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De Luca M, D'Assante R, Iacoviello M, Triggiani V, Rengo G, De Giorgi A, Limongelli G, Masarone D, Volterrani M, Mancini A, Passantino A, Perrone Filardi P, Sciacqua A, Vriz O, Castello R, Campo M, Lisco G, Modesti PA, Paolillo S, Suzuki T, Salzano A, Marra AM, Bossone E, Cittadini A. Subclinical hypothyroidism predicts outcome in heart failure: insights from the T.O.S.CA. registry. Intern Emerg Med 2024:10.1007/s11739-024-03665-w. [PMID: 38850355 DOI: 10.1007/s11739-024-03665-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 05/28/2024] [Indexed: 06/10/2024]
Abstract
Subclinical hypothyroidism (SH), defined as increased serum thyroid-stimulating hormone (TSH) with normal free T4 (fT4) levels, is frequently observed in the general population. Prevalence ranges from 0.6% to 1.8% in the adult population, depending on age, sex, and iodine intake. Several studies reported a worse prognosis in patients with heart failure with reduced ejection fraction (HFrEF) and SH, but they considered heterogeneous populations suffering mainly from severe SH. Aim of this study was to evaluate if SH was independently associated with the occurrence of cardiovascular death considering 30 months of follow-up. 277 HFrEF patients enrolled in the prospective, multicenter, observational T.O.S.CA. (Terapia Ormonale Scompenso CArdiaco) registry, were included in this analysis. Patients were divided into two groups according to the presence of SH (serum TSH levels > 4.5 mIU/L with normal fT4 levels). Data regarding clinical status, echocardiography, and survival were analyzed. Twenty-three patients displayed SH (87% mild vs 13% severe), while 254 were euthyroid. No differences were found in terms of age, sex, HF etiology, and left ventricular ejection fraction. When compared with the euthyroid group, SH patients showed higher TSH levels (7.7 ± 4.1 vs 1.6 ± 0.9, p < 0.001), as expected, with comparable levels of fT4 (1.3 ± 0.3 vs 1.3 ± 0.3, p = NS). When corrected for established predictors of poor outcome in HF, the presence of SH resulted to be an independent predictor of cardiovascular mortality (HR: 2.96; 5-95% CI:1.13-7.74; p = 0.03). Since thyroid tests are widely available and inexpensive, they should be performed in HF patients to detect subclinical disorders, evaluate replacement therapy, and improve prognosis.
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Affiliation(s)
- Mariarosaria De Luca
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Roberta D'Assante
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Massimo Iacoviello
- Cardiology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122, Foggia, Italy
| | - Vincenzo Triggiani
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari 'A Moro', Bari, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
- Istituti Clinici Scientifici ICS Maugeri-S.P.A.-Istituti Di Ricovero E Cura a Carattere Scientifico (IRCCS) Istituto Scientifico Di Telese Terme, Telese, Italy
| | - Alfredo De Giorgi
- Clinical Medicine Unit, Department of Medicine, Azienda Ospedaliero-Universitaria S. Anna, Ferrara, Italy
| | - Giuseppe Limongelli
- Division of Cardiology, Monaldi Hospital, Azienda Ospedaliera Dei Colli, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Daniele Masarone
- Division of Cardiology, Monaldi Hospital, Azienda Ospedaliera Dei Colli, University of Campania Luigi Vanvitelli, Caserta, Italy
| | | | - Antonio Mancini
- Operative Unit of Endocrinology, Catholic University of the Sacred Heart, Rome, Italy
| | | | | | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Olga Vriz
- Heart Center Department, King Faisal Hospital & Research Center, Riyadh, Saudi Arabia
| | - Roberto Castello
- Division of General Medicine, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Michela Campo
- Department of Medical and Surgical Sciences, Unit of Endocrinology and Metabolic Diseases, University of Foggia, Foggia, Italy
| | - Giuseppe Lisco
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari 'A Moro', Bari, Italy
| | - Pietro Amedeo Modesti
- Department of Medical Sciences, School of Medicine, Pharmacy and Prevention, University of Ferrara, Ferrara, Italy
| | - Stefania Paolillo
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Toru Suzuki
- Department of Cardiovascular Sciences, University of Leicester, NIHR Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Andrea Salzano
- Cardiology Unit, A.O.R.N. Antonio Cardarelli, Naples, Italy
| | - Alberto Maria Marra
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Eduardo Bossone
- Department of Public Health, University "Federico II" of Naples, Naples, Italy
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University, Naples, Italy.
- Division of Internal Medicine & Metabolism & Rehabilitation, University Federico II, 80131, Naples, Italy.
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2
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Berezin AE, Berezin AA. Extracellular vesicles in heart failure. Adv Clin Chem 2024; 119:1-32. [PMID: 38514208 DOI: 10.1016/bs.acc.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Physiologically, extracellular vesicles (EVs) have been implicated as crucial mediators of immune response, cell homeostasis, angiogenesis, cell differentiation and growth, and tissue repair. In heart failure (HF) they may act as regulators of cardiac remodeling, microvascular inflammation, micro environmental changes, tissue fibrosis, atherosclerosis, neovascularization of plaques, endothelial dysfunction, thrombosis, and reciprocal heart-remote organ interaction. The chapter summaries the nomenclature, isolation, detection of EVs, their biologic role and function physiologically as well as in the pathogenesis of HF. Current challenges to the utilization of EVs as diagnostic and predictive biomarkers in HF are also discussed.
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Affiliation(s)
- Alexander E Berezin
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University Salzburg, Salzburg, Austria.
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3
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Suades R, Vilella-Figuerola A, Padró T, Mirabet S, Badimon L. Red Blood Cells and Endothelium Derived Circulating Extracellular Vesicles in Health and Chronic Heart Failure: A Focus on Phosphatidylserine Dynamics in Vesiculation. Int J Mol Sci 2023; 24:11824. [PMID: 37511585 PMCID: PMC10380787 DOI: 10.3390/ijms241411824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
Circulating extracellular microvesicles (cEVs) are characterised by presenting surface antigens of parental cells. Since their biogenesis involves the translocation of phosphatidylserine (PS) from the inner to the outer leaflet of the plasma membrane, exposed PS has been considered as a recognition hallmark of cEVs. However, not all cEVs externalise PS. In this study, we have phenotypically and quantitatively characterised cEVs by flow cytometry, paying special attention to the proportions of PS in chronic heart failure patients (cHF; n = 119) and a reference non-HF group (n = 21). PS--cEVs were predominantly found in both groups. Parental markers showed differential pattern depending on the PS exposure. Endothelium-derived and connexin 43-rich cEVs were mainly PS--cEVs and significantly increased in cHF. On the contrary, platelet-derived cEVs were mostly PS+ and were increased in the non-HF group. We observed similar levels of PS+- and PS--cEVs in non-HF subjects when analysing immune cell-derived Evs, but there was a subset-specific difference in cHF patients. Indeed, those cEVs carrying CD45+, CD29+, CD11b+, and CD15+ were mainly PS+-cEVs, while those carrying CD14+, CD3+, and CD56+ were mainly PS--cEVs. In conclusion, endothelial and red blood cells are stressed in cHF patients, as detected by a high shedding of cEVs. Despite PS+-cEVs and PS--cEVs representing two distinct cEV populations, their release and potential function as both biomarkers and shuttles for cell communication seem unrelated to their PS content.
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Affiliation(s)
- Rosa Suades
- Cardiovascular Program ICCC, Research Institute of Hospital Santa Creu i Sant Pau, IIB Sant Pau, 08049 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Alba Vilella-Figuerola
- Cardiovascular Program ICCC, Research Institute of Hospital Santa Creu i Sant Pau, IIB Sant Pau, 08049 Barcelona, Spain
| | - Teresa Padró
- Cardiovascular Program ICCC, Research Institute of Hospital Santa Creu i Sant Pau, IIB Sant Pau, 08049 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Sonia Mirabet
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Cardiology Department, Hospital Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - Lina Badimon
- Cardiovascular Program ICCC, Research Institute of Hospital Santa Creu i Sant Pau, IIB Sant Pau, 08049 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Cardiovascular Research Chair, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
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Hamali HA, Mobarki AA, Akhter MS, Saboor M, Madkhali AM, Halawani AJ, Hakami AM, Eisa ZM, Dobie G, Hobani Y. Elevated levels of procoagulant microvesicles in patients with dengue fever. Future Virol 2020. [DOI: 10.2217/fvl-2020-0202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: The levels of procoagulant microvesicles (MVs) and tissue factor (TF)-bearing MVs may be increased in many conditions, including dengue fever (DF). This study aimed to measure the levels of MVs and TF-bearing MVs in patients with DF and matched healthy controls. Materials & methods: Levels of MVs and TF-bearing MVs in the plasma of patients with DF and matched healthy controls were measured using functional assay. Results: The patient group had significantly elevated levels of MVs (p < 0.001) and slightly increased levels of TF-bearing MVs (p = 0.454) compared with the matched healthy controls. Conclusion: Elevated levels of MVs and TF-bearing MVs could be used as biomarkers to evaluate the hemostatic function of patients with DF.
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Affiliation(s)
- Hassan A Hamali
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| | - Abdullah A Mobarki
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| | - Mohammad S Akhter
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| | - Muhammad Saboor
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
- Medical Research Center, Jazan University, Gizan, Saudi Arabia
| | - Aymen M Madkhali
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| | - Amr J Halawani
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| | | | - Zaki M Eisa
- Saudi Centre for Disease prevention & Control, Gizan, Saudi Arabia
| | - Gasim Dobie
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
| | - Yahya Hobani
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia
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5
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Bielecka-Dabrowa A, Godoy B, Suzuki T, Banach M, von Haehling S. Subclinical hypothyroidism and the development of heart failure: an overview of risk and effects on cardiac function. Clin Res Cardiol 2018; 108:225-233. [PMID: 30091084 DOI: 10.1007/s00392-018-1340-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 07/18/2018] [Indexed: 01/07/2023]
Abstract
The prevalence of subclinical hypothyroidism (SCH) ranges from 5 to 15% of the general population. However, it remains controversial if SCH warrants life-long thyroxine replacement therapy. Patients with a thyroid-stimulating hormone (TSH) level > 10 mIU/L have a higher risk of developing heart failure with reduced ejection fraction as compared to subjects with normal thyroid function. However, abnormally high TSH levels could also be connected with an overall lower metabolic rate and better survival in elderly subjects. The potential mechanisms responsible for diastolic dysfunction of the left ventricle (LV) in SCH are connected with endothelial dysfunction and arterial stiffness, inflammatory state and are driven by TSH apoptosis-derived microparticles. The impact of SCH on LV systolic function is more controversial, and it is connected not only with cardiac remodelling but also with predisposition of patients with SCH to the conditions leading to heart failure. This review presents an overview of processes in the context of potential benefits of thyroxine supplementation therapy.
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Affiliation(s)
- Agata Bielecka-Dabrowa
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz (UMED), Lodz, Poland.,Department of Cardiology and Congenital Diseases of Adults, Polish Mother's Memorial Hospital Research Institute (ICZMP), Lodz, Poland
| | - Breno Godoy
- Department of Cardiology and Pneumology, University Medical Centre Goettingen (UMG), Georg-August-University, Robert-Koch-Strasse 40, 37075, Goettingen, Germany
| | - Tsuyoshi Suzuki
- Department of Cardiology and Pneumology, University Medical Centre Goettingen (UMG), Georg-August-University, Robert-Koch-Strasse 40, 37075, Goettingen, Germany.,Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz (UMED), Lodz, Poland
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University Medical Centre Goettingen (UMG), Georg-August-University, Robert-Koch-Strasse 40, 37075, Goettingen, Germany.
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6
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Pomatto MAC, Gai C, Deregibus MC, Tetta C, Camussi G. Noncoding RNAs Carried by Extracellular Vesicles in Endocrine Diseases. Int J Endocrinol 2018; 2018:4302096. [PMID: 29808089 PMCID: PMC5902008 DOI: 10.1155/2018/4302096] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/16/2018] [Indexed: 02/06/2023] Open
Abstract
RNA molecules are essential and fine regulators of important biological processes. Their role is well documented also in the endocrine system, both in physiological and pathological conditions. Increasing interest is arising about the function and the importance of noncoding RNAs shuttled by extracellular vesicles (EVs). In fact, EV membrane protects nucleic acids from enzyme degradation. Nowadays, the research on EVs and their cargoes, as well as their biological functions, faces the lack of standardization in EV purification. Here, the main techniques for EV isolation are discussed and compared for their advantages and vulnerabilities. Despite the possible discrepancy due to methodological variability, EVs and their RNA content are reported to be key mediators of intercellular communication in pathologies of main endocrine organs, including the pancreas, thyroid, and reproductive system. In particular, the present work describes the role of RNAs contained in EVs in pathogenesis and progression of several metabolic dysfunctions, including obesity and diabetes, and their related manifestations. Their importance in the establishment and progression of thyroid autoimmunity disorders and complicated pregnancy is also discussed. Preliminary studies highlight the attractive possibility to use RNAs contained in EVs as biomarkers suggesting their exploitation for new diagnostic approaches in endocrinology.
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Affiliation(s)
| | - Chiara Gai
- Stem Cell Laboratory, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Maria Chiara Deregibus
- Stem Cell Laboratory, Department of Medical Sciences, University of Turin, Turin, Italy
- 2i3T Scarl, Univerity of Turin, Turin, Italy
| | - Ciro Tetta
- Unicyte AG, Oberdorf, Nidwalden, Switzerland
| | - Giovanni Camussi
- Stem Cell Laboratory, Department of Medical Sciences, University of Turin, Turin, Italy
- 2i3T Scarl, Univerity of Turin, Turin, Italy
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7
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Bak P, Hjortshøj CS, Gaede P, Idorn L, Søndergaard L, Jensen AS. Subclinical hypothyroidism: A common finding in adult patients with cyanotic congenital heart disease. CONGENIT HEART DIS 2017; 13:263-270. [PMID: 29280293 DOI: 10.1111/chd.12565] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/24/2017] [Accepted: 11/18/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Cyanotic congenital heart disease is a systemic disease, with effects on multiple organ systems. A high prevalence of subclinical hypothyroidism (SCH) has been reported in a small cohort of cyanotic congenital heart disease patients. Subclinical hypothyroidism has been associated with various adverse cardiovascular effects, as well as an increased risk of progression to overt hypothyroidism. The aim of this study was to examine the prevalence of SCH in cyanotic congenital heart disease patients, consider possible etiologies, and evaluate thyroid function over time. METHODS First, 90 clinically stable cyanotic congenital heart disease patients were examined with blood samples (thyroid-stimulating hormone, C-reactive protein, hemoglobin, hematocrit, and N-terminal pro-brain-natriuretic peptide) in a cross-sectional descriptive study. Second, a longitudinal follow-up study of 43 patients originating from the first study part, was carried out. These patients had thyroid function parameters (thyroid-stimulating hormone, thyroid hormones, and thyroid peroxidase antibodies) evaluated biannually. RESULTS Elevated thyroid-stimulating hormone was present in 24% of the 90 screened patients. During follow-up (6.5 ± 1.0 years), SCH (defined as ≥2 consecutive elevated thyroid-stimulating hormone values) was present in 26%. Three patients progressed to overt hypothyroidism. Patients with SCH were younger (34 ± 12 vs 42 ± 16 years; P = .01) and had a lower oxygen saturation (80 ± 5 vs 84 ± 6%; P = .03). CONCLUSION Subclinical hypothyroidism is a very common finding in cyanotic congenital heart disease. This is not associated with increased levels of C-reactive protein, heart failure, or autoimmunity but appears to be associated with cyanosis and age. Since the clinical impact of SCH is uncertain, further studies are needed to determine this. Regular thyroid evaluation is recommended in cyanotic congenital heart disease patients since SCH can develop to overt hypothyroidism.
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Affiliation(s)
- Peter Bak
- Department of Anesthesiology, North Zealand Hospital, Hillerod, Denmark
| | | | - Peter Gaede
- Department of Cardiology and Endocrinology, Slagelse Hospital, Slagelse, Denmark
| | - Lars Idorn
- Department of Pediatrics, Rigshospitalet, Copenhagen, Denmark
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8
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Carmona A, Agüera ML, Luna-Ruiz C, Buendía P, Calleros L, García-Jerez A, Rodríguez-Puyol M, Arias M, Arias-Guillen M, de Arriba G, Ballarin J, Bernis C, Fernández E, García-Rebollo S, Mancha J, Del Peso G, Pérez E, Poch E, Portolés JM, Rodríguez-Puyol D, Sánchez-Villanueva R, Sarro F, Torres A, Martín-Malo A, Aljama P, Ramírez R, Carracedo J. Markers of endothelial damage in patients with chronic kidney disease on hemodialysis. Am J Physiol Renal Physiol 2017; 312:F673-F681. [PMID: 28077371 DOI: 10.1152/ajprenal.00013.2016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 01/09/2017] [Accepted: 01/09/2017] [Indexed: 12/22/2022] Open
Abstract
Patients with Stage 5 chronic kidney disease who are on hemodialysis (HD) remain in a chronic inflammatory state, characterized by the accumulation of uremic toxins that induce endothelial damage and cardiovascular disease (CVD). Our aim was to examine microvesicles (MVs), monocyte subpopulations, and angiopoietins (Ang) to identify prognostic markers in HD patients with or without diabetes mellitus (DM). A total of 160 prevalent HD patients from 10 centers across Spain were obtained from the Biobank of the Nephrology Renal Network (Madrid, Spain): 80 patients with DM and 80 patients without DM who were matched for clinical and demographic criteria. MVs from plasma and several monocyte subpopulations (CD142+/CD16+, CD14+/CD162+) were analyzed by flow cytometry, and the plasma concentrations of Ang1 and Ang2 were quantified by ELISA. Data on CVD were gathered over the 5.5 yr after these samples were obtained. MV level, monocyte subpopulations (CD14+/CD162+ and CD142+/CD16+), and Ang2-to-Ang1 ratios increased in HD patients with DM compared with non-DM patients. Moreover, MV level above the median (264 MVs/µl) was associated independently with greater mortality. MVs, monocyte subpopulations, and Ang2-to-Ang1 ratio can be used as predictors for CVD. In addition, MV level has a potential predictive value in the prevention of CVD in HD patients. These parameters undergo more extensive changes in patients with DM.
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Affiliation(s)
- Andrés Carmona
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain
| | - Maria L Agüera
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Unidad de Gestión Clínica Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain.,Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain
| | - Carlos Luna-Ruiz
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain
| | - Paula Buendía
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Calleros
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Biologia de Sistemas Department, Alcalá de Henares University, Madrid, Spain.,Biobanco Redes Temáticas de Investigación Cooperativa en Salud Red Renal, Instituto de Salud Carlos III, Madrid, Spain
| | - Andrea García-Jerez
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Biologia de Sistemas Department, Alcalá de Henares University, Madrid, Spain.,Biobanco Redes Temáticas de Investigación Cooperativa en Salud Red Renal, Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Rodríguez-Puyol
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Biologia de Sistemas Department, Alcalá de Henares University, Madrid, Spain.,Biobanco Redes Temáticas de Investigación Cooperativa en Salud Red Renal, Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Arias
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Marta Arias-Guillen
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Departamento de Nefrologia y Trasplante Renal, Hospital Clinic de Barcelona, Institut D'Investigacions Biomediques August Pi I Sunyer, Universidad de Barcelona, Barcelona, Spain
| | - Gabriel de Arriba
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Hospital Universitario de Guadalajara, Guadalajara, Spain.,Departamento de Medicina y Especialidades Médicas, Alcalá de Henares University, Madrid, Spain
| | - Jose Ballarin
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Fundació Puigvert, Barcelona, Spain
| | - Carmen Bernis
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Hospital Universitario La Princesa Madrid, Madrid, Spain
| | - Elvira Fernández
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Hospital Universitari Arnau de Villanova de Lleida, Lleida, Spain
| | - Sagrario García-Rebollo
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Nefrología. Hospital Universitario de Canarias, Improving Biomedical Research and Innovation in the Canary Islands-Centro de Investigación Biomédica de Canarias, Universidad de La Laguna, La Laguna, Spain
| | - Javier Mancha
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Gloria Del Peso
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Hospital Universitario La Paz, Madrid, Spain
| | - Estefanía Pérez
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Nefrología. Hospital Universitario de Canarias, Improving Biomedical Research and Innovation in the Canary Islands-Centro de Investigación Biomédica de Canarias, Universidad de La Laguna, La Laguna, Spain
| | - Esteban Poch
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Departamento de Nefrologia y Trasplante Renal, Hospital Clinic de Barcelona, Institut D'Investigacions Biomediques August Pi I Sunyer, Universidad de Barcelona, Barcelona, Spain
| | - Jose M Portolés
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Hospital Puerta de Hierro, Madrid, Spain; and
| | - Diego Rodríguez-Puyol
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Rafael Sánchez-Villanueva
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Hospital Universitario La Paz, Madrid, Spain
| | - Felipe Sarro
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Hospital Universitari Arnau de Villanova de Lleida, Lleida, Spain
| | - Armando Torres
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Nefrología. Hospital Universitario de Canarias, Improving Biomedical Research and Innovation in the Canary Islands-Centro de Investigación Biomédica de Canarias, Universidad de La Laguna, La Laguna, Spain
| | - Alejandro Martín-Malo
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Unidad de Gestión Clínica Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain.,Departamento de Medicina (Medicina, Dermatología y Otorrinolaringología), Universidad de Córdoba, Córdoba, Spain.,Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain
| | - Pedro Aljama
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Unidad de Gestión Clínica Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain.,Departamento de Medicina (Medicina, Dermatología y Otorrinolaringología), Universidad de Córdoba, Córdoba, Spain.,Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Ramírez
- Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Biologia de Sistemas Department, Alcalá de Henares University, Madrid, Spain
| | - Julia Carracedo
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; .,Unidad de Gestión Clínica Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain.,Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.,Departament of Animal Physiology II, Faculty Biology, Complutense University, Madrid, Spain
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Abstract
Heart failure (HF) continues to have a sufficient impact on morbidity, mortality, and disability in developed countries. Growing evidence supports the hypothesis that microparticles (MPs) might contribute to the pathogenesis of the HF development playing a pivotal role in the regulation of the endogenous repair system, thrombosis, coagulation, inflammation, immunity, and metabolic memory phenomenon. Therefore, there is a large body of data clarifying the predictive value of MP numerous in circulation among subjects with HF. Although the determination of MP signature is better than measurement of single MP circulating level, there is not yet close confirmation that immune phenotype of cells produced MPs are important for HF prediction and development. The aim of the chapter is to summarize knowledge regarding the role of various MPs in diagnosis and prognosis of HF. The role of MPs as a delivery vehicle for drugs attenuated cardiac remodeling is considered.
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10
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Kalra P, Yeragani VK, Prasanna Kumar KM. Cardiac autonomic function and vascular profile in subclinical hypothyroidism: Increased beat-to-beat QT variability. Indian J Endocrinol Metab 2016; 20:605-611. [PMID: 27730068 PMCID: PMC5040038 DOI: 10.4103/2230-8210.190527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Patients with subclinical hypothyroidism (SH) may have higher incidence of coronary heart disease and autonomic dysfunction. DESIGN OF THE STUDY Prospective case control study. AIM AND OBJECTIVES To evaluate beat-to-beat QT variability and vascular stiffness in patients with SH compared to normal controls. MATERIALS AND METHODS We compared linear and nonlinear measures of cardiac repolarization liability using beat-to-beat QT intervals derived from the surface electrocardiogram during supine posture and vascular indices including pulse wave velocity and ankle-brachial index (ABI) during supine posture between female patients with SH and age- and sex-matched normal controls. Spectral analysis was done at very low frequency (LF) (0.003-0.04 Hz), Low frequency (LF) (0.04-0.15 Hz), and high frequency (HF) (0.15-0.4 Hz). The HF represents vagal regulation (parasympathetic) and LF represents both parasympathetic and sympathetic regulation. RESULTS We recruited 58 women with a mean age of 31.83 ± 8.9 years and 49 controls with mean age of 32.4 ± 9.9 years (P = NS). QT variability index (QTvi) was higher in cases compared to controls (P = 0.01). The ratio of LF/HF of R-R interval which is an index of sympathovagal tone was significantly more in cases compared to controls (P = 0.02). The difference in the left minus the right ABI was significant between cases and controls (P = 0.03). CONCLUSIONS The cases had lower parasympathetic activity as compared to controls, and there was a predominance of sympathetic activity in cases. QTvi may be an important noninvasive tool in this group of patients to study the risk of cardiovascular mortality.
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Affiliation(s)
- Pramila Kalra
- Department of Endocrinology, M.S. Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Vikram K. Yeragani
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - K. M. Prasanna Kumar
- Centre for Diabetes and Endocrine Care, Bangalore Diabetes Hospital, Bengaluru, Karnataka, India
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11
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Sorisky A. Subclinical Hypothyroidism - What is Responsible for its Association with Cardiovascular Disease? EUROPEAN ENDOCRINOLOGY 2016; 12:96-98. [PMID: 29632595 PMCID: PMC5813449 DOI: 10.17925/ee.2016.12.02.96] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 05/25/2016] [Indexed: 01/07/2023]
Abstract
Subclinical hypothyroidism (SH) is a common condition, with prevalence estimates ranging from 4–20%, depending on the population demographics. Although epidemiological analysis associates it with an increased risk of cardiovascular disease, clinical practice guidelines express uncertainty about whether to monitor or to treat. As we await large-scale, well-designed randomised clinical trials regarding treatment of SH, a review of pathophysiological considerations may be informative to better understand this disorder.
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Affiliation(s)
- Alexander Sorisky
- Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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