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Vahidinia Z, Azami Tameh A, Barati S, Izadpanah M, Seyed Hosseini E. Nrf2 activation: a key mechanism in stem cell exosomes-mediated therapies. Cell Mol Biol Lett 2024; 29:30. [PMID: 38431569 PMCID: PMC10909300 DOI: 10.1186/s11658-024-00551-3] [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] [Received: 12/13/2023] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
Exosomes are nano-sized membrane extracellular vesicles which can be released from various types of cells. Exosomes originating from inflammatory or injured cells can have detrimental effects on recipient cells, while exosomes derived from stem cells not only facilitate the repair and regeneration of damaged tissues but also inhibit inflammation and provide protective effects against various diseases, suggesting they may serve as an alternative strategy of stem cells transplantation. Exosomes have a fundamental role in communication between cells, through the transfer of proteins, bioactive lipids and nucleic acids (like miRNAs and mRNAs) between cells. This transfer significantly impacts both the physiological and pathological functions of recipient cells. Nuclear factor erythroid 2-related factor 2 (Nrf2), a transcription factor, is able to mitigate damage caused by oxidative stress and inflammation through various signaling pathways. The positive effects resulting from the activation of the Nrf2 signaling pathway in different disorders have been documented in various types of literature. Studies have confirmed that exosomes derived from stem cells could act as Nrf2 effective agonists. However, limited studies have explored the Nrf2 role in the therapeutic effects of stem cell-derived exosomes. This review provides a comprehensive overview of the existing knowledge concerning the role of Nrf2 signaling pathways in the impact exerted by stem cell exosomes in some common diseases.
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Affiliation(s)
- Zeinab Vahidinia
- Anatomical Sciences Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran.
| | - Abolfazl Azami Tameh
- Anatomical Sciences Research Center, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Shirin Barati
- Department of Anatomy, Saveh University of Medical Sciences, Saveh, Iran
| | - Melika Izadpanah
- Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elahe Seyed Hosseini
- Gametogenesis Research Center, Institute for Basic Sciences, Kashan University of Medical Science, Kashan, Iran
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Sun JH, Liu XK, Xing XW, Yang Y, Xuan HH, Fu BB. Value of Cardiac Troponin, Myoglobin Combined with Heart-type Fatty Acid-binding Protein Detection in Diagnosis of Early Acute Myocardial Infarction. Pak J Med Sci 2023; 39:1690-1694. [PMID: 37936785 PMCID: PMC10626125 DOI: 10.12669/pjms.39.6.7101] [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: 09/07/2022] [Revised: 07/03/2023] [Accepted: 07/19/2023] [Indexed: 11/09/2023] Open
Abstract
Objective To evaluate the value of cardiac troponin(cTn), myoglobin(Myo) combined with heart-type fatty acid-binding protein(H-FABP) detection in the diagnosis of early acute myocardial infarction(AMI). Methods This study was a clinical comparative study. Eighty patients with AMI hospitalized in Tangshan Workers' Hospital were selected as study group, and another 80 individuals receiving normal physical examination were selected as control group from September 20, 2021 to September 20, 2022. The concentrations of cTn, Myo and H-FABPP, diagnostic indicators, the sensitivity and specificity of combined diagnosis, as well as the diagnostic efficacy for AMI were compared between the two groups. Results The levels of cTn, Myo and H-FABPP in the study group were significantly higher than those in the control group(P= 0.00). Multivariate logistic regression analysis showed that cTn, Myo and H-FABP were all relevant indicators for AMI. H-FABP alone has better diagnostic efficacy for AMI. The area under the curve of their combined detection, the specificity, and the sensitivity were higher than those of cTn, Myo and H-FABP alone, indicating that their combined application has the best diagnostic efficiency. cTn, Myo and H-FABP levels were positively correlated with Glu, TC, LDL-C and hs-CRP levels(P< 0.01), while negatively correlated with HDL level(P< 0.01). Conclusions The combined detection of cardiac markers such as cTn, Myo and H-FABP presents higher sensitivity and specificity in the diagnosis of AMI compared with any single detection, and can provide better data support for the definite diagnosis of AMI, with high clinical application value.
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Affiliation(s)
- Jian hua Sun
- Jian hua Sun, Department of Cardiology, Tangshan Workers’ Hospital, Tangshan, 063000, Hebei, P.R. China
| | - Xiao kun Liu
- Xiao kun Liu, Department of Cardiology, Tangshan Workers’ Hospital, Tangshan, 063000, Hebei, P.R. China
| | - Xiao wei Xing
- Xiao wei Xing, Department of Cardiology, Tangshan Workers’ Hospital, Tangshan, 063000, Hebei, P.R. China
| | - Yang Yang
- Yang Yang, Department of Cardiology, Tangshan Workers’ Hospital, Tangshan, 063000, Hebei, P.R. China
| | - Hui hong Xuan
- Hui hong Xuan, Department of Cardiology, Tangshan Workers’ Hospital, Tangshan, 063000, Hebei, P.R. China
| | - Bin bin Fu
- Bin bin Fu, Department of Cardiology, Tangshan Qianxi people’s Hospital, Tangshan, 064303, Hebei, P.R. China
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Djokovic A, Krljanac G, Matic P, Zivic R, Djulejic V, Marjanovic Haljilji M, Popovic D, Filipovic B, Apostolovic S. Pathophysiology of spontaneous coronary artery dissection: hematoma, not thrombus. Front Cardiovasc Med 2023; 10:1260478. [PMID: 37928766 PMCID: PMC10623160 DOI: 10.3389/fcvm.2023.1260478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023] Open
Abstract
Spontaneous coronary artery dissection (SCAD) accounts for 1.7%-4% of all acute coronary syndrome presentations, particularly among young women with an emerging awareness of its importance. The demarcation of acute SCAD from coronary atherothrombosis and the proper therapeutic approach still represents a major clinical challenge. Certain arteriopathies and triggers are related to SCAD, with high variability in their prevalence, and often, the cause remains unknown. The objective of this review is to provide contemporary knowledge of the pathophysiology of SCAD and possible therapeutic solutions.
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Affiliation(s)
- Aleksandra Djokovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Department of Cardiology, University Hospital Center Bezanijska Kosa, Belgrade, Serbia
| | - Gordana Krljanac
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Cardiology Clinic, University Clinical Center of Serbia, Belgrade, Serbia
| | - Predrag Matic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Vascular Surgery, Institute for Cardiovascular Diseases “Dedinje”, Belgrade, Serbia
| | - Rastko Zivic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Department for Surgery, Clinical Hospital Center Dr Dragisa Misovic “Dedinje”, BelgradeSerbia
| | - Vuk Djulejic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Faculty of Medicine, Institute of Anatomy, Belgrade, Serbia
| | | | - Dusan Popovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Department for Gastroenterology, Clinical Hospital Center Dr Dragisa Misovic “Dedinje”, BelgradeSerbia
| | - Branka Filipovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Department for Gastroenterology, Clinical Hospital Center Dr Dragisa Misovic “Dedinje”, BelgradeSerbia
| | - Svetlana Apostolovic
- Coronary Care Unit, Cardiology Clinic, University Clinical Center of Nis, Nis, Serbia
- Faculty of Medicine, University of Nis, Nis, Serbia
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Guan X, Liang T, Fan J, Yang W, Wu D, Li X. The value of Copeptin, myocardial fatty acid-binding protein and myocardial markers in the early diagnosis of acute myocardial infarction. Am J Transl Res 2022; 14:8002-8008. [PMID: 36505320 PMCID: PMC9730107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/08/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate and detect the value of Copeptin, myocardial fatty acid binding protein (H-FABP) and myocardial markers in the early diagnosis of acute myocardial infarction (AMI). METHOD A retrospective analysis was carried out in 153 patients with chest pain who came to Xianyang Hospital of Yan'an University from August 2019 to April 2022, of whom 87 patients were finally diagnosed with AMI. Cardiac troponin I (cTnI), Copeptin, and H-FABP levels were measured immediately at the patient's visit. Receiver operating characteristic (ROC) curve was drawn to evaluate and compare the value of Copeptin, H-FABP and cTnI in early diagnosis of AMI and their joint effect in improving the accuracy of early diagnosis of AMI. RESULTS (1) The levels of Copeptin, H-FABP and cTnI in AMI patients were evidently higher than those in non-AMI patients with chest pain. (2) The diagnostic sensitivity and specificity of Copeptin were 82.89% and 64.37%, respectively. Those of cTnI were 78.95% and 64.37% respectively, and those of H-FABP were 85.53% and 75.86%, respectively. The AUC size under the ROC curve was H-FABP > hopeptin > cTnI. (3) Joint detection of Copeptin, H-FABP and cTnI was better than mono-detection in early diagnosis of AMI. CONCLUSION H-FABP has high accuracy in detecting early AMI, which is better than cTnI and Copeptin, but the joint detection of the three is of the highest value.
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Affiliation(s)
- Xin Guan
- Cardiovascular Department I, Baoji City People’s HospitalBaoji 721000, Shaanxi, China
| | - Tian Liang
- Department of Cardiovascular Medicine, Xianyang Hospital of Yan’an UniversityXianyang 712000, Shaanxi, China
| | - Jianyun Fan
- Cardiovascular Department I, Baoji City People’s HospitalBaoji 721000, Shaanxi, China
| | - Wenyou Yang
- Cardiovascular Department I, Baoji City People’s HospitalBaoji 721000, Shaanxi, China
| | - Dongliang Wu
- Department of Cardiovascular Medicine, Xianyang Hospital of Yan’an UniversityXianyang 712000, Shaanxi, China
| | - Xinguo Li
- Department of Cardiovascular Medicine, Xianyang Hospital of Yan’an UniversityXianyang 712000, Shaanxi, China
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Gédéon T, Akl E, D'Souza R, Altit G, Rowe H, Flannery A, Siriki P, Bhatia K, Thorne S, Malhamé I. Acute Myocardial Infarction in Pregnancy. Curr Probl Cardiol 2022; 47:101327. [PMID: 35901856 DOI: 10.1016/j.cpcardiol.2022.101327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 07/17/2022] [Indexed: 11/03/2022]
Abstract
Cardiovascular disease, and particularly ischemic heart disease, is a leading cause of maternal morbidity and mortality in high-income countries. The incidence of acute myocardial infarction (AMI) has been rising over the past two decades due to increasing maternal age and a higher prevalence of cardiovascular risk factors in the pregnant population. Causes of AMI in pregnancy are diverse and may require specific considerations for their diagnosis and management. In this narrative review, we provide an overview of physiologic changes, risk factors, and etiologies leading to AMI in pregnancy, as well as diagnostic tools, reperfusion strategies, and pharmacological treatments for this complex population. In addition, we outline considerations for labor and delivery planning and long-term follow-up of patients with AMI in pregnancy.
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Affiliation(s)
- Tara Gédéon
- Department of Medicine, McGill University Health Centre, Montreal, Canada
| | - Elie Akl
- Department of Medicine, McGill University Health Centre, Montreal, Canada
| | - Rohan D'Souza
- Department of Obstetrics and Gynaecology, McMaster University, Hamilton, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Gabriel Altit
- Department of Paediatrics, McGill University Health Centre, Montreal, Canada
| | - Hilary Rowe
- Department of Pharmacy, Nanaimo Regional General Hospital, Island Health, Nanaimo, Canada; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Alexandria Flannery
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Canada
| | | | - Kailash Bhatia
- Department of Anaesthesia, Manchester University Hospitals and St Mary's Hospital, University of Manchester, Manchester, United Kingdom
| | - Sara Thorne
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Isabelle Malhamé
- Department of Medicine, McGill University Health Centre, Montreal, Canada; Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Canada.
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Cardiac Magnetic Resonance Assessment of the Protective Effect of Remote Ischemic Postconditioning on Coronary Microcirculation after Reperfusion Therapy for Acute ST-Segment Elevation Myocardial Infarction. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:5629763. [PMID: 35836923 PMCID: PMC9276513 DOI: 10.1155/2022/5629763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022]
Abstract
This study intends to evaluate the characteristics of coronary microcirculatory function in patients with myocardial infarction undergoing reperfusion and its predictive value in assessing cardiac function, myocardial activity, recovery of ventricular wall motion after infarction, and distant myocardial remodeling by cardiac magnetic resonance technique (CMRI). Materials and Methods. The 293 cases of patients with myocardial infarction treated in our hospital from August 2017 to August 2021 were selected as the subjects of this retrospective study, 13 cases were shed due to transfer and moving, and the rest were divided into 140 cases each in the emergency and elective groups according to emergency percutaneous coronary intervention (PCI) and elective PCI. The patients' myocardial infarct volume ventricular volume, microcirculatory obstruction volume ventricular volume, microcirculatory obstruction volume/myocardial infarct volume, and LVEF, combined with BP and troponin T, were analysed by CMR for comparative analysis, hemodynamic, and cardiac function index differences. Results. The hemodynamics (CO, CI, SV, SI, LVSW1, and LCW) measured at different times were significantly different between the two groups; patients in the emergency group had significantly lower EDV and ESV than the elective group at 7-10 d postoperatively; and EDV, ESV, and LVEF improved in both groups after 3 months, while EDV, ESV, and LVEF improved significantly better in the emergency group than in the elective group, and the difference was statistically significant (P < 0.05). The myocardial infarct quality, VSM score, and ventricular wall motion abnormality score were significantly lower in the emergency group than in the elective group from 7 to 10 d after PCI; myocardial infarct quality, VSM score, and ventricular wall motion abnormality score improved in both groups at 3 months after PCI; and the degree of improvement of myocardial infarct quality and VSM score was significantly better in the emergency group than in the elective group (P < 0.05). Conclusion. Acute myocardial infarction patients with significant effect of emergency PCI treatment can be on their postmyocardial infarction left ventricular function, and in the treatment of coronary heart disease, myocardial infarction diagnosis has a certain reference value.
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Wang L, Shao C, Han C, Li P, Wang F, Wang Y, Li J. Correlation of ApoE gene polymorphism with acute myocardial infarction and aspirin resistance after percutaneous coronary intervention. Am J Transl Res 2022; 14:3303-3310. [PMID: 35702102 PMCID: PMC9185036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 03/31/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To determine the correlation of Apolipoprotein E (ApoE) gene polymorphism with acute myocardial infarction (AMI) and aspirin (APC) resistance after percutaneous coronary intervention (PCI). METHODS In this randomized controlled trial (The Second People's Hospital of Lianyungang Ethics Committee No.L1719), a total of 120 AMI patients admitted to the Second People's Hospital of Lianyungang from January 2019 to June 2020 were enrolled into the research group (Res group) and 120 healthy individuals during the same time period into the control group (Con group). ApoE gene polymorphism was detected by gene microarray and analyzed statistically. The occurrence of APC resistance after PCI was recorded, and the relationship between ApoE gene polymorphism and APC resistance was analyzed. RESULTS The Res group showed a significantly lower level of ε3/ε3 gene and significantly higher levels of ε3/ε4 and ε4/ε4 genes than the Con group (all P<0.05), but no notable difference was found in the distribution of ApoE ε2 between the two groups (P>0.05). ApoE ε3 carriers were the main carriers in both groups. However, the Res group showed a lower frequency of ApoE ε3 and a higher frequency of ApoE ε4 compared to the Con group (both P<0.05), and patients with more severe AMI had a significantly higher frequency of ApoE ε4 genotype (P<0.05). According to logistic regression analysis, carrying ApoE ε4 allele (ε3/ε4, ε4/ε4) was a risk factor for AMI (P<0.05). Additionally, patients with APC resistance had a significantly higher frequency of ApoE ε4 allele than those without it (P<0.05). A higher frequency of ApoE ε4 allele was also a risk factor of APC resistance in AMI patients after PCI, and its adjusted risk ratio (OR) was 2.26 times (P<0.05). Moreover, no significant difference was observed among patients with different ApoE genotypes in the incidence of adverse events (P>0.05). CONCLUSION ApoE gene polymorphism is correlated with AMI and APC resistance after PCI, and ApoE ε4 genotype is probably the risk allele for AMI.
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Affiliation(s)
- Luoqing Wang
- Department of Cardiovascular Medicine, Lianyungang Second People’s Hospital Affiliated to Bengbu Medical CollegeLianyungang 222006, Jiangsu, China
| | - Chen Shao
- Department of Cardiovascular Medicine, Lianyungang Second People’s Hospital Affiliated to Bengbu Medical CollegeLianyungang 222006, Jiangsu, China
| | - Cuimin Han
- Department of Cardiovascular Medicine, Lianyungang Second People’s Hospital Affiliated to Bengbu Medical CollegeLianyungang 222006, Jiangsu, China
| | - Peng Li
- Department of Cardiovascular Medicine, Lianyungang Second People’s Hospital Affiliated to Bengbu Medical CollegeLianyungang 222006, Jiangsu, China
| | - Feixiang Wang
- Department of Cardiovascular Medicine, Lianyungang Second People’s Hospital Affiliated to Bengbu Medical CollegeLianyungang 222006, Jiangsu, China
| | - Yilian Wang
- Department of Cardiovascular Medicine, Lianyungang Second People’s Hospital Affiliated to Bengbu Medical CollegeLianyungang 222006, Jiangsu, China
| | - Junping Li
- Department of Electrocardiogram, Lianyungang Second People’s Hospital Affiliated to Bengbu Medical CollegeLianyungang 222006, Jiangsu, China
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Ke WL, Huang ZW, Peng CL, Ke YP. m 6A demethylase FTO regulates the apoptosis and inflammation of cardiomyocytes via YAP1 in ischemia-reperfusion injury. Bioengineered 2022; 13:5443-5452. [PMID: 35176940 PMCID: PMC8974143 DOI: 10.1080/21655979.2022.2030572] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 12/31/2021] [Accepted: 01/04/2022] [Indexed: 01/13/2023] Open
Abstract
Reperfusion therapy after acute myocardial infarction can induce myocardial ischemia-reperfusion injury (IRI). Novel evidence has illustrated that N6-methyladenosine (m6A) modification modulates the myocardial IRI progression. Here, our study focuses on the role of m6A methyltransferase fat mass and obesity-associated protein (FTO) in myocardial ischemia/reoxygenation injury and explores potential regulatory mechanisms. Results discovered that FTO down-expressed in myocardial IRI mice and hypoxia/reoxygenation (H/R)-induced cardiomyocytes. Functionally, FTO overexpression attenuated the H/R-induced apoptosis and inflammation of cardiomyocytes. Mechanistically, methylated RNA immunoprecipitation quantitative polymerase chain reaction (MeRIP-qPCR) assay and RIP assay revealed that Yap1 mRNA acted as the target of FTO in cardiomyocytes. Moreover, FTO uninstalled the methylation of Yap1 mRNA, and enforced the stability of Yap1 mRNA. Taken together, our study reveals the role of FTO in H/R-induced myocardial cell injury via m6A-dependent manner, which may provide a new approach to improve myocardial IRI.
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Affiliation(s)
- Wei-Liang Ke
- Department of Cardiology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, P.R. China
| | - Zhi-Wen Huang
- Department of Cardiology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, P.R. China
| | - Chun-Ling Peng
- Physical Examination Center, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, P.R. China
| | - Yi-Ping Ke
- Physical Examination Center, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, P.R. China
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Xiao H, Wu D, Yang T, Fu W, Yang L, Hu C, Wan H, Hu X, Zhang C, Wu T. Extracellular vesicles derived from HBMSCs improved myocardial infarction through inhibiting zinc finger antisense 1 and activating Akt/Nrf2/HO-1 pathway. Bioengineered 2022; 13:905-916. [PMID: 34974805 PMCID: PMC8805844 DOI: 10.1080/21655979.2021.2014389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/25/2022] Open
Abstract
Myocardial infarction (MI) is believed to be one of the most common cardiovascular diseases, and it is seriously threatening the health of people in the world. The extracellular vesicles (EVs) isolated from mesenchymal stem cells and zinc finger antisense 1 (ZFAS1) have been believed to be involved in the regulation of MI, but the mechanism has not been fully clarified. Left anterior descending artery ligation was used to establish MI animal model, hypoxia treatment was applied to establish MI cell model. CCK8, transwell, and wound healing methods were applied to measure cell proliferation, invasion, and migration. Overexpression of ZFAS1 was established via transfecting pcDNA-ZFAS1. Overexpression of ZFAS1 significantly reversed the influence of EVs on cell migration, invasion, and apoptosis. Similar effect of EVs and ZFAS1 on morphological changes of MI rat heart tissues were also observed. The activation of Akt/Nrf2/HO-1 pathway by EVs was remarkably suppressed by pcDNA-ZFAS1. Inhibitor of Akt/Nrf2/HO-1 pathway remarkably reversed the impact of EVs on the cell viability. EVs might improve MI through inhibiting ZFAS1 and promoting Akt/Nrf2/HO-1 pathway. This study might provide a new thought for the prevention and treatment of MI damage through regulating ZFAS1 or Akt/Nrf2/HO-1 pathway.
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Affiliation(s)
- Huiling Xiao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Dan Wu
- Department of medical technology, Jiangxi Health Vocational College, Nanchang, Jiangxi, China
| | - Tao Yang
- Department of Emergency, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Wei Fu
- Department of Emergency, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lu Yang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chenkai Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Hongbing Wan
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaomin Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chenjie Zhang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tao Wu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Merlo AC, Rosa GM, Porto I. Pregnancy-related acute myocardial infarction: a review of the recent literature. Clin Res Cardiol 2021; 111:723-731. [PMID: 34510263 PMCID: PMC9242969 DOI: 10.1007/s00392-021-01937-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/30/2021] [Indexed: 12/18/2022]
Abstract
Pregnancy-related acute myocardial infarction is a rare and potentially life-threatening cardiovascular event, the incidence of which is growing due to the heightened prevalence of several risk factors, including increased maternal age. Its main aetiology is spontaneous coronary artery dissection, which particularly occurs in pregnancy and may engender severe clinical scenarios. Therefore, despite frequently atypical and deceptive presentations, early recognition of such a dangerous complication of gestation is paramount. Notwithstanding diagnostic and therapeutic improvements, pregnancy-related acute myocardial infarction often carries unfavourable outcomes, as emergent management is difficult owing to significant limitations in the use of ionising radiation-e.g. during coronary angiography, potentially harmful to the foetus even at low doses. Notably, however, maternal mortality has steadily decreased in recent decades, indicating enhanced awareness and major medical advances in this field. In our paper, we review the recent literature on pregnancy-related acute myocardial infarction and highlight the key points in its management.
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Affiliation(s)
- Andrea Carlo Merlo
- Department of Internal Medicine and Medical Specialties (DIMI), Chair of Cardiovascular Diseases, University of Genoa, Genoa, Italy
| | - Gian Marco Rosa
- Department of Internal Medicine and Medical Specialties (DIMI), Chair of Cardiovascular Diseases, University of Genoa, Genoa, Italy
- Cardiology Unit, DICATOV-Cardiothoracic and Vascular Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Italo Porto
- Department of Internal Medicine and Medical Specialties (DIMI), Chair of Cardiovascular Diseases, University of Genoa, Genoa, Italy.
- Cardiology Unit, DICATOV-Cardiothoracic and Vascular Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
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Embolia coronaria durante la gestación. Importancia de realizar un correcto intercambio de acenocumarol a heparina. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2021. [DOI: 10.1016/j.gine.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Dai NN, Zhou R, Zhuo YL, Sun L, Xiao MY, Wu SJ, Yu HX, Li QY. Acute myocardial infarction in twin pregnancy after assisted reproduction: A case report. World J Clin Cases 2021; 9:4294-4302. [PMID: 34141793 PMCID: PMC8173408 DOI: 10.12998/wjcc.v9.i17.4294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/16/2021] [Accepted: 04/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) during pregnancy is rare, especially in twin pregnancy, and it can endanger the lives of the mother and children. Except for conventional cardiovascular risk factors, pregnancy and assisted reproduction can increase the risk of AMI during pregnancy. AMI develops secondary to different etiologies, such as coronary spasm and spontaneous coronary artery dissection.
CASE SUMMARY A 33-year-old woman, with twin pregnancy in the 31st week of gestation, presented to the hospital with intermittent chest tightness for 12 wk, aggravation for 1 wk, and chest pain for 4 h. Combined with the electrocardiogram and hypersensitive troponin results, she was diagnosed with acute ST-elevation myocardial infarction. Although the patient had no related medical history, she presented several risk factors, such as age greater than 30 years, assisted reproduction, and hyperlipidemia. After diagnosis, the patient received antiplatelet and anticoagulant treatment. Cesarean section and coronary angiography performed 7 d later showed stenosis and thrombus shadow of the right coronary artery. After receiving medication, the patient was in good condition.
CONCLUSION This case suggests that, with the widespread use of assisted reproductive technology, more attention should be paid to perinatal healthcare, especially when chest pain occurs, to facilitate early diagnosis and intervention of AMI, and the etiology of AMI in pregnancy needs to be differentiated, especially between coronary spasm and spontaneous coronary artery dissection.
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Affiliation(s)
- Ni-Ni Dai
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Rong Zhou
- Department of Sleep Medicine, Peking University Sixth Hospital, Beijing 100191, China
| | - Yan-Ling Zhuo
- Department of Rehabilitation, Beijing United Family Rehabilitation Hospital, Beijing 100016, China
| | - Li Sun
- Department of Rehabilitation, Beijing United Family Rehabilitation Hospital, Beijing 100016, China
| | - Ming-Yue Xiao
- Department of Rehabilitation, Beijing United Family Rehabilitation Hospital, Beijing 100016, China
| | - Si-Jing Wu
- Department of Cardiology, Beijing Anzhen hospital, Beijing 100029, China
| | - Hai-Xu Yu
- Department of Cardiology, Peking University Third Hospital, Beijing 100191, China
| | - Qiu-Yu Li
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
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13
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Khaing PH, Buchanan GL, Kunadian V. Diagnostic Angiograms and Percutaneous Coronary Interventions in Pregnancy. ACTA ACUST UNITED AC 2020; 15:e04. [PMID: 32536975 PMCID: PMC7277904 DOI: 10.15420/icr.2020.02] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/02/2020] [Indexed: 12/12/2022]
Abstract
Cardiovascular disease is the leading indirect cause of maternal mortality in the UK. Pregnancy increases the risk of acute MI (AMI) by three- to fourfold secondary to the profound physiological changes that place an extra burden on the cardiovascular system. AMI is not always recognised in pregnancy and there is concern among both clinicians and patients regarding catheter-based interventions due to fears of foetal irradiation and risks to the foetus. This article evaluates the current state of knowledge on AMI in pregnancy with particular emphasis on pregnancy-associated spontaneous coronary artery dissection and percutaneous coronary intervention as the revascularisation procedure for AMI. Special considerations that must be made in patients requiring percutaneous coronary intervention for pregnancy-associated spontaneous coronary artery dissection and the current recommendations on arterial access, methods of minimising radiation and stent selection are discussed.
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Affiliation(s)
- Phyo Htet Khaing
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University Newcastle upon Tyne, UK
| | | | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital Newcastle Upon Tyne, UK
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14
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Oreh AC, Imagbenikaro EOU, Adelaja AM, Ezeogu L. Pregnancy-associated myocardial infarction following elective caesarean section for two previous caesarean sections and myomectomy. J Family Med Prim Care 2020; 9:2528-2530. [PMID: 32754537 PMCID: PMC7380765 DOI: 10.4103/jfmpc.jfmpc_225_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/13/2020] [Accepted: 04/07/2020] [Indexed: 11/04/2022] Open
Abstract
A 39-year-old woman, gravida 4, para 2 + 1 (2 alive) for elective second repeat caesarean delivery on account of two previous caesarean sections and one open myomectomy. Following the caesarean section, she developed sudden cardiac failure and was transferred to the intensive care unit for mechanical ventilation support. Congestive cardiac failure secondary to non ST segment elevation myocardial infarction (NSTEMI) was subsequently diagnosed following an electrocardiogram (ECG), echocardiography, and cardiac enzyme assay. The presented case demonstrates the importance of skilled delivery and efficient referral services in developing countries to minimize poor maternal and fetal outcomes in pregnancy-related heart disease.
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Affiliation(s)
- Adaeze Chidinma Oreh
- Department of Family Medicine, Garki Hospital Abuja, Nigeria
- Department of Hospital Services, Federal Ministry of Health Abuja, Nigeria
| | | | | | - Lawrence Ezeogu
- Department of Obstetrics and Gynecology, Garki Hospital Abuja, Nigeria
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