1
|
Rosca CI, Lighezan DF, Nisulescu DD, Sharma A, Neagu MN, Nistor D, Georgescu D, Kundnani NR. Metabolic Syndrome: A Strange Companion of Atrial Fibrillation; A Blessing in Disguise from the Neuropsychiatric Point of View. Biomedicines 2023; 11:2012. [PMID: 37509651 PMCID: PMC10377522 DOI: 10.3390/biomedicines11072012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Background: The concept of metabolic syndrome (MetSy) brings together components that individually represent a risk factor for cardiovascular diseases, which over time can prove to be more harmful if a combined effect of these is exhibited. Method: A single-centre retrospective study in an academic medical unit was conducted. We analysed the link between the MetSy and the occurrence of neuropsychic complications among atrial fibrillation (AF) patients. We sifted through the files of the patients admitted during 2015-2016 to the Municipal Emergency University Hospital Timisoara, Romania, with the diagnosis of AF. We divided these AF patients into two groups: the first group comprised patients with atrial fibrillation and MetSy (267 patients), while the second group comprised AF patients without MetSy (843 patients). We analysed the occurrence of neuropsychic changes (stroke, Parkinson's disease, dementia, cognitive impairment, and silent lacunar infarction) among the two groups. Results: Cognitive impairment (p-value = 0.0081) and dementia (p-value < 0.0001) were less frequent in patients with AF and MetSy than in those with AF without MetSy. Regarding the presence of stroke and Parkinson's disease (PD), we could not demonstrate the existence of any statistically significant difference between the two groups. Using logistic regression (enter test), we found that MetSy might have a protective effect (OR = 0.4040, 95% CI [0.2132; 0.7654], p-value = 0.0054) for the occurrence of dementia in those patients. Furthermore, obesity was the only factor with a possible protective effect from all the constituents of the MetSy when analysed together (with a significance level of p-value = 0.0004 for the logistic regression). The protective effect of MetSy against stroke occurrence was supplementarily proven by a longer period of survival without stroke from the AF diagnosis (3.521 years, p = 0.0304) compared to patients with AF without MetSy (3.286 years to first stroke occurrence). Conclusions: Metabolic syndrome might offer protection against the occurrence of dementia among patients with AF, but no effect was noted when compared with the presence of stroke. Further studies on larger cohorts can help us reach a conclusion regarding the positive effects of the metabolic syndrome.
Collapse
Affiliation(s)
- Ciprian Ilie Rosca
- Department of Internal Medicine I-Medical Semiotics I, Centre for Advanced Research in Cardiovascular Pathology and Haemostasis, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timișoara, Romania
| | - Daniel Florin Lighezan
- Department of Internal Medicine I-Medical Semiotics I, Centre for Advanced Research in Cardiovascular Pathology and Haemostasis, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timișoara, Romania
| | | | - Abhinav Sharma
- Department of Cardiology-Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 3000041 Timișoara, Romania
| | - Marioara Nicula Neagu
- Faculty of Bioengineering of Animal Resources, Discipline of Physiology, University of Life Sciences "King Mihai I" from Timisoara, 300645 Timisoara, Romania
| | - Daciana Nistor
- Department of Functional Sciences, Physiology, Centre of Imuno-Physiology and Biotechnologies (CIFBIOTEH), Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Centre for Gene and Cellular Therapies in Cancer, 3000723 Timisoara, Romania
| | - Doina Georgescu
- Department of Internal Medicine I-Medical Semiotics I, Centre for Advanced Research in Cardiovascular Pathology and Haemostasis, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 300041 Timișoara, Romania
| | - Nilima Rajpal Kundnani
- Department of Cardiology-Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. no. 2, 3000041 Timișoara, Romania
| |
Collapse
|
2
|
HFpEF and Atrial Fibrillation: The Enigmatic Interplay of Dysmetabolism, Biomarkers, and Vascular Endothelial Dysfunction. DISEASE MARKERS 2022; 2022:9539676. [DOI: 10.1155/2022/9539676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/20/2022] [Indexed: 11/18/2022]
Abstract
Background. Heart failure with preserved ejection fraction (HFpEF) has a complex pathophysiology that encompasses systemic proinflammatory state and dysregulated levels of cardiometabolic and oxidative stress biomarkers. The prevalence of both HFpEF and atrial fibrillation (AF) is continuously rising, especially in the elderly. The aim of our study was to explore if there were any differences in biomarker levels and vascular function in the elderly patients with HFpEF with and without AF and to assess interconnections between clinically relevant biomarkers and cardiac and vascular function. Methods. This was a cross-sectional study of
years with HFpEF who were divided into 2 groups based on the presence or absence of AF. We have sonographically assessed echocardiographic parameters of left ventricular systolic and diastolic function and the peripheral vascular function parameters, namely, pulse wave velocity (PWV) and flow-mediated dilation (FMD). NT-proBNP, irisin, leptin, adiponectin, insulin-like growth factor 1 (IGF-1), and malondialdehyde (MDA) blood levels were determined. Results. Fifty-two patients (mean age
years, 67% females) were included. Patients with HFpEF and AF had significantly lower levels of irisin (median 4.75 vs. 13.5 ng/mL,
), leptin (median 9.5 vs. 15.0 ng/L,
), and MDA (median 293 vs. 450 ng/mL,
) and significantly higher values of NT-proBNP (median 2365 vs. 529 ng/L,
) but not vascular function parameters, as compared to HFpEF patients without AF. MDA was significantly correlated with diastolic function (
,
) and FMD (
,
), while adiponectin was inversely associated with FMD (
,
) and left ventricular ejection fraction (
,
). Conclusions. Our results have demonstrated that patients with HFpEF and AF have significantly lower leptin, irisin, and MDA levels compared to patients with HFpEF but without AF. These results offer new insights into the complexity of vascular function and cardiometabolic and oxidative stress biomarkers in the context of HFpEF, AF, and aging.
Collapse
|
3
|
Khokhlova A, Myachina T, Butova X, Kochurova A, Polyakova E, Galagudza M, Solovyova O, Kopylova G, Shchepkin D. The Acute Effects of Leptin on the Contractility of Isolated Rat Atrial and Ventricular Cardiomyocytes. Int J Mol Sci 2022; 23:ijms23158356. [PMID: 35955485 PMCID: PMC9369024 DOI: 10.3390/ijms23158356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023] Open
Abstract
Leptin is a pleiotropic peptide playing an important role in the regulation of cardiac functions. It is not clear whether leptin directly modulates the mechanical function of atrial cardiomyocytes. We compared the acute effects of leptin on the characteristics of mechanically non-loaded sarcomere shortening and cytosolic Ca2+ concentration ([Ca2+]i) transients in single rat atrial and ventricular cardiomyocytes. We also studied the functional properties of myosin obtained from cardiomyocytes using an in vitro motility assay and assessed the sarcomeric protein phosphorylation. Single cardiomyocytes were exposed to 5, 20, and 60 nM leptin for 60 min. In ventricular cardiomyocytes, 60 nM leptin depressed sarcomere shortening amplitude and decreased the rates of shortening and relaxation. These effects were accompanied by a decrease in the phosphorylation of cMyBP-C, an increase in Tpm phosphorylation, and a slowdown of the sliding velocity of thin filaments over myosin in the in vitro motility assay. In contrast, in atrial cardiomyocytes, the phosphorylation of cMyBP-C and TnI increased, and the characteristics of sarcomere shortening did not change. Leptin had no effect on the characteristics of [Ca2+]i transients in ventricular cardiomyocytes, while 5 nM leptin prolonged [Ca2+]i transients in atrial cardiomyocytes. Thus, leptin-induced changes in contractility of ventricular cardiomyocytes may be attributed to the direct effects of leptin on cross-bridge kinetics and sarcomeric protein properties rather than changes in [Ca2+]i. We also suggest that the observed differences between atrial and ventricular cardiomyocytes may be associated with the peculiarities of the expression of leptin receptors, as well as signaling pathways in the atrial and ventricular myocardium.
Collapse
Affiliation(s)
- Anastasia Khokhlova
- Institute of Immunology and Physiology, Russian Academy of Sciences, Pervomajskaya Str. 106, 620049 Yekaterinburg, Russia; (T.M.); (X.B.); (A.K.); (O.S.); (G.K.); (D.S.)
- Correspondence:
| | - Tatiana Myachina
- Institute of Immunology and Physiology, Russian Academy of Sciences, Pervomajskaya Str. 106, 620049 Yekaterinburg, Russia; (T.M.); (X.B.); (A.K.); (O.S.); (G.K.); (D.S.)
| | - Xenia Butova
- Institute of Immunology and Physiology, Russian Academy of Sciences, Pervomajskaya Str. 106, 620049 Yekaterinburg, Russia; (T.M.); (X.B.); (A.K.); (O.S.); (G.K.); (D.S.)
| | - Anastasia Kochurova
- Institute of Immunology and Physiology, Russian Academy of Sciences, Pervomajskaya Str. 106, 620049 Yekaterinburg, Russia; (T.M.); (X.B.); (A.K.); (O.S.); (G.K.); (D.S.)
| | - Ekaterina Polyakova
- Almazov National Medical Research Centre, Institute of Experimental Medicine, Akkuratova Str. 2, 197341 Saint-Petersburg, Russia; (E.P.); (M.G.)
| | - Michael Galagudza
- Almazov National Medical Research Centre, Institute of Experimental Medicine, Akkuratova Str. 2, 197341 Saint-Petersburg, Russia; (E.P.); (M.G.)
| | - Olga Solovyova
- Institute of Immunology and Physiology, Russian Academy of Sciences, Pervomajskaya Str. 106, 620049 Yekaterinburg, Russia; (T.M.); (X.B.); (A.K.); (O.S.); (G.K.); (D.S.)
| | - Galina Kopylova
- Institute of Immunology and Physiology, Russian Academy of Sciences, Pervomajskaya Str. 106, 620049 Yekaterinburg, Russia; (T.M.); (X.B.); (A.K.); (O.S.); (G.K.); (D.S.)
| | - Daniil Shchepkin
- Institute of Immunology and Physiology, Russian Academy of Sciences, Pervomajskaya Str. 106, 620049 Yekaterinburg, Russia; (T.M.); (X.B.); (A.K.); (O.S.); (G.K.); (D.S.)
| |
Collapse
|