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Babapoor-Farrokhran S, Alzubi J, Port Z, Kaul R, Rasekhi RT, Farrokhran AB, Sooknanan N, Wiener PC, Khraisha O, Frishman WH, Mainigi SK, Aronow WS. Left Atrial Appendage Closure: What Do We Know? Cardiol Rev 2023:00045415-990000000-00146. [PMID: 37643211 DOI: 10.1097/crd.0000000000000601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Atrial fibrillation (AF) is the most common arrhythmia in the United States and the most common cause of embolic cerebrovascular events, with the majority of these thrombi originating in the left atrial appendage. The left atrial appendage (LAA) has separate developmental, ultrastructural, and physiological characteristics from the left atrium. Although LAA anatomy is highly variable, it can be categorized into 4 types: cactus, cauliflower, chicken wing, and windsock. The cauliflower type is associated with higher stroke risk in patients with nonvalvular AF. Although the cornerstone of therapy to prevent embolic strokes from AF has been anticoagulation with thrombin inhibitors, a large group of patients are unable to tolerate anticoagulation due to bleeding. This has led to the development and advancement of multiple surgical and percutaneous LAA closure devices to prevent embolic cerebrovascular accidents without the need for anticoagulation. In this article, we discuss the outcomes of major studies that utilized surgical LAA occlusion and its effectiveness. Furthermore, we summarize nonsurgical methods of LAA closure and future directions regarding LAA closure.
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Affiliation(s)
- Savalan Babapoor-Farrokhran
- From the Leon H. Charney Division of Cardiology, Cardiac Electrophysiology, NYU Langone Health, New York University School of Medicine, NY
| | - Jafar Alzubi
- vision of Cardiology, Department of Medicine, Einstein Medical Center, Philadelphia, PA
| | - Zachary Port
- vision of Cardiology, Department of Medicine, Einstein Medical Center, Philadelphia, PA
| | - Risheek Kaul
- From the Leon H. Charney Division of Cardiology, Cardiac Electrophysiology, NYU Langone Health, New York University School of Medicine, NY
| | | | | | - Naveen Sooknanan
- vision of Cardiology, Department of Medicine, Einstein Medical Center, Philadelphia, PA
| | - Philip C Wiener
- Department of Internal Medicine, Division of Cardiology, Washington University in St. Louis, St. Louis, MO
| | - Ola Khraisha
- vision of Cardiology, Department of Medicine, Einstein Medical Center, Philadelphia, PA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - William H Frishman
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY
| | - Sumeet K Mainigi
- vision of Cardiology, Department of Medicine, Einstein Medical Center, Philadelphia, PA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Wilbert S Aronow
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY
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2
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Fatkin D, Ohanian M, Brown KJ. A Novel Role for FKBP5 in Atrial Cardiomyopathy. Circ Res 2023; 133:45-47. [PMID: 37347835 DOI: 10.1161/circresaha.123.322988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Affiliation(s)
- Diane Fatkin
- Molecular Cardiology Division, Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia (D.F., M.O.)
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, New South Wales, Australia (D.F.)
- Cardiology Department, St. Vincent's Hospital, Darlinghurst, New South Wales, Australia (D.F.)
| | - Monique Ohanian
- Molecular Cardiology Division, Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia (D.F., M.O.)
| | - Kemar J Brown
- Division of Cardiology, Massachusetts General Hospital, Boston (K.J.B.)
- Department of Genetics, Harvard Medical School, Boston, MA (K.J.B.)
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Vlachopoulou D, Balomenakis C, Kartas A, Samaras A, Papazoglou AS, Moysidis DV, Barmpagiannos K, Kyriakou M, Papanastasiou A, Baroutidou A, Vouloagkas I, Tzikas A, Giannakoulas G. Cardioselective versus Non-Cardioselective Beta-Blockers and Outcomes in Patients with Atrial Fibrillation and Chronic Obstructive Pulmonary Disease. J Clin Med 2023; 12:jcm12093063. [PMID: 37176504 PMCID: PMC10179681 DOI: 10.3390/jcm12093063] [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: 03/30/2023] [Revised: 04/17/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Background: Atrial fibrillation (AF) and chronic obstructive pulmonary disease (COPD) have been independently associated with increased mortality; however, there is no evidence regarding beta-blocker cardioselectivity and long-term outcomes in patients with AF and concurrent COPD. Methods: This post hoc analysis of the MISOAC-AF randomized trial (NCT02941978) included patients hospitalized with comorbid AF. At discharge, all patients were classified according to the presence of COPD; patients with COPD on beta-blockers were classified according to beta-blocker cardioselectivity. Adjusted hazard ratios (aHRs) were calculated by using multivariable Cox regression models. The primary outcome was all-cause mortality, and the secondary outcomes were cardiovascular mortality and hospitalizations. Results: Of 1103 patients with AF, 145 (13%) had comorbid COPD. Comorbid COPD was associated with an increased risk of all-cause (aHR, 1.33; 95% confidence interval (CI), 1.02 to 1.73) and cardiovascular mortality (aHR 1.47; 95% CI, 1.10 to 1.99), but not with increased risk of hospitalizations (aHR 1.10; 95% CI, 0.82 to 1.48). The use of cardioselective versus non-cardioselective beta-blockers was associated with similar all-cause mortality (aHR 1.10; 95% CI, 0.63 to 1.94), cardiovascular mortality (aHR 1.33; 95% CI, 0.71 to 2.51), and hospitalizations (aHR 1.65; 95% CI 0.80 to 3.38). Conclusions: In recently hospitalized patients with AF, the presence of COPD was independently associated with increased risk of all-cause and cardiovascular mortality. No difference between cardioselective and non-cardioselective beta-blockers, regarding clinical outcomes, was identified.
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Affiliation(s)
- Dimitra Vlachopoulou
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Charalampos Balomenakis
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Anastasios Kartas
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Athanasios Samaras
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Andreas S Papazoglou
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Dimitrios V Moysidis
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Konstantinos Barmpagiannos
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Melina Kyriakou
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Anastasios Papanastasiou
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Amalia Baroutidou
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Ioannis Vouloagkas
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Apostolos Tzikas
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
- Interbalkan European Medical Center, Asklipiou 10, 555 35 Thessaloniki, Greece
| | - George Giannakoulas
- First Department of Cardiology, AHEPA University Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
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Santillana N, Astudillo-Guerrero C, D’Espessailles A, Cruz G. White Adipose Tissue Dysfunction: Pathophysiology and Emergent Measurements. Nutrients 2023; 15:nu15071722. [PMID: 37049561 PMCID: PMC10096946 DOI: 10.3390/nu15071722] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
White adipose tissue (AT) dysfunction plays an important role in the development of cardiometabolic alterations associated with obesity. AT dysfunction is characterized by the loss of the expansion capacity of the AT, an increment in adipocyte hypertrophy, and changes in the secretion profile of adipose cells, associated with accumulation of macrophages and inflammation. Since not all people with an excess of adiposity develop comorbidities, it is necessary to find simple tools that can evidence AT dysfunction and allow the detection of those people with the potential to develop metabolic alterations. This review focuses on the current pathophysiological mechanisms of white AT dysfunction and emerging measurements to assess its functionality.
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Affiliation(s)
- Natalia Santillana
- Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago 8380453, Chile
| | - Camila Astudillo-Guerrero
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile
- Programa de Doctorado en Ciencias Mención Neurociencia, Universidad de Valparaíso, Valparaíso 2360102, Chile
| | - Amanda D’Espessailles
- Instituto de Ciencias de la Salud, Universidad de O’Higgins, Rancagua 2820000, Chile
| | - Gonzalo Cruz
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile
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Sato T, Takeda N. The roles of HIF-1α signaling in cardiovascular diseases. J Cardiol 2023; 81:202-208. [PMID: 36127212 DOI: 10.1016/j.jjcc.2022.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 12/29/2022]
Abstract
Oxygen is essential for living organisms. Molecular oxygen binds to hemoglobin and is delivered to every organ in the body. In several cardiovascular diseases or anemia, local oxygen tension drops below its physiological level and tissue hypoxia develops. In such conditions, the expression of hypoxia-responsive genes increases to alleviate the respective condition. The hypoxia-responsive genes include the genes coding erythropoietin (EPO), vascular endothelial growth factor-A, and glycolytic enzymes. Hypoxia-inducible factor (HIF)-1α, HIF-2α, and HIF-3α are transcription factors that regulate the hypoxia-responsive genes. The HIF-α proteins are continuously degraded by an oxygen-dependent degrading pathway involving HIF-prolyl hydroxylases (HIF-PHs) and von Hippel-Lindau tumor suppressor protein. However, upon hypoxia, this degradation ceases and the HIF-α proteins form heterodimers with HIF-1β (a constitutive subunit of HIF), which results in the induction of hypoxia responsive genes. HIF-1α and HIF-2α are potential therapeutic targets for renal anemia, where EPO production is impaired due to chronic kidney diseases. Small molecule HIF-PH inhibitors are currently used to activate HIF-α signaling and to increase plasma hemoglobin levels by restoring EPO production. In this review, we will discuss the current understanding of the roles of the HIF-α signaling pathway in cardiovascular diseases. This will include the roles of HIF-1α in cardiomyocytes as well as in stromal cells including macrophages.
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Affiliation(s)
- Tatsuyuki Sato
- Division of Cardiology and Metabolism, Center for Molecular Medicine, Jichi Medical University, Tochigi, Japan
| | - Norihiko Takeda
- Division of Cardiology and Metabolism, Center for Molecular Medicine, Jichi Medical University, Tochigi, Japan.
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Tai M, Shi H, Wang H, Ma X, Gao M, Chang Q, Li F, Zeng Q, Shi Y, Guo Y. Pilot study of peripheral blood chemokines as biomarkers for atrial fibrillation-related thromboembolism and bleeding in elderly patients. Front Public Health 2022; 10:844087. [PMID: 36211709 PMCID: PMC9538109 DOI: 10.3389/fpubh.2022.844087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 08/26/2022] [Indexed: 01/21/2023] Open
Abstract
Background The scoring systems currently used to identify the potential for thrombosis and bleeding events in high-risk atrial fibrillation patients have certain limitations. The aim of this pilot study was to identify inflammatory chemokines with potential utility as sensitive biomarkers for the risk of thrombosis and bleeding in elderly patients with non-valvular atrial fibrillation. Methods From January 1, 2014, to December 31, 2017, 200 consecutive elderly patients with atrial fibrillation (average age: 87.6 ± 7.7 years) were enrolled and followed up for 2 years to observe thromboembolic (arterial and venous) and bleeding events. Serum was collected upon enrollment, and the baseline levels of 27 chemokines were analyzed. During the 2-year follow-up, 12 patients were lost to follow-up. Among the 188 patients, there were 32 cases (17.0%) of AF-related thrombosis, 36 cases (19.1%) of arterial thrombosis, and 35 cases (18.6%) of major bleeding events. Results Among 188 patients, 30 patients without clinical events (control group), 23 with arterial thrombosis, 15 with atrial fibrillation-related venous thromboembolism, and 12 with major bleeding were selected and randomly matched to compare chemokine levels. The baseline levels of interleukin-6, interleukin-10, vascular cell adhesion molecule-1, chemokine C-C-motif ligand, B-lymphocyte chemoattractant 1, interleukin-4, E-selectin, fractalkine, C-X-C motif chemokine 12, and granulocyte chemotactic protein 2 were found to differ statistically among the four groups (p < 0.05). Compared with that in the control group, the level of interleukin-4 in patients with atrial fibrillation-related thrombosis, arterial thrombosis, or major bleeding increased by 53-fold (0.53 vs. 0.01 pg/ml), 17-fold (0.17 vs. 0.01 pg/ml), and 19-fold (0.19 vs. 0.01 pg/ml), respectively. Compared with that in the control group, the level of interleukin-6 in patients with arterial thrombosis increased by six-fold (39.78 vs. 4.98 pg/ml). Conclusions Among elderly patients with atrial fibrillation at high risk of thromboembolism and bleeding, the baseline levels of interleukin-6, interleukin-4, and E-selectin were significantly increased in those that experienced thrombosis and bleeding events during the 2-year follow-up, indicating that these chemokines may serve as potential biomarkers for an increased risk of thrombosis and bleeding in this population. Clinical trial registration number ChiCTR-OCH-13003479.
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Affiliation(s)
- Meihui Tai
- Chinese PLA Medical College, Pulmonary Vessel and Thrombotic Disease, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Haiyan Shi
- Department of Gastroenterology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Hao Wang
- Department of Cardiology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xiao Ma
- Department of Cardiology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Meng Gao
- Department of Cardiology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Qing Chang
- Department of Cardiology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Fang Li
- Department of Gastroenterology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Qiang Zeng
- Health Management Institute, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yang Shi
- Health Management Institute, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yutao Guo
- Chinese PLA Medical College, Pulmonary Vessel and Thrombotic Disease, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China,*Correspondence: Yutao Guo
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Hypoxia signaling in human health and diseases: implications and prospects for therapeutics. Signal Transduct Target Ther 2022; 7:218. [PMID: 35798726 PMCID: PMC9261907 DOI: 10.1038/s41392-022-01080-1] [Citation(s) in RCA: 96] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 02/07/2023] Open
Abstract
Molecular oxygen (O2) is essential for most biological reactions in mammalian cells. When the intracellular oxygen content decreases, it is called hypoxia. The process of hypoxia is linked to several biological processes, including pathogenic microbe infection, metabolic adaptation, cancer, acute and chronic diseases, and other stress responses. The mechanism underlying cells respond to oxygen changes to mediate subsequent signal response is the central question during hypoxia. Hypoxia-inducible factors (HIFs) sense hypoxia to regulate the expressions of a series of downstream genes expression, which participate in multiple processes including cell metabolism, cell growth/death, cell proliferation, glycolysis, immune response, microbe infection, tumorigenesis, and metastasis. Importantly, hypoxia signaling also interacts with other cellular pathways, such as phosphoinositide 3-kinase (PI3K)-mammalian target of rapamycin (mTOR) signaling, nuclear factor kappa-B (NF-κB) pathway, extracellular signal-regulated kinases (ERK) signaling, and endoplasmic reticulum (ER) stress. This paper systematically reviews the mechanisms of hypoxia signaling activation, the control of HIF signaling, and the function of HIF signaling in human health and diseases. In addition, the therapeutic targets involved in HIF signaling to balance health and diseases are summarized and highlighted, which would provide novel strategies for the design and development of therapeutic drugs.
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Yakovlev AV, Chernyshev RS, Sakhonchik KS, Shilov SN, Grakova EV, Kop’eva KV, Teplyakov AT, Efremov IA, Kessler MS, Yakovleva NF, Grebenkina IA. Prognostic value of hypoxia-inducible factor-1 alpha gene polymorphism in patients with heart failure with preserved ejection fraction and obstructive sleep apnea. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To study the associations of hypoxia-inducible factor-1 alpha (HIF-1α) gene polymorphism (rs11549465) with the clinical course of heart failure (HF) with reserved ejection fraction (HFpEF) in patients with obesity and moderate and severe obstructive sleep apnea (OSA).Material and methods. The study included 76 men with HFpEF and OSAS. Patients underwent a polysomnography, echocardiography, and a 6-minute walk test. In addition, apnea/hypopnea index was calculated, and the level of N-terminal pro-brain natriuretic peptide (NT-proBNP) was assessed. HIF1A gene polymorphisms (rs11549465) were analyzed using polymerase chain reaction. After 12-month follow-up, the clinical course of HF was assessed.Results. The T/T genotype of the HIF1A gene was associated with a high risk of HF progression (p=0,004), development of supraventricular premature beats (p=0,004) and atrial fibrillation (p=0,039). Carrying the T/T genotype was associated with severe OSA (p=0,006) and increased NT-proBNP (p=0,044), and also correlated with certain echocardiographic characteristics of myocardial remodeling.Conclusion. T/T genotype of the HIF1A gene is associated with OSA severity and increased NT-proBNP, as well as with the severity of left and right heart remodeling. The carriage of this genotype was associated with an unfavorable course of HF and an increased risk of atrial fibrillation in patients with HFpEF and OSA.
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Affiliation(s)
| | | | | | | | - E. V. Grakova
- Cardiology Research Institute, Tomsk National Research Medical Center
| | - K. V. Kop’eva
- Cardiology Research Institute, Tomsk National Research Medical Center
| | - A. T. Teplyakov
- Cardiology Research Institute, Tomsk National Research Medical Center
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Liu Z, Zhen Y, Lin F, Zheng X, Liu X, Sun G, Ye Z, Wen J, Liu P. Resting heart rate as a preoperative predictor of postoperative atrial fibrillation after pulmonary thromboendarterectomy. J Card Surg 2022; 37:1644-1650. [PMID: 35274764 DOI: 10.1111/jocs.16407] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/13/2022] [Accepted: 02/17/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND As a marker of the autonomic nervous system, resting heart rate is a predictor of postoperative atrial fibrillation (POAF). However, its predictive value for POAF after pulmonary thromboendarterectomy (PTE) has not been adequately studied. METHODS We enrolled 97 patients who underwent PTE in our hospital from December 2016 to November 2021 in this retrospective study. Almost all preoperative characteristics, including electrocardiogram, demographics, hematologic and biochemical indices, echocardiography, and pulmonary hemodynamics, were compared between patients with and without POAF. Multivariate logistic regression analysis was used to identify the independent risk factors for POAF after PTE. RESULTS Overall, 21 patients (21.6%) suffered from POAF after PTE. Compared with patients without POAF, those with POAF were older (p = .049), with a higher resting heart rate (p = .012), and higher platelet count (p = .040). In the binary logistic regression analysis, the resting heart rate (odds ratio [OR] = 1.043, 95% confidence interval [CI] = 1.009-1.078, p = .012) and age (OR = 1.051, 95% CI = 1.003-1.102, p = .037) were independent risk factors for POAF after PTE. The optimal cutoff point of resting heart rate was 89.5 with sensitivity and specificity of 47.6% and 77.6%. When the cutoff value of the age was 54.5, its sensitivity for predicting POAF was 71.4%, with a specificity of 59.2%. CONCLUSIONS POAF is common after PTE surgery, and the incidence may be underestimated. The resting heart rate and age are independent preoperative risk factors for POAF after PTE. Considering the lower predictive power of the resting heart and age, further large-scale studies are needed.
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Affiliation(s)
- Zhan Liu
- Departmen of Cardiovascular Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China.,Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Yanan Zhen
- Departmen of Cardiovascular Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China.,Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Fan Lin
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Xia Zheng
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Xiaopeng Liu
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Guang Sun
- Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Zhidong Ye
- Departmen of Cardiovascular Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China.,Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Jianyan Wen
- Departmen of Cardiovascular Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China.,Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Peng Liu
- Departmen of Cardiovascular Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China.,Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
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Khanyukov OO, Zaiats IO. NITRIC OXIDE DONATORS IN COMPLEX TREATMENT OF PATIENTS WITH CORONARY HEART DISEASE AND ANEMIA: ANTIISCHEMIC AND ANTIARRHYTHMIC EFFECTS. BULLETIN OF PROBLEMS BIOLOGY AND MEDICINE 2022. [DOI: 10.29254/2077-4214-2022-3-166-277-282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - I. O. Zaiats
- Dnipro Medical Institute of Traditional and Non-Traditional Medicine
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11
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Wang H, Chen Y, Zhao S, Wang X, Lu K, Xiao H. Effect of Sox9 on TGF-β1-mediated atrial fibrosis. Acta Biochim Biophys Sin (Shanghai) 2021; 53:1450-1458. [PMID: 34596216 DOI: 10.1093/abbs/gmab132] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Indexed: 01/02/2023] Open
Abstract
Atrial fibrosis is a crucial mechanism responsible for atrial fibrillation (AF). Sex-determining region Y-box containing gene 9 (Sox9) plays a pivotal role in fibrosis of many organs such as the skin, kidney, and liver. However, there are few studies about the occurrence and maintenance of Sox9 in atrial fibrosis. In this study, we investigated the role of Sox9 in the fibrotic phenotype of human atrial tissues and rat atrial fibroblasts in vitro. In the human right atrial tissue, Masson's trichrome staining, immunofluorescence, real-time quantitative polymerase chain reaction, and western blot analysis were carried out to explore the relationship between Sox9 and atrial fibrosis at the morphological, functional, and molecular levels. In cultured atrial fibroblasts, Sox9 was overexpressed by adenovirus or depleted by siRNA, and then, recombinant human transforming growth factor (TGF)-β1 was added. Immunofluorescence analysis, western blot analysis, Transwell assay, and scratch assay were used to analyze the cells. In patient atrial tissues, Sox9 was increased with worsened atrial fibrosis, and this increase was related to AF severity. In rat atrial fibroblasts, Sox9 was promoted by TGF-β1, and the α-smooth muscle actin (α-SMA) protein level and the ability of cell migration were increased after Sox9 overexpression by adenovirus, while the α-SMA protein level and the cell migration ability were decreased after Sox9 depletion by siRNA. In conclusion, Sox9 is involved in the regulation of fibrosis in the atria and may be located downstream of TGF-β1. Our findings may provide a new perspective to treat atrial fibrosis during AF.
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Affiliation(s)
- Hechuan Wang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Yiqi Chen
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Shuting Zhao
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Xiaowen Wang
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Kai Lu
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Hua Xiao
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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12
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Pecoraro M, Marzocco S, Popolo A. Diazoxide Needs Mitochondrial Connexin43 to Exert Its Cytoprotective Effect in a Cellular Model of CoCl 2-Induced Hypoxia. Int J Mol Sci 2021; 22:ijms222111599. [PMID: 34769027 PMCID: PMC8583808 DOI: 10.3390/ijms222111599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 02/07/2023] Open
Abstract
Hypoxia is the leading cause of death in cardiomyocytes. Cells respond to oxygen deprivation by activating cytoprotective programs, such as mitochondrial connexin43 (mCx43) overexpression and the opening of mitochondrial KATP channels, aimed to reduce mitochondrial dysfunction. In this study we used an in vitro model of CoCl2-induced hypoxia to demonstrate that mCx43 and KATP channels cooperate to induce cytoprotection. CoCl2 administration induces apoptosis in H9c2 cells by increasing mitochondrial ROS production, intracellular and mitochondrial calcium overload and by inducing mitochondrial membrane depolarization. Diazoxide, an opener of KATP channels, reduces all these deleterious effects of CoCl2 only in the presence of mCx43. In fact, our results demonstrate that in the presence of radicicol, an inhibitor of Cx43 translocation to mitochondria, the cytoprotective effects of diazoxide disappear. In conclusion, these data confirm that there exists a close functional link between mCx43 and KATP channels.
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Hung CL, Sung KT, Chang SC, Liu YY, Kuo JY, Huang WH, Su CH, Liu CC, Tsai SY, Liu CY, Lee AS, Pan SH, Wang SW, Hou CJY, Hung TC, Yeh HI. Variant Aldehyde Dehydrogenase 2 ( ALDH2*2) as a Risk Factor for Mechanical LA Substrate Formation and Atrial Fibrillation with Modest Alcohol Consumption in Ethnic Asians. Biomolecules 2021; 11:1559. [PMID: 34827557 PMCID: PMC8615757 DOI: 10.3390/biom11111559] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/14/2021] [Accepted: 10/16/2021] [Indexed: 12/30/2022] Open
Abstract
Aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism is a common genetic variant in Asians that is responsible for defective toxic aldehyde and lipid peroxidation metabolism after alcohol consumption. The extent to which low alcohol consumption may cause atrial substrates to trigger atrial fibrillation (AF) development in users with ALDH2 variants remains to be determined. We prospectively enrolled 249 ethnic Asians, including 56 non-drinkers and 193 habitual drinkers (135 (70%) as ALDH2 wild-type: GG, rs671; 58 (30%) as ALDH2 variants: G/A or A/A, rs671). Novel left atrial (LA) mechanical substrates with dynamic characteristics were assessed using a speckle-tracking algorithm and correlated to daily alcohol consumption and ALDH2 genotypes. Despite modest and comparable alcohol consumption by the habitual alcohol users (14.3 [8.3~28.6] and 12.3 [6.3~30.7] g/day for those without and with ALDH2 polymorphism, p = 0.31), there was a substantial and graded increase in the 4-HNE adduct and prolonged PR, and a reduction in novel LA mechanical parameters (including peak atrial longitudinal strain (PALS) and phasic strain rates (reservoir, conduit, and booster pump functions), p < 0.05), rather than an LA emptying fraction (LAEF) or LA volume index across non-drinkers, and in habitual drinkers without and with ALDH2 polymorphism (all p < 0.05). The presence of ALDH2 polymorphism worsened the association between increasing daily alcohol dose and LAEF, PALS, and phasic reservoir and booster functions (all Pinteraction: <0.05). Binge drinking superimposed on regular alcohol use exclusively further worsened LA booster pump function compared to regular drinking without binge use (1.66 ± 0.57 vs. 1.97 ± 0.56 1/s, p = 0.001). Impaired LA booster function further independently helped to predict AF after consideration of the CHARGE-AF score (adjusted 1.68 (95% CI: 1.06-2.67), p = 0.028, per 1 z-score increment). Habitual modest alcohol consumption led to mechanical LA substrate formation in an ethnic Asian population, which was more pronounced in subjects harboring ALDH2 variants. Impaired LA booster functions may serve as a useful predictor of AF in such populations.
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Affiliation(s)
- Chung-Lieh Hung
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (C.-L.H.); (K.-T.S.); (S.-C.C.); (Y.-Y.L.); (J.-Y.K.); (C.-H.S.); (S.-Y.T.); (C.-Y.L.); (A.-S.L.); (S.-W.W.); (C.J.-Y.H.); (T.-C.H.)
- Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan;
- Institute of Biomedical Sciences, Mackay Medical College, New Taipei City 25245, Taiwan
| | - Kuo-Tzu Sung
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (C.-L.H.); (K.-T.S.); (S.-C.C.); (Y.-Y.L.); (J.-Y.K.); (C.-H.S.); (S.-Y.T.); (C.-Y.L.); (A.-S.L.); (S.-W.W.); (C.J.-Y.H.); (T.-C.H.)
- Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan;
| | - Shun-Chuan Chang
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (C.-L.H.); (K.-T.S.); (S.-C.C.); (Y.-Y.L.); (J.-Y.K.); (C.-H.S.); (S.-Y.T.); (C.-Y.L.); (A.-S.L.); (S.-W.W.); (C.J.-Y.H.); (T.-C.H.)
| | - Yen-Yu Liu
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (C.-L.H.); (K.-T.S.); (S.-C.C.); (Y.-Y.L.); (J.-Y.K.); (C.-H.S.); (S.-Y.T.); (C.-Y.L.); (A.-S.L.); (S.-W.W.); (C.J.-Y.H.); (T.-C.H.)
- Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan;
- Institute of Biomedical Sciences, Mackay Medical College, New Taipei City 25245, Taiwan
- Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Jen-Yuan Kuo
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (C.-L.H.); (K.-T.S.); (S.-C.C.); (Y.-Y.L.); (J.-Y.K.); (C.-H.S.); (S.-Y.T.); (C.-Y.L.); (A.-S.L.); (S.-W.W.); (C.J.-Y.H.); (T.-C.H.)
- Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan;
| | - Wen-Hung Huang
- Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan;
| | - Cheng-Huang Su
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (C.-L.H.); (K.-T.S.); (S.-C.C.); (Y.-Y.L.); (J.-Y.K.); (C.-H.S.); (S.-Y.T.); (C.-Y.L.); (A.-S.L.); (S.-W.W.); (C.J.-Y.H.); (T.-C.H.)
- Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan;
| | - Chuan-Chuan Liu
- Department of Physiology Examination, MacKay Memorial Hospital, New Taipei City 25160, Taiwan;
| | - Shin-Yi Tsai
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (C.-L.H.); (K.-T.S.); (S.-C.C.); (Y.-Y.L.); (J.-Y.K.); (C.-H.S.); (S.-Y.T.); (C.-Y.L.); (A.-S.L.); (S.-W.W.); (C.J.-Y.H.); (T.-C.H.)
- Institute of Biomedical Sciences, Mackay Medical College, New Taipei City 25245, Taiwan
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Chia-Yuan Liu
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (C.-L.H.); (K.-T.S.); (S.-C.C.); (Y.-Y.L.); (J.-Y.K.); (C.-H.S.); (S.-Y.T.); (C.-Y.L.); (A.-S.L.); (S.-W.W.); (C.J.-Y.H.); (T.-C.H.)
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - An-Sheng Lee
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (C.-L.H.); (K.-T.S.); (S.-C.C.); (Y.-Y.L.); (J.-Y.K.); (C.-H.S.); (S.-Y.T.); (C.-Y.L.); (A.-S.L.); (S.-W.W.); (C.J.-Y.H.); (T.-C.H.)
| | - Szu-Hua Pan
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan;
- Genome and Systems Biology Degree Program, Academia Sinica and National Taiwan University, Taipei 10617, Taiwan
- Doctoral Degree Program of Translational Medicine, College of Medicine, National Taiwan University, Taipei 10051, Taiwan
| | - Shih-Wei Wang
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (C.-L.H.); (K.-T.S.); (S.-C.C.); (Y.-Y.L.); (J.-Y.K.); (C.-H.S.); (S.-Y.T.); (C.-Y.L.); (A.-S.L.); (S.-W.W.); (C.J.-Y.H.); (T.-C.H.)
- Institute of Biomedical Sciences, Mackay Medical College, New Taipei City 25245, Taiwan
| | - Charles Jia-Yin Hou
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (C.-L.H.); (K.-T.S.); (S.-C.C.); (Y.-Y.L.); (J.-Y.K.); (C.-H.S.); (S.-Y.T.); (C.-Y.L.); (A.-S.L.); (S.-W.W.); (C.J.-Y.H.); (T.-C.H.)
- Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan;
| | - Ta-Chuan Hung
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (C.-L.H.); (K.-T.S.); (S.-C.C.); (Y.-Y.L.); (J.-Y.K.); (C.-H.S.); (S.-Y.T.); (C.-Y.L.); (A.-S.L.); (S.-W.W.); (C.J.-Y.H.); (T.-C.H.)
- Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan;
- Mackay Junior College of Medicine, Nursing and Management, Taipei 11260, Taiwan
| | - Hung-I Yeh
- Department of Medicine, Mackay Medical College, New Taipei City 25245, Taiwan; (C.-L.H.); (K.-T.S.); (S.-C.C.); (Y.-Y.L.); (J.-Y.K.); (C.-H.S.); (S.-Y.T.); (C.-Y.L.); (A.-S.L.); (S.-W.W.); (C.J.-Y.H.); (T.-C.H.)
- Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan;
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A Review of the Molecular Mechanisms Underlying Cardiac Fibrosis and Atrial Fibrillation. J Clin Med 2021; 10:jcm10194430. [PMID: 34640448 PMCID: PMC8509789 DOI: 10.3390/jcm10194430] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 01/03/2023] Open
Abstract
The cellular and molecular mechanism involved in the pathogenesis of atrial fibrosis are highly complex. We have reviewed the literature that covers the effectors, signal transduction and physiopathogenesis concerning extracellular matrix (ECM) dysregulation and atrial fibrosis in atrial fibrillation (AF). At the molecular level: angiotensin II, transforming growth factor-β1, inflammation, and oxidative stress are particularly important for ECM dysregulation and atrial fibrotic remodelling in AF. We conclude that the Ang-II-MAPK and TGF-β1-Smad signalling pathways play a major, central role in regulating atrial fibrotic remodelling in AF. The above signalling pathways induce the expression of genes encoding profibrotic molecules (MMP, CTGF, TGF-β1). An important mechanism is also the generation of reactive oxygen species. This pathway induced by the interaction of Ang II with the AT2R receptor and the activation of NADPH oxidase. Additionally, the interplay between cardiac MMPs and their endogenous tissue inhibitors of MMPs, is thought to be critical in atrial ECM metabolism and fibrosis. We also review recent evidence about the role of changes in the miRNAs expression in AF pathophysiology and their potential as therapeutic targets. Furthermore, keeping the balance between miRNA molecules exerting anti-/profibrotic effects is of key importance for the control of atrial fibrosis in AF.
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