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Gan S, Zhao L, Salman O, Wang Z, Ebert C, Azzo JD, Dib MJ, Zamani P, Cohen JB, Kammerhoff K, Schafer P, Seiffert DA, Ramirez-Valle F, Gordon DA, Cvijic ME, Gunawardhana K, Liu L, Chang CP, Cappola TP, Chirinos JA. Proteomic Correlates of the Urinary Protein/Creatinine Ratio in Heart Failure With Preserved Ejection Fraction. Am J Cardiol 2023; 206:312-319. [PMID: 37734292 PMCID: PMC10874232 DOI: 10.1016/j.amjcard.2023.08.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 09/23/2023]
Abstract
Proteinuria is common in heart failure with preserved ejection fraction (HFpEF), but its biologic correlates are poorly understood. We assessed the relation between 49 plasma proteins and the urinary protein/creatinine ratio (UPCR) in 365 participants in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial. Linear regression and network analysis were used to represent relations between protein biomarkers and UPCR. Higher UPCR was associated with older age, a greater proportion of female gender, smaller prevalence of previous myocardial infarction, and greater prevalence of diabetes, insulin use, smoking, and statin use, in addition to a lower estimated glomerular filtration rate, hematocrit, and diastolic blood pressure. Growth differentiation factor 15 (GDF-15; β = 0.15, p <0.0001), followed by N-terminal proatrial natriuretic peptide (NT-proANP; β = 0.774, p <0.0001), adiponectin (β = 0.0005, p <0.0001), fibroblast growth factor 23 (FGF-23, β = 0.177; p <0.0001), and soluble tumor necrosis factor receptors I (β = 0.002, p <0.0001) and II (β = 0.093, p <0.0001) revealed the strongest associations with UPCR. Network analysis showed that UPCR is linked to various proteins primarily through FGF-23, which, along with GDF-15, indicated node characteristics with strong connectivity, whereas UPCR did not. In a model that included FGF-23 and UPCR, the former was predictive of the risk of death or heart-failure hospital admission (standardized hazard ratio 1.83, 95% confidence interval 1.49 to 2.26, p <0.0001) and/or all-cause death (standardized hazard ratio 1.59, 95% confidence interval 1.22 to 2.07, p = 0.0005), whereas UPCR was not prognostic. Proteinuria in HFpEF exhibits distinct proteomic correlates, primarily through its association with FGF-23, a well-known prognostic marker in HFpEF. However, in contrast to FGF-23, UPCR does not hold independent prognostic value.
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Affiliation(s)
- Sushrima Gan
- Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Cardiovascular Medicine, Hospital of The University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lei Zhao
- Bristol-Myers Squibb Company, Lawrenceville, New Jersey
| | - Oday Salman
- Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Cardiovascular Medicine, Hospital of The University of Pennsylvania, Philadelphia, Pennsylvania
| | - Zhaoqing Wang
- Bristol-Myers Squibb Company, Lawrenceville, New Jersey
| | | | - Joe David Azzo
- Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Cardiovascular Medicine, Hospital of The University of Pennsylvania, Philadelphia, Pennsylvania
| | - Marie Joe Dib
- Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Cardiovascular Medicine, Hospital of The University of Pennsylvania, Philadelphia, Pennsylvania
| | - Payman Zamani
- Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Cardiovascular Medicine, Hospital of The University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jordana B Cohen
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Biostatistics, Epidemiology, and Informatics
| | | | - Peter Schafer
- Bristol-Myers Squibb Company, Lawrenceville, New Jersey
| | | | | | | | | | | | - Laura Liu
- Bristol-Myers Squibb Company, Lawrenceville, New Jersey
| | | | - Thomas P Cappola
- Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Cardiovascular Medicine, Hospital of The University of Pennsylvania, Philadelphia, Pennsylvania
| | - Julio A Chirinos
- Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Cardiovascular Medicine, Hospital of The University of Pennsylvania, Philadelphia, Pennsylvania.
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2
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Liao LP, Yang Y, Wu Y, Li W. Correlation analysis of the triglyceride glucose index and heart failure with preserved ejection fraction in essential hypertensive patients. Clin Cardiol 2022; 45:936-942. [PMID: 35770315 PMCID: PMC9451667 DOI: 10.1002/clc.23881] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Triglyceride glucose index (TyG index) is a novel marker of insulin resistance. Studies have shown that TyG index is closely associated with the occurrence of hypertension and cardiovascular disease. However, little is known about the correlation between TyG index and the occurrence of heart failure with preserved ejection fraction (HFpEF) in hypertensive patients. HYPOTHESIS Our study assumes that TyG index strongly correlates with occurence of HFpEF in hypertensive patients. METHODS This research enrolled 559 hypertensive patients (273 patients with HFpEF and 286 without HFpEF) admitted to the Department of Cardiology of Jiading Branch of Shanghai General Hospital from 2020 to 2021 as the study subjects. Gender, age, diastolic blood pressure, systolic blood pressure (SBP), and heart rate (HR) were recorded at admission. Medication history and fasting blood samples were harvested after admission to detect laboratory index. Cardiac function and ventricular structure index were measured by echocardiography. Pearson correlation analysis was conducted to identify the correlation of TyG index with cardiac function and ventricular structure. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of TyG index in HFpEF with hypertension. RESULTS HFpEF patients had higher diuretic use frequencies, fasting plasma glucose, NT-proBNP, triglycerides, TyG index, left atrial diameter (LAD), left ventricular mass index (LVMI), the ratio of peak E-velocity of mitral orifice to peak velocity of early diastolic mitral annulus (E/e'), and SBP but lower ratio of peak E of early diastolic maximum blood flow velocity to peak A of late diastolic maximum blood flow velocity of mitral orifice (E/A) and average e' than non-HFpEF patients. Moreover, TyG index was correlated with LAD, left ventricular ejection fraction (LVEF), LVMI, average e', E/e', and NT-proBNP. The multivariate regression analysis suggested that TyG index, E/e', and NT-proBNP were independent risk factors for HFpEF in hypertensive patients. Compared with E/e' and NT-proBNP, the area under the ROC curve (0.778 [95% confidence interval: 0.707-0.849]) was the largest for TyG index. CONCLUSION TyG index is higher in HFpEF patients than in non-HFpEF patients and related to cardiac diastolic function, which strongly correlates with occurrence of HFpEF in hypertensive patients.
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Affiliation(s)
- Li Ping Liao
- Cardiology Department, Jiading Branch of Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yang Yang
- Cardiology DepartmentThe First Affiliated Hospital of Anhui Medical UniversityHefeiAnhuiChina
| | - Yilin Wu
- Cardiology Department, Jiading Branch of Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Weizhen Li
- Cardiology Department, Shanghai General HospitalShanghai JiaoTong University School of MedicineShanghaiChina
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3
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de Alencar AKN, Wang H, de Oliveira GMM, Sun X, Zapata-Sudo G, Groban L. Crossroads between Estrogen Loss, Obesity, and Heart Failure with Preserved Ejection Fraction. Arq Bras Cardiol 2021; 117:1191-1201. [PMID: 34644788 PMCID: PMC8757160 DOI: 10.36660/abc.20200855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/16/2020] [Accepted: 01/27/2021] [Indexed: 11/24/2022] Open
Abstract
The prevalence of obesity and heart failure with preserved ejection fraction (HFpEF) increases significantly in postmenopausal women. Although obesity is a risk factor for left ventricular diastolic dysfunction (LVDD), the mechanisms that link the cessation of ovarian hormone production, and particularly estrogens, to the development of obesity, LVDD, and HFpEF in aging females are unclear. Clinical, and epidemiologic studies show that postmenopausal women with abdominal obesity (defined by waist circumference) are at greater risk for developing HFpEF than men or women without abdominal obesity. The study presents a review of clinical data that support a mechanistic link between estrogen loss plus obesity and left ventricular remodeling with LVDD. It also seeks to discuss potential cell and molecular mechanisms for estrogen-mediated protection against adverse adipocyte cell types, tissue depots, function, and metabolism that may contribute to LVDD and HFpEF.
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Affiliation(s)
| | - Hao Wang
- Wake Forest School of MedicineDepartments of AnesthesiologyWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Departments of Anesthesiology, Winston-Salem, North Carolina - Estados Unidos da América
- Wake Forest School of MedicineWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Internal Medicine-Section of Molecular Medicine, Winston-Salem, North Carolina - Estados Unidos da América
| | - Gláucia Maria Moraes de Oliveira
- Universidade Federal do Rio de JaneiroDepartamento de Clínica MédicaFaculdade de MedicinaRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro - Departamento de Clínica Médica, Faculdade de Medicina, Rio de Janeiro, RJ - Brasil
| | - Xuming Sun
- Wake Forest School of MedicineDepartments of AnesthesiologyWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Departments of Anesthesiology, Winston-Salem, North Carolina - Estados Unidos da América
| | - Gisele Zapata-Sudo
- Universidade Federal do Rio de JaneiroInstituto de Ciências BiomédicasRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro - Instituto de Ciências Biomédicas, Rio de Janeiro, RJ - Brasil
- Universidade Federal do Rio de JaneiroInstituto de Cardiologia Edson SaadFaculdade de MedicinaRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro - Instituto de Cardiologia Edson Saad, Faculdade de Medicina, Rio de Janeiro, RJ - Brasil
| | - Leanne Groban
- Wake Forest School of MedicineDepartments of AnesthesiologyWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Departments of Anesthesiology, Winston-Salem, North Carolina - Estados Unidos da América
- Wake Forest School of MedicineWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Internal Medicine-Section of Molecular Medicine, Winston-Salem, North Carolina - Estados Unidos da América
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4
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Obesity-associated cardiovascular risk in women: hypertension and heart failure. Clin Sci (Lond) 2021; 135:1523-1544. [PMID: 34160010 DOI: 10.1042/cs20210384] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/14/2021] [Accepted: 06/07/2021] [Indexed: 02/07/2023]
Abstract
The pathogenesis of obesity-associated cardiovascular diseases begins long prior to the presentation of a cardiovascular event. In both men and women, cardiovascular events, and their associated hospitalizations and mortality, are often clinically predisposed by the presentation of a chronic cardiovascular risk factor. Obesity increases the risk of cardiovascular diseases in both sexes, however, the clinical prevalence of obesity, as well as its contribution to crucial cardiovascular risk factors is dependent on sex. The mechanisms via which obesity leads to cardiovascular risk is also discrepant in women between their premenopausal, pregnancy and postmenopausal phases of life. Emerging data indicate that at all reproductive statuses and ages, the presentation of a cardiovascular event in obese women is strongly associated with hypertension and its subsequent chronic risk factor, heart failure with preserved ejection fraction (HFpEF). In addition, emerging evidence indicates that obesity increases the risk of both hypertension and heart failure in pregnancy. This review will summarize clinical and experimental data on the female-specific prevalence and mechanisms of hypertension and heart failure in women across reproductive stages and highlight the particular risks in pregnancy as well as emerging data in a high-risk ethnicity in women of African ancestry (AA).
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5
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Zhang S, Jin R, Li B. Serum NT-proBNP and TUG1 as novel biomarkers for elderly hypertensive patients with heart failure with preserved ejection fraction. Exp Ther Med 2021; 21:446. [PMID: 33747182 PMCID: PMC7967840 DOI: 10.3892/etm.2021.9874] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/08/2020] [Indexed: 02/06/2023] Open
Abstract
Patients with heart failure with preserved ejection fraction (HFPEF) account for ~50% of all cases of heart failure and their clinical prognosis is poor. The present study attempted to investigate the diagnostic value of circulating long non-coding RNA taurine upregulated gene 1 (TUG1) for HFPEF in subjects with hypertension. Between January 2017 and January 2019, 80 aged/elderly hypertensive patients with or without HFPEF were recruited for the present study. The concentration of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the serum was measured using ELISA and TUG1 expression levels were determined using reverse transcription-quantitative PCR. Echocardiography was used for the determination of cardiac function. The results indicated that the levels of NT-proBNP and TUG1 were increased in the serum of hypertensive patients with HFPEF. Pearson analysis demonstrated that NT-proBNP and TUG1 were positively correlated with the left atrial diameter and negatively correlated with the ratio of the peak flow velocity in the early diastolic phase to the peak flow velocity in the late diastolic phase. In addition, a positive correlation was confirmed between TUG1 and NT-proBNP levels. Receiver operating characteristic curve analysis demonstrated that TUG1 and NT-proBNP were useful biomarkers for the diagnosis of HFPEF. In conclusion, it was observed that NT-proBNP and TUG1 were increased in the serum of hypertensive patients with HFPEF. Furthermore, TUG1 and NT-proBNP were indicated to be useful plasma biomarkers for the diagnosis of HFPEF.
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Affiliation(s)
- Shuang Zhang
- Ultrasonic Department, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121000, P.R. China
| | - Rize Jin
- Ultrasonic Department, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121000, P.R. China
| | - Bi Li
- Ultrasonic Department, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121000, P.R. China
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Aleksenko L, Quaye IK. Pregnancy-induced Cardiovascular Pathologies: Importance of Structural Components and Lipids. Am J Med Sci 2020; 360:447-466. [PMID: 32540145 DOI: 10.1016/j.amjms.2020.05.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 03/09/2020] [Accepted: 05/07/2020] [Indexed: 01/22/2023]
Abstract
Pregnancy leads to adaptations for maternal and fetal energy needs. The cardiovascular system bears the brunt of the adaptations as the heart and vessels enable nutrient supply to maternal organs facilitated by the placenta to the fetus. The components of the cardiovascular system are critical in the balance between maternal homeostatic and fetus driven homeorhetic regulation. Since lipids intersect maternal cardiovascular function and fetal needs with growth and in stress, factors affecting lipid deposition and mobilization impact risk outcomes. Here, the cardiovascular components and functional derangements associated with cardiovascular pathology in pregnancy, vis-à-vis lipid deposition, mobilization and maternal and/or cardiac and fetal energy needs are detailed. Most reports on the components and associated pathology in pregnancy, are on derangements affecting the extracellular matrix and epicardial fat, followed by the endothelium, vascular smooth muscle, pericytes and myocytes. Targeted studies on all cardiovascular components and pathological outcomes in pregnancy will enhance targeted interventions.
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Affiliation(s)
- Larysa Aleksenko
- Division of Obstetrics and Gynecology, Department of Clinical Sciences, Lund University, Lund, Sweden.
| | - Isaac K Quaye
- Regent University College of Science and Technology, Accra, Ghana
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Kaya BC, Elkan H. Impact of Weight Loss with Laparoscopic Sleeve Gastrectomy on Left Ventricular Diastolic Function: a Prospective Study. Obes Surg 2020; 30:3280-3286. [DOI: 10.1007/s11695-020-04573-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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8
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Features of Adipokines Metabolism in Women with Arterial Hypertension and Obesity, Depending on the Left Ventricular Diastolic Function. Fam Med 2019. [DOI: 10.30841/2307-5112.5-6.2019.194133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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9
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Han X, Wang Y, Fu M, Song Y, Wang J, Cui X, Fan Y, Cao J, Luo J, Sun A, Zou Y, Hu K, Zhou J, Ge J. Effects of Adiponectin on Diastolic Function in Mice Underwent Transverse Aorta Constriction. J Cardiovasc Transl Res 2019; 13:225-237. [PMID: 31621035 PMCID: PMC7166206 DOI: 10.1007/s12265-019-09913-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/05/2019] [Indexed: 02/06/2023]
Abstract
Diastolic dysfunction is common in various cardiovascular diseases, which could be affected by adiponectin (APN). Nevertheless, the effects of APN on diastolic dysfunction in pressure overload model induced by transverse aorta constriction (TAC) remain to be further elucidated. Here, we demonstrated that treatment of APN attenuated diastolic dysfunction and cardiac hypertrophy in TAC mice. Notably, APN also improved active relaxation of adult cardiomyocytes, increased N2BA/N2B ratios of titin isoform, and reduced collagen type I to type III ratio and lysyl oxidase (Lox) expressions in the myocardial tissue. Moreover, APN supplementation suppressed TAC-induced oxidative stress. In vitro, inhibition of AMPK by compound C (Cpc) abrogated the effect of APN on modulation of titin isoform shift and the anti-hypertrophic effect of APN on cardiomyocytes induced by AngII. In summary, our findings indicate that APN could attenuate diastolic dysfunction in TAC mice, which are at least partially mediated by AMPK pathway.
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Affiliation(s)
- Xueting Han
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yanyan Wang
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mingqiang Fu
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yu Song
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jingfeng Wang
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaotong Cui
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuyuan Fan
- North Sichuan Medical College, Nanchong, Sichuan, China
| | - Juan Cao
- North Sichuan Medical College, Nanchong, Sichuan, China
| | - Jie Luo
- North Sichuan Medical College, Nanchong, Sichuan, China
| | - Aijun Sun
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yunzeng Zou
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Kai Hu
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jingmin Zhou
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Junbo Ge
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.
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10
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Dombrovska NS, Nastina OM, Voloshko VI, Pleskach OY. MORPHOLOGICAL AND FUNCTIONAL MYOCARDIAL ABNORMALITIES IN THE CHORNOBYL NPP ACCIDENT CLEAN-UP WORKERS OF «IODINE» PERIOD HAVING GOT TYPE 2 DIABETES MELLITUS. PROBLEMY RADIAT︠S︡IĬNOÏ MEDYT︠S︡YNY TA RADIOBIOLOHIÏ 2019; 23:302-330. [PMID: 30582854 DOI: 10.33145/2304-8336-2018-23-302-330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Evaluation of morphological and functional myocardial abnormalities in the Chornobyl NPP (ChNPP)accident clean-up workers (ACUW) of the «iodine» period exposed to ionizing radiation at a young age and havinggot the type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS The ChNPP ACUW of «iodine» period (n=111) exposed to ionizing radiation (IR) at a young age(18-35 years) were involved in the study. Subjects having got the T2DM were included in study Group I (n = 66), per-sons with normal glucose challenge test were selected as a comparison Group II (n = 45). External radiation doses (ERD)ranged from 10 to 860 mSv. The Group III (clinical control) included persons having got the T2DM with no radiationexposure in a history (n=20). Group IV was the normative one. There was no statistical difference between the groups inage, sociodemographic characteristics and level of education. Echocardiography and cardiac Doppler sonography wereperformed in one- and two-dimensional regimens according to the recommendations of the European Association ofEchocardiography. Total adiponectin and proinflammatory cytokine (TNF-α and IL-6) concentrations were assayed by theimmunoenzyme method. Statistical processing of data was carried out using the Microsoft® Exel 2002 software. RESULTS Myocardial remodeling in the ChNPP ACUW of a «iodine» period having the T2DM occurred through a sig-nificant increase of its linear parameters. Volumetric parameters (EDV, ESV and their indexes) were within maximumpermissible limits significantly exceeding however the values in the Group IV. There was aт increase in myocardialmass of the left ventricle and its indices with the formation of structural-geometric abnormalities, mainly in theform of concentric hypertrophy with a decrease in the myocardial contractile capacity. There was no differences ofthe vast majority of key morphometric parameters of myocardium in the dose subgroups, while in persons with ERD> 500 mSv the incidence of serious left ventricular hypertrophy (LVMMI > 149 g/m2) significantly exceeded thisvalue in individuals with lower ERD. At a maximum ERD the more intense fibroplastic processes were observed inmyocardium [a significant increase in the interstitial collagen volumetric fraction (ICVF)] as compared to the caseswith ERD up to 50 mSv. Intensification of myocardial fibroblastic processes occurred in the comparizin group andgroup off clinical control. In combination with concentric myocardial hypertrophy this may lead to an increased riskof cardiovascular complications. Strong negative correlation was revealed between the parameters of left ventricu-lar structure in diastole and adiponectin level in the ChNPP ACUW of a «iodine» period with diagnosed T2DM, high-lighting its cardioprotective effect. At the same time, the content of FNP-α and IL-6 proinflammatory cytokines hada positive correlation with the main parameters of abnormal myocardial remodeling, indicating the possibility oftheir role in unfavorable cardiovascular modifications. CONCLUSIONS The decreased adiponectin level and elevated levels of TNF-α and IL-6 in the ChNPP ACUW of a«iodine» period having got the T2DM are the meaningful factors in progression of LV geometric remodeling. Togetherwith fibroplastic processes (a significant increase in ICVF) this may be a basis for the development of myocardialremodeling processes, namely a concentric hypertrophy, which is a prerequisite for the development of complica-tions in cardiovascular system.
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Affiliation(s)
- N S Dombrovska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine
| | - O M Nastina
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine
| | - V I Voloshko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine
| | - O Ya Pleskach
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Melnykova str., Kyiv, 04050, Ukraine
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Sawada N, Daimon M, Kawata T, Nakao T, Kimura K, Nakanishi K, Kurano M, Hirokawa M, Xu B, Yamanaka Y, Kato TS, Watanabe M, Yatomi Y, Komuro I. The Significance of the Effect of Visceral Adiposity on Left Ventricular Diastolic Function in the General Population. Sci Rep 2019; 9:4435. [PMID: 30872595 PMCID: PMC6418254 DOI: 10.1038/s41598-018-37137-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/27/2018] [Indexed: 02/08/2023] Open
Abstract
We evaluated the association between visceral adiposity and left ventricular (LV) diastolic function in association with plasma adiponectin levels in 213 subjects without overt cardiac diseases. Abdominal visceral fat area was quantified by computed tomography. Excessive visceral fat was significantly associated with impaired diastolic parameters including E/A, E′ and E/E′. Although serum adiponectin levels decreased with increased visceral adiposity, there was no independent association between serum adiponectin levels and diastolic parameters, which suggest that the role of adiponectin in this association might be indirect.
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Affiliation(s)
- Naoko Sawada
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Masao Daimon
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan. .,Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan.
| | - Takayuki Kawata
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Tomoko Nakao
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan.,Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Koichi Kimura
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Koki Nakanishi
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Makoto Kurano
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Megumi Hirokawa
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Boqing Xu
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuko Yamanaka
- Department of Cardiovascular Medicine, Jichi Medical University, Tochigi, Japan
| | - Tomoko S Kato
- Department of Cardiology, The Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Masafumi Watanabe
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
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12
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Ndumele CE, Cobb L, Lazo M, Bello NA, Shah A, Nambi V, Blumenthal RS, Gerstenblith G, Solomon SD, Ballantyne CM, Selvin E, Coresh J. Weight History and Subclinical Myocardial Damage. Clin Chem 2018; 64:201-209. [PMID: 29158254 PMCID: PMC6219376 DOI: 10.1373/clinchem.2017.282798] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 11/03/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Excess weight is associated with subclinical myocardial damage, as reflected by high-sensitivity cardiac troponin T (hs-cTnT) concentrations, which portends high heart failure risk. However, the association between weight history and myocardial damage is unknown. METHODS We evaluated 9062 Atherosclerosis Risk in Communities (ARIC) visit 4 (1996-1999) participants with a body mass index (BMI) ≥ 18.5 kg/m2 and no previous cardiovascular disease. We cross-tabulated visit 4 ("current") BMI categories of normal weight, overweight, and obese with those at visit 1 (1987-1989) and with BMI categories calculated from self-reported weight at age 25 years. Duration of obesity was calculated in years. A cumulative weight measure of "excess BMI-years" was also calculated [product of mean BMI (centered at 25 kg/m2) over all ARIC time points × follow-up duration]. We used logistic regression to estimate associations of weight history metrics with increased hs-cTnT (≥14 ng/L) at visit 4. RESULTS Overall, 623 individuals (7%) had increased hs-cTnT at visit 4. Within each current BMI category, previous excess weight was associated with increased hs-cTnT, with the strongest associations for those with past and current obesity [odds ratio (OR), 3.85; 95% CI, 2.51-5.90 for obesity at age 25 years and visit 4]. Each 10-year longer obesity duration was associated with increased hs-cTnT (OR, 1.26; 95% CI, 1.17-1.35). Each 100 higher excess BMI-years was also progressively associated with increased hs-cTnT (OR, 1.21; 95% CI, 1.14-1.27). CONCLUSIONS Previous obesity and greater cumulative weight from young adulthood increase the likelihood of myocardial damage, indicating long-term toxic effects of adiposity on the myocardium and the need for weight maintenance strategies targeting the entire life span.
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Affiliation(s)
- Chiadi E Ndumele
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD;
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Mariana Lazo
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Natalie A Bello
- Division of Cardiology, Columbia University Medical Center, New York, NY
| | - Amil Shah
- Division of Cardiology, Brigham and Women's Hospital, Boston, MA
| | - Vijay Nambi
- Michael E. DeBakey Veterans Affairs Hospital, Houston, TX
- Division of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Gary Gerstenblith
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Scott D Solomon
- Division of Cardiology, Brigham and Women's Hospital, Boston, MA
| | - Christie M Ballantyne
- Division of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX
| | - Elizabeth Selvin
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Josef Coresh
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Francisco C, Neves JS, Falcão-Pires I, Leite-Moreira A. Can Adiponectin Help us to Target Diastolic Dysfunction? Cardiovasc Drugs Ther 2017; 30:635-644. [PMID: 27757724 DOI: 10.1007/s10557-016-6694-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Adiponectin is the most abundant adipokine and exhibits anti-inflammatory, antiatherogenic and antidiabetic properties. Unlike other adipokines, it inversely correlates with body weight and obesity-linked cardiovascular complications. Diastolic dysfunction is the main mechanism responsible for approximately half of all heart failure cases, the so-called heart failure with preserved ejection fraction (HFpEF), but therapeutic strategies specifically directed towards these patients are still lacking. In the last years, a link between adiponectin and diastolic dysfunction has been suggested. There are several mechanisms through which adiponectin may prevent most of the pathophysiologic mechanisms underlying diastolic dysfunction and HFpEF, including the prevention of myocardial hypertrophy, cardiac fibrosis, nitrative and oxidative stress, atherosclerosis and inflammation, while promoting angiogenesis. Thus, understanding the mechanisms underlying adiponectin-mediated improvement of diastolic function has become an exciting field of research, making adiponectin a promising therapeutic target. In this review, we explore the relevance of adiponectin signaling for the prevention of diastolic dysfunction and identify prospective therapeutic targets aiming at the treatment of this clinical condition.
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Affiliation(s)
- Catarina Francisco
- Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Alameda Hernâni Monteiro, 4200-319, Porto, Portugal
| | - João Sérgio Neves
- Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Alameda Hernâni Monteiro, 4200-319, Porto, Portugal
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Inês Falcão-Pires
- Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Alameda Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Adelino Leite-Moreira
- Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Alameda Hernâni Monteiro, 4200-319, Porto, Portugal.
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14
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Faxén UL, Hage C, Andreasson A, Donal E, Daubert JC, Linde C, Brismar K, Lund LH. HFpEF and HFrEF exhibit different phenotypes as assessed by leptin and adiponectin. Int J Cardiol 2017; 228:709-716. [DOI: 10.1016/j.ijcard.2016.11.194] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/06/2016] [Indexed: 12/18/2022]
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Obesity Paradox in Off-Pump Coronary Artery Bypass Surgery: Does It Benefit the Elderly? Ann Thorac Surg 2016; 102:1974-1980. [DOI: 10.1016/j.athoracsur.2016.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 03/14/2016] [Accepted: 05/02/2016] [Indexed: 11/21/2022]
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16
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Serrano-Ferrer J, Crendal E, Walther G, Vinet A, Dutheil F, Naughton G, Lesourd B, Chapier R, Courteix D, Obert P. Effects of lifestyle intervention on left ventricular regional myocardial function in metabolic syndrome patients from the RESOLVE randomized trial. Metabolism 2016; 65:1350-60. [PMID: 27506742 DOI: 10.1016/j.metabol.2016.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/07/2016] [Accepted: 05/11/2016] [Indexed: 12/18/2022]
Abstract
AIMS The purpose of our study was to determine the effect of lifestyle intervention on left ventricular (LV) regional myocardial function in patients with metabolic syndrome (MetS) and investigate the relationships of the changes in myocardial function to changes in epicardial adipose tissue (EAT), inflammatory profile and MetS components. METHODS Eighty-seven MetS patients were enrolled in a 6month lifestyle intervention program based on dietary management and increased physical activity, and compared with 44 aged and sex-matched healthy controls. MetS individuals were allocated to different groups randomized (computer-generated randomization) on exercise modalities (high-intensity dominant resistance or aerobic training, and moderate-intensity of both modes). EAT was measured by transthoracic echocardiography and LV longitudinal strains and strain rates were obtained using vector velocity imaging. Blood chemistry allowed assessments of adipocytokines (TNF-α: tumor necrosis factor α, PAI active: active plasminogen activator inhibitor-1 and adiponectin) and glucose tolerance markers. RESULTS Regardless of exercise training modalities, lifestyle intervention improved significantly LV strains and strain rates (p<0.001) as well as metabolic and inflammatory profiles. Stepwise multiple regression analyses revealed EAT (β=0.73, p<0.01), log adiponectin (β=-0.13, p<0.05) and log TNF-α (β=0.15, p<0.05) as independent predictors of LV longitudinal strain (R(2)=0.74, p<0.001) while myocardial function improvement consecutive to lifestyle intervention was explained by EAT changes only (R(2)=0.54, p<0.001). CONCLUSION The mechanisms through which regional myocardial function is impaired in MetS and improved consecutive to intervention involved EAT, possibly via paracrine effects of adipocytokines. EAT should be considered as a future therapeutic target of interest in the treatment of metabolic-related cardiac diseases.
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Affiliation(s)
- Juan Serrano-Ferrer
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, Avignon, France
| | - Edward Crendal
- Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia
| | - Guillaume Walther
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, Avignon, France
| | - Agnes Vinet
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, Avignon, France
| | - Frédéric Dutheil
- Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia; EA3533 AME2P, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Clermont Auvergne University, Clermont-Ferrand, France; Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Geraldine Naughton
- Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia
| | - Bruno Lesourd
- EA3533 AME2P, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Clermont Auvergne University, Clermont-Ferrand, France
| | - Robert Chapier
- EA3533 AME2P, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Clermont Auvergne University, Clermont-Ferrand, France
| | - Daniel Courteix
- Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia; EA3533 AME2P, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions, Clermont Auvergne University, Clermont-Ferrand, France
| | - Philippe Obert
- EA4278 LaPEC, Laboratory of Cardiovascular Pharm-Ecology, Avignon University, Avignon, France; Australian Catholic University, Faculty of Health, School of Exercise Science, East Melbourne, Victoria, Australia.
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17
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Ndumele CE, Matsushita K, Lazo M, Bello N, Blumenthal RS, Gerstenblith G, Nambi V, Ballantyne CM, Solomon SD, Selvin E, Folsom AR, Coresh J. Obesity and Subtypes of Incident Cardiovascular Disease. J Am Heart Assoc 2016; 5:e003921. [PMID: 27468925 PMCID: PMC5015307 DOI: 10.1161/jaha.116.003921] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 06/23/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Obesity is a risk factor for various subtypes of cardiovascular disease (CVD), including coronary heart disease (CHD), heart failure (HF), and stroke. Nevertheless, there are limited comparisons of the associations of obesity with each of these CVD subtypes, particularly regarding the extent to which they are unexplained by traditional CVD mediators. METHODS AND RESULTS We followed 13 730 participants in the Atherosclerosis Risk in Communities (ARIC) study who had a body mass index ≥18.5 and no CVD at baseline (visit 1, 1987-1989). We compared the association of higher body mass index with incident HF, CHD, and stroke before and after adjusting for traditional CVD mediators (including systolic blood pressure, diabetes mellitus, and lipid measures). Over a median follow-up of 23 years, there were 2235 HF events, 1653 CHD events, and 986 strokes. After adjustment for demographics, smoking, physical activity, and alcohol intake, higher body mass index had the strongest association with incident HF among CVD subtypes, with hazard ratios for severe obesity (body mass index ≥35 versus normal weight) of 3.74 (95% CI 3.24-4.31) for HF, 2.00 (95% CI 1.67-2.40) for CHD, and 1.75 (95% CI 1.40-2.20) for stroke (P<0.0001 for comparisons of HF versus CHD or stroke). Further adjustment for traditional mediators fully explained the association of higher body mass index with CHD and stroke but not with HF (hazard ratio 2.27, 95% CI 1.94-2.64). CONCLUSIONS The link between obesity and HF was stronger than those for other CVD subtypes and was uniquely unexplained by traditional risk factors. Weight management is likely critical for optimal HF prevention, and nontraditional pathways linking obesity to HF need to be elucidated.
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Affiliation(s)
- Chiadi E Ndumele
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Kunihiro Matsushita
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Mariana Lazo
- Department of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Natalie Bello
- Division of Cardiology, Columbia University Medical Center, New York, NY
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Gary Gerstenblith
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Vijay Nambi
- Michael E DeBakey Veterans Affairs Hospital, Houston, TX Division of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX
| | - Christie M Ballantyne
- Division of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX
| | - Scott D Solomon
- Division of Cardiology, Brigham and Womens' Hospital, Boston, MA
| | - Elizabeth Selvin
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Aaron R Folsom
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Josef Coresh
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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18
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Yanagihara H, Ushijima K, Arakawa Y, Aizawa KI, Fujimura A. Effects of telmisartan and olmesartan on insulin sensitivity and renal function in spontaneously hypertensive rats fed a high fat diet. J Pharmacol Sci 2016; 131:190-7. [PMID: 27430988 DOI: 10.1016/j.jphs.2016.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 06/05/2016] [Accepted: 06/20/2016] [Indexed: 02/07/2023] Open
Abstract
Although telmisartan, an angiotensin II receptor blocker (ARB), has an agonistic action for proliferator-activated receptor (PPAR)-γ in vitro, it remains to be determined whether telmisartan exerts such an action in vivo using a non-toxic dose (<5 mg/kg in rats). To address the issue, telmisartan (2 mg/kg) and olmesartan (2 mg/kg), another ARB without PPAR-γ agonistic action, were given to spontaneously hypertensive rats (SHR) fed a high fat diet (HFD). HFD decreased plasma adiponectin, and caused insulin resistance, hypertriglyceridemia and renal damage, which were improved by ARBs. Protective effects of telmisartan and olmesartan did not significantly differ. In addition, in vitro study showed that 1 μM of telmisartan did not elevate the mRNA expression of adipose protein 2, which is a PPAR-γ-stimulated adipogenic marker gene, in preadipocytes with 3% albumin. To obtain 1 μM of plasma concentration, oral dose of telmisartan was calculated to be 6 mg/kg, which indicates that PPAR-γ agonistic action is negligible with a non-toxic dose of telmisartan (<5 mg/kg) in rats. This study showed that 2 mg/kg of telmisartan and olmesartan ameliorated insulin resistance, hypertriglyceridemia and renal damage in SHR fed a HFD. As beneficial effects of telmisartan and olmesartan did not significantly differ, these were mediated through the PPAR-γ-independent actions.
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Affiliation(s)
- Hayato Yanagihara
- Division of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University, Tochigi, 329-0498, Japan
| | - Kentaro Ushijima
- Division of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University, Tochigi, 329-0498, Japan
| | - Yusuke Arakawa
- Division of Nephrology, Department of Internal Medicine, Nippon Medical University, Tokyo, Japan
| | - Ken-Ichi Aizawa
- Division of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University, Tochigi, 329-0498, Japan
| | - Akio Fujimura
- Division of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University, Tochigi, 329-0498, Japan.
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Sente T, Van Berendoncks AM, Hoymans VY, Vrints CJ. Adiponectin resistance in skeletal muscle: pathophysiological implications in chronic heart failure. J Cachexia Sarcopenia Muscle 2016; 7:261-74. [PMID: 27239409 PMCID: PMC4864225 DOI: 10.1002/jcsm.12086] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 09/25/2015] [Indexed: 12/20/2022] Open
Abstract
Skeletal muscle wasting is a common complication of chronic heart failure (CHF) and linked to poor patient prognosis. In recent years, adiponectin was postulated to be centrally involved in CHF-associated metabolic failure and muscle wasting. This review discusses current knowledge on the role of adiponectin in CHF. Particular emphasis will be given to the complex interaction mechanisms and the intracellular pathways underlying adiponectin resistance in skeletal muscle of CHF patients. In this review, we propose that the resistance process is multifactorial, integrating abnormalities emanating from insulin signalling, mitochondrial biogenesis, and ceramide metabolism.
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Affiliation(s)
- Tahnee Sente
- Laboratory for Cellular and Molecular Cardiology Antwerp University Hospital Edegem Belgium; Cardiovascular Diseases, Department of Translational Pathophysiological Research University of Antwerp Wilrijk Belgium
| | - An M Van Berendoncks
- Laboratory for Cellular and Molecular Cardiology Antwerp University Hospital Edegem Belgium; Cardiovascular Diseases, Department of Translational Pathophysiological Research University of Antwerp Wilrijk Belgium
| | - Vicky Y Hoymans
- Laboratory for Cellular and Molecular Cardiology Antwerp University Hospital Edegem Belgium; Cardiovascular Diseases, Department of Translational Pathophysiological Research University of Antwerp Wilrijk Belgium
| | - Christiaan J Vrints
- Laboratory for Cellular and Molecular Cardiology Antwerp University Hospital Edegem Belgium; Cardiovascular Diseases, Department of Translational Pathophysiological Research University of Antwerp Wilrijk Belgium
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20
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Fontes-Carvalho R, Pimenta J, Bettencourt P, Leite-Moreira A, Azevedo A. Association between plasma leptin and adiponectin levels and diastolic function in the general population. Expert Opin Ther Targets 2015; 19:1283-91. [DOI: 10.1517/14728222.2015.1019468] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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21
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Low-molecular-weight adiponectin is more closely associated with disease activity of rheumatoid arthritis than other adiponectin multimeric forms. Clin Rheumatol 2015; 34:1025-30. [PMID: 25750183 DOI: 10.1007/s10067-015-2899-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 12/31/2014] [Accepted: 02/11/2015] [Indexed: 12/29/2022]
Abstract
Adiponectin is divided into high-molecular-weight (HMW), medium-molecular-weight (MMW), and low-molecular-weight (LMW) forms. These forms differ not only in the number of adiponectin molecules but also in their biological activity. There are conflicting findings regarding the role of adiponectin in rheumatoid arthritis (RA). Moreover, few reports have described the relationships between serum adiponectin multimers levels and RA. Therefore, we examined the association of total adiponectin and its multimers with RA. Two study groups were examined: 180 recently diagnosed untreated RA patients with disease duration less than 1 year (RA group) and 160 age- and sex-matched control subjects (control group). RA-related factors, blood pressure, body mass index, glucose, complete lipid profile, and adiponectin multimers were measured. The levels of total adiponectin and each multimer of adiponectin were significantly lower in the RA than in the control (P < 0.01). Serum levels of total, HMW, MMW, and LMW were positively correlated with triglycerides levels and negatively correlated with the Disease Activity Score for 28 joints (DAS28). Multivariate regression analysis showed that total, HMW, and MMW adiponectin were independently associated with serum triglycerides level. LMW adiponectin was independently correlated with serum triglycerides level and DAS28. The decreased LMW adiponectin levels may be associated with disease activity of RA.
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Peer M, Mashavi M, Matas Z, Harpaz D, Shargorodsky M. Adiponectin as an Independent Predictor of Left Ventricular Hypertrophy in Nondiabetic Patients With Hypertension. Angiology 2015; 66:219-224. [DOI: 10.1177/0003319714523332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
We evaluated novel and traditional biomarkers as well as hemodynamic parameters associated with the development of left ventricular hypertrophy (LVH) in nondiabetic patients with hypertension. Nondiabetic patients with hypertension (n = 86) were evaluated for lipids, glucose, insulin, homeostasis model assessment-insulin resistance (HOMA-IR), adiponectin, aldosterone, renin, matrix metalloproteinase 2, and endothelin. Arterial elasticity was evaluated using pulse wave contour. The LVH parameters were assessed echographically. Adiponectin was significantly and inversely associated with left ventricular mass (LVM; P = .032). The aldosterone–renin ratio (ARR) was significantly, positively associated with LVM ( P = .031). Fasting insulin as well as HOMA-IR was significantly, positively associated with LVM ( P = .036 and P = .025, respectively). In multiple linear regression analysis, adiponectin and ARR remained a significant predictor of LVM. The present study found that adiponectin and ARR are important independent determinants of LVH in nondiabetic patients with hypertension.
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Affiliation(s)
- Maya Peer
- Department of Internal Medicine, Wolfson Medical Center, Holon, Israel
| | - Margarita Mashavi
- Department of Internal Medicine, Wolfson Medical Center, Holon, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Zipora Matas
- Department of Biochemistry, Wolfson Medical Center, Holon, Israel
| | - David Harpaz
- Department of Cardiology , Wolfson Medical Center, Holon, Israel
| | - Marina Shargorodsky
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Endocrinology, Wolfson Medical Center, Holon, Israel
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23
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Role of RAAS and adipokines in cardiovascular protection: effect of different doses of angiotensin II receptor blocker on adipokines level in hypertensive patients. ACTA ACUST UNITED AC 2014; 8:709-14. [DOI: 10.1016/j.jash.2014.07.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 07/23/2014] [Accepted: 07/26/2014] [Indexed: 01/24/2023]
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24
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Tanaka K, Wilson RM, Essick EE, Duffen JL, Scherer PE, Ouchi N, Sam F. Effects of adiponectin on calcium-handling proteins in heart failure with preserved ejection fraction. Circ Heart Fail 2014; 7:976-85. [PMID: 25149095 DOI: 10.1161/circheartfailure.114.001279] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Despite the increasing prevalence of heart failure with preserved ejection fraction (HFpEF) in humans, there remains no therapeutic options for HFpEF. Adiponectin, an adipocyte-derived cytokine, exerts cardioprotective actions, and its deficiency is implicated in the development of hypertension and HF with reduced ejection fraction. Similarly, adiponectin deficiency in HFpEF exacerbates left ventricular hypertrophy, diastolic dysfunction, and HF. However, the therapeutic effects of adiponectin in HFpEF remain unknown. We sought to test the hypothesis that chronic adiponectin overexpression protects against the progression of HF in a murine model of HFpEF. METHODS AND RESULTS Adiponectin transgenic and wild-type mice underwent uninephrectomy, a continuous saline or d-aldosterone infusion and given 1.0% sodium chloride drinking water for 4 weeks. Aldosterone-infused wild-type mice developed HFpEF with hypertension, left ventricular hypertrophy, and diastolic dysfunction. Aldosterone infusion increased myocardial oxidative stress and decreased sarcoplasmic reticulum Ca(2+)-ATPase protein expression in HFpEF. Although total phospholamban protein expression was unchanged, there was a decreased expression of protein kinase A-dependent phospholamban phosphorylation at Ser16 and CaMKII (Ca(2+)/calmodulin-dependent protein kinase II)-dependent phospholamban phosphorylation at Thr17. Adiponectin overexpression in aldosterone-infused mice ameliorated left ventricular hypertrophy, diastolic dysfunction, lung congestion, and myocardial oxidative stress without affecting blood pressure and left ventricular EF. This improvement in diastolic dysfunction parameters in aldosterone-infused adiponectin transgenic mice was accompanied by the preserved protein expression of protein kinase A-dependent phosphorylation of phospholamban at Ser16. Adiponectin replacement prevented the progression of aldosterone-induced HFpEF, independent of blood pressure, by improving diastolic dysfunction and by modulating cardiac hypertrophy. CONCLUSIONS These findings suggest that adiponectin may have therapeutic effects in patients with HFpEF.
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Affiliation(s)
- Komei Tanaka
- From the Whitaker Cardiovascular Institute (K.T., R.M.W., E.E.E., J.L.D., N.O., F.S.) and Cardiovascular Section and Evans Department of Medicine (F.S.), Boston University School of Medicine, MA; and Touchstone Diabetes Center, Departments of Internal Medicine and Cell Biology, University of Texas Southwestern Medical Center, Dallas (P.E.S.)
| | - Richard M Wilson
- From the Whitaker Cardiovascular Institute (K.T., R.M.W., E.E.E., J.L.D., N.O., F.S.) and Cardiovascular Section and Evans Department of Medicine (F.S.), Boston University School of Medicine, MA; and Touchstone Diabetes Center, Departments of Internal Medicine and Cell Biology, University of Texas Southwestern Medical Center, Dallas (P.E.S.)
| | - Eric E Essick
- From the Whitaker Cardiovascular Institute (K.T., R.M.W., E.E.E., J.L.D., N.O., F.S.) and Cardiovascular Section and Evans Department of Medicine (F.S.), Boston University School of Medicine, MA; and Touchstone Diabetes Center, Departments of Internal Medicine and Cell Biology, University of Texas Southwestern Medical Center, Dallas (P.E.S.)
| | - Jennifer L Duffen
- From the Whitaker Cardiovascular Institute (K.T., R.M.W., E.E.E., J.L.D., N.O., F.S.) and Cardiovascular Section and Evans Department of Medicine (F.S.), Boston University School of Medicine, MA; and Touchstone Diabetes Center, Departments of Internal Medicine and Cell Biology, University of Texas Southwestern Medical Center, Dallas (P.E.S.)
| | - Philipp E Scherer
- From the Whitaker Cardiovascular Institute (K.T., R.M.W., E.E.E., J.L.D., N.O., F.S.) and Cardiovascular Section and Evans Department of Medicine (F.S.), Boston University School of Medicine, MA; and Touchstone Diabetes Center, Departments of Internal Medicine and Cell Biology, University of Texas Southwestern Medical Center, Dallas (P.E.S.)
| | - Noriyuki Ouchi
- From the Whitaker Cardiovascular Institute (K.T., R.M.W., E.E.E., J.L.D., N.O., F.S.) and Cardiovascular Section and Evans Department of Medicine (F.S.), Boston University School of Medicine, MA; and Touchstone Diabetes Center, Departments of Internal Medicine and Cell Biology, University of Texas Southwestern Medical Center, Dallas (P.E.S.)
| | - Flora Sam
- From the Whitaker Cardiovascular Institute (K.T., R.M.W., E.E.E., J.L.D., N.O., F.S.) and Cardiovascular Section and Evans Department of Medicine (F.S.), Boston University School of Medicine, MA; and Touchstone Diabetes Center, Departments of Internal Medicine and Cell Biology, University of Texas Southwestern Medical Center, Dallas (P.E.S.).
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25
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Grossini E, Prodam F, Walker GE, Sigaudo L, Farruggio S, Bellofatto K, Marotta P, Molinari C, Mary D, Bona G, Vacca G. Effect of monomeric adiponectin on cardiac function and perfusion in anesthetized pig. J Endocrinol 2014; 222:137-49. [PMID: 24860147 DOI: 10.1530/joe-14-0170] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Adiponectin, the most abundant adipokine released by adipose tissue, appears to play an important role in the regulation of vascular endothelial and cardiac function. To date, however, the physiological effects of human monomeric adiponectin on the coronary vasculature and myocardial systo-diastolic function, as well as on parasympathetic/sympathetic involvement and nitric oxide (NO) release, have not yet been investigated. Thus, we planned to determine the primary in vivo effects of human monomeric adiponectin on coronary blood flow and cardiac contractility/relaxation and the related role of autonomic nervous system, adiponectin receptors, and NO. In 30 anesthetized pigs, human monomeric adiponectin was infused into the left anterior descending coronary artery at constant heart rate and arterial blood pressure, and the effects on coronary blood flow, left ventricular systo-diastolic function, myocardial oxygen metabolism, and NO release were examined. The mechanisms of the observed hemodynamic responses were also analyzed by repeating the highest dose of human monomeric adiponectin infusion after autonomic nervous system and NO blockade, and after specific adiponectin 1 receptor antagonist administration. Intracoronary human monomeric adiponectin caused dose-related increases of coronary blood flow and cardiac function. Those effects were accompanied by increased coronary NO release and coronary adiponectin levels. Moreover, the vascular effects of the peptide were prevented by blockade of β2-adrenoceptors and NO synthase, whereas all effects of human monomeric adiponectin were prevented by adiponectin 1 receptor inhibitor. In conclusion, human monomeric adiponectin primarily increased coronary blood flow and cardiac systo-diastolic function through the involvement of specific receptors, β2-adrenoceptors, and NO release.
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Affiliation(s)
- Elena Grossini
- Laboratory of Physiology and Experimental SurgeryDepartment of Translational Medicine, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carita, Corso Mazzini 36, I-28100 Novara, ItalyPediatric UnitDepartment of Health Sciences, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 36, I-28100 Novara, Italy
| | - Flavia Prodam
- Laboratory of Physiology and Experimental SurgeryDepartment of Translational Medicine, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carita, Corso Mazzini 36, I-28100 Novara, ItalyPediatric UnitDepartment of Health Sciences, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 36, I-28100 Novara, Italy
| | - Gillian Elisabeth Walker
- Laboratory of Physiology and Experimental SurgeryDepartment of Translational Medicine, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carita, Corso Mazzini 36, I-28100 Novara, ItalyPediatric UnitDepartment of Health Sciences, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 36, I-28100 Novara, Italy
| | - Lorenzo Sigaudo
- Laboratory of Physiology and Experimental SurgeryDepartment of Translational Medicine, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carita, Corso Mazzini 36, I-28100 Novara, ItalyPediatric UnitDepartment of Health Sciences, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 36, I-28100 Novara, Italy
| | - Serena Farruggio
- Laboratory of Physiology and Experimental SurgeryDepartment of Translational Medicine, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carita, Corso Mazzini 36, I-28100 Novara, ItalyPediatric UnitDepartment of Health Sciences, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 36, I-28100 Novara, Italy
| | - Kevin Bellofatto
- Laboratory of Physiology and Experimental SurgeryDepartment of Translational Medicine, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carita, Corso Mazzini 36, I-28100 Novara, ItalyPediatric UnitDepartment of Health Sciences, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 36, I-28100 Novara, Italy
| | - Patrizia Marotta
- Laboratory of Physiology and Experimental SurgeryDepartment of Translational Medicine, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carita, Corso Mazzini 36, I-28100 Novara, ItalyPediatric UnitDepartment of Health Sciences, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 36, I-28100 Novara, Italy
| | - Claudio Molinari
- Laboratory of Physiology and Experimental SurgeryDepartment of Translational Medicine, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carita, Corso Mazzini 36, I-28100 Novara, ItalyPediatric UnitDepartment of Health Sciences, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 36, I-28100 Novara, Italy
| | - David Mary
- Laboratory of Physiology and Experimental SurgeryDepartment of Translational Medicine, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carita, Corso Mazzini 36, I-28100 Novara, ItalyPediatric UnitDepartment of Health Sciences, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 36, I-28100 Novara, Italy
| | - Gianni Bona
- Laboratory of Physiology and Experimental SurgeryDepartment of Translational Medicine, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carita, Corso Mazzini 36, I-28100 Novara, ItalyPediatric UnitDepartment of Health Sciences, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 36, I-28100 Novara, Italy
| | - Giovanni Vacca
- Laboratory of Physiology and Experimental SurgeryDepartment of Translational Medicine, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carita, Corso Mazzini 36, I-28100 Novara, ItalyPediatric UnitDepartment of Health Sciences, University Eastern Piedmont 'A. Avogadro', Via Solaroli 17, Azienda Ospedaliera Universitaria Maggiore della Carità, Corso Mazzini 36, I-28100 Novara, Italy
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26
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Gelzinis TA. New Insights Into Diastolic Dysfunction and Heart Failure With Preserved Ejection Fraction. Semin Cardiothorac Vasc Anesth 2013; 18:208-17. [DOI: 10.1177/1089253213510748] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
As the population ages, the incidence of patients presenting for surgical procedures with diastolic dysfunction and heart failure with preserved ejection fraction will rise. This review will discuss the most current and relevant information on the pathophysiology, treatment, and perioperative management of these patients.
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Ichikawa R, Daimon M, Miyazaki T, Kawata T, Miyazaki S, Maruyama M, Chiang SJ, Suzuki H, Ito C, Sato F, Watada H, Daida H. Influencing factors on cardiac structure and function beyond glycemic control in patients with type 2 diabetes mellitus. Cardiovasc Diabetol 2013; 12:38. [PMID: 23446214 PMCID: PMC3598845 DOI: 10.1186/1475-2840-12-38] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 02/17/2013] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND We hypothesized that clinical factors other than glycemic control may influence abnormal cardiac function in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the independent factors for abnormal cardiac function among clinical factors in T2DM. METHODS We studied 148 asymptomatic patients with T2DM without overt heart disease. Echocardiographic findings were compared between diabetic patients and 68 age-matched healthy subjects. Early (E) and late (A) diastolic mitral flow velocity and early diastolic mitral annular velocity (e') were measured for assessing left ventricular (LV) diastolic function. We evaluated insulin resistance, non-esterified fatty acid, high-sensitive CRP, estimated glomerular filtration rate, waist/hip ratio, abdominal visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and other clinical characteristics in addition to glycemic control. VAT and SAT were quantified by computed tomography. RESULTS In T2DM, E/A and e' were significantly lower, and E/e', left atrial volume and LV mass were significantly greater than in control subjects. In multivariate liner regression analysis, VAT was an independent determinant of left atrial volume (β =0.203, p=0.011), E/A (β =-0.208, p=0.002), e' (β =-0.354, p<0.001) and E/e' (β=0.220, p=0.003). Age was also an independent determinant, whereas fasting plasma glucose and hemoglobin A1c levels were not. In addition to systolic blood pressure, waist-hip ratio (β=0.173, p=0.024) and VAT/SAT ratio (β=0.162, p=0.049) were independent determinants of LV mass. CONCLUSION Excessive visceral fat accompanied by adipocyte dysfunction may play a greater role than glycemic control in the development of diastolic dysfunction and LV hypertrophy in T2DM.
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Affiliation(s)
- Ryoko Ichikawa
- Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan
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28
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Kossaify A, Nicolas N. Impact of overweight and obesity on left ventricular diastolic function and value of tissue Doppler echocardiography. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2013; 7:43-50. [PMID: 23471126 PMCID: PMC3583263 DOI: 10.4137/cmc.s11156] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background Diastolic dysfunction is a common cause of heart failure with preserved systolic function in obese patients. Objective To assess diastolic function in a series of overweight and obese patients using conventional and tissue Doppler echocardiography. Setting and method University hospital; left ventricular diastolic function was evaluated in 99 patients (mean age 61.59 ± 13.9 years); body mass index and waist circumference were assessed, and patients were subdivided into three groups according to their body mass index (kg/m2): [normal, (18.5–24.9); overweight, (25–29.9); obese, (>29.9)]. Peak early (E) and late (A) transmitral flow and peak early (E′) diastolic mitral annulus velocities were measured. Results Diastolic dysfunction was significantly higher in the overweight/obese groups compared to the normal body mass index group. The analysis was made with regard to waist circumference and other clinical characteristics, and multivariate regression analysis showed a direct and independent effect of body mass index on diastolic function [OR: 2.75; CI: 1.34–5.67; P = 0.006]. Discussion was made in view of the latest clinical data. Also, an insight into normal weight obesity is presented and discussed. Conclusion Overweight and obesity are found to have an independent negative impact on diastolic function as assessed by tissue Doppler imaging.
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Affiliation(s)
- Antoine Kossaify
- Echocardiography Unit, Cardiology Division, USEK-University Hospital ND Secours, Byblos, Lebanon
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