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Ma ZP, Wang SW, Xue LY, Zhang XD, Zheng W, Zhao YX, Yuan SR, Li GY, Yu YN, Wang JN, Zhang TL. A study on the application of radiomics based on cardiac MR non-enhanced cine sequence in the early diagnosis of hypertensive heart disease. BMC Med Imaging 2024; 24:124. [PMID: 38802736 PMCID: PMC11129462 DOI: 10.1186/s12880-024-01301-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND The prevalence of hypertensive heart disease (HHD) is high and there is currently no easy way to detect early HHD. Explore the application of radiomics using cardiac magnetic resonance (CMR) non-enhanced cine sequences in diagnosing HHD and latent cardiac changes caused by hypertension. METHODS 132 patients who underwent CMR scanning were divided into groups: HHD (42), hypertension with normal cardiac structure and function (HWN) group (46), and normal control (NOR) group (44). Myocardial regions of the end-diastolic (ED) and end-systolic (ES) phases of the CMR short-axis cine sequence images were segmented into regions of interest (ROI). Three feature subsets (ED, ES, and ED combined with ES) were established after radiomic least absolute shrinkage and selection operator feature selection. Nine radiomic models were built using random forest (RF), support vector machine (SVM), and naive Bayes. Model performance was analyzed using receiver operating characteristic curves, and metrics like accuracy, area under the curve (AUC), precision, recall, and specificity. RESULTS The feature subsets included first-order, shape, and texture features. SVM of ED combined with ES achieved the highest accuracy (0.833), with a macro-average AUC of 0.941. AUCs for HHD, HWN, and NOR identification were 0.967, 0.876, and 0.963, respectively. Precisions were 0.972, 0.740, and 0.826; recalls were 0.833, 0.804, and 0.863, respectively; and specificities were 0.989, 0.863, and 0.909, respectively. CONCLUSIONS Radiomics technology using CMR non-enhanced cine sequences can detect early cardiac changes due to hypertension. It holds promise for future use in screening for latent cardiac damage in early HHD.
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Affiliation(s)
- Ze-Peng Ma
- Department of Radiology, Affiliated Hospital of Hebei University/ Clinical Medical College, Hebei University, Baoding, 071000, China
- Hebei Key Laboratory of Precise Imaging of Inflammation Related Tumors, Baoding, 071000, China
| | - Shi-Wei Wang
- College of Quality and Technical Supervision, Hebei University, Baoding, 071002, China
| | - Lin-Yan Xue
- College of Quality and Technical Supervision, Hebei University, Baoding, 071002, China
| | - Xiao-Dan Zhang
- Department of Ultrasound, Affiliated Hospital of Hebei University, 212 Yuhua East Road, Baoding, 071000, China.
| | - Wei Zheng
- College of Electronic and Information Engineering, Hebei University, Baoding, 071002, China
| | - Yong-Xia Zhao
- Department of Radiology, Affiliated Hospital of Hebei University/ Clinical Medical College, Hebei University, Baoding, 071000, China
| | - Shuang-Rui Yuan
- Department of Radiology, Affiliated Hospital of Hebei University/ Clinical Medical College, Hebei University, Baoding, 071000, China
| | - Gao-Yang Li
- Department of Radiology, Affiliated Hospital of Hebei University/ Clinical Medical College, Hebei University, Baoding, 071000, China
| | - Ya-Nan Yu
- Department of Radiology, Affiliated Hospital of Hebei University/ Clinical Medical College, Hebei University, Baoding, 071000, China
| | - Jia-Ning Wang
- Department of Radiology, Affiliated Hospital of Hebei University/ Clinical Medical College, Hebei University, Baoding, 071000, China
| | - Tian-Le Zhang
- Department of Radiology, Affiliated Hospital of Hebei University/ Clinical Medical College, Hebei University, Baoding, 071000, China
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Chalise U, Hale TM. Fibroblasts under pressure: cardiac fibroblast responses to hypertension and antihypertensive therapies. Am J Physiol Heart Circ Physiol 2024; 326:H223-H237. [PMID: 37999643 PMCID: PMC11219059 DOI: 10.1152/ajpheart.00401.2023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023]
Abstract
Approximately 50% of Americans have hypertension, which significantly increases the risk of heart failure. In response to increased peripheral resistance in hypertension, intensified mechanical stretch in the myocardium induces cardiomyocyte hypertrophy and fibroblast activation to withstand increased pressure overload. This changes the structure and function of the heart, leading to pathological cardiac remodeling and eventual progression to heart failure. In the presence of hypertensive stimuli, cardiac fibroblasts activate and differentiate to myofibroblast phenotype capable of enhanced extracellular matrix secretion in coordination with other cell types, mainly cardiomyocytes. Both systemic and local renin-angiotensin-aldosterone system activation lead to increased angiotensin II stimulation of fibroblasts. Angiotensin II directly activates fibrotic signaling such as transforming growth factor β/SMAD and mitogen-activated protein kinase (MAPK) signaling to produce extracellular matrix comprised of collagens and matricellular proteins. With the advent of single-cell RNA sequencing techniques, heterogeneity in fibroblast populations has been identified in the left ventricle in models of hypertension and pressure overload. The various clusters of fibroblasts reveal a range of phenotypes and activation states. Select antihypertensive therapies have been shown to be effective in limiting fibrosis, with some having direct actions on cardiac fibroblasts. The present review focuses on the fibroblast-specific changes that occur in response to hypertension and pressure overload, the knowledge gained from single-cell analyses, and the effect of antihypertensive therapies. Understanding the dynamics of hypertensive fibroblast populations and their similarities and differences by sex is crucial for the advent of new targets and personalized medicine.
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Affiliation(s)
- Upendra Chalise
- Department of Medicine, University of Minnesota-Twin Cities, Minneapolis, Minnesota, United States
| | - Taben M Hale
- Department of Basic Medical Sciences, University of Arizona, College of Medicine-Phoenix, Phoenix, Arizona, United States
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Raj P, Sayfee K, Yu L, Sabra A, Wijekoon C, Malunga L, Thandapilly SJ, Netticadan T. Oat Beta-Glucan Alone and in Combination with Hydrochlorothiazide Lowers High Blood Pressure in Male but Not Female Spontaneously Hypertensive Rats. Nutrients 2023; 15:3180. [PMID: 37513599 PMCID: PMC10385299 DOI: 10.3390/nu15143180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Oats are considered a functional food due to the beneficial health effects associated with their consumption and are suitable to be explored for their ability to prevent or manage chronic disease, such as hypertension. Here, we examined the cardiovascular benefits of an oat beta-glucan extract in male and female spontaneously hypertensive rats (SHRs) to unravel its sex-specific roles when used with an anti-hypertensive medication, hydrochlorothiazide. Five-week-old male and female SHRs and Wistar-Kyoto (WKY) rats were treated with oat beta-glucan and hydrochlorothiazide for 15 weeks. Twenty-week-old male and female SHRs showed high blood pressure (BP), cardiac remodeling, and cardiac dysfunction. These animals also had significantly increased levels of malondialdehyde (MDA), angiotensin II, and norepinephrine. Treatments with beta-glucan and hydrochlorothiazide were able to differentially prevent high BP, cardiac dysfunction, and alterations in malondialdehyde (MDA), angiotensin II, and norepinephrine in 20-week-old male and female SHRs. To conclude, beta-glucan alone and in combination with hydrochlorothiazide may be a promising a strategy for managing hypertension and related cardiac complications.
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Affiliation(s)
- Pema Raj
- St. Boniface Hospital Research Centre, Winnipeg, MB R2H 2A6, Canada
| | - Karen Sayfee
- St. Boniface Hospital Research Centre, Winnipeg, MB R2H 2A6, Canada
- Canadian Centre for Agri-Food Research in Health and Medicine, Winnipeg, MB R2H 2A6, Canada
| | - Liping Yu
- St. Boniface Hospital Research Centre, Winnipeg, MB R2H 2A6, Canada
- Canadian Centre for Agri-Food Research in Health and Medicine, Winnipeg, MB R2H 2A6, Canada
- Agriculture and Agri-Food Canada, Winnipeg, MB R2H 2A6, Canada
| | - Ali Sabra
- St. Boniface Hospital Research Centre, Winnipeg, MB R2H 2A6, Canada
- Agriculture and Agri-Food Canada, Winnipeg, MB R2H 2A6, Canada
| | - Champa Wijekoon
- St. Boniface Hospital Research Centre, Winnipeg, MB R2H 2A6, Canada
- Canadian Centre for Agri-Food Research in Health and Medicine, Winnipeg, MB R2H 2A6, Canada
- Agriculture and Agri-Food Canada, Winnipeg, MB R2H 2A6, Canada
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, MB R2H 2A6, Canada
| | - Lovemore Malunga
- Agriculture and Agri-Food Canada, Winnipeg, MB R2H 2A6, Canada
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, MB R2H 2A6, Canada
- Richardson Center for Food Technology and Research, Winnipeg, MB R2H 2A6, Canada
| | - Sijo Joseph Thandapilly
- Agriculture and Agri-Food Canada, Winnipeg, MB R2H 2A6, Canada
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, MB R2H 2A6, Canada
- Richardson Center for Food Technology and Research, Winnipeg, MB R2H 2A6, Canada
| | - Thomas Netticadan
- St. Boniface Hospital Research Centre, Winnipeg, MB R2H 2A6, Canada
- Canadian Centre for Agri-Food Research in Health and Medicine, Winnipeg, MB R2H 2A6, Canada
- Agriculture and Agri-Food Canada, Winnipeg, MB R2H 2A6, Canada
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, MB R2H 2A6, Canada
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB R2H 2A6, Canada
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Li Q, Li N, Liang X, Liu Y, Chen L, Lao H, Wei S, Xiao J, Qi X. The study of antecedent clinical manifestations of hypertensive heart disease in cohort of hypertension. Aging (Albany NY) 2023; 15:1890-1917. [PMID: 36812472 PMCID: PMC10085586 DOI: 10.18632/aging.204510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/17/2021] [Indexed: 02/21/2023]
Abstract
Hypertensive heart disease presents increasing morbidity and mortality worldwide, however, the data about its epidemics and its specific symptoms in hypertension patients is scarce. To assess the frequency and correlated symptoms of hypertensive heart disease, 800 hypertension patients were randomly recruited for this study per the guidelines of the American College of Cardiology. The diagnosis of heart disease and its typical symptoms (palpitation and angina) were analyzed for the frequency of hypertensive heart disease in hypertension cohort. Cross-tabulation analysis was used to study the correlation between psychiatric indexes (annoy, amnesia, irritableness, depression, anxiety, and fear) and palpitation, the correlation between physical disorders (backache, lumbar debility, and numbness of limbs) and palpitation, and the correlation between symptoms (dizziness, daze, headache, and tinnitus) and palpitation presented in hypertensive patients. It was found that around half of patients suffered hypertensive heart disease, which correlated to certain physical and mental symptoms. Significant correlation exists between palpitation and annoy / amnesia. Significant correlation exists between palpitation and backache / lumbar debility / numbness of limbs; and significant correlation exists between palpitation and dizziness / daze / headache / tinnitus. These results provide clinical insights into the modifiable antecedent clinical conditions which are risk factors for hypertensive heart disease in elderly and will help improve early management of this disease.
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Affiliation(s)
- Qian Li
- The American Academy of Tradition Chinese Medicine Inc. Roseville, MN 55113, USA
| | - Na Li
- Qingdao Fifth People’s Hospital, Qingdao 266002, Shandong, China
| | - Xiao Liang
- Saint Mary’s University of Minnesota, Minneapolis, MN 55404, USA
| | - Yanjie Liu
- Department of Neck-Shoulder-Lumbocrural Pain Treatment, Yantai Hospital of Traditional Chinese Medicine, Yantai 264013, Shandong, China
| | - Li Chen
- Department of Science and Education, Shandong Provincial Third Hospital, Jinan 250031, Shandong, China
| | - Huimin Lao
- Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan 250011, Shandong, China
| | - Sheng Wei
- Experimental Center, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong, China.,Key Laboratory of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong, China
| | - Jun Xiao
- The Macrohard Institute of Health, Roseville, MI 48066, USA
| | - Xiaoqiang Qi
- The Macrohard Institute of Health, Roseville, MI 48066, USA.,University of Missouri-Columbia, Columbia, MO 65212, USA
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Zhang S, Qian ZM, Chen L, Zhao X, Cai M, Wang C, Zou H, Wu Y, Zhang Z, Li H, Lin H. Exposure to Air Pollution during Pre-Hypertension and Subsequent Hypertension, Cardiovascular Disease, and Death: A Trajectory Analysis of the UK Biobank Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:17008. [PMID: 36696106 PMCID: PMC9875843 DOI: 10.1289/ehp10967] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 11/27/2022] [Accepted: 12/15/2022] [Indexed: 05/28/2023]
Abstract
BACKGROUND The associations between air pollution exposure and morbidity and mortality of cardiovascular diseases (CVDs) have been widely reported; however, evidence on such associations across different dynamic disease trajectories remain unknown. OBJECTIVE We examined whether ambient air pollution during the prehypertension (pre-HTN) stage could aggravate the progression from hypertension (HTN) to CVD, and consequent death. METHODS A total of 168,010 adults with pre-HTN (120 - 139 mmHg systolic blood pressure or 80 - 89 mmHg diastolic blood pressure) from the UK Biobank were included in this analysis. We used a multistate model to explore the associations between five air pollutants (PM 2.5 , PM 2.5 absorbance, PM 10 , NO 2 , and NO x ) and the risk of six disease transitions (from pre-HTN to HTN, from pre-HTN to CVD, from pre-HTN to death, from HTN to CVD, from HTN to death, and from CVD to death). Mediation analyses were further conducted to explore the role of intermediate diseases in the dynamic progression of CVDs. RESULTS During a median follow-up of 12 y, 13,743 (8.18%) of participants with pre-HTN developed HTN, whereas 12,825 (7.63%) and 4,467 (2.66%) directly developed CVD or died, respectively. Air pollution was positively associated with the dynamic disease progression. For example, a per-interquartile range increase of PM 2.5 was significantly associated with the hazard ratios (HRs) of 1.105 [95% confidence intervals (CI): 1.083, 1.127], 1.045 (95% CI: 1.022, 1.068), and 1.086 (95% CI: 1.047, 1.126) in the transition from pre-HTN to HTN, CVD, and death, respectively. Higher levels of air pollution were associated with increased transition probability of disease progression. Mediation analyses indicated that intermediate diseases subsequently significantly mediated air pollutant-associated risk to develop more serious disease. CONCLUSIONS This study provides evidence that air pollution might play a role in the early stages of CVD progression. Controlling air pollution might be an effective measure to prevent CVD progression and reduce the disease burden of CVD. https://doi.org/10.1289/EHP10967.
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Affiliation(s)
- Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Lan Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Hongtao Zou
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yinglin Wu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Haitao Li
- Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Ahmad F, Karim A, Khan J, Qaisar R. Plasma zonulin correlates with cardiac dysfunction and poor physical performance in patients with chronic heart failure. Life Sci 2022; 311:121150. [DOI: 10.1016/j.lfs.2022.121150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/20/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022]
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Hossain MZ, Chew-Graham CA, Sowden E, Blakeman T, Wellwood I, Tierney S, Deaton C. Challenges in the management of people with heart failure with preserved ejection fraction (HFpEF) in primary care: A qualitative study of general practitioner perspectives. Chronic Illn 2022; 18:410-425. [PMID: 33401942 PMCID: PMC9163769 DOI: 10.1177/1742395320983871] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To explore the perspectives of general practitioners (GPs) on the identification and management of people, including those from ethnic minority groups, with Heart Failure with Preserved Ejection Fraction (HFpEF). METHODS Qualitative study. Semi-structured, face-to-face or telephone interviews and focus groups were conducted with 35 GPs in England, which were audio-recorded and transcribed verbatim. Framework analysis was used to manage and interpret data. RESULTS Themes presented reflect four inter-related challenges: GPs' 1) lack of understanding HFpEF, impacting on 2) difficulties in communicating the diagnosis, leading to 3) uncertainty in managing people with HFpEF, further hindered by (4) discontinuity across the primary/secondary interface. All were considered more challenging by GPs when managing people from different cultures and languages. DISCUSSION HFpEF is not well understood by GPs, leading to diagnostic difficulty, management uncertainty and potential inequity in care offered. People with HFpEF are seen as complex, with multiple long-term conditions and requiring personalised care. Challenges in their management occur across the healthcare system. This study has identified learning needs for GPs around identification and on-going support for people with HFpEF in primary care. It will contribute to the development of more flexible and patient-centred pathways across the primary/secondary care interface.
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Affiliation(s)
- Muhammad Z Hossain
- Faculty of Medicine and Health Sciences, School of Medicine, Keele University, Keele, UK
| | - Carolyn A Chew-Graham
- Faculty of Medicine and Health Sciences, School of Medicine, Keele University, Keele, UK
| | - Emma Sowden
- NIHR School for Primary Care Research, Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK
| | - Tom Blakeman
- NIHR School for Primary Care Research, Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK
| | - Ian Wellwood
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Christi Deaton
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, School of Clinical Medicine, Cambridge, UK
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Zhang G, Shi K, Yan WF, Li XM, Li Y, Guo YK, Yang ZG. Effects of diabetes mellitus on left ventricular function and remodeling in hypertensive patients with heart failure with reduced ejection fraction: assessment with 3.0 T MRI feature tracking. Cardiovasc Diabetol 2022; 21:69. [PMID: 35524215 PMCID: PMC9077817 DOI: 10.1186/s12933-022-01504-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 04/18/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Heart failure with reduced ejection fraction (HFrEF) is a major health burden worldwide with high morbidity and mortality. Comorbidities of HFrEF complicate treatment and lead to poor prognosis, among which hypertension (HTN) and diabetes mellitus (DM) are common and frequently cooccur. DM was found to have additive effects on cardiac function and structure in hypertensive patients, while its effects on the HFrEF cohort in the context of HTN remain unclear. METHODS A total of 171 patients with HFrEF were enrolled in our study, consisting of 51 HFrEF controls, 72 hypertensive HFrEF patients (HTN-HFrEF [DM-]) and 48 hypertensive HFrEF patients with comorbid DM (HTN-HFrEF [DM+]). Cardiac MRI-derived left ventricular (LV) strains, including global radial (GRPS), circumferential (GCPS) and longitudinal (GLPS) peak strain, and remodeling parameters were measured and compared among groups. The determinants of impaired LV function and LV remodeling in HFrEF patients were investigated by multivariable linear regression analyses. RESULTS Despite a similar LV ejection fraction, patients in the HTN-HFrEF (DM+) and HTN-HFrEF (DM-) groups showed a higher LV mass index and LV remodeling index than those in the HFrEF control group (all p < 0.05). Compared with the HTN-HFrEF (DM-) and HFrEF control groups, the HTN-HFrEF (DM+) group exhibited the most severe GLPS impairment (p < 0.001). After adjustment for covariates in HFrEF patients, DM was found to be an independent determinant of impaired LV strains in all three directions (GRPS [β = - 0.189; p = 0.011], GCPS [β = 0.217; p = 0.005], GLPS [β = 0.237; p = 0.002]). HTN was associated with impaired GLPS (β = 0.185; p = 0.016) only. However, HTN rather than DM was associated with LV remodeling in HFrEF patients in the multivariable regression analysis (p < 0.05). CONCLUSIONS DM aggravated LV longitudinal dysfunction in hypertensive HFrEF patients without further changes in LV remodeling, indicating that HFrEF patients with comorbid HTN and DM may have a hidden high-risk phenotype of heart failure that requires more advanced and personalized management.
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Affiliation(s)
- Ge Zhang
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Radiology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Ke Shi
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei-Feng Yan
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xue-Ming Li
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuan Li
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ying-Kun Guo
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhi-Gang Yang
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Linde C, Ekström M, Eriksson MJ, Maret E, Wallén H, Lyngå P, Wedén U, Cabrera C, Löfström U, Stenudd J, Lund LH, Persson B, Persson H, Hage C. Baseline characteristics of 547 new onset heart failure patients in the PREFERS heart failure study. ESC Heart Fail 2022; 9:2125-2138. [PMID: 35403374 PMCID: PMC9288754 DOI: 10.1002/ehf2.13922] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/15/2022] [Accepted: 03/22/2022] [Indexed: 11/12/2022] Open
Abstract
Aim Methods and results Conclusions
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Affiliation(s)
- Cecilia Linde
- Department of Medicine Karolinska Institute Stockholm Sweden
- Department of Cardiology Karolinska University Hospital Stockholm S‐17176 Sweden
| | - Mattias Ekström
- Department of Cardiology Danderyd Hospital Stockholm Sweden
- Department of Clinical Sciences, Danderyd Hospital Karolinska Institute Stockholm Sweden
| | - Maria J. Eriksson
- Department of Molecular Medicine and Surgery Karolinska Institute Stockholm Sweden
- Department of Clinical Physiology Karolinska University Hospital Stockholm Sweden
| | - Eva Maret
- Department of Molecular Medicine and Surgery Karolinska Institute Stockholm Sweden
- Department of Clinical Physiology Karolinska University Hospital Stockholm Sweden
| | - Håkan Wallén
- Department of Cardiology Danderyd Hospital Stockholm Sweden
- Department of Clinical Sciences, Danderyd Hospital Karolinska Institute Stockholm Sweden
| | - Patrik Lyngå
- Department of Cardiology South Hospital Stockholm Sweden
- Department of Clinical Science and Education Södersjukhuset Karolinska Institute Stockholm Sweden
| | - Ulla Wedén
- Department of Cardiology Karolinska University Hospital Stockholm S‐17176 Sweden
| | - Carin Cabrera
- Department of Cardiology South Hospital Stockholm Sweden
- Department of Clinical Science and Education Södersjukhuset Karolinska Institute Stockholm Sweden
| | - Ulrika Löfström
- Department of Cardiology Capio St Göran Hospital Stockholm Sweden
| | - Jenny Stenudd
- Department of Cardiology Danderyd Hospital Stockholm Sweden
| | - Lars H. Lund
- Department of Medicine Karolinska Institute Stockholm Sweden
- Department of Cardiology Karolinska University Hospital Stockholm S‐17176 Sweden
| | - Bengt Persson
- Department of Cell and Molecular Biology, Science for Life Laboratory Uppsala University Uppsala Sweden
- Department of Medical Biochemistry and Biophysics, Science for Life Laboratory Karolina Institute Stockholm Sweden
| | - Hans Persson
- Department of Cardiology Danderyd Hospital Stockholm Sweden
- Department of Clinical Sciences, Danderyd Hospital Karolinska Institute Stockholm Sweden
| | - Camilla Hage
- Department of Medicine Karolinska Institute Stockholm Sweden
- Department of Cardiology Karolinska University Hospital Stockholm S‐17176 Sweden
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Tan J, He Y, Li Z, Xu X, Zhang Q, Xu Q, Zhang L, Xiang S, Tang X, Zhao W. Establishment and Validation of a Non-invasive Diagnostic Nomogram to Identify Heart Failure in Patients With Coronary Heart Disease. Front Cardiovasc Med 2022; 9:875702. [PMID: 35463796 PMCID: PMC9021443 DOI: 10.3389/fcvm.2022.875702] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/16/2022] [Indexed: 12/12/2022] Open
Abstract
Background Heart failure (HF) is an end-stage manifestation of and cause of death in coronary heart disease (CHD). The objective of this study was to establish and validate a non-invasive diagnostic nomogram to identify HF in patients with CHD. Methods We retrospectively analyzed the clinical data of 44,772 CHD patients from five tertiary hospitals. Univariate logistic regression analyses and least absolute shrinkage and selection operator (LASSO) regression analyses were used to identify independent factors. A nomogram based on the multivariate logistic regression model was constructed using these independent factors. The concordance index (C-index), receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis (DCA), and clinical impact curves (CIC) were used to evaluate the predictive accuracy and clinical value of this nomogram. Results The predictive factors in the multivariate model included hypertension, age, and the total bilirubin, uric acid, urea nitrogen, triglyceride, and total cholesterol levels. The area under the curve (AUC) values of the nomogram in the training set, internal validation set, external validation set1, and external validation set2 were 0.720 (95% CI: 0.712-0.727), 0.723 (95% CI: 0.712-0.735), 0.692 (95% CI: 0.674-0.710), and 0.655 (95% CI: 0.634-0.677), respectively. The calibration curves indicated that the nomogram had strong calibration. DCA and CIC indicated that the nomogram can be used as an effective tool in clinical practice. Conclusion The developed predictive model combines the clinical and laboratory factors of patients with CHD and is useful in individualized prediction of HF probability for clinical decision-making during treatment and management.
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Affiliation(s)
- Juntao Tan
- Operation Management Office, Affiliated Banan Hospital of Chongqing Medical University, Chongqing, China
| | - Yuxin He
- Department of Medical Administration, Affiliated Banan Hospital of Chongqing Medical University, Chongqing, China
| | - Zhanbiao Li
- Operation Management Office, Affiliated Banan Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaomei Xu
- Department of Gastroenterology, The Fifth People’s Hospital of Chengdu, Chengdu, China
- Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhang
- Department of Science and Education, Affiliated Banan Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Xu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
- Library, Chongqing Medical University, Chongqing, China
| | - Lingqin Zhang
- Department of Biomedical Equipment, People’s Hospital of Chongqing Bishan District, Chongqing, China
| | - Shoushu Xiang
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Xuewen Tang
- Department of Cardiology, Affiliated Banan Hospital of Chongqing Medical University, Chongqing, China
| | - Wenlong Zhao
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
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11
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Kiuchi S, Ikeda T. Management of hypertension associated with cardiovascular failure. J Cardiol 2021; 79:698-702. [PMID: 34895981 DOI: 10.1016/j.jjcc.2021.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
Hypertension (HT) treatment should focus on the prevention of new-onset heart failure (HF) or its exacerbation due to the increasing trend of HF incidence in Japan. According to the SPRINT trial, strict control of blood pressure (BP) of approximately 120 mmHg suppresses the progression of HF stages A and B to a more severe stage. However, in stages C and D, the target value for BP reduction differs depending on whether HF is HF reduced ejection fraction (EF) (HFrEF) or HF preserved EF (HFpEF). Additionally, the relationship between BP control and the prognosis of HF mostly showed the J-curve phenomenon in both HFrEF and HFpEF; however, patients with HFpEF need a lower target BP value than those with HFrEF. One reason is that vascular failure is associated with the pathophysiology of HF. Therefore, it is important to utilize an antihypertensive treatment strategy that considers vascular insufficiency. In addition, the presence or absence of compelling indications is important for the selection of antihypertensive (with cardioprotective effects for HF) medications. The uptitration of cardioprotective medications such as angiotensin-converting enzyme inhibitors/angiotensin II type 1a receptor blockers and beta-blockers is recommended in patients with HFrEF; however, it is often not practically possible to increase the dosage. In these cases, the use of medications in combination with other medication classes is also useful. Moreover, it is also useful to properly use medications of the same class considering their onset of action and half-life in the blood. It is still unclear how cardioprotective medications are used in patients with HFrEF, especially on certain age groups. The optimal initiation and continuation of cardioprotective medications should be carefully determined.
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Affiliation(s)
- Shunsuke Kiuchi
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine, Tokyo, Japan.
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
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12
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Krueger KJ, Rahman FK, Shen Q, Vacek J, Hiebert JB, Pierce JD. Mitochondrial bioenergetics and D-ribose in HFpEF: a brief narrative review. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1504. [PMID: 34805366 PMCID: PMC8573443 DOI: 10.21037/atm-21-2291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/15/2021] [Indexed: 11/24/2022]
Abstract
Objective In this review article, we briefly describe the status of treatment options for HFpEF and the role of mitochondrial dysfunction in the pathogenesis of HFpEF as an alternative therapeutic target. We also examine the mechanisms of D-ribose in cellular energy production and discuss the potential disadvantages and benefits of supplemental use of D-ribose in patients with HFpEF. Background Heart failure is a major cardiovascular disease that impacts over 6 million Americans and is one of the leading causes for morbidity and mortality. Patients with heart failure often experience shortness of breath and fatigue along with impaired physical capacity, all leading to poor quality of life. As a subtype of heart failure, heart failure with preserved ejection fraction (HFpEF) is characterized with impaired diastolic function. Currently, there are no effective treatments specifically for HFpEF, thus clinicians and researchers are searching for therapies to improve cardiac function. Emerging evidence indicate that mitochondrial dysfunction and impaired cardiac bioenergetics are among the underlying mechanisms for HFpEF. There is increased interest in investigating the use of supplements such as D-ribose to enhance mitochondrial function and improve production of adenosine triphosphate (ATP). Methods For this narrative review, more than 100 relevant scientific articles were considered from various databases (e.g., PubMed, Web of Science, CINAHL, and Google Scholar) using the keywords “Heart Failure”, “HFpEF”, “D-ribose”, “ATP”, “Mitochondria”, Bioenergetics”, and “Cellular Respiration”. Conclusions It is essential to find potential targeted therapeutic treatments for HFpEF. Since there is evidence that the HFpEF is related to impaired myocardial bioenergetics, enhancing mitochondrial function could augment cardiac function. Using a supplement such as D-ribose could improve mitochondrial function by increasing ATP and enhancing cardiac performance for patients with HFpEF. There is a recently completed clinical trial with HFpEF patients that indicates D-ribose increases ATP production and improves cardiac ejection fraction.
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Affiliation(s)
- Kathryn J Krueger
- School of Nursing, University of Kansas Medical Center, Kansas City, KS, USA
| | - Faith K Rahman
- School of Nursing, University of Kansas Medical Center, Kansas City, KS, USA
| | - Qiuhua Shen
- School of Nursing, University of Kansas Medical Center, Kansas City, KS, USA
| | - James Vacek
- The University of Kansas Health System, Kansas City, KS, USA
| | - John B Hiebert
- School of Nursing, University of Kansas Medical Center, Kansas City, KS, USA
| | - Janet D Pierce
- School of Nursing, University of Kansas Medical Center, Kansas City, KS, USA
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13
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Mitsnefes MM, Xu Y, Ng DK, Hill G, Kimball T, Furth SL, Warady BA. Diastolic Function and Ambulatory Hypertension in Children With Chronic Kidney Disease. Hypertension 2021; 78:1347-1354. [PMID: 34601967 PMCID: PMC8516735 DOI: 10.1161/hypertensionaha.121.17449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Mark M Mitsnefes
- Cincinnati Children's Hospital Medical Center, OH (M.M.M., G.H.)
| | - Yunwen Xu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.X., D.K.N.)
| | - Derek K Ng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.X., D.K.N.)
| | - Garick Hill
- Cincinnati Children's Hospital Medical Center, OH (M.M.M., G.H.)
| | - Thomas Kimball
- Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center, New Orleans, LA (T.K.)
| | - Susan L Furth
- Department of Pediatrics, Division of Nephrology, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania (S.L.F.)
| | - Bradley A Warady
- Department of Pediatrics, Division of Nephrology, Children's Mercy Kansas City, MO (B.A.W.)
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14
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Kahyaoglu M, Gecmen C, Candan O, Celik M, Yilmaz Y, Bayam E, Cakmak EO, Izgi IA, Kirma C. The usefulness of morphology-voltage-P wave duration ECG score for predicting early left atrial dysfunction in hypertensive patients. Clin Exp Hypertens 2021; 43:572-578. [PMID: 33866872 DOI: 10.1080/10641963.2021.1916945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Left atrial (LA) function is an important predictor of adverse cardiovascular outcomes in patients with hypertension (HT). Therefore, recognition of subtle LA dysfunction in the early stages of HT is essential for controlling modifiable variables. Several electrocardiographic and echocardiographic parameters have been studied to show early LA dysfunction. The goal of this study was to investigate the relationship between newly defined morphology-voltage-P wave duration electrocardiography (MVP ECG) score and early LA dysfunction in hypertensive patients. MATERIALS AND METHODS Eighty-nine hypertensive patients were included in this study. Based on speckle tracking echocardiography results, the patients were divided into two groups: 67 patients with normal LA function were included in Group 1, and 22 patients with abnormal LA function in Group 2. RESULTS Age, diabetes mellitus history, duration of HT history, left ventricular mass index, E/Em, and MVP ECG score values were statistically significant between the two groups. Based on the results of the multivariate logistic regression test, duration of HT history, E/Em, and MVP ECG score were determined as independent predictive parameters for early LA dysfunction in hypertensive patients. CONCLUSION In conclusion, MVP ECG score assessment could be a novel approach to detect early LA dysfunction in hypertensive patients.
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Affiliation(s)
- Muzaffer Kahyaoglu
- Department of Cardiology , Gaziantep Abdulkadir Yuksel State Hospital, Gaziantep, Turkey
| | - Cetin Gecmen
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Ozkan Candan
- Department of Cardiology, Uşak University, School of Medicine, Uşak, Turkey
| | - Mehmet Celik
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Yusuf Yilmaz
- Department of Cardiology, Goztepe Education and Research Hospital, Istanbul, Turkey
| | - Emrah Bayam
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Ender Ozgun Cakmak
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Ibrahim Akin Izgi
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Cevat Kirma
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
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15
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Goldberg JF, Peters EJ, Tolley EA, Hagler MN, Joshi VM, Wallace SE, Nouer SS, Beasley GS, Martinez HR, Ryan KA, Absi MA, Strelsin JR, Towbin JA, Triplett BM. Association of persistent tachycardia with early myocardial dysfunction in children undergoing allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2021; 56:2544-2554. [PMID: 34017071 DOI: 10.1038/s41409-021-01330-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/15/2021] [Accepted: 04/22/2021] [Indexed: 12/26/2022]
Abstract
Cancer survivors who have undergone hematopoietic cell transplantation (HCT) are at risk for myocardial dysfunction. Children who receive allogenic HCT encounter systemic inflammation resulting in tachycardia and hypertension. The effect of these abnormalities on myocardial function is not known. The aim of this study was to determine whether cardiac dysfunction early after HCT can be predicted by tachycardia or hypertension, within a retrospective single-center sample of pediatric HCT recipients. Early tachycardia or hypertension was defined as a majority of values taken from infusion date to 90 days post-infusion being abnormal. Ejection fraction <53% determined systolic dysfunction. A composite score of accepted pediatric diastolic abnormalities determined diastolic dysfunction. Among 80 subjects (median age 8 years), early tachycardia, systolic dysfunction, and diastolic dysfunction were present in 64%, 25%, and 48% of the sample, respectively. In multivariable models, early tachycardia was an independent predictor of early systolic dysfunction (OR = 12.6 [1.4-112.8], p = 0.024) and diastolic dysfunction (OR = 3.9 [1.3-11.5], p = 0.013). Tachycardia and cardiac dysfunction are common and associated with one another in the early period after pediatric HCT. Future studies may elucidate the role of tachycardia and myocardial dysfunction early after HCT as important predictors of future cardiovascular dysfunction.
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Affiliation(s)
- Jason F Goldberg
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA. .,Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Emily J Peters
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Elizabeth A Tolley
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Mazal N Hagler
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Vijaya M Joshi
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA.,Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Shelby E Wallace
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Simonne S Nouer
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Gary S Beasley
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA.,Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Hugo R Martinez
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA.,Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kaitlin A Ryan
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA.,Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Mohammed A Absi
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA.,Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jenny R Strelsin
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA.,Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jeffrey A Towbin
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA.,Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Brandon M Triplett
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA.,Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
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16
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Stacey RB, Hundley WG. Integrating Measures of Myocardial Fibrosis in the Transition from Hypertensive Heart Disease to Heart Failure. Curr Hypertens Rep 2021; 23:22. [PMID: 33881630 DOI: 10.1007/s11906-021-01135-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2021] [Indexed: 01/19/2023]
Abstract
PURPOSE OF REVIEW This review aims to summarize recent developments in identifying and quantifying both the presence and amount of myocardial fibrosis by imaging and biomarkers. Further, this review seeks to describe in general ways how this information may be used to identify hypertension and the transition to heart failure with preserved ejection fraction. RECENT FINDINGS Recent studies using cardiac magnetic resonance imaging highlight the progressive nature of fibrosis from normal individuals to those with hypertension to those with clinical heart failure. However, separating hypertensive patients from those with heart failure remains challenging. Recent studies involving echocardiography show the subclinical myocardial strain changes between hypertensive heart disease and heart failure. Lastly, recent studies highlight the potential use of biomarkers to identify those with hypertension at the greatest risk of developing heart failure. In light of the heterogeneous nature between hypertension and heart failure with preserved ejection fraction, an integrated approach with cardiac imaging and biomarker analysis may enable clinicians and investigators to more accurately characterize, prevent, and treat heart failure in those with hypertension.
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Affiliation(s)
- R Brandon Stacey
- Division of Cardiovascular Medicine, Wake Forest University School of Medicine, Watlington Hall, Medical Center Boulevard, Winston-Salem, NC, 27157-1045, USA.
| | - W Gregory Hundley
- Division of Cardiovascular Medicine, Wake Forest University School of Medicine, Watlington Hall, Medical Center Boulevard, Winston-Salem, NC, 27157-1045, USA.,Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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17
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Raj P, Ames N, Joseph Thandapilly S, Yu L, Netticadan T. The effects of oat ingredients on blood pressure in spontaneously hypertensive rats. J Food Biochem 2020; 44:e13402. [PMID: 32713035 DOI: 10.1111/jfbc.13402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/04/2020] [Accepted: 06/28/2020] [Indexed: 12/12/2022]
Abstract
This study investigated the blood pressure (BP) lowering and cardioprotective effects of oat avenanthramide C and beta-glucan alone or in combination in spontaneously hypertensive rats (SHR). Five-weeks-old male SHR and Wistar-Kyoto rats received vehicle, avenanthramide C and beta-glucan alone or a combination of avenanthramide C and beta-glucan via gavage for 15 weeks. BP was measured at 0, 10, and 15 weeks of treatment. Echocardiography was performed at 15 weeks of treatment. Oxidative stress and inflammation were also measured. Beta-glucan alone prevented the increase in systolic and diastolic BP in SHR, but avenanthramide C alone or the combination did not prevent the increase in systolic and diastolic BP. SHRs treated with beta-glucan and not avenanthramide C or the combination reduced isovolumetric relaxation time when compared to SHR treated with vehicle. Beta-glucan and avenanthramide C decreased the levels of malondialdehyde, a marker of oxidative stress in SHR. In conclusion, beta-glucan is a potential antihypertensive agent that may alleviate cardiovascular abnormalities. PRACTICAL APPLICATIONS: Oats products are believed to contain many bioactives that possess potential beneficial properties against chronic diseases. Specifically, oats beta-glucan has been well-established for its efficacy in positively modulating the risk factor for dyslipidemia. This preliminary in vivo study shows that beta-glucan is a potential antihypertensive agent that may alleviate cardiac dysfunction as well. In light of the current findings, further human studies may establish the efficacy of oats beta-glucan in hypertensive patients alongside the current antihypertensive medications. This novel attribute established via rigorous studies may provide an impetus for oats products and oats industry. Last but not least, it will also help improve the cardiovascular disease burden in a cost-effective way.
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Affiliation(s)
- Pema Raj
- Agriculture and Agri-Food Canada, Winnipeg, MB, Canada
- Canadian Centre for Agri-Food Research in Health and Medicine, Winnipeg, MB, Canada
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada
| | - Nancy Ames
- Agriculture and Agri-Food Canada, Winnipeg, MB, Canada
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
- Richardson Center for Functional Foods and Nutraceuticals, Winnipeg, MB, Canada
| | - Sijo Joseph Thandapilly
- Agriculture and Agri-Food Canada, Winnipeg, MB, Canada
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
- Richardson Center for Functional Foods and Nutraceuticals, Winnipeg, MB, Canada
| | - Liping Yu
- Agriculture and Agri-Food Canada, Winnipeg, MB, Canada
- Canadian Centre for Agri-Food Research in Health and Medicine, Winnipeg, MB, Canada
| | - Thomas Netticadan
- Agriculture and Agri-Food Canada, Winnipeg, MB, Canada
- Canadian Centre for Agri-Food Research in Health and Medicine, Winnipeg, MB, Canada
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada
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18
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19
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Ekström M, Hellman A, Hasselström J, Hage C, Kahan T, Ugander M, Wallén H, Persson H, Linde C. The transition from hypertension to hypertensive heart disease and heart failure: the PREFERS Hypertension study. ESC Heart Fail 2020; 7:737-746. [PMID: 32073753 PMCID: PMC7160482 DOI: 10.1002/ehf2.12612] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/28/2019] [Accepted: 12/22/2019] [Indexed: 01/09/2023] Open
Abstract
Aims Despite evidence‐based therapeutic approaches, target blood pressure is obtained by less than half of patients with hypertension. Hypertension is associated with a significant risk for heart failure, in particular heart failure with preserved left ventricular (LV) ejection fraction (HFpEF). Although treatment is suggested to be given early after hypertension diagnosis, there is still no evidence‐based medical treatment for HFpEF. We aim to study the underlying mechanisms behind the transition from uncomplicated hypertension to hypertensive heart disease (HHD) and HFpEF. To this end, we will combine cardiac imaging techniques and measurements of circulating fibrosis markers to longitudinally monitor fibrosis development in patients with hypertension. Methods and results In a prospective cohort study, 250 patients with primary hypertension and 60 healthy controls will be characterized at inclusion and after 1 and 6 years. Doppler echocardiography, cardiac magnetic resonance imaging, and electrocardiogram will be used for measures of cardiac structure and function over time. Blood biomarkers reflecting myocardial fibrosis, inflammation, and endothelial dysfunction will be analysed. As a proxy for HFpEF development, the primary endpoint is to measure echocardiographic changes in LV function and structure (E/e′ and LAVI) and to relate these measures of LV filling to blood pressure, biomarkers, electrocardiogram, and cardiac magnetic resonance. Conclusions We aim to study the timeline and transition from uncomplicated hypertension to HHD and HFpEF. In order to identify subjects prone to develop HHD and HFpEF, we want to find biomarkers and cardiac imaging variables to explain disease progression. Ultimately, we aim at finding new pathways to prevent HFpEF.
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Affiliation(s)
- Mattias Ekström
- Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Karolinska Institutet, Solna, Sweden
| | - Anna Hellman
- Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Karolinska Institutet, Solna, Sweden
| | - Jan Hasselström
- Department of Neurobiology, Care Sciences and Society, Centre for Family Medicine, Karolinska Institutet, Solna, Sweden
| | - Camilla Hage
- Department of Medicine, Division of Cardiology, Karolinska Institutet, Solna, Sweden
| | - Thomas Kahan
- Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Karolinska Institutet, Solna, Sweden
| | - Martin Ugander
- Department of Molecular Medicine and Surgery, Department of Clinical Physiology, Karolinska Institutet, Solna, Sweden
| | - Håkan Wallén
- Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Karolinska Institutet, Solna, Sweden
| | - Hans Persson
- Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Karolinska Institutet, Solna, Sweden
| | - Cecilia Linde
- Department of Medicine, Division of Cardiology, Karolinska Institutet, Solna, Sweden
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