume, fibrotic content, and myocyte cross-sectional area were significantly reduced in the atorvastatin compared to the control group. Atorvastatin modulated expression levels of proteins related to collagen metabolism, including MMP1, TIMP1, COL I, PCPE, and SPARC, in remote infarct regions. Atorvastatin had anti-inflammatory effects, as indicated by lower expression levels of TLR4, IL-1, and NF-kB p50. Conclusion Treatment with atorvastatin for 4 weeks was able to attenuate ventricular dysfunction, fibrosis, and left ventricular hypertrophy after MI in rats, perhaps in part through effects on collagen metabolism and inflammation. Atorvastatin may be useful for limiting ventricular remodeling after myocardial ischemic events.
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Abstract
Postoperative atrial fibrillation (PoAF), a common complication of cardiac surgery, contributes significantly to morbidity, mortality, and increasing healthcare costs. Despite advances in surgical and medical management, the overall incidence of PoAF has not changed significantly, partly because of the limited understanding of mechanisms underlying acute surgery-related factors, such as myocardial injury, inflammation, sympathetic activation, and oxidative stress, which play an important role in the initiation of PoAF, whereas a preexisting atrial substrate appears to be more important in the maintenance of this dysrhythmia. Thus, in a majority of patients, PoAF becomes a manifestation of an underlying arrhythmogenic substrate that is unmasked after acute surgical stress. As such, the ability to identify which patients have this proarrhythmic substrate and are, therefore, at high risk for developing AF postoperatively, is important for the improved selection for prophylactic interventions, closer monitoring for complications, and establishing the probability of AF in the long term. This review highlights the role of the underlying substrate in promoting PoAF, proposed mechanisms, and the potential role of serum biomarkers to identify patients at risk for PoAF.
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78
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Andersen JK, Oma I, Prayson RA, Kvelstad IL, Almdahl SM, Fagerland MW, Hollan I. Inflammatory cell infiltrates in the heart of patients with coronary artery disease with and without inflammatory rheumatic disease: a biopsy study. Arthritis Res Ther 2016; 18:232. [PMID: 27729056 PMCID: PMC5059899 DOI: 10.1186/s13075-016-1136-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 09/20/2016] [Indexed: 11/10/2022] Open
Abstract
Background The cause of premature cardiovascular disease (CVD) in inflammatory rheumatic diseases (IRDs) has not been fully elucidated. As inflammation may play a role, we wanted to compare the occurrence and extent of inflammatory cell infiltrates (ICIs), small vessel vasculitis, and the amount of adipose tissue and collagen in cardiac biopsies taken from patients with coronary artery disease with and without IRDs. Methods From among the Feiring Heart Biopsy Study subjects, we selected patients undergoing coronary artery bypass grafting from whom paraffin-embedded, formalin-fixed specimens from the right atrium were available. The sample comprised 48 patients with IRD and 40 non-IRD patients. Hematoxylin and eosin staining was used to examine the presence and location of ICIs and vasculitis, and Lendrum (Martius yellow, scarlet, and blue) staining was carried out for collagen and adipose tissue. Results Epicardial ICIs were found in 27 (56 %) patients with IRD and 24 (60 %) non-IRD patients. There were no significant differences between patients with IRD and non-IRD patients in the amount of cardiac ICIs and adipose tissue, but patients with IRD had more collagen in the myocardium than non-IRD patients. Small vessel vasculitis was not observed in any cardiac specimen. Patients with epicardial ICIs were, on average, 7 years younger than those without. Conclusions Our results do not support the notion that inflammation in cardiac peri-, epi-, and myocardium plays a more important role in CVD of patients with IRD than non-IRD patients. The increased amount of collagen in the myocardium of patients with IRD suggests differences in extracellular matrix composition and/or mass, which might play a role in cardiac remodeling, and represent targets for novel therapies against heart failure.
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Affiliation(s)
- Jacqueline K Andersen
- Department of Health, Technology and Society, Norwegian University of Science and Technology (NTNU), Teknologiveien 22, 2815, Gjøvik, Norway.
| | - Ingvild Oma
- Department of Pathology, Innlandet Hospital Trust, Lillehammer, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Richard A Prayson
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | | | - Sven Martin Almdahl
- Department of Cardiothoracic and Vascular Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Morten Wang Fagerland
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Ivana Hollan
- Hospital for Rheumatic Diseases, Lillehammer, Norway.,Department of Research, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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79
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Treatment with tumor necrosis factor inhibitors restores coronary microvascular function in young patients with severe psoriasis. Atherosclerosis 2016; 251:25-30. [DOI: 10.1016/j.atherosclerosis.2016.05.036] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 05/01/2016] [Accepted: 05/20/2016] [Indexed: 02/07/2023]
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80
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Standardized Chinese Formula Xin-Ke-Shu inhibits the myocardium Ca(2+) overloading and metabolic alternations in isoproterenol-induced myocardial infarction rats. Sci Rep 2016; 6:30208. [PMID: 27457884 PMCID: PMC4960537 DOI: 10.1038/srep30208] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 06/30/2016] [Indexed: 01/20/2023] Open
Abstract
Xin-Ke-Shu (XKS) is a traditional Chinese patent medicine used for treatment of coronary heart diseases in China. However, its mechanism of action is still unclear. In this paper, the mediation of XKS on the isoproterenol (ISO)-induced myocardial infarction (MI) rat were evaluated based on a tissue-targeted metabonomics in vitro/vivo. The result indicated that twelve metabolic pathways were involved in the therapeutic effect of XKS in vivo, where seven pathways were associated with the Ca2+ overloading mechanism. In agreement with regulation on metabolic variations, XKS markedly reversed the over-expressions of three involved proteins including phospholipase A2 IIA (PLA2 IIA), calcium/calmodulin-dependent protein kinase II (CaMK II) and Pro-Caspase-3. The metabolic regulations of XKS on H9c2 cell also partially confirmed its metabolic effect. These metabolic characteristics in vitro/vivo and western blotting analysis suggested that XKS protected from MI metabolic perturbation major via inhibition of Ca2+ overloading mechanism. Furthermore, 11 active ingredients of XKS exerted steady affinity with the three proteins through the molecular docking study. Our findings indicate that the metabonomics in vitro/vivo combined with western blotting analysis offers the opportunity to gain insight into the comprehensive efficacy of TCMs on the whole metabolic network.
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81
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Hassoun E, Safrin M, Ziv H, Pri-Chen S, Kessler E. Procollagen C-Proteinase Enhancer 1 (PCPE-1) as a Plasma Marker of Muscle and Liver Fibrosis in Mice. PLoS One 2016; 11:e0159606. [PMID: 27458976 PMCID: PMC4961444 DOI: 10.1371/journal.pone.0159606] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 07/05/2016] [Indexed: 01/06/2023] Open
Abstract
Current non-invasive diagnostic methods of fibrosis are limited in their ability to identify early and intermediate stages of fibrosis and assess the efficacy of therapy. New biomarkers of fibrosis are therefore constantly sought for, leading us to evaluate procollagen C-proteinase enhancer 1 (PCPE-1), a fibrosis-related extracellular matrix glycoprotein, as a plasma marker of fibrosis. A sandwich ELISA that permitted accurate measurements of PCPE-1 concentrations in mouse plasma was established. Tissue fibrosis was assessed using histochemical, immunofluorescence, and immunoblotting analyses for type I collagen and PCPE-1. The normal plasma concentration of PCPE-1 in 6 weeks to 4 months old mice was ~200 ng/ml (189.5 ± 11.3 to 206.8 ± 13.8 ng/ml). PCPE-1 plasma concentrations in four and 8.5 months old mdx mice displaying fibrotic diaphragms increased 27 and 40% respectively relatively to age-matched control mice, an increase comparable to that of the N-propeptide of procollagen type III (PIIINP), a known blood marker of fibrosis. PCPE-1 plasma levels in mice with CCl4-induced liver fibrosis increased 34 to 50% relatively to respective controls and reflected the severity of the disease, namely increased gradually during the progression of fibrosis and went down to basal levels during recovery, in parallel to changes in the liver content of collagen I and PCPE-1. The results favor PCPE-1 as a potential new clinically valuable fibrosis biomarker.
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Affiliation(s)
- Eyal Hassoun
- Maurice and Gabriela Goldschleger Eye Research Institute, Tel-Aviv University Sackler Faculty of Medicine, Sheba Medical Center, Tel-Hashomer, 52621, Israel
| | - Mary Safrin
- Maurice and Gabriela Goldschleger Eye Research Institute, Tel-Aviv University Sackler Faculty of Medicine, Sheba Medical Center, Tel-Hashomer, 52621, Israel
| | - Hana Ziv
- Maurice and Gabriela Goldschleger Eye Research Institute, Tel-Aviv University Sackler Faculty of Medicine, Sheba Medical Center, Tel-Hashomer, 52621, Israel
| | - Sarah Pri-Chen
- Maurice and Gabriela Goldschleger Eye Research Institute, Tel-Aviv University Sackler Faculty of Medicine, Sheba Medical Center, Tel-Hashomer, 52621, Israel
| | - Efrat Kessler
- Maurice and Gabriela Goldschleger Eye Research Institute, Tel-Aviv University Sackler Faculty of Medicine, Sheba Medical Center, Tel-Hashomer, 52621, Israel
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Association of cystatin C with heart failure with preserved ejection fraction in elderly hypertensive patients: potential role of altered collagen metabolism. J Hypertens 2016; 34:130-8. [PMID: 26575701 DOI: 10.1097/hjh.0000000000000757] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Cystatin C has been shown to be associated with heart failure with preserved ejection fraction (HFPEF). In addition, myocardial fibrosis has been involved in diastolic dysfunction in HFPEF. Therefore, we hypothesized that increased cystatin C levels may be associated with altered collagen metabolism, contributing to diastolic dysfunction in patients with HFPEF. METHODS One hundred and forty-one elderly hypertensive patients with HFPEF were included. Cardiac morphology and function was assessed by echocardiography. Circulating levels of cystatin C, biomarkers of collagen type I synthesis (carboxy-terminal propeptide of procollagen type I) and degradation [matrix metalloproteinase-1 (MMP-1) and its inhibitor TIMP-1] and osteopontin were analyzed by ELISA. Twenty elderly sex-matched patients with no identifiable cardiac disease were used as controls. In-vitro studies were performed in human cardiac fibroblasts. RESULTS Compared with controls, cystatin C was increased (P < 0.001) in patients with HFPEF, even in those with a normal estimated glomerular filtration rate (eGFR; P < 0.05). Cystatin C was directly correlated with the estimated pulmonary capillary wedge pressure (P < 0.01), TIMP-1 and osteopontin (P < 0.001) and inversely correlated with MMP-1:TIMP-1 (P < 0.01), but not with carboxy-terminal propeptide of procollagen type I or MMP-1 in all patients with HFPEF. These associations were independent of eGFR. In vitro, osteopontin (P < 0.01) and TIMP-1 (P < 0.001) increased in the supernatant of cardiac fibroblasts exposed to cystatin C. CONCLUSION In patients with HFPEF of hypertensive origin, cystatin C is increased and associated with diastolic dysfunction and alterations in collagen metabolism independently of eGFR. An excess of cystatin C might contribute to diastolic dysfunction in HFPEF by facilitating myocardial fibrosis via accumulation of osteopontin and TIMP-1.
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Dewey CM, Spitler KM, Ponce JM, Hall DD, Grueter CE. Cardiac-Secreted Factors as Peripheral Metabolic Regulators and Potential Disease Biomarkers. J Am Heart Assoc 2016; 5:e003101. [PMID: 27247337 PMCID: PMC4937259 DOI: 10.1161/jaha.115.003101] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Colleen M Dewey
- Division of Cardiovascular Medicine, Department of Internal Medicine and François M. Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Kathryn M Spitler
- Division of Cardiovascular Medicine, Department of Internal Medicine and François M. Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Jessica M Ponce
- Division of Cardiovascular Medicine, Department of Internal Medicine and François M. Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Duane D Hall
- Division of Cardiovascular Medicine, Department of Internal Medicine and François M. Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Chad E Grueter
- Division of Cardiovascular Medicine, Department of Internal Medicine and François M. Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, IA Fraternal Order of Eagles Diabetes Research Center, Papajohn Biomedical Institute, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
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84
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Petrovic I, Stankovic I, Milasinovic G, Nikcevic G, Kircanski B, Jovanovic V, Raspopovic S, Radovanovic N, Pavlovic SU. The Relationship of Myocardial Collagen Metabolism and Reverse Remodeling after Cardiac Resynchronization Therapy. J Med Biochem 2016; 35:130-136. [PMID: 28356872 PMCID: PMC5346789 DOI: 10.1515/jomb-2016-0001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/25/2015] [Indexed: 01/08/2023] Open
Abstract
Background In the majority of patients with a wide QRS complex and heart failure resistant to optimal medical therapy, cardiac resynchronization therapy (CRT) leads to reverse ventricular remodeling and possibly to changes in cardiac collagen synthesis and degradation. We investigated the relationship of biomarkers of myocardial collagen metabolism and volumetric response to CRT. Methods We prospectively studied 46 heart failure patients (mean age 61±9 years, 87% male) who underwent CRT implantation. Plasma concentrations of amino-terminal propeptide type I (PINP), a marker of collagen synthesis, and carboxy-terminal collagen telopeptide (CITP), a marker of collagen degradation, were measured before and 6 months after CRT. Response to CRT was defined as 15% or greater reduction in left ventricular end-systolic volume at 6-month follow-up. Results Baseline PINP levels showed a negative correlation with both left ventricular end-diastolic volume (r=-0.51; p=0.032), and end-systolic diameter (r=-0.47; p=0.049). After 6 months of device implantation, 28 patients (61%) responded to CRT. No significant differences in the baseline levels of PINP and CITP between responders and nonresponders were observed (p>0.05 for both). During follow-up, responders demonstrated a significant increase in serum PINP level from 31.37±18.40 to 39.2±19.19 μg/L (p=0.049), whereas in non-responders serum PINP levels did not significantly change (from 28.12±21.55 to 34.47± 18.64 μg/L; p=0.125). There were no significant changes in CITP levels in both responders and non-responders (p>0.05). Conclusions Left ventricular reverse remodeling induced by CRT is associated with an increased collagen synthesis in the first 6 months of CRT implantation.
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Affiliation(s)
- Ivana Petrovic
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivan Stankovic
- Department of Cardiology, University Clinical Hospital Centre Zemun, Belgrade, Serbia
| | - Goran Milasinovic
- School of Medicine, University of Belgrade, Belgrade, Serbia; Pacemaker Center, Clinical Center of Serbia, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Gabrijela Nikcevic
- Pacemaker Center, Clinical Center of Serbia, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Bratislav Kircanski
- Pacemaker Center, Clinical Center of Serbia, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Velibor Jovanovic
- Pacemaker Center, Clinical Center of Serbia, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Srdjan Raspopovic
- Pacemaker Center, Clinical Center of Serbia, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Nikola Radovanovic
- Pacemaker Center, Clinical Center of Serbia, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Sinisa U Pavlovic
- School of Medicine, University of Belgrade, Belgrade, Serbia; Pacemaker Center, Clinical Center of Serbia, Medical Faculty, University of Belgrade, Belgrade, Serbia
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Abstract
Calcified aortic stenosis is one of the most common causes of heart failure in the elderly. Current guidelines recommend aortic valve replacement in patients with severe disease and evidence of decompensation based on either symptoms or impaired systolic ejection fraction. However, symptoms are often subjective whilst impaired ejection fraction is not a sensitive marker of ventricular decompensation. Interest has surrounded the use of cardiac biochemical markers as objective measures of left ventricular decompensation in aortic stenosis. We will first examine mechanisms of release of biochemical markers associated with myocardial wall stress (BNP/NT-proBNP), myocardial fibrosis (markers of collagen metabolism, galectin-3, soluble ST2) and myocyte death/myocardial ischemia (high-sensitivity cardiac troponins, heart-type fatty acid binding protein, myosin-binding protein C); and discuss future directions of these markers.
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Affiliation(s)
- Calvin W L Chin
- a Department of Cardiovascular Medicine , National Heart Center Singapore , Singapore .,b Duke-NUS Graduate Medical School , Singapore
| | - Andie H Djohan
- c Barts and the London School of Medicine & Dentistry, Queen Mary, University of London , London , UK , and
| | - Chim C Lang
- d Division of Cardiovascular and Diabetes Medicine , University of Dundee , Dundee , UK
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86
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Morine KJ, Paruchuri V, Qiao X, Mohammad N, Mcgraw A, Yunis A, Jaffe I, Kapur NK. Circulating multimarker profile of patients with symptomatic heart failure supports enhanced fibrotic degradation and decreased angiogenesis. Biomarkers 2015; 21:91-7. [PMID: 26667393 DOI: 10.3109/1354750x.2015.1118539] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Heart failure (HF) involves myocardial fibrosis and dysregulated angiogenesis. OBJECTIVE We explored whether biomarkers of fibrosis and angiogenesis correlate with HF severity. METHODS Biomarkers of fibrosis [procollagen types I and III (PIP and P3NP), carboxyterminal-telopeptide of type I collagen (ICTP), matrix metalloproteases (MMP2 and MMP9), tissue inhibitor of MMP1 (TIMP1)]; and angiogenesis [placental growth factor (PGF), vascular endothelial growth factor (VEGF), soluble Fms-like tyrosine kinase-1 (sFlt1)] were measured in 52 HF patients and 19 controls. RESULTS P3NP, ICTP, MMP2, TIMP1, PGF, and sFlt1 levels were elevated in HF, while PIP/ICTP, PGF/sFlt1, and VEGF/sFlt1 ratios were reduced. PIP/ICTP, MMP-9/TIMP1, and VEGF/sFlt1 ratios were lowest among patients with severe HF. CONCLUSIONS Severe HF is associated with collagen breakdown and reduced angiogenesis. A multimarker approach may guide therapeutic targeting of fibrosis and angiogenesis in HF.
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Affiliation(s)
- Kevin J Morine
- a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA
| | - Vikram Paruchuri
- a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA
| | - Xiaoying Qiao
- a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA
| | - Najwa Mohammad
- a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA
| | - Adam Mcgraw
- a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA
| | - Adil Yunis
- a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA
| | - Iris Jaffe
- a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA
| | - Navin K Kapur
- a Division of Cardiology , Department of Medicine, Tufts Medical Center, Molecular Cardiology Research Institute , Boston , MA , USA
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Ma S, Liu W, Liu P, Liu J, Chen L, Qin C. Tanshinone IIA treatment alleviated the rat gingival connective tissue overgrowth induced by cyclosporine A. J Periodontal Res 2015; 51:567-76. [PMID: 26547660 DOI: 10.1111/jre.12335] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2015] [Indexed: 01/09/2023]
Affiliation(s)
- S. Ma
- Department of Periodontics; the First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
- Longjiang Scholar Laboratory; the First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - W. Liu
- Department of Periodontics; the First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - P. Liu
- Department of Periodontics; the First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - J. Liu
- Department of Periodontics; the First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - L. Chen
- Longjiang Scholar Laboratory; the First Affiliated Hospital; Harbin Medical University; Harbin Heilongjiang China
| | - C. Qin
- Department of Biomedical Sciences and Center for Craniofacial Research and Diagnosis; Texas, A&M University, Baylor College of Dentistry; Dallas TX USA
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Altara R, Gu YM, Struijker-Boudier HAJ, Thijs L, Staessen JA, Blankesteijn WM. Left Ventricular Dysfunction and CXCR3 Ligands in Hypertension: From Animal Experiments to a Population-Based Pilot Study. PLoS One 2015; 10:e0141394. [PMID: 26506526 PMCID: PMC4624781 DOI: 10.1371/journal.pone.0141394] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 09/01/2015] [Indexed: 01/14/2023] Open
Abstract
Detecting left ventricular (LV) dysfunction at an early stage is key in addressing the heart failure epidemic. In proteome profiling experiments in mice subjected either to aortic banding or sham, the circulating CXCR3 ligands monokine induced by interferon-γ (MIG) and interferon-γ inducible protein 10 (IP10) were 5 to 40 fold up-regulated at eight weeks. We assessed the diagnostic value of circulating NT-pro BNP and CXCR3 ligands (MIG, IP10, Interferon-inducible T-cell alpha chemo-attractant [I–TAC]) in patients with hypertension (≥140/90 mm Hg) associated with subclinical (n = 19) or symptomatic (n = 16) diastolic LV dysfunction on echocardiography and healthy controls. NT–pro BNP, MIG, IP10, I–TAC all increased (p ≤ 0.014) across the categories of worsening left ventricular dysfunction. In patients with symptomatic disease, MIG, IP10, and I–TAC increased 210% (p = 0.015), 140% (p = 0.007) and 120% (p = 0.035) more than NT-pro BNP. The optimal discrimination limits, obtained by maximizing Youden’s index were 246 pmol/L, 65 pg/mL, 93 pg/mL, and 24 pg/mL, respectively. The odds ratios associated with the four biomarkers were significant (p ≤ 0.010), ranging from 4.00 for IP10 to 9.69 for MIG. With adjustment for NT–pro BNP, the CXCR3 ligands retained significance (p ≤ 0.028). Adding optimized thresholds for the CXCR3 ligands to NT–pro BNP enhanced (p ≤ 0.014) the integrated discrimination improvement and the net reclassification improvement. In conclusion, congruent with the concept that inflammation plays a key role in the pathogenesis of LV dysfunction, MIG, IP10 and I–TAC add diagnostic accuracy over and beyond NT–pro BNP.
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Affiliation(s)
- Raffaele Altara
- Department of Pharmacology and Toxicology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Yu-Mei Gu
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Harry A. J. Struijker-Boudier
- Department of Pharmacology and Toxicology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Jan A. Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- VitaK Research and Development, Maastricht University, Maastricht, The Netherlands
| | - W. Matthijs Blankesteijn
- Department of Pharmacology and Toxicology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- * E-mail:
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Agarwal I, Glazer NL, Barasch E, Djousse L, Gottdiener JS, Ix JH, Kizer JR, Rimm EB, Siscovick DS, King GL, Mukamal KJ. Associations between metabolic dysregulation and circulating biomarkers of fibrosis: the Cardiovascular Health Study. Metabolism 2015; 64:1316-23. [PMID: 26282733 PMCID: PMC4939831 DOI: 10.1016/j.metabol.2015.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/11/2015] [Accepted: 07/16/2015] [Indexed: 01/05/2023]
Abstract
AIM Fibrosis is one postulated pathway by which diabetes produces cardiac and other systemic complications. Our aim was to determine which metabolic parameters are associated with circulating fibrosis-related biomarkers transforming growth factor-β (TGF-β) and procollagen type III N-terminal propeptide (PIIINP). METHODS We used linear regression to determine the cross-sectional associations of diverse metabolic parameters, including fasting glucose, fasting insulin, body mass index, fatty acid binding protein 4, and non-esterified fatty acids, with circulating levels of TGF-β (n = 1559) and PIIINP (n = 3024) among community-living older adults in the Cardiovascular Health Study. RESULTS Among the main metabolic parameters we examined, only fasting glucose was associated with TGF-β (P = 0.03). In contrast, multiple metabolic parameters were associated with PIIINP, including fasting insulin, body mass index, and non-esterified fatty acids (P<0.001, P<0.001, P=0.001, respectively). These associations remained statistically significant after mutual adjustment, except the association between BMI and PIIINP. CONCLUSIONS Isolated hyperglycemia is associated with higher serum concentrations of TGF-β, while a broader phenotype of insulin resistance is associated with higher serum PIIINP. Whether simultaneous pharmacologic targeting of these two metabolic phenotypes can synergistically reduce the risk of cardiac and other manifestations of fibrosis remains to be determined.
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Affiliation(s)
- Isha Agarwal
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
| | | | - Eddy Barasch
- Department of Research and Education, St. Francis Hospital, The Heart Center, Roslyn, NY, USA; SUNY at Stony Brook, Stony Brook, NY, USA
| | - Luc Djousse
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - John S Gottdiener
- Department of Medicine, University of Maryland Medical School, Baltimore, MD, USA
| | - Joachim H Ix
- Department of Medicine, University of California San Diego, San Diego, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Jorge R Kizer
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Epidemiology, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Eric B Rimm
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - David S Siscovick
- The New York Academy of Medicine, New York, NY, USA; Department of Medicine, Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA; Department of Epidemiology, Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - George L King
- Research Division, Joslin Diabetes Center and Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Ken J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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“Targeting the Heart” in Heart Failure. JACC-HEART FAILURE 2015; 3:661-9. [DOI: 10.1016/j.jchf.2015.04.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 04/08/2015] [Accepted: 04/18/2015] [Indexed: 12/15/2022]
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91
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Patheja P, Dasgupta R, Dube A, Ahlawat S, Verma RS, Gupta PK. The use of optical trap and microbeam to investigate the mechanical and transport characteristics of tunneling nanotubes in tumor spheroids. JOURNAL OF BIOPHOTONICS 2015; 8:730-9. [PMID: 25355694 DOI: 10.1002/jbio.201400086] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 09/29/2014] [Accepted: 10/06/2014] [Indexed: 05/02/2023]
Abstract
The use of optical trap and microbeam for investigating mechanical and transport properties of inter cellular tunneling nanotubes (TnTs) in tumor spheroids has been demonstrated. TnTs in tumor spheroids have been visualized by manipulating TnT connected cells using optical tweezers. Functionality of the TnTs for transferring cytoplasmic vesicles and injected dye molecules by optoporation method has been studied. Further, the TnTs could be longitudinally stretched by manipulating the connected cells and their elastic response was studied. Manipulation of cells at the surface of tumor spheroid using optical tweezers and injection of fluorescent dye into a trapped cell using optoporation technique.
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Affiliation(s)
- Pooja Patheja
- Laser Biomedical Applications and Instrumentation Division, Raja Ramanna Centre for Advanced Technology, Indore, 452013, India.
| | - Raktim Dasgupta
- Laser Biomedical Applications and Instrumentation Division, Raja Ramanna Centre for Advanced Technology, Indore, 452013, India.
- Department of Theory and Bio-systems, Max Planck Institute of Colloids and Interfaces, 14476, Potsdam, Germany.
| | - Alok Dube
- Laser Biomedical Applications and Instrumentation Division, Raja Ramanna Centre for Advanced Technology, Indore, 452013, India
| | - Sunita Ahlawat
- Laser Biomedical Applications and Instrumentation Division, Raja Ramanna Centre for Advanced Technology, Indore, 452013, India
| | - Ravi Shanker Verma
- Laser Biomedical Applications and Instrumentation Division, Raja Ramanna Centre for Advanced Technology, Indore, 452013, India
| | - Pradeep Kumar Gupta
- Laser Biomedical Applications and Instrumentation Division, Raja Ramanna Centre for Advanced Technology, Indore, 452013, India
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92
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Prior DL, Somaratne JB, Jenkins AJ, Yii M, Newcomb AE, Schalkwijk CG, Black MJ, Kelly DJ, Campbell DJ. Calibrated integrated backscatter and myocardial fibrosis in patients undergoing cardiac surgery. Open Heart 2015; 2:e000278. [PMID: 26339497 PMCID: PMC4555070 DOI: 10.1136/openhrt-2015-000278] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 06/16/2015] [Accepted: 07/31/2015] [Indexed: 12/29/2022] Open
Abstract
Objective The reported association between calibrated integrated backscatter (cIB) and myocardial fibrosis is based on study of patients with dilated or hypertrophic cardiomyopathy and extensive (mean 15–34%) fibrosis. Its association with lesser degrees of fibrosis is unknown. We examined the relationship between cIB and myocardial fibrosis in patients with coronary artery disease. Methods Myocardial histology was examined in left ventricular epicardial biopsies from 40 patients (29 men and 11 women) undergoing coronary artery bypass graft surgery, who had preoperative echocardiography with cIB measurement. Results Total fibrosis (picrosirius red staining) varied from 0.7% to 4%, and in contrast to previous reports, cIB showed weak inverse associations with total fibrosis (r=−0.32, p=0.047) and interstitial fibrosis (r=−0.34, p=0.03). However, cIB was not significantly associated with other histological parameters, including immunostaining for collagens I and III, the advanced glycation end product (AGE) Nε-(carboxymethyl)lysine (CML) and the receptor for AGEs (RAGE). When biomarkers were examined, cIB was weakly associated with log plasma levels of amino-terminal pro-B-type natriuretic peptide (r=0.34, p=0.03), creatinine (r=0.33, p=0.04) and glomerular filtration rate (r=−0.33, p=0.04), and was more strongly associated with log plasma levels of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) (r=0.44, p=0.01) and soluble RAGE (r=0.53, p=0.002). Conclusions Higher cIB was not a marker of increased myocardial fibrosis in patients with coronary artery disease, but was associated with higher plasma levels of sVEGFR-1 and soluble RAGE. The role of cIB as a non-invasive index of fibrosis in clinical studies of patients without extensive fibrosis is, therefore, questionable.
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Affiliation(s)
- David L Prior
- Department of Cardiology , St. Vincent's Hospital Melbourne , Fitzroy , Australia ; Department of Medicine , University of Melbourne, St. Vincent's Hospital Melbourne , Fitzroy , Australia ; St. Vincent's Institute of Medical Research , Fitzroy , Australia
| | | | - Alicia J Jenkins
- Department of Medicine , University of Melbourne, St. Vincent's Hospital Melbourne , Fitzroy , Australia
| | - Michael Yii
- Department of Cardiothoracic Surgery , St. Vincent's Hospital Melbourne , Fitzroy , Australia ; Department of Surgery , University of Melbourne, St. Vincent's Hospital Melbourne , Fitzroy , Australia
| | - Andrew E Newcomb
- Department of Cardiothoracic Surgery , St. Vincent's Hospital Melbourne , Fitzroy , Australia ; Department of Surgery , University of Melbourne, St. Vincent's Hospital Melbourne , Fitzroy , Australia
| | - Casper G Schalkwijk
- Department of Internal Medicine , University of Maastricht , Maastricht , The Netherlands
| | - Mary J Black
- Department of Anatomy and Developmental Biology , Monash University , Clayton , Australia
| | - Darren J Kelly
- Department of Medicine , University of Melbourne, St. Vincent's Hospital Melbourne , Fitzroy , Australia
| | - Duncan J Campbell
- Department of Medicine , University of Melbourne, St. Vincent's Hospital Melbourne , Fitzroy , Australia ; St. Vincent's Institute of Medical Research , Fitzroy , Australia
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López B, González A, Ravassa S, Beaumont J, Moreno MU, San José G, Querejeta R, Díez J. Circulating Biomarkers of Myocardial Fibrosis: The Need for a Reappraisal. J Am Coll Cardiol 2015; 65:2449-56. [PMID: 26046739 DOI: 10.1016/j.jacc.2015.04.026] [Citation(s) in RCA: 180] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 04/17/2015] [Accepted: 04/18/2015] [Indexed: 01/16/2023]
Abstract
Myocardial fibrosis impairs cardiac function, in addition to facilitating arrhythmias and ischemia, and thus influences the evolution and outcome of cardiac diseases. Its assessment is therefore clinically relevant. Although tissue biopsy is the gold standard for the diagnosis of myocardial fibrosis, a number of circulating biomarkers have been proposed for the noninvasive assessment of this lesion. A review of the published clinical data available on these biomarkers shows that most of them lack proof that they actually reflect the myocardial accumulation of fibrous tissue. In this "call to action" article, we propose that this absence of proof may lead to misinterpretations when considering the incremental value provided by the biomarkers with respect to traditional diagnostic tools in the clinical handling of patients. We thus argue that strategies are needed to more strictly validate whether a given circulating biomarker actually reflects histologically proven myocardial fibrosis before it is applied clinically.
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Affiliation(s)
- Begoña López
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Arantxa González
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Susana Ravassa
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Javier Beaumont
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - María U Moreno
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Gorka San José
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Ramon Querejeta
- Division of Cardiology, Donostia University Hospital, University of the Basque Country, San Sebastian, Spain
| | - Javier Díez
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, University of Navarra, Pamplona, Spain.
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Yamamoto T, Tsujimoto M, Sowa H. Safety of daily teriparatide treatment: a post hoc analysis of a Phase III study to investigate the possible association of teriparatide treatment with calcium homeostasis in patients with serum procollagen type I N-terminal propeptide elevation. Clin Interv Aging 2015; 10:1101-9. [PMID: 26185429 PMCID: PMC4500620 DOI: 10.2147/cia.s83549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Serum procollagen type I N-terminal propeptide (PINP), a representative marker of bone anabolic action, is strongly related to bone mineral density during teriparatide therapy. This post hoc study analyzed data from a Phase III study (ClinicalTrials.gov identifier NCT00433160) to determine if there was an association between serum PINP elevation and serum calcium concentration or calcium metabolism-related disorders. RESEARCH DESIGN AND METHODS Japanese subjects with osteoporosis at high risk of fracture were randomized 2:1 to teriparatide 20 μg/day (n=137) or placebo (n=70) for a 12-month double-blind treatment period, followed by 12 months of open-label teriparatide treatment of all subjects. MAIN OUTCOME MEASURES Serum PINP levels were measured at baseline, and after 1, 3, 6, 12, 18, and 24 months of treatment. Serum calcium levels were measured at baseline, and after 1, 3, 6, 9, 12, 15, 18, 21, and 24 months of treatment. RESULTS Serum PINP increased from baseline to 1 month of treatment and then remained high through 24 months. Twenty-eight of 195 subjects experienced PINP elevations >200 μg/L during teriparatide treatment. Serum calcium concentration in both the teriparatide and placebo groups remained within the normal range. There was no clinically relevant difference in serum calcium concentration between subjects with PINP >200 μg/L and subjects with PINP ≤200 μg/L. Two subjects experienced hypercalcemia and recovered without altering teriparatide treatment. Adverse events possibly related to calcium metabolism disorders included periarthritis calcarea (one subject) and chondrocalcinosis pyrophosphate (two subjects), but neither was accompanied with a significant increase in PINP or serum calcium concentration. CONCLUSION Although the moderate size of this study prevented statistical analysis of any potential association between calcium metabolism-related disorders and elevated PINP, this analysis suggests that there was no association between serum PINP elevation during daily teriparatide treatment and serum calcium concentration or calcium metabolism-related disorders in Japanese subjects.
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Affiliation(s)
- Takanori Yamamoto
- Medical Science, Lilly Research Laboratories, Medicines Development Unit Japan
| | - Mika Tsujimoto
- Asia Pacific Statistical Science-Japan, Science and Regulatory Affairs, LRL MDU-Japan, Eli Lilly Japan K.K, Kobe, Hyogo, Japan
| | - Hideaki Sowa
- Medical Science, Lilly Research Laboratories, Medicines Development Unit Japan
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95
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Campbell KS, Sorrell VL. Cell- and molecular-level mechanisms contributing to diastolic dysfunction in HFpEF. J Appl Physiol (1985) 2015; 119:1228-32. [PMID: 25911687 DOI: 10.1152/japplphysiol.01168.2014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 04/12/2015] [Indexed: 02/08/2023] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is the default diagnosis for patients who have symptoms of heart failure, an ejection fraction >0.5, and evidence of diastolic dysfunction. The clinical condition, which was largely unrecognized 30 years ago, is now a major health problem and currently accounts for 50% of all patients with heart failure. Clinical studies show that patients with HFpEF exhibit increased passive stiffness of the ventricles and a slower rate of pressure decline during diastole. This review discusses some of the cell- and molecular-level mechanisms that contribute to these effects and focuses on data obtained using human samples. Collagen cross linking, modulation of protein kinase G-related pathways, Ca(2+) handling, and strain-dependent detachment of cross bridges are highlighted as potential factors that could be modulated to improve ventricular function in patients with HFpEF.
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Affiliation(s)
- Kenneth S Campbell
- Department of Physiology and Center for Muscle Biology, Linda and Jack Gill Heart Institute, University of Kentucky, Lexington, Kentucky; and
| | - Vincent L Sorrell
- Division of Cardiovascular Medicine, Linda and Jack Gill Heart Institute, University of Kentucky, Lexington, Kentucky
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96
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Seetho IW, Ramírez-Torres A, Albalat A, Mullen W, Mischak H, Parker RJ, Craig S, Duffy N, Hardy KJ, Burniston JG, Wilding JPH. Urinary proteomic profiling in severe obesity and obstructive sleep apnoea with CPAP treatment. Sleep Sci 2015; 8:58-67. [PMID: 26483946 PMCID: PMC4608901 DOI: 10.1016/j.slsci.2015.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 06/23/2015] [Accepted: 06/24/2015] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Obstructive sleep apnoea (OSA) is common in obesity and is associated with cardiovascular and metabolic complications. Continuous positive airway pressure (CPAP) in OSA may lead to physiological changes reflected in the urinary proteome. The aim of this study was to characterise the urinary proteome in severely obese adult subjects with OSA who were receiving CPAP compared with severely obese subjects without OSA. METHODS Severely obese subjects with and without OSA were recruited. Subjects with OSA were receiving CPAP. Body composition and blood pressure measurements were recorded. Urinary samples were analysed by Capillary Electrophoresis-Mass Spectrometry (CE-MS). RESULTS Twenty-seven subjects with OSA-on-CPAP (age 49±7years, BMI 43±7 kg/m(2)) and 25 controls without OSA (age 52±9years, BMI 39±4 kg/m(2)) were studied. Age and BMI were not significantly different between groups. Mean CPAP use for OSA patients was 14.5±1.0 months. Metabolic syndrome was present in 14(52%) of those with OSA compared with 6(24%) of controls (p=0.039). A urinary proteome comprising 15 peptides was identified showing differential expression between the groups (p<0.01). Although correction for multiple testing did not reach significance, sequences were determined for 8 peptides demonstrating origins from collagens, fibrinogen beta chain and T-cadherin that may be associated with underlying cardiovascular disease mechanisms in OSA. CONCLUSIONS The urinary proteome is compared in OSA with CPAP and without OSA in severe obesity. The effects of CPAP on OSA may lead to changes in the urinary peptides but further research work is needed to investigate the potential role for urinary proteomics in characterising urinary peptide profiles in OSA.
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Affiliation(s)
- Ian W Seetho
- Department of Obesity & Endocrinology, University of Liverpool, UK
| | - Adela Ramírez-Torres
- Mosaiques Diagnostics GmbH, Hannover, Germany
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Amaya Albalat
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - William Mullen
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Harald Mischak
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Robert J Parker
- Department of Respiratory Medicine, University Hospital Aintree, Liverpool, UK
| | - Sonya Craig
- Department of Respiratory Medicine, University Hospital Aintree, Liverpool, UK
| | - Nick Duffy
- Department of Respiratory Medicine, University Hospital Aintree, Liverpool, UK
| | - Kevin J Hardy
- Department of Diabetes & Endocrinology, St Helens & Knowsley Teaching Hospitals, UK
| | - Jatin G Burniston
- School of Sports & Exercise Sciences, Liverpool John Moores University, UK
| | - John PH Wilding
- Department of Obesity & Endocrinology, University of Liverpool, UK
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97
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Maulik SK, Mishra S. Hypertrophy to failure: what goes wrong with the fibers of the heart? Indian Heart J 2015; 67:66-9. [PMID: 25820056 DOI: 10.1016/j.ihj.2015.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 02/04/2015] [Indexed: 10/23/2022] Open
Affiliation(s)
- S K Maulik
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India.
| | - S Mishra
- Professor, Department of Cardiology, AIIMS, New Delhi, India
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98
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Zhang YJ, Ma N, Su F, Liu H, Mei J. Increased TRPM6 expression in atrial fibrillation patients contribute to atrial fibrosis. Exp Mol Pathol 2015; 98:486-90. [PMID: 25796343 DOI: 10.1016/j.yexmp.2015.03.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 03/16/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Transient receptor potential (TRP) family plays important roles in cardiovascular system. We investigated the relationship between transient receptor potential channel subfamily M6 (TRPM6) and atrial fibrosis in rheumatic heart disease patients with atrial fibrillation (AF). METHODS The right atrial tissue samples were obtained from 64 patients with rheumatic heart diseases who underwent heart valve replacement surgery, and composed of 34 sinus rhythm (SR) patients and 30 AF patients. Hematoxylin and Eosin (HE) staining was used to observe cross-sectional area (CSA) of myocardial cell. Masson staining and measurement of connective tissue growth factor (CTGF), transforming growth factor beta 1 (TGF-β 1), and collagen type I/III (Collagen I/III) were performed to determine atrial fibrosis. The mRNA and protein levels of TRPM6 were detected by real-time quantitative polymerase chain reaction (RT-PCR) and western blotting, respectively. RESULTS Marked increases were observed in CSA of myocardial cell and myocardial collagen volume fraction in AF group compared with the SR group (all P<0.05). The mRNA levels of myocardial fibrosis markers (CTGF, TGF-beta 1, Collagen I/III) in AF group increased significantly compared to the SR group (all P<0.05). TRPM6 mRNA and protein levels in AF group were elevated markedly in comparison with SR group (P<0.01). CONCLUSION These findings revealed that increased TRPM6 mRNA and protein levels may contribute to atrial fibrosis, and suggested that TRPM6 might be involved in AF development by promoting fibrogenesis.
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Affiliation(s)
- Yun-Jiao Zhang
- Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, PR China
| | - Nan Ma
- Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, PR China
| | - Feng Su
- Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, PR China
| | - Hao Liu
- Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, PR China
| | - Ju Mei
- Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, PR China.
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Ravassa S, Kuznetsova T, Varo N, Thijs L, Delles C, Dominiczak A, Díez J, Staessen JA. Biomarkers of cardiomyocyte injury and stress identify left atrial and left ventricular remodelling and dysfunction: A population-based study. Int J Cardiol 2015; 185:177-85. [PMID: 25796005 DOI: 10.1016/j.ijcard.2015.03.046] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 12/22/2014] [Accepted: 03/03/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND/OBJECTIVES The validation of effective screening tools for the identification of patients with subclinical myocardial remodelling is a major clinical need. Thus, we explored the associations of circulating biomarkers of cardiomyocyte injury and stress with subclinical cardiac remodelling and dysfunction, and with biomarkers reflecting collagen turnover. METHODS We randomly recruited 727 subjects from a general population (51.2% women; mean age 51.3 years). Measurements included echocardiographic left atrial (LA) and left ventricular (LV) structure and function, quantification of high sensitivity cardiac Troponin T (hs-cTnT), NT-proBNP, and biomarkers of collagen types I and III turnover. RESULTS In unadjusted and adjusted analyses, the prevalence of LA enlargement (LAE), LV hypertrophy (LVH) and LV diastolic dysfunction (LVDD) increased with higher hs-cTnT (P ≤ 0.031). NT-proBNP was independently associated with LVDD (P=0.009). Both biomarkers combined yielded significant integrated discrimination and net reclassification improvements (P ≤ 0.014 and P ≤ 0.009, respectively) for LAE, LVH and LVDD, over the conventional risk factors, and were independently and positively associated with biomarkers of collagen type I turnover. In a sensitivity analysis, after excluding participants with previous cardiac diseases, our findings remained consistent. CONCLUSIONS Our population-based study suggested that subclinical LV and LA remodelling were associated with hs-cTnT, and that, in combination with NT-proBNP, hs-cTnT showed incremental diagnostic utility over the conventional risk factors. Both biomarkers were associated with biomarkers of collagen type I turnover. Thus, biomarkers of cardiomyocyte microinjury and hemodynamic stress may stimulate fibrosis-related mechanisms and facilitate the diagnosis of subclinical LA and LV remodelling and dysfunction in the general population.
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Affiliation(s)
- Susana Ravassa
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain
| | - Tatiana Kuznetsova
- The Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Nerea Varo
- Department of Biochemistry, University of Navarra Clinic, University of Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona Spain
| | - Lutgarde Thijs
- The Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, UK
| | - Anna Dominiczak
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, UK
| | - Javier Díez
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain; Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, University of Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain.
| | - Jan A Staessen
- The Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium; Department of Epidemiology, University of Maastricht, Maastricht, The Netherlands.
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Löfsjögård J, Kahan T, Díez J, López B, González A, Edner M, Henriksson P, Mejhert M, Persson H. Biomarkers of collagen type I metabolism are related to B-type natriuretic peptide, left ventricular size, and diastolic function in heart failure. J Cardiovasc Med (Hagerstown) 2015; 15:463-9. [PMID: 24983265 DOI: 10.2459/01.jcm.0000435617.86180.0b] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Myocardial collagen metabolism can be assessed indirectly by circulating biomarkers. We aimed to examine associations between myocardial collagen type I synthesis and degradation, and echocardiographic, clinical, and B-type natriuretic peptide (BNP) findings in heart failure. METHODS We studied 57 women and 75 men 60 years or older with systolic heart failure (New York Heart Association II-IV and an ejection fraction ≤ 45%). Mean age was 75 years, blood pressure 134/80 mmHg, ejection fraction 34%, and median BNP 210 ng/l. Analyses of the carboxy-terminal propeptide of procollagen type I (PICP, biomarker of collagen type I synthesis) and the serum carboxy-terminal telopeptide of collagen type I (CITP, biomarker of collagen type I degradation) were measured. Extensive echocardiographic examinations were performed, including variables of dyssynchrony. RESULTS Increased collagen synthesis (PICP) was independently related to increased BNP levels (r = 0.24, P = 0.018). Furthermore, independent associations were found between PICP and left ventricular size, isovolumic relaxation time, and relative wall thickness. Increased collagen degradation (CITP) was independently related to increased BNP levels (r = 0.35, P < 0.001). Also, univariable, but not multivariable, associations were found between CITP and E/E' septal and QRS duration. CONCLUSION Biomarkers of collagen type I synthesis and degradation are independently related to BNP and to indices of left ventricular size and diastolic function in systolic heart failure. It is proposed that BNP may contribute to alterations in collagen type I metabolism in systolic heart failure.
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Affiliation(s)
- Johan Löfsjögård
- aDivision of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet bDepartment of Cardiology, Danderyd University Hospital, Stockholm, Sweden cDivision of Cardiovascular Sciences, Centre of Applied Medical Research dDepartment of Cardiology and Cardiac Surgery, School of Medicine, University of Navarra, Pamplona, Spain eErsta Hospital, Stockholm, Sweden
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