1
|
Yeter HH, Levent M, Sahiner L, Yildirim T, Yilmaz R. Association of vascular endothelial growth factor-C, plasma angiotensinogen and left ventricular hypertrophy in patients with hemodialysis. Ther Apher Dial 2024. [PMID: 38894556 DOI: 10.1111/1744-9987.14178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/19/2024] [Accepted: 06/04/2024] [Indexed: 06/21/2024]
Abstract
INTRODUCTION This study aims to examine the relationship between fluid overload, Vascular Endothelial Growth Factor C (VEGF-C), plasma Angiotensinogen (pAGT), and echocardiography findings in hemodialysis patients. METHODS This was a single-center, cross-sectional study. Patients were divided into two groups according to mid-week inter-dialytic weight gain (mIDWG): (1) mIDWG ≤3% and (2) mIDW >3%. RESULTS A total of 55 patients were enrolled in this study. While the mean pAGT and left ventricular mass index were significantly higher in patients with mIDWG >3% compared to patients with mIDWG ≤3%, VEGF-C was similar between groups. pAGT ≥76.8 mcg/L, VEGF-C ≤175.5 pg/ML, and pAGT /VEGF-C ≥0.45 were significant cut-offs for the prediction of left ventricular hypertrophy(LVH). Univariate logistic regression analysis revealed that these cut-off values were significantly associated with LVH. CONCLUSION Renin-angiotensin-aldosterone system activation may persist in hemodialysis patients with excessive IDWG. Additionally, pAGT and VEGF-C could be risk factors for the development of LVH.
Collapse
Affiliation(s)
- Haci Hasan Yeter
- Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Levent
- Department of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Levent Sahiner
- Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tolga Yildirim
- Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Rahmi Yilmaz
- Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
2
|
Kumar R, Chhillar N, Gupta DS, Kaur G, Singhal S, Chauhan T. Cholesterol Homeostasis, Mechanisms of Molecular Pathways, and Cardiac Health: A Current Outlook. Curr Probl Cardiol 2024; 49:102081. [PMID: 37716543 DOI: 10.1016/j.cpcardiol.2023.102081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/18/2023]
Abstract
The metabolism of lipoproteins, which regulate the transit of the lipid to and from tissues, is crucial to maintaining cholesterol homeostasis. Cardiac remodeling is referred to as a set of molecular, cellular, and interstitial changes that, following injury, affect the size, shape, function, mass, and geometry of the heart. Acetyl coenzyme A (acetyl CoA), which can be made from glucose, amino acids, or fatty acids, is the precursor for the synthesis of cholesterol. In this article, the authors explain concepts behind cardiac remodeling, its clinical ramifications, and the pathophysiological roles played by numerous various components, such as cell death, neurohormonal activation, oxidative stress, contractile proteins, energy metabolism, collagen, calcium transport, inflammation, and geometry. The levels of cholesterol are traditionally regulated by 2 biological mechanisms at the transcriptional stage. First, the SREBP transcription factor family regulates the transcription of crucial rate-limiting cholesterogenic and lipogenic proteins, which in turn limits cholesterol production. Immune cells become activated, differentiated, and divided, during an immune response with the objective of eradicating the danger signal. In addition to creating ATP, which is used as energy, this process relies on metabolic reprogramming of both catabolic and anabolic pathways to create metabolites that play a crucial role in regulating the response. Because of changes in signal transduction, malfunction of the sarcoplasmic reticulum and sarcolemma, impairment of calcium handling, increases in cardiac fibrosis, and progressive loss of cardiomyocytes, oxidative stress appears to be the primary mechanism that causes the transition from cardiac hypertrophy to heart failure. De novo cholesterol production, intestinal cholesterol absorption, and biliary cholesterol output are consequently crucial processes in cholesterol homeostasis. In the article's final section, the pharmacological management of cardiac remodeling is explored. The route of treatment is explained in different steps: including, promising, and potential strategies. This chapter offers a brief overview of the history of the study of cholesterol absorption as well as the different potential therapeutic targets.
Collapse
Affiliation(s)
| | - Neelam Chhillar
- Deparetment of Biochemistry, School of Medicine, DY Patil University, Navi Mumbai, India
| | - Dhruv Sanjay Gupta
- Department of Pharmacology, SPP School of Pharmacy & Technology Management, SVKM's NMIMS, Mumbai, India
| | - Ginpreet Kaur
- Department of Pharmacology, SPP School of Pharmacy & Technology Management, SVKM's NMIMS, Mumbai, India
| | - Shailey Singhal
- Cluster of Applied Sciences, University of Petroleum and Energy Studies, Dehradun, India
| | - Tanya Chauhan
- Division of Forensic Biology, National Forensic Sciences University, Delhi Campus (LNJN NICFS) Delhi, India
| |
Collapse
|
3
|
Xiang S, Zuo M, Deng Y, Luo X, Dong Q, Chen J, Siu CW, Yin L. Volume markers in left ventricular diastolic dysfunction and adverse outcomes in peritoneal dialysis patients: a prospective cohort study. Sci Rep 2023; 13:16892. [PMID: 37803046 PMCID: PMC10558440 DOI: 10.1038/s41598-023-43442-x] [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: 07/25/2023] [Accepted: 09/24/2023] [Indexed: 10/08/2023] Open
Abstract
Left ventricular diastolic dysfunction (LVDD) is an early event associated with cardiovascular complications and poor prognosis in chronic kidney disease patients undergoing dialysis. In this study, we investigated whether diastolic dysfunction, measured by the E/E' ratio, affects adverse outcomes in peritoneal dialysis (PD) patients (n = 148). Our results showed that patients with an E/E' ratio ≥ 15 were more likely to be female, have a longer dialysis vintage, have significantly higher left atrial volume index and left atrial kinetic energy levels, have lower E' levels and LV hypertrophy (LVH) degree, and have higher volume markers. Kaplan-Meier curves revealed that patients with a higher E/E' ratio had worse survival and a higher risk of heart failure than those with a lower E/E' ratio. Subgroup analysis demonstrated that non-diabetic patients with a higher E/E' ratio had a higher risk of heart failure than those with a lower E/E' ratio. Cox proportional hazard regression analysis indicated that the ECW/ICW ratio was strongly associated with LVDD and confirmed that the E/E' ratio was an independent risk factor for overall death. Our study suggests that monitoring the E/E' ratio in PD patients is important for improving their prognosis.
Collapse
Affiliation(s)
- Shoubo Xiang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Mingliang Zuo
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
| | - Yan Deng
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xian Luo
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Qianhua Dong
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jin Chen
- Department of Nephrology, Institute of Nephrology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Chung-Wah Siu
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
| | - Lixue Yin
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
| |
Collapse
|
4
|
Faitatzidou D, Dipla K, Theodorakopoulou MP, Koutlas A, Tsitouridis A, Dimitriadis C, Pateinakis P, Zafeiridis A, Papagianni A, Jadoul M, Sarafidis P. Heart rate variability at rest and in response to stress: Comparative study between hemodialysis and peritoneal dialysis patients. Exp Biol Med (Maywood) 2023; 248:1745-1753. [PMID: 37916412 PMCID: PMC10792413 DOI: 10.1177/15353702231198081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 07/10/2023] [Indexed: 11/03/2023] Open
Abstract
Cardiac arrhythmias and sudden death are the leading causes of mortality in end-stage kidney disease (ESKD). Autonomic nervous system (ANS) dysfunction contributes to this arrhythmogenic background. This study compared heart rate variability (HRV) indices between hemodialysis (HD) and peritoneal dialysis (PD) patients, both at rest and in response to mental and physical stimulation maneuvers. Thirty-four HD and 34 PD patients matched for age, sex, and dialysis vintage, and 17 age- and sex-matched controls were studied. ANS function was examined by linear and non-linear HRV indices. Heart rate was recorded continuously (Finometer-PRO) at rest and during ANS maneuvers (orthostatic, mental-arithmetic, sit-to-stand, handgrip exercise tests). At rest, no significant differences between HD and PD were observed in HRV (root mean square of successive differences [RMSSD]: HD = 57.1 ± 81.1 vs PD = 69.6 ± 113.4 ms; P = 0.792), except for detrended fluctuation analysis (DFA-α1) (HD = 0.87 ± 0.40 vs PD = 0.70 ± 0.20; P = 0.047). DFA-α1 was significantly lower in PD than controls (1.00 ± 0.33; P < 0.05). All HRV indices during the mental-arithmetic test (RMSSD: HD = 128.2 ± 346.0 vs PD = 87.5 ± 150.0 ms; P = 0.893) and the physical stress tests were similar between HD and PD. The standard deviation along the line-of-identity (SD2)/the standard deviation perpendicular to the line-of-identity (SD1) ratio during mental-arithmetic was marginally lower in HD and significantly lower in PD than controls (PD = 1.31 ± 0.47 vs controls = 1.79 ± 0.64; P < 0.05). Both dialysis groups presented similar patterns in HRV responses during orthostatic and handgrip exercise tests. After the sit-to-stand, RMSSD, SD1, SD2, and DFA-α2 were higher compared to rest only in HD (RMSSD = 57.1 ± 81.1 vs 126.7 ± 185.7 ms; P = 0.028), suggesting a greater difficulty of HD patients in recovering normal ANS function in response to physical stress. In conclusion, HRV indices at rest and after mental and physical stimulation did not differ between HD and PD; however, the ANS responses following the sit-to-stand test were more impaired in HD. These findings suggest that ANS dysfunction is not largely affected by dialysis modality, but small differences in normal ANS recovery may exist.
Collapse
Affiliation(s)
- Danai Faitatzidou
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki GR54642, Greece
| | - Konstantina Dipla
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Thessaloniki GR57001, Greece
| | - Marieta P Theodorakopoulou
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki GR54642, Greece
| | - Aggelos Koutlas
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Thessaloniki GR57001, Greece
| | - Alexandros Tsitouridis
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki GR54642, Greece
| | - Chrysostomos Dimitriadis
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki GR54642, Greece
| | - Panagiotis Pateinakis
- Department of Nephrology, Papageorgiou General Hospital, Thessaloniki GR56429, Greece
| | - Andreas Zafeiridis
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Thessaloniki GR57001, Greece
| | - Aikaterini Papagianni
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki GR54642, Greece
| | - Michel Jadoul
- Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels B-1200, Belgium
| | - Pantelis Sarafidis
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki GR54642, Greece
| |
Collapse
|
5
|
Zhang L, Zhang X, Xue S. Left Heart Failure Caused by Capacity Overload in Peritoneal Dialysis Patients. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5422333. [PMID: 35607309 PMCID: PMC9124112 DOI: 10.1155/2022/5422333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/23/2022] [Accepted: 03/02/2022] [Indexed: 11/17/2022]
Abstract
Background This study sets out to investigate the incidence of acute left ventricular failure in peritoneal dialysis patients with different volume loads and to analyze the related risk factors for LVF in these patients. Methods This study involved patients who received peritoneal dialysis in our hospital between September 2018 and January 2021. The demographic data and biochemical indicators of the patients were collected. The bioimpedance analysis method was used to determine the volume overload [overhydration (OH)] level of patients, and cardiac color Doppler ultrasound was used to detect changes in their cardiac structure. According to the LVF diagnostic criteria of symptoms and laboratory tests, the patients were divided into the LVF and non-LVF groups and then divided according to their OH level into the normal volume (OH ≤1.1 L) and volume overload (OH >1.1 L) groups. The incidence of LVF in was analyzed in patients with different volume loads, and logistic regression was used to identify the risk factors for LVF. Results Among the 226 peritoneal dialysis patients enrolled in this study, 125 patients (55.3%) had LVF. The normal volume group (n = 68, 30.1%) included 22 patients (32.4%) with LVF, and the volume overload group (n = 158, 69.9%) included 84 patients (53.2%) with LVF. In the volume overload group, 74 patients (46.8%) had subclinical volume overload, including 35 patients (47.3%) with LVF, and 84 patients (53.2%) had clinical volume overload, including 65 patients (77.4%) LVF. Multivariate logistic regression analysis revealed a high OH level (OR = 1.862, 95% CI: 1.353-2.668, P < 0.001) and low hemoglobin level (OR = 0.845, 95% CI: 0.721-0.980, P = 0.008) to be independent risk factors for LVF. Conclusions LVF has a high incidence in peritoneal dialysis patients, especially those with volume overload. A high OH level and low hemoglobin level are independent risk factors for LVF.
Collapse
Affiliation(s)
- Lin Zhang
- Department of Nephrology, Municipal Hospital Affiliated to Xuzhou Medical University, Xuzhou First People's Hospital, Xuzhou, China
| | - Xiaocui Zhang
- Department of Pediatrics, East Hospital of the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Song Xue
- Department of Cardiology, Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| |
Collapse
|