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Nardi E, Arena V. Glandular cardiac myxoma with intraepithelial ductal neoplasia features: Report of the first case. Cardiovasc Pathol 2024; 72:107663. [PMID: 38815841 DOI: 10.1016/j.carpath.2024.107663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/01/2024] Open
Abstract
Cardiac myxoma are the most common primary tumor of the heart in adults. In approximately 2-5%, glandular differentiation occurs within these tumors. In the presence of glandular features attention must be taken to exclude and prevent a misdiagnosis of cardiac metastases of adenocarcinoma. Nevertheless, the localization in the left atrium, the solitary disposition of the cardiac mass, the histological features and the immunohistochemistry performed, argued against the possibility of a metastatic nature of the tumor. We report the case of an 80-year-old woman, with a prior medical history of breast cancer, that underwent surgery for a cardiac myxoma that histologically showed glandular features. Herein, we highlight the importance of a careful diagnosis of this entity, as it can be easily confused for a metastasis, especially in patients with a history of malignancy.
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Affiliation(s)
- Eleonora Nardi
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy.
| | - Vincenzo Arena
- Area of Pathology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Anatomia Patologica, Rome, Italy
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52
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Harmouch W, Zhang JR, Peterson JM, Uran DP, Buja LM, Zhao B, Boor PJ, Murrieta JI, Chatila K, Stevenson HL. A challenging case of eosinophilic myocarditis leading to heart failure and transplantation. Cardiovasc Pathol 2024; 72:107666. [PMID: 38871199 DOI: 10.1016/j.carpath.2024.107666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 05/30/2024] [Accepted: 06/01/2024] [Indexed: 06/15/2024] Open
Abstract
The large spectrum of etiologies, severities, and histologic appearances of eosinophilic myocarditis (EoM) poses challenges to its diagnosis and management. Endomyocardial biopsy is the current gold standard for diagnosis. However, cardiovascular magnetic resonance imaging is becoming more frequently used to diagnose acute myocarditis because of enhanced sensitivity when compared to histopathologic examination, and its less invasive nature. We report a complicated case of EoM in a male in his mid-thirties that led to fulminant cardiogenic shock that required immunosuppressive therapy on day 5 of admission and implantation of a left ventricular assist device (LVAD) on day 30. EoM was diagnosed on histopathologic examination of the resected fragment of the left ventricular myocardium. Nine months after the initial presentation, the patient ultimately required heart transplantation. The explanted heart showed minimal residual interstitial inflammation with evidence of mildly active intimal arteritis and patchy areas of interstitial fibrosis. In this report, we describe our patient's clinical features and correlate them with imaging and histopathologic findings to illustrate the difficulty in diagnosing EoM, particularly in this complicated patient that ultimately required heart transplantation. The diagnosis can be challenging due to the variable histopathologic features, clinical presentation, and utilization of therapeutic medications and devices.
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Affiliation(s)
- Wissam Harmouch
- Departments of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA.
| | - Jared R Zhang
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Joshua M Peterson
- Departments of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Diana Palacio Uran
- Departments of Radiology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Louis Maximilian Buja
- Department of Pathology and Laboratory Medicine, University of Texas Health Science Center, Houston, Texas, USA; Cardiovascular Pathology Research Laboratory, Texas Heart Institute, CHI St. Luke's Hospital, Houston, Texas, USA
| | - Bihong Zhao
- Department of Pathology and Laboratory Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | - Paul J Boor
- Departments of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Jose Iturrizaga Murrieta
- Departments of Division of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Khaled Chatila
- Departments of Division of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Heather L Stevenson
- Departments of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
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Sarode K, Patel A, Arrington K, Makhija R, Mukherjee D. Pericardial Decompression Syndrome: A Comprehensive Review of a Controversial Entity. Int J Angiol 2024; 33:139-147. [PMID: 39131808 PMCID: PMC11315602 DOI: 10.1055/s-0044-1780536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024] Open
Abstract
Pericardial decompression syndrome is an ambiguous clinical entity which has generated controversy regarding its existence. Following pericardial decompression, patients experienced clinical deterioration ranging in complications from pulmonary edema to death that could not be attributed to any other distinct clinical pathology. Multiple theories have suggested the pathophysiology behind pericardial decompression syndrome is related to preload-afterload mismatch following pericardial decompression, coronary microvascular ischemia, and stress from high adrenergic state. Our review aims to describe this syndrome by analyzing demographics, etiology of pericardial effusion, method of drainage, volume of pericardial fluid removed, time to decompensation, and clinical outcomes. A systematic review of MEDLINE/PubMed and Google Scholar literature databases were queried for case reports, case series, review articles, and abstracts published in English journals between 1983 and December 2022. Each author's interpretation of echocardiographic and/or pulmonary arterial catheterization data provided in the case reports was used to characterize ventricular dysfunction. Based on our inclusion criteria, 72 cases of pericardial decompression syndrome were included in our review. Our results showed that phenotypic heterogeneity was present based on echocardiographic findings of right/left or biventricular failure with similar proportions in each type of ventricular dysfunction. Time to decompensation was similar between immediate, subacute, and acute cases with presentation varying between hypoxic respiratory failure and shock. This review article highlights theories behind the pathophysiology, clinical outcomes, and therapeutic options in this high mortality condition.
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Affiliation(s)
- Karan Sarode
- Department of Cardiovascular Medicine, Texas Tech University Health Sciences Center, El Paso, Texas
| | - Amar Patel
- Department of Cardiovascular Medicine, Texas Tech University Health Sciences Center, El Paso, Texas
| | - Kedzie Arrington
- Department of Cardiovascular Medicine, Texas Tech University Health Sciences Center, El Paso, Texas
| | - Rakhee Makhija
- Department of Cardiovascular Medicine, Texas Tech University Health Sciences Center, El Paso, Texas
| | - Debabrata Mukherjee
- Department of Cardiovascular Medicine, Texas Tech University Health Sciences Center, El Paso, Texas
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Jha A, Patel P, Krishnan AM, Sherif AA, Mishra AK, Mohamed A, Thirupathy U, Bhattad PB, Roumia M. Burden and predictors of thirty-day readmission in patients with NSTEMI: a retrospective analysis of the 2020 NRD database. Coron Artery Dis 2024:00019501-990000000-00262. [PMID: 39190333 DOI: 10.1097/mca.0000000000001419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
BACKGROUND Non-ST-segment elevation myocardial infarction (NSTEMI) is an entity which was defined as a type of a coronary syndrome with positive cardiac biomarker of myocardial necrosis with no ST-segment elevation in ECG. Currently, the centers for Medicare and Medicaid services (CMS) Hospital readmission reduction program assistance risk-adjusted 30-day readmission rates for five major clinical entities which includes acute myocardial infarction. METHODS We performed this retrospective study to look into the current burden and predictors of NSTEMI readmission. Data were obtained from the Nationwide Readmission Database for the year 2020. We analyzed data on hospital readmission of 336 620 adults who were admitted for NSTEMI. RESULTS The 30-day readmission rate was 13.5% with NSTEMI being the most common cause of readmission. Mortality was higher in readmitted patients compared to index admission (5.4 vs 3.6%, P = 0.000). Higher risk of readmission was associated with female sex, higher Charlson comorbidity index, and longer length of stay. Lower risk of admission was seen in patients from smaller communities, patients who underwent percutaneous coronary intervention, and discharged to rehabilitation facilities. CONCLUSION Although we found an improvement in readmission rates compared to prior studies, about 13% of patients continue to get readmitted within 30 days causing significant cost to the healthcare system and often these patients have worse outcomes. We need continuing large-scale studies to identify quality measures to prevent readmission, improve mortality during readmission, and make better use of financial resources.
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Affiliation(s)
- Anil Jha
- Division of Cardiovascular Medicine, Department of Cardiovascular Medicine, St. Vincent Hospital, Worcester, Massachusetts
| | - Palak Patel
- Division of Cardiovascular Medicine, Department of Cardiovascular Medicine, St. Vincent Hospital, Worcester, Massachusetts
| | - Anand M Krishnan
- Department of Cardiovascular Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont
| | - Akil A Sherif
- Division of Cardiovascular Medicine, Department of Cardiovascular Medicine, St. Vincent Hospital, Worcester, Massachusetts
| | - Ajay K Mishra
- Division of Cardiovascular Medicine, Department of Cardiovascular Medicine, St. Vincent Hospital, Worcester, Massachusetts
| | - Ahmed Mohamed
- Division of Cardiovascular Medicine, Department of Cardiovascular Medicine, St. Vincent Hospital, Worcester, Massachusetts
| | - Umabalan Thirupathy
- Department of Internal Medicine, St. Vincent Hospital, Worcester, Massachusetts, USA
| | - Pradnya B Bhattad
- Division of Cardiovascular Medicine, Department of Cardiovascular Medicine, St. Vincent Hospital, Worcester, Massachusetts
| | - Mazen Roumia
- Division of Cardiovascular Medicine, Department of Cardiovascular Medicine, St. Vincent Hospital, Worcester, Massachusetts
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Ahmadi SS, Bagherzadeh O, Sargazi M, Kalantar F, Najafi MAE, Vahedi MM, Afshari AR, Sahebkar A. Harnessing the therapeutic potential of phytochemicals in neuroblastoma. Biofactors 2024. [PMID: 39189819 DOI: 10.1002/biof.2115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/31/2024] [Indexed: 08/28/2024]
Abstract
Neuroblastomas are the most common solid tumors outside of the brain that originate from immature neural crest cells, accounting for about 10% of all pediatric malignancies. The treatment for neuroblastomas involves a multimodal schedule, including surgery, radiation, chemotherapy, and immunotherapy. All these modalities are limited by side effects that might be severe, poor prognosis, and a high risk of recurrence. In the quest for additional therapeutic approaches, phytochemicals have attracted attention owing to their reported antitumor properties, safety, and multimechanistic mode of action. Several studies have used plant-derived bioactive compounds such as phenolics and flavonoids, suggesting modulation of biomolecules and signal transduction pathways involved in neuroblastoma. We reviewed the findings of recent preclinical and clinical studies demonstrating the effects of phytochemicals on neuroblastoma, shedding light on their molecular mechanism of action and potential therapeutic applications.
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Affiliation(s)
- Seyed Sajad Ahmadi
- Department of Ophthalmology, Khatam-Ol-Anbia Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Omid Bagherzadeh
- Department of Ophthalmology, Khatam-Ol-Anbia Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Meysam Sargazi
- Department of Ophthalmology, Alzahra Eye Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farnaz Kalantar
- Departman of Pharmacology, Faculty of Pharmacy and Pharmaceutical sciences, Islamic Azad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Amin Elahi Najafi
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Mohammad Mahdi Vahedi
- Department of Pharmacology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Amir R Afshari
- Department of Basic Sciences, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
- Department of Physiology and Pharmacology, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
- Natural Products and Medicinal Plants Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Amirhossein Sahebkar
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Safariyan M, Azimi A, Pourmasumi S, Mohammadi V, Xu X, Hermis AH, Al-Jabri MM, Zakeri MA. Case report of spontaneous coronary artery dissection in a 50‑year‑old man. BMC Cardiovasc Disord 2024; 24:451. [PMID: 39192212 DOI: 10.1186/s12872-024-04124-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 08/14/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Spontaneous Coronary Artery Dissection (SCAD) is an acute coronary event of uncertain origin. SCAD occurs when the coronary artery wall dissects non-traumatically and non-atherosclerotically, leading to the formation of an intramural hematoma or intimal tear, ultimately compressing and restricting the true lumen, or even occluding it. The management of SCAD remains controversial despite modern imaging techniques. In addition to supportive drug therapy, percutaneous coronary intervention (PCI) is another option that can be used as an effective treatment modality. CASE PRESENTATION We describe A 50-year-old male with SCAD presented to the hospital emergency department complaining of chest pain. Coronary angiography incidentally showed spiral dissection from the proximal to distal right coronary artery (RCA). Three overlapping coroflex stents were deployed from the distal to the proximal RCA. CONCLUSIONS To stabilize the coronary artery in Acute Coronary Syndrome (ACS) patients due to SCAD, prompt interventions such as stenting and angioplasty are needed. However, it is necessary to pay attention to the clinical condition of patients and quick diagnosis for the recovery of patients and reduction of complications.
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Affiliation(s)
- Mohammad Safariyan
- Department of Cardiology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Azra Azimi
- Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Soheila Pourmasumi
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Pistachio Safety Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Vahid Mohammadi
- Department of Cardiology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Xiao Xu
- Department of Nursing, Nantong Health College of Jiangsu Province, Nantong, China
| | | | - Mohammed Musaed Al-Jabri
- Department of Nursing Science, Prince Sattam bin Abdulaziz University, Wadi Aldawaser, Saudi Arabia
| | - Mohammad Ali Zakeri
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Hu H, Xu Z, Zhang Z, Song P, Stull F, Xu P, Tang H. Rational design of a flavoenzyme for aerobic nicotine catabolism. mBio 2024:e0205024. [PMID: 39191403 DOI: 10.1128/mbio.02050-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 07/23/2024] [Indexed: 08/29/2024] Open
Abstract
Enzymatic therapy with nicotine-degrading enzyme is a new strategy in treating nicotine addiction, which can reduce nicotine concentrations and weaken withdrawal in the rat model. However, when O2 is used as the electron acceptor, no satisfactory performance has been achieved with one of the most commonly studied and efficient nicotine-catabolizing enzymes, NicA2. To obtain more efficient nicotine-degrading enzyme, we rationally designed and engineered a flavoenzyme Pnao, which shares high structural similarity with NicA2 (RMSD = 1.143 Å) and efficiently catalyze pseudooxynicotine into 3-succinoyl-semialdehyde pyridine using O2. Through amino acid alterations with NicA2, five Pnao mutants were generated, which can degrade nicotine in Tris-HCl buffer and retain catabolic activity on its natural substrate. Nicotine-1'-N-oxide was identified as one of the reaction products. Four of the derivative mutants showed activity in rat serum and Trp220 and Asn224 were found critical for enzyme specificity. Our findings offer a novel avenue for research into aerobic nicotine catabolism and provide a promising method of generating additional nicotine-catalytic enzymes. IMPORTANCE Nicotine, the main active substance in tobacco, results in cigarette addiction and various diseases. There have been some attempts at using nicotine oxidoreductase, NicA2, as a therapeutic for nicotine cessation. However, it uses cytochrome c as it is electron acceptor, which is impractical for therapeutic use compared with using O2 as an oxidant. Thus, amino acid alteration was performed on Pnao using NicA2 as model. Five of the mutants generated degraded nicotine at a rate similar to NicA2, and one of the catabolic compounds was identified as nicotine-1'-N-oxide. Our research highlights a new direction in developing enzymes that efficiently catabolize nicotine without co-enzymes and suggests that structure-similar human original MAOA (or B) may assist with nicotine cessation after being engineered.
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Affiliation(s)
- Haiyang Hu
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic and Developmental Sciences, and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Zhaoyong Xu
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic and Developmental Sciences, and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiyao Zhang
- Department of Chemistry, Western Michigan University, Kalamazoo, Michigan, USA
| | - Peizhi Song
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic and Developmental Sciences, and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Frederick Stull
- Department of Chemistry, Western Michigan University, Kalamazoo, Michigan, USA
| | - Ping Xu
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic and Developmental Sciences, and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Hongzhi Tang
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic and Developmental Sciences, and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
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Lindberg H, Vaktnäs J, Rasmussen M, Larsson I. Treating the disease and meeting the person with the illness-patient perspectives of needs during infective endocarditis, a qualitative study. PLoS One 2024; 19:e0309373. [PMID: 39190763 DOI: 10.1371/journal.pone.0309373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 08/10/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Infective endocarditis (IE) is a rare but severe infectious disease. Patients with IE are treated for weeks in the hospital and have profound impairments to their health. New treatment modalities increase options for outpatient care. Little is known about how patients perceive their disease and hospitalisation. We aimed to explore the needs of patients with IE during hospitalisation and the first few months after discharge. METHODS In this qualitative study, 20 patients (45-86 years of age) hospitalised due to IE in Swedish hospitals were interviewed a median of 112 (67-221) days after hospitalisation. Data were analysed with qualitative content analysis, identifying eight subcategories, two categories, and an overall theme. RESULTS The overall theme illuminated a spectrum of needs of patients suffering from IE, between treating the disease and meeting the person with the illness. The needs encompassed eight axes with dual focus on both medical excellence and person-centred care. Medical excellence was needed to optimally treat, supervise, and offer follow-up on this rare and severe disease; patients longed to come home, and there were issues of reliability in the healthcare system. Person-centred care was requested, including individualised information leading to knowledge, reorientation, the beginning of health restoration, and being met as a unique person. Symptoms of fatigue, wasting, and cognitive and mental distress were often neglected by the caregiver. CONCLUSIONS This explorative study shows the patient's needs as important areas in a spectrum between medical excellence and person-centred care. Care in specialised units secure quality. Early discharge is requested by patients. Multiprofessional individualizing outpatient care needs to develop with preserved safety and medical excellence. The disease trajectory after discharge progresses slowly, and the possibility of mitigating its progress is still unclear. Person-centred care, screening for delayed restoration and rehabilitation after endocarditis are important fields for future studies.
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Affiliation(s)
- Helena Lindberg
- Department of Infectious Diseases, Hospital of Halland, Halmstad, Sweden
- Department of Clinical Sciences Lund, Division of Infection Medicine, Lund University, Lund, Sweden
| | - Johan Vaktnäs
- Department of Oncology and Palliative Medicine, Hospital of Halland, Varberg, Sweden
| | - Magnus Rasmussen
- Department of Clinical Sciences Lund, Division of Infection Medicine, Lund University, Lund, Sweden
| | - Ingrid Larsson
- Department of Health and Nursing, School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
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Teitgen AE, Hock MT, McCabe KJ, Childers MC, Huber GA, Marzban B, Beard DA, McCammon JA, Regnier M, McCulloch AD. Multiscale modeling shows how 2'-deoxy-ATP rescues ventricular function in heart failure. Proc Natl Acad Sci U S A 2024; 121:e2322077121. [PMID: 39172779 DOI: 10.1073/pnas.2322077121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 07/22/2024] [Indexed: 08/24/2024] Open
Abstract
2'-deoxy-ATP (dATP) improves cardiac function by increasing the rate of crossbridge cycling and Ca[Formula: see text] transient decay. However, the mechanisms of these effects and how therapeutic responses to dATP are achieved when dATP is only a small fraction of the total ATP pool remain poorly understood. Here, we used a multiscale computational modeling approach to analyze the mechanisms by which dATP improves ventricular function. We integrated atomistic simulations of prepowerstroke myosin and actomyosin association, filament-scale Markov state modeling of sarcomere mechanics, cell-scale analysis of myocyte Ca[Formula: see text] dynamics and contraction, organ-scale modeling of biventricular mechanoenergetics, and systems level modeling of circulatory dynamics. Molecular and Brownian dynamics simulations showed that dATP increases the actomyosin association rate by 1.9 fold. Markov state models predicted that dATP increases the pool of myosin heads available for crossbridge cycling, increasing steady-state force development at low dATP fractions by 1.3 fold due to mechanosensing and nearest-neighbor cooperativity. This was found to be the dominant mechanism by which small amounts of dATP can improve contractile function at myofilament to organ scales. Together with faster myocyte Ca[Formula: see text] handling, this led to improved ventricular contractility, especially in a failing heart model in which dATP increased ejection fraction by 16% and the energy efficiency of cardiac contraction by 1%. This work represents a complete multiscale model analysis of a small molecule myosin modulator from single molecule to organ system biophysics and elucidates how the molecular mechanisms of dATP may improve cardiovascular function in heart failure with reduced ejection fraction.
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Affiliation(s)
- Abigail E Teitgen
- Department of Bioengineering, University of California San Diego, La Jolla, CA 92093
| | - Marcus T Hock
- Department of Bioengineering, University of California San Diego, La Jolla, CA 92093
| | - Kimberly J McCabe
- Department of Computational Physiology, Simula Research Laboratory, Oslo 0164, Norway
| | - Matthew C Childers
- Department of Bioengineering, University of Washington, Seattle, WA 98109
| | - Gary A Huber
- Department of Chemistry and Biochemistry, University of California San Diego, La Jolla, CA 92093
| | - Bahador Marzban
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48109
| | - Daniel A Beard
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48109
| | - J Andrew McCammon
- Department of Chemistry and Biochemistry, University of California San Diego, La Jolla, CA 92093
| | - Michael Regnier
- Department of Bioengineering, University of Washington, Seattle, WA 98109
| | - Andrew D McCulloch
- Department of Bioengineering, University of California San Diego, La Jolla, CA 92093
- Department of Medicine, University of California San Diego, La Jolla, CA 92093
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Raidou V, Mitete K, Kourek C, Antonopoulos M, Soulele T, Kolovou K, Vlahodimitris I, Vasileiadis I, Dimopoulos S. Quality of life and functional capacity in patients after cardiac surgery intensive care unit. World J Cardiol 2024; 16:436-447. [DOI: 10.4330/wjc.v16.i8.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 06/24/2024] [Accepted: 07/22/2024] [Indexed: 08/26/2024] Open
Abstract
Coronary heart disease and aortic stenosis are prevalent cardiovascular diseases worldwide, leading to morbidity and mortality. Coronary artery bypass grafting (CABG) and surgical aortic valve replacement (SAVR) have therapeutic benefits, including improved postoperative quality of life (QoL) and enhanced patient functional capacity which are key indicators of cardiac surgery outcome. In this article, we review the latest studies of QoL outcomes and functional capacity in patients who underwent cardiac surgery. Many standardized instruments are used to evaluate QoL and functional conditions. Preoperative health status, age, length of intensive care unit stay, operative risk, type of procedure, and other pre-, intra-, and postoperative factors affect postoperative QoL. Elderly patients experience impaired physical status soon after cardiac surgery, but it improves in the following period. CABG and SAVR are associated with increases of physical and mental health and functional capacity in the immediate postoperative and the long long-term. Cardiac rehabilitation improves patient functional capacity, QoL, and frailty following cardiac surgery.
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Affiliation(s)
- Vasiliki Raidou
- Clinical Ergospirometry, Exercise, and Rehabilitation Laboratory, Department of First Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens 10676, Greece
| | - Katerina Mitete
- Clinical Ergospirometry, Exercise, and Rehabilitation Laboratory, Department of First Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens 10676, Greece
| | - Christos Kourek
- Clinical Ergospirometry, Exercise, and Rehabilitation Laboratory, Department of First Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens 10676, Greece
| | - Michael Antonopoulos
- Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece
| | - Theodora Soulele
- Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece
| | - Kyriaki Kolovou
- Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece
| | - Ioannis Vlahodimitris
- Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece
| | - Ioannis Vasileiadis
- Clinical Ergospirometry, Exercise, and Rehabilitation Laboratory, Department of First Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens 10676, Greece
| | - Stavros Dimopoulos
- Clinical Ergospirometry, Exercise, and Rehabilitation Laboratory, Department of First Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens 10676, Greece
- Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece
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61
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Hinton SM. Preventing Vertical Transmission of Chagas Disease: An Emerging Public Health Issue in Perinatal Care. J Midwifery Womens Health 2024. [PMID: 39188043 DOI: 10.1111/jmwh.13682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
Chagas [shah-guhs] disease, caused by the Trypanosoma cruzi parasite, presents a growing concern for health care providers overseeing perinatal care in the United States due to existing and expanding vector-borne transmission and population migration. This life-threatening disease can be transmitted vertically during pregnancy, although adequate testing and treatment can effectively reduce morbidity and mortality caused by Chagas disease. This article presents an overview of the disease burden in the United States and its implications for perinatal care providers including recommended testing and treatment practices and the information needed for patient education and shared decision-making regarding the management of care for individuals at risk of Chagas disease. Being informed about Chagas disease and its implications is needed for all individuals providing perinatal care and is especially critical for those overseeing the care of refugee and immigrant populations.
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Affiliation(s)
- Sarah M Hinton
- Commonsense Childbirth, Winter Garden, Florida
- Academy of Continuing Education, Midwives College of Utah, Salt Lake City, Utah
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Safwan M, Bourgleh MS, Aldoush M, Haider KH. Tissue-source effect on mesenchymal stem cells as living biodrugs for heart failure: Systematic review and meta-analysis. World J Cardiol 2024; 16:469-483. [DOI: 10.4330/wjc.v16.i8.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/24/2024] [Accepted: 07/23/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND Mesenchymal stem cells (MSCs), as living biodrugs, have entered advanced phases of clinical assessment for cardiac function restoration in patients with myocardial infarction and heart failure. While MSCs are available from diverse tissue sources, bone-marrow-derived MSCs (BM-MSCs) remain the most well-studied cell type, besides umbilical-cord-derived MSCs (UC-MSCs). The latter offers advantages, including noninvasive availability without ethical considerations.
AIM To compare the safety and efficacy of BM-MSCs and UC-MSCs in terms of left ventricular ejection fraction (LVEF), 6-min walking distance (6MWD), and major adverse cardiac events (MACEs).
METHODS Five databases were systematically searched to identify randomized controlled trials (RCTs). Thirteen RCTs (693 patients) were included using predefined eligibility criteria. Weighted mean differences and odds ratio (OR) for the changes in the estimated treatment effects.
RESULTS UC-MSCs significantly improved LVEF vs controls by 5.08% [95% confidence interval (CI): 2.20%-7.95%] at 6 mo and 2.78% (95%CI: 0.86%-4.70%) at 12 mo. However, no significant effect was observed for BM-MSCs vs controls. No significant changes were observed in the 6MWD with either of the two cell types. Also, no differences were observed for MACEs, except rehospitalization rates, which were lower only with BM-MSCs (odds ratio 0.48, 95%CI: 0.24-0.97) vs controls.
CONCLUSION UC-MSCs significantly improved LVEF compared with BM-MSCs. Their advantageous characteristics position them as a promising alternative to MSC-based therapy.
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Affiliation(s)
- Moaz Safwan
- Department of Basic Sciences, Sulaiman Al Rajhi University, Al Bukairiyah 51941, Saudi Arabia
| | - Mariam Safwan Bourgleh
- Department of Basic Sciences, Sulaiman Al Rajhi University, Al Bukairiyah 51941, Saudi Arabia
| | - Mohamed Aldoush
- Department of Basic Sciences, Sulaiman Al Rajhi University, Al Bukairiyah 51941, Saudi Arabia
| | - Khawaja Husnain Haider
- Department of Basic Sciences, Sulaiman Al Rajhi University, Al Bukairiyah 51941, Saudi Arabia
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Jansson AK, Schumacher TL, Kocanda L, Whatnall M, Fenwick M, Betts D, Bauman A, Kerr J, Duncan MJ, Collins CE, Boyle A, Inder KJ, Plotnikoff RC. A Systematic Review of the Completion of Cardiac Rehabilitation Programs for Adults Aged 18-50 Years. J Cardiopulm Rehabil Prev 2024:01273116-990000000-00165. [PMID: 39185913 DOI: 10.1097/hcr.0000000000000881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
OBJECTIVE To perform a systematic review of completion rates of cardiac rehabilitation (CR) in adults aged 18 to 50 yr and describe how core components were reported, measured, and tailored to those under 50 yr. REVIEW METHODS Database search of MEDLINE, Embase, Emcare, PsycINFO, CINAHL, Scopus, and the Cochrane Library based on keywords, including articles from January 1, 1990. The last search was performed on April 21, 2023. Following the Preferred Reporting Items for Systematic Review and Meta-Analyses protocol, eligible articles contained adults (aged between 18 and 50 yr) who had participated in a CR program. SUMMARY Out of the articles screened (n = 24,517), 33 reports across 31 independent studies were considered eligible (n = 1958 patients aged ≤50 yr). Cardiac rehabilitation completion rates ranged from 64% to 100%; however, only 5 studies presented a completion rate definition. The length of the program ranged from 7 d to 20 wk, with most (65%) ranging between 6 and 12 wk. While the studies included in this systematic review indicated relatively high rates of completing CR, these are likely to overrepresent the true completion rates as few definitions were provided that could be compared to completion rates used in clinical practice. This systematic review also found that all interventions prescribed exercise (eg, aerobic alone or combined with resistance training or yoga) but had very limited inclusion or description of other integral components of CR (eg, initial assessment and smoking cessation) or how they were assessed and individualized to meet the needs of younger attendees.
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Affiliation(s)
- Anna K Jansson
- Author Affiliations: Centre for Active Living and Learning, School of Education, The University of Newcastle, Newcastle, New South Wales, Australia (Drs Jansson and Plotnikoff); Active Living Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia (Dr Jansson, Mr Fenwick, and Drs Duncan and Plotnikoff); Department of Rural Health, The University of Newcastle, Tamworth, New South Wales, Australia (Drs Schumacher and Kocanda); School of Health Science, College of Health and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia (Drs Whatnall and Collins); Food and Nutrition Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia (Drs Kocanda, Whatnall, and Collins); School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia (Mr Fenwick and Drs Duncan and Boyle); Cancer Council NSW, Sydney, New South Wales, Australia (Mrs Betts); School of Public Health, University of Sydney, Sydney, New South Wales, Australia (Dr Bauman); Hunter New England Health, Newcastle, New South Wales, Australia (Ms Kerr and Dr Inder); and School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia (Dr Inder)
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64
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de-Miguel-Yanes JM, Jimenez-Garcia R, Hernandez-Barrera V, de-Miguel-Diez J, Jimenez-Sierra A, Zamorano-León JJ, Cuadrado-Corrales N, Lopez-de-Andres A. An observational study of therapeutic procedures and in-hospital outcomes among patients admitted for acute myocardial infarction in Spain, 2016-2022: the role of diabetes mellitus. Cardiovasc Diabetol 2024; 23:313. [PMID: 39182091 PMCID: PMC11344913 DOI: 10.1186/s12933-024-02403-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 08/14/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND We used the Spanish national hospital discharge data from 2016 to 2022 to analyze procedures and hospital outcomes among patients aged ≥ 18 years admitted for ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) according to diabetes mellitus (DM) status (non-diabetic, type 1-DM or type 2-DM). METHODS We built logistic regression models for STEMI/NSTEMI stratified by DM status to identify variables associated with in-hospital mortality (IHM). We analyzed the effect of DM on IHM. RESULTS Spanish hospitals reported 201,950 STEMIs (72.7% non-diabetic, 0.5% type 1-DM, and 26.8% type 2-DM; 26.3% female) and 167,285 NSTEMIs (61.6% non-diabetic, 0.6% type 1-DM, and 37.8% type 2-DM; 30.9% female). In STEMI, the frequency of percutaneous coronary intervention (PCI) increased among non-diabetic people (60.4% vs. 68.6%; p < 0.001) and people with type 2-DM (53.6% vs. 66.1%; p < 0.001). In NSTEMI, the frequency of PCI increased among non-diabetic people (43.7% vs. 45.7%; p < 0.001) and people with type 2-DM (39.1% vs. 42.8%; p < 0.001). In NSTEMI, the frequency of coronary artery by-pass grafting (CABG) increased among non-diabetic people (2.8% vs. 3.5%; p < 0.001) and people with type 2-DM (3.7% vs. 5.0%; p < 0.001). In the entire population, lower IHM was associated with undergoing PCI (odds ratio [OR] [95% confidence interval] = 0.34 [0.32-0.35] in STEMI; 0.24 [0.23-0.26] in NSTEMI) or CABG (0.33 [0.27-0.40] in STEMI; 0.45 [0.38-0.53] in NSTEMI). IHM decreased over time in STEMI (OR = 0.86 [0.80-0.93]). Type 2-DM was associated with higher IHM in STEMI (OR = 1.06 [1.01-1.11]). CONCLUSIONS PCI and CABG were associated with lower IHM in people admitted for STEMI/NSTEMI. Type 2-DM was associated with IHM in STEMI.
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MESH Headings
- Humans
- Female
- ST Elevation Myocardial Infarction/therapy
- ST Elevation Myocardial Infarction/mortality
- ST Elevation Myocardial Infarction/diagnosis
- ST Elevation Myocardial Infarction/epidemiology
- Male
- Spain/epidemiology
- Hospital Mortality
- Percutaneous Coronary Intervention/mortality
- Percutaneous Coronary Intervention/adverse effects
- Percutaneous Coronary Intervention/trends
- Aged
- Middle Aged
- Non-ST Elevated Myocardial Infarction/therapy
- Non-ST Elevated Myocardial Infarction/mortality
- Non-ST Elevated Myocardial Infarction/diagnosis
- Non-ST Elevated Myocardial Infarction/epidemiology
- Treatment Outcome
- Risk Factors
- Time Factors
- Risk Assessment
- Diabetes Mellitus, Type 1/diagnosis
- Diabetes Mellitus, Type 1/epidemiology
- Diabetes Mellitus, Type 1/mortality
- Diabetes Mellitus, Type 1/therapy
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 2/diagnosis
- Diabetes Mellitus, Type 2/mortality
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/therapy
- Patient Admission
- Aged, 80 and over
- Databases, Factual
- Diabetes Mellitus/epidemiology
- Diabetes Mellitus/diagnosis
- Diabetes Mellitus/mortality
- Diabetes Mellitus/therapy
- Adult
- Coronary Artery Bypass/mortality
- Coronary Artery Bypass/adverse effects
- Coronary Artery Bypass/trends
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Affiliation(s)
- Jose M de-Miguel-Yanes
- Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, Madrid, Spain
| | - Rodrigo Jimenez-Garcia
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain.
| | - Valentin Hernandez-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Javier de-Miguel-Diez
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid,, Madrid, Spain
| | | | - Jose J Zamorano-León
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Natividad Cuadrado-Corrales
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
| | - Ana Lopez-de-Andres
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040, Madrid, Spain
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65
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Van Ochten N, deQuillfeldt NP, Edward JA, Meyer M, Bollinger D, Le P, Frasca K, Garcia Rivera MV, Moudgal AN, Rogers K. Challenging chest pain: salmonella myopericarditis. BMJ Case Rep 2024; 17:e260573. [PMID: 39181573 DOI: 10.1136/bcr-2024-260573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024] Open
Abstract
Salmonella infections have been associated with cardiovascular complications, including myocarditis and myopericarditis. This presentation of Salmonella myopericarditis highlights key clinical features to aid in diagnosis and the importance of prompt treatment with antibiotics, colchicine and non-steroidal anti-inflammatory drugs (NSAIDs).
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Affiliation(s)
- Natalie Van Ochten
- Department of Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Natalie P deQuillfeldt
- Department of Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Justin A Edward
- Department of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Marita Meyer
- Department of Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Daniel Bollinger
- University of Colorado Medical School, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Preston Le
- University of Colorado Medical School, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Katherine Frasca
- Department of Infectious Disease, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mirian V Garcia Rivera
- Department of Infectious Disease, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Anita N Moudgal
- Department of Infectious Disease, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kevin Rogers
- Department of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Takase B, Ikeda T, Shimizu W, Abe H, Aiba T, Chinushi M, Koba S, Kusano K, Niwano S, Takahashi N, Takatsuki S, Tanno K, Watanabe E, Yoshioka K, Amino M, Fujino T, Iwasaki YK, Kohno R, Kinoshita T, Kurita Y, Masaki N, Murata H, Shinohara T, Yada H, Yodogawa K, Kimura T, Kurita T, Nogami A, Sumitomo N. JCS/JHRS 2022 Guideline on Diagnosis and Risk Assessment of Arrhythmia. Circ J 2024; 88:1509-1595. [PMID: 37690816 DOI: 10.1253/circj.cj-22-0827] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Affiliation(s)
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Haruhiko Abe
- Department of Heart Rhythm Management, University of Occupational and Environmental Health, Japan
| | - Takeshi Aiba
- Department of Clinical Laboratory Medicine and Genetics, National Cerebral and Cardiovascular Center
| | - Masaomi Chinushi
- School of Health Sciences, Niigata University School of Medicine
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Shinichi Niwano
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Seiji Takatsuki
- Department of Cardiology, Keio University School of Medicine
| | - Kaoru Tanno
- Cardiology Division, Cardiovascular Center, Showa University Koto-Toyosu Hospital
| | - Eiichi Watanabe
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital
| | | | - Mari Amino
- Department of Cardiology, Tokai University School of Medicine
| | - Tadashi Fujino
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
| | - Yu-Ki Iwasaki
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Ritsuko Kohno
- Department of Heart Rhythm Management, University of Occupational and Environmental Health, Japan
| | - Toshio Kinoshita
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
| | - Yasuo Kurita
- Cardiovascular Center, International University of Health and Welfare, Mita Hospital
| | - Nobuyuki Masaki
- Department of Intensive Care Medicine, National Defense Medical College
| | | | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Hirotaka Yada
- Department of Cardiology, International University of Health and Welfare, Mita Hospital
| | - Kenji Yodogawa
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Takeshi Kimura
- Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | | | - Akihiko Nogami
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center
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67
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Skaf-Gonçalves L, Peçanha D, Kasal D, Tibirica E. Acute effects of energy drink consumption on microvascular reactivity in young male volunteers at rest: a randomized trial. Braz J Med Biol Res 2024; 57:e13624. [PMID: 39194032 DOI: 10.1590/1414-431x2024e13624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 06/14/2024] [Indexed: 08/29/2024] Open
Abstract
Energy drinks are nonalcoholic beverages whose main ingredients are sugar, taurine, and caffeine. The consumption of energy drinks is increasing worldwide, but only a few conflicting studies have investigated the vascular effects of energy drinks in young adults. The aim of this study was to evaluate microvascular reactivity before and after energy drinks consumption in young healthy male volunteers. This was a cross-sectional prospective study. Microvascular reactivity signals were evaluated in the skin of the forearm using laser speckle contrast imaging with acetylcholine (ACh) iontophoresis before and 90 and 180 min after the randomized consumption of one ED or the same volume of water (control), followed by a postocclusive reactive hyperemia (PORH) test. Thirty-two volunteers were evaluated (age: 25.4±4.3 years). Energy drink consumption prevented the rest-induced reduction in cutaneous vascular conductance over time that was observed in the control group. In the control group, there were significant reductions in microvascular vasodilation at 90 and 180 min compared to baseline (P=0.004), but this was not the case in the energy drink group (P=0.76). Our results demonstrated that the reduction in microvascular conductance associated with prolonged immobility can be prevented by the consumption of one energy drink, highlighting the vasodilator effects of this beverage in young individuals at rest. The between-study variability in terms of the brand of energy drinks and the ingested volume, as well as the method of vascular evaluation and the inclusion criteria, may explain the discrepancies among previous studies on the vascular effects of energy drinks.
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Affiliation(s)
| | - D Peçanha
- Instituto National de Cardiologia, Rio de Janeiro, RJ, Brasil
| | - D Kasal
- Instituto National de Cardiologia, Rio de Janeiro, RJ, Brasil
- Departamento de Clínica Médica, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - E Tibirica
- Instituto National de Cardiologia, Rio de Janeiro, RJ, Brasil
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Li S, Wang Y, Xu N, Xie D. Association between C-reactive protein to albumin ratio and subclinical myocardial injury in the general population free from cardiovascular disease. J Cardiothorac Surg 2024; 19:487. [PMID: 39175007 PMCID: PMC11342680 DOI: 10.1186/s13019-024-02988-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 08/13/2024] [Indexed: 08/24/2024] Open
Abstract
OBJECTIVE The study aimed to examine the role of the C-reactive protein to albumin ratio (CAR) as an inflammatory biomarker in relation to subclinical myocardial injury (SC-MI), addressing the limited knowledge of their association. METHODS The study included 5,949 individuals without cardiovascular disease (CVD) from the National Health and Nutrition Examination Survey. SC-MI was identified through a Cardiac Infarction Injury Score (CIIS) of ≥ 10 units based on a 12-lead electrocardiogram. The study used multivariate logistic regression models, adjusted for potential confounders, to evaluate the relationship between CAR and SC-MI. Subgroup analyses were conducted to substantiate the results, and the non-linear correlation was assessed via restricted cubic spline (RCS) regression. RESULTS The RCS curve showed a significant positive correlation between CAR and SC-MI (P for nonlinear = 0.2496). When adjusted for all confounders, individuals in the highest tertile of CAR exhibited a higher likelihood of SC-MI compared to those in the lowest tertile, with an odds ratio (OR) of 1.21 (95% CI: 1.06-1.39, P for trend = 0.029). A 10-unit increment in CAR was linked to a 3.6% heightened risk of SC-MI [OR = 1.036 (95% CI: 1.006, 1.066)], with this association being more prominent among male adults, non-smokers, married individuals, those without diabetes mellitus, and those with no history of cancer. CONCLUSION The findings of this study suggest a positive correlation between CAR and SC-MI among the US adult population, indicating the potential of CAR in enhancing SC-MI prevention strategies in the general population.
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Affiliation(s)
- Shuiying Li
- Department of Cardiology, Ningbo Ninth Hospital, No. 68 Xiangbei Road, Jiangbei District, Ningbo, 315000, Zhejiang, China
| | - Yichen Wang
- Department of Hyperbaric Oxygen, Rehabilitation Hospital Affiliated to National Research Center for Rehabilitation Technical Aids, Beijing, 100000, China
| | - Na Xu
- Department of Cardiology, Ningbo Ninth Hospital, No. 68 Xiangbei Road, Jiangbei District, Ningbo, 315000, Zhejiang, China
| | - Daqi Xie
- Department of Cardiology, Ningbo Ninth Hospital, No. 68 Xiangbei Road, Jiangbei District, Ningbo, 315000, Zhejiang, China.
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69
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Nielsen DL, Juhl CB, Nielsen OH, Chen IM, Herrmann J. Immune Checkpoint Inhibitor-Induced Cardiotoxicity: A Systematic Review and Meta-Analysis. JAMA Oncol 2024:2822706. [PMID: 39172480 PMCID: PMC11342217 DOI: 10.1001/jamaoncol.2024.3065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/17/2024] [Indexed: 08/23/2024]
Abstract
Importance Immune checkpoint inhibitors (ICIs) improve outcomes in a wide range of cancers; however, serious adverse effects, including cardiovascular adverse effects (CVAEs), can occur. Objective To determine the incidence of CVAEs and analyze data on the management of myocarditis in patients exposed to ICIs. Data Sources PubMed, Embase, and Cochrane Central Register of Controlled Trials from inception were searched on April 4, 2023. Study Selection Two separate studies were performed. Key inclusion criteria for study 1 were phases 1 to 4 trials involving adults with malignant neoplasms treated with an ICI and toxicity data; for study 2, publications (case reports and retrospective analyses) on clinical manifestations and treatment of patients with ICI-induced CVAEs. Studies with dose escalation or fewer than 11 patients in each group and all case reports, retrospective analyses, letters, reviews, and editorials were excluded from study 1. Studies not published in English were excluded from study 2. Data Extraction and Synthesis The PRISMA guidelines and Cochrane Handbook for Systematic Reviews were followed. Data were extracted independently by 2 researchers. A meta-analysis of the incidence of CVAEs in clinical trials and a systematic review of the evidence for the management of myocarditis were performed. Data were pooled using a random-effects model. Main Outcomes and Measures In study 1, the primary outcome was incidence CVAEs in clinical trials with ICIs and ICI combination therapies. Study 2 examined evidence supporting specific management strategies that may decrease the mortality rate of myocarditis. The primary outcomes were planned before data collection began. Results In study 1, a total of 83 315 unique participants in 589 unique trials were included in the meta-analysis. Incidence of CVAEs induced by anti-programmed cell death 1 and/or programmed cell death ligand 1 was 0.80% (95% CI, 0%-1.66%) in clinical trials, with no differences between the compounds, except for cemiplimab, which was associated with a higher risk of CVAEs. Incidence of CVAEs following ipilimumab treatment was 1.07% (95% CI, 0%-2.58%). The incidence of myocarditis was significantly higher following treatment with dual ICIs. However, CVAE incidence was not higher with dual ICIs, ICI combination with chemotherapy, or tyrosine kinase inhibitors. Evidence from randomized clinical trials on recommended monitoring and treatment strategies for ICI-induced myocarditis was lacking. Study 2 showed that myocarditis-associated mortality occurred in 83 of 220 patients (37.7%). Prospective data from 40 patients with myocarditis indicated that systematic screening for respiratory muscle involvement, coupled with active ventilation, prompt use of abatacept, and the addition of ruxolitinib, may decrease the mortality rate. Conclusions and Relevance Immune checkpoint inhibitor-induced CVAEs and/or myocarditis were recorded in 1.07% of patients in clinical trials. The CVAE mortality risk remains high, justifying the need for monitoring and management strategies for which evidence from randomized clinical trials is absent. Early recognition, ICI therapy cessation, prompt initiation of corticosteroid therapy, and escalation of therapy are all crucial elements for achieving optimal outcomes. Prospective clinical trials or at least prospective registration of treatments and outcomes are highly warranted.
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Affiliation(s)
- Dorte Lisbet Nielsen
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Carsten Bogh Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ole Haagen Nielsen
- Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Inna Markovna Chen
- Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Joerg Herrmann
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
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70
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Savage ML, Hay K, Sundar H, Maharajan R, Murdoch DJ, Latchumanadhas K, Ezhilan DM, Kalaichelvan U, Denman R, Ranasinghe I, Subban V, Walters DL, Mullasari A, Raffel OC. Clinical characteristics and outcomes of Australian and Indian ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). Indian Heart J 2024:S0019-4832(24)00164-0. [PMID: 39181445 DOI: 10.1016/j.ihj.2024.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/12/2024] [Accepted: 08/20/2024] [Indexed: 08/27/2024] Open
Abstract
INTRODUCTION The incidence of STEMI and subsequent mortality has been reported to be higher in Indian populations compared to developed countries. However, there is limited data directly comparing contemporary primary percutaneous coronary intervention (pPCI) treatment strategies and clinical outcomes for STEMI patients between developed and developing countries. MATERIALS AND METHODS We compared population demographics, procedural characteristics, times to reperfusion and mortality in STEMI patients treated with pPCI between two tertiary referral centers in India and Australia respectively over a 3-year period (1st Jan 2017-31st Dec 2019). RESULTS A total of 1293 STEMI presentations (896 Indian vs 397 Australian) were included. On average, Indian patients had lower median BMI than Australian patients (BMI 25.4 vs 27.8; p < 0.001), were significantly younger (mean age 56.0 vs 63.2 years; p < 0.001), more likely male (84 % vs 80 %; p = 0.046) and diabetic (48 % vs 18 %); p < 0.001). Radial access (50 % vs 88 %; p < 0.001) and TIMI III flow post PCI was also significantly lower (85 % vs 96 %; p < 0.001) with median door-to-balloon time significantly shorter in the Indian cohort (20mins vs 43mins; p < 0.001); however, median symptom to balloon time was significantly longer (245mins vs 160mins; p < 0.001). No significant differences in 30-day mortality (4.0 % vs 2.8 % Australian; p = 0.209) or 1-year mortality (6.5 % vs 4.3 %; p = 0.120) were observed. CONCLUSION Significant differences in demographics and presentation characteristics exist between Indian and Australian STEMI patients treated with pPCI. Indian patients had significantly longer pre-hospital delays and lower achievement of TIMI III flow post PCI, yet shorter in-hospital time to treatment.
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Affiliation(s)
- M L Savage
- Cardiology Department, The Prince Charles Hospital, Brisbane, QLD, Australia; School of Clinical Medicine, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
| | - K Hay
- Cardiology Department, The Prince Charles Hospital, Brisbane, QLD, Australia; QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - H Sundar
- Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India
| | - R Maharajan
- Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India
| | - D J Murdoch
- Cardiology Department, The Prince Charles Hospital, Brisbane, QLD, Australia; School of Clinical Medicine, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - K Latchumanadhas
- Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India
| | - D M Ezhilan
- Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India
| | - U Kalaichelvan
- Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India
| | - R Denman
- Cardiology Department, The Prince Charles Hospital, Brisbane, QLD, Australia; School of Clinical Medicine, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - I Ranasinghe
- Cardiology Department, The Prince Charles Hospital, Brisbane, QLD, Australia; School of Clinical Medicine, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - V Subban
- Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India
| | - D L Walters
- Cardiology Department, The Prince Charles Hospital, Brisbane, QLD, Australia; School of Clinical Medicine, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - A Mullasari
- Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India
| | - O C Raffel
- Cardiology Department, The Prince Charles Hospital, Brisbane, QLD, Australia; School of Clinical Medicine, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
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71
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Bellofatto IA, Nikolaou PE, Andreadou I, Canepa M, Carbone F, Ghigo A, Heusch G, Kleinbongard P, Maack C, Podesser BK, Stamatelopoulos K, Stellos K, Vilahur G, Montecucco F, Liberale L. Mechanisms of damage and therapies for cardiac amyloidosis: a role for inflammation? Clin Res Cardiol 2024:10.1007/s00392-024-02522-2. [PMID: 39167195 DOI: 10.1007/s00392-024-02522-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 08/12/2024] [Indexed: 08/23/2024]
Abstract
The term cardiac amyloidosis (CA) refers to the accumulation of extracellular amyloid deposits in the heart because of different conditions often affecting multiple organs including brain, kidney and liver. Notably, cardiac involvement significantly impacts prognosis of amyloidosis, with cardiac biomarkers playing a pivotal role in prognostic stratification. Therapeutic management poses a challenge due to limited response to conventional heart failure therapies, necessitating targeted approaches aimed at preventing, halting or reversing amyloid deposition. Mechanisms underlying organ damage in CA are multifactorial, involving proteotoxicity, oxidative stress, and mechanical interference. While the role of inflammation in CA remains incompletely understood, emerging evidence suggests its potential contribution to disease progression as well as its utility as a therapeutic target. This review reports on the cardiac involvement in systemic amyloidosis, its prognostic role and how to assess it. Current and emerging therapies will be critically discussed underscoring the need for further efforts aiming at elucidating CA pathophysiology. The emerging evidence suggesting the contribution of inflammation to disease progression and its prognostic role will also be reviewed possibly offering insights into novel therapeutic avenues for CA.
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Affiliation(s)
- Ilaria Anna Bellofatto
- Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
| | - Panagiota Efstathia Nikolaou
- Laboratory of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis, Zografou, 15771, Athens, Greece
| | - Ioanna Andreadou
- Laboratory of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens, Panepistimiopolis, Zografou, 15771, Athens, Greece
| | - Marco Canepa
- Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
- Cardiology Unit, Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Federico Carbone
- Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino Genoa-Italian Cardiovascular Network, L.Go R. Benzi 10, 16132, Genoa, Italy
| | - Alessandra Ghigo
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center "Guido Tarone", University of Torino, Turin, Italy
| | - Gerd Heusch
- Institute for Pathophysiology, West German Heart and Vascular Center, University of Duisburg-Essen, Essen, Germany
| | - Petra Kleinbongard
- Institute for Pathophysiology, West German Heart and Vascular Center, University of Duisburg-Essen, Essen, Germany
| | - Christoph Maack
- Department of Translational Research, Comprehensive Heart Failure Center (CHFC), and Medical Clinic I, University Clinic Würzburg, Würzburg, Germany
| | - Bruno K Podesser
- Ludwig Boltzmann Institute for Cardiovascular Research at the Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Vienna, Austria
| | - Kimon Stamatelopoulos
- Angiology and Endothelial Pathophysiology Unit, Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Stellos
- Department of Cardiovascular Research, European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Gemma Vilahur
- Research Institute, Hospital de La Santa Creu I Sant Pau, IIB-Sant Pau, C/Sant Antoni Mª Claret 167, 08025, Barcelona, Spain
- CiberCV, Institute Carlos III, Madrid, Spain
| | - Fabrizio Montecucco
- Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino Genoa-Italian Cardiovascular Network, L.Go R. Benzi 10, 16132, Genoa, Italy
| | - Luca Liberale
- Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy.
- IRCCS Ospedale Policlinico San Martino Genoa-Italian Cardiovascular Network, L.Go R. Benzi 10, 16132, Genoa, Italy.
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72
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Zhang Y, Chen H, Ma Q, Jia H, Ma H, Du Z, Liu Y, Zhang X, Zhang Y, Guan Y, Ma H. Electrophysiological Mechanism of Catestatin Antiarrhythmia: Enhancement of Ito, IK, and IK1 and Inhibition of ICa-L in Rat Ventricular Myocytes. J Am Heart Assoc 2024; 13:e035415. [PMID: 39158577 DOI: 10.1161/jaha.124.035415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/09/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Cardiovascular disease remains one of the leading causes of death globally. Myocardial ischemia and infarction, in particular, frequently cause disturbances in cardiac electrical activity that can trigger ventricular arrhythmias. We aimed to investigate whether catestatin, an endogenous catecholamine-inhibiting peptide, ameliorates myocardial ischemia-induced ventricular arrhythmias in rats and the underlying ionic mechanisms. METHODS AND RESULTS Adult male Sprague-Dawley rats were randomly divided into control and catestatin groups. Ventricular arrhythmias were induced by ligation of the left anterior descending coronary artery and electrical stimulation. Action potential, transient outward potassium current, delayed rectifier potassium current, inward rectifying potassium current, and L-type calcium current (ICa-L) of rat ventricular myocytes were recorded using a patch-clamp technique. Catestatin notably reduced ventricular arrhythmia caused by myocardial ischemia/reperfusion and electrical stimulation of rats. In ventricular myocytes, catestatin markedly shortened the action potential duration of ventricular myocytes, which was counteracted by potassium channel antagonists TEACl and 4-AP, and ICa-L current channel agonist Bay K8644. In addition, catestatin significantly increased transient outward potassium current, delayed rectifier potassium current, and inward rectifying potassium current density in a concentration-dependent manner. Catestatin accelerated the activation and decelerated the inactivation of the transient outward potassium current channel. Furthermore, catestatin decreased ICa-L current density in a concentration-dependent manner. Catestatin also accelerated the inactivation of the ICa-L channel and slowed down the recovery of ICa-L from inactivation. CONCLUSIONS Catestatin enhances the activity of transient outward potassium current, delayed rectifier potassium current, and inward rectifying potassium current, while suppressing the ICa-L in ventricular myocytes, leading to shortened action potential duration and ultimately reducing the ventricular arrhythmia in rats.
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MESH Headings
- Animals
- Male
- Myocytes, Cardiac/drug effects
- Myocytes, Cardiac/metabolism
- Rats, Sprague-Dawley
- Chromogranin A/pharmacology
- Chromogranin A/metabolism
- Action Potentials/drug effects
- Peptide Fragments/pharmacology
- Calcium Channels, L-Type/metabolism
- Calcium Channels, L-Type/drug effects
- Arrhythmias, Cardiac/physiopathology
- Arrhythmias, Cardiac/prevention & control
- Arrhythmias, Cardiac/metabolism
- Anti-Arrhythmia Agents/pharmacology
- Heart Ventricles/drug effects
- Heart Ventricles/metabolism
- Heart Ventricles/physiopathology
- Potassium Channels, Inwardly Rectifying/metabolism
- Potassium Channels, Inwardly Rectifying/drug effects
- Disease Models, Animal
- Potassium Channel Blockers/pharmacology
- Rats
- Patch-Clamp Techniques
- Delayed Rectifier Potassium Channels/metabolism
- Delayed Rectifier Potassium Channels/drug effects
- Potassium Channels/metabolism
- Potassium Channels/drug effects
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Affiliation(s)
- Ying Zhang
- Department of Physiology Hebei Medical University Shijiazhuang Hebei China
| | - Hua Chen
- Department of Cardiovascular Care Unit Hebei General Hospital Shijiazhuang Hebei China
| | - Qingmin Ma
- Department of Ophthalmology Hebei General Hospital Shijiazhuang Hebei China
| | - Hui Jia
- Department of Physiology Hebei Medical University Shijiazhuang Hebei China
| | - Hongyu Ma
- Department of Physiology Hebei Medical University Shijiazhuang Hebei China
| | - Zishuo Du
- Department of Physiology Hebei Medical University Shijiazhuang Hebei China
| | - Yan Liu
- Department of Endocrinology The Third Hospital of Hebei Medical University Shijiazhuang Hebei China
| | - Xiangjian Zhang
- Hebei Collaborative Innovation Center for Cardio-Cerebrovascular Disease Shijiazhuang Hebei China
| | - Yi Zhang
- Department of Physiology Hebei Medical University Shijiazhuang Hebei China
- Hebei Collaborative Innovation Center for Cardio-Cerebrovascular Disease Shijiazhuang Hebei China
| | - Yue Guan
- Department of Physiology Hebei Medical University Shijiazhuang Hebei China
- Hebei Collaborative Innovation Center for Cardio-Cerebrovascular Disease Shijiazhuang Hebei China
| | - Huijie Ma
- Department of Physiology Hebei Medical University Shijiazhuang Hebei China
- The Key Laboratory of Neural and Vascular Biology, Ministry of Education Hebei Medical University Shijiazhuang Hebei China
- Key Laboratory of Neurophysiology of Hebei Province Shijiazhuang Hebei China
- Hebei Collaborative Innovation Center for Cardio-Cerebrovascular Disease Shijiazhuang Hebei China
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73
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Prathumsap N, Ongnok B, Khuanjing T, Arinno A, Maneechote C, Chunchai T, Arunsak B, Kerdphoo S, Chattipakorn SC, Chattipakorn N. Muscarinic and nicotinic receptors stimulation by vagus nerve stimulation ameliorates trastuzumab-induced cardiotoxicity via reducing programmed cell death in rats. Toxicol Appl Pharmacol 2024; 491:117074. [PMID: 39168189 DOI: 10.1016/j.taap.2024.117074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 08/15/2024] [Accepted: 08/16/2024] [Indexed: 08/23/2024]
Abstract
Despite its efficacy in human epidermal growth factor receptor 2 positive cancer treatment, trastuzumab-induced cardiotoxicity (TIC) has become a growing concern. Due to the lack of cardiomyocyte regeneration and proliferation in adult heart, cell death significantly contributes to cardiovascular diseases. Cardiac autonomic modulation by vagus nerve stimulation (VNS) has shown cardioprotective effects in several heart disease models, while the effects of VNS and its underlying mechanisms against TIC have not been found. Forty adult male Wistar rats were divided into 5 groups: (i) control without VNS (CSham) group, (ii) trastuzumab (4 mg/kg/day, i.p.) without VNS (TSham) group, (iii) trastuzumab + VNS (TVNS) group, (iv) trastuzumab + VNS + mAChR blocker (atropine; 1 mg/kg/day, ip, TVNS + Atro) group, and (v) trastuzumab + VNS + nAChR blocker (mecamylamine; 7.5 mg/kg/day, ip, TVNS + Mec) group. Our results showed that trastuzumab induced cardiac dysfunction by increasing autonomic dysfunction, mitochondrial dysfunction/dynamics imbalance, and cardiomyocyte death including apoptosis, autophagic deficiency, pyroptosis, and ferroptosis, which were notably alleviated by VNS. However, mAChR and nAChR blockers significantly inhibited the beneficial effects of VNS on cardiac autonomic dysfunction, mitochondrial dysfunction, cardiomyocyte apoptosis, pyroptosis, and ferroptosis. Only nAChR could counteract the protective effects of VNS on cardiac mitochondrial dynamics imbalance and autophagy insufficiency. Therefore, VNS prevented TIC by rebalancing autonomic activity, ameliorating mitochondrial dysfunction and cardiomyocyte death through mAChR and nAChR activation. The current study provides a novel perspective elucidating the potential treatment of VNS, thus also offering other pharmacological therapeutic promises in TIC patients.
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Affiliation(s)
- Nanthip Prathumsap
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Benjamin Ongnok
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Thawatchai Khuanjing
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Apiwan Arinno
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chayodom Maneechote
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Titikorn Chunchai
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Busarin Arunsak
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Sasiwan Kerdphoo
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Siriporn C Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai 50200, Thailand; Department of Oral Biology and Diagnostic Science, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nipon Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai 50200, Thailand.
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74
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Li Y, Zhong W, Liu Z, Huang C, Peng J, Li H. Aldehyde Dehydrogenase 2 rs671 G/A and a/A Genotypes are Associated with the Risk of Acute Myocardial Infarction. Int J Gen Med 2024; 17:3591-3600. [PMID: 39184908 PMCID: PMC11342949 DOI: 10.2147/ijgm.s475756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 08/10/2024] [Indexed: 08/27/2024] Open
Abstract
Background Aldehyde dehydrogenase 2 (ALDH2) is a key catalytic enzyme involved in the aldehyde metabolism that plays an important role in the occurrence and development of acute myocardial infarction (AMI). However, the relationship of ALDH2 polymorphism and susceptibility to AMI may differ among different regions and populations, and it has not yet been reported in Hakka population. The purpose of the present study was to investigate it in this population. Methods Four hundred and nineteen AMI patients and 636 individuals without AMI were included in the present study. The ALDH2 rs671 polymorphism was genotyped using polymerase chain reaction (PCR)-microarray. Differences in ALDH2 rs671 genotypes and alleles between patients and controls were compared, and the relationship between ALDH2 rs671 genotypes and AMI risk was analyzed. Results Patients with AMI had a lower frequency of ALDH2 rs671 G/G genotype (43.2% vs 52.7%, p=0.003), and a higher G/A genotype (45.6% vs 38.5%, p=0.025) than controls. And AMI patients had a lower frequency of ALDH2 rs671 G allele (66.0% vs 71.9%), and a higher A allele (34.0% vs 28.1%) (p=0.004) than controls. Logistic regression analysis showed that overweight (body mass index (BMI)≥24.0 kg/m2 vs BMI 18.5-23.9 kg/m2: odds ratio (OR) 2.046, 95% confidence interval (CI): 1.520-2.754, p<0.001), history of hypertension (yes vs no: OR 3.464, 95% CI: 2.515-4.770, p<0.001), ALDH2 rs671 G/A genotype (G/A vs G/G: OR 1.476, 95% CI: 1.102-1.976, p=0.009), and A/A genotype (A/A vs G/G: OR 1.656, 95% CI: 1.027-2.668, p=0.038) maybe the independent risk factors for AMI. Conclusion Overweight (BMI≥24.0 kg/m2), a history of hypertension, and ALDH2 rs671 G/A or A/A genotypes increased the risk of developing AMI in Hakka population.
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Affiliation(s)
- Youqian Li
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Wei Zhong
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Zhidong Liu
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Changjing Huang
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Junyin Peng
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Hanlin Li
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
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Mussarat A, Stielper Z, Hayden C, Guillory S. Severe Hyponatremia Secondary to Syndrome of Inappropriate Antidiuretic Hormone (SIADH): A Rare Cause of Takotsubo (Stress) Cardiomyopathy. Am J Med Sci 2024:S0002-9629(24)01404-6. [PMID: 39168409 DOI: 10.1016/j.amjms.2024.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 08/12/2024] [Accepted: 08/12/2024] [Indexed: 08/23/2024]
Affiliation(s)
- Asad Mussarat
- LSU Health Sciences Center New Orleans, Department of Internal Medicine, 2021 Perdido Street New Orleans, LA 70448
| | - Zachary Stielper
- LSU Health Sciences Center New Orleans, Department of Internal Medicine, 2021 Perdido Street New Orleans, LA 70448
| | - Christopher Hayden
- LSU Health Sciences Center New Orleans, Department of Internal Medicine, 2021 Perdido Street New Orleans, LA 70448
| | - Shane Guillory
- LSUHSC New Orleans, Department of Internal Medicine, Chief of Hospital Medicine, 2021 Perdido Street 5(th) Floor 5139 New Orleans, LA 70448.
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76
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Zhang L, Wang X, Chen XW. The biogenesis and transport of triglyceride-rich lipoproteins. Trends Endocrinol Metab 2024:S1043-2760(24)00196-6. [PMID: 39164120 DOI: 10.1016/j.tem.2024.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 07/16/2024] [Accepted: 07/19/2024] [Indexed: 08/22/2024]
Abstract
Triglyceride-rich lipoproteins (TRLs) play essential roles in human health and disease by transporting bulk lipids into the circulation. This review summarizes the fundamental mechanisms and diverse factors governing lipoprotein production, secretion, and regulation. Emphasizing the broader implications for human health, we outline the intricate landscape of lipoprotein research and highlight the potential coordination between the biogenesis and transport of TRLs in physiology, particularly the unexpected coupling of metabolic enzymes and transport machineries. Challenges and opportunities in lipoprotein biology with respect to inherited diseases and viral infections are also discussed. Further characterization of the biogenesis and transport of TRLs will advance both basic research in lipid biology and translational medicine for metabolic diseases.
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Affiliation(s)
- Linqi Zhang
- State Key Laboratory of Membrane Biology, Peking University, Beijing 100871, PR China; Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing 100871, PR China
| | - Xiao Wang
- State Key Laboratory of Membrane Biology, Peking University, Beijing 100871, PR China; Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing 100871, PR China.
| | - Xiao-Wei Chen
- State Key Laboratory of Membrane Biology, Peking University, Beijing 100871, PR China; Institute of Molecular Medicine, College of Future Technology, Peking University, Beijing 100871, PR China; Peking University (PKU)-Tsinghua University (THU) Joint Center for Life Sciences, Peking University, Beijing 100871, PR China.
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Alizadehasl A, Amini-Salehi E, Jebelli SFH, Hosseini K, Aliabadi AY, Yazzaf R, Nobakht S. Presentation of mitral valve cleft with concurrent atrial septal defect and ventricular septal defect detected by three-dimensional transesophageal echocardiography: a case report. J Med Case Rep 2024; 18:387. [PMID: 39153999 PMCID: PMC11330598 DOI: 10.1186/s13256-024-04704-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 07/12/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Cleft in the mitral valve leaflet is a primary cause of congenital mitral regurgitation, stemming from developmental anomalies in the mitral valve and frequently associated with other congenital heart defects. Concurrent presence of cleft in mitral valve leaflet with atrial septal defect and ventricular septal defect is relatively rare. Echocardiography, especially transesophageal echocardiography, is essential in diagnosing cleft mitral valve leaflet and related congenital heart defects, providing critical, detailed imagery for accurate assessment. This study presents a young female patient whose anterior mitral cleft, along with atrial septal defect and ventricular septal defect, was revealed through three-dimensional transesophageal echocardiography. CASE PRESENTATION A 25-year-old Iranian female, experiencing progressive dyspnea and diminished physical capacity over 3 months, was referred to our hospital. Initial examination and transthoracic echocardiography indicated severe mitral regurgitation. Further evaluation with transesophageal echocardiography corroborated these findings and identified a cleft in the anterior mitral valve leaflet, coupled with mild left ventricular enlargement and significant left atrial enlargement. The complexity of the patient's condition was heightened by the diagnosis of cleft mitral valve leaflet in conjunction with atrial septal defect and ventricular septal defect, showing the complex nature of congenital defects. CONCLUSION This case emphasizes the critical role of transthoracic echocardiography in diagnosing cleft of mitral valve leaflet and associated cardiac anomalies, showcasing its superiority over transthoracic echocardiography for detailed visualization of cardiac structures. The identification of multiple congenital defects highlights the necessity for a comprehensive diagnostic approach to manage and treat patients with complex congenital heart diseases effectively. Future research should aim to refine diagnostic methodologies to enhance patient outcomes for cleft of mitral valve leaflets and related congenital conditions.
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Affiliation(s)
- Azin Alizadehasl
- Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Science, Tehran, Iran
| | - Ehsan Amini-Salehi
- Guilan University of Medical Sciences, Razi Hospital, Sardar-Jangle Ave., P.O. Box 41448-95655, Rasht, Iran.
| | - Seyedeh Fatemeh Hosseini Jebelli
- Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Science, Tehran, Iran
| | - Kaveh Hosseini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Yalameh Aliabadi
- Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Science, Tehran, Iran
| | - Rosa Yazzaf
- Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Science, Tehran, Iran
| | - Sara Nobakht
- Guilan University of Medical Sciences, Razi Hospital, Sardar-Jangle Ave., P.O. Box 41448-95655, Rasht, Iran.
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Greenhalgh T, Sivan M, Perlowski A, Nikolich JŽ. Long COVID: a clinical update. Lancet 2024; 404:707-724. [PMID: 39096925 DOI: 10.1016/s0140-6736(24)01136-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 05/07/2024] [Accepted: 05/30/2024] [Indexed: 08/05/2024]
Abstract
Post-COVID-19 condition (also known as long COVID) is generally defined as symptoms persisting for 3 months or more after acute COVID-19. Long COVID can affect multiple organ systems and lead to severe and protracted impairment of function as a result of organ damage. The burden of this disease, both on the individual and on health systems and national economies, is high. In this interdisciplinary Review, with a coauthor with lived experience of severe long COVID, we sought to bring together multiple streams of literature on the epidemiology, pathophysiology (including the hypothesised mechanisms of organ damage), lived experience and clinical manifestations, and clinical investigation and management of long COVID. Although current approaches to long COVID care are largely symptomatic and supportive, recent advances in clinical phenotyping, deep molecular profiling, and biomarker identification might herald a more mechanism-informed and personally tailored approach to clinical care. We also cover the organisation of services for long COVID, approaches to preventing long COVID, and suggestions for future research.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford, UK.
| | - Manoj Sivan
- Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine University of Leeds, Leeds General Infirmary, Leeds, UK
| | | | - Janko Ž Nikolich
- Department of Immunobiology and University of Arizona Center on Aging, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA; The Aegis Consortium for Pandemic-Free Future, University of Arizona Health Sciences, Tucson, AZ, USA
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Li XN, Liu YT, Kang S, Qu Yang DZ, Xiao HY, Ma WK, Shen CX, Pan JW. Interdependence between myocardial deformation and perfusion in patients with T2DM and HFpEF: a feature-tracking and stress perfusion CMR study. Cardiovasc Diabetol 2024; 23:303. [PMID: 39152461 PMCID: PMC11330131 DOI: 10.1186/s12933-024-02380-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 07/29/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Patients with diabetes have an increased risk of developing heart failure with preserved ejection fraction (HFpEF). This study aimed to compare indices of myocardial deformation and perfusion between patients with type 2 diabetes mellitus (T2DM) with and without HFpEF and to investigate the relationship between myocardial strain and perfusion reserve. METHODS This study included 156 patients with T2DM without obstructive coronary artery disease (CAD) and 50 healthy volunteers who underwent cardiac magnetic resonance (CMR) examination at our center. Patients with T2DM were subdivided into the T2DM-HFpEF (n = 74) and the T2DM-non-HFpEF (n = 82) groups. The parameters of left ventricular (LV) and left atrial (LA) strain as well as stress myocardial perfusion were compared. The correlation between myocardial deformation and perfusion parameters was also assessed. Mediation analyses were used to evaluate the direct and indirect effects of T2DM on LA strain. RESULTS Patients with T2DM and HFpEF had reduced LV radial peak systolic strain rate (PSSR), LV circumferential peak diastolic strain rate (PDSR), LA reservoir strain, global myocardial perfusion reserve index (MPRI), and increased LA booster strain compared to patients with T2DM without HFpEF (all P < 0.05). Furthermore, LV longitudinal PSSR, LA reservoir, and LA conduit strain were notably impaired in patients with T2DM without HFpEF compared to controls (all P < 0.05), but LV torsion, LV radial PSSR, and LA booster strain compensated for these alterations (all P < 0.05). Multivariate linear regression analysis demonstrated that LA reservoir and LA booster strain were independently associated with global MPRI (β = 0.259, P < 0.001; β = - 0.326, P < 0.001, respectively). Further, the difference in LA reservoir and LA booster strain between patients with T2DM with and without HFpEF was totally mediated by global MPRI. Global stress PI, LA booster, global rest PI, and global MPRI showed high accuracy in diagnosing HFpEF among patients with T2DM (areas under the curve [AUC]: 0.803, 0.790, 0.740, 0.740, respectively). CONCLUSIONS Patients with T2DM and HFpEF exhibited significant LV systolic and diastolic deformation, decreased LA reservoir strain, severe impairment of myocardial perfusion, and elevated LA booster strain that is a compensatory response in HFpEF. Global MPRI was identified as an independent influencing factor on LA reservoir and LA booster strain. The difference in LA reservoir and LA booster strain between patients with T2DM with and without HFpEF was totally mediated by global MPRI, suggesting a possible mechanistic link between microcirculation impairment and cardiac dysfunction in diabetes. Myocardial perfusion and LA strain may prove valuable for diagnosing and managing HFpEF in the future.
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Affiliation(s)
- Xin-Ni Li
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Yu-Ting Liu
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Sang Kang
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Dan Zeng Qu Yang
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Huo-Yuan Xiao
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Wen-Kun Ma
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Cheng-Xing Shen
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
| | - Jing-Wei Pan
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
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Novak JS, Lischin A, Uapinyoying P, Hindupur R, Moon YJ, Bhattacharya S, Tiufekchiev S, Barone V, Mázala DAG, Gamu IH, Walters G, Panchapakesan K, Jaiswal JK. Failure to Resolve Inflammation Contributes to Juvenile-Onset Cardiomyopathy in a Mouse Model of Duchenne Muscular Dystrophy. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.08.15.607998. [PMID: 39185176 PMCID: PMC11343189 DOI: 10.1101/2024.08.15.607998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
The absence of dystrophin protein causes cardiac dysfunction in boys with Duchenne Muscular Dystrophy (DMD). However, the common mouse model of DMD (B10- mdx ) does not manifest cardiac deficits until late adulthood limiting our understanding of the mechanism and therapeutic approaches to target the pediatric-onset cardiac pathology in DMD. We show the mdx mouse model on the DBA/2J genetic background (D2- mdx ) displays juvenile-onset cardiomyopathy. Molecular and histological analysis revealed heightened leukocyte chemotactic signaling and failure to resolve inflammation, leading to chronic inflammation and extracellular matrix (ECM) fibrosis, causing cardiac pathology in juvenile D2- mdx mice. We show that pharmacologically activating the N-formyl peptide receptor 2 (FPR2) - a receptor that physiologically resolves acute inflammation, mitigated chronic cardiac inflammation and fibrosis, and prevented juvenile onset cardiomyopathy in the D2-mdx mice. These studies offer insights into pediatric onset of cardiac damage in DMD, a new therapeutic target, and identify a drug-based potential therapy.
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81
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Rihan M, Sharma SS. Compound 3K attenuates isoproterenol-induced cardiac hypertrophy by inhibiting pyruvate kinase M2 (PKM2) pathway. Life Sci 2024; 351:122837. [PMID: 38879156 DOI: 10.1016/j.lfs.2024.122837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/31/2024] [Accepted: 06/11/2024] [Indexed: 06/21/2024]
Abstract
AIM Chronic sympathetic stimulation has been identified as a primary factor in the pathogenesis of cardiac hypertrophy (CH). However, there is no appropriate treatment available for the management of CH. Recently, it has been revealed that pyruvate kinase M2 (PKM2) plays a significant role in cardiac remodeling, fibrosis, and hypertrophy. However, the therapeutic potential of selective PKM2 inhibitor has not yet been explored in cardiac hypertrophy. Thus, in the current study, we have studied the cardioprotective potential of Compound 3K, a selective PKM2 inhibitor in isoproterenol-induced CH model. METHODS To induce cardiac hypertrophy, male Wistar rats were subcutaneously administered isoproterenol (ISO, 5 mg/kg/day) for 14 days. Compound 3K at dosages of 2 and 4 mg/kg orally was administered to ISO-treated rats for 14 days to explore its effects on various parameters like ECG, ventricular functions, hypertrophic markers, histology, inflammation, and protein expression were performed. RESULTS Fourteen days administration of ISO resulted in the induction of CH, which was evidenced by alterations in ECG, ventricular dysfunctions, increase in hypertrophy markers, and fibrosis. The immunoblotting of hypertrophy heart revealed the significant rise in PKM2 and reduction in PKM1 protein expression. Treatment with Compound 3K led to downregulation of PKM2 and upregulation of PKM1 protein expression. Compound 3K showed cardioprotective effects by improving ECG, cardiac functions, hypertrophy markers, inflammation, and fibrosis. Further, it also reduced cardiac expression of PKM2-associated splicing protein, HIF-1α, and caspase-3. CONCLUSION Our findings suggest that Compound 3K has a potential cardioprotective effect via PKM2 inhibition in isoproterenol-induced CH.
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Affiliation(s)
- Mohd Rihan
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), S.A.S Nagar (Mohali) 160062, Punjab, India
| | - Shyam Sunder Sharma
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), S.A.S Nagar (Mohali) 160062, Punjab, India.
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82
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Gera P, Oliveira VD, Frishman WH, Aronow WS. Cardiac Manifestations of Hemochromatosis. Cardiol Rev 2024:00045415-990000000-00313. [PMID: 39145627 DOI: 10.1097/crd.0000000000000762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Cardiac hemochromatosis, a consequence of primary or secondary iron-overload conditions, poses a threat to patient health, leading to cardiomyopathy and heart failure. This review aims to compile comprehensive information on cardiac hemochromatosis, elucidating its pathophysiology, clinical presentation, diagnosis, and management strategies. Primary and secondary hemochromatosis, genetic and acquired forms, can result in cardiotoxicity by means of iron dysregulation. Diagnostic tools, including biochemical markers, electrocardiography, echocardiography, and magnetic resonance imaging (MRI), are utilized for early detection as well as long-term monitoring post-treatment. For treatment options, phlebotomy is the standard, but for some patients (such as those with anemia), chelation therapy is an alternative option. Other potential therapies include erythrocytapheresis, calcium channel blockers, and hepcidin-targeted approaches, for which more research is needed to understand cardiac function benefits. With the onset of cardiac symptoms, patient health rapidly deteriorates. Thus, timely intervention to mitigate associated morbidity and mortality by means of screening can promote and prolong patient survival.
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Affiliation(s)
- Priyanka Gera
- From the Departments of Cardiology and Medicine, New York Medical College, Westchester Medical Center, Valhalla, NY
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83
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Geng X, Wang DW, Li H. The pivotal role of neutrophil extracellular traps in cardiovascular diseases: Mechanisms and therapeutic implications. Biomed Pharmacother 2024; 179:117289. [PMID: 39151311 DOI: 10.1016/j.biopha.2024.117289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 08/05/2024] [Accepted: 08/08/2024] [Indexed: 08/19/2024] Open
Abstract
Cardiovascular diseases (CVDs) continue to pose a significant burden on global health, prominently contributing to morbidity and mortality rates worldwide. Recent years have witnessed an increasing recognition of the intricate involvement of neutrophil extracellular traps (NETs) in the pathology of diverse cardiovascular conditions. This review provides a comprehensive analysis of the multifaceted functions of NETs in cardiovascular diseases, shedding light on the impact on atherosclerosis, myocardial infarction, heart failure, myocarditis, atrial fibrillation, aortic stenosis, and the potential therapeutic avenues targeting NETs.
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Affiliation(s)
- Xinyu Geng
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Dao Wen Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Huihui Li
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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84
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Yang Y, Wang Y, Wang Y, Ke T, Zhao L. PCSK9 inhibitor effectively alleviated cognitive dysfunction in a type 2 diabetes mellitus rat model. PeerJ 2024; 12:e17676. [PMID: 39157774 PMCID: PMC11330219 DOI: 10.7717/peerj.17676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 06/12/2024] [Indexed: 08/20/2024] Open
Abstract
Background The incidence of diabetes-associated cognitive dysfunction (DACD) is increasing; however, few clinical intervention measures are available for the prevention and treatment of this disease. Research has shown that proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, particularly SBC-115076, have a protective effect against various neurodegenerative diseases. However, their role in DACD remains unknown. In this study, we aimed to explore the impact of PCSK9 inhibitors on DACD. Methods Male Sprague-Dawley (SD) rats were used to establish an animal model of type 2 diabetes mellitus (T2DM). The rats were randomly divided into three groups: the Control group (Control, healthy rats, n = 8), the Model group (Model, rats with T2DM, n = 8), and the PCSK9 inhibitor-treated group (Treat, T2DM rats treated with PCSK9 inhibitors, n = 8). To assess the spatial learning and memory of the rats in each group, the Morris water maze (MWM) test was conducted. Hematoxylin-eosin staining and Nissl staining procedures were performed to assess the structural characteristics and functional status of the neurons of rats from each group. Transmission electron microscopy was used to examine the morphology and structure of the hippocampal neurons. Determine serum PCSK9 and lipid metabolism indicators in each group of rats. Use qRT-PCR to detect the expression levels of interleukin (IL)-1β, IL-6, and tumor necrosis factor-alpha (TNF-α) in the hippocampal tissues of each group of rats. Western blot was used to detect the expression of PCSK9 and low-density lipoprotein receptor (LDLR) in the hippocampal tissues of rats. In addition, a 4D label-free quantitative proteomics approach was used to analyse protein expression in rat hippocampal tissues. The expression of selected proteins in hippocampal tissues was verified by parallel reaction monitoring (PRM) and immunohistochemistry (IHC). Results The results showed that the PCSK9 inhibitor alleviated cognitive dysfunction in T2DM rats. PCSK9 inhibitors can reduce PCSK9, total cholesterol (TC), and low-density lipoprotein (LDL) levels in the serum of T2DM rats. Meanwhile, it was found that PCSK9 inhibitors can reduce the expression of PCSK9, IL-1β, IL-6, and TNF-α in the hippocampal tissues of T2DM rats, while increasing the expression of LDLR. Thirteen potential target proteins for the action of PCSK9 inhibitors on DACD rats were identified. PRM and IHC revealed that PCSK9 inhibitors effectively counteracted the downregulation of transthyretin in DACD rats. Conclusion This study uncovered the target proteins and specific mechanisms of PCSK9 inhibitors in DACD, providing an experimental basis for the clinical application of PCSK9 inhibitors for the potential treatment of DACD.
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Affiliation(s)
- Yang Yang
- Department of Endocrinology, the Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Yeying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yuwen Wang
- Department of Endocrinology, the Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Tingyu Ke
- Department of Endocrinology, the Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Ling Zhao
- Department of Endocrinology, the Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
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85
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Kaltsas A, Zikopoulos A, Dimitriadis F, Sheshi D, Politis M, Moustakli E, Symeonidis EN, Chrisofos M, Sofikitis N, Zachariou A. Oxidative Stress and Erectile Dysfunction: Pathophysiology, Impacts, and Potential Treatments. Curr Issues Mol Biol 2024; 46:8807-8834. [PMID: 39194738 DOI: 10.3390/cimb46080521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 08/01/2024] [Accepted: 08/13/2024] [Indexed: 08/29/2024] Open
Abstract
Erectile dysfunction (ED) is a prevalent condition affecting men's sexual health, with oxidative stress (OS) having recently been identified as a significant contributing causative factor. This narrative review aims to elucidate the role of OS in the pathophysiology of ED, focusing on impact, mechanisms, and potential therapeutic interventions. Key findings indicate that OS disrupts endothelial function and nitric oxide (NO) signaling, crucial for erectile function. Various sources of reactive oxygen species (ROS) and their detrimental effects on penile tissue are discussed, including aging, diabetes mellitus, hypertension, hyperlipidemia, smoking, obesity, alcohol consumption, psychological stress, hyperhomocysteinemia, chronic kidney disease, and sickle cell disease. Major sources of ROS, such as NADPH oxidase, xanthine oxidase, uncoupled endothelial NO synthase (eNOS), and mitochondrial electron transport, are identified. NO is scavenged by these ROS, leading to endothelial dysfunction characterized by reduced NO availability, impaired vasodilation, increased vascular tone, and inflammation. This ultimately results in ED due to decreased blood flow to penile tissue and the inability to achieve or maintain an erection. Furthermore, ROS impact the transmission of nitrergic neurotransmitters by causing the death of nitrergic neurons and reducing the signaling of neuronal NO synthase (nNOS), exacerbating ED. Therapeutic approaches targeting OS, including antioxidants and lifestyle modifications, show promise in ameliorating ED symptoms. The review underscores the need for further research to develop effective treatments, emphasizing the interplay between OS and vascular health in ED. Integrating pharmacological and non-pharmacological strategies could enhance clinical outcomes for ED patients, advocating for OS management in ED treatment protocols to improve patient quality of life.
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Affiliation(s)
- Aris Kaltsas
- Third Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | | | - Fotios Dimitriadis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Danja Sheshi
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Magdalena Politis
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Efthalia Moustakli
- Laboratory of Medical Genetics, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Evangelos N Symeonidis
- Department of Urology II, European Interbalkan Medical Center, 55535 Thessaloniki, Greece
| | - Michael Chrisofos
- Third Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Nikolaos Sofikitis
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Athanasios Zachariou
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
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86
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Zhang T, Qian Y, Mo L, Dong X, Xue Q, Zheng N, Qi Y, Jiang Y. Chronic ethanol exposure induces cardiac fibroblast transdifferentiation via ceramide accumulation and oxidative stress. Toxicol Mech Methods 2024:1-12. [PMID: 39143746 DOI: 10.1080/15376516.2024.2388762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 07/10/2024] [Accepted: 07/31/2024] [Indexed: 08/16/2024]
Abstract
AIMS Excessive alcohol consumption is associated with cardiac dysfunction and the development of myocardial fibrosis. In this study, we aimed to investigate the direct impacts of ethanol on myocardial fibroblasts and elucidate the underlying mechanism responsible for chronic ethanol-induced myocardial fibrosis. METHODS Rat primary cardiac fibroblasts exposed to ethanol for 24 h and C57BL/6J mice fed on Lieber-DeCarli diet to establish an ethanol intoxication model in vitro and in vivo, respectively. Histological analyses, molecular biology techniques, and analytical chemistry methods were then conducted. RESULTS AND CONCLUSION In vivo and vitro experiments revealed that chronic ethanol exposure induced increased myocardial fibrosis and augmented the transdifferentiation of myocardial fibroblasts. Simultaneously, it elicited an upregulation in the production of long-chain and very-long-chain ceramides in cardiac fibroblasts. The excessive accumulation of ceramide leads to elevated levels of intracellular oxidative stress, culminating in the activation of TGF-β-SMAD3 signaling and the development of fibrosis. Intervention of these pathways with pharmacological inhibitors in vitro or in vivo inhibited fibrosis. In conclusion, ethanol increased ceramides and reactive oxygen species (ROS) in cardiac fibroblasts, resulting in the activation of TGF-β-SMAD3 signaling, transdifferentiation of fibroblasts, and myocardial fibrosis.
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Affiliation(s)
- Tianyi Zhang
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Yile Qian
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Lingjie Mo
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Xiaoru Dong
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Qiupeng Xue
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Nianchang Zheng
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Yanyu Qi
- School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Yan Jiang
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai, China
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87
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Li Z, Wei H, Li R, Wu B, Xu M, Yang X, Zhang Y, Liu Y. The effects of antihypertensive drugs on glucose metabolism. Diabetes Obes Metab 2024. [PMID: 39140233 DOI: 10.1111/dom.15821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 06/28/2024] [Accepted: 07/08/2024] [Indexed: 08/15/2024]
Abstract
Abnormal glucose metabolism is a common disease of the endocrine system. The effects of drugs on glucose metabolism have been reported frequently in recent years, and since abnormal glucose metabolism increases the risk of microvascular and macrovascular complications, metabolic disorders, and infection, clinicians need to pay close attention to these effects. A variety of common drugs can affect glucose metabolism and have different mechanisms of action. Hypertension is a common chronic cardiovascular disease that requires long-term medication. Studies have shown that various antihypertensive drugs also have an impact on glucose metabolism. Among them, α-receptor blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers can improve insulin resistance, while β-receptor blockers, thiazides and loop diuretics can impair glucose metabolism. The aim of this review was to discuss the mechanisms underlying the effects of various antihypertensive drugs on glucose metabolism in order to provide reference information for rational clinical drug use.
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Affiliation(s)
- Zhe Li
- Department of Endocrinology, The First Hospital of Shanxi Medical University, Taiyuan, China
- The First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Hongxia Wei
- Department of Endocrinology, The First Hospital of Shanxi Medical University, Taiyuan, China
- The First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Ru Li
- Department of Endocrinology, The First Hospital of Shanxi Medical University, Taiyuan, China
- The First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Baofeng Wu
- Department of Endocrinology, The First Hospital of Shanxi Medical University, Taiyuan, China
- The First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Ming Xu
- Department of Endocrinology, The First Hospital of Shanxi Medical University, Taiyuan, China
- The First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Xifeng Yang
- Department of Endocrinology, The First Hospital of Shanxi Medical University, Taiyuan, China
- The First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Yi Zhang
- Department of Pharmacology, Shanxi Medical University, Taiyuan, China
- Medicinal Basic Research Innovation Center of Chronic Kidney Disease, Ministry of Education, Shanxi Medical University, Taiyuan, China
| | - Yunfeng Liu
- Department of Endocrinology, The First Hospital of Shanxi Medical University, Taiyuan, China
- Medicinal Basic Research Innovation Center of Chronic Kidney Disease, Ministry of Education, Shanxi Medical University, Taiyuan, China
- Clinical Research Center For Metabolic Diseases Of Shanxi Medical University, Taiyuan, China
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88
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Paydar JA, Parekh D, Sheldon RS. Neurally-mediated syncope Associated with Neck Sarcoma. Can J Cardiol 2024:S0828-282X(24)00921-8. [PMID: 39151560 DOI: 10.1016/j.cjca.2024.08.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 08/08/2024] [Accepted: 08/12/2024] [Indexed: 08/19/2024] Open
Abstract
A 60-year-old male presented with recurrent syncopes and a right-sided neck mass, due to squamous cell carcinoma. His syncopes were caused by bradycardias and hypotension, requiring transvenous pacing and vasopressors. Surgical resection and radiotherapy relieved the hemodynamic symptoms. This case report of an unusual response to presumed carotid sinus compression highlights the need for a multidisciplinary approach in addressing the etiology of reflex syncope in patients with oncological conditions.
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Affiliation(s)
- John A Paydar
- Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada, T2N 2T9
| | - Dwip Parekh
- Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada, T2N 2T9
| | - Robert S Sheldon
- Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada, T2N 2T9.
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89
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Taheri A, Khezri R, Dehghan A, Rezaeian M, Aune D, Rezaei F. Hypertension among persons with type 2 diabetes and its related demographic, socioeconomic and lifestyle factors in the Fasa cohort study. Sci Rep 2024; 14:18892. [PMID: 39143111 PMCID: PMC11324949 DOI: 10.1038/s41598-024-69062-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 07/31/2024] [Indexed: 08/16/2024] Open
Abstract
Hypertension is a very common comorbidity in type 2 diabetes patients, which leads to important health and treatment challenges. The present study was conducted with the aim of determining the prevalence of hypertension and its risk factors in type 2 diabetes patients. This study was conducted using cross-sectional data from 1245 participants aged between 35 and 70 years and diagnosed with type 2 diabetes at baseline in the Fasa cohort study. The prevalence hypertension was determined and multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between various risk factors and hypertension prevalence. The average age of the participants was 53.5 ± 8.7 years and 71.7% (n = 893) were female and 28.3% (n = 352) were male. The prevalence of hypertension in people with type 2 diabetes was 45.5% (n = 566). Higher age (AOR, 95% CI: 8.1, 4.6-14.3), female gender (OR, 95% CI: 1.8, 1.2-2.5), Fars (AOR, 95% CI: 1.6, 1.1-2.4) and Turk (AOR, 95% CI: 1.6, 1.1-2.5) vs. other ethnicity, and overweight (AOR, 95% CI: 1.8, 1.38-2.38) and obesity (AOR, 95% CI: 2.7, 2.0-3.8) vs. BMI < 25 was associated with a higher prevalence of hypertension, while higher physical activity (AOR, 95% CI: 0.57, 0.42-0.78) was associated with lower prevalence of hypertension in the multivariable model. The prevalence of hypertension in persons with type 2 diabetes was high and increased with greater age, in some ethnic groups, and with higher BMI and low physical activity. Further prospective studies are needed to investigate these associations in this population.
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Affiliation(s)
- Ali Taheri
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Rozhan Khezri
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Azizallah Dehghan
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mehdi Rezaeian
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Fatemeh Rezaei
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran.
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran.
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Herreros-Cabello A, Bosch-Nicolau P, Pérez-Molina JA, Salvador F, Monge-Maillo B, Rodriguez-Palomares JF, Ribeiro ALP, Sánchez-Montalvá A, Sabino EC, Norman FF, Fresno M, Gironès N, Molina I. Identification of Chagas disease biomarkers using untargeted metabolomics. Sci Rep 2024; 14:18768. [PMID: 39138245 PMCID: PMC11322173 DOI: 10.1038/s41598-024-69205-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 08/01/2024] [Indexed: 08/15/2024] Open
Abstract
Untargeted metabolomic analysis is a powerful tool used for the discovery of novel biomarkers. Chagas disease (CD), caused by Trypanosoma cruzi, is a neglected tropical disease that affects 6-7 million people with approximately 30% developing cardiac manifestations. The most significant clinical challenge lies in its long latency period after acute infection, and the lack of surrogate markers to predict disease progression or cure. In this cross-sectional study, we analyzed sera from 120 individuals divided into four groups: 31 indeterminate CD, 41 chronic chagasic cardiomyopathy (CCC), 18 Latin Americans with other cardiomyopathies and 30 healthy volunteers. Using a high-throughput panel of 986 metabolites, we identified three distinct profiles among individuals with cardiomyopathy, indeterminate CD and healthy volunteers. After a more stringent analysis, we identified some potential biomarkers. Among peptides, phenylacetylglutamine and fibrinopeptide B (1-13) exhibited an increasing trend from controls to ICD and CCC. Conversely, reduced levels of bilirubin and biliverdin alongside elevated urobilin correlated with disease progression. Finally, elevated levels of cystathionine, phenol glucuronide and vanillactate among amino acids distinguished CCC individuals from ICD and controls. Our novel exploratory study using metabolomics identified potential biomarker candidates, either alone or in combination that if confirmed, can be translated into clinical practice.
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Affiliation(s)
- Alfonso Herreros-Cabello
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Madrid, Spain
- Departamento de Biología Molecular, Universidad Autónoma de Madrid (UAM), 28049, Madrid, Spain
| | - Pau Bosch-Nicolau
- Infectious Diseases Department, Vall d'Hebron University Hospital, International Health Unit Vall d'Hebron-Drassanes, PROSICS Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José A Pérez-Molina
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Fernando Salvador
- Infectious Diseases Department, Vall d'Hebron University Hospital, International Health Unit Vall d'Hebron-Drassanes, PROSICS Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Begoña Monge-Maillo
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Jose F Rodriguez-Palomares
- Department of Cardiology, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Adrián Sánchez-Montalvá
- Infectious Diseases Department, Vall d'Hebron University Hospital, International Health Unit Vall d'Hebron-Drassanes, PROSICS Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ester Cerdeira Sabino
- Faculdade de Medicina, Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, Brazil
| | - Francesca F Norman
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Manuel Fresno
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Madrid, Spain
- Departamento de Biología Molecular, Universidad Autónoma de Madrid (UAM), 28049, Madrid, Spain
- Instituto Universitario de Biología Molecular, Universidad Autónoma de Madrid (IUBM-UAM), Madrid, Spain
- Instituto de Investigación Sanitaria, Hospital Universitario de La Princesa, Madrid, Spain
| | - Núria Gironès
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Madrid, Spain
- Departamento de Biología Molecular, Universidad Autónoma de Madrid (UAM), 28049, Madrid, Spain
- Instituto Universitario de Biología Molecular, Universidad Autónoma de Madrid (IUBM-UAM), Madrid, Spain
- Instituto de Investigación Sanitaria, Hospital Universitario de La Princesa, Madrid, Spain
| | - Israel Molina
- Infectious Diseases Department, Vall d'Hebron University Hospital, International Health Unit Vall d'Hebron-Drassanes, PROSICS Barcelona, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
- Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain.
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91
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Littmann L. It's Greek To Me: Electrocardiographic Lambda Sign. Am J Med 2024:S0002-9343(24)00499-6. [PMID: 39142362 DOI: 10.1016/j.amjmed.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 08/07/2024] [Indexed: 08/16/2024]
Affiliation(s)
- Laszlo Littmann
- From the Department of Internal Medicine, Atrium Health Carolinas Medical Center, Charlotte, North Carolina, USA.
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92
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Yang C, Song X, Sun H, Chen X, Liu C, Chen M. Cardiovascular adverse events associated with PARP inhibitors for ovarian cancer: a real world study (RWS) with Bayesian disproportional analysis based on the FDA adverse event reporting system (FAERS). Expert Opin Drug Saf 2024:1-8. [PMID: 39132853 DOI: 10.1080/14740338.2024.2390640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/27/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND To investigate the pharmacovigilance (PV) and make pairwise comparisons on reporting proportion, seriousness, and severity of outcomes of major adverse cardiovascular events (MACE) among poly(ADP-ribose) polymerase-inhibitors (PARPis) in treating ovarian cancer, fallopian tube carcinoma, and primary peritoneal cancer (collectively named EOC) from the US Food and Drug Administration Adverse Event Reporting System (FAERS). RESEARCH DESIGN AND METHODS Data on adverse cardiovascular events reports related to EOC treatment submitted to FAERS from the first quarter of 2015 to the second quarter of 2023 were harvested. Three PARPis were identified: olaparib, niraparib, and rucaparib. RESULTS Eventually, a total of 258,596 eligible records were enrolled with 12,331 reports including 5,292 reports of MACE and 7,039 reports of other cardiovascular events. For the primary composite endpoint, a PV signal associated with MACE was detected in niraparib (ROR = 1.12; IC025 = 0.03), whereas it was not detected in olaparib and rucaparib; For the secondary endpoint, PV signals associated with other cardiovascular events were detected in niraparib (ROR = 1.17;IC025 = 0.04), but not in olaparib and rucaparib. CONCLUSIONS For EOC patients, close monitoring of blood pressure, heart rate, and coagulation function should be conducted when selecting niraparib for treatment.
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Affiliation(s)
- Chenguang Yang
- Department of Gynaecology and Obstetrics, Affiliated Xuancheng Hospital of Wannan Medical College, Xuancheng, Anhui Province, China
| | - Xuan Song
- Department of General Medicine, Affiliated Xuancheng Hospital of Wannan Medical College, Xuancheng, Anhui Province, China
| | - Hongmei Sun
- Department of Gynaecology and Obstetrics, Affiliated Xuancheng Hospital of Wannan Medical College, Xuancheng, Anhui Province, China
| | - Xi Chen
- Department of Epidemiology and Statistics, School of Public Health, Medical College, Zhejiang University, Zhejiang, China
| | - Chengjiang Liu
- Department of General Medicine, Affiliated Anqing First People's Hospital of Anhui Medical University, Hefei, China
| | - Min Chen
- Department of Gynaecology and Obstetrics, Affiliated Xuancheng Hospital of Wannan Medical College, Xuancheng, Anhui Province, China
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93
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Song W, Chen Z, Zheng Y, Xu Y, Sun Y, Zhao Z, Xie B, Zhang N, Geng X, Wang Y, Zhao J, Zhang X, Xu Y, Tse G, Li G, Hong L, Liu T. Clinical and electrocardiographic characteristics of immune checkpoint inhibitor-related myocarditis. J Electrocardiol 2024; 86:153779. [PMID: 39151303 DOI: 10.1016/j.jelectrocard.2024.153779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/07/2024] [Accepted: 08/04/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Immune checkpoint inhibitor (ICI) has become a major breakthrough in the field of tumor therapy, leading to improved survival. This study evaluated the clinical and electrocardiographic characteristics of patients with ICI-related myocarditis. METHODS Patients with ICI-related myocarditis were enrolled from 4 centers in China until September 2023. Demographic data (age, sex, comorbidity), types of ICI, clinical manifestations, electrocardiogram (ECG) and treatment were analyzed retrospectively. Arrhythmia and characteristics of ECG were compared according to prognosis and grading. RESULTS A total of 29 participants (13 females with a median age of 63.25 years) with ICI-related myocarditis were enrolled. Lung cancer was the most, with a proportion of 31.03 % (9/29). The median time from the first administration of ICI to the diagnosis of myocarditis was 50 days. Camrelizumab was the main type of ICI (9/29). Most patients had non-specific symptoms, dyspnea (n = 16) and palpitation (n = 9) were common. The overall mortality rate was 37.93 % (11/29) with a median follow-up of 9(4,11) days. Compared with the survivors, P-wave abnormality was more common in participants who were dead (24.14 %vs6.90 %, p = 0.010). A total of 19 patients with severe ICI-related myocarditis were included in this study. The proportions of sinus tachycardia (34.48 %vs0.00 %, p = 0.005), premature ventricular complex (27.59 %vs0.00 %, p = 0.027) and atrioventricular block (34.48 %vs3.45 %, p = 0.044) were higher in severe ICI-related myocarditis. CONCLUSIONS Clinical manifestations of ICI-related myocarditis usually lacked specificity. ECGs can be manifested as new-onset arrhythmias, ST-T segment changes, fragmented QRS complex, abnormal P wave, prolonged QTc interval and multi‑lead low voltage.
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Affiliation(s)
- Wenhua Song
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Ziliang Chen
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Yi Zheng
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Yu Xu
- Department of Oncology, Tianjin Huanghe Hospital, Tianjin 300110, China
| | - Yihong Sun
- Department of Cardiology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Zhiqiang Zhao
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Bingxin Xie
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Nan Zhang
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Xuhong Geng
- Department of Function, Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, China
| | - Yueying Wang
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Jun Zhao
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Xiaowei Zhang
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Yanmin Xu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China; School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China; Cardiac Electrophysiology Unit, Cardiovascular Analytics Group, PowerHealth Limited, Hong Kong, China
| | - Guangping Li
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Lili Hong
- Department of Oncology, Tianjin Huanghe Hospital, Tianjin 300110, China.
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China.
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94
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Ibrahim Z, Khan NA, Siddiqui R, Qaisar R, Marzook H, Soares NC, Elmoselhi AB. Gut matters in microgravity: potential link of gut microbiota and its metabolites to cardiovascular and musculoskeletal well-being. Nutr Metab (Lond) 2024; 21:66. [PMID: 39123239 PMCID: PMC11316329 DOI: 10.1186/s12986-024-00836-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 07/27/2024] [Indexed: 08/12/2024] Open
Abstract
The gut microbiota and its secreted metabolites play a significant role in cardiovascular and musculoskeletal health and diseases. The dysregulation of the intestinal microbiota poses a significant threat to cardiovascular and skeletal muscle well-being. Nonetheless, the precise molecular mechanisms underlying these changes remain unclear. Furthermore, microgravity presents several challenges to cardiovascular and musculoskeletal health compromising muscle strength, endothelial dysfunction, and metabolic changes. The purpose of this review is to critically examine the role of gut microbiota metabolites on cardiovascular and skeletal muscle functions and dysfunctions. It also explores the molecular mechanisms that drive microgravity-induced deconditioning in both cardiovascular and skeletal muscle. Key findings in this review highlight that several alterations in gut microbiota and secreted metabolites in microgravity mirror characteristics seen in cardiovascular and skeletal muscle diseases. Those alterations include increased levels of Firmicutes/Bacteroidetes (F/B) ratio, elevated lipopolysaccharide levels (LPS), increased in para-cresol (p-cresol) and secondary metabolites, along with reduction in bile acids and Akkermansia muciniphila bacteria. Highlighting the potential, modulating gut microbiota in microgravity conditions could play a significant role in mitigating cardiovascular and skeletal muscle diseases not only during space flight but also in prolonged bed rest scenarios here on Earth.
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Affiliation(s)
- Zeinab Ibrahim
- Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah, 27272, UAE
- Basic Medical Sciences Department, College of Medicine, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Naveed A Khan
- Microbiota Research Center, Istinye University, Istanbul, 34010, Turkey
| | - Ruqaiyyah Siddiqui
- Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Edinburgh, EH14 4AS,, UK
- Microbiota Research Center, Istinye University, Istanbul, 34010, Turkey
| | - Rizwan Qaisar
- Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah, 27272, UAE
- Basic Medical Sciences Department, College of Medicine, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Hezlin Marzook
- Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah, 27272, UAE
| | - Nelson C Soares
- Center for Applied and Translational Genomics (CATG), Mohammed Bin Rashid university of Medicine and Health Sciences, Dubai, 0000, United Arab Emirates
- Laboratory of Proteomics, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Av Padre Cruz, Lisbon, 1649-016, Portugal
| | - Adel B Elmoselhi
- Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah, 27272, UAE.
- Basic Medical Sciences Department, College of Medicine, University of Sharjah, Sharjah, 27272, United Arab Emirates.
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95
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Yadav BK, Maskey S, Bhattarai A, Pradhananga S, Shakya S, Regmi A. Association of serum homocysteine with vitamin B12 and folate levels in women with pre-eclampsia in a tertiary health care center in Nepal. BMC Womens Health 2024; 24:451. [PMID: 39123143 PMCID: PMC11311945 DOI: 10.1186/s12905-024-03284-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Pre-eclampsia is a syndrome that chiefly includes the development of new-onset hypertension and proteinuria after 20 weeks of pregnancy. Pre-eclampsia is one of the major causes of mortality and morbidity in Nepal. Hyperhomocysteinemia may be a cause of the endothelial dysfunction provoked by oxidative stress in pre-eclampsia. This study was designed to evaluate the association of homocysteine with Vitamin B12 and folate in patients with pre-eclampsia. METHOD An observational cross sectional study was performed in the Gynecology and Obstetrics Department of TUTH involving seventy two subjects with pre-eclampsia. Blood pressure, urinary protein levels, serum homocysteine, Vitamin B12 and folate levels were compared in both mild and severe forms of pre-eclampsia. Concentration of Vitamin B12 and folate were measured using Vitros ECI and homocysteine was measured using CLIA. SPSS 23.0 was used to analyze the data. Tests were performed with Mann Whitney Test and Spearman's rank correlation test. A p-value < 0.05 was considered statistically significant. RESULTS This study showed no significant difference in age and weeks of gestation in both mild and severe forms of pre-eclampsia. Mean concentration of homocysteine was higher (13.1 ± 6.4 micromol/L) in severe Pre-eclampsia as compared to mild cases (7.6 ± 2.8 micromol/L). Mean concentration of folate was lower in severe cases (35.4 ± 24.1 micromol/L) when compared with mild cases of pre-eclampsia (57 ± 23.4 micromol/L). CONCLUSION Homocysteine levels were increased in severe Pre-eclampsia when compared with mild pre-eclampsia and this finding can be used to predict and prevent complications in patients with pre-eclampsia.
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Affiliation(s)
- Binod Kumar Yadav
- Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - Suvana Maskey
- Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - Aseem Bhattarai
- Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - Salina Pradhananga
- Kantipur Dental College Teaching Hospital and Research Center, Kathmandu, Nepal.
| | - Sabina Shakya
- Kathmandu Path Lab and Diagnostic Center, Kathmandu, Nepal
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96
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Wong B, Ryan C, Fagbamigbe A, Bray JJ, McNamee B, Niranjan V, Zhou S, Bogdanet D, Reddin C, McDonald K, Ledwidge M. Alcohol consumption and heart failure: a dose-response meta-analysis. Cochrane Database Syst Rev 2024; 8:CD015398. [PMID: 39119865 PMCID: PMC11311231 DOI: 10.1002/14651858.cd015398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
OBJECTIVES This is a protocol for a Cochrane Review (prototype). The objectives are as follows: Main objective To assess the effects of alcohol consumption on the progression to symptomatic (stage C) heart failure in people at risk for heart failure (stage A) or in people with pre-heart failure (stage B). Secondary objectives To assess the effects of alcohol consumption on progression of left ventricular dysfunction in people with stage A or stage B heart failure. We will assess the effect of alcohol consumption on the development of heart failure with reduced ejection fraction, mildly reduced ejection fraction, and preserved ejection fraction. We also aim to evaluate the effects of alcohol consumption on the development of symptomatic (stage C) heart failure over the short, medium and long term.
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Affiliation(s)
- Bethany Wong
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Cardiovascular Research, HeartBeat Trust, Dublin, Ireland
| | - Cristin Ryan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Adeniyi Fagbamigbe
- Research Methods and Evaluation, Centre for Healthcare and Community, Coventry University, Coventry, UK
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Jonathan Jh Bray
- Oxford Heart Centre, Oxford University Hospitals Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford, UK
| | | | - Vikram Niranjan
- School of Public Health, University College Dublin, Dublin, Ireland
| | - Shuaiwei Zhou
- Cardiovascular Research, HeartBeat Trust, Dublin, Ireland
| | - Delia Bogdanet
- Department of Endocrinology, University of Galway, Galway, Ireland
| | - Catriona Reddin
- Department of Geriatrics, University of Galway, Galway, Ireland
| | - Ken McDonald
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Cardiovascular Research, HeartBeat Trust, Dublin, Ireland
| | - Mark Ledwidge
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Cardiovascular Research, HeartBeat Trust, Dublin, Ireland
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97
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Wifstad SV, Kildahl HA, Holte E, Berg EAR, Grenne B, Salvesen Ø, Dalen H, Lovstakken L. EasyPISA: Automatic Integrated PISA Measurements of Mitral Regurgitation From 2-D Color-Doppler Using Deep Learning. ULTRASOUND IN MEDICINE & BIOLOGY 2024:S0301-5629(24)00254-0. [PMID: 39122609 DOI: 10.1016/j.ultrasmedbio.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 06/14/2024] [Accepted: 06/18/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVE The proximal isovelocity surface area (PISA) method is a well-established approach for mitral regurgitation (MR) quantification. However, it exhibits high inter-observer variability and inaccuracies in cases of non-hemispherical flow convergence and non-holosystolic MR. To address this, we present EasyPISA, a framework for automated integrated PISA measurements taken directly from 2-D color-Doppler sequences. METHODS We trained convolutional neural networks (UNet/Attention UNet) on 1171 images from 196 recordings (54 patients) to detect and segment flow convergence zones in 2-D color-Doppler images. Different preprocessing schemes and model architectures were compared. Flow convergence surface areas were estimated, accounting for non-hemispherical convergence, and regurgitant volume (RVol) was computed by integrating the flow rate over time. EasyPISA was retrospectively applied to 26 MR patient examinations, comparing results with reference PISA RVol measurements, severity grades, and cMRI RVol measurements for 13 patients. RESULTS The UNet trained on duplex images achieved the best results (precision: 0.63, recall: 0.95, dice: 0.58, flow rate error: 10.4 ml/s). Mitigation of false-positive segmentation on the atrial side of the mitral valve was achieved through integration with a mitral valve segmentation network. The intraclass correlation coefficient was 0.83 between EasyPISA and PISA, and 0.66 between EasyPISA and cMRI. Relative standard deviations were 46% and 53%, respectively. Receiver operator characteristics demonstrated a mean area under the curve between 0.90 and 0.97 for EasyPISA RVol estimates and reference severity grades. CONCLUSION EasyPISA demonstrates promising results for fully automated integrated PISA measurements in MR, offering potential benefits in workload reduction and mitigating inter-observer variability in MR assessment.
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Affiliation(s)
- Sigurd Vangen Wifstad
- University of Science and Technology (NTNU), Prinsesse Kristinas Gate 3, 7030, Trondheim, Norway.
| | - Henrik Agerup Kildahl
- University of Science and Technology (NTNU), Prinsesse Kristinas Gate 3, 7030, Trondheim, Norway; Clinic of Thoracic Surgery, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Espen Holte
- University of Science and Technology (NTNU), Prinsesse Kristinas Gate 3, 7030, Trondheim, Norway; Clinic of Cardiology, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Erik Andreas Rye Berg
- University of Science and Technology (NTNU), Prinsesse Kristinas Gate 3, 7030, Trondheim, Norway; Clinic of Cardiology, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Bjørnar Grenne
- University of Science and Technology (NTNU), Prinsesse Kristinas Gate 3, 7030, Trondheim, Norway; Clinic of Cardiology, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Øyvind Salvesen
- University of Science and Technology (NTNU), Prinsesse Kristinas Gate 3, 7030, Trondheim, Norway
| | - Håvard Dalen
- University of Science and Technology (NTNU), Prinsesse Kristinas Gate 3, 7030, Trondheim, Norway; Clinic of Cardiology, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Lasse Lovstakken
- University of Science and Technology (NTNU), Prinsesse Kristinas Gate 3, 7030, Trondheim, Norway
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98
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Insenser MR, Nattero-Chávez L, Luque-Ramírez M, Quiñones SDL, Quintero-Tobar A, Samino S, Amigó N, Dorado Avendaño B, Fiers T, Escobar-Morreale HF. Investigating the Link between Intermediate Metabolism, Sexual Dimorphism, and Cardiac Autonomic Dysfunction in Patients with Type 1 Diabetes. Metabolites 2024; 14:436. [PMID: 39195532 DOI: 10.3390/metabo14080436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 07/24/2024] [Accepted: 08/02/2024] [Indexed: 08/29/2024] Open
Abstract
Sexual dimorphism influences cardiovascular outcomes in type 1 diabetes (T1D), with women facing a higher relative risk of macrovascular events compared to men, especially after menopause. This study hypothesizes that abnormalities in intermediate metabolism may be associated with cardiac autonomic neuropathy (CAN) in T1D. We aim to assess low molecular weight metabolites (LMWM) as markers of CAN in T1D, considering the effects of sexual dimorphism and age. In this cross-sectional study, we included 323 subjects with T1D (147 women and 176 men), with a mean age of 41 ± 13 years. A total of 44 women and 41 men were over 50 years old. CAN was assessed using Ewing's tests, and serum metabolites were analyzed by proton nuclear magnetic resonance spectroscopy (1H-NMR). Patients with CAN had lower levels of valine, isoleucine, and threonine, and higher levels of lactate, compared to those without CAN. These differences persisted after adjusting for BMI and estimated glucose disposal rate (eGDR). In a logistic regression model (R² = 0.178, p < 0.001), the main determinants of CAN included isoleucine [Exp(β) = 0.972 (95% CI 0.952; 0.003)], age [Exp(β) = 1.031 (95% CI 1.010; 1.053)], A1c [Exp(β) = 1.361 (95% CI 1.058; 1.752)], and microangiopathy [Exp(β) = 2.560 (95% CI 1.372; 4.778)]. Sex influenced LMWM profiles, with over half of the metabolites differing between men and women. However, no interactions were found between CAN and sex, or between sex, age, and CAN, on metabolomics profiles. Our findings suggest an association between CAN and LMWM levels in T1D. The sexual dimorphism observed in amino acid metabolites was unaffected by the presence of CAN.
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Affiliation(s)
- María Rosa Insenser
- Diabetes, Obesity and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Universidad de Alcalá, 28034 Madrid, Spain
| | - Lía Nattero-Chávez
- Diabetes, Obesity and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Universidad de Alcalá, 28034 Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Manuel Luque-Ramírez
- Diabetes, Obesity and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Universidad de Alcalá, 28034 Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Sara de Lope Quiñones
- Diabetes, Obesity and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Universidad de Alcalá, 28034 Madrid, Spain
| | - Alejandra Quintero-Tobar
- Diabetes, Obesity and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Universidad de Alcalá, 28034 Madrid, Spain
| | - Sara Samino
- Biosfer Teslab, CIBERDEM, 43206 Tarragona, Spain
| | - Núria Amigó
- Biosfer Teslab, CIBERDEM, 43206 Tarragona, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Department of Basic Medical Sciences, Universitat Rovira i Virgili (URV), 43002 Tarragona, Spain
| | - Beatriz Dorado Avendaño
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Tom Fiers
- Laboratory for Hormonology and Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Héctor F Escobar-Morreale
- Diabetes, Obesity and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Universidad de Alcalá, 28034 Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
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Song Y, Wang M, Li Y, Lian Y. The evaluation value of atherogenic index of plasma and high-sensitivity C-reactive protein for the degree of coronary artery lesion in premature coronary artery disease. BMC Cardiovasc Disord 2024; 24:410. [PMID: 39107719 PMCID: PMC11301844 DOI: 10.1186/s12872-024-04014-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 06/26/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Premature coronary artery disease (PCAD) is prevailing. We aimed to investigate the evaluation value of atherogenic index of plasma (AIP) and high-sensitivity C-reactive protein (hs-CRP) for the occurrence and severity of coronary artery lesion in PCAD patients. METHODS PCAD (PACD group)/non-PCAD (control group) patients were enrolled. The coronary artery lesion degree was evaluated using Gensini score (GS). PCAD patients were allocated into the low/medium/high GS groups, with general clinical baseline data analyzed. Plasma hs-CRP/AIP levels were compared in PCAD patients with different disease degree. Correlations between plasma hs-CRP/AIP with Gensini score, independent risk factors affecting the occurrence of PCAD, and the predictive value of hs-CRP/AIP/their combination for the occurrence and degree of PCAD were evaluated by Spearman correlation analysis/Logistic multivariate regression/receiver operating characteristic (ROC) curve. The differences in the area under the curve (AUC) were compared using MedCalc-Comparison of ROC curves. RESULTS Plasma hs-CRP/AIP levels in the PCAD group were increased. Plasma hs-CRP/AIP levels varied significantly among PCAD patients with different disease degree. Plasma hs-CRP/AIP levels were markedly positively correlated with the Gensini score. Smoking history/homocysteine/fasting blood-glucose/hs-CRP/AIP were all independent risk factors affecting PCAD occurrence. The AUC of hs-CRP and AIP combination predicting the occurrence of PCAD was 0.950 (90.80% sensitivity/93.33% specificity). hs-CRP/AIP combination assisted in predicting the disease degree in PCAD patients. CONCLUSIONS AIP and hs-CRP are independent risk factors for the occurrence of PCAD, and their combination has high predictive value for PCAD occurrence and disease degree, which are both positively correlated with coronary artery lesion degree.
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Affiliation(s)
- Yuwei Song
- Department of General Practice, Heping Hospital Affiliated to Changzhi Medical College, 110 Yan'an South Road, Luzhou District, Changzhi, Shanxi Province, 046000, China
| | - Mengmeng Wang
- Department of General Practice, Heping Hospital Affiliated to Changzhi Medical College, 110 Yan'an South Road, Luzhou District, Changzhi, Shanxi Province, 046000, China
| | - Yijun Li
- Department of General Practice, Heping Hospital Affiliated to Changzhi Medical College, 110 Yan'an South Road, Luzhou District, Changzhi, Shanxi Province, 046000, China
| | - Yajun Lian
- Department of General Practice, Heping Hospital Affiliated to Changzhi Medical College, 110 Yan'an South Road, Luzhou District, Changzhi, Shanxi Province, 046000, China.
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100
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Abu-Tahon MA, Alshammari FA, Shahhat IM, Ghareib M, Abdallah WE. Eco-Friendly Synthesis, Characterization, and Biomedical Applications of Biosynthesized Bimetallic Silver-Gold Nanoparticles by Culture Supernatant of Aspergillus niger. Appl Biochem Biotechnol 2024:10.1007/s12010-024-05035-w. [PMID: 39106026 DOI: 10.1007/s12010-024-05035-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2024] [Indexed: 08/07/2024]
Abstract
Green synthesis of bimetallic nanoparticles of noble metals is highly desirable in nanomedicine because of their potential use as anticoagulant, thrombolytic and anticancer agents. In this study, it was discovered that the filamentous fungus Aspergillus niger proved effective in producing bimetallic Ag-Au nanoparticles. A. niger culture supernatant was able to produce Ag-AuNPs by reducing the solution of chloroauric acid/silver nitrate (1.0:1.0 mM) within 2 min at 100 °C and pH 8. Experimental Ag-AuNP detection was performed by visually observing the color change to reddish brown. The produced nanoparticles displayed maximal absorbance at 530 nm in UV-vis spectroscopy. According to transmission electron microscopy, most of the nanoparticles were spherical, with a mean diameter of 8-10 nm. The biosynthesis of Ag-AuNPs by A. niger was confirmed by Fourier transform infrared spectroscopy, X-ray diffraction and energy dispersive X-ray analytical techniques. Its zeta potential was discovered to be -34.01 mV. The biosynthesized Ag-AuNPs exhibited effective thrombolytic and antiplatelet aggregation actions by totally preventing and dissolving the blood clot which was verified by microscopic examination, amelioration of blood coagulation assays, and carrageenan-induced tail thrombosis model. The findings verified the effectiveness of biosynthesized Ag-AuNPs as a powerful antitumor agent against HepG2 and A549 cell lines with IC50 values of 15.57 and 27.07 μg/mL, respectively. Crystal violet assay validated the cytopathic effects of Ag-AuNPs on A549 and HepG2 cell lines. Therefore, the produced Ag-AuNPs from A. niger are a promising candidate in the management of thrombosis.
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Affiliation(s)
- Medhat Ahmed Abu-Tahon
- Department of Biology, Faculty of Science and Arts, Northern Border University, Rafha, Saudi Arabia.
- Biological and Geological Sciences Department, Faculty of Education, Ain Shams University, Roxy, Heliopolis, Cairo, P.C.11757, Egypt.
| | - Fahdah Ayed Alshammari
- Department of Biology, Faculty of Science, Northern Border University, Arar, Saudi Arabia
| | - Ismail Mahmoud Shahhat
- Department of Biology, Faculty of Science, Northern Border University, Arar, Saudi Arabia
- Egyptian Drug Authority, Cairo, Egypt
| | - Mohamed Ghareib
- Biological and Geological Sciences Department, Faculty of Education, Ain Shams University, Roxy, Heliopolis, Cairo, P.C.11757, Egypt
| | - Wafaa E Abdallah
- Biological and Geological Sciences Department, Faculty of Education, Ain Shams University, Roxy, Heliopolis, Cairo, P.C.11757, Egypt
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