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Abudureyimu M, Luo X, Jiang L, Jin X, Pan C, Yu W, Ge J, Zhang Y, Ren J. FBXL4 protects against HFpEF through Drp1-Mediated regulation of mitochondrial dynamics and the downstream SERCA2a. Redox Biol 2024; 70:103081. [PMID: 38359748 PMCID: PMC10878117 DOI: 10.1016/j.redox.2024.103081] [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: 01/29/2024] [Revised: 02/08/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024] Open
Abstract
AIMS Heart failure with preserved ejection fraction (HFpEF) is a devastating health issue although limited knowledge is available for its pathogenesis and therapeutics. Given the perceived involvement of mitochondrial dysfunction in HFpEF, this study was designed to examine the role of mitochondrial dynamics in the etiology of HFpEF. METHOD AND RESULTS Adult mice were placed on a high fat diet plus l-NAME in drinking water ('two-hit' challenge to mimic obesity and hypertension) for 15 consecutive weeks. Mass spectrometry revealed pronounced changes in mitochondrial fission protein Drp1 and E3 ligase FBXL4 in 'two-hit' mouse hearts. Transfection of FBXL4 rescued against HFpEF-compromised diastolic function, cardiac geometry, and mitochondrial integrity without affecting systolic performance, in conjunction with altered mitochondrial dynamics and integrity (hyperactivation of Drp1 and unchecked fission). Mass spectrometry and co-IP analyses unveiled an interaction between FBXL4 and Drp1 to foster ubiquitination and degradation of Drp1. Truncated mutants of FBXL4 (Delta-Fbox) disengaged interaction between FBXL4 and Drp1. Metabolomic and proteomics findings identified deranged fatty acid and glucose metabolism in HFpEF patients and mice. A cellular model was established with concurrent exposure of high glucose and palmitic acid as a 'double-damage' insult to mimic diastolic anomalies in HFpEF. Transfection of FBXL4 mitigated 'double-damage'-induced cardiomyocyte diastolic dysfunction and mitochondrial injury, the effects were abolished and mimicked by Drp1 knock-in and knock-out, respectively. HFpEF downregulated sarco(endo)plasmic reticulum (SR) Ca2+ uptake protein SERCA2a while upregulating phospholamban, RYR1, IP3R1, IP3R3 and Na+-Ca2+ exchanger with unaltered SR Ca2+ load. FBXL4 ablated 'two-hit' or 'double-damage'-induced changes in SERCA2a, phospholamban and mitochondrial injury. CONCLUSION FBXL4 rescued against HFpEF-induced cardiac remodeling, diastolic dysfunction, and mitochondrial injury through reverting hyperactivation of Drp1-mediated mitochondrial fission, underscoring the therapeutic promises of FBXL4 in HFpEF.
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Affiliation(s)
- Miyesaier Abudureyimu
- Cardiovascular Department, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, 200031, China; National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Xuanming Luo
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China; Department of General Surgery, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, 200031, China
| | - Lingling Jiang
- Cardiovascular Department, Shanghai Xuhui Central Hospital, Fudan University, Shanghai, 200031, China; National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China
| | - Xuejuan Jin
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, National Health Commission, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai, 200032, China
| | - Cuizhen Pan
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, National Health Commission, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai, 200032, China
| | - Wei Yu
- Xianning Medical College, Hubei University of Science and Technology, Xianning, 437100, China
| | - Junbo Ge
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, National Health Commission, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai, 200032, China
| | - Yingmei Zhang
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, National Health Commission, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai, 200032, China
| | - Jun Ren
- National Clinical Research Center for Interventional Medicine, Shanghai, 200032, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, National Health Commission, Shanghai, 200032, China; Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai, 200032, China.
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Jones TLM, Woulfe KC. Considering impact of age and sex on cardiac cytoskeletal components. Am J Physiol Heart Circ Physiol 2024; 326:H470-H478. [PMID: 38133622 PMCID: PMC11219061 DOI: 10.1152/ajpheart.00619.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/08/2023] [Accepted: 12/21/2023] [Indexed: 12/23/2023]
Abstract
The cardiac cytoskeletal components are integral to cardiomyocyte function and are responsible for contraction, sustaining cell structure, and providing scaffolding to direct signaling. Cytoskeletal components have been implicated in cardiac pathology; however, less attention has been paid to age-related modifications of cardiac cytoskeletal components and how these contribute to dysfunction with increased age. Moreover, significant sex differences in cardiac aging have been identified, but we still lack a complete understanding to the mechanisms behind these differences. This review summarizes what is known about how key cardiomyocyte cytoskeletal components are modified because of age, as well as reported sex-specific differences. Thorough consideration of both age and sex as integral players in cytoskeletal function may reveal potential avenues for more personalized therapeutics.
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Affiliation(s)
- Timothy L M Jones
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Kathleen C Woulfe
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
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Zhou D, Yan M, Cheng Q, Feng X, Tang S, Feng Y. Prevalence and prognosis of left ventricular diastolic dysfunction in community hypertension patients. BMC Cardiovasc Disord 2022; 22:265. [PMID: 35698035 PMCID: PMC9195252 DOI: 10.1186/s12872-022-02709-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/08/2022] [Indexed: 11/10/2022] Open
Abstract
Left ventricular diastolic dysfunction (LVDD) is common in hypertension and is a predictor of increased cardiovascular risk, however the effect of LVDD, detected by new guideline, on major adverse cardiac events (MACE) is unknown in hypertensive patients without known cardiovascular disease. The present study aims to evaluate LVDD in a community hypertension cohort study and assess the effect of LVDD on MACE. we studied 283 asymptomatic nonischemic patients with hypertension who had baseline echocardiogram between 2012 and 2014. Patients were followed for MACE (myocardial infarction, coronary revascularization procedures, heart failure, stroke, all-cause mortality) with mean follow-up of 5.4 years. A Cox proportional hazards model was used to assess the association of LVDD with MACE. At baseline, 35 of the 283 hypertensions were diagnosed with LVDD (12.3%) and 25 patients were women (15.5%). Women had higher frequency of LVDD than men (8%). During follow-up, there were 26.6% patients occurring MACE in the LVDD group at baseline, 9.9% patients occurring MACE in the group with normal diastolic function. In multivariable Cox regression analyses, LVDD was a stronger predictor of MACE (HR: 2.5; 95% CI: 1.20 to 5.25; c- statistics 0.805) than E/e' ratio (HR: 1.13; 95% CI: 1.04 to 1.22). LVDD was strongly associated with MACE in hypertension patients.
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Affiliation(s)
- Dan Zhou
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, People's Republic of China
| | - Mengqi Yan
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, People's Republic of China
| | - Qi Cheng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, People's Republic of China
| | - Xiaoxuan Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, People's Republic of China
| | - Songtao Tang
- Department of Internal Medicine, Community Health Center of Liaobu Community, Dongguan, 523411, China
| | - Yingqing Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, People's Republic of China.
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Heuschmann PU, Montellano FA, Ungethüm K, Rücker V, Wiedmann S, Mackenrodt D, Quilitzsch A, Ludwig T, Kraft P, Albert J, Morbach C, Frantz S, Störk S, Haeusler KG, Kleinschnitz C. Prevalence and determinants of systolic and diastolic cardiac dysfunction and heart failure in acute ischemic stroke patients: The SICFAIL study. ESC Heart Fail 2021; 8:1117-1129. [PMID: 33350167 PMCID: PMC8006617 DOI: 10.1002/ehf2.13145] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 10/24/2020] [Accepted: 11/15/2020] [Indexed: 01/17/2023] Open
Abstract
AIMS Ischaemic stroke (IS) might induce alterations of cardiac function. Prospective data on frequency of cardiac dysfunction and heart failure (HF) after IS are lacking. We assessed prevalence and determinants of diastolic dysfunction (DD), systolic dysfunction (SD), and HF in patients with acute IS. METHODS AND RESULTS The Stroke-Induced Cardiac FAILure in mice and men (SICFAIL) study is a prospective, hospital-based cohort study. Patients with IS underwent a comprehensive assessment of cardiac function in the acute phase (median 4 days after IS) including clinical examination, standardized transthoracic echocardiography by expert sonographers, and determination of blood-based biomarkers. Information on demographics, lifestyle, risk factors, symptoms suggestive of HF, and medical history was collected by a standardized personal interview. Applying current guidelines, cardiac dysfunction was classified based on echocardiographic criteria into SD (left ventricular ejection fraction < 52% in men or <54% in women) and DD (≥3 signs of DD in patients without SD). Clinically overt HF was classified into HF with reduced, mid-range, or preserved ejection fraction. Between January 2014 and February 2017, 696 IS patients were enrolled. Of them, patients with sufficient echocardiographic data on SD were included in the analyses {n = 644 patients [median age 71 years (interquartile range 60-78), 61.5% male]}. In these patients, full assessment of DD was feasible in 549 patients without SD (94%). Prevalence of cardiac dysfunction and HF was as follows: SD 9.6% [95% confidence interval (CI) 7.6-12.2%]; DD in patients without SD 23.3% (95% CI 20.0-27.0%); and clinically overt HF 5.4% (95% CI 3.9-7.5%) with subcategories of HF with preserved ejection fraction 4.35%, HF with mid-range ejection fraction 0.31%, and HF with reduced ejection fraction 0.78%. In multivariable analysis, SD and fulfilment of HF criteria were associated with history of coronary heart disease [SD: odds ratio (OR) 3.87, 95% CI 1.93-7.75, P = 0.0001; HF: OR 2.29, 95% CI 1.04-5.05, P = 0.0406] and high-sensitive troponin T at baseline (SD: OR 1.78, 95% CI 1.31-2.42, P = 0.0003; HF: OR 1.66, 95% CI 1.17-2.33, P = 0.004); DD was associated with older age (OR 1.08, 95% CI 1.05-1.11, P < 0.0001) and treated hypertension vs. no hypertension (OR 2.84, 95% CI 1.23-6.54, P = 0.0405). CONCLUSIONS A substantial proportion of the study population exhibited subclinical and clinical cardiac dysfunction. SICFAIL provides reliable data on prevalence and determinants of SD, DD, and clinically overt HF in patients with acute IS according to current guidelines, enabling further clarification of its aetiological and prognostic role.
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Affiliation(s)
- Peter U. Heuschmann
- Institute of Clinical Epidemiology and BiometryUniversity of WürzburgJosef‐Schneider‐Str. 2Würzburg97080Germany
- Comprehensive Heart Failure CenterUniversity and University Hospital WürzburgWürzburgGermany
- Clinical Trial CenterUniversity Hospital WürzburgWürzburgGermany
| | - Felipe A. Montellano
- Institute of Clinical Epidemiology and BiometryUniversity of WürzburgJosef‐Schneider‐Str. 2Würzburg97080Germany
- Interdisciplinary Center for Clinical ResearchUniversity of WürzburgWürzburgGermany
| | - Kathrin Ungethüm
- Institute of Clinical Epidemiology and BiometryUniversity of WürzburgJosef‐Schneider‐Str. 2Würzburg97080Germany
| | - Viktoria Rücker
- Institute of Clinical Epidemiology and BiometryUniversity of WürzburgJosef‐Schneider‐Str. 2Würzburg97080Germany
| | - Silke Wiedmann
- Institute of Clinical Epidemiology and BiometryUniversity of WürzburgJosef‐Schneider‐Str. 2Würzburg97080Germany
- Comprehensive Heart Failure CenterUniversity and University Hospital WürzburgWürzburgGermany
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
| | - Daniel Mackenrodt
- Institute of Clinical Epidemiology and BiometryUniversity of WürzburgJosef‐Schneider‐Str. 2Würzburg97080Germany
- Comprehensive Heart Failure CenterUniversity and University Hospital WürzburgWürzburgGermany
- Department of NeurologyUniversity Hospital WürzburgWürzburgGermany
| | - Anika Quilitzsch
- Institute of Clinical Epidemiology and BiometryUniversity of WürzburgJosef‐Schneider‐Str. 2Würzburg97080Germany
| | - Timo Ludwig
- Institute of Clinical Epidemiology and BiometryUniversity of WürzburgJosef‐Schneider‐Str. 2Würzburg97080Germany
| | - Peter Kraft
- Department of NeurologyUniversity Hospital WürzburgWürzburgGermany
- Department of NeurologyKlinikum Main‐SpessartLohr am MainGermany
| | - Judith Albert
- Comprehensive Heart Failure CenterUniversity and University Hospital WürzburgWürzburgGermany
- Department of Internal Medicine IUniversity Hospital WürzburgWürzburgGermany
| | - Caroline Morbach
- Comprehensive Heart Failure CenterUniversity and University Hospital WürzburgWürzburgGermany
- Department of Internal Medicine IUniversity Hospital WürzburgWürzburgGermany
| | - Stefan Frantz
- Comprehensive Heart Failure CenterUniversity and University Hospital WürzburgWürzburgGermany
- Department of Internal Medicine IUniversity Hospital WürzburgWürzburgGermany
| | - Stefan Störk
- Comprehensive Heart Failure CenterUniversity and University Hospital WürzburgWürzburgGermany
- Department of Internal Medicine IUniversity Hospital WürzburgWürzburgGermany
| | - Karl Georg Haeusler
- Comprehensive Heart Failure CenterUniversity and University Hospital WürzburgWürzburgGermany
- Department of NeurologyUniversity Hospital WürzburgWürzburgGermany
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Gohar A, Kievit RF, Valstar GB, Hoes AW, Van Riet EE, van Mourik Y, Bertens LC, Boonman-Winter LJ, Bots ML, Den Ruijter HM, Rutten FH. Opportunistic screening models for high-risk men and women to detect diastolic dysfunction and heart failure with preserved ejection fraction in the community. Eur J Prev Cardiol 2018; 26:613-623. [PMID: 30482050 PMCID: PMC6431757 DOI: 10.1177/2047487318816774] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background The prevalence of undetected left ventricular diastolic dysfunction is high, especially in the elderly with comorbidities. Left ventricular diastolic dysfunction is a prognostic indicator of heart failure, in particularly of heart failure with preserved ejection fraction and of future cardiovascular and all-cause mortality. Therefore we aimed to develop sex-specific diagnostic models to enable the early identification of men and women at high-risk of left ventricular diastolic dysfunction with or without symptoms of heart failure who require more aggressive preventative strategies. Design Individual patient data from four primary care heart failure-screening studies were analysed (1371 participants, excluding patients classified as heart failure and left ventricular ejection fraction <50%). Methods Eleven candidate predictors were entered into logistic regression models to be associated with the presence of left ventricular diastolic dysfunction/heart failure with preserved ejection fraction in men and women separately. Internal-external cross-validation was performed to develop and validate the models. Results Increased age and β-blocker therapy remained as predictors in both the models for men and women. The model for men additionally consisted of increased body mass index, moderate to severe shortness of breath, increased pulse pressure and history of ischaemic heart disease. The models performed moderately and similarly well in men (c-statistics range 0.60–0.75) and women (c-statistics range 0.51–0.76) and the performance improved significantly following the addition of N-terminal pro b-type natriuretic peptide (c-statistics range 0.61–0.80 in women and 0.68–0.80 in men). Conclusions We provide an easy-to-use screening tool for use in the community, which can improve the early detection of left ventricular diastolic dysfunction/heart failure with preserved ejection fraction in high-risk men and women and optimise tailoring of preventive interventions.
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Affiliation(s)
- Aisha Gohar
- Julius Center for Health Sciences and Primary Care, Utrecht University, The Netherlands
- Laboratory for Experimental Cardiology, Utrecht University, The Netherlands
- Aisha Gohar, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 AB Utrecht, The Netherlands.
| | - Rogier F Kievit
- Julius Center for Health Sciences and Primary Care, Utrecht University, The Netherlands
| | - Gideon B Valstar
- Laboratory for Experimental Cardiology, Utrecht University, The Netherlands
| | - Arno W Hoes
- Julius Center for Health Sciences and Primary Care, Utrecht University, The Netherlands
| | - Evelien E Van Riet
- Julius Center for Health Sciences and Primary Care, Utrecht University, The Netherlands
| | - Yvonne van Mourik
- Julius Center for Health Sciences and Primary Care, Utrecht University, The Netherlands
| | - Loes C Bertens
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, The Netherlands
| | | | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, Utrecht University, The Netherlands
| | | | - Frans H Rutten
- Julius Center for Health Sciences and Primary Care, Utrecht University, The Netherlands
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