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Plott C, Harb T, Arvanitis M, Gerstenblith G, Blumenthal R, Leucker T. Neurocardiac Axis Physiology and Clinical Applications. IJC HEART & VASCULATURE 2024; 54:101488. [PMID: 39224460 PMCID: PMC11367645 DOI: 10.1016/j.ijcha.2024.101488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 08/05/2024] [Accepted: 08/08/2024] [Indexed: 09/04/2024]
Abstract
The neurocardiac axis constitutes the neuronal circuits between the arteries, heart, brain, and immune organs (including thymus, spleen, lymph nodes, and mucosal associated lymphoid tissue) that together form the cardiovascular brain circuit. This network allows the individual to maintain homeostasis in a variety of environmental situations. However, in dysfunctional states, such as exposure to environments with chronic stressors and sympathetic activation, this axis can also contribute to the development of atherosclerotic vascular disease as well as other cardiovascular pathologies and it is increasingly being recognized as an integral part of the pathogenesis of cardiovascular disease. This review article focuses on 1) the normal functioning of the neurocardiac axis; 2) pathophysiology of the neurocardiac axis; 3) clinical implications of this axis in hypertension, atherosclerotic disease, and heart failure with an update on treatments under investigation; and 4) quantification methods in research and clinical practice to measure components of the axis and future research areas.
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Affiliation(s)
- Caroline Plott
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Tarek Harb
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Marios Arvanitis
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Gary Gerstenblith
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Roger Blumenthal
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Thorsten Leucker
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
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Cardiometabolic-based chronic disease: adiposity and dysglycemia drivers of heart failure. Heart Fail Rev 2023; 28:47-61. [PMID: 35368233 DOI: 10.1007/s10741-022-10233-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2022] [Indexed: 02/07/2023]
Abstract
Heart failure (HF) is a complex clinical syndrome, associated with high rates of mortality, hospitalization, and impairment of quality of life. Obesity and type 2 diabetes are major cardiometabolic drivers, represented as distinct stages of adiposity- and dysglycemia-based chronic disease (ABCD, DBCD), respectively, and leading to cardiometabolic-based chronic disease (CMBCD). This review focuses on one aspect of the CMBCD model: how ABCD and DBCD influence genesis and progression of HF phenotypes. Specifically, the relationships of ABCD and DBCD stages with structural and functional heart disease, HF risk, and outcomes in overt HF are detailed. Also, evidence-based lifestyle, pharmacological, and procedural interventions that promote or reverse cardiac remodeling and outcomes in individuals at risk or with HF are discussed. In summary, driver-based chronic disease models for individuals at risk or with HF can expose prevention targets for more comprehensive interventions to improve clinical outcomes. Future randomized trials that investigate structured lifestyle, pharmacological, and procedural therapies specifically tailored for the CMBCD model are needed to develop personalized care plans to decrease HF susceptibility and improve outcomes.
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Heart rate variability and the risk of heart failure and its subtypes in post-menopausal women: The Women's Health Initiative study. PLoS One 2022; 17:e0276585. [PMID: 36282885 PMCID: PMC9595519 DOI: 10.1371/journal.pone.0276585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Background Low heart rate variability (HRV), a measure of autonomic imbalance, is associated with increased risk of coronary heart disease (CHD) and heart failure (HF). However, its relationship with HF subtypes; heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) has not been studied prior. Methods and findings We conducted a longitudinal study in Women’s Health Initiative study cohort to investigate the association of baseline quartiles of resting heart rate (rHR) and HRV measures; SDNN (SD of normal-to-normal RR interval) and RMSSD (root mean square of successive difference of RR interval) measured by twelve-lead electrocardiogram (ECG) on enrollment, with the risk of hospitalized HF and its subtypes. Total of 28,603 post-menopausal women, predominantly non-Hispanic whites (69%), with a mean (SD) age of 62.6 (7.1) years, free of baseline CHD and HF were included. In a fully adjusted cox-proportional hazards regression model which adjusted for age, race, BMI, alcohol intake, education, physical activity, hyperlipidemia, hypertension, left ventricular hypertrophy, use of beta-blocker, calcium-channel blocker, hormone therapy, and time-varying incident CHD, the hazard ratios of lowest quartile of HRV (Q1) with HF risk were significant (Q1 SDNN compared to Q4 SDNN: 1.22, 95% CI 1.07, 1.39; Q1 RMSSD compared to Q4 RMSSD: 1.17, 95% CI 1.02, 1.33). On subgroup analysis of HF subtypes, low HRV was associated with elevated HFpEF risk (Q1 vs Q4 SDNN: 1.22, 95% CI 1.02, 1.47) but not with HFrEF (Q1 vs Q4 SDNN: 1.19, 95% CI 0.95, 1.50; Q1 RMSSD: 1.13, 95% CI 0.90, 1.43). Conclusion Low HRV is associated with elevated overall hospitalized HF risk and HFpEF risk in post-menopausal women. Whether interventions to increase HRV through healthy lifestyle changes will decrease HF risk warrants further investigation.
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Lymperopoulos A, Cora N, Maning J, Brill AR, Sizova A. Signaling and function of cardiac autonomic nervous system receptors: Insights from the GPCR signalling universe. FEBS J 2021; 288:2645-2659. [DOI: 10.1111/febs.15771] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/02/2021] [Accepted: 02/16/2021] [Indexed: 12/16/2022]
Affiliation(s)
- Anastasios Lymperopoulos
- Laboratory for the Study of Neurohormonal Control of the Circulation Department of Pharmaceutical Sciences Nova Southeastern University Fort Lauderdale FL USA
| | - Natalie Cora
- Laboratory for the Study of Neurohormonal Control of the Circulation Department of Pharmaceutical Sciences Nova Southeastern University Fort Lauderdale FL USA
| | - Jennifer Maning
- Laboratory for the Study of Neurohormonal Control of the Circulation Department of Pharmaceutical Sciences Nova Southeastern University Fort Lauderdale FL USA
| | - Ava R. Brill
- Laboratory for the Study of Neurohormonal Control of the Circulation Department of Pharmaceutical Sciences Nova Southeastern University Fort Lauderdale FL USA
| | - Anastasiya Sizova
- Laboratory for the Study of Neurohormonal Control of the Circulation Department of Pharmaceutical Sciences Nova Southeastern University Fort Lauderdale FL USA
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Bollmann P, Werner F, Jaron M, Bruns TA, Wache H, Runte J, Boknik P, Kirchhefer U, Müller FU, Buchwalow IB, Rothemund S, Neumann J, Gergs U. Initial Characterization of Stressed Transgenic Mice With Cardiomyocyte-Specific Overexpression of Protein Phosphatase 2C. Front Pharmacol 2021; 11:591773. [PMID: 33597873 PMCID: PMC7883593 DOI: 10.3389/fphar.2020.591773] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/07/2020] [Indexed: 12/17/2022] Open
Abstract
As part of our ongoing studies on the potential pathophysiological role of serine/threonine phosphatases (PP) in the mammalian heart, we have generated mice with cardiac-specific overexpression of PP2Cβ (PP2C-TG) and compared them with littermate wild type mice (WT) serving as a control. Cardiac fibrosis was noted histologically in PP2C-TG. Collagen 1a, interleukin-6 and the natriuretic peptides ANP and BNP were augmented in PP2C-TG vs. WT (p < 0.05). Left atrial preparations from PP2C-TG were less resistant to hypoxia than atria from WT. PP2C-TG maintained cardiac function after the injection of lipopolysaccharide (LPS, a model of sepsis) and chronic isoproterenol treatment (a model of heart failure) better than WT. Crossbreeding of PP2C-TG mice with PP2A-TG mice (a genetic model of heart failure) resulted in double transgenic (DT) mice that exhibited a pronounced increase of heart weight in contrast to the mild hypertrophy noted in the mono-transgenic mice. The ejection fraction was reduced in PP2C-TG and in PP2A-TG mice compared with WT, but the reduction was the highest in DT compared with WT. PP2A enzyme activity was enhanced in PP2A-TG and DT mice compared with WT and PP2C-TG mice. In summary, cardiac overexpression of PP2Cβ and co-overexpression of both the catalytic subunit of PP2A and PP2Cβ were detrimental to cardiac function. PP2Cβ overexpression made cardiac preparations less resistant to hypoxia than WT, leading to fibrosis, but PP2Cβ overexpression led to better adaptation to some stressors, such as LPS or chronic β-adrenergic stimulation. Hence, the effect of PP2Cβ is context sensitive.
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Affiliation(s)
- Paula Bollmann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Franziska Werner
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Marko Jaron
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Tom A Bruns
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Hartmut Wache
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Jochen Runte
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Peter Boknik
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Westfälische Wilhelms-Universität, Münster, Germany
| | - Uwe Kirchhefer
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Westfälische Wilhelms-Universität, Münster, Germany
| | - Frank U Müller
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Westfälische Wilhelms-Universität, Münster, Germany
| | | | | | - Joachim Neumann
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Ulrich Gergs
- Institut für Pharmakologie und Toxikologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
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6
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Coutinho e Silva RDS, Zanoni FL, Simas R, Moreira LFP. Perspectives of bilateral thoracic sympathectomy for treatment of heart failure. Clinics (Sao Paulo) 2021; 76:e3248. [PMID: 34378733 PMCID: PMC8311637 DOI: 10.6061/clinics/2021/e3248] [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: 06/17/2021] [Accepted: 07/14/2021] [Indexed: 11/18/2022] Open
Abstract
Surgical neuromodulation therapies are still considered a last resort when standard therapies have failed for patients with progressive heart failure (HF). Although a number of experimental studies have provided robust evidence of its effectiveness, the lack of strong clinical evidence discourages practitioners. Thoracic unilateral sympathectomy has been extensively studied and has failed to show significant clinical improvement in HF patients. Most recently, bilateral sympathectomy effect was associated with a high degree of success in HF models, opening the perspective to be investigated in randomized controlled clinical trials. In addition, a series of clinical trials showed that bilateral sympathectomy was associated with a decreased risk of sudden death, which is an important outcome in patients with HF. These aspects indicates that bilateral sympathectomy could be an important alternative in the treatment of HF wherein pharmacological treatment barely reaches the target dose.
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Affiliation(s)
- Raphael dos Santos Coutinho e Silva
- Laboratorio Cirurgico de Pesquisa Cardiovascular (LIM-11), Instituto do Coracao (Incor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Corresponding author. E-mail:
| | - Fernando Luiz Zanoni
- Laboratorio Cirurgico de Pesquisa Cardiovascular (LIM-11), Instituto do Coracao (Incor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Rafael Simas
- The Rolf Luft Research Center for Diabetes and Endocrinology, Karolinska Institutet, Stockholm, Sweden
| | - Luiz Felipe Pinho Moreira
- Laboratorio Cirurgico de Pesquisa Cardiovascular (LIM-11), Instituto do Coracao (Incor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
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7
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Schranz D. Pharmacological Heart Failure Therapy in Children: Focus on Inotropic Support. Handb Exp Pharmacol 2020; 261:177-192. [PMID: 31707469 DOI: 10.1007/164_2019_267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Pediatric heart failure is a clinical syndrome, which needs to be distinctly defined and the pathophysiological consequences considered. Pharmacological treatment depends on the disease- and age-specific myocardial characteristics. Acute and chronic low cardiac output is the result of an inadequate heart rate (rhythm), myocardial contractility, preload and afterload, and also ventriculo-ventricular interaction, synchrony, atrio-ventricular and ventricular-arterial coupling. The treatment of choice is curing the cause of heart failure, if possible.Acute HF therapy is still based to the use of catecholamines and inodilators. The cornerstone of chronic HF treatment consists of blocking the endogenous, neuro-humoral axis, in particular the adrenergic and renin-angiotensin-aldosterone system.Before neprilysin inhibitors are used in young children, their potential side-effect for inducing Alzheimer disease needs to be clarified. The focus of the current review is put on the differential use of the inotropic drugs as epinephrine, norepinephrine, dopamine and dobutamine, and also the inodilators milrinone and levosimendan. Considering effects and side-effects of any cardiac stimulating treatment strategy, co-medication with ß-blockers, angiotensin converting inhibitors (ACEIs), angiotensin blockers (ARBs) and mineralocorticoid receptor antagonists (MRAs) is not a contradiction, but a senseful measure, even still during the acute inotropic treatment.Missing sophisticated clinical trials using accurate entry criteria and clinically relevant endpoints, there is especially in cardiovascular diagnosis and treatment of young children a compromise of evidence-based versus pathophysiology-based procedures. But based on the pharmacological and pathophysiological knowledge a hypothesis-driven individualized treatment is already currently possible and therefore indicated.
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Affiliation(s)
- Dietmar Schranz
- Pediatric Heart Center, Johann Wolfgang Goethe University Clinic, Frankfurt, Germany.
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Pitoulis FG, Watson SA, Perbellini F, Terracciano CM. Myocardial slices come to age: an intermediate complexity in vitro cardiac model for translational research. Cardiovasc Res 2020; 116:1275-1287. [PMID: 31868875 PMCID: PMC7243278 DOI: 10.1093/cvr/cvz341] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/31/2019] [Accepted: 12/19/2019] [Indexed: 12/17/2022] Open
Abstract
Although past decades have witnessed significant reductions in mortality of heart failure together with advances in our understanding of its cellular, molecular, and whole-heart features, a lot of basic cardiac research still fails to translate into clinical practice. In this review we examine myocardial slices, a novel model in the translational arena. Myocardial slices are living ultra-thin sections of heart tissue. Slices maintain the myocardium's native function (contractility, electrophysiology) and structure (multicellularity, extracellular matrix) and can be prepared from animal and human tissue. The discussion begins with the history and current advances in the model, the different interlaboratory methods of preparation and their potential impact on results. We then contextualize slices' advantages and limitations by comparing it with other cardiac models. Recently, sophisticated methods have enabled slices to be cultured chronically in vitro while preserving the functional and structural phenotype. This is more timely now than ever where chronic physiologically relevant in vitro platforms for assessment of therapeutic strategies are urgently needed. We interrogate the technological developments that have permitted this, their limitations, and future directions. Finally, we look into the general obstacles faced by the translational field, and how implementation of research systems utilizing slices could help in resolving these.
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Affiliation(s)
- Fotios G Pitoulis
- Laboratory of Cell Electrophysiology, Department of Myocardial Function, Imperial College London, National Heart and Lung Institute, 4th Floor ICTEM Building Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Samuel A Watson
- Laboratory of Cell Electrophysiology, Department of Myocardial Function, Imperial College London, National Heart and Lung Institute, 4th Floor ICTEM Building Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - Filippo Perbellini
- Laboratory of Cell Electrophysiology, Department of Myocardial Function, Imperial College London, National Heart and Lung Institute, 4th Floor ICTEM Building Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
- Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies, Hannover, Germany
| | - Cesare M Terracciano
- Laboratory of Cell Electrophysiology, Department of Myocardial Function, Imperial College London, National Heart and Lung Institute, 4th Floor ICTEM Building Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
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Beta Adrenergic Blocker Use in Patients With Chronic Obstructive Pulmonary Disease and Concurrent Chronic Heart Failure With a Low Ejection Fraction. Cardiol Rev 2020; 28:20-25. [PMID: 31804289 DOI: 10.1097/crd.0000000000000284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) often coexist and present clinicians with diagnostic and therapeutic challenges. Beta-blockers are a cornerstone of CHF treatment, in patients with a low ejection fraction, while beta-agonists are utilized for COPD. These 2 therapies exert opposing pharmacological effects. COPD patients are at an increased risk of mortality from cardiovascular events. In addition to CHF, beta-blockers are used in a number of cardiovascular conditions because of their cardioprotective properties as well as their mortality benefit. However, there is reluctance among physicians to use beta-blockers in patients with COPD because of fear of inducing bronchospasms, despite increasing evidence of their safety and mortality benefits. The majority of this evidence comes from observational studies showing that beta-blockers are safe and well tolerated, with minimal effect on respiratory function. Furthermore, beta-blockers have been shown to lower the mortality risk in patients with COPD alone, as well as in those with COPD and CHF. Large clinical trials are needed in order to dispel the mistrust of beta-blocker use in COPD patients. The current evidence supports the use of cardioselective beta-blockers in patients with COPD. As the population continues to live longer, comorbidities become ever more present, and cardioselective beta-blockers should not be withheld from patients with COPD and coexistent CHF, because the benefits outweigh the risks.
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Cristina-Oliveira M, Meireles K, Spranger MD, O'Leary DS, Roschel H, Peçanha T. Clinical safety of blood flow-restricted training? A comprehensive review of altered muscle metaboreflex in cardiovascular disease during ischemic exercise. Am J Physiol Heart Circ Physiol 2019; 318:H90-H109. [PMID: 31702969 DOI: 10.1152/ajpheart.00468.2019] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Blood flow restriction training (BFRT) is an increasingly widespread method of exercise that involves imposed restriction of blood flow to the exercising muscle. Blood flow restriction is achieved by inflating a pneumatic pressure cuff (or a tourniquet) positioned proximal to the exercising muscle before, and during, the bout of exercise (i.e., ischemic exercise). Low-intensity BFRT with resistance training promotes comparable increases in muscle mass and strength observed during high-intensity exercise without blood flow restriction. BFRT has expanded into the clinical research setting as a potential therapeutic approach to treat functionally impaired individuals, such as the elderly, and patients with orthopedic and cardiovascular disease/conditions. However, questions regarding the safety of BFRT must be fully examined and addressed before the implementation of this exercise methodology in the clinical setting. In this respect, there is a general concern that BFRT may generate abnormal reflex-mediated cardiovascular responses. Indeed, the muscle metaboreflex is an ischemia-induced, sympathoexcitatory pressor reflex originating in skeletal muscle, and the present review synthesizes evidence that BFRT may elicit abnormal cardiovascular responses resulting from increased metaboreflex activation. Importantly, abnormal cardiovascular responses are more clearly evidenced in populations with increased cardiovascular risk (e.g., elderly and individuals with cardiovascular disease). The evidence provided in the present review draws into question the cardiovascular safety of BFRT, which clearly needs to be further investigated in future studies. This information will be paramount for the consideration of BFRT exercise implementation in clinical populations.
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Affiliation(s)
- Michelle Cristina-Oliveira
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Kamila Meireles
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Marty D Spranger
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Donal S O'Leary
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Tiago Peçanha
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
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Watson SA, Duff J, Bardi I, Zabielska M, Atanur SS, Jabbour RJ, Simon A, Tomas A, Smolenski RT, Harding SE, Perbellini F, Terracciano CM. Biomimetic electromechanical stimulation to maintain adult myocardial slices in vitro. Nat Commun 2019; 10:2168. [PMID: 31092830 PMCID: PMC6520377 DOI: 10.1038/s41467-019-10175-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 04/24/2019] [Indexed: 01/01/2023] Open
Abstract
Adult cardiac tissue undergoes a rapid process of dedifferentiation when cultured outside the body. The in vivo environment, particularly constant electromechanical stimulation, is fundamental to the regulation of cardiac structure and function. We investigated the role of electromechanical stimulation in preventing culture-induced dedifferentiation of adult cardiac tissue using rat, rabbit and human heart failure myocardial slices. Here we report that the application of a preload equivalent to sarcomere length (SL) = 2.2 μm is optimal for the maintenance of rat myocardial slice structural, functional and transcriptional properties at 24 h. Gene sets associated with the preservation of structure and function are activated, while gene sets involved in dedifferentiation are suppressed. The maximum contractility of human heart failure myocardial slices at 24 h is also optimally maintained at SL = 2.2 μm. Rabbit myocardial slices cultured at SL = 2.2 μm remain stable for 5 days. This approach substantially prolongs the culture of adult cardiac tissue in vitro.
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Affiliation(s)
- Samuel A Watson
- National Heart & Lung Institute, Imperial College London, London, W12 0NN, UK
| | - James Duff
- National Heart & Lung Institute, Imperial College London, London, W12 0NN, UK
| | - Ifigeneia Bardi
- National Heart & Lung Institute, Imperial College London, London, W12 0NN, UK
| | - Magdalena Zabielska
- Department of Biochemistry, Medical University of Gdańsk, Gdańsk, 80-210, Poland
| | - Santosh S Atanur
- Faculty of Medicine, Department of Medicine, Imperial College London, London, SW7 2AZ, UK
| | - Richard J Jabbour
- National Heart & Lung Institute, Imperial College London, London, W12 0NN, UK
| | - André Simon
- Department of Cardiothoracic Transplantation & Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, Harefield, UB9 6JH, UK
| | - Alejandra Tomas
- Section of Cell Biology and Functional Genomics, Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Imperial College London, London, W12 0NN, UK
| | - Ryszard T Smolenski
- Department of Biochemistry, Medical University of Gdańsk, Gdańsk, 80-210, Poland
| | - Sian E Harding
- National Heart & Lung Institute, Imperial College London, London, W12 0NN, UK
| | - Filippo Perbellini
- National Heart & Lung Institute, Imperial College London, London, W12 0NN, UK.
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12
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Sheng Y, Zhu L. The crosstalk between autonomic nervous system and blood vessels. INTERNATIONAL JOURNAL OF PHYSIOLOGY, PATHOPHYSIOLOGY AND PHARMACOLOGY 2018; 10:17-28. [PMID: 29593847 PMCID: PMC5871626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 02/24/2018] [Indexed: 06/08/2023]
Abstract
The autonomic nervous system (ANS), comprised of two primary branches, sympathetic and parasympathetic nervous system, plays an essential role in the regulation of vascular wall contractility and tension. The sympathetic and parasympathetic nerves work together to balance the functions of autonomic effector organs. The neurotransmitters released from the varicosities in the ANS can regulate the vascular tone. Norepinephrine (NE), adenosine triphosphate (ATP) and Neuropeptide Y (NPY) function as vasoconstrictors, whereas acetylcholine (Ach) and calcitonin gene-related peptide (CGRP) can mediate vasodilation. On the other hand, vascular factors, such as endothelium-derived relaxing factor nitric oxide (NO), and constriction factor endothelin, play an important role in the autonomic nervous system in physiologic conditions. Endothelial dysfunction and inflammation are associated with the sympathetic nerve activity in the pathological conditions, such as hypertension, heart failure, and diabetes mellitus. The dysfunction of the autonomic nervous system could be a risk factor for vascular diseases and the overactive sympathetic nerve is detrimental to the blood vessel. In this review, we summarize findings concerning the crosstalk between ANS and blood vessels in both physiological and pathological conditions and hope to provide insight into the development of therapeutic interventions of vascular diseases.
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Affiliation(s)
- Yulan Sheng
- Cyrus Tang Hematology Center, Collaborative Innovation Center of Hematology of Jiangsu Province, State Key Laboratory of Radiation Medicine and Protection, Soochow UniversitySuzhou 215123, China
| | - Li Zhu
- Cyrus Tang Hematology Center, Collaborative Innovation Center of Hematology of Jiangsu Province, State Key Laboratory of Radiation Medicine and Protection, Soochow UniversitySuzhou 215123, China
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Lachowska K, Gruchała M, Narkiewicz K, Hering D. Sympathetic Activation in Chronic Heart Failure: Potential Benefits of Interventional Therapies. Curr Hypertens Rep 2017; 18:51. [PMID: 27193773 DOI: 10.1007/s11906-016-0660-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Heart failure (HF) is a major and growing public health problem. This condition is associated with poor prognosis, a high rate of mortality, frequent hospitalization and increasing costs to health care systems. Pharmacological approaches aimed at reducing morbidity and mortality in HF have primarily focused on inhibition of the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system (SNS), both of which have been associated with disease development, progression and adverse cardiovascular (CV) outcomes. The increasing number of hospitalizations for HF decompensation suggests the failure of available treatment options, indicating the necessity for alternative therapeutic approaches. Alongside pharmacological and cardiac resynchronization therapies in selected patients with arrhythmia, recent advancements in the management of HF have been directed at inhibiting relevant neurogenic pathways underlying disease development and progression. Initial evidence regarding the safety and effectiveness of interventional procedures suggests that HF patients may benefit from novel adjunctive therapies. Here we review the critical role of sympathetic activation in HF and the rationale for therapeutic interventions including device-based and interventional approaches aimed at restoring autonomic neural balance in this condition.
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Affiliation(s)
- Kamila Lachowska
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Gruchała
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Dagmara Hering
- Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, The University of Western Australia, Level 3 MRF Building, Rear 50 Murray Street, Perth, WA, 6000, MDBP: M570, Australia.
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Renal denervation in heart failure: Modulating the sympathetic nervous system. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.repce.2016.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Delgado Silva J. Renal denervation in heart failure: Modulating the sympathetic nervous system. Rev Port Cardiol 2016; 36:53-54. [PMID: 27979323 DOI: 10.1016/j.repc.2016.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Joana Delgado Silva
- Centro Hospitalar e Universitário de Coimbra, Hospital Geral, Coimbra, Portugal.
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Scofield SLC, Amin P, Singh M, Singh K. Extracellular Ubiquitin: Role in Myocyte Apoptosis and Myocardial Remodeling. Compr Physiol 2015; 6:527-60. [PMID: 26756642 DOI: 10.1002/cphy.c150025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Ubiquitin (UB) is a highly conserved low molecular weight (8.5 kDa) protein. It consists of 76 amino acid residues and is found in all eukaryotic cells. The covalent linkage of UB to a variety of cellular proteins (ubiquitination) is one of the most common posttranslational modifications in eukaryotic cells. This modification generally regulates protein turnover and protects the cells from damaged or misfolded proteins. The polyubiquitination of proteins serves as a signal for degradation via the 26S proteasome pathway. UB is present in trace amounts in body fluids. Elevated levels of UB are described in the serum or plasma of patients under a variety of conditions. Extracellular UB is proposed to have pleiotropic roles including regulation of immune response, anti-inflammatory, and neuroprotective activities. CXCR4 is identified as receptor for extracellular UB in hematopoietic cells. Heart failure represents a major cause of morbidity and mortality in western society. Cardiac remodeling is a determinant of the clinical course of heart failure. The components involved in myocardial remodeling include-myocytes, fibroblasts, interstitium, and coronary vasculature. Increased sympathetic nerve activity in the form of norepinephrine is a common feature during heart failure. Acting via β-adrenergic receptor (β-AR), norepinephrine is shown to induce myocyte apoptosis and myocardial fibrosis. β-AR stimulation increases extracellular levels of UB in myocytes, and UB inhibits β-AR-stimulated increases in myocyte apoptosis and myocardial fibrosis. This review summarizes intracellular and extracellular functions of UB with particular emphasis on the role of extracellular UB in cardiac myocyte apoptosis and myocardial remodeling.
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Affiliation(s)
- Stephanie L C Scofield
- Department of Biomedical Sciences, East Tennessee State University, Johnson City, Tennessee, USA
| | - Parthiv Amin
- Department of Biomedical Sciences, East Tennessee State University, Johnson City, Tennessee, USA
| | - Mahipal Singh
- Department of Biomedical Sciences, East Tennessee State University, Johnson City, Tennessee, USA
| | - Krishna Singh
- Department of Biomedical Sciences, East Tennessee State University, Johnson City, Tennessee, USA; Center for Inflammation, Infectious Disease and Immunity, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, USA; James H. Quillen VA Medical Center, East Tennessee State University, Johnson City, Tennessee, USA.,Department of Medicine, Albany Medical College, Albany, New York, USA.,Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, Rensselaer, New York, USA
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Clementi A, Virzì GM, Brocca A, de Cal M, Pastori S, Clementi M, Granata A, Vescovo G, Ronco C. Advances in the pathogenesis of cardiorenal syndrome type 3. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2015; 2015:148082. [PMID: 25821551 PMCID: PMC4364019 DOI: 10.1155/2015/148082] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 02/23/2015] [Indexed: 12/23/2022]
Abstract
Cardiorenal syndrome (CRS) type 3 is a subclassification of the CRS whereby an episode of acute kidney injury (AKI) leads to the development of acute cardiac injury or dysfunction. In general, there is limited understanding of the pathophysiologic mechanisms involved in CRS type 3. An episode of AKI may have effects that depend on the severity and duration of AKI and that both directly and indirectly predispose to an acute cardiac event. Experimental data suggest that cardiac dysfunction may be related to immune system activation, inflammatory mediators release, oxidative stress, and cellular apoptosis which are well documented in the setting of AKI. Moreover, significant derangements, such as fluid and electrolyte imbalance, metabolic acidosis, and uremia, which are typical features of acute kidney injury, may impair cardiac function. In this review, we will focus on multiple factors possibly involved in the pathogenesis issues regarding CRS type 3.
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Affiliation(s)
- Anna Clementi
- Department of Nephrology and Dialysis, San Giovanni Di Dio, Agrigento 92100, Italy
| | - Grazia Maria Virzì
- Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza 36100, Italy
- International Renal Research Institute Vicenza (IRRIV), Italy
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padua, Italy
| | - Alessandra Brocca
- Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza 36100, Italy
- International Renal Research Institute Vicenza (IRRIV), Italy
- Department of Medicine (DIMED), University of Padova, Padova 35128, Italy
| | - Massimo de Cal
- Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza 36100, Italy
- International Renal Research Institute Vicenza (IRRIV), Italy
| | - Silvia Pastori
- Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza 36100, Italy
- International Renal Research Institute Vicenza (IRRIV), Italy
| | - Maurizio Clementi
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padua, Italy
| | - Antonio Granata
- Department of Nephrology and Dialysis, San Giovanni Di Dio, Agrigento 92100, Italy
| | - Giorgio Vescovo
- Internal Medicine, San Bortolo Hospital, Vicenza 36100, Italy
| | - Claudio Ronco
- Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza 36100, Italy
- International Renal Research Institute Vicenza (IRRIV), Italy
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Deo R, Katz R, de Boer IH, Sotoodehnia N, Kestenbaum B, Mukamal KJ, Chonchol M, Sarnak MJ, Siscovick D, Shlipak MG, Ix JH. Fibroblast growth factor 23 and sudden versus non-sudden cardiac death: the Cardiovascular Health Study. Am J Kidney Dis 2015; 66:40-6. [PMID: 25572028 DOI: 10.1053/j.ajkd.2014.10.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 10/29/2014] [Indexed: 01/19/2023]
Abstract
BACKGROUND Elevated fibroblast growth factor 23 (FGF-23) concentrations are associated with greater risk of cardiovascular events and mortality, especially among people with chronic kidney disease (CKD). Because individuals with CKD are at an increased risk of sudden cardiac death (SCD), we sought to understand whether FGF-23 level is a stronger risk factor for SCD versus non-SCD. STUDY DESIGN Cohort study. SETTING & PARTICIPANTS 3,244 participants 65 years or older in the community-based Cardiovascular Health Study. PREDICTOR Plasma FGF-23 concentrations. OUTCOMES We assessed SCD and non-SCD in these analyses. SCD was adjudicated rigorously and was defined as a sudden pulseless condition of cardiac origin in a previously stable person occurring out of hospital or in the emergency department. MEASUREMENTS We estimated associations of baseline FGF-23 concentrations with SCD and non-SCD using Cox proportional hazards models after adjustment for demographics, cardiovascular risk factors, comorbid conditions, and kidney function. We also tested whether associations differed by CKD status. RESULTS During a median follow-up of 8.1 years, there were 118 adjudicated SCD and 570 non-SCD events. After multivariable adjustment for demographics, cardiovascular risk factors, comorbid conditions, and parameters of kidney function, higher FGF-23 concentrations were an independent risk factor for non-SCD (HR [per doubling], 1.17; 95% CI, 1.06-1.30). However, elevated FGF-23 concentrations were not associated independently with SCD (HR [per doubling], 1.07; 95% CI, 0.85-1.35). In stratified analysis by CKD status (36.5% of cohort), doubling of FGF-23 concentrations was associated independently with non-SCD (adjusted HR, 1.26; 95% CI, 1.10-1.45). A similar magnitude of association was observed between FGF-23 level and SCD in the CKD subgroup; however, it was not significant (HR, 1.20; 95% CI, 0.89-1.62). LIMITATIONS Limited power to detect moderate-sized effects between FGF-23 level and SCD in both the primary and stratified analyses. CONCLUSIONS In this population-based study, FGF-23 level elevations were associated independently with non-SCD. Among individuals with CKD, the associations between FGF-23 level and SCD and non-SCD were similar.
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Affiliation(s)
- Rajat Deo
- Section of Electrophysiology, Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA.
| | - Ronit Katz
- Kidney Research Institute, University of Washington, Seattle, WA
| | - Ian H de Boer
- Kidney Research Institute, University of Washington, Seattle, WA; Division of Nephrology, University of Washington, Seattle, WA
| | | | - Bryan Kestenbaum
- Kidney Research Institute, University of Washington, Seattle, WA; Division of Nephrology, University of Washington, Seattle, WA
| | - Kenneth J Mukamal
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Denver Health Sciences Center, Aurora, CO
| | - Mark J Sarnak
- Division of Nephrology, Tufts Medical Center, Boston, MA
| | - David Siscovick
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA; Department of Medicine, University of Washington, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA; Department of Health Services, University of Washington, Seattle, WA; Center for Health Studies, Group Health, Seattle, WA
| | - Michael G Shlipak
- General Internal Medicine Section, Veterans Affairs Medical Center, San Francisco, CA; Department of Medicine, University of California, San Francisco, CA; Department of Epidemiology, University of California, San Francisco, CA; Department of Biostatistics, University of California, San Francisco, CA
| | - Joachim H Ix
- Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, San Diego, CA; Division of Nephrology and Preventive Medicine, University of California, San Diego, San Diego, CA
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Abstract
The pathophysiology of heart failure (HF) is characterized by hemodynamic abnormalities that result in neurohormonal activation and autonomic imbalance with increase in sympathetic activity and withdrawal of vagal activity. Alterations in receptor activation from this autonomic imbalance may have profound effects on cardiac function and structure. Inhibition of the sympathetic drive to the heart through β-receptor blockade has become a standard component of therapy for HF with a dilated left ventricle because of its effectiveness in inhibiting the ventricular structural remodeling process and in prolonging life. Several devices for selective modulation of sympathetic and vagal activity have recently been developed in an attempt to alter the natural history of HF. The optimal counteraction of the excessive sympathetic activity is still unclear. A profound decrease in adrenergic support with excessive blockade of the sympathetic nervous system may result in adverse outcomes in clinical HF. In this review, we analyze the data supporting a contributory role of the autonomic functional alterations on the course of HF, the techniques used to assess autonomic nervous system activity, the evidence for clinical effectiveness of pharmacological and device interventions, and the potential future role of autonomic nervous system modifiers in the management of this syndrome.
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Affiliation(s)
- Viorel G Florea
- From the Minneapolis VA Health Care System, Section of Cardiology (V.G.F.) and Rasmussen Center for Cardiovascular Disease Prevention, Department of Medicine (J.N.C.), University of Minnesota Medical School
| | - Jay N Cohn
- From the Minneapolis VA Health Care System, Section of Cardiology (V.G.F.) and Rasmussen Center for Cardiovascular Disease Prevention, Department of Medicine (J.N.C.), University of Minnesota Medical School.
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Antihypertensive action of allantoin in animals. BIOMED RESEARCH INTERNATIONAL 2014; 2014:690135. [PMID: 24745022 PMCID: PMC3972943 DOI: 10.1155/2014/690135] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 02/10/2014] [Indexed: 01/16/2023]
Abstract
The agonists of imidazoline I-1 receptors (I-1R) are widely used to lower blood pressure. It has been indicated that guanidinium derivatives show an ability to activate imidazoline receptors. Also, allantoin has a chemical stricture similar to guanidinium derivatives. Thus, it is of special interest to characterize the effect of allantoin on I-1R. In conscious male spontaneous hypertensive rats (SHRs), mean blood pressure (MBP) was recorded using the tail-cuff method. Furthermore, the hemodynamic analyses in catheterized rats were applied to measure the actions of allantoin in vivo. Allantoin decreased blood pressures in SHRs at 30 minutes, as the most effective time. Also, this antihypertensive action was shown in a dose-dependent manner from SHRs treated with allantoin. Moreover, in anesthetized rats, allantoin inhibited cardiac contractility and heart rate as showing in hemodynamic dP/dt max significantly. Also, the peripheral blood flow was markedly increased by allantoin. Both actions were diminished by efaroxan at the dose sufficient to block I-1R. Thus, we suggest that allantoin, as I-1R agonist, has the potential to develop as a new therapeutic agent for hypertension in the future.
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Xu JX, Si M, Zhang HR, Chen XJ, Zhang XD, Wang C, Du XN, Zhang HL. Phosphoinositide kinases play key roles in norepinephrine- and angiotensin II-induced increase in phosphatidylinositol 4,5-bisphosphate and modulation of cardiac function. J Biol Chem 2014; 289:6941-6948. [PMID: 24448808 DOI: 10.1074/jbc.m113.527952] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The seemly paradoxical Gq agonist-stimulated phosphoinositide production has long been known, but the underlying mechanism and its physiological significance are not known. In this study, we studied cardiac phosphoinositide levels in both cells and whole animals under the stimulation of norepinephrine (NE), angiotensin II (Ang II), and other physiologically relevant interventions. The results demonstrated that activation of membrane receptors related to NE or Ang II caused an initial increase and a later fall in phosphatidylinositol 4,5-bisphosphate (PIP2) levels in the primary cultured cardiomyocytes from adult rats. The possible mechanism underlying this increase in PIP2 was found to be through an enhanced activity of phosphatidylinositol 4-kinase IIIβ, which was mediated by an up-regulated interaction between phosphatidylinositol 4-kinase IIIβ and PKC; the increased activity of phosphatidylinositol 4-phosphate 5-kinase γ was also involved for NE-induced increase of PIP2. When the systolic functions of the NE/Ang II-treated cells were measured, a maintained or failed contractility was found to be correlated with a rise or fall in corresponding PIP2 levels. In two animal models of cardiac hypertrophy, PIP2 levels were significantly reduced in hypertrophic hearts induced by isoprenaline but not in those induced by swimming exercise. This study describes a novel mechanism for phosphoinositide metabolism and modulation of cardiac function.
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Affiliation(s)
- Jia-Xi Xu
- Key Laboratory of Neural and Vascular Biology, Ministry of Education, the Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Province, and the Department of Pharmacology, Hebei Medical University, Shijiazhuang, Hebei 050017, China
| | - Man Si
- Key Laboratory of Neural and Vascular Biology, Ministry of Education, the Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Province, and the Department of Pharmacology, Hebei Medical University, Shijiazhuang, Hebei 050017, China
| | - Hui-Ran Zhang
- Key Laboratory of Neural and Vascular Biology, Ministry of Education, the Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Province, and the Department of Pharmacology, Hebei Medical University, Shijiazhuang, Hebei 050017, China
| | - Xing-Juan Chen
- Key Laboratory of Neural and Vascular Biology, Ministry of Education, the Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Province, and the Department of Pharmacology, Hebei Medical University, Shijiazhuang, Hebei 050017, China
| | - Xi-Dong Zhang
- Key Laboratory of Neural and Vascular Biology, Ministry of Education, the Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Province, and the Department of Pharmacology, Hebei Medical University, Shijiazhuang, Hebei 050017, China
| | - Chuan Wang
- Key Laboratory of Neural and Vascular Biology, Ministry of Education, the Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Province, and the Department of Pharmacology, Hebei Medical University, Shijiazhuang, Hebei 050017, China
| | - Xiao-Na Du
- Key Laboratory of Neural and Vascular Biology, Ministry of Education, the Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Province, and the Department of Pharmacology, Hebei Medical University, Shijiazhuang, Hebei 050017, China
| | - Hai-Lin Zhang
- Key Laboratory of Neural and Vascular Biology, Ministry of Education, the Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Province, and the Department of Pharmacology, Hebei Medical University, Shijiazhuang, Hebei 050017, China.
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The effect of taurine on chronic heart failure: actions of taurine against catecholamine and angiotensin II. Amino Acids 2013; 46:111-9. [DOI: 10.1007/s00726-013-1507-z] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 04/29/2013] [Indexed: 11/26/2022]
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Lunde IG, Kvaløy H, Austbø B, Christensen G, Carlson CR. Angiotensin II and norepinephrine activate specific calcineurin-dependent NFAT transcription factor isoforms in cardiomyocytes. J Appl Physiol (1985) 2011; 111:1278-89. [PMID: 21474694 DOI: 10.1152/japplphysiol.01383.2010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Norepinephrine (NE) and angiotensin II (ANG II) are primary effectors of the sympathetic adrenergic and the renin-angiotensin-aldosterone systems, mediating hypertrophic, apoptotic, and fibrotic events in the myocardium. As NE and ANG II have been shown to affect intracellular calcium in cardiomyocytes, we hypothesized that they activate the calcium-sensitive, prohypertrophic calcineurin-nuclear factor of activated T-cell (NFATc) signaling pathway. More specifically, we have investigated isoform-specific activation of NFAT in NE- and ANG II-stimulated cardiomyocytes, as it is likely that each of the four calcineurin-dependent isoforms, c1-c4, play specific roles. We have stimulated neonatal ventriculocytes from C57/B6 and NFAT-luciferase reporter mice with ANG II or NE and quantified NFAT activity by luciferase activity and phospho-immunoblotting. ANG II and NE increased calcineurin-dependent NFAT activity 2.4- and 1.9-fold, measured as luciferase activity after 24 h of stimulation, and induced protein synthesis, measured by radioactive leucine incorporation after 24 and 72 h. To optimize measurements of NFAT isoforms, we examined the specificity of NFAT antibodies on peptide arrays and by immunoblotting with designed blocking peptides. Western analyses showed that both effectors activate NFATc1 and c4, while NFATc2 activity was regulated by NE only, as measured by phospho-NFAT levels. Neither ANG II nor NE activated NFATc3. As today's main therapies for heart failure aim at antagonizing the adrenergic and renin-angiotensin-aldosterone systems, understanding their intracellular actions is of importance, and our data, through validating a method for measuring myocardial NFATs, indicate that ANG II and NE activate specific NFATc isoforms in cardiomyocytes.
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Affiliation(s)
- Ida G Lunde
- Institute for Experimental Medical Research, Oslo Univ. Hospital-Ullevaal, Bldg. 7, 4 floor, Kirkeveien 166, 0407 Oslo, Norway.
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Oyama MA, Sisson DD, Prošek R, Bulmer BJ, Luethy MW, Fuentes VL. Carvedilol in Dogs with Dilated Cardiomyopathy. J Vet Intern Med 2007. [DOI: 10.1111/j.1939-1676.2007.tb01949.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Rolim NPL, Mattos KC, Brum PC, Baldo MVC, Middlekauff HR, Negrão CE. The decreased oxygen uptake during progressive exercise in ischemia-induced heart failure is due to reduced cardiac output rate. Braz J Med Biol Res 2006; 39:297-304. [PMID: 16470319 DOI: 10.1590/s0100-879x2006000200018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We tested the hypothesis that the inability to increase cardiac output during exercise would explain the decreased rate of oxygen uptake (VO2) in recent onset, ischemia-induced heart failure rats. Nine normal control rats and 6 rats with ischemic heart failure were studied. Myocardial infarction was induced by coronary ligation. VO2 was measured during a ramp protocol test on a treadmill using a metabolic mask. Cardiac output was measured with a flow probe placed around the ascending aorta. Left ventricular end-diastolic pressure was higher in ischemic heart failure rats compared with normal control rats (17 +/- 0.4 vs 8 +/- 0.8 mmHg, P = 0.0001). Resting cardiac index (CI) tended to be lower in ischemic heart failure rats (P = 0.07). Resting heart rate (HR) and stroke volume index (SVI) did not differ significantly between ischemic heart failure rats and normal control rats. Peak VO2 was lower in ischemic heart failure rats (73.72 +/- 7.37 vs 109.02 +/- 27.87 mL min(-1) kg(-1), P = 0.005). The VO2 and CI responses during exercise were significantly lower in ischemic heart failure rats than in normal control rats. The temporal response of SVI, but not of HR, was significantly lower in ischemic heart failure rats than in normal control rats. Peak CI, HR, and SVI were lower in ischemic heart failure rats. The reduction in VO2 response during incremental exercise in an ischemic model of heart failure is due to the decreased cardiac output response, largely caused by depressed stroke volume kinetics.
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Affiliation(s)
- N P L Rolim
- Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP, Brazil
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Feldman DS, Carnes CA, Abraham WT, Bristow MR. Mechanisms of disease: beta-adrenergic receptors--alterations in signal transduction and pharmacogenomics in heart failure. ACTA ACUST UNITED AC 2005; 2:475-83. [PMID: 16265588 DOI: 10.1038/ncpcardio0309] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2005] [Accepted: 06/23/2005] [Indexed: 01/08/2023]
Abstract
Beta-adrenergic signaling is an important regulator of myocardial function. During the progression of heart failure (HF), a reproducible series of biochemical events occurs that affects beta-adrenergic receptor (beta-AR) signaling and cardiac function. Furthermore, there are pathophysiologic alterations in the expression and regulation of proteins that are regulated by beta-ARs during HF. Analyses of these complex signaling pathways have led to a better understanding of HF mechanisms and the use of beta-adrenergic antagonists, which have notably altered HF-related morbidity and mortality. Despite therapeutic advances that have affected beta-AR signaling, HF remains a leading cause of hospitalization and a principal cause of death in industrialized nations. In this review, we summarize current insights into beta-adrenergic signal-transduction pathways, the best-described beta-AR polymorphisms, and therapies that target the beta-AR pathway in HF.
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Affiliation(s)
- David S Feldman
- Davis Heart and Lung Research Institute, Division of Cardiology/Medicine, Ohio State University, Columbus, OH 43210, USA.
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Wenzel RR, Mitchell A, Siffert W, Bührmann S, Philipp T, Schäfers RF. The I1-imidazoline agonist moxonidine decreases sympathetic tone under physical and mental stress. Br J Clin Pharmacol 2004; 57:545-51. [PMID: 15089806 PMCID: PMC1884505 DOI: 10.1111/j.1365-2125.2003.02058.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
AIMS Moxonidine is an I1-imidazoline receptor agonist that reduces blood pressure by inhibition of central sympathetic activity. The effects of the drug under physical and mental stress have not been studied in detail. METHODS We investigated the effects of 0.4 mg moxonidine orally on sympathetic activity, blood pressure and heart rate in a double-blind, placebo-controlled crossover study in 12 healthy volunteers. The subjects underwent physical exercise test using bicycle ergometry and a mental stress test using an adaptive reaction test device. Potential association of parameters with the GNB3 C825T polymorphism was also assessed. RESULTS Under resting conditions, moxonidine decreased plasma noradrenaline (NA: -66.1 +/- 12 pg ml(-1); P < 0.01 vs placebo) and adrenaline (A: -18.8 +/- 6 pg ml(-1); P < 0.05 vs placebo). Physical exercise evoked a significant increase in plasma NA and A (NA: 760 +/- 98 pg ml(-1); A: 97 +/- 9 pg ml(-1); P < 0.001 vs baseline), which was significantly reduced after pretreatment with moxonidine (NA: 627 +/- 68 pg ml(-1); P < 0.05 vs placebo; A: 42.8 +/- 4 pg ml(-1); P < 0.01 vs placebo). Maximal physical exercise capacity was not limited by moxonidine (NS). During the mental stress test, increases in NA (placebo: 146 +/- 24 pg ml(-1), moxonidine: 84 +/- 26 pg ml(-1); P < 0.01 vs placebo) and A (placebo: 22.8 +/- 9 pg ml(-1), moxonidine: 8.0 +/- 8 pg ml(-1); P < 0.01 vs placebo) were significantly reduced after pretreatment with moxonidine. Increases in blood pressure during mental stress were significantly lower after pretreatment with moxonidine (P < 0.05 vs placebo). There was no association of the response to moxonidine with GNB3 genotypes (NS). CONCLUSIONS Moxonidine decreases total sympathetic tone under basal conditions as well as during physical exercise and mental stress without limiting absolute exercise capacity. Thus, moxonidine appears suitable for the treatment of patients with high SNS activity and hypertension induced by physical or mental stress. As the drug does not reduce exercise capacity, it may be considered as an alternative to beta-adrenoceptor blockers in selected patients.
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Affiliation(s)
- René R Wenzel
- Department of Internal Medicine, A. O. Krankenhaus Zell A. See, Austria.
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Smiley LM, Camp TM, Lucchesi PA, Tyagi SC. Peroxisome proliferator ameliorates endocardial endothelial and muscarinic dysfunction in spontaneously hypertensive rats. Antioxid Redox Signal 2004; 6:367-74. [PMID: 15025938 DOI: 10.1089/152308604322899431] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Spontaneously hypertensive rats (SHR) develop hypertension (HT) at the age of 2-6 weeks. Endocardial endothelial (EE) dysfunction, autonomic suppression, left ventricle hypertrophy (LVH), and fibrosis are hallmarks of HT. The mechanism of EE dysfunction, LVH, and fibrosis in SHR is largely unknown. It is known, however, that the levels of peroxisome proliferator-activated receptor gamma (PPARgamma) are negatively correlated with EE function, LVH, and HT. PPARgamma ameliorates EE dysfunction and LVH, in part, by increasing endothelial nitric oxide (eNO) and muscarinic activity. Male SHR and normotensive Wistar rats (NWR) at 1 week of age were administered 8 micro g/ml ciglitazone (CZ), a PPARgamma agonist, in drinking water. The rats were grouped as follows: NWR, NWR+CZ, SHR, SHR+CZ, at 2 and 6 weeks (n = 6 in each group). The levels of PPARgamma were low in the nuclear extracts of the left ventricle (LV) in SHR, but increased in CZ-treated rats, measured by western analysis. The contractile response to norepinephrine in cardiac rings prepared from the above groups of rats, measured in tissue myobath and normalized by tissue weight, demonstrated no difference in the maximum response to norepinephrine in any group. However, the EC(50) was significantly lower in SHR at 2 weeks (SHR2wk) than in any other groups, and CZ normalized this decrease. The response to acetylcholine demonstrated no difference in EC(50); however, the maximum response was attenuated in SHR2wk, and substantially increased in SHR6wk as compared with age-matched NWR, suggesting that early in HT eNO dysfunction in SHR2wk leads to depression of autonomic muscarinic cholinergic receptor in SHR6wk. The PPARgamma agonist ameliorated both the early eNO dysfunction and late autonomic suppression in HT. The response to nitroprusside demonstrated no change in EC(50); however, the maximum response was attenuated only in SHR6wk. There were significant fibrosis, LVH, and increased LV pressure in SHR6wk compared with any other group, and CZ regressed LVH and LV pressure. Results suggest that early in HT, except for eNO dysfunction, other contractile responses are preserved; however, at 6 weeks there is significant nonendothelial cell dysfunction, and treatment with CZ reverses this nonendothelial dysfunction as well.
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Affiliation(s)
- Lane M Smiley
- Department of Physiology and Biophysics, University of Louisville Health Sciences Center, Louisville, KY, USA
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Sundstrom JB, Martinson DE, Mosunjac M, Bostik P, McMullan LK, Donahoe RM, Gravanis MB, Ansari AA. Norepinephrine enhances adhesion of HIV-1-infected leukocytes to cardiac microvascular endothelial cells. Exp Biol Med (Maywood) 2003; 228:730-40. [PMID: 12773706 DOI: 10.1177/153537020322800613] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Recent reports have indicated that norepinephrine (NE) enhances HIV replication in infected monocytes and promotes increased expression of select matrix metalloproteinases associated with dilated cardiomyopathy (DCM) in vitro in co-cultures of HIV-infected leukocytes and human cardiac microvascular endothelial cells (HMVEC-C). The influence of NE on HIV infection and leukocyte-endothelial interactions suggests a pathogenic role in AIDS-related cardiovascular disease. This study examined the effects of norepinephrine (NE) and HIV-1 infection on leukocyte adhesion to HMVEC-C. Both flow and static conditions were examined and the expression of selected adhesion molecules and cytokines were monitored in parallel. NE pretreatment resulted in a detectable, dose-dependent increase of leukocyte-endothelial adhesion (LEA) with both HIV-1-infected and -uninfected peripheral blood mononuclear cells (PBMCs) relative to media controls after 48 hr in co-culture with HMVEC-C in vitro. However, the combination of NE plus HIV infection resulted in a significant (P < 0.0001) 18-fold increase in LEA over uninfected media controls. Increased levels in both cell-associated and -soluble ICAM-1 and E-Selectin but not VCAM-1 correlated with increased LEA and with HIV-1 infection or NE pretreatment. Blocking antibodies specific for ICAM-1 or E-Selectin inhibited HIV-NE-induced LEA. These data suggest a model in which NE primes HIV-1-infected leukocytes for enhanced adhesion and localization in HMVEC-C where they can initiate and participate in vascular injury associated with AIDS-related cardiomyopathy.
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Affiliation(s)
- J B Sundstrom
- Department of Pathology, Emory University, Atlanta, Georgia 30322, USA.
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Brum PC, Kosek J, Patterson A, Bernstein D, Kobilka B. Abnormal cardiac function associated with sympathetic nervous system hyperactivity in mice. Am J Physiol Heart Circ Physiol 2002; 283:H1838-45. [PMID: 12384461 DOI: 10.1152/ajpheart.01063.2001] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
alpha(2A)-Adrenergic receptors (ARs) in the midbrain regulate sympathetic nervous system activity, and both alpha(2A)-ARs and alpha(2C)-ARs regulate catecholamine release from sympathetic nerve terminals in cardiac tissue. Disruption of both alpha(2A)- and alpha(2C)-ARs in mice leads to chronically elevated sympathetic tone and decreased cardiac function by 4 mo of age. These knockout mice have increased mortality, reduced exercise capacity, decreased peak oxygen uptake, and decreased cardiac contractility relative to wild-type controls. Moreover, we observed significant abnormalities in the ultrastructure of cardiac myocytes from alpha(2A)/alpha(2C)-AR knockout mice by electron microscopy. Our results demonstrate that chronic elevation of sympathetic tone can lead to abnormal cardiac function in the absence of prior myocardial injury or genetically induced alterations in myocardial structural or functional proteins. These mice provide a physiologically relevant animal model for investigating the role of the sympathetic nervous system in the development and progression of heart failure.
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Affiliation(s)
- Patricia C Brum
- Department of Medicine, Stanford University, Stanford, CA 94305, USA
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Abstract
Patients with chronic heart failure have increased sympathetic nervous system activity that contributes to deterioration of cardiovascular function over time. Long-term beta-blocker therapy prevents such deterioration through inhibition of this neurohormonal pathway. The impressive survival data collected from several large studies have made beta-blockers a component of standard therapy for New York Heart Association class II to III heart failure. Although there are differences in the pharmacological properties of the beta-blockers shown to improve morbidity and mortality in heart failure, there is little evidence to suggest that such properties constitute any major advantages in clinical outcome. Carvedilol and extended-release metoprolol succinate are 2 beta-blockers currently approved in the United States for the treatment of patients with heart failure. Both agents have shown similar risk reductions in overall and cause-specific mortality; however, no outcome data from a comparative trial are available to support the use of one agent over the other. Regardless of the agent chosen, appropriate dosing and titration of beta-blockers are essential for successful therapy.
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Affiliation(s)
- Marrick L Kukin
- The Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Gold PW, Chrousos GP. Organization of the stress system and its dysregulation in melancholic and atypical depression: high vs low CRH/NE states. Mol Psychiatry 2002; 7:254-75. [PMID: 11920153 DOI: 10.1038/sj.mp.4001032] [Citation(s) in RCA: 875] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2001] [Accepted: 10/17/2001] [Indexed: 01/17/2023]
Abstract
Stress precipitates depression and alters its natural history. Major depression and the stress response share similar phenomena, mediators and circuitries. Thus, many of the features of major depression potentially reflect dysregulations of the stress response. The stress response itself consists of alterations in levels of anxiety, a loss of cognitive and affective flexibility, activation of the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system, and inhibition of vegetative processes that are likely to impede survival during a life-threatening situation (eg sleep, sexual activity, and endocrine programs for growth and reproduction). Because depression is a heterogeneous illness, we studied two diagnostic subtypes, melancholic and atypical depression. In melancholia, the stress response seems hyperactive, and patients are anxious, dread the future, lose responsiveness to the environment, have insomnia, lose their appetite, and a diurnal variation with depression at its worst in the morning. They also have an activated CRH system and may have diminished activities of the growth hormone and reproductive axes. Patients with atypical depression present with a syndrome that seems the antithesis of melancholia. They are lethargic, fatigued, hyperphagic, hypersomnic, reactive to the environment, and show diurnal variation of depression that is at its best in the morning. In contrast to melancholia, we have advanced several lines of evidence of a down-regulated hypothalamic-pituitary adrenal axis and CRH deficiency in atypical depression, and our data show us that these are of central origin. Given the diversity of effects exerted by CRH and cortisol, the differences in melancholic and atypical depression suggest that studies of depression should examine each subtype separately. In the present paper, we shall first review the mediators and circuitries of the stress system to lay the groundwork for placing in context physiologic and structural alterations in depression that may occur as part of stress system dysfunction.
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Affiliation(s)
- P W Gold
- Clinical Neuroendocrinology Branch, Intramural Research Program, NIMH/NIH, NIH Clinical Center, Room 2D-46-1284, Bethesda, MD 20892-1284, USA.
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Gold PW, Gabry KE, Yasuda MR, Chrousos GP. Divergent endocrine abnormalities in melancholic and atypical depression: clinical and pathophysiologic implications. Endocrinol Metab Clin North Am 2002; 31:37-62, vi. [PMID: 12055990 DOI: 10.1016/s0889-8529(01)00022-6] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Mediators of neuroendocrine and autonomic function seem to play important roles in the core symptoms of major depression. Although centrally directed corticotropin-releasing hormones and norepinephrine contribute to core symptoms such as alterations in anxiety, arousal, and mood, they also exert significant potentially clinically relevant effects on key processes that proceed in the periphery. Thus, the core clinical manifestations of major depression may represent a fraction of a complicated systemic illness that not only influences thought and feeling, but also the processes involved in premature cardiovascular disease, osteoporosis, and premature death. Subdividing patients with major depression into meaningful biologic subgroups will facilitate the elucidation of the mechanisms that underlie the central and peripheral manifestations of major depressive illness.
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Affiliation(s)
- Philip W Gold
- Clinical Endocrinology Branch, Intramural Research Program, National Institute of Mental Health, Bathesda, MD 20892, USA.
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Raasch W, Betge S, Dendorfer A, Bartels T, Dominiak P. Angiotensin converting enzyme inhibition improves cardiac neuronal uptake of noradrenaline in spontaneously hypertensive rats. J Hypertens 2001; 19:1827-33. [PMID: 11593103 DOI: 10.1097/00004872-200110000-00017] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES It has been shown that a diminished sympathetic activity contributes to the hypotensive and cardioprotective actions of angiotensin converting enzyme (ACE) inhibitors (ACEI). Besides an inhibition of central sympathetic tone and peripheral noradrenaline release, we hypothesized that the interactions of ACEI with the sympathetic system may include a modulation of neuronal catecholamine uptake by peripheral nerves. DESIGN We investigated the influence of fosinopril on noradrenergic uptake into cardiac neurones in vitro and in vivo in acute and chronic models. METHODS AND RESULTS Acute administration of fosinoprilat to isolated perfused rat hearts increased the extraction of [3H]-noradrenaline from the perfusate by 39%. Treatment (14 days) of spontaneously hypertensive rats (SHR) with fosinopril (20 mg/kg per day) enhanced the cardiac uptake of i.v. administered [3H]-noradrenaline by 28%. The endogenous left ventricular content of noradrenaline was increased by 49% after an antihypertensive treatment of SHR with fosinopril (20 mg/kg per day). Identical increases in cardiac noradrenaline stores (53%) were observed in SHR treated with a blood pressure ineffective dose of fosinopril (0.2 mg/kg per day). The myocardial content of adrenaline was increased in parallel to noradrenaline after both dose regimes. CONCLUSIONS It is concluded that ACEI increases neuronal uptake of catecholamines in SHR in a blood pressure-independent manner. This effect occurs acutely and is independent of central sympathetic activity. Therefore, we hypothesize that ACEI modulate the activity of the cardiac noradrenaline transporter by direct activation. The improved uptake of noradrenaline may contribute to the antihypertensive and cardioprotective effects of ACEI.
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Affiliation(s)
- W Raasch
- Institute of Experimental and Clinical Pharmacology and Toxicology, Medical University of Luebeck, Germany.
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Eichhorn EJ, Young JB. Optimizing the use of beta-blockers in the effective treatment and management of heart failure: a case study approach. Am J Med 2001; 110 Suppl 5A:11S-20S. [PMID: 11259752 DOI: 10.1016/s0002-9343(01)00667-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Today, heart failure is an increasing concern in the United States. Its prognoses are poor and its treatment is a complicated endeavor, because heart failure is not a single disease state. Rather, it is a syndrome with a cyclic pathophysiology composed of multiple mechanisms. Effective case management of heart failure must address each of the many changes involved in this syndrome, and therapy must be individualized, especially because patients with heart failure often require regimens of five or more drugs. In special populations, such as the elderly and/or patients with concomitant diseases requiring added medication, polypharmacy becomes an important issue. Maintaining consistent compliance with the treatment regimen and patient education regarding symptoms of fluid retention can be critical. Currently, beta-blockers, in addition to standard therapy, are recommended as first-line treatment in mild-to-moderate heart failure. The three cases presented in this article illustrate some common scenarios encountered and clinical decisions made when beta-blockers are used in the management of heart failure.
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Affiliation(s)
- E J Eichhorn
- Department of Internal Medicine, Division of Cardiology, The University of Texas, Southwestern Medical Center, the Cardiac Catheterization Laboratory, Dallas Veterans Administration Medical Center, (EJE), Dallas, Texas, USA
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Boesch ST, Dobler G, Ramoner R, Corvin S, Thurnher M, Bartsch G, Klocker H. Effects of alpha1-adrenoceptor antagonists on cultured prostatic smooth muscle cells. THE PROSTATE. SUPPLEMENT 2001; 9:34-41. [PMID: 11056501 DOI: 10.1002/1097-0045(2000)45:9+<34::aid-pros8>3.0.co;2-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND alpha1-adrenoceptor (alpha1-AR) antagonists, used to relieve the lower tract urinary symptoms (LUTS) in benign prostate hyperplasia (BPH) patients, are thought to act in inhibiting the contraction of stromal smooth muscle. An attempt was made using new technology to visualize and quantify the effect of alpha1-AR antagonists in a cell culture model of prostatic smooth muscle cells (SMC). METHODS Prostatic smooth muscle cells cultured from human prostate tissue were treated with alpha1-AR agonists and antagonists. The effects on cell growth, cell contraction, differentiation status, and apoptosis were determined by means of an MTT cell viability assay, time-lapse video microscopy, RT-PCR analysis, and FACS analysis of annexin V/propidium iodide-stained cells, respectively. RESULTS Prostatic smooth muscle cells derived from prostate tissue expressed SMC-specific markers. They showed spontaneous contractions, and phenylephrine increased the percentage of contracting cells by 3-fold. alpha1-AR antagonists inhibited spontaneous as well as phenylephrine-induced contractions. Long-term treatment with doxazosin induced differentiation tended towards a contractile phenotype, as indicated by an increase of the ratio of smooth muscle heavy chain myosin subtypes SM2/SM1. There was, however, no effect on cell growth. High concentrations of antagonist (100 microM) induced apoptosis in about 80% of the treated SMC. This effect was not cell-type-specific and was also seen in skin fibroblasts and immortalized prostate epithelial cells. CONCLUSION In an easy-to-handle cell culture model of prostatic smooth muscle cells, the effects of alpha1-AR antagonists on cell contraction, growth, and differentiation can be investigated. The results indicate that in addition to inhibition of cell contraction, alpha1-AR antagonists have the potential to induce apoptosis.
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Affiliation(s)
- S T Boesch
- Department of Urology, University of Innsbruck, Innsbruck, Austria
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Zoccali C, Benedetto FA, Mallamaci F, Tripepi G, Candela V, Labate C, Tassone F. Left ventricular hypertrophy and nocturnal hypoxemia in hemodialysis patients. J Hypertens 2001; 19:287-93. [PMID: 11212972 DOI: 10.1097/00004872-200102000-00016] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Nocturnal hypoxemia has recently been proposed as a cardiovascular risk factor in patients with chronic renal failure. In this study we have tested the hypothesis that this disturbance is associated with left ventricular hypertrophy (LVH) in dialysis patients. METHODS During a mid-week non-dialysis day, 38 hemodialysis patients underwent continuous monitoring of arterial O2 saturation (SaO2) during night-time as well as 24 h ambulatory blood pressure monitoring and echocardiography. RESULTS Eighteen patients had one or more episodes of O2 desaturation during night-time (average: 21 episodes; range 1 to 120) while the other 20 had no episode. Neither day-time arterial pressure nor heart rate were significantly associated with nocturnal hypoxemia. However there was a significant correlation between the night/day systolic ratio and the severity of hypoxemia during night-time (r = 0.36, P = 0.03). On multivariate analysis, nocturnal hypoxemia proved to be the stronger independent predictor of relative wall thickness, mean wall thickness and left ventricular mass index, suggesting that nocturnal O2 desaturation is linked to concentric hypertrophy and to concentric geometry of the left ventricle. Accordingly, the proportion of patients with such geometric alteration was higher (chi2 = 4.1, P = 0.04) in patients with a pulse oximetry severity score > 50th percentile [15 of 19 (79%)] than in those below this threshold [nine of 19 (47%)]. CONCLUSIONS Nocturnal hypoxemia is an important correlate of LVH in hemodialysis patients. Such an association is largely independent of arterial pressure. These data further underscore the importance of disturbed respiratory control as a cardiovascular risk factor in dialysis patients.
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Affiliation(s)
- C Zoccali
- CNR, Centre of Clinical Physiology and Division of Nephrology Ospedali Riuniti, Reggio Cal, Italy.
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Gu C, Ma YC, Benjamin J, Littman D, Chao MV, Huang XY. Apoptotic signaling through the beta -adrenergic receptor. A new Gs effector pathway. J Biol Chem 2000; 275:20726-33. [PMID: 10767282 DOI: 10.1074/jbc.m000152200] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Stimulation of beta-adrenergic receptor normally results in signaling by the heterotrimeric G protein G(s), leading to the activation of adenylyl cyclase, production of cAMP, and activation of cAMP-dependent protein kinase (PKA). Here we report that cell death of thymocytes can be induced after stimulation of beta-adrenergic receptor, or by addition of exogenous cAMP. Apoptotic cell death in both cases was observed with the appearance of terminal deoxynucleotidyl transferase-mediated UTP end labeling reactivity and the activation of caspase-3 in S49 T cells. Using thymocytes deficient in either Galpha(s) or PKA, we find that engagement of beta-adrenergic receptors initiated a Galpha(s)-dependent, PKA-independent pathway leading to apoptosis. This alternative pathway involves Src family tyrosine kinase Lck. Furthermore, we show that Lck protein kinase activity can be directly stimulated by purified Galpha(s). Our data reveal a new signaling pathway for Galpha(s), distinct from the classical PKA pathway, that accounts for the apoptotic action of beta-adrenergic receptors.
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Affiliation(s)
- C Gu
- Graduate Program of Cell Biology and Genetics, Graduate Program of Physiology, Biophysics and Molecular Medicine, and the Department of Physiology, Cornell University Medical College, New York, New York 10021, USA
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Elsässer A, Suzuki K, Schaper J. Unresolved issues regarding the role of apoptosis in the pathogenesis of ischemic injury and heart failure. J Mol Cell Cardiol 2000; 32:711-24. [PMID: 10775477 DOI: 10.1006/jmcc.2000.1125] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
UNLABELLED Apoptosis is "suicidal" programmed cell death followed by necrosis, i.e. cellular degradation. This review presents a critical evaluation of the methods used for detection of apoptosis and on data regarding the role of apoptosis in ischemia and heart failure. METHODS DNA laddering by electrophoresis and the TUNEL method in histology for the final stage of apoptosis, Annexin V labeling, evidence of caspase activation, cleavage of substrates, measurements of mitochondrial pro-apoptotic and anti-apoptotic factors (Bcl-2, Bax and others) and determination of the mitochondrial transitional pore potential. Much work has been carried out regarding the mechanism and the importance of apoptosis in ischemia and heart failure but many issues still remain unsolved: (1)Time needed for completion of apoptosis from stimulus to DNA fragmentation? (2)Importance of mitochondrial pathway considering the fact that cardiomyocytes contain the highest volume density of mitochondria of all mammalian cells (25% in humans, 37% in mice)? (3)Means of removal of dead cells, disconnection at the intercalated disc from neighbouring myocytes, time frame of this process? (4)Reversibility of apoptosis? (5)Differences between physiological (postnatal differentiation of the conduction system) v pathological apoptotic cell death? (6)Why do cells, under ischemic conditions, die by either apoptosis or oncosis? (7)Is apoptosis an epiphenomenon or a true cause of heart failure? (8)Quantification of the rate of apoptosis in different pathophysiological situations? Clarification of these unresolved issues will then allow an estimation of the importance of apoptosis in cardiac pathophysiology and, if necessary because the role of apoptosis has been established, the development of new therapeutic concepts.
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Affiliation(s)
- A Elsässer
- Dept. of Cardiology, University of Freiburg/Br, Germany
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Wang YM, Xu F, Gainetdinov RR, Caron MG. Genetic approaches to studying norepinephrine function: knockout of the mouse norepinephrine transporter gene. Biol Psychiatry 1999; 46:1124-30. [PMID: 10560019 DOI: 10.1016/s0006-3223(99)00245-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Norepinephrine is an important chemical messenger in the nervous system. It regulates affective states, learning and memory, endocrine and autonomic functions. It has been implicated in depression, aggression, and addiction, as well as cardiac and thermal dysregulation. The norepinephrine transporter functions by uptaking norepinephrine back into the cell for cyclic use, and is a direct target of a number of antidepressants and psychostimulants. Functional deletion (knockout) of monamine transporters results in increases in extracellular levels of neurotransmitters, thereby prolonging their actions. For the norepinephrine transporter knockout mice, this altered state of the norepinephrine system should simulate the therapeutic effects of norepinephrine selective antidepressants and some of the effects of psychostimulants. Careful use of such an animal model can hopefully provide valuable insight into the multiple roles norepinephrine plays in normal and pathological physiology.
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Affiliation(s)
- Y M Wang
- Howard Hughes Medical Institute, Department of Cell Biology, Duke University Medical Center, Durham, NC 27710, USA
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