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Mao R, Wang F, Zhong Y, Meng X, Zhang T, Li J. Association of biological age acceleration with cardiac morphology, function, and incident heart failure: insights from UK Biobank participants. Eur Heart J Cardiovasc Imaging 2024; 25:1315-1323. [PMID: 38747402 DOI: 10.1093/ehjci/jeae126] [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: 11/12/2023] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 08/28/2024] Open
Abstract
AIMS Advanced age is associated with an increased risk of adverse cardiovascular events. The relationship between biological age acceleration (BAA), cardiac size, cardiac function, and heart failure (HF) is not well-defined. METHODS AND RESULTS Utilizing the UK Biobank cohort, we assessed biological age using the Klemera-Doubal and PhenoAge methods. BAA was quantified by residual analysis compared with chronological age. Cardiovascular magnetic resonance (CMR) imaging provided detailed insights into cardiac structure and function. We employed multivariate regression to examine links between BAA and CMR-derived cardiac phenotypes. Cox proportional hazard regression models analysis was applied to explore the causative relationship between BAA and HF. Additionally, Mendelian randomization was used to investigate the genetic underpinnings of these associations. A significant correlation was found between increased BAA and deleterious changes in cardiac structure, such as diminished left ventricular mass, lower overall ventricular volume, and reduced stroke volumes across ventricles and atria. Throughout a median follow-up of 13.8 years, participants with greater biological aging showed a heightened risk of HF [26% per standard deviation (SD) increase in KDM-BA acceleration, 95% confidence intervals (CI): 23-28%; 33% per SD increase in PhenoAge acceleration, 95% CI: 32-35%]. Mendelian randomization analysis suggests a likely causal link between BAA, vital cardiac metrics, and HF risk. CONCLUSION In this cohort, accelerated biological aging may serve as a risk indicator for altered cardiac dimensions, functionality, and the onset of heart failure among middle-aged and elderly adults. It holds promise as a focal point for evaluating risk and developing targeted interventions.
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Affiliation(s)
- Rui Mao
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
| | - Fan Wang
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
| | - Yun Zhong
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
| | - Xin Meng
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
| | - Tongtong Zhang
- The Center of Gastrointestinal and Minimally Invasive Surgery, The Third People's Hospital of Chengdu, 82 Qinglong Street, Chengdu, Sichuan Province 610031, China
- Medical Research Center, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, The Second Chengdu Hospital Affiliated to Chongqing Medical University, 82 Qinglong Street, Chengdu, Sichuan Province 610031, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
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Zhou L, Nishimura A, Umezawa K, Kato Y, Mi X, Ito T, Urano Y, Akaike T, Nishida M. Supersulfide catabolism participates in maladaptive remodeling of cardiac cells. J Pharmacol Sci 2024; 155:121-130. [PMID: 38880546 DOI: 10.1016/j.jphs.2024.05.002] [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: 03/06/2024] [Revised: 04/29/2024] [Accepted: 05/17/2024] [Indexed: 06/18/2024] Open
Abstract
The atrophic myocardium resulting from mechanical unloading and nutritional deprivation is considered crucial as maladaptive remodeling directly associated with heart failure, as well as interstitial fibrosis. Conversely, myocardial hypertrophy resulting from hemodynamic loading is perceived as compensatory stress adaptation. We previously reported the abundant presence of highly redox-active polysulfide molecules, termed supersulfide, with two or more sulfur atoms catenated in normal hearts, and the supersulfide catabolism in pathologic hearts after myocardial infarction correlated with worsened prognosis of heart failure. However, the impact of supersulfide on myocardial remodeling remains unclear. Here, we investigated the involvement of supersulfide metabolism in cardiomyocyte remodeling, using a model of adenosine 5'-triphosphate (ATP) receptor-stimulated atrophy and endothelin-1 receptor-stimulated hypertrophy in neonatal rat cardiomyocytes. Results revealed contrasting changes in intracellular supersulfide and its catabolite, hydrogen sulfide (H2S), between cardiomyocyte atrophy and hypertrophy. Stimulation of cardiomyocytes with ATP decreased supersulfide activity, while H2S accumulation itself did not affect cardiomyocyte atrophy. This supersulfide catabolism was also involved in myofibroblast formation of neonatal rat cardiac fibroblasts. Thus, unraveling supersulfide metabolism during myocardial remodeling may lead to the development of novel therapeutic strategies to improve heart failure.
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Affiliation(s)
- 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
| | - 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
| | - Keitaro Umezawa
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, 173-0015, Japan
| | - Yuri Kato
- Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Xinya Mi
- Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Tomoya Ito
- National Institute for Physiological Sciences, National Institutes of Natural Sciences (NINS), Okazaki, 444-8787, Japan; Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Yasuteru Urano
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, 113-0033, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Takaaki Akaike
- Graduate School of Medicine, Tohoku University, Sendai, 980-8575, 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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3
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Leischik R, Foshag P, Krittanawong C, Jehn U, Vollenberg R, Strauss M. Structural and functional cardiac parameters across occupations: a cross-sectional study in differing work environments. Sci Rep 2024; 14:12115. [PMID: 38802474 PMCID: PMC11130339 DOI: 10.1038/s41598-024-62190-0] [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: 01/02/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
Previous investigations have highlighted notable variations in cardiovascular risk indicators associated with various professional categories. However, only a few studies have examined structural and functional cardiac parameters using echocardiography within distinct occupational groups. Hence, this study endeavored to assess cardiac structural and functional parameters in three additional occupations: firefighters (FFs), police officers (POs), and office workers (OWs). This prospective study encompassed 197 male participants (97 FFs, 54 POs, and 46 OWs) from Germany. All participants underwent 2D and Doppler echocardiography in resting conditions; standard parasternal and apical axis views were employed to evaluate structural (diastolic and systolic) and functional (systolic and diastolic function, and strain) cardiac parameters. All three occupational groups exhibited a tendency towards septal hypertrophy. Notably, OWs exhibited the largest diastolic interventricular septum diameter (IVSd), at 1.33 ± 0.25 cm. IVSd significantly varied between POs and OWs (p = 0.000) and between POs and FFs (p = 0.025). Additionally, during diastole a substantially larger left ventricular posterior wall diameter (LVPWd) was observed in OWs compared to FFs (p = 0.001) and POs (p = 0.013). The left ventricular diastolic cavity diameter (LVIDd) and the left ventricular systolic cavity diameter (LVIDs) were significantly higher in POs than they were in FFs (LVIDd: p = 0.001; LVIDs: p = 0.009), and the LVIDd was notably higher in FFs (p = 0.015) and POs compared to OWs (p = 0.000). FFs exhibited significantly better diastolic function, indicated by higher diastolic peak velocity ratios (MV E/A ratio) and E/E' ratios, compared to POs (E/A ratio: p = 0.025; E/E' ratio: p = 0.014). No significant difference in diastolic performance was found between OWs and FFs. Significantly higher E'(lateral) values were noted in POs compared to FFs (p = 0.003) and OWs (p = 0.004). Ejection fraction did not significantly differ among FFs, POs, and OWs (p > 0.6). The left ventricular mass (LV Mass) was notably higher in POs than it was in FFs (p = 0.039) and OWs (p = 0.033). Strain parameter differences were notably improved in two- (p = 0.006) and four-chamber (p = 0.018) views for FFs compared to POs. Concentric remodeling was the predominant change observed in all three occupational groups. Significant differences in the presence of various forms of hypertrophy were observed in FFs, POs, and OWs (exact Fisher test p-values: FFs vs. OWs = 0.021, POs vs. OWs = 0.002). OWs demonstrated notably higher rates of concentric remodeling than FFs did (71.77% vs. 47.9%). This study underscores disparities in both functional and structural parameters in diverse occupational groups. Larger prospective studies are warranted to investigate and delineate differences in structural and functional cardiac parameters across occupational groups, and to discern their associated effects and risks on the cardiovascular health of these distinct professional cohorts.
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Affiliation(s)
- Roman Leischik
- Department of Cardiology, Faculty of Health, School of Medicine, University Witten/Herdecke, 58455, Witten, Germany.
| | - Peter Foshag
- Department of Cardiology, Faculty of Health, School of Medicine, University Witten/Herdecke, 58455, Witten, Germany
| | | | - Ulrich Jehn
- Department of Medicine D, Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Muenster, 48149, Muenster, Germany
| | - Richard Vollenberg
- Department of Medicine B, Gastroenterology and Hepatology, University Hospital Münster, 48149, Muenster, Germany
| | - Markus Strauss
- Department of Cardiology, Faculty of Health, School of Medicine, University Witten/Herdecke, 58455, Witten, Germany.
- Department of Cardiology I, Coronary and Peripheral Vascular Disease, Heart Failure Medicine, University Hospital Muenster, Cardiol, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
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Wang J, Guo Y, Zhou H, Hua Y, Wan H, Yang J. Investigating the Mechanistic of Danhong Injection in Brain Damage Caused by Cardiac I/R Injury via Bioinformatics, Computer Simulation, and Experimental Validation. ACS OMEGA 2024; 9:18341-18357. [PMID: 38680343 PMCID: PMC11044240 DOI: 10.1021/acsomega.4c00200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE Cardiac ischemia-reperfusion (I/R) injury has negative effects on the brain and can even lead to the occurrence of ischemic stroke. Clinical evidence shows that Danhong injection (DHI) protects the heart and brain following ischemic events. This study investigated the mechanisms and key active compounds underlying the therapeutic effect of DHI against brain damage induced by cardiac I/R injury. METHODS The gene expression omnibus database provided GSE66360 and GSE22255 data sets. The R programming language was used to identify the common differentially expressed genes (cDEGs). Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis were performed, and protein-protein interaction network was constructed. Active compounds of DHI were collected from the Traditional Chinese Medicine Systems Pharmacology database. Molecular docking and molecular dynamics simulations were performed. The MMPBSA method was used to calculate the binding-free energy. The pkCSM server and DruLiTo software were used for Absorption, Distribution, metabolism, excretion, and toxicity (ADMET) analysis and drug-likeness analysis. Finally, in vitro experiments were conducted to validate the results. RESULTS A total of 27 cDEGs had been identified. The PPI and enrichment results indicated that TNF-α was considered to be the core target. A total of 80 active compounds were retrieved. The molecular docking results indicated that tanshinone I (TSI), tanshinone IIA (TSIIA), and hydroxyl safflower yellow A (HSYA) were selected as core active compounds. Molecular dynamics verification revealed that the conformations were relatively stable without significant fluctuations. MMPBSA analysis revealed that the binding energies of TSI, TSIIA, and HSYA with TNF-α were -36.01, -21.71, and -14.80 kcal/mol, respectively. LEU57 residue of TNF-α has the highest contribution. TSI and TSIIA passed both the ADMET analysis and drug-likeness screening, whereas HSYA did not. Experimental verification confirmed that DHI and TSIIA reduced the expression of TNF-α, NLRP3, and IL-1β in the injured H9C2 and rat brain microvascular endothelial cells. CONCLUSION TNF-α can be considered to be a key target for BD-CI/R. TSIIA in DHI exerts a significant inhibitory effect on the inflammatory damage of BD-CI/R, providing new insights for future drug development.
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Affiliation(s)
- Jinfu Wang
- School
of Basic Medical Sciences, Zhejiang Chinese
Medical University, Hangzhou, Zhejiang 310053, China
| | - Yan Guo
- Hangzhou
TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China
| | - Huifen Zhou
- School
of Basic Medical Sciences, Zhejiang Chinese
Medical University, Hangzhou, Zhejiang 310053, China
- Key
Laboratory of TCM Encephalopathy of Zhejiang Province, Hangzhou, Zhejiang 310053, China
| | - Yanjie Hua
- College
of Life Science, Zhejiang Chinese Medical
University, Hangzhou, Zhejiang 310053, China
| | - Haitong Wan
- School
of Basic Medical Sciences, Zhejiang Chinese
Medical University, Hangzhou, Zhejiang 310053, China
- Key
Laboratory of TCM Encephalopathy of Zhejiang Province, Hangzhou, Zhejiang 310053, China
| | - Jiehong Yang
- School
of Basic Medical Sciences, Zhejiang Chinese
Medical University, Hangzhou, Zhejiang 310053, China
- Key
Laboratory of TCM Encephalopathy of Zhejiang Province, Hangzhou, Zhejiang 310053, China
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5
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Sawano S, Kodera S, Sato M, Shinohara H, Kobayashi A, Takiguchi H, Hirose K, Kamon T, Saito A, Kiriyama H, Miura M, Minatsuki S, Kikuchi H, Takeda N, Morita H, Komuro I. Multimodality Risk Assessment of Patients with Ischemic Heart Disease Using Deep Learning Models Applied to Electrocardiograms and Chest X-rays. Int Heart J 2024; 65:29-38. [PMID: 38296576 DOI: 10.1536/ihj.23-402] [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] [Indexed: 02/08/2024]
Abstract
Comprehensive management approaches for patients with ischemic heart disease (IHD) are important aids for prognostication and treatment planning. While single-modality deep neural networks (DNNs) have shown promising performance for detecting cardiac abnormalities, the potential benefits of using DNNs for multimodality risk assessment in patients with IHD have not been reported. The purpose of this study was to investigate the effectiveness of multimodality risk assessment in patients with IHD using a DNN that utilizes 12-lead electrocardiograms (ECGs) and chest X-rays (CXRs), with the prediction of major adverse cardiovascular events (MACEs) being of particular concern.DNN models were applied to detection of left ventricular systolic dysfunction (LVSD) on ECGs and identification of cardiomegaly findings on CXRs. A total of 2107 patients who underwent elective percutaneous coronary intervention were categorized into 4 groups according to the models' outputs: Dual-modality high-risk (n = 105), ECG high-risk (n = 181), CXR high-risk (n = 392), and No-risk (n = 1,429).A total of 342 MACEs were observed. The incidence of a MACE was the highest in the Dual-modality high-risk group (P < 0.001). Multivariate Cox hazards analysis for predicting MACE revealed that the Dual-modality high-risk group had a significantly higher risk of MACE than the No-risk group (hazard ratio (HR): 2.370, P < 0.001), the ECG high-risk group (HR: 1.906, P = 0.010), and the CXR high-risk group (HR: 1.624, P = 0.018), after controlling for confounding factors.The results suggest the usefulness of multimodality risk assessment using DNN models applied to 12-lead ECG and CXR data from patients with IHD.
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Affiliation(s)
- Shinnosuke Sawano
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Satoshi Kodera
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Masataka Sato
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Hiroki Shinohara
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Atsushi Kobayashi
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Hiroshi Takiguchi
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Kazutoshi Hirose
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Tatsuya Kamon
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Akihito Saito
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Hiroyuki Kiriyama
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Mizuki Miura
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Shun Minatsuki
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Hironobu Kikuchi
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Norifumi Takeda
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo Hospital
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Chiang CY, Huang JH, Chiu KM, Chen JS. Impact of Recurrent Mitral Regurgitation on Left Ventricular Mass Regression and Cardiac Events following Mitral Valve Repair. J Clin Med 2023; 13:235. [PMID: 38202242 PMCID: PMC10779914 DOI: 10.3390/jcm13010235] [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: 11/28/2023] [Revised: 12/26/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Mitral valve regurgitation results in volume overload, followed by left ventricular remodeling. Variation of reverse remodeling following mitral repair influences the clinical outcomes. We aimed to evaluate the association between recurrent mitral regurgitation and mass regression following mitral valve repair and the impact on major adverse cardiovascular events. METHODS A retrospective cohort study was conducted on 164 consecutive patients with severe mitral regurgitation who underwent elective mitral valve repair. Subgroups were classified based on the presence of recurrent mitral regurgitation exceeding moderate severity. The hemodynamic parameters were evaluated according to geometry, mass, and function with Doppler echocardiography before and after surgery. Cox regression analysis was performed to evaluate the association between hemodynamics and mass regression and clinical outcomes. RESULTS The results for MR indicated 110 cases with non-recurrent MR and 54 with recurrent MR, along with 31 major adverse cardiovascular events. The tracked echocardiographic results revealed less reduction in dimension and volume, along with less mass regression in the recurrent MR subgroup. Significant differences were revealed in the relative change of the LV end-diastolic volume index and relative mass regression between subgroups. The relative change in the LVEDVI was proportionally correlated with relative mass regression. Cox regression analysis identified correlations with major adverse cardiovascular events, including suture annuloplasty, recurrent mitral regurgitation, tracked LV mass, relative LV mass regression, and systolic dysfunction. CONCLUSION LV mass regression and relative change of the LV end-diastolic volume could be risk predictors of recurrent mitral regurgitation. The extent of LV mass regression is correlated with adverse cardiac events.
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Affiliation(s)
- Chih-Yao Chiang
- Department of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan; (C.-Y.C.); (J.-H.H.)
- Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, National Defense Medical Center, Taipei 114201, Taiwan
| | - Jih-Hsin Huang
- Department of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan; (C.-Y.C.); (J.-H.H.)
| | - Kuan-Ming Chiu
- Department of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan; (C.-Y.C.); (J.-H.H.)
| | - Jer-Shen Chen
- Department of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan; (C.-Y.C.); (J.-H.H.)
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Kan A, Leng Y, Li S, Lin F, Fang Q, Tao X, Hu M, Gong L. The predictive value of coronary microvascular dysfunction for left ventricular reverse remodelling in dilated cardiomyopathy. Front Cardiovasc Med 2023; 10:1301509. [PMID: 38111885 PMCID: PMC10726051 DOI: 10.3389/fcvm.2023.1301509] [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: 09/25/2023] [Accepted: 11/20/2023] [Indexed: 12/20/2023] Open
Abstract
Aims To evaluate the degree of coronary microvascular dysfunction (CMD) in dilated cardiomyopathy (DCM) patients by cardiac magnetic resonance (CMR) first-pass perfusion parameters and to examine the correlation between myocardial perfusion and left ventricle reverse remodelling (LVRR). Methods In this study, 94 DCM patients and 35 healthy controls matched for age and sex were included. Myocardial perfusion parameters, including upslope, time to maximum signal intensity (Timemax), maximum signal intensity (SImax), baseline signal intensity (SIbaseline), and the difference between maximum and baseline signal intensity (SImax-baseline) were measured. Additionally, left ventricular (LV) structure, function parameters, and late gadolinium enhancement (LGE) were also recorded. The parameters were compared between healthy controls and DCM patients. Univariable and multivariable logistic regression analyses were used to determine the predictors of LVRR. Results With a median follow-up period of 12 months [interquartile range (IQR), 8-13], 41 DCM patients (44%) achieved LVRR. Compared with healthy controls, DCM patients presented CMD with reduced upslope, SIbaseline, and increased Timemax (all p < 0.01). Timemax, SImax, and SImax-baseline were further decreased in LVRR than non-LVRR group (Timemax: 60.35 [IQR, 51.46-74.71] vs. 72.41 [IQR, 59.68-97.70], p = 0.017; SImax: 723.52 [IQR, 209.76-909.27] vs. 810.92 [IQR, 581.30-996.89], p = 0.049; SImax-baseline: 462.99 [IQR, 152.25-580.43] vs. 551.13 [IQR, 402.57-675.36], p = 0.038). In the analysis of multivariate logistic regression, Timemax [odds ratio (OR) 0.98; 95% confidence interval (CI) 0.95-1.00; p = 0.032)], heart rate (OR 1.04; 95% CI 1.01-1.08; p = 0.029), LV remodelling index (OR 1.73; 95% CI 1.06-3.00; p = 0.038) and LGE extent (OR 0.85; 95% CI 0.73-0.96; p = 0.021) were independent predictors of LVRR. Conclusions CMD could be found in DCM patients and was more impaired in patients with non-LVRR than LVRR patients. Timemax at baseline was an independent predictor of LVRR in DCM.
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Affiliation(s)
- Ao Kan
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yinping Leng
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shuhao Li
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Fang Lin
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qimin Fang
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xinwei Tao
- Department of Medical, Bayer Healthcare, Shanghai, China
| | - Mengyao Hu
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lianggeng Gong
- Department of Radiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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8
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Kan A, Fang Q, Li S, Liu W, Tao X, Huang K, Hu M, Feng Z, Gong L. The potential predictive value of cardiac mechanics for left ventricular reverse remodelling in dilated cardiomyopathy. ESC Heart Fail 2023; 10:3340-3351. [PMID: 37697922 PMCID: PMC10682859 DOI: 10.1002/ehf2.14529] [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: 04/09/2023] [Revised: 06/21/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023] Open
Abstract
AIMS Left ventricular reverse remodelling (LVRR) is an important objective of optimal medical management for dilated cardiomyopathy (DCM) patients, as it is associated with favourable long-term outcomes. Cardiac magnetic resonance (CMR) can comprehensively assess cardiac structure and function. We aimed to assess the CMR parameters at baseline and investigate independent variables to predict LVRR in DCM patients. METHODS AND RESULTS Nighty-eight initially diagnosed DCM patients who underwent CMR and echocardiography examinations at baseline were included. CMR parameters and feature tracking (FT) based left ventricular (LV) global strain (nStrain) and nStrain indexed to LV cardiac mass index (rStrain) were measured. The predictors of LVRR were determined by multivariate logistic regression analyses. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of CMR parameters and were compared by the DeLong test. At a median follow-up time of 9 [interquartile range, 7-12] months, 35 DCM patients (36%) achieved LVRR. The patients with LVRR had lower LV volume, mass, LGE extent and stroke volume index (LVSVi) and higher left ventricular remodelling index (LVRI), nStrains, rStrains, and peak systolic strain rate (PSSR) in the longitudinal direction and rStrains in the circumferential direction at baseline (all P < 0.05). In the multivariate logistic regression analyses, LVRI [per SD, odds ratio (OR) 1.79; 95% confidence interval (CI) 1.08-2.98; P = 0.024] and the ratio of global longitudinal peak strain (rGLPS) (per SD, OR 1.88; 95% CI 1.18-3.01; P = 0.008) were independent predictors of LVRR. The combination of LVSVi, LVRI, and rGLPS had a greater area under the curve (AUC) than the combination of LVSVi and LVRI (0.75 vs. 0.68), but not significantly (P = 0.09). CONCLUSIONS Patients with LVRR had a lower LV volume index, lower LVSV index, lower LGE extent, higher LVRI, and preserved myocardial deformation in the longitudinal direction at baseline. LVRI and rGLPS at baseline were independent determinants of LVRR.
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Affiliation(s)
- Ao Kan
- Department of RadiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Qimin Fang
- Department of RadiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Shuhao Li
- Department of RadiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Wenying Liu
- Department of RadiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | | | - Kaiyao Huang
- Department of RadiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Mengyao Hu
- Department of RadiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Zhaofeng Feng
- Department of RadiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Lianggeng Gong
- Department of RadiologyThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
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9
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Owesny P, Grune T. The link between obesity and aging - insights into cardiac energy metabolism. Mech Ageing Dev 2023; 216:111870. [PMID: 37689316 DOI: 10.1016/j.mad.2023.111870] [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: 07/11/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
Obesity and aging are well-established risk factors for a range of diseases, including cardiovascular diseases and type 2 diabetes. Given the escalating prevalence of obesity, the aging population, and the subsequent increase in cardiovascular diseases, it is crucial to investigate the underlying mechanisms involved. Both aging and obesity have profound effects on the energy metabolism through various mechanisms, including metabolic inflexibility, altered substrate utilization for energy production, deregulated nutrient sensing, and mitochondrial dysfunction. In this review, we aim to present and discuss the hypothesis that obesity, due to its similarity in changes observed in the aging heart, may accelerate the process of cardiac aging and exacerbate the clinical outcomes of elderly individuals with obesity.
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Affiliation(s)
- Patricia Owesny
- Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Tilman Grune
- Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; DZHK (German Center for Cardiovascular Research), partner site Berlin, Berlin, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
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10
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Farzi M, Coveney S, Afzali M, Zdora M, Lygate CA, Rau C, Frangi AF, Dall'Armellina E, Teh I, Schneider JE. Measuring cardiomyocyte cellular characteristics in cardiac hypertrophy using diffusion-weighted MRI. Magn Reson Med 2023; 90:2144-2157. [PMID: 37345727 PMCID: PMC10962572 DOI: 10.1002/mrm.29775] [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: 01/23/2023] [Revised: 05/05/2023] [Accepted: 06/02/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE This paper presents a hierarchical modeling approach for estimating cardiomyocyte major and minor diameters and intracellular volume fraction (ICV) using diffusion-weighted MRI (DWI) data in ex vivo mouse hearts. METHODS DWI data were acquired on two healthy controls and two hearts 3 weeks post transverse aortic constriction (TAC) using a bespoke diffusion scheme with multiple diffusion times (Δ $$ \Delta $$ ), q-shells and diffusion encoding directions. Firstly, a bi-exponential tensor model was fitted separately at each diffusion time to disentangle the dependence on diffusion times from diffusion weightings, that is, b-values. The slow-diffusing component was attributed to the restricted diffusion inside cardiomyocytes. ICV was then extrapolated atΔ = 0 $$ \Delta =0 $$ using linear regression. Secondly, given the secondary and the tertiary diffusion eigenvalue measurements for the slow-diffusing component obtained at different diffusion times, major and minor diameters were estimated assuming a cylinder model with an elliptical cross-section (ECS). High-resolution three-dimensional synchrotron X-ray imaging (SRI) data from the same specimen was utilized to evaluate the biophysical parameters. RESULTS Estimated parameters using DWI data were (control 1/control 2 vs. TAC 1/TAC 2): major diameter-17.4μ $$ \mu $$ m/18.0μ $$ \mu $$ m versus 19.2μ $$ \mu $$ m/19.0μ $$ \mu $$ m; minor diameter-10.2μ $$ \mu $$ m/9.4μ $$ \mu $$ m versus 12.8μ $$ \mu $$ m/13.4μ $$ \mu $$ m; and ICV-62%/62% versus 68%/47%. These findings were consistent with SRI measurements. CONCLUSION The proposed method allowed for accurate estimation of biophysical parameters suggesting cardiomyocyte diameters as sensitive biomarkers of hypertrophy in the heart.
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Affiliation(s)
- Mohsen Farzi
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Sam Coveney
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Maryam Afzali
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of PsychologyCardiff UniversityCardiffUK
| | - Marie‐Christine Zdora
- Diamond Light Source Ltd.Harwell Science and Innovation CampusDidcotUK
- Department of Physics & AstronomyUniversity College LondonLondonUK
| | - Craig A. Lygate
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
| | - Christoph Rau
- Diamond Light Source Ltd.Harwell Science and Innovation CampusDidcotUK
| | - Alejandro F. Frangi
- Centre for Computational Imaging and Simulation Technologies in Biomedicine (CISTIB), School of ComputingUniversity of LeedsLeedsUK
| | - Erica Dall'Armellina
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Irvin Teh
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Jürgen E. Schneider
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
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11
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Algül S, Dorsch LM, Sorop O, Vink A, Michels M, Dos Remedios CG, Dalinghaus M, Merkus D, Duncker DJ, Kuster DWD, van der Velden J. The microtubule signature in cardiac disease: etiology, disease stage, and age dependency. J Comp Physiol B 2023; 193:581-595. [PMID: 37644284 PMCID: PMC10533615 DOI: 10.1007/s00360-023-01509-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/31/2023]
Abstract
Employing animal models to study heart failure (HF) has become indispensable to discover and test novel therapies, but their translatability remains challenging. Although cytoskeletal alterations are linked to HF, the tubulin signature of common experimental models has been incompletely defined. Here, we assessed the tubulin signature in a large set of human cardiac samples and myocardium of animal models with cardiac remodeling caused by pressure overload, myocardial infarction or a gene defect. We studied levels of total, acetylated, and detyrosinated α-tubulin and desmin in cardiac tissue from hypertrophic (HCM) and dilated cardiomyopathy (DCM) patients with an idiopathic (n = 7), ischemic (n = 7) or genetic origin (n = 59), and in a pressure-overload concentric hypertrophic pig model (n = 32), pigs with a myocardial infarction (n = 28), mature pigs (n = 6), and mice (n = 15) carrying the HCM-associated MYBPC32373insG mutation. In the human samples, detyrosinated α-tubulin was increased 4-fold in end-stage HCM and 14-fold in pediatric DCM patients. Acetylated α-tubulin was increased twofold in ischemic patients. Across different animal models, the tubulin signature remained mostly unaltered. Only mature pigs were characterized by a 0.5-fold decrease in levels of total, acetylated, and detyrosinated α-tubulin. Moreover, we showed increased desmin levels in biopsies from NYHA class II HCM patients (2.5-fold) and the pressure-overload pig model (0.2-0.3-fold). Together, our data suggest that desmin levels increase early on in concentric hypertrophy and that animal models only partially recapitulate the proliferated and modified tubulin signature observed clinically. Our data warrant careful consideration when studying maladaptive responses to changes in the tubulin content in animal models.
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Affiliation(s)
- Sıla Algül
- Department of Physiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, O2 Building, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands.
| | - Larissa M Dorsch
- Department of Physiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, O2 Building, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - Oana Sorop
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Aryan Vink
- Department of Pathology, University Medical Center, Utrecht, The Netherlands
| | - Michelle Michels
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Cristobal G Dos Remedios
- Mechanobiology Laboratory at Victor Chang Cardiac Research Institute, Darlinghurst, NSW, 2010, Australia
| | - Michiel Dalinghaus
- Department of Pediatric Cardiology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Daphne Merkus
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Dirk J Duncker
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Diederik W D Kuster
- Department of Physiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, O2 Building, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - Jolanda van der Velden
- Department of Physiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Cardiovascular Sciences, O2 Building, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
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12
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Moady G, Ertracht O, Shuster-Biton E, Daud E, Atar S. The Role of Extracellular Signal-Regulated Kinase Pathways in Different Models of Cardiac Hypertrophy in Rats. Biomedicines 2023; 11:2337. [PMID: 37760779 PMCID: PMC10525208 DOI: 10.3390/biomedicines11092337] [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: 07/19/2023] [Revised: 08/08/2023] [Accepted: 08/13/2023] [Indexed: 09/29/2023] Open
Abstract
Cardiac hypertrophy develops following different triggers of pressure or volume overload. In several previous studies, different hypertrophy types were demonstrated following alterations in extracellular signal-regulated kinase (ERK) pathway activation. In the current study, we studied two types of cardiac hypertrophy models in rats: eccentric and concentric hypertrophy. For the eccentric hypertrophy model, iron deficiency anemia caused by a low-iron diet was implemented, while surgical aortic constriction was used to induce aortic stenosis (AS) and concentric cardiac hypertrophy. The hearts were evaluated using echocardiography, histological sections, and scanning electron microscopy. The expression of ERK1/2 was analyzed using Western blot. During the study period, anemic rats developed eccentric hypertrophy characterized by an enlarged left ventricle (LV) cavity cross-sectional area (CSA) (59.9 ± 5.1 mm2 vs. 47 ± 8.1 mm2, p = 0.002), thinner septum (2.1 ± 0.3 mm vs. 2.5 ± 0.2 mm, p < 0.05), and reduced left ventricular ejection fraction (LVEF) (52.6% + 4.7 vs. 60.3% + 2.8, p < 0.05). Rats with AS developed concentric hypertrophy with a thicker septum (2.8 ± 0.6 vs. 2.4 ± 0.1 p < 0.05), increased LV muscle cross-sectional area (79.5 ± 9.33 mm2 vs. 57.9 ± 5.0 mm2, p < 0.001), and increased LVEF (70.3% + 2.8 vs. 60.0% + 2.1, p < 0.05). ERK1/2 expression decreased in the anemic rats and increased in the rats with AS. Nevertheless, the p-ERK and the p-MEK did not change significantly in all the examined models. We concluded that ERK1/2 expression was altered by the type of hypertrophy and the change in LVEF.
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Affiliation(s)
- Gassan Moady
- The Cardiology Department, Galilee Medical Center, Nahariya 2210001, Israel; (E.D.); (S.A.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel;
| | - Offir Ertracht
- The Cardiovascular Research Laboratory, Medical Research Institute, Galilee Medical Center, Nahariya 2210001, Israel;
| | - Efrat Shuster-Biton
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel;
- The Cardiovascular Research Laboratory, Medical Research Institute, Galilee Medical Center, Nahariya 2210001, Israel;
| | - Elias Daud
- The Cardiology Department, Galilee Medical Center, Nahariya 2210001, Israel; (E.D.); (S.A.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel;
| | - Shaul Atar
- The Cardiology Department, Galilee Medical Center, Nahariya 2210001, Israel; (E.D.); (S.A.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel;
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13
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Varadarajan V, Gidding S, Wu C, Carr J, Lima JA. Imaging Early Life Cardiovascular Phenotype. Circ Res 2023; 132:1607-1627. [PMID: 37289903 PMCID: PMC10501740 DOI: 10.1161/circresaha.123.322054] [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: 02/07/2023] [Accepted: 04/30/2023] [Indexed: 06/10/2023]
Abstract
The growing epidemics of obesity, hypertension, and diabetes, in addition to worsening environmental factors such as air pollution, water scarcity, and climate change, have fueled the continuously increasing prevalence of cardiovascular diseases (CVDs). This has caused a markedly increasing burden of CVDs that includes mortality and morbidity worldwide. Identification of subclinical CVD before overt symptoms can lead to earlier deployment of preventative pharmacological and nonpharmacologic strategies. In this regard, noninvasive imaging techniques play a significant role in identifying early CVD phenotypes. An armamentarium of imaging techniques including vascular ultrasound, echocardiography, magnetic resonance imaging, computed tomography, noninvasive computed tomography angiography, positron emission tomography, and nuclear imaging, with intrinsic strengths and limitations can be utilized to delineate incipient CVD for both clinical and research purposes. In this article, we review the various imaging modalities used for the evaluation, characterization, and quantification of early subclinical cardiovascular diseases.
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Affiliation(s)
- Vinithra Varadarajan
- Division of Cardiology, Department of Medicine Johns Hopkins University, Baltimore, MD
| | | | - Colin Wu
- Department of Medicine, National Heart, Lung and Blood Institute, Bethesda, MD
| | - Jeffrey Carr
- Department Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN
| | - Joao A.C. Lima
- Division of Cardiology, Department of Medicine Johns Hopkins University, Baltimore, MD
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14
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Wan S, Cui Z, Wu L, Zhang F, Liu T, Hu J, Tian J, Yu B, Liu F, Kou J, Li F. Ginsenoside Rd promotes omentin secretion in adipose through TBK1-AMPK to improve mitochondrial biogenesis via WNT5A/Ca 2+ pathways in heart failure. Redox Biol 2023; 60:102610. [PMID: 36652744 PMCID: PMC9860421 DOI: 10.1016/j.redox.2023.102610] [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: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
Ginsenoside Rd is an active ingredient in Panax ginseng CA Mey and can be absorbed into the adipose tissue. Adipokines play an important role in the treatment of cardiovascular diseases. However, the potential benefit of Rd on heart failure (HF) and the underlying mechanism associated with the crosstalk between adipocytes and cardiomyocytes remains to be illustrated. Here, the results identified that Rd improved cardiac function and inhibited cardiac pathological changes in transverse aortic constriction (TAC), coronary ligation (CAL) and isoproterenol (ISO)-induced HF mice. And Rd promoted the release of omentin from the adipose tissue and up-regulated omentin expression in lipopolysaccharide (LPS)-induced 3T3-L1 adipocytes. Further, Rd could increase TBK1 and AMPK phosphorylation in adipocytes. And also, the TBK1-AMPK signaling pathway regulated the expression of omentin in LPS-induced adipocytes. Moreover, the omentin mRNA expression was significantly decreased by TBK1 knockdown in LPS-induced 3T3-L1 adipocytes. Additionally, molecular docking and SPR analysis confirmed that Rd had a certain binding ability with TBK1, and co-treatment with TBK1 inhibitors or TBK1 knockdown partially abolished the effect of Rd on increasing the omentin expression and the ratio of p-AMPK to AMPK in adipocytes. Moreover, we found that circulating omentin level diminished in the HF patients compared with healthy subjects. Meanwhile, the adipose tissue-specific overexpression of omentin improved cardiac function, reduced myocardial infarct size and ameliorated cardiac pathological features in CAL-induced HF mice. Consistently, exogenous omentin reduced mtROS levels and restored ΔψM to improve oxygen and glucose deprivation (OGD)-induced cardiomyocytes injury. Further, omentin inhibited the WNT5A/Ca2+ signaling pathway and promoted mitochondrial biogenesis function to ameliorate myocardial ischemia injury. However, WNT5A knockdown inhibited the impairment of mitochondrial biogenesis and partially counteracted the cardioprotective effect of omentin in vitro. Therefore, this study indicated that Rd promoted omentin secretion from adipocytes through the TBK1-AMPK pathway to improve mitochondrial biogenesis function via WNT5A/Ca2+ signaling pathway to ameliorate myocardial ischemia injury, which provided a new therapeutic mechanism and potential drugs for the treatment of HF.
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Affiliation(s)
- Shiyao Wan
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - ZeKun Cui
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Lingling Wu
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Fan Zhang
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Tao Liu
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Jingui Hu
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Jiangwei Tian
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Boyang Yu
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Fuming Liu
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.
| | - Junping Kou
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China.
| | - Fang Li
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China.
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15
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Jiménez-Castilla L, Opazo-Ríos L, Marin-Royo G, Orejudo M, Rodrigues-Diez R, Ballesteros-Martínez C, Soto-Catalán M, Caro-Ordieres T, Artaiz I, Suarez-Cortés T, Zazpe A, Hernández G, Cortés M, Tuñón J, Briones AM, Egido J, Gómez-Guerrero C. The Synthetic Flavonoid Hidrosmin Improves Endothelial Dysfunction and Atherosclerotic Lesions in Diabetic Mice. Antioxidants (Basel) 2022; 11:antiox11122499. [PMID: 36552707 PMCID: PMC9774734 DOI: 10.3390/antiox11122499] [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: 10/31/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
In diabetes, chronic hyperglycemia, dyslipidemia, inflammation and oxidative stress contribute to the progression of macro/microvascular complications. Recently, benefits of the use of flavonoids in these conditions have been established. This study investigates, in two different mouse models of diabetes, the vasculoprotective effects of the synthetic flavonoid hidrosmin on endothelial dysfunction and atherogenesis. In a type 2 diabetes model of leptin-receptor-deficient (db/db) mice, orally administered hidrosmin (600 mg/kg/day) for 16 weeks markedly improved vascular function in aorta and mesenteric arteries without affecting vascular structural properties, as assessed by wire and pressure myography. In streptozotocin-induced type 1 diabetic apolipoprotein E-deficient mice, hidrosmin treatment for 7 weeks reduced atherosclerotic plaque size and lipid content; increased markers of plaque stability; and decreased markers of inflammation, senescence and oxidative stress in aorta. Hidrosmin showed cardiovascular safety, as neither functional nor structural abnormalities were noted in diabetic hearts. Ex vivo, hidrosmin induced vascular relaxation that was blocked by nitric oxide synthase (NOS) inhibition. In vitro, hidrosmin stimulated endothelial NOS activity and NO production and downregulated hyperglycemia-induced inflammatory and oxidant genes in vascular smooth muscle cells. Our results highlight hidrosmin as a potential add-on therapy in the treatment of macrovascular complications of diabetes.
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Affiliation(s)
- Luna Jiménez-Castilla
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, 28040 Madrid, Spain
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), 28029 Madrid, Spain
| | - Lucas Opazo-Ríos
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, 28040 Madrid, Spain
- Facultad de Ciencias de la Salud, Universidad de Las Américas, Concepción-Talcahuano 4301099, Chile
- Correspondence: (L.O.-R.); (R.R.-D.); (C.G.-G.); Tel.: +56-920463280 (L.O.-R.); +34-686826139 (R.R.-D.); +34-915504800 (ext. 3126) (C.G.-G.)
| | - Gema Marin-Royo
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, 28040 Madrid, Spain
| | - Macarena Orejudo
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, 28040 Madrid, Spain
| | - Raquel Rodrigues-Diez
- Departamento de Farmacología, Universidad Autónoma de Madrid, Instituto de Investigación Hospital La Paz, 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
- Department of Physiology, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Correspondence: (L.O.-R.); (R.R.-D.); (C.G.-G.); Tel.: +56-920463280 (L.O.-R.); +34-686826139 (R.R.-D.); +34-915504800 (ext. 3126) (C.G.-G.)
| | - Constanza Ballesteros-Martínez
- Departamento de Farmacología, Universidad Autónoma de Madrid, Instituto de Investigación Hospital La Paz, 28029 Madrid, Spain
| | - Manuel Soto-Catalán
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, 28040 Madrid, Spain
| | - Teresa Caro-Ordieres
- Department of Research, Development, and Innovation, FAES Farma, 48940 Bilbao, Spain
| | - Inés Artaiz
- Department of Research, Development, and Innovation, FAES Farma, 48940 Bilbao, Spain
| | - Tatiana Suarez-Cortés
- Department of Research, Development, and Innovation, FAES Farma, 48940 Bilbao, Spain
| | - Arturo Zazpe
- Department of Research, Development, and Innovation, FAES Farma, 48940 Bilbao, Spain
| | - Gonzalo Hernández
- Department of Research, Development, and Innovation, FAES Farma, 48940 Bilbao, Spain
| | - Marcelino Cortés
- Department of Cardiology, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - José Tuñón
- Department of Cardiology, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Ana M. Briones
- Departamento de Farmacología, Universidad Autónoma de Madrid, Instituto de Investigación Hospital La Paz, 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Jesús Egido
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, 28040 Madrid, Spain
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), 28029 Madrid, Spain
| | - Carmen Gómez-Guerrero
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, 28040 Madrid, Spain
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), 28029 Madrid, Spain
- Correspondence: (L.O.-R.); (R.R.-D.); (C.G.-G.); Tel.: +56-920463280 (L.O.-R.); +34-686826139 (R.R.-D.); +34-915504800 (ext. 3126) (C.G.-G.)
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16
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Chen JS, Huang JH, Chiu KM, Chiang CY. Extent of Left Ventricular Mass Regression and Impact of Global Left Ventricular Afterload on Cardiac Events and Mortality after Aortic Valve Replacement. J Clin Med 2022; 11:jcm11247482. [PMID: 36556098 PMCID: PMC9783780 DOI: 10.3390/jcm11247482] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Patient-prosthesis mismatch (PPM) causes a high transvalvular pressure gradient and residual left ventricular (LV) hypertrophy, consequently influencing long-term results. This study aimed to find the relationships between hemodynamic parameters and LV mass regression and determine the risk predictors of major adverse cardiovascular and cerebral events (MACCE) after aortic valve replacement (AVR) for aortic stenosis. Methods and Results: Preoperative and postoperative Doppler echocardiography data were evaluated for 120 patients after AVR. The patients' mean age was 67.7 years; 55% of the patients were male. Forty-four (37%) patients suffered from MACCE during a mean follow-up period of 3.6 ± 2 years. The following hemodynamic parameters at follow-up were associated with lower relative indexed LV mass (LVMI) regression: lower postoperative indexed effective orifice area, greater mean transvalvular pressure gradient (MPG), greater stroke work loss (SWL), and concentric or eccentric LV remodeling mode. The following hemodynamic parameters at follow-up were associated with a higher risk of MACCE: higher valvuloarterial impedance (ZVA), greater SWL, greater MPG, greater relative wall thickness, greater LVMI, and hypertrophic LV remodeling mode. Lower relative LVMI regression was associated with a higher risk of MACCE (hazard ratio, 1.01: 95% confidence interval, 1.003-1.03). The corresponding cutoff of relative LVMI regression was -14%. Conclusions: Changes in hemodynamic parameters were independently associated with relative LVMI regression. Impaired reverse remodeling and persistent residual LV hypertrophy were independent risk predictors of MACCE. An LVMI regression lower than 14% indicated higher MACCE. A postoperative ZVA greater than 3.5 mmHg/mL/m2 was an independent risk predictor of cardiac events and mortality after AVR. Preventive strategies should be used at the time of the operation to avoid PPM.
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Affiliation(s)
- Jer-Shen Chen
- Department of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan
- Department of Healthcare Administration, Asian Eastern University of Science and Technology, New Taipei City 220303, Taiwan
| | - Jih-Hsin Huang
- Department of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan
- Department of Applied Cosmetology, LeeMing Institute of Technology, New Taipei City 243083, Taiwan
| | - Kuan-Ming Chiu
- Department of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan 320315, Taiwan
| | - Chih-Yao Chiang
- Department of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan
- Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, National Defense Medical Center, Taipei 114201, Taiwan
- Correspondence: ; Tel.: +886-2-7728-1618; Fax: +886-2-7738-6057
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Sarzani R, Allevi M, Di Pentima C, Schiavi P, Spannella F, Giulietti F. Role of Cardiac Natriuretic Peptides in Heart Structure and Function. Int J Mol Sci 2022; 23:ijms232214415. [PMID: 36430893 PMCID: PMC9697447 DOI: 10.3390/ijms232214415] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/22/2022] Open
Abstract
Cardiac natriuretic peptides (NPs), atrial NP (ANP) and B-type NP (BNP) are true hormones produced and released by cardiomyocytes, exerting several systemic effects. Together with C-type NP (CNP), mainly expressed by endothelial cells, they also exert several paracrine and autocrine activities on the heart itself, contributing to cardiovascular (CV) health. In addition to their natriuretic, vasorelaxant, metabolic and antiproliferative systemic properties, NPs prevent cardiac hypertrophy, fibrosis, arrhythmias and cardiomyopathies, counteracting the development and progression of heart failure (HF). Moreover, recent studies revealed that a protein structurally similar to NPs mainly produced by skeletal muscles and osteoblasts called musclin/osteocrin is able to interact with the NPs clearance receptor, attenuating cardiac dysfunction and myocardial fibrosis and promoting heart protection during pathological overload. This narrative review is focused on the direct activities of this molecule family on the heart, reporting both experimental and human studies that are clinically relevant for physicians.
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Affiliation(s)
- Riccardo Sarzani
- Internal Medicine and Geriatrics, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Nazionale di Ricovero e Cura per Anziani (IRCCS INRCA), 60127 Ancona, Italy
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, 60126 Ancona, Italy
- Correspondence: (R.S.); Tel.: +39-071-5964696
| | - Massimiliano Allevi
- Internal Medicine and Geriatrics, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Nazionale di Ricovero e Cura per Anziani (IRCCS INRCA), 60127 Ancona, Italy
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Chiara Di Pentima
- Internal Medicine and Geriatrics, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Nazionale di Ricovero e Cura per Anziani (IRCCS INRCA), 60127 Ancona, Italy
| | - Paola Schiavi
- Internal Medicine and Geriatrics, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Nazionale di Ricovero e Cura per Anziani (IRCCS INRCA), 60127 Ancona, Italy
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Francesco Spannella
- Internal Medicine and Geriatrics, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Nazionale di Ricovero e Cura per Anziani (IRCCS INRCA), 60127 Ancona, Italy
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Federico Giulietti
- Internal Medicine and Geriatrics, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Nazionale di Ricovero e Cura per Anziani (IRCCS INRCA), 60127 Ancona, Italy
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18
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Hu J, Liu T, Fu F, Cui Z, Lai Q, Zhang Y, Yu B, Liu F, Kou J, Li F. Omentin1 ameliorates myocardial ischemia-induced heart failure via SIRT3/FOXO3a-dependent mitochondrial dynamical homeostasis and mitophagy. Lab Invest 2022; 20:447. [PMID: 36192726 PMCID: PMC9531426 DOI: 10.1186/s12967-022-03642-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/16/2022] [Indexed: 12/03/2022]
Abstract
Background Adipose tissue-derived adipokines are involved in various crosstalk between adipose tissue and other organs. Omentin1, a novel adipokine, exerts vital roles in the maintenance of body metabolism, insulin resistance and the like. However, the protective effect of omentin1 in myocardial ischemia (MI)-induced heart failure (HF) and its specific mechanism remains unclear and to be elucidated. Methods The model of MI-induced HF mice and oxygen glucose deprivation (OGD)-injured cardiomyocytes were performed. Mice with overexpression of omentin1 were constructed by a fat-specific adeno-associated virus (AAV) vector system. Results We demonstrated that circulating omentin1 level diminished in HF patients compared with healthy subjects. Furthermore, the fat-specific overexpression of omentin1 ameliorated cardiac function, cardiac hypertrophy, infarct size and cardiac pathological features, and also enhanced SIRT3/FOXO3a signaling in HF mice. Additionally, administration with AAV-omentin1 increased mitochondrial fusion and decreased mitochondrial fission in HF mice, as evidenced by up-regulated expression of Mfn2 and OPA1, and downregulation of p-Drp1(Ser616). Then, it also promoted PINK1/Parkin-dependent mitophagy. Simultaneously, treatment with recombinant omentin1 strengthened OGD-injured cardiomyocyte viability, restrained LDH release, and enhanced the mitochondrial accumulation of SIRT3 and nucleus transduction of FOXO3a. Besides, omentin1 also ameliorated unbalanced mitochondrial fusion-fission dynamics and activated mitophagy, thereby, improving the damaged mitochondria morphology and controlling mitochondrial quality in OGD-injured cardiomyocytes. Interestingly, SIRT3 played an important role in the improvement effects of omentin1 on mitochondrial function, unbalanced mitochondrial fusion-fission dynamics and mitophagy. Conclusion Omentin1 improves MI-induced HF and myocardial injury by maintaining mitochondrial dynamical homeostasis and activating mitophagy via upregulation of SIRT3/FOXO3a signaling. This study provides evidence for further application of omentin1 in cardiovascular diseases from the perspective of crosstalk between heart and adipose tissue. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-022-03642-x.
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Affiliation(s)
- Jingui Hu
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, 211198, People's Republic of China
| | - Tao Liu
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, 211198, People's Republic of China
| | - Fei Fu
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, 211198, People's Republic of China
| | - Zekun Cui
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, 211198, People's Republic of China
| | - Qiong Lai
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, 211198, People's Republic of China
| | - Yuanyuan Zhang
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, 211198, People's Republic of China
| | - Boyang Yu
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, 211198, People's Republic of China
| | - Fuming Liu
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China
| | - Junping Kou
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, 211198, People's Republic of China.
| | - Fang Li
- Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, 211198, People's Republic of China.
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19
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Silva-Bermúdez LS, Vargas-Villanueva A, Sánchez-Vallejo CA, Palacio AC, Buitrago AF, Mendivil CO. Peri-event plasma PCSK9 and hsCRP after an acute myocardial infarction correlate with early deterioration of left ventricular ejection fraction: a cohort study. Lipids Health Dis 2022; 21:61. [PMID: 35864531 PMCID: PMC9306073 DOI: 10.1186/s12944-022-01672-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022] Open
Abstract
Background It is important to identify patients at increased risk of worsening of left ventricular ejection fraction (LVEF) after a myocardial infarction (MI). We aimed to identify the association of various potential biomarkers with LVEF impairment after an MI in South American patients. Methods We studied adult patients admitted to a University Hospital and diagnosed with an acute MI. Plasma concentrations of high-sensitivity C-reactive protein (hsCRP), proprotein convertase subtilisin/kexin type 9 (PCSK9), N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and heart-type fatty-acid-binding protein (FABP3) were determined in samples drawn shortly after the event. Participants had a follow-up visit at least 45 days after the event. The primary endpoint was defined as any decline in LVEF at follow-up relative to baseline. Results The study included 106 patients (77.4% men, 22.6% women), mean age was 64.1, mean baseline LVEF was 56.6, 19% had a prior MI. We obtained a follow-up evaluation in 100 (94.4%) of participants, mean follow-up time was 163 days. There was a significant correlation between baseline PCSK9 and hsCRP (r = 0.39, p < 0.001). Baseline hsCRP concentrations were higher in patients who developed the endpoint than in those who did not (32.1 versus 21.2 mg/L, p = 0.066). After multivariate adjustment, baseline PCSK9, male sex and age were significantly associated with impairment in LVEF. The absolute change in LVEF was inversely correlated with baseline hsCRP (standardized coefficient = − 0.246, p = 0.004). Conclusion High plasma levels of PCSK9 and hsCRP were associated with early decreases in LVEF after an MI in Latin American patients.
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Affiliation(s)
- Lina S Silva-Bermúdez
- Universidad de los Andes, School of Medicine, Carrera 7 No 116-05, Of 413, Bogotá, 110111, Colombia
| | - Andrea Vargas-Villanueva
- Universidad de los Andes, School of Medicine, Carrera 7 No 116-05, Of 413, Bogotá, 110111, Colombia.,Critical Care and Intensive Medicine Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Carlos A Sánchez-Vallejo
- Cardiology Section, Internal Medicine Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Ana C Palacio
- Cardiology Section, Internal Medicine Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Andrés F Buitrago
- Cardiology Section, Internal Medicine Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Carlos O Mendivil
- Universidad de los Andes, School of Medicine, Carrera 7 No 116-05, Of 413, Bogotá, 110111, Colombia. .,Endocrinology Section, Internal Medicine Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia.
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20
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Nguyen-Thu H, Ohyama Y, Taketomi-Takahashi A, Nguyen-Cong T, Sumiyoshi H, Nakamura T, Kurabayashi M, Tsushima Y. Pulmonary Artery Diameter (PAD) and the Pulmonary Artery to Aorta Ratio (PAD/AAD) as Assessed by Non-contrast Cardiac CT: The Association with Left Ventricular (LV) Remodeling and the LV Function. Intern Med 2022; 61:1809-1815. [PMID: 34776495 PMCID: PMC9259815 DOI: 10.2169/internalmedicine.8605-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/28/2021] [Indexed: 11/14/2022] Open
Abstract
Objective Dilatation of the pulmonary artery itself (PAD: pulmonary artery diameter) or in relation to the ascending aorta (PAD/AAD: pulmonary artery diameter to ascending aortic diameter ratio) has been reported to be associated with pulmonary hypertension and with a prognostic outcome of either heart failure or cardiovascular events. We herein aimed to assess the correlations between pulmonary hypertension-related parameters PAD (or PAD/AAD) and left ventricular (LV) remodeling and LV function. Methods This retrospective study included 193 patients (ages: 67±12 years) who underwent both coronary CT angiography (CCTA) and echocardiography. The PAD and the AAD were measured on a transaxial non-contrast CCTA image at the level of the pulmonary artery bifurcation. Left ventricular mass (LVM), relative wall thickness ratio (RWT), left ventricular ejection fraction (LVEF), left atrial volume (LAV), and early mitral inflow velocity to mitral annular early diastolic velocity ratio (E/e') were evaluated by echocardiography. The relationships between PAD (or PAD/AAD) and echocardiography parameters were assessed, and adjusted for the demographic data and cardiovascular disease (CVD) risk factors by a multivariable linear regression analysis. Results PAD (mean±SD: 2.6±0.4 cm) was positively correlated with LVM (r=0.34, p<0.001), LAV (r=0.41, p<0.001), and E/e' (r=0.29, p<0.001). PAD/AAD (mean±SD: 0.76±0.12 cm) was positively correlated with LVM (r=0.12, p=0.09), LAV (r=0.24, p<0.001), and E/e' (r=0.15, p=0.04). These correlations remained significant after adjusting for demographic data and CVD risk factors. PAD (or PAD/AAD) did not correlate with LVEF or RWT (p>0.05). Conclusion Greater PAD or PAD/AAD is significantly associated with LV remodeling and an impaired LV function.
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Affiliation(s)
- Huong Nguyen-Thu
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Japan
- Department of Radiology, Bach Mai Hospital, Viet Nam
| | - Yoshiaki Ohyama
- Clinical Investigation and Research Unit, Gunma University Hospital, Japan
| | - Ayako Taketomi-Takahashi
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Japan
| | - Tien Nguyen-Cong
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Japan
- Department of Radiology, Bach Mai Hospital, Viet Nam
| | - Hisako Sumiyoshi
- Clinical Investigation and Research Unit, Gunma University Hospital, Japan
| | - Tetsuya Nakamura
- Clinical Investigation and Research Unit, Gunma University Hospital, Japan
| | - Masahiko Kurabayashi
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Japan
| | - Yoshito Tsushima
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Japan
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21
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Chowdhary A, Thirunavukarasu S, Jex N, Coles L, Bowers C, Sengupta A, Swoboda P, Witte K, Cubbon R, Xue H, Kellman P, Greenwood J, Plein S, Levelt E. Coronary microvascular function and visceral adiposity in patients with normal body weight and type 2 diabetes. Obesity (Silver Spring) 2022; 30:1079-1090. [PMID: 35357083 PMCID: PMC9314597 DOI: 10.1002/oby.23413] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study sought to assess whether diabetes affects coronary microvascular function in individuals with normal body weight. METHODS Seventy-five participants (30 patients with type 2 diabetes [T2D] who were overweight [O-T2D], 15 patients with T2D who were lean [LnT2D], 15 healthy volunteers who were lean [LnHV], and 15 healthy volunteers who were overweight [O-HV]) without established cardiovascular disease were recruited. Participants underwent magnetic resonance imaging for assessment of subcutaneous, epicardial, and visceral adipose tissue areas, adenosine stress myocardial blood flow (MBF), and cardiac structure and function. RESULTS Stress MBF was reduced only in the O-T2D group (mean [SD], LnHV = 2.07 [0.47] mL/g/min, O-HV = 2.08 [0.42] mL/g/min, LnT2D = 2.16 [0.36] mL/g/min, O-T2D = 1.60 [0.28] mL/g/min; p ≤ 0.0001). Accumulation of visceral fat was evident in the LnT2D group at similar levels to the O-HV group (LnHV = 127 [53] cm2 , O-HV = 181 [60] cm2 , LnT2D = 182 [99] cm2 , O-T2D = 288 [72] cm2 ; p < 0.0001). Only the O-T2D group showed reductions in left ventricular ejection fraction (LnHV = 63% [4%], O-HV = 63% [4%], LnT2D = 60% [5%], O-T2D = 58% [6%]; p = 0.0008) and global longitudinal strain (LnHV = -15.1% [3.1%], O-HV= -15.2% [3.7%], LnT2D = -13.4% [2.7%], O-T2D = -11.1% [2.8%]; p = 0.002) compared with both control groups. CONCLUSIONS Patients with T2D and normal body weight do not show alterations in global stress MBF, but they do show significant increases in visceral adiposity. Patients with T2D who were overweight and had no prior cardiovascular disease showed an increase in visceral adiposity and significant reductions in stress MBF.
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Affiliation(s)
- Amrit Chowdhary
- Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science DepartmentLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Sharmaine Thirunavukarasu
- Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science DepartmentLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Nicholas Jex
- Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science DepartmentLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Lauren Coles
- Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science DepartmentLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Charles Bowers
- Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science DepartmentLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Anshuman Sengupta
- Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science DepartmentLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Peter Swoboda
- Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science DepartmentLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Klaus Witte
- Discovery and Translational Science DepartmentLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Richard Cubbon
- Discovery and Translational Science DepartmentLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Hui Xue
- National Heart, Lung, and Blood InstituteNational Institutes of HealthDepartment of Health and Human ServicesBethesdaMarylandUSA
| | - Peter Kellman
- National Heart, Lung, and Blood InstituteNational Institutes of HealthDepartment of Health and Human ServicesBethesdaMarylandUSA
| | - John Greenwood
- Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science DepartmentLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Sven Plein
- Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science DepartmentLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Eylem Levelt
- Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science DepartmentLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
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22
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Aluja D, Delgado-Tomás S, Ruiz-Meana M, Barrabés JA, Inserte J. Calpains as Potential Therapeutic Targets for Myocardial Hypertrophy. Int J Mol Sci 2022; 23:ijms23084103. [PMID: 35456920 PMCID: PMC9032729 DOI: 10.3390/ijms23084103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/26/2022] [Accepted: 04/06/2022] [Indexed: 11/25/2022] Open
Abstract
Despite advances in its treatment, heart failure remains a major cause of morbidity and mortality, evidencing an urgent need for novel mechanism-based targets and strategies. Myocardial hypertrophy, caused by a wide variety of chronic stress stimuli, represents an independent risk factor for the development of heart failure, and its prevention constitutes a clinical objective. Recent studies performed in preclinical animal models support the contribution of the Ca2+-dependent cysteine proteases calpains in regulating the hypertrophic process and highlight the feasibility of their long-term inhibition as a pharmacological strategy. In this review, we discuss the existing evidence implicating calpains in the development of cardiac hypertrophy, as well as the latest advances in unraveling the underlying mechanisms. Finally, we provide an updated overview of calpain inhibitors that have been explored in preclinical models of cardiac hypertrophy and the progress made in developing new compounds that may serve for testing the efficacy of calpain inhibition in the treatment of pathological cardiac hypertrophy.
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Affiliation(s)
- David Aluja
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (D.A.); (S.D.-T.); (M.R.-M.); (J.A.B.)
| | - Sara Delgado-Tomás
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (D.A.); (S.D.-T.); (M.R.-M.); (J.A.B.)
| | - Marisol Ruiz-Meana
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (D.A.); (S.D.-T.); (M.R.-M.); (J.A.B.)
- Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - José A. Barrabés
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (D.A.); (S.D.-T.); (M.R.-M.); (J.A.B.)
- Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Javier Inserte
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain; (D.A.); (S.D.-T.); (M.R.-M.); (J.A.B.)
- Centro de Investigación en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-934894038
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23
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He Y, Ling Y, Guo W, Li Q, Yu S, Huang H, Zhang R, Gong Z, Liu J, Mo L, Yi S, Lai D, Yao Y, Liu J, Chen J, Liu Y, Chen S. Prevalence and Prognosis of HFimpEF Developed From Patients With Heart Failure With Reduced Ejection Fraction: Systematic Review and Meta-Analysis. Front Cardiovasc Med 2021; 8:757596. [PMID: 34901217 PMCID: PMC8655693 DOI: 10.3389/fcvm.2021.757596] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/15/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Heart failure with improved ejection fraction (HFimpEF) is classified as a new type of heart failure, and its prevalence and prognosis are not consistent in previous studies. There is no systematic review and meta-analysis regarding the prevalence and prognosis of the HFimpEF. Method: A systematic search was performed in MEDLINE, EMBASE, and Cochrane Library from inception to May 22, 2021 (PROSPERO registration: CRD42021260422). Studies were included for analysis if the prognosis of mortality or hospitalization were reported in HFimpEF or in patients with heart failure with recovered ejection fraction (HFrecEF). The primary outcome was all-cause mortality. Cardiac hospitalization, all-cause hospitalization, and composite events of mortality and hospitalization were considered as secondary outcomes. Result: Nine studies consisting of 9,491 heart failure patients were eventually included. During an average follow-up of 3.8 years, the pooled prevalence of HFimpEF was 22.64%. HFimpEF had a lower risk of mortality compared with heart failure patients with reduced ejection fraction (HFrEF) (adjusted HR: 0.44, 95% CI: 0.33-0.60). HFimpEF was also associated with a lower risk of cardiac hospitalization (HR: 0.40, 95% CI: 0.20-0.82) and the composite endpoint of mortality and hospitalization (HR: 0.56, 95% CI: 0.44-0.73). Compared with patients with preserved ejection fraction (HFpEF), HFimpEF was associated with a moderately lower risk of mortality (HR: 0.42, 95% CI: 0.32-0.55) and hospitalization (HR: 0.73, 95% CI: 0.58-0.92). Conclusion: Around 22.64% of patients with HFrEF would be treated to become HFimpEF, who would then obtain a 56% decrease in mortality risk. Meanwhile, HFimpEF is associated with lower heart failure hospitalization. Further studies are required to explore how to promote left ventricular ejection fraction improvement and improve the prognosis of persistent HFrEF in patients. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021260422, identifier: CRD42021260422.
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Affiliation(s)
- Yibo He
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yihang Ling
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wei Guo
- Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qiang Li
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Sijia Yu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Haozhang Huang
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Rongting Zhang
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Zhiwen Gong
- Department of Cardiology, First People's Hospital of Kashgar Prefecture, Kashgar, China
- Department of Cardiology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jiaxuan Liu
- Department of Cardiology, First People's Hospital of Kashgar Prefecture, Kashgar, China
- Department of Cardiology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Liyi Mo
- Department of Cardiology, First People's Hospital of Kashgar Prefecture, Kashgar, China
- Department of Cardiology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Shixin Yi
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Disheng Lai
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Younan Yao
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jin Liu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jiyan Chen
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yong Liu
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shiqun Chen
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Zhang X, Zheng C, Gao Z, Wang L, Chen C, Zheng Y, Meng Y. PKM2 promotes angiotensin-II-induced cardiac remodelling by activating TGF-β/Smad2/3 and Jak2/Stat3 pathways through oxidative stress. J Cell Mol Med 2021; 25:10711-10723. [PMID: 34687136 PMCID: PMC8581335 DOI: 10.1111/jcmm.17007] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 09/24/2021] [Accepted: 10/04/2021] [Indexed: 12/30/2022] Open
Abstract
Hypertensive cardiac remodelling is a common cause of heart failure. However, the molecular mechanisms regulating cardiac remodelling remain unclear. Pyruvate kinase isozyme type M2 (PKM2) is a key regulator of the processes of glycolysis and oxidative phosphorylation, but the roles in cardiac remodelling remain unknown. In the present study, we found that PKM2 was enhanced in angiotensin II (Ang II)-treated cardiac fibroblasts and hypertensive mouse hearts. Suppression of PKM2 by shikonin alleviated cardiomyocyte hypertrophy and fibrosis in Ang-II-induced cardiac remodelling in vivo. Furthermore, inhibition of PKM2 markedly attenuated the function of cardiac fibroblasts including proliferation, migration and collagen synthesis in vitro. Mechanistically, suppression of PKM2 inhibited cardiac remodelling by suppressing TGF-β/Smad2/3, Jak2/Stat3 signalling pathways and oxidative stress. Together, this study suggests that PKM2 is an aggravator in Ang-II-mediated cardiac remodelling. The negative modulation of PKM2 may provide a promising therapeutic approach for hypertensive cardiac remodelling.
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Affiliation(s)
- Xiyu Zhang
- Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Diseases, Beijing Lab for Cardiovascular Precision Medicine, Department of Pathology, Capital Medical University, Beijing, China
| | - Cuiting Zheng
- Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Diseases, Beijing Lab for Cardiovascular Precision Medicine, Department of Pathology, Capital Medical University, Beijing, China
| | - Zhenqiang Gao
- Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Diseases, Beijing Lab for Cardiovascular Precision Medicine, Department of Pathology, Capital Medical University, Beijing, China
| | - Lingling Wang
- Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Chen Chen
- China-America Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Yuanyuan Zheng
- Department of Pharmacology, Capital Medical University, Beijing, China
| | - Yan Meng
- Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Diseases, Beijing Lab for Cardiovascular Precision Medicine, Department of Pathology, Capital Medical University, Beijing, China
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25
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Hebbard C, Lee B, Katare R, Garikipati VNS. Diabetes, Heart Failure, and COVID-19: An Update. Front Physiol 2021; 12:706185. [PMID: 34721055 PMCID: PMC8554151 DOI: 10.3389/fphys.2021.706185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/03/2021] [Indexed: 01/08/2023] Open
Abstract
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a pandemic by the WHO in March 2020. As of August 2021, more than 220 countries have been affected, accounting for 211,844,613 confirmed cases and 4,432,802 deaths worldwide. A new delta variant wave is sweeping through the globe. While previous reports consistently have demonstrated worse prognoses for patients with existing cardiovascular disease than for those without, new studies are showing a possible link between SARS-CoV-2 infection and an increased incidence of new-onset heart disease and diabetes, regardless of disease severity. If this trend is true, with hundreds of millions infected, the disease burden could portend a potentially troubling increase in heart disease and diabetes in the future. Focusing on heart failure in this review, we discuss the current data at the intersection of COVID, heart failure, and diabetes, from clinical findings to potential mechanisms of how SARS-CoV-2 infection could increase the incidence of those pathologies. Additionally, we posit questions for future research areas regarding the significance for patient care.
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Affiliation(s)
- Carleigh Hebbard
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Brooke Lee
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Rajesh Katare
- Department of Physiology–HeartOtago, University of Otago, Dunedin, New Zealand
| | - Venkata Naga Srikanth Garikipati
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United States
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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26
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Cardiac computed tomography for left ventricular remodeling assessment: does it mean echocardiography moves for the past? J Hypertens 2021; 39:602-603. [PMID: 33649280 DOI: 10.1097/hjh.0000000000002741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Malev E, Luneva E, Reeva S, Timofeev E, Omelchenko M, Zemtsovsky E. Circulating transforming growth factor-beta levels and myocardial remodeling in young adults with mitral valve prolapse patients. PROGRESS IN PEDIATRIC CARDIOLOGY 2021. [DOI: 10.1016/j.ppedcard.2021.101347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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28
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Metformin Attenuates Postinfarction Myocardial Fibrosis and Inflammation in Mice. Int J Mol Sci 2021; 22:ijms22179393. [PMID: 34502314 PMCID: PMC8430638 DOI: 10.3390/ijms22179393] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/22/2021] [Accepted: 08/26/2021] [Indexed: 11/17/2022] Open
Abstract
Diabetes is a major risk factor for the development of cardiovascular disease with a higher incidence of myocardial infarction. This study explores the role of metformin, a first-line antihyperglycemic agent, in postinfarction fibrotic and inflammatory remodeling in mice. Three-month-old C57BI/6J mice were submitted to 30 min cardiac ischemia followed by reperfusion for 14 days. Intraperitoneal treatment with metformin (5 mg/kg) was initiated 15 min after the onset of reperfusion and maintained for 14 days. Real-time PCR was used to determine the levels of COL3A1, αSMA, CD68, TNF-α and IL-6. Increased collagen deposition and infiltration of macrophages in heart tissues are associated with upregulation of the inflammation-associated genes in mice after 14 days of reperfusion. Metformin treatment markedly reduced postinfarction fibrotic remodeling and CD68-positive cell population in mice. Moreover, metformin resulted in reduced expression of COL3A1, αSMA and CD68 after 14 days of reperfusion. Taken together, these results open new perspectives for the use of metformin as a drug that counteracts adverse myocardial fibroticand inflammatory remodeling after MI.
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29
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Nie C, Zou R, Pan S, A R, Gao Y, Yang H, Bai J, Xi S, Wang X, Hong X, Yang W. Hydrogen gas inhalation ameliorates cardiac remodelling and fibrosis by regulating NLRP3 inflammasome in myocardial infarction rats. J Cell Mol Med 2021; 25:8997-9010. [PMID: 34402164 PMCID: PMC8435412 DOI: 10.1111/jcmm.16863] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/19/2021] [Accepted: 08/05/2021] [Indexed: 12/14/2022] Open
Abstract
It is noteworthy that prolonged cardiac structural changes and excessive fibrosis caused by myocardial infarction (MI) seriously interfere with the treatment of heart failure in clinical practice. Currently, there are no effective and practical means of either prevention or treatment. Thus, novel therapeutic approaches are critical for the long‐term quality of life of individuals with myocardial ischaemia. Herein, we aimed to explore the protective effect of H2, a novel gas signal molecule with anti‐oxidative stress and anti‐inflammatory effects, on cardiac remodelling and fibrosis in MI rats, and to explore its possible mechanism. First, we successfully established MI model rats, which were then exposed to H2 inhalation with 2% concentration for 28 days (3 hours/day). The results showed that hydrogen gas can significantly improve cardiac function and reduce the area of cardiac fibrosis. In vitro experiments further proved that H2 can reduce the hypoxia‐induced damage to cardiomyocytes and alleviate angiotensin II‐induced migration and activation of cardiac fibroblasts. In conclusion, herein, we illustrated for the first time that inhalation of H2 ameliorates myocardial infarction‐induced cardiac remodelling and fibrosis in MI rats and exert its protective effect mainly through inhibiting NLRP3‐mediated pyroptosis.
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Affiliation(s)
- Chaoqun Nie
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Rentong Zou
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shuang Pan
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Rong A
- NHC and CAMS Key Laboratory of Molecular Probe and Targeted Theranostics, Molecular Imaging Research Center (MIRC, Harbin Medical University, Harbin, China
| | - Yunan Gao
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hongxiao Yang
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Juncai Bai
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shuiqing Xi
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xue Wang
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xiaojian Hong
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Yang
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
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30
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Yao X, Zhang L, Zhao G, Pang H, Li T, Han X, Liu M. Predictors for intraoperative heart failure in children undergoing foreign-body removal. Medicine (Baltimore) 2021; 100:e26626. [PMID: 34260551 PMCID: PMC8284771 DOI: 10.1097/md.0000000000026626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 05/11/2021] [Accepted: 05/27/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT This study aimed to determine the predictors for intraoperative heart failure (HF) in children undergoing foreign-body removal. The clinical data of all children with tracheobronchial foreign-body aspiration admitted to the First, Second, and Fourth Affiliated Hospitals of Harbin Medical University between January 1996 and September 2018 were analyzed. The variables with significant difference in univariate analysis were involved into the multivariate Logistic model to determine the predictors for intraoperative tachycardia. In total, 300 tracheobronchial foreign-body aspiration children were eligible for the study, among whom 60 cases (20%) suffered from HF during the operation. Between the children HF and those without HF, the differences were pronounced in history of allergy, history of asthma, congenital heart disease, preoperative respiratory infection, retention time of foreign bodies, duration of operation, and poor anesthesia effect (P < .05). Multivariate analysis results showed that history of allergy (odds ratio [OR]: 1.395, 95% confidence interval [95% CI]: 1.202-1.620, P < .001), congenital heart disease [OR: 3.071, 95% CI: 1.141-8.264, P < .001], preoperative respiratory infection [OR: 2.345, 95% CI: 1.027-5.355, P = .043], retention time of foreign bodies [OR: 1.013, 95% CI: 1.010-1.016, P < .001], duration of operation [OR: 1.030, 95% CI: 1.027-1.033, P < .001], and poor anesthesia effect [OR: 1.125, 95% CI: 1.117-1.134, P < .001] were identified as the influencing factors for intraoperative HF. In conclusions, for children undergoing foreign-body removal, history of allergy, congenital heart disease, preoperative respiratory infection, retention time of foreign bodies, duration of operation, and poor anesthesia effect are associated with an increased risk of intraoperative HF.
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Affiliation(s)
- Xianyi Yao
- Department of Otolaryngology, The Fourth Affiliated Hospital of Harbin Medical University
| | - Lei Zhang
- Department of Otolaryngology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang
| | - Guangyu Zhao
- Department of Otolaryngology, Zhalantun People's Hospital, Zhalantun, Inner Mongolia
| | - Haifeng Pang
- Department of Otolaryngology, The Fourth Affiliated Hospital of Harbin Medical University
| | - Tingting Li
- Department of Otolaryngology, The Fourth Affiliated Hospital of Harbin Medical University
| | - Xiao Han
- Department of Otolaryngology, The Fourth Affiliated Hospital of Harbin Medical University
| | - Ming Liu
- Department of Otolaryngology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
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31
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Zhang X, Zheng C, Gao Z, Chen H, Li K, Wang L, Zheng Y, Li C, Zhang H, Gong M, Zhang H, Meng Y. SLC7A11/xCT Prevents Cardiac Hypertrophy by Inhibiting Ferroptosis. Cardiovasc Drugs Ther 2021; 36:437-447. [PMID: 34259984 DOI: 10.1007/s10557-021-07220-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE Systemic hypertension may induce adverse hypertrophy of the left cardiac ventricle. Pathological cardiac hypertrophy is a common cause of heart failure. We investigated the significance of ferroptosis repressor xCT in hypertrophic cardiomyopathy. METHODS xCT expression in angiotensin II (Ang II)-treated mouse hearts and rat cardiomyocytes was determined using qRT-PCR and Western blotting. Cardiac hypertrophy was induced by Ang II infusion in xCT knockout mice and their wildtype counterparts. Blood pressure, cardiac pump function, and pathological changes of cardiac remodeling were analyzed in these mice. Cell death, oxidative stress, and xCT-mediated ferroptosis were examined in Ang II-treated rat cardiomyocytes. RESULTS After Ang II infusion, xCT was downregulated at day 1 but upregulated at day 14 at both mRNA and protein levels. It was also decreased in Ang II-treated cardiomyocytes, but not in cardiofibroblasts. Inhibition of xCT exacerbated cardiomyocyte hypertrophy and boosted the levels of ferroptosis biomarkers Ptgs2, malondialdehyde, and reactive oxygen species induced by Ang II, while overexpression of xCT opposed these detrimental effects. Furthermore, knockout of xCT aggravated Ang II-mediated mouse cardiac fibrosis, hypertrophy, and dysfunction. Ferrostatin-1, a ferroptosis inhibitor, alleviated the exacerbation of cardiomyocyte hypertrophy caused by inhibiting xCT in cultured rat cells or ablating xCT in mice. CONCLUSION xCT acts as a suppressor in Ang II-mediated cardiac hypertrophy by blocking ferroptosis. Positive modulation of xCT may therefore represent a novel therapeutic approach against cardiac hypertrophic diseases.
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Affiliation(s)
- Xiyu Zhang
- Department of Pathology, Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Diseases, Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, Beijing, China
| | - Cuiting Zheng
- Department of Pathology, Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Diseases, Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, Beijing, China
| | - Zhenqiang Gao
- Department of Pathology, Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Diseases, Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, Beijing, China
| | - Hongyu Chen
- State Key Laboratory of Medical Molecular Biology, Department of Physiology, Institute of Basic Medical Sciences and School of Basic Medicine, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Kai Li
- State Key Laboratory of Medical Molecular Biology, Department of Physiology, Institute of Basic Medical Sciences and School of Basic Medicine, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Lingling Wang
- Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yuanyuan Zheng
- Department of Pharmacology, Capital Medical University, Beijing, China
| | - Chunjia Li
- Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China
| | - Hongjia Zhang
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Beijing Aortic Disease Center, Beijing Laboratory for Cardiovascular Precision Medicine, and Beijing Engineering Research Center of Vascular Prostheses, Capital Medical University, Beijing, China
| | - Ming Gong
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Beijing Aortic Disease Center, Beijing Laboratory for Cardiovascular Precision Medicine, and Beijing Engineering Research Center of Vascular Prostheses, Capital Medical University, Beijing, China
| | - Hongbing Zhang
- State Key Laboratory of Medical Molecular Biology, Department of Physiology, Institute of Basic Medical Sciences and School of Basic Medicine, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
| | - Yan Meng
- Department of Pathology, Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular Diseases, Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, Beijing, China.
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32
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Decoding the complexity of circular RNAs in cardiovascular disease. Pharmacol Res 2021; 171:105766. [PMID: 34271160 DOI: 10.1016/j.phrs.2021.105766] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/23/2021] [Accepted: 07/09/2021] [Indexed: 12/23/2022]
Abstract
Circular RNAs (circRNAs) are a new class of covalently circularized noncoding RNAs widely expressed in the human heart. Emerging evidence suggests they have a regulatory role in a variety of cardiovascular diseases (CVDs). This review's current focus includes our understanding of circRNA classification, biogenesis, function, stability, degradation mechanisms, and their roles in various cardiovascular disease conditions. Our knowledge of circRNA, the relatively recent member of the noncoding RNA family, is still in its infancy; however, recent literature proposes circRNAs may be promising targets for the understanding and treatment of CVD.
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Wang K, Youngson E, Bakal JA, Thomas J, McAlister FA, Oudit GY. Cardiac reverse remodelling and health status in patients with chronic heart failure. ESC Heart Fail 2021; 8:3106-3118. [PMID: 34002942 PMCID: PMC8318501 DOI: 10.1002/ehf2.13417] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/10/2021] [Accepted: 04/30/2021] [Indexed: 12/16/2022] Open
Abstract
AIMS This study aims to assess long-term changes in left ventricular ejection fraction (LVEF) together with echocardiographic markers of cardiac remodelling and their association with prognosis and patient-reported quality of life (QoL). METHODS AND RESULTS We conducted a retrospective analysis of serial echocardiograms performed between January 2009 and December 2019 in 1089 patients (median age 63 years, 71.0% men) enrolled in the Mazankowski Heart Function Clinic Registry who had at least two echocardiograms separated by ≥12 months. We classified the patients into four subgroups by their baseline and LVEF trajectories: persistent heart failure with reduced ejection fraction (persistent HFrEF, n = 364), recovered ejection fraction (HFrecEF, n = 325), transient recovery in ejection fraction (HFtrecEF, n = 117), and preserved ejection fraction (HFpEF, n = 283); 4490 echocardiograms were included in the present analysis, with 4.1 ± 1.8 echocardiograms available per patient during follow-up. Reductions in echocardiographic markers of cardiac remodelling, including LVIDd [adjusted odds ratio (aOR): 2.22, 95% confidence interval (CI) 1.75-2.86], LVIDs (aOR: 2.44, 95% CI 2.00-2.94), left ventricular mass index (aOR: 1.15, 95% CI 1.09-1.22), E/e' ratio (aOR: 1.15, 95% CI 1.02-1.30), left atrial volume index (aOR: 1.10, 95% CI 1.03-1.16), along with an increase in the maximum recommended daily dose of renin-angiotensin system inhibitors (aOR: 1.04, 95% CI 1.01-1.07) and mineralocorticoid-receptor antagonists (aOR: 1.06, 95% CI 1.01-1.11) at 2 years, strongly predicted the HFrecEF classification, which was further sustained at 5 years of follow-up. However, changes in these parameters were mostly absent in patients experiencing only a transient recovery in LVEF (HFtrecEF), closely resembling patients with persistent HFrEF. In the multivariable analysis, HFrecEF patients had lower risk of all-cause mortality alone [adjusted hazard ratio (aHR): 0.46, 95% CI 0.23-0.93], and composite all-cause (aHR: 0.59, 95% CI 0.49-0.73), cardiovascular (aHR: 0.47, 95% CI 0.36-0.61), and heart failure (aHR: 0.50, 95% CI 0.35-0.70) related hospitalizations with mortality than patients with persistent HFrEF. QoL assessed through the shortened Kansas City Cardiomyopathy Questionnaire-12 at the end of follow-up was greater in patients with HFrecEF by 5.2, 12.4, and 9.4 points than persistent HFrEF, HFtrecEF, and HFpEF, respectively. CONCLUSIONS Patients with HFrecEF experienced progressive normalization in echocardiographic markers of cardiac remodelling characterized by reductions in left ventricular dimensions and mass in tandem with reductions in left atrial volume and E/e' ratio, which is associated with better prognosis and QoL.
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Affiliation(s)
- Kaiming Wang
- Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, T6G 2S2, Canada.,Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Erik Youngson
- Alberta Strategy for Patient Oriented Research (SPOR) Unit, University of Alberta, Edmonton, Alberta, Canada
| | - Jeffrey A Bakal
- Alberta Strategy for Patient Oriented Research (SPOR) Unit, University of Alberta, Edmonton, Alberta, Canada
| | - Jissy Thomas
- Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, T6G 2S2, Canada.,Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Finlay A McAlister
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.,Alberta Strategy for Patient Oriented Research (SPOR) Unit, University of Alberta, Edmonton, Alberta, Canada.,Division of General Internal Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Gavin Y Oudit
- Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, T6G 2S2, Canada.,Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
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Khan AA, Al-Omary MS, Collins NJ, Attia J, Boyle AJ. Natural history and prognostic implications of left ventricular end-diastolic pressure in reperfused ST-segment elevation myocardial infarction: an analysis of the thrombolysis in myocardial infarction (TIMI) II randomized controlled trial. BMC Cardiovasc Disord 2021; 21:243. [PMID: 34001032 PMCID: PMC8130170 DOI: 10.1186/s12872-021-02046-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/04/2021] [Indexed: 12/15/2022] Open
Abstract
Background The aim of the current study is to assess the natural history and prognostic value of elevated left ventricular end-diastolic pressure (LVEDP) in patients with ST-segment elevation myocardial infarction (STEMI) after reperfusion with thrombolysis; we utilize data from the Thrombolysis in Myocardial Infarction (TIMI) II study.
Methods A total of 3339 patients were randomized to either an invasive (n = 1681) or a conservative (n = 1658) strategy in the TIMI II study following thrombolysis. To make the current cohort as relevant as possible to modern pharmaco-invasively managed cohorts, patients in the invasive arm with TIMI flow grade ≥ 2 (N = 1201) at initial catheterization are included in the analysis. Of these, 259 patients had a second catheterization prior to hospital discharge, and these were used to define the natural history of LVEDP in reperfused STEMI. Results The median LVEDP for the whole cohort was 18 mmHg (IQR: 12–23). Patients were divided into quartiles by LVEDP measured during the first cardiac catheterization. During a median follow up of 3 (IQR: 2.1–3.2) years, quartile 4 (highest LVEDP) had the highest incidence of mortality and heart failure admissions. In the cohort with paired catheterization data, the LVEDP dropped slightly from 18 mmHg (1QR: 12–22) to 15 mmHg (IQR: 10–20) (p = 0.01) from the first to the pre-hospital discharge catheterization. Conclusions LVEDP remains largely stable during hospitalisation post-STEMI. Elevated LVEDP is a predictor of death and heart failure hospitalization in STEMI patients undergoing successful thrombolysis. Graphic abstract ![]()
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Affiliation(s)
- Arshad A Khan
- Department of Cardiovascular Medicine, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW, 2310, Australia.,The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Mohammed S Al-Omary
- Department of Cardiovascular Medicine, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW, 2310, Australia.,The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Nicholas J Collins
- Department of Cardiovascular Medicine, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW, 2310, Australia.,The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - John Attia
- Department of Cardiovascular Medicine, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW, 2310, Australia.,The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Andrew J Boyle
- Department of Cardiovascular Medicine, John Hunter Hospital, Locked Bag 1, HRMC, Newcastle, NSW, 2310, Australia. .,The University of Newcastle, Newcastle, Australia. .,Hunter Medical Research Institute, Newcastle, Australia.
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35
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Cutugno S, Ingrassia T, Nigrelli V, Pasta S. On the Left Ventricular Remodeling of Patients with Stenotic Aortic Valve: A Statistical Shape Analysis. Bioengineering (Basel) 2021; 8:66. [PMID: 34068270 PMCID: PMC8153107 DOI: 10.3390/bioengineering8050066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/27/2021] [Accepted: 05/12/2021] [Indexed: 12/04/2022] Open
Abstract
The left ventricle (LV) constantly changes its shape and function as a response to pathological conditions, and this process is known as remodeling. In the presence of aortic stenosis (AS), the degenerative process is not limited to the aortic valve but also involves the remodeling of LV. Statistical shape analysis (SSA) offers a powerful tool for the visualization and quantification of the geometrical and functional patterns of any anatomic changes. In this paper, a SSA method was developed to determine shape descriptors of the LV under different degrees of AS and thus to shed light on the mechanistic link between shape and function. A total of n=86 patients underwent computed tomography (CT) for the evaluation of valvulopathy were segmented to obtain the LV surface and then were automatically aligned to a reference template by rigid registrations and transformations. Shape modes of the anatomical LV variation induced by the degree of AS were assessed by principal component analysis (PCA). The first shape mode represented nearly 50% of the total variance of LV shape in our patient population and was mainly associated to a spherical LV geometry. At Pearson's analysis, the first shape mode was positively correlated to both the end-diastolic volume (p<0.01, R=0.814) and end-systolic volume (p<0.01, and R=0.922), suggesting LV impairment in patients with severe AS. A predictive model built with PCA-related shape modes achieved better performance in stratifying the occurrence of adverse events with respect to a baseline model using clinical demographic data as risk predictors. This study demonstrated the potential of SSA approaches to detect the association of complex 3D shape features with functional LV parameters.
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Affiliation(s)
| | - Tommaso Ingrassia
- Dipartimento di Ingegneria (DING), Università degli Studi di Palermo, Viale delle Scienze Ed.8, 90128 Palermo, Italy; (S.C.); (V.N.); (S.P.)
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Valizadeh G, Babapour Mofrad F, Shalbaf A. Parametric-based feature selection via spherical harmonic coefficients for the left ventricle myocardial infarction screening. Med Biol Eng Comput 2021; 59:1261-1283. [PMID: 33983494 DOI: 10.1007/s11517-021-02372-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 04/27/2021] [Indexed: 11/30/2022]
Abstract
Computer-aided diagnosis (CAD) of heart diseases using machine learning techniques has recently received much attention. In this study, we present a novel parametric-based feature selection method using the three-dimensional spherical harmonic (SHs) shape descriptors of the left ventricle (LV) for intelligent myocardial infarction (MI) classification. The main hypothesis is that the SH coefficients of the parameterized endocardial shapes in MI patients are recognizable and distinguishable from healthy subjects. The SH parameterization, expansion, and registration of the LV endocardial shapes were performed, then parametric-based features were extracted. The proposed method performance was investigated by varying considered phases (i.e., the end-systole (ES) or the end-diastole (ED) frames), the spatial alignment procedures based on three modes (i.e., the center of the apical (CoA), the center of mass (CoM), and the center of the basal (CoB)), and considered orders of SH coefficients. After applying principal component analysis (PCA) on the feature vectors, support vector machine (SVM), K-nearest neighbors (K-NN), and random forest (RF) were trained and tested using the leave-one-out cross-validation (LOOCV). The proposed method validation was performed via a dataset containing healthy and MI subjects selected from the automated cardiac diagnosis challenge (ACDC) database. The promising results show the effectiveness of the proposed classification model. SVM reached the best performance with accuracy, sensitivity, specificity, and F-score of 97.50%, 95.00%, 100.00%, and 97.56%, respectively, using the introduced optimum feature set. This study demonstrates the robustness of combining the SH coefficients and machine learning techniques. We also quantify and notably highlight the contribution of different parameters in the classification and finally introduce an optimal feature set with maximum discriminant strength for the MI classification task. Moreover, the obtained results confirm that the proposed method performs more accurately than conventional point-based methods and also the current start-of-the-art, i.e., clinical measures. We showed our method's generalizability using employing it in dilated cardiomyopathy (DCM) detection and achieving promising results too. Parametric-based feature selection via spherical harmonics coefficients for the left ventricle myocardial infarction screening.
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Affiliation(s)
- Gelareh Valizadeh
- Department of Medical Radiation Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Farshid Babapour Mofrad
- Department of Medical Radiation Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran.
| | - Ahmad Shalbaf
- Department of Biomedical Engineering and Medical Physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Raisi-Estabragh Z, Kenawy AAM, Aung N, Cooper J, Munroe PB, Harvey NC, Petersen SE, Khanji MY. Variation in left ventricular cardiac magnetic resonance normal reference ranges: systematic review and meta-analysis. Eur Heart J Cardiovasc Imaging 2021; 22:494-504. [PMID: 32460308 PMCID: PMC8081427 DOI: 10.1093/ehjci/jeaa089] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/09/2020] [Accepted: 04/09/2020] [Indexed: 12/29/2022] Open
Abstract
AIMS To determine population-related and technical sources of variation in cardiac magnetic resonance (CMR) reference ranges for left ventricular (LV) quantification through a formal systematic review and meta-analysis. METHODS AND RESULTS This study is registered with the International Prospective Register of Systematic Reviews (CRD42019147161). Relevant studies were identified through electronic searches and assessed by two independent reviewers based on predefined criteria. Fifteen studies comprising 2132 women and 1890 men aged 20-91 years are included in the analysis. Pooled LV reference ranges calculated using random effects meta-analysis with inverse variance weighting revealed significant differences by age, sex, and ethnicity. Men had larger LV volumes and higher LV mass than women [LV end-diastolic volume (mean difference = 6.1 mL/m2, P-value = 0.014), LV end-systolic volume (MD = 4 mL/m2, P-value = 0.033), LV mass (mean difference = 12 g/m2, P-value = 7.8 × 10-9)]. Younger individuals had larger LV end-diastolic volumes than older ages (20-40 years vs. ≥65 years: women MD = 14.0 mL/m2, men MD = 14.7 mL/m2). East Asians (Chinese, Korean, Singaporean-Chinese, n = 514) had lower LV mass than Caucasians (women: MD = 6.4 g/m2, P-value = 0.016; men: MD = 9.8 g/m2, P-value = 6.7 × 10-5). Between-study heterogeneity was high for all LV parameters despite stratification by population-related factors. Sensitivity analyses identified differences in contouring methodology, magnet strength, and post-processing software as potential sources of heterogeneity. CONCLUSION There is significant variation between CMR normal reference ranges due to multiple population-related and technical factors. Whilst there is need for population-stratified reference ranges, limited sample sizes and technical heterogeneity precludes derivation of meaningful unified ranges from existing reports. Wider representation of different populations and standardization of image analysis is urgently needed to establish such reference distributions.
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Affiliation(s)
- Zahra Raisi-Estabragh
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
| | - Asmaa A M Kenawy
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
| | - Nay Aung
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
| | - Jackie Cooper
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Patricia B Munroe
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit (MRCLEU), Tremona Rd, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
| | - Mohammed Y Khanji
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
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Kabir R, Sinha P, Mishra S, Ebenebe OV, Taube N, Oeing CU, Keceli G, Chen R, Paolocci N, Rule A, Kohr MJ. Inorganic arsenic induces sex-dependent pathological hypertrophy in the heart. Am J Physiol Heart Circ Physiol 2021; 320:H1321-H1336. [PMID: 33481702 PMCID: PMC8260381 DOI: 10.1152/ajpheart.00435.2020] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 01/17/2023]
Abstract
Arsenic exposure though drinking water is widespread and well associated with adverse cardiovascular outcomes, yet the pathophysiological mechanisms by which iAS induces these effects are largely unknown. Recently, an epidemiological study in an American population with a low burden of cardiovascular risk factors found that iAS exposure was associated with altered left ventricular geometry. Considering the possibility that iAS directly induces cardiac remodeling independently of hypertension, we investigated the impact of an environmentally relevant iAS exposure on the structure and function of male and female hearts. Adult male and female C56BL/6J mice were exposed to 615 μg/L iAS for 8 wk. Males exhibited increased systolic blood pressure via tail cuff photoplethysmography, left ventricular wall thickening via transthoracic echocardiography, and increased plasma atrial natriuretic peptide via enzyme immunoassay. RT-qPCR revealed increased myocardial RNA transcripts of Acta1, Myh7, and Nppa and decreased Myh6, providing evidence of pathological hypertrophy in the male heart. Similar changes were not detected in females, and nitric oxide-dependent mechanisms of cardioprotection in the heart appeared to remain intact. Further investigation found that Rcan1 was upregulated in male hearts and that iAS activated NFAT in HEK-293 cells via luciferase assay. Interestingly, iAS induced similar hypertrophic gene expression changes in neonatal rat ventricular myocytes, which were blocked by calcineurin inhibition, suggesting that iAS may induce pathological cardiac hypertrophy in part by targeting the calcineurin-NFAT pathway. As such, these results highlight iAS exposure as an independent cardiovascular risk factor and provide biological impetus for its removal from human consumption.NEW & NOTEWORTHY This investigation provides the first mechanistic link between an environmentally relevant dose of inorganic arsenic (iAS) and pathological hypertrophy in the heart. By demonstrating that iAS exposure may cause pathological cardiac hypertrophy not only by increasing systolic blood pressure but also by potentially activating calcineurin-nuclear factor of activated T cells and inducing fetal gene expression, these results provide novel mechanistic insight into the theat of iAS exposure to the heart, which is necessary to identify targets for medical and public health intervention.
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MESH Headings
- Animals
- Arsenites/toxicity
- Calcineurin/metabolism
- Female
- Gene Expression Regulation
- HEK293 Cells
- Humans
- Hypertrophy, Left Ventricular/chemically induced
- Hypertrophy, Left Ventricular/metabolism
- Hypertrophy, Left Ventricular/pathology
- Hypertrophy, Left Ventricular/physiopathology
- Isolated Heart Preparation
- Male
- Mice, Inbred C57BL
- Myocytes, Cardiac/drug effects
- Myocytes, Cardiac/metabolism
- Myocytes, Cardiac/pathology
- NFATC Transcription Factors/metabolism
- Sex Factors
- Signal Transduction
- Sodium Compounds/toxicity
- Time Factors
- Ventricular Function, Left/drug effects
- Ventricular Remodeling/drug effects
- Water Pollutants, Chemical/toxicity
- Mice
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Affiliation(s)
- Raihan Kabir
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Prithvi Sinha
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Sumita Mishra
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Obialunanma V Ebenebe
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nicole Taube
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Chistian U Oeing
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gizem Keceli
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rui Chen
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nazareno Paolocci
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Ana Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Mark J Kohr
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Raisi-Estabragh Z, Harvey NC, Neubauer S, Petersen SE. Cardiovascular magnetic resonance imaging in the UK Biobank: a major international health research resource. Eur Heart J Cardiovasc Imaging 2021; 22:251-258. [PMID: 33164079 PMCID: PMC7899275 DOI: 10.1093/ehjci/jeaa297] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2020] [Indexed: 12/12/2022] Open
Abstract
The UK Biobank (UKB) is a health research resource of major international importance, incorporating comprehensive characterization of >500 000 men and women recruited between 2006 and 2010 from across the UK. There is prospective tracking of health outcomes for all participants through linkages with national cohorts (death registers, cancer registers, electronic hospital records, and primary care records). The dataset has been enhanced with the UKB imaging study, which aims to scan a subset of 100 000 participants. The imaging protocol includes magnetic resonance imaging of the brain, heart, and abdomen, carotid ultrasound, and whole-body dual X-ray absorptiometry. Since its launch in 2015, over 48 000 participants have completed the imaging study with scheduled completion in 2023. Repeat imaging of 10 000 participants has been approved and commenced in 2019. The cardiovascular magnetic resonance (CMR) scan provides detailed assessment of cardiac structure and function comprising bright blood anatomic assessment (sagittal, coronal, and axial), left and right ventricular cine images (long and short axes), myocardial tagging, native T1 mapping, aortic flow, and imaging of the thoracic aorta. The UKB is an open access resource available to health researchers across all scientific disciplines from both academia and industry with no preferential access or exclusivity. In this paper, we consider how we may best utilize the UKB CMR data to advance cardiovascular research and review notable achievements to date.
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Affiliation(s)
- Zahra Raisi-Estabragh
- William Harvey Research Institute, Centre for Advanced Cardiovascular Imaging, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, Department of Cardiac Imaging, St. Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, OX3 9DU, UK
| | - Steffen E Petersen
- William Harvey Research Institute, Centre for Advanced Cardiovascular Imaging, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, Department of Cardiac Imaging, St. Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
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40
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Lorbeer R, Rospleszcz S, Schlett CL, Rado SD, Thorand B, Meisinger C, Rathmann W, Heier M, Vasan RS, Bamberg F, Peters A, Lieb W. Association of antecedent cardiovascular risk factor levels and trajectories with cardiovascular magnetic resonance-derived cardiac function and structure. J Cardiovasc Magn Reson 2021; 23:2. [PMID: 33390171 PMCID: PMC7780638 DOI: 10.1186/s12968-020-00698-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 12/09/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The association of longitudinal trajectories of cardiovascular risk factors with cardiovascular magnetic resonance (CMR)-measures of cardiac structure and function in the community is not well known. Therefore we aimed to relate risk factor levels from different examination cycles to CMR-measures of the left ventricle (LV) and right ventricle in a population-based cohort. METHODS We assessed conventional cardiovascular disease risk factors in 349 participants (143 women; aged 25-59 years) at three examination cycles (Exam 1 [baseline], at Exam 2 [7-years follow-up] and at Exam 3 [14-years follow-up]) of the KORA S4 cohort and related single-point measurements of individual risk factors and longitudinal trajectories of these risk factors to various CMR-measures obtained at Exam 3. RESULTS High levels of diastolic blood pressure, waist circumference, and LDL-cholesterol at the individual exams were associated with worse cardiac function and structure. Trajectory clusters representing higher levels of the individual risk factors were associated with worse cardiac function and structure compared to low risk trajectory clusters of individual risk factors. Multivariable (combining different risk factors) trajectory clusters were associated with different cardiac parameters in a graded fashion (e.g. decrease of LV stroke volume for middle risk cluster β = - 4.91 ml/m2, 95% CI - 7.89; - 1.94, p < 0.01 and high risk cluster β = - 7.00 ml/m2, 95% CI - 10.73; - 3.28, p < 0.001 compared to the low risk cluster). The multivariable longitudinal trajectory clusters added significantly to explain variation in CMR traits beyond the multivariable risk profile obtained at Exam 3. CONCLUSIONS Cardiovascular disease risk factor levels, measured over a time period of 14 years, were associated with CMR-derived measures of cardiac structure and function. Longitudinal multivariable trajectory clusters explained a greater proportion of the inter-individual variation in cardiac traits than multiple risk factor assessed contemporaneous with the CMR exam.
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Affiliation(s)
- Roberto Lorbeer
- Department of Radiology, University Hospital, LMU Munich, Pettenkoferstr. 8a, 80336, Munich, Germany.
- German Center for Cardiovascular Disease Research (DZHK E.V.), Munich, Germany.
| | - Susanne Rospleszcz
- German Center for Cardiovascular Disease Research (DZHK E.V.), Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Chair of Epidemiology, Institute of Medical Information Processing, Biometrics and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center, University Freiburg, Freiburg, Germany
| | - Sophia D Rado
- Department of Diagnostic and Interventional Radiology, Eberhard Karl University Tübingen, Tübingen, Germany
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD E.V.), Neuherberg, Germany
| | - Christa Meisinger
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Chair of Epidemiology, LMU Munich, UNIKA-T Augsburg, Augsburg, Germany
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Düsseldorf, Germany
- Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
| | - Margit Heier
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany
| | - Ramachandran S Vasan
- Preventive Medicine and Epidemiology Section, Boston University School of Medicine and Framingham Heart Study, Framingham, MA, USA
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center, University Freiburg, Freiburg, Germany
| | - Annette Peters
- German Center for Cardiovascular Disease Research (DZHK E.V.), Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Chair of Epidemiology, Institute of Medical Information Processing, Biometrics and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- German Center for Diabetes Research (DZD E.V.), Neuherberg, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, Kiel University, Kiel, Germany
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Guzzetti E, Tastet L, Annabi MS, Capoulade R, Shen M, Bernard J, García J, Le Ven F, Arsenault M, Bédard E, Larose E, Clavel MA, Pibarot P. Effect of Regional Upper Septal Hypertrophy on Echocardiographic Assessment of Left Ventricular Mass and Remodeling in Aortic Stenosis. J Am Soc Echocardiogr 2021; 34:62-71. [DOI: 10.1016/j.echo.2020.08.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 01/09/2023]
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Ke Q, Liu F, Tang Y, Chen J, Hu H, Sun X, Tan W. The protective effect of isosteviol sodium on cardiac function and myocardial remodelling in transverse aortic constriction rat. J Cell Mol Med 2021; 25:1166-1177. [PMID: 33336505 PMCID: PMC7812303 DOI: 10.1111/jcmm.16182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/10/2020] [Accepted: 11/25/2020] [Indexed: 11/30/2022] Open
Abstract
Pathological hypertrophy contributes to heart failure and there is not quite effective treatment to invert this process. Isosteviol has been shown to protect the heart against ischaemia-reperfusion injury and isoproterenol-induced cardiac hypertrophy, but its effect on pressure overload-induced cardiac hypertrophy is still unknown. Pressure overload induced by transverse aortic constriction (TAC) causes cardiac hypertrophy in rats to mimic the pathological condition in human. This study examined the effects of isosteviol sodium (STVNa) on cardiac hypertrophy by the TAC model and cellular assays in vitro. Cardiac function test, electrocardiogram analysis and histological analysis were conducted. The effects of STVNa on calcium transient of the adult rat ventricular cells and the proliferation of neonatal rat cardiac fibroblasts were also studied in vitro. Cardiac hypertrophy was observed after 3-week TAC while the extensive cardiac dysfunction and electronic remodelling were observed after 9-week TAC. Both STVNa and sildenafil (positive drug) treatment reversed the two process, but STVNa appeared to be more superior in some aspects and did not change calcium transient considerably. STVNa also reversed TAC-induced cardiac fibrosis in vivo and TGF-β1-induced fibroblast proliferation in vitro. Moreover, STVNa, but not sildenafil, reversed impairment of the autonomic nervous system induced by 9-week TAC.
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Affiliation(s)
- Qingjin Ke
- Institute of Biomedical and Pharmaceutical SciencesGuangdong University of TechnologyGuangzhouChina
| | - Fei Liu
- Institute of Biomedical and Pharmaceutical SciencesGuangdong University of TechnologyGuangzhouChina
| | - Yuxin Tang
- Institute of Biomedical and Pharmaceutical SciencesGuangdong University of TechnologyGuangzhouChina
| | - Jiedi Chen
- Institute of Biomedical and Pharmaceutical SciencesGuangdong University of TechnologyGuangzhouChina
| | - Hui Hu
- Institute of Biomedical and Pharmaceutical SciencesGuangdong University of TechnologyGuangzhouChina
| | - Xiaoou Sun
- Institute of Biomedical and Pharmaceutical SciencesGuangdong University of TechnologyGuangzhouChina
| | - Wen Tan
- Institute of Biomedical and Pharmaceutical SciencesGuangdong University of TechnologyGuangzhouChina
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Arterial hypertension and morphologic abnormalities of cardiac chambers: results from the Copenhagen General Population Study. J Hypertens 2020; 39:703-710. [PMID: 33394866 DOI: 10.1097/hjh.0000000000002705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES In patients with arterial hypertension (AH), hypertension-mediated organ damage may be manifested by cardiac chamber enlargement and/or remodeling. Cardiac computed tomography imaging has emerged as an important method for morphological assessment of cardiac chambers. We tested the hypothesis that prevalence of cardiac chamber abnormalities is specifically related to clinical categories of AH in the general population. METHODS We studied 4747 individuals, mean age was 60 years (range: 40-93), 46% were men, undergoing 320-detector computed tomography in the Copenhagen General Population Study. Clinical categories of AH were: normotensive (n = 2484), untreated hypertensive (n = 1301), treated controlled hypertensive (n = 412) and treated uncontrolled hypertensive (n = 550). Chamber abnormalities in the form of left ventricular (LV) concentric remodeling, LV eccentric hypertrophy, LV concentric hypertrophy or left atrial enlargement were assessed, in addition to LV or right ventricular enlargement. RESULTS Chamber abnormalities were present in 23% of all individuals. Combined LV and left atrial abnormalities were rare (<2%). LV concentric remodeling (10%) was the most prevalent abnormality, and most commonly found in individuals with treated hypertension. LV and right ventricular enlargements were unrelated to hypertension. The highest frequencies of chamber abnormalities were found in individuals of elevated blood pressure (BP) with (40%) or without (32%) treatment, as opposed to individuals of normal BP with (27%) or without (14%) treatment, P less than 0.0001. CONCLUSION In a general population cohort, untreated or inadequately treated AH was associated with the highest prevalence of cardiac chamber enlargement and remodeling. These observations suggest a strong link between elevated BPs and development of hypertension-mediated organ damage.
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44
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Apaydin DC, Jaramillo PAM, Corradi L, Cosco F, Rathjen FG, Kammertoens T, Filosa A, Sawamiphak S. Early-Life Stress Regulates Cardiac Development through an IL-4-Glucocorticoid Signaling Balance. Cell Rep 2020; 33:108404. [PMID: 33207196 DOI: 10.1016/j.celrep.2020.108404] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/21/2020] [Accepted: 10/27/2020] [Indexed: 01/06/2023] Open
Abstract
Stressful experiences early in life can increase the risk of cardiovascular diseases. However, it remains largely unknown how stress influences susceptibility to the disease onset. Here, we show that exposure to brain-processed stress disrupts myocardial growth by reducing cardiomyocyte mitotic activity. Activation of the glucocorticoid receptor (GR), the primary stress response pathway, reduces cardiomyocyte numbers, disrupts trabecular formation, and leads to contractile dysfunction of the developing myocardium. However, a physiological level of GR signaling is required to prevent cardiomyocyte hyperproliferation. Mechanistically, we identify an antagonistic interaction between the GR and the cytokine interleukin-4 (IL-4) as a key player in cardiac development. IL-4 signals transcription of key regulators of cell-cycle progression in cardiomyocytes via signal transducer and activator of transcription 3 (Stat3). GR, on the contrary, inhibits this signaling system. Thus, our findings uncover an interplay between stress and immune signaling pathways critical to orchestrating physiological growth of the heart.
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Affiliation(s)
- Dilem C Apaydin
- Max Delbrück Center for Molecular Medicine, Robert-Rössle-Straße 10, 13092 Berlin, Germany
| | | | - Laura Corradi
- Max Delbrück Center for Molecular Medicine, Robert-Rössle-Straße 10, 13092 Berlin, Germany
| | - Francesca Cosco
- Max Delbrück Center for Molecular Medicine, Robert-Rössle-Straße 10, 13092 Berlin, Germany
| | - Fritz G Rathjen
- Max Delbrück Center for Molecular Medicine, Robert-Rössle-Straße 10, 13092 Berlin, Germany
| | - Thomas Kammertoens
- Max Delbrück Center for Molecular Medicine, Robert-Rössle-Straße 10, 13092 Berlin, Germany; Institute of Immunology, Charité Campus Berlin Buch, Lindenberger Weg 80, 13125 Berlin, Germany
| | - Alessandro Filosa
- Max Delbrück Center for Molecular Medicine, Robert-Rössle-Straße 10, 13092 Berlin, Germany
| | - Suphansa Sawamiphak
- Max Delbrück Center for Molecular Medicine, Robert-Rössle-Straße 10, 13092 Berlin, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
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Keijzer LBH, Caenen A, Voorneveld J, Strachinaru M, Bowen DJ, van de Wouw J, Sorop O, Merkus D, Duncker DJ, van der Steen AFW, de Jong N, Bosch JG, Vos HJ. A direct comparison of natural and acoustic-radiation-force-induced cardiac mechanical waves. Sci Rep 2020; 10:18431. [PMID: 33116234 PMCID: PMC7595170 DOI: 10.1038/s41598-020-75401-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 10/15/2020] [Indexed: 12/30/2022] Open
Abstract
Natural and active shear wave elastography (SWE) are potential ultrasound-based techniques to non-invasively assess myocardial stiffness, which could improve current diagnosis of heart failure. This study aims to bridge the knowledge gap between both techniques and discuss their respective impacts on cardiac stiffness evaluation. We recorded the mechanical waves occurring after aortic and mitral valve closure (AVC, MVC) and those induced by acoustic radiation force throughout the cardiac cycle in four pigs after sternotomy. Natural SWE showed a higher feasibility than active SWE, which is an advantage for clinical application. Median propagation speeds of 2.5-4.0 m/s and 1.6-4.0 m/s were obtained after AVC and MVC, whereas ARF-based median speeds of 0.9-1.2 m/s and 2.1-3.8 m/s were reported for diastole and systole, respectively. The different wave characteristics in both methods, such as the frequency content, complicate the direct comparison of waves. Nevertheless, a good match was found in propagation speeds between natural and active SWE at the moment of valve closure, and the natural waves showed higher propagation speeds than in diastole. Furthermore, the results demonstrated that the natural waves occur in between diastole and systole identified with active SWE, and thus represent a myocardial stiffness in between relaxation and contraction.
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Affiliation(s)
- Lana B H Keijzer
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
| | - Annette Caenen
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
- IBiTech-bioMMeda, Ghent University, Ghent, Belgium.
- Cardiovascular Imaging and Dynamics Lab, Catholic University of Leuven, Leuven, Belgium.
| | - Jason Voorneveld
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Daniel J Bowen
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Jens van de Wouw
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Oana Sorop
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Daphne Merkus
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Dirk J Duncker
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Antonius F W van der Steen
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Nico de Jong
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Johan G Bosch
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Hendrik J Vos
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
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46
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Khan AA, Davies AJ, Whitehead NJ, McGee M, Al-Omary MS, Baker D, Bhagwandeen R, Renner I, Majeed T, Hatton R, Collins NJ, Attia J, Boyle AJ. Targeting elevated left ventricular end-diastolic pressure following primary percutaneous coronary intervention for ST-segment elevation myocardial infarction – a phase one safety and feasibility study. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2020; 9:758-763. [DOI: 10.1177/2048872618819657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
Elevated left ventricular end diastolic pressure (LVEDP) is an independent predictor of mortality and heart failure in patients with ST-segment elevation myocardial infarction (STEMI). Whether lowering elevated LVEDP improves outcomes remains unknown.
Methods:
This non-randomized, single blinded study with prospective enrolment and sequential group allocation recruited patients undergoing primary percutaneous coronary intervention for STEMI with LVEDP ⩾ 20 mmHg measured immediately after primary percutaneous coronary intervention. The intervention arm (n=10) received furosemide 40 mg intravenous bolus plus escalating doses of glyceryl trinitrate (100 µg per min to a maximum of 1000 µg) during simultaneous measurement of LVEDP. The control group (n=10) received corresponding normal saline boluses with simultaneous measurement of LVEDP (10 readings over 10 min). Efficacy endpoints were final LVEDP achieved, and the dose of glyceryl trinitrate needed to reduce LVEDP by ⩾ 20%. Safety endpoint was symptomatic hypotension (systolic blood pressure < 90 mmHg).
Results:
From 1 April 2017 to 23 August 2017 we enrolled 20 patients (age: 64±9 years, males: 60%, n=12, anterior STEMI: 65%, n=13). The mean LVEDP for the whole cohort (n=20) was 29±4 mmHg (intervention group: 28±3 mmHg vs. control group: 31±5 mmHg; p=0.1). The LVEDP dropped from 28±3 to 16±2 mmHg in the glyceryl trinitrate + furosemide group (p <0.01) but remained unchanged in the control group. The median dose of glyceryl trinitrate required to produce ⩾ 20% reduction in LVEDP in the intervention group was 200 µg (range: 100–800). One patient experienced asymptomatic decline in systolic blood pressure to below 90 mmHg. There was no correlation between LVEDP and left ventricular ejection fraction.
Conclusion:
The administration of glyceryl trinitrate plus furosemide in patients with elevated LVEDP following primary percutaneous coronary intervention for STEMI safely reduces LVEDP.
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Affiliation(s)
- Arshad A Khan
- John Hunter Hospital, Newcastle, Australia
- The University of Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | | | | | | | - Mohammed S Al-Omary
- John Hunter Hospital, Newcastle, Australia
- The University of Newcastle, Australia
| | | | | | | | - Tazeen Majeed
- The University of Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | | | - Nicholas J Collins
- John Hunter Hospital, Newcastle, Australia
- The University of Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | - John Attia
- John Hunter Hospital, Newcastle, Australia
- The University of Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | - Andrew J Boyle
- John Hunter Hospital, Newcastle, Australia
- The University of Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
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47
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The Impact of Valvuloarterial Impedance on Left Ventricular Geometrical Change after Transcatheter Aortic Valve Replacement: A Comparison between Valvuloarterial Impedance and Mean Pressure Gradient. J Clin Med 2020; 9:jcm9103143. [PMID: 33003289 PMCID: PMC7600915 DOI: 10.3390/jcm9103143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 11/17/2022] Open
Abstract
Increase in left ventricular (LV) mass develops as a compensatory mechanism against pressure overload in aortic valve stenosis. However, long-standing LV geometrical changes are related to poor prognosis. The LV geometrical change occurs after transcatheter aortic valve replacement (TAVR). The present study aimed to investigate the relationship between improvement in valvuloarterial impedance (Zva) and change in LV mass index (LVMI) and the ratio of LVMI to LV end-diastolic volume index (LVMI/LVEDVI). We compared these relationships to that between Zva and mean pressure gradient (MPG). Baseline and follow-up transthoracic echocardiograms of 301 patients who underwent TAVR from November 2011 to December 2015 were reviewed. Spearman correlation coefficient (ρ) was used to compare ΔLVMI and ΔLVMI/LVEDVI with Zva or MPG. The correlation between ΔZva and ΔLVMI (ρ = 0.47, p < 0.001) was superior to that between ΔMPG and ΔLVMI (ρ = 0.15, p = 0.009) (p for comparison < 0.001). The correlation between ΔZva and ΔLVMI/LVEDVI was statistically significant (ρ = 0.54, p < 0.001); in contrast, that of ΔMPG and ΔLVMI/LVEDVI was not. The improvement in Zva after TAVR was more closely related to LVMI and LVMI/LVEDVI reduction than MPG reduction.
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48
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Nwabuo CC, Moreira HT, Vasconcellos HD, Mewton N, Opdahl A, Ogunyankin KO, Ambale-Venkatesh B, Schreiner PJ, Armstrong AAC, Lewis CE, Jacobs DR, Lloyd-Jones D, Gidding SS, Lima JAC. Left ventricular global function index predicts incident heart failure and cardiovascular disease in young adults: the coronary artery risk development in young adults (CARDIA) study. Eur Heart J Cardiovasc Imaging 2020; 20:533-540. [PMID: 30247530 DOI: 10.1093/ehjci/jey123] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/14/2018] [Indexed: 12/26/2022] Open
Abstract
AIMS Left ventricular (LV) ejection fraction (LVEF) is an extensively utilized marker of LV function that is often interpreted without recourse to alterations in LV geometry and hypertrophy. LV global function index (LVGFI) is a novel marker that incorporates LV structure in the assessment of LV cardiac performance. We evaluated the prognostic utility of LVGFI from young adulthood into middle age for incident heart failure (HF) and cardiovascular disease (CVD) in comparison to LVEF. METHODS AND RESULTS Included were 4107 CARDIA participants with echocardiograms in Year-5 (1990-1991). LVGFI was defined as LV stroke volume/LV global volume*100, where LV global volume was the sum of the LV mean cavity volume ((LV end-diastolic volume + LV end-systolic volume)/2) and myocardial volume (LV mass/density). Adjusted Cox proportional hazard models were utilized to predict incident HF and CVD outcomes. Mean age of participants was 29.8 ± 3.7 years, 55% female, and 48.7% black. Higher body mass index [beta coefficient (B) = -0.11 standard error (SE) = 0.02, P < 0.001], higher blood pressure (B = -0.04, SE = 0.01, P < 0.01), smoking (B = -0.82, SE = 0.22, P < 0.001), male sex (P < 0.001), and black race (P < 0.001) were associated with worse LVGFI. A total of 207 incident CVD events were observed over the course of 98 035 person-years at risk. Higher LVGFI was associated with HF, hazard ratio (HR) = 0.70, 95% confidence interval (CI) (0.54-0.91), hard CVD HR = 0.83, 95% CI (0.71-0.96), and all CVD HR = 0.83, 95% CI (0.72-0.96). For HF outcomes, Harrell's C-statistic for LVGFI (0.80) was greater than LVEF (0.66). CONCLUSION LVGFI is a strong, independent predictor of incident HF and CVD that provides incremental prognostic value compared with LVEF. Male sex, black race, obesity, hypertension, and smoking are associated with worse LVGFI in the early adult lifespan.
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Affiliation(s)
- Chike C Nwabuo
- Department of Medicine, Harvard Medical School, 330 Mount Auburn St, Cambridge, MA, USA.,Division of Cardiology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 524, Baltimore, MD, USA
| | - Henrique T Moreira
- Division of Cardiology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 524, Baltimore, MD, USA.,Division of Cardiology, Universidade of Sao Paulo, Av. Bandeirantes, 3.900 Monte Alegre, Ribeirão Preto, SP, Brazil
| | - Henrique D Vasconcellos
- Division of Cardiology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 524, Baltimore, MD, USA
| | - Nathan Mewton
- Division of Cardiology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 524, Baltimore, MD, USA
| | - Anders Opdahl
- Department of cardiology, Oslo University hospital, Sognsvannsveien 20, Oslo, Norway
| | - Kofo O Ogunyankin
- Department of Preventive Medicine, Northwestern University, 675 N St Clair St STE 19-100, Chicago, IL, USA
| | - Bharath Ambale-Venkatesh
- Division of Cardiology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 524, Baltimore, MD, USA
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Minneapolis, MN, USA
| | - Anderson A C Armstrong
- Division of Cardiology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 524, Baltimore, MD, USA
| | - Cora E Lewis
- Division of preventive medicine, University of Alabama, 619 19th St, Birmingham, AL, UK
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Minneapolis, MN, USA
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University, 675 N St Clair St STE 19-100, Chicago, IL, USA
| | - Samuel S Gidding
- Division of Pediatrics Cardiology, Nemours Cardiac Center, 1600 Rockland Road Wilmington, DE, USA
| | - João A C Lima
- Division of Cardiology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N. Wolfe Street, Blalock 524, Baltimore, MD, USA
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49
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Xu M, Ge Z, Huang J, Shao X, Li J, Mrcp, Yang J. Modified Cornell electrocardiographic criteria in the assessment of left ventricular hypertrophy geometry of patients with essential hypertension. J Clin Hypertens (Greenwich) 2020; 22:1239-1246. [PMID: 32639109 PMCID: PMC7497263 DOI: 10.1111/jch.13919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/24/2020] [Accepted: 06/07/2020] [Indexed: 01/10/2023]
Abstract
To evaluate the value of modified Cornell electrocardiographic criteria in the assessment of left ventricular hypertrophy (LVH) for patients with essential hypertension. A total of 381 patients with essential hypertension diagnosed in our hospital were selected. Using the left ventricle (LV) geometric patterns classified by the American Society of Echocardiography (ASE), we examined the distribution of the modified Cornell criteria of Ravl + SD (the deepest S wave in 12‐lead ECG) in different geometric patterns and analyzed the correlation of modified Cornell criteria with changes in the LV geometric patterns using multiple linear regression analysis. The distribution of modified Cornell criteria, Sokolow‐Lyon criteria (RV5/V6 + SV1), and Cornell criteria (Ravl + SV3) in gender‐specific hypertensive geometric patterns were significantly different (P ≤ .01 for all). The voltage of Ravl + SD in male patients showed an increase trend in the normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH) groups, and this increase trend was significantly in the unadjusted model and the adjusted model. The voltages of Ravl + SV3 and RV5/V6 + SV1 of male patients in CR, CH and RH groups showed a gradual increase trend, but the increase trend in CR group has no statistical significance compared to that in NG group (P ≥ .05). The voltages of Ravl + SD, RV5/V6 + SV1, and Ravl + SV3 in female patients in CR, CH and EH groups showed a trend of increase after decrease in the adjusted model. In conclusion, the modified Cornell criteria could dynamically reflect left ventricular hypertensive geometry of male patients.
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Affiliation(s)
- Min Xu
- Department of Echocardiography of The Third Affiliated Hospital of Soochow University, Chang Zhou, China.,Department of Echocardiography of The First Affiliated Hospital of Soochow University, Su Zhou, China
| | - Zhixiang Ge
- Department of Echocardiography of The Third Affiliated Hospital of Soochow University, Chang Zhou, China
| | - Jun Huang
- Department of Echocardiography of The Affiliated Hospital of Nanjing Medical University, Chang Zhou, China
| | - Xiaoliang Shao
- Department of Nuclear Medicine of The Third Affiliated Hospital of Soochow University, Chang Zhou, China
| | | | - Mrcp
- Department of General Surgery of The Third Affiliated Hospital of Soochow University, Chang Zhou, China
| | - Junhua Yang
- Department of Echocardiography of The First Affiliated Hospital of Soochow University, Su Zhou, China
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50
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Gilbert K, Mauger C, Young AA, Suinesiaputra A. Artificial Intelligence in Cardiac Imaging With Statistical Atlases of Cardiac Anatomy. Front Cardiovasc Med 2020; 7:102. [PMID: 32695795 PMCID: PMC7338378 DOI: 10.3389/fcvm.2020.00102] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 05/14/2020] [Indexed: 12/14/2022] Open
Abstract
In many cardiovascular pathologies, the shape and motion of the heart provide important clues to understanding the mechanisms of the disease and how it progresses over time. With the advent of large-scale cardiac data, statistical modeling of cardiac anatomy has become a powerful tool to provide automated, precise quantification of the status of patient-specific heart geometry with respect to reference populations. Powered by supervised or unsupervised machine learning algorithms, statistical cardiac shape analysis can be used to automatically identify and quantify the severity of heart diseases, to provide morphometric indices that are optimally associated with clinical factors, and to evaluate the likelihood of adverse outcomes. Recently, statistical cardiac atlases have been integrated with deep neural networks to enable anatomical consistency of cardiac segmentation, registration, and automated quality control. These combinations have already shown significant improvements in performance and avoid gross anatomical errors that could make the results unusable. This current trend is expected to grow in the near future. Here, we aim to provide a mini review highlighting recent advances in statistical atlasing of cardiac function in the context of artificial intelligence in cardiac imaging.
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Affiliation(s)
- Kathleen Gilbert
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Charlène Mauger
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.,Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
| | - Alistair A Young
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand.,Department of Biomedical Engineering, King's College London, London, United Kingdom
| | - Avan Suinesiaputra
- Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand.,Centre for Computational Imaging and Simulation Technologies in Biomedicine, School of Computing, University of Leeds, Leeds, United Kingdom.,School of Medicine, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
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