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Yang Z, Tang Y, Sun W, Wen J, Tang D, Luo Y, Xiang C, Huang L, Xia L. Left Atrial Strain for Prediction of Left Ventricular Reverse Remodeling After ST-segment Elevation Myocardial Infarction by Cardiac Magnetic Resonance Feature Tracking. J Thorac Imaging 2024:00005382-990000000-00141. [PMID: 38856048 DOI: 10.1097/rti.0000000000000795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
PURPOSE The study aimed to investigate the potential utility of left atrial (LA) strain by using cardiac magnetic resonance feature-tracking (CMR-FT) to predict left ventricular reverse remodeling (LVRR) following ST-segment elevation myocardial infarction (STEMI). MATERIALS AND METHODS Patients with a first STEMI treated by primary percutaneous coronary intervention were consecutively enrolled in the prospective study and underwent CMR scans at 5 days and 4 months. LA global longitudinal strain (reservoir strain [εs], conduit strain [εe], booster strain [εa]) and corresponding strain rate were assessed by CMR-FT using cine images. LVRR was defined as a reduction in the LV end-systolic volume index of >10% from baseline to follow-up. Logistic regression analyses were performed to determine the predictors of LVRR. RESULTS Of 90 patients analyzed, patients with LVRR (n=35, 39%) showed higher values of LA strain and strain rate and less extensive infarct size (IS) compared with patients without LVRR (n=55, 61%) at initial and second CMR. The LVRR group demonstrated significant improvements in LV and LA cardiac function over time, especially the obvious increase in LA strain and strain rate. In multivariate logistic regression analyses, εs and εe, together with IS, were independent predictors of LVRR. The combination of εs and IS could optimally predict the LVRR with the highest area under the curve of 0.743. CONCLUSIONS Post-STEMI patients with LVRR presented better recovery from cardiac function and LA deformation compared with patients without LVRR. Assessment of εs and εe by using CMR-FT after STEMI enabled prediction of LVRR.
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Affiliation(s)
- Zhaoxia Yang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Yuanyuan Tang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Wenzhe Sun
- Department of Neurology, Xinqiao Hospital and the Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jinyang Wen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Dazhong Tang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Yi Luo
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Chunlin Xiang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Lu Huang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
| | - Liming Xia
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei
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Wang F, Li C, Zhang X. Sacubitril/valsartan improves the prognosis of acute myocardial infarction: a meta-analysis. Coron Artery Dis 2024; 35:231-238. [PMID: 38299259 DOI: 10.1097/mca.0000000000001332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
OBJECTIVE To systematically evaluate the effect of sacubitril/valsartan (SV) on the prognosis of patients with acute myocardial infarction (AMI), and to provide evidence for expanding the clinical application of SV. METHODS PubMed, EMbase, Web of Science, and Cochrane Library were searched from inception to October 2023 for randomized controlled trials (RCTs) of SV in patients with AMI. The article was screened and evaluated by the Cochrane 5.1.0 bias risk assessment tool. RevMan5.3 was used for meta-analysis of the outcome indicators. RESULTS Ten RCTs involving 7230 patients were included. The results showed that SV increased left ventricular eject fraction ( MD = 2.86, 95% CI [1.81-3.90], P < 0.00001) and reduced readmission rate ( RR = 0.46, 95% CI [0.32-0.68], P < 0.0001), decreased N-terminal pro-brain natriuretic peptide ( MD = -477.46, 95% CI [-914.96 to -39.96], P = 0.03), and reduced major adverse cardiovascular and cerebrovascular event (MACCE) ( RR = 0.48, 95% CI [0.27-0.85], P = 0.01). There was no significant difference in the rate of adverse reaction (AR) between the trial group and the control group ( RR = 0.88, 95% CI [0.60-1.30], P = 0.52). CONCLUSION SV can effectively improve the prognosis of AMI, prevent complications, and there is no significant difference in safety compared with angiotensin-converting enzyme inhibitor/angiotensin receptor blocker.
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Affiliation(s)
- Fang Wang
- School of Pharmacy, Weifang Medical University
| | - Chengde Li
- School of Pharmacy, Weifang Medical University
| | - Xuezheng Zhang
- Department of Health Care Medicine, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China
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3
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Liu Y, Cui C, Li Y, Wang Y, Hu Y, Bai M, Huang D, Zheng Q, Liu L. Predictive value of the echocardiographic noninvasive myocardial work index for left ventricular reverse remodeling in patients with multivessel coronary artery disease after percutaneous coronary intervention. Quant Imaging Med Surg 2022; 12:3725-3737. [PMID: 35782270 PMCID: PMC9246722 DOI: 10.21037/qims-21-1066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 04/15/2022] [Indexed: 09/29/2023]
Abstract
BACKGROUND Coronary artery disease (CAD) can lead to left ventricular (LV) remodeling, which, in adverse cases, has been associated with heart failure and increased mortality. Here, we aimed to evaluate the predictive value of the noninvasive myocardial work index (NIMWI) for LV reverse remodeling in patients with multivessel CAD after percutaneous coronary intervention (PCI). METHODS A total of 88 consecutive patients with multivessel CAD treated with PCI were identified and categorized according to the presence of LV reverse remodeling 3 months after PCI [≥15% decrease in the LV end diastolic volume (LVEDV)]. With the LV pressure-strain loop (PSL) technique, NIMWIs, including the global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE), were statistically compared between the reverse LV remodeling group and nonreverse LV remodeling group 1 week before PCI. RESULTS Significantly lower GWI, GCW, and GWE, and significantly higher GWW were observed in the reverse LV remodeling group compared with the nonreverse LV remodeling group (P<0.05). Left ventricular mass index (LVMI), GCW, and GWE were independently associated with early LV reverse remodeling. Receiver operating characteristic (ROC) curve analysis demonstrated that GCW was the most powerful predictor of early LV reverse remodeling in patients with CAD [area under the curve (AUC) =0.867]. The optimal cutoff GCW value predictive of early LV reverse remodeling was 1,438.5 mmHg% (sensitivity, 85%; specificity, 70%). CONCLUSIONS GCW, among the NIMWIs, may be the major predictor of LV reverse remodeling in patients with multivessel CAD after PCI. NIMWI could potentially provide a new reference index for the quantitative evaluation of LV myocardial work.
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Affiliation(s)
- Yuanyuan Liu
- Department of Ultrasound, Fuwai Central China Cardiovascular Hospital, Henan Provincial People’s Hospital, Central China Fuwai Hospital of Zhengzhou University, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Cunying Cui
- Department of Ultrasound, Fuwai Central China Cardiovascular Hospital, Henan Provincial People’s Hospital, Central China Fuwai Hospital of Zhengzhou University, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanan Li
- Department of Ultrasound, Fuwai Central China Cardiovascular Hospital, Henan Provincial People’s Hospital, Central China Fuwai Hospital of Zhengzhou University, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying Wang
- Department of Ultrasound, Fuwai Central China Cardiovascular Hospital, Henan Provincial People’s Hospital, Central China Fuwai Hospital of Zhengzhou University, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanbin Hu
- Department of Ultrasound, Fuwai Central China Cardiovascular Hospital, Henan Provincial People’s Hospital, Central China Fuwai Hospital of Zhengzhou University, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Minfu Bai
- Department of Cardiology, Henan Provincial People’s Hospital, Fuwai Central China Cardiovascular Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Danqing Huang
- Department of Ultrasound, Fuwai Central China Cardiovascular Hospital, Henan Provincial People’s Hospital, Central China Fuwai Hospital of Zhengzhou University, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Qiang Zheng
- School of Computer and Control Engineering, Yantai University, Yantai, China
| | - Lin Liu
- Department of Ultrasound, Fuwai Central China Cardiovascular Hospital, Henan Provincial People’s Hospital, Central China Fuwai Hospital of Zhengzhou University, People’s Hospital of Zhengzhou University, Zhengzhou, China
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Terenicheva MA, Stukalova OV, Shakhnovich RM, Ternovoy SK. The role of cardiac magnetic resonance imaging in defining the prognosis of patients with acute <i>ST</i>-segment elevation myocardial infarction. Part 2. Assessment of the disease prognosis. TERAPEVT ARKH 2022; 94:552-557. [DOI: 10.26442/00403660.2022.04.201458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 11/22/2022]
Abstract
Currently the incidence of congestive heart failure after ST-segment elevation myocardial infarction (STEMI) tends to increase. Reperfusion therapy is still the only effective method to reduce an infarct size. Therefore, there is a high unmet need of novel cardioprotective treatments that would improve outcomes in such patients. Recent advances in cardiovascular magnetic resonance (CMR) methods enabled the identification of certain new infarct characteristics associated with the development of heart failure and sudden cardiac death. These characteristics can help identify new groups of high risk patients and used as a targets for novel cardioprotective treatments. This part of the review summarizes novel CMR-based characteristics of myocardial infarction and their role in the prognostic stratification of STEMI patients.
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MitraClip implantation in real-world: clinical relevance of different patterns of left ventricular remodeling. Hellenic J Cardiol 2021; 64:7-14. [PMID: 34843994 DOI: 10.1016/j.hjc.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/25/2021] [Accepted: 10/08/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The role of left ventricular (LV) volumes and ejection fraction (EF) in the selection of patients candidates to MitraClip procedure remains matter of debate. To assess the pattern of LV remodeling and its clinical implications after MitraClip procedures, and to evaluate the role of LV ejection fraction (EF) in patient selection. METHODS Complete echocardiography was performed before, at discharge,1,6, and 12-month in 45 patients treated with MitraClip for severe mitral regurgitation (MR) [age 78.2±8.3 yrs, NYHA 3.74±0.44, EF 36.5±12.8%]. From baseline to 6-month reverse and adverse LV-R was defined as ≥15 % decrease and ≥10% increase in LV end-systolic volume, respectively. RESULTS At 6-month, sustained reduction of MR≤2 was observed in all patients, but 2; reverse, adverse and no LV-R occurred in 51% (N=23), 18% (N=8) and 31% (N=14) patients. Baseline LV end-diastolic volume was an independent predictor of reverse LV-R [P=0.004], whereas EF was not. During follow-up (17.5±9.3 months), freedom from the composite endpoint (mortality and hospitalization for heart failure) was observed in 50% of adverse/no LV-R vs. 95.7% of reverse LV-R patients (P=0.006). At Cox analysis, adverse LV-R and adverse/no LV-R were associated with composite endpoint with adjusted hazard ratio of 5.6 (95% CI 1.65-19.00) and 10.08 (95% CI 1.29-78.6), respectively. CONCLUSIONS After MitraClip implantation, sustained adverse or no LV-R occurred in one-in-two patients and was associated with poor prognosis. Large LV volumes may help us to avoid futility of procedure.
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Cheng XJ, Li L, Xin BQ. MiR-124 Regulates the Inflammation and Apoptosis in Myocardial Infarction Rats by Targeting STAT3. Cardiovasc Toxicol 2021; 21:710-720. [PMID: 34037971 DOI: 10.1007/s12012-021-09661-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 05/17/2021] [Indexed: 11/27/2022]
Abstract
This study aimed to discover the effect of miR-124/STAT3 axis on the inflammation and cell apoptosis in myocardial infarction (MI) rats. Sprague-Dawley (SD) male rats were selected for establishing MI models and divided into Sham, MI, MI + anti-miR-124 and MI + Ad-miR-124 groups. Cardiac function was detected via echocardiography. Hematoxylin & eosin (HE) and triphenyltetrazolium chloride (TTC) staining were used to observe the pathological changes and infarction area, while transferase (TdT)-mediated D-UTP-biotin nick end labeling (TUNEL) assay was to observe myocardial apoptosis. Enzyme-linked immunosorbent assay (ELISA) was used to determine the serum levels of inflammatory cytokines. Quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and western blotting were performed to determine the mRNA and protein levels, respectively. Dual luciferase reporter gene assay revealed that STAT3 was a target gene of miR-124. The expression levels of miR-124 were increased and the pSTAT3/STAT3 ratio was reduced in the MI rats. The rats in the MI group showed enhanced LVEDD and LVESD, reduced LVEF and LVFS, as well as larger myocardial infarction area compared with the Sham group, Besides, IL-1β, IL-6, TNF-α and MCP-1 levels were elevated and the expressions of Bax/Bcl-2 ratio and cleaved caspase-3 were downregulated in MI group. We further found that silencing miR-124 improved cardiac function, reduced infarction area and the levels of inflammatory cytokines, as well as prevented myocardial apoptosis in MI rats. Silencing miR-124 could inhibit the inflammation and apoptosis of myocardial cells, thereby relieving the MI injury via upregulation of STAT3.
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Affiliation(s)
- Xiao-Jing Cheng
- Department of Cardiovascular Medicine, Rizhao People's Hospital, No. 126, Taian Road, Donggang District, Rizhao, 276800, Shandong, China
| | - Lei Li
- Department of Cardiovascular Medicine, Rizhao People's Hospital, No. 126, Taian Road, Donggang District, Rizhao, 276800, Shandong, China
| | - Ben-Qiang Xin
- Department of Cardiovascular Medicine, Rizhao People's Hospital, No. 126, Taian Road, Donggang District, Rizhao, 276800, Shandong, China.
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Zhang DY, Gao T, Xu RJ, Sun L, Zhang CF, Bai L, Chen W, Liu KY, Zhou Y, Jiao X, Zhang GH, Guo RL, Li JX, Gao Y, Jiao WJ, Tian H. SIRT3 Transfection of Aged Human Bone Marrow-Derived Mesenchymal Stem Cells Improves Cell Therapy-Mediated Myocardial Repair. Rejuvenation Res 2020; 23:453-464. [PMID: 32228121 DOI: 10.1089/rej.2019.2260] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Sirtuin 3 (SIRT3) is a deacetylase important for antioxidant protection, cell longevity, and aging. We hypothesized that SIRT3 improve oxidative resistance of aged cells and improve cell therapy in aged patients. In vitro, the proliferation and oxidative resistance of human mesenchymal stem cells (hMSCs) significantly declined with age. The expression and activity of antioxidant enzymes, including catalase (CAT) and manganese superoxide dismutase (MnSOD), increased after transfection of SIRT3 in hMSCs from older donors (O-hMSCs). The protein level of Forkhead box O3a (FOXO3a) in nucleus increased after SIRT3 overexpression. The antioxidant capacity of O-hMSCs increased after SIRT3 overexpression. 3-Amino-1,2,4-triazole (3-AT, CAT inhibitor) or diethyldithiocarbamate (DETC, SOD inhibitor) that was used to inhibit CAT or SOD activity significantly blocked the antioxidant function of SIRT3. When two inhibitors were used together, the antioxidant function of SIRT3 almost disappeared. Following myocardial infarction and intramyocardial injections of O-hMSCs in rats in vivo, the survival rate of O-hMSCs increased by SIRT3 transfection. The cardiac function of rats was improved after SIRT3-overexpressed O-hMSC transplantation. The infarct size, collagen content, and expression levels of matrix metalloproteinase 2 (MMP2) and MMP9 decreased. Besides, the protein level of vascular endothelial growth factor A and vascular density increased after cell transplantation with SIRT3-modified O-hMSCs. These results indicate that damage resistance of hMSCs decline with age and SIRT3 might protect O-hMSCs against oxidative damage by activating CAT and MnSOD through transferring FOXO3a into nucleus. Meanwhile, the therapeutic effect of aged hMSC transplantation can be improved by SIRT3 overexpression.
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Affiliation(s)
- Dong-Yang Zhang
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.,Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tong Gao
- Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Rong-Jian Xu
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lu Sun
- Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chun-Feng Zhang
- Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Long Bai
- Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Chen
- Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Kai-Yu Liu
- Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yang Zhou
- Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xuan Jiao
- Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Gui-Huan Zhang
- Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Rui-Lin Guo
- The Second Clinical College of Harbin Medical University, Harbin, China
| | - Jing-Xuan Li
- The Second Clinical College of Harbin Medical University, Harbin, China
| | - Ying Gao
- The Second Clinical College of Harbin Medical University, Harbin, China
| | - Wen-Jie Jiao
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hai Tian
- Future Medical Laboratory, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Reduction of Left Ventricular Dilation Beyond the First Year After Anterior Myocardial Infarction. J Card Fail 2019; 25:645-653. [DOI: 10.1016/j.cardfail.2019.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 03/05/2019] [Accepted: 03/19/2019] [Indexed: 11/24/2022]
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Jenner J, Sörensson P, Pernow J, Caidahl K, Eriksson MJ. Contrast Enhancement and Image Quality Influence Two- and Three-dimensional Echocardiographic Determination of Left Ventricular Volumes: Comparison With Magnetic Resonance Imaging. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2019; 13:1179546819831980. [PMID: 30858745 PMCID: PMC6402058 DOI: 10.1177/1179546819831980] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/28/2019] [Indexed: 12/21/2022]
Abstract
Purpose: To evaluate the effect of image quality and contrast enhancement (CE) on left ventricular (LV) volume determination by two- (2D) and three-dimensional (3D) echocardiography (2DE/3DE). Methods: We studied 32 post-myocardial infarction (MI) patients without (2DE/3DE) and with CE (CE2DE/CE3DE), in comparison with cardiac magnetic resonance imaging (CMR). Results: Two-dimensional echocardiography showed the largest negative bias versus CMR for diastolic and systolic volumes (−59, −28 mL, respectively) with lower biases for CE2DE (−37, −22 mL), 3DE (−31, −17 mL), and CE3DE (−17, −11 mL). Bias for ejection fraction (EF) ranged from −2.1% for 2DE to +1.4% for CE3DE. Agreement (intraclass correlation coefficient, ICC) for EF between CMR and 3DE (0.86 without and 0.85 with contrast) was better than for 2DE (0.73 without and 0.69 with contrast). The inter-/intra-observer coefficients of variation for EF varied from 16%/10% (2DE) to 6.9%/6.6% (CE2DE), and 8.3%/4.8% (3DE) to 6.7%/6.8% (CE3DE), respectively. The agreement (ICC) with CMR for EF measured by 2DE/3DE changed from 0.64/0.84 with poor image quality to 0.81/0.87 with moderate to good image quality. Conclusions: Three-dimensional echocardiography was more accurate than 2DE for estimating LV volumes, with less inter-/intra-observer variability in EF values. Contrast enhancement improved accuracy for both 2DE and 3DE and improved the inter-observer variability of EF estimates for 2DE and 3DE. Image quality had more impact on the agreement of EF values with CMR for 2DE than for 3DE. Our results emphasize the importance of using the same technique for longitudinal studies of LV EF and specially LV volumes.
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Affiliation(s)
- Jonas Jenner
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Peder Sörensson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - John Pernow
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - Kenneth Caidahl
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria J Eriksson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
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Reverse, stationary and progressive left ventricular dilatation in dilated and nondilated ventricles on admission following first anterior STEMI. Coron Artery Dis 2019; 30:11-19. [DOI: 10.1097/mca.0000000000000665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Left ventricular reverse remodeling in patients with anterior wall ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2018; 14:373-382. [PMID: 30603027 PMCID: PMC6309837 DOI: 10.5114/aic.2018.79867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 09/17/2018] [Indexed: 12/28/2022] Open
Abstract
Introduction The study aimed to evaluate the prevalence and predictors of left ventricular (LV) reverse remodeling and its impact on long-term prognosis in patients with anterior ST-segment elevation myocardial infarction (STEMI). Aim To assess the percentage of reverse remodeling and its prognostic factors in anterior STEMI patients. Material and methods This observational study included 40 patients with first ever STEMI of the anterior wall. LV reverse remodeling was defined as the reduction of left ventricular end-systolic volume (ΔLVESV) by ≥ 10% in 3D transthoracic echocardiography (3D-TTE) at 3-month follow-up. 3D-TTE and speckle tracking imaging were performed during index hospitalization, while 3D-TTE and cardiac magnetic resonance (CMR) were performed at 3 months following the procedure. Patients were followed up for a median time of 3.4 years in order to evaluate major adverse cardiovascular events. Results Left ventricular reverse remodeling at 3-month follow-up was confirmed in 15 (37.5%) patients. The presence of reverse remodeling was predicted by lower troponin levels (unit OR = 0.86, p = 0.02), lower sum of ST-segment elevations before (unit OR = 0.87, p = 0.03) and after PCI (unit OR = 0.40, p = 0.03), lower maximal ST-segment elevation after PCI (unit OR = 0.01, p = 0.03), lower wall motion score index (unit OR 0.40, p = 0.03) and more negative anterior wall global longitudinal strain (unit OR = 0.88, p = 0.045). Nine MACE were reported in the without reverse remodeling group only. Non-significantly better event-free survival in the reverse remodeling group was demonstrated (log-rank p = 0.07). Conclusions Development of reverse modeling in patients with optimal revascularization and tailored pharmacotherapy is relatively high. Further studies are warranted in order to adjudicate its prognostic role for the prediction of adverse events.
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Miñana G, Núñez J, Bayés-Genís A, Revuelta-López E, Ríos-Navarro C, Núñez E, Chorro FJ, López-Lereu MP, Monmeneu JV, Lupón J, Bodí V. ST2 and left ventricular remodeling after ST-segment elevation myocardial infarction: A cardiac magnetic resonance study. Int J Cardiol 2018; 270:336-342. [DOI: 10.1016/j.ijcard.2018.06.073] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/04/2018] [Accepted: 06/18/2018] [Indexed: 12/12/2022]
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13
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Zhang DY, Zhang CF, Fu BC, Sun L, Wang XQ, Chen W, Liu W, Liu KY, Du GQ, Ma CY, Jiang SL, Li RK, Tian H. Sirtuin3 protects aged human mesenchymal stem cells against oxidative stress and enhances efficacy of cell therapy for ischaemic heart diseases. J Cell Mol Med 2018; 22:5504-5517. [PMID: 30091830 PMCID: PMC6201360 DOI: 10.1111/jcmm.13821] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/19/2018] [Accepted: 07/04/2018] [Indexed: 12/19/2022] Open
Abstract
Sirtuin3 (SIRT3) is associated with oxidative stress and lifespan. However, the possible mechanisms underlying its influence are unknown. We hypothesized that SIRT3 increases the antioxidant capacity of aged cells and improves the efficacy of human mesenchymal stem cell (hMSC) therapy for ischaemic heart diseases in aged patients. In vitro, the antioxidant capacity of old hMSCs (O‐hMSCs) was increased after SIRT3 overexpression using a gene transfection technique, while the antioxidant capacity of young hMSCs (Y‐hMSCs) was decreased by SIRT3 silencing. The levels of forkhead box O3a (FoxO3a) in the nucleus, and antioxidant enzymes Mn‐superoxide dismutase (MnSOD) and catalase (CAT) increased in SIRT3‐overexpressed O‐hMSCs while they decreased in SIRT3‐silenced Y‐hMSCs after oxidative stress. Following myocardial infarction in adult rats in vivo, infarct size decreased and cardiac function was significantly enhanced after cell transplantation with SIRT3 overexpressed O‐hMSCs. The number of apoptotic cells decreased and the survival rate of transplanted cells increased following SIRT3 overexpression in O‐hMSCs. SIRT3 protects aged hMSCs against oxidative stress by positively regulating antioxidant enzymes (MnSOD and CAT) via increasing the expression of FoxO3a in the nucleus. The efficacy of aged hMSC transplantation therapy for ischaemic heart diseases can be improved by SIRT3 overexpression.
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Affiliation(s)
- Dong-Yang Zhang
- Department of Cardiovascular Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.,Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China
| | - Chun-Feng Zhang
- Department of Cardiovascular Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.,Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China
| | - Bi-Cheng Fu
- Department of Cardiovascular Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.,Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China
| | - Lu Sun
- Department of Cardiovascular Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.,Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China
| | - Xue-Qing Wang
- Department of Cardiovascular Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.,Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China
| | - Wei Chen
- Department of Cardiovascular Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.,Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China
| | - Wei Liu
- Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China
| | - Kai-Yu Liu
- Department of Cardiovascular Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.,Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China
| | - Guo-Qing Du
- Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China
| | - Chong-Yi Ma
- Department of Cardiovascular Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.,Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China
| | - Shu-Lin Jiang
- Department of Cardiovascular Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.,Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China
| | - Ren-Ke Li
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada.,Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Hai Tian
- Department of Cardiovascular Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.,Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, Heilongjiang, China
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14
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Awadalla H, Saleh MA, Abdel Kader M, Mansour A. Left ventricular torsion assessed by two-dimensional echocardiography speckle tracking as a predictor of left ventricular remodeling and short-term outcome following primary percutaneous coronary intervention for acute myocardial infarction: A single-center experience. Echocardiography 2017; 34:1159-1169. [PMID: 28752661 DOI: 10.1111/echo.13611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
AIMS Left ventricular (LV) torsion is a novel method to assess systolic LV function. This study aimed at exploring the utility of 2D speckle tracking-based assessment of left ventricular torsion in patients with acute myocardial infarction (AMI) undertaking primary percutaneous intervention (pPCI) in predicting left ventricular remodeling. METHODS AND RESULTS The study included 115 patients (mean±SD, age 52.2±9.67, males 84.3%) who underwent pPCI for AMI. Echocardiographic assessment of LV torsion by two-dimensional speckle tracking was performed early after the index pPCI. Patients underwent repeat echocardiography at 6 months to detect remodeling. LV torsion in the acute setting was significantly lower in those who demonstrated LV remodeling at follow-up compared to those without remodeling (7.56±1.95 vs 15.16±4.65; P<.005). Multivariate analysis identified peak CK & CK-MB elevation (β=-0.767 and -0.725; P<.001), SWMA index (β=-0.843; P<.001), and Simpson's derived LV ejection fraction (LVEF; β=0.802; P<.001) as independent predictors of baseline LV torsion. It also identified peak LV torsion (β: 0.27; 95% CI: 0.15-0.5, P=.001) and SWMA index (β: 1.07, 95% CI: 1.03-1.12, P=.005) as independent predictors of LV remodeling. Baseline Killip's grades II and higher (β: 48.6; 95% CI 5.5-428, P<.001) and diabetes mellitus (β: 29.7; 95% CI 1.1-763, P<.05) were independent predictors of mortality. CONCLUSION Left ventricular torsion in acute MI setting is impaired and predicts subsequent LV remodeling at 6-month follow-up.
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Affiliation(s)
- Hany Awadalla
- Department of Cardiovascular Medicine, Ain Shams University Hospitals and Medical School, Cairo, Egypt
| | - Mohamed Ayman Saleh
- Department of Cardiovascular Medicine, Ain Shams University Hospitals and Medical School, Cairo, Egypt
| | - Mohamed Abdel Kader
- Department of Cardiovascular Medicine, Ain Shams University Hospitals and Medical School, Cairo, Egypt
| | - Amr Mansour
- Department of Cardiovascular Medicine, Ain Shams University Hospitals and Medical School, Cairo, Egypt
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15
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Choe JC, Cha KS, Yun EY, Ahn J, Park JS, Lee HW, Oh JH, Kim JS, Choi JH, Park YH, Lee HC, Kim JH, Chun KJ, Hong TJ, Ahn Y, Jeong MH, Chae SC, Kim YJ. Reverse Left Ventricular Remodelling in ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention: Incidence, Predictors, and Impact on Outcome. Heart Lung Circ 2017; 27:154-164. [PMID: 28487063 DOI: 10.1016/j.hlc.2017.02.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 12/15/2016] [Accepted: 02/16/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUD We investigated reverse left ventricular remodelling (r-LVR), defined as a reduction of >10% in left ventricular end-systolic volume (LVESV) during follow-up, in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI). METHODS STEMI patients (n=1,237) undergoing PPCI with echocardiography at baseline and 6-month follow-up were classified into r-LVR (n=466) and no r-LVR groups (n=771). The primary outcome was composite major adverse cardiac events (MACE; all-cause death, myocardial infarction, any revascularisation). RESULTS r-LVR occurred in 466 patients (37.7%) and was associated with maximum troponin, door-to-balloon time, direct arrival to PPCI-capable hospital, coronary disease extent, initial left ventricular ejection fraction (LVEF), and LVESV. After propensity score (PS)-matching, initial LVEF and LVESV remained significant. During a median 403-day follow-up, 2-year MACE occurred in 166 patients (13.4%); its frequency was similar between groups (entire cohort: 13.5% vs. 13.4%, p=0.247; PS-matched: 11.8% vs. 11.8%, p=0.987). Kaplan-Meier estimates showed that MACE-free survival was comparable between groups (entire cohort: 86.5% vs. 86.6%, log rank p=0.939; PS-matched: 88.2% vs. 88.2%, log rank p=0.867). In Cox proportional hazard analysis, r-LVR was not associated with MACE (entire cohort: hazard ratio [HR] 1.018, 95% confidential interval [CI] 0.675-1.534, p=0.934; PS-matched: HR 1.001, 95% CI 0.578-1.731, p=0.999). CONCLUSION We identified independent predictors of r-LVR and showed that while r-LVR occurred in 38% of our patients, it was not associated with clinical outcomes.
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Affiliation(s)
| | - Kwang Soo Cha
- Pusan National University Hospital, Busan, South Korea.
| | - Eun Young Yun
- Pusan National University Hospital, Busan, South Korea
| | - Jinhee Ahn
- Pusan National University Hospital, Busan, South Korea
| | - Jin Sup Park
- Pusan National University Hospital, Busan, South Korea
| | - Hye Won Lee
- Pusan National University Hospital, Busan, South Korea
| | - Jun-Hyok Oh
- Pusan National University Hospital, Busan, South Korea
| | - Jeong Su Kim
- Pusan National University Yangsan Hospital, Yangsan, South Korea
| | | | - Yong Hyun Park
- Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Han Cheol Lee
- Pusan National University Hospital, Busan, South Korea
| | - June Hong Kim
- Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Kook Jin Chun
- Pusan National University Yangsan Hospital, Yangsan, South Korea
| | | | - Youngkeun Ahn
- Chonnam National University Hospital, Gwangju, South Korea
| | - Myung Ho Jeong
- Chonnam National University Hospital, Gwangju, South Korea
| | | | - Young Jo Kim
- Yeungnam University Hospital, Daegu, South Korea
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16
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Nishino S, Watanabe N, Kimura T, Enriquez-Sarano M, Nakama T, Furugen M, Koiwaya H, Ashikaga K, Kuriyama N, Shibata Y. The Course of Ischemic Mitral Regurgitation in Acute Myocardial Infarction After Primary Percutaneous Coronary Intervention. Circ Cardiovasc Imaging 2016; 9:e004841. [DOI: 10.1161/circimaging.116.004841] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 06/24/2016] [Indexed: 11/16/2022]
Abstract
Background—
Previously published evidence on ischemic mitral regurgitation (IMR) and its adverse prognosis after myocardial infarction has been based on the severity of IMR in the subacute or chronic period of myocardial infarction. However, the state of IMR can vary from the early stage to the chronic stage as a result of various responses of myocardium after primary percutaneous coronary intervention (PCI).
Methods and Results—
Standard echocardiography was serially performed in 546 consecutive patients with first-onset acute myocardial infarction (1) immediately after their arrival (pre-PCI), (2) before discharge (early post-PCI), and (3) 6 to 8 months after PCI (late post-PCI). The course of IMR after primary PCI and the prognostic impact of the IMR in each phase were investigated. IMR was found in 193/546 (35%) patients at the emergency room. In the acute phase after PCI, IMR improved in 63 patients. IMR worsened in 78 patients despite successful PCI. Shorter onset-to-reperfusion time and nontotal occlusion before PCI were the independent predictors of early improvement of IMR. In the chronic phase, IMR improved in 79 patients and worsened in 36 patients. Lower peak creatine kinase–myocardial band was an independent predictor of late improvement of IMR. IMR before PCI worsened 30-day prognosis (
P
=0.02), and persistent IMR in the chronic phase worsened long-term prognosis (
P
=0.04) after primary PCI.
Conclusions—
Degrees of IMR changed in the early and chronic phase after primary PCI for acute myocardial infarction. IMR on arrival and persistent IMR in the chronic phase worsened short-term and long-term prognosis after acute myocardial infarction, respectively.
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Affiliation(s)
- Shun Nishino
- From the Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center, Japan (S.N., N.W., T.N., M.F., H.K., K.A., N.K., Y.S.); and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (T.K., M.E.-S.)
| | - Nozomi Watanabe
- From the Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center, Japan (S.N., N.W., T.N., M.F., H.K., K.A., N.K., Y.S.); and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (T.K., M.E.-S.)
| | - Toshiyuki Kimura
- From the Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center, Japan (S.N., N.W., T.N., M.F., H.K., K.A., N.K., Y.S.); and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (T.K., M.E.-S.)
| | - Maurice Enriquez-Sarano
- From the Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center, Japan (S.N., N.W., T.N., M.F., H.K., K.A., N.K., Y.S.); and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (T.K., M.E.-S.)
| | - Tatsuya Nakama
- From the Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center, Japan (S.N., N.W., T.N., M.F., H.K., K.A., N.K., Y.S.); and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (T.K., M.E.-S.)
| | - Makoto Furugen
- From the Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center, Japan (S.N., N.W., T.N., M.F., H.K., K.A., N.K., Y.S.); and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (T.K., M.E.-S.)
| | - Hiroshi Koiwaya
- From the Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center, Japan (S.N., N.W., T.N., M.F., H.K., K.A., N.K., Y.S.); and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (T.K., M.E.-S.)
| | - Keiichi Ashikaga
- From the Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center, Japan (S.N., N.W., T.N., M.F., H.K., K.A., N.K., Y.S.); and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (T.K., M.E.-S.)
| | - Nehiro Kuriyama
- From the Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center, Japan (S.N., N.W., T.N., M.F., H.K., K.A., N.K., Y.S.); and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (T.K., M.E.-S.)
| | - Yoshisato Shibata
- From the Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center, Japan (S.N., N.W., T.N., M.F., H.K., K.A., N.K., Y.S.); and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (T.K., M.E.-S.)
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17
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Bodi V, Monmeneu JV, Ortiz-Perez JT, Lopez-Lereu MP, Bonanad C, Husser O, Minana G, Gomez C, Nunez J, Forteza MJ, Hervas A, de Dios E, Moratal D, Bosch X, Chorro FJ. Prediction of Reverse Remodeling at Cardiac MR Imaging Soon after First ST-Segment-Elevation Myocardial Infarction: Results of a Large Prospective Registry. Radiology 2015; 278:54-63. [PMID: 26348232 DOI: 10.1148/radiol.2015142674] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To assess predictors of reverse remodeling by using cardiac magnetic resonance (MR) imaging soon after ST-segment-elevation myocardial infarction (STEMI). MATERIALS AND METHODS Written informed consent was obtained from all patients, and the study protocol was approved by the institutional committee on human research, ensuring that it conformed to the ethical guidelines of the 1975 Declaration of Helsinki. Five hundred seven patients (mean age, 58 years; age range, 24-89 years) with a first STEMI were prospectively studied. Infarct size and microvascular obstruction (MVO) were quantified at late gadolinium-enhanced imaging. Reverse remodeling was defined as a decrease in left ventricular (LV) end-systolic volume index (LVESVI) of more than 10% from 1 week to 6 months after STEMI. For statistical analysis, a simple (from a clinical perspective) multiple regression model preanalyzing infarct size and MVO were applied via univariate receiver operating characteristic techniques. RESULTS Patients with reverse remodeling (n = 211, 42%) had a lesser extent (percentage of LV mass) of 1-week infarct size (mean ± standard deviation: 18% ± 13 vs 23% ± 14) and MVO (median, 0% vs 0%; interquartile range, 0%-1% vs 0%-4%) than those without reverse remodeling (n = 296, 58%) (P < .001 in pairwise comparisons). The independent predictors of reverse remodeling were infarct size (odds ratio, 0.98; 95% confidence interval [CI]: 0.97, 0.99; P = .04) and MVO (odds ratio, 0.92; 95% CI: 0.86, 0.99; P = .03). Once infarct size and MVO were dichotomized by using univariate receiver operating characteristic techniques, the only independent predictor of reverse remodeling was the presence of simultaneous nonextensive infarct-size MVO (infarct size < 30% of LV mass and MVO < 2.5% of LV mass) (odds ratio, 3.2; 95% CI: 1.8, 5.7; P < .001). CONCLUSION Assessment of infarct size and MVO with cardiac MR imaging soon after STEMI enables one to make a decision in the prediction of reverse remodeling.
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Affiliation(s)
- Vicente Bodi
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - Jose V Monmeneu
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - Jose T Ortiz-Perez
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - Maria P Lopez-Lereu
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - Clara Bonanad
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - Oliver Husser
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - Gemma Minana
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - Cristina Gomez
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - Julio Nunez
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - Maria J Forteza
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - Arantxa Hervas
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - Elena de Dios
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - David Moratal
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - Xavier Bosch
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
| | - Francisco J Chorro
- From the Department of Cardiology, Hospital Clínico Universitario, Universidad de Valencia, INCLIVA, Avenida Blasco Ibañez 17, 46010 Valencia, Spain (V.B., C.B., G.M., C.G., J.N., M.J.F., A.H., E.d.D., F.J.C.); ERESA, Valencia, Spain (J.V.M., M.P.L.L.); Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain (J.T.O.P., X.B.); Klinik für Herz-und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany (O.H.); and Center for Biomaterials and Tissue Engineering, Universidad Politécnica de Valencia, Valencia, Spain (D.M.)
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18
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Puhl SL, Müller A, Wagner M, Devaux Y, Böhm M, Wagner DR, Maack C. Exercise attenuates inflammation and limits scar thinning after myocardial infarction in mice. Am J Physiol Heart Circ Physiol 2015; 309:H345-59. [PMID: 26001415 DOI: 10.1152/ajpheart.00683.2014] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 05/10/2015] [Indexed: 12/16/2022]
Abstract
Although exercise mediates beneficial effects in patients after myocardial infarction (MI), the underlying mechanisms as well as the question of whether an early start of exercise after MI is safe or even beneficial are incompletely resolved. The present study analyzed the effects of exercise before and reinitiated early after MI on cardiac remodeling and function. Male C57BL/6N mice were housed sedentary or with the opportunity to voluntarily exercise for 6 wk before MI induction (ligation of the left anterior descending coronary artery) or sham operation. After a 5-day exercise-free phase after MI, mice were allowed to reexercise for another 4 wk. Exercise before MI induced adaptive hypertrophy with moderate increases in heart weight, cardiomyocyte diameter, and left ventricular (LV) end-diastolic volume, but without fibrosis. In sedentary mice, MI induced eccentric LV hypertrophy with massive fibrosis but maintained systolic LV function. While in exercised mice gross LV end-diastolic volumes and systolic function did not differ from sedentary mice after MI, LV collagen content and thinning of the infarcted area were reduced. This was associated with ameliorated activation of inflammation, mediated by TNF-α, IL-1β, and IL-6, as well as reduced activation of matrix metalloproteinase 9. In contrast, no differences in the activation patterns of various MAPKs or adenosine receptor expressions were observed 5 wk after MI in sedentary or exercised mice. In conclusion, continuous exercise training before and with an early reonset after MI ameliorates adverse LV remodeling by attenuating inflammation, fibrosis, and scar thinning. Therefore, an early reonset of exercise after MI can be encouraged.
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Affiliation(s)
- Sarah-Lena Puhl
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany; and
| | - Andreas Müller
- Klinik für Interventionelle Radiologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Michael Wagner
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany; and
| | - Yvan Devaux
- Laboratory of Cardiovascular Research, Centre de Recherche Public-Santé, Luxembourg; and
| | - Michael Böhm
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany; and
| | - Daniel R Wagner
- Division of Cardiology, Centre Hospitalier Luxembourg, Luxembourg
| | - Christoph Maack
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany; and
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19
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Epoxyeicosatrienoic acids and cardioprotection: the road to translation. J Mol Cell Cardiol 2014; 74:199-208. [PMID: 24893205 DOI: 10.1016/j.yjmcc.2014.05.016] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 04/30/2014] [Accepted: 05/16/2014] [Indexed: 01/10/2023]
Abstract
Cardiovascular disease, including acute myocardial infarction (AMI), is the leading cause of morbidity and mortality globally, despite well-established treatments. The discovery and development of novel therapeutics that prevent the progression of devastating consequences following AMI are thus important in reducing the global burden of this devastating disease. Scientific evidence for the protective effects of epoxyeicosatrienoic acids (EETs) in the cardiovascular system is rapidly emerging and suggests that promoting the effects of these cytochrome P450-derived epoxyeicosanoids is a potentially viable clinical therapeutic strategy. Through a translational lens, this review will provide insight into the potential clinical utility of this therapeutic strategy for AMI by 1) outlining the known cardioprotective effects of EETs and underlying mechanisms demonstrated in preclinical models of AMI with a particular focus on myocardial ischemia-reperfusion injury, 2) describing studies in human cohorts that demonstrate a relationship between EETs and associated pathways with coronary artery disease risk, and 3) discussing preclinical and clinical areas that require further investigation in order to increase the probability of successfully translating this rapidly emerging body of evidence into a clinically applicable therapeutic strategy for AMI.
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