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El Khayari A, Hakam SM, Malka G, Rochette L, El Fatimy R. New insights into the cardio-renal benefits of SGLT2 inhibitors and the coordinated role of miR-30 family. Genes Dis 2024; 11:101174. [PMID: 39224109 PMCID: PMC11367061 DOI: 10.1016/j.gendis.2023.101174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 09/15/2023] [Accepted: 10/10/2023] [Indexed: 09/04/2024] Open
Abstract
Sodium-glucose co-transporter inhibitors (SGLTis) are the latest class of anti-hyperglycemic agents. In addition to inhibiting the absorption of glucose by the kidney causing glycosuria, these drugs also demonstrate cardio-renal benefits in diabetic subjects. miR-30 family, one of the most abundant microRNAs in the heart, has recently been linked to a setting of cardiovascular diseases and has been proposed as novel biomarkers in kidney dysfunctions as well; their expression is consistently dysregulated in a variety of cardio-renal dysfunctions. The mechanistic involvement and the potential interplay between miR-30 and SGLT2i effects have yet to be thoroughly elucidated. Recent research has stressed the relevance of this cluster of microRNAs as modulators of several pathological processes in the heart and kidneys, raising the possibility of these small ncRNAs playing a central role in various cardiovascular complications, notably, endothelial dysfunction and pathological remodeling. Here, we review current evidence supporting the pleiotropic effects of SGLT2is in cardiovascular and renal outcomes and investigate the link and the coordinated implication of the miR-30 family in endothelial dysfunction and cardiac remodeling. We also discuss the emerging role of circulating miR-30 as non-invasive biomarkers and attractive therapeutic targets for cardiovascular diseases and kidney diseases. Clinical evidence, as well as metabolic, cellular, and molecular aspects, are comprehensively covered.
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Affiliation(s)
- Abdellatif El Khayari
- Institute of Biological Sciences (ISSB-P), UM6P Faculty of Medical Sciences, Mohammed VI Polytechnic University (UM6P), Ben-Guerir 43150, Morocco
| | - Soukaina Miya Hakam
- Institute of Biological Sciences (ISSB-P), UM6P Faculty of Medical Sciences, Mohammed VI Polytechnic University (UM6P), Ben-Guerir 43150, Morocco
| | - Gabriel Malka
- Institute of Biological Sciences (ISSB-P), UM6P Faculty of Medical Sciences, Mohammed VI Polytechnic University (UM6P), Ben-Guerir 43150, Morocco
| | - Luc Rochette
- Equipe d'Accueil (EA 7460): Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), Université de Bourgogne – Franche Comté, Faculté des Sciences de Santé, 7 Bd Jeanne d'Arc, Dijon 21000, France
| | - Rachid El Fatimy
- Institute of Biological Sciences (ISSB-P), UM6P Faculty of Medical Sciences, Mohammed VI Polytechnic University (UM6P), Ben-Guerir 43150, Morocco
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Xu H, Song X, Zhang X, Wang G, Cheng X, Zhang L, Wang Z, Li R, Ai C, Wang X, Pu L, Chen Z, Liu W. SIRT1 regulates mitochondrial fission to alleviate high altitude hypoxia inducedcardiac dysfunction in rats via the PGC-1α-DRP1/FIS1/MFF pathway. Apoptosis 2024; 29:1663-1678. [PMID: 38678130 DOI: 10.1007/s10495-024-01954-5] [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] [Accepted: 03/10/2024] [Indexed: 04/29/2024]
Abstract
High-altitude exposure has been linked to cardiac dysfunction. Silent information regulator factor 2-related enzyme 1 (sirtuin 1, SIRT1), a nicotinamide adenine dinucleotide-dependent deacetylase, plays a crucial role in regulating numerous cardiovascular diseases. However, the relationship between SIRT1 and cardiac dysfunction induced by hypobaric hypoxia (HH) remains unexplored. This study aims to assess the impact of SIRT1 on HH-induced cardiac dysfunction and delve into the underlying mechanisms, both in vivo and in vitro. In this study, we have demonstrated that exposure to HH results in cardiomyocyte injury, along with the downregulation of SIRT1 and mitochondrial dysfunction. Upregulating SIRT1 significantly inhibits mitochondrial fission, improves mitochondrial function, reduces cardiomyocyte injury, and consequently enhances cardiac function in HH-exposed rats. Additionally, HH exposure triggers aberrant expression of mitochondrial fission-regulated proteins, with a decrease in PPARγ coactivator 1 alpha (PGC-1α) and mitochondrial fission factor (MFF) and an increase in mitochondrial fission 1 (FIS1) and dynamin-related protein 1 (DRP1), all of which are mitigated by SIRT1 upregulation. Furthermore, inhibiting PGC-1α diminishes the positive effects of SIRT1 regulation on the expression of DRP1, MFF, and FIS1, as well as mitochondrial fission. These findings demonstrate that SIRT1 alleviates HHinduced cardiac dysfunction by preventing mitochondrial fission through the PGC-1α-DRP1/FIS1/MFF pathway.
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Affiliation(s)
- Hongbao Xu
- Department of Environmental Medicine, Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Xiaona Song
- Department of Environmental Medicine, Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Xiaoru Zhang
- State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, National Clinical Research Center for Blood Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China
| | - Guangrui Wang
- Department of Environmental Medicine, Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Xiaoling Cheng
- Department of Environmental Medicine, Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Ling Zhang
- Department of Environmental Medicine, Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Zirou Wang
- Department of Environmental Medicine, Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Ran Li
- Department of Environmental Medicine, Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Chongyi Ai
- Department of Environmental Medicine, Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Xinxing Wang
- Department of Environmental Medicine, Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Lingling Pu
- Department of Environmental Medicine, Tianjin Institute of Environmental and Operational Medicine, Tianjin, China.
| | - Zhaoli Chen
- Department of Environmental Medicine, Tianjin Institute of Environmental and Operational Medicine, Tianjin, China.
| | - Weili Liu
- Department of Environmental Medicine, Tianjin Institute of Environmental and Operational Medicine, Tianjin, China.
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Correale M, D'Alessandro D, Tricarico L, Ceci V, Mazzeo P, Capasso R, Ferrara S, Barile M, Di Nunno N, Rossi L, Vitullo A, Granatiero M, Granato M, Iacoviello M, Brunetti ND. Left ventricular reverse remodeling after combined ARNI and SGLT2 therapy in heart failure patients with reduced or mildly reduced ejection fraction. INTERNATIONAL JOURNAL OF CARDIOLOGY. HEART & VASCULATURE 2024; 54:101492. [PMID: 39247434 PMCID: PMC11379978 DOI: 10.1016/j.ijcha.2024.101492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Accepted: 08/11/2024] [Indexed: 09/10/2024]
Abstract
Background Cardiac remodeling is an adverse phenomenon linked to heart failure (HF) progression. Cardiac remodeling could represent the real therapeutic goal in the treatment of patients with HF and reduced ejection fraction (HFrEF), being potentially reversed through different pharmacotherapies. Currently, there are well-established drugs such as ACEi/ARBs and β-blockers with anti-remodeling effects. More recently, ARNI effects on cardiac remodeling were also demonstrated; additional potential benefits of gliflozins remain non clearly demonstrated. Aim of study To evaluate possible changes in cardiac remodeling in patients with HFrEF/HFmrEF in treatment with ARNI or ARNI plus SGLT2i and the potential benefit on cardiac remodeling of adding SGLT2i to ARNI. Methods Between June 2021 and August 2023, 100 consecutive patients with HFrEF/HFmrEF underwent conventional and advanced echocardiography (TDI, 2DSTE): patients were therefore divided into three groups according to therapy with neither ARNI nor SGLT2i, just ARNI or both. After 3 months, all patients underwent echocardiographic follow-up. Results After a 3 months of therapy, significant improvements were observed for LVEF, LVEDD, LVEDV, LVESV, LV mass, E/e', LV GLS, TAPSE (ANOVA p< 0.01 in all cases), RV S' velocity (ANOVA p< 0.001).The trend in favor of additional treatment with SGTL2i over ARNI remained statistically significant even after multivariable analysis (p< 0.001 for LVEF, LVEDD; p< 0.01 for LV GLS, TAPSE, TRVS; p< 0.05 for LV mass). Conclusions SGLT2i therapy when added to the standard treatment for HFrEF and HFmrEF is associated with an improved biventricular function and ventricular dimensions at follow-up.
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Affiliation(s)
- Michele Correale
- Cardiothoracic Department, Ospedali Riuniti University Hospital, Foggia, Italy
| | - Damiano D'Alessandro
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Lucia Tricarico
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Vincenzo Ceci
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Pietro Mazzeo
- Cardiovascular Department. Azienda Ospedaliera Regionale "San Carlo", Potenza, Italy
| | - Raffaele Capasso
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Massimo Barile
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Nicola Di Nunno
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Luciano Rossi
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonio Vitullo
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Michele Granatiero
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Mattia Granato
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Massimo Iacoviello
- Associate Prof, Department of Medical and Surgical Sciences, University of Foggia, Italy
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Chang J, Zhu Y, Yang Z, Wang Z, Wang M, Chen L. Airborne polystyrene nanoplastics exposure leads to heart failure via ECM-receptor interaction and PI3K/AKT/BCL-2 pathways. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 954:176469. [PMID: 39317253 DOI: 10.1016/j.scitotenv.2024.176469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 08/30/2024] [Accepted: 09/20/2024] [Indexed: 09/26/2024]
Abstract
Environmental contamination has been recognized as a significant threat to human well-being, and recent findings of microplastic presence in human cardiac tissues have raised concerns. However, research on the effects of airborne nanoplastics (NPs) on cardiac physiology remains limited. We utilized a comprehensive body exposure apparatus to simulate the impact of airborne polystyrene NPs pollution, focusing on understanding how airborne NPs affect cardiac morphology and function. Following two weeks of NPs exposure, mice exhibited a 23.89 ± 8.30 % reduction in heart mass, a 20.05 ± 2.97 % decrease in heart rate as detected, and a myocardial electrical conduction block. Echocardiography showed significant changes in cardiac contractility, with increases in cardiac ejection fraction and stroke volume of 13.00 ± 3.00 % and 43.00 ± 17.00 %, respectively. In addition, histologic assessments revealed signs of ventricular hypertrophy, ventricular myocardial hypertrophy, and myocardial necrotic fibrosis. Of particular interest, our mechanistic investigations highlighted the harmful effects of NPs on cardiac structure and function, mediated through extracellular matrix (ECM) receptor interactions and the PI3K/AKT/BCL-2 signaling pathway. The insights gained provide a foundation for understanding the risks posed by airborne NPs to human cardiac health, emphasizing the need for increased vigilance and implementation of mitigation strategies in environmental management.
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Affiliation(s)
- Jinghao Chang
- Medical School, Tianjin University, Tianjin 300072, China
| | - Yuchen Zhu
- Medical School, Tianjin University, Tianjin 300072, China
| | - Ziye Yang
- Medical School, Tianjin University, Tianjin 300072, China; School of Environmental Science and Engineering, Tianjin University, Tianjin 300072, China.
| | - Ziqi Wang
- Medical School, Tianjin University, Tianjin 300072, China
| | - Meixue Wang
- Medical School, Tianjin University, Tianjin 300072, China
| | - Liqun Chen
- Medical School, Tianjin University, Tianjin 300072, China.
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5
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Huang W, Zhao R. Clinical outcomes in type 2 diabetes patients with chronic heart failure treated with metformin: a meta-analysis. Endocrine 2024:10.1007/s12020-024-04025-6. [PMID: 39277567 DOI: 10.1007/s12020-024-04025-6] [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: 07/08/2024] [Accepted: 08/28/2024] [Indexed: 09/17/2024]
Abstract
OBJECTIVE To explore outcomes of metformin (Met) as an antihyperglycemic agent in patients with type 2 diabetes mellitus (T2DM) combined with chronic heart failure (CHF). METHODS This article employed a meta-analysis approach to systematically search several databases. Stata 15.1 software was employed for statistical analysis. RESULTS This meta-analysis encompassed 15 randomized controlled trials, involving 20,595 patients with T2DM and CHF. The results revealed that in comparison to the non-Met group, the Met group exhibited a significantly reduced risk of all-cause mortality (RR = 0.72, 95%CI: 0.60-0.87) and a notably lower risk of cardiovascular mortality (RR = 0.52, 95%CI:0.29-0.92). However, there was no significant difference in the risk of hospitalization due to heart failure (RR = 0.85, 95%CI: 0.70-1.04). Furthermore, the Met group demonstrated significant improvements in NT-proBNP levels compared to the non-Met group (WMD = -132.91, 95%CI: -173.03, -92.79). Regarding the enhancement of Left Ventricular Ejection Fraction and Left Ventricular End-Diastolic Dimension levels, no statistically significant differences were observed between the two groups. CONCLUSION In individuals with T2DM and CHF, the use of Met is linked to a decreased likelihood of all-cause mortality and cardiovascular-related mortality. Furthermore, it can enhance cardiac function in CHF patients without elevating the risk of hospitalization due to heart failure, establishing its safety and potential benefits.
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Affiliation(s)
- Wenxia Huang
- Department of Cardiovascular Medicine, Hainan General Hospital Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Rongchen Zhao
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China.
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Cui X, Guo J, Yuan P, Dai Y, Du P, Yu F, Sun Z, Zhang J, Cheng K, Tang J. Bioderived Nanoparticles for Cardiac Repair. ACS NANO 2024; 18:24622-24649. [PMID: 39185722 DOI: 10.1021/acsnano.3c07878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Biobased therapy represents a promising strategy for myocardial repair. However, the limitations of using live cells, including the risk of immunogenicity of allogeneic cells and inconsistent therapeutic efficacy of autologous cells together with low stability, result in an unsatisfactory clinical outcomes. Therefore, cell-free strategies for cardiac tissue repair have been proposed as alternative strategies. Cell-free strategies, primarily based on the paracrine effects of cellular therapy, have demonstrated their potential to inhibit apoptosis, reduce inflammation, and promote on-site cell migration and proliferation, as well as angiogenesis, after an infarction and have been explored preclinically and clinically. Among various cell-free modalities, bioderived nanoparticles, including adeno-associated virus (AAV), extracellular vesicles, cell membrane-coated nanoparticles, and exosome-mimetic nanovesicles, have emerged as promising strategies due to their improved biological function and therapeutic effect. The main focus of this review is the development of existing cellular nanoparticles and their fundamental working mechanisms, as well as the challenges and opportunities. The key processes and requirements for cardiac tissue repair are summarized first. Various cellular nanoparticle modalities are further highlighted, together with their advantages and limitations. Finally, we discuss various delivery approaches that offer potential pathways for researchers and clinicians to translate cell-free strategies for cardiac tissue repair into clinical practice.
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Affiliation(s)
- Xiaolin Cui
- Cardiac and Osteochondral Tissue Engineering (COTE) Group, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
| | - Jiacheng Guo
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
- Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, Henan 450052, China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan 450052, China
| | - Peiyu Yuan
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
- Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, Henan 450052, China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan 450052, China
| | - Yichen Dai
- Cardiac and Osteochondral Tissue Engineering (COTE) Group, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, China
| | - Pengchong Du
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
- Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, Henan 450052, China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan 450052, China
| | - Fengyi Yu
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
- Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, Henan 450052, China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan 450052, China
| | - Zhaowei Sun
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
- Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, Henan 450052, China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan 450052, China
| | - Jinying Zhang
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
- Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, Henan 450052, China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan 450052, China
| | - Ke Cheng
- Department of Biomedical Engineering, Columbia University, New York, New York 10027, United States
| | - Junnan Tang
- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China
- Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, Henan 450052, China
- Henan Province Clinical Research Center for Cardiovascular Diseases, Zhengzhou, Henan 450052, China
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Wu P, Zhao Y, Guo X, Liu X, Hu Y, Xiao Y, Xu L, Huang N, Li Y, Wang Y, Ren T, Wu Q, Wang R, Zhang X, Wu Z, Li S. Prognostic Value of Resting Left Ventricular Sphericity Indexes in Coronary Artery Disease With Preserved Ejection Fraction. J Am Heart Assoc 2024; 13:e032169. [PMID: 39189479 DOI: 10.1161/jaha.123.032169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 07/02/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Adverse left ventricular remodeling is a significant cardiovascular predictor for patients with coronary artery disease and preserved left ventricular ejection fraction (LVEF). However, the remodeling indexes reflecting left ventricular spherization by myocardial perfusion imaging are underexplored. METHODS AND RESULTS 727 patients (mean age 59.8±13.5 years, 329 women) diagnosed or suspected coronary artery disease with preserved LVEF who underwent resting myocardial perfusion imaging were retrospectively enrolled. The myocardial perfusion imaging findings including the total perfusion deficit and sphericity indexes (shape index (SI) and eccentricity index (EI) obtained from gated (QGS) and non-gated (QPS) images) were collected. Major adverse cardiovascular events (MACE) were followed up for 45.1±22.0 months. All patients were divided into 4 subgroups based on total perfusion deficit at 10% and LVEF at 65%. Univariable comparative analyses were performed in 5 cohorts (all patients and 4 subgroups). Patients who experienced MACE displayed higher SI and/or lower EI (all P<0.05). Kaplan-Meier survival analyses suggested significant differences for SIQPS in all 5 cohorts, for EIQPS and EIQGS in 4 cohorts, and for end-systolic and end-diastolic SIQGS in 3 cohorts (all P<0.05). Multivariate Cox analysis showed that abnormal SI and EI remained statistically significant predictors for MACE after adjusting for total perfusion deficit, LVEF, and other confounding factors. CONCLUSIONS For patients diagnosed or suspected of coronary artery disease with preserved or supra-normal LVEF, resting sphericity indexes by myocardial perfusion imaging displayed incremental long-term prognostic value. Among these indicators, SIQPS is particularly promising across different perfusion or preserved functional conditions.
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Affiliation(s)
- Ping Wu
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine Shanxi Medical University Taiyuan China
| | - Yuting Zhao
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
| | - Xiaoshan Guo
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine Shanxi Medical University Taiyuan China
| | - Xia Liu
- Department of Radiology Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University Taiyuan China
| | - Yingqi Hu
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Yuxin Xiao
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Li Xu
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Nan Huang
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
| | - Yuanyuan Li
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Yanhui Wang
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Tailin Ren
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Qiuyan Wu
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Ruonan Wang
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Shanxi Key Laboratory of Molecular Imaging Shanxi Medical University Taiyuan Shanxi China
| | - Xiaoli Zhang
- Laboratory for Molecular Imaging, Department of Nuclear Medicine Beijing Anzhen Hospital, Capital Medical University Beijing China
| | - Zhifang Wu
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine Shanxi Medical University Taiyuan China
| | - Sijin Li
- Department of Nuclear Medicine First Hospital of Shanxi Medical University Taiyuan China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine Shanxi Medical University Taiyuan China
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8
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Mehrhof F, Hohendanner F, Blanck O, Hindricks G, Zips D, Hausmann F. [Cardiac irradiation for improvement of left ventricular function]. Strahlenther Onkol 2024; 200:847-849. [PMID: 39017687 DOI: 10.1007/s00066-024-02259-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2024] [Indexed: 07/18/2024]
Affiliation(s)
- Felix Mehrhof
- Klinik für Radioonkologie und Strahlentherapie, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland.
| | - Felix Hohendanner
- Charité - Universitätsmedizin Berlin, Gliedkörperschaft der Freien Universität Berlin und Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
- Klinik für Kardiologie, Angiologie und Intensivmedizin, Deutsches Herzzentrum der Charité, Augustenburger Platz 1, Berlin, Deutschland
- DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Partnerstandort Berlin, Berlin, Deutschland
| | - Oliver Blanck
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - Gerhard Hindricks
- Klinik für Kardiologie, Angiologie und Intensivmedizin, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Charitéplatz 1, Berlin, Deutschland
| | - Daniel Zips
- Klinik für Radioonkologie und Strahlentherapie, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland
| | - Franziska Hausmann
- Klinik für Radioonkologie und Strahlentherapie, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland
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Banjar S, Alharbi S, Omer I, Al Zaid N, Alghamdi A, Abuthiyab N, Alzahrani A. Effect of sodium-glucose co-transporter 2 inhibitors (SGLT2i) on N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and structural changes following myocardial infarction: A systematic review and meta-analysis. Int J Cardiol 2024; 410:132239. [PMID: 38852858 DOI: 10.1016/j.ijcard.2024.132239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are anti-hyperglycemic drugs and have been proven to have cardiovascular protective effects for patients with heart failure regardless of their diabetes status. However, the benefit of SGLT2i following myocardial infarction (MI) remains incompletely established. This review aimed to investigate the impact of SGLT2i on NT-proBNP levels and structural changes post-MI. METHOD Medline, ClinicalTrial.gov, Scopus, and Directory of open-access journals were searched to retrieve the relevant articles. Eligible studies were randomized clinical trials that assessed NT-proBNP and cardiac structural changes in patients who received SGLT2i compared to placebo following MI. Two reviewers independently screened articles, extracted data, and assessed study quality. RESULT Four studies were included in this review, including patients with and without diabetes. While two studies showed no marked decrease from the baseline in NT-proBNP levels between the SGLT2i group and the control group, two studies reported a substantial reduction. The meta-analysis included three of these studies, with a total of 238 participants. The meta-analysis did not find a statistically significant drop in NT-proBNP levels post-MI in the SGLT2 inhibitors group compared to placebo (pooled SMD = 0.16, 95% CI 0.57-0.26, P 0.45). Furthermore, different echocardiographic parameters were reported in the included trials, yet no meta-analysis could be conducted to assess the influence of SGLT2i on cardiac remodeling post-MI. CONCLUSION SGLT2i did not result in a statistically significant reduction of NT-proBNP level subsequent to myocardial infarction. A knowledge gap exists regarding the impact of these agents on cardiac remodeling post-MI. Future high-quality clinical trials are needed to provide more robust evidence.
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Affiliation(s)
- Sereen Banjar
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
| | - Sarah Alharbi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Ibrahim Omer
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Nura Al Zaid
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Arwa Alghamdi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Noorah Abuthiyab
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Atif Alzahrani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Department of Cardiac Sciences, Ministry of the National Guard- Health Affairs, Jeddah, Saudi Arabia
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10
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Ninh VK, Calcagno DM, Yu JD, Zhang B, Taghdiri N, Sehgal R, Mesfin JM, Chen CJ, Kalhor K, Toomu A, Duran JM, Adler E, Hu J, Zhang K, Christman KL, Fu Z, Bintu B, King KR. Spatially clustered type I interferon responses at injury borderzones. Nature 2024; 633:174-181. [PMID: 39198639 PMCID: PMC11374671 DOI: 10.1038/s41586-024-07806-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/09/2024] [Indexed: 09/01/2024]
Abstract
Sterile inflammation after myocardial infarction is classically credited to myeloid cells interacting with dead cell debris in the infarct zone1,2. Here we show that cardiomyocytes are the dominant initiators of a previously undescribed type I interferon response in the infarct borderzone. Using spatial transcriptomics analysis in mice and humans, we find that myocardial infarction induces colonies of interferon-induced cells (IFNICs) expressing interferon-stimulated genes decorating the borderzone, where cardiomyocytes experience mechanical stress, nuclear rupture and escape of chromosomal DNA. Cardiomyocyte-selective deletion of Irf3 abrogated IFNIC colonies, whereas mice lacking Irf3 in fibroblasts, macrophages, neutrophils or endothelial cells, Ccr2-deficient mice or plasmacytoid-dendritic-cell-depleted mice did not. Interferons blunted the protective matricellular programs and contractile function of borderzone fibroblasts, and increased vulnerability to pathological remodelling. In mice that died after myocardial infarction, IFNIC colonies were immediately adjacent to sites of ventricular rupture, while mice lacking IFNICs were protected from rupture and exhibited improved survival3. Together, these results reveal a pathological borderzone niche characterized by a cardiomyocyte-initiated innate immune response. We suggest that selective inhibition of IRF3 activation in non-immune cells could limit ischaemic cardiomyopathy while avoiding broad immunosuppression.
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Affiliation(s)
- V K Ninh
- Division of Cardiology and Cardiovascular Institute, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - D M Calcagno
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
| | - J D Yu
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
| | - B Zhang
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
| | - N Taghdiri
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
| | - R Sehgal
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
| | - J M Mesfin
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | - C J Chen
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
| | - K Kalhor
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
| | - A Toomu
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
| | - J M Duran
- Division of Cardiology and Cardiovascular Institute, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - E Adler
- Division of Cardiology and Cardiovascular Institute, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - J Hu
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - K Zhang
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
| | - K L Christman
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | - Z Fu
- Division of Cardiology and Cardiovascular Institute, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - B Bintu
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
- Cellular and Molecular Medicine, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - K R King
- Division of Cardiology and Cardiovascular Institute, Department of Medicine, University of California San Diego, La Jolla, CA, USA.
- Department of Bioengineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA.
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11
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Yan T, Wang L, Chen X, Yin H, He W, Liu J, Liu S, Li X, Wang Y, Peng L. Predicting Left Ventricular Adverse Remodeling After Transcatheter Aortic Valve Replacement: A Radiomics Approach. Acad Radiol 2024; 31:3560-3569. [PMID: 38821814 DOI: 10.1016/j.acra.2024.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 06/02/2024]
Abstract
RATIONALE AND OBJECTIVES To develop a radiomics model based on cardiac computed tomography (CT) for predicting left ventricular adverse remodeling (LVAR) in patients with severe aortic stenosis (AS) who underwent transcatheter aortic valve replacement (TAVR). MATERIALS AND METHODS Patients with severe AS who underwent TAVR from January 2019 to December 2022 were recruited. The cohort was divided into adverse remodeling group and non-adverse remodeling group based on LVAR occurrence, and further randomly divided into a training set and a validation set at an 8:2 ratio. Left ventricular radiomics features were extracted from cardiac CT. The least absolute shrinkage and selection operator regression was utilized to select the most relevant radiomics features and clinical features. The radiomics features were used to construct the Radscore, which was then combined with the selected clinical features to build a nomogram. The predictive performance of the models was evaluated using the area under the curve (AUC), while the clinical value of the models was assessed using calibration curves and decision curve analysis. RESULTS A total of 273 patients were finally enrolled, including 71 with adverse remodeling and 202 with non-adverse remodeling. 12 radiomics features and five clinical features were extracted to construct the radiomics model, clinical model, and nomogram, respectively. The radiomics model outperformed the clinical model (training AUC: 0.799 vs. 0.760; validation AUC: 0.766 vs. 0.755). The nomogram showed highest accuracy (training AUC: 0.859, validation AUC: 0.837) and was deemed most clinically valuable by decision curve analysis. CONCLUSION The cardiac CT-based radiomics features could predict LVAR after TAVR in patients with severe AS.
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Affiliation(s)
- Tingli Yan
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China; Department of Radiology, Chengdu Universal Dicom Medical Imaging Diagnostic Center, Chengdu, China
| | - Lujing Wang
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiaoyi Chen
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Hongkun Yin
- Infervision Medical Technology 9Co., Ltd, Beijing, China
| | - Wenzhang He
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Liu
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Shengmei Liu
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xue Li
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Yinqiu Wang
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Liqing Peng
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
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12
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Behrman B, Aronow WS, Frishman WH. Recovery From Left Ventricular Dysfunction. Cardiol Rev 2024; 32:408-416. [PMID: 35674727 DOI: 10.1097/crd.0000000000000462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The treatment of heart failure is an evolving field of cardiology, with increasingly available therapeutics and significant disease burden. With the effective treatments available, we see a substantial patient population whose once reduced ejection fraction (EF) has normalized. Studies have assessed the natural history of these patients with improved EF and found improved mortality as compared with those patients with persistently reduced EF, with some evidence stating that each 5% increase in left ventricular EF correlates with a 4.9-fold decrease in the odds of mortality. This prognostic divergence has led to the recognition of this subset of patients as having a unique heart failure diagnosis, distinct from heart failure with reduced EF (HFrEF) or heart failure with preserved EF and to the adoption of the term heart failure with recovered EF. These patients, despite having improved mortality, do retain some of the molecular and histologic changes seen in HFrEF and are still at risk for decline in left ventricular function and adverse cardiac events, particularly when medical therapy is stopped. This distinction between recovery of EF and true myocardial recovery led to recent guidelines recommending continuation of guideline-directed medical therapy indefinitely, as well as surveillance echocardiography.
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Affiliation(s)
- Basha Behrman
- From the Department of Medicine, Westchester Medical Center, Valhalla, NY
| | - Wilbert S Aronow
- Department of Cardiology, Westchester Medical Center, Valhalla, NY
- New York Medical College, Valhalla, NY
| | - William H Frishman
- Department of Cardiology, Westchester Medical Center, Valhalla, NY
- New York Medical College, Valhalla, NY
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13
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Kim KA, Kim SH, Lee KY, Yoon AH, Hwang BH, Choo EH, Kim JJ, Choi IJ, Kim CJ, Lim S, Park MW, Yoo KD, Jeon DS, Ahn Y, Jeong MH, Chang K. Predictors and Long-Term Clinical Impact of Heart Failure With Improved Ejection Fraction After Acute Myocardial Infarction. J Am Heart Assoc 2024; 13:e034920. [PMID: 39158557 DOI: 10.1161/jaha.124.034920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 07/15/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Little is known about the characteristics and long-term clinical outcomes of patients with heart failure with improved ejection fraction (HFimpEF) after acute myocardial infarction. METHODS AND RESULTS From a multicenter, consecutive cohort of patients with acute myocardial infarction undergoing percutaneous coronary intervention, patients with an initial echocardiogram with left ventricular ejection fraction ≤40% and at least 1 follow-up echocardiogram after 14 days and within 2 years of the initial event were considered for analyses. HFimpEF was defined as an initial left ventricular ejection fraction ≤40% and serial left ventricular ejection fraction >40% with an increase of ≥10% from baseline at follow-up. Independent factors predicting HFimpEF were identified, and clinical outcomes of patients with HFimpEF were compared with those without improvement. From an initial cohort of 10 719 patients with acute myocardial infarction, 191 patients with HFimpEF and 256 patients with non-HFimpEF who had initial and follow-up echocardiographic data were analyzed. The median follow-up duration was 4.5 (interquartile range, 2.9-5.0) years. The factors predicting HFimpEF were lower peak creatine kinase myocardial band, smaller left ventricular dimensions, lower ratio between early mitral inflow velocity and mitral annular early diastolic velocity ', and the use of β blockers or renin-angiotensin system blockers at discharge. HFimpEF was associated with a significantly decreased risk of all-cause death compared with non-HFimpEF (hazard ratio, 0.377 [95% CI, 0.234-0.609]; P<0.001). In 2-year landmark analysis, these findings were consistent not only before but also after the landmark point. Similar findings were true for cardiovascular death and admission for heart failure. CONCLUSIONS Patients with HFimpEF after acute myocardial infarction showed distinct clinical and echocardiographic characteristics and were associated with better long-term clinical outcomes. REGISTRATION URL: https://www.clinicaltrials.gov; Unique Identifier: NCT02806102.
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Affiliation(s)
- Kyung An Kim
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital The Catholic University of Korea Seoul Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea Seoul Republic of Korea
- Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital The Catholic University of Korea Incheon Republic of Korea
| | - Sang Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital The Catholic University of Korea Seoul Republic of Korea
- Division of Cardiology, Department of Internal Medicine The Armed Forces Capital Hospital Seongnam Republic of Korea
| | - Kwan Yong Lee
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital The Catholic University of Korea Seoul Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea Seoul Republic of Korea
| | - Andrew H Yoon
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital The Catholic University of Korea Seoul Republic of Korea
| | - Byung-Hee Hwang
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital The Catholic University of Korea Seoul Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea Seoul Republic of Korea
| | - Eun Ho Choo
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital The Catholic University of Korea Seoul Republic of Korea
| | - Jin Jin Kim
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital The Catholic University of Korea Seoul Republic of Korea
| | - Ik Jun Choi
- Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital The Catholic University of Korea Incheon Republic of Korea
| | - Chan Joon Kim
- Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital The Catholic University of Korea Uijeongbu Republic of Korea
| | - Sungmin Lim
- Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital The Catholic University of Korea Uijeongbu Republic of Korea
| | - Mahn-Won Park
- Division of Cardiology, Department of Internal Medicine, Daejeon St. Mary's Hospital The Catholic University of Korea Daejeon Republic of Korea
| | - Ki-Dong Yoo
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital The Catholic University of Korea Suwon Republic of Korea
| | - Doo Soo Jeon
- Division of Cardiology, Department of Internal Medicine The Armed Forces Capital Hospital Seongnam Republic of Korea
| | - Youngkeun Ahn
- Cardiovascular Center Chonnam National University Hospital, Chonnam National University Gwangju Republic of Korea
| | - Myung Ho Jeong
- Cardiovascular Center Chonnam National University Hospital, Chonnam National University Gwangju Republic of Korea
| | - Kiyuk Chang
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital The Catholic University of Korea Seoul Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea Seoul Republic of Korea
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14
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Wang K, Wang L, He F, Li H, Fang Y, Hu G, Wang X. Relationship of changes in QRS duration with left ventricular ejection fraction in patients with acute ST segment elevation myocardial infarction treated with primary percutaneous coronary intervention. Heliyon 2024; 10:e35078. [PMID: 39165983 PMCID: PMC11333898 DOI: 10.1016/j.heliyon.2024.e35078] [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: 05/30/2024] [Revised: 07/21/2024] [Accepted: 07/22/2024] [Indexed: 08/22/2024] Open
Abstract
Objective To assess the changes in QRS duration (△QRSd) before and after primary percutaneous coronary intervention(PPCI) regarding the relation of left ventricular ejection fraction (LVEF) in patients after a first acute ST segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI). Methods A total of 244 patients with STEMI were enrolled, and clinical, biochemical, and angiographic parameters were compared between two groups based on LVEF at 6 months post-discharge. QRS duration (QRSd) was analyzed in relation to LVEF, and feature selection using least absolute shrinkage and selection operator(LASSO) regression was performed. Logistic regression analysis and receiver operating characteristic (ROC) curve evaluation were conducted to identify predictors and assess model efficacy. Results Significant differences were observed between the two groups in terms of various parameters, including age, time from symptom onset to balloon dilation (STB), N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, Left ventricular end-diastolic volume(LVEDV) at baseline, left ventricular end-systolic volume(LVESV)at baseline, left ventricular end-diastolic diameter (LVDD)at baseline and six months, hospital length of stay(days), ST-segment resolution (STR), the left anterior descending artery as the infarction-related artery (IRA-LAD), frequency of TIMI 3 flow post PPCI, thrombus aspiration and/or intracoronary thrombolysis, the use of tirofiban, and the number of implanted stents(stents).In addition, postoperative QRSd and △QRSd were significantly higher in patients with left ventricular systolic dysfunction(LVSD). LASSO regression selected six variables as predictors of postoperative LVEF. Logistic regression analysis identified age, STB, NT-proBNP, LVESV at baseline,△QRSd, and stents, as independent factors associated with LVSD within six months for patients with a first occurrence of STEMI. The models achieved AUC values of 0.906 (using ΔQRSd),0.922(using 6 variables excluding ΔQRSd) and 0.962 (using 6 variables). Conclusion This study identified ΔQRSd as a potential predictor of LVSD in patients with STEMI. The developed models showed good efficacy in predicting postoperative LVEF changes. These findings may contribute to risk stratification and individualized management strategies for STEMI patients.
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Affiliation(s)
- Kai Wang
- Department of Cardiology, Second Affiliated Hospital of Anhui Medical University, China
| | | | - Fei He
- Department of Cardiology, Second Affiliated Hospital of Anhui Medical University, China
| | - Haoliang Li
- Department of Cardiology, Second Affiliated Hospital of Anhui Medical University, China
| | - Yu Fang
- Department of Cardiology, Second Affiliated Hospital of Anhui Medical University, China
| | - Guangquan Hu
- Department of Cardiology, Second Affiliated Hospital of Anhui Medical University, China
| | - Xiaochen Wang
- Department of Cardiology, Second Affiliated Hospital of Anhui Medical University, China
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15
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Junqueira A, Gomes MJ, Lima ARR, Pontes THD, Rodrigues EA, Damatto FC, Depra I, Paschoareli GL, Pagan LU, Fernandes AAH, Oliveira-Jr SA, Pacagnelli FL, Okoshi MP, Okoshi K. Effects of concurrent training and N-acetylcysteine supplementation on cardiac remodeling and oxidative stress in middle-aged spontaneously hypertensive rats. BMC Cardiovasc Disord 2024; 24:409. [PMID: 39103770 DOI: 10.1186/s12872-024-04075-8] [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: 03/07/2024] [Accepted: 07/24/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND This study evaluated the effects of concurrent isolated training (T) or training combined with the antioxidant N-acetylcysteine (NAC) on cardiac remodeling and oxidative stress in spontaneously hypertensive rats (SHR). METHODS Six-month-old male SHR were divided into sedentary (S, n = 12), concurrent training (T, n = 13), sedentary supplemented with NAC (SNAC, n = 13), and concurrent training with NAC supplementation (TNAC, n = 14) groups. T and TNAC rats were trained three times a week on a treadmill and ladder; NAC supplemented groups received 120 mg/kg/day NAC in rat chow for eight weeks. Myocardial antioxidant enzyme activity and lipid hydroperoxide concentration were assessed by spectrophotometry. Gene expression of NADPH oxidase subunits Nox2, Nox4, p22 phox, and p47 phox was evaluated by real time RT-PCR. Statistical analysis was performed using ANOVA and Bonferroni or Kruskal-Wallis and Dunn. RESULTS Echocardiogram showed concentric remodeling in TNAC, characterized by increased relative wall thickness (S 0.40 ± 0.04; T 0.39 ± 0.03; SNAC 0.40 ± 0.04; TNAC 0.43 ± 0.04 *; * p < 0.05 vs T and SNAC) and diastolic posterior wall thickness (S 1.50 ± 0.12; T 1.52 ± 0.10; SNAC 1.56 ± 0.12; TNAC 1.62 ± 0.14 * mm; * p < 0.05 vs T), with improved contractile function (posterior wall shortening velocity: S 39.4 ± 5.01; T 36.4 ± 2.96; SNAC 39.7 ± 3.44; TNAC 41.6 ± 3.57 * mm/s; * p < 0.05 vs T). Myocardial lipid hydroperoxide concentration was lower in NAC treated groups (S 210 ± 48; T 182 ± 43; SNAC 159 ± 33 *; TNAC 110 ± 23 *# nmol/g tissue; * p < 0.05 vs S, # p < 0.05 vs T and SNAC). Nox 2 and p22 phox expression was higher and p47 phox lower in T than S [S 1.37 (0.66-1.66); T 0.78 (0.61-1.04) *; SNAC 1.07 (1.01-1.38); TNAC 1.06 (1.01-1.15) arbitrary units; * p < 0.05 vs S]. NADPH oxidase subunits did not differ between TNAC, SNAC, and S groups. CONCLUSION N-acetylcysteine supplementation alone reduces oxidative stress in untreated spontaneously hypertensive rats. The combination of N-acetylcysteine and concurrent exercise further decreases oxidative stress. However, the lower oxidative stress does not translate into improved cardiac remodeling and function in untreated spontaneously hypertensive rats.
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Affiliation(s)
- Adriana Junqueira
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, SP, Brazil.
- Physiotherapy Department, University of Western Sao Paulo, Presidente Prudente, SP, Brazil.
| | - Mariana J Gomes
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Aline R R Lima
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Thierres H D Pontes
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Eder A Rodrigues
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Felipe C Damatto
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Igor Depra
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Guilherme L Paschoareli
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Luana U Pagan
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Ana A H Fernandes
- Institute of Biosciences, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | | | - Francis L Pacagnelli
- Physiotherapy Department, University of Western Sao Paulo, Presidente Prudente, SP, Brazil
| | - Marina P Okoshi
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Katashi Okoshi
- Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
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16
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Jha M, Musani S, McCarthy I, Hundley WG, Carr JJ, Terry JG, Oshunbade A, Vasan RS, Butler J, Hall M, Mitchell GF, Fox E, Tsao CW. Subclinical association of aortic stiffness with cardiac structure and function in African-Americans: The Jackson Heart Study. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024; 40:1705-1712. [PMID: 38909092 DOI: 10.1007/s10554-024-03159-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/03/2024] [Indexed: 06/24/2024]
Abstract
Cardiovascular disease (CVD) morbidity and mortality are high among black adults. We aimed to study the granular subclinical relations of aortic stiffness and left ventricular (LV) function and remodeling in blacks, in whom limited data are available. In the Jackson Heart Study, 1050 U.S. community-dwelling black adults without CVD underwent 1.5 T cardiovascular magnetic resonance. We assessed regional and global aortic stiffness and LV structure and function, including LV mass indexed to body surface area (LVMI), end-diastolic volume (LVEDV), ejection fraction (EF), and global and regional circumferential strain (Ecc). Phase contrast images of the cross-sectional aorta at the pulmonary artery bifurcation and abdominal aorta bifurcation were acquired to measure pulse wave velocity of the aortic arch (AA-PWV) and thoracic aorta (T-PWV). Results of multivariable-adjusted analyses are presented as SD unit change in LV variables per SD change in PWV variables. Participants were 62% women with mean age of 59 ± 10 years. Higher AA-PWV and T-PWV were associated with greater LVMI: for T-PWV, β = 0.10, 95% CI = 0.03-0.16, p = 0.002. Higher AA-PWV and T-PWV were associated with worse (more positive) Ecc at the LV base (for AA-PWV, β = 0.13, 95% CI = 0.05-0.20, p = 0.0007), but not mid-LV or apex. AA-PWV and T-PWV were not associated with LV mass/LVEDV or EF. In this cross-sectional study of blacks without CVD in the U.S., aortic stiffness is associated with subclinical adverse LV function in basal segments. Future studies may elucidate the temporal relationships of aortic stiffness on the pattern and progression of LV remodeling, dysfunction, and associated prognosis in blacks.
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Affiliation(s)
- Mawra Jha
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RW-453, Boston, MA, 02215, USA
| | - Solomon Musani
- Division of Cardiovascular Disease, University of Mississippi Medical Center, Jackson, MS, USA
- Jackson Heart Study, Jackson, MS, USA
| | | | - W Gregory Hundley
- Pauley Heart Center, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - John Jeffrey Carr
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James G Terry
- Pauley Heart Center, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Adebamike Oshunbade
- Division of Cardiovascular Disease, University of Mississippi Medical Center, Jackson, MS, USA
| | - Ramachandran S Vasan
- Sections of Preventive Medicine and Epidemiology and Cardiology, Department of Medicine, Department of Epidemiology, Boston University School of Medicine, Boston University School of Public Health, Boston, MA, USA
| | - Javed Butler
- Division of Cardiovascular Disease, University of Mississippi Medical Center, Jackson, MS, USA
| | - Michael Hall
- Division of Cardiovascular Disease, University of Mississippi Medical Center, Jackson, MS, USA
| | | | - Ervin Fox
- Division of Cardiovascular Disease, University of Mississippi Medical Center, Jackson, MS, USA
- Jackson Heart Study, Jackson, MS, USA
| | - Connie W Tsao
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RW-453, Boston, MA, 02215, USA.
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17
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Gregolin CS, do Nascimento M, de Souza SLB, Mota GAF, Luvizotto RDAM, Sugizaki MM, Bazan SGZ, de Campos DHS, Camacho CRC, Cicogna AC, do Nascimento AF. Cardiac dysfunction in sucrose-fed rats is associated with alterations of phospholamban phosphorylation and TNF-α levels. Mol Cell Endocrinol 2024; 589:112236. [PMID: 38608803 DOI: 10.1016/j.mce.2024.112236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024]
Abstract
INTRODUCTION High sucrose intake is linked to cardiovascular disease, a major global cause of mortality worldwide. Calcium mishandling and inflammation play crucial roles in cardiac disease pathophysiology. OBJECTIVE Evaluate if sucrose-induced obesity is related to deterioration of myocardial function due to alterations in the calcium-handling proteins in association with proinflammatory cytokines. METHODS Wistar rats were divided into control and sucrose groups. Over eight weeks, Sucrose group received 30% sucrose water. Cardiac function was determined in vivo using echocardiography and in vitro using papillary muscle assay. Western blotting was used to detect calcium handling protein; ELISA assay was used to assess TNF-α and IL-6 levels. RESULTS Sucrose led to cardiac dysfunction. RYR2, SERCA2, NCX, pPBL Ser16 and L-type calcium channels were unchanged. However, pPBL-Thr17, and TNF-α levels were elevated in the S group. CONCLUSION Sucrose induced cardiac dysfunction and decreased myocardial contractility in association with altered pPBL-Thr17 and elevated cardiac pro-inflammatory TNF-α.
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Affiliation(s)
- Cristina Schmitt Gregolin
- Department of Pathology, Medical School (FMB) of São Paulo State University (Unesp), Botucatu Campus, São Paulo, Brazil
| | - Milena do Nascimento
- Institute of Health Sciences, Federal University of Mato Grosso (UFMT), Sinop, Mato Grosso, Brazil
| | | | - Gustavo Augusto Ferreira Mota
- Department of Internal Medicine, Botucatu School of Medicine, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | | | - Mário Mateus Sugizaki
- Institute of Health Sciences, Federal University of Mato Grosso (UFMT), Sinop, Mato Grosso, Brazil
| | - Silméia Garcia Zanati Bazan
- Department of Internal Medicine, Botucatu School of Medicine, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Dijon Henrique Salomé de Campos
- Department of Internal Medicine, Botucatu School of Medicine, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Camila Renata Corrêa Camacho
- Department of Pathology, Medical School (FMB) of São Paulo State University (Unesp), Botucatu Campus, São Paulo, Brazil
| | - Antonio Carlos Cicogna
- Department of Internal Medicine, Botucatu School of Medicine, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
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18
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Chen G, Wang P, Zhang Y, Li N, Fu L, Chen Y, Geng X, Han Y, Qin L, Gao B, Yu T, Mi J. Ultrasound parameters of arteries and heart in normal fetuses. Cardiovasc Ultrasound 2024; 22:9. [PMID: 39075466 PMCID: PMC11285228 DOI: 10.1186/s12947-024-00328-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 07/22/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Currently, no normal ultrasound data of the fetuses during the 20-40 gestation have been obtained for references of fetal growth and development. If such ultrasound data existed for prenatal diagnosis of possible diseases and abnormalities, neonates would be able to get timely treatment immediately after birth. This study was thus performed to obtain ultrasound parameters of normal fetuses during the 20-40 week gestation and the distribution of ultrasound parameters with the gestational age for references of detecting potential fetal diseases and abnormalities. METHODS Normal fetuses without any abnormalities were enrolled, and the ultrasound parameters of the general biology, arteries, and aorta were measured and analyzed. RESULTS 417 normal fetuses were enrolled. A significant (P < 0.05) negative correlation with the gestational age was detected in the peak systolic velocity/peak diastolic velocity (S/D), pulsatility index (PI) and resistance index (RI) of the umbilical artery (UA). A relatively stable relationship with the gestational age was detected in the fetal weight%, S/D, PI and RI of the middle cerebral artery (MCA), peak systolic velocity (PSV) and velocity time integral (VTI) of the intra-abdominal UA, fetal heart to chest ratio, mitral valve (MV)- and tricuspid valve (TV)-E/A peak flow velocity, aortic isthmic Z-score and displacement, distance between the brachiocephalic artery-left common carotid artery (BA-LCCA) and LCCA-left subclavian artery (LSA), Z-score of aorta, ascending aorta (AAO), pulmonary artery (PA), main pulmonary artery (MPA), and descending aorta (DAO). A significant (P < 0.05) positive correlation with the gestational age was detected in the fetal biological data, MCA PSV and VTI, free-UA PSV and VTI and cardio-thoracic ratio, cardiac parameters, ductus arteriosus (DA) and isthmus diameter, aortic parameters, PA and MPA diameter, MPA PSV and VTI, isthmus flow volume and velocity and PA flow volume, DA and BA parameters, and LCCA and LSA parameters (flow volume, PSV, and VTI). CONCLUSION A certain correlation and distribution trend is detected in the ultrasound parameters of normal fetuses, and the ratios among different parameters remain relative stable. These findings can be used for determination of abnormal growth of the fetuses in prenatal ultrasound scan.
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Affiliation(s)
- Guihong Chen
- Department of Medical Ultrasound, Research Center for Clinical Medicine Sciences, The Fourth Hospital of Shijiazhuang, No.16 Tangu North Street, Shijiazhuang, 050000, Hebei Province, China
| | - Pin Wang
- Department of Medical Ultrasound, Research Center for Clinical Medicine Sciences, The Fourth Hospital of Shijiazhuang, No.16 Tangu North Street, Shijiazhuang, 050000, Hebei Province, China
| | - Yanhong Zhang
- Department of Medical Ultrasound, Research Center for Clinical Medicine Sciences, The Fourth Hospital of Shijiazhuang, No.16 Tangu North Street, Shijiazhuang, 050000, Hebei Province, China
| | - Na Li
- Department of Medical Ultrasound, Research Center for Clinical Medicine Sciences, The Fourth Hospital of Shijiazhuang, No.16 Tangu North Street, Shijiazhuang, 050000, Hebei Province, China
| | - Liman Fu
- Department of Medical Ultrasound, Research Center for Clinical Medicine Sciences, The Fourth Hospital of Shijiazhuang, No.16 Tangu North Street, Shijiazhuang, 050000, Hebei Province, China
| | - Yu Chen
- Department of Medical Ultrasound, Research Center for Clinical Medicine Sciences, The Fourth Hospital of Shijiazhuang, No.16 Tangu North Street, Shijiazhuang, 050000, Hebei Province, China
| | - Xuna Geng
- Department of Medical Ultrasound, Research Center for Clinical Medicine Sciences, The Fourth Hospital of Shijiazhuang, No.16 Tangu North Street, Shijiazhuang, 050000, Hebei Province, China
| | - Yongfeng Han
- Department of Medical Ultrasound, Research Center for Clinical Medicine Sciences, The Fourth Hospital of Shijiazhuang, No.16 Tangu North Street, Shijiazhuang, 050000, Hebei Province, China
| | - Lu Qin
- Department of Medical Ultrasound, Research Center for Clinical Medicine Sciences, The Fourth Hospital of Shijiazhuang, No.16 Tangu North Street, Shijiazhuang, 050000, Hebei Province, China
| | - Bulang Gao
- Cardiology Department, Shijiazhuang People's Hospital, No. 365, Jianhua South Street, Shijiazhuang, 050000, Hebei Province, China
| | - Tianxiao Yu
- Department of Medical Ultrasound, Research Center for Clinical Medicine Sciences, The Fourth Hospital of Shijiazhuang, No.16 Tangu North Street, Shijiazhuang, 050000, Hebei Province, China.
| | - Jie Mi
- Cardiology Department, Shijiazhuang People's Hospital, No. 365, Jianhua South Street, Shijiazhuang, 050000, Hebei Province, China.
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19
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Wang X, Sun L. REEP5 mediates the function of CLEC5A to alleviate myocardial infarction by inhibiting endoplasmic reticulum stress-induced apoptosis. BMC Cardiovasc Disord 2024; 24:382. [PMID: 39044150 PMCID: PMC11265427 DOI: 10.1186/s12872-024-04018-3] [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: 12/01/2023] [Accepted: 06/27/2024] [Indexed: 07/25/2024] Open
Abstract
MI (myocardial infarction) often triggers severe heart failure and is one of the leading causes of death worldwide. Receptor expression-enhancing protein 5 (REEP5), a member of REEPs, acts as regulators of endoplasmic reticulum (ER) affecting cardiac functions. Based on GSE114695 profile data, REEP5 was decreased in the left ventricle of MI mice. However, its role and potential mechanism in MI remain to be investigated. In the present study, the mouse MI model was established by ligation of the left anterior descending artery. REEP5 expression was downregulated in the infarct penumbra area of MI mice. Next, its role during MI was explored by gain-of-function. Interestingly, REEP5 overexpression improved left ventricular function of mice with MI, accompanied with reduced infarct size. In cardiomyocytes, REEP5 overexpression inhibited ER stress, accompanied with repressive phosphorylation of PERK and IRE1α, and the decreased nuclear translocation of ATF6. Subsequently, REEP5 overexpression downregulated the levels of Chop and cleaved caspase-12, further alleviating ER stress-induced apoptosis, which was consistent with the in vivo results. Moreover, REEP5 was found to bind to C-type lectin member 5 A (CLEC5A), a protein that triggers cardiac dysfunction. CLEC5A, whose expression was elevated in hypoxia-induced cell models, led to cardiomyocyte apoptosis. Noteworthily, REEP5 overexpression markedly abolished the effects of CLEC5A on ER stress-induced apoptosis. Taken together, REEP5 mediated the function of CLEC5A to relieve MI via inhibiting ER stress-induced apoptosis in vivo and in vitro. REEP5 may be a promising target for treating MI.
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Affiliation(s)
- Xin Wang
- Department of Cardiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Limin Sun
- Department of General Practice, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China.
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20
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Black N, Bradley J, Schelbert EB, Bonnett LJ, Lewis GA, Lagan J, Orsborne C, Brown PF, Soltani F, Fröjdh F, Ugander M, Wong TC, Fukui M, Cavalcante JL, Naish JH, Williams SG, McDonagh T, Schmitt M, Miller CA. Remote myocardial fibrosis predicts adverse outcome in patients with myocardial infarction on clinical cardiovascular magnetic resonance imaging. J Cardiovasc Magn Reson 2024; 26:101064. [PMID: 39053856 PMCID: PMC11347049 DOI: 10.1016/j.jocmr.2024.101064] [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: 11/14/2023] [Revised: 07/04/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Heart failure (HF) most commonly occurs in patients who have had a myocardial infarction (MI), but factors other than MI size may be deterministic. Fibrosis of myocardium remote from the MI is associated with adverse remodeling. We aimed to 1) investigate the association between remote myocardial fibrosis, measured using cardiovascular magnetic resonance (CMR) extracellular volume fraction (ECV), and HF and death following MI, 2) identify predictors of remote myocardial fibrosis in patients with evidence of MI and determine the relationship with infarct size. METHODS Multicenter prospective cohort study of 1199 consecutive patients undergoing CMR with evidence of MI on late gadolinium enhancement. Median follow-up was 1133 (895-1442) days. Cox proportional hazards modeling was used to identify factors predictive of the primary outcome, a composite of first hospitalization for HF (HHF) or all-cause mortality, post-CMR. Linear regression modeling was used to identify determinants of remote ECV. RESULTS Remote myocardial fibrosis was a strong predictor of primary outcome (χ2: 15.6, hazard ratio [HR]: 1.07 per 1% increase in ECV, 95% confidence interval [CI]: 1.04-1.11, p < 0.001) and was separately predictive of both HHF and death. The strongest predictors of remote ECV were diabetes, sex, natriuretic peptides, and body mass index, but, despite extensive phenotyping, the adjusted model R2 was only 0.283. The relationship between infarct size and remote fibrosis was very weak. CONCLUSION Myocardial fibrosis, measured using CMR ECV, is a strong predictor of HHF and death in patients with evidence of MI. The mechanisms underlying remote myocardial fibrosis formation post-MI remain poorly understood, but factors other than infarct size appear to be important.
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Affiliation(s)
- Nicholas Black
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK
| | - Joshua Bradley
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK
| | - Erik B Schelbert
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA; UPMC Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Laura J Bonnett
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Gavin A Lewis
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Jakub Lagan
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK; Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Christopher Orsborne
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK
| | - Pamela F Brown
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK; South Tees NHS Foundation Trust, Middlesbrough, UK
| | - Fardad Soltani
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK
| | - Fredrika Fröjdh
- Department of Clinical Physiology, Karolinska University Hospital, and Karolinska Institutet, Stockholm, Sweden
| | - Martin Ugander
- Department of Clinical Physiology, Karolinska University Hospital, and Karolinska Institutet, Stockholm, Sweden; Kolling Institute, Royal North Shore Hospital, and University of Sydney, Sydney, Australia
| | - Timothy C Wong
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA; UPMC Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA
| | - Miho Fukui
- Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Joao L Cavalcante
- Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Josephine H Naish
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK
| | - Simon G Williams
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Matthias Schmitt
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK
| | - Christopher A Miller
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Manchester, UK; Wellcome Centre for Cell-Matrix Research, Division of Cell-Matrix Biology & Regenerative Medicine, School of Biology, Faculty of Biology, Medicine & Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
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21
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Lou Y, Hua Y, Yang J, Shi J, Jiang L, Yang Y. A nomogram for predicting CRT response based on multi-parameter features. BMC Cardiovasc Disord 2024; 24:376. [PMID: 39030503 PMCID: PMC11264749 DOI: 10.1186/s12872-024-04033-4] [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: 04/08/2024] [Accepted: 07/08/2024] [Indexed: 07/21/2024] Open
Abstract
OBJECTIVE To construct a nomogram for predicting the responsiveness of cardiac resynchronization therapy (CRT) in patients with chronic heart failure and verify its predictive efficacy. METHOD A retrospective study was conducted including 109 patients with chronic heart failure who successfully received CRT from January 2018 to December 2022. According to patients after six months of the CRT preoperative improving acuity in the left ventricular ejection fraction is 5% or at least improve grade 1 NYHA heart function classification, divided into responsive group and non-responsive group. Clinical data of patients were collected, and LASSO regression analysis and multivariate logistic regression analysis were used to explore relative factors. A nomogram was constructed, and the predictive performance of the nomogram was evaluated using the calibration curve and decision curve analysis (DCA). RESULTS Among the 109 patients, 61 were assigned to the CRT-responsive group, while 48 were assigned to the non-responsive group. LASSO regression analysis showed that left ventricular end-systolic volume, diffuse fibrosis, and left bundle branch block (LBBB) were independent factors for CRT responsiveness in patients with heart failure (P < 0.05). Based on the above three predictive factors, a nomogram was constructed. The ROC curve analysis showed that the area under the curve (AUC) was 0.865 (95% CI 0.794-0.935). The calibration curve analysis showed that the predicted probability of the nomogram is consistent with the actual occurrence rate. DCA showed that the line graph model has an excellent clinical net benefit rate. CONCLUSION The nomogram constructed based on clinical features, laboratory, and imaging examinations in this study has high discrimination and calibration in predicting CRT responsiveness in patients with chronic heart failure.
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Affiliation(s)
- Yuxuan Lou
- Southeast University, Nanjing, 210009, Jiangsu, China
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Yang Hua
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Jiaming Yang
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Jing Shi
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Lei Jiang
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Yang Yang
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
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22
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Derda AA, Abelmann M, Sonnenschein K, Sieweke JT, Bavendiek U, Bauersachs J, Thum T, Berliner D. Discontinuation of afterload-reducing drugs decreases left ventricular outflow tract obstruction in hypertrophic obstructive cardiomyopathy. Front Cardiovasc Med 2024; 11:1403422. [PMID: 39081367 PMCID: PMC11286422 DOI: 10.3389/fcvm.2024.1403422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 07/02/2024] [Indexed: 08/02/2024] Open
Abstract
Background Hypertrophic cardiomyopathy (HCM), the most common genetic heart disease, is classified into hypertrophic non-obstructive and hypertrophic obstructive cardiomyopathy (HOCM). Patients with HOCM and coexisting heart failure or arterial hypertension are often prescribed afterload-reducing drugs. Although recommended in current guidelines, data on the direct effect of discontinuing afterload-reducing medication are scarce. This study aims to demonstrate the benefit of discontinuing afterload-reducing medication in HOCM patients. Methods This monocentric retrospective analysis included 24 patients with HOCM with afterload-reducing medication, including angiotensin-converting enzyme inhibitors, angiotensin-1 receptor blocker and dihydropyridine-calcium channel blocker, at their first outpatient visit. Effects of discontinuing this medication on LVOTO were examined compared to patients with persistent use despite medical advice. Results 16 patients discontinued their afterload-reducing drugs, resulting in a significant decrease in median LVOT gradient from 86.5 [60.5-109.3] mmHg to 61.5 [28.3-97.50] mmHg (p = 0.0004). In 6 patients, beta-blocker therapy was initiated simultaneously, or the dose was increased. Regardless, LVOT gradient reduction was also significant in the remaining 10 patients (p = 0.001). The gradient was not changed significantly in the 8 patients continuing their afterload-reducing medication. Conclusions Discontinuation of afterload-reducing drugs significantly decreases LVOTO. Our study underscores the significance of abstaining from afterload-reducing drugs in HOCM patients, particularly in patients with concomitant hypertension or heart failure. According to recently published European guidelines, HOCM patients should preferably be treated with beta-blockers or non-dihydropyridine-calcium channel blockers.
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Affiliation(s)
- Anselm A. Derda
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | - Malin Abelmann
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | - Kristina Sonnenschein
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | - Jan-Thorben Sieweke
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Udo Bavendiek
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany
| | - Dominik Berliner
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
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23
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Sun Q, Chen W, Wu R, Tao B, Wang P, Sun B, Alvarez JF, Ma F, Galindo DC, Maroney SP, Saviola AJ, Hansen KC, Li S, Deb A. Serine protease inhibitor, SerpinA3n, regulates cardiac remodelling after myocardial infarction. Cardiovasc Res 2024; 120:943-953. [PMID: 38666458 DOI: 10.1093/cvr/cvae075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 01/07/2024] [Accepted: 02/02/2024] [Indexed: 07/03/2024] Open
Abstract
AIMS Following myocardial infarction (MI), the heart repairs itself via a fibrotic repair response. The degree of fibrosis is determined by the balance between deposition of extracellular matrix (ECM) by activated fibroblasts and breakdown of nascent scar tissue by proteases that are secreted predominantly by inflammatory cells. Excessive proteolytic activity and matrix turnover has been observed in human heart failure, and protease inhibitors in the injured heart regulate matrix breakdown. Serine protease inhibitors (Serpins) represent the largest and the most functionally diverse family of evolutionary conserved protease inhibitors, and levels of the specific Serpin, SerpinA3, have been strongly associated with clinical outcomes in human MI as well as non-ischaemic cardiomyopathies. Yet, the role of Serpins in regulating cardiac remodelling is poorly understood. The aim of this study was to understand the role of Serpins in regulating scar formation after MI. METHODS AND RESULTS Using a SerpinA3n conditional knockout mice model, we observed the robust expression of Serpins in the infarcted murine heart and demonstrate that genetic deletion of SerpinA3n (mouse homologue of SerpinA3) leads to increased activity of substrate proteases, poorly compacted matrix, and significantly worse post-infarct cardiac function. Single-cell transcriptomics complemented with histology in SerpinA3n-deficient animals demonstrated increased inflammation, adverse myocyte hypertrophy, and expression of pro-hypertrophic genes. Proteomic analysis of scar tissue demonstrated decreased cross-linking of ECM peptides consistent with increased proteolysis in SerpinA3n-deficient animals. CONCLUSION Our study demonstrates a hitherto unappreciated causal role of Serpins in regulating matrix function and post-infarct cardiac remodelling.
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Affiliation(s)
- Qihao Sun
- Division of Cardiology, Department of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Cardiovascular Theme, David Geffen School of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Department of Molecular, Cell & Developmental Biology, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- Eli & Edythe Broad Center of Regenerative Medicine & Stem Cell Research, University of California, 615 Charles E Young Drive S, Los Angeles, California, 90095 CA, USA
- Molecular Biology Institute, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- California NanoSystems Institute, University of California, 570 Westwood Plaza, Los Angeles, California, 90095 CA, USA
| | - Wei Chen
- Division of Cardiology, Department of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Cardiovascular Theme, David Geffen School of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Department of Molecular, Cell & Developmental Biology, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- Eli & Edythe Broad Center of Regenerative Medicine & Stem Cell Research, University of California, 615 Charles E Young Drive S, Los Angeles, California, 90095 CA, USA
- Molecular Biology Institute, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- California NanoSystems Institute, University of California, 570 Westwood Plaza, Los Angeles, California, 90095 CA, USA
| | - Rimao Wu
- Division of Cardiology, Department of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Cardiovascular Theme, David Geffen School of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Department of Molecular, Cell & Developmental Biology, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- Eli & Edythe Broad Center of Regenerative Medicine & Stem Cell Research, University of California, 615 Charles E Young Drive S, Los Angeles, California, 90095 CA, USA
- Molecular Biology Institute, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- California NanoSystems Institute, University of California, 570 Westwood Plaza, Los Angeles, California, 90095 CA, USA
| | - Bo Tao
- Division of Cardiology, Department of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Cardiovascular Theme, David Geffen School of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Department of Molecular, Cell & Developmental Biology, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- Eli & Edythe Broad Center of Regenerative Medicine & Stem Cell Research, University of California, 615 Charles E Young Drive S, Los Angeles, California, 90095 CA, USA
- Molecular Biology Institute, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- California NanoSystems Institute, University of California, 570 Westwood Plaza, Los Angeles, California, 90095 CA, USA
| | - Ping Wang
- Division of Cardiology, Department of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Cardiovascular Theme, David Geffen School of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Department of Molecular, Cell & Developmental Biology, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- Eli & Edythe Broad Center of Regenerative Medicine & Stem Cell Research, University of California, 615 Charles E Young Drive S, Los Angeles, California, 90095 CA, USA
- Molecular Biology Institute, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- California NanoSystems Institute, University of California, 570 Westwood Plaza, Los Angeles, California, 90095 CA, USA
| | - Baiming Sun
- Division of Cardiology, Department of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Cardiovascular Theme, David Geffen School of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Department of Molecular, Cell & Developmental Biology, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- Eli & Edythe Broad Center of Regenerative Medicine & Stem Cell Research, University of California, 615 Charles E Young Drive S, Los Angeles, California, 90095 CA, USA
- Molecular Biology Institute, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- California NanoSystems Institute, University of California, 570 Westwood Plaza, Los Angeles, California, 90095 CA, USA
| | - Juan F Alvarez
- Division of Cardiology, Department of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Cardiovascular Theme, David Geffen School of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Department of Molecular, Cell & Developmental Biology, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- Eli & Edythe Broad Center of Regenerative Medicine & Stem Cell Research, University of California, 615 Charles E Young Drive S, Los Angeles, California, 90095 CA, USA
- Molecular Biology Institute, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- California NanoSystems Institute, University of California, 570 Westwood Plaza, Los Angeles, California, 90095 CA, USA
| | - Feiyang Ma
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - David Ceja Galindo
- Biochemistry and Molecular Genetics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Sean P Maroney
- Biochemistry and Molecular Genetics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Anthony J Saviola
- Biochemistry and Molecular Genetics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Kirk C Hansen
- Biochemistry and Molecular Genetics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Shen Li
- Division of Cardiology, Department of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Cardiovascular Theme, David Geffen School of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Department of Molecular, Cell & Developmental Biology, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- Eli & Edythe Broad Center of Regenerative Medicine & Stem Cell Research, University of California, 615 Charles E Young Drive S, Los Angeles, California, 90095 CA, USA
- Molecular Biology Institute, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- California NanoSystems Institute, University of California, 570 Westwood Plaza, Los Angeles, California, 90095 CA, USA
| | - Arjun Deb
- Division of Cardiology, Department of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Cardiovascular Theme, David Geffen School of Medicine, University of California, 675 Charles E Young Drive South, Los Angeles, California, 90095 CA, USA
- Department of Molecular, Cell & Developmental Biology, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- Eli & Edythe Broad Center of Regenerative Medicine & Stem Cell Research, University of California, 615 Charles E Young Drive S, Los Angeles, California, 90095 CA, USA
- Molecular Biology Institute, University of California, 610 Charles E Young Dr S, Los Angeles, California, 90095 CA, USA
- California NanoSystems Institute, University of California, 570 Westwood Plaza, Los Angeles, California, 90095 CA, USA
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Parletta AC, Cerri GC, Gasparini CRB, Panico K, Vieira-Junior DN, Zacarias-Rodrigues LM, Senger N, de Almeida Silva A, Fevereiro M, Diniz GP, Irigoyen MCC, Barreto-Chaves MLM. Cardiac hypertrophy that affects hyperthyroidism occurs independently of the NLRP3 inflammasome. Pflugers Arch 2024; 476:1065-1075. [PMID: 38679646 DOI: 10.1007/s00424-024-02965-6] [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: 01/04/2024] [Revised: 03/26/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024]
Abstract
Cardiac hypertrophy (CH) is an adaptive response to maintain cardiac function; however, persistent stress responses lead to contractile dysfunction and heart failure. Although inflammation is involved in these processes, the mechanisms that control cardiac inflammation and hypertrophy still need to be clarified. The NLRP3 inflammasome is a cytosolic multiprotein complex that mediates IL-1β production. The priming step of NLRP3 is essential for increasing the expression of its components and occurs following NF-κB activation. Hyperthyroidism triggers CH, which can progress to maladaptive CH and even heart failure. We have shown in a previous study that thyroid hormone (TH)-induced CH is linked to the upregulation of S100A8, leading to NF-κB activation. Therefore, we aimed to investigate whether the NLRP3 inflammasome is involved in TH-induced CH and its potential role in CH pathophysiology. Hyperthyroidism was induced in NLRP3 knockout (NLRP3-KO), Caspase-1-KO and Wild Type (WT) male mice of the C57Bl/6J strain, aged 8-12 weeks, by triiodothyronine (7 μg/100 g BW, i.p.) administered daily for 14 days. Morphological and cardiac functional analysis besides molecular assays showed, for the first time, that TH-induced CH is accompanied by reduced NLRP3 expression in the heart and that it occurs independently of the NLRP3 inflammasome and caspase 1-related pathways. However, NLRP3 is important for the maintenance of basal cardiac function since NLRP3-KO mice had impaired diastolic function and reduced heart rate, ejection fraction, and fractional shortening compared with WT mice.
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Affiliation(s)
- Aline Cristina Parletta
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 2415, Butanta, Sao Paulo, 05508-000, Brazil
| | - Gabriela Cavazza Cerri
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 2415, Butanta, Sao Paulo, 05508-000, Brazil
| | - Claudia Ribeiro Borba Gasparini
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 2415, Butanta, Sao Paulo, 05508-000, Brazil
| | - Karine Panico
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 2415, Butanta, Sao Paulo, 05508-000, Brazil
| | - Denival Nascimento Vieira-Junior
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 2415, Butanta, Sao Paulo, 05508-000, Brazil
| | - Larissa Maria Zacarias-Rodrigues
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 2415, Butanta, Sao Paulo, 05508-000, Brazil
| | - Nathalia Senger
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 2415, Butanta, Sao Paulo, 05508-000, Brazil
| | - Amanda de Almeida Silva
- Department of Cardiopneumology, Heart Institute, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Marina Fevereiro
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 2415, Butanta, Sao Paulo, 05508-000, Brazil
| | - Gabriela Placoná Diniz
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 2415, Butanta, Sao Paulo, 05508-000, Brazil
- Center for Regenerative Medicine, University of South Florida Health Heart Institute, Morsani School of Medicine, University of South Florida, Tampa, FL, USA
| | - Maria Cláudia Costa Irigoyen
- Department of Cardiopneumology, Heart Institute, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Maria Luiza Morais Barreto-Chaves
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 2415, Butanta, Sao Paulo, 05508-000, Brazil.
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25
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McNeill SM, Zhao P. The roles of RGS proteins in cardiometabolic disease. Br J Pharmacol 2024; 181:2319-2337. [PMID: 36964984 DOI: 10.1111/bph.16076] [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: 09/21/2022] [Revised: 02/12/2023] [Accepted: 03/20/2023] [Indexed: 03/27/2023] Open
Abstract
G protein-coupled receptors (GPCRs) are the most prominent receptors on the surface of the cell and play a central role in the regulation of cardiac and metabolic functions. GPCRs transmit extracellular stimuli to the interior of the cells by activating one or more heterotrimeric G proteins. The duration and intensity of G protein-mediated signalling are tightly controlled by a large array of intracellular mediators, including the regulator of G protein signalling (RGS) proteins. RGS proteins selectively promote the GTPase activity of a subset of Gα subunits, thus serving as negative regulators in a pathway-dependent manner. In the current review, we summarise the involvement of RGS proteins in cardiometabolic function with a focus on their tissue distribution, mechanisms of action and dysregulation under various disease conditions. We also discuss the potential therapeutic applications for targeting RGS proteins in treating cardiometabolic conditions and current progress in developing RGS modulators. LINKED ARTICLES: This article is part of a themed issue Therapeutic Targeting of G Protein-Coupled Receptors: hot topics from the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists 2021 Virtual Annual Scientific Meeting. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v181.14/issuetoc.
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Affiliation(s)
- Samantha M McNeill
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Peishen Zhao
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- ARC Centre for Cryo-Electron Microscopy of Membrane Proteins (CCeMMP), Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
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26
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Yoshioka G, Tanaka A, Sonoda S, Kaneko T, Hongo H, Yokoi K, Natsuaki M, Node K. Importance of reassessment to identify trajectories of chronic transition of clinical indicators in post-myocardial infarction management. Cardiovasc Interv Ther 2024; 39:234-240. [PMID: 38615302 DOI: 10.1007/s12928-024-01000-w] [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: 03/25/2024] [Accepted: 03/30/2024] [Indexed: 04/15/2024]
Abstract
Despite advances in multidisciplinary acute care for myocardial infarction (MI), the clinical need to manage heart failure and elevated mortality risks in the remote phase of MI remains unmet. Various prognostic models have been established using clinical indicators obtained during the acute phase of MI; however, most of these indicators also show chronic changes in the post-MI phase. Although relevant guidelines recommend follow-up assessments of some clinical indicators in the chronic phase, systematic reassessment has not yet been fully established and implemented in a real-world clinical setting. Therefore, clinical evidence of the impact of such chronic transitions on the post-MI prognosis is lacking. We speculate that post-MI reassessment of key clinical indicators and the impact of their chronic transition patterns on long-term prognoses can improve the quality of post-MI risk stratification and help identify residual risk factors. Several recent studies have investigated the impact of the chronic transition of some clinical indicators, such as serum albumin level, mitral regurgitation, and left-ventricular dysfunction, on post-MI prognosis. Interestingly, even in MI survivors with these indicators within their respective normal ranges in the acute phase of MI, chronic transition to an abnormal range was associated with worsening cardiovascular outcomes. On the basis of these recent insights, we discuss the clinical significance of post-MI reassessment to identify the trajectories of several clinical indicators and elucidate the potential residual risk factors affecting adverse outcomes in MI survivors.
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Affiliation(s)
- Goro Yoshioka
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Shinjo Sonoda
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
| | - Tetsuya Kaneko
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Hiroshi Hongo
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Kensuke Yokoi
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Masahiro Natsuaki
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
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27
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McCracken C, Szabo L, Abdulelah ZA, Condurache DG, Vago H, Nichols TE, Petersen SE, Neubauer S, Raisi-Estabragh Z. Ventricular volume asymmetry as a novel imaging biomarker for disease discrimination and outcome prediction. EUROPEAN HEART JOURNAL OPEN 2024; 4:oeae059. [PMID: 39119202 PMCID: PMC11306927 DOI: 10.1093/ehjopen/oeae059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/15/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024]
Abstract
Aims Disruption of the predictable symmetry of the healthy heart may be an indicator of cardiovascular risk. This study defines the population distribution of ventricular asymmetry and its relationships across a range of prevalent and incident cardiorespiratory diseases. Methods and results The analysis includes 44 796 UK Biobank participants (average age 64.1 ± 7.7 years; 51.9% women). Cardiovascular magnetic resonance (CMR) metrics were derived using previously validated automated pipelines. Ventricular asymmetry was expressed as the ratio of left and right ventricular (LV and RV) end-diastolic volumes. Clinical outcomes were defined through linked health records. Incident events were those occurring for the first time after imaging, longitudinally tracked over an average follow-up time of 4.75 ± 1.52 years. The normal range for ventricular symmetry was defined in a healthy subset. Participants with values outside the 5th-95th percentiles of the healthy distribution were classed as either LV dominant (LV/RV > 112%) or RV dominant (LV/RV < 80%) asymmetry. Associations of LV and RV dominant asymmetry with vascular risk factors, CMR features, and prevalent and incident cardiovascular diseases (CVDs) were examined using regression models, adjusting for vascular risk factors, prevalent diseases, and conventional CMR measures. Left ventricular dominance was linked to an array of pre-existing vascular risk factors and CVDs, and a two-fold increased risk of incident heart failure, non-ischaemic cardiomyopathies, and left-sided valvular disorders. Right ventricular dominance was associated with an elevated risk of all-cause mortality. Conclusion Ventricular asymmetry has clinical utility for cardiovascular risk assessment, providing information that is incremental to traditional risk factors and conventional CMR metrics.
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Affiliation(s)
- Celeste McCracken
- Division of Cardiovascular Medicine, Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Liliana Szabo
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Heart and Vascular Center, Semmelweis University, Budapest 1122, Hungary
| | - Zaid A Abdulelah
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
| | - Dorina-Gabriela Condurache
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Hajnalka Vago
- Heart and Vascular Center, Semmelweis University, Budapest 1122, Hungary
- Department of Sports Medicine, Semmelweis University, Budapest 1085, Hungary
| | - Thomas E Nichols
- Wellcome Centre for Integrative Neuroimaging (WIN FMRIB), University of Oxford, Oxford OX3 9DA, UK
- Big Data Institute, University of Oxford, Oxford OX3 7LF, UK
- Nuffield Department Population Health, Big Data Institute, University of Oxford, Oxford OX3 7LF, UK
| | - Steffen E Petersen
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Health Data Research UK, London NW1 2BE, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Zahra Raisi-Estabragh
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
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28
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Nishimura A, Tang X, Zhou L, Ito T, Kato Y, Nishida M. Sulfur metabolism as a new therapeutic target of heart failure. J Pharmacol Sci 2024; 155:75-83. [PMID: 38797536 DOI: 10.1016/j.jphs.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/07/2024] [Accepted: 04/21/2024] [Indexed: 05/29/2024] Open
Abstract
Sulfur-based redox signaling has long attracted attention as critical mechanisms underlying the development of cardiac diseases and resultant heart failure. Especially, post-translational modifications of cysteine (Cys) thiols in proteins mediate oxidative stress-dependent cardiac remodeling including myocardial hypertrophy, senescence, and interstitial fibrosis. However, we recently revealed the existence of Cys persulfides and Cys polysulfides in cells and tissues, which show higher redox activities than Cys and substantially contribute to redox signaling and energy metabolism. We have established simple evaluation methods that can detect polysulfides in proteins and inorganic polysulfides in cells and revealed that polysulfides abundantly expressed in normal hearts are dramatically catabolized by exposure to ischemic/hypoxic and environmental electrophilic stress, which causes vulnerability of the heart to mechanical load. Accumulation of hydrogen sulfide, a nucleophilic catabolite of persulfides/polysulfides, may lead to reductive stress in ischemic hearts, and perturbation of polysulfide catabolism can improve chronic heart failure after myocardial infarction in mice. This review focuses on the (patho)physiological role of sulfur metabolism in hearts, and proposes that sulfur catabolism during ischemic/hypoxic stress has great potential as a new therapeutic strategy for the treatment of ischemic heart failure.
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Affiliation(s)
- Akiyuki Nishimura
- National Institute for Physiological Sciences, National Institutes of Natural Sciences (NINS), Okazaki, 444-8787, Japan; Exploratory Research Center on Life and Living Systems, NINS, Okazaki, 444-8787, Japan; SOKENDAI (The Graduate University for Advanced Studies), Okazaki, 444-8787, Japan.
| | - Xiaokang Tang
- National Institute for Physiological Sciences, National Institutes of Natural Sciences (NINS), Okazaki, 444-8787, Japan; Exploratory Research Center on Life and Living Systems, NINS, Okazaki, 444-8787, Japan; SOKENDAI (The Graduate University for Advanced Studies), Okazaki, 444-8787, Japan
| | - Liuchenzi Zhou
- National Institute for Physiological Sciences, National Institutes of Natural Sciences (NINS), Okazaki, 444-8787, Japan; Exploratory Research Center on Life and Living Systems, NINS, Okazaki, 444-8787, Japan; SOKENDAI (The Graduate University for Advanced Studies), Okazaki, 444-8787, Japan
| | - Tomoya Ito
- Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Yuri Kato
- Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Motohiro Nishida
- National Institute for Physiological Sciences, National Institutes of Natural Sciences (NINS), Okazaki, 444-8787, Japan; Exploratory Research Center on Life and Living Systems, NINS, Okazaki, 444-8787, Japan; SOKENDAI (The Graduate University for Advanced Studies), Okazaki, 444-8787, Japan; Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
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29
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Eghan P, Folson AA, Donkor A, Kokuro C, Amo Wiafe Y. Relationship between hypertensive disorders of pregnancy (HDP) and cardiac remodeling during pregnancy: Systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2024; 298:108-115. [PMID: 38749071 DOI: 10.1016/j.ejogrb.2024.05.003] [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: 11/07/2023] [Revised: 04/30/2024] [Accepted: 05/07/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES Hypertensive disorders of pregnancy (HDP) are among the leading causes of maternal morbidity and mortality. The primary objective of this study was to ascertain whether maternal cardiac remodeling is more prevalent in HDP than normotensive pregnancy and if significant change in aortic root size is involved. The secondary objective was to determine the types of cardiac remodeling often associated with HDP. METHODS A systematic search was conducted across four electronic databases, including Medline, PubMed, Cochrane and EMBASE. The reference lists of selected articles were also searched to ensure no relevant studies were missed. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed in this systematic review. RESULTS Out of 5,278 articles identified by the search terms, 9 were eligible for inclusion in the meta-analysis. The investigation unveiled a greater prevalence of maternal cardiac remodeling in HDP than normotensive pregnancies. The commonest type of maternal cardiac remodeling in both HDP and normotensive pregnancies was eccentric left ventricular hypertrophy, followed by concentric left ventricular remodeling which was more specific to HDP. Notably, left atrial diameter was significantly increased in HDP than normotensive pregnancies, suggesting higher prevalence of diastolic dysfunction. Additionally, the aortic root dimension was significantly increased in HDP than normotensive pregnancies. CONCLUSION This study underscores the importance of monitoring cardiac health in pregnancy, particularly in those with hypertensive disorders, in order to mitigate potential complications and improve maternal outcomes. Finally, the risk of aortic dissection that may occur as a long-term effect of aortic root enlargement in women with history of HDP ought to be investigated in future studies.
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Affiliation(s)
- Philip Eghan
- Department of Radiology, University of Ghana Medical Centre, Accra, Ghana; Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Aba A Folson
- Department of Internal Medicine and Therapeutics, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Andrew Donkor
- Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Collins Kokuro
- Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi Ghana
| | - Yaw Amo Wiafe
- Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
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30
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Bulnes JF, González L, Velásquez L, Orellana MP, Venturelli PM, Martínez G. Role of inflammation and evidence for the use of colchicine in patients with acute coronary syndrome. Front Cardiovasc Med 2024; 11:1356023. [PMID: 38993522 PMCID: PMC11236697 DOI: 10.3389/fcvm.2024.1356023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/29/2024] [Indexed: 07/13/2024] Open
Abstract
Acute Coronary Syndrome (ACS) significantly contributes to cardiovascular death worldwide. ACS may arise from the disruption of an atherosclerotic plaque, ultimately leading to acute ischemia and myocardial infarction. In the pathogenesis of atherosclerosis, inflammation assumes a pivotal role, not solely in the initiation and complications of atherosclerotic plaque formation, but also in the myocardial response to ischemic insult. Acute inflammatory processes, coupled with time to reperfusion, orchestrate ischemic and reperfusion injuries, dictating infarct magnitude and acute left ventricular (LV) remodeling. Conversely, chronic inflammation, alongside neurohumoral activation, governs persistent LV remodeling. The interplay between chronic LV remodeling and recurrent ischemic episodes delineates the progression of the disease toward heart failure and cardiovascular death. Colchicine exerts anti-inflammatory properties affecting both the myocardium and atherosclerotic plaque by modulating the activity of monocyte/macrophages, neutrophils, and platelets. This modulation can potentially result in a more favorable LV remodeling and forestalls the recurrence of ACS. This narrative review aims to delineate the role of inflammation across the different phases of ACS pathophysiology and describe the mechanistic underpinnings of colchicine, exploring its purported role in modulating each of these stages.
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Affiliation(s)
- Juan Francisco Bulnes
- División de Enfermedades Cardiovasculares, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Leticia González
- Centro de Imágenes Biomédicas, Departamento de Radiología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Leonardo Velásquez
- División de Enfermedades Cardiovasculares, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - María Paz Orellana
- División de Enfermedades Cardiovasculares, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paula Muñoz Venturelli
- Centro de Estudios Clínicos, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Gonzalo Martínez
- División de Enfermedades Cardiovasculares, Pontificia Universidad Católica de Chile, Santiago, Chile
- Heart Research Institute, Sydney, NSW, Australia
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31
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Askani E, Rospleszcz S, Lorbeer R, Wintergerst C, Müller-Peltzer K, Nattenmüller J, Hasic D, von Krüchten R, Kellner E, Reisert M, Rathmann W, Peters A, Schlett CL, Bamberg F, Storz C. MRI-based adrenal gland volume is associated with cardiovascular alterations in individuals without prior cardiovascular disease. Sci Rep 2024; 14:14664. [PMID: 38918570 PMCID: PMC11199666 DOI: 10.1038/s41598-024-65673-2] [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: 02/16/2024] [Accepted: 06/24/2024] [Indexed: 06/27/2024] Open
Abstract
Aim of this study was to analyse the associations of cardiovascular health and adrenal gland volume as a rather new imaging biomarker of chronic hypothalamic-pituitary-adrenal (HPA) axis activation. The study population originates from the KORA population-based cross-sectional prospective cohort. 400 participants without known cardiovascular disease underwent a whole-body MRI. Manual segmentation of adrenal glands was performed on VIBE-Dixon gradient-echo sequence. MRI based evaluation of cardiac parameters was achieved semi-automatically. Cardiometabolic risk factors were obtained through standardized interviews and medical examination. Univariate and multivariate associations were derived. Bi-directional causal mediation analysis was performed. 351 participants were eligible for analysis (56 ± 9.1 years, male 58.7%). In multivariate analysis, significant associations were observed between adrenal gland volume and hypertension (outcome hypertension: Odds Ratio = 1.11, 95% CI [1.01, 1.21], p = 0.028), left ventricular remodelling index (LVRI) (outcome LVRI: β = 0.01, 95% CI [0.00, 0.02], p = 0.011), and left ventricular (LV) wall thickness (outcome LV wall thickness: β = 0.06, 95% CI [0.02, 0.09], p = 0.005). In bi-directional causal mediation analysis adrenal gland volume had a borderline significant mediating effect on the association between hypertension and LVRI (p = 0.052) as well as wall thickness (p = 0.054). MRI-based assessment of adrenal gland enlargement is associated with hypertension and LV remodelling. Adrenal gland volume may serve as an indirect cardiovascular imaging biomarker.
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Affiliation(s)
- Esther Askani
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Susanne Rospleszcz
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany
- Institute of Epidemiology, Helmholtz Centre Munich, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Cardiovascular Disease Research (DZHK E.V.), Munich, Germany
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilans-University Hospital, Munich, Germany
| | - Charlotte Wintergerst
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Müller-Peltzer
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johanna Nattenmüller
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dunja Hasic
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ricarda von Krüchten
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Elias Kellner
- Medical Physics, Department of Radiology, Medical Centre - University of Freiburg, Freiburg, Germany
| | - Marco Reisert
- Medical Physics, Department of Radiology, Medical Centre - University of Freiburg, Freiburg, Germany
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Duesseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Site Neuherberg, Neuherberg, Germany
| | - Annette Peters
- Department of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany
- Institute of Epidemiology, Helmholtz Centre Munich, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Cardiovascular Disease Research (DZHK E.V.), Munich, Germany
- German Center for Diabetes Research (DZD), Partner Site Neuherberg, Neuherberg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Corinna Storz
- Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany.
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Wu D, Ono R, Wang S, Kobayashi Y, Sughimoto K, Liu H. Pulse wave signal-driven machine learning for identifying left ventricular enlargement in heart failure patients. Biomed Eng Online 2024; 23:60. [PMID: 38909231 PMCID: PMC11193305 DOI: 10.1186/s12938-024-01257-5] [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: 12/25/2023] [Accepted: 06/12/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND Left ventricular enlargement (LVE) is a common manifestation of cardiac remodeling that is closely associated with cardiac dysfunction, heart failure (HF), and arrhythmias. This study aimed to propose a machine learning (ML)-based strategy to identify LVE in HF patients by means of pulse wave signals. METHOD We constructed two high-quality pulse wave datasets comprising a non-LVE group and an LVE group based on the 264 HF patients. Fourier series calculations were employed to determine if significant frequency differences existed between the two datasets, thereby ensuring their validity. Then, the ML-based identification was undertaken by means of classification and regression models: a weighted random forest model was employed for binary classification of the datasets, and a densely connected convolutional network was utilized to directly estimate the left ventricular diastolic diameter index (LVDdI) through regression. Finally, the accuracy of the two models was validated by comparing their results with clinical measurements, using accuracy and the area under the receiver operating characteristic curve (AUC-ROC) to assess their capability for identifying LVE patients. RESULTS The classification model exhibited superior performance with an accuracy of 0.91 and an AUC-ROC of 0.93. The regression model achieved an accuracy of 0.88 and an AUC-ROC of 0.89, indicating that both models can quickly and accurately identify LVE in HF patients. CONCLUSION The proposed ML methods are verified to achieve effective classification and regression with good performance for identifying LVE in HF patients based on pulse wave signals. This study thus demonstrates the feasibility and potential of the ML-based strategy for clinical practice while offering an effective and robust tool for diagnosing and intervening ventricular remodeling.
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Affiliation(s)
- Dandan Wu
- Graduate School of Science and Engineering, Chiba University, Chiba, Japan
| | - Ryohei Ono
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Sirui Wang
- Graduate School of Science and Engineering, Chiba University, Chiba, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Koichi Sughimoto
- Graduate School of Science and Engineering, Chiba University, Chiba, Japan
| | - Hao Liu
- Graduate School of Science and Engineering, Chiba University, Chiba, Japan.
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Chen ZY, Ji SJ, Huang CW, Tu WZ, Ren XY, Guo R, Xie X. In situ reprogramming of cardiac fibroblasts into cardiomyocytes in mouse heart with chemicals. Acta Pharmacol Sin 2024:10.1038/s41401-024-01308-6. [PMID: 38890526 DOI: 10.1038/s41401-024-01308-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/07/2024] [Indexed: 06/20/2024] Open
Abstract
Cardiomyocytes are terminal differentiated cells and have limited ability to proliferate or regenerate. Condition like myocardial infarction causes massive death of cardiomyocytes and is the leading cause of death. Previous studies have demonstrated that cardiac fibroblasts can be induced to transdifferentiate into cardiomyocytes in vitro and in vivo by forced expression of cardiac transcription factors and microRNAs. Our previous study have demonstrated that full chemical cocktails could also induce fibroblast to cardiomyocyte transdifferentiation both in vitro and in vivo. With the development of tissue clearing techniques, it is possible to visualize the reprogramming at the whole-organ level. In this study, we investigated the effect of the chemical cocktail CRFVPTM in inducing in situ fibroblast to cardiomyocyte transdifferentiation with two strains of genetic tracing mice, and the reprogramming was observed at whole-heart level with CUBIC tissue clearing technique and 3D imaging. In addition, single-cell RNA sequencing (scRNA-seq) confirmed the generation of cardiomyocytes from cardiac fibroblasts which carries the tracing marker. Our study confirms the use of small molecule cocktails in inducing in situ fibroblast to cardiomyocyte reprogramming at the whole-heart level and proof-of-conceptly providing a new source of naturally incorporated cardiomyocytes to help heart regeneration.
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Affiliation(s)
- Zi-Yang Chen
- State Key Laboratory of Drug Research, the National Center for Drug Screening, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
- School of Pharmacy, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Si-Jia Ji
- State Key Laboratory of Drug Research, the National Center for Drug Screening, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
- School of Pharmacy, University of Chinese Academy of Sciences, Beijing, 100049, China
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 200031, China
| | - Chen-Wen Huang
- State Key Laboratory of Drug Research, the National Center for Drug Screening, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Wan-Zhi Tu
- State Key Laboratory of Drug Research, the National Center for Drug Screening, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
- School of Pharmacy, University of Chinese Academy of Sciences, Beijing, 100049, China
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 200031, China
| | - Xin-Yue Ren
- State Key Laboratory of Drug Research, the National Center for Drug Screening, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
- School of Pharmacy, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Ren Guo
- State Key Laboratory of Drug Research, the National Center for Drug Screening, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
- Shandong Laboratory of Yantai Drug Discovery, Bohai Rim Advanced Research Institute for Drug Discovery, Yantai, 264119, China
| | - Xin Xie
- State Key Laboratory of Drug Research, the National Center for Drug Screening, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China.
- School of Pharmacy, University of Chinese Academy of Sciences, Beijing, 100049, China.
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 200031, China.
- Shandong Laboratory of Yantai Drug Discovery, Bohai Rim Advanced Research Institute for Drug Discovery, Yantai, 264119, China.
- School of Pharmaceutical Science and Technology, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, 310024, China.
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Hassan A, Samaan K, Asfour A, Baghdady Y, Samaan AA. Ventricular remodeling and hemodynamic changes in heart failure patients with non-ischemic dilated cardiomyopathy following dapagliflozin initiation. Egypt Heart J 2024; 76:76. [PMID: 38888761 PMCID: PMC11189362 DOI: 10.1186/s43044-024-00508-z] [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: 04/04/2024] [Accepted: 06/07/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND In heart failure with reduced ejection fraction (HFrEF), sodium-glucose co-transporter inhibitors (SGLT-2i) have persistently shown cardiovascular benefits through different trials. However, their impact on ventricular remodeling and cardiac hemodynamics has not been sufficiently studied. This study aimed to study how SGLT-2i initiation affects invasive hemodynamics and cardiac magnetic resonance imaging (CMR)-derived ventricular volumes, function, and fraction of the extracellular volume (ECV) in HFrEF patients with non-ischemic dilated cardiomyopathy (NIDCM). RESULTS In this study, 23 patients with HFrEF and a mean age of 42, including 82.6% males, all have NIDCM and underwent right heart catheterization and CMR at the initiation of dapagliflozin and at 6-month follow-up. The addition of dapagliflozin resulted in significant reductions in the following invasive hemodynamic parameters compared to baseline: left ventricular end-diastolic pressure (23.4 vs 19.7 mmHg, p = 0.003), mean pulmonary artery pressure (31.3 vs 27.7 mmHg, p = 0.03), and systemic vascular resistance (18 vs 15 Wood units, p = 0.047). Among the studied CMR-derived measurements, only the percentage of extracellular volume fraction was significantly less at follow-up (33.7 vs 32.16%, p = 0.001). Additionally, functional class showed significant improvement with a notable reduction of the NT-proBNP level and a considerable decrease in diuretic dose (median: 40 vs 80 mg, p = 0.01). CONCLUSION Adding dapagliflozin to patients with HFrEF due to NIDCM improved invasively measured hemodynamics and significantly reduced left ventricular extracellular volume fraction measured by CMR, with no significant change in ventricular volumes or ejection fraction.
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Affiliation(s)
- Ahmed Hassan
- Department of Cardiovascular Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Kerollos Samaan
- Department of Cardiovascular Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Asfour
- Department of Cardiovascular Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yasser Baghdady
- Department of Cardiovascular Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amir Anwar Samaan
- Department of Cardiovascular Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
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Ma YL, Kong CY, Guo Z, Wang MY, Wang P, Liu FY, Yang D, Yang Z, Tang QZ. Semaglutide ameliorates cardiac remodeling in male mice by optimizing energy substrate utilization through the Creb5/NR4a1 axis. Nat Commun 2024; 15:4757. [PMID: 38834564 PMCID: PMC11150406 DOI: 10.1038/s41467-024-48970-2] [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: 01/10/2024] [Accepted: 05/15/2024] [Indexed: 06/06/2024] Open
Abstract
Semaglutide, a glucagon-like peptide-1 receptor agonist, is clinically used as a glucose-lowering and weight loss medication due to its effects on energy metabolism. In heart failure, energy production is impaired due to altered mitochondrial function and increased glycolysis. However, the impact of semaglutide on cardiomyocyte metabolism under pressure overload remains unclear. Here we demonstrate that semaglutide improves cardiac function and reduces hypertrophy and fibrosis in a mouse model of pressure overload-induced heart failure. Semaglutide preserves mitochondrial structure and function under chronic stress. Metabolomics reveals that semaglutide reduces mitochondrial damage, lipid accumulation, and ATP deficiency by promoting pyruvate entry into the tricarboxylic acid cycle and increasing fatty acid oxidation. Transcriptional analysis shows that semaglutide regulates myocardial energy metabolism through the Creb5/NR4a1 axis in the PI3K/AKT pathway, reducing NR4a1 expression and its translocation to mitochondria. NR4a1 knockdown ameliorates mitochondrial dysfunction and abnormal glucose and lipid metabolism in the heart. These findings suggest that semaglutide may be a therapeutic agent for improving cardiac remodeling by modulating energy metabolism.
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Affiliation(s)
- Yu-Lan Ma
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, PR China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, PR China
| | - Chun-Yan Kong
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, PR China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, PR China
| | - Zhen Guo
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, PR China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, PR China
| | - Ming-Yu Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, PR China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, PR China
| | - Pan Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, PR China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, PR China
| | - Fang-Yuan Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, PR China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, PR China
| | - Dan Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, PR China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, PR China
| | - Zheng Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, PR China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, PR China
| | - Qi-Zhu Tang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, PR China.
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, 430060, PR China.
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Matta A, Ohlmann P, Nader V, Moussallem N, Carrié D, Roncalli J. A review of therapeutic approaches for post-infarction left ventricular remodeling. Curr Probl Cardiol 2024; 49:102562. [PMID: 38599556 DOI: 10.1016/j.cpcardiol.2024.102562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 04/07/2024] [Indexed: 04/12/2024]
Abstract
Left ventricular remodeling is an adaptive process initially developed in response to acute myocardial infarction (AMI), but it ends up with negative adverse outcomes such as infarcted wall thinning, ventricular dilation, and cardiac dysfunction. A prolonged excessive inflammatory reaction to cardiomyocytes death and necrosis plays the crucial role in the pathophysiological mechanisms. The pharmacological treatment includes nitroglycerine, β-blockers, ACEi/ARBs, SGLT2i, mineralocorticoid receptor antagonists, and some miscellaneous aspects. Stem cells therapy, CD34+ cells transplantation and gene therapy constitute the promissing therapeutic approaches for post AMI cardiac remodeling, thereby enhancing angiogenesis, cardiomyocytes differenciation and left ventricular function on top of inhibiting apoptosis, inflammation, and collagen deposition. All these lead to reduce infarct size, scar formation and myocardial fibrosis.
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Affiliation(s)
- Anthony Matta
- Department of Cardiology, Civilian Hospitals of Colmar, Colmar, France; School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon.
| | - Patrick Ohlmann
- Department of Cardiology, Strasbourg University Hospital, Strasbourg, France
| | - Vanessa Nader
- Department of Cardiology, Civilian Hospitals of Colmar, Colmar, France
| | - Nicolas Moussallem
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon
| | - Didier Carrié
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
| | - Jerome Roncalli
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
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Guedes MR, de Noronha SISR, Chírico MTT, da Costa GDC, de Freitas Castro T, de Brito RCF, Vieira LG, Reis TO, Ribeiro MC, Reis AB, Carneiro CM, Bezerra FS, Montano N, da Silva VJD, de Menezes RCA, Chianca-Jr DA, Silva FCDS. Ivabradine restores tonic cardiovascular autonomic control and reduces tachycardia, hypertension and left ventricular inflammation in post-weaning protein malnourished rats. Life Sci 2024; 346:122636. [PMID: 38614307 DOI: 10.1016/j.lfs.2024.122636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/22/2024] [Accepted: 04/10/2024] [Indexed: 04/15/2024]
Abstract
Malnutrition results in autonomic imbalance and heart hypertrophy. Overexpression of hyperpolarization-activated cyclic nucleotide-gated channels (HCN) in the left ventricles (LV) is linked to hypertrophied hearts and abnormal myocardium automaticity. Given that ivabradine (IVA) has emerging pleiotropic effects, in addition to the widely known bradycardic response, this study evaluated if IVA treatment could repair the autonomic control and cardiac damages in malnourished rats. AIM Assess the impact of IVA on tonic cardiovascular autonomic control and its relationship with hemodynamics regulation, LV inflammation, and HCN gene expression in post-weaning protein malnutrition condition. MAIN METHODS After weaning, male rats were divided into control (CG; 22 % protein) and malnourished (MG; 6 % protein) groups. At 35 days, groups were subdivided into CG-PBS, CG-IVA, MG-PBS and MG-IVA (PBS 1 ml/kg or IVA 1 mg/kg) received during 8 days. We performed jugular vein cannulation and electrode implant for drug delivery and ECG registration to assess tonic cardiovascular autonomic control; femoral cannulation for blood pressure (BP) and heart rate (HR) assessment; and LV collection to evaluate ventricular remodeling and HCN gene expression investigation. KEY FINDINGS Malnutrition induced BP and HR increases, sympathetic system dominance, and LV remodeling without affecting HCN gene expression. IVA reversed the cardiovascular autonomic imbalance; prevented hypertension and tachycardia; and inhibited the LV inflammatory process and fiber thickening caused by malnutrition. SIGNIFICANCE Our findings suggest that ivabradine protects against malnutrition-mediated cardiovascular damage. Moreover, our results propose these effects were not attributed to HCN expression changes, but rather to IVA pleiotropic effects on autonomic control and inflammation.
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Affiliation(s)
- Mariana Reis Guedes
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Sylvana Izaura Salyba Rendeiro de Noronha
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Máira Tereza Talma Chírico
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Gabriela Dias Carvalho da Costa
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Thalles de Freitas Castro
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Rory Cristiane Fortes de Brito
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Lucas Gabriel Vieira
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Thayane Oliveira Reis
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Marcelo Carlos Ribeiro
- Statistics Department, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Alexandre Barbosa Reis
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Cláudia Martins Carneiro
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Frank Silva Bezerra
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Nicola Montano
- Department of Clinical Sciences and Community Health, IRCCS Ca' Granda Foundation, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
| | - Valdo José Dias da Silva
- Department of Biochemistry, Pharmacology and Physiology, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil; Graduate Program in Physiological Sciences, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil.
| | - Rodrigo Cunha Alvim de Menezes
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Deoclécio Alves Chianca-Jr
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Fernanda Cacilda Dos Santos Silva
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
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Zhang TY, An DA, Fang Y, Zhou H, Yan H, Chen B, Lu R, Fang W, Wang Q, Che X, Xu Y, Huang J, Jin H, Shen J, Mou S, Wu LM. Assessment of the Prognostic Value of MRI Left Ventricular Global Function Index (LVGFI) in Patients With End-Stage Renal Disease Under Maintenance Dialysis. J Magn Reson Imaging 2024; 59:2275-2286. [PMID: 37668069 DOI: 10.1002/jmri.28979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Left ventricular global function index (LVGFI) integrates LV volumetric and functional parameters. In patients with end-stage renal disease (ESRD), cardiac injury manifests as LV hypertrophy and dysfunction. However, the prognostic value of LVGFI in this population remains unclear. PURPOSE To investigate the association of LVGFI with major adverse cardiac events (MACE) in patients with ESRD. STUDY TYPE Prospective. POPULATION One hundred fifty-eight ESRD patients (mean age: 54.1 ± 14.4 years; 105 male) on maintenance dialysis. FILED STRENGTH/SEQUENCE 3.0 T, balanced steady-state free precession (bSSFP) cine and modified Look-Locker inversion recovery (MOLLI) sequences. ASSESSMENT LV volumetric and functional parameters were determined from bSSFP images. LVGFI was calculated as the ratio of stroke volume to global volume and native T1 was determined from MOLLI T1 maps. MACE was recorded on follow up. Models were developed to predict MACE from conventional risk factors combined with LVGFI, GLS, native T1, and LV mass index (LVMI), respectively. Subgroup analyses were further performed in participants with LVEF above median. STATISTICAL TESTS Cox proportional hazard regression and log-rank test were used to investigate the association between LVGFI and MACE. The predictive models were evaluated and compared using Harrell's C-statistics and DeLong tests. A P value <0.05 was considered statistically significant. RESULTS Thirty-four MACE occurred during the median follow-up period of 26 months. The hazard of MACE increased by 114% for each 10% decrease in LVGFI in univariable analysis. The predictive model consisting of LVGFI (C-statistic: 0.724) had significantly better predictive performance than the others (all P < 0.001). These results were consistent in patients (N = 79) with LVEF > median (63.54%). DATA CONCLUSION LVGFI is a novel marker for MACE risk stratification in patients with ESRD and was better able to predict MACE than native T1 mapping and GLS. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Tian-Yi Zhang
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Uremia Diagnosis and Treatment Center, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Dong-Aolei An
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Fang
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Uremia Diagnosis and Treatment Center, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hang Zhou
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Uremia Diagnosis and Treatment Center, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hao Yan
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Uremia Diagnosis and Treatment Center, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Binghua Chen
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Renhua Lu
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Uremia Diagnosis and Treatment Center, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei Fang
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Uremia Diagnosis and Treatment Center, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qin Wang
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Uremia Diagnosis and Treatment Center, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiajing Che
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Uremia Diagnosis and Treatment Center, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yao Xu
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Uremia Diagnosis and Treatment Center, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiaying Huang
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Uremia Diagnosis and Treatment Center, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Haijiao Jin
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Uremia Diagnosis and Treatment Center, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jianxiao Shen
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Uremia Diagnosis and Treatment Center, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shan Mou
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Uremia Diagnosis and Treatment Center, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lian-Ming Wu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Zhang Y, Yang D, Jia Q, Yan J, An F. The effect of glucagon-like peptide-1 receptor agonists on cardiac function and structure in patients with or without type 2 diabetes mellitus: An updated systematic review and meta-analysis. Diabetes Obes Metab 2024; 26:2401-2411. [PMID: 38528818 DOI: 10.1111/dom.15557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/07/2024] [Accepted: 02/19/2024] [Indexed: 03/27/2024]
Abstract
AIMS To conduct an updated systematic review and meta-analysis to evaluate the efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RAs) with regard to cardiac function and structure in people with or without type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS We conducted a systematic search using the PubMed, Embase and ClinicalTrials.gov online databases. The primary outcome of interest was changes in mitral inflow E-velocity to tissue Doppler e' velocity (E/e') ratio. Secondary outcomes included other indicators of cardiac reverse remodelling and functional capacity comprising changes in left ventricular mass (LVM), left ventricular global longitudinal strain, left ventricular end-diastolic volume, left ventricular end-systolic volume, left ventricular ejection fraction (LVEF), early to atrial mitral inflow velocity ratio, left atrial volume (LAV), N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and 6-min walk test (6MWT) results. RESULTS A total of 15 trials involving 898 patients were included in this analysis. GLP-1RAs significantly improved E/e' ratio (mean difference [MD] = -0.73; 95% confidence interval [CI] -1.34, -0.13), LVM (MD = -3.86 g; 95% CI -7.60, -0.12), LAV (MD = -8.20 mL; 95% CI -12.37, -4.04), NT-proBNP level (standardized MD = -0.27; 95% CI -0.47, -0.06), and 6MWT result (MD = +22.31 m; 95% CI 1.64, 42.99). However, GLP-1RAs had no effect on LVEF (MD = +0.31%; 95% CI -1.02, 1.64). CONCLUSIONS In this systematic review and meta-analysis, GLP-1RAs were found to have a positive impact on left ventricle diastolic function, hypertrophy, and exercise capacity, but had no effect on systolic function.
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Affiliation(s)
- Yu Zhang
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodelling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Danning Yang
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodelling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Qiufeng Jia
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodelling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Jie Yan
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodelling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Fengshuang An
- National Key Laboratory for Innovation and Transformation of Luobing Theory; The Key Laboratory of Cardiovascular Remodelling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
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Afshani MR, Torfi E, Akiash N, Jahanshahi A, Mohamadi A, Sherafat O. Effect of empagliflozin on left ventricular volumes in type 2 diabetes or prediabetes heart failure patients with reduced ejection fraction. Acta Cardiol 2024; 79:419-425. [PMID: 38511517 DOI: 10.1080/00015385.2023.2240130] [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: 04/03/2023] [Accepted: 07/19/2023] [Indexed: 03/22/2024]
Abstract
OBJECTIVE Sodium-glucose cotransporter 2 (SGLT2) inhibitors, such as empagliflozin are antidiabetic drugs that have recently been reported to have cardio-protective action; however, their effect on cardiac structure and function in heart failure with reduced ejection fraction (HFrEF) has not yet been determined. This study evaluates the efficacy of empagliflozin on left ventricular (LV) volumes in type 2 diabetes or prediabetes patients with HFrEF. METHODS This randomised, double-blind, trial study was conducted on 104 patients with type 2 diabetes or prediabetes with HFrEF referred to Imam Khomeini and Golestan hospitals in Ahvaz, Iran. The patients were randomised to receive empagliflozin (10 mg once daily) in addition to standard treatments of HFrEF or receive only standard treatments (control group) for six months. During the six months of follow-up, changes in LV volumes, LVEF, hospitalisation for heart failure (HF) were evaluated. RESULTS Empagliflozin reduced LVEDVI and LVESVI by 10.0 and 8.0 mL/m2 (p < 0.0001). Furthermore, a significant increase in LVEF was observed in the empagliflozin group (p < 0.0001) without any significant change in the control group (p = 0.389). The hospitalisation rate was lower in the empagliflozin group than the control group (3.8% vs. 23.1%; p = 0.008). CONCLUSIONS Empagliflozin is effective in reducing LV volumes and hospitalisation rate in patients with type 2 diabetes and prediabetes and HFrEF. Therefore, treatment with empagliflozin for six months was associated with a significant reduction in adverse cardiovascular outcomes in these patients.
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Affiliation(s)
- Mohammad Reza Afshani
- Internal Cardiology, Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ekhlas Torfi
- Internal Cardiology, Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nehzat Akiash
- Echocardiography, Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alireza Jahanshahi
- Endocrinology and Metabolism, Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Asghar Mohamadi
- Instructor of Nursing, Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Omid Sherafat
- Department of Cardiology, Resident of Cardiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Kasa G, Teis A, Juncà G, Aimo A, Lupón J, Cediel G, Santiago-Vacas E, Codina P, Ferrer-Sistach E, Vallejo-Camazón N, López-Ayerbe J, Bayés-Genis A, Delgado V. Clinical and prognostic implications of left ventricular dilatation in heart failure. Eur Heart J Cardiovasc Imaging 2024; 25:849-856. [PMID: 38246859 DOI: 10.1093/ehjci/jeae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/23/2024] Open
Abstract
AIMS To assess the agreement between left ventricular end-diastolic diameter index (LVEDDi) and volume index (LVEDVi) to define LV dilatation and to investigate the respective prognostic implications in patients with heart failure (HF). METHODS AND RESULTS Patients with HF symptoms and LV ejection fraction (LVEF) < 50% undergoing cardiac magnetic resonance were evaluated retrospectively. LV dilatation was defined as LVEDDi or LVEDVi above the upper normal limit according to published reference values. Patients were followed up for the combined endpoint of cardiovascular death or HF hospitalization during 5 years. A total of 564 patients (median age 64 years; 79% men) were included. LVEDDi had a modest correlation with LVEDVi (r = 0.682, P < 0.001). LV dilatation was noted in 84% of patients using LVEDVi-based definition and in 73% using LVEDDi-based definition, whereas 20% of patients displayed discordant definitions of LV dilatation. During a median follow-up of 2.8 years, patients with both dilated LVEDDi and LVEDVi had the highest cumulative event rate (HR 3.00, 95% CI 1.15-7.81, P = 0.024). Both LVEDDi and LVEDVi were independently associated with the primary outcome (hazard ratio 3.29, 95%, P < 0.001 and 2.8, P = 0.009; respectively). CONCLUSION The majority of patients with HF and LVEF < 50% present both increased LVEDDi and LVEDVi whereas 20% show discordant linear and volumetric definitions of LV dilatation. Patients with increased LVEDDi and LVEDVi have the worst clinical outcomes suggesting that the assessment of these two metrics is needed for better risk stratification.
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Affiliation(s)
- Gizem Kasa
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain
| | - Albert Teis
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain
| | - Gladys Juncà
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain
| | - Alberto Aimo
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Josep Lupón
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain
- Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - German Cediel
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Evelyn Santiago-Vacas
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain
| | - Pau Codina
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain
| | - Elena Ferrer-Sistach
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain
| | - Nuria Vallejo-Camazón
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain
| | - Jorge López-Ayerbe
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain
| | - Antoni Bayés-Genis
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain
- Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Victoria Delgado
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet s/n, Barcelona 08916, Spain
- Centre for Comparative Medicine and Bioimage (CMCiB), Germans Trias i Pujol Research Institute (IGTP), Camí del Tanatori, Badalona 08916, Spain
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Malikides O, Simantirakis E, Zacharis E, Fragkiadakis K, Kochiadakis G, Marketou M. Cardiac Remodeling and Ventricular Pacing: From Genes to Mechanics. Genes (Basel) 2024; 15:671. [PMID: 38927607 PMCID: PMC11203142 DOI: 10.3390/genes15060671] [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: 04/24/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
Cardiac remodeling and ventricular pacing represent intertwined phenomena with profound implications for cardiovascular health and therapeutic interventions. This review explores the intricate relationship between cardiac remodeling and ventricular pacing, spanning from the molecular underpinnings to biomechanical alterations. Beginning with an examination of genetic predispositions and cellular signaling pathways, we delve into the mechanisms driving myocardial structural changes and electrical remodeling in response to pacing stimuli. Insights into the dynamic interplay between pacing strategies and adaptive or maladaptive remodeling processes are synthesized, shedding light on the clinical implications for patients with various cardiovascular pathologies. By bridging the gap between basic science discoveries and clinical translation, this review aims to provide a comprehensive understanding of cardiac remodeling in the context of ventricular pacing, paving the way for future advancements in cardiovascular care.
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Affiliation(s)
- Onoufrios Malikides
- Department of Cardiology, University General Hospital of Heraklion, 71003 Heraklion, Greece; (E.S.); (E.Z.); (K.F.); (G.K.); (M.M.)
| | - Emmanouel Simantirakis
- Department of Cardiology, University General Hospital of Heraklion, 71003 Heraklion, Greece; (E.S.); (E.Z.); (K.F.); (G.K.); (M.M.)
- Medical School, University of Crete, 71003 Heraklion, Greece
| | - Evangelos Zacharis
- Department of Cardiology, University General Hospital of Heraklion, 71003 Heraklion, Greece; (E.S.); (E.Z.); (K.F.); (G.K.); (M.M.)
- Medical School, University of Crete, 71003 Heraklion, Greece
| | - Konstantinos Fragkiadakis
- Department of Cardiology, University General Hospital of Heraklion, 71003 Heraklion, Greece; (E.S.); (E.Z.); (K.F.); (G.K.); (M.M.)
- Medical School, University of Crete, 71003 Heraklion, Greece
| | - George Kochiadakis
- Department of Cardiology, University General Hospital of Heraklion, 71003 Heraklion, Greece; (E.S.); (E.Z.); (K.F.); (G.K.); (M.M.)
- Medical School, University of Crete, 71003 Heraklion, Greece
| | - Maria Marketou
- Department of Cardiology, University General Hospital of Heraklion, 71003 Heraklion, Greece; (E.S.); (E.Z.); (K.F.); (G.K.); (M.M.)
- Medical School, University of Crete, 71003 Heraklion, Greece
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Sardu C, Vittoria Marfella L, Giordano V, Lepre CC, D'Amico G, Volpicelli M, Contaldi C, Galiero R, Caturano A, Casolaro F, Sasso FC, Uran C, Cozzolino D, Nicoletti M, Signoriello G, Paolisso G, Marfella R. Left bundle branch pacing and cardiac remodeling in HF patients with type 2 diabetes mellitus: epigenetic pathways and clinical outcomes. Front Pharmacol 2024; 15:1402782. [PMID: 38835659 PMCID: PMC11148384 DOI: 10.3389/fphar.2024.1402782] [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: 03/18/2024] [Accepted: 04/05/2024] [Indexed: 06/06/2024] Open
Abstract
Background Left bundle branch (LBB) pacing could achieve cardiac resynchronization therapy (CRT) in patients who cannot be resynchronized via the placement of the left ventricle (LV) lead into the coronary sinus. LBB pacing could improve cardiovascular outcomes in heart failure (HF) patients with LBB block who are affected by type 2 diabetes mellitus (T2DM). Study hypothesis LBB pacing could increase the number of CRT responders and lead to the best clinical outcomes in HF patients with T2DM, inducing cardiac remodeling and improving left ventricle ejection fraction (LVEF) via microRNA (miR) modulation. Methods In a multicenter observational study, we enrolled 334 HF patients with LBB block and an indication to receive LBB pacing for CRT. In these patients, we evaluated the CRT responder rate, clinical outcomes, and miR expression at 1 year of follow-up. Results At 1 year of follow-up, we had 223 responders (66.8%), 132 hospitalizations for HF (39.5%), 24 cardiac deaths (7.2%), and 37 all-cause deaths (11.1%), with a higher rate of HF hospitalizations (77 (69.4%) vs 55 (24.7%), p < 0.05), and cardiac deaths (13 (11.7% vs 11 (4.9%), p < 0.05) in non-responders vs responders. At the end of follow-up, we found the lowest expression of miR-26, miR-29, miR-30, miR-92, and miR-145 in LBB-pacing non-responders vs responders (p < 0.05), and a direct correlation between miR-30 (0.340, [0.833-1.915]; p 0.001), the 6-minute-walking test (6MWT; 0.168, [0.008-0.060]; p 0.011), angiotensin-receptor-neprilysin inhibitors (ARNI; 0.157, [0.183-4.877]; p 0.035), sodium-glucose-transporter-2 inhibitors (0.245, [2.242-7.283]; p 0.001), and LVEF improvements. C reactive protein (CRP) inversely correlated with LVEF improvement (-0.220, [-(0.066-0.263)]; p 0.001). ARNI (1.373, CI 95% [1.007-1.872], p 0.045), miR-30 (2.713, CI 95% [1.543-4.769], p 0.001), and 6MWT (1.288, CI 95% [1.084-1.998], p 0.001) were predictors of LBB pacing responders at 1 year of follow-up. Conclusion LBB-pacing responders evidenced miR modulation, which was linked to significant improvement of the cardiac pump. Specifically, miR-30 was linked to cardiac pump improvement and predicted responders at 1 year of follow-up in patients with T2DM.
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Affiliation(s)
- Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ludovica Vittoria Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Valerio Giordano
- Department of Cardiovascular Disease, "Vallo Della Lucania" Hospital, Salerno, Italy
| | - Caterina Claudia Lepre
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Mario Volpicelli
- Cardiovascular Department, Santa Maria Delle Grazie Hospital, Nola, Italy
| | | | - Raffaele Galiero
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alfredo Caturano
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Flavia Casolaro
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Carlo Uran
- Department of Cardiovascular Diseases, San Giuseppe e Melorio Hospital, Santa Maria Capua Vetere, Italy
| | - Domenico Cozzolino
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maddalena Nicoletti
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Signoriello
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
- UniCAMILLUS International Medical University, Rome, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
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Dhalla NS, Mota KO, Elimban V, Shah AK, de Vasconcelos CML, Bhullar SK. Role of Vasoactive Hormone-Induced Signal Transduction in Cardiac Hypertrophy and Heart Failure. Cells 2024; 13:856. [PMID: 38786079 PMCID: PMC11119949 DOI: 10.3390/cells13100856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
Heart failure is the common concluding pathway for a majority of cardiovascular diseases and is associated with cardiac dysfunction. Since heart failure is invariably preceded by adaptive or maladaptive cardiac hypertrophy, several biochemical mechanisms have been proposed to explain the development of cardiac hypertrophy and progression to heart failure. One of these includes the activation of different neuroendocrine systems for elevating the circulating levels of different vasoactive hormones such as catecholamines, angiotensin II, vasopressin, serotonin and endothelins. All these hormones are released in the circulation and stimulate different signal transduction systems by acting on their respective receptors on the cell membrane to promote protein synthesis in cardiomyocytes and induce cardiac hypertrophy. The elevated levels of these vasoactive hormones induce hemodynamic overload, increase ventricular wall tension, increase protein synthesis and the occurrence of cardiac remodeling. In addition, there occurs an increase in proinflammatory cytokines and collagen synthesis for the induction of myocardial fibrosis and the transition of adaptive to maladaptive hypertrophy. The prolonged exposure of the hypertrophied heart to these vasoactive hormones has been reported to result in the oxidation of catecholamines and serotonin via monoamine oxidase as well as the activation of NADPH oxidase via angiotensin II and endothelins to promote oxidative stress. The development of oxidative stress produces subcellular defects, Ca2+-handling abnormalities, mitochondrial Ca2+-overload and cardiac dysfunction by activating different proteases and depressing cardiac gene expression, in addition to destabilizing the extracellular matrix upon activating some metalloproteinases. These observations support the view that elevated levels of various vasoactive hormones, by producing hemodynamic overload and activating their respective receptor-mediated signal transduction mechanisms, induce cardiac hypertrophy. Furthermore, the occurrence of oxidative stress due to the prolonged exposure of the hypertrophied heart to these hormones plays a critical role in the progression of heart failure.
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Affiliation(s)
- Naranjan S. Dhalla
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Department of Physiology and Pathophysiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R2H 2A6, Canada; (V.E.); (S.K.B.)
| | - Karina O. Mota
- Department of Physiology, Center of Biological and Health Sciences, Federal University of Sergipe, Sao Cristóvao 49100-000, Brazil; (K.O.M.); (C.M.L.d.V.)
| | - Vijayan Elimban
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Department of Physiology and Pathophysiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R2H 2A6, Canada; (V.E.); (S.K.B.)
| | - Anureet K. Shah
- Department of Nutrition and Food Science, California State University, Los Angeles, CA 90032-8162, USA;
| | - Carla M. L. de Vasconcelos
- Department of Physiology, Center of Biological and Health Sciences, Federal University of Sergipe, Sao Cristóvao 49100-000, Brazil; (K.O.M.); (C.M.L.d.V.)
| | - Sukhwinder K. Bhullar
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Department of Physiology and Pathophysiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R2H 2A6, Canada; (V.E.); (S.K.B.)
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Kutumova E, Kovaleva A, Sharipov R, Lifshits G, Kolpakov F. Mathematical modelling of the influence of ACE I/D polymorphism on blood pressure and antihypertensive therapy. Heliyon 2024; 10:e29988. [PMID: 38707445 PMCID: PMC11068647 DOI: 10.1016/j.heliyon.2024.e29988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/29/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024] Open
Abstract
The angiotensin-converting enzyme (ACE) gene (ACE) insertion/deletion (I/D) polymorphism raises the possibility of personalising ACE inhibitor therapy to optimise its efficiency and reduce side effects in genetically distinct subgroups. However, the extent of its influence among these subgroups is unknown. Therefore, we extended our computational model of blood pressure regulation to investigate the effect of the ACE I/D polymorphism on haemodynamic parameters in humans undergoing antihypertensive therapy. The model showed that the dependence of blood pressure on serum ACE activity is a function of saturation and therefore, the lack of association between ACE I/D and blood pressure levels may be due to high ACE activity in specific populations. Additionally, in an extended model simulating the effects of different classes of antihypertensive drugs, we explored the relationship between ACE I/D and the efficacy of inhibitors of the renin-angiotensin-aldosterone system. The model predicted that the response of cardiovascular and renal parameters to treatment directly depends on ACE activity. However, significant differences in parameter changes were observed only between groups with high and low ACE levels, while different ACE I/D genotypes within the same group had similar changes in absolute values. We conclude that a single genetic variant is responsible for only a small fraction of heredity in treatment success and its predictive value is limited.
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Affiliation(s)
- Elena Kutumova
- Department of Computational Biology, Sirius University of Science and Technology, Sirius, Krasnodar region, Russia
- Laboratory of Bioinformatics, Federal Research Center for Information and Computational Technologies, Novosibirsk, Russia
- Biosoft.Ru, Ltd., Novosibirsk, Russia
| | - Anna Kovaleva
- Laboratory for Personalized Medicine, Center of New Medical Technologies, Institute of Chemical Biology and Fundamental Medicine SB RAS, Novosibirsk, Russia
| | - Ruslan Sharipov
- Laboratory of Bioinformatics, Federal Research Center for Information and Computational Technologies, Novosibirsk, Russia
- Biosoft.Ru, Ltd., Novosibirsk, Russia
- Specialized Educational Scientific Center, Novosibirsk State University, Novosibirsk, Russia
| | - Galina Lifshits
- Laboratory for Personalized Medicine, Center of New Medical Technologies, Institute of Chemical Biology and Fundamental Medicine SB RAS, Novosibirsk, Russia
| | - Fedor Kolpakov
- Department of Computational Biology, Sirius University of Science and Technology, Sirius, Krasnodar region, Russia
- Laboratory of Bioinformatics, Federal Research Center for Information and Computational Technologies, Novosibirsk, Russia
- Biosoft.Ru, Ltd., Novosibirsk, Russia
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Apolínová K, Pérez FA, Dyballa S, Coppe B, Mercader Huber N, Terriente J, Di Donato V. ZebraReg-a novel platform for discovering regulators of cardiac regeneration using zebrafish. Front Cell Dev Biol 2024; 12:1384423. [PMID: 38799508 PMCID: PMC11116629 DOI: 10.3389/fcell.2024.1384423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
Cardiovascular disease is the leading cause of death worldwide with myocardial infarction being the most prevalent. Currently, no cure is available to either prevent or revert the massive death of cardiomyocytes that occurs after a myocardial infarction. Adult mammalian hearts display a limited regeneration capacity, but it is insufficient to allow complete myocardial recovery. In contrast, the injured zebrafish heart muscle regenerates efficiently through robust proliferation of pre-existing myocardial cells. Thus, zebrafish allows its exploitation for studying the genetic programs behind cardiac regeneration, which may be present, albeit dormant, in the adult human heart. To this end, we have established ZebraReg, a novel and versatile automated platform for studying heart regeneration kinetics after the specific ablation of cardiomyocytes in zebrafish larvae. In combination with automated heart imaging, the platform can be integrated with genetic or pharmacological approaches and used for medium-throughput screening of presumed modulators of heart regeneration. We demonstrate the versatility of the platform by identifying both anti- and pro-regenerative effects of genes and drugs. In conclusion, we present a tool which may be utilised to streamline the process of target validation of novel gene regulators of regeneration, and the discovery of new drug therapies to regenerate the heart after myocardial infarction.
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Affiliation(s)
- Kateřina Apolínová
- ZeClinics SL, Barcelona, Spain
- Biomedicine, Department of Medicine and Life Sciences, Faculty of Health and Life Sciences, Pompeu Fabra University, Barcelona, Spain
| | | | | | - Benedetta Coppe
- Developmental Biology and Regeneration, Institute of Anatomy, University of Bern, Bern, Switzerland
- Department for Biomedical Research DBMR, University of Bern, Bern, Switzerland
| | - Nadia Mercader Huber
- Developmental Biology and Regeneration, Institute of Anatomy, University of Bern, Bern, Switzerland
- Department for Biomedical Research DBMR, University of Bern, Bern, Switzerland
- Centro Nacional de Investigaciones Cardiovasculares CNIC, Madrid, Spain
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Song M, Choi DB, Im JS, Song YN, Kim JH, Lee H, An J, Kim A, Choi H, Kim JC, Han C, Jeon YK, Kim SJ, Woo DH. Modeling acute myocardial infarction and cardiac fibrosis using human induced pluripotent stem cell-derived multi-cellular heart organoids. Cell Death Dis 2024; 15:308. [PMID: 38693114 PMCID: PMC11063052 DOI: 10.1038/s41419-024-06703-9] [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: 10/15/2023] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/03/2024]
Abstract
Heart disease involves irreversible myocardial injury that leads to high morbidity and mortality rates. Numerous cell-based cardiac in vitro models have been proposed as complementary approaches to non-clinical animal research. However, most of these approaches struggle to accurately replicate adult human heart conditions, such as myocardial infarction and ventricular remodeling pathology. The intricate interplay between various cell types within the adult heart, including cardiomyocytes, fibroblasts, and endothelial cells, contributes to the complexity of most heart diseases. Consequently, the mechanisms behind heart disease induction cannot be attributed to a single-cell type. Thus, the use of multi-cellular models becomes essential for creating clinically relevant in vitro cell models. This study focuses on generating self-organizing heart organoids (HOs) using human-induced pluripotent stem cells (hiPSCs). These organoids consist of cardiomyocytes, fibroblasts, and endothelial cells, mimicking the cellular composition of the human heart. The multi-cellular composition of HOs was confirmed through various techniques, including immunohistochemistry, flow cytometry, q-PCR, and single-cell RNA sequencing. Subsequently, HOs were subjected to hypoxia-induced ischemia and ischemia-reperfusion (IR) injuries within controlled culture conditions. The resulting phenotypes resembled those of acute myocardial infarction (AMI), characterized by cardiac cell death, biomarker secretion, functional deficits, alterations in calcium ion handling, and changes in beating properties. Additionally, the HOs subjected to IR efficiently exhibited cardiac fibrosis, displaying collagen deposition, disrupted calcium ion handling, and electrophysiological anomalies that emulate heart disease. These findings hold significant implications for the advancement of in vivo-like 3D heart and disease modeling. These disease models present a promising alternative to animal experimentation for studying cardiac diseases, and they also serve as a platform for drug screening to identify potential therapeutic targets.
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Affiliation(s)
- Myeongjin Song
- Department of Commercializing Organoid Technology, NEXEL Co., Ltd., Seoul, 07802, Korea
| | - Da Bin Choi
- Department of Commercializing Organoid Technology, NEXEL Co., Ltd., Seoul, 07802, Korea
| | - Jeong Suk Im
- Department of Commercializing Organoid Technology, NEXEL Co., Ltd., Seoul, 07802, Korea
| | - Ye Na Song
- Department of Commercializing Organoid Technology, NEXEL Co., Ltd., Seoul, 07802, Korea
| | - Ji Hyun Kim
- Department of Commercializing Organoid Technology, NEXEL Co., Ltd., Seoul, 07802, Korea
| | - Hanbyeol Lee
- Centre for Research, Hudson Institute of Medical Research, Monash University, Clayton, VIC, 3168, Australia
| | - Jieun An
- Department of Commercializing iPSC Technology, NEXEL Co., Ltd., Seoul, 07802, Korea
| | - Ami Kim
- Department of Commercializing iPSC Technology, NEXEL Co., Ltd., Seoul, 07802, Korea
| | - Hwan Choi
- Department of Commercializing iPSC Technology, NEXEL Co., Ltd., Seoul, 07802, Korea
| | - Joon-Chul Kim
- Department of Commercializing Organoid Technology, NEXEL Co., Ltd., Seoul, 07802, Korea
| | - Choongseong Han
- Department of Commercializing Organoid Technology, NEXEL Co., Ltd., Seoul, 07802, Korea
- Department of Commercializing iPSC Technology, NEXEL Co., Ltd., Seoul, 07802, Korea
| | - Young Keul Jeon
- Department of Physiology, Seoul National University College of Medicine, Seoul, 03080, Korea
- Ischemic/Hypoxic Disease Institute, Seoul National University, College of Medicine, Seoul, 03080, Korea
| | - Sung Joon Kim
- Department of Physiology, Seoul National University College of Medicine, Seoul, 03080, Korea
- Ischemic/Hypoxic Disease Institute, Seoul National University, College of Medicine, Seoul, 03080, Korea
| | - Dong-Hun Woo
- Department of Commercializing Organoid Technology, NEXEL Co., Ltd., Seoul, 07802, Korea.
- Department of Commercializing iPSC Technology, NEXEL Co., Ltd., Seoul, 07802, Korea.
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Oliveros E, Grapsa J. Finding New Echocardiographic Parameters for Reverse Cardiac Remodeling: Isovolumic Contraction Velocity in Heart Failure with Reduced Ejection Fraction and Effect of Sacubitril/Valsartan: the PROVE-HF Study. J Card Fail 2024; 30:666-668. [PMID: 38160996 DOI: 10.1016/j.cardfail.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 11/30/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Estefania Oliveros
- Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, PA, USA.
| | - Julia Grapsa
- Guy's and St Thomas' NHS Trust Hospitals, London, UK
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49
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Corral Acero J, Lamata P, Eitel I, Zacur E, Evertz R, Lange T, Backhaus SJ, Stiermaier T, Thiele H, Bueno-Orovio A, Schuster A, Grau V. Comprehensive characterization of cardiac contraction for improved post-infarction risk assessment. Sci Rep 2024; 14:8951. [PMID: 38637609 PMCID: PMC11026383 DOI: 10.1038/s41598-024-59114-3] [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: 09/30/2023] [Accepted: 04/08/2024] [Indexed: 04/20/2024] Open
Abstract
This study aims at identifying risk-related patterns of left ventricular contraction dynamics via novel volume transient characterization. A multicenter cohort of AMI survivors (n = 1021) who underwent Cardiac Magnetic Resonance (CMR) after infarction was considered for the study. The clinical endpoint was the 12-month rate of major adverse cardiac events (MACE, n = 73), consisting of all-cause death, reinfarction, and new congestive heart failure. Cardiac function was characterized from CMR in 3 potential directions: by (1) volume temporal transients (i.e. contraction dynamics); (2) feature tracking strain analysis (i.e. bulk tissue peak contraction); and (3) 3D shape analysis (i.e. 3D contraction morphology). A fully automated pipeline was developed to extract conventional and novel artificial-intelligence-derived metrics of cardiac contraction, and their relationship with MACE was investigated. Any of the 3 proposed directions demonstrated its additional prognostic value on top of established CMR indexes, myocardial injury markers, basic characteristics, and cardiovascular risk factors (P < 0.001). The combination of these 3 directions of enhancement towards a final CMR risk model improved MACE prediction by 13% compared to clinical baseline (0.774 (0.771-0.777) vs. 0.683 (0.681-0.685) cross-validated AUC, P < 0.001). The study evidences the contribution of the novel contraction characterization, enabled by a fully automated pipeline, to post-infarction assessment.
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Affiliation(s)
- Jorge Corral Acero
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK.
| | - Pablo Lamata
- Department of Digital Twins for Healthcare, School of Biomedical Engineering and Imaging Sciences, King's College London, 4th Floor North Wing, St Thomas' Hospital, London, SE1 7EH, UK.
| | - Ingo Eitel
- Medical Clinic II, Cardiology, Angiology and Intensive Care Medicine, University Heart Centre Lübeck, Lübeck, Germany
- University Hospital Schleswig-Holstein, Lübeck, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Ernesto Zacur
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Ruben Evertz
- Department of Cardiology and Pneumology, University Medical Centre Göttingen, Georg-August University, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Lower Saxony, Göttingen, Germany
| | - Torben Lange
- Department of Cardiology and Pneumology, University Medical Centre Göttingen, Georg-August University, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Lower Saxony, Göttingen, Germany
| | - Sören J Backhaus
- Department of Cardiology, Campus Kerckhoff of the Justus-Liebig-University Giessen, Kerckhoff-Clinic, Bad Nauheim, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Bad Nauheim, Germany
| | - Thomas Stiermaier
- Medical Clinic II, Cardiology, Angiology and Intensive Care Medicine, University Heart Centre Lübeck, Lübeck, Germany
- University Hospital Schleswig-Holstein, Lübeck, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany
| | - Holger Thiele
- Department of Internal Medicine/Cardiology and Leipzig Heart Science, Heart Centre Leipzig at University of Leipzig, Leipzig, Germany
| | | | - Andreas Schuster
- Department of Cardiology and Pneumology, University Medical Centre Göttingen, Georg-August University, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Lower Saxony, Göttingen, Germany
| | - Vicente Grau
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK
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50
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Bhushan S, Huang X, Jiang F, Xiao Z. Impact of angiotensin receptor-neprilysin inhibition (ARNI) in improving ejection fraction and left and right ventricular remodeling in heart failure. Curr Probl Cardiol 2024; 49:102464. [PMID: 38369206 DOI: 10.1016/j.cpcardiol.2024.102464] [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: 02/09/2024] [Revised: 02/09/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024]
Abstract
Angiotensin receptor neprilysin inhibitors (ARNI), a new therapeutic class of agents acting on the renin angiotensin aldosterone system (RAAS) and neutral endopeptidase system has been developed in treatment of ventricular remodeling and has attracted considerable attention. The first in class is LCZ696, which is a molecule that combines Valsartan (ARB) and Sacubitril (neprilysin inhibitor) within a single substance. Sacubitril-Valsartan is the first angiotensin receptor enkephalin inhibitors (ARNI), which can block angiotensin II type 1 receptor (AT1R) while inhibiting enkephalin (NEP) and effectively reverse ventricular remodeling in heart failure patients. It has been recommended by the European and American authoritative guidelines on heart failure as Class I for the treatment of chronic heart failure particularly as intensive care medicine. Sacubitril-Valsartan demonstrated significant effects in improving left ventricular performance and remodeling in patients with heart failure with reduced ejection fraction. Sacubitril acts on increased levels of circulating natriuretic peptides by preventing their enzymatic breakdown and Valsartan, which acts to lessen the effects of the RAAS. However, not more research has been done on its effects on the right ventricle remodeling. This review aimed to assess the impact of angiotensin receptor neprilysin inhibitors on left and right ventricular remodeling in heart failure patients.
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Affiliation(s)
- Sandeep Bhushan
- Department of Cardio-Thoracic Surgery, Chengdu Second People's Hospital, Chengdu, Sichuan 610017, China
| | - Xin Huang
- Department of Anesthesiology, West China Hospital of Medicine, Sichuan University, Sichuan 610017, China
| | - Fenglin Jiang
- Department of Anesthesia and Surgery, Chengdu Second People's Hospital, Chengdu, Sichuan 610017, China
| | - Zongwei Xiao
- Department of Cardio-Thoracic Surgery, Chengdu Second People's Hospital, Chengdu, Sichuan 610017, China.
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