1
|
Ichimata S, Hata Y, Nishida N. Clinicopathologic Appearance of Advanced Ketoacidosis With Basal Vacuolation in Renal Tubules. Arch Pathol Lab Med 2021; 146:1102-1113. [PMID: 34936698 DOI: 10.5858/arpa.2021-0226-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Basal vacuolization (BV) in renal tubules is a histopathologic hallmark of advanced ketoacidosis that enables us to retrospectively diagnose these cases. OBJECTIVE.— To clarify the pathologic background and serologic findings of ketoacidosis with BV, and to reveal the pathologic findings by each pathologic background. DESIGN.— We examined 664 serial autopsy cases. A systemic histopathologic examination and measurement of serum β-hydroxybutyrate concentration were performed for the cases with BV. The extent of steatosis and fibrosis in the organs and the degree of coronary artery stenosis were semiquantitatively investigated. Immunohistochemistry for adipophilin was also performed to analyze its usefulness for the pathologic diagnosis. RESULTS.— Basal vacuolization was found in 16 cases, all of which showed a pathologic serum β-hydroxybutyrate concentration. The main background of ketoacidosis was considered as alcohol abuse in 6 cases, diabetes in 5, malnutrition in 3, and hypothermia and infection in 1 case each. Severe hepatic fibrosis was observed only in the alcohol-abuser group. Moreover, cardiac steatosis was more severe in patients with possible alcohol abuse than in those with other causes. Immunohistochemistry for adipophilin showed immunoreactivity consistent with BV in 13 of 16 cases. There was no correlation between β-hydroxybutyrate concentration and either the postmortem or storage interval. CONCLUSIONS.— Basal vacuolization may be a useful finding for detecting ketoacidosis cases in a postmortem investigation. Serum β-hydroxybutyrate was a stable and reliable compound for the definitive diagnosis of ketoacidosis in such cases. The present study showed that pathologic changes in some organs may vary by each pathologic background of ketoacidosis with BV.
Collapse
Affiliation(s)
- Shojiro Ichimata
- From the Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yukiko Hata
- From the Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Naoki Nishida
- From the Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| |
Collapse
|
2
|
Fernández-Solà J. The Effects of Ethanol on the Heart: Alcoholic Cardiomyopathy. Nutrients 2020; 12:E572. [PMID: 32098364 PMCID: PMC7071520 DOI: 10.3390/nu12020572] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 02/17/2020] [Accepted: 02/17/2020] [Indexed: 02/07/2023] Open
Abstract
Alcoholic-dilated Cardiomyopathy (ACM) is the most prevalent form of ethanol-induced heart damage. Ethanol induces ACM in a dose-dependent manner, independently of nutrition, vitamin, or electrolyte disturbances. It has synergistic effects with other heart risk factors. ACM produces a progressive reduction in myocardial contractility and heart chamber dilatation, leading to heart failure episodes and arrhythmias. Pathologically, ethanol induces myocytolysis, apoptosis, and necrosis of myocytes, with repair mechanisms causing hypertrophy and interstitial fibrosis. Myocyte ethanol targets include changes in membrane composition, receptors, ion channels, intracellular [Ca2+] transients, and structural proteins, and disrupt sarcomere contractility. Cardiac remodeling tries to compensate for this damage, establishing a balance between aggression and defense mechanisms. The final process of ACM is the result of dosage and individual predisposition. The ACM prognosis depends on the degree of persistent ethanol intake. Abstinence is the preferred goal, although controlled drinking may still improve cardiac function. New strategies are addressed to decrease myocyte hypertrophy and interstitial fibrosis and try to improve myocyte regeneration, minimizing ethanol-related cardiac damage. Growth factors and cardiomyokines are relevant molecules that may modify this process. Cardiac transplantation is the final measure in end-stage ACM but is limited to those subjects able to achieve abstinence.
Collapse
Affiliation(s)
- Joaquim Fernández-Solà
- Alcohol Unit, Internal Medicine Department, Hospital Clínic, Institut de Recerca August Pi i Sunyer (IDIBAPS), University of Barcelona, 08007 Catalunya, Spain;
- Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
| |
Collapse
|
3
|
Cao Z, Zhang T, Xu C, Jia Y, Wang T, Zhu B. AIN-93 Diet as an Alternative Model to Lieber-DeCarli Diet for Alcoholic Cardiomyopathy. Alcohol Clin Exp Res 2019; 43:1452-1461. [PMID: 31034614 DOI: 10.1111/acer.14069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/23/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Lieber-DeCarli alcoholic liquid diet is a classical method for establishing animal models of alcoholic cardiomyopathy (ACM). No study has reported whether the AIN-93 diet, which is widely used as a standard diet for both long-term and short-term studies with laboratory animals, could be used to construct the ACM animal model. The present study intended to investigate whether the AIN-93 diet could be used to establish a mouse ACM model. METHODS Twenty-four C57BL/6 male mice were randomly divided into 4 equally sized groups. In ethanol (EtOH)-fed groups, mice were fed a 4%-EtOH (w/v, 28% of total calories) alcoholic liquid diet of Lieber-DeCarli or the AIN-93 diet for chronic alcohol exposure for 180 days. In control-fed groups, mice were fed with non-EtOH liquid diets with the same calories as EtOH-fed groups. Morphological observations of the hearts and molecular investigation of the brain natriuretic peptide (BNP) were carried out by echocardiography, hematoxylin and eosin (H&E) and immunohistochemistry (IHC) staining, real-time quantitative polymerase chain reaction (qPCR), and enzyme-linked immunosorbent assay. RESULTS Echocardiography showed that mice fed with either the 4%-EtOH Lieber-DeCarli diet or the 4%-EtOH AIN-93 diet had dilated ventricles and poor cardiac function. IHC staining of BNP, qPCR of BNP mRNA, and plasma concentration of BNP showed an up-regulated expression in mice fed with both the 4%-EtOH Lieber-DeCarli and 4%-EtOH AIN-93 diets. Less fatty liver was also observed in mice fed the AIN-93 alcoholic diet than those fed the Lieber-DeCarli alcoholic diet. CONCLUSIONS The AIN-93 alcoholic liquid diet can be used to establish ACM animal models, as with the conventional Lieber-DeCarli alcoholic liquid diet.
Collapse
Affiliation(s)
- Zhipeng Cao
- Department of Forensic Pathology, School of Forensic Medicine, China Medical University, Shenyang, China
| | - Tianyi Zhang
- Department of Forensic Pathology, School of Forensic Medicine, China Medical University, Shenyang, China
| | - Chengyang Xu
- The third clinical department of China Medical University, Shenyang, China
| | - Yuqing Jia
- Department of Forensic Pathology, School of Forensic Medicine, China Medical University, Shenyang, China
| | - Tianqi Wang
- Department of Forensic Pathology, School of Forensic Medicine, China Medical University, Shenyang, China
| | - Baoli Zhu
- Department of Forensic Pathology, School of Forensic Medicine, China Medical University, Shenyang, China
| |
Collapse
|
4
|
Mustroph J, Lebek S, Maier LS, Neef S. Mechanisms of cardiac ethanol toxicity and novel treatment options. Pharmacol Ther 2018; 197:1-10. [PMID: 30557629 DOI: 10.1016/j.pharmthera.2018.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Ethanol can acutely and chronically alter cardiomyocyte and whole-organ function in the heart. Importantly, ethanol acutely and chronically predisposes to arrhythmias, while chronic abuse can induce heart failure. However, the molecular mechanisms of ethanol toxicity in the heart are incompletely understood. In this review, we summarize the current mechanistic knowledge on cardiac ethanol toxicity, with a focus on druggable pathways. Ethanol effects on excitation-contraction coupling, oxidative stress, apoptosis, and cardiac metabolism, as well as effects of ethanol metabolites will be discussed. Important recent findings have been gained by investigation of acute ethanol effects. These include a renewed focus on reactive oxygen species (ROS) and induction of SR Ca2+ leak by CaMKII-mediated pathways downstream of ROS. Furthermore, a clinical outlook into potential novel treatment options is provided.
Collapse
Affiliation(s)
- Julian Mustroph
- Department of Internal Medicine II, University Medical Center Regensburg, Germany
| | - Simon Lebek
- Department of Internal Medicine II, University Medical Center Regensburg, Germany
| | - Lars S Maier
- Department of Internal Medicine II, University Medical Center Regensburg, Germany
| | - Stefan Neef
- Department of Internal Medicine II, University Medical Center Regensburg, Germany.
| |
Collapse
|
5
|
Voskoboinik A, Costello BT, Kalman E, Prabhu S, Sugumar H, Wong G, Nalliah C, Ling LH, McLellan A, Hettige T, Springer F, La Gerche A, Kalman JM, Taylor AJ, Kistler PM. Regular Alcohol Consumption Is Associated With Impaired Atrial Mechanical Function in the Atrial Fibrillation Population. JACC Clin Electrophysiol 2018; 4:1451-1459. [DOI: 10.1016/j.jacep.2018.07.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 07/13/2018] [Accepted: 07/20/2018] [Indexed: 02/07/2023]
|
6
|
Li X, Nie Y, Lian H, Hu S. Histopathologic features of alcoholic cardiomyopathy compared with idiopathic dilated cardiomyopathy. Medicine (Baltimore) 2018; 97:e12259. [PMID: 30278496 PMCID: PMC6181549 DOI: 10.1097/md.0000000000012259] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The histologic difference between alcoholic cardiomyopathy (ACM) and idiopathic dilated cardiomyopathy (IDCM) is unclear. The present study aimed to identify the quantitative pathologic features of ACM compared with IDCM. METHODS Specimens from 6 regions (anterior left ventricle [LV], lateral LV, inferior LV, interventricular septum [IVS], anterior right ventricle [RV], and inferior RV) were sampled from each explanted heart. Specimens from 4 healthy donor hearts were obtained as normal control. Tissues were sectioned and Masson trichrome stained. Histomorphometry was performed to evaluate the amount of myocyte, fibrosis, fatty tissue, and interstitium by Image-Pro Plus 6.0 (Media Cybernetics). RESULTS A total of 408 specimens were obtained from 34 ACMs and 34 IDCMs; 8 specimens were obtained from 4 healthy donor hearts. Compared to healthy donor hearts, we observed an increase in fibrosis which replaces myocytes in myocardium of end-stage cardiomyopathy. The overall myocyte ratio in myocardium was 69.5 ± 8.7% in ACM vs 71.9 ± 7.4% in IDCM (P < .05). The percentage of interstitium was 10.8 ± 4.8% in ACM vs 9.2 ± 6.2% in IDCM (P < .05). A significant difference of fibrosis, fatty tissue was not discovered. Moreover, the myocyte area was 65.37 ± 11.8% in ACM LV vs 70.03 ± 9.0% in IDCM LV (P < .001). CONCLUSION We described histologic characteristics in ACM and IDCM. There might be a quantitative difference of myocyte, interstitium in myocardium between ACM and IDCM, especially in LV. No difference was found in the percentage of fibrosis between the 2 groups.
Collapse
|
7
|
Munteanu C, Rosioru C, Tarba C, Lang C. Long-term consumption of energy drinks induces biochemical and ultrastructural alterations in the heart muscle. Anatol J Cardiol 2018; 19:326-323. [PMID: 29724975 PMCID: PMC6280269 DOI: 10.14744/anatoljcardiol.2018.90094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Energy drinks (EDs) target young and active individuals and they are being marketed as enhancers of energy, concentration, and physical and cognitive performance. Their long-term consumption raises serious health concerns related to cardiovascular events. Here we investigate the effects of long-term Red Bull® consumption and its combination with alcohol on certain biochemical parameters and the ultrastructure of the myocardium. METHODS Male Wistar rats were categorized into four groups and given different treatments via oral administration. The Control (C) group received tap water, the Red Bull (RB) group received 1.5 ml/100 g body weight of Red Bull, the ethanol group (E) received 0.486 mg/100 g body weight of ethanol, and the Red Bull and ethanol (RBE) received a combination of the two beverages for 30 days. In the last 6 days of the experiment, the animals were tested for their physical performance by conducting a weight-loaded forced swim test. Immediately after swimming exhaustion, the animals were sacrificed under anesthesia and samples of the heart muscle were harvested for ultrastructural and biochemical analyses. RESULTS Our results showed a significant increase in the heart glucose and glycogen concentrations in the RB and RBE groups. Total cholesterol concentration significantly decreased in the RBE and RB groups. Total protein concentration and ALT and AST activities increased in all groups. The biochemical changes were accompanied by ultrastructural alterations. CONCLUSION Based on these results, we recommend that athletes and active persons should avoid the long-term consumption of the Red Bull ED and, particularly, its combination with alcohol.
Collapse
Affiliation(s)
| | | | | | - Camelia Lang
- Department of Molecular Biology and Biotechnology, Babes-Bolyai University; Cluj-Napoca-Romania.
| |
Collapse
|
8
|
Wang S, Ren J. Role of autophagy and regulatory mechanisms in alcoholic cardiomyopathy. Biochim Biophys Acta Mol Basis Dis 2018; 1864:2003-2009. [PMID: 29555210 DOI: 10.1016/j.bbadis.2018.03.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/11/2018] [Accepted: 03/14/2018] [Indexed: 12/11/2022]
Abstract
Alcoholism is accompanied with a high incidence of cardiac morbidity and mortality due to the development of alcoholic cardiomyopathy, manifested as dilation of one or both ventricles, reduced ventricular wall thickness, myofibrillary disarray, interstitial fibrosis, hypertrophy and contractile dysfunction. Several theories have been postulated for the etiology of alcoholic cardiomyopathy including ethanol/acetaldehyde toxicity, mitochondrial production of reactive oxygen species, oxidative injury, apoptosis, impaired myofilament Ca2+ sensitivity and protein synthesis, altered fatty acid extraction and deposition, as well as accelerated protein catabolism. In particular, buildup of long-lived or dysfunctional organelles has been reported to contribute to cardiac structural and functional damage following alcoholism. Removal of cell debris and defective organelles by autophagy is essential to the maintenance of cardiac homeostasis in physiological and pathological conditions. However, insufficient understanding is currently available with regards to the involvement of autophagy in the pathogenesis of alcoholic cardiomyopathy. This review summarizes the recent findings on the pathophysiological role of dysregulated autophagy in one set and development of alcoholic cardiomyopathy. A thorough understanding of how autophagy is affected in alcoholism, and subsequently, contributes to the pathogenesis of alcoholic heart injury, will offer therapeutic guidance towards the management of alcoholic cardiomyopathy.
Collapse
Affiliation(s)
- Shuyi Wang
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China; Center for Cardiovascular Research and Alternative Medicine, Biomedical Science Graduate Program, University of Wyoming College of Health Sciences, Laramie, WY 82071, USA
| | - Jun Ren
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China; Center for Cardiovascular Research and Alternative Medicine, Biomedical Science Graduate Program, University of Wyoming College of Health Sciences, Laramie, WY 82071, USA.
| |
Collapse
|
9
|
Hung CL, Lai YJ, Chi PC, Chen LC, Tseng YM, Kuo JY, Lin CI, Chen YC, Lin SJ, Yeh HI. Dose-related ethanol intake, Cx43 and Nav1.5 remodeling: Exploring insights of altered ventricular conduction and QRS fragmentation in excessive alcohol users. J Mol Cell Cardiol 2017; 114:150-160. [PMID: 29097069 DOI: 10.1016/j.yjmcc.2017.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/05/2017] [Accepted: 10/27/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Chronic, excessive ethanol intake has been linked with various electrical instabilities, conduction disturbances, and even sudden cardiac death, but the underlying cause for the latter is insufficiently delineated. METHODS We studied surface electrocardiography (ECG) in a community-dwelling cohort with moderate-to-heavy daily alcohol intake (grouped as >90g/day, ≤90g/day, and nonintake). RESULTS Compared with nonintake, heavier alcohol users showed markedly widened QRS duration and higher prevalence of QRS fragmentation (64.3%, 50.9%, and 33.7%, respectively, χ2 12.0, both p<0.05) on surface ECG across the 3 groups. These findings were successfully recapitulated in 14-week-old C57BL/6 mice that were chronically given a 4% or 6% alcohol diet and showed dose-related slower action potential upstroke, reduced resting membrane potential, and disorganized or decreased intraventricular conduction (all p<0.05). Immunodetection further revealed increased ventricular collagen I depots with Cx43 downregulation and remodeling, together with clustered and diminished membrane Nav1.5 distribution. Administration of Cx43 blocker (heptanol) and Nav1.5 inhibitor (tetrodotoxin) in the mice each attenuated the suppression ventricular conduction compared with nonintake mice (p<0.05). CONCLUSIONS Chronic excessive alcohol ingestion is associated with dose-related phenotypic intraventricular conduction disturbances and QRS fragmentation that can be recapitulated in mice. The mechanisms may involve suppressed gap junction and sodium channel functions, together with enhanced cardiac fibrosis that may contribute to arrhythmogenesis.
Collapse
Affiliation(s)
- Chung-Lieh Hung
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Jun Lai
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Po-Ching Chi
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Liang-Chia Chen
- Department of Mechanical Engineering, National Taiwan University, Taipei, Taiwan
| | - Ya-Ming Tseng
- Division of Cardiology, Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jen-Yuan Kuo
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-I Lin
- Institute of Physiology, National Defense Medical Center, Taipei, Taiwan; Department of Biophysics, National Defense Medical Center, Taipei, Taiwan
| | - Yao-Chang Chen
- Biomedical Engineering, National Defense Medical Center, Taipei, Taiwan
| | - Shing-Jong Lin
- Institute of Clinical Medicine, and, Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Hung-I Yeh
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
10
|
Steiner JL, Lang CH. Etiology of alcoholic cardiomyopathy: Mitochondria, oxidative stress and apoptosis. Int J Biochem Cell Biol 2017; 89:125-135. [PMID: 28606389 DOI: 10.1016/j.biocel.2017.06.009] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/07/2017] [Accepted: 06/08/2017] [Indexed: 12/16/2022]
Abstract
Putative mechanisms leading to the development of alcoholic cardiomyopathy (ACM) include the interrelated cellular processes of mitochondria metabolism, oxidative stress and apoptosis. As mitochondria fuel the constant energy demands of this continually contracting tissue, it is not surprising that alcohol-induced molecular changes in this organelle contribute to cardiac dysfunction and ACM. As the causal relationship of these processes with ACM has already been established, the primary objective of this review is to provide an update of the experimental findings to more completely understand the aforementioned mechanisms. Accordingly, recent data indicate that alcohol impairs mitochondria function assessed by membrane potential and respiratory chain activity. Indictors of oxidative stress including superoxide dismutase, glutathione metabolites and malondialdehyde are also adversely affected by alcohol oftentimes in a sex-dependent manner. Additionally, myocardial apoptosis is increased based on assessment of TUNEL staining and caspase activity. Recent work has also emerged linking alcohol-induced oxidative stress with apoptosis providing new insight on the codependence of these interrelated mechanisms in ACM. Attention is also given to methodological differences including the dose of alcohol, experimental model system and the use of males versus females to highlight inconsistencies and areas that would benefit from establishment of a consistent model.
Collapse
Affiliation(s)
- Jennifer L Steiner
- Department of Cellular and Molecular Physiology, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, United States.
| | - Charles H Lang
- Department of Cellular and Molecular Physiology, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, United States.
| |
Collapse
|
11
|
The Impact of Environmental Factors in Influencing Epigenetics Related to Oxidative States in the Cardiovascular System. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:2712751. [PMID: 28607629 PMCID: PMC5457758 DOI: 10.1155/2017/2712751] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 04/03/2017] [Accepted: 04/12/2017] [Indexed: 12/14/2022]
Abstract
Oxidative states exert a significant influence on a wide range of biological and molecular processes and functions. When their balance is shifted towards enhanced amounts of free radicals, pathological phenomena can occur, as the generation of reactive oxygen species (ROS) in tissue microenvironment or in the systemic circulation can be detrimental. Epidemic chronic diseases of western societies, such as cardiovascular disease, obesity, and diabetes correlate with the imbalance of redox homeostasis. Current advances in our understanding of epigenetics have revealed a parallel scenario showing the influence of oxidative stress as a major regulator of epigenetic gene regulation via modification of DNA methylation, histones, and microRNAs. This has provided both the biological link and a potential molecular explanation between oxidative stress and cardiovascular/metabolic phenomena. Accordingly, in this review, we will provide current insights on the physiological and pathological impact of changes in oxidative states on cardiovascular disorders, by specifically focusing on the influence of epigenetic regulation. A special emphasis will highlight the effect on epigenetic regulation of human's current life habits, external and environmental factors, including food intake, tobacco, air pollution, and antioxidant-based approaches. Additionally, the strategy to quantify oxidative states in humans in order to determine which biological marker could best match a subject's profile will be discussed.
Collapse
|
12
|
Wang Y, Li G, Sun Y, Shan G, Xu R, Guo L. Left Ventricular Strain and Rotation by 2-D Speckle Tracking Echocardiography Identify Early Alcoholic Cardiomyopathy. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:1741-1749. [PMID: 27156014 DOI: 10.1016/j.ultrasmedbio.2016.03.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 03/17/2016] [Accepted: 03/22/2016] [Indexed: 06/05/2023]
Abstract
This study assessed whether 2-D speckle tracking echocardiography (STE) derived from left ventricular (LV) strain and rotation is capable of detecting LV dysfunction associated with alcoholic cardiomyopathy. Ninety-two male chronic alcoholic patients were grouped by alcohol intake amount and duration: mild (n = 30; >90 mg ethanol daily, 3-5 d per wk for 5-8 y); moderate (n = 30; >90-150 mg ethanol daily, 3-5 d per wk for 9-20 y); and severe (n = 32; >150 mg ethanol daily, 6-7 d per wk for >10 y). Thirty non-drinkers were recruited as healthy controls. Rotation and twist values were lower in the severe group compared with the other groups (p < 0.05). The moderate and severe alcohol groups demonstrated lower longitudinal, circumferential and radial strain values and early to late filling (E/A) ratios compared with the mild group and non-drinkers (all p < 0.05). 2-D STE-derived strain and rotation are reliable echocardiographic markers for detecting left ventricular dysfunction in patients at risk of developing alcoholic cardiomyopathy.
Collapse
Affiliation(s)
- Yuanzheng Wang
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Guangsen Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
| | - Yanhong Sun
- Department of Functional, The First People's Hospital of Khorchin, Tongliao, Inner Mongolia, China
| | - Guoxin Shan
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Rui Xu
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Lijuan Guo
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| |
Collapse
|
13
|
Matyas C, Varga ZV, Mukhopadhyay P, Paloczi J, Lajtos T, Erdelyi K, Nemeth BT, Nan M, Hasko G, Gao B, Pacher P. Chronic plus binge ethanol feeding induces myocardial oxidative stress, mitochondrial and cardiovascular dysfunction, and steatosis. Am J Physiol Heart Circ Physiol 2016; 310:H1658-70. [PMID: 27106042 DOI: 10.1152/ajpheart.00214.2016] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 04/15/2016] [Indexed: 12/31/2022]
Abstract
Alcoholic cardiomyopathy in humans develops in response to chronic excessive alcohol consumption; however, good models of alcohol-induced cardiomyopathy in mice are lacking. Herein we describe mouse models of alcoholic cardiomyopathies induced by chronic and binge ethanol (EtOH) feeding and characterize detailed hemodynamic alterations, mitochondrial function, and redox signaling in these models. Mice were fed a liquid diet containing 5% EtOH for 10, 20, and 40 days (d) combined with single or multiple EtOH binges (5 g/kg body wt). Isocalorically pair-fed mice served as controls. Left ventricular (LV) function and morphology were assessed by invasive pressure-volume conductance approach and by echocardiography. Mitochondrial complex (I, II, IV) activities, 3-nitrotyrosine (3-NT) levels, gene expression of markers of oxidative stress (gp91phox, p47phox), mitochondrial biogenesis (PGC1α, peroxisome proliferator-activated receptor α), and fibrosis were examined. Cardiac steatosis and fibrosis were investigated by histological/immunohistochemical methods. Chronic and binge EtOH feeding (already in 10 days EtOH plus single binge group) was characterized by contractile dysfunction (decreased slope of end-systolic pressure-volume relationship and preload recruitable stroke work), impaired relaxation (decreased time constant of LV pressure decay and maximal slope of systolic pressure decrement), and vascular dysfunction (impaired arterial elastance and lower total peripheral resistance). This was accompanied by enhanced myocardial oxidative/nitrative stress (3-NT; gp91phox; p47phox; angiotensin II receptor, type 1a) and deterioration of mitochondrial complex I, II, IV activities and mitochondrial biogenesis, excessive cardiac steatosis, and higher mortality. Collectively, chronic plus binge EtOH feeding in mice leads to alcohol-induced cardiomyopathies (National Institute on Alcohol Abuse and Alcoholism models) characterized by increased myocardial oxidative/nitrative stress, impaired mitochondrial function and biogenesis, and enhanced cardiac steatosis.
Collapse
Affiliation(s)
- Csaba Matyas
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland; Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Zoltan V Varga
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
| | - Partha Mukhopadhyay
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
| | - Janos Paloczi
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
| | - Tamas Lajtos
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
| | - Katalin Erdelyi
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
| | - Balazs T Nemeth
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
| | - Mintong Nan
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
| | - Gyorgy Hasko
- Department of Surgery, Rutgers New Jersey Medical School, University Heights, Newark, New Jersey; and
| | - Bin Gao
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
| | - Pal Pacher
- Laboratory of Cardiovascular Physiology and Tissue Injury, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland;
| |
Collapse
|
14
|
Abstract
The heart and vascular system are susceptible to the harmful effects of alcohol. Alcohol is an active toxin that undergoes widespread diffusion throughout the body, causing multiple synchronous and synergistic effects. Alcohol consumption decreases myocardial contractility and induces arrhythmias and dilated cardiomyopathy, resulting in progressive cardiovascular dysfunction and structural damage. Alcohol, whether at binge doses or a high cumulative lifetime consumption-both of which should be discouraged-is clearly deleterious for the cardiovascular system, increasing the incidence of total and cardiovascular mortality, coronary and peripheral artery disease, heart failure, stroke, hypertension, dyslipidaemia, and diabetes mellitus. However, epidemiological, case-control studies and meta-analyses have shown a U-type bimodal relationship so that low-to-moderate alcohol consumption (particularly of wine or beer) is associated with a decrease in cardiovascular events and mortality, compared with abstention. Potential confounding influences-alcohol-dose quantification, tobacco use, diet, exercise, lifestyle, cancer risk, accidents, and dependence-can affect the results of studies of both low-dose and high-dose alcohol consumption. Mendelian methodological approaches have led to doubts regarding the beneficial cardiovascular effects of alcohol, and the overall balance of beneficial and detrimental effects should be considered when making individual and population-wide recommendations, as reductions in alcohol consumption should provide overall health benefits.
Collapse
|
15
|
Abstract
Alcoholic cardiomyopathy (ACM) is a specific heart muscle disease found in individuals with a history of long-term heavy alcohol consumption. ACM is associated with a number of adverse histological, cellular, and structural changes within the myocardium. Several mechanisms are implicated in mediating the adverse effects of ethanol, including the generation of oxidative stress, apoptotic cell death, impaired mitochondrial bioenergetics/stress, derangements in fatty acid metabolism and transport, and accelerated protein catabolism. In this review, we discuss the evidence for such mechanisms and present the potential importance of drinking patterns, genetic susceptibility, nutritional factors, race, and sex. The purpose of this review is to provide a mechanistic paradigm for future research in the area of ACM.
Collapse
Affiliation(s)
- Mariann R. Piano
- Professor and Department Head, Department of Biobehavioral Health Science (MC 807), University of Illinois at Chicago, 845 S. Damen Ave., Chicago, IL 60612, 312-413-0132 (TEL), 312-996-4979,
| | - Shane A. Phillips
- Associate Professor and Associate Department Head, Department of Physical Therapy, University of Illinois at Chicago, 1919 W. Taylor St. (MC 898), Chicago, IL 60612, 312-355-0277 (TEL),
| |
Collapse
|
16
|
González-Reimers E, Santolaria-Fernández F, Martín-González MC, Fernández-Rodríguez CM, Quintero-Platt G. Alcoholism: A systemic proinflammatory condition. World J Gastroenterol 2014; 20:14660-14671. [PMID: 25356029 PMCID: PMC4209532 DOI: 10.3748/wjg.v20.i40.14660] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 05/29/2014] [Indexed: 02/06/2023] Open
Abstract
Excessive ethanol consumption affects virtually any organ, both by indirect and direct mechanisms. Considerable research in the last two decades has widened the knowledge about the paramount importance of proinflammatory cytokines and oxidative damage in the pathogenesis of many of the systemic manifestations of alcoholism. These cytokines derive primarily from activated Kupffer cells exposed to Gram-negative intestinal bacteria, which reach the liver in supra-physiological amounts due to ethanol-mediated increased gut permeability. Reactive oxygen species (ROS) that enhance the inflammatory response are generated both by activation of Kupffer cells and by the direct metabolic effects of ethanol. The effects of this increased cytokine secretion and ROS generation lie far beyond liver damage. In addition to the classic consequences of endotoxemia associated with liver cirrhosis that were described several decades ago, important research in the last ten years has shown that cytokines may also induce damage in remote organs such as brain, bone, muscle, heart, lung, gonads, peripheral nerve, and pancreas. These effects are even seen in alcoholics without significant liver disease. Therefore, alcoholism can be viewed as an inflammatory condition, a concept which opens the possibility of using new therapeutic weapons to treat some of the complications of this devastating and frequent disease. In this review we examine some of the most outstanding consequences of the altered cytokine regulation that occurs in alcoholics in organs other than the liver.
Collapse
|
17
|
Laurent D, Mathew JE, Mitry M, Taft M, Force A, Edwards JG. Chronic ethanol consumption increases myocardial mitochondrial DNA mutations: a potential contribution by mitochondrial topoisomerases. Alcohol Alcohol 2014; 49:381-9. [PMID: 24852753 PMCID: PMC4060737 DOI: 10.1093/alcalc/agu029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 03/26/2014] [Accepted: 03/27/2014] [Indexed: 11/14/2022] Open
Abstract
AIMS Alcoholic cardiomyopathy (ACM) presents as decreased myocardial contractility, arrhythmias and secondary non-ischemic dilated cardiomyopathy leading to heart failure. Mitochondrial dysfunction is known to have a significant role in the development and complications of ACM. This study investigated if chronic ethanol feeding promoted myocardial mitochondrial topoisomerase dysfunction as one underlying cause of mitochondrial DNA (mtDNA) damage and mitochondrial dysfunction in ACM. METHODS The impact of chronic ethanol exposure on the myocardial mitochondria was examined in both neonatal cardiomyocytes using 50 mM ethanol for 6 days and in rats assigned to control or ethanol feeding groups for 4 months. RESULTS Chronic ethanol feeding led to significant (P < 0.05) decreases in M-mode Fractional Shortening, ejection fraction, and the cardiac output index as well as increases in Tau. Ethanol feeding promoted mitochondrial dysfunction as evidenced by significantly decreased left ventricle cytochrome oxidase activity and decreases in mitochondrial protein content. Both in rats and in cultured cardiomyocytes, chronic ethanol presentation significantly increased mtDNA damage. Using isolated myocardial mitochondria, both mitochondrial topoisomerase-dependent DNA cleavage and DNA relaxation were significantly altered by ethanol feeding. CONCLUSION Chronic ethanol feeding compromised cardiovascular and mitochondrial function as a result of a decline in mtDNA integrity that was in part the consequence of mitochondrial topoisomerase dysfunction. Understanding the regulation of the mitochondrial topoisomerases is critical for protection of mtDNA, not only for the management of alcoholic cardiomyopathy, but also for the many other clinical treatments that targets the topoisomerases in the alcoholic patient.
Collapse
Affiliation(s)
- D Laurent
- Department of Physiology, New York Medical College, Valhalla, NY, USA
| | - J E Mathew
- Department of Physiology, New York Medical College, Valhalla, NY, USA
| | - M Mitry
- Department of Physiology, New York Medical College, Valhalla, NY, USA
| | - M Taft
- Department of Physiology, New York Medical College, Valhalla, NY, USA
| | - A Force
- Department of Physiology, New York Medical College, Valhalla, NY, USA
| | - J G Edwards
- Department of Physiology, New York Medical College, Valhalla, NY, USA
| |
Collapse
|
18
|
Hu C, Ge F, Hyodo E, Arai K, Iwata S, Lobdell H, Walewski JL, Zhou S, Clugston RD, Jiang H, Zizola CP, Bharadwaj KG, Blaner WS, Homma S, Schulze PC, Goldberg IJ, Berk PD. Chronic ethanol consumption increases cardiomyocyte fatty acid uptake and decreases ventricular contractile function in C57BL/6J mice. J Mol Cell Cardiol 2013; 59:30-40. [PMID: 23422163 PMCID: PMC3647020 DOI: 10.1016/j.yjmcc.2013.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 02/01/2013] [Accepted: 02/02/2013] [Indexed: 02/07/2023]
Abstract
Alcohol, a major cause of human cardiomyopathy, decreases cardiac contractility in both animals and man. However, key features of alcohol-related human heart disease are not consistently reproduced in animal models. Accordingly, we studied cardiac histology, contractile function, cardiomyocyte long chain fatty acid (LCFA) uptake, and gene expression in male C57BL/6J mice consuming 0, 10, 14, or 18% ethanol in drinking water for 3months. At sacrifice, all EtOH groups had mildly decreased body and increased heart weights, dose-dependent increases in cardiac triglycerides and a marked increase in cardiac fatty acid ethyl esters. [(3)H]-oleic acid uptake kinetics demonstrated increased facilitated cardiomyocyte LCFA uptake, associated with increased expression of genes encoding the LCFA transporters CD36 and Slc27a1 (FATP1) in EtOH-fed animals. Although SCD-1 expression was increased, lipidomic analysis did not indicate significantly increased de novo LCFA synthesis. By echocardiography, ejection fraction (EF) and the related fractional shortening (FS) of left ventricular diameter during systole were reduced and negatively correlated with cardiac triglycerides. Expression of myocardial PGC-1α and multiple downstream target genes in the oxidative phosphorylation pathway, including several in the electron transport and ATP synthase complexes of the inner mitochondrial membrane, were down-regulated. Cardiac ATP was correspondingly reduced. The data suggest that decreased expression of PGC-1α and its target genes result in decreased cardiac ATP levels, which may explain the decrease in myocardial contractile function caused by chronic EtOH intake. This model recapitulates important features of human alcoholic cardiomyopathy and illustrates a potentially important pathophysiologic link between cardiac lipid metabolism and function.
Collapse
Affiliation(s)
- Chunguang Hu
- The Department of Medicine, Division of Digestive & Liver Disease, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Affiliation(s)
- Irma Laonigro
- Department of Medical and Occupational Sciences; Institute of Internal Medicine, University of Foggia; Foggia Italy
| | - Michele Correale
- Department of Cardiology; ‘Ospedali Riuniti’ OO.RR, University of Foggia; viale L Pinto, 1 71100 Foggia Italy
| | - Matteo Di Biase
- Department of Cardiology; ‘Ospedali Riuniti’ OO.RR, University of Foggia; viale L Pinto, 1 71100 Foggia Italy
| | - Emanuele Altomare
- Department of Medical and Occupational Sciences; Institute of Internal Medicine, University of Foggia; Foggia Italy
| |
Collapse
|
20
|
Mashimo K, Sato S, Ohno Y. Chronic effects of ethanol on cultured myocardial cells: ultrastructural and morphometric studies. Virchows Arch 2003; 442:356-63. [PMID: 12715171 DOI: 10.1007/s00428-003-0768-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2002] [Accepted: 12/17/2002] [Indexed: 10/25/2022]
Abstract
Ultrastructural alterations of the myocardium due to chronic ethanol exposure were investigated using an in vitro system-mouse ventricular myocardial cells in a monolayer culture, which were spontaneously and synchronously contracting-by chronic exposure to 12.5, 50, and 200 mM ethanol for up to 21 days. Morphometric analyses revealed that exposure to 12.5 mM ethanol for 14 days induced an increase in the number of residual bodies, which are lysosomes containing electron-dense, amorphous materials. Some cells exposed to 50 mM ethanol for 14 days contained an accumulation of glycogen granules, increasing in inverse proportion to the mitochondrial volume. The volumetric proportion of myofibrils on day 14 decreased as the ethanol dose became lower, and was in proportion to large and giant mitochondria within the limits of three ethanol groups. Dose-dependent increases in the size and volumetric proportion of mitochondria were observed after the 14-day exposure; at a low dose (12.5 mM) mitochondria of usual size tended to increase, whereas at a high dose (200 mM) giant mitochondria increased. Coincidentally with this mitochondrial increase or gigantism, all ethanol groups showed higher beat rates than the control. Consequently, it is most likely that chronic 14-day exposures to these three ethanol doses remodel the cellular function of the in vitro myocardium in different ways; the 200-mM dose induced mitochondrial hypertrophy, an adaptive response to switch myocardial energy metabolism over to some special one; the 50-mM dose was a boundary dose; and the 12.5-mM dose mostly mimicked the chronic in vivo administration of ethanol and induced slightly degenerative alterations-increased residual bodies and lysosomes, decreased myofibrils and lowered mitochondrial respiratory function.
Collapse
Affiliation(s)
- Keiko Mashimo
- Department of Legal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8602 Tokyo, Japan.
| | | | | |
Collapse
|
21
|
Abstract
In the United States, in both sexes and all races, long-term heavy alcohol consumption (of any beverage type) is the leading cause of a nonischemic, dilated cardiomyopathy, herein referred to as alcoholic cardiomyopathy (ACM). ACM is a specific heart muscle disease of a known cause that occurs in two stages: an asymptomatic stage and a symptomatic stage. In general, alcoholic patients consuming > 90 g of alcohol a day (approximately seven to eight standard drinks per day) for > 5 years are at risk for the development of asymptomatic ACM. Those who continue to drink may become symptomatic and develop signs and symptoms of heart failure. ACM is characterized by an increase in myocardial mass, dilation of the ventricles, and wall thinning. Changes in ventricular function may depend on the stage, in that asymptomatic ACM is associated with diastolic dysfunction, whereas systolic dysfunction is a common finding in symptomatic ACM patients. The pathophysiology of ACM is complex and may involve cell death (possibly due to apoptosis) and changes in many aspects of myocyte function. ACM remains an important cause of a dilated cardiomyopathy, and in latter stages can lead to heart failure. Alcohol abstinence, as well as the use of specific heart failure pharmacotherapies, is critical in improving ventricular function and outcomes in these patients.
Collapse
Affiliation(s)
- Mariann R Piano
- University of Illinois at Chicago College of Nursing, Chicago, IL 60612, USA.
| |
Collapse
|
22
|
Friedman HS. Cardiovascular effects of alcohol. RECENT DEVELOPMENTS IN ALCOHOLISM : AN OFFICIAL PUBLICATION OF THE AMERICAN MEDICAL SOCIETY ON ALCOHOLISM, THE RESEARCH SOCIETY ON ALCOHOLISM, AND THE NATIONAL COUNCIL ON ALCOHOLISM 1998; 14:135-66. [PMID: 9751945 DOI: 10.1007/0-306-47148-5_6] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The ingestion of one or two alcoholic drinks can affect heart rate, blood pressure, cardiac output, myocardial contractility, and regional blood flow. These actions generally are not clinically important. In the presence of cardiovascular disease, however, even such small quantities of alcohol might result in transient unfavorable hemodynamic changes. Moreover, alcohol abuse can produce cardiac arrhythmias, hypertension, cardiomyopathy, stroke, and even sudden death. In contrast, moderate alcohol use produces changes that have an overall favorable effect on atherosclerotic-related vascular diseases. Because cardiovascular disease due to atherosclerosis is the leading cause of death in Western society, this desirable effect of alcohol use outweighs its detrimental actions, resulting in favorable findings in population studies. Nevertheless, the body of evidence argues against encouraging alcohol use for its cardiovascular effects.
Collapse
Affiliation(s)
- H S Friedman
- Department of Medicine, Long Island College Hospital, Brooklyn, New York, USA
| |
Collapse
|
23
|
Vecchia LL, Mezzena G, Ometto R, Finocchi G, Bedogni F, Soffiati G, Vincenzi M. Detectable serum troponin I in patients with heart failure of nonmyocardial ischemic origin. Am J Cardiol 1997. [DOI: 10.1016/s0002-9149(97)00291-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
24
|
Abstract
Cardiomyopathies are the group of diseases affecting the cardiac muscle. Although they have never been related to oxidative stress diseases, an analysis of the causes of these pathologies reveals the presence of a pro-oxidative agent or that the intracardiocytic balance between oxidation and antioxidation has been broken. In support of this hypothesis, we analyse the pro-oxidative factors which co-operate with other factors or by themselves to promote the development of this group of pathologies. We show also data demonstrating that the tissue and cellular damages are characteristic of an oxidative stress situation. Finally, we present evidence that in some cases of particular cardiomyopathies, the use of antioxidative strategies greatly improves the health of the patients. Therefore, we suggest that the use of antioxidants can be an alternative or complementary therapy in this group of diseases.
Collapse
Affiliation(s)
- D Romero-Alvira
- Servicio de Cardiología, Hospital Miguel Servet, Zaragoza, Spain
| | | | | |
Collapse
|
25
|
La Vecchia LL, Bedogni F, Bozzola L, Bevilacqua P, Ometto R, Vincenzi M. Prediction of recovery after abstinence in alcoholic cardiomyopathy: role of hemodynamic and morphometric parameters. Clin Cardiol 1996; 19:45-50. [PMID: 8903537 DOI: 10.1002/clc.4960190109] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The aim of the study is to describe the hemodynamic and morphometric characteristics of patients with alcoholic cardiomyopathy (ACM) and to evaluate whether these parameters can identify the subgroup of patients in whom recovery of cardiac function after abstinence will occur. Nineteen male patients (mean age 52.4 years, range 39-64 years) with symptomatic left ventricular dysfunction (LVD) [ejection fraction (EF) <50%] and a history of chronic heavy alcohol intake were submitted to a full invasive work-up including right ventricular endomyocardial biopsy (EMB). Counseling aimed at obtaining abstention and clinical follow-up were regularly performed in all patients. The two requisites necessary to define recovery were (1) an increase in left ventricular EF, and (2) improvement of symptoms. The former was defined as a gain in left ventricular EF > 15% from baseline; the latter, as a gain of at least one New York Heart Association (NYHA) functional class. Using these criteria, 9 alcoholic patients (48%) (Group A) improved significantly, while 10 (52%) (Group B) either stabilized or deteriorated at 2 years' follow-up. Group A patients had significantly lower pulmonary artery mean pressure (27.8 mmHg +/- 13.3 vs. 40.3 mmHg +/- 12.4; p < 0.05) and pulmonary capillary wedge pressure (18.4 mmHg +/- 8.9 vs. 26.5 mmHg +/- 7.7; p < 0.05) compared with Group B. All other hemodynamic data did not show statistically significant differences in the two groups. Quantitative evaluation of myocardial hypertrophy and interstitial fibrosis performed on EMB tissue samples using the morphometric approach was not predictive of recovery. Improvement in cardiac performance and functional class was detected in about one-half of patients with ACM who abstained from alcohol, and occurred even in cases presenting with severe LVD. Recovery is associated with significantly lower pulmonary artery and pulmonary wedge pressures. The morphometric evaluation of EMB does not provide adjunctive prognostic information in these patients.
Collapse
Affiliation(s)
- L L La Vecchia
- Division of Clinical Cardiology, University of Verona, Vicenza, Italy
| | | | | | | | | | | |
Collapse
|
26
|
Denison H, Berkowicz A, Wendestam C, Wallerstedt S. Ischemic heart disease and epilepsy: two major causes of out-hospital natural death in male alcoholics. Forensic Sci Int 1995; 73:19-33. [PMID: 7750879 DOI: 10.1016/0379-0738(95)01712-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The objectives of this research were to study the distribution of in- and out-hospital deaths and causes of death in male alcoholics and in particular to analyze obscure cases. In a population-based sample of 1123 men treated in one detoxification unit during 1986-1989, 97 patients with alcohol dependence (DSM-III-R) died < or = 1 year after in-hospital detoxification. In each case, the cause and the manner of death were assessed by scrutiny of information in hospital and autopsy records, toxicological examinations, and police reports. The results were that 71 of the 97 men died outside hospital. The overall autopsy rate was 89%. Ischemic heart disease accounted for 18 out of 41 evaluable natural out-hospital deaths. Epileptic seizures were judged to be the cause of death in five cases and could also have contributed to seven out of eight obscure out-hospital deaths. Ethanol in blood or urine was detected in 19 of the 23 deaths attributed to trauma or intoxication, whereas only four out of the 18 out-hospital deaths from ischemic heart disease were ethanol-positive. It was concluded that early detection and adequate treatment of ischemic heart disease and epilepsy might improve prognosis in patients with alcohol dependence. The use of clinical information could be of crucial importance in evaluating possible causes of death, especially in obscure cases.
Collapse
Affiliation(s)
- H Denison
- Department of Medicine, University of Göteburg, Ostra Hospital, Sweden
| | | | | | | |
Collapse
|
27
|
Affiliation(s)
- E L Arsura
- Kern Medical Center, Bakersfield, California
| | | | | | | |
Collapse
|
28
|
Ribière C, Hininger I, Rouach H, Nordmann R. Effects of chronic ethanol administration on free radical defence in rat myocardium. Biochem Pharmacol 1992; 44:1495-500. [PMID: 1417973 DOI: 10.1016/0006-2952(92)90463-s] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Cellular protection against free radical reactions was measured in myocardium from ethanol-fed rats using ethanol administration in drinking water as a model of moderate alcohol intoxication. The activities of Cu,Zn-superoxide dismutase (SOD) and glutathione-S-transferase were higher in ethanol-fed rats than in controls, whereas Mn-SOD, catalase and glutathione peroxidase activities were not altered by ethanol treatment. Myocardial zinc was higher and selenium concentration lower in ethanol-fed rats than in controls. Ethanol consumption, which failed to modify the myocardial vitamin E level, did not result in increased lipid peroxidation, but decreased cytosolic and membraneous protein thiols.
Collapse
Affiliation(s)
- C Ribière
- Department of Biomedical Research on Alcoholism, Faculté de Médecine, Paris, France
| | | | | | | |
Collapse
|
29
|
|
30
|
Therapeutic effect of the antioxidant dibunol in experimental alcohol cardiomyopathy. Bull Exp Biol Med 1990. [DOI: 10.1007/bf00839874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
31
|
Shol'ts DM, Tsyplenkova VG, Vikhert AM. Disturbances of myocardial morphology in rats taking alcohol for 20 weeks and abstinent for 6 weeks. Bull Exp Biol Med 1989. [DOI: 10.1007/bf00840676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
32
|
Antonenkov VD, Pirozhkov SV, Popova SV, Panchenko LF. Effect of chronic ethanol, catalase inhibitor 3-amino-1,2,4-triazole and clofibrate treatment on lipid peroxidation in rat myocardium. THE INTERNATIONAL JOURNAL OF BIOCHEMISTRY 1989; 21:1313-8. [PMID: 2612724 DOI: 10.1016/0020-711x(89)90150-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
1. The effect of chronic alcohol consumption, catalase inhibitor 3-amino-1,2,4-triazole (amino-triazole) and peroxisome proliferator clofibrate on the level of Fe/ADP-ascorbate-induced lipid peroxidation has been studied in the rat myocardium. The intensity of lipid peroxidation was measured using chemiluminescence technique and malondialdehyde formation. 2. Combined us well as separate treatment with ethanol (36% of dietary calories) and aminotriazole caused elevation of the rate of lipid peroxidation in the nuclear-free homogenate or total particulate fraction of the rat heart. The most pronounced effect was noted during combined application of ethanol and aminotriazole. 3. Prolonged clofibrate treatment significantly increased the level of nonenzymatic lipid peroxidation in the rat myocardium. 4. Peroxidative alteration of the myocardial lipids in vivo was evaluated by measurement of conjugated dienes (absorbance at 233 nm). Separate ethanol, aminotriazole or clofibrate treatment did not affect the level of u.v. absorption of lipids from the total particulate fraction. However, when ethanol and aminotriazole were administered simultaneously an increase of conjugated diene formation was observed. 5. The data obtained confirm the hypothesis that ethanol or clofibrate-induced activation of the myocardial lipid peroxidation may be due to the increase of hydrogen peroxide-generating capacity of the heart microperoxisomes.
Collapse
|
33
|
|
34
|
Abstract
Seven hundred fifty-two cases of instantaneous sudden cardiac death were studied. Alcoholic cardiomyopathy was found in 127 cases (16.9%), predominantly in men under age 50 (73%). The heart was enlarged, with an average mass of 441 +/- 8 g. Light microscopy revealed uneven thinning and atrophy of the cardiomyocytes, with fatty infiltration and development of fatty tissue around the vessels of the left ventricle and interventricular septum, up to the subendocardial areas. In the majority of cardiomyocytes, electron microscopy showed atrophy of the myofibrils, pronounced dilation of the sarcoplasmic reticulum, lipids in the cytoplasm, mitochondriosis and an increased number of lysosomes and alterations of the mitochondria. Unchanged cardiomyocytes were characterized by hypertrophy and numerous ribosomes, and had developed a granular endoplasmic reticulum. Also observed were interstitial edema, an enlarged cardiomyocyte-capillary space, thinning of the capillary walls, flattening of the endothelium and a plethora and aggregation of erythrocytes. Decreases in mitochondrial enzyme activity were studied by enzyme histochemistry. Analogous pathologic changes may be individually present in other types of myocardial disease, but the complex of changes is specific for alcoholic cardiomyopathy. The frequency of alcoholic cardiomyopathy among victims of sudden death suggests that alcoholic cardiomyopathy is a risk factor for sudden cardiac death.
Collapse
|