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Abstract
Heart failure (HF) is a major cardiovascular complication of diabetes mellitus (DM). The greatest risk factor for HF is age, and data indicate that 6 to 10 % of individuals over the age of 65 years suffer from HF. Patients with DM have a 2.5-fold increased risk for developing HF than individuals without DM. The 25 to 40 % of patients with HF who have DM have worse outcome (death from cardiovascular disease or hospitalization for worsening HF) than patients without DM. Hyperglycemia is a risk factor for the development of HF with an increase in incidence of HF rising from 10 % at hemoglobin A1c (HbA1c) 8.0 to 9.0 % to 71 % at a HbA1c > 10 %. Patients with DM and HF are equally distributed between those with low ejection fractions and those with normal ejection fractions. The HF treatment regimens for patients with HF and DM (blockade of angiotensin II synthesis or action, cardioselective β-adrenergic blockade, mineralocorticoid receptor blockade, and diuretics) are the same as for HF patients without DM, though the benefit on clinical outcomes is not as great. The new angiotensin-neprilysin inhibitors appear to provide increase outcome benefits in both HF patients with or without DM. Glycemic control impacts the clinical outcomes in patients with HF and DM in a U-shaped relationship with poorer survival at low and high mean HbA1c levels. The optimal chronic glycemic control occurs at an HbA1c of 7.5 to 8.0 % for patients with DM who have symptoms of HF.
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Affiliation(s)
- Gül Bahtiyar
- Division of Endocrinology, State University of New York Health Science Center, Brooklyn, NY, USA
- Department of Medicine, Woodhull Medical Mental Health Center, Brooklyn, NY, USA
- Division of Endocrinology, New York University School of Medicine, New York, NY, USA
| | - David Gutterman
- Division of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Harold Lebovitz
- Division of Endocrinology, State University of New York Health Science Center, Brooklyn, NY, USA.
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252
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Qu H, Lin K, Wang H, Wei H, Ji B, Yang Z, Peng C, Xiao X, Deng H. 1,25(OH) 2 D 3 improves cardiac dysfunction, hypertrophy, and fibrosis through PARP1/SIRT1/mTOR-related mechanisms in type 1 diabetes. Mol Nutr Food Res 2016; 61. [PMID: 27561793 DOI: 10.1002/mnfr.201600338] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 08/13/2016] [Accepted: 08/16/2016] [Indexed: 11/06/2022]
Abstract
SCOPE Diabetic cardiomyopathy is one of the most important cardiac complications associated with diabetes. However, the mechanisms underlying diabetic cardiomyopathy remain unclear. The PARP1, SIRT1, and mTOR pathways have been implicated in cardiac diseases, and they are also associated with diabetes. 1,25(OH)2 D3 was recently recognized as a potential PARP1inhibitor in a macrophage cell line. The aim of our study was to investigate whether 1,25(OH)2 D3 can improve diabetic cardiomyopathy through a vitamin D receptor (VDR)-dependent mechanism associated with the PARP1/SIRT1/mTOR pathway. METHODS AND RESULTS 1,25(OH)2 D3 -treated diabetic rats displayed improved left ventricular wall thickness and end-diastolic/systolic diameter, end-diastolic/systolic volume, left ventricular ejection fraction, fractional shortening, atrial natriuretic peptide, and brain natriuretic peptide gene expression, and interstitial fibrosis compared with untreated diabetic rats, while silencing the VDR gene in DM rats blocked the above results. 1,25(OH)2 D3 treatment also decreased PARP1 and increased SIRT1 expression levels and repressed the phosphorylation of mTOR. Treating neonatal cardiomyocytes with 1,25(OH)2 D3 and a PARP1 inhibitor decreased PARP1 and increased SIRT1 protein expression. CONCLUSION The present study demonstrates that 1,25(OH)2 D3 treatment has the potential to improve diabetic cardiomyopathy in rats and suggests that VD-VDR signaling induces this protective effect against diabetic cardiomyopathy might partly through the PARP1/SIRT1/mTOR pathway.
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Affiliation(s)
- Hua Qu
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Ke Lin
- Department of Neurology, Chongqing Emergency Medical Center (The Fourth People's Hospital of Chongqing), Chongqing, P. R. China
| | - Hang Wang
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Huili Wei
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Baolan Ji
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Zengsong Yang
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Chuan Peng
- Laboratory of Lipid and Glucose Metabolism, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Xiaoqiu Xiao
- Laboratory of Lipid and Glucose Metabolism, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Huacong Deng
- Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
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Argulian E, Sengupta PP. Speckle Tracking Echocardiographic Imaging in Metabolic Cardiomyopathies. CURRENT CARDIOVASCULAR IMAGING REPORTS 2016. [DOI: 10.1007/s12410-016-9390-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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254
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Bhattacharya K, Pontin J, Thompson S. Dietary Management of the Ketogenic Glycogen Storage Diseases. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2016. [DOI: 10.1177/2326409816661359] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Kaustuv Bhattacharya
- Genetic Metabolic Disorders Service, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
- Discipline of Paediatrics and Child Health, Sydney University, Sydney, New South Wales, Australia
| | - Jennifer Pontin
- Genetic Metabolic Disorders Service, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Sue Thompson
- Genetic Metabolic Disorders Service, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
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255
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Evaluation of right atrial function by two-dimensional speckle-tracking echocardiography in patients with right ventricular myocardial infarction. Int J Cardiovasc Imaging 2016; 33:47-56. [DOI: 10.1007/s10554-016-0975-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 08/29/2016] [Indexed: 01/18/2023]
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256
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Apocynin influence on oxidative stress and cardiac remodeling of spontaneously hypertensive rats with diabetes mellitus. Cardiovasc Diabetol 2016; 15:126. [PMID: 27585437 PMCID: PMC5009715 DOI: 10.1186/s12933-016-0442-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/18/2016] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Although increased oxidative stress is a major component of diabetic hypertensive cardiomyopathy, research into the effects of antioxidants on cardiac remodeling remains scarce. The actions of antioxidant apocynin include inhibiting reactive oxygen species (ROS) generation by nicotinamide adenine dinucleotide phosphate (NADPH) oxidases and ROS scavenging. We evaluated the effects of apocynin on cardiac remodeling in spontaneously hypertensive rats (SHR) with diabetes mellitus (DM). METHODS Male SHR were divided into four groups: control (SHR, n = 16); SHR treated with apocynin (SHR-APO; 16 mg/kg/day, added to drinking water; n = 16); diabetic SHR (SHR-DM, n = 13); and SHR-DM treated with apocynin (SHR-DM-APO, n = 14), for eight weeks. DM was induced by streptozotocin (40 mg/kg, single dose). Statistical analyzes: ANOVA and Tukey or Mann-Whitney. RESULTS Echocardiogram in diabetic groups showed higher left ventricular and left atrium diameters indexed for body weight, and higher isovolumetric relaxation time than normoglycemic rats; systolic function did not differ between groups. Isolated papillary muscle showed impaired contractile and relaxation function in diabetic groups. Developed tension was lower in SHR-APO than SHR. Myocardial hydroxyproline concentration was higher in SHR-DM than SHR, interstitial collagen fraction was higher in SHR-DM-APO than SHR-APO, and type III collagen protein expression was lower in SHR-DM and SHR-DM-APO than their controls. Type I collagen and lysyl oxidase expression did not differ between groups. Apocynin did not change collagen tissue. Myocardial lipid hydroperoxide concentration was higher in SHR-DM than SHR and SHR-DM-APO. Glutathione peroxidase activity was lower and catalase higher in SHR-DM than SHR. Apocynin attenuated antioxidant enzyme activity changes in SHR-DM-APO. Advanced glycation end-products and NADPH oxidase activity did not differ between groups. CONCLUSION Apocynin reduces oxidative stress independently of NADPH oxidase activity and does not change ventricular or myocardial function in spontaneously hypertensive rats with diabetes mellitus. The apocynin-induced myocardial functional impairment in SHR shows that apocynin actions need to be clarified during sustained chronic pressure overload.
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257
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Gonçalves N, Gomes-Ferreira C, Moura C, Roncon-Albuquerque R, Leite-Moreira A, Falcão-Pires I. Worse cardiac remodeling in response to pressure overload in type 2 diabetes mellitus. Int J Cardiol 2016; 217:195-204. [DOI: 10.1016/j.ijcard.2016.04.178] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 04/19/2016] [Accepted: 04/30/2016] [Indexed: 12/17/2022]
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Schernthaner G, Cahn A, Raz I. Is the Use of DPP-4 Inhibitors Associated With an Increased Risk for Heart Failure? Lessons From EXAMINE, SAVOR-TIMI 53, and TECOS. Diabetes Care 2016; 39 Suppl 2:S210-8. [PMID: 27440835 DOI: 10.2337/dcs15-3009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
| | - Avivit Cahn
- Department of Internal Medicine, Hadassah University Hospital, Jerusalem, Israel
| | - Itamar Raz
- Department of Internal Medicine, Hadassah University Hospital, Jerusalem, Israel
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260
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Hodzic A, Ribault V, Maragnes P, Milliez P, Saloux E, Labombarda F. Decreased regional left ventricular myocardial strain in type 1 diabetic children: a first sign of diabetic cardiomyopathy? J Transl Int Med 2016; 4:81-87. [PMID: 28191526 DOI: 10.1515/jtim-2016-0025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Type 1 diabetes is a major cardiovascular risk factor associated with an excess of mortality in young adults due to premature cardiovascular events, which includes heart failure. The relation between type 1 diabetes and cardiac structure and function in children was poorly documented. Our study investigates (1) whether type 1 diabetic children have echocardiographic signs of subclinical cardiac dysfunction assessed by tissue Doppler strain and (2) whether state of metabolic control and diabetes duration have any influence on the cardiac event. METHODS Standard echocardiography and tissue Doppler imaging were prospectively performed in type 1 diabetic children. Left ventricular dimensions, standard indices of systolic and diastolic function, and septal longitudinal strain were investigated. RESULTS Thirty consecutive asymptomatic diabetic children (age: 12.4 [5-17] years; males: 53%) were compared to 30 age and sex-matched healthy control subjects. Left ventricular mass index and diastolic septal thickness were significantly increased in diabetic children. There was no difference between two groups as regards the left ventricular ejection fraction and conventional mitral Doppler parameters (E, A, Ea). The global longitudinal systolic strain and strain rate were found to be decreased in children with diabetes. The global longitudinal early diastolic strain rate (Esr) was negatively correlated with metabolic control. Longitudinal strain was not correlated with diabetes duration. CONCLUSION Children with Type 1 diabetes had subclinical alterations in left ventricular size and longitudinal myocardial deformation.
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Affiliation(s)
- Amir Hodzic
- Department of Cardiology, Caen CHU, Caen, F-14000, France
| | | | | | - Paul Milliez
- Department of Cardiology, Caen CHU, Caen, F-14000, France
| | - Eric Saloux
- Department of Cardiology, Caen CHU, Caen, F-14000, France
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261
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Wu HE, Baumgardt SL, Fang J, Paterson M, Liu Y, Du J, Shi Y, Qiao S, Bosnjak ZJ, Warltier DC, Kersten JR, Ge ZD. Cardiomyocyte GTP Cyclohydrolase 1 Protects the Heart Against Diabetic Cardiomyopathy. Sci Rep 2016; 6:27925. [PMID: 27295516 PMCID: PMC4904741 DOI: 10.1038/srep27925] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 05/26/2016] [Indexed: 02/06/2023] Open
Abstract
Diabetic cardiomyopathy increases the risk of heart failure and death. At present, there are no effective approaches to preventing its development in the clinic. Here we report that reduction of cardiac GTP cyclohydrolase 1 (GCH1) degradation by genetic and pharmacological approaches protects the heart against diabetic cardiomyopathy. Diabetic cardiomyopathy was induced in C57BL/6 wild-type mice and transgenic mice with cardiomyocyte-specific overexpression of GCH1 with streptozotocin, and control animals were given citrate buffer. We found that diabetes-induced degradation of cardiac GCH1 proteins contributed to adverse cardiac remodeling and dysfunction in C57BL/6 mice, concomitant with decreases in tetrahydrobiopterin, dimeric and phosphorylated neuronal nitric oxide synthase, sarcoplasmic reticulum Ca(2+) handling proteins, intracellular [Ca(2+)]i, and sarcoplasmic reticulum Ca(2+) content and increases in phosphorylated p-38 mitogen-activated protein kinase and superoxide production. Interestingly, GCH-1 overexpression abrogated these detrimental effects of diabetes. Furthermore, we found that MG 132, an inhibitor for 26S proteasome, preserved cardiac GCH1 proteins and ameliorated cardiac remodeling and dysfunction during diabetes. This study deepens our understanding of impaired cardiac function in diabetes, identifies GCH1 as a modulator of cardiac remodeling and function, and reveals a new therapeutic target for diabetic cardiomyopathy.
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Affiliation(s)
- Hsiang-En Wu
- Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
- National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Boulevard, Baltimore, MA 21224, USA
| | - Shelley L. Baumgardt
- Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Juan Fang
- Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Mark Paterson
- Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Yanan Liu
- Department of Medicine, Columbia University, 630 W. 168th Street, New York, NY 10032, USA
| | - Jianhai Du
- Department of Biochemistry, University of Washington, 1705 NE Pacific Street, Seattle, WA 98195, USA
| | - Yang Shi
- Aurora Research Institute, Aurora Health Care, 750 W. Virginia Street, Milwaukee, WI 53234, USA
| | - Shigang Qiao
- Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Zeljko J. Bosnjak
- Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
- Department of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - David C. Warltier
- Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Judy R. Kersten
- Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Zhi-Dong Ge
- Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
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262
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Hensel KO. Non-ischemic diabetic cardiomyopathy may initially exhibit a transient subclinical phase of hyperdynamic myocardial performance. Med Hypotheses 2016; 94:7-10. [PMID: 27515189 DOI: 10.1016/j.mehy.2016.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 06/02/2016] [Indexed: 01/14/2023]
Abstract
Cardiovascular complications are the key cause for mortality in diabetes mellitus. Besides ischemia-related cardiac malfunction there is growing evidence for non-ischemic diabetes-associated heart failure in both type 1 and type 2 diabetes mellitus. The underlying pathophysiology of non-ischemic diabetic cardiomyopathy (NIDC) is poorly understood and data on myocardial mechanics in early stages of the disease are rare. However, several studies in both human and experimental animal settings have reported prima facie unexplained features indicating myocardial hyperdynamics early in the course of the disease. The new hypothesis is that - other than previously thought - NIDC may be non-linear and initially feature an asymptomatic subclinical phase of myocardial hypercontractility that precedes the long-term development of diabetes-associated cardiac dysfunction and ultimately heart failure. Diabetes-induced metabolic imbalances may lead to a paradoxic inotropic increase and inefficient myocardial mechanics that finally result in a gradual deterioration of myocardial performance. In conclusion, diabetic patients should be screened regularly and early in the course of the disease utilizing ultra-sensitive myocardial deformation imaging in order to identify patients at risk for diabetes-associated heart failure. Moreover, hyperdynamic myocardial deformation might help distinguish non-ischemic from ischemic diabetic cardiomyopathy. Further studies are needed to illuminate the underlying pathophysiological mechanisms, the exact spatiotemporal evolvement of diabetic cardiomyopathy and its long-term relation to clinical outcome parameters.
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Affiliation(s)
- Kai O Hensel
- HELIOS University Hospital Wuppertal, Department of Pediatrics, Center for Clinical and Translational Research (CCTR), Witten/Herdecke University, Faculty of Health, Germany.
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263
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Kowsari AA, Hosseinsabet A. Evaluation of the Right Ventricular Function in Prediabetes: A 2-D Speckle Tracking Echocardiographic Study. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:1321-1329. [PMID: 26996526 DOI: 10.1016/j.ultrasmedbio.2016.01.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 01/03/2016] [Accepted: 01/23/2016] [Indexed: 06/05/2023]
Abstract
Pre-diabetes is a common condition associated with cardiovascular changes. The aim of our study was to evaluate the right ventricular (RV) function as assessed by 2-D speckle tracking echocardiography in pre-diabetic patients. This study recruited 94 patients (33 normal patients, 31 pre-diabetic patients and 30 diabetic patients). The absolute amount of the global peak systolic strain, the systolic strain rate and the early diastolic strain rate of the RV free wall (RVFW) was higher in the control group than in the pre-diabetic and diabetic groups. These indices were not different between the pre-diabetic and diabetic groups. The global late diastolic strain rate of RVFW was the same between the three groups. Also, pre-diabetes and diabetes were the independent predictors of the RVFW global peak systolic strain, systolic strain rate and diastolic strain rate. Our study demonstrated that the RV systolic and diastolic functions were impaired in the pre-diabetic and diabetic patients without obstructive coronary artery disease. Also, pre-diabetes and diabetes were independent predictors of systolic and diastolic functions of the RV.
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Affiliation(s)
- Ali-Asghar Kowsari
- Cardiology Department, Gerash Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Hosseinsabet
- Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
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264
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Cherubini A, Cioffi G, Mazzone C, Faganello G, Barbati G, Tarantini L, Russo G, Stefenelli C, Humar F, Grande E, Fisicaro M, Pandullo C, Di Lenarda A. Echocardiographic markers of inducible myocardial ischemia at baseline evaluation preparatory to exercise stress echocardiography. Cardiovasc Ultrasound 2016; 14:21. [PMID: 27246240 PMCID: PMC4888406 DOI: 10.1186/s12947-016-0064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 05/24/2016] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Tissue Doppler Imaging (TDI) is a sensible and feasible method to detect longitudinal left ventricular (LV) systolic dysfunction (LVSD) in patients with diabetes mellitus, hypertension or ischemic heart disease. In this study, we hypothesized that longitudinal LVSD assessed by TDI predicted inducible myocardial ischemia independently of other echocardiographic variables (assessed as coexisting potential markers) in patients at increased cardiovascular (CV) risk. METHODS Two hundred one patients at high CV risk defined according to the ESC Guidelines 2012 underwent exercise stress echocardiography (ExSEcho) for primary prevention. Echocardiographic parameters were measured at rest and peak exercise. RESULTS ExSEcho classified 168 (83.6 %) patients as non-ischemic and 33 (16,4 %) as ischemic. Baseline clinical characteristics were similar between the groups, but ischemic had higher blood pressure, received more frequently beta-blockers and antiplatelet agents than non-ischemic patients. The former had greater LV size, lower relative wall thickness and higher left atrial systolic force (LASF) than the latter. LV systolic longitudinal function (measure as peak S') was significantly lower in ischemic than non-ischemic patients (8.7 ± 2.1 vs 9.7 ± 2.7 cm/sec, p = 0.001). The factors independently related to myocardial ischemia at multivariate logistic analysis were: lower peak S', higher LV circumferential end-systolic stress and LASF. CONCLUSIONS In asymptomatic patients at increased risk for adverse CV events baseline longitudinal LVSD together with higher LV circumferential end-systolic stress and LASF were the factors associated with myocardial ischemia induced by ExSEcho. The assessment of these factors at standard echocardiography might help the physicians for improving the risk stratification among these patients for ExSEcho.
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Affiliation(s)
- Antonella Cherubini
- Cardiovascular Center, Health Authority n° 1 and University of Trieste, Trieste, Italy
| | - Giovanni Cioffi
- Cardiology Department Villa Bianca Hospital, Trento, Italy.
- Echocardiography Laboratory, Villa Bianca Hospital, via Piave 78, 38100, Trento, Italy.
| | - Carmine Mazzone
- Cardiovascular Center, Health Authority n° 1 and University of Trieste, Trieste, Italy
| | - Giorgio Faganello
- Cardiovascular Center, Health Authority n° 1 and University of Trieste, Trieste, Italy
| | - Giulia Barbati
- Cardiovascular Center, Health Authority n° 1 and University of Trieste, Trieste, Italy
| | - Luigi Tarantini
- Cardiology Department St. Martino Hospital Azienda Sanitaria Locale n. 1, Belluno, Italy
| | - Giulia Russo
- Cardiovascular Center, Health Authority n° 1 and University of Trieste, Trieste, Italy
| | | | - Franco Humar
- Cardiovascular Center, Health Authority n° 1 and University of Trieste, Trieste, Italy
| | - Eliana Grande
- Cardiovascular Center, Health Authority n° 1 and University of Trieste, Trieste, Italy
| | - Maurizio Fisicaro
- Cardiovascular Center, Health Authority n° 1 and University of Trieste, Trieste, Italy
| | - Claudio Pandullo
- Cardiovascular Center, Health Authority n° 1 and University of Trieste, Trieste, Italy
| | - Andrea Di Lenarda
- Cardiovascular Center, Health Authority n° 1 and University of Trieste, Trieste, Italy
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Akhtar MS, Pillai KK, Hassan MQ, Dhyani N, Ismail MV, Najmi AK. Levosimendan reduces myocardial damage and improves cardiodynamics in streptozotocin induced diabetic cardiomyopathy via SERCA2a/NCX1 pathway. Life Sci 2016; 153:55-65. [DOI: 10.1016/j.lfs.2016.03.049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/17/2016] [Accepted: 03/25/2016] [Indexed: 01/01/2023]
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266
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Suran D, Sinkovic A, Naji F. Tissue Doppler imaging is a sensitive echocardiographic technique to detect subclinical systolic and diastolic dysfunction of both ventricles in type 1 diabetes mellitus. BMC Cardiovasc Disord 2016; 16:72. [PMID: 27102111 PMCID: PMC4840968 DOI: 10.1186/s12872-016-0242-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 04/08/2016] [Indexed: 01/18/2023] Open
Abstract
Background Subclinical left (LV) and right ventricular (RV) dysfunction has been demonstrated in type 2 diabetes mellitus and evidence indicates impaired LV diastolic function in type 1 diabetes mellitus (T1DM) as well. The aim of our study was to evaluate the role of tissue Doppler imaging (TDI) in assessment of global LV and RV function in T1DM patients. Methods A detailed two-dimensional, pulsed wave Doppler and pulsed wave TDI analysis was performed in 53 normotensive middle-aged T1DM patients and compared to healthy controls. Results In T1DM patients TDI analysis revealed reduced mean mitral septal and lateral E’ velocities as well as reduced mean tricuspid E˙t velocity compared to healthy controls (E’sept 8.89 ± 1.89 cm/s vs. 11.50 ± 2.41 cm/s, p < 0.001; E’lat 12.29 ± 2.58 cm/s vs.15.30 ± 2.95 cm/s, p < 0,001; E’t 13.56 ± 2.91 cm/s vs. 15.60 ± 2.99 cm/s, p = 0.001). Mean ratios E/E’sept, E/E’lat and E/E’t were significantly higher in diabetics with cutoff value of 7.4 for E/E’sept and 3.4 for E/E’t, differentiating diabetics with LV and RV diastolic impairement from matched healthy controls (sensitivity 76.5 %, specificity 73.8 % for E/E’sept and sensitivity 72.1 %, specificity 66.7 % for E/E’t). Myocardial acceleration during isovolumetric contraction (IVA) measured at the septal mitral (LV IVA) and lateral tricuspid annulus (RV IVA) was the only parameter indicating reduced contractility of both ventricles in diabetics compared to controls (LV IVA 230.70 ± 61.26 cm/s2 vs. 283.32 ± 59.74 cm/s2, p < 0,001; RV IVA 275.48 ± 68.08 cm/s2 vs. 316.86 ± 80.95 cm/s2, p = 0.011). LV IVA had better diagnostic accuracy than RV IVA to predict early contractile impairement in T1DM patients (area under the curve 0.758, p < 0.001 for LV IVA and 0.648, p = 0.017 for RV IVA). Conclusions TDI is essential to detect subclinical diastolic deterioration of both ventricles in T1DM patients. TDI-derived IVA might be useful to assess early systolic alterations of both ventricles in T1DM patients.
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Affiliation(s)
- David Suran
- Department of Cardiology and Angiology, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia.
| | - Andreja Sinkovic
- Department of Medical Intensive Care, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia
| | - Franjo Naji
- Department of Cardiology and Angiology, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia
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Hou J, Zheng D, Fung G, Deng H, Chen L, Liang J, Jiang Y, Hu Y. Mangiferin suppressed advanced glycation end products (AGEs) through NF-κB deactivation and displayed anti-inflammatory effects in streptozotocin and high fat diet-diabetic cardiomyopathy rats. Can J Physiol Pharmacol 2016; 94:332-40. [PMID: 26751764 DOI: 10.1139/cjpp-2015-0073] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Given the importance of the aggregation of advanced glycation end products (AGEs) and cardiac inflammation in the onset and progression of diabetic cardiomyopathy (DCM), our objective in this study was to demonstrate the cardioprotective effect of mangiferin, an antidiabetic and anti-inflammatory agent, on diabetic rat model. The DCM model was established by a high-fat diet and a low dose of streptozotocin. DCM rats were treated orally with mangiferin (20 mg/kg) for 16 weeks. Serum and left ventricular myocardium were collected for determination of inflammatory cytokines. AGEs mRNA and protein expression of nuclear factor kappa B (NF-κB) and receptor for AGEs (RAGE) in myocardium were assayed by real-time PCR and Western blot. ROS levels were measured by dihydroethidium fluorescence staining. NF-κB binding activity was assayed by TransAM NF-κB p65 ELISA kit. Chronic treatment with mangiferin decreased the levels of myocardial enzymes (CK-MB, LDH) and inflammatory mediators (TNF-α, IL-1β). Meanwhile, NF-κB is inhibited by the reduction of nuclear translocation of p65 subunit, and mangiferin reduced AGE production and decreased the mRNA and protein expression of RAGE in DCM rats. Our data indicated that mangiferin could significantly ameliorate DCM by preventing the release of inflammatory cytokines, and inhibiting ROS accumulation, AGE/RAGE production, and NF-κB nuclear translocation, suggesting that mangiferin treatment might be beneficial in DCM.
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Affiliation(s)
- Jun Hou
- Department of Pharmacy, Chengdu Military General Hospital, Chengdu, China
- Centre for Heart Lung Innovation, St. Paul’s Hospital, Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Dezhi Zheng
- Department of Cardiovascular Surgery, Jinan Military General Hospital, Jinan, China
| | - Gabriel Fung
- Centre for Heart Lung Innovation, St. Paul’s Hospital, Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Haoyu Deng
- Centre for Heart Lung Innovation, St. Paul’s Hospital, Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Lin Chen
- Department of Cardiovascular Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Jiali Liang
- Department of Cardiovascular Surgery, Jinan Military General Hospital, Jinan, China
| | - Yan Jiang
- Department of Pharmacy, Chengdu Military General Hospital, Chengdu, China
| | - Yonghe Hu
- Department of Traditional Chinese Medicine, Chengdu Military General Hospital, Chengdu, China
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268
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Joubert M, Bellevre D, Legallois D, Elie N, Coulbault L, Allouche S, Manrique A. Hyperglycemia-Induced Hypovolemia Is Involved in Early Cardiac Magnetic Resonance Alterations in Streptozotocin-Induced Diabetic Mice: A Comparison with Furosemide-Induced Hypovolemia. PLoS One 2016; 11:e0149808. [PMID: 26901278 PMCID: PMC4763166 DOI: 10.1371/journal.pone.0149808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 02/04/2016] [Indexed: 12/18/2022] Open
Abstract
Aims The aim of the study was to assess the early features of diabetic cardiomyopathy using cardiac magnetic resonance within the first week after streptozotocin injection in mice. We focused on the relationship between left ventricular function and hypovolemia markers in diabetic animals compared to a hypovolemic rodent model. Methods and Results Swiss mice were randomized into control (group C), streptozotocin-induced diabetes (group D) and furosemide-induced hypovolemia (group F) groups. Cardiac magnetic resonance, non-invasive blood pressure, urine volume, plasma markers of dehydration and cardiac histology were assessed in all groups. Mean blood glucose was higher in diabetic animals than in groups C and F (30.5±5.8 compared to 10.4±2.1 and 11.1±2.8 mmol/L, respectively; p<0.01). Diuresis was increased in animals from group D and F compared to C (14650±11499 and 1533±540 compared to 192±111 μL/24 h; p<0.05). End diastolic and end systolic volumes were lower in group D than in group C at week 1 (1.52±0.36 vs. 1.93±0.35 and 0.54±0.22 vs. 0.75±0.18 mL/kg, p<0.05). These left ventricular volume values in group D were comparable to those observed in the acute hypovolemia model (group F). Increased dehydration plasma markers and an absence of obvious intrinsic myocardial damage (evaluated by cardiac magnetic resonance and histology) suggest that a hemodynamic mechanism underlies the very early drop in left ventricular volumes in group D and provides a potential link to hyperglycemic osmotic diuresis. Conclusions Researchers using cardiac magnetic resonance in hyperglycemic rodent models should be aware of this hemodynamic mechanism, which may partially explain modifications in cardiac parameters in addition to diabetic myocardial damage.
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Affiliation(s)
- Michael Joubert
- Diabetes care unit, Caen University Hospital, Caen, France
- EA4650 Université Caen Normandie, GIP Cyceron, Caen, France
- * E-mail:
| | - Dimitri Bellevre
- Nuclear Medicine department, Caen University Hospital, Caen, France
- EA4650 Université Caen Normandie, GIP Cyceron, Caen, France
| | - Damien Legallois
- Cardiology unit, Caen University Hospital, Caen, France
- EA4650 Université Caen Normandie, GIP Cyceron, Caen, France
| | - Nicolas Elie
- CMABIO-HIQ facility, SF4206 ICORE, IBFA, Université Caen Normandie, Caen, France
| | - Laurent Coulbault
- Biochemical unit, Caen University Hospital, Caen, France
- EA4650 Université Caen Normandie, GIP Cyceron, Caen, France
| | - Stéphane Allouche
- Biochemical unit, Caen University Hospital, Caen, France
- EA4650 Université Caen Normandie, GIP Cyceron, Caen, France
| | - Alain Manrique
- Nuclear Medicine department, Caen University Hospital, Caen, France
- EA4650 Université Caen Normandie, GIP Cyceron, Caen, France
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269
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Zhao YZ, Zhang M, Tian XQ, Zheng L, Lu CT. Using basic fibroblast growth factor nanoliposome combined with ultrasound-introduced technology to early intervene the diabetic cardiomyopathy. Int J Nanomedicine 2016; 11:675-86. [PMID: 26937188 PMCID: PMC4762584 DOI: 10.2147/ijn.s99376] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Basic fibroblast growth factor (bFGF)-loaded liposome (bFGF-lip) combined with ultrasound-targeted microbubble destruction (UTMD) technique was investigated to prevent diabetic cardiomyopathy (DCM). Cardiac function and myocardial ultrastructure were assessed. Terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end labeling (TUNEL) staining, immunohistochemistry staining, and Western blot assay were used to investigate the signal pathway underlying the expression of bFGF in DCM treatment. From Mason staining and TUNEL staining, bFGF-lip + UTMD group showed significant differences from the diabetes group and other groups treated with bFGF or bFGF-lip. The diabetes group showed similar results (myocardial capillary density, collagen volume fraction, and cardiac myocyte apoptosis index) to other bFGF treatment groups. Indexes from transthoracic echocardiography and hemodynamic evaluation also proved the same conclusion. These results confirmed that the abnormalities including diastolic dysfunctions, myocardial fibrosis, and metabolic disturbances could be suppressed by the different extents of twice-weekly bFGF treatments for 12 consecutive weeks (free bFGF or bFGF-lip +/− UTMD), with the strongest improvements observed in the bFGF-lip + UTMD group. The group combining bFGF-lip with UTMD demonstrated the highest level of bFGF expression among all the groups. The bFGF activated the PI3K/AKT signal pathway, causing the reduction of myocardial cell apoptosis and increase of microvascular density. This strategy using bFGF-lip and UTMD is a potential strategy in early intervention of DCM in diabetes.
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Affiliation(s)
- Ying-Zheng Zhao
- College of Pharmaceutical Sciences, Wenzhou Medical University, Zhejiang, People's Republic of China; Department of Ultrasonography, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Ming Zhang
- College of Pharmaceutical Sciences, Wenzhou Medical University, Zhejiang, People's Republic of China
| | - Xin-Qiao Tian
- Department of Ultrasonic Diagnosis, Henan Provincial People's Hospital, Zhengzhou City, Henan, People's Republic of China
| | - Lei Zheng
- Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Cui-Tao Lu
- College of Pharmaceutical Sciences, Wenzhou Medical University, Zhejiang, People's Republic of China; Department of Ultrasonography, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
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270
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Yu H, Zhen J, Yang Y, Gu J, Wu S, Liu Q. Ginsenoside Rg1 ameliorates diabetic cardiomyopathy by inhibiting endoplasmic reticulum stress-induced apoptosis in a streptozotocin-induced diabetes rat model. J Cell Mol Med 2016; 20:623-31. [PMID: 26869403 PMCID: PMC5125941 DOI: 10.1111/jcmm.12739] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 10/18/2015] [Indexed: 12/21/2022] Open
Abstract
Ginsenoside Rg1 has been demonstrated to have cardiovascular protective effects. However, whether the cardioprotective effects of ginsenoside Rg1 are mediated by endoplasmic reticulum (ER) stress‐induced apoptosis remain unclear. In this study, among 80 male Wistar rats, 15 rats were randomly selected as controls; the remaining 65 rats received a diet rich in fat and sugar content for 4 weeks, followed by intraperitoneal injection of streptozotocin (STZ, 40 mg/kg) to establish a diabetes model. Seven days after STZ injection, 10 rats were randomly selected as diabetic model (DM) controls, 45 eligible diabetic rats were randomized to three treatment groups and administered ginsenoside Rg1 in a dosage of 10, 15 or 20 mg/kg/day, respectively. After 12 weeks of treatment, rats were killed and serum samples obtained to determine cardiac troponin (cTn)‐I. Myocardial tissues were harvested for morphological analysis to detect myocardial cell apoptosis, and to analyse protein expression of glucose‐regulated protein 78 (GRP78), C/EBP homologous protein (CHOP), and Caspase‐12. Treatment with ginsenoside Rg1 (10–20 mg/kg) significantly reduced serum cTnI levels compared with DM control group (all P < 0.01). Ginsenoside Rg1 (15 and 20 mg/kg) significantly reduced the percentage of apoptotic myocardial cells and improved the parameters of cardiac function. Haematoxylin and eosin and Masson staining indicated that ginsenoside Rg1 could attenuate myocardial lesions and myocardial collagen volume fraction. Additionally, ginsenoside Rg1 significantly reduced GRP78, CHOP, and cleaved Caspase‐12 protein expression in a dose‐dependent manner. These findings suggest that ginsenoside Rg1 appeared to ameliorate diabetic cardiomyopathy by inhibiting ER stress‐induced apoptosis in diabetic rats.
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Affiliation(s)
- Haitao Yu
- Cardiology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Juan Zhen
- Cardiology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yang Yang
- Cardiology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Jinning Gu
- Cardiology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Suisheng Wu
- Cardiology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Quan Liu
- Cardiology, The First Hospital of Jilin University, Changchun, Jilin, China
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271
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Raut SK, Kumar A, Singh GB, Nahar U, Sharma V, Mittal A, Sharma R, Khullar M. miR-30c Mediates Upregulation of Cdc42 and Pak1 in Diabetic Cardiomyopathy. Cardiovasc Ther 2016; 33:89-97. [PMID: 25781190 DOI: 10.1111/1755-5922.12113] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
AIM Cardiac hypertrophy and myocardial fibrosis significantly contribute to the pathogenesis of diabetic cardiomyopathy (DCM). Altered expression of several genes and their regulation by microRNAs has been reported in hypertrophied failing hearts. This study aims to examine the role of Cdc42, Pak1, and miR-30c in the pathogenesis of cardiac hypertrophy in DCM. METHODS DCM was induced in Wistar rats by low-dose streptozotocin-high-fat diet for 12 weeks. Cardiac expression of Cdc42, Pak1 and miR-30c, and hypertrophy markers (ANP and β-MHC) was studied in DCM vs control rats and in high-glucose (HG)-treated H9c2 cardiomyocytes. RESULTS Diabetic rats showed cardiomyocyte hypertrophy, increased heart-to-body weight ratio, and an increased expression of ANP and β-MHC. Cardiac expression of Cdc42 and Pak1 genes was increased in diabetic hearts and in HG-treated cardiomyocytes. miR-30c was identified to target Cdc42 and Pak1 genes, and cardiac miR-30c expression was found to be decreased in DCM rats, patients with DCM, and in HG-treated cardiomyocytes. miR-30c overexpression decreased Cdc42 and Pak1 genes and attenuated HG-induced cardiomyocyte hypertrophy, whereas miR-30c inhibition increased Cdc42 and Pak1 gene expression and myocyte hypertrophy in HG-treated cardiomyocytes. CONCLUSION Downregulation of miR-30c mediates prohypertrophic effects of hyperglycemia in DCM by upregulation of Cdc42 and Pak1 genes.
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Affiliation(s)
- Satish K Raut
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Akhilesh Kumar
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Gurinder B Singh
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma Nahar
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vibhuti Sharma
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anupam Mittal
- Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajni Sharma
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Madhu Khullar
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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272
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Lejay A, Fang F, John R, Van JA, Barr M, Thaveau F, Chakfe N, Geny B, Scholey JW. Ischemia reperfusion injury, ischemic conditioning and diabetes mellitus. J Mol Cell Cardiol 2016; 91:11-22. [DOI: 10.1016/j.yjmcc.2015.12.020] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 11/15/2015] [Accepted: 12/20/2015] [Indexed: 01/08/2023]
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273
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Zhao YZ, Zhang M, Wong HL, Tian XQ, Zheng L, Yu XC, Tian FR, Mao KL, Fan ZL, Chen PP, Li XK, Lu CT. Prevent diabetic cardiomyopathy in diabetic rats by combined therapy of aFGF-loaded nanoparticles and ultrasound-targeted microbubble destruction technique. J Control Release 2016; 223:11-21. [DOI: 10.1016/j.jconrel.2015.12.030] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 12/10/2015] [Accepted: 12/16/2015] [Indexed: 01/01/2023]
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274
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Caporali A, Miscianinov V, Saif J, Emanueli C. MicroRNA transport in cardiovascular complication of diabetes. Biochim Biophys Acta Mol Cell Biol Lipids 2016; 1861:2111-2120. [PMID: 26806392 DOI: 10.1016/j.bbalip.2016.01.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 01/17/2016] [Accepted: 01/18/2016] [Indexed: 12/20/2022]
Abstract
MicroRNAs (miRNAs) are post-transcriptional inhibitory regulators of gene expression by binding to complementary messenger RNA (mRNA) transcripts. Extracellular miRNAs are transported by membrane-derived vesicles (exosomes and microparticles), lipoproteins, and other ribonucleoprotein complexes. Extracellular microRNAs are emerging as important mediators of intercellular communications, being involved in the transmission of biological signals between cells. Several miRNAs have been identified as having a primary impact on many biological processes that are of direct relevance to cardiovascular complications of diabetes. Whether the extracellular miRNAs are directly involved in the regulation of these processes is yet to be established. Here, we review recent progresses in extracellular miRNA biology and the role of extracellular miRNA in diabetes induced cardiovascular disease, describing the regulators affecting miRNA transport and the mechanisms for different miRNA transporters. In addition, we discuss the advancement of the research in this field and identify the associated challenges. This article is part of a Special Issue entitled: MicroRNAs and lipid/energy metabolism and related diseases edited by Carlos Fernández-Hernando and Yajaira Suárez.
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Affiliation(s)
- Andrea Caporali
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Vladislav Miscianinov
- University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Jaimy Saif
- Bristol Heart Institute, University of Bristol, Bristol, UK
| | - Costanza Emanueli
- Bristol Heart Institute, University of Bristol, Bristol, UK; National Heart Lung Institute, Imperial College London, London, UK.
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275
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León LE, Rani S, Fernandez M, Larico M, Calligaris SD. Subclinical Detection of Diabetic Cardiomyopathy with MicroRNAs: Challenges and Perspectives. J Diabetes Res 2016; 2016:6143129. [PMID: 26770988 PMCID: PMC4684873 DOI: 10.1155/2016/6143129] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 07/17/2015] [Accepted: 07/26/2015] [Indexed: 02/08/2023] Open
Abstract
The prevalence of cardiac diabetic diseases has been increased around the world, being the most common cause of death and disability among diabetic patients. In particular, diabetic cardiomyopathy is characterized with a diastolic dysfunction and cardiac remodelling without signs of hypertension and coronary artery diseases. In an early stage, it is an asymptomatic disease; however, clinical studies demonstrate that diabetic myocardia are more vulnerable to injury derived by acute myocardial infarct and are the worst prognosis for rehabilitation. Currently, biochemical and imaging diagnostic methods are unable to detect subclinical manifestation of the disease (prior to diastolic dysfunction). In this review, we elaborately discuss the current scientific evidences to propose circulating microRNAs as promising biomarkers for early detection of diabetic cardiomyopathy and, then, to identify patients at high risk of diabetic cardiomyopathy development. Moreover, here we summarise the research strategies to identify miRNAs as potential biomarkers, present limitations, challenges, and future perspectives.
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Affiliation(s)
- Luis E. León
- Centro de Genética y Genómica, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, 7710162 Santiago, Chile
| | - Sweta Rani
- Regenerative Medicine Institute (REMEDI), National University of Ireland, Galway, Ireland
| | | | | | - Sebastián D. Calligaris
- Centro de Medicina Regenerativa, Facultad de Medicina, Clínica Alemana-Universidad del Desarrollo, 7710162 Santiago, Chile
- *Sebastián D. Calligaris:
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276
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Shaver A, Nichols A, Thompson E, Mallick A, Payne K, Jones C, Manne NDPK, Sundaram S, Shapiro JI, Sodhi K. Role of Serum Biomarkers in Early Detection of Diabetic Cardiomyopathy in the West Virginian Population. Int J Med Sci 2016; 13:161-8. [PMID: 26941576 PMCID: PMC4773280 DOI: 10.7150/ijms.14141] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 01/04/2016] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Diabetic cardiomyopathy (DCM) is an established complication of diabetes mellitus. In West Virginia, the especially high incidence of diabetes and heart failure validate the necessity of developing new strategies for earlier detection of DCM. Since most DCM patients remain asymptomatic until the later stages of the disease when the fibrotic complications become irreversible, we aimed to explore biomarkers that can identify early-stage DCM. METHODS The patients were grouped into 4 categories based on clinical diabetic and cardiac parameters: Control, Diabetes (DM), Diastolic dysfunction (DD), and Diabetes with diastolic dysfunction (DM+DD), the last group being the preclinical DCM group. RESULTS Echocardiography images indicated severe diastolic dysfunction in patients with DD+DM and DD compared to DM or control patients. In the DM and DM+DD groups, TNFα, isoprostane, and leptin were elevated compared to control (p<0.05), as were clinical markers HDL, glucose and hemoglobin A1C. Fibrotic markers IGFBP7 and TGF-β followed the same trend. The Control group showed higher beneficial levels of adiponectin and bilirubin, which were reduced in the DM and DM+DD groups (p<0.05). CONCLUSION The results from our study support the clinical application of biomarkers in diagnosing early stage DCM, which will enable attenuation of disease progression prior to the onset of irreversible complications.
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Affiliation(s)
- Adam Shaver
- 1. Department of Medicine Joan C. Edwards School of Medicine, Marshall University
| | - Alexandra Nichols
- 1. Department of Medicine Joan C. Edwards School of Medicine, Marshall University
| | | | - Amrita Mallick
- 1. Department of Medicine Joan C. Edwards School of Medicine, Marshall University
| | - Kristen Payne
- 1. Department of Medicine Joan C. Edwards School of Medicine, Marshall University
| | - Chris Jones
- 2. Department of Cardiology, Marshall University
| | | | - Shanmuga Sundaram
- 1. Department of Medicine Joan C. Edwards School of Medicine, Marshall University
| | - Joseph I Shapiro
- 1. Department of Medicine Joan C. Edwards School of Medicine, Marshall University
| | - Komal Sodhi
- 4. Department of Surgery and Pharmacology, Marshall University, USA
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277
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Hensel KO, Grimmer F, Roskopf M, Jenke AC, Wirth S, Heusch A. Subclinical Alterations of Cardiac Mechanics Present Early in the Course of Pediatric Type 1 Diabetes Mellitus: A Prospective Blinded Speckle Tracking Stress Echocardiography Study. J Diabetes Res 2016; 2016:2583747. [PMID: 26839891 PMCID: PMC4709644 DOI: 10.1155/2016/2583747] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 10/21/2015] [Accepted: 10/27/2015] [Indexed: 01/14/2023] Open
Abstract
Diabetic cardiomyopathy substantially accounts for mortality in diabetes mellitus. The pathophysiological mechanism underlying diabetes-associated nonischemic heart failure is poorly understood and clinical data on myocardial mechanics in early stages of diabetes are lacking. In this study we utilize speckle tracking echocardiography combined with physical stress testing in order to evaluate whether left ventricular (LV) myocardial performance is altered early in the course of uncomplicated type 1 diabetes mellitus (T1DM). 40 consecutive asymptomatic normotensive children and adolescents with T1DM (mean age 11.5 ± 3.1 years and mean disease duration 4.3 ± 3.5 years) and 44 age- and gender-matched healthy controls were assessed using conventional and quantitative echocardiography (strain and strain rate) during bicycle ergometer stress testing. Strikingly, T1DM patients had increased LV longitudinal (p = 0.019) and circumferential (p = 0.016) strain rate both at rest and during exercise (p = 0.021). This was more pronounced in T1DM patients with a longer disease duration (p = 0.038). T1DM patients with serum HbA1c > 9% showed impaired longitudinal (p = 0.008) and circumferential strain (p = 0.005) and a reduced E/A-ratio (p = 0.018). In conclusion, asymptomatic T1DM patients have signs of hyperdynamic LV contractility early in the course of the disease. Moreover, poor glycemic control is associated with early subclinical LV systolic and diastolic impairment.
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Affiliation(s)
- Kai O. Hensel
- Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany
- *Kai O. Hensel:
| | - Franziska Grimmer
- Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany
| | - Markus Roskopf
- Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany
| | - Andreas C. Jenke
- Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany
| | - Stefan Wirth
- Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany
| | - Andreas Heusch
- Department of Pediatrics, HELIOS Medical Center Wuppertal, Centre for Clinical & Translational Research (CCTR), Centre for Biomedical Education & Research (ZBAF), Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany
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278
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Bando YK, Murohara T. Heart Failure as a Comorbidity of Diabetes: Role of Dipeptidyl Peptidase 4. J Atheroscler Thromb 2015; 23:147-54. [PMID: 26607352 DOI: 10.5551/jat.33225] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Heart failure is a primary cause of death worldwide, and it is notable that heart failure patients exhibit a high incidence of diabetes. On the other hand, comorbid diabetes significantly worsens the prognosis of heart failure, even independently of complicated coronary artery disease.To date, heart failure caused by diabetes has been designated as "diabetic cardiomyopathy (DMC)," and a recent cohort study of the large-scale (1.9 million people) research platform of linked electronic medical records in UK (CALIBER registry) demonstrated that heart failure and peripheral arterial disease are the most common initial manifestations of cardiovascular disease in type 2 diabetes. The underlying pathophysiology has been characterized as microvasculopathy, myocardial hypertrophy, and cardiac fibrosis; however, these evidences are mostly obtained under a preclinical setting, and its clinical application on DMC in terms of its diagnosis and therapeutic intervention yet has reached practical. Our group has focused on and clarified the molecular mechanisms underlying DMC both in preclinical and clinical settings and has found the primary role of "dipeptidyl peptidase-4 (DPP4)" in the pathogenesis of diabetic microvasculopathy in the heart. Moreover, there are evidences implicating the potent role of circulating DPP4 activity in the diagnosis of diastolic heart failure. The present review aimed to review the current comprehension regarding diabetes and heart failure and discuss the therapeutic and diagnostic roles of DPP4.
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Affiliation(s)
- Yasuko K Bando
- Department of Cardiology, Nagoya University Graduate School of Medicine
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279
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Diop SB, Bodmer R. Gaining Insights into Diabetic Cardiomyopathy from Drosophila. Trends Endocrinol Metab 2015; 26:618-627. [PMID: 26482877 PMCID: PMC4638170 DOI: 10.1016/j.tem.2015.09.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 09/27/2015] [Accepted: 09/28/2015] [Indexed: 12/21/2022]
Abstract
The high degree of genetic conservation between Drosophila melanogaster and mammals has helped to translate many important findings into new knowledge, and has led to better understanding of many biological processes in vertebrates. For over a century, the Drosophila model has been used in studies aimed at understanding the molecular mechanisms implicated in heredity, development, disease progression, and aging. The current epidemic of obesity and associated diabetic cardiomyopathy and heart failure has led to a shift in Drosophila research towards understanding the basic mechanisms leading to metabolic syndrome and associated cardiac risk factors. We discuss recent findings in Drosophila that highlight the importance of this organism as an excellent model for studying the effects of metabolic imbalance on cardiac function.
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Affiliation(s)
- Soda Balla Diop
- Development, Aging, and Regeneration Program, Sanford Burnham Prebys Medical Dicovery Institute, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA.
| | - Rolf Bodmer
- Development, Aging, and Regeneration Program, Sanford Burnham Prebys Medical Dicovery Institute, 10901 North Torrey Pines Road, La Jolla, CA 92037, USA.
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280
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Jani Y, Kamberi A, Xhunga S, Pocesta B, Ferati F, Lala D, Zeqiri A, Rexhepi A. The influence of type 2 diabetes and gender on ventricular repolarization dispersion in patients with sub-clinic left ventricular diastolic dysfunction. AMERICAN JOURNAL OF CARDIOVASCULAR DISEASE 2015; 5:155-66. [PMID: 26550530 PMCID: PMC4620119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 09/02/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To assess the influence of type 2 DM and gender, on the QT dispersion, Tpeak-Tend dispersion of ventricular repolarization, in patients with sub-clinic left ventricular diastolic dysfunction of the heart. BACKGROUND QT dispersion, that reflects spatial inhomogeneity in ventricular repolarization, Tpeak-Tend dispersion, this on the other hand reflects transmural inhomogeneity in ventricular repolarization, that is increased in an early stage of cardiomyopathy, and in patients with left ventricular diastolic dysfunction, as well. The left ventricular diastolic dysfunction, a basic characteristic of diabetic heart disease (diabetic cardiomyopathy), that developes earlier than systolic dysfunction, suggests that diastolic markers might be sensitive for early cardiac injury. It is also demonstrated that gender has complex influence on indices of myocardial repolarization abnormalities such as QT interval and QT dispersion. MATERIAL AND METHODS We performed an observational study including 300 diabetic patients with similar epidemiological-demographic characteristics recruited in our institution from May 2009 to July 2014, divided into two groups. Demographic and laboratory echocardiographic data were obtained, twelve lead resting electrocardiography, QT, QTc, Tpeak-Tend-intervals and dispersion, were determined manually, and were compared between various groups. For statistical analysis a t-test, X(2) test, and logistic regression are used according to the type of variables. A p value <0.05 was considered statistically significant for a confidence interval of 95%. RESULTS QTc max. interval, QTc dispersion and Tpeak-Tend dispersion, were significantly higher in diabetic group with subclinical LV (left ventricular) diastolic dysfunction, than in diabetic group with normal left ventricular diastolic function (445.24±14.7 ms vs. 433.55±14.4 ms, P<0.000; 44.98±18.78 ms vs. 32.05±17.9 ms, P<0.000; 32.60±1.6 ms vs. 17.46±2.0 ms, P<0.02. Prolonged QTc max. interval was found in 33% of patients, indiabetic group with subclinical left ventricular diastolic dysfunction vs. 13.3% of patients in diabetic group with normal left ventricular diastolic function, (Chi-square: 16.77, P<0.0001). A prolonged QTc dispersion, was found in 40.6% of patients, in diabetic group with subclinical left ventricular diastolic dysfunction vs. 20% of patients in diabetic group with normal left ventricular diastolic function Chi-square: 14.11, P<0.0002). A prolonged dispersion of Tpeak-Tend interval was found in 24% of patients in diabetic group with subclinical left ventricular diastolic dysfunction vs. 13.3% of patients in diabetic group with normal left ventricular diastolic function (Chi-square: 12.00, P<0.005). Females in diabetic group with subclinical left ventricular diastolic dysfunction in comparison with males in diabetic group with subclinical left ventricular diastolic dysfunction, have a significantly prolonged: mean QTc max. interval (23.3% vs. 10%, Chisquare: 12.0, P<0.005), mean QTc dispersion (27.3% vs. 13.3%, Chi-square: 10.24, P<0.001), mean Tpeak-Tend interval (10% vs. 3.3%, Chi-square: 5.77, P<0.01), mean Tpek-Tend dispersion (16.6% vs. 6.6%, Chi-square: 8.39, P<0.003). CONCLUSION The present study has shown that influences of type 2 diabetes and gender in diabetics with sub-clinical left-ventricular diastolic dysfunction are reflected in a set of electrophysiological parameters that indicate a prolonged and more heterogeneous repolarization than in diabetic patients with normal diastolic function. In addition, it demonstrates that there exist differences between diabetic females with sub-clinic LV dysfunction and those with diabetes and normal LV function in the prevalence of increased set of electrophysiological parameters that indicate a prolonged and more heterogeneous repolarization.
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Affiliation(s)
- Ylber Jani
- Private Health Institute “Heart Diagnostica”Debar, Republic of Macedonia
| | - Ahmet Kamberi
- Department of Cardiology Faculty of Medicine, “Mother Teresa” UniversityTirana, Republic of Albania
| | - Sotir Xhunga
- Department of Cardiology Medical CenterDures, Republic of Albania
| | - Bekim Pocesta
- Department of Cardiology Faculty of Medicine, “Ss Kiril and Metodij” UniversitySkopje, Republic of Macedonia
| | - Fatmir Ferati
- Department of Internal Medicine Faculty of MedicineTetovo, Republic of Macedonia
| | - Dali Lala
- Private Health Institute of Family Medicine “Florenc”Tetovo, Republic of Macedonija
| | - Agim Zeqiri
- Department of Internal Medicine, General Hospital “DR Ferit Murat”Gostivar, Republic of Macedonia
| | - Atila Rexhepi
- Department of Internal Medicine Faculty of MedicineTetovo, Republic of Macedonia
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281
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Mokhtari B, Badalzadeh R, Alihemmati A, Mohammadi M. Phosphorylation of GSK-3β and reduction of apoptosis as targets of troxerutin effect on reperfusion injury of diabetic myocardium. Eur J Pharmacol 2015; 765:316-21. [DOI: 10.1016/j.ejphar.2015.08.056] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 08/28/2015] [Accepted: 08/28/2015] [Indexed: 02/02/2023]
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282
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Capobianco E, Pelesson M, Careaga V, Fornes D, Canosa I, Higa R, Maier M, Jawerbaum A. Intrauterine programming of lipid metabolic alterations in the heart of the offspring of diabetic rats is prevented by maternal diets enriched in olive oil. Mol Nutr Food Res 2015; 59:1997-2007. [DOI: 10.1002/mnfr.201500334] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/05/2015] [Accepted: 07/07/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Evangelina Capobianco
- Laboratory of Reproduction and Metabolism; CEFYBO-CONICET, School of Medicine; University of Buenos Aires; Buenos Aires Argentina
| | - Magalí Pelesson
- Laboratory of Reproduction and Metabolism; CEFYBO-CONICET, School of Medicine; University of Buenos Aires; Buenos Aires Argentina
| | - Valeria Careaga
- UMYMFOR (CONICET-UBA); Department of Organic Chemistry; School of Exact and Natural Sciences; University of Buenos Aires; Buenos Aires Argentina
| | - Daiana Fornes
- Laboratory of Reproduction and Metabolism; CEFYBO-CONICET, School of Medicine; University of Buenos Aires; Buenos Aires Argentina
| | - Ivana Canosa
- UMYMFOR (CONICET-UBA); Department of Organic Chemistry; School of Exact and Natural Sciences; University of Buenos Aires; Buenos Aires Argentina
| | - Romina Higa
- Laboratory of Reproduction and Metabolism; CEFYBO-CONICET, School of Medicine; University of Buenos Aires; Buenos Aires Argentina
| | - Marta Maier
- UMYMFOR (CONICET-UBA); Department of Organic Chemistry; School of Exact and Natural Sciences; University of Buenos Aires; Buenos Aires Argentina
| | - Alicia Jawerbaum
- Laboratory of Reproduction and Metabolism; CEFYBO-CONICET, School of Medicine; University of Buenos Aires; Buenos Aires Argentina
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283
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McCormick LM, Heck PM, Ring LS, Kydd AC, Clarke SJ, Hoole SP, Dutka DP. Glucagon-like peptide-1 protects against ischemic left ventricular dysfunction during hyperglycemia in patients with coronary artery disease and type 2 diabetes mellitus. Cardiovasc Diabetol 2015; 14:102. [PMID: 26253538 PMCID: PMC4528379 DOI: 10.1186/s12933-015-0259-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 07/17/2015] [Indexed: 01/08/2023] Open
Abstract
Background Enhancement of myocardial
glucose uptake may reduce fatty acid oxidation and improve tolerance to ischemia. Hyperglycemia, in association with hyperinsulinemia, stimulates this metabolic change but may have deleterious effects on left ventricular (LV) function. The incretin hormone, glucagon-like peptide-1 (GLP-1), also has favorable cardiovascular effects, and has emerged as an alternative method of altering myocardial substrate utilization. In patients with coronary artery disease (CAD), we investigated: (1) the effect of a hyperinsulinemic hyperglycemic clamp (HHC) on myocardial performance during dobutamine stress echocardiography (DSE), and (2) whether an infusion of GLP-1(7-36) at the time of HHC protects against ischemic LV dysfunction during DSE in patients with type 2 diabetes mellitus (T2DM). Methods In study 1, twelve patients underwent two DSEs with tissue Doppler imaging (TDI)—one during the steady-state phase of a HHC. In study 2, ten patients with T2DM underwent two DSEs with TDI during the steady-state phase of a HHC. GLP-1(7-36) was infused intravenously at 1.2 pmol/kg/min during one of the scans. In both studies, global LV function was assessed by ejection fraction and mitral annular systolic velocity, and regional wall LV function was assessed using peak systolic velocity, strain and strain rate from 12 paired non-apical segments. Results In study 1, the HHC (compared with control) increased glucose (13.0 ± 1.9 versus 4.8 ± 0.5 mmol/l, p < 0.0001) and insulin (1,212 ± 514 versus 114 ± 47 pmol/l, p = 0.01) concentrations, and reduced FFA levels (249 ± 175 versus 1,001 ± 333 μmol/l, p < 0.0001), but had no net effect on either global or regional LV function. In study 2, GLP-1 enhanced both global (ejection fraction, 77.5 ± 5.0 versus 71.3 ± 4.3%, p = 0.004) and regional (peak systolic strain −18.1 ± 6.6 versus −15.5 ± 5.4%, p < 0.0001) myocardial performance at peak stress and at 30 min recovery. These effects were predominantly driven by a reduction in contractile dysfunction in regions subject to demand ischemia. Conclusions In patients with CAD, hyperinsulinemic hyperglycemia has a neutral effect on LV function during DSE. However, GLP-1 at the time of hyperglycemia improves myocardial tolerance to demand ischemia in patients with T2DM. Trial Registration: http://www.isrctn.org. Unique identifier ISRCTN69686930
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Affiliation(s)
- Liam M McCormick
- Department of Cardiovascular Medicine, University of Cambridge, Cambridge, UK.
| | - Patrick M Heck
- Department of Cardiovascular Medicine, University of Cambridge, Cambridge, UK.
| | - Liam S Ring
- Department of Cardiovascular Medicine, University of Cambridge, Cambridge, UK.
| | - Anna C Kydd
- Department of Cardiovascular Medicine, University of Cambridge, Cambridge, UK.
| | - Sophie J Clarke
- Department of Cardiovascular Medicine, University of Cambridge, Cambridge, UK.
| | - Stephen P Hoole
- Department of Cardiovascular Medicine, University of Cambridge, Cambridge, UK.
| | - David P Dutka
- Department of Cardiovascular Medicine, University of Cambridge, Cambridge, UK. .,Department of Cardiovascular Medicine, ACCI Level 6, Addenbrooke's Hospital, Box 110, Hills Rd, Cambridge, CB2 0QQ, UK.
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284
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Guimaraes JFC, Muzio BP, Rosa CM, Nascimento AF, Sugizaki MM, Fernandes AAH, Cicogna AC, Padovani CR, Okoshi MP, Okoshi K. Rutin administration attenuates myocardial dysfunction in diabetic rats. Cardiovasc Diabetol 2015; 14:90. [PMID: 26185015 PMCID: PMC4504040 DOI: 10.1186/s12933-015-0255-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 07/03/2015] [Indexed: 01/08/2023] Open
Abstract
Background Oxidative stress plays a major role in diabetic cardiomyopathy pathogenesis. Anti-oxidant therapy has been investigated in preventing or treating several diabetic complications. However, anti-oxidant action on diabetic-induced cardiac remodeling is not completely clear. This study evaluated the effects of rutin, a flavonoid, on cardiac and myocardial function in diabetic rats. Methods Wistar rats were assigned into control (C, n = 14); control-rutin (C-R, n = 14); diabetes mellitus (DM, n = 16); and DM-rutin (DM-R, n = 16) groups. Seven days after inducing diabetes (streptozotocin, 60 mg/kg, i.p.), rutin was injected intraperitoneally once a week (50 mg/kg) for 7 weeks. Echocardiogram was performed and myocardial function assessed in left ventricular (LV) papillary muscles. Serum insulin concentration was measured by ELISA. Statistics: One-way ANOVA and Tukey’s post hoc test. Results Glycemia was higher in DM than DM-R and C and in DM-R than C-R. Insulin concentration was lower in diabetic groups than controls (C 2.45 ± 0.67; C-R 2.09 ± 0.52; DM 0.59 ± 0.18; DM-R 0.82 ± 0.21 ng/mL). Echocardiogram showed no differences between C-R and C. DM had increased LV systolic diameter compared to C, and increased left atrium diameter/body weight (BW) ratio and LV mass/BW ratio compared to C and DM-R. Septal wall thickness, LV diastolic diameter/BW ratio, and relative wall thickness were lower in DM-R than DM. Fractional shortening and posterior wall shortening velocity were lower in DM than C and DM-R. In papillary muscle preparation, DM and DM-R presented higher time to peak tension and time from peak tension to 50% relaxation than controls; time to peak tension was lower in DM-R than DM. Under 0.625 and 1.25 mM extracellular calcium concentrations, DM had higher developed tension than C. Conclusion Rutin attenuates cardiac remodeling and left ventricular and myocardial dysfunction caused by streptozotocin-induced diabetes mellitus.
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Affiliation(s)
- Julliano F C Guimaraes
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil.
| | - Bruno P Muzio
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil.
| | - Camila M Rosa
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil.
| | - Andre F Nascimento
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil.
| | - Mario M Sugizaki
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil.
| | - Ana A H Fernandes
- Department of Chemistry and Biochemistry, Institute of Biosciences, Sao Paulo State University, UNESP, Botucatu, Brazil.
| | - Antonio C Cicogna
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil.
| | - Carlos R Padovani
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil.
| | - Marina P Okoshi
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil.
| | - Katashi Okoshi
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil. .,Departamento de Clinica Medica, Faculdade de Medicina de Botucatu, UNESP Rubiao Junior, S/N 18618-970, Botucatu, SP, Brazil.
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285
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Dexrazoxane protects breast cancer patients with diabetes from chemotherapy-induced cardiotoxicity. Am J Med Sci 2015; 349:406-12. [PMID: 25723884 DOI: 10.1097/maj.0000000000000432] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND To evaluate the cardioprotective effect of dexrazoxane (DEX) on chemotherapy in patients with breast cancer with concurrent type 2 diabetes mellitus (DM2). METHODS Eighty female patients with breast cancer with DM2 were randomly assigned to receive chemotherapy only or chemotherapy plus DEX. All patients received 80 mg/m epirubicin and 500 mg/m cyclophosphamide by intravenous infusion every 3 weeks for a total of 6 cycles. The group assigned to receive chemotherapy alone received placebo 30 minutes before epirubicin administration. The group assigned to receive chemotherapy plus DEX received 800 mg/m DEX 30 minutes before epirubicin administration. Cardiac function and hematology before and after 6 cycles of chemotherapy were analyzed. RESULTS There was no difference in baseline systole or diastole function between the 2 DM2 groups. Patients receiving chemotherapy alone experienced significantly greater reductions in Ea and significantly greater elevations in E/Ea and Tei index in comparison with patients receiving chemotherapy plus DEX. After chemotherapy, superoxide dismutase was significantly reduced, and serum malondialdehyde (MDA) was significantly increased in patients with DM2. Serum superoxide dismutase levels were comparable between the 2 groups before and after chemotherapy, MDA levels were comparable between the 2 groups before chemotherapy, whereas serum MDA was significantly higher after chemotherapy in the chemotherapy alone group in comparison with the group that received DEX. CONCULSIONS DEX protects against cardiotoxicity induced by chemotherapy in patients with breast cancer with concurrent DM2.
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286
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Jędrzejewska I, Król W, Światowiec A, Wilczewska A, Grzywanowska-Łaniewska I, Dłużniewski M, Braksator W. Left and right ventricular systolic function impairment in type 1 diabetic young adults assessed by 2D speckle tracking echocardiography. Eur Heart J Cardiovasc Imaging 2015; 17:438-46. [PMID: 26160403 DOI: 10.1093/ehjci/jev164] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 06/04/2015] [Indexed: 11/14/2022] Open
Abstract
AIMS Subclinical left ventricular (LV) and right ventricular (RV) systolic dysfunction has been proved in type 2 diabetes mellitus (DM). There is lack of uniform data on systolic myocardial function in type 1 DM. The aim of this study was to evaluate LV and RV function with 2D speckle tracking echocardiography (2D STE) in adult type 1 diabetic patients. METHODS AND RESULTS Totally, 50 patients with type 1 DM and 50 control subjects in the same range of age were prospectively evaluated. The 2D STE assessment of LV longitudinal, radial, circumferential strain and RV free-wall longitudinal strain was performed. In diabetic group, left ventricular global longitudinal strain (LVGLS), left ventricular global circumferential strain (LVGCS), left ventricular radial strain at basal level (LVRS-basal), and right ventricular free-wall global longitudinal strain (RVGLS) were significantly lower compared with the controls: LVGLS (-20.3 ± 2.0% vs. -22.2 ± 1.8%, P < 0.001), LVGCS (-21.1 ± 2.5% vs. -22.2 ± 2.4%, P < 0.05), LVRS-basal (50.5% ± 11.5 vs. 57.1% ±17.0, P < 0.05), and RVGLS (-30.1% ± 3.5 vs. -32.7% ± 3.9, P < 0.01). Multivariable logistic regression analysis showed that the only independent predictor of reduced LVGLS was low-density lipoprotein cholesterol [odds ratio 3.65 (95% confidence interval: 1.27-10.5), P = 0.014]. CONCLUSION Type 1 DM is associated with subclinical LV systolic dysfunction and worse RV systolic function, which can be detected with 2D STE.
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Affiliation(s)
- Ilona Jędrzejewska
- Department of Cardiology, Medical University of Warsaw, Brodnowski Hospital, ul. Kondratowicza 8, 03-242 Warsaw, Poland
| | - Wojciech Król
- Department of Cardiology, Medical University of Warsaw, Brodnowski Hospital, ul. Kondratowicza 8, 03-242 Warsaw, Poland
| | - Andrzej Światowiec
- Department of Cardiology, Medical University of Warsaw, Brodnowski Hospital, ul. Kondratowicza 8, 03-242 Warsaw, Poland
| | - Agnieszka Wilczewska
- Diabetes Outpatients Clinic, Medical University of Warsaw, Brodnowski Hospital, Warsaw, Poland
| | - Iwonna Grzywanowska-Łaniewska
- Department of Cardiology, Medical University of Warsaw, Brodnowski Hospital, ul. Kondratowicza 8, 03-242 Warsaw, Poland
| | - Mirosław Dłużniewski
- Department of Cardiology, Medical University of Warsaw, Brodnowski Hospital, ul. Kondratowicza 8, 03-242 Warsaw, Poland
| | - Wojciech Braksator
- Department of Cardiology, Medical University of Warsaw, Brodnowski Hospital, ul. Kondratowicza 8, 03-242 Warsaw, Poland
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287
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Murfitt L, Whiteley G, Iqbal MM, Kitmitto A. Targeting caveolin-3 for the treatment of diabetic cardiomyopathy. Pharmacol Ther 2015; 151:50-71. [PMID: 25779609 DOI: 10.1016/j.pharmthera.2015.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 03/09/2015] [Indexed: 12/21/2022]
Abstract
Diabetes is a global health problem with more than 550 million people predicted to be diabetic by 2030. A major complication of diabetes is cardiovascular disease, which accounts for over two-thirds of mortality and morbidity in diabetic patients. This increased risk has led to the definition of a diabetic cardiomyopathy phenotype characterised by early left ventricular dysfunction with normal ejection fraction. Here we review the aetiology of diabetic cardiomyopathy and explore the involvement of the protein caveolin-3 (Cav3). Cav3 forms part of a complex mechanism regulating insulin signalling and glucose uptake, processes that are impaired in diabetes. Further, Cav3 is key for stabilisation and trafficking of cardiac ion channels to the plasma membrane and so contributes to the cardiac action potential shape and duration. In addition, Cav3 has direct and indirect interactions with proteins involved in excitation-contraction coupling and so has the potential to influence cardiac contractility. Significantly, both impaired contractility and rhythm disturbances are hallmarks of diabetic cardiomyopathy. We review here how changes to Cav3 expression levels and altered relationships with interacting partners may be contributory factors to several of the pathological features identified in diabetic cardiomyopathy. Finally, the review concludes by considering ways in which levels of Cav3 may be manipulated in order to develop novel therapeutic approaches for treating diabetic cardiomyopathy.
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Affiliation(s)
- Lucy Murfitt
- Institute of Cardiovascular Sciences, Faculty of Medical and Human Sciences, University of Manchester, M13 9NT, UK
| | - Gareth Whiteley
- Institute of Cardiovascular Sciences, Faculty of Medical and Human Sciences, University of Manchester, M13 9NT, UK
| | - Mohammad M Iqbal
- Institute of Cardiovascular Sciences, Faculty of Medical and Human Sciences, University of Manchester, M13 9NT, UK
| | - Ashraf Kitmitto
- Institute of Cardiovascular Sciences, Faculty of Medical and Human Sciences, University of Manchester, M13 9NT, UK.
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288
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Abstract
Type 2 diabetes mellitus escalates the risk of heart failure partly via its ability to induce a cardiomyopathic state that is independent of coronary artery disease and hypertension. Although the pathogenesis of diabetic cardiomyopathy has yet to be fully elucidated, aberrations in cardiac substrate metabolism and energetics are thought to be key drivers. These aberrations include excessive fatty acid utilisation and storage, suppressed glucose oxidation and impaired mitochondrial oxidative phosphorylation. An appreciation of how these abnormalities arise and synergise to promote adverse cardiac remodelling is critical to their effective amelioration. This review focuses on disturbances in myocardial fuel (fatty acids and glucose) flux and energetics in type 2 diabetes, how these disturbances relate to the development of diabetic cardiomyopathy and the potential therapeutic agents that could be used to correct them.
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Affiliation(s)
- Nelson Amaral
- British Heart Foundation Centre of Excellence, Cardiovascular Division, King's College London, London, UK
| | - Darlington O Okonko
- British Heart Foundation Centre of Excellence, Cardiovascular Division, King's College London, London, UK
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289
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Barsanti C, Lenzarini F, Kusmic C. Diagnostic and prognostic utility of non-invasive imaging in diabetes management. World J Diabetes 2015; 6:792-806. [PMID: 26131322 PMCID: PMC4478576 DOI: 10.4239/wjd.v6.i6.792] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 12/23/2014] [Accepted: 04/14/2015] [Indexed: 02/05/2023] Open
Abstract
Medical imaging technologies are acquiring an increasing relevance to assist clinicians in diagnosis and to guide management and therapeutic treatment of patients, thanks to their non invasive and high resolution properties. Computed tomography, magnetic resonance imaging, and ultrasonography are the most used imaging modalities to provide detailed morphological reconstructions of tissues and organs. In addition, the use of contrast dyes or radionuclide-labeled tracers permits to get functional and quantitative information about tissue physiology and metabolism in normal and disease state. In recent years, the development of multimodal and hydrid imaging techniques is coming to be the new frontier of medical imaging for the possibility to overcome limitations of single modalities and to obtain physiological and pathophysiological measurements within an accurate anatomical framework. Moreover, the employment of molecular probes, such as ligands or antibodies, allows a selective in vivo targeting of biomolecules involved in specific cellular processes, so expanding the potentialities of imaging techniques for clinical and research applications. This review is aimed to give a survey of characteristics of main diagnostic non-invasive imaging techniques. Current clinical appliances and future perspectives of imaging in the diagnostic and prognostic assessment of diabetic complications affecting different organ systems will be particularly addressed.
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290
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Gürdal A, Kasikcioglu E, Yakal S, Bugra Z. Impact of diabetes and diastolic dysfunction on exercise capacity in normotensive patients without coronary artery disease. Diab Vasc Dis Res 2015; 12:181-8. [PMID: 25670849 DOI: 10.1177/1479164114565631] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The aim of this study was to determine the impact of diabetes and diastolic dysfunction on exercise capacity in asymptomatic, normotensive patients with type 2 diabetes without coronary artery disease. METHODS A total of 43 type 2 diabetes patients (age: 50 ± 5 years) and 20 healthy controls (age: 48 ± 4 years) were enrolled. Diastolic function was investigated by conventional pulsed-wave (PW) Doppler and tissue Doppler imaging (TDI). Exercise capacity was evaluated with cardiopulmonary exercise testing (CPET). RESULTS In patients with type 2 diabetes, increase in resting heart rate (HR-rest) (p = 0.013), decrease in maximum heart rate during exercise (HR-max) (p < 0.001) and exercise time (p < 0.001) compared with controls were significant. Patients had significantly increased minute ventilation volume (VE)/maximum carbon dioxide discharge (VCO2) ratio (p < 0.001), decreased maximum oxygen consumption (VO2-max) (p < 0.001), oxygen consumption at anaerobic threshold (VO2-an) (p < 0.001) and maximum carbon dioxide discharge (VCO2) (p < 0.001) compared to controls indicating significantly reduced exercise capacity. HbA1c was inversely correlated with VO2-max (r = -0.456, p < 0.01) independent of the absence or presence of mild diastolic dysfunction. CONCLUSION Exercise capacity was found to be significantly decreased in normotensive patients with type 2 diabetes without coronary artery disease, and this decrease was independent of diastolic dysfunction.
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Affiliation(s)
- Ahmet Gürdal
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erdem Kasikcioglu
- Department of Sports Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sertac Yakal
- Department of Sports Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zehra Bugra
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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291
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Badalzadeh R, Mokhtari B, Yavari R. Contribution of apoptosis in myocardial reperfusion injury and loss of cardioprotection in diabetes mellitus. J Physiol Sci 2015; 65:201-15. [PMID: 25726180 PMCID: PMC10717803 DOI: 10.1007/s12576-015-0365-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 02/11/2015] [Indexed: 12/21/2022]
Abstract
Ischemic heart disease is one of the major causes of death worldwide. Ischemia is a condition in which blood flow of the myocardium declines, leading to cardiomyocyte death. However, reperfusion of ischemic regions decreases the rate of mortality, but it can also cause later complications. In a clinical setting, ischemic heart disease is always coincident with other co-morbidities such as diabetes. The risk of heart disease increases 2-3 times in diabetic patients. Apoptosis is considered to be one of the main pathophysiological mechanisms of myocardial ischemia-reperfusion injury. Diabetes can disrupt the anti-apoptotic intracellular signaling cascades involved in myocardial protection. Therefore, targeting these changes may be an effective cardioprotective approach in the diabetic myocardium against ischemia-reperfusion injury. In this article, we review the interaction of diabetes with the pathophysiology of myocardial ischemia-reperfusion injury, focusing on the contribution of apoptosis in this context, and then discuss the alterations of pro-apoptotic or anti-apoptotic pathways probably responsible for the loss of cardioprotection in diabetes.
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Affiliation(s)
- Reza Badalzadeh
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Physiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behnaz Mokhtari
- Department of Physiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Raana Yavari
- Department of Physiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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292
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Yang JT, Qian LB, Zhang FJ, Wang J, Ai H, Tang LH, Wang HP. Cardioprotective Effects of Luteolin on Ischemia/Reperfusion Injury in Diabetic Rats Are Modulated by eNOS and the Mitochondrial Permeability Transition Pathway. J Cardiovasc Pharmacol 2015; 65:349-56. [PMID: 25502309 DOI: 10.1097/fjc.0000000000000202] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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293
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Liu X, Xu Q, Wang X, Zhao Z, Zhang L, Zhong L, Li L, Kang W, Zhang Y, Ge Z. Irbesartan ameliorates diabetic cardiomyopathy by regulating protein kinase D and ER stress activation in a type 2 diabetes rat model. Pharmacol Res 2015; 93:43-51. [DOI: 10.1016/j.phrs.2015.01.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 01/11/2015] [Accepted: 01/12/2015] [Indexed: 02/06/2023]
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294
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Parry HM, Deshmukh H, Levin D, Van Zuydam N, Elder DHJ, Morris AD, Struthers AD, Palmer CNA, Doney ASF, Lang CC. Both high and low HbA1c predict incident heart failure in type 2 diabetes mellitus. Circ Heart Fail 2015; 8:236-42. [PMID: 25561089 PMCID: PMC4366571 DOI: 10.1161/circheartfailure.113.000920] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus is an independent risk factor for heart failure development, but the relationship between incident heart failure and antecedent glycemia has not been evaluated. METHODS AND RESULTS The Genetics of Diabetes Audit and Research in Tayside Study study holds data for 8683 individuals with type 2 diabetes mellitus. Dispensed prescribing, hospital admission data, and echocardiography reports were linked to extract incident heart failure cases from December 1998 to August 2011. All available HbA1c measures until heart failure development or end of study were used to model HbA1c time-dependently. Individuals were observed from study enrolment until heart failure development or end of study. Proportional hazard regression calculated heart failure development risk associated with specific HbA1c ranges accounting for comorbidities associated with heart failure, including blood pressure, body mass index, and coronary artery disease. Seven hundred and one individuals with type 2 diabetes mellitus (8%) developed heart failure during follow up (mean 5.5 years, ±2.8 years). Time-updated analysis with longitudinal HbA1c showed that both HbA1c <6% (hazard ratio =1.60; 95% confidence interval, 1.38-1.86; P value <0.0001) and HbA1c >10% (hazard ratio =1.80; 95% confidence interval, 1.60-2.16; P value <0.0001) were independently associated with the risk of heart failure. CONCLUSIONS Both high and low HbA1c predicted heart failure development in our cohort, forming a U-shaped relationship.
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Affiliation(s)
- Helen M Parry
- From the Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital, University of Dundee, Dundee, United Kingdom.
| | - Harshal Deshmukh
- From the Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital, University of Dundee, Dundee, United Kingdom
| | - Daniel Levin
- From the Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital, University of Dundee, Dundee, United Kingdom
| | - Natalie Van Zuydam
- From the Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital, University of Dundee, Dundee, United Kingdom
| | - Douglas H J Elder
- From the Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital, University of Dundee, Dundee, United Kingdom
| | - Andrew D Morris
- From the Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital, University of Dundee, Dundee, United Kingdom
| | - Allan D Struthers
- From the Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital, University of Dundee, Dundee, United Kingdom
| | - Colin N A Palmer
- From the Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital, University of Dundee, Dundee, United Kingdom
| | - Alex S F Doney
- From the Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital, University of Dundee, Dundee, United Kingdom
| | - Chim C Lang
- From the Division of Cardiovascular and Diabetes Medicine, Ninewells Hospital, University of Dundee, Dundee, United Kingdom
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295
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KLF15 and PPARα Cooperate to Regulate Cardiomyocyte Lipid Gene Expression and Oxidation. PPAR Res 2015; 2015:201625. [PMID: 25815008 PMCID: PMC4357137 DOI: 10.1155/2015/201625] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 02/19/2015] [Indexed: 12/13/2022] Open
Abstract
The metabolic myocardium is an omnivore and utilizes various carbon substrates to meet its energetic demand. While the adult heart preferentially consumes fatty acids (FAs) over carbohydrates, myocardial fuel plasticity is essential for organismal survival. This metabolic plasticity governing fuel utilization is under robust transcriptional control and studies over the past decade have illuminated members of the nuclear receptor family of factors (e.g., PPARα) as important regulators of myocardial lipid metabolism. However, given the complexity of myocardial metabolism in health and disease, it is likely that other molecular pathways are likely operative and elucidation of such pathways may provide the foundation for novel therapeutic approaches. We previously demonstrated that Kruppel-like factor 15 (KLF15) is an independent regulator of cardiac lipid metabolism thus raising the possibility that KLF15 and PPARα operate in a coordinated fashion to regulate myocardial gene expression requisite for lipid oxidation. In the current study, we show that KLF15 binds to, cooperates with, and is required for the induction of canonical PPARα-mediated gene expression and lipid oxidation in cardiomyocytes. As such, this study establishes a molecular module involving KLF15 and PPARα and provides fundamental insights into the molecular regulation of cardiac lipid metabolism.
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296
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Johnson EJ, Dieter BP, Marsh SA. Evidence for distinct effects of exercise in different cardiac hypertrophic disorders. Life Sci 2015; 123:100-6. [PMID: 25632833 PMCID: PMC4339313 DOI: 10.1016/j.lfs.2015.01.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 12/05/2014] [Accepted: 01/02/2015] [Indexed: 02/08/2023]
Abstract
Aerobic exercise training (AET) attenuates or reverses pathological cardiac remodeling after insults such as chronic hypertension and myocardial infarction. The phenotype of the pathologically hypertrophied heart depends on the insult; therefore, it is likely that distinct types of pathological hypertrophy require different exercise regimens. However, the mechanisms by which AET improves the structure and function of the pathologically hypertrophied heart are not well understood, and exercise research uses highly inconsistent exercise regimens in diverse patient populations. There is a clear need for systematic research to identify precise exercise prescriptions for different conditions of pathological hypertrophy. Therefore, this review synthesizes existing evidence for the distinct mechanisms by which AET benefits the heart in different pathological hypertrophy conditions, suggests strategic exercise prescriptions for these conditions, and highlights areas for future research.
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Affiliation(s)
- Emily J Johnson
- Graduate Program in Pharmaceutical Sciences, College of Pharmacy, Washington State University, Spokane, WA, USA
| | - Brad P Dieter
- Graduate Program in Movement Sciences, College of Education, University of Idaho, Moscow, ID, USA; Section of Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, WA, USA
| | - Susan A Marsh
- Section of Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, WA, USA.
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297
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Bashir A, Coggan AR, Gropler RJ. In vivo creatine kinase reaction kinetics at rest and stress in type II diabetic rat heart. Physiol Rep 2015; 3:3/1/e12248. [PMID: 25626865 PMCID: PMC4387746 DOI: 10.14814/phy2.12248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The effects of type II diabetes on cardiac creatine kinase (CK) enzyme activity and/or flux are unknown. We therefore measured steady‐state phosphocreatine (PCr) and adenosine triphosphate (ATP) content and forward CK reaction kinetic parameters in Zucker Diabetic Fatty (ZDF) rat hearts, a type II diabetes research model. At baseline the PCr to ATP ratio (PCr/ATP) was significantly lower in diabetic heart when compared with matched controls (1.71 ± 0.21 vs. 2.26 ± 0.24, P < 0.01). Furthermore, the forward CK reaction rate constant (kf) was higher in diabetic animals (0.52 ± 0.09 s−1 vs. 0.35 ± 0.06 s−1, P < 0.01) and CK flux calculated as a product of PCr concentration ([PCr]) and kf was similar between two groups (4.32 ± 1.05 μmol/g/s vs. 4.94 ± 1.23 μmol/g/s, P = 0.20). Dobutamine administration resulted in similar increases in heart rate (~38%) and kf (~0.12 s−1) in both groups. No significant change in PCr and ATP content was observed with dobutamine. In summary, our data showed reduced PCr/ATP in diabetic myocardium as an indicator of cardiac energy deficit. The forward CK reaction rate constant is elevated at baseline which might reflect a compensatory mechanics to support energy flux through the CK shuttle and maintain constant ATP supply. When hearts were stimulated similar increase in kf was observed in both groups thus it seems that CK shuttle does not limit ATP supply for the range of workload studied. Noninvasive 31P MRS was used to measure PCr concentration ([PCr]) and creatine kinase (CK) reaction flux in type II diabetic rat hearts. [PCr] was reduced in diabetic myocardium as compared to controls, indicative of impairment in mitochondrial ATP production. The forward CK reaction rate constant was elevated, possibly reflecting a compensatory mechanism to support increased flux through the CK shuttle required to support cardiac work. CK reaction velocity increased in both diabetic and control hearts to maintain constant ATP content at higher work.
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Affiliation(s)
- Adil Bashir
- Cardiovascular Imaging Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Andrew R Coggan
- Cardiovascular Imaging Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Robert J Gropler
- Cardiovascular Imaging Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
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298
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Kouzu H, Miki T, Tanno M, Kuno A, Yano T, Itoh T, Sato T, Sunaga D, Murase H, Tobisawa T, Ogasawara M, Ishikawa S, Miura T. Excessive degradation of adenine nucleotides by up-regulated AMP deaminase underlies afterload-induced diastolic dysfunction in the type 2 diabetic heart. J Mol Cell Cardiol 2015; 80:136-45. [PMID: 25599963 DOI: 10.1016/j.yjmcc.2015.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 12/25/2014] [Accepted: 01/09/2015] [Indexed: 01/09/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is often complicated with diastolic heart failure, which decompensates under increased afterload. Focusing on cardiac metabolomes, we examined mechanisms by which T2DM augments ventricular diastolic stiffness in response to pressure overloading. Pressure-volume relationships (PVRs) and myocardial metabolomes were determined at baseline and during elevation of aortic pressure by phenylephrine infusion in a model of T2DM, OLETF, and its non-diabetic control, LETO. Pressure overloading augmented diastolic stiffness without change in systolic reserve in OLETF as indicated by a left-upward shift of end-diastolic PVR. In contrast, PVRs under cardioplegic arrest in buffer-perfused isolated hearts were similar in OLETF and LETO, indicating that extracellular matrix or titin remodeling does not contribute to the afterload-induced increase in stiffness of the beating ventricle of OLETF. Metabolome analyses revealed impaired glycolysis and facilitation of the pentose phosphate pathway in OLETF. Pressure overloading significantly reduced ATP and total adenine nucleotides by 34% and 40%, respectively, in OLETF but not in LETO, while NADH-to-NAD(+) ratios were similar in the two groups. The decline in ATP by pressure overloading in OLETF was associated with increased inosine 5-monophosphate and decreased adenosine levels, being consistent with the 2.5-times higher activity of cardiac AMP deaminase in OLETF. Tissue ATP level was negatively correlated with tau of LV pressure and LVEDP. These results suggest that ATP depletion due to excessive degradation of adenine nucleotides by up-regulated AMP deaminase underlies ventricular stiffening during acute pressure overloading in T2DM hearts.
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Affiliation(s)
- Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takayuki Miki
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masaya Tanno
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Atsushi Kuno
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Pharmacology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takahito Itoh
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tatsuya Sato
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Daisuke Sunaga
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiromichi Murase
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshiyuki Tobisawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Makoto Ogasawara
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Satoko Ishikawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tetsuji Miura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
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299
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Rouet P, Harmancey R, Turkieh A, Caubère C, Barutaut M, Koukoui F, Dambrin C, Galinier M, Smih F. [A matter of fat: APOO regulates mitochondrial function in the heart]. Med Sci (Paris) 2015; 31:31-4. [PMID: 25658728 DOI: 10.1051/medsci/20153101010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Philippe Rouet
- Inserm U1048, équipe 7, obésité et insuffisance cardiaque : approches moléculaires et cliniques, BP 84225, 1, avenue Jean Poulhès, 31432 Toulouse Cedex 4, France
| | - Romain Harmancey
- Inserm U1048, équipe 7, obésité et insuffisance cardiaque : approches moléculaires et cliniques, BP 84225, 1, avenue Jean Poulhès, 31432 Toulouse Cedex 4, France
| | - Annie Turkieh
- Inserm U1048, équipe 7, obésité et insuffisance cardiaque : approches moléculaires et cliniques, BP 84225, 1, avenue Jean Poulhès, 31432 Toulouse Cedex 4, France
| | - Céline Caubère
- Inserm U1048, équipe 7, obésité et insuffisance cardiaque : approches moléculaires et cliniques, BP 84225, 1, avenue Jean Poulhès, 31432 Toulouse Cedex 4, France
| | - Manon Barutaut
- Inserm U1048, équipe 7, obésité et insuffisance cardiaque : approches moléculaires et cliniques, BP 84225, 1, avenue Jean Poulhès, 31432 Toulouse Cedex 4, France
| | - François Koukoui
- Inserm U1048, équipe 7, obésité et insuffisance cardiaque : approches moléculaires et cliniques, BP 84225, 1, avenue Jean Poulhès, 31432 Toulouse Cedex 4, France
| | - Camille Dambrin
- Inserm U1048, équipe 7, obésité et insuffisance cardiaque : approches moléculaires et cliniques, BP 84225, 1, avenue Jean Poulhès, 31432 Toulouse Cedex 4, France
| | - Michel Galinier
- Inserm U1048, équipe 7, obésité et insuffisance cardiaque : approches moléculaires et cliniques, BP 84225, 1, avenue Jean Poulhès, 31432 Toulouse Cedex 4, France
| | - Fatima Smih
- Inserm U1048, équipe 7, obésité et insuffisance cardiaque : approches moléculaires et cliniques, BP 84225, 1, avenue Jean Poulhès, 31432 Toulouse Cedex 4, France
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300
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Gimenes C, Gimenes R, Rosa CM, Xavier NP, Campos DHS, Fernandes AAH, Cezar MDM, Guirado GN, Cicogna AC, Takamoto AHR, Okoshi MP, Okoshi K. Low Intensity Physical Exercise Attenuates Cardiac Remodeling and Myocardial Oxidative Stress and Dysfunction in Diabetic Rats. J Diabetes Res 2015; 2015:457848. [PMID: 26509175 PMCID: PMC4609864 DOI: 10.1155/2015/457848] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 01/04/2015] [Indexed: 12/31/2022] Open
Abstract
UNLABELLED We evaluated the effects of a low intensity aerobic exercise protocol on cardiac remodeling and myocardial function in diabetic rats. Wistar rats were assigned into four groups: sedentary control (C-Sed), exercised control (C-Ex), sedentary diabetes (DM-Sed), and exercised diabetes (DM-Ex). Diabetes was induced by intraperitoneal injection of streptozotocin. Rats exercised for 9 weeks in treadmill at 11 m/min, 18 min/day. Myocardial function was evaluated in left ventricular (LV) papillary muscles and oxidative stress in LV tissue. Statistical analysis was given by ANOVA or Kruskal-Wallis. Echocardiogram showed diabetic groups with higher LV diastolic diameter-to-body weight ratio and lower posterior wall shortening velocity than controls. Left atrium diameter was lower in DM-Ex than DM-Sed (C-Sed: 5.73 ± 0.49; C-Ex: 5.67 ± 0.53; DM-Sed: 6.41 ± 0.54; DM-Ex: 5.81 ± 0.50 mm; P < 0.05 DM-Sed vs C-Sed and DM-Ex). Papillary muscle function was depressed in DM-Sed compared to C-Sed. Exercise attenuated this change in DM-Ex. Lipid hydroperoxide concentration was higher in DM-Sed than C-Sed and DM-Ex. Catalase and superoxide dismutase activities were lower in diabetics than controls and higher in DM-Ex than DM-Sed. Glutathione peroxidase activity was lower in DM-Sed than C-Sed and DM-Ex. CONCLUSION Low intensity exercise attenuates left atrium dilation and myocardial oxidative stress and dysfunction in type 1 diabetic rats.
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Affiliation(s)
- C. Gimenes
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), S/N, Rubião Junior District, 18618 970 Botucatu, SP, Brazil
- Sagrado Coração University, Bauru, SP, Brazil
| | - R. Gimenes
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), S/N, Rubião Junior District, 18618 970 Botucatu, SP, Brazil
| | - C. M. Rosa
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), S/N, Rubião Junior District, 18618 970 Botucatu, SP, Brazil
| | - N. P. Xavier
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), S/N, Rubião Junior District, 18618 970 Botucatu, SP, Brazil
| | - D. H. S. Campos
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), S/N, Rubião Junior District, 18618 970 Botucatu, SP, Brazil
| | - A. A. H. Fernandes
- Department of Chemistry and Biochemistry, Institute of Biosciences, São Paulo State University (UNESP), Brazil
| | - M. D. M. Cezar
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), S/N, Rubião Junior District, 18618 970 Botucatu, SP, Brazil
| | - G. N. Guirado
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), S/N, Rubião Junior District, 18618 970 Botucatu, SP, Brazil
| | - A. C. Cicogna
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), S/N, Rubião Junior District, 18618 970 Botucatu, SP, Brazil
| | - A. H. R. Takamoto
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), S/N, Rubião Junior District, 18618 970 Botucatu, SP, Brazil
| | - M. P. Okoshi
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), S/N, Rubião Junior District, 18618 970 Botucatu, SP, Brazil
| | - K. Okoshi
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), S/N, Rubião Junior District, 18618 970 Botucatu, SP, Brazil
- *K. Okoshi:
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