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Wang C, Qin Y, Zhang X, Yang Y, Wu X, Liu J, Qin S, Chen K, Xiao W. Effect of Dapagliflozin on Indicators of Myocardial Fibrosis and Levels of Inflammatory Factors in Heart Failure Patients. DISEASE MARKERS 2022; 2022:5834218. [PMID: 36105253 PMCID: PMC9467782 DOI: 10.1155/2022/5834218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/24/2022] [Indexed: 11/20/2022]
Abstract
Objective To explore the effect of dapagliflozin on the myocardial fibrosis and the levels of inflammatory factors in heart failure patients. Methods 60 patients with T2DM who were diagnosed as acute left heart failure or acute exacerbation of chronic left heart failure in the Department of Cardiology of our hospital from November 1, 2020, to December 31, 2021, during hospitalization were the study subjects. According to the treatment regimen, they were divided into the experimental group (EG) which received dapagliflozin and conventional drugs and the control group (CG) which received conventional drugs, with 30 cases in each group to compare and analyze the clinical indicators such as myocardial fibrosis and inflammatory factors. Results The levels of TNF-α, IL-1β, IL-6, and hs-CRP in the two groups were decreased gradually after treatment, and the levels of TNF-α, IL-1β, IL-6, and hs-CRP in the EG were visibly lower compared with those in the CG at week 4 of treatment (P < 0.05). The cardiac function evaluation of patients showed that the levels of LVEF and LVEDD in both groups were gradually improved after treatment, with a significant difference from the fourth week. In other words, compared with the CG, the LVEF level in the EG was obviously higher (P < 0.05), the LVEDD level was distinctly lower (P < 0.05), and the levels of ST2, BNP, and MCP-1 in the EG were clearly lower at week 4 of treatment (P < 0.05) with a statistical significance in difference. Conclusion Dapagliflozin has a definite curative effect in heart failure patients with type 2 diabetes mellitus, which can effectively reduce the inflammatory response of patients and inhibit the myocardial fibrosis, and has a potential value in improving cardiac function and promoting prognosis.
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Affiliation(s)
- Chuanqiang Wang
- Department of Cardiology, The Third Hospital of Hebei Medical University, 050051 Shijiazhuang City, Hebei Province, China
| | - Yiteng Qin
- Basic Medicine College, Hebei Medical University, 050017 Shijiazhuang City, Hebei Province, China
| | - Xiaojun Zhang
- Department of Cardiology, The Third Hospital of Hebei Medical University, 050051 Shijiazhuang City, Hebei Province, China
| | - Yang Yang
- Department of Cardiology, The Third Hospital of Hebei Medical University, 050051 Shijiazhuang City, Hebei Province, China
| | - Xuan Wu
- Department of Cardiology, The Third Hospital of Hebei Medical University, 050051 Shijiazhuang City, Hebei Province, China
| | - Jing Liu
- Department of Cardiology, The Third Hospital of Hebei Medical University, 050051 Shijiazhuang City, Hebei Province, China
| | - Shuhui Qin
- Hebei Orthopedic Research Institution, 050051 Shijiazhuang City, Hebei Province, China
| | - Ke Chen
- Catheter Room, Third Hospital of Hebei Medical University, 050051 Shijiazhuang City, Hebei Province, China
| | - Wenliang Xiao
- Department of Cardiology, The Third Hospital of Hebei Medical University, 050051 Shijiazhuang City, Hebei Province, China
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Amador-Martínez I, García-Ballhaus J, Buelna-Chontal M, Cortés-González C, Massó F, Jaisser F, Barrera-Chimal J. Early inflammatory changes and CC chemokine ligand-8 upregulation in the heart contribute to uremic cardiomyopathy. FASEB J 2021; 35:e21761. [PMID: 34245616 DOI: 10.1096/fj.202100746r] [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: 05/06/2021] [Revised: 06/08/2021] [Accepted: 06/14/2021] [Indexed: 12/23/2022]
Abstract
Uremic cardiomyopathy is a common complication in chronic kidney disease (CKD) patients, accounting for a high mortality rate. Several mechanisms have been proposed to link CKD and cardiac alterations; however, the early cardiac modifications that occur in CKD that may trigger cardiac remodeling and dysfunction remain largely unexplored. Here, in a mouse model of CKD induced by 5/6 nephrectomy, we first analyzed the early transcriptional and inflammatory changes that occur in the heart. Five days after 5/6 nephrectomy, RNA-sequencing showed the upregulation of 54 genes in the cardiac tissue of CKD mice and the enrichment of biological processes related to immune system processes. Increased cardiac infiltration of T-CD4+ lymphocytes, myeloid cells, and macrophages during early CKD was observed. Next, since CC chemokine ligand-8 (CCL8) was one of the most upregulated genes in the heart of mice with early CKD, we investigated the effect of acute and transient CCL8 inhibition on uremic cardiomyopathy severity. An increase in CCL8 protein levels was confirmed in the heart of early CKD mice. CCL8 inhibition attenuated the early infiltration of T-CD4+ lymphocytes and macrophages to the cardiac tissue, leading to a protection against chronic cardiac fibrotic remodeling, inflammation and cardiac dysfunction induced by CKD. Altogether, our data show the occurrence of transcriptional and inflammatory changes in the heart during the early phases of CKD and identify CCL8 as a key contributor to the early cardiac inflammatory state that triggers further cardiac remodeling and dysfunction in uremic cardiomyopathy.
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Affiliation(s)
- Isabel Amador-Martínez
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico.,Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Investigación UNAM-INC, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Johannes García-Ballhaus
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico.,Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Investigación UNAM-INC, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Mabel Buelna-Chontal
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - César Cortés-González
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Felipe Massó
- Laboratorio de Medicina Traslacional, Unidad de Investigación UNAM-INC, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Frédéric Jaisser
- INSERM, UMRS 1138, Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Paris, France.,French-Clinical Research Infrastructure Network (F-CRIN), INI-CRCT, INSERM Centre d'Investigations Cliniques-Plurithématique 1433, UMR 1116, CHRU de Nancy, Université de Lorraine, Nancy, France
| | - Jonatan Barrera-Chimal
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico.,Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Investigación UNAM-INC, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
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Francois A, Canella A, Marcho LM, Stratton MS. Protein acetylation in cardiac aging. J Mol Cell Cardiol 2021; 157:90-97. [PMID: 33915138 DOI: 10.1016/j.yjmcc.2021.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 03/14/2021] [Accepted: 04/21/2021] [Indexed: 11/15/2022]
Abstract
Biological aging is attributed to progressive dysfunction in systems governing genetic and metabolic integrity. At the cellular level, aging is evident by accumulated DNA damage and mutation, reactive oxygen species, alternate lipid and protein modifications, alternate gene expression programs, and mitochondrial dysfunction. These effects sum to drive altered tissue morphology and organ dysfunction. Protein-acylation has emerged as a critical mediator of age-dependent changes in these processes. Despite decades of research focus from academia and industry, heart failure remains a leading cause of death in the United States while the 5 year mortality rate for heart failure remains over 40%. Over 90% of heart failure deaths occur in patients over the age of 65 and heart failure is the leading cause of hospitalization in Medicare beneficiaries. In 1931, Cole and Koch discovered age-dependent accumulation of phosphates in skeletal muscle. These and similar findings provided supporting evidence for, now well accepted, theories linking metabolism and aging. Nearly two decades later, age-associated alterations in biochemical molecules were described in the heart. From these small beginnings, the field has grown substantially in recent years. This growing research focus on cardiac aging has, in part, been driven by advances on multiple public health fronts that allow population level clinical presentation of aging related disorders. It is estimated that by 2030, 25% of the worldwide population will be over the age of 65. This review provides an overview of acetylation-dependent regulation of biological processes related to cardiac aging and introduces emerging non-acetyl, acyl-lysine modifications in cardiac function and aging.
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Affiliation(s)
- Ashley Francois
- Department of Physiology and Cell Biology, Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Alessandro Canella
- Department of Physiology and Cell Biology, Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Lynn M Marcho
- Department of Physiology and Cell Biology, Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Matthew S Stratton
- Department of Physiology and Cell Biology, Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Cordero A, Martínez Rey-Rañal E, Moreno MJ, Escribano D, Moreno-Arribas J, Quintanilla MA, Zuazola P, Núñez J, Bertomeu-González V. Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome. J Clin Med 2021; 10:1653. [PMID: 33924437 PMCID: PMC8069470 DOI: 10.3390/jcm10081653] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND N-terminal pro-brain natural peptide (NT-pro-BNP) is a well-established biomarker of tissue congestion and has prognostic value in patients with heart failure (HF). Nonetheless, there is scarce evidence on its predictive capacity for HF re-admission after an acute coronary syndrome (ACS). We performed a prospective, single-center study in all patients discharged after an ACS. HF re-admission was analyzed by competing risk regression, taking all-cause mortality as a competing event. Results are presented as sub-hazard ratios (sHR). Recurrent hospitalizations were tested by negative binomial regression, and results are presented as incidence risk ratio (IRR). RESULTS Of the 2133 included patients, 528 (24.8%) had HF during the ACS hospitalization, and their pro-BNP levels were higher (3220 pg/mL vs. 684.2 pg/mL; p < 0.001). In-hospital mortality was 2.9%, and pro-BNP was similarly higher in these patients. Increased pro-BNP levels were correlated to increased risk of HF or death during the hospitalization. Over follow-up (median 38 months) 243 (11.7%) patients had at least one hospital readmission for HF and 151 (7.1%) had more than one. Complete revascularization had a preventive effect on HF readmission, whereas several other variables were associated with higher risk. Pro-BNP was independently associated with HF admission (sHR: 1.47) and readmission (IRR: 1.45) at any age. Significant interactions were found for the predictive value of pro-BNP in women, diabetes, renal dysfunction, STEMI and patients without troponin elevation. CONCLUSIONS In-hospital determination of pro-BNP is an independent predictor of HF readmission after an ACS.
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Affiliation(s)
- Alberto Cordero
- Cardiology Department, Hospital Universitario de San Juan, 03550 Alicante, Spain; (E.M.R.-R.); (M.J.M.); (D.E.); (J.M.-A.); (M.A.Q.); (P.Z.); (V.B.-G.)
- Unidad de Investigación en Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), 46020 Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226-CB16/11/00420), 28028 Madrid, Spain;
| | - Elías Martínez Rey-Rañal
- Cardiology Department, Hospital Universitario de San Juan, 03550 Alicante, Spain; (E.M.R.-R.); (M.J.M.); (D.E.); (J.M.-A.); (M.A.Q.); (P.Z.); (V.B.-G.)
| | - María J. Moreno
- Cardiology Department, Hospital Universitario de San Juan, 03550 Alicante, Spain; (E.M.R.-R.); (M.J.M.); (D.E.); (J.M.-A.); (M.A.Q.); (P.Z.); (V.B.-G.)
| | - David Escribano
- Cardiology Department, Hospital Universitario de San Juan, 03550 Alicante, Spain; (E.M.R.-R.); (M.J.M.); (D.E.); (J.M.-A.); (M.A.Q.); (P.Z.); (V.B.-G.)
- Unidad de Investigación en Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), 46020 Valencia, Spain
| | - José Moreno-Arribas
- Cardiology Department, Hospital Universitario de San Juan, 03550 Alicante, Spain; (E.M.R.-R.); (M.J.M.); (D.E.); (J.M.-A.); (M.A.Q.); (P.Z.); (V.B.-G.)
- Unidad de Investigación en Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), 46020 Valencia, Spain
| | - Maria A. Quintanilla
- Cardiology Department, Hospital Universitario de San Juan, 03550 Alicante, Spain; (E.M.R.-R.); (M.J.M.); (D.E.); (J.M.-A.); (M.A.Q.); (P.Z.); (V.B.-G.)
| | - Pilar Zuazola
- Cardiology Department, Hospital Universitario de San Juan, 03550 Alicante, Spain; (E.M.R.-R.); (M.J.M.); (D.E.); (J.M.-A.); (M.A.Q.); (P.Z.); (V.B.-G.)
| | - Julio Núñez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226-CB16/11/00420), 28028 Madrid, Spain;
- Cardiology Department, Hospital Clínico Universitario, 46010 Valencia, Spain
- Instituto de Investigación Sanitaria (INCLIVA), Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | - Vicente Bertomeu-González
- Cardiology Department, Hospital Universitario de San Juan, 03550 Alicante, Spain; (E.M.R.-R.); (M.J.M.); (D.E.); (J.M.-A.); (M.A.Q.); (P.Z.); (V.B.-G.)
- Unidad de Investigación en Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), 46020 Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV CB16/11/00226-CB16/11/00420), 28028 Madrid, Spain;
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