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Carmona-Puerta R, Choque-Laura JL, Chávez-González E, Peñaló-Batista J, Martínez-Sánchez MDC, Lorenzo-Martínez E. Associated factors with the occurrence of in-hospital cardiac arrest in patients admitted to internal medicine wards for non-cardiovascular causes. Med Clin (Barc) 2024; 162:574-580. [PMID: 38637218 DOI: 10.1016/j.medcli.2024.01.014] [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: 08/27/2023] [Revised: 01/05/2024] [Accepted: 01/09/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND AND OBJECTIVE In-hospital cardiac arrest (IHCA) has a low survival rate, so it is essential to recognize the cases with the highest probability of developing it. The aim of this study is to identify factors associated with the occurrence of IHCA. MATERIAL AND METHODS A single-center case-control study was conducted including 65 patients admitted to internal medicine wards for non-cardiovascular causes who experienced IHCA, matched with 210 admitted controls who did not present with IHCA. RESULTS The main reason for admission was pneumonia. The most prevalent comorbidity was arterial hypertension. Four characteristics were strongly and independently associated with IHCA presentation, these are electrical left ventricular hypertrophy (LVH) (OR: 13.8; 95% IC: 4.7-40.7), atrial fibrillation (OR: 9.4: 95% CI: 4.3-20.6), the use of drugs with known risk of torsades de pointes (OR: 2.7; 95% CI: 1.3-5.5) and the combination of the categories known risk plus conditional risk (OR: 17.1; 95% CI: 6.7-50.1). The first two detected in the electrocardiogram taken at the time of admission. CONCLUSION In admitted patients for non-cardiovascular causes, the use of drugs with a known risk of torsades de pointes, as well as the detection of electrical LVH and atrial fibrillation in the initial electrocardiogram, is independently associated with a higher probability of suffering a IHCA.
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Affiliation(s)
| | - José Luis Choque-Laura
- Servicio de Medicina Interna, Hospital Municipal Boliviano Holandés, Provincia Murillo, El Alto, Bolivia
| | - Elibet Chávez-González
- Servicio de Arritmología y Electrofisiología, Hospital Universitario Cardiocentro Ernesto Guevara, Santa Clara, Cuba
| | - Joel Peñaló-Batista
- Universidad Católica del Cibao (UCATECI), Centro de Medicina Familiar Especializada (CEMEFE), La Vega, República Dominicana
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Di Paolo M, Mezzetti E, Leoni M, Scatena A, Passino C. Sudden cardiac death during scuba diving: a case report of a patient with unknown hypertrophic cardiomyopathy. Eur Heart J Case Rep 2024; 8:ytae217. [PMID: 38745730 PMCID: PMC11091920 DOI: 10.1093/ehjcr/ytae217] [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: 09/18/2023] [Revised: 04/15/2024] [Accepted: 04/22/2024] [Indexed: 05/16/2024]
Abstract
Background Scuba diving is a recreational activity usually considered at low impact on cardiovascular system. However, when diving, increased ambient pressure exerts several effects on the cardiovascular and pulmonary systems, mainly due to redistribution of peripheral blood into the central circulation. This phenomenon, also known as blood shift, may produce a significant overload on a non-healthy heart. Case summary We present the case of a female patient who experienced sudden cardiac death during scuba diving: post-mortem cardiac magnetic resonance and autopsy revealed that the patient was affected by previously unknown hypertrophic cardiomyopathy. Discussion Diving exposes the body to significant physiological changes that may overstress a diseased heart. This case suggests the need for some cardiovascular exams, such as an echocardiogram or, at least, an electrocardiogram, for screening cardiovascular abnormalities in subjects who wish to practice scuba diving.
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Affiliation(s)
- Marco Di Paolo
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, Via Roma 55, 56100 Pisa, Italy
| | - Eleonora Mezzetti
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, Via Roma 55, 56100 Pisa, Italy
| | - Matteo Leoni
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, Via Roma 55, 56100 Pisa, Italy
| | - Andrea Scatena
- Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, Via Roma 55, 56100 Pisa, Italy
| | - Claudio Passino
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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Kim YJ, Park KM. Possible Mechanisms for Adverse Cardiac Events Caused by Exercise-Induced Hypertension in Long-Distance Middle-Aged Runners: A Review. J Clin Med 2024; 13:2184. [PMID: 38673457 PMCID: PMC11050973 DOI: 10.3390/jcm13082184] [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: 02/19/2024] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
Sudden cardiac death (SCD) is rare among athletes. However, hypertrophic cardiomyopathy is the leading cause of SCD among those <35 years of age. Meanwhile, coronary artery disease (CAD) is the primary SCD cause among those ≥35 years of age. CAD-induced plaque ruptures are believed to be a significant cause of cardiovascular diseases in middle-aged individuals who participate in extreme long-distance running activities such as marathons. A total of 1970 articles related to EIH were identified using search terms. Out of these, 1946 studies were excluded for reasons such as arterial hypertension, exercise-induced pulmonary hypertension, the absence of exercise stress testing (EST), and a lack of relevance to EIH. The study analyzed 24 studies related to both long-distance runners with exercise-induced hypertension (EIH) and the general public. Among these, 11 studies were quasi-experimentally designed studies used in randomized controlled trials (RCTs) on long-distance runners with EIH. Additionally, 12 studies utilized cohort designs, and one study with a quasi-experimental design was conducted among the general population. Recent studies suggest that an imbalance between oxygen demand and supply due to ventricular hypertrophy may be the actual cause of cardiovascular disease, regardless of CAD. Exercising excessively over an extended period can reduce endothelial function and increase arterial stiffness, which in turn increases afterload and leads to an excessive increase in blood pressure during exercise. Exercise-induced hypertension (EIH), which increases the morbidity rate of resting hypertension and is a risk factor for cardio-cerebro-vascular diseases, is more prevalent in middle-aged long-distance runners than in runners from other age groups, and it increases the prevalence of critical arrhythmias, such as atrial fibrillation or ventricular arrhythmias. EIH is associated with angiotensin II activity, and angiotensin II receptor blockers show promising effects in middle-aged runners. Further, guidelines for preventing excessive participation in races and restricting exercise intensity and frequency would be useful. This review identifies EIH as a potential risk factor for cardiovascular diseases and describes how EIH induces SCD.
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Affiliation(s)
- Young-Joo Kim
- Department of Exercise Rehabilitation Welfare, Sungshin Women’s University, 34 da-gil, Bomun-ro, Seongbuk-gu, Seoul 02844, Republic of Korea
| | - Kyoung-Min Park
- Division of Cardiology, Department of Internal Medicine, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
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Sakboonyarat B, Poovieng J, Rangsin R. Factors associated with electrocardiographic left ventricular hypertrophy among patients with hypertension in Thailand. Clin Hypertens 2024; 30:8. [PMID: 38556865 PMCID: PMC10983697 DOI: 10.1186/s40885-024-00267-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/27/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Left ventricular hypertrophy (LVH) strongly predicts cardiovascular diseases (CVD) and death. One-fourth of Thai adults suffer from hypertension. Nevertheless, the information on LVH among Thai patients with hypertension is not well characterized. We aimed to identify the prevalence and factors associated with electrocardiographic LVH (ECG-LVH) among patients with hypertension in Thailand. METHODS The present study obtained the dataset from the Thailand Diabetes Mellitus/Hypertension study, which included hypertension patients aged 20 years and older receiving continuous care at outpatient clinics in hospitals nationwide in 2011-2015 and 2018. Meanwhile, those without a record of 12-lead electrocardiography (ECG) were excluded from the analysis. ECG-LVH was defined as the LVH noted regarding ECG interpretation in the medical records. Multivariable logistic regression analysis was utilized for determining factors associated with ECG-LVH and presented as the adjusted odds ratio (AOR) and 95% confidence interval (CI). RESULTS From 226,420 hypertensive patients in the Thailand Diabetes Mellitus/Hypertension study, 38,807 individuals (17.1%) with ECG data recorded were included in the analysis. The mean age was 64.8 ± 11.5 years, and 62.2% were women. Overall, 1,557 study participants had ECG-LVH, with an estimated prevalence of 4.0% (95% CI, 3.8-4.2%). Age-adjusted ECG-LVH prevalence among women and men was 3.4 and 5.1%, respectively (P < 0.001). Multivariable analysis determined factors associated with ECG-LVH, including being men (AOR, 1.49; 95% CI, 1.31-1.69), individuals aged 70 to 79 years (AOR, 1.56; 95% CI, 1.20-2.02) and ≥ 80 years (AOR, 2.10; 95% CI, 1.58-2.78) compared to individuals aged less than 50 years, current smokers (AOR, 1.26; 95% CI, 1.09-1.46) compared to those who never smoked, systolic blood pressure ≥ 140 mmHg and diastolic blood pressure ≥ 90 mmHg (AOR, 1.58; 95% CI, 1.30-1.92) compared to systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg. CONCLUSIONS The current study illustrated the prevalence of ECG-LVH among Thai patients with hypertension who had ECG recorded and identified high-risk groups who tended to have ECG-LVH. The findings underscore the need for targeted interventions, particularly among high-risk groups such as older individuals, men, and current smokers, to address modifiable factors associated with ECG-LVH.
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Affiliation(s)
- Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand.
| | - Jaturon Poovieng
- Pulmonary and Critical Care Division, Department of Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
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Gill JR. Commentary on: Deveci C, Demircin S. A retrospective analysis of cardiovascular deaths: A 5-year autopsy study of 1045 cases in Antalya, Turkey. J Forensic Sci. 2023;68(6):2085-92. https://doi.org/10.1111/1556-4029.15328. J Forensic Sci 2024; 69:745. [PMID: 38159036 DOI: 10.1111/1556-4029.15456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Affiliation(s)
- James R Gill
- Office of the Chief Medical Examiner, Farmington, Connecticut, USA
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Hiyamuta H, Yamada S, Nakano T, Taniguchi M, Masutani K, Tsuruya K, Kitazono T. Impact of Electrocardiographic Parameters on Sudden Death in Patients Receiving Maintenance Hemodialysis: Ten-Year Outcomes of the Q-Cohort Study. J Atheroscler Thromb 2024; 31:214-231. [PMID: 37730375 PMCID: PMC10918032 DOI: 10.5551/jat.64255] [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: 03/22/2023] [Accepted: 07/13/2023] [Indexed: 09/22/2023] Open
Abstract
AIM Sudden death is one of the most common causes of death among hemodialysis patients. Electrocardiography (ECG) is a noninvasive and inexpensive test that is regularly performed in hemodialysis clinics. However, the association between abnormal ECG findings and the risk of sudden death in hemodialysis patients is yet to be fully elucidated. Thus, the aim of this study was to determine the ECG parameters linked to sudden death in patients undergoing hemodialysis. METHODS The Q-Cohort Study is a multicenter, longitudinal, observational study of hemodialysis patients. In this study, 1,153 Japanese hemodialysis patients aged ≥ 18 years with ECG data recorded within 1 year of study enrollment were followed up for 10 years. Cox proportional hazards models were used to estimate the multivariate-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between ECG parameters and sudden death. RESULTS During the median follow-up period of 9.0 years, 517 patients died, 76 of whom exhibited sudden death. After adjusting for confounding factors, higher heart rate, QT prolongation, and left ventricular hypertrophy as per the Sokolow-Lyon voltage criteria were found to be independently associated with an increased risk of sudden death. The adjusted HRs [95% CIs] for each abnormal ECG parameter were 2.02 [1.05-3.89], 2.10 [1.30-1.77], and 1.91 [1.18-3.09], respectively. CONCLUSIONS Higher heart rate, QT prolongation, and left ventricular hypertrophy on ECG have been determined to be associated with an increased risk of sudden death. Therefore, regular ECG recording could enable medical practitioners to identify hemodialysis patients who require intervention to prevent lethal arrhythmia.
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Affiliation(s)
- Hiroto Hiyamuta
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shunsuke Yamada
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiaki Nakano
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Kosuke Masutani
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | | | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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7
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Conners KM, Avery CL, Syed FF. Advancing Cardiovascular Risk Assessment with Artificial Intelligence: Opportunities and Implications in North Carolina. N C Med J 2024; 85:10.18043/001c.91424. [PMID: 38938760 PMCID: PMC11208038 DOI: 10.18043/001c.91424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
Cardiovascular disease mortality is increasing in North Carolina with persistent inequality by race, income, and location. Artificial intelligence (AI) can repurpose the widely available electrocardiogram (ECG) for enhanced assessment of cardiac dysfunction. By identifying accelerated cardiac aging from the ECG, AI offers novel insights into risk assessment and prevention.
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Affiliation(s)
- Katherine M Conners
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Christy L Avery
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Faisal F Syed
- Division of Cardiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Koraćević G, Mićić S, Stojanović M, Zdravkovic M, Simić D, Kostić T, Atanasković V, Janković-Tomašević R. Beta-blockers in Hypertensive Left Ventricular Hypertrophy and Atrial Fibrillation Prevention. Curr Vasc Pharmacol 2024; 22:19-27. [PMID: 38031765 DOI: 10.2174/0115701611264647231110101700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/23/2023] [Accepted: 10/02/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Hypertensive left ventricular hypertrophy (HTN LVH) is a key risk factor for atrial fibrillation (AF). OBJECTIVE To evaluate the possible role of beta-blockers (BBs) in addition to a renin-angiotensinaldosterone system (RAAS) blocker in AF prevention in patients with HTN LVH. METHODS We performed a PubMed, Elsevier, SAGE, Oxford, and Google Scholar search with the search items 'beta blocker hypertension left ventricular hypertrophy patient' from 2013-2023. In the end, a 'snowball search', based on the references of relevant papers as well as from papers that cited them was performed. RESULTS HTN LVH is a risk factor for AF. In turn, AF substantially complicates HTN LVH and contributes to the genesis of heart failure (HF) with preserved ejection fraction (HFpEF). The prognosis of HFpEF is comparable with that of HF with reduced EF (HFrEF), and, regardless of the type, HF is associated with five-year mortality of 50-75%. The antiarrhythmic properties of BBs are wellrecognized, and BBs as a class of drugs are - in general - recommended to decrease the incidence of AF in HTN. CONCLUSION BBs are recommended (as a class) for AF prevention in several contemporary guidelines for HTN. LVH regression in HTN - used as a single criterion for the choice of antihypertensive medication - does not capture this protective effect. Consequently, it is worth studying how meaningful this antiarrhythmic action (to prevent AF) of BBs is in patients with HTN LVH in addition to a RAAS blocker.
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Affiliation(s)
- Goran Koraćević
- Department of Cardiovascular Diseases, University Clinical Center Niš, Serbia
- Faculty of Medicine, Niš University, Serbia
| | - Sladjana Mićić
- Department of Nephrology, University Clinical Center Niš, Serbia
| | | | - Marija Zdravkovic
- Department of Cardiology, University Hospital Medical Center Bežanijska kosa and Faculty of Medicine, University of Belgrade, Serbia
| | - Dragan Simić
- Department of Cardiovascular Diseases, University Clinical Center Belgrade, Serbia
| | - Tomislav Kostić
- Department of Cardiovascular Diseases, University Clinical Center Niš, Serbia
- Faculty of Medicine, Niš University, Serbia
| | - Vesna Atanasković
- Department of Cardiovascular Diseases, University Clinical Center Niš, Serbia
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Yang T, Kong J, Shao X, Meng Z, Liang P, Zhou N, Jing J, Zhang F, Cheng M, Liu Z, Xu X, Li Y, Guo Y, Wang T, Chen J, Sun X, Zhang Z, Zhang F, Jin B, Wang W, Huang M, Zhang K, Wang H, Li D. A statistical study of postmortem heart weight in Chinese adults. Forensic Sci Int 2024; 354:111912. [PMID: 38103455 DOI: 10.1016/j.forsciint.2023.111912] [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: 09/09/2023] [Revised: 12/02/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Objective assessment of cardiac hypertrophy in forensic pathology practice is of great significance for forensic pathologists, for whom reference values for normal heart weights are needed. Developed regions such as Europe, the United States, and Japan recalculate the weight of human organs at regular intervals, but in China, there has been no systematic calculation of the weights of human organs since 2006. AIMS To statistically analyse the heart weight of Chinese adults postmortem and obtain a reference range. MATERIALS AND METHODS 4170 adult autopsy reports were collected from 12 forensic departments in 10 provinces in China. The causes of death were classified by sex, and heart weight and the heart weight/body height ratio reference values were further calculated according to different body mass index and body heights. Finally, the cutoff value of cardiac hypertrophy in Chinese adults was calculated. RESULTS In the group of non-cardiovascular disease causes of death, the cardiac weight of the electric death group was higher, while the heart weight of the prolonged bed-rest group was significantly reduced. After the electric death and prolonged bed-rest groups were excluded, heart weight, the heart weight/body height ratio, and cutoff values for cardiac hypertrophy were further classified and analysed according to body mass index. The mean reference values for heart weight in men and women with normal weight status were 325.82 ± 41.60 g and 286.39 ± 44.84 g, and the heart weight/body height ratios were 1.95 ± 0.23 in men and 1.82 ± 0.27, respectively. The cutoff values for cardiac hypertrophy were 387.35 g for men and 346.80 g for women. CONCLUSION The heart weight reference values of both sexes in this study were significantly higher than those in 2006, which is considered related to the development of China's economy and the improvement of people's living standards. This study also suggests the need for a new round of statistical surveys and updated data on the weight of other organs.
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Affiliation(s)
- Tengfei Yang
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Jiangwei Kong
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Xilin Shao
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Zilin Meng
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Peiyu Liang
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Nian Zhou
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Jiayu Jing
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Fu Zhang
- Guangdong Public Security Department, Guangzhou, China
| | - Ming Cheng
- Guangdong Public Security Department, Guangzhou, China
| | - Zengjia Liu
- Institute of Forensic Medicine and Laboratory Medicine, Jining Medical University, Jining, China
| | - Xiang Xu
- School of Forensic Medicine, Wannan Medical College, Wuhu, China
| | - Yingmin Li
- Collaborative Innovation Center of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang, China
| | - Yadong Guo
- Department of Forensic Medicine,School of Basic Medicine, Central South University, Changsha, China
| | - Tao Wang
- Department of Forensic Medicine, School of Biology & Basic Medical Sciences of Suzhou Medical School, Soochow University, Soochow, China
| | - Jianhua Chen
- Department of Forensic Medicine, Hainan Medical University, Haikou, China
| | - Xupeng Sun
- School of Forensic Medicine, Xinxiang Medical University, Xinxiang, China
| | - Zhong Zhang
- Wenzhou Medical University Forensic Center, Wenzhou, China
| | - Feng Zhang
- Wenzhou Medical University Forensic Center, Wenzhou, China
| | - Bo Jin
- Department of Forensic Pathology, Institute of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong, China
| | - Wei Wang
- Department of Forensic Pathology, Institute of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong, China
| | - Mengxue Huang
- Department of Forensic Pathology, Sichuan Huada Judicial Expertise Institute, Chengdu, China
| | - Kui Zhang
- Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Huijun Wang
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China
| | - Dongri Li
- Department of Forensic Evidence Science, School of Forensic Medicine, Southern Medical University, Guangzhou, China; Guangdong Province Research Center of Traffic Accident Identification Engineering Technology, Guangzhou, China; Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, China.
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Cao S, Wang X, Xing L, Zhang W. Effects of Long-Term Administration of Bovine Bone Gelatin Peptides on Myocardial Hypertrophy in Spontaneously Hypertensive Rats. Nutrients 2023; 15:5021. [PMID: 38140281 PMCID: PMC10745459 DOI: 10.3390/nu15245021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023] Open
Abstract
The research purpose was to investigate the effects and the underlying molecular mechanisms of bovine bone gelatin peptides (BGP) on myocardial hypertrophy in spontaneously hypertensive rats (SHR). BGP relieved myocardial hypertrophy and fibrosis in SHR rats in a dose-dependent manner by reducing the left ventricular mass index, myocardial cell diameter, myocardial fibrosis area, and levels of myocardial hypertrophy markers (atrial natriuretic and brain natriuretic peptide). Label-free quantitative proteomics analysis showed that long-term administration of BGP changed the left ventricle proteomes of SHR. The 37 differentially expressed proteins in the high-dose BGP group participated in multiple signaling pathways associated with cardiac hypertrophy and fibrosis indicating that BGP could play a cardioprotective effect on SHR rats by targeting multiple signaling pathways. Further validation experiments showed that a high dose of BGP inhibited the expression of phosphoinositide 3-kinase (Pi3k), phosphorylated protein kinase B (p-Akt), and transforming growth factor-beta 1 (TGF-β1) in the myocardial tissue of SHR rats. Together, BGP could be an effective candidate for functional nutritional supplements to inhibit myocardial hypertrophy and fibrosis by negatively regulating the TGF-β1 and Pi3k/Akt signaling pathways.
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Affiliation(s)
- Songmin Cao
- School of Food Science and Engineering, Ningxia University, Yinchuan 750021, China; (S.C.); (X.W.)
| | - Xinyu Wang
- School of Food Science and Engineering, Ningxia University, Yinchuan 750021, China; (S.C.); (X.W.)
| | - Lujuan Xing
- Key Lab of Meat Processing and Quality Control, MOE, College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China;
| | - Wangang Zhang
- Key Lab of Meat Processing and Quality Control, MOE, College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China;
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Rahim FO, Sakita FM, Coaxum L, Maro AV, Ford JS, Hatter K, Gedion K, Ezad SM, Galson SW, Bloomfield GS, Limkakeng AT, Kessy MS, Mmbaga B, Hertz JT. Longitudinal ECG changes among adults with HIV in Tanzania: A prospective cohort study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002525. [PMID: 37878582 PMCID: PMC10599566 DOI: 10.1371/journal.pgph.0002525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/22/2023] [Indexed: 10/27/2023]
Abstract
The prevalence of cardiovascular disease (CVD) is rising among people with HIV (PWH) in sub-Saharan Africa (SSA). Despite the utility of the electrocardiogram (ECG) in screening for CVD, there is limited data regarding longitudinal ECG changes among PWH in SSA. In this study, we aimed to describe ECG changes over a 6-month period in a cohort of PWH in northern Tanzania. Between September 2020 and March 2021, adult PWH were recruited from Majengo HIV Care and Treatment Clinic (MCTC) in Moshi, Tanzania. Trained research assistants surveyed participants and obtained a baseline ECG. Participants then returned to MCTC for a 6-month follow-up, where another ECG was obtained. Two independent physician adjudicators interpreted baseline and follow-up ECGs for rhythm, left ventricular hypertrophy (LVH), bundle branch blocks, ST-segment changes, and T-wave inversion, using standardized criteria. New ECG abnormalities were defined as those that were absent in a patient's baseline ECG but present in their 6-month follow-up ECG. Of 500 enrolled participants, 476 (95.2%) completed follow-up. The mean (± SD) age of participants was 45.7 (± 11.0) years, 351 (73.7%) were female, and 495 (99.8%) were taking antiretroviral therapy. At baseline, 248 (52.1%) participants had one or more ECG abnormalities, the most common of which were LVH (n = 108, 22.7%) and T-wave inversion (n = 89, 18.7%). At six months, 112 (23.5%) participants developed new ECG abnormalities, including 40 (8.0%) cases of new T-wave inversion, 22 (4.6%) cases of new LVH, 12 (2.5%) cases of new ST elevation, and 11 (2.3%) cases of new prolonged QTc. Therefore, new ECG changes were common over a relatively short 6-month period, which suggests that subclinical CVD may develop rapidly in PWH in Tanzania. These data highlight the need for additional studies on CVD in PWH in SSA and the importance of routine CVD screening in this high-risk population.
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Affiliation(s)
- Faraan O. Rahim
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Francis M. Sakita
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Lauren Coaxum
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | | | - James S. Ford
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, California, United States of America
| | - Kate Hatter
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Kalipa Gedion
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Saad M. Ezad
- British Heart Foundation Centre of Research Excellence and NIHR Biomedical Research Centre at the School of Cardiovascular and Metabolic Medicine and Sciences, King’s College London, London, United Kingdom
| | - Sophie W. Galson
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Gerald S. Bloomfield
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Internal Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Alexander T. Limkakeng
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | | | - Blandina Mmbaga
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Julian T. Hertz
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina, United States of America
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12
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Hookana I, Holmström L, Eskuri MAE, Pakanen L, Ollila MM, Kiviniemi AM, Kenttä T, Vähätalo J, Tulppo M, Lepojärvi ES, Piltonen T, Perkiömäki J, Tikkanen JT, Huikuri H, Junttila MJ. Characteristics of women with ischemic sudden cardiac death. Ann Med 2023; 55:2258911. [PMID: 37795698 PMCID: PMC10557538 DOI: 10.1080/07853890.2023.2258911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Sudden cardiac death (SCD) is a significant mode of death causing 15-20% of all deaths in high-income countries. Coronary artery disease (CAD) is the most common cause of SCD in both sexes, and SCD is often the first manifestation of underlying CAD in women. This case-control study aimed to determine the factors associated with SCD due to CAD in women. METHODS The study group consisted of women with CAD-related SCD (N = 888) derived from the Fingesture study conducted in Northern Finland from 1998 to 2017. All SCDs underwent medicolegal autopsy. The control group consisted of women with angiographically verified CAD without SCD occurring during the 5-year-follow-up (N = 610). To compare these groups, we used medical records, autopsy findings, echocardiograms, and electrocardiograms (ECGs). RESULTS Subjects with SCD were older (73.2 ± 11.3 vs. 68.8 ± 8.0, p < 0.001) and were more likely to be smokers or ex-smokers (37.1% vs. 27.6%, p = 0.045) compared to control patients. The proportion of subjects with prior myocardial infarction (MI) was higher in controls (46.9% vs. 41.4% in SCD subjects, p = 0.037), but in contrast, SCD subjects were more likely to have underlying silent MI (25.6% vs. 2.4% in CAD controls, p < 0.001). Left ventricular hypertrophy (LVH) was more common finding in SCD subjects (70.9% vs. 55.1% in controls, p < 0.001). Various electrocardiographic abnormalities were more common in subjects with SCD, including higher heart rate, atrial fibrillation, prolonged QTc interval, wide or fragmented QRS complex and early repolarization. The prevalence of Q waves and T inversions did not differ between the groups. CONCLUSIONS Underlying LVH and previous MI with myocardial scarring are common and often undiagnosed in women with CAD-related SCD. These results suggest that untreated CAD with concomitant myocardial disease is an important factor in SCD in women.
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Affiliation(s)
- I. Hookana
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - L. Holmström
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - M. A. E. Eskuri
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - L. Pakanen
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, Oulu, Finland
- Department of Forensic Medicine, Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - M. M. Ollila
- Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - A. M. Kiviniemi
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - T. Kenttä
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - J. Vähätalo
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - M. Tulppo
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - E. S. Lepojärvi
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - T. Piltonen
- Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - J. Perkiömäki
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - J. T. Tikkanen
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - H. V. Huikuri
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - M. J. Junttila
- Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu and Biocenter Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
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13
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Dobreva EA, Gorbacheva AM, Bibik EE, Eremkina AK, Elfimova AR, Salimkhanov RK, Kovaleva EV, Maganeva IS, Mokrysheva NG. Cardiovascular and metabolic status in patients with primary hyperparathyroidism: a single-center experience. Front Endocrinol (Lausanne) 2023; 14:1266728. [PMID: 37842310 PMCID: PMC10570793 DOI: 10.3389/fendo.2023.1266728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/08/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Cardiovascular diseases (CVD) and metabolic disorders (MD) have retained leading positions in the structure of morbidity and mortality for many years. Primary hyperparathyroidism (PHPT) is also associated with a greater incidence of CVD and MD. The aim of the present study was to describe the prevalence and structure of CVD and MD in hospitalized patients with PHPT and to search for possible associations between these pathologies. Methods 838 patients with a verified PHPT were included in the study. The studied cohort was divided into 2 groups according to their age at the time of admission: patients aged 18 to 49 years (group A, n = 150); patients aged 50 years and older (group B, n = 688). Results There were no significant differences between two groups in parameters of calcium-phosphorus metabolism. Obesity was diagnosed in 24.2% of patients in group A and in 35.9% in group B. Type 2 diabetes mellitus was more common in older patients (14.4% in group B vs. 2.6% in group A). Arterial hypertension, ischemic heart disease, chronic heart failure and brachiocephalic arteries atherosclerosis were more frequent in older patients, occurring in 79.1%, 10.8%, 8.4%, and 84% of cases respectively. The cutoff points that increased the risk of CVD detection turned out to be age above 56 years, eGFR below 92 ml/min/1.73m2, BMI above 28.3 kg/m2. Discussion The present study demonstrated a high incidence of some CVD, as well as disorders of lipid, carbohydrate and purine metabolism in patients with PHPT.
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Affiliation(s)
- Ekaterina A. Dobreva
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Anna M. Gorbacheva
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Ekaterina E. Bibik
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Anna K. Eremkina
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Alina R. Elfimova
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Rustam Kh. Salimkhanov
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Elena V. Kovaleva
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Irina S. Maganeva
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
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14
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Kowalski S, Goniewicz K, Moskal A, Al-Wathinani AM, Goniewicz M. Symptoms in Hypertensive Patients Presented to the Emergency Medical Service: A Comprehensive Retrospective Analysis in Clinical Settings. J Clin Med 2023; 12:5495. [PMID: 37685560 PMCID: PMC10487958 DOI: 10.3390/jcm12175495] [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: 08/03/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Hypertension is a prevalent condition with a variety of accompanying symptoms. Gender differences, specific blood pressure readings, and early signs of organ complications present intricate interplays in hypertensive individuals. OBJECTIVE This study aimed to investigate the relationship between hypertension and its accompanying symptoms, emphasizing gender-specific differences and potential indicators of organ complications. METHODS Data from 2002 participants were analyzed from a retrospective study, focusing on the presentation of symptoms, blood pressure values, and potential organ complications associated with these symptoms. RESULTS Of the participants, 68.8% were women with an average age of 69. Women were, on average, 8 years older than men. The average systolic blood pressure (SBP) was 188 mmHg. High-blood pressure was accompanied by symptoms in 84.9% of participants. Among those with an SBP > 180 mmHg, headaches were reported by 24.7%, and dizziness by 15.7%. Interestingly, as SBP increased, heart palpitations reports diminished with a mere 4.8% of those with SBP > 180 mmHg noting this symptom. Younger men exhibited increased chest pain and heart palpitations, while younger women more commonly reported headaches and nausea/vomiting. A significant relationship was identified between pulse pressure (PP) and symptoms, with dizziness in women and chest pain/discomfort in men being most pronounced. CONCLUSIONS The study underlines the importance of in-depth research on hypertensive individuals for improved symptom recognition and management. The data highlight the gender and age-specific symptom presentations and their correlation with blood pressure metrics, suggesting a need for patient-specific intervention strategies.
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Affiliation(s)
- Sebastian Kowalski
- Department of Emergency Medicine, Medical University of Lublin, 20-081 Lublin, Poland;
| | | | - Adrian Moskal
- Hospital Emergency Department, Voivodship Hospital in Krosno, 38-400 Krosno, Poland
| | - Ahmed M. Al-Wathinani
- Department of Emergency Medical Services, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Mariusz Goniewicz
- Department of Emergency Medicine, Medical University of Lublin, 20-081 Lublin, Poland;
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15
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Bazgir F, Nau J, Nakhaei-Rad S, Amin E, Wolf MJ, Saucerman JJ, Lorenz K, Ahmadian MR. The Microenvironment of the Pathogenesis of Cardiac Hypertrophy. Cells 2023; 12:1780. [PMID: 37443814 PMCID: PMC10341218 DOI: 10.3390/cells12131780] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
Pathological cardiac hypertrophy is a key risk factor for the development of heart failure and predisposes individuals to cardiac arrhythmia and sudden death. While physiological cardiac hypertrophy is adaptive, hypertrophy resulting from conditions comprising hypertension, aortic stenosis, or genetic mutations, such as hypertrophic cardiomyopathy, is maladaptive. Here, we highlight the essential role and reciprocal interactions involving both cardiomyocytes and non-myocardial cells in response to pathological conditions. Prolonged cardiovascular stress causes cardiomyocytes and non-myocardial cells to enter an activated state releasing numerous pro-hypertrophic, pro-fibrotic, and pro-inflammatory mediators such as vasoactive hormones, growth factors, and cytokines, i.e., commencing signaling events that collectively cause cardiac hypertrophy. Fibrotic remodeling is mediated by cardiac fibroblasts as the central players, but also endothelial cells and resident and infiltrating immune cells enhance these processes. Many of these hypertrophic mediators are now being integrated into computational models that provide system-level insights and will help to translate our knowledge into new pharmacological targets. This perspective article summarizes the last decades' advances in cardiac hypertrophy research and discusses the herein-involved complex myocardial microenvironment and signaling components.
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Affiliation(s)
- Farhad Bazgir
- Institute of Biochemistry and Molecular Biology II, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (F.B.); (J.N.)
| | - Julia Nau
- Institute of Biochemistry and Molecular Biology II, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (F.B.); (J.N.)
| | - Saeideh Nakhaei-Rad
- Stem Cell Biology, and Regenerative Medicine Research Group, Institute of Biotechnology, Ferdowsi University of Mashhad, Mashhad 91779-48974, Iran;
| | - Ehsan Amin
- Institute of Neural and Sensory Physiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany;
| | - Matthew J. Wolf
- Department of Medicine and Robert M. Berne Cardiovascular Research Center, University of Virginia, Charlottesville, VA 22908, USA;
| | - Jeffry J. Saucerman
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA;
| | - Kristina Lorenz
- Institute of Pharmacology and Toxicology, University of Würzburg, Leibniz Institute for Analytical Sciences, 97078 Würzburg, Germany;
| | - Mohammad Reza Ahmadian
- Institute of Biochemistry and Molecular Biology II, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (F.B.); (J.N.)
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16
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Li X, Sun C, Zhang J, Hu L, Yu Z, Zhang X, Wang Z, Chen J, Wu M, Liu L. Protective effects of paeoniflorin on cardiovascular diseases: A pharmacological and mechanistic overview. Front Pharmacol 2023; 14:1122969. [PMID: 37324475 PMCID: PMC10267833 DOI: 10.3389/fphar.2023.1122969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/10/2023] [Indexed: 06/17/2023] Open
Abstract
Background and ethnopharmacological relevance: The morbidity and mortality of cardiovascular diseases (CVDs) are among the highest of all diseases, necessitating the search for effective drugs and the improvement of prognosis for CVD patients. Paeoniflorin (5beta-[(Benzoyloxy)methyl] tetrahydro-5-hydroxy-2-methyl-2,5-methano-1H-3,4-dioxacyclobuta [cd] pentalen-1alpha (2H)-yl-beta-D-glucopyranoside, C23H28O11) is mostly derived from the plants of the family Paeoniaceae (a single genus family) and is known to possess multiple pharmacological properties in the treatment of CVDs, making it a promising agent for the protection of the cardiovascular system. Aim of the study: This review evaluates the pharmacological effects and potential mechanisms of paeoniflorin in the treatment of CVDs, with the aim of advancing its further development and application. Methods: Various relevant literatures were searched in PubMed, ScienceDirect, Google Scholar and Web of Science. All eligible studies were analyzed and summarized in this review. Results: Paeoniflorin is a natural drug with great potential for development, which can protect the cardiovascular system by regulating glucose and lipid metabolism, exerting anti-inflammatory, anti-oxidative stress, and anti-arteriosclerotic activities, improving cardiac function, and inhibiting cardiac remodeling. However, paeoniflorin was found to have low bioavailability, and its toxicology and safety must be further studied and analyzed, and clinical studies related to it must be carried out. Conclusion: Before paeoniflorin can be used as an effective therapeutic drug for CVDs, further in-depth experimental research, clinical trials, and structural modifications or development of new preparations are required.
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Affiliation(s)
- Xiaoya Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Changxin Sun
- Beijing University of Chinese Medicine, Beijing, China
| | - Jingyi Zhang
- Beijing University of Chinese Medicine, Beijing, China
| | - Lanqing Hu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zongliang Yu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaonan Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zeping Wang
- Beijing University of Chinese Medicine, Beijing, China
| | - Jiye Chen
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Min Wu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Longtao Liu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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17
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Sakboonyarat B, Poovieng J, Srisawat P, Hatthachote P, Mungthin M, Rangsin R, Jongcherdchootrakul K. Prevalence, awareness, and control of hypertension and associated factors among Royal Thai Army personnel in Thailand from 2017 to 2021. Sci Rep 2023; 13:6946. [PMID: 37117457 PMCID: PMC10141845 DOI: 10.1038/s41598-023-34023-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/22/2023] [Indexed: 04/30/2023] Open
Abstract
Hypertension (HTN) is a potential risk factor for cardiovascular diseases. We aimed to determine the prevalence, awareness, and control of HTN among RTA personnel in Thailand. We conducted a series of cross-sectional studies from 2017 to 2021. HTN was defined by systolic blood pressure (BP) ≥ 140 mmHg or a diastolic BP ≥ 90 mmHg from a physical health examination, a history of HTN diagnosed by medical personnel, or taking antihypertensive medication. A total of 504,484 participants were included in the present study. The overall HTN prevalence was 29.4%. The prevalence of HTN among males was 30.5%, while it was 17.1% among females. Of the RTA personnel with HTN, 35.9% were aware of their condition. The overall control of HTN among RTA personnel with HTN was 15.8% in 2017 and 17.6% in 2021. Behavioral factors associated with HTN were current smoking, alcohol consumption, and sedentary behavior. A higher BMI was associated with higher HTN prevalence and HTN awareness but less likely to have controllable HTN. Male participants, younger individuals, current alcohol use, and sedentary behavior were associated with a lower prevalence of HTN awareness and controlled HTN. Current tobacco use was also associated with a lower prevalence of HTN awareness.
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Affiliation(s)
- Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Jaturon Poovieng
- Department of Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Phutsapong Srisawat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Panadda Hatthachote
- Department of Physiology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Kanlaya Jongcherdchootrakul
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand.
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18
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The value of myocardial work in patients with left ventricular hypertrophy. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2023; 39:1105-1113. [PMID: 36922462 DOI: 10.1007/s10554-023-02818-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/11/2023] [Indexed: 03/18/2023]
Abstract
Myocardial work derived from pressure-strain analysis resembles a novel non-invasive method for myocardial function evaluation. Left ventricular hypertrophy (LVH) is commonly detected in Fabry disease (FD), cardiac amyloidosis (CA) and hypertension (HTN). The study aimed to demonstrate the characteristics of myocardial work in patients with LVH suffering from FD, CA, and HTN. Echocardiography were performed in patients with LVH suffering from FD (n = 13), light chain associated cardiac amyloidosis (AL-CA) (n = 29) and HTN (n = 72), 25 healthy controls were also included in the current study. Conventional and myocardial work parameters were assessed and compared among FD, AL-CA, HTN and controls. Patients with FD and AL-CA were included in the group of infiltrative cardiomyopathy. Logistic regression analysis was used to identify independent predictors for discriminating infiltrative cardiomyopathy from hypertension. Compared with controls, HTN patients had preserved global work index (GWI) and global constructive work (GCW) and reduced global longitudinal strain (GLS) and global work efficiency (GWE) (p < 0.05), but patients with FD and AL-CA had reduced GLS, GWI, GCW and GWE and increased global wasted work (GWW) (p < 0.05). GWI and GCW could discriminate infiltrative cardiomyopathy from HTN independently with high accuracy (GWI cut-off value 1626 mmHg%, sensitivity 0.87, specificity 0.82, area under the curve 0.90; GCW cut-off value 2021 mmHg%, sensitivity 0.84, specificity 0.88, area under the curve 0.91). GWI and GCW were reduced in FD and AL-CA patients, but not in patients with HTN. Myocardial work had an addictive value in differentiating infiltrative cardiomyopathy from hypertension.
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19
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Wong M, Parsi K, Myers K, De Maeseneer M, Caprini J, Cavezzi A, Connor DE, Davies AH, Gianesini S, Gillet JL, Grondin L, Guex JJ, Hamel-Desnos C, Morrison N, Mosti G, Orrego A, Partsch H, Rabe E, Raymond-Martimbeau P, Schadeck M, Simkin R, Tessari L, Thibault PK, Ulloa JH, Whiteley M, Yamaki T, Zimmet S, Kang M, Vuong S, Yang A, Zhang L. Sclerotherapy of lower limb veins: Indications, contraindications and treatment strategies to prevent complications - A consensus document of the International Union of Phlebology-2023. Phlebology 2023; 38:205-258. [PMID: 36916540 DOI: 10.1177/02683555231151350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Sclerotherapy is a non-invasive procedure commonly used to treat superficial venous disease, vascular malformations and other ectatic vascular lesions. While extremely rare, sclerotherapy may be complicated by serious adverse events. OBJECTIVES To categorise contraindications to sclerotherapy based on the available scientific evidence. METHODS An international, multi-disciplinary panel of phlebologists reviewed the available scientific evidence and developed consensus where evidence was lacking or limited. RESULTS Absolute Contraindications to sclerotherapy where the risk of harm would outweigh any benefits include known hypersensitivity to sclerosing agents; acute venous thromboembolism (VTE); severe neurological or cardiac adverse events complicating a previous sclerotherapy treatment; severe acute systemic illness or infection; and critical limb ischaemia. Relative Contraindications to sclerotherapy where the potential benefits of the proposed treatment would outweigh the risk of harm or the risks may be mitigated by other measures include pregnancy, postpartum and breastfeeding; hypercoagulable states with risk of VTE; risk of neurological adverse events; risk of cardiac adverse events and poorly controlled chronic systemic illness. Conditions and circumstances where Warnings and Precautions should be considered before proceeding with sclerotherapy include risk of cutaneous necrosis or cosmetic complications such as pigmentation and telangiectatic matting; intake of medications such as the oral contraceptive and other exogenous oestrogens, disulfiram and minocycline; and psychosocial factors and psychiatric comorbidities that may increase the risk of adverse events or compromise optimal treatment outcomes. CONCLUSIONS Sclerotherapy can achieve safe clinical outcomes provided that (1) patient-related risk factors and in particular all material risks are (1a) adequately identified and the risk benefit ratio is clearly and openly discussed with treatment candidates within a reasonable timeframe prior to the actual procedure; (1b) when an individual is not a suitable candidate for the proposed intervention, conservative treatment options including the option of 'no intervention as a treatment option' are discussed; (1c) complex cases are referred for treatment in controlled and standardised settings and by practitioners with more expertise in the field; (1d) only suitable individuals with no absolute contraindications or those with relative contraindications where the benefits outweigh the risks are offered intervention; (1e) if proceeding with intervention, appropriate prophylactic measures and other risk-mitigating strategies are adopted and appropriate follow-up is organised; and (2) procedure-related risk factors are minimised by ensuring the treating physicians (2a) have adequate training in general phlebology with additional training in duplex ultrasound, procedural phlebology and in particular sclerotherapy; (2b) maintain their knowledge and competency over time and (2c) review and optimise their treatment strategies and techniques on a regular basis to keep up with the ongoing progress in medical technology and contemporary scientific evidence.
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Affiliation(s)
- Mandy Wong
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kurosh Parsi
- Department of Dermatology, St Vincent's Hospital, Sydney, Darlinghurst, NSW, Australia.,Faculty of Medicine, 7800University of New South Wales, Sydney, NSW, Australia.,Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia.,Australasian College of Phlebology, Chatswood, NSW, Australia
| | - Kenneth Myers
- Australasian College of Phlebology, Chatswood, NSW, Australia
| | | | - Joseph Caprini
- University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | | | - David E Connor
- Department of Dermatology, St Vincent's Hospital, Sydney, Darlinghurst, NSW, Australia.,Faculty of Medicine, 7800University of New South Wales, Sydney, NSW, Australia.,Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia
| | - Alun H Davies
- 4615Department of Surgery & Cancer, Imperial College London, UK
| | - Sergio Gianesini
- Department of Translational Medicine, University of Ferrara, Italy
| | | | | | | | - Claudine Hamel-Desnos
- Department of Vascular Medicine, Saint Martin Private Hospital Ramsay GdS, Caen,France and Paris Saint Joseph Hospital Group, France
| | | | | | | | | | - Eberhard Rabe
- Emeritus, Department of Dermatology, University of Bonn, Germany
| | | | | | - Roberto Simkin
- Faculty of Medicine, 28196University of Buenos Aires, Argentina
| | | | - Paul K Thibault
- Australasian College of Phlebology, Chatswood, NSW, Australia.,Central Vein and Cosmetic Medical Centre, Newcastle, Australia
| | - Jorge H Ulloa
- Hospital Universitario Fundación Santa Fé - Universidad de los Andes, Bogotá, Colombia
| | | | - Takashi Yamaki
- Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University Adachi Medical Center, Japan
| | | | - Mina Kang
- Department of Dermatology, St Vincent's Hospital, Sydney, Darlinghurst, NSW, Australia.,Faculty of Medicine, 7800University of New South Wales, Sydney, NSW, Australia.,Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia
| | - Selene Vuong
- Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia
| | - Anes Yang
- Department of Dermatology, St Vincent's Hospital, Sydney, Darlinghurst, NSW, Australia.,Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia
| | - Lois Zhang
- Department of Dermatology, St Vincent's Hospital, Sydney, Darlinghurst, NSW, Australia.,Faculty of Medicine, 7800University of New South Wales, Sydney, NSW, Australia.,Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, NSW, Australia
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20
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Salah H, El-Gazzar RM, Abd El-Wahab EW, Charl F. Oxidative stress and adverse cardiovascular effects among professional divers in Egypt. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2023; 20:159-169. [PMID: 36716173 DOI: 10.1080/15459624.2023.2173364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Professional divers are exposed to unique multifactorial hazards in their working environment and adverse cardiovascular effects such as ischemia, arrhythmia, stroke, and death are associated with professional diving. Cardiovascular events are aggravated by diving-induced oxidative stress and account for one-fourth of diving fatalities. This study aimed to measure oxidative and cardiovascular stress in a group of professional divers in Alexandria, Egypt using a panel of biomarkers. A comparative cross-sectional study was conducted between June 2017 and May 2018 at the General Naval Hospital in Alexandria. A total of 50 professional divers and a comparison group of 50 marine seafarers sharing similar maritime environments were enrolled in the study. Participants were clinically evaluated by electrocardiography (ECG) and plasma measurement of trace metals (Fe+, Cu+, and Zn+), electrolytes (Na+, K+, Ca+), and oxidative stress biomarkers (OSBMs; MDA, TAS, GST, GSH, GR, GPx, SOD, and CAT). Significant ECG abnormalities including short corrected QT interval, sinus bradycardia, left ventricular hypertrophy, early repolarization, first-degree heart block, and intraventricular conduction defect were identified among divers. Biochemical analyses revealed high mean levels of FBG [89.0 ± 12.46 vs. 100.5 ± 29.03 mg/dl], LDH-C [41.46 ± 4.01 vs. 39.34 ± 4.34 mg/dl], electrolyte imbalance [higher Na+ (9.44 ± 0.52 vs. 9.19 ± 0.60 mmol/L), and lower Ca+ (141.72 ± 3.53 and 143.26 ± 3.99 mmol/L)], disturbed trace metals [Fe+ and Zn+ (101.1 ± 38.17 vs. 147.6 ± 38.08 and 85.52 ± 27.37 vs. 116.6 ± 21.95 µm/dl, respectively), higher Cu+ (271.3 ± 75.01 vs. 100.8 ± 30.20 µm/dl)], and higher OSBMs (high MDA and reduced CAT, GPx, GSH, GR, and GST enzyme levels) among professional divers compared to the marine seafarers (t-test p < 0.05). Oxidative stress and trace metal imbalance are associated with the pathophysiology of cardiovascular disease; this association, together with electrophysiological changes of ECG may serve as biomarkers for cardiovascular risk assessment in diver periodic medical examinations.
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Affiliation(s)
- Hanie Salah
- Department of Occupational Health and Industrial Medicine, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Ragaa M El-Gazzar
- Department of Occupational Health and Industrial Medicine, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Ekram W Abd El-Wahab
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Fahmy Charl
- Department of Occupational Health and Industrial Medicine, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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21
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Welcome MO, Dogo D, Nikos E Mastorakis. Cellular mechanisms and molecular pathways linking bitter taste receptor signalling to cardiac inflammation, oxidative stress, arrhythmia and contractile dysfunction in heart diseases. Inflammopharmacology 2023; 31:89-117. [PMID: 36471190 PMCID: PMC9734786 DOI: 10.1007/s10787-022-01086-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/11/2022] [Indexed: 12/12/2022]
Abstract
Heart diseases and related complications constitute a leading cause of death and socioeconomic threat worldwide. Despite intense efforts and research on the pathogenetic mechanisms of these diseases, the underlying cellular and molecular mechanisms are yet to be completely understood. Several lines of evidence indicate a critical role of inflammatory and oxidative stress responses in the development and progression of heart diseases. Nevertheless, the molecular machinery that drives cardiac inflammation and oxidative stress is not completely known. Recent data suggest an important role of cardiac bitter taste receptors (TAS2Rs) in the pathogenetic mechanism of heart diseases. Independent groups of researchers have demonstrated a central role of TAS2Rs in mediating inflammatory, oxidative stress responses, autophagy, impulse generation/propagation and contractile activities in the heart, suggesting that dysfunctional TAS2R signalling may predispose to cardiac inflammatory and oxidative stress disorders, characterised by contractile dysfunction and arrhythmia. Moreover, cardiac TAS2Rs act as gateway surveillance units that monitor and detect toxigenic or pathogenic molecules, including microbial components, and initiate responses that ultimately culminate in protection of the host against the aggression. Unfortunately, however, the molecular mechanisms that link TAS2R sensing of the cardiac milieu to inflammatory and oxidative stress responses are not clearly known. Therefore, we sought to review the possible role of TAS2R signalling in the pathophysiology of cardiac inflammation, oxidative stress, arrhythmia and contractile dysfunction in heart diseases. Potential therapeutic significance of targeting TAS2R or its downstream signalling molecules in cardiac inflammation, oxidative stress, arrhythmia and contractile dysfunction is also discussed.
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Affiliation(s)
- Menizibeya O Welcome
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Nile University of Nigeria, Plot 681 Cadastral Zone, C-00 Research and Institution Area, Jabi Airport Road Bypass, FCT, Abuja, Nigeria.
| | - Dilli Dogo
- Department of Surgery, Faculty of Clinical Sciences, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria
| | - Nikos E Mastorakis
- Technical University of Sofia, Klement Ohridksi 8, Sofia, 1000, Bulgaria
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22
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Zheng W, Mu J, Yan Y, Chu C, Su X, Ren Y, Chen F, Luo D. Association of rate pressure product trajectories at an early age with left ventricular hypertrophy in midlife: a prospective cohort study. Hypertens Res 2023; 46:321-329. [PMID: 36280736 DOI: 10.1038/s41440-022-01076-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 02/07/2023]
Abstract
The joint effect of blood pressure (BP) and heart rate (HR) on cardiovascular disease is unclear. Rate pressure product (RPP), the product of systolic BP and HR, is assessed in this study. This study aimed to determine the longitudinal patterns of RPP from childhood to adulthood and to explore the relationship between RPP trajectories in early life and left ventricular hypertrophy (LVH) in midlife. We included individuals with 3 or more RPP values from 7 visits over a 30-year follow-up period in the Hanzhong Adolescent Hypertension Study cohort to fit trajectory groups and performed logistic regression to evaluate the relative risk of developing LVH. Three discrete trajectories in RPP were identified among 2412 participants assessed from childhood to middle-aged adulthood, which were tagged as "low stable," "moderate stable," and "moderate increasing". A higher waist-to-hip ratio, smoking, alcohol consumption, hypertension, diabetes, and hyperlipidemia were associated with increased RPP trajectories. The Cornell voltage product was positively correlated with RPP in 2017 and was higher in the moderate-stable and moderate-increasing groups than in the low-stable group in RPP trajectories. Compared with the low-stable group, the ORs of LVH were 1.65 (1.13, 2.92) for the moderate-stable and 3.56 (2.26, 5.44) for the moderate-increasing group. Subjects with moderate-stable and moderate-increasing trajectories showed higher probabilities of LVH at an elderly age than those in the low stable trajectory group even after adjusting for multiple cardiovascular risk factors. RPP trajectories are identifiable from childhood and are associated with LVH in midlife. Monitoring RPP trajectories from early life may be an effective approach to predict cardiovascular health status later in life.
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Affiliation(s)
- Wenling Zheng
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, China.,Department of Geriatric-Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jianjun Mu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, China.
| | - Yu Yan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, China
| | - Chao Chu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University and Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, China
| | - Xianming Su
- Department of Geriatric-Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yanping Ren
- Department of Geriatric-Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fangyao Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Dan Luo
- Department of Geriatric-Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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23
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Gomes MFP, de Moura EDOC, Cardoso NM, da Silva GA, Dos Santos ACC, de Souza FS, Estadella D, Lambertucci RH, Lago JHG, Medeiros A. Supplementation with okra combined or not with exercise training is able to protect the heart of animals with metabolic syndrome. Sci Rep 2023; 13:1468. [PMID: 36702820 PMCID: PMC9879946 DOI: 10.1038/s41598-023-28072-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 01/12/2023] [Indexed: 01/27/2023] Open
Abstract
The metabolic syndrome (MetS) is a clinical manifestation strongly associated with cardiovascular disease, the main cause of death worldwide. In view of this scenario, many therapeutic proposals have appeared in order to optimize the treatment of individuals with MetS, including the practice of exercise training (ET) and the consumption of okra (O). The aim of the present study was to evaluate the effect of O consumption and/or ET in animals with MetS. In all, 32 male Zucker rats (fa/fa) at 10 weeks old were randomly distributed into four groups of 8 animals each: MetS, MetS+O, MetS+ET and MetS+ET+O, and 8 lean Zucker rats (fa/ +) comprised the control group. Okra was administered by orogastric gavage 2x/day (morning and night, 100 mg/kg), 5 days/week, for 6 weeks. The ET was performed on a treadmill 1x/day (afternoon), 5 days/week, 60 min/day, in an intensity of 70% of maximal capacity, for the same days of O treatment. It was found that, O consumption alone was able to promote improved insulin sensitivity (MetS 93.93 ± 8.54 mg/dL vs. MetS+O 69.95 ± 18.7 mg/dL, p ≤ 0.05, d = 1.65, CI = 50.32 -89.58, triglyceride reduction (MetS 492.9 ± 97.8 mg/dL vs. MetS+O 334.9 ± 98.0 mg/dL, p ≤ 0.05, d = 1.61, CI = 193.2-398.7). In addition, it promoted a reduction in systolic blood pressure (MetS 149.0 ± 9.3 mmHg vs. MetS+O 132.0 ± 11.4 mmHg, p ≤ 0.05, d = 1.63, CI = 120-140), prevented an increase in cardiac collagen (MetS 12.60 ± 2.08% vs. MetS+O 7.52 ± 0.77%, p ≤ 0.05, d = 3.24, CI = 6.56-8.49). When associated with ET, the results were similar. Thus, we conclude that O consumption combined or not with aerobic ET can have a protective effect on the cardiac tissue of rats with MetS.
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Affiliation(s)
- Moisés Felipe Pereira Gomes
- Department of Bioscience, Universidade Federal de São Paulo (UNIFESP), R. Silva Jardim, 136 - Vila Matias, Santos, SP, 11015-020, Brazil.
- Center for Applied Social Sciences and Health, Universidade Católica de Santos (Unisantos), Av. Conselheiro Nébias, 300, Vila Matias, Santos, SP, 11015-002, Brazil.
| | | | - Naiara Magalhães Cardoso
- Department of Bioscience, Universidade Federal de São Paulo (UNIFESP), R. Silva Jardim, 136 - Vila Matias, Santos, SP, 11015-020, Brazil
| | - Graziele Aparecida da Silva
- Department of Bioscience, Universidade Federal de São Paulo (UNIFESP), R. Silva Jardim, 136 - Vila Matias, Santos, SP, 11015-020, Brazil
| | - Ana Carolina Cardoso Dos Santos
- Department of Bioscience, Universidade Federal de São Paulo (UNIFESP), R. Silva Jardim, 136 - Vila Matias, Santos, SP, 11015-020, Brazil
| | - Fernanda Samantha de Souza
- Institute of Environmental, Chemical and Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), Rua Prof. Artur Riedel, n° 275, Eldorado, Diadema, SP, 09972-270, Brazil
| | - Débora Estadella
- Department of Bioscience, Universidade Federal de São Paulo (UNIFESP), R. Silva Jardim, 136 - Vila Matias, Santos, SP, 11015-020, Brazil
| | - Rafael Herling Lambertucci
- Department of Bioscience, Universidade Federal de São Paulo (UNIFESP), R. Silva Jardim, 136 - Vila Matias, Santos, SP, 11015-020, Brazil
| | - João Henrique Ghilardi Lago
- Center of Natural and Human Sciences, Universidade Federal Do ABC, Av. Dos Estados, 500, Bangú, Santo André, SP, 09210-580, Brazil
| | - Alessandra Medeiros
- Department of Bioscience, Universidade Federal de São Paulo (UNIFESP), R. Silva Jardim, 136 - Vila Matias, Santos, SP, 11015-020, Brazil
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24
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Yao B, Wu R, Chen BH, Wesemann LD, Xu JR, Zhou Y, Wu LM. Cardiovascular magnetic resonance myocardial feature tracking for the determination of left atrial strain in hypertensive left ventricular hypertrophy and hypertrophic cardiomyopathy. Clin Radiol 2023; 78:e409-e416. [PMID: 36746719 DOI: 10.1016/j.crad.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/07/2022] [Accepted: 12/28/2022] [Indexed: 01/23/2023]
Abstract
AIM To measure the left atrial (LA) function in patients with hypertrophic cardiomyopathy (HCM; with [OHCM] and without obstruction [NOHCM]) and hypertension-related left ventricular hypertrophy (H-LVH) using cardiovascular magnetic resonance imaging feature tracking (CMR-FT). MATERIALS AND METHODS Patients who met the criteria for HCM (n=68), H-LVH (n=46), and 30 healthy controls participated. Left atrial strain was analysed using CMR-FT in cine images with two and four chambers. RESULTS The strain rate and LA strain measurements showed that patients with HCM, and H-LVH had impaired conduit and reservoir functions (versus controls). These capacities were more severely impaired in OHCM than those seen in NOHCM and H-LVH. The LA volume parameters (LAVIpac, LAVImin and LAVImax) from the OHCM group were higher than both the NOHCM and H-LVH groups (all p<0.05). There were differences between the OHCM and H-LVH groups in terms of the parameters for LA reservoir function (εs), booster pump function (SRa), and conduit function (SRe, LA passive EF, εe; p<0.05). The strongest correlations included the associations between LA total EF and εs, εe and LA passive EF, and SRe and LA passive EF. CONCLUSION CMR-FT can reliably identify LA dysfunction and deformation in the early stages of HCM and H-LVH.
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Affiliation(s)
- B Yao
- Department of Radiology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215000, China
| | - R Wu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - B-H Chen
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - L D Wesemann
- Department of Radiology, School of Medicine, Wayne State University, Detroit, MI 48201, USA
| | - J-R Xu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Y Zhou
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - L-M Wu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
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25
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Comparison of the Results of Cardiopulmonary Exercise Testing between Healthy Peers and Pediatric Patients with Different Echocardiographic Severity of Mitral Valve Prolapse. Life (Basel) 2023; 13:life13020302. [PMID: 36836660 PMCID: PMC9958875 DOI: 10.3390/life13020302] [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: 12/28/2022] [Revised: 01/15/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
Patients with mitral valve prolapse (MVP) have been reported to have exercise intolerance. However, the underlying pathophysiological mechanisms and their physical fitness remain unclear. We aimed to determine the exercise capacity of patients with MVP through the cardiopulmonary exercise test (CPET). We retrospectively collected the data of 45 patients with a diagnosis of MVP. Their CPET and echocardiogram results were compared with 76 healthy individuals as primary outcomes. No significant differences regarding the patient's baseline characteristics and echocardiographic data were found between the two groups, except for the lower body mass index (BMI) of the MVP group. Patients in the MVP group demonstrated a similar peak metabolic equivalent (MET), but a significantly lower peak rate pressure product (PRPP) (p = 0.048). Patients with MVP possessed similar exercise capacity to healthy individuals. The reduced PRPP may indicate compromised coronary perfusion and subtle left ventricular function impairment.
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26
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Egbe AC, Miranda WR, Jain CC, Connolly HM. On-treatment blood pressure and cardiovascular mortality in adults with repaired coarctation of aorta. Am Heart J 2023; 255:22-30. [PMID: 36220358 DOI: 10.1016/j.ahj.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Although, hypertension is common in adults with repaired coarctation of aorta (COA), there are no data about on-treatment blood pressure (BP), and its relationship to outcomes in this population. The purpose of this study was to determine the relationship between on-treatment BP and cardiovascular mortality in adults with repaired COA. METHODS Retrospective study of adults with repaired COA on antihypertensive therapy (n = 461, age 39 ± 11). All BP measurements obtained within the first 3 years were averaged to determine the on-treatment BP, and the patients were stratified into BP quartiles using the cut-off points from the guidelines. RESULTS Being in the upper systolic BP (SBP) quartiles (SBP 120-129, 130-139 and ≥140) was associated with higher risk of cardiovascular mortality (HR 1.05, 95%CI 1.01-1.07, HR 1.12, 95%CI 1.04 to 1.15 and HR 1.39, 95%CI 1.13 to 1.59), as compared to being the lowest SBP quartile. We observed a 7% increase in the risk of cardiovascular mortality for every 5 mmHg increase in SBP, and a 4% increase in risk of cardiovascular mortality for every 5 mmHg increase in DBP. CONCLUSIONS Collectively, these data suggest that even s less severe form of hypertension SBP (120-129 mmHg) was not benign, and perhaps should be considered for antihypertensive therapy. A randomized controlled clinical trial is required to determine whether this group of patients (SBP 120 to 129 mmHg) would benefit from antihypertensive therapy, and to determine the optimal type and intensity of antihypertensive therapy in this population.
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Affiliation(s)
- Alexander C Egbe
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.
| | | | | | - Heidi M Connolly
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
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27
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Chen YY, Chung FP, Lin YJ, Chien KL, Chang WT. Exploring the Risk Factors of Sudden Cardiac Death Using an Electrocardiography and Medical Ultrasonography for the General Population Without a History of Coronary Artery Disease or Left Ventricular Ejection Fraction <35% and Aged >35 Years - A Novel Point-Based Prediction Model Based on the Chin-Shan Community Cardiovascular Cohort. Circ J 2022; 87:139-149. [PMID: 36047166 DOI: 10.1253/circj.cj-22-0322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Most of the factors and prediction models of sudden cardiac death (SCD) have been developed without considering the Asia population. The purpose of this study is to construct a point-based prediction model for the general population in Asia.Methods and Results: Chin-Shan Community Cardiovascular Cohort (CCCC) is a community-based longitudinal cohort initiated between 1990 and 1991, enrolling participants aged ≥35 years and following them up until 2005. Participants with coronary artery disease (CAD) or a left ventricular ejection fraction (LVEF) of 35% were excluded from this study. The Framingham risk score function was used to derive a simple point-based prediction model. Based on bootstrapping, a novel model (CCCC-SCD-Score) was validated. A total of 2,105 participants were analyzed. The incidence rate of SCD was 0.406 per 1,000 person-years. The CCCC-SCD-Score score was calculated using age groups (maximal points=4), left ventricular hypertrophy, hypertension, left ventricular ejection fraction <40%, aortic flow rate >190 cm/s, and carotid plaque scores ≥5 (point=1 for each risk factor). The C-index of the CCCC-SCD-Score in predicting SCD risks was 0.888 (95% confidence interval: 0.807-0.969). CONCLUSIONS For the general Asian population without a history of CAD or a LVEF <35% and who are aged >35 years, the novel model-based scoring system effectively identifies the risk for SCD using the clinical factors, electrocardiographic and echocardiographic data.
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Affiliation(s)
- Yun-Yu Chen
- Institute of Epidemiology and Preventive Medicine College of Public Health, National Taiwan University.,Heart Rhythm Center and Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital
| | - Fa-Po Chung
- Heart Rhythm Center and Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital.,Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, School of Medicine, National Yang Ming Chiao Tung University
| | - Yenn-Jiang Lin
- Heart Rhythm Center and Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital.,Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, School of Medicine, National Yang Ming Chiao Tung University
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine College of Public Health, National Taiwan University
| | - Wei-Tien Chang
- Department of Emergency Medicine, National Taiwan University Hospital
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28
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Hamada M, Ogimoto A, Otani T, Ohshima K, Kono T, Watanabe Y, Tasaka T, Ikeda S. Changes of left ventricular remodeling due to increased afterload in patients with essential hypertension. Int J Cardiol 2022; 367:74-80. [PMID: 36064037 DOI: 10.1016/j.ijcard.2022.08.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/16/2022] [Accepted: 08/24/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND It is unclear whether afterload mismatch occurs during the initial stage of essential hypertension (EHT). Additionally, critical left ventricular hypertrophy (LVH) between preserved and reduced systolic functions in hypertension is also unclear. Thus, we aimed to clarify these points. METHODS Forty-five normal control subjects (NCS) and 140 EHT patients participated. EHT patients were subdivided into three groups: group I, without LVH (n = 37); group II, with LVH (n = 80); and group III, with LVH and LV heart failure (LVHF) (n = 23). Routine electrocardiographic and echocardiographic parameters, V5R/V6R ratio, relative wall thickness (RWT), LV mass (LVM) index, and peak systolic wall stress (PSWS) were measured. RESULTS In group I, LV systolic functions were preserved despite the increase of PSWS. In group II, LVH advanced, but LV systolic functions remained normal. A negative T-wave was observed in 69% of group II and 100% of group III. A significant correlation between RWT and LVM index was seen in NCS and groups I and II (r2 = 0.545, P < 0.0001) but not in group III. Afterload mismatch occurred in group III due to the decrease in V5R/V6R ratio, the increase of LV end-diastolic dimension, and the LV systolic dysfunctions, which are caused by exhaustion of preload reserve. The boundary of the LVM index between groups II and III was approximately 180 g/m2. CONCLUSION Afterload mismatch did not occur in group I, but it was observed in group III due to the exhaustion of preload reserve.
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Affiliation(s)
- Mareomi Hamada
- Division of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime 798-8510, Japan.
| | - Akiyoshi Ogimoto
- Division of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime 798-8510, Japan
| | - Takashi Otani
- Hoshinooka Cardiovascular Clinic, 1-5-5, Higashi-ishii, Matsuyama, Ehime 790-0932, Japan
| | - Kiyotaka Ohshima
- Division of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime 798-8510, Japan
| | - Tamami Kono
- Division of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime 798-8510, Japan
| | - Yuta Watanabe
- Division of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime 798-8510, Japan
| | - Tatsuro Tasaka
- Division of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime 798-8510, Japan
| | - Shuntaro Ikeda
- Department of Community and Emergency Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan
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29
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Erfanifar A, Mahjani M, Gohari S, Hassanian-Moghaddam H. Fatal overdose from injection of human growth hormone; a case report and review of the literature. BMC Endocr Disord 2022; 22:271. [PMID: 36348360 PMCID: PMC9644502 DOI: 10.1186/s12902-022-01193-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 10/29/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Human growth hormone (HGH) is a categorized as a performance-enhancing substance. HGH has been abused by athletes for doping purposes. CASE PRESENTATION We present a first lethal case of HGH acute toxicity. A young-agitated-athlete with a history of somatropin for the past 2-year, who had hallucinations referred to the emergency department reporting to have abused of 300 mg subcutaneous injections of HGH. He was tachycardic with mild hypertension. Lab data revealed hypernatremia (157 mEq/L), hyperkalemia (5.3 mEq/L), high LDH (1448 U/L), and CPK (2620 U/L), in favor of rhabdomyolysis. Routine drug screening tests were negative for all substances. He was intubated due to low O2 saturation and progressive loss of consciousness. After several episodes of hyperthermia, hypertension, and possibly pulmonary embolism, he died subsequent to somatropin overdose. CONCLUSIONS Complications of HGH misuse can be life-threatening and athletes should be warned of its deleterious effects.
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Affiliation(s)
- Azam Erfanifar
- Department of Internal Medicine, School of Medicine, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Mahjani
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Family Medicine, Alborz University of Medical Science, Alborz, Iran
| | - Sepehr Gohari
- Department of Family Medicine, Alborz University of Medical Science, Alborz, Iran
- Student Research Center, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hossein Hassanian-Moghaddam
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Clinical Toxicology, Loghman-Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, South Karegar Street, Kamali St, Tehran, Iran.
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30
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Kunz M, Götzinger F, Emrich I, Schwenger V, Böhm M, Mahfoud F. Cardio-renal interaction - Clinical trials update 2022. Nutr Metab Cardiovasc Dis 2022; 32:2451-2458. [PMID: 36064690 DOI: 10.1016/j.numecd.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 10/31/2022]
Abstract
AIMS Chronic kidney disease is a common cardiovascular risk indicator and strongly associated with increased morbidity and mortality. The heart and kidneys are pathophysiologically closely connected, which becomes particularly obvious in patients with cardiorenal syndrome. This review summarizes clinically relevant studies on the cardio-renal interaction published in 2021 and 2022. DATA SYNTHESIS Selected trials published in high-impact journals were chosen from the database Pubmed and included in this review. New evidence about the selective mineralocorticoid receptor antagonist finerenone and the renoprotective sodium-glucose co-transporter-2-inhibitors (SGLT2-Inhibitors) are discussed and we update on novel insights about the treatment of arterial hypertension in patients with severe chronic kidney disease with the thiazide-like diuretic chlorthalidone. Finally, data on infective endocarditis in patients on chronic hemodialysis and the treatment of secondary hyperparathyroidism with the calcimimetic drug etelcalcetide in patients with end stage kidney disease are critically reviewed. CONCLUSION Several important studies investigating cardio-renal interactions were recently published may affect clinical practice. The graphical abstract (Fig. 1) depicts the most relevant clinical studies investigating cardio-renal interactions.
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Affiliation(s)
- Michael Kunz
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital Saarland, Saarland University, 66424 Homburg, Germany.
| | - Felix Götzinger
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital Saarland, Saarland University, 66424 Homburg, Germany
| | - Insa Emrich
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital Saarland, Saarland University, 66424 Homburg, Germany
| | - Vedat Schwenger
- Department of Nephrology, Klinikum der Landeshauptstadt Stuttgart gKAöR - Katharinenhospital, 70174 Stuttgart, Germany
| | - Michael Böhm
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital Saarland, Saarland University, 66424 Homburg, Germany
| | - Felix Mahfoud
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital Saarland, Saarland University, 66424 Homburg, Germany
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Fei SH, Liu ZF, Xie HN, Tong JN, Fang ZM, Chen Y, Yao YS. A meta-analysis of the diagnostic value of microRNA for hypertensive left ventricular hypertrophy. Front Cardiovasc Med 2022; 9:994826. [PMID: 36386321 PMCID: PMC9643699 DOI: 10.3389/fcvm.2022.994826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/12/2022] [Indexed: 11/30/2022] Open
Abstract
In this study, the diagnostic value of microRNAs (miRNAs) for hypertension (HTN) with left ventricular hypertrophy (LVH) were evaluated by meta-analysis. A correlation study of the diagnostic value of miRNAs in HTN with LVH was conducted using a computer search of the China Knowledge Network (CNKI), Wanfang, VIP, China Biomedical Literature Database (CBM), PubMed, Web of Science, and Embase. Studies from the time of database creation to May 2022 were evaluated. The quality assessment of diagnostic accuracy studies-2 (QUADAS-2) tool in RevMan 5.3 was used to evaluate the quality of the literature, and Meta-Disc 1.4 and Stata 16.0, were used to calculate the combined sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic advantage ratio (DOR), and their 95% confidence intervals. Subject working characteristic curves were plotted and the area under the curve (AUC) was calculated using Stata 16.0. Seven publications and 8 studies were included. miRNA diagnoses of HTN with LVH had SENcombined = 0.84, SPEcombined = 0.80, PLRcombined = 4.2, NLRcombined = 0.20, DORcombined = 21, and AUCcombined = 0.89. Subgroup analysis showed that the sensitivity of plasma miRNA for the diagnosis of HTN with LVH was 0.85, which was higher than that of serum which was 0.83. The specificity of serum miRNA for the diagnosis of HTN with LVH was 0.82, which was higher than that of plasma which was 0.78, and the diagnostic accuracy of miRNA in serum DOR was 23, which was higher than that of plasma DOR which was 20. In the diagnosis of HTN with LVH, miRNA has high sensitivity and specificity and is a better biological marker.
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Affiliation(s)
- Su-Hai Fei
- School of Public Health, Wannan Medical College, Wuhu, China
- Wannan Medical College, Institute of Chronic Disease Prevention and Control, Wuhu, China
| | - Zhen-Feng Liu
- School of Public Health, Wannan Medical College, Wuhu, China
- Wannan Medical College, Institute of Chronic Disease Prevention and Control, Wuhu, China
| | - Hai-Ning Xie
- School of Public Health, Wannan Medical College, Wuhu, China
- Wannan Medical College, Institute of Chronic Disease Prevention and Control, Wuhu, China
| | - Jia-Ni Tong
- School of Public Health, Wannan Medical College, Wuhu, China
- Wannan Medical College, Institute of Chronic Disease Prevention and Control, Wuhu, China
| | - Zheng-Mei Fang
- School of Public Health, Wannan Medical College, Wuhu, China
- Wannan Medical College, Institute of Chronic Disease Prevention and Control, Wuhu, China
| | - Yan Chen
- School of Public Health, Wannan Medical College, Wuhu, China
- Wannan Medical College, Institute of Chronic Disease Prevention and Control, Wuhu, China
- *Correspondence: Yan Chen
| | - Ying-Shui Yao
- School of Public Health, Wannan Medical College, Wuhu, China
- Wannan Medical College, Institute of Chronic Disease Prevention and Control, Wuhu, China
- Department of Clinical Medicine, Anhui College of Traditional Chinese Medicine, Wuhu, China
- Ying-Shui Yao
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Salah H, El-gazzar RM, Abd El-wahab EW, Charl F. Oxidative and cardiovascular stress among professional divers in Egypt.. [DOI: 10.1101/2022.10.20.22281338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
AbstractObjectivesProfessional divers are exposed to unique multifactorial hazards in their working environment and cardiovascular effects are tremendous. Cardiovascular events are aggravated by diving-induced oxidative stress and account for one fourth of diving fatalities. The aim of this study was to assess the oxidative and cardiovascular stress in a group of professional divers in Alexandria, Egypt using a panel of biomarkers.MethodsA comparative cross-sectional study was conducted between June 2017 and May 2018 at the General Naval Hospital in Alexandria. We recruited 50 professional divers (n=50) and a comparison group of 50 marine seafarers sharing similar maritime environments. Participants were clinically evaluated by electrocardiography (ECG) and assessment of some trace metals (Fe+, Cu+and Zn+) and oxidative stress biomarkers (OSBMs; MDA, TAS, GST, GSH, GR, GPx, SOD and CAT).Results: Significant ECG abnormalities including short corrected QT interval, sinus bradycardia, left ventricular hypertrophy, early repolarization, 1stdegree heart block, intraventricular conduction defect were obvious among divers. The mean levels of FBG, LDH-C, Na+, Ca+, trace metals and OSBMs were significantly higher among professional divers compared to the marine seafarers (p< 0.5).ConclusionThe risk of CVD in professional divers is alarmingly high and possibly contributed by OS. Including cardiovascular risk assessment in divers’ periodic examinations is of utmost importance.
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Sato R, Vatic M, da Fonseca GWP, von Haehling S. Sarcopenia and Frailty in Heart Failure: Is There a Biomarker Signature? Curr Heart Fail Rep 2022; 19:400-411. [PMID: 36261756 DOI: 10.1007/s11897-022-00575-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 10/24/2022]
Abstract
PURPOSE OF REVIEW Sarcopenia and frailty are common in patients with heart failure (HF) and are strongly associated with prognosis. This review aims to examine promising biomarkers that can guide physicians in identifying sarcopenia and frailty in HF. RECENT FINDINGS Traditional biomarkers including C-reactive protein, aminotransaminase, myostatin, and urinary creatinine as well as novel biomarkers including microRNAs, suppression of tumorigenicity 2 (ST2), galectin-3, and procollagen type III N-terminal peptide may help in predicting the development of sarcopenia and frailty in HF patients. Among those biomarkers, aminotransferase, urinary creatinine, and ST2 predicted the prognosis in HF patients with sarcopenia and frailty. This review outlines the current knowledge of biomarkers that are considered promising for diagnosing sarcopenia and frailty in HF. The listed biomarkers might support the diagnosis, prognosis, and therapeutic decisions for sarcopenia and frailty in HF patients.
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Affiliation(s)
- Ryosuke Sato
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075, Gottingen, Germany
| | - Mirela Vatic
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075, Gottingen, Germany
| | | | - Stephan von Haehling
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Gottingen, Germany.
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Xiao H, Li M, Li A, Amaerjiang N, Zunong J, Vermund SH, Pérez-Escamilla R, Song M, Hu Y, Jiang G. Passive Smoking Exposure Modifies Cardiovascular Structure and Function: Beijing Child Growth and Health Cohort (PROC) Study. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:14585-14593. [PMID: 36094430 DOI: 10.1021/acs.est.2c00991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Passive smoking exposure in children is prevalent worldwide and exposes children to respiratory and systemic toxins. In this study, we enrolled 568 children to study how secondhand smoke (SHS) might affect children's cardiovascular health in China. The measurement of nicotine and its metabolites in urine showed that 78.9% of children were exposed to SHS. Children exposed to SHS had greater interventricular septum thickness (p = 0.005) and left ventricular mass index (p = 0.008) than nonexposed children. Urinary norcotinine levels were associated with increased ascending aorta diameter (β = 0.10, 95%CI 0.02-0.17) and decreased left ventricular end systolic diameter (β = -0.10, 95%CI -0.19 to -0.01). The effects of SHS exposure on cardiovascular function: norcotinine levels associated with lower left ventricular mass index (β = -0.32, 95%CI -0.59 to -0.05), left ventricular end diastolic volume index (β = -0.43, 95%CI -0.85 to -0.02), and left ventricular end systolic volume index (β = -0.20, 95%CI -0.37 to -0.03). Moreover, there no no significant associations of nicotine, cotinine, and trans-3'-hydroxycotinine with cardiovascular health. Overall, SHS exposure in children remains prevalent in Beijing and may affect children's cardiovascular development, in both structure and function. It suggests that stricter and practical measures are needed toward the elimination of tobacco use in children's environments.
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Affiliation(s)
- Huidi Xiao
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Menglong Li
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Aijing Li
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, People's Republic of China
- University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Nubiya Amaerjiang
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Jiawulan Zunong
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Sten H Vermund
- Yale School of Public Health, Yale University, New Haven, Connecticut 06510-3201, United States
| | - Rafael Pérez-Escamilla
- Yale School of Public Health, Yale University, New Haven, Connecticut 06510-3201, United States
| | - Maoyong Song
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, People's Republic of China
- University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Yifei Hu
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, People's Republic of China
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Zhu F, Li P, Sheng Y. Treatment of myocardial interstitial fibrosis in pathological myocardial hypertrophy. Front Pharmacol 2022; 13:1004181. [PMID: 36249793 PMCID: PMC9561344 DOI: 10.3389/fphar.2022.1004181] [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: 07/27/2022] [Accepted: 09/14/2022] [Indexed: 01/09/2023] Open
Abstract
Pathological myocardial hypertrophy can be caused by a variety of diseases, mainly accompanied by myocardial interstitial fibrosis (MIF), which is a diffuse and patchy process, appearing as a combination of interstitial micro-scars and perivascular collagen fiber deposition. Different stimuli may trigger MIF without cell death by activating a variety of fibrotic signaling pathways in mesenchymal cells. This manuscript summarizes the current knowledge about the mechanism and harmful outcomes of MIF in pathological myocardial hypertrophy, discusses the circulating and imaging biomarkers that can be used to identify this lesion, and reviews the currently available and potential future treatments that allow the individualized management of patients with pathological myocardial hypertrophy.
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Affiliation(s)
- Fuyu Zhu
- Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Peng Li
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China,*Correspondence: Yanhui Sheng, ; Peng Li,
| | - Yanhui Sheng
- Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China,Department of Cardiology, Jiangsu Province Hospital, Nanjing, China,*Correspondence: Yanhui Sheng, ; Peng Li,
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36
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The high-intensity interval training mitigates the cardiac remodeling in spontaneously hypertensive rats. Life Sci 2022; 308:120959. [PMID: 36108768 DOI: 10.1016/j.lfs.2022.120959] [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: 12/09/2021] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/23/2022]
Abstract
AIM To evaluate the influence of high-intensity interval training (HIIT) on cardiac structural and functional characteristics and myocardial mitogen-activated protein kinase (MAPK) signaling in hypertensive rats. METHODS Male rats (12 months old) were divided into three groups: Wistar Kyoto rats (WKY, n = 8); sedentary spontaneously hypertensive rats (SED-SHR, n = 10), and trained spontaneously hypertensive rats (HIIT-SHR, n = 10). Systolic blood pressure (SBP), functional capacity, echocardiography, isolated papillary muscle, and gene expression of MAPK gene-encoding proteins associated with Elk1, cJun, ATF2, MEF2 were analyzed. KEY FINDINGS HIIT decreased SBP and increased functional capacity, left ventricular diastolic diameter, posterior wall thickness-left ventricle, relative wall thickness-left ventricle, and resting tension of the papillary muscle. In hypertensive rats, we observed a decrease in the gene-encoding ATF2 protein; this decrease was reversed by HIIT. SIGNIFICANCE The influence of HIIT in the SHR model in the compensated hypertension phase generated an increase in cardiac hypertrophy, attenuated myocardial diastolic dysfunction, lowered blood pressure, improved functional capacity, and reversed the alteration in gene-encoding ATF2 protein.
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Improved evaluation of left ventricular hypertrophy using the spatial QRS-T angle by electrocardiography. Sci Rep 2022; 12:15106. [PMID: 36068245 PMCID: PMC9448768 DOI: 10.1038/s41598-022-16712-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/14/2022] [Indexed: 11/28/2022] Open
Abstract
Electrocardiographic (ECG) signs of left ventricular hypertrophy (LVH) lack sensitivity. The aim was to identify LVH based on an abnormal spatial peaks QRS-T angle, evaluate its diagnostic performance compared to conventional ECG criteria for LVH, and its prognostic performance. This was an observational study with four cohorts with a QRS duration < 120 ms. Based on healthy volunteers (n = 921), an abnormal spatial peaks QRS-T angle was defined as ≥ 40° for females and ≥ 55° for males. In other healthy volunteers (n = 461), the specificity of the QRS-T angle to detect LVH was 96% (females) and 98% (males). In patients with at least moderate LVH by cardiac imaging (n = 225), the QRS-T angle had a higher sensitivity than conventional ECG criteria (93–97% vs 13–56%, p < 0.001 for all). In clinical consecutive patients (n = 783), of those who did not have any LVH, 238/556 (43%) had an abnormal QRS-T angle. There was an association with hospitalization for heart failure or all-cause death in univariable and multivariable analysis. An abnormal QRS-T angle rarely occurred in healthy volunteers, was a mainstay of moderate or greater LVH, was common in clinical patients without LVH but with cardiac co-morbidities, and associated with outcomes.
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Ikeno Y, Truong VTT, Tanaka A, Prakash SK. The Effect of Ascending Aortic Repair on Left Ventricular Remodeling. Am J Cardiol 2022; 182:89-94. [PMID: 36068098 DOI: 10.1016/j.amjcard.2022.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/01/2022]
Abstract
Left ventricular (LV) hypertrophy is common in patients with thoracic aortic diseases and is associated with increased long-term mortality. Thoracic aortic aneurysms are reported to increase LV afterload because of kinetic energy loss within the aneurysm sac, which may improve after surgical repair. However, LV afterload may also increase because of the stiffness of prosthetics used for aortic repair. We sought to investigate the long-term effect of surgical aortic repair with prostheses on postsurgical LV mass. We reviewed patients who underwent ascending aortic replacement with a prosthesis at our institution from January 2008 to December 2018. We calculated the LV mass index based on pre- and postoperative echocardiogram measurements. The primary outcome was the change in LV mass index 6 months after aortic repair. Patients aged <18 years and those who had concomitant cardiac operations, severe aortic valve disease, or who had no echocardiographic data were excluded. Of 1,008 patients who underwent ascending aortic replacement, 134 (51 with acute aortic dissections) were included. The median baseline and follow-up LV mass index were 107 (90 to 135) g/m2 and 101 (83 to 123) g/m2, respectively. Overall, there was a significant reduction of LV mass index over time (p = 0.03). LV mass index decreased in 77 patients (59%). Presentation due to acute aortic dissection (p = 0.03) and baseline LV mass index (p <0.001) were significant predictors of LV mass reduction. In conclusion, LV mass index may significantly decrease over time after the aortic repair, but the course is highly variable. The largest decrease occurred in patients who presented because of aortic dissections rather than for elective repair of aneurysms.
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Affiliation(s)
- Yuki Ikeno
- Department of Cardiothoracic and Vascular Surgery, Houston, Texas
| | - Van Thi Thanh Truong
- Center for Clinical Research and Evidence-Based Medicine, Department of Pediatrics, Houston, Texas
| | - Akiko Tanaka
- Department of Cardiothoracic and Vascular Surgery, Houston, Texas
| | - Siddharth K Prakash
- Department of Internal Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, Texas.
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Zhang H, Fu T, Sun J, Zou S, Qiu S, Zhang J, Su S, Shi C, Li DP, Xu Y. Pharmacological suppression of Nedd4-2 rescues the reduction of Kv11.1 channels in pathological cardiac hypertrophy. Front Pharmacol 2022; 13:942769. [PMID: 36059970 PMCID: PMC9428276 DOI: 10.3389/fphar.2022.942769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
The human ether-á-go-go-related gene (hERG) encodes the pore-forming subunit (Kv11.1), conducting a rapidly delayed rectifier K+ current (IKr). Reduction of IKr in pathological cardiac hypertrophy (pCH) contributes to increased susceptibility to arrhythmias. However, practical approaches to prevent IKr deficiency are lacking. Our study investigated the involvement of ubiquitin ligase Nedd4-2-dependent ubiquitination in IKr reduction and sought an intervening approach in pCH. Angiotensin II (Ang II) induced a pCH phenotype in guinea pig, accompanied by increased incidences of sudden death and higher susceptibility to arrhythmias. Patch-clamp recordings revealed a significant IKr reduction in pCH cardiomyocytes. Kv11.1 protein expression was decreased whereas its mRNA level did not change. In addition, Nedd4-2 protein expression was increased in pCH, accompanied by an enhanced Nedd4-2 and Kv11.1 binding detected by immunoprecipitation analysis. Cardiac-specific overexpression of inactive form of Nedd4-2 shortened the prolonged QT interval, reversed IKr reduction, and decreased susceptibility to arrhythmias. A synthesized peptide containing the PY motif in Kv11.1 C-terminus binding to Nedd4-2 and a cell-penetrating sequence antagonized Nedd4-2-dependent degradation of the channel and increased the surface abundance and function of hERG channel in HEK cells. In addition, in vivo administration of the PY peptide shortened QT interval and action potential duration, and enhanced IKr in pCH. We conclude that Nedd4-2-dependent ubiquitination is critically involved in IKr deficiency in pCH. Pharmacological suppression of Nedd4-2 represents a novel approach for antiarrhythmic therapy in pCH.
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Affiliation(s)
- Hua Zhang
- Department of Pharmacology, The Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Tian Fu
- Department of Pharmacology, The Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Jinglei Sun
- Department of Pharmacology, The Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Sihao Zou
- Department of Pharmacology, The Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Suhua Qiu
- Department of Pharmacology, The Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Jiali Zhang
- Department of Pharmacology, The Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Shi Su
- Department of Pharmacology, The Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Chenxia Shi
- Department of Pharmacology, The Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - De-Pei Li
- Center for Precision Medicine, Department of Medicine, School of Medicine University of Missouri, Columbia, MO, United States
- *Correspondence: Yanfang Xu, ; De-Pei Li,
| | - Yanfang Xu
- Department of Pharmacology, The Key Laboratory of New Drug Pharmacology and Toxicology, Hebei Medical University, Shijiazhuang, Hebei Province, China
- *Correspondence: Yanfang Xu, ; De-Pei Li,
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Zigmantaitė V, Jonušaitė E, Grigalevičiūtė R, Kučinskas A, Treinys R, Navalinskas A, Žvikas V, Jakštas V, Pudžiuvelytė L, Bernatonienė J, Mačianskienė R, Jurevičius J. Evaluation of the Cardiac Electrophysiological and Haemodynamic Effects of Elsholtzia ciliata Essential Oil on Swine. Pharmaceuticals (Basel) 2022; 15:ph15080982. [PMID: 36015131 PMCID: PMC9414655 DOI: 10.3390/ph15080982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/01/2022] [Accepted: 08/06/2022] [Indexed: 11/16/2022] Open
Abstract
The demand for the development of novel medicines with few side effects and no proarrhythmic properties is increasing. Extensive research on herbal extracts has been conducted with the expectation that the compounds will exert precise effects without harmful side effects. Elsholtzia ciliata (Thunb.) Hyl. essential oil (EO) possesses antiarrhythmic properties similar to those of class 1B antiarrhythmics, such as prolonging myocardial activation of the QRS complex and shortening the QT interval. In this study, we determined the kinetic profile of EO phytocompounds and the effects of EO on heart electrical activity and arterial blood pressure. For this study, we chose to use local breed pigs that were anaesthetized. The effects of an intravenous bolus of EO on ECG parameters, arterial blood pressure, heart rate variability, and blood levels of haematological and biochemical parameters were registered and evaluated. Following an intravenous injection of a bolus, EO exerted a vasodilatory effect, resulting in significant reductions in arterial blood pressure. EO also increased the heart rate and altered ECG parameters. The bolus of EO prolonged the QRS complex, shortened the QT interval, and nonmonotonically altered the PQ interval. After the administration of a bolus of EO, the activity of the autonomic nervous system was altered. This study confirms that EO possesses similar properties to class 1B antiarrhythmics and exerts a hypotensive effect; it reduces arterial blood pressure possibly by modulating peripheral vascular resistance.
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Affiliation(s)
- Vilma Zigmantaitė
- Biological Research Center, Lithuanian University of Health Sciences, Tilžės St. 18/7, LT47181 Kaunas, Lithuania
- Correspondence: ; Tel.: +370-675-36043
| | - Eglė Jonušaitė
- Biological Research Center, Lithuanian University of Health Sciences, Tilžės St. 18/7, LT47181 Kaunas, Lithuania
| | - Ramunė Grigalevičiūtė
- Biological Research Center, Lithuanian University of Health Sciences, Tilžės St. 18/7, LT47181 Kaunas, Lithuania
| | - Audrius Kučinskas
- Biological Research Center, Lithuanian University of Health Sciences, Tilžės St. 18/7, LT47181 Kaunas, Lithuania
| | - Rimantas Treinys
- Laboratory of Membrane Biophysics, Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių Ave. 15, LT50162 Kaunas, Lithuania
| | - Antanas Navalinskas
- Laboratory of Membrane Biophysics, Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių Ave. 15, LT50162 Kaunas, Lithuania
| | - Vaidotas Žvikas
- Institute of Pharmaceutical Technologies, Faculty of Pharmacy, Lithuanian University of Health Sciences, Sukilėlių Ave. 13, LT50162 Kaunas, Lithuania
| | - Valdas Jakštas
- Institute of Pharmaceutical Technologies, Faculty of Pharmacy, Lithuanian University of Health Sciences, Sukilėlių Ave. 13, LT50162 Kaunas, Lithuania
- Laboratory of Biopharmaceutical Research, Institute of Pharmaceutical Technologies, Faculty of Pharmacy, Medical Academy, Lithuanian University of Health Sciences, Sukilėlių Ave. 13, LT50162 Kaunas, Lithuania
| | - Lauryna Pudžiuvelytė
- Institute of Pharmaceutical Technologies, Faculty of Pharmacy, Lithuanian University of Health Sciences, Sukilėlių Ave. 13, LT50162 Kaunas, Lithuania
- Department of Drug Technology and Social Pharmacy, Medical Academy, Lithuanian University of Health Sciences, Sukilėlių Ave. 13, LT50162 Kaunas, Lithuania
| | - Jurga Bernatonienė
- Institute of Pharmaceutical Technologies, Faculty of Pharmacy, Lithuanian University of Health Sciences, Sukilėlių Ave. 13, LT50162 Kaunas, Lithuania
- Department of Drug Technology and Social Pharmacy, Medical Academy, Lithuanian University of Health Sciences, Sukilėlių Ave. 13, LT50162 Kaunas, Lithuania
| | - Regina Mačianskienė
- Laboratory of Membrane Biophysics, Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių Ave. 15, LT50162 Kaunas, Lithuania
| | - Jonas Jurevičius
- Laboratory of Membrane Biophysics, Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių Ave. 15, LT50162 Kaunas, Lithuania
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Brosolo G, Catena C, Da Porto A, Bulfone L, Vacca A, Verheyen ND, Sechi LA. Differences in Regulation of Cortisol Secretion Contribute to Left Ventricular Abnormalities in Patients With Essential Hypertension. Hypertension 2022; 79:1435-1444. [PMID: 35535606 DOI: 10.1161/hypertensionaha.122.19472] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Left ventricular (LV) abnormalities were reported in patients with overt and subclinical Cushing syndrome. The aim of this study was to investigate the relationships of daily plasma cortisol profile and cortisol response to an overnight suppression test with cardiac changes in patients with hypertension. METHODS In a cross-sectional study, we included 136 nondiabetic, patients with essential hypertension who were free of cardiovascular and renal complications. Plasma cortisol was measured at 8 am, 3 pm, and 12 am and at 8 am after overnight suppression with 1 mg dexamethasone (dexamethasone suppression test [DST]). Echocardiography was performed with standard B-mode and tissue-Doppler imaging. RESULTS LV hypertrophy was present in 30% and LV diastolic dysfunction in 51% of patients who were older and had significantly higher body mass index, systolic blood pressure, duration of hypertension, and 12 am and DST cortisol. LV mass index and relative wall thickness increased progressively across tertiles of DST cortisol, together with progressive worsening of diastolic function. LV mass index was directly related to age, systolic blood pressure, duration of hypertension, and 12 am and DST cortisol, and inversely to creatinine clearance. Multivariate regression analysis showed independent correlation of LV mass index with body mass index, systolic blood pressure, and 12 am and DST cortisol. Logistic regression showed that DST cortisol independently predicted LV hypertrophy. CONCLUSIONS Midnight and DST plasma cortisol levels are independent determinants of LV mass and geometry in patients with essential hypertension suggesting that even minor changes in regulation of cortisol secretion could contribute to cardiac abnormalities in these patients.
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Affiliation(s)
- Gabriele Brosolo
- Hypertension Unit, Division of Internal Medicine, Department of Medicine, University of Udine, Udine, Italy (G.B., C.C., A.D.P., L.B., A.V., L.A.S.)
| | - Cristiana Catena
- Hypertension Unit, Division of Internal Medicine, Department of Medicine, University of Udine, Udine, Italy (G.B., C.C., A.D.P., L.B., A.V., L.A.S.)
| | - Andrea Da Porto
- Hypertension Unit, Division of Internal Medicine, Department of Medicine, University of Udine, Udine, Italy (G.B., C.C., A.D.P., L.B., A.V., L.A.S.)
| | - Luca Bulfone
- Hypertension Unit, Division of Internal Medicine, Department of Medicine, University of Udine, Udine, Italy (G.B., C.C., A.D.P., L.B., A.V., L.A.S.)
| | - Antonio Vacca
- Hypertension Unit, Division of Internal Medicine, Department of Medicine, University of Udine, Udine, Italy (G.B., C.C., A.D.P., L.B., A.V., L.A.S.)
| | | | - Leonardo A Sechi
- Hypertension Unit, Division of Internal Medicine, Department of Medicine, University of Udine, Udine, Italy (G.B., C.C., A.D.P., L.B., A.V., L.A.S.)
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Kim J, Cho SI, Park JH, Song J, Ahn S, Cho H, Moon S. Risk of hypertension and treatment on out-of-hospital cardiac arrest incidence: A case-control study. Medicine (Baltimore) 2022; 101:e29161. [PMID: 35665725 PMCID: PMC9276230 DOI: 10.1097/md.0000000000029161] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/15/2022] [Indexed: 01/04/2023] Open
Abstract
Hypertension (HTN) is a high risk factor for major cardiovascular adverse events. This study aimed to investigate the effect of HTN risk on out-of-hospital cardiac arrest (OHCA) incidence and determine whether the effect of HTN on OHCA incidence differs according to antihypertensive medication.This case-control study used the Korean Cardiac Arrest Resuscitation Consortium and Korean Community Health Survey (CHS). Cases were defined as emergency medical service-treated adult OHCA patients presumed to have a cardiac etiology from 2015 to 2017. Patients without information on HTN diagnosis were excluded from the study. The Korean CHS database's controls were matched at a 1:2 ratio with strata, including age, gender, and county of residence. Multivariable conditional logistic regression analysis was conducted to estimate HTN risk and antihypertensive treatment on OHCA incidence,A total of 2633 OHCA patients and 5266 community-based controls were enrolled in this study. Among them, 1176 (44.7%) patients and 2049 (38.9%) controls were diagnosed with HTN. HTN was associated with an increased risk of OHCA (adjusted odds ratio [AOR]: 1.19 [1.07-1.32]). On comparing HTN with or without the antihypertensive treatment group with the non-HTN-diagnosed group (as a reference), the HTN without treatment group had the highest AOR (95% confidence interval) (3.41 [2.74-4.24]). The AOR in the HTN treatment group was reduced to that in the non-HTN-diagnosed group (0.96 [0.86-1.08]).HTN increased OHCA risk, and the HTN without treatment group had the highest OHCA risk. Conversely, OHCA risk decreased to the non-HTN-diagnosed group level with HTN treatment.
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Affiliation(s)
- Jooyeong Kim
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Sung-il Cho
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Jong-Hak Park
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Juhyun Song
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Sejoong Ahn
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Hanjin Cho
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Sungwoo Moon
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
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Huang H, Deng Y, Cheng S, Zhang N, Cai M, Niu H, Chen X, Gu M, Liu X, Yu Y, Hua W. Comorbid Hypertension Reduces the Risk of Ventricular Arrhythmia in Chronic Heart Failure Patients with Implantable Cardioverter-Defibrillators. J Clin Med 2022; 11:2816. [PMID: 35628944 PMCID: PMC9146543 DOI: 10.3390/jcm11102816] [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: 04/25/2022] [Revised: 05/11/2022] [Accepted: 05/14/2022] [Indexed: 12/10/2022] Open
Abstract
AIMS Low blood pressure (BP) has been shown to be associated with increased mortality in patients with chronic heart failure. This study was designed to evaluate the relationships between diagnosed hypertension and the risk of ventricular arrhythmia (VA) and all-cause death in chronic heart failure (CHF) patients with implantable cardioverter-defibrillators (ICD), including those with preserved left ventricular ejection fraction (HFpEF) and indication for ICD secondary prevention. We hypothesized that a stable hypertension status, along with an increasing BP level, is associated with a reduction in the risk of VA in this population, thereby limiting ICD efficacy. METHODS We retrospectively enrolled 964 CHF patients, with hypertension diagnosis and hospitalized BP measurements obtained before ICD implantation. The primary outcome measure was defined as the composite of SCD, appropriate ICD therapy, and sustained VT. The secondary endpoint was time to death or heart transplantation (HTx). We performed multivariable Cox proportional hazard regression and entropy balancing to calculate weights to control for baseline imbalances with or without hypertension. The Fine-Gray subdistribution hazard model was used to confirm the results. The effect of random BP measurements on the primary outcome was illustrated in the Cox model with inverse probability weighting. RESULTS The 964 patients had a mean (SD) age of 58.9 (13.1) years; 762 (79.0%) were men. During the interrogation follow-up [median 2.81 years (interquartile range: 1.32-5.27 years)], 380 patients (39.4%) reached the primary outcome. A total of 244 (45.2%) VA events in non-hypertension patients and 136 (32.1%) in hypertension patients were observed. A total of 202 (21.0%) patients died, and 31 (3.2%) patients underwent heart transplantation (incidence 5.89 per 100 person-years; 95% CI: 5.16-6.70 per 100 person-years) during a median survival follow-up of 4.5 (IQR 2.8-6.8) years. A lower cumulative incidence of VA events was observed in hypertension patients in the initial unadjusted Kaplan-Meier time-to-event analysis [hazard ratio (HR): 0.65, 95% confidence interval (CI): 0.53-0.80]. The protective effect was robust after entropy balancing (HR: 0.71, 95% CI: 0.56-0.89) and counting death as a competing risk (HR: 0.71, 95% CI: 0.51-1.00). Hypertension diagnosis did not associate with all-cause mortality in this population. Random systolic blood pressure was negatively associated with VA outcomes (p = 0.065). CONCLUSIONS In hospitalized chronic heart failure patients with implantable cardioverter-defibrillators, the hypertension status and higher systolic blood pressure measurements are independently associated with a lower risk of combined endpoints of ventricular arrhythmia and sudden cardiac death but not with all-cause mortality. Randomized controlled trials are needed to confirm the protective effect of hypertension on ventricular arrhythmia in chronic heart failure patients.
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Affiliation(s)
- Hao Huang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (H.H.); (Y.D.); (S.C.); (N.Z.); (M.C.); (H.N.); (X.C.); (M.G.); (X.L.); (Y.Y.)
| | - Yu Deng
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (H.H.); (Y.D.); (S.C.); (N.Z.); (M.C.); (H.N.); (X.C.); (M.G.); (X.L.); (Y.Y.)
| | - Sijing Cheng
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (H.H.); (Y.D.); (S.C.); (N.Z.); (M.C.); (H.N.); (X.C.); (M.G.); (X.L.); (Y.Y.)
| | - Nixiao Zhang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (H.H.); (Y.D.); (S.C.); (N.Z.); (M.C.); (H.N.); (X.C.); (M.G.); (X.L.); (Y.Y.)
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Minsi Cai
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (H.H.); (Y.D.); (S.C.); (N.Z.); (M.C.); (H.N.); (X.C.); (M.G.); (X.L.); (Y.Y.)
| | - Hongxia Niu
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (H.H.); (Y.D.); (S.C.); (N.Z.); (M.C.); (H.N.); (X.C.); (M.G.); (X.L.); (Y.Y.)
| | - Xuhua Chen
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (H.H.); (Y.D.); (S.C.); (N.Z.); (M.C.); (H.N.); (X.C.); (M.G.); (X.L.); (Y.Y.)
| | - Min Gu
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (H.H.); (Y.D.); (S.C.); (N.Z.); (M.C.); (H.N.); (X.C.); (M.G.); (X.L.); (Y.Y.)
| | - Xi Liu
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (H.H.); (Y.D.); (S.C.); (N.Z.); (M.C.); (H.N.); (X.C.); (M.G.); (X.L.); (Y.Y.)
| | - Yu Yu
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (H.H.); (Y.D.); (S.C.); (N.Z.); (M.C.); (H.N.); (X.C.); (M.G.); (X.L.); (Y.Y.)
| | - Wei Hua
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; (H.H.); (Y.D.); (S.C.); (N.Z.); (M.C.); (H.N.); (X.C.); (M.G.); (X.L.); (Y.Y.)
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Westaby JD, Miles C, Chis Ster I, Cooper STE, Antonios TF, Meijles D, Behr ER, Sheppard MN. Characterisation of hypertensive heart disease: pathological insights from a sudden cardiac death cohort to inform clinical practice. J Hum Hypertens 2022; 36:246-253. [PMID: 33654238 DOI: 10.1038/s41371-021-00507-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/26/2021] [Accepted: 02/04/2021] [Indexed: 11/09/2022]
Abstract
Hypertensive heart disease refers to changes in the myocardium that result from hypertension. The relationship between hypertensive heart disease and sudden cardiac death is well established, but there are few pathological studies. We examined the clinical and pathological features of hypertensive heart disease in sudden cardiac death victims from a national cardiovascular pathology registry. We investigated 5239 cases of sudden cardiac death between 1994 and 2018. Hearts were examined by two expert cardiac pathologists. Diagnostic criteria included history of hypertension, increased heart weight and left ventricular wall thickness in the absence of other causes. Collagen was quantified using picrosirius red staining and imaging software. Of 75 sudden cardiac death cases due to hypertensive heart disease (age at death: 54 ± 16 years; 56% males), 56 (75%) reported no prior cardiac symptoms. Thirty-four (45%) recorded a BMI ≥ 30. Only two (2.7%) had hypertensive heart disease diagnosed antemortem. Four (5%) were diagnosed clinically with hypertrophic cardiomyopathy, but lacked myocyte disarray at autopsy. All hearts showed concentric left ventricular hypertrophy and myocyte hypertrophy. Fibrosis was identified microscopically in 59 cases (81%). The posterior left ventricular wall showed the greatest increase in the percentage of collagen in hypertensive diseased hearts compared to controls (25.2% vs 17.9%, p = 0.034). Most sudden deaths due to hypertensive heart disease occur without prior cardiac symptoms; thus, clinical risk stratification is challenging. Hypertensive heart disease can be misdiagnosed in life as hypertrophic cardiomyopathy which has major implications for relatives. Pathologists require a history of hypertension and histology for a definitive diagnosis of hypertensive heart disease.
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Affiliation(s)
- J D Westaby
- Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's University of London, London, SW17 0RE, UK.
| | - C Miles
- Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's University of London, London, SW17 0RE, UK
| | - I Chis Ster
- Infection and Immunity Research Institute, St George's University of London, London, SW17 0RE, UK
| | - S T E Cooper
- Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's University of London, London, SW17 0RE, UK
| | - T F Antonios
- Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's University of London, London, SW17 0RE, UK
| | - D Meijles
- Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's University of London, London, SW17 0RE, UK
| | - E R Behr
- Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's University of London, London, SW17 0RE, UK
| | - M N Sheppard
- Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St George's University of London, London, SW17 0RE, UK
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Cui YK, Hong YX, Wu WY, Han WM, Wu Y, Wu C, Li GR, Wang Y. Acacetin ameliorates cardiac hypertrophy by activating Sirt1/AMPK/PGC-1α pathway. Eur J Pharmacol 2022; 920:174858. [PMID: 35219729 DOI: 10.1016/j.ejphar.2022.174858] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/15/2022] [Accepted: 02/22/2022] [Indexed: 12/20/2022]
Abstract
Cardiac hypertrophy is a major risk factor for developing heart failure. This study investigates the effects of the natural flavone acacetin on myocardial hypertrophy in cellular level and whole animals. In cardiomyocytes from neonatal rat with hypertrophy induced by angiotensin II (Ang II), acacetin at 0.3, 1, and 3 μM reduced the increased myocyte surface area, brain natriuretic peptide (BNP), and ROS production by upregulating anti-oxidative molecules (i.e. Nrf2, SOD1, SOD2, HO-1), anti-apoptotic protein Bcl-2, and downregulating the pro-apoptotic protein Bax and the inflammatory cytokine IL-6 in a concentration-dependent manner. In addition, acacetin rescued Ang II-induced impairment of PGC-1α, PPARα and pAMPK. These beneficial effects of acacetin were mediated by activation of Sirt1, which was confirmed in cardiac hypertrophy induced by abdominal aorta constriction (AAC) in SD rats. Acacetin prodrug (10 mg/kg, s.c., b.i.d.) treatment reduced the elevated artery blood pressure, improved the increased heart size and thickness of left ventricular wall and the ventricular fibrosis associated with inhibiting myocardial fibrosis and BNP, and reversed the impaired protective signal molecules including PGC-1α, Nrf2, PPARα, pAMPK and Sirt1 of left ventricular tissue. Our results demonstrate the novel pharmacological effect that acacetin ameliorates cardiac hypertrophy via Sirt1-mediated activation of AMPK/PGC-1α signal molecules followed by reducing oxidation, inflammation and apoptosis.
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Affiliation(s)
- Yu-Kai Cui
- Xiamen Cardiovascular Hospital, School of Medicine, Xiamen University, Xiamen, 361009, China
| | - Yi-Xiang Hong
- Xiamen Cardiovascular Hospital, School of Medicine, Xiamen University, Xiamen, 361009, China
| | - Wei-Yin Wu
- Xiamen Cardiovascular Hospital, School of Medicine, Xiamen University, Xiamen, 361009, China
| | - Wei-Min Han
- Xiamen Cardiovascular Hospital, School of Medicine, Xiamen University, Xiamen, 361009, China
| | - Yao Wu
- Xiamen Cardiovascular Hospital, School of Medicine, Xiamen University, Xiamen, 361009, China
| | - Chan Wu
- Xiamen Cardiovascular Hospital, School of Medicine, Xiamen University, Xiamen, 361009, China
| | - Gui-Rong Li
- Xiamen Cardiovascular Hospital, School of Medicine, Xiamen University, Xiamen, 361009, China; Nanjing Amazigh Pharma Limited, Nanjing, Jiangsu, 210032, China.
| | - Yan Wang
- Xiamen Cardiovascular Hospital, School of Medicine, Xiamen University, Xiamen, 361009, China.
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Li T, Wang W, Gan W, Lv S, Zeng Z, Hou Y, Yan Z, Zhang R, Yang M. Comprehensive bioinformatics analysis identifies LAPTM5 as a potential blood biomarker for hypertensive patients with left ventricular hypertrophy. Aging (Albany NY) 2022; 14:1508-1528. [PMID: 35157609 PMCID: PMC8876903 DOI: 10.18632/aging.203894] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/11/2021] [Indexed: 11/29/2022]
Abstract
Left ventricular hypertrophy (LVH) is a pivotal manifestation of hypertensive organ damage associated with an increased cardiovascular risk. However, early diagnostic biomarkers for assessing LVH in patients with hypertension (HT) remain indefinite. Here, multiple bioinformatics tools combined with an experimental verification strategy were used to identify blood biomarkers for hypertensive LVH. GSE74144 mRNA expression profiles were downloaded from the Gene Expression Omnibus (GEO) database to screen candidate biomarkers, which were used to perform weighted gene co-expression network analysis (WGCNA) and establish the least absolute shrinkage and selection operator (LASSO) regression model, combined with support vector machine-recursive feature elimination (SVM-RFE) algorithms. Finally, the potential blood biomarkers were verified in an animal model. A total of 142 hub genes in peripheral blood leukocytes were identified between HT with LVH and HT without LVH, which were mainly involved in the ATP metabolic process, oxidative phosphorylation, and mitochondrial structure and function. Notably, lysosomal associated transmembrane protein 5 (LAPTM5) was identified as the potential diagnostic marker of hypertensive LVH, which showed strong correlations with diverse marker sets of reactive oxygen species (ROS) and autophagy. RT-PCR validation of blood samples and cardiac magnetic resonance imaging (CMRI) showed that the expression of LAPTM5 was significantly higher in the HT with LVH model than in normal controls, LAPTM5 demonstrated a positive association with the left ventricle wall thickness as well as electrocardiogram (ECG) parameters widths of the QRS complex and QTc interval. In conclusion, LAPTM5 may be a potential biomarker for the diagnosis of LVH in patients with HT, and it can provide new insights for future studies on the occurrence and the molecular mechanisms of hypertensive LVH.
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Affiliation(s)
- Tiegang Li
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Weiqi Wang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Wenqiang Gan
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Silin Lv
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Zifan Zeng
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Yufang Hou
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Zheng Yan
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Rixin Zhang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Min Yang
- State Key Laboratory of Bioactive Substances and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
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Chen H, Qiao H, Zhao Q, Wei F. microRNA-135a-5p regulates NOD-like receptor family pyrin domain containing 3 inflammasome-mediated hypertensive cardiac inflammation and fibrosis via thioredoxin-interacting protein. Bioengineered 2022; 13:4658-4673. [PMID: 35148667 PMCID: PMC8973706 DOI: 10.1080/21655979.2021.2024956] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Hypertension is a severe public health problem that induces cardiac injury with alterations of gene expressions. The current study sought to evaluate the mechanism of microRNA(miR)-135a-5p in NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome-mediation of cardiac inflammation and hypertensive cardiac fibrosis. Firstly, hypertensive mouse models were established using angiotensin II (Ang II), followed by miR-135a-5p agomir treatment. Subsequently, mouse blood pressure and basic cardiac function indexes, histopathological changes, and cardiac fibrosis were all determined, in addition to detection of factors related to inflammation and fibrosis. Additionally, mice cardiac fibroblasts (CFs) were isolated and treated with Ang II. The binding relationship of miR-135a-5p and thioredoxin-interacting protein (TXNIP) was predicted and testified, while the interaction of TXNIP and NLRP3 was detected by means of a co-immunoprecipitation assay. It was found that miR-135a-5p was poorly-expressed in Ang II-treated mice and further exerted cardioprotective effects against hypertensive heart diseases. Moreover, over-expression of miR-135a-5p resulted in inhibition of inflammatory infiltration and almost eliminated cardiac fibrosis, as evidenced by decreased Collagen (COL)-I, COL-III, a-smooth muscle actin, NLRP3, tumor necrosis factor-α, and interleukin-6. Mechanically, miR-135a-5p inhibited TXNIP expression to block the binding of TXNIP and NLRP3. On the other hand, TXNIP up-regulation reversed the protective role of miR-135a-5p over-expression in CFs. Collectively, our findings indicated that miR-135a-5p over-expression inhibited TXNIP expression to block the binding of TXNIP and NLRP3, thereby alleviating hypertensive cardiac inflammation and fibrosis.
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Affiliation(s)
- Hao Chen
- Department of Cardiovascular Center, The 8th Medical Center of General Hospital of PLA, Beijing, China
| | - Huilian Qiao
- Department of Pathology, Air Force Medical Center PLA, Beijing, China
| | - Qiang Zhao
- Department of Cardiovascular Center, The 8th Medical Center of General Hospital of PLA, Beijing, China
| | - Fuling Wei
- Department of Cardiovascular Center, The 8th Medical Center of General Hospital of PLA, Beijing, China
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Tirandi A, Carbone F, Montecucco F, Liberale L. The role of metabolic syndrome in sudden cardiac death risk: Recent evidence and future directions. Eur J Clin Invest 2022; 52:e13693. [PMID: 34714544 PMCID: PMC9286662 DOI: 10.1111/eci.13693] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/23/2021] [Accepted: 09/28/2021] [Indexed: 12/14/2022]
Abstract
Metabolic syndrome (MetS) is a frequent condition whose deleterious effects on the cardiovascular system are often underestimated. MetS is nowadays considered a real pandemic with an estimated prevalence of 25% in general population. Individuals with MetS are at high risk of sudden cardiac death (SCD) as this condition accounts for 50% of all cardiac deaths in such a population. Of interest, recent studies demonstrated that individuals with MetS show 70% increased risk of SCD even without previous history of coronary heart disease (CHD). However, little is known about the interplay between the two conditions. MetS is a complex disease determined by genetic predisposition, unhealthy lifestyle and ageing with deleterious effects on different organs. MetS components trigger a systemic chronic low-grade pro-inflammatory state, associated with excess of sympathetic activity, cardiac hypertrophy, arrhythmias and atherosclerosis. Thus, MetS has an important burden on the cardiovascular system as demonstrated by both preclinical and clinical evidence. The aim of this review is to summarize recent evidence concerning the association between MetS and SCD, showing possible common aetiological processes, and to indicate prospective for future studies and therapeutic targets.
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Affiliation(s)
- Amedeo Tirandi
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino Genoa - Italian Cardiovascular Network, Genoa, Italy
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino Genoa - Italian Cardiovascular Network, Genoa, Italy
| | - Luca Liberale
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy.,Center for Molecular Cardiology, University of Zürich, Schlieren, Switzerland
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Liu Y, Dong Y, Dong Z, Song J, Zhang Z, Liang L, Liu X, Sun L, Li X, Zhang M, Chen Y, Miao R, Zhong J. Expression Profiles of Circular RNA in Aortic Vascular Tissues of Spontaneously Hypertensive Rats. Front Cardiovasc Med 2022; 8:814402. [PMID: 34988135 PMCID: PMC8720857 DOI: 10.3389/fcvm.2021.814402] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 12/01/2021] [Indexed: 01/05/2023] Open
Abstract
Background: Circular RNAs (circRNAs), as a kind of endogenous non-coding RNA, have been implicated in ischemic heart diseases and vascular diseases. Based on theirs high stability with a closed loop structure, circRNAs function as a sponge and bind specific miRNAs to exert inhibitory effects in heart and vasculature, thereby regulating their target gene and protein expression, via competitive endogenous RNA (ceRNA) mechanism. However, the exact roles and underlying mechanisms of circRNAs in hypertension and related cardiovascular diseases remain largely unknown. Methods and Results: High-throughput RNA sequencing (RNA-seq) was used to analyze the differentially expressed (DE) circRNAs in aortic vascular tissues of spontaneously hypertensive rats (SHR). Compared with the Wistar-Kyoto (WKY) rats, there were marked increases in the levels of systolic blood pressure, diastolic blood pressure and mean blood pressure in SHR under awake conditions via the tail-cuff methodology. Totally, compared with WKY rats, 485 DE circRNAs were found in aortic vascular tissues of SHR with 279 up-regulated circRNAs and 206 down-regulated circRNAs. Furthermore, circRNA-target microRNAs (miRNAs) and the target messenger RNAs (mRNAs) of miRNAs were predicted by the miRanda and Targetscan softwares, respectively. Additionally, real-time RT-PCR analysis verified that downregulation of rno_circRNA_0009197, and upregulation of rno_circRNA_0005818, rno_circRNA_0005304, rno_circRNA_0005506, and rno_circRNA_0009301 were observed in aorta of SHR when compared with that of WKY rats. Then, the potential ceRNA regulatory mechanism was constructed via integrating 5 validated circRNAs, 31 predicted miRNAs, and 266 target mRNAs. More importantly, three hub genes (NOTCH1, FOXO3, and STAT3) were recognized according to PPI network and three promising circRNA-miRNA-mRNA regulatory axes were found in hypertensive rat aorta, including rno_circRNA_0005818/miR-615/NOTCH1, rno_circRNA_0009197/ miR-509-5p/FOXO3, and rno_circRNA_0005818/miR-10b-5p/STAT3, respectively. Conclusions: Our results demonstrated for the first time that circRNAs are expressed aberrantly in aortic vascular tissues of hypertensive rats and may serve as a sponge linking with relevant miRNAs participating in pathogenesis of hypertension and related ischemic heart diseases via the circRNA-miRNA-mRNA ceRNAnetwork mechanism.
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Affiliation(s)
- Ying Liu
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Ying Dong
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Zhaojie Dong
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Jiawei Song
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Zhenzhou Zhang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lirong Liang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xiaoyan Liu
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lanlan Sun
- Department of Echocardiography, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xueting Li
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Miwen Zhang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yihang Chen
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Ran Miao
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Jiuchang Zhong
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.,Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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50
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Wang J, Li H, Lv Z, Luo X, Deng W, Zou T, Zhang Y, Sang W, Wang X. The miR-214-3p/c-Ski axis modulates endothelial-mesenchymal transition in human coronary artery endothelial cells in vitro and in mice model in vivo. Hum Cell 2022; 35:486-497. [PMID: 34978047 DOI: 10.1007/s13577-021-00653-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/20/2021] [Indexed: 01/08/2023]
Abstract
Cardiovascular disease (CVD) is a leading non-communicable disease with a high fatality rate worldwide. Hypertension, a common cardiovascular condition, is a significant risk factor for the development of heart failure because the activation of the renin-angiotensin system (RAS) is considered to be the major promoting reason behind myocardial fibrosis (MF). In this study, Angiotensin II (Ang II) stimulation-induced endothelial to mesenchymal transition (End-MT) in HCAECs, including the decrease of CD31 level, the increase of α-SMA, collagen I, slug, snail, and TGF-β1 levels, and the promotion of Smad2/3 phosphorylation. Meanwhile, the c-Ski level was reduced in Ang II-stimulated HCAECs. In HCAECs, Ang II-induced changes could be partially attenuated by c-Ski overexpression. miR-214-3p directly targeted c-Ski and inhibited c-Ski expression. Moreover, miR-214-3p inhibition reduced Ang II-caused End-MT in HCAECs. miR-214-3p overexpression further enhanced Ang II-induced End-MT, while c-Ski overexpression could markedly reverse the effects of miR-214-3p overexpression. In the Ang II-induced mouse cardiac hypertrophic model, Ang II-caused increase of cellular cross-sectional area and cardiac fibrosis were partially ameliorated by LV-c-Ski; when mice were co-treated with LV-c-Ski and agomir-214-3p, the beneficial effects of LV-c-Ski were reversed. In conclusion, the miR-214-3p/c-Ski axis modulated Ang II-induced End-MT in HCAECs and cardiac hypertrophy and fibrosis in the mice model.
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Affiliation(s)
- Juan Wang
- Department of Cardiology, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Hongjian Li
- Department of Hypertension, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China.
| | - Zhongying Lv
- Department of Hypertension, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Xiaomei Luo
- Department of Hypertension, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Wei Deng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Ting Zou
- Department of Hypertension, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Yue Zhang
- Department of Hypertension, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Wanyue Sang
- Department of Hypertension, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Xuehua Wang
- Department of Hypertension, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
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