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Ramos-Maqueda J, Migueles JH, Molina-Jiménez M, Ruiz-González D, Cabrera-Borrego E, Ruiz Salas A, Soriano-Maldonado A, Jimenez-Jaimez J. Lifestyle physical activity and rapid-rate non-sustained ventricular tachycardia in arrhythmogenic cardiomyopathy. Heart 2023:heartjnl-2022-321824. [PMID: 36849235 DOI: 10.1136/heartjnl-2022-321824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 02/06/2023] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE To investigate the association of accelerometer-measured lifestyle physical activity with rapid-rate non-sustained ventricular tachycardias (RR-NSVTs) in patients with arrhythmogenic cardiomyopathy (AC). METHODS This multicentre, observational study enrolled 72 patients with AC, including right, left and biventricular forms of the disease, with underlying desmosomal and non-desmosomal mutations. Lifestyle physical activity, objectively monitored with accelerometers (ie, movement sensors) and RR-NSVT, identified as >188 bpm and >18 beats from a textile Holter ECG for 30 days. RESULTS Sixty-three patients with AC (38±17.6 years, 57% men) were included. A total of 17 patients experienced ≥1 RR-NSVTs, and a total of 35 events were recorded. The odds of occurrence of ≥1 RR-NSVT during the recording did not increase as a function of either total physical activity (OR 0.95, 95% CI (CI95%) 0.68 to 1.30 for 60 min increase) or moderate-to-vigorous activities (OR 0.89, CI95% 0.71 to 1.08 for 5 min increase). Participants presenting RR-NSVTs during the recording (n=17) did not present greater odds of RR-NSVT in the days with more time either in total physical activity (OR 1.05, CI95% 0.84 to 1.29 for additional 60 min) or moderate-to-vigorous activities (OR 1.05, CI95% 0.97 to 1.12 for additional 5 min). Physical activity levels were neither different between the patients with and without RR-NSVTs during the recording period nor in the days of occurrence of RR-NSVT compared with the rest of the days. Finally, 4 of the 35 RR-NSVTs recorded in the 30 days occurred during physical activity (3 during moderate-to-vigorous intensity and 1 during light-intensity activities). CONCLUSIONS These findings suggest that lifestyle physical activity is not associated with RR-NSVTs in patients with AC.
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Affiliation(s)
- Javier Ramos-Maqueda
- Cardiology Department, Lozano Blesa Clinical University Hospital, Zaragoza, Spain.,GIIS032 Research Group, Aragon Institute of Biohealth Research, Zaragoza, Spain
| | - Jairo H Migueles
- Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden.,PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, University of Granada, Granada, Spain
| | - María Molina-Jiménez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Cardiovascular Research Group (MPE05 and CTS 1064), Instituto de Investigacion Biosanitaria de Granada, IBS, Granada, Spain
| | - David Ruiz-González
- Department of Education, Faculty of Education Sciences, and SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Eva Cabrera-Borrego
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Amalio Ruiz Salas
- UGC del Corazón, Universidad de Málaga, Instituto de Biomedicina de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, and SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Juan Jimenez-Jaimez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain .,Cardiovascular Research Group (MPE05 and CTS 1064), Instituto de Investigacion Biosanitaria de Granada, IBS, Granada, Spain
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2
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Elliott PM, Anastasakis A, Asimaki A, Basso C, Bauce B, Brooke MA, Calkins H, Corrado D, Duru F, Green KJ, Judge DP, Kelsell D, Lambiase PD, McKenna WJ, Pilichou K, Protonotarios A, Saffitz JE, Syrris P, Tandri H, Te Riele A, Thiene G, Tsatsopoulou A, van Tintelen JP. Definition and treatment of arrhythmogenic cardiomyopathy: an updated expert panel report. Eur J Heart Fail 2019; 21:955-964. [PMID: 31210398 DOI: 10.1002/ejhf.1534] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/14/2019] [Accepted: 05/18/2019] [Indexed: 12/13/2022] Open
Abstract
It is 35 years since the first description of arrhythmogenic right ventricular cardiomyopathy (ARVC) and more than 20 years since the first reports establishing desmosomal gene mutations as a major cause of the disease. Early advances in the understanding of the clinical, pathological and genetic architecture of ARVC resulted in consensus diagnostic criteria, which proved to be sensitive but not entirely specific for the disease. In more recent years, clinical and genetic data from families and the recognition of a much broader spectrum of structural disorders affecting both ventricles and associated with a propensity to ventricular arrhythmia have raised many questions about pathogenesis, disease terminology and clinical management. In this paper, we present the conclusions of an expert round table that aimed to summarise the current state of the art in arrhythmogenic cardiomyopathies and to define future research priorities.
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Affiliation(s)
- Perry M Elliott
- University College London & St. Bartholomew's Hospital, London, UK
| | - Aris Anastasakis
- Unit of Inherited and Rare Cardiovascular Diseases, Onassis Cardiac Surgery Centre, Athens, Greece
| | - Angeliki Asimaki
- Molecular and Clinical Sciences Research Institute, St Georges University, London, UK
| | - Cristina Basso
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Padua, Italy
| | - Barbara Bauce
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Padua, Italy
| | - Matthew A Brooke
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Hugh Calkins
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Domenico Corrado
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Padua, Italy
| | - Firat Duru
- Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland
| | - Kathleen J Green
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Daniel P Judge
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - David Kelsell
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Pier D Lambiase
- University College London & St. Bartholomew's Hospital, London, UK
| | - William J McKenna
- Institute of Cardiovascular Science, University College London, London, UK
| | - Kalliopi Pilichou
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Padua, Italy
| | | | - Jeffrey E Saffitz
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA, USA
| | - Petros Syrris
- Institute of Cardiovascular Science, University College London, London, UK
| | - Hari Tandri
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anneline Te Riele
- Division of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gaetano Thiene
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Padua, Italy
| | | | - J Peter van Tintelen
- Department of Clinical Genetics, Amsterdam Cardiovascular Sciences, University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
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3
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Rurali E, Pilato CA, Perrucci GL, Scopece A, Stadiotti I, Moschetta D, Casella M, Cogliati E, Sommariva E, Pompilio G, Nigro P. Cyclophilin A in Arrhythmogenic Cardiomyopathy Cardiac Remodeling. Int J Mol Sci 2019; 20:ijms20102403. [PMID: 31096574 PMCID: PMC6566687 DOI: 10.3390/ijms20102403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/07/2019] [Accepted: 05/12/2019] [Indexed: 12/16/2022] Open
Abstract
Arrhythmogenic cardiomyopathy (ACM) is a genetic disorder characterized by the progressive substitution of functional myocardium with noncontractile fibro-fatty tissue contributing to ventricular arrhythmias and sudden cardiac death. Cyclophilin A (CyPA) is a ubiquitous protein involved in several pathological mechanisms, which also characterize ACM (i.e., fibrosis, inflammation, and adipogenesis). Nevertheless, the involvement of CyPA in ACM cardiac remodeling has not been investigated yet. Thus, we first evaluated CyPA expression levels in the right ventricle (RV) tissue specimens obtained from ACM patients and healthy controls (HC) by immunohistochemistry. Then, we took advantage of ACM- and HC-derived cardiac mesenchymal stromal cells (C-MSC) to assess CyPA modulation during adipogenic differentiation. Interestingly, CyPA was more expressed in the RV sections obtained from ACM vs. HC subjects and positively correlated with the adipose replacement extent. Moreover, CyPA was upregulated at early stages of C-MSC adipogenic differentiation and was secreted at higher level over time in ACM- derived C-MSC. Our study provides novel ex vivo and in vitro information on CyPA expression in ACM remodeling paving the way for future C-MSC-based mechanistic and therapeutic investigations.
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Affiliation(s)
- Erica Rurali
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20138 Milano, Italy.
| | - Chiara Assunta Pilato
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20138 Milano, Italy.
| | - Gianluca Lorenzo Perrucci
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20138 Milano, Italy.
| | - Alessandro Scopece
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20138 Milano, Italy.
| | - Ilaria Stadiotti
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20138 Milano, Italy.
| | - Donato Moschetta
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20138 Milano, Italy.
| | - Michela Casella
- Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, 20138 Milano, Italy.
| | | | - Elena Sommariva
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20138 Milano, Italy.
| | - Giulio Pompilio
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20138 Milano, Italy.
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, 20126 Milano, Italy.
- Department of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, 20138 Milano, Italy.
| | - Patrizia Nigro
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20138 Milano, Italy.
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Tsatsopoulou A, Bossone E. Common presentation of rare diseases: Arrhythmogenic right ventricular cardiomyopathy and its mimics. Int J Cardiol 2018; 257:371-377. [PMID: 29506736 DOI: 10.1016/j.ijcard.2018.01.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 01/04/2018] [Accepted: 01/11/2018] [Indexed: 02/07/2023]
Abstract
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is the most common phenotype described within the spectrum of arrhythmogenic cardiomyopathies. It usually presents in early adolescence with severe ventricular arrhythmias along with cardiac structural and functional alterations mainly of the right ventricular myocardium. Though the estimated prevalence of ARVC in the general population is only 1:5000, it represents one of the most common causes of juvenile sudden death. However, detection of early RV dysfunction in ARVC may be challenging requiring high clinical suspicion and an algorithmic approach. A thorough family history of juvenile sudden death, ventricular arrhythmias and ICD implants should always be sought. Diagnosis usually requires electrocardiographic interpretation as well as cardiac imaging. In this article, the key diagnostic steps in the assessment of ARVC and diagnostic red flags that aid its differential diagnosis are discussed.
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5
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Tsatsopoulou A. Arrhythmogenic right ventricular cardiomyopathy and pregnancy. Int J Cardiol 2018; 258:199-200. [PMID: 29544930 DOI: 10.1016/j.ijcard.2018.01.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 01/18/2018] [Indexed: 12/24/2022]
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Harmon KG, Drezner JA, O'Connor FG, Asplund C, Finnoff JT. Should Electrocardiograms Be Part of the Preparticipation Physical Examination? PM R 2016; 8:S24-35. [PMID: 26972265 DOI: 10.1016/j.pmrj.2016.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 01/07/2016] [Indexed: 12/23/2022]
Affiliation(s)
- Kimberly G Harmon
- Sports Medicine Section, Departments of Family Medicine and Orthopaedics and Sports Medicine, University of Washington, Sports Medicine Center at Husky Stadium UW Medicine, Seattle, WA(∗)
| | - Jonathan A Drezner
- Sports Medicine Section, Departments of Family Medicine and Orthopaedics and Sports Medicine, University of Washington, Sports Medicine Center at Husky Stadium UW Medicine, Seattle, WA(†)
| | - Francis G O'Connor
- Military and Emergency Medicine, Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, MD(‡)
| | - Chad Asplund
- Athletic Medicine, Health Services Division, Georgia Southern University, Statesboro, GA(§)
| | - Jonathan T Finnoff
- Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester; and Mayo Clinic Sports Medicine Center, 600 Hennepin Ave, #310, Minneapolis, MN 55403(‖).
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Schwarz S, Boscheri A, Christle J, Duvinage A, Esefeld K, Fricke H, Pitsch N, Pressler A, Weichenberger M, Halle M. [Exercise training in the therapy of heart diseases: Current evidence and future options]. Herz 2016; 41:159-69; quiz 170-1. [PMID: 26914583 DOI: 10.1007/s00059-016-4403-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Exercise training has been firmly established as an additional therapeutic strategy in addition to pharmacological and interventional treatment in patients with cardiovascular disease. Benefits for quality of life as well as prognosis have been confirmed for cardiovascular risk factors, ischemic heart disease, after myocardial infarction, in heart failure with preserved as well as reduced ejection fraction, in atrial fibrillation and in patients after catheter-assisted aortic valve implantation (TAVI), with an implantable cardioverter defibrillator (ICD) or with left ventricular assist devices (VAD). Training programs have to be tailored according to the disease, stage of disease, comorbidities, age of the patient, medication as well as exercise capacity. For prescribing exercise mode and intensity, a maximum exercise test has to be performed. Ideally, this is accompanied by spirometry to assess maximum values such as maximum oxygen consumption. Training intensity will then be prescribed according to the optimal training range and maximum training intensity.
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Affiliation(s)
- S Schwarz
- Präventive und Rehabilitative Sportmedizin, Klinikum rechts der Isar, TU München, Georg-Brauchle-Ring 56, 80992, München, Deutschland
| | - A Boscheri
- Präventive und Rehabilitative Sportmedizin, Klinikum rechts der Isar, TU München, Georg-Brauchle-Ring 56, 80992, München, Deutschland
| | - J Christle
- Präventive und Rehabilitative Sportmedizin, Klinikum rechts der Isar, TU München, Georg-Brauchle-Ring 56, 80992, München, Deutschland
| | - A Duvinage
- Präventive und Rehabilitative Sportmedizin, Klinikum rechts der Isar, TU München, Georg-Brauchle-Ring 56, 80992, München, Deutschland
- Deutsches Zentrum für Herzkreislaufforschung (DZHK), Munich Heart Alliance, München, Deutschland
| | - K Esefeld
- Präventive und Rehabilitative Sportmedizin, Klinikum rechts der Isar, TU München, Georg-Brauchle-Ring 56, 80992, München, Deutschland
| | - H Fricke
- Präventive und Rehabilitative Sportmedizin, Klinikum rechts der Isar, TU München, Georg-Brauchle-Ring 56, 80992, München, Deutschland
| | - N Pitsch
- Präventive und Rehabilitative Sportmedizin, Klinikum rechts der Isar, TU München, Georg-Brauchle-Ring 56, 80992, München, Deutschland
| | - A Pressler
- Präventive und Rehabilitative Sportmedizin, Klinikum rechts der Isar, TU München, Georg-Brauchle-Ring 56, 80992, München, Deutschland
| | - M Weichenberger
- Präventive und Rehabilitative Sportmedizin, Klinikum rechts der Isar, TU München, Georg-Brauchle-Ring 56, 80992, München, Deutschland
| | - M Halle
- Präventive und Rehabilitative Sportmedizin, Klinikum rechts der Isar, TU München, Georg-Brauchle-Ring 56, 80992, München, Deutschland.
- Deutsches Zentrum für Herzkreislaufforschung (DZHK), Munich Heart Alliance, München, Deutschland.
- Else Kröner-Fresenius-Zentrum, Klinikum rechts der Isar, München, Deutschland.
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Górski A, Weber-Dabrowska B. The potential role of endogenous bacteriophages in controlling invading pathogens. Cell Mol Life Sci 2005; 62:511-9. [PMID: 15747058 DOI: 10.1007/s00018-004-4403-6] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Bacteriophages (phages) are omnipresent in our environment, and recent studies highlight their potential impact on the microbial world. Phages can also be present in mammalian organisms, including man (intestines, oral cavity, urine, sputum and serum). Data are available which suggest that those endogenous phages could play an important role in eliminating bacteria and regulating the body ecosystem. Furthermore, our most recent findings suggest that phages can exert immunosuppressive action in the gut, helping control local inflammatory and autoimmune reactions, and demonstrate anticancer activity. We hypothesize that phages could act in concert with the immune system in immunosurveillance against bacteria, viruses and cancer.
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Affiliation(s)
- Andrzej Górski
- L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53114, Wroclaw, Poland.
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