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Broncano J, Bhalla S, Gutierrez FR, Vargas D, Williamson EE, Makan M, Luna A. Cardiac MRI in Pulmonary Hypertension: From Magnet to Bedside. Radiographics 2020; 40:982-1002. [PMID: 32609599 DOI: 10.1148/rg.2020190179] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Pulmonary hypertension (PH) is a disease characterized by progressive rise of pulmonary artery (PA) pressure, which can lead to right ventricular (RV) failure. It is usually diagnosed late because of the nonspecificity of its symptoms. RV performance and adaptation to an increased afterload, reflecting the interaction of the PA and RV as a morphofunctional unit, constitute a critical determinant of morbidity and mortality in these patients. Therefore, early detection of dysfunction may prevent treatment failure. Cardiac MRI constitutes one of the most complete diagnostic modalities for diagnosing PH. It allows evaluation of the morphology and hemodynamics of the PA and RV. Several cine steady-state free-precession (SSFP)-derived parameters (indexed RV end-diastolic volume or RV systolic volume) and phase-contrast regional area change have been suggested as powerful biomarkers for prognosis and treatment. Recently, new cardiac MRI sequences have been added to clinical protocols for PH evaluation, providing brand-new information. Strain analysis with myocardial feature tracking can help detect early RV dysfunction, even with preserved ejection fraction. Four-dimensional flow cardiac MRI can enhance assessment of advanced RV and PA hemodynamics. Late gadolinium enhancement (LGE) imaging may allow detection of replacement fibrosis in PH patients, which is associated with poor outcome. T1 mapping may help detect interstitial fibrosis, even with normal LGE imaging results. The authors analyze the imaging workup of PH with a focus on the role of morphologic and functional cardiac MRI in diagnosis and management of PH, including some of the newer techniques. Online supplemental material is available for this article. ©RSNA, 2020.
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Affiliation(s)
- Jordi Broncano
- From the Department of Radiology, Hospital San Juan de Dios, Hospital de la Cruz Roja, RESSALTA HT Médica, Avenida el Brillante 36, 14012 Córdoba, Spain (J.B.); Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (S.B., F.R.G.); Department of Radiology, University of Colorado-Anschutz Medical Campus, Aurora, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (E.E.W.); Cardiovascular Division, Barnes Jewish Heart and Vascular Center, St Louis, Mo (M.M.); and MRI Section, Department of Radiology, Clínica Las Nieves, SERCOSA HT Médica, Jaén, Spain (A.L.)
| | - Sanjeev Bhalla
- From the Department of Radiology, Hospital San Juan de Dios, Hospital de la Cruz Roja, RESSALTA HT Médica, Avenida el Brillante 36, 14012 Córdoba, Spain (J.B.); Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (S.B., F.R.G.); Department of Radiology, University of Colorado-Anschutz Medical Campus, Aurora, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (E.E.W.); Cardiovascular Division, Barnes Jewish Heart and Vascular Center, St Louis, Mo (M.M.); and MRI Section, Department of Radiology, Clínica Las Nieves, SERCOSA HT Médica, Jaén, Spain (A.L.)
| | - Fernando R Gutierrez
- From the Department of Radiology, Hospital San Juan de Dios, Hospital de la Cruz Roja, RESSALTA HT Médica, Avenida el Brillante 36, 14012 Córdoba, Spain (J.B.); Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (S.B., F.R.G.); Department of Radiology, University of Colorado-Anschutz Medical Campus, Aurora, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (E.E.W.); Cardiovascular Division, Barnes Jewish Heart and Vascular Center, St Louis, Mo (M.M.); and MRI Section, Department of Radiology, Clínica Las Nieves, SERCOSA HT Médica, Jaén, Spain (A.L.)
| | - Daniel Vargas
- From the Department of Radiology, Hospital San Juan de Dios, Hospital de la Cruz Roja, RESSALTA HT Médica, Avenida el Brillante 36, 14012 Córdoba, Spain (J.B.); Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (S.B., F.R.G.); Department of Radiology, University of Colorado-Anschutz Medical Campus, Aurora, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (E.E.W.); Cardiovascular Division, Barnes Jewish Heart and Vascular Center, St Louis, Mo (M.M.); and MRI Section, Department of Radiology, Clínica Las Nieves, SERCOSA HT Médica, Jaén, Spain (A.L.)
| | - Eric E Williamson
- From the Department of Radiology, Hospital San Juan de Dios, Hospital de la Cruz Roja, RESSALTA HT Médica, Avenida el Brillante 36, 14012 Córdoba, Spain (J.B.); Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (S.B., F.R.G.); Department of Radiology, University of Colorado-Anschutz Medical Campus, Aurora, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (E.E.W.); Cardiovascular Division, Barnes Jewish Heart and Vascular Center, St Louis, Mo (M.M.); and MRI Section, Department of Radiology, Clínica Las Nieves, SERCOSA HT Médica, Jaén, Spain (A.L.)
| | - Majesh Makan
- From the Department of Radiology, Hospital San Juan de Dios, Hospital de la Cruz Roja, RESSALTA HT Médica, Avenida el Brillante 36, 14012 Córdoba, Spain (J.B.); Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (S.B., F.R.G.); Department of Radiology, University of Colorado-Anschutz Medical Campus, Aurora, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (E.E.W.); Cardiovascular Division, Barnes Jewish Heart and Vascular Center, St Louis, Mo (M.M.); and MRI Section, Department of Radiology, Clínica Las Nieves, SERCOSA HT Médica, Jaén, Spain (A.L.)
| | - Antonio Luna
- From the Department of Radiology, Hospital San Juan de Dios, Hospital de la Cruz Roja, RESSALTA HT Médica, Avenida el Brillante 36, 14012 Córdoba, Spain (J.B.); Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (S.B., F.R.G.); Department of Radiology, University of Colorado-Anschutz Medical Campus, Aurora, Colo (D.V.); Department of Radiology, Mayo Clinic, Rochester, Minn (E.E.W.); Cardiovascular Division, Barnes Jewish Heart and Vascular Center, St Louis, Mo (M.M.); and MRI Section, Department of Radiology, Clínica Las Nieves, SERCOSA HT Médica, Jaén, Spain (A.L.)
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Jiang Y, Zhou Y, Peng G, Tian H, Pan D, Liu L, Yang X, Li C, Li W, Chen L, Ran P, Dai A. Two-pore channels mediated receptor-operated Ca 2+ entry in pulmonary artery smooth muscle cells in response to hypoxia. Int J Biochem Cell Biol 2018; 97:28-35. [PMID: 29355755 DOI: 10.1016/j.biocel.2018.01.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/12/2018] [Accepted: 01/15/2018] [Indexed: 01/26/2023]
Abstract
The aim of this study was to investigate the influence of two-pore channels mediated receptor-operated Ca2+ entry on pulmonary arterial smooth muscle cell (PASMC) under hypoxia conditions. PASMCs were separated using the direct adherent culture method. The cultured cells were observed under optic microscope and the phenotypes of cells were identified by immunohistochemistry. The expression of NAADP was examined by ELISA. CaN, TPC1, TPC2 and NFATc3 protein levels were examined using Western blotting. Real-time PCR was utilized to detect the level of TPC1 and TPC2 mRNA. Fluorescent probe technique was used to explore the [Ca2+]i in PASMCs. Proliferation and migration of PASMCs were examined by MTT assay and Transwell, respectively. The results showed that cells displayed a typical "peak-valley" growth pattern and positive for α-actin staining. Expression of NAADP, CaN, NFATc3, TPC1 and TPC2 under PASMCs exposed to hypoxia after 24 h and 48 h were higher than control, however, cells treated with Ned-19 were significantly decreased compared with control. Levels of CaN and NFATc3 protein collected from RPASMCs transfected with TPCs siRNA were observably decreased than scrambled siRNA. Under hypoxia condition for 12 h, 24 h and 48 h, TPC1 and TPC2 mRNA levels were higher in PASMCs compared as control. The [Ca2+]i evoked by hypoxia significantly increased than normoxia group. Nevertheless, the [Ca2+]i of the groups treated with Ned-19 and transfected with TPCs siRNA were markedly lower compared with control. In conclusion, the TPCs influence on function of pulmonary artery smooth muscle cells by mediated Ca2+ Signals under hypoxia condition.
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Affiliation(s)
- Yongliang Jiang
- Respiratory Medicine, Hunan Provincial People's Hospital, Changsha 410219, PR China
| | - Yumin Zhou
- State Key Lab of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510120, PR China
| | - Gongyong Peng
- State Key Lab of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510120, PR China
| | - Heshen Tian
- Respiratory Medicine, Hunan Provincial People's Hospital, Changsha 410219, PR China
| | - Dan Pan
- Respiratory Medicine, Hunan Provincial People's Hospital, Changsha 410219, PR China
| | - Lei Liu
- Respiratory Medicine, Hunan Provincial People's Hospital, Changsha 410219, PR China
| | - Xing Yang
- Respiratory Medicine, Hunan Provincial People's Hospital, Changsha 410219, PR China
| | - Chao Li
- Respiratory Medicine, Hunan Provincial People's Hospital, Changsha 410219, PR China
| | - Wen Li
- Respiratory Medicine, Hunan Provincial People's Hospital, Changsha 410219, PR China
| | - Ling Chen
- Respiratory Medicine, Hunan Provincial People's Hospital, Changsha 410219, PR China
| | - Pixin Ran
- State Key Lab of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510120, PR China.
| | - Aiguo Dai
- Respiratory Medicine, Hunan Provincial People's Hospital, Changsha 410219, PR China; Institute of Respiratory Medicine, Changsha Medical College, Changsha 410219, PR China.
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Hartman W, Helan M, Smelter D, Sathish V, Thompson M, Pabelick CM, Johnson B, Prakash YS. Role of Hypoxia-Induced Brain Derived Neurotrophic Factor in Human Pulmonary Artery Smooth Muscle. PLoS One 2015; 10:e0129489. [PMID: 26192455 PMCID: PMC4507987 DOI: 10.1371/journal.pone.0129489] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 05/08/2015] [Indexed: 01/28/2023] Open
Abstract
Background Hypoxia effects on pulmonary artery structure and function are key to diseases such as pulmonary hypertension. Recent studies suggest that growth factors called neurotrophins, particularly brain-derived neurotrophic factor (BDNF), can influence lung structure and function, and their role in the pulmonary artery warrants further investigation. In this study, we examined the effect of hypoxia on BDNF in humans, and the influence of hypoxia-enhanced BDNF expression and signaling in human pulmonary artery smooth muscle cells (PASMCs). Methods and Results 48h of 1% hypoxia enhanced BDNF and TrkB expression, as well as release of BDNF. In arteries of patients with pulmonary hypertension, BDNF expression and release was higher at baseline. In isolated PASMCs, hypoxia-induced BDNF increased intracellular Ca2+ responses to serotonin: an effect altered by HIF1α inhibition or by neutralization of extracellular BDNF via chimeric TrkB-Fc. Enhanced BDNF/TrkB signaling increased PASMC survival and proliferation, and decreased apoptosis following hypoxia. Conclusions Enhanced expression and signaling of the BDNF-TrkB system in PASMCs is a potential mechanism by which hypoxia can promote changes in pulmonary artery structure and function. Accordingly, the BDNF-TrkB system could be a key player in the pathogenesis of hypoxia-induced pulmonary vascular diseases, and thus a potential target for therapy.
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Affiliation(s)
- William Hartman
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, 55905, United States of America
- * E-mail:
| | - Martin Helan
- International Clinical Research Center, Department of Cardiovascular Diseases, St. Anne's University Hospital, Brno, Czech Republic
- Department of Anesthesiology and Intensive Care, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
| | - Dan Smelter
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, 55905, United States of America
| | - Venkatachalem Sathish
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, 55905, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, 55905, United States of America
| | - Michael Thompson
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, 55905, United States of America
| | - Christina M. Pabelick
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, 55905, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, 55905, United States of America
| | - Bruce Johnson
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, 55905, United States of America
- Department of Internal Medicine, Division of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, 55905, United States of America
| | - Y. S. Prakash
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, 55905, United States of America
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, 55905, United States of America
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Helan M, Aravamudan B, Hartman WR, Thompson MA, Johnson BD, Pabelick CM, Prakash Y. BDNF secretion by human pulmonary artery endothelial cells in response to hypoxia. J Mol Cell Cardiol 2014; 68:89-97. [PMID: 24462831 PMCID: PMC3977651 DOI: 10.1016/j.yjmcc.2014.01.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 12/24/2013] [Accepted: 01/14/2014] [Indexed: 12/31/2022]
Abstract
Within human pulmonary artery, neurotrophin growth factors [NTs; e.g. brain-derived neurotrophic factor (BDNF)] and their high-affinity receptors (tropomyosin-related kinase; Trk) and low-affinity receptors p75 neurotrophin receptor (p75NTR) have been reported, but their functional role is incompletely understood. We tested the hypothesis that BDNF is produced by human pulmonary artery endothelial cells (PAECs). In the context of hypoxia as a risk factor for pulmonary hypertension, we examined the effect of hypoxia on BDNF secretion and consequent autocrine effects on pulmonary endothelium. Initial ELISA analysis of circulating BDNF in 30 healthy human volunteers showed that 72 h exposure to high altitude (~11,000 ft, alveolar PO2 = 100 mmHg) results in higher BDNF compared to samples taken at sea level. Separately, in human PAECs exposed for 24h to normoxia vs. hypoxia (1-3% O2), ELISA of extracellular media showed increased BDNF levels. Furthermore, quantitative PCR of PAECs showed 3-fold enhancement of BDNF gene transcription with hypoxia. In PAECs, BDNF induced NO production (measured using an NO-sensitive fluorescent dye DAF2-DA) that was significantly higher under hypoxic conditions, an effect also noted with the TrkB agonist 7,8-DHF. Importantly, hypoxia-induced NO was blunted by neutralization of secreted BDNF using the chimeric TrkB-Fc. Both hypoxia and BDNF increased iNOS (but not eNOS) mRNA expression. In accordance, BDNF enhancement of NO in hypoxia was not blunted by 50 nM L-NAME (eNOS inhibition) but substantially lower with 100 μM L-NAME (eNOS and iNOS inhibition). Hypoxia and BDNF also induced expression of hypoxia inducible factor 1 alpha (HIF-1α), a subunit of the transcription factor HIF-1, and pharmacological inhibition of HIF-1 diminished hypoxia effects on BDNF expression and secretion, and NO production. These results indicate that human PAECs express and secrete BDNF in response to hypoxia via a HIF-1-regulated pathway.
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Affiliation(s)
- Martin Helan
- Department of Anesthesiology, Mayo Clinic, Rochester
- ICRC, International Clinical Research Center, Brno, Czech Republic
- Department of Anesthesiology and Intensive Care, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | | | - William R. Hartman
- Department of Anesthesiology, Mayo Clinic, Rochester
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester
| | | | | | - Christina M. Pabelick
- Department of Anesthesiology, Mayo Clinic, Rochester
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester
| | - Y.S. Prakash
- Department of Anesthesiology, Mayo Clinic, Rochester
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester
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