1
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Abnormal Mitochondrial Function and Morphology in Heart Transplanted Patients with Cardiac Allograft Vasculopathy. J Heart Lung Transplant 2022; 41:732-741. [DOI: 10.1016/j.healun.2022.01.1376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 12/28/2021] [Accepted: 01/23/2022] [Indexed: 11/16/2022] Open
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2
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Dashkevich A, Hagl C, Beyersdorf F, Nykänen AI, Lemström KB. VEGF Pathways in the Lymphatics of Healthy and Diseased Heart. Microcirculation 2016; 23:5-14. [PMID: 26190445 DOI: 10.1111/micc.12220] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 07/13/2015] [Indexed: 12/17/2022]
Abstract
Cardiac lymphatic system is a rare focus of the modern cardiovascular research. Nevertheless, the growing body of evidence is depicting lymphatic endothelium as an important functional unit in healthy and diseased myocardium. Since the discovery of angiogenic VEGF-A in 1983 and lymphangiogenic VEGF-C in 1997, an increasing amount of knowledge has accumulated on the essential roles of VEGF ligands and receptors in physiological and pathological angiogenesis and lymphangiogenesis. Tissue adaptation to several stimuli such as hypoxia, pathogen invasion, degenerative process and inflammation often involves coordinated changes in both blood and lymphatic vessels. As lymphatic vessels are involved in the initiation and resolution of inflammation and regulation of tissue edema, VEGF family members may have important roles in myocardial lymphatics in healthy and in cardiac disease. We will review the properties of VEGF ligands and receptors concentrating on their lymphatic vessel effects first in normal myocardium and then in cardiac disease.
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Affiliation(s)
- Alexey Dashkevich
- Cardiac Surgery, University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany.,Cardiac Surgery, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland.,Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Christian Hagl
- Cardiac Surgery, University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | | | - Antti I Nykänen
- Cardiac Surgery, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland.,Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Karl B Lemström
- Cardiac Surgery, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland.,Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland
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3
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Tabit CE, Chen P, Kim GH, Fedson SE, Sayer G, Coplan MJ, Jeevanandam V, Uriel N, Liao JK. Elevated Angiopoietin-2 Level in Patients With Continuous-Flow Left Ventricular Assist Devices Leads to Altered Angiogenesis and Is Associated With Higher Nonsurgical Bleeding. Circulation 2016; 134:141-52. [PMID: 27354285 DOI: 10.1161/circulationaha.115.019692] [Citation(s) in RCA: 114] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 05/18/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND Nonsurgical bleeding is the most common adverse event in patients with continuous-flow left ventricular assist devices (LVADs) and is caused by arteriovenous malformations. We hypothesized that deregulation of an angiogenic factor, angiopoietin-2 (Ang-2), in patients with LVADs leads to increased angiogenesis and higher nonsurgical bleeding. METHODS Ang-2 and thrombin levels were measured by ELISA and Western blotting, respectively, in blood samples from 101 patients with heart failure, LVAD, or orthotopic heart transplantation. Ang-2 expression in endothelial biopsy was quantified by immunofluorescence. Angiogenesis was determined by in vitro tube formation from serum from each patient with or without Ang-2-blocking antibody. Ang-2 gene expression was measured by reverse transcription-polymerase chain reaction in endothelial cells incubated with plasma from each patient with or without the thrombin receptor blocker vorapaxar. RESULTS Compared with patients with heart failure or those with orthotopic heart transplantation, serum levels and endothelial expression of Ang-2 were higher in LVAD patients (P=0.001 and P<0.001, respectively). This corresponded to an increased angiogenic potential of serum from patients with LVADs (P<0.001), which was normalized with Ang-2 blockade. Furthermore, plasma from LVAD patients contained higher amounts of thrombin (P=0.003), which was associated with activation of the contact coagulation system. Plasma from LVAD patients induced more Ang-2 gene expression in endothelial cells (P<0.001), which was reduced with thrombin receptor blockade (P=0.013). LVAD patients with Ang-2 levels above the mean (12.32 ng/mL) had more nonsurgical bleeding events compared with patients with Ang-2 levels below the mean (P=0.003). CONCLUSIONS Our findings indicate that thrombin-induced Ang-2 expression in LVAD patients leads to increased angiogenesis in vitro and may be associated with higher nonsurgical bleeding events. Ang-2 therefore may contribute to arteriovenous malformation formation and subsequent bleeding in LVAD patients.
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Affiliation(s)
- Corey E Tabit
- From the Department of Medicine, Section of Cardiology (C.E.T., P.C., G.H.K., G.S., M.J.C., N.U., J.K.L.) and Department of Surgery, Section of Cardiac and Thoracic Surgery (V.T.), University of Chicago, IL; and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX (S.E.F.)
| | - Phetcharat Chen
- From the Department of Medicine, Section of Cardiology (C.E.T., P.C., G.H.K., G.S., M.J.C., N.U., J.K.L.) and Department of Surgery, Section of Cardiac and Thoracic Surgery (V.T.), University of Chicago, IL; and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX (S.E.F.)
| | - Gene H Kim
- From the Department of Medicine, Section of Cardiology (C.E.T., P.C., G.H.K., G.S., M.J.C., N.U., J.K.L.) and Department of Surgery, Section of Cardiac and Thoracic Surgery (V.T.), University of Chicago, IL; and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX (S.E.F.)
| | - Savitri E Fedson
- From the Department of Medicine, Section of Cardiology (C.E.T., P.C., G.H.K., G.S., M.J.C., N.U., J.K.L.) and Department of Surgery, Section of Cardiac and Thoracic Surgery (V.T.), University of Chicago, IL; and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX (S.E.F.)
| | - Gabriel Sayer
- From the Department of Medicine, Section of Cardiology (C.E.T., P.C., G.H.K., G.S., M.J.C., N.U., J.K.L.) and Department of Surgery, Section of Cardiac and Thoracic Surgery (V.T.), University of Chicago, IL; and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX (S.E.F.)
| | - Mitchell J Coplan
- From the Department of Medicine, Section of Cardiology (C.E.T., P.C., G.H.K., G.S., M.J.C., N.U., J.K.L.) and Department of Surgery, Section of Cardiac and Thoracic Surgery (V.T.), University of Chicago, IL; and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX (S.E.F.)
| | - Valluvan Jeevanandam
- From the Department of Medicine, Section of Cardiology (C.E.T., P.C., G.H.K., G.S., M.J.C., N.U., J.K.L.) and Department of Surgery, Section of Cardiac and Thoracic Surgery (V.T.), University of Chicago, IL; and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX (S.E.F.)
| | - Nir Uriel
- From the Department of Medicine, Section of Cardiology (C.E.T., P.C., G.H.K., G.S., M.J.C., N.U., J.K.L.) and Department of Surgery, Section of Cardiac and Thoracic Surgery (V.T.), University of Chicago, IL; and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX (S.E.F.)
| | - James K Liao
- From the Department of Medicine, Section of Cardiology (C.E.T., P.C., G.H.K., G.S., M.J.C., N.U., J.K.L.) and Department of Surgery, Section of Cardiac and Thoracic Surgery (V.T.), University of Chicago, IL; and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX (S.E.F.).
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4
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Haas S, Jahnke HG, Moerbt N, von Bergen M, Aharinejad S, Andrukhova O, Robitzki AA. DIGE proteome analysis reveals suitability of ischemic cardiac in vitro model for studying cellular response to acute ischemia and regeneration. PLoS One 2012; 7:e31669. [PMID: 22384053 PMCID: PMC3285183 DOI: 10.1371/journal.pone.0031669] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Accepted: 01/11/2012] [Indexed: 11/18/2022] Open
Abstract
Proteomic analysis of myocardial tissue from patient population is suited to yield insights into cellular and molecular mechanisms taking place in cardiovascular diseases. However, it has been limited by small sized biopsies and complicated by high variances between patients. Therefore, there is a high demand for suitable model systems with the capability to simulate ischemic and cardiotoxic effects in vitro, under defined conditions. In this context, we established an in vitro ischemia/reperfusion cardiac disease model based on the contractile HL-1 cell line. To identify pathways involved in the cellular alterations induced by ischemia and thereby defining disease-specific biomarkers and potential target structures for new drug candidates we used fluorescence 2D-difference gel electrophoresis. By comparing spot density changes in ischemic and reperfusion samples we detected several protein spots that were differentially abundant. Using MALDI-TOF/TOF-MS and ESI-MS the proteins were identified and subsequently grouped by functionality. Most prominent were changes in apoptosis signalling, cell structure and energy-metabolism. Alterations were confirmed by analysis of human biopsies from patients with ischemic cardiomyopathy.With the establishment of our in vitro disease model for ischemia injury target identification via proteomic research becomes independent from rare human material and will create new possibilities in cardiac research.
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Affiliation(s)
- Sina Haas
- Division of Molecular Biological-Biochemical Processing Technology, Center for Biotechnology and Biomedicine, Universität Leipzig, Leipzig, Germany
| | - Heinz-Georg Jahnke
- Division of Molecular Biological-Biochemical Processing Technology, Center for Biotechnology and Biomedicine, Universität Leipzig, Leipzig, Germany
| | - Nora Moerbt
- Department of Proteomics, Helmholtz Centre for Environmental Research, Leipzig, Germany
| | - Martin von Bergen
- Department of Proteomics, Helmholtz Centre for Environmental Research, Leipzig, Germany
- Department of Metabolomics, Helmholtz Centre for Environmental Research, Leipzig, Germany
| | - Seyedhossein Aharinejad
- Department of Cardiac Surgery, Center of Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
- Department for Cardiovascular Research, Center of Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Olena Andrukhova
- Department for Cardiovascular Research, Center of Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
- Department for Biomedical Sciences, Institute of Pathophysiology, University of Veterinary Medicine, Vienna, Austria
| | - Andrea A. Robitzki
- Division of Molecular Biological-Biochemical Processing Technology, Center for Biotechnology and Biomedicine, Universität Leipzig, Leipzig, Germany
- * E-mail:
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5
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Jensen PR, Peitersen T, Karlsson M, In 't Zandt R, Gisselsson A, Hansson G, Meier S, Lerche MH. Tissue-specific short chain fatty acid metabolism and slow metabolic recovery after ischemia from hyperpolarized NMR in vivo. J Biol Chem 2009; 284:36077-36082. [PMID: 19861411 DOI: 10.1074/jbc.m109.066407] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Mechanistic details of mammalian metabolism in vivo and dynamic metabolic changes in intact organisms are difficult to monitor because of the lack of spatial, chemical, or temporal resolution when applying traditional analytical tools. These limitations can be addressed by sensitivity enhancement technology for fast in vivo NMR assays of enzymatic fluxes in tissues of interest. We apply this methodology to characterize organ-specific short chain fatty acid metabolism and the changes of carnitine and coenzyme A pools in ischemia reperfusion. This is achieved by assaying acetyl-CoA synthetase and acetyl-carnitine transferase catalyzed transformations in vivo. The fast and predominant flux of acetate and propionate signal into acyl-carnitine pools shows the efficient buffering of free CoA levels. Sizeable acetyl-carnitine formation from exogenous acetate is even found in liver, where acetyl-CoA synthetase and acetyl-carnitine transferase activities have been assumed sequestered in different compartments. In vivo assays of altered acetate metabolism were applied to characterize pathological changes of acetate metabolism upon ischemia. Coenzyme pools in ischemic skeletal muscle are reduced in vivo even 1 h after disturbing muscle perfusion. Impaired mitochondrial metabolism and slow restoration of free CoA are corroborated by assays employing fumarate to show persistently reduced tricarboxylic acid (TCA) cycle activity upon ischemia. In the same animal model, anaerobic metabolism of pyruvate and tissue perfusion normalize faster than mitochondrial bioenergetics.
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Affiliation(s)
- Pernille R Jensen
- Imagnia AB, 200 41 Malmö, Sweden, Gamle Carlsberg Vej 10, 2500 Valby, Denmark
| | - Torben Peitersen
- Imagnia AB, 200 41 Malmö, Sweden, Gamle Carlsberg Vej 10, 2500 Valby, Denmark
| | - Magnus Karlsson
- Imagnia AB, 200 41 Malmö, Sweden, Gamle Carlsberg Vej 10, 2500 Valby, Denmark
| | - René In 't Zandt
- Imagnia AB, 200 41 Malmö, Sweden, Gamle Carlsberg Vej 10, 2500 Valby, Denmark
| | - Anna Gisselsson
- Imagnia AB, 200 41 Malmö, Sweden, Gamle Carlsberg Vej 10, 2500 Valby, Denmark
| | - Georg Hansson
- Imagnia AB, 200 41 Malmö, Sweden, Gamle Carlsberg Vej 10, 2500 Valby, Denmark
| | - Sebastian Meier
- Carlsberg Laboratory, Gamle Carlsberg Vej 10, 2500 Valby, Denmark
| | - Mathilde H Lerche
- Imagnia AB, 200 41 Malmö, Sweden, Gamle Carlsberg Vej 10, 2500 Valby, Denmark.
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6
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Larose E, Behrendt D, Kinlay S, Selwyn AP, Ganz P, Fang JC. Endothelin-1 Is a Key Mediator of Coronary Vasoconstriction in Patients With Transplant Coronary Arteriosclerosis. Circ Heart Fail 2009; 2:409-16. [DOI: 10.1161/circheartfailure.108.836759] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Transplant coronary arteriosclerosis (TCA) is the principal long-term complication in cardiac transplant recipients. The mediators responsible for vascular proliferation and vasoconstriction typical of TCA remain largely unknown. We tested whether endothelin-1 (ET-1), a potent vasoconstrictor and mitogen, contributes to the pathogenesis and manifestations of TCA.
Methods and Results—
BQ-123, an ET-1 receptor-A antagonist, was infused into a coronary artery (40 nmol/min for 60 minutes) of 18 subjects, 6�4 years after transplantation. Vasomotor responses were measured in the infused artery and in a noninfused control artery in patients with (n=10) and without (n=8) advanced TCA (108 total coronary segments). Changes in diameters were compared at 15-minute intervals up to 60 minutes. Contribution of ET-1 to coronary constrictor tone was assessed by comparing vasodilation from BQ-123 with that of the maximal vasodilator nitroglycerin (200-μg intracoronary bolus).
BQ-123 dilated coronary arteries of transplanted patients (8.4% at 60 minutes versus −0.4% in noninfused arteries,
P
<0.001). Dilation was greater for arteries with advanced TCA defined as diameter stenosis ≥15% (dilation 15.2% with versus 0.6% without advanced TCA,
P
=0.004). Judged against the response to nitroglycerin, ET-1 accounted for 53.2% of coronary tone in advanced TCA but only 12.9% without advanced TCA.
Conclusions—
This study shows for the first time in humans that ET-1 is an important mediator of coronary vasoconstriction in TCA and accounts for >50% of the increased vasomotor tone. Therapeutic targeting of ET-1 may retard the development of TCA.
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Affiliation(s)
- Eric Larose
- From the Multidisciplinary Department of Cardiology (E.L.), Quebec Heart and Lung Institute at Laval Hospital and Laval University, Quebec, Canada; the Klinik fur Kardiologie (D.B.), Pneumologie und Angiologie, Universitaetsklinikum, Duesseldorf, Germany; the Cardiovascular Division (S.K., A.P.S.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass; the Division of Cardiology (P.G.), San Francisco General Hospital, University of California, San Francisco,
| | - Dominik Behrendt
- From the Multidisciplinary Department of Cardiology (E.L.), Quebec Heart and Lung Institute at Laval Hospital and Laval University, Quebec, Canada; the Klinik fur Kardiologie (D.B.), Pneumologie und Angiologie, Universitaetsklinikum, Duesseldorf, Germany; the Cardiovascular Division (S.K., A.P.S.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass; the Division of Cardiology (P.G.), San Francisco General Hospital, University of California, San Francisco,
| | - Scott Kinlay
- From the Multidisciplinary Department of Cardiology (E.L.), Quebec Heart and Lung Institute at Laval Hospital and Laval University, Quebec, Canada; the Klinik fur Kardiologie (D.B.), Pneumologie und Angiologie, Universitaetsklinikum, Duesseldorf, Germany; the Cardiovascular Division (S.K., A.P.S.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass; the Division of Cardiology (P.G.), San Francisco General Hospital, University of California, San Francisco,
| | - Andrew P. Selwyn
- From the Multidisciplinary Department of Cardiology (E.L.), Quebec Heart and Lung Institute at Laval Hospital and Laval University, Quebec, Canada; the Klinik fur Kardiologie (D.B.), Pneumologie und Angiologie, Universitaetsklinikum, Duesseldorf, Germany; the Cardiovascular Division (S.K., A.P.S.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass; the Division of Cardiology (P.G.), San Francisco General Hospital, University of California, San Francisco,
| | - Peter Ganz
- From the Multidisciplinary Department of Cardiology (E.L.), Quebec Heart and Lung Institute at Laval Hospital and Laval University, Quebec, Canada; the Klinik fur Kardiologie (D.B.), Pneumologie und Angiologie, Universitaetsklinikum, Duesseldorf, Germany; the Cardiovascular Division (S.K., A.P.S.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass; the Division of Cardiology (P.G.), San Francisco General Hospital, University of California, San Francisco,
| | - James C. Fang
- From the Multidisciplinary Department of Cardiology (E.L.), Quebec Heart and Lung Institute at Laval Hospital and Laval University, Quebec, Canada; the Klinik fur Kardiologie (D.B.), Pneumologie und Angiologie, Universitaetsklinikum, Duesseldorf, Germany; the Cardiovascular Division (S.K., A.P.S.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass; the Division of Cardiology (P.G.), San Francisco General Hospital, University of California, San Francisco,
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7
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Basic and applied research at the department of cardio-thoracic surgery: work in progress. Wien Klin Wochenschr 2008. [DOI: 10.1007/s00508-008-1044-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Heart transplantation in Vienna: 25 years of experience. Wien Klin Wochenschr 2008. [DOI: 10.1007/s00508-008-1042-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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de Resende MM, Kriegel AJ, Greene AS. Combined effects of low-dose spironolactone and captopril therapy in a rat model of genetic hypertrophic cardiomyopathy. J Cardiovasc Pharmacol 2007; 48:265-73. [PMID: 17204904 DOI: 10.1097/01.fjc.0000248236.43760.86] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
For several years, the severe side effects associated with the use of high doses of the aldosterone antagonist, spironolactone, limited its clinical use. Studies have recently shown efficacy and minimal side effects of low-dose spironolactone combined with standard therapy in the treatment of heart failure and hypertensive patients. The authors evaluated the effects of low-dose spironolactone alone or in combination with angiotensin-converting enzyme (ACE) inhibitors on the progression of left ventricular dysfunction and remodeling in a congenic rat model of hypertrophic cardiomyopathy. The congenic SS-16/Mcwi rats developed severe cardiac hypertrophy despite being normotensive even on high-salt diet. SS-16/Mcwi and SS/Mcwi rats were fed a low-salt (0.4% NaCl) diet and were treated with vehicle (CON), spironolactone (20 mg/kg/d subcutaneously), captopril (100 mg/kg/d drinking water), or both spironolactone and captopril for 4 weeks. Blood pressure, plasma peptides, cardiac fibrosis, and echocardiography measurements were evaluated. Spironolactone at a low dose had no effect on blood pressure, cardiac hypertrophy, and fibrosis in either strain. However, in combination with captopril, spironolactone decreased the cardiac hypertrophy more than captopril treatment alone. In the SS-16/Mcwi rats, the combined therapy significantly preserved the cardiac index when compared with control. These data indicate that the addition of low-dose spironolactone to captopril treatment was more effective in preventing the progression of heart hypertrophy and ventricular dysfunction in the SS-16/Mcwi than captopril alone. This study suggests that combined spironolactone and captopril therapy may be useful in the treatment of hypertrophic cardiomyopathy.
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MESH Headings
- Administration, Oral
- Aldosterone/blood
- Angiotensin II/blood
- Angiotensin-Converting Enzyme Inhibitors/administration & dosage
- Angiotensin-Converting Enzyme Inhibitors/therapeutic use
- Animals
- Animals, Congenic
- Atrial Natriuretic Factor/blood
- Blood Pressure/drug effects
- Captopril/administration & dosage
- Captopril/therapeutic use
- Cardiomyopathy, Hypertrophic/drug therapy
- Cardiomyopathy, Hypertrophic/genetics
- Cardiomyopathy, Hypertrophic/pathology
- Disease Models, Animal
- Diuretics/administration & dosage
- Diuretics/therapeutic use
- Dose-Response Relationship, Drug
- Drug Therapy, Combination
- Echocardiography/methods
- Injections, Subcutaneous
- Myocardium/pathology
- Organ Size/drug effects
- Random Allocation
- Rats
- Rats, Inbred Strains
- Spironolactone/administration & dosage
- Spironolactone/therapeutic use
- Ventricular Function, Left/drug effects
- Weight Loss/drug effects
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10
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Aharinejad S, Krenn K, Paulus P, Schäfer R, Zuckermann A, Grimm M, Abraham D. Differential role of TGF-beta1/bFGF and ET-1 in graft fibrosis in heart failure patients. Am J Transplant 2005; 5:2185-92. [PMID: 16095497 DOI: 10.1111/j.1600-6143.2005.01006.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Collagen overproduction characteristic for dilated cardiomyopathy (DCM) is coregulated by endothelin (ET)-1, transforming growth factor (TGF)-beta1, basic fibroblast growth factor (bFGF) and matrix metalloproteases (MMPs). Whether these molecules affect grafts transplanted to heart failure patients is unknown. In 67 idiopathic DCM patients, 31 patients with ischemic cardiomyopathy (ICM) and 16 controls, the myocardial bFGF, TGF-beta1, pro-collagen (PrCol) type 1 (PrCol1-alpha1, -alpha2) and MMP expressions were examined using real-time RT-PCR or Western blotting. mRNA expression was measured in grafts for 1 year. TGF-beta1/bFGF stimulation or gene silencing was used to examine their effect on collagen synthesis in cardiac tissue cultures. TGF-beta1 and PrCol1 were upregulated in DCM only, while bFGF was upregulated in both groups versus controls. TGF-beta1 downregulated MMP-1 and upregulated collagen 1, whereas bFGF upregulated MMP-13 in DCM tissue. Post-transplant PrCol1-alpha1, -alpha2 and ET-1 mRNA increased over time in grafts of DCM patients only, while other factors returned to control baseline levels in DCM and ICM. These data indicate that cardiac transplantation corrects the dysregulated TGF/bFGF/MMP-1/MMP-13, but not the excess collagen and ET-1 synthesis in cardiac grafts transplanted to DCM patients. ET-1 might be a major pathologic trigger for graft fibrosis in DCM.
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Affiliation(s)
- Seyedhossein Aharinejad
- Department of Cardio-Thoracic Surgery, Vienna Medical University, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
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11
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Schäfer R, Abraham D, Paulus P, Blumer R, Grimm M, Wojta J, Aharinejad S. Impaired VE-cadherin/beta-catenin expression mediates endothelial cell degeneration in dilated cardiomyopathy. Circulation 2003; 108:1585-91. [PMID: 12963640 DOI: 10.1161/01.cir.0000091085.12422.19] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The cross-talk between vascular endothelial growth factor (VEGF)-A, angiopoietin (Ang), and VE-cadherin coregulates endothelial cell (EC) survival. Cardiac expression of VEGF-A but not its receptor KDR is blunted in dilated cardiomyopathy (DCM). Whether VE-cadherin/Ang function is affected in DCM is unknown. METHODS AND RESULTS The myocardial expression of VE-cadherin/beta-catenin, Ang-1, Ang-2, and their receptor Tie-2 was examined in DCM, ischemic cardiomyopathy (ICM), and in control subjects through the use of real-time RT-PCR, Western blotting, and immunocytochemistry. EC degeneration was quantified by TEM. RNA interference against VE-cadherin and VEGF deprivation and stimulation were applied to cultured DCM myocardium and human microvascular ECs to examine the interplay between VEGF, VE-cadherin/beta-catenin, and Ang-2. Analysis of tissue sections with similar rates of EC degeneration in both patient groups showed that VE-cadherin/beta-catenin expression was downregulated in DCM only (P<0.05). Although Ang-1 was not changed, Ang-2 expression was downregulated and Tie-2 protein expression was upregulated both in DCM and ICM (P<0.05). The ratio of degenerated to normal ECs was significantly higher in DCM versus ICM (P<0.05). Targeted VE-cadherin gene silencing in cultured human ECs resulted in similar degenerative effects observed in myocardial ECs of DCM patients. In vitro experiments indicated that VE-cadherin/beta-catenin expression is independent of VEGF. CONCLUSIONS These results indicate for the first time that the EC survival is impaired in myocardium of patients with DCM involving VE-cadherin/beta-catenin, probably independent of VEGF. Targeting VE-cadherin might be of benefit to counteract the selective EC pathology in DCM.
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Affiliation(s)
- Romana Schäfer
- Laboratory for Cardiovascular Research, Department of Anatomy, University of Vienna, Vienna, Austria
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12
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Strametz-Juranek J, Pacher R, Kos T, Woloszczuk W, Grimm M, Zuckermann A, Stanek B. Sequential big endothelin plasma levels in heart transplant recipients during bridging therapy and after successful heart transplantation. J Heart Lung Transplant 2003; 22:731-7. [PMID: 12873540 DOI: 10.1016/s1053-2498(02)00642-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The purpose of this study was to investigate the impact of successful heart transplantation in patients with refractory heart failure receiving bridging therapy on sequential plasma levels of big endothelin, norepinephrine, atrial natriuretic peptide and aldosterone. METHODS Fourteen patients (2 women, 12 men) accepted for heart transplantation were studied. All had severe chronic heart failure refractory to optimized oral therapy with angiotensin-converting enzyme inhibitors and furosemide, were in New York Heart Association functional Class IV, and had a left ventricular ejection fraction of <15%, Right heart catheterization was performed in all patients (cardiac index 1.9 +/- 0.1 liters/min. m(2), pulmonary capillary wedge pressure 30 +/- 2 mmHg, systemic vascular resistance index 2,827 +/- 253 dyn. s/cm(5). m(2)). As bridging therapy, patients received either prostaglandin E(1), prostaglandin E(1) and dobutamine or dobutamine alone as a continuous infusion. Neurohumoral variables were measured prior to bridging therapy and 3.5 months before and 7 and 10 months after successful heart transplantation. RESULTS Big endothelin, norepinephrine and atrial natriuretic peptide plasma levels decreased from 7.4 +/- 2.9 fmol/ml, 1112 +/- 686 pg/ml and 366 +/- 312 pg/ml to 6.0 +/- 4.5 fmol/ml, 720 +/- 503 pg/ml and 198 +/- 160 pg/ml, respectively, after bridging therapy, and further to 2.1 +/- 0.9 fmol/ml (p < 0.00001 vs baseline), 527 +/- 31 pg/ml (p < 0.02 vs baseline) and 115 +/- 70 pg/ml (p < 0.03 vs baseline), respectively, after cardiac transplantation. Aldosterone plasma levels decreased from 242 +/- 220 pg/ml to 183 +/- 142 pg/ml during bridging therapy and increased after heart transplantation to 252 +/- 189 pg/ml. Plasma creatinine levels increased from 1.2 +/- 0.4 mg/dl at baseline to 1.4 +/- 0.2 mg/dl after transplantation (NS). CONCLUSIONS The study suggests that excessive overproduction of big endothelin, atrial natriuretic peptide and norepinephrine is predominantly related to pump failure and, after cardiac transplantation, a moderate spillover of big endothelin persists. Its specific origin, however, remains to be elucidated. Furthermore, our data suggest a protective effect of prostaglandin E(1) on kidney function after heart transplantation.
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Vasků A, Spinarová L, Goldbergová M, Muzik J, Spinar J, Vítovec J, Toman J, Vácha J. The double heterozygote of two endothelin-1 gene polymorphisms (G8002A and -3A/-4A) is related to big endothelin levels in chronic heart failure. Exp Mol Pathol 2002; 73:230-3. [PMID: 12565798 DOI: 10.1006/exmp.2002.2453] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to focus on the relationship among the associated genotypes of G (8002) A and -3A/-4A endothelin-1 (ET-1) gene polymorphisms and some clinical and/or biochemical parameters in Czech (Caucasian) patients with chronic heart failure. Included in the study were 103 patients with chronic heart failure (functional classes NYHA II-IV, ejection fraction < 40%). The ET-1 gene polymorphisms were detected by polymerase chain reaction (PCR) and restriction fragment length polymorphism methods. A significant decrease in the ET-1-associated genotype AG3A4A number (double heterozygote) was observed in CHF patients with plasma big endothelin levels above 0.7 pmol/L compared to those with levels below 0.7 pmol/L (OR = 0.19; 95% confidence interval = 0.06-0.57; P = 0.005; Pcorr = 0.03). We found a significant decrease in the AG3A4A genotype number in the other groups compared to the group of patients with both big endothelin and endothelin-1 levels under 0.7 pmol/L (OR = 0.22; 95% confidence interval = 0.07-0.79; P = 0.02). The double heterozygote variants of two ET-1 gene polymorphisms were associated with significantly less risk for chronic heart failure with higher levels of big endothelin.
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Affiliation(s)
- A Vasků
- Institute of Pathological Physiology, Faculty of Medicine, Masaryk University, Komenského nám. 2, 662 43 Brno, Czech Republic
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