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Ríos-Navarro C, Gavara J, de Dios E, Pérez-Solé N, Molina-García T, Marcos-Garcés V, Ruiz-Saurí A, Bayés-Genís A, Carrión-Valero F, Chorro FJ, Bodí V. Effect of serum from patients with ST-segment elevation myocardial infarction on endothelial cells. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024; 77:254-264. [PMID: 37696331 DOI: 10.1016/j.rec.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/07/2023] [Indexed: 09/13/2023]
Abstract
INTRODUCTION AND OBJECTIVES Clinical and experimental studies have shown that, in patients with reperfused ST-segment elevation myocardial infarction (STEMI), abnormalities in the endothelial monolayer are initiated during ischemia but rapidly intensify upon restoration of blood perfusion to the ischemic area. We aimed to evaluate the effect of serum isolated after revascularization from STEMI patients on the degree of endothelial permeability in vitro, by promoting endothelial cell apoptosis and necrosis in vitro. We also investigated the association between the percentage of serum-induced endothelial cell apoptosis or necrosis in vitro and the extent of cardiovascular magnetic resonance (CMR)-derived parameters of reperfusion injury (edema, hemorrhage, and microvascular obstruction). METHODS Human coronary artery endothelial cells were incubated with serum isolated 24hours after revascularization from 43 STEMI patients who underwent CMR and 14 control participants. We assessed the effect of STEMI serum on activation of apoptosis and necrosis, as well as on the permeability and structure of the endothelial monolayer. RESULTS Serum from STEMI patients increased apoptosis (P <.01) and necrosis (P <.05) in human coronary artery endothelial cells and caused increased permeability of the endothelial monolayer in vitro (P <.01), due to enlarged intercellular spaces (P <.05 vs control in all cases). Higher serum-induced necrosis was associated with greater endothelial permeability in vitro (P <.05) and with more extensive CMR-derived indices of reperfusion injury and infarct size. CONCLUSIONS Postreperfusion serum activates necrosis and apoptosis in endothelial cells and increases the degree of endothelial permeability in vitro. The more potent the necrosis-triggering effect of serum, the more deleterious the consequences in terms of the resulting cardiac structure.
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Affiliation(s)
- César Ríos-Navarro
- Instituto de Investigación Sanitaria (INCLIVA), Valencia, Spain; Departamento de Patología, Facultad de Medicina, Universidad de Valencia, Valencia, Spain
| | - José Gavara
- Centro de Biomateriales e Ingeniería Tisular, Universidad Politécnica de Valencia, Valencia, Spain
| | - Elena de Dios
- Departamento de Medicina, Facultad de Medicina, Universidad de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Spain
| | | | | | - Víctor Marcos-Garcés
- Instituto de Investigación Sanitaria (INCLIVA), Valencia, Spain; Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Amparo Ruiz-Saurí
- Instituto de Investigación Sanitaria (INCLIVA), Valencia, Spain; Departamento de Patología, Facultad de Medicina, Universidad de Valencia, Valencia, Spain
| | - Antoni Bayés-Genís
- Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Spain; Instituto de Investigación en Ciencias de la Salud Germans Trias i Pujol, Can Ruti Campus, Badalona, Spain; Servicio de Cardiología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain; Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Francisco Carrión-Valero
- Instituto de Investigación Sanitaria (INCLIVA), Valencia, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Valencia, Valencia, Spain; Servicio de Neumología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Francisco J Chorro
- Instituto de Investigación Sanitaria (INCLIVA), Valencia, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Vicente Bodí
- Instituto de Investigación Sanitaria (INCLIVA), Valencia, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain.
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Ortega M, Molina-García T, Gavara J, de Dios E, Pérez-Solé N, Marcos-Garcés V, Chorro FJ, Rios-Navarro C, Ruiz-Sauri A, Bodi V. Novel Targets Regulating the Role of Endothelial Cells and Angiogenesis after Infarction: A RNA Sequencing Analysis. Int J Mol Sci 2023; 24:15698. [PMID: 37958681 PMCID: PMC10649670 DOI: 10.3390/ijms242115698] [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: 10/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Endothelial cells (ECs) are a key target for cardioprotection due to their role in preserving cardiac microvasculature and homeostasis after myocardial infarction (MI). Our goal is to identify the genes involved in post-MI EC proliferation, EC apoptosis, and angiogenesis regulation via RNA-sequencing transcriptomic datasets. Using eight studies from the Gene Expression Omnibus, RNA-sequencing data from 92 mice submitted to different times of coronary ischemia or sham were chosen. Functional enrichment analysis was performed based on gene ontology biological processes (BPs). Apoptosis-related BPs are activated up to day 3 after ischemia onset, whereas endothelial proliferation occurs from day 3 onwards, including an overrepresentation of up to 37 genes. Endothelial apoptosis post-MI is triggered via both the extrinsic and intrinsic signaling pathways, as reflected by the overrepresentation of 13 and 2 specific genes, respectively. BPs implicated in new vessel formation are upregulated soon after ischemia onset, whilst the mechanisms aiming at angiogenesis repression can be detected at day 3. Overall, 51 pro-angiogenic and 29 anti-angiogenic factors displayed altered transcriptomic expression post-MI. This is the first study using RNA sequencing datasets to evaluate the genes participating in post-MI endothelium physiology and angiogenesis regulation. These novel data could lay the groundwork to advance understanding of the implication of ECs after MI.
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Affiliation(s)
- María Ortega
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (M.O.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (F.J.C.); (V.B.)
| | - Tamara Molina-García
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (M.O.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (F.J.C.); (V.B.)
| | - Jose Gavara
- Centro de Biomateriales e Ingeniería Tisular, Universidad Politécnica de Valencia, 46010 Valencia, Spain;
| | - Elena de Dios
- Centro de Investigación Biomédica en Red (CIBER)-CV, 28029 Madrid, Spain;
| | - Nerea Pérez-Solé
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (M.O.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (F.J.C.); (V.B.)
| | - Victor Marcos-Garcés
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (M.O.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (F.J.C.); (V.B.)
- Cardiology Department, Hospital Clínico Universitario, 46010 Valencia, Spain
| | - Francisco J. Chorro
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (M.O.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (F.J.C.); (V.B.)
- Centro de Investigación Biomédica en Red (CIBER)-CV, 28029 Madrid, Spain;
- Cardiology Department, Hospital Clínico Universitario, 46010 Valencia, Spain
- Department of Medicine, University of Valencia, 46010 Valencia, Spain
| | - Cesar Rios-Navarro
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (M.O.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (F.J.C.); (V.B.)
- Department of Pathology, University of Valencia, 46010 Valencia, Spain
| | - Amparo Ruiz-Sauri
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (M.O.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (F.J.C.); (V.B.)
- Department of Pathology, University of Valencia, 46010 Valencia, Spain
| | - Vicente Bodi
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain; (M.O.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (F.J.C.); (V.B.)
- Centro de Investigación Biomédica en Red (CIBER)-CV, 28029 Madrid, Spain;
- Cardiology Department, Hospital Clínico Universitario, 46010 Valencia, Spain
- Department of Medicine, University of Valencia, 46010 Valencia, Spain
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3
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Blázquez-Bujeda Á, Ortega M, de Dios E, Gavara J, Perez-Solé N, Molina-Garcia T, Marcos-Garcés V, Diaz A, Chorro FJ, Rios-Navarro C, Bodí V, Ruiz-Sauri A. Changes in the extracellular matrix at microvascular obstruction area after reperfused myocardial infarction: A morphometric study. Ann Anat 2023; 250:152138. [PMID: 37506775 DOI: 10.1016/j.aanat.2023.152138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 07/03/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Extracellular matrix (ECM) suffers substantial alterations after myocardial infarction (MI), including the invasion of leukocyte subtypes. Despite a complete reopening at epicardial level, hypoperfusion within the infarcted myocardium, known as microvascular obstruction (MVO), occurs and exerts a negative impact on ventricular remodeling. In this study, ECM composition at MVO regions was described using a morphometric analysis. METHODS MI was induced in female swine (n = 10) by transitory 90-minute coronary occlusion followed by seven days of reperfusion. Prior to euthanasia, intracoronary thioflavin-S was infused. Within the infarcted myocardium, regions displaying MVO (thioflavin-S-) or no MVO (thioflavin-S+) were isolated and stained to morphometrically compare ECM composition. RESULTS As reflected by cell invasion through ECM, areas with MVO displayed an enlarged presence of neutrophils and lymphocytes, whilst no differences in the amount of macrophages and myofibroblasts were detected compared to infarcted myocardium without MVO. Indeed, those regions with macroscopic MVO showed lower capillary density than areas without MVO. Lastly, a significant reduction in the extension of total collagen, type I, but not type III, collagen, laminin, and fibronectin together with an augmentation of polysaccharides were noted in areas showing MVO compared to those without microvascular injury. CONCLUSIONS ECM composition in infarcted regions with MVO isolated from female swine displays a higher presence of inflammatory infiltrate and polysaccharides as well as reduced number of microvessels and collagen content compared to those areas without microvascular hypoperfusion. These characteristics might underlie the development of adverse ventricular remodeling in MI patients with extensive MVO.
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Affiliation(s)
| | - Maria Ortega
- INCLIVA Health Research Institute, Valencia, Spain
| | - Elena de Dios
- Department of Medicine, Universidad de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red (CIBER)-CV, Madrid, Spain
| | - Jose Gavara
- Centro de Biomateriales e Ingeniería Tisular, Universidad Politécnica de Valencia, Valencia, Spain
| | | | | | - Victor Marcos-Garcés
- INCLIVA Health Research Institute, Valencia, Spain; Cardiology Department, Hospital Clinico Universitario, Valencia, Spain
| | - Ana Diaz
- Unidad Central de Investigación Biomédica, Universidad de Valencia, Valencia, Spain
| | - Francisco J Chorro
- INCLIVA Health Research Institute, Valencia, Spain; Department of Medicine, Universidad de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red (CIBER)-CV, Madrid, Spain; Cardiology Department, Hospital Clinico Universitario, Valencia, Spain
| | - Cesar Rios-Navarro
- Department of Pathology, Universidad de Valencia, Valencia, Spain; INCLIVA Health Research Institute, Valencia, Spain.
| | - Vicente Bodí
- INCLIVA Health Research Institute, Valencia, Spain; Department of Medicine, Universidad de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red (CIBER)-CV, Madrid, Spain; Cardiology Department, Hospital Clinico Universitario, Valencia, Spain.
| | - Amparo Ruiz-Sauri
- Department of Pathology, Universidad de Valencia, Valencia, Spain; INCLIVA Health Research Institute, Valencia, Spain
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Bodi V, Gavara J, Lopez-Lereu MP, Monmeneu JV, de Dios E, Perez-Sole N, Bonanad C, Marcos-Garces V, Canoves J, Minana G, Nunez J, Moratal D, Chorro FJ, Rodríguez-Palomares JF, Freixa A, Borrás R, Ortiz-Pérez JT, Rios-Navarro C. Impact of Persistent Microvascular Obstruction Late After STEMI on Adverse LV Remodeling: A CMR Study. JACC Cardiovasc Imaging 2023:S1936-878X(23)00094-3. [PMID: 37052556 DOI: 10.1016/j.jcmg.2023.01.021] [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: 05/12/2022] [Revised: 12/23/2022] [Accepted: 01/26/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Little is known about the occurrence and implications of persistent microvascular obstruction (MVO) after reperfused ST-segment elevation myocardial infarction (STEMI). OBJECTIVES The authors used cardiac magnetic resonance (CMR) to characterize the impact of persistent MVO on adverse left ventricular remodeling (ALVR). METHODS A prospective registry of 471 STEMI patients underwent CMR 7 (IQR: 5-10) days and 198 (IQR: 167-231) days after infarction. MVO (≥1 segment) and ALVR (relative increase >15% at follow-up CMR) of left ventricular end-diastolic index (LVEDVI) and left ventricular end-systolic volume index (LVESVI) were determined. RESULTS One-week MVO occurred in 209 patients (44%) and persisted in 30 (6%). Extent of MVO (P = 0.026) and intramyocardial hemorrhage (P = 0.001) at 1 week were independently associated with the magnitude of MVO at follow-up CMR. Compared with patients without MVO (n = 262, 56%) or with MVO only at 1 week (n = 179, 38%), those with persistent MVO at follow-up (n = 30, 6%) showed higher rates of ALVR-LVEDVI (22%, 27%, 50%; P = 0.003) and ALVR-LVESVI (20%, 21%, 53%; P < 0.001). After adjustment, persistent MVO at follow-up (≥1 segment) was independently associated with ΔLVEDVI (relative increase, %) (P < 0.001) and ΔLVESVI (P < 0.001). Compared with a 1:1 propensity score-matched population on CMR variables made up of 30 patients with MVO only at 1 week, patients with persistent MVO more frequently displayed ALVR-LVEDVI (12% vs 50%; P = 0.003) and ALVR-LVESVI (12% vs 53%; P = 0.001). CONCLUSIONS MVO persists in a small percentage of patients in chronic phase after STEMI and exerts deleterious effects in terms of LV remodeling. These findings fuel the need for further research on microvascular injury repair.
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Affiliation(s)
- Vicente Bodi
- Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain; Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.
| | - Jose Gavara
- Center for Biomaterials and Tissue Engineering, Universitat Politècnica de València, Valencia, Spain
| | | | - Jose V Monmeneu
- Cardiovascular Magnetic Resonance Unit, Grupo ASCIRES, Valencia, Spain
| | - Elena de Dios
- Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
| | - Nerea Perez-Sole
- Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Clara Bonanad
- Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain; Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Victor Marcos-Garces
- Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Joaquim Canoves
- Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain; Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Gema Minana
- Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain; Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
| | - Julio Nunez
- Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain; Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
| | - David Moratal
- Center for Biomaterials and Tissue Engineering, Universitat Politècnica de València, Valencia, Spain
| | - Francisco J Chorro
- Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain; Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain; Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain
| | - Jose F Rodríguez-Palomares
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain; Department of Cardiology, Hospital Universitario Vall d'Hebron, Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrea Freixa
- Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain; Cardiovascular Institute, Hospital Clínic, Barcelona, Spain
| | - Roger Borrás
- Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain; Cardiovascular Institute, Hospital Clínic, Barcelona, Spain
| | - Jose T Ortiz-Pérez
- Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain; Cardiovascular Institute, Hospital Clínic, Barcelona, Spain
| | - Cesar Rios-Navarro
- Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia, Valencia, Spain
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Ríos-Navarro C, Gavara J, Bodí V. Microvascular injury after acute myocardial infarction. Focus on the catheterization laboratory. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2022; 75:777-779. [PMID: 35676174 DOI: 10.1016/j.rec.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
| | - José Gavara
- Centro de Biomateriales e Ingeniería Tisular, Universidad Politécnica de Valencia, Valencia, Spain
| | - Vicente Bodí
- INCLIVA - Instituto de Investigación Sanitaria, Valencia, Spain; Departamento de Medicina, Universidad de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario, Valencia, Spain.
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6
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Ríos-Navarro C, Gavara J, Núñez J, Revuelta-López E, Monmeneu JV, López-Lereu MP, de Dios E, Pérez-Solé N, Vila JM, Oltra R, Chorro FJ, Bayés-Genís A, Bodi V. EpCAM y obstrucción microvascular en pacientes con un IAMCEST: estudio con resonancia magnética cardiaca. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Daño microvascular tras un infarto agudo de miocardio. Foco en el laboratorio de hemodinámica. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Rios-Navarro C, Daghbouche-Rubio N, Gavara J, de Dios E, Perez N, Vila JM, Chorro FJ, Ruiz-Sauri A, Bodi V. Ischemia-reperfusion injury to coronary arteries: Comprehensive microscopic study after reperfused myocardial infarction. Ann Anat 2021; 238:151785. [PMID: 34144157 DOI: 10.1016/j.aanat.2021.151785] [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: 01/22/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Coronary arteries supply oxygen and nutrients to the heart. We evaluated the dynamics of microscopic damage throughout the ischemia-reperfusion process in the wall of coronary arteries following myocardial infarction (MI). METHODS In a swine model of reperfused MI, animals were divided into one control and four MI groups: 90-min ischemia without reperfusion, or followed by one minute, one week or one month reperfusion. Left anterior descending (LAD; infarct-related artery) and control right coronary arteries (RCA) were isolated. Taking the balloon inflation region as a reference, we isolated the proximal and distal LAD areas, performing histological staining and immunohistochemistry. RESULTS Although mild changes in tunica intima were observed during ischemia, an almost complete absence of endothelium, and abnormal breaks in the internal elastic layer were found post-revascularization. In tunica media, increased thickness was observed soon after reperfusion, whereas larger thickness, disorganized muscle cell distribution and edema were found one week after reperfusion. This damage was more pronounced in distal rather than proximal LAD, whereas no changes were detected in RCA. In the tunica adventitia, vasa vasorum density decayed during ischemia in both LAD regions, but was restored after one month. Leukocyte adhesion to the artery was observed post-revascularization, developing into a massive presence in the three layers one week post-reperfusion. CONCLUSIONS Ischemia-reperfusion can itself induce damage in the wall of the epicardial coronary artery, becoming more pronounced in the region distal to balloon inflation. Exploring these abnormalities will provide insight into the pathophysiology of coronary circulation and MI.
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Affiliation(s)
| | | | - Jose Gavara
- INCLIVA Health Research Institute, Valencia, Spain
| | - Elena de Dios
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red - Cardiovascular, Spain
| | - Nerea Perez
- INCLIVA Health Research Institute, Valencia, Spain
| | - Jose M Vila
- INCLIVA Health Research Institute, Valencia, Spain; Department of Physiology, School of Medicine, University of Valencia, Valencia, Spain
| | - Francisco J Chorro
- INCLIVA Health Research Institute, Valencia, Spain; Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red - Cardiovascular, Spain; Cardiology Department, Hospital Clinico Universitario, Valencia, Spain
| | - Amparo Ruiz-Sauri
- INCLIVA Health Research Institute, Valencia, Spain; Department of Pathology, School of Medicine, University of Valencia, Valencia, Spain.
| | - Vicente Bodi
- INCLIVA Health Research Institute, Valencia, Spain; Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red - Cardiovascular, Spain; Cardiology Department, Hospital Clinico Universitario, Valencia, Spain.
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9
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Ríos-Navarro C, Gavara J, Núñez J, Revuelta-López E, Monmeneu JV, López-Lereu MP, de Dios E, Pérez-Solé N, Vila JM, Oltra R, Chorro FJ, Bayés-Genís A, Bodi V. EpCAM and microvascular obstruction in patients with STEMI: a cardiac magnetic resonance study. ACTA ACUST UNITED AC 2021; 75:384-391. [PMID: 34045168 DOI: 10.1016/j.rec.2021.04.006] [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: 12/04/2020] [Accepted: 04/15/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND OBJECTIVES Microvascular obstruction (MVO) is negatively associated with cardiac structure and worse prognosis after ST-segment elevation myocardial infarction (STEMI). Epithelial cell adhesion molecule (EpCAM), involved in epithelium adhesion, is an understudied area in the MVO setting. We aimed to determine whether EpCAM is associated with the appearance of cardiac magnetic resonance (CMR)-derived MVO and long-term systolic function in reperfused STEMI. METHODS We prospectively included 106 patients with a first STEMI treated with percutaneous coronary intervention, quantifying serum levels of EpCAM 24hours postreperfusion. All patients underwent CMR imaging 1 week and 6 months post-STEMI. The independent correlation of EpCAM with MVO, systolic volume indices, and left ventricular ejection fraction was evaluated. RESULTS The mean age of the sample was 59±13 years and 76% were male. Patients were dichotomized according to median EpCAM (4.48 pg/mL). At 1-week CMR, lower EpCAM was related to extensive MVO (P=.021) and larger infarct size (P=.019). At presentation, EpCAM values were significantly associated with the presence of MVO in univariate (OR, 0.58; 95%CI, 0.38-0.88; P=.011) and multivariate logistic regression models (OR, 0.55; 95%CI, 0.35-0.87; P=.010). Although MVO tends to resolve at chronic phases, decreased EpCAM was associated with worse systolic function: reduced left ventricular ejection fraction (P=.009) and higher left ventricular end-systolic volume (P=.043). CONCLUSIONS EpCAM is associated with the occurrence of CMR-derived MVO at acute phases and long-term adverse ventricular remodeling post-STEMI.
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Affiliation(s)
| | - José Gavara
- Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain
| | - Julio Núñez
- Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain; Departamento de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Medicina, Facultad de Medicina, Universitat de Valencia, Valencia, Spain
| | - Elena Revuelta-López
- Instituto del Corazón, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - José V Monmeneu
- Unidad de Resonancia Magnética Cardiovascular, Exploraciones Radiológicas Especiales (ERESA), Valencia, Spain
| | - María P López-Lereu
- Unidad de Resonancia Magnética Cardiovascular, Exploraciones Radiológicas Especiales (ERESA), Valencia, Spain
| | - Elena de Dios
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Medicina, Facultad de Medicina, Universitat de Valencia, Valencia, Spain
| | | | - José M Vila
- Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain; Departamento de Fisiología, Facultad de Medicina, Universitat de Valencia, Valencia, Spain
| | - Ricardo Oltra
- Unidad de Cuidados Intensivos, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Francisco J Chorro
- Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain; Departamento de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Medicina, Facultad de Medicina, Universitat de Valencia, Valencia, Spain
| | - Antoni Bayés-Genís
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Instituto del Corazón, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Vicente Bodi
- Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain; Departamento de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Medicina, Facultad de Medicina, Universitat de Valencia, Valencia, Spain.
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10
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Rios-Navarro C, Dios ED, Forteza MJ, Bodi V. Unraveling the thread of uncontrolled immune response in COVID-19 and STEMI: an emerging need for knowledge sharing. Am J Physiol Heart Circ Physiol 2021; 320:H2240-H2254. [PMID: 33844596 PMCID: PMC8384574 DOI: 10.1152/ajpheart.00934.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The outbreak of severe acute respiratory syndrome coronavirus 2 that first emerged in Wuhan in December 2019 has resulted in the devastating pandemic of coronavirus disease 2019, creating an emerging need for knowledge sharing. Meanwhile, myocardial infarction is and will probably remain the foremost cause of death in the Western world throughout the coming decades. Severe deregulation of the immune system can unnecessarily expand the inflammatory response and participate in target and multiple organ failure, in infection but also in critical illness. Indeed, the course and fate of inflammatory cells observed in severe ST-elevation myocardial infarction (neutrophilia, monocytosis, and lymphopenia) almost perfectly mirror those recently reported in severe coronavirus disease 2019. A pleiotropic proinflammatory imbalance hampers adaptive immunity in favor of uncontrolled innate immunity and is associated with poorer structural and clinical outcomes. The goal of the present review is to gain greater insight into the cellular and molecular mechanisms underlying this canonical activation and downregulation of the two arms of the immune response in both entities, to better understand their pathophysiology and to open the door to innovative therapeutic options. Knowledge sharing can pave the way for therapies with the potential to significantly reduce mortality in both infectious and noninfectious scenarios.
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Affiliation(s)
- Cesar Rios-Navarro
- INCLIVA Health Research Institute, University of Valencia, Valencia, Spain
| | - Elena de Dios
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain.,Centro de Investigación Biomédica en Red-Cardiovascular, University of Valencia, Valencia, Spain
| | - Maria J Forteza
- Department of Medicine, Center of Molecular Medicine, Cardiovascular Medicine Unit, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Vicente Bodi
- INCLIVA Health Research Institute, University of Valencia, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain.,Centro de Investigación Biomédica en Red-Cardiovascular, University of Valencia, Valencia, Spain.,Cardiology Department, Hospital Clinico Universitario, University of Valencia, Valencia, Spain
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11
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de Dios E, Rios-Navarro C, Pérez-Solé N, Gavara J, Marcos-Garcés V, Forteza MJ, Oltra R, Vila JM, Chorro FJ, Bodi V. Overexpression of genes involved in lymphocyte activation and regulation are associated with reduced CRM-derived cardiac remodelling after STEMI. Int Immunopharmacol 2021; 95:107490. [PMID: 33677257 DOI: 10.1016/j.intimp.2021.107490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/03/2021] [Accepted: 02/07/2021] [Indexed: 11/19/2022]
Abstract
AIMS Lymphopenia after ST-segment elevation myocardial infarction (STEMI) correlates with deleterious cardiac consequences and worse prognosis. An in-depth examination of genes implicated in lymphocyte proliferation, activation and regulation and their association with short- and long-term cardiac structure and function is therefore of great interest. METHODS Peripheral blood mononuclear cells were isolated from 10 control subjects and 64 patients with a first STEMI treated with primary percutaneous coronary intervention and submitted to cardiac magnetic resonance after 1 week and 6 months. mRNA expression of genes implicated in lymphocyte activation (CD25 and CD69) and regulation [programmed death (PD)-1 and cytotoxic T-lymphocyte antigen (CTLA)-4] were determined by qRT-PCR. RESULTS In comparison to controls, STEMI patients showed heightened mRNA expression of CD25 and lower PD-1 and CTLA-4 96 h after coronary reperfusion. Patients with extensive infarctions (>30% of left ventricular mass) at 1 week displayed a notable reduction in CD25, CD69, PD-1, and CTLA-4 expression (p < 0.05). However, CD25 was the only predictor of 1-week extensive infarct size in multivariate logistic regression analysis (odds ratio 0.019; 95% confidence interval [0.001-0.505]; p = 0.018). Regarding long-term ventricular function, mRNA expression of CD25 under the mean value was associated with worse ventricular function and more adverse remodelling. CONCLUSIONS Following STEMI, heightened expression of genes expressed in regulatory T cells (CD25 and CD69) and immune checkpoints (PD-1 and CTLA-4) correlates with a better short- and long-term cardiac structure and function. Advancing understanding of the pathophysiology of lymphopenia and evaluating novel immunomodulatory therapies will help translate these results into future clinical trials.
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Affiliation(s)
- Elena de Dios
- Centro de Investigación Biomédica en Red - Cardiovascular (CIBER-CV), 28029 Madrid, Spain; Medicine Department, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
| | | | | | - Jose Gavara
- Institute of Health Research-INCLIVA, 46010 Valencia, Spain
| | | | - Maria J Forteza
- Cardiovascular Medicine Unit, Center of Molecular Medicine, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, 171 77 Stockholm, Sweden
| | - Ricardo Oltra
- Intensive Care Unit, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | - José M Vila
- Institute of Health Research-INCLIVA, 46010 Valencia, Spain; Physiology Department, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
| | - Francisco J Chorro
- Centro de Investigación Biomédica en Red - Cardiovascular (CIBER-CV), 28029 Madrid, Spain; Medicine Department, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; Institute of Health Research-INCLIVA, 46010 Valencia, Spain; Cardiology Department, Hospital Clínico Universitario, 46010 Valencia, Spain
| | - Vicente Bodi
- Centro de Investigación Biomédica en Red - Cardiovascular (CIBER-CV), 28029 Madrid, Spain; Medicine Department, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; Institute of Health Research-INCLIVA, 46010 Valencia, Spain; Cardiology Department, Hospital Clínico Universitario, 46010 Valencia, Spain.
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12
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Implicación de la isoforma antiangiogénica VEGF-A165b en la angiogénesis y la función sistólica tras un infarto de miocardio reperfundido. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.03.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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13
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Rios-Navarro C, Ortega M, Marcos-Garces V, Gavara J, de Dios E, Perez-Sole N, Chorro FJ, Bodi V, Ruiz-Sauri A. Interstitial changes after reperfused myocardial infarction in swine: morphometric and genetic analysis. BMC Vet Res 2020; 16:262. [PMID: 32727469 PMCID: PMC7388500 DOI: 10.1186/s12917-020-02465-6] [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: 02/25/2020] [Accepted: 07/07/2020] [Indexed: 11/26/2022] Open
Abstract
Background Following myocardial infarction (MI), we aimed to characterize morphometric and genetic changes in extracellular matrix (ECM) components from ischemia onset until late phases after coronary reperfusion in necrotic and salvaged myocardium. Results Swine were divided into one control (n = 5) and three MI groups: 90-min of ischemia without reperfusion, or followed by 1-week or 1-month reperfusion (n = 5 per group). In samples from the necrotic and salvaged areas, ECM components were morphometrically quantified and mRNA levels of factors involved in ECM remodeling were evaluated. After 90-min of ischemia, fibronectin, laminin, and elastic fibers content as well as upregulated mRNA expression of tissue inhibitors of metalloproteinases (TIMP)1, TIMP2, TIMP3 and connective tissue growth factor increased in the necrotic and salvaged myocardium. In both reperfused MI groups, collagen-I, collagen-III, elastic fibers, glycosaminoglycans, laminin, and fibronectin levels heightened in the necrotic but not the salvaged myocardium. Moreover, mRNA expression of TIMP1, TIMP2 and TIMP3, as well as metalloproteinase-2 and metalloproteinase-9 heightened in the necrotic but not in the salvaged myocardium. Conclusions Matrix remodeling starts after ischemia onset in both necrotic and salvaged myocardium. Even if ECM composition from the salvaged myocardium was altered after severe ischemia, ECM makes a full recovery to normal composition after reperfusion. Therefore, rapid coronary reperfusion is essential not only to save cardiomyocytes but also to preserve matrix, thus avoiding impaired left ventricular remodeling.
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Affiliation(s)
| | - Maria Ortega
- Pathology Department, School of Medicine, University of Valencia, Av Blasco Ibañez 15, 46010, Valencia, Spain
| | - Victor Marcos-Garces
- Cardiology Department, Hospital Clinico Universitario, Av Blasco Ibanez, 17 46010, Valencia, Spain
| | - Jose Gavara
- INCLIVA Health Research Institute, Valencia, Spain
| | - Elena de Dios
- INCLIVA Health Research Institute, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | | | - Francisco J Chorro
- INCLIVA Health Research Institute, Valencia, Spain.,Cardiology Department, Hospital Clinico Universitario, Av Blasco Ibanez, 17 46010, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain.,Centro de Investigación Biomédica en Red - Cardiovascular (CIBER-CV), Madrid, Spain
| | - Vicente Bodi
- INCLIVA Health Research Institute, Valencia, Spain. .,Cardiology Department, Hospital Clinico Universitario, Av Blasco Ibanez, 17 46010, Valencia, Spain. .,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain. .,Centro de Investigación Biomédica en Red - Cardiovascular (CIBER-CV), Madrid, Spain.
| | - Amparo Ruiz-Sauri
- INCLIVA Health Research Institute, Valencia, Spain. .,Pathology Department, School of Medicine, University of Valencia, Av Blasco Ibañez 15, 46010, Valencia, Spain.
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14
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Role of antiangiogenic VEGF-A 165b in angiogenesis and systolic function after reperfused myocardial infarction. ACTA ACUST UNITED AC 2020; 74:131-139. [PMID: 32474003 DOI: 10.1016/j.rec.2020.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 03/30/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION AND OBJECTIVES Angiogenesis helps to reestablish microcirculation after myocardial infarction (MI). In this study, we aimed to further understand the role of the antiangiogenic isoform vascular endothelial growth factor (VEGF)-A165b after MI and to explore its potential as a coadjuvant therapy to coronary reperfusion. METHODS Two mice MI models were formed: a) permanent coronary ligation (nonreperfused MI); b) transient 45-minute coronary occlusion followed by reperfusion (reperfused MI); in both models, animals underwent echocardiography before euthanasia at day 21 after MI induction. We determined serum and myocardial VEGF-A165b levels. In both experimental MI models, we assessed the functional and structural role of VEGF-A165b blockade. In a cohort of 104 ST-segment elevation MI patients, circulating VEGF-A165b levels were correlated with cardiovascular magnetic resonance-derived left ventricular ejection fraction at 6 months and with the occurrence of adverse events (death, heart failure, and/or reinfarction). RESULTS In both models, circulating and myocardial VEGF-A165b levels were increased 21 days after MI induction. Serum VEGF-A165b levels inversely correlated with systolic function evaluated by echocardiography. VEGF-A165b blockade increased capillary density, reduced infarct size, and enhanced left ventricular function in reperfused, but not in nonreperfused, MI experiments. In patients, higher VEGF-A165b levels correlated with depressed ejection fraction and worse outcomes. CONCLUSIONS In experimental and clinical studies, higher serum VEGF-A165b levels are associated with worse systolic function. Their blockade enhances neoangiogenesis, reduces infarct size, and increases ejection fraction in reperfused, but not in nonreperfused, MI experiments. Therefore, VEGF-A165b neutralization represents a potential coadjuvant therapy to coronary reperfusion.
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15
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Carretero A, Gomez-Cabrera MC, Rios-Navarro C, Salvador-Pascual A, Bodi V, Viña J. Early reductive stress and late onset overexpression of antioxidant enzymes in experimental myocardial infarction. Free Radic Res 2020; 54:173-184. [PMID: 32103692 DOI: 10.1080/10715762.2020.1735632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Reductive stress is defined as a pathophysiological situation in which the cell becomes more reduced than in the normal, resting state. It represents a disturbance in the redox state that is harmful to biological systems. Our aim was to study the occurrence of reductive stress in the early phases of experimental myocardial infarction and to determine the mechanisms leading to such stress using a swine model. During the ischemic period, we found a decrease in the oxidized to reduced glutathione ratio (GSSG/GSH) (0.7-0.3), in the lactate to pyruvate ratio (42.7-132.4), in protein glutathionylation (111.8-96.1), and in p38 phosphorylation (0.9-0.4). This was accompanied by a significant increase in the expression of Thioredoxin (TXN) (0.6-1.9) and peroxiredoxin (PRDX6) (0.6-1.6) in different left ventricle areas. After reperfusion, there was a massive increase in oxidative damage markers including lipid peroxidation (0.2-0.4), protein carbonylation (144.9-462.8), and glutathionylation (111.8-176.8). Concomitantly, we found an activation of nuclear factor erythroid 2-related factor 2 (Nrf2) (1.2-6.1) and of a set of antioxidant enzymes including TXN, PRDX6, glutathione peroxidase (GPX1), glutathione reductase (GSR), and glucose 6 phosphate dehydrogenase (G6PD). We describe an early reductive, followed by a late onset oxidative stress (1 week and 1 month after reperfusion) in a swine myocardial infarction model. The occurrence of an early reductive phase may explain the lack of effectiveness of antioxidant therapies when administered in the early phases after reperfusion of ischemic hearts.
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Affiliation(s)
- Aitor Carretero
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES-ISCIII, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - Mari Carmen Gomez-Cabrera
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES-ISCIII, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - Cesar Rios-Navarro
- Department of Cardiology, Hospital Clínico Universitario, INCLIVA, Valencia, Spain
| | - Andrea Salvador-Pascual
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES-ISCIII, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - Vicente Bodi
- Department of Cardiology, Hospital Clínico Universitario, INCLIVA, Valencia, Spain.,Department of Medicine, Faculty of Medicine, Universitat de València, Valencia, Spain.,Centro de Investigación Biomédica en Red - Cardiovascular (CIBERCV), Madrid, Spain
| | - Jose Viña
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES-ISCIII, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
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16
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Rios-Navarro C, Marcos-Garces V, Bayes-Genis A, Husser O, Nuñez J, Bodi V. Microvascular Obstruction in ST-Segment Elevation Myocardial Infarction: Looking Back to Move Forward. Focus on CMR. J Clin Med 2019; 8:E1805. [PMID: 31661823 PMCID: PMC6912395 DOI: 10.3390/jcm8111805] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/22/2019] [Accepted: 10/25/2019] [Indexed: 12/14/2022] Open
Abstract
After a myocardial infarction (MI), despite the resolution of the coronary occlusion, the deterioration of myocardial perfusion persists in a considerable number of patients. This phenomenon is known as microvascular obstruction (MVO). Initially, the focus was placed on re-establishing blood flow in the epicardial artery. Then, the observation that MVO has profound negative structural and prognostic repercussions revived interest in microcirculation. In the near future, the availability of co-adjuvant therapies (beyond timely coronary reperfusion) aimed at preventing, minimizing, and repairing MVOs and finding convincing answers to questions regarding what, when, how, and where to administer these therapies will be of utmost importance. The objective of this work is to review the state-of-the-art concepts on pathophysiology, diagnostic methods, and structural and clinical implications of MVOs in patients with ST-segment elevation MIs. Based on this knowledge we discuss previously-tested and future opportunities for the prevention and repair of MVO.
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Affiliation(s)
| | | | - Antoni Bayes-Genis
- Centro de Investigación Biomédica en Red-Cardiovascular (CIBER-CV), 28029 Madrid, Spain.
- Cardiology Department and Heart Failure Unit, Hospital Universitari Germans Trias i Pujol (Badalona) and Department of Medicine Universitat Autonoma de Barcelona, 08916 Barcelona, Spain.
| | - Oliver Husser
- Department of Cardiology, St-Johannes Hospital, 44137 Dortmund, Germany.
| | - Julio Nuñez
- Institute of Health Research INCLIVA, 46010 Valencia, Spain.
- Cardiology Department, Hospital Clínico Universitario, 46010 Valencia, Spain.
- Centro de Investigación Biomédica en Red-Cardiovascular (CIBER-CV), 28029 Madrid, Spain.
- Department of Medicine, Universidad de Valencia, 46010 Valencia, Spain.
| | - Vicente Bodi
- Institute of Health Research INCLIVA, 46010 Valencia, Spain.
- Cardiology Department, Hospital Clínico Universitario, 46010 Valencia, Spain.
- Centro de Investigación Biomédica en Red-Cardiovascular (CIBER-CV), 28029 Madrid, Spain.
- Department of Medicine, Universidad de Valencia, 46010 Valencia, Spain.
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17
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Sheng Z, Lu W, Zuo Z, Wang D, Zuo P, Yao Y, Ma G. MicroRNA-7b attenuates ischemia/reperfusion-induced H9C2 cardiomyocyte apoptosis via the hypoxia inducible factor-1/p-p38 pathway. J Cell Biochem 2018; 120:9947-9955. [PMID: 30548297 DOI: 10.1002/jcb.28277] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 10/24/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE MicroRNAs (miRNAs) have been shown to play crucial roles in the occurrence, development, and treatment of many cardiovascular diseases. Coronary heart disease (CAD)-related miRNAs are still a growing research area. miR-7b was reported to be downregulated in acute myocardial infarction (AMI) myocardium tissues. However, it remains largely unknown whether miR-7b is involved in the pathogenesis and progression of the AMI ischemia/reperfusion (I/R) injury. METHODS Male C57BL/6 J mice and H9C2 cells were used as models in this study. Masson staining, real-time polymerase chain reaction, Western blot analysis, and terminal deoxynucleotidyl transferase-mediated dUTP nick-end-labeling immunofluorescence staining assays were performed to detect the related indicators in the study. SPSS 17.0 software was used to calculate the experimental data. RESULTS The results showed that miR-7b expression is downregulated after I/R in mice, and miR-7b could inhibit apoptosis in I/R-induced H9C2 cells via upregulating hypoxia-inducible factor 1a (HIF1a). The inhibitory effect of miR-7b on I/R-induced apoptosis in H9C2 cells was blocked by HIF1a silencing. In addition, our data suggested that the p-P38 pathway may be involved in the role of miR-7 in I/R-induced H9C2 cell apoptosis. CONCLUSION We confirmed that the overexpression of miR-7b inhibits I/R-induced apoptosis in H9C2 cells by targeting the HIF1a/p-P38 pathway. Our findings not only demonstrate the potential role of miR-7b in attenuating I/R-induced apoptosis but also provide a new insight into the better prevention of the I/R injury by mediating HIF-1 and p-P38.
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Affiliation(s)
- Zulong Sheng
- Department of Cardiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
| | - Wenbin Lu
- Department of Cardiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
| | - Zhi Zuo
- Department of Cardiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
| | - Dong Wang
- Department of Cardiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
| | - Pengfei Zuo
- Department of Cardiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
| | - Yuyu Yao
- Department of Cardiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
| | - Genshan Ma
- Department of Cardiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
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18
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Rios-Navarro C, Gavara J, Vidal V, Bonanad C, Racugno P, Bayes-Genis A, Miñana G, Husser O, Oltra R, Nuñez J, Chorro FJ, Bodi V, Ruiz-Sauri A. Characterization and implications of the dynamics of eosinophils in blood and in the infarcted myocardium after coronary reperfusion. PLoS One 2018; 13:e0206344. [PMID: 30365558 PMCID: PMC6203260 DOI: 10.1371/journal.pone.0206344] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/11/2018] [Indexed: 12/12/2022] Open
Abstract
Objective We characterized the dynamics of eosinophils in blood and in the infarcted myocardium in patients and in a swine model of reperfused myocardial infarction (MI). The association of eosinophil dynamics with various outcomes was assessed. Methods Serial eosinophil count and pre-discharge cardiac magnetic resonance were carried out in a prospective series of 620 patients with a first ST-elevation MI. In a swine model of reperfused MI, the dynamics of circulating eosinophils and their presence in the infarcted myocardium were determined. In autopsies from chronic MI patients, eosinophils were quantified. Results Patient eosinophil count sharply decreased 12h post-reperfusion compared to arrival. A lower minimum eosinophil count was associated with more extensive edema, microvascular obstruction, and infarct size as measured by cardiac magnetic resonance, and also with a higher rate of cardiac events (death, re-infarction, or heart failure) during follow-up. In the experimental model, eosinophil count boosted during ischemia and dropped back immediately post-reperfusion. Myocardial samples revealed progressive eosinophil migration into the infarcted myocardium, especially areas with microvascular obstruction. Markers of eosinophil maturation and survival (interleukin-5), degranulation (eosinophil cationic protein) and migration (eotoxin-1) were detected in the blood of patients, and in porcine myocardium. Eosinophil infiltration was detected in autopsies from chronic MI patients. Conclusion Eosinopenia post-MI was associated with an impaired cardiac structure and adverse events. The decay in circulating eosinophils soon after reperfusion mirrors their migration into the infarcted myocardium, as reflected by their presence in heart samples from swine and patients. Further studies are needed to understanding this unexplored pathway and its therapeutic implications.
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Affiliation(s)
- Cesar Rios-Navarro
- Institute of Health Research-INCLIVA, Valencia, Spain
- Cardiology Department, Hospital Clinico Universitario, Valencia, Spain
| | - Jose Gavara
- Institute of Health Research-INCLIVA, Valencia, Spain
- Cardiology Department, Hospital Clinico Universitario, Valencia, Spain
| | - Veronica Vidal
- Medicine Department, School of Medicine, University of Valencia, Valencia, Spain
| | - Clara Bonanad
- Institute of Health Research-INCLIVA, Valencia, Spain
- Cardiology Department, Hospital Clinico Universitario, Valencia, Spain
| | - Paolo Racugno
- Institute of Health Research-INCLIVA, Valencia, Spain
- Cardiology Department, Hospital Clinico Universitario, Valencia, Spain
| | - Antoni Bayes-Genis
- Cardiology Department and Heart Failure Unit, Hospital Universitari Germans Trias iPujol, Badalona, Spain, Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red–Cardiovascular (CIBER-CV), Madrid, Spain
| | - Gema Miñana
- Institute of Health Research-INCLIVA, Valencia, Spain
- Cardiology Department, Hospital Clinico Universitario, Valencia, Spain
- Medicine Department, School of Medicine, University of Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red–Cardiovascular (CIBER-CV), Madrid, Spain
| | - Oliver Husser
- Department of Cardiology, St.-Johannes-Hospital, Dortmund, Germany
| | - Ricardo Oltra
- Intensive Care Unit, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Julio Nuñez
- Institute of Health Research-INCLIVA, Valencia, Spain
- Cardiology Department, Hospital Clinico Universitario, Valencia, Spain
- Medicine Department, School of Medicine, University of Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red–Cardiovascular (CIBER-CV), Madrid, Spain
| | - Francisco J. Chorro
- Institute of Health Research-INCLIVA, Valencia, Spain
- Cardiology Department, Hospital Clinico Universitario, Valencia, Spain
- Medicine Department, School of Medicine, University of Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red–Cardiovascular (CIBER-CV), Madrid, Spain
| | - Vicente Bodi
- Institute of Health Research-INCLIVA, Valencia, Spain
- Cardiology Department, Hospital Clinico Universitario, Valencia, Spain
- Medicine Department, School of Medicine, University of Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red–Cardiovascular (CIBER-CV), Madrid, Spain
- * E-mail:
| | - Amparo Ruiz-Sauri
- Institute of Health Research-INCLIVA, Valencia, Spain
- Pathology Department, School of Medicine, University of Valencia, Valencia, Spain
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19
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Fracassi F, Niccoli G. Angiogénesis y obstrucción microvascular: ¿constituye ya una diana terapéutica? Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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20
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Fracassi F, Niccoli G. Angiogenesis and Microvascular Obstruction: Still a Research Topic or a New Therapeutic Target? ACTA ACUST UNITED AC 2017; 71:420-422. [PMID: 29129526 DOI: 10.1016/j.rec.2017.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 09/15/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Francesco Fracassi
- Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Giampaolo Niccoli
- Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
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