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Yan J, Ai C, Chen Q, Wang Q, Zhu Y, Li M, Chen K, He M, Shen M, Chen L, Zhang R, Zheng C, Liao W, Bin J, Lin H, Ma S, Tan N, Liao Y. CircMap4k2 Reactivated by Aneurysm Plication Alleviates Residual Cardiac Remodeling After SVR by Enhancing Cardiomyocyte Proliferation in Post-MI Mice. J Adv Res 2023:S2090-1232(23)00373-9. [PMID: 38043608 DOI: 10.1016/j.jare.2023.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 12/05/2023] Open
Abstract
INTRODUCTION Surgical ventricular reconstruction (SVR) is an alternative therapeutic approach in patients with refractory heart failure (HF), but residual remodeling after SVR limits the improvement of HF. Recently, we reported that SVR may act as an environmental cue to reactivate endogenous proliferation of cardiomyocytes; however, it is unclear whether enhancing endogenous cardiomyocyte regeneration further improves HF after SVR. OBJECTIVES We aimed to explore whether circular RNAs (circRNAs) would involved in SVR and their mechanisms. METHODS Male C57BL/6 mice were subjected to myocardial infarction (MI) or sham surgery. Four weeks later, MI mice with a large ventricular aneurysm underwent SVR or a second open-chest operation only. Echocardiography and histological analysis were used to evaluate heart function, cardiac remodeling, and myocardial regeneration. Sequencing of circular RNAs, RNA immunoprecipitation, RNA pulldown, and luciferase reporter assay were used to explore the underlying mechanisms. RESULTS SVR markedly attenuated cardiac remodeling and induced cardiomyocyte regeneration, as evidenced by positive staining of Ki-67, phospho-histone H3 (pH3), and Aurora B in the plication zone, but significant residual remodeling still existed in comparison with the sham group. Sequencing results showed that SVR altered the expression profile of cardiac circRNAs, and circMap4k2 was identified as the most upregulated one. After characterizing circMap4k2, we noted that overexpression of circMap4k2 significantly promoted proliferation of cardiomyocytes in cultured neonatal rat cardiomyocytes and silencing of circMap4k2 significantly inhibited it; similar results were obtained in SVR-treated MI mice but not in MI mice without SVR treatment. Residual cardiac remodeling after SVR was further attenuated by circMap4k2 overexpression. CircMap4k2 bound with miR-106a-3p and inhibited cardiomyocyte proliferation by targeting a downstream effector of the antizyme inhibitor 1 (Azin1) gene. CONCLUSIONS CircMap4k2 acts as an environmental cue and targets the miR-106a-3p/Azin1 pathway to increase cardiac regeneration in the plication zone and attenuate residual remodeling after SVR.
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Affiliation(s)
- Junyu Yan
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chenzhi Ai
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qi Chen
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qiuhan Wang
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yingqi Zhu
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Mingjue Li
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Kaitong Chen
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Mingyuan He
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Mengjia Shen
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lu Chen
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Rui Zhang
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Cankun Zheng
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wangjun Liao
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jianping Bin
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hairuo Lin
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Siyuan Ma
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ning Tan
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
| | - Yulin Liao
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Shock and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, China; Cardiovascular Center, the Affiliated Sixth Hospital, School of Medicine, South China University of Technology, Guangzhou, China.
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Zhao Y, Godier-Furnemont A, Bax NA, Bouten CV, Brown LM, Fine B, Vunjak-Novakovic G. Changes in extracellular matrix in failing human non-ischemic and ischemic hearts with mechanical unloading. J Mol Cell Cardiol 2022; 166:137-151. [PMID: 35219725 PMCID: PMC9035113 DOI: 10.1016/j.yjmcc.2022.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/28/2022] [Accepted: 02/11/2022] [Indexed: 10/19/2022]
Abstract
Ischemic and non-ischemic cardiomyopathies have distinct etiologies and underlying disease mechanisms, which require in-depth investigation for improved therapeutic interventions. The goal of this study was to use clinically obtained myocardium from healthy and heart failure patients, and characterize the changes in extracellular matrix (ECM) in ischemic and non-ischemic failing hearts, with and without mechanical unloading. Using tissue engineering methodologies, we also investigated how diseased human ECM, in the absence of systemic factors, can influence cardiomyocyte function. Heart tissues from heart failure patients with ischemic and non-ischemic cardiomyopathy were compared to explore differential disease phenotypes and reverse remodeling potential of left ventricular assisted device (LVAD) support at transcriptomic, proteomic and structural levels. The collected data demonstrated that the differential ECM compositions recapitulated the disease microenvironment and induced cardiomyocytes to undergo disease-like functional alterations. In addition, our study also revealed molecular profiles of non-ischemic and ischemic heart failure patients and explored the underlying mechanisms of etiology-specific impact on clinical outcome of LVAD support and tendency towards reverse remodeling.
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Sarmiento-Cobos M, Rivera C, Okida LF, Cogollo VJ, Montorfano L, Gutierrez Blanco D, Lo Menzo E, Szomstein S, Rosenthal RJ. Left ventricular mass index and ventricular contractility improvement in patients with severe obesity following rapid weight loss after bariatric surgery. Surg Obes Relat Dis 2021; 17:1140-1145. [PMID: 33812788 DOI: 10.1016/j.soard.2021.01.040] [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: 09/24/2020] [Revised: 01/24/2021] [Accepted: 01/29/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Obesity is a well-known risk factor for heart disease, resulting in a broad spectrum of cardiovascular changes. Left ventricular mass (LVM) and contractility are recognized markers of cardiac function. OBJECTIVES To determine the changes of LVM and contractility after bariatric surgery (BaS). SETTING University hospital, United States METHODS: To determine the cardiac changes in ventricular mass, ventricular contractility, and left ventricular shortening fraction (LVSF), we retrospectively reviewed the 2-dimensional echocardiographic parameters of patients with obesity who underwent BaS at our institution. We compared these results before and after BaS. RESULTS A total of 40 patients met the inclusion criteria. The majority were females (57.5%; n = 23), with an average age of 63.5 ± 12.1. The excess body mass index (BMI) lost at 12 months was 48.9 ± 28.9%. The percent total weight loss after BaS was 16.46 ± 9.9%. The left ventricular mass was 234.9 ± 88.1 grams before and 181.5 ± 52.7 grams after BaS (P = .002). The LVM index was 101.3 ± 38.3 g/m2 before versus 86.7 ± 26.6 g/m2 after BaS (P = .005). The LVSF was 31% ± 8.8% before and 36.3% ± 8.2% after BaS (P = .007). We found a good correlation between the decrease in LVM index and the BMI after BaS (P = .03). CONCLUSION Rapid weight loss results in a decrease of the LVM index, as well as improvement in the left ventricular muscle contractility. Our results suggest that there is left ventricular remodeling and an improvement of heart dynamics following bariatric surgery. Further studies are needed to better assess these findings.
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Affiliation(s)
- Mauricio Sarmiento-Cobos
- Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic, Weston, Florida
| | - Carlos Rivera
- Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic, Weston, Florida
| | - Luis Felipe Okida
- Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic, Weston, Florida
| | - Vicente J Cogollo
- Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic, Weston, Florida
| | - Lisandro Montorfano
- Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic, Weston, Florida
| | - David Gutierrez Blanco
- Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic, Weston, Florida
| | - Emanuele Lo Menzo
- Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic, Weston, Florida
| | - Samuel Szomstein
- Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic, Weston, Florida
| | - Raul J Rosenthal
- Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic, Weston, Florida.
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Kaya U, Çolak A, Becit N, Ceviz M, Kocak H. Application of Circular Patch Plasty (Dor Procedure) or Linear Repair Techniques in the Treatment of Left Ventricular Aneurysms. Braz J Cardiovasc Surg 2018; 33:135-142. [PMID: 29898142 PMCID: PMC5985839 DOI: 10.21470/1678-9741-2017-0093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 09/12/2017] [Indexed: 11/06/2022] Open
Abstract
Objective The aim of this study was to evaluate early clinical outcomes and
echocardiographic measurements of the left ventricle in patients who
underwent left ventricular aneurysm repair using two different techniques
associated to myocardial revascularization. Methods Eighty-nine patients (74 males, 15 females; mean age 58±8.4 years;
range: 41 to 80 years) underwent post-infarction left ventricular aneurysm
repair and myocardial revascularization performed between 1996 and 2016.
Ventricular reconstruction was performed using endoventricular circular
patch plasty (Dor procedure) (n=48; group A) or linear repair technique
(n=41; group B). Results Multi-vessel disease in 55 (61.7%) and isolated left anterior descending
(LAD) disease in 34 (38.2%) patients were identified. Five (5.6%) patients
underwent aneurysmectomy alone, while the remaining 84 (94.3%) patients had
aneurysmectomy with bypass. The mean number of grafts per patient was
2.1±1.2 with the Dor procedure and 2.9±1.3 with the linear
repair technique. In-hospital mortality occurred in 4.1% and 7.3% in group A
and group B, respectively (P>0.05). Conclusion The results of our study demonstrate that post-infarction left ventricular
aneurysm repair can be performed with both techniques with acceptable
surgical risk and with satisfactory hemodynamic improvement.
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Juliani PS, Das-Neves-Pereira JC, Monteiro R, Correia AT, Moreira LFP, Jatene FB. Left ventricular chamber geometry in cardiomyopathies: insights from a computerized anatomical study. ESC Heart Fail 2018; 5:355-364. [PMID: 29465824 PMCID: PMC5933952 DOI: 10.1002/ehf2.12261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 12/22/2017] [Indexed: 11/20/2022] Open
Abstract
Aims Some authors have hypothesized that left ventricular chamber dilatation in ischaemic and idiopathic cardiomyopathies results in spherical transformation. Aiming to characterize how this transformation occurs, a study was performed by comparing normal and dilated specimens regarding sphericity and proportionality in left heart chambers. It is important to provide data for the development of therapeutic strategies in these diseases. Methods and results An anatomical study was performed by comparing normal (n = 10), ischaemic (n = 15), and idiopathic (n = 18) dilated human cardiomyopathic specimens regarding left ventricular chambers and their segmental proportionality to normal hearts. It was performed by capturing and processing images with proper software in three different levels of left ventricular chamber (basal, equatorial, and apical). These obtained data were analysed based on sphericity and proportionality by two dedicated indexes. Spherical shape: Calculated segmental indexes showed that dilated specimens were not spherical because they were smaller than as expected for a spherical shape (all values were <70% of a perfect sphere). Proportionality: There was no difference between basal index perimeters among groups, but apical index was lower in dilated specimens than in normal hearts, and so dilatation was not proportional to normal hearts. Conclusions Left ventricular chambers of anatomical specimens with dilated cardiomyopathies did not display a spherical shape and were not proportional to normal hearts.
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Affiliation(s)
- Paulo Sérgio Juliani
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina, Serviço de Cirurgia Toracica, Universidade de São Paulo, Av. Doutor Enéas de Carvalho Aguiar, 44, 5° andar, bloco II, sala 7, 04503-000, São Paulo, SP, Brazil
| | - João-Carlos Das-Neves-Pereira
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina, Serviço de Cirurgia Toracica, Universidade de São Paulo, Av. Doutor Enéas de Carvalho Aguiar, 44, 5° andar, bloco II, sala 7, 04503-000, São Paulo, SP, Brazil
| | - Rosangela Monteiro
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina, Serviço de Cirurgia Toracica, Universidade de São Paulo, Av. Doutor Enéas de Carvalho Aguiar, 44, 5° andar, bloco II, sala 7, 04503-000, São Paulo, SP, Brazil
| | - Aristides Tadeu Correia
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina, Serviço de Cirurgia Toracica, Universidade de São Paulo, Av. Doutor Enéas de Carvalho Aguiar, 44, 5° andar, bloco II, sala 7, 04503-000, São Paulo, SP, Brazil
| | - Luiz Felipe Pinho Moreira
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina, Serviço de Cirurgia Toracica, Universidade de São Paulo, Av. Doutor Enéas de Carvalho Aguiar, 44, 5° andar, bloco II, sala 7, 04503-000, São Paulo, SP, Brazil
| | - Fabio Biscegli Jatene
- Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina, Serviço de Cirurgia Toracica, Universidade de São Paulo, Av. Doutor Enéas de Carvalho Aguiar, 44, 5° andar, bloco II, sala 7, 04503-000, São Paulo, SP, Brazil
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Shelmerdine SC, Barber JL, George CD. Applications of Laplace's law in clinical medicine: a radiological pictorial review. Br J Hosp Med (Lond) 2016; 74:451-6. [PMID: 23958983 DOI: 10.12968/hmed.2013.74.8.451] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- S C Shelmerdine
- Specialist Registrar in Clinical Radiology in the Department of Radiology, St Georges Hospital, London
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Sagic D, Otasevic P, Sievert H, Elsasser A, Mitrovic V, Gradinac S. Percutaneous implantation of the left ventricular partitioning device for chronic heart failure: a pilot study with 1-year follow-up. Eur J Heart Fail 2014; 12:600-6. [DOI: 10.1093/eurjhf/hfq051] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Dragan Sagic
- Dedinje Cardiovascular Institute; Belgrade Serbia
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Bozdag-Turan I, Bermaoui B, Paranskaya L, GökmenTuran R, D'Ancona G, Kische S, Birkemeyer R, Jovanovic B, Schuetz J, Akin I, Turan CH, Ortak J, Hauenstein K, Nienaber CA, Ince H. Challenges in patient selection for the parachute device implantation. Catheter Cardiovasc Interv 2013; 82:E718-25. [DOI: 10.1002/ccd.24940] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 03/04/2013] [Accepted: 04/07/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Ilkay Bozdag-Turan
- Department of Internal Medicine, Division of Cardiology; University Hospital Rostock; Germany
| | - Benjamin Bermaoui
- Institute Diagnostic and Interventional Radiology; University of Rostock; Germany
| | - Liliya Paranskaya
- Department of Internal Medicine, Division of Cardiology; University Hospital Rostock; Germany
| | - R. GökmenTuran
- Department of Internal Medicine, Division of Cardiology; University Hospital Rostock; Germany
| | - Giuseppe D'Ancona
- Department of Internal Medicine, Division of Cardiology; University Hospital Rostock; Germany
| | - Stephan Kische
- Department of Internal Medicine, Division of Cardiology; University Hospital Rostock; Germany
| | - Ralph Birkemeyer
- Department of Internal Medicine, Division of Cardiology; University Hospital Rostock; Germany
| | - Bojan Jovanovic
- Department of Internal Medicine, Division of Cardiology; University Hospital Rostock; Germany
| | - Jan Schuetz
- Department of Internal Medicine, Division of Cardiology; University Hospital Rostock; Germany
| | - Ibrahim Akin
- Department of Internal Medicine, Division of Cardiology; University Hospital Rostock; Germany
| | - Cem Hakan Turan
- Department of Internal Medicine, Division of Cardiology; University Hospital Rostock; Germany
| | - Jasmin Ortak
- Department of Internal Medicine, Division of Cardiology; University Hospital Rostock; Germany
| | - K. Hauenstein
- Institute Diagnostic and Interventional Radiology; University of Rostock; Germany
| | - Cristoph Anton Nienaber
- Department of Internal Medicine, Division of Cardiology; University Hospital Rostock; Germany
| | - Hueseyin Ince
- Department of Internal Medicine, Division of Cardiology; University Hospital Rostock; Germany
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Pasipoularides A. Evaluation of right and left ventricular diastolic filling. J Cardiovasc Transl Res 2013; 6:623-39. [PMID: 23585308 PMCID: PMC3713169 DOI: 10.1007/s12265-013-9461-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 03/27/2013] [Indexed: 01/08/2023]
Abstract
A conceptual fluid-dynamics framework for diastolic filling is developed. The convective deceleration load (CDL) is identified as an important determinant of ventricular inflow during the E wave (A wave) upstroke. Convective deceleration occurs as blood moves from the inflow anulus through larger-area cross-sections toward the expanding walls. Chamber dilatation underlies previously unrecognized alterations in intraventricular flow dynamics. The larger the chamber, the larger becomes the endocardial surface and the CDL. CDL magnitude affects strongly the attainable E wave (A wave) peak. This underlies the concept of diastolic ventriculoannular disproportion. Large vortices, whose strength decreases with chamber dilatation, ensue after the E wave peak and impound inflow kinetic energy, averting an inflow-impeding, convective Bernoulli pressure rise. This reduces the CDL by a variable extent depending on vortical intensity. Accordingly, the filling vortex facilitates filling to varying degrees, depending on chamber volume. The new framework provides stimulus for functional genomics research, aimed at new insights into ventricular remodeling.
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MESH Headings
- Animals
- Biomechanical Phenomena
- Diastole
- Disease Progression
- Genetic Predisposition to Disease
- Genomics
- Heart Failure/genetics
- Heart Failure/physiopathology
- Humans
- Hypertrophy, Left Ventricular/genetics
- Hypertrophy, Left Ventricular/physiopathology
- Hypertrophy, Right Ventricular/genetics
- Hypertrophy, Right Ventricular/physiopathology
- Models, Cardiovascular
- Phenotype
- Stroke Volume
- Ventricular Dysfunction, Left/genetics
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Dysfunction, Right/genetics
- Ventricular Dysfunction, Right/physiopathology
- Ventricular Function, Left/genetics
- Ventricular Function, Right/genetics
- Ventricular Pressure
- Ventricular Remodeling
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Affiliation(s)
- Ares Pasipoularides
- Department of Surgery, Duke University School of Medicine, HAFS-7th floor, DUMC 3704, Durham, NC 27710, USA.
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Ng XW, Huang Y, Chen HH, Burnett JC, Boey FYC, Venkatraman SS. Cenderitide-eluting film for potential cardiac patch applications. PLoS One 2013; 8:e68346. [PMID: 23861890 PMCID: PMC3701647 DOI: 10.1371/journal.pone.0068346] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 05/28/2013] [Indexed: 11/19/2022] Open
Abstract
Cenderitide, also known as CD-NP, is a designer peptide developed by combining native mammalian c-type natriuretic peptide (CNP) and the C-terminus isolated from the dendroapis natriuretic peptide (DNP) of the venom from the green mamba. In early studies, intravenous and subcutaneous infusion of cenderitide was reported to reduce left ventricular (LV) mass and ameliorate cardiac remodelling. In this work, biodegradable polymeric films encapsulating CD-NP were developed and were investigated for their in vitro release and degradation characteristics. Subsequently, the bioactivity of released peptide and its effects on human cardiac fibroblast (HCF) were explored. We achieved sustained release from three films with low, intermediate and high release profiles for 30 days. Moreover, the bioactivity of released peptide was verified from the elevated production of cyclic guanosine monophospate (cGMP). The CD-NP released from films was able to inhibit the proliferation of hypertrophic HCF as well as suppress DNA synthesis in HCF. Furthermore, the sustained delivery from films showed comparable or superior suppressive actions on hypertrophic HCF compared to daily infusion of CD-NP. The results suggest that these films could be used to inhibit fibrosis and reduce cardiac remodelling via local delivery as cardiac patches.
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Affiliation(s)
- Xu Wen Ng
- School of Materials Science & Engineering, Nanyang Technological University, Singapore, Singapore
| | - Yingying Huang
- School of Materials Science & Engineering, Nanyang Technological University, Singapore, Singapore
| | - Horng H. Chen
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - John C. Burnett
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Freddy Y. C. Boey
- School of Materials Science & Engineering, Nanyang Technological University, Singapore, Singapore
| | - Subbu S. Venkatraman
- School of Materials Science & Engineering, Nanyang Technological University, Singapore, Singapore
- * E-mail:
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Percutaneous implantation of a parachute device for treatment of ischemic heart failure. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2013; 14:236-40. [PMID: 23706577 DOI: 10.1016/j.carrev.2013.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 04/11/2013] [Indexed: 11/23/2022]
Abstract
Congestive heart failure (CHF) secondary to ischemic cardiomyopathy is associated with significant morbidity and mortality despite currently available medical therapy. The Parachute(TM) device is a novel left ventricular partitioning device that is delivered percutaneously in the left ventricle (LV) in patients with anteroapical regional wall motion abnormalities, dilated LV and systolic dysfunction after anterior myocardial infarction with favorable clinical and LV hemodynamic improvements post-implantation. Here, we do review the current literature and present a case of the Parachute device implantation.
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Leontyev S, Schlegel F, Spath C, Schmiedel R, Nichtitz M, Boldt A, Rübsamen R, Salameh A, Kostelka M, Mohr FW, Dhein S. Transplantation of engineered heart tissue as a biological cardiac assist device for treatment of dilated cardiomyopathy. Eur J Heart Fail 2013; 15:23-35. [PMID: 23243122 DOI: 10.1093/eurjhf/hfs200] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
AIM The aim of this study was to characterize an alternative treatment for dilated cardiomyopathy (DCM) using a novel cardiac biological assist device created from engineered heart tissue (EHT). METHODS AND RESULTS The EHTs were constructed in vitro from matrigel, collagen, and neonatal rat cardiomyocytes as small ring-like spontaneously contracting devices. DCM was induced in 50 rats by 6 weeks doxorubicin treatment (2.5 mg/kg/week). After 38 drug-free days, rats underwent either implantation of EHT (DCM-EHT, n = 13), which was sutured around the ventricles, or sham operation (DCM-Sham, n = 12). Eleven untreated healthy rats served as the control group. Rats were investigated using a Millar catheter for pressure-volume loop recording, and by echocardiography 30 days after operation. Thereafter, the hearts were excised and investigated functionally, histologically, and biochemically. Doxorubicin led to the development of DCM with reduced fractional shortening (FS), reduced dP/dt(max), increased systolic and diastolic LV diameters, and reduced response to dobutamine. In DCM-Sham, these changes were further enhanced, while in DCM-EHT we found improved FS, dP/dt(max), and dobutamine responsiveness. In isolated hearts, electrical multielectrode mapping revealed that EHT was electrically activated synchronously to the recipient heart. Histologically, we found increased vascularization in the EHT and the recipient heart, and EHT vessels connected to the coronary system. CONCLUSIONS Implantation of EHT improves LV performance in rats with doxorubicin-induced DCM.
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Affiliation(s)
- Sergey Leontyev
- Clinic for Cardiac Surgery, Heart Centre Leipzig, Leipzig, Germany
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13
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Silva G, Melica B, Pires de Morais G, Sousa O, Bettencourt N, Ribeiro J, Simões L, Gama V. Percutaneous implantation of a ventricular partitioning device for treatment of ischemic heart failure: Initial experience of a center. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.repce.2012.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Silva G, Melica B, Pires de Morais G, Sousa O, Bettencourt N, Ribeiro J, Simões L, Gama V. Percutaneous implantation of a ventricular partitioning device for treatment of ischemic heart failure: Initial experience of a center. Rev Port Cardiol 2012; 31:795-801. [DOI: 10.1016/j.repc.2012.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2012] [Accepted: 07/02/2012] [Indexed: 10/27/2022] Open
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Zouein FA, Zgheib C, Liechty KW, Booz GW. Post-infarct biomaterials, left ventricular remodeling, and heart failure: is good good enough? ACTA ACUST UNITED AC 2012; 18:284-90. [PMID: 22612796 DOI: 10.1111/j.1751-7133.2012.00298.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Fouad A Zouein
- Department of Pharmacology and Toxicology,the Department of Surgery, The Center for Excellence in Cardiovascular-Renal Research, The University of Mississippi Medical Center, Jackson, MS 39216-4505, USA
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Nelson DM, Ma Z, Fujimoto KL, Hashizume R, Wagner WR. Intra-myocardial biomaterial injection therapy in the treatment of heart failure: Materials, outcomes and challenges. Acta Biomater 2011; 7:1-15. [PMID: 20619368 PMCID: PMC3208237 DOI: 10.1016/j.actbio.2010.06.039] [Citation(s) in RCA: 145] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 06/25/2010] [Accepted: 06/29/2010] [Indexed: 12/31/2022]
Abstract
Heart failure initiated by coronary artery disease and myocardial infarction (MI) is a widespread, debilitating condition for which there are a limited number of options to prevent disease progression. Intra-myocardial biomaterial injection following MI theoretically provides a means to reduce the stresses experienced by the infarcted ventricular wall, which may alter the pathological remodeling process in a positive manner. Furthermore, biomaterial injection provides an opportunity to concurrently introduce cellular components and depots of bioactive agents. Biologically derived, synthetic and hybrid materials have been applied, as well as materials designed expressly for this purpose, although optimal design parameters, including degradation rate and profile, injectability, elastic modulus and various possible bioactivities, largely remain to be elucidated. This review seeks to summarize the current body of growing literature where biomaterial injection, with and without concurrent pharmaceutical or cellular delivery, has been pursued to improve functional outcomes following MI. The literature to date generally demonstrates acute functional benefits associated with biomaterial injection therapy across a broad variety of animal models and material compositions. Further functional improvements have been reported when cellular or pharmaceutical agents have been incorporated into the delivery system. Despite these encouraging early results, the specific mechanisms behind the observed functional improvements remain to be fully explored and future studies employing hypothesis-driven material design and selection may increase the potential of this approach to alleviate the morbidity and mortality of heart failure.
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Affiliation(s)
- Devin M Nelson
- Department of Bioengineering, University of Pittsburgh, PA 15219, USA
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Shin MS, Ahn TH, Kim OR, Chung WJ, Kang WC, Lee KH, Moon CI, Choi IS, Shin EK, Lim CY. Real-time 3-dimensional echocardiography of the heart 13 years after partial left ventriculectomy. Korean Circ J 2010; 40:295-8. [PMID: 20589204 PMCID: PMC2893372 DOI: 10.4070/kcj.2010.40.6.295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Accepted: 12/31/2009] [Indexed: 11/11/2022] Open
Affiliation(s)
- Mi-Seung Shin
- Division of Cardiology, Department of Internal Medicine, Gachon University, Gil Hospital, Incheon, Korea
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Yeh CC, Malhotra D, Li H, Nicholas S, Tu R, Mann MJ. Surgical ventricular reconstruction in mice: elucidating potential targets for combined molecular/surgical intervention. J Thorac Cardiovasc Surg 2009; 137:942-9. [PMID: 19327522 DOI: 10.1016/j.jtcvs.2008.09.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Revised: 09/03/2008] [Accepted: 09/12/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We hypothesize that persistent alterations in molecular signaling may drive recurrent pathologic remodeling even after the reduction of mechanical stress achieved via surgical ventricular reconstruction. We developed a murine model of surgical ventricular reconstruction that would facilitate molecular analysis of the postreconstruction myocardium and allow future exploitation of genetic models. METHODS C57/B6 mice underwent coronary artery ligation. For surgical ventricular reconstruction at 4 weeks after myocardial infarction, a purse-string suture (7-0 polypropylene) achieved at least partial exclusion of the apical aneurysm. Serial echocardiography was correlated to measurements of apoptosis and to Western blot analysis of key signaling cascades. RESULTS An immediate 21.7% +/- 2.6% improvement in fractional shortening was seen in the remaining myocardium after surgical ventricular reconstruction. Reduction in left ventricular volume and improved function persisted at 1 week, but recurrent dilatation at 4 weeks (left ventricular end-diastolic volume of 63.5 +/- 2.5 vs 42.1 +/- 5.4 microL immediately after reconstruction; P < .05) was associated with a loss of functional improvement (fractional shortening 41.2% +/- 2% vs 46% +/- 0.9%; P < .01). At 1 week after surgical ventricular reconstruction, there was a transient reduction in myocardial apoptosis. A steady reduction in cardioprotective myocardial Akt activation, however, was not affected by ventricular reconstruction. CONCLUSION This murine model recapitulates both the immediate benefits of surgical ventricular reconstruction and the longer-term recurrence of dilated cardiomyopathy seen previously in some animal models and human studies. Early analysis has begun to implicate persistent signaling changes in the postinfarction myocardium that may be responsible for recurrent dilatation after surgical ventricular reconstruction and that may become targets for combined surgical and molecular interventions.
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Affiliation(s)
- Che-Chung Yeh
- Division of Cardiothoracic Surgery University of California, San Francisco and VA Medical Center, San Francisco, CA 94121, USA
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Kang M, Chung KY, Walker JW. G-protein coupled receptor signaling in myocardium: not for the faint of heart. Physiology (Bethesda) 2007; 22:174-84. [PMID: 17557938 DOI: 10.1152/physiol.00051.2006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Catecholamines, endothelin-1 and angiotensin II are among a diverse group of diffusible extracellular signals that regulate pump function of the heart by binding to G-protein coupled receptors (GPCR). When the body demands a temporary boost of power output or if temporary budgeting of resources is required, these signals can adjust heart rate and contractile strength to maintain continuous perfusion of all vascular beds with nutrient- and oxygen-rich blood. Given adequate time in the face of prolonged challenges, activation of GPCRs can also promote "remodeling of the heart" by increasing cell size, organ size, and chamber dimensions, or by varying tissue composition and altering the expression of protein isoforms controlling excitability and contractility. A common feature of heart disease is the state of chronic activation of GPCR signaling systems. Paradoxically, whereas acute activation is beneficial, chronic activation often contributes to further deterioration of cardiac performance. A better understanding of how chronic GPCR activation contributes to the development of heart disease is needed so that it can be translated into better prevention and therapeutic strategies in the clinic.
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Affiliation(s)
- Misuk Kang
- Department of Physiology, University of Wisconsin School of Medicine, Madison, Wisconsin, USA
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