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Dogon G, Rigal E, Potel E, Josse M, Rochette L, Bejot Y, Vergely C. Growth/differentiation factor 15 (GDF15) expression in the heart after myocardial infarction and cardioprotective effect of pre-ischemic rGDF15 administration. Sci Rep 2024; 14:12949. [PMID: 38839839 PMCID: PMC11153639 DOI: 10.1038/s41598-024-63880-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 06/03/2024] [Indexed: 06/07/2024] Open
Abstract
Growth/differentiation factor-15 (GDF15) is considered an unfavourable prognostic biomarker for cardiovascular disease in clinical data, while experimental studies suggest it has cardioprotective potential. This study focuses on the direct cardiac effects of GDF15 during ischemia-reperfusion injury in Wistar male rats, employing concentrations relevant to patients at high cardiovascular risk. Initially, we examined circulating levels and heart tissue expression of GDF15 in rats subjected to ischemia-reperfusion and sham operations in vivo. We then evaluated the cardiac effects of GDF15 both in vivo and ex vivo, administering recombinant GDF15 either before 30 min of ischemia (preconditioning) or at the onset of reperfusion (postconditioning). We compared infarct size and cardiac contractile recovery between control and rGDF15-treated rats. Contrary to our expectations, ischemia-reperfusion did not increase GDF15 plasma levels compared to sham-operated rats. However, cardiac protein and mRNA expression increased in the infarcted zone of the ischemic heart after 24 h of reperfusion. Notably, preconditioning with rGDF15 had a cardioprotective effect, reducing infarct size both in vivo (65 ± 5% in control vs. 42 ± 6% in rGDF15 groups) and ex vivo (60 ± 4% in control vs. 45 ± 4% in rGDF15 groups), while enhancing cardiac contractile recovery ex vivo. However, postconditioning with rGDF15 did not alter infarct size or the recovery of contractile parameters in vivo or ex vivo. These novel findings reveal that the short-term exogenous administration of rGDF15 before ischemia, at physiologically relevant levels, protects the heart against ischemia-reperfusion injury in both in vivo and ex vivo settings. The ex vivo results indicate that rGDF15 operates independently of the inflammatory, endocrine and nervous systems, suggesting direct and potent cardioprotective properties against ischemia-reperfusion injury.
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Affiliation(s)
- Geoffrey Dogon
- Research Team: Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), Faculty of Health Sciences, University of Burgundy, 7 Bd Jeanne d'Arc, 21000, Dijon, France
| | - Eve Rigal
- Research Team: Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), Faculty of Health Sciences, University of Burgundy, 7 Bd Jeanne d'Arc, 21000, Dijon, France
| | - Eliot Potel
- Research Team: Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), Faculty of Health Sciences, University of Burgundy, 7 Bd Jeanne d'Arc, 21000, Dijon, France
| | - Marie Josse
- Research Team: Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), Faculty of Health Sciences, University of Burgundy, 7 Bd Jeanne d'Arc, 21000, Dijon, France
| | - Luc Rochette
- Research Team: Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), Faculty of Health Sciences, University of Burgundy, 7 Bd Jeanne d'Arc, 21000, Dijon, France
| | - Yannick Bejot
- Research Team: Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), Faculty of Health Sciences, University of Burgundy, 7 Bd Jeanne d'Arc, 21000, Dijon, France
- Department of Neurology, Dijon University Hospital, Dijon, France
| | - Catherine Vergely
- Research Team: Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), Faculty of Health Sciences, University of Burgundy, 7 Bd Jeanne d'Arc, 21000, Dijon, France.
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2
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Pandey A, Okaj I, Ichhpuniani S, Tao B, Kaur H, Spence JD, Young J, Healey JS, Devereaux PJ, Um KJ, Benz AP, Conen D, Whitlock RP, Belley-Cote EP, McIntyre WF. Risk Scores for Prediction of Postoperative Atrial Fibrillation After Cardiac Surgery: A Systematic Review and Meta-Analysis. Am J Cardiol 2023; 209:232-240. [PMID: 37922611 DOI: 10.1016/j.amjcard.2023.08.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 11/07/2023]
Abstract
Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery and is associated with poor clinical outcomes. The objective of this systematic review and meta-analysis was to assess the performance of risk scores to predict POAF in cardiac surgery patients. We searched MEDLINE, Embase, and Cochrane CENTRAL for studies that developed/evaluated a POAF risk prediction model. Pairs of reviewers independently screened studies and extracted data. We pooled area under the receiver operating curves (AUCs), sensitivity and specificity, and adjusted odds ratios from multivariable regression analyses using the generic inverse variance method and random effects models. Forty-three studies (n = 63,847) were included in the quantitative synthesis. Most scores were originally developed for other purposes but evaluated for predicting POAF. Pooled AUC revealed moderate POAF discrimination for the EuroSCORE II (AUC 0.59, 95% confidence interval [CI] 0.54 to 0.65), Society of Thoracic Surgeons (AUC 0.60, 95% CI 0.56 to 0.63), EuroSCORE (AUC 0.63, 95% CI 0.58 to 0.68), CHADS2 (AUC 0.66, 95% CI 0.57 to 0.75), POAF Score (AUC 0.66, 95% CI 0.63 to 0.68), HATCH (AUC 0.67, 95% CI 0.57 to 0.75), CHA2DS2-VASc (AUC 0.68, 95% CI 0.60 to 0.75) and SYNTAX scores (AUC 0.74, 95% CI 0.71 to 0.78). Pooled analyses at specific cutoffs of the CHA2DS2-VASc, CHADS2, HATCH, and POAF scores demonstrated moderate-to-high sensitivity (range 46% to 87%) and low-to-moderate specificity (range 31% to 70%) for POAF prediction. In conclusion, existing clinical risk scores offer at best moderate prediction for POAF after cardiac surgery. Better models are needed to guide POAF risk stratification in cardiac surgery patients.
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Affiliation(s)
- Arjun Pandey
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Iva Okaj
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Brendan Tao
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hargun Kaur
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Jack Young
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Jeff S Healey
- Population Health Research Institute, Hamilton, Ontario, Canada; Division of Cardiology, McMaster University, Hamilton, Ontario, Canada
| | - P J Devereaux
- Population Health Research Institute, Hamilton, Ontario, Canada; Division of Cardiology, McMaster University, Hamilton, Ontario, Canada
| | - Kevin J Um
- Division of Cardiology, McMaster University, Hamilton, Ontario, Canada
| | | | - David Conen
- Population Health Research Institute, Hamilton, Ontario, Canada; Division of Cardiology, McMaster University, Hamilton, Ontario, Canada
| | | | - Emilie P Belley-Cote
- Population Health Research Institute, Hamilton, Ontario, Canada; Division of Cardiology, McMaster University, Hamilton, Ontario, Canada
| | - William F McIntyre
- Population Health Research Institute, Hamilton, Ontario, Canada; Division of Cardiology, McMaster University, Hamilton, Ontario, Canada.
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3
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Tan Z, Song T, Huang S, Liu M, Ma J, Zhang J, Yu P, Liu X. Relationship between serum growth differentiation factor 15, fibroblast growth factor-23 and risk of atrial fibrillation: A systematic review and meta-analysis. Front Cardiovasc Med 2022; 9:899667. [PMID: 35990956 PMCID: PMC9386045 DOI: 10.3389/fcvm.2022.899667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background and objectiveGrowth differentiation factor-15 (GDF-15) and fibroblast growth factor-23 (FGF-23) are considered predictors of the incidence of cardiovascular diseases. The present meta-analysis aimed to elucidate the associations between GDF-15 and FGF-23 in the risk of atrial fibrillation (AF).MethodsAn electronic search was conducted in the Cochrane Library, PubMed, and Embase databases from inception until February 27, 2021. The study protocol was registered in the PROSPERO database (CRD42020182226).ResultsIn total, 15 studies that enrolled 36,017 participants were included. Both serum FGF-23 and GDF-15 were elevated in patients with AF. Analysis of categorical variables showed higher serum FGF-23 levels were associated with an increased risk of AF [relative risk (RR) = 1.28, 95% confidence interval (CI): 1.05–1.56]. In contrast, this association was not found with GDF-15 (RR = 0.91, 95% CI: 0.20–4.04). In dose-response analysis, a linear positive association was noted between serum FGF-23 levels and the risk of AF (P nonlinear = 0.9507), with a RR elevation of 7% for every 20 pg/ml increase in the serum FGF-23 levels (95% CI: 1.02–1.13). No remarkable relationship was found between serum GDF-15 levels and the risk of AF, and the overall RR for the association between a 100 ng/L increment in GDF-15 levels and AF was 1.01 (95% CI: 0.998–1.02).ConclusionOur study showed a positive linear correlation between serum FGF-23 levels and the risk of AF. However, no significant association was found between GDF-15 and the risk of AF. Further studies are warranted to clarify whether serum FGF-23 levels may be considered in predicting the risk of AF.Systematic Review Registration:http:www.york.ac.uk/inst/crd, identifier CRD42020182226.
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Affiliation(s)
- Ziqi Tan
- Department of Endocrine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tiangang Song
- Department of Endocrine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shanshan Huang
- Department of Endocrine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Menglu Liu
- Department of Cardiology, Seventh People's Hospital of Zhengzhou, Henan, China
| | - Jianyong Ma
- Department of Pharmacology and Systems Physiology University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Jing Zhang
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Peng Yu
- Department of Endocrine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Peng Yu
| | - Xiao Liu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Xiao Liu
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Prince-Wright L, Akinyemi O, Nnorom S, Bauer E, Cornwell III E, Fullum T. Postoperative atrial fibrillation following non-cardiac surgery: Predictors and risk of mortality. Am J Surg 2022; 224:1062-1067. [DOI: 10.1016/j.amjsurg.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 05/31/2022] [Accepted: 07/16/2022] [Indexed: 11/01/2022]
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5
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Chen M, Ding N, Mok Y, Mathews L, Hoogeveen RC, Ballantyne CM, Chen LY, Coresh J, Matsushita K. Growth Differentiation Factor 15 and the Subsequent Risk of Atrial Fibrillation: The Atherosclerosis Risk in Communities Study. Clin Chem 2022; 68:1084-1093. [PMID: 35762561 DOI: 10.1093/clinchem/hvac096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/19/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Growth differentiation factor 15 (GDF-15) is a stress-responsive biomarker associated with several types of cardiovascular diseases. However, conflicting results have been reported regarding its association with incident atrial fibrillation (AF) in the general population. METHODS In 10 234 White and Black Atherosclerosis Risk in Communities (ARIC) Study participants (mean age 60 years, 20.5% Blacks) free of AF at baseline (1993 to 1995), we quantified the association of GDF-15 with incident AF using Cox regression models. GDF-15 concentration was measured by an aptamer-based proteomic method. AF was defined as AF diagnosis by electrocardiogram at subsequent ARIC visits or AF diagnosis in hospitalization records or death certificates. Harrell's c-statistic and categorical net reclassification improvement were computed for risk discrimination and reclassification. RESULTS There were 2217 cases of incident AF over a median follow-up of 20.6 years (incidence rate 12.3 cases/1000 person-years). After adjusting for potential confounders, GDF-15 was independently associated with incident AF, with a hazard ratio (HR) of 1.42 (95% CI, 1.24-1.62) for the top vs bottom quartile. The result remained consistent (HR 1.23 [95% CI, 1.07-1.41]) even after further adjusting for 2 cardiac biomarkers, cardiac troponin T and natriuretic peptide. The results were largely consistent across demographic subgroups. The addition of GDF-15 modestly improved the c-statistic by 0.003 (95% CI, 0.001-0.006) beyond known risk factors of AF. CONCLUSIONS In this community-based biracial cohort, higher concentrations of GDF-15 were independently associated with incident AF, supporting its potential value as a clinical marker of AF risk.
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Affiliation(s)
- Mengkun Chen
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
| | - Ning Ding
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
| | - Yejin Mok
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
| | - Lena Mathews
- Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
| | - Ron C Hoogeveen
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Lin Yee Chen
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.,Lillehei Heart Institute and Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
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GDF15 and Cardiac Cells: Current Concepts and New Insights. Int J Mol Sci 2021; 22:ijms22168889. [PMID: 34445593 PMCID: PMC8396208 DOI: 10.3390/ijms22168889] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 02/06/2023] Open
Abstract
Growth and differentiation factor 15 (GDF15) belongs to the transforming growth factor-β (TGF-β) superfamily of proteins. Glial-derived neurotrophic factor (GDNF) family receptor α-like (GFRAL) is an endogenous receptor for GDF15 detected selectively in the brain. GDF15 is not normally expressed in the tissue but is prominently induced by “injury”. Serum levels of GDF15 are also increased by aging and in response to cellular stress and mitochondrial dysfunction. It acts as an inflammatory marker and plays a role in the pathogenesis of cardiovascular diseases, metabolic disorders, and neurodegenerative processes. Identified as a new heart-derived endocrine hormone that regulates body growth, GDF15 has a local cardioprotective role, presumably due to its autocrine/paracrine properties: antioxidative, anti-inflammatory, antiapoptotic. GDF15 expression is highly induced in cardiomyocytes after ischemia/reperfusion and in the heart within hours after myocardial infarction (MI). Recent studies show associations between GDF15, inflammation, and cardiac fibrosis during heart failure and MI. However, the reason for this increase in GDF15 production has not been clearly identified. Experimental and clinical studies support the potential use of GDF15 as a novel therapeutic target (1) by modulating metabolic activity and (2) promoting an adaptive angiogenesis and cardiac regenerative process during cardiovascular diseases. In this review, we comment on new aspects of the biology of GDF15 as a cardiac hormone and show that GDF15 may be a predictive biomarker of adverse cardiac events.
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Pericardial NT-Pro-BNP and GDF-15 as Biomarkers of Atrial Fibrillation and Atrial Matrix Remodeling in Aortic Stenosis. Diagnostics (Basel) 2021; 11:diagnostics11081422. [PMID: 34441356 PMCID: PMC8392313 DOI: 10.3390/diagnostics11081422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/17/2021] [Accepted: 08/03/2021] [Indexed: 12/11/2022] Open
Abstract
Aims: This study aimed to evaluate the association of GDF-15 and NT-pro-BNP in two different biological matrices with AF in severe aortic stenosis patients undergoing aortic valve replacement surgery (AVR), its association with atrial matrix remodeling, as well as with 30-day postoperative outcomes. Main Methods: One hundred and twenty-six patients between 2009 and 2019 with severe aortic stenosis undergoing AVR surgery in a tertiary hospital were assessed. Key Findings: pericardial fluid GDF-15 and pericardial fluid and serum NT-pro-BNP were increased in AF patients with aortic stenosis. COL1A1 and COL3A1 gene expression increased when pericardial fluid NT-pro-BNP values were higher. TIMP4 was positively correlated with pericardial fluid GDF-15. Significance: GDF-15 and NT-pro-BNP in the pericardial fluid are biomarkers of atrial fibrillation in aortic stenosis and correlate with atrial matrix remodeling. AKI is predicted by both serum and pericardial fluid GDF-15.
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Rochette L, Zeller M, Cottin Y, Vergely C. Insights Into Mechanisms of GDF15 and Receptor GFRAL: Therapeutic Targets. Trends Endocrinol Metab 2020; 31:939-951. [PMID: 33172749 DOI: 10.1016/j.tem.2020.10.004] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/25/2020] [Accepted: 10/16/2020] [Indexed: 12/17/2022]
Abstract
Growth and differentiation factor 15 (GDF15) belongs to the transforming growth factor-β (TGF-β) superfamily proteins. GDF15 acts as an inflammatory marker, and it plays a role in pathogenesis of tumors, ischemic diseases, metabolic disorders, and neurodegenerative processes. GDF15 is not normally expressed in the tissue; it is prominently induced following 'injury'. GDF15 functions are critical for the regulation of endothelial adaptations after vascular damage. Recently, four research groups simultaneously identified glial-derived neurotrophic factor (GDNF)-family receptor α-like (GFRAL) in the brain, an orphan receptor as the receptor for GDF15, signaling through the coreceptor RET. In this article, new aspects of the biology of GDF15 and receptor GFRAL, and their relationship with various pathologies, are commented on.
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Affiliation(s)
- Luc Rochette
- Research team, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2, EA 7460), University of Bourgogne Franche-Comté, UFR des Sciences de Santé, 7 boulevard Jeanne d' Arc, 21079 DIJON, France.
| | - Marianne Zeller
- Research team, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2, EA 7460), University of Bourgogne Franche-Comté, UFR des Sciences de Santé, 7 boulevard Jeanne d' Arc, 21079 DIJON, France
| | - Yves Cottin
- Research team, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2, EA 7460), University of Bourgogne Franche-Comté, UFR des Sciences de Santé, 7 boulevard Jeanne d' Arc, 21079 DIJON, France; Cardiology Unit, Dijon University Hospital Center, Dijon, France
| | - Catherine Vergely
- Research team, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2, EA 7460), University of Bourgogne Franche-Comté, UFR des Sciences de Santé, 7 boulevard Jeanne d' Arc, 21079 DIJON, France
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Sarkar S, Legere S, Haidl I, Marshall J, MacLeod JB, Aguiar C, Lutchmedial S, Hassan A, Brunt KR, Kienesberger P, Pulinilkunnil T, Légaré JF. Serum GDF15, a Promising Biomarker in Obese Patients Undergoing Heart Surgery. Front Cardiovasc Med 2020; 7:103. [PMID: 32671100 PMCID: PMC7327098 DOI: 10.3389/fcvm.2020.00103] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/18/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Obesity is a risk factor that negatively impacts outcomes in patients undergoing heart surgery by mechanisms that are not well-defined nor predicated on BMI alone. This knowledge gap has fuelled a search for biomarkers associated with cardiovascular diseases that could provide clinical insight to surgeons. One such biomarker is growth differentiation factor15(GDF15), associated with inflammation, metabolism, and heart failure outcomes but not yet examined in the context of obesity and cardiac surgery outcomes. Methods: Patients undergoing open-heart surgery were consented and enrolled for blood and tissue (atria) sampling at the time of surgery. Biomarker analysis was carried out using ELISA and western blot/qPCR, respectively. Biomarker screening was classified by inflammation(NLR, GDF15, Galectin3, ST2, TNFR2), heart failure(HF)/remodeling(NT-proBNP) and metabolism(glycemia, lipid profile). Patients were categorized based on BMI: obese group (BMI ≥30.0) and non-obese group(BMI 20.0–29.9). Subsequent stratification of GDF15 high patients was conservatively set as being in the 75th percentile. Results: A total of 80 patients undergoing any open-heart surgical interventions were included in the study. Obese (mean BMI = 35.8, n = 38) and non-obese (mean BMI = 25.7, n = 42) groups had no significant differences in age, sex, or co-morbidities. Compared to other biomarkers, plasma GDF15 (mean 1,736 vs. 1,207 ng/l, p < 0.001) was significantly higher in obese patients compared to non-obese. Plasma GDF15 also displayed a significant linear correlation with BMI (R2 = 0.097; p = 0.0049). Atria tissue was shown to be a significant source of GDF15 protein and tissue levels significantly correlated with plasma GDF15 (R2 = 0.4, p = 0.0004). Obesity was not associated with early/late mortality at median follow-up >2years. However, patients with high GDF15 (>1,580 ng/l) had reduced survival (65%) compared to the remaining patients with lower GDF15 levels (95%) by Kaplan Meier Analysis (median >2 years; p = 0.007). Conclusions: Circulating GDF15 is a salient biomarker likely sourced from heart tissue that appears to predict higher risk obese patients for adverse outcomes. More importantly, elevated GDF15 accounted for more sensitive outcome association than BMI at 2 years post-cardiac surgery, suggesting it heralds links to pathogenicity and should be actively studied prospectively and dynamically in a post-operative follow-up. Trial number: NCT03248921.
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Affiliation(s)
- Shreya Sarkar
- New Brunswick Heart Centre, Saint John, NB, Canada.,Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada
| | - Stephanie Legere
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | - Ian Haidl
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | - Jean Marshall
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | | | - Christie Aguiar
- New Brunswick Heart Centre, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada
| | - Sohrab Lutchmedial
- New Brunswick Heart Centre, Saint John, NB, Canada.,Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada
| | - Ansar Hassan
- New Brunswick Heart Centre, Saint John, NB, Canada.,Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada
| | - Keith R Brunt
- New Brunswick Heart Centre, Saint John, NB, Canada.,Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Petra Kienesberger
- Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada.,Department of Biochemistry, Dalhousie University, Halifax, NS, Canada
| | - Thomas Pulinilkunnil
- Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada.,Department of Biochemistry, Dalhousie University, Halifax, NS, Canada
| | - Jean-François Légaré
- New Brunswick Heart Centre, Saint John, NB, Canada.,Dalhousie Medicine New Brunswick, Saint John, NB, Canada.,IMPART Investigator Team Canada, Saint John, NB, Canada
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10
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Pooria A, Pourya A, Gheini A. Postoperative complications associated with coronary artery bypass graft surgery and their therapeutic interventions. Future Cardiol 2020; 16:481-496. [PMID: 32495650 DOI: 10.2217/fca-2019-0049] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Coronary artery disease is one of the commonest surgery demanding cardiovascular diseases. Coronary artery bypass graft surgery is practiced all over the world for the treatment of coronary artery disease. Systemic trauma during the surgery is associated with a wide range of complications, some of which are fatal. Preoperative risk factors such as age, previous illness and obesity are common predictors of these adverse events. Advances in therapeutic medicine have allowed timely treatment of these adverse events and co-morbidities. This review summarizes some of the most occurring complications associated with coronary artery bypass graft and corresponding treatment options.
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Affiliation(s)
- Ali Pooria
- Department of Cardiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Afsoun Pourya
- Student of Research committee, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Gheini
- Department of Cardiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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11
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Should we predict post-operative atrial fibrillation with atrial cardiomyopathy biomarkers? Int J Cardiol 2020; 307:71-72. [PMID: 32145940 DOI: 10.1016/j.ijcard.2020.02.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/09/2020] [Accepted: 02/18/2020] [Indexed: 12/22/2022]
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12
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Emced K. Atrial fibrillation and gamma glutamyl transferase; Off-pump versus on-pump Coronary Artery Bypass surgery. SANAMED 2020. [DOI: 10.24125/sanamed.v15i2.440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introduction: Atrial fibrillation (AF) which can be seen as a complication of the open-heart surgery, may cause serious problems on postoperative period. The exact pathophysiology of AF is unknown but it is thought that factors such as oxidative stress might cause AF. Material and methods: We retrospectively surveyed the serum gamma-glutamyl transferase (GGT) levels which is accepted as a mediator of oxidative stres, for the Post Operative Atrial Fibrillation (POAF) that occur after of-pump versus on-pump Coronary Artery Bypass Graft (CABG) surgery. Our study included 183 cases (101 male, 72 female; median age 63 ± 4.3 years) of which CABG was performed. Results: Echocardiography, routine blood tests, electrocardiography (ECG), test for the serum GGT levels were performed in preoperative and postoperative period to all participants. AF developed in 34 patients (35 %) in Group I and 19 patients (20 %) in Group II. There were no significant differences between two groups (of-pump versus on-pump) in terms of gender, cardiovascular risk factors and the severity of the coronary artery disease. In patients who has developed AF in postoperative period had significantly higher serum GGT levels. Conclusion: This study has shown that serum GGT levels were found to be significantly higher in patients whom AF has developed after on-pump CABG surgery.
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Yuan X, Bhat OM, Lohner H, Li N, Zhang Y, Li PL. Inhibitory effects of growth differentiation factor 11 on autophagy deficiency-induced dedifferentiation of arterial smooth muscle cells. Am J Physiol Heart Circ Physiol 2019; 316:H345-H356. [PMID: 30462553 PMCID: PMC6397385 DOI: 10.1152/ajpheart.00342.2018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/24/2018] [Accepted: 11/15/2018] [Indexed: 12/27/2022]
Abstract
Growth differentiation factor (GDF)11 has been reported to reverse age-related cardiac hypertrophy in mice and cause youthful regeneration of cardiomyocytes. The present study attempted to test a hypothesis that GDF11 counteracts the pathologic dedifferentiation of mouse carotid arterial smooth muscle cells (CASMCs) due to deficient autophagy. By real-time RT-PCR and Western blot analysis, exogenously administrated GDF11 was found to promote CASMC differentiation with increased expression of various differentiation markers (α-smooth muscle actin, myogenin, myogenic differentiation, and myosin heavy chain) as well as decreased expression of dedifferentiation markers (vimentin and proliferating cell nuclear antigen). Upregulation of the GDF11 gene by trichostatin A (TSA) or CRISPR-cas9 activating plasmids also stimulated the differentiation of CASMCs. Either GDF11 or TSA treatment blocked 7-ketocholesterol-induced CASMC dedifferentiation and autophagosome accumulation as well as lysosome inhibitor bafilomycin-induced dedifferentiation and autophagosome accumulation. Moreover, in CASMCs from mice lacking the CD38 gene, an autophagy deficiency model in CASMCs, GDF11 also inhibited its phenotypic transition to dedifferentiation status. Correspondingly, TSA treatment was shown to decrease GDF11 expression and reverse CASMC dedifferentiation in the partial ligated carotid artery of mice. The inhibitory effects of TSA on dedifferentiation of CASMCs were accompanied by reduced autophagosome accumulation in the arterial wall, which was accompanied by attenuated neointima formation in partial ligated carotid arteries. We concluded that GDF11 promotes CASMC differentiation and prevents the phenotypic transition of these cells induced by autophagosome accumulation during different pathological stimulations, such as Western diet, lysosome function deficiency, and inflammation. NEW & NOTEWORTHY The present study demonstrates that growth differentiation factor (GDF)11 promotes autophagy and subsequent differentiation in carotid arterial smooth muscle cells. Upregulation of GDF11 counteracts dedifferentiation under different pathological conditions. These findings provide novel insights into the regulatory role of GDF11 in the counteracting of sclerotic arterial diseases and also suggest that activation or induction of GDF11 may be a new therapeutic strategy for the treatment or prevention of these diseases.
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Affiliation(s)
- Xinxu Yuan
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University , Richmond, Virginia
| | - Owais M Bhat
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University , Richmond, Virginia
| | - Hannah Lohner
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University , Richmond, Virginia
| | - Ningjun Li
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University , Richmond, Virginia
| | - Yang Zhang
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston , Houston, Texas
| | - Pin-Lan Li
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University , Richmond, Virginia
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Yamashita K, Hu N, Ranjan R, Selzman CH, Dosdall DJ. Clinical Risk Factors for Postoperative Atrial Fibrillation among Patients after Cardiac Surgery. Thorac Cardiovasc Surg 2018; 67:107-116. [PMID: 30071562 DOI: 10.1055/s-0038-1667065] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Postoperative atrial fibrillation (POAF) is a common arrhythmia following cardiac surgery and is associated with increased health-care costs, complications, and mortality. The etiology of POAF is incompletely understood and its prediction remains suboptimal. Using data from published studies, we performed a systemic review and meta-analysis to identify preoperative clinical risk factors associated with patients at increased risk of POAF. METHODS A systematic search of PubMed, MEDLINE, and EMBASE databases was performed. RESULTS Twenty-four studies that reported univariate analysis results regarding POAF risk factors, published from 2001 to May 2017, were included in this meta-analysis with a total number of 36,834 subjects. Eighteen studies were performed in the United States and Europe and 16 studies were prospective cohort studies. The standardized mean difference (SMD) between POAF and non-POAF groups was significantly different (reported as [SMD: 95% confidence interval, CI]) for age (0.55: 0.47-0.63), left atrial diameter (0.45: 0.15-0.75), and left ventricular ejection fraction (0.30: 0.14-0.47). The pooled odds ratios (ORs) (reported as [OR: 95% CI]) demonstrated that heart failure (1.56: 1.31-1.96), chronic obstructive pulmonary disease (1.36: 1.13-1.64), hypertension (1.29: 1.12-1.48), and myocardial infarction (1.18: 1.05-1.34) were significant predictors of POAF incidence, while diabetes was marginally significant (1.06: 1.00-1.13). CONCLUSION The present analysis suggested that older age and history of heart failure were significant risk factors for POAF consistently whether the included studies were prospective or retrospective datasets.
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Affiliation(s)
- Kennosuke Yamashita
- Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah, United States.,Division of Cardiovascular Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Nan Hu
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, United States.,Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Ravi Ranjan
- Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah, United States.,Division of Cardiovascular Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Craig H Selzman
- Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah, United States.,Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah, United States
| | - Derek J Dosdall
- Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah, United States.,Division of Cardiovascular Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States.,Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah, United States
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Doulamis IP, Samanidis G, Tzani A, Antoranz A, Gkogkos A, Konstantopoulos P, Pliaka V, Minia A, Alexopoulos LG, Perrea DN, Perreas K. Proteomic profile of patients with atrial fibrillation undergoing cardiac surgery†. Interact Cardiovasc Thorac Surg 2018; 28:94-101. [PMID: 29992263 DOI: 10.1093/icvts/ivy210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 06/01/2018] [Indexed: 12/19/2022] Open
Affiliation(s)
- Ilias P Doulamis
- Laboratory for Experimental Surgery and Surgical Research “N.S Christeas”, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Samanidis
- First Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece
| | - Aspasia Tzani
- Laboratory for Experimental Surgery and Surgical Research “N.S Christeas”, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Anastasios Gkogkos
- Laboratory for Experimental Surgery and Surgical Research “N.S Christeas”, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Konstantopoulos
- Laboratory for Experimental Surgery and Surgical Research “N.S Christeas”, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Leonidas G Alexopoulos
- Protatonce Ltd, Athens, Greece
- Department of Mechanical Engineering, Laboratory for Experimental Surgery and Surgical Research “N.S Christeas”,National Technical University of Athens, Athens, Greece
| | - Despina N Perrea
- Laboratory for Experimental Surgery and Surgical Research “N.S Christeas”, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Perreas
- First Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece
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16
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Plasma levels of growth differentiation factor-15 are associated with myocardial injury in patients undergoing off-pump coronary artery bypass grafting. Sci Rep 2016; 6:28221. [PMID: 27311391 PMCID: PMC4911561 DOI: 10.1038/srep28221] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 06/01/2016] [Indexed: 12/20/2022] Open
Abstract
Growth differentiation factor-15 (GDF-15) has recently emerged as a risk predictor in patients with cardiovascular diseases. We therefore aimed to investigate the role of GDF-15 in the occurrence of cardiac injury during off-pump coronary artery bypass grafting (OPCAB). 55 consecutive patients with coronary artery diseases were recruited in this prospective, observational study. All patients were operated for OPCAB surgery. Serial blood samples were collected preoperatively, 12 hours and 36 hours after surgery. GDF-15, together with C-reactive protein, cardiac troponin I, creatine kinase MB and N-terminal pro B-type natriuretic peptide levels in plasma were measured at each time-point. GDF-15 levels increased significantly at 12 hours after surgery, attaining nearly 2.5 times the baseline levels (p < 0.001). Postoperative GDF-15 levels correlated positively with cTnI (p = 0.003) and EuroSCORE II (p = 0.013). According to the ROC curves, postoperative plasma GDF-15 was found to be the best biomarker to predict perioperative cardiac injury, compared with cTnI, CK-MB and EuroSCORE II. Circulating GDF-15 is a promising novel biomarker for identifying perioperative myocardial injury in patients undergoing OPCAB.
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Methangkool E, Howard-Quijano K, Mahajan A. The Problem With Predicting Postoperative Atrial Fibrillation. J Cardiothorac Vasc Anesth 2015; 29:1115-6. [PMID: 26384624 DOI: 10.1053/j.jvca.2015.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Emily Methangkool
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at the University of California Los Angeles Los Angeles, CA
| | - Kimberly Howard-Quijano
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at the University of California Los Angeles Los Angeles, CA
| | - Aman Mahajan
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at the University of California Los Angeles Los Angeles, CA
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