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Yang K, Shan X, Songru Y, Fu M, Zhao P, Guo W, Xu M, Chen H, Lu R, Zhang C. Network pharmacology integrated with experimental validation to elucidate the mechanisms of action of the Guizhi-Gancao Decoction in the treatment of phenylephrine-induced cardiac hypertrophy. PHARMACEUTICAL BIOLOGY 2024; 62:456-471. [PMID: 38773737 PMCID: PMC11123502 DOI: 10.1080/13880209.2024.2354335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 04/28/2024] [Indexed: 05/24/2024]
Abstract
CONTEXT The mechanisms of Traditional Chinese Medicine (TCM) Guizhi-Gancao Decoction (GGD) remain unknown. OBJECTIVE This study explores the mechanisms of GGD against cardiac hypertrophy. MATERIALS AND METHODS Network pharmacology analysis was carried out to identify the potential targets of GGD. In vivo experiments, C57BL/6J mice were divided into Con, phenylephrine (PE, 10 mg/kg/d), 2-chloroadenosine (CADO, the stable analogue of adenosine, 2 mg/kg/d), GGD (5.4 g/kg/d) and GGD (5.4 g/kg/d) + CGS15943 (a nonselective adenosine receptor antagonist, 4 mg/kg/d). In vitro experiments, primary neonatal rat cardiomyocytes (NRCM) were divided into Con, PE (100 µM), CADO (5 µM), GGD (10-5 g/mL) and GGD (10-5 g/mL) + CGS15943 (5 µM). Ultrasound, H&E and Masson staining, hypertrophic genes expression and cell surface area were conducted to verify the GGD efficacy. Adenosine receptors (ADORs) expression were tested via real-time polymerase chain reaction (PCR), western blotting and immunofluorescence analysis. RESULTS Network pharmacology identified ADORs among those of the core targets of GGD. In vitro experiments demonstrated that GGD attenuated PE-induced increased surface area (with an EC50 of 5.484 × 10-6 g/mL). In vivo data shown that GGD attenuated PE-induced ventricular wall thickening. In vitro and in vivo data indicated that GGD alleviated PE-induced hypertrophic gene expression (e.g., ANP, BNP and MYH7/MYH6), A1AR over-expression and A2aAR down-expression. Moreover, CADO exerts effects similar to GGD, whereas CGS15943 eliminated most effects of GGD. DISCUSSION AND CONCLUSIONS Our findings suggest the mechanism by which GGD inhibits cardiac hypertrophy, highlighting regulation of ADORs as a potential therapeutic strategy for HF.
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Affiliation(s)
- Kaijing Yang
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoli Shan
- Public Laboratory Platform, School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yang Songru
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mengwei Fu
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Pei Zhao
- Public Laboratory Platform, School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Guo
- Department of Pathology, School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ming Xu
- Department of Physiology, School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huihua Chen
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rong Lu
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chen Zhang
- Department of Pathology, School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Kang Z, Wu Y, Ding Y, Zhang Y, Cai X, Yang H, Wei J. Investigation of the efficacy of Dengzhan Shengmai capsule against heart failure with preserved ejection fraction. JOURNAL OF ETHNOPHARMACOLOGY 2024; 333:118419. [PMID: 38838924 DOI: 10.1016/j.jep.2024.118419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/20/2024] [Accepted: 06/02/2024] [Indexed: 06/07/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Heart failure with preserved ejection fraction (HFpEF) has emerged as a condition with high incidence and mortality rates in recent years. Dengzhan Shengmai capsule (DZSMC) is a Chinese patent medicine based on the classic recipe "Shengmai powder". The relevant Chinese medicine ratio of Erigeron breviscapus (Vaniot) Hand.-Mazz., Panax ginseng C.A.Mey., Schisandra chinensis (Turcz.) Baill., and Ophiopogon japonicus (Thunb.) Ker Gawl. Is 30 : 6: 6 : 11. Traditional Chinese medicine (TCM) is being increasingly explored as a safe and effective treatment modality for HFpEF. Clinical studies have shown that DZSMCs can effectively treat heart failure, however, the mechanism of action of DZSMCs in the treatment of HFpEF are still not clear. AIM OF THE STUDY To investigate the efficacy and underlying mechanisms of Dengzhan Shengmai capsule (DZSMC), in the treatment of HFpEF by focusing on its ability to treat microvascular inflammation. MATERIALS AND METHODS First, the efficacy of DZSMCs against HFpEF was predicted by network pharmacology. After 3 days of adaptive feeding in SPF-grade polypropylene cages, the mice in the Model group, DZSMC group, and Captopli group underwent single kidney resection, and micropumps were implanted in their backs for continuous infusion of aldosterone at a rate of 0.3 μg/h for 4 weeks. Moreover, the mice were given DZSMCs or Captopli via oral gavage for four weeks. Overall, cardiac function was evaluated in mice, and cardiac ultrasound and blood biochemical indices were evaluated in HFpEF mice. RESULTS DZSMCs can ameliorate myocardial hypertrophy and cardiomyocyte damage caused by excessive myocardial stress, ultimately mitigating long-term cardiac impairment; it aids in the restoration of myocardial fibre proliferation and enhances mitochondrial morphology and function. In a murine model of ventricular hypertrophy and left ventricular dysfunction, which are indicative of cardiac insufficiency, the administration of DZSMCs resulted in notable improvements. Echocardiographic and overall assessments of cardiac function revealed a reduction in cardiac dysfunction and ventricular hypertrophy post-DZSMC intervention. Moreover, intervention with DZSMCs led to a reduction in the serum levels of several markers associated with chronic systemic inflammation, such as sST2, IL1RL1, CRP, and IL-6. Simultaneously, the levels of indicators of microvascular inflammation, including VCAM and E-SELECTIN, also decreased following DZSMC intervention. These findings suggest the potential multifaceted impact of DZSMCs in alleviating cardiac abnormalities, mitigating systemic inflammation, and reducing microvascular inflammatory markers, highlighting their promising therapeutic role in managing myocardial health. CONCLUSIONS These results provide novel evidence that DZSMCs improve HFpEF by regulating microvascular inflammation.
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Affiliation(s)
- Ziyi Kang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Yue Wu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Yurong Ding
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Yi Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Xinyang Cai
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Hongjun Yang
- China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Junying Wei
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
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Li W, Liu J, Jiao R, Liu Z, Zhang T, Chai D, Meng L, Yang Z, Liu Y, Gu X, Li X, Yang C. Baricitinib alleviates cardiac fibrosis and inflammation induced by chronic sympathetic activation. Int Immunopharmacol 2024; 140:112894. [PMID: 39126736 DOI: 10.1016/j.intimp.2024.112894] [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: 06/27/2024] [Revised: 07/31/2024] [Accepted: 08/05/2024] [Indexed: 08/12/2024]
Abstract
Cardiac fibrosis is characterized by the over-proliferation, over-transdifferentiation and over-deposition of extracellular matrix (ECM) of cardiac fibroblasts (CFs). Cardiac sympathetic activation is one of the leading causes of myocardial fibrosis. Meanwhile, cardiac fibrosis is often together with cardiac inflammation, which accelerates fibrosis by mediating inflammatory cytokines secretion. Recently, the Janus kinase/signal transducer and activator of transcription (JAK/STAT3) signaling pathway has been confirmed by its vital role during the progression of cardiac fibrosis. Thus, JAK/STAT3 signaling pathway is thought to be a potential therapeutic target for cardiac fibrosis. Baricitinib (BR), a novel JAK1/2 inhibitor, has been reported excellent effects of anti-fibrosis in multiple fibrotic diseases. However, little is known about whether and how BR ameliorates cardiac fibrosis caused by chronic sympathetic activation. Isoproterenol (ISO), a β-Adrenergic receptor (β-AR) nonselective agonist, was used to modulate chronic sympathetic activation in mice. As expected, our results proved that BR ameliorated ISO-induced cardiac dysfunction. Meanwhile, BR attenuated ISO-induced cardiac fibrosis and cardiac inflammation in mice. Moreover, BR also inhibited ISO-induced cardiac fibroblasts activation and macrophages pro-inflammatory secretion. As for mechanism studies, BR reduced ISO-induced cardiac fibroblasts by JAK2/STAT3 and PI3K/Akt signaling, while reduced ISO-induced macrophages pro-inflammatory secretion by JAK1/STAT3 and NF-κB signaling. In summary, BR alleviates cardiac fibrosis and inflammation caused by chronic sympathetic activation. The underlying mechanism involves BR-mediated suppression of JAK1/2/STAT3, PI3K/Akt and NF-κB signaling.
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Affiliation(s)
- Wenqi Li
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy, Nankai University, Haihe Education Park, 38 Tongyan Road, Tianjin 300353, China
| | - Jing Liu
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy, Nankai University, Haihe Education Park, 38 Tongyan Road, Tianjin 300353, China
| | - Ran Jiao
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy, Nankai University, Haihe Education Park, 38 Tongyan Road, Tianjin 300353, China
| | - Zhigang Liu
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy, Nankai University, Haihe Education Park, 38 Tongyan Road, Tianjin 300353, China
| | - Tiantian Zhang
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy, Nankai University, Haihe Education Park, 38 Tongyan Road, Tianjin 300353, China
| | - Dan Chai
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy, Nankai University, Haihe Education Park, 38 Tongyan Road, Tianjin 300353, China
| | - Lingxin Meng
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy, Nankai University, Haihe Education Park, 38 Tongyan Road, Tianjin 300353, China
| | - Zhongyi Yang
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy, Nankai University, Haihe Education Park, 38 Tongyan Road, Tianjin 300353, China
| | - Yuming Liu
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy, Nankai University, Haihe Education Park, 38 Tongyan Road, Tianjin 300353, China
| | - Xiaoting Gu
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy, Nankai University, Haihe Education Park, 38 Tongyan Road, Tianjin 300353, China; Tianjin Key Laboratory of Molecular Drug Research, International Joint Academy of Biomedicine, Tianjin 300457, China.
| | - Xiaohe Li
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy, Nankai University, Haihe Education Park, 38 Tongyan Road, Tianjin 300353, China; Tianjin Key Laboratory of Molecular Drug Research, International Joint Academy of Biomedicine, Tianjin 300457, China.
| | - Cheng Yang
- State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy, Nankai University, Haihe Education Park, 38 Tongyan Road, Tianjin 300353, China; Tianjin Key Laboratory of Molecular Drug Research, International Joint Academy of Biomedicine, Tianjin 300457, China.
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4
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Friday JM, Cleland JGF, Pellicori P, Wolters MK, McMurray JJV, Jhund PS, Forsyth P, McAllister DA, Graham FJ, Jones Y, Lewsey J. Loop diuretic therapy with or without heart failure: impact on prognosis. Eur Heart J 2024; 45:3837-3849. [PMID: 38845446 PMCID: PMC11452746 DOI: 10.1093/eurheartj/ehae345] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 03/23/2024] [Accepted: 05/16/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND AND AIMS Many patients are prescribed loop diuretics without a diagnostic record of heart failure. Little is known about their characteristics and prognosis. METHODS Glasgow regional health records (2009-16) were obtained for adults with cardiovascular disease or taking loop diuretics. Outcomes were investigated using Cox models with hazard ratios adjusted for age, sex, socioeconomic deprivation, and comorbid disease (adjHR). RESULTS Of 198 898 patients (median age 65 years; 55% women), 161 935 (81%) neither took loop diuretics nor had a diagnostic record of heart failure (reference group), 23 963 (12%) were taking loop diuretics but had no heart failure recorded, 7844 (4%) had heart failure recorded and took loop diuretics, and 5156 (3%) had heart failure recorded but were not receiving loop diuretics. Compared to the reference group, five-year mortality was only slightly higher for heart failure in the absence of loop diuretics [22%; adjHR 1.2 (95% CI 1.1-1.3)], substantially higher for those taking loop diuretics with no record of heart failure [40%; adjHR 1.8 (95% CI 1.7-1.8)], and highest for heart failure treated with loop diuretics [52%; adjHR 2.2 (95% CI 2.0-2.2)]. CONCLUSIONS For patients with cardiovascular disease, many are prescribed loop diuretics without a recorded diagnosis of heart failure. Mortality is more strongly associated with loop diuretic use than with a record of heart failure. The diagnosis of heart failure may be often missed, or loop diuretic use is associated with other conditions with a prognosis similar to heart failure, or inappropriate loop diuretic use increases mortality; all might be true.
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Affiliation(s)
- Jocelyn M Friday
- School of Cardiovascular and Metabolic Health, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK
| | - John G F Cleland
- School of Cardiovascular and Metabolic Health, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK
| | - Pierpaolo Pellicori
- School of Cardiovascular and Metabolic Health, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK
| | - Maria K Wolters
- School of Cardiovascular and Metabolic Health, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK
- Institute for Design Informatics, School of Informatics, University of Edinburgh, Edinburgh, UK
| | - John J V McMurray
- School of Cardiovascular and Metabolic Health, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK
| | - Pardeep S Jhund
- School of Cardiovascular and Metabolic Health, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK
| | - Paul Forsyth
- Pharmacy Department, NHS Greater Glasgow & Clyde, Glasgow, UK
| | | | - Fraser J Graham
- School of Cardiovascular and Metabolic Health, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK
| | - Yola Jones
- School of Cardiovascular and Metabolic Health, University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK
| | - Jim Lewsey
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Woeckel M, Rospleszcz S, Wolf K, Breitner-Busch S, Ingrisch M, Bamberg F, Ricke J, Schlett CL, Storz C, Schneider A, Stoecklein S, Peters A. Association between Long-Term Exposure to Traffic-Related Air Pollution and Cardio-Metabolic Phenotypes: An MRI Data-Based Analysis. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024. [PMID: 39365792 DOI: 10.1021/acs.est.4c03163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/06/2024]
Abstract
Long-term exposure to traffic-related air pollution (TRAP) is associated with cardiometabolic disease; however, its role in subclinical stages of disease development is unclear. Thus, we aimed to explore this association in a cross-sectional analysis, with cardiometabolic phenotypes derived from magnetic resonance imaging (MRI). Phenotypes of the left (LV) and right cardiac ventricle, whole-body adipose tissue (AT), and organ-specific AT were obtained by MRI in 400 participants of the KORA cohort. Land-use regression models were used to estimate residential long-term exposures to TRAP, e.g., nitrogen dioxides (NO2) or particle number concentration (PNC). Associations between TRAP and MRI phenotypes were modeled using linear regression. Participants' mean age was 56 ± 9 years, and 42% were female. Long-term exposure to TRAP was associated with decreased LV wall thickness; a 6.0 μg/m3 increase in NO2 was associated with a -1.9% [95% confidence interval: -3.7%; -0.1%] decrease in mean global LV wall thickness. Furthermore, we found associations between TRAP and increased cardiac AT. A 2,242 n/cm3 increase in PNC was associated with a 4.3% [-1.7%; 10.4%] increase in mean total cardiac AT. Associations were more pronounced in women and in participants with diabetes. Our exploratory study indicates that long-term exposure to TRAP is associated with subclinical cardiometabolic disease states, particularly in metabolically vulnerable subgroups.
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Affiliation(s)
- Margarethe Woeckel
- Institute of Epidemiology, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg 85764, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München (LMU Munich), Munich 81377, Germany
| | - Susanne Rospleszcz
- Institute of Epidemiology, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg 85764, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München (LMU Munich), Munich 81377, Germany
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg 85764, Germany
| | - Susanne Breitner-Busch
- Institute of Epidemiology, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg 85764, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München (LMU Munich), Munich 81377, Germany
| | - Michael Ingrisch
- Department of Radiology, Ludwig-Maximilians-Universität Hospital Munich, Munich 81377, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Jens Ricke
- Department of Radiology, Ludwig-Maximilians-Universität Hospital Munich, Munich 81377, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
| | - Corinna Storz
- Department of Neuroradiology, Medical Center, University of Freiburg, Freiburg 79106, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg 85764, Germany
| | - Sophia Stoecklein
- Department of Radiology, Ludwig-Maximilians-Universität Hospital Munich, Munich 81377, Germany
| | - Annette Peters
- Institute of Epidemiology, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg 85764, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München (LMU Munich), Munich 81377, Germany
- German Center for Cardiovascular Disease Research (DZHK), Munich Heart Alliance, Munich 80336, Germany
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Liu R, Yao J, Chen K, Peng W. Association between biomarkers of zinc and copper status and heart failure: a meta-analysis. ESC Heart Fail 2024; 11:2546-2556. [PMID: 38690587 PMCID: PMC11424300 DOI: 10.1002/ehf2.14837] [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: 09/18/2023] [Revised: 03/23/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024] Open
Abstract
AIMS Previous studies have investigated the relationship between heart failure (HF) and levels of zinc and copper, but conflicting results have been reported. This meta-analysis aims to clarify the role of zinc and copper in HF progression by examining the associations between HF and concentrations of these minerals. METHODS AND RESULTS We utilized STATA 12.0 software to calculate the standard mean difference (SMD) and 95% confidence interval (CI) for serum zinc and copper levels in patients with HF compared with healthy controls (HCs). The meta-analysis indicated a lower serum zinc level in patients with HF compared with HCs, using a random effects model (SMD = -0.77; 95% CI: -1.01, -0.54; I2 = 61.9%, the P-value for Q test = 0.002). Additionally, the meta-analysis showed an increased serum copper level in patients with HF compared with HCs, using a random effects model (SMD = 0.66; 95% CI: 0.09, 1.23; I2 = 93.8%, the P-value for Q test < 0.001). Meta-regression analysis indicated that publication year, age, and gender were not responsible for heterogeneity across studies. CONCLUSIONS This meta-analysis demonstrates that patients with HF have lower serum zinc and higher copper concentrations compared with healthy subjects. However, the potential of zinc supplementation as a therapy for HF should be approached with caution. The heterogeneity among the included studies was found to be high. It is recommended that further well-designed large sample studies be conducted to validate these findings.
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Affiliation(s)
- Ruixin Liu
- Intensive Care UnitJinhua Municipal Central Hospital Medical GroupJinhuaChina
| | - Jiali Yao
- Intensive Care UnitJinhua Municipal Central Hospital Medical GroupJinhuaChina
| | - Kexian Chen
- Intensive Care UnitJinhua Municipal Central Hospital Medical GroupJinhuaChina
| | - Wei Peng
- Intensive Care UnitJinhua Municipal Central Hospital Medical GroupJinhuaChina
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Yu L, Cai S, Guo X. m6A RNA methylation modification is involved in the disease course of heart failure. Biotechnol Genet Eng Rev 2024; 40:961-975. [PMID: 36943073 DOI: 10.1080/02648725.2023.2191086] [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: 02/10/2023] [Accepted: 03/08/2023] [Indexed: 03/23/2023]
Abstract
We explored N6-methyladenosine (m6A) RNA methylation as one of the gene regulatory mechanisms in heart failure (HF) biology. Understanding the different physiological mechanisms will facilitate the prevention and individualized treatment of HF. The Gene Expression Omnibus (GEO) database served as the source of the data. In GSE116250, differential analysis between ischemic cardiomyopathy (ICM), dilated cardiomyopathy (DCM) and controls yielded differentially expressed m6A regulators. Differential analysis between HF and controls in GSE131296 identifies m6A-modified genes and then performs enrichment analysis. Protein-protein interaction (PPI) network analysis was performed for the differentially expressed ICM- or DCM-associated genes in GSE116250 and GSE55296, respectively. Finally, the diagnostic genes for ICM and DCM were predicted using receiver operating characteristic (ROC) curve. YTHDC1, HNRNPC and HNRNPA2B1 were significantly downregulated in GSE116250 in DCM and ICM compared with controls. A total of 195 genes were identified in GSE131296 as subject to m6A alteration. These genes may play a role in HF through the MAPK signaling pathway and p53 signaling pathway. PPI network analysis identified CCL5, CXCR4 and CCL2 as key genes for ICM and IL-6 as a key gene for DCM. Through ROC curves, we identified m6A-modified APLP1, KLF2 as potential diagnostic genes for ICM, and m6A-modified FGF7, FREM1 and C14orf132 as potential diagnostic genes for DCM. Our findings support m6A modifying mechanisms in HF etiology that contribute to the treatment of HF. Thus, our data suggest that m6A methylation may be an interesting target for therapeutic intervention.
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Affiliation(s)
- Liyan Yu
- Department of gerontology, Yantaishan Hospital, Yantai, Shandong, China
| | - Shuxia Cai
- Department of gerontology, Yantaishan Hospital, Yantai, Shandong, China
| | - Xiuli Guo
- Department of gerontology, Yantaishan Hospital, Yantai, Shandong, China
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8
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Kerrigan L, Edgar K, Russell-Hallinan A, Cappa O, Glezeva N, Galan-Arriola C, Oliver E, Ibanez B, Baugh J, Collier P, Ledwidge M, McDonald K, Simpson D, Das S, Grieve DJ, Watson CJ. Integrin beta-like 1 is regulated by DNA methylation and increased in heart failure patients. ESC Heart Fail 2024. [PMID: 39233619 DOI: 10.1002/ehf2.15050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/17/2024] [Accepted: 08/21/2024] [Indexed: 09/06/2024] Open
Abstract
AIMS Dynamic alterations in cardiac DNA methylation have been implicated in the development of heart failure (HF) with evidence of ischaemic heart disease (IHD); however, there is limited research into cell specific, DNA methylation sensitive genes that are affected by dysregulated DNA methylation patterns. In this study, we aimed to identify DNA methylation sensitive genes in the ischaemic heart and elucidate their role in cardiac fibrosis. METHODS A multi-omics integrative analysis was carried out on RNA sequencing and methylation sequencing on HF with IHD (n = 9) versus non-failing (n = 9) left ventricular tissue, which identified Integrin beta-like 1 (ITGBL1) as a gene of interest. Expression of Itgbl1 was assessed in three animal models of HF; an ischaemia-reperfusion pig model, a myocardial infarction mouse model and an angiotensin-II infused mouse model. Single nuclei RNA sequencing was carried out on heart tissue from angiotensin-II infused mice to establish the expression profile of Itgbl1 across cardiac cell populations. Subsequent in vitro analyses were conducted to elucidate a role for ITGBL1 in human cardiac fibroblasts. DNA pyrosequencing was applied to assess ITGBL1 CpG methylation status in genomic DNA from human cardiac tissue and stimulated cardiac fibroblasts. RESULTS ITGBL1 was >2-fold up-regulated (FDR adj P = 0.03) and >10-fold hypomethylated (FDR adj P = 0.01) in human HF with IHD left ventricular tissue compared with non-failing controls. Expression of Itgbl1 was up-regulated in three isolated animal models of HF and showed conserved correlation between increased Itgbl1 and diastolic dysfunction. Single nuclei RNA sequencing highlighted that Itgbl1 is primarily expressed in cardiac fibroblasts, while functional studies elucidated a role for ITGBL1 in cardiac fibroblast migration, evident in 50% reduced 24 h fibroblast wound closure occurring subsequent to siRNA-targeted ITGBL1 knockdown. Lastly, evidence provided from DNA pyrosequencing supports the theory that differential expression of ITGBL1 is caused by DNA hypomethylation. CONCLUSIONS ITGBL1 is a gene that is mainly expressed in fibroblasts, plays an important role in cardiac fibroblast migration, and whose expression is significantly increased in the failing heart. The mechanism by which increased ITGBL1 occurs is through DNA hypomethylation.
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Affiliation(s)
- Lauren Kerrigan
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Kevin Edgar
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Adam Russell-Hallinan
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Oisin Cappa
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Nadezhda Glezeva
- UCD Conway Institute and Research and Innovation Programme for Chronic Disease, School of Medicine, University College Dublin, Dublin, Ireland
| | | | - Eduardo Oliver
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Borja Ibanez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - John Baugh
- UCD Conway Institute and Research and Innovation Programme for Chronic Disease, School of Medicine, University College Dublin, Dublin, Ireland
| | - Patrick Collier
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Mark Ledwidge
- UCD Conway Institute and Research and Innovation Programme for Chronic Disease, School of Medicine, University College Dublin, Dublin, Ireland
| | - Ken McDonald
- UCD Conway Institute and Research and Innovation Programme for Chronic Disease, School of Medicine, University College Dublin, Dublin, Ireland
| | - David Simpson
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | | | - David J Grieve
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Chris J Watson
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
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Barbagelata L, Masson W, Lobo M, Bluro I. Semaglutide and heart failure: Updated meta-analysis. Curr Probl Cardiol 2024; 49:102721. [PMID: 38908729 DOI: 10.1016/j.cpcardiol.2024.102721] [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: 06/14/2024] [Accepted: 06/19/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Heart failure (HF) is a major contributor to global health challenges, affecting mortality rates and healthcare expenditure. Glucagon-like peptide-1 receptor agonists (GLP-1RA) offer promise in HF management, though their precise impact is unclear. The main objective of this study was to evaluate the effect of semaglutide on HF-related outcomes. METHODS We conducted a meta-analysis of studies assessing the effects of semaglutide therapy on HF-related outcomes. This meta-analysis was performed according to PRISMA guidelines. Randomized clinical trials or observational cohorts studies with a follow-up duration ≥ 6 months were included. The random-effects model was performed. RESULTS Six randomised clinical trials (n = 28,762 patients) and two observational studies were identified and considered eligible for this systematic review. A total of 14,608 subjects were assigned to the semaglutide group and 14,716 individuals were assigned to control or placebo groups. Overall, this meta-analysis shows that semaglutide use was associated with an decreased risk of HF (OR: 0.74; 95 % CI: 0.58 to 0.94, I2 45 %), compared to placebo or control groups. The analytical evaluation does not suggest publication bias, and the sensitivity analysis demonstrated that the result was robust. CONCLUSION This meta-analysis demonstrates that the use of semaglutide is associated with a reduction in clinical events related to HF. As HF is a heterogeneous clinical condition, further studies will be necessary to analyze this association in different subgroups of patients.
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Affiliation(s)
- Leandro Barbagelata
- Department of Cardiology. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - Walter Masson
- Department of Cardiology. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Martín Lobo
- Department of Cardiology, Hospital Militar Campo de Mayo, Buenos Aires, Argentina
| | - Ignacio Bluro
- Department of Cardiology. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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10
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Zwijnen AW, Watzema L, Ridwan Y, van Der Pluijm I, Smal I, Essers J. Self-adaptive deep learning-based segmentation for universal and functional clinical and preclinical CT image analysis. Comput Biol Med 2024; 179:108853. [PMID: 39013341 DOI: 10.1016/j.compbiomed.2024.108853] [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: 12/01/2023] [Revised: 07/04/2024] [Accepted: 07/04/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Methods to monitor cardiac functioning non-invasively can accelerate preclinical and clinical research into novel treatment options for heart failure. However, manual image analysis of cardiac substructures is resource-intensive and error-prone. While automated methods exist for clinical CT images, translating these to preclinical μCT data is challenging. We employed deep learning to automate the extraction of quantitative data from both CT and μCT images. METHODS We collected a public dataset of cardiac CT images of human patients, as well as acquired μCT images of wild-type and accelerated aging mice. The left ventricle, myocardium, and right ventricle were manually segmented in the μCT training set. After template-based heart detection, two separate segmentation neural networks were trained using the nnU-Net framework. RESULTS The mean Dice score of the CT segmentation results (0.925 ± 0.019, n = 40) was superior to those achieved by state-of-the-art algorithms. Automated and manual segmentations of the μCT training set were nearly identical. The estimated median Dice score (0.940) of the test set results was comparable to existing methods. The automated volume metrics were similar to manual expert observations. In aging mice, ejection fractions had significantly decreased, and myocardial volume increased by age 24 weeks. CONCLUSIONS With further optimization, automated data extraction expands the application of (μ)CT imaging, while reducing subjectivity and workload. The proposed method efficiently measures the left and right ventricular ejection fraction and myocardial mass. With uniform translation between image types, cardiac functioning in diastolic and systolic phases can be monitored in both animals and humans.
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Affiliation(s)
- Anne-Wietje Zwijnen
- Department of Molecular Genetics, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Yanto Ridwan
- AMIE Core Facility, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Ingrid van Der Pluijm
- Department of Molecular Genetics, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ihor Smal
- Department of Cell Biology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jeroen Essers
- Department of Molecular Genetics, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Radiotherapy, Erasmus University Medical Center, Rotterdam, the Netherlands.
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11
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Jiang R, Sun C, Yang Y, Sun Q, Bai X. Causal relationship between chronic obstructive pulmonary disease and heart failure: A Mendelian randomization study. Heart Lung 2024; 67:12-18. [PMID: 38631108 DOI: 10.1016/j.hrtlng.2024.04.007] [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: 08/30/2023] [Revised: 04/03/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Causal association between chronic obstructive pulmonary disease (COPD) and heart failure (HF) has been controversial. This study used Mendelian Randomization (MR) analysis to clarify the potential causal connection between these two conditions. OBJECTIVES The purpose of the study was to investigate the causal relationship between COPD and HF based on the hypothesis that the genetic predisposition to COPD could lead to an increased risk of developing HF METHODS: A two-sample MR analysis of genetic data was performed for COPD and HF. This study was based on genome-wide association study (GWAS) data, including 6,915 patients with confirmed COPD and 186,723 controls. The odds ratios (ORs) and their 95 % confidence intervals (95 %CIs) were estimated using a fixed effects inverse variance weighting (IVW) method. Several supplementary statistical methods, including MR-Egger, weighted median, maximum likelihood, penalized weighted median, and random effects IVW, were applied to enhance the robustness of findings. Moreover, MR-PRESSO was employed as an alternative method for statistical detection. RESULTS Pooled data for HF were obtained from different GWASs, including 4,7309 confirmed HF patients and 930,014 controls. The MR analysis, based on the IVW model, revealed that COPD was significantly associated with an increased risk of HF. Specifically, the obtained findings showed that COPD patients had a higher risk of developing HF (Model 1: OR = 1.068, 95 %CI: 1.006-1.134, p = 0.031; Model 2: OR = 1.038, 95 %CI: 1.006-1.071, p = 0.020), indicating a causal relationship between COPD and HF. No evidence was found to suggest a reverse causal effect of HF on COPD incidence. CONCLUSION The MR analysis substantiates a causal link between COPD and HF, with no evidence supporting a reverse causation from HF to COPD. These findings underscore the importance of proactive COPD management as a potential strategy to prevent the development of HF, highlighting the need for targeted interventions in patients with COPD to mitigate their risk of HF.
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Affiliation(s)
- Rui Jiang
- Department of Cardiology, Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, PR China
| | - Chang Sun
- Department of Cardiology, Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, PR China
| | - Ying Yang
- Department of Cardiology, Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, PR China
| | - Qi Sun
- Department of Cardiology, Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, PR China
| | - Xiuping Bai
- Department of Cardiology, Fourth Affiliated Hospital of Harbin Medical University, Harbin 150001, PR China.
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12
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Li J, Long B, Xie W, Zhang Y, Yang C, Liu M, Xu X, Lan L. Outcomes of extracorporeal membrane oxygenation cannulation strategy in lung transplantation: A retrospective cohort study. Asian J Surg 2024:S1015-9584(24)01811-6. [PMID: 39218749 DOI: 10.1016/j.asjsur.2024.08.073] [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: 03/11/2024] [Revised: 07/21/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVES Extracorporeal membrane oxygenation (ECMO) with different cannulation strategies is determined according to surgical position and patient condition. However, no cannulation guidelines have been proposed. This retrospective study assessed the outcomes of diverse ECMO cannulation strategies in patients undergoing lung transplantation (LTx). METHODS Data of patients undergoing intraoperative veno-arterial ECMO-assisted LTx were retrospectively collected from December 1st, 2015 to October 31st, 2021. Patients were classified into three groups based on the different cannulation strategies: femoral artery-femoral vein (F-F)-ECMO, axillary artery-femoral vein (A-F)-ECMO, and ascending aorta-femoral vein (AAO-F)-ECMO. The F-F-ECMO, A-F-ECMO, and AAO-F-ECMO groups comprised 34, 44, and 30 patients, respectively. MAIN RESULTS The AAO-F-ECMO group exhibited a significantly shorter duration of postoperative ECMO therapy (3 vs. 2 vs. 0 days, P < 0.01).the level of postoperative proBNP was lower on the third and seventh days (P < 0.001). AAO-F-ECMO patients had a significantly lower incidence of postoperative infections, heart failure, and bleeding (P < 0.05). Similar outcomes were observed in postoperative survival rates among the three groups (P > 0.05). CONCLUSIONS Ascending aorta-femoral vein ECMO can provide sufficient and effective aerobic blood to perfuse organs with fewer side effects than cannulation in the femoral artery-femoral vein or axillary artery-femoral vein.
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Affiliation(s)
- Jiayang Li
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bu Long
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wenjie Xie
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yaoliang Zhang
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chao Yang
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mengyang Liu
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xin Xu
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Lan Lan
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
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Mao R, Wang F, Zhong Y, Meng X, Zhang T, Li J. Association of biological age acceleration with cardiac morphology, function, and incident heart failure: insights from UK Biobank participants. Eur Heart J Cardiovasc Imaging 2024; 25:1315-1323. [PMID: 38747402 DOI: 10.1093/ehjci/jeae126] [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: 11/12/2023] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 08/28/2024] Open
Abstract
AIMS Advanced age is associated with an increased risk of adverse cardiovascular events. The relationship between biological age acceleration (BAA), cardiac size, cardiac function, and heart failure (HF) is not well-defined. METHODS AND RESULTS Utilizing the UK Biobank cohort, we assessed biological age using the Klemera-Doubal and PhenoAge methods. BAA was quantified by residual analysis compared with chronological age. Cardiovascular magnetic resonance (CMR) imaging provided detailed insights into cardiac structure and function. We employed multivariate regression to examine links between BAA and CMR-derived cardiac phenotypes. Cox proportional hazard regression models analysis was applied to explore the causative relationship between BAA and HF. Additionally, Mendelian randomization was used to investigate the genetic underpinnings of these associations. A significant correlation was found between increased BAA and deleterious changes in cardiac structure, such as diminished left ventricular mass, lower overall ventricular volume, and reduced stroke volumes across ventricles and atria. Throughout a median follow-up of 13.8 years, participants with greater biological aging showed a heightened risk of HF [26% per standard deviation (SD) increase in KDM-BA acceleration, 95% confidence intervals (CI): 23-28%; 33% per SD increase in PhenoAge acceleration, 95% CI: 32-35%]. Mendelian randomization analysis suggests a likely causal link between BAA, vital cardiac metrics, and HF risk. CONCLUSION In this cohort, accelerated biological aging may serve as a risk indicator for altered cardiac dimensions, functionality, and the onset of heart failure among middle-aged and elderly adults. It holds promise as a focal point for evaluating risk and developing targeted interventions.
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Affiliation(s)
- Rui Mao
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
| | - Fan Wang
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
| | - Yun Zhong
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
| | - Xin Meng
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
| | - Tongtong Zhang
- The Center of Gastrointestinal and Minimally Invasive Surgery, The Third People's Hospital of Chengdu, 82 Qinglong Street, Chengdu, Sichuan Province 610031, China
- Medical Research Center, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, The Second Chengdu Hospital Affiliated to Chongqing Medical University, 82 Qinglong Street, Chengdu, Sichuan Province 610031, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
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14
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Zheng H, Wu K, Wu W, Huang Z, Wang X, Fu P, Wang Y, Chen Z, Cai Z, Cai Z, Lan Y, Wu S, Chen Y. Relationship of the trajectory of the triglyceride-glucose index with heart failure: the Kailuan study. Lipids Health Dis 2024; 23:257. [PMID: 39164722 PMCID: PMC11334604 DOI: 10.1186/s12944-024-02254-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 08/13/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND A high triglyceride-glucose index (TyG) is associated with a higher risk of incident heart failure. However, the effects of longitudinal patterns of TyG index on the risk of heart failure remain to be characterized. Therefore, in the present study, we aimed to characterize the relationship between the trajectory of TyG index and the risk of heart failure. METHODS We performed a prospective study of 56,149 participants in the Kailuan study who attended three consecutive surveys in 2006-2007, 2008-2009, and 2010-2011 and had no history of heart failure or cancer before the third wave survey (2010-2011). The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2], and we used latent mixture modeling to characterize the trajectory of the TyG index over the period 2006-2010. Additionally, Cox proportional risk models were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for incident heart failure for the various TyG index trajectory groups. RESULTS From 2006 to 2010, four different TyG trajectories were identified: low-stable (n = 13,554; range, 7.98-8.07), moderate low-stable (n = 29,435; range, 8.60-8.65), moderate high-stable (n = 11,262; range, 9.31-9.30), and elevated-stable (n = 1,898; range, 10.04-10.25). A total of 1,312 new heart failure events occurred during a median follow-up period of 10.04 years. After adjustment for potential confounders, the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident heart failure for the elevated-stable, moderate high-stable, and moderate low-stable groups were 1.55 (1.15, 2.08), 1.32 (1.08, 1.60), and 1.17 (0.99, 1.37), respectively, compared to the low-stable group. CONCLUSIONS Higher TyG index trajectories were associated with a higher risk of heart failure. This suggests that monitoring TyG index trajectory may help identify individuals at high risk for heart failure and highlights the importance of early control of blood glucose and lipids for the prevention of heart failure.
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Affiliation(s)
- Huancong Zheng
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
- Shantou University Medical College, Shantou, China
| | - Kuangyi Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
- Shantou University Medical College, Shantou, China
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
| | - Zegui Huang
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xianxuan Wang
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Peng Fu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
- Shantou University Medical College, Shantou, China
| | - Yuxian Wang
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
- Shantou University Medical College, Shantou, China
| | - Zekai Chen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Zefeng Cai
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
| | - Zhiwei Cai
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
- Shantou University Medical College, Shantou, China
| | - Yulong Lan
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Road, Tangshan, 063000, China.
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North Road, Shantou, 515000, China.
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15
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Tang R, Lin L, Liu Y, Li H. Bibliometric and visual analysis of global publications on kaempferol. Front Nutr 2024; 11:1442574. [PMID: 39221164 PMCID: PMC11362042 DOI: 10.3389/fnut.2024.1442574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Accepted: 08/06/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction Kaempferol, a flavonoid found in numerous foods and medicinal plants, offers a range of health benefits such as anti-inflammatory, antioxidant, antiviral, anticancer, cardioprotective, and neuroprotective effects. Methods Herein, a bibliometric and visual analysis of global publications on kaempferol was performed to map the evolution of frontiers and hotspots in the field. Using the search string TS = kaempferol, bibliometric data for this analysis was extracted from the Web of Science Core Collection database and analyzed using the VOSviewer, CiteSpace, and Scimago Graphica software. Results As a result, by February 26, 2024, 11,214 publications were identified, comprising articles (n = 10,746, 96%) and review articles (n = 468, 4%). Globally, the annual number of kaempferol publications surpassed 100 per year since 2000, exceeded 500 per year since 2018, and further crossed the threshold of 1,000 per year starting in 2022. The major contributing countries were China, the United States of America, and India, while the top three institutes of the citations of kaempferol were the Chinese Academy of Sciences, Consejo Superio de Investigaciones Cientficas, and Uniersidade do Porto. These publications were mainly published in agricultural and food chemistry journals, food chemistry, and phytochemistry. Discussion The keywords frequently mentioned include phenolic compounds, antioxidant activity, flavonoids, NF-kappa B, inflammation, bioactive compounds, etc. Anti-inflammation, anti-oxidation, and anti-cancer have consistently been the focus of kaempferol research, while cardiovascular protection, neuroprotection, antiviral, and anti-bacterial effects have emerged as recent highlights. The field of kaempferol research is thriving.
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Affiliation(s)
- Ruying Tang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Longfei Lin
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuling Liu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hui Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
- Institute of Traditional Chinese Medicine Health Industry, China Academy of Chinese Medical Sciences, Nanchang, China
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Chen Z, Huo X, Huang Y, Cheng Z, Xu X, Li Z. Elevated plasma solMER concentrations link ambient PM 2.5 and PAHs to myocardial injury and reduced left ventricular systolic function in children. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 355:124151. [PMID: 38740242 DOI: 10.1016/j.envpol.2024.124151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/16/2024]
Abstract
Exposure to fine particulate matter (PM2.5) and polycyclic aromatic hydrocarbons (PAHs) is known to be associated with the polarization of pro-inflammatory macrophages and the development of various cardiovascular diseases. The pro-inflammatory polarization of resident cardiac macrophages (cMacs) enhances the cleavage of membrane-bound myeloid-epithelial-reproductive receptor tyrosine kinase (MerTK) and promotes the formation of soluble MerTK (solMER). This process influences the involvement of cMacs in cardiac repair, thus leading to an imbalance in cardiac homeostasis, myocardial injury, and reduced cardiac function. However, the relative impacts of PM2.5 and PAHs on human cMacs have yet to be elucidated. In this study, we aimed to investigate the effects of PM2.5 and PAH exposure on solMER in terms of myocardial injury and left ventricular (LV) systolic function in healthy children. A total of 258 children (aged three to six years) were recruited from Guiyu (an area exposed to e-waste) and Haojiang (a reference area). Mean daily PM2.5 concentration data were collected to calculate the individual chronic daily intake (CDI) of PM2.5. We determined concentrations of solMER and creatine kinase MB (CKMB) in plasma, and hydroxylated PAHs (OH-PAHs) in urine. LV systolic function was evaluated by stroke volume (SV). Higher CDI values and OH-PAH concentrations were detected in the exposed group. Plasma solMER and CKMB were higher in the exposed group and were associated with a reduced SV. Elevated CDI and 1-hydroxynaphthalene (1-OHNa) were associated with a higher solMER. Furthermore, increased solMER concentrations were associated with a lower SV and higher CKMB. CDI and 1-OHNa were positively associated with CKMB and mediated by solMER. In conclusion, exposure to PM2.5 and PAHs may lead to the pro-inflammatory polarization of cMacs and increase the risk of myocardial injury and systolic function impairment in children. Furthermore, the pro-inflammatory polarization of cMacs may mediate cardiotoxicity caused by PM2.5 and PAHs.
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Affiliation(s)
- Zihan Chen
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou, 515000, Guangdong, China; Shantou University Medical College, Shantou, 15041, Guangdong, China
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou, 511443, Guangdong, China
| | - Yu Huang
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Zhiheng Cheng
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, Shantou, 515041, Guangdong, China; Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, Shantou University Medical College, Shantou, 515041, Guangdong, China; Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Zhi Li
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou, 515000, Guangdong, China.
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Pan J, Zhou T, Na K, Xu K, Yan C, Song H, Han Y. Identification of hub modules and therapeutic targets associated with CD8 +T-cells in HF and their pan-cancer analysis. Sci Rep 2024; 14:18823. [PMID: 39138291 PMCID: PMC11322555 DOI: 10.1038/s41598-024-68504-6] [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: 01/04/2024] [Accepted: 07/24/2024] [Indexed: 08/15/2024] Open
Abstract
Heart failure (HF) is a terminal condition of multiple cardiovascular disorders. Cancer is a deadly disease worldwide. The relationship between HF and cancer remains poorly understood. The Gene Expression Omnibus database was used to download the RNA sequencing data of 356 patients with hypertrophic cardiomyopathy-induced HF and non-HF. A co-expression network was established through the weighted correlation network analysis (WGCNA) to identify hub genes of HF and cancer. Cox risk analysis was performed to predict the prognostic risks of HF hub genes in pan-cancer. HF was linked to immune response pathway by the analysis of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). A positive correlation was observed between the expression levels of 4 hub genes and the infiltration of CD8+T-cells in pan-cancer. 4 hub genes were identified as beneficial prognostic factors in several cancers. Western blotting and real-time polymerase chain reaction validated the high expression of GZMM, NKG7, and ZAP70 in both mice and patients with HF compared to control groups. Our study highlights the shared immune pathogenesis of HF and cancer and provides valuable insights for developing novel therapeutic strategies, offering new opportunities for improving the management and treatment outcomes of both HF and cancer.
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Affiliation(s)
- Jing Pan
- School of Life Science and Biochemistry, Shenyang Pharmaceutical University, Wenhua Road 103, Shenyang, 110016, Liaoning Province, China
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Wenhua Road 83, Shenyang, 110016, Liaoning Province, China
| | - Ting Zhou
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei Province, China
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Wenhua Road 83, Shenyang, 110016, Liaoning Province, China
| | - Kun Na
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Wenhua Road 83, Shenyang, 110016, Liaoning Province, China
| | - Kai Xu
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Wenhua Road 83, Shenyang, 110016, Liaoning Province, China
| | - Chenghui Yan
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Wenhua Road 83, Shenyang, 110016, Liaoning Province, China
| | - Haixu Song
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Wenhua Road 83, Shenyang, 110016, Liaoning Province, China.
| | - Yaling Han
- School of Life Science and Biochemistry, Shenyang Pharmaceutical University, Wenhua Road 103, Shenyang, 110016, Liaoning Province, China.
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Wenhua Road 83, Shenyang, 110016, Liaoning Province, China.
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18
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Ingimarsdóttir IJ, Hansen JS, Bergmann HM, Einarsson H. The Icelandic Heart Failure Registry-A nationwide assessment tool for HF care and intervention in HF treatment. ESC Heart Fail 2024. [PMID: 39104306 DOI: 10.1002/ehf2.15012] [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: 01/30/2024] [Revised: 07/13/2024] [Accepted: 07/16/2024] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION The incidence of heart failure (HF) is increasing, largely because populations are both ageing and growing. Most clinical HF treatment trials are conducted on selected cohorts, only a few of which include elderly patients, among whom HF is common. HF registries can include all HF patients, independent of age or comorbidity profile, and thus reflect reality in healthcare management. METHODS The Icelandic Heart Failure Registry (IHFR) was created in the autumn of 2019 and has operated since 1 January 2020. Based on the Swedish Heart Failure Registry (SwedeHF), it quickly acquired several extensions. All patients admitted for HF to the Department of Cardiology (DC) at Landspítali - The National University Hospital of Iceland are included. Several variables are collected, including the aetiology of HF, comorbidities, clinical assessment at admission, blood tests, imaging results, treatment given and medical therapy at discharge. RESULTS During the 3 years from 2020 to 2022, the DC admitted 1890 patients. As some were readmitted during the study period, the true total was 2384 admissions. Because the IHFR 2023 edition includes 327 variables, automation of many of them is imperative for data collection. CONCLUSION HF is a heterogenous disease with numerous underlying factors. HF management differs among HF phenotypes. A registry can serve as an unbiased indicator of care quality and has the potential to be studied in the future to assess the long-term effects of HF treatment. A registry like the IHFR, therefore, can impact the treatment of all patients recorded in it, reduce the rate of readmissions and even optimize HF management costs.
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Affiliation(s)
- Inga Jóna Ingimarsdóttir
- Department of Cardiology, Landspítali - The National University Hospital of Iceland, Reykjavík, Iceland
- Department of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Johan Sindri Hansen
- Department of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Hekla María Bergmann
- Department of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
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Røsand Ø, Wang J, Scrimgeour N, Marwarha G, Høydal MA. Exosomal Preconditioning of Human iPSC-Derived Cardiomyocytes Beneficially Alters Cardiac Electrophysiology and Micro RNA Expression. Int J Mol Sci 2024; 25:8460. [PMID: 39126028 PMCID: PMC11313350 DOI: 10.3390/ijms25158460] [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: 06/13/2024] [Revised: 07/27/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
Experimental evidence, both in vitro and in vivo, has indicated cardioprotective effects of extracellular vesicles (EVs) derived from various cell types, including induced pluripotent stem cell-derived cardiomyocytes. The biological effects of EV secretion, particularly in the context of ischemia and cardiac electrophysiology, remain to be fully explored. Therefore, the goal of this study was to unveil the effects of exosome (EXO)-mediated cell-cell signaling during hypoxia by employing a simulated preconditioning approach on human-induced pluripotent stem cell-derived cardiomyocytes (hIPSC-CMs). Electrophysiological activity of hIPSC-CMs was measured using a multielectrode array (MEA) system. A total of 16 h of hypoxic stress drastically increased the beat period. Moreover, hIPSC-CMs preconditioned with EXOs displayed significantly longer beat periods compared with non-treated cells after 16 h of hypoxia (+15.7%, p < 0.05). Furthermore, preconditioning with hypoxic EXOs resulted in faster excitation-contraction (EC) coupling compared with non-treated hIPSC-CMs after 16 h of hypoxia (-25.3%, p < 0.05). Additionally, microRNA (miR) sequencing and gene target prediction analysis of the non-treated and pre-conditioned hIPSC-CMs identified 10 differentially regulated miRs and 44 gene targets. These results shed light on the intricate involvement of miRs, emphasizing gene targets associated with cell survival, contraction, apoptosis, reactive oxygen species (ROS) regulation, and ion channel modulation. Overall, this study demonstrates that EXOs secreted by hIPSC-CM during hypoxia beneficially alter electrophysiological properties in recipient cells exposed to hypoxic stress, which could play a crucial role in the development of targeted interventions to improve outcomes in ischemic heart conditions.
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Affiliation(s)
| | | | | | | | - Morten Andre Høydal
- Group of Molecular and Cellular Cardiology, Department of Circulation and Medical Imaging, Faculty of Medicine and Health, Norwegian University of Science and Technology (NTNU), 7030 Trondheim, Norway; (Ø.R.); (J.W.); (N.S.); (G.M.)
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20
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Boesing M, Bierreth F, Abig K, Giezendanner S, Leuppi-Taegtmeyer AB, Lüthi-Corridori G, Maier S, Züsli S, Leuppi JD, Dieterle T. Effects of serial NT-proBNP measurements in patients with acute decompensated heart failure: Results of the POC-HF pilot trial. Glob Cardiol Sci Pract 2024; 2024:e202431. [PMID: 39351482 PMCID: PMC11439418 DOI: 10.21542/gcsp.2024.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 07/23/2024] [Indexed: 10/04/2024] Open
Abstract
INTRODUCTION Serial N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurements have proven to be useful for therapy monitoring in patients hospitalized for acute decompensated heart failure (ADHF). The POC-HF pilot study investigated whether serial NT-proBNP measurements influenced treatment decisions in these patients. METHODS Patients hospitalized for ADHF were randomly assigned to an intervention group (serial NT-proBNP measurements made available to treating physicians) or a control group (care as usual). HF therapy was administered at the discretion of the treating physician. The primary endpoint was dose changes in HF therapy during hospitalization. Secondary endpoints included changes in NT-proBNP levels, recovery from HF symptoms, length of hospital stay, and quality of life. RESULTS 52 patients (35% female; mean age 81.8 years) were included. The availability of serial NT-proBNP values was associated with higher dosages of ACE inhibitors (relative treatment effect (RTE) day 11:0.74, p = 0.007) and loop diuretics (RTE day 11:0.77, p = 0.005), and lower dosages of beta-blockers (RTE day 11:0.43, p = 0.002). NT-proBNP levels decreased (-752 pg/ml, p = 0.162) and recovery rates from ADHF symptoms were more pronounced in the intervention group, but without statistical significance. No differences were found in terms of the length of hospital stay and quality of life. CONCLUSION The results of this pilot trial indicate that serial NT-proBNP measurements are possibly associated with faster up-titration of HF medication, more pronounced NT-proBNP decrease, and faster recovery from symptoms than symptom-guided therapy in patients hospitalized for ADHF. These preliminary findings require further validation through larger studies. TRIAL REGISTRATION http://www.swissethics.ch BASEC-ID 2017-01030, registered on 28 December 2017.
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Affiliation(s)
- Maria Boesing
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Frederick Bierreth
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Kristin Abig
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Stéphanie Giezendanner
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Anne B. Leuppi-Taegtmeyer
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
- Department of Patient Safety, Medical Directorate, University Hospital Basel, Basel, Switzerland
| | - Giorgia Lüthi-Corridori
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Sabrina Maier
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Stephanie Züsli
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Jörg D. Leuppi
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Thomas Dieterle
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
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21
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Beyer SE, Imnadze G, Sommer P. [New pacing strategies for heart failure]. INNERE MEDIZIN (HEIDELBERG, GERMANY) 2024; 65:778-786. [PMID: 38967707 DOI: 10.1007/s00108-024-01747-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/06/2024]
Abstract
In patients with a reduced left ventricular (LV) systolic function (ejection fraction < 35%) and a left bundle branch block with a QRS duration > 130 ms, cardiac resynchronization therapy (CRT) can contribute to an improvement in the quality of life and a reduction in mortality. The resynchronization is mostly achieved by pacing via an epicardial LV lead in the coronary sinus; however, this approach is often limited by the patient's venous anatomy and an increase in the stimulation threshold over time. In addition, up to 30% of patients do not respond to the intervention. New treatment approaches involve direct stimulation of the conduction system by pacing of the bundle of His or left bundle branch. This enables a more physiological propagation of the stimulus. Pacing of the left bundle branch is achieved by advancing the lead into the right ventricle and screwing it deep into the interventricular septum. Due to the relatively large target area of the left bundle branch the success rate is very high (currently > 90%). Observational studies have shown a greater reduction in the QRS duration, a more pronounced improvement in systolic function and a lower hospitalization rate for heart failure associated with conduction system pacing compared to CRT using a coronary sinus lead. These findings have been confirmed in small randomized trials. Therefore, the use of left bundle branch pacing should be considered not only as a bail out in the case of failed resynchronization using coronary sinus lead placement but increasingly also as an initial pacing strategy. The results of the first large randomized trials are expected to be released in late 2024.
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Affiliation(s)
- Sebastian E Beyer
- Klinik für Elektrophysiologie, Herz- und Diabeteszentrum NRW, Ruhr Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Deutschland
| | - Guram Imnadze
- Klinik für Elektrophysiologie, Herz- und Diabeteszentrum NRW, Ruhr Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Deutschland
| | - Philipp Sommer
- Klinik für Elektrophysiologie, Herz- und Diabeteszentrum NRW, Ruhr Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Deutschland.
- Herz- und Diabeteszentrum NRW, Georgstr. 11, 32545, Bad Oeynhausen, Deutschland.
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22
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Kaushal N, Attarwala H, Iqbal MJ, Saini R, Van L, Liang M. Translational pharmacokinetic/pharmacodynamic model for mRNA-0184, an investigational therapeutic for the treatment of heart failure. Clin Transl Sci 2024; 17:e13894. [PMID: 39072952 DOI: 10.1111/cts.13894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/27/2024] [Accepted: 06/30/2024] [Indexed: 07/30/2024] Open
Abstract
Heart failure (HF) is a complex, progressive disorder that is associated with substantial morbidity and mortality on a global scale. Relaxin-2 is a naturally occurring hormone that may have potential therapeutic benefit for patients with HF. To investigate the therapeutic potential of relaxin in the treatment of patients with HF, mRNA-0184, a novel, investigational, lipid nanoparticle (LNP)-encapsulated mRNA therapy that encodes for human relaxin-2 fused to variable light chain kappa (Rel2-vlk) was developed. A translational semi-mechanistic population pharmacokinetic (PK)/pharmacodynamic (PD) model was developed using data from non-human primates at dose levels ranging from 0.15 to 1 mg/kg. The PK/PD model was able to describe the PK of Rel2-vlk mRNA and translated Rel2-vlk protein in non-human primates adequately with relatively precise estimates. The preclinical PK/PD model was then scaled allometrically to determine the human mRNA-0184 dose that would achieve therapeutic levels of Rel2-vlk protein expression in patients with stable HF with reduced ejection fraction. Model-based simulations derived from the scaled PK/PD model support the selection of 0.025 mg/kg as an appropriate starting human dose of mRNA-0184 to achieve average trough relaxin levels between 1 and 2.5 ng/mL, which is the potential exposure for cardioprotective action of relaxin.
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Affiliation(s)
| | | | | | | | - Linh Van
- Moderna, Inc., Cambridge, Massachusetts, USA
| | - Min Liang
- Moderna, Inc., Cambridge, Massachusetts, USA
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23
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Tatar S, İcli A, Arıbaş A, Akilli NB, Akilli H, Sertdemir AL. Diastolic Strain Parameters are Associated with Short Term Mortality and Rehospitalization in Patients with Advanced Heart Failure. Arq Bras Cardiol 2024; 121:e20230670. [PMID: 39194040 DOI: 10.36660/abc.20230670] [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: 09/23/2023] [Accepted: 05/15/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Heart failure (HF) is a leading cause of hospitalization and mortality worldwide and places a great economic burden on healthcare systems. Identification of prognostic factors in HF patients is of great importance to establish optimal management strategies and to avoid unnecessary invasive and costly procedures in end-stage patients. OBJECTIVES In the current study, we aimed to investigate the association between diastolic strain parameters including E/e' SR, and short-term outcomes in advanced HF patients. METHODS The population study included 116 advanced HF with reduced ejection fraction (HFrEF) patients. Clinical, laboratory, and echocardiographic evaluations of the patients were performed within the first 24 hours of hospital admission. Patients were followed for one month and any re-hospitalization due to worsening of HF symptoms and any mortality was recorded. The level of significance adopted in the statistical analysis was 5%. RESULTS E/e' SR was significantly higher in the patient group compared to the control group (p=0.001). During one-month follow-up, 13.8% of patients died and 37.1% of patients were rehospitalized. Serum NT-ProBNP (p=0.034) and E/e' SR (p=0.033) were found to be independent predictors of mortality and ACEİ use (p=0.027) and apical 3C strain (p=0.011) were found to be independent predictors of rehospitalization in the patient group. CONCLUSION Findings of the current prospective study demonstrate that E/e' SR measured by speckle tracking echocardiography is an independent and sensitive predictor of short-term mortality in advanced HFrEF patients and may have a role in the identification of end-stage HFrEF patients.
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Affiliation(s)
- Sefa Tatar
- Necmettin Erbakan Universitesi - Kardiyoloji, Konya - Turquia
| | - Abdullah İcli
- Necmettin Erbakan Universitesi - Kardiyoloji, Konya - Turquia
| | - Alpay Arıbaş
- Necmettin Erbakan Universitesi - Kardiyoloji, Konya - Turquia
| | | | - Hakan Akilli
- Necmettin Erbakan Universitesi - Kardiyoloji, Konya - Turquia
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24
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Brito D, Fonseca C, Franco F, Lopes V, Gonçalves S, Baptista R, Sequeira J, Marques I, Rego R, Pimenta J, Silva-Cardoso J, Lopes M, Almeida M. Beyond clinical trials - The cost saving associated with dapagliflozin use in Portugal hospital clinical practice. Rev Port Cardiol 2024:S0870-2551(24)00226-9. [PMID: 39067787 DOI: 10.1016/j.repc.2024.04.012] [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: 02/22/2024] [Revised: 04/11/2024] [Accepted: 04/26/2024] [Indexed: 07/30/2024] Open
Abstract
INTRODUCTION AND OBJECTIVES Heart failure (HF) is a clinical syndrome associated with substantial morbidity, mortality, and healthcare costs. Dapagliflozin has proven efficacy in reducing the risk of death and hospitalization in HF patients, regardless of left ventricular ejection fraction (LVEF). This paper aimed to project the potential impact of dapagliflozin on healthcare costs related to HF subsequent hospitalizations (HFHs) in Portuguese hospitals. METHODS The total number of HF-related hospitalizations (hHF), HFHs, and the average length of stay for patients with a primary diagnosis of HF from six Portuguese hospitals, between January 2019 and December 2021, were collected and aggregated by hospital classification. Costs associated with HFHs were calculated according to Portuguese legislation and considering conservative, average, and complex approaches. Cost-saving projections were based on extrapolations from hHF risk reductions reported in dapagliflozin clinical trials. RESULTS Considering a 26% risk reduction in hHF reported on pooled-analysis of DAPA-HF and DELIVER as the expected reduction in HFHs, the use of dapagliflozin would be associated with cost savings ranging from EUR 1612851.54 up to EUR 6587360.09, when considering all hospitals and the different approaches, between 2019 and 2021. A similar projection is observed based on 24% RRR derived by weighting DAPA-HF and DELIVER sub-analyses and PORTHOS epidemiological data. CONCLUSIONS In this projection, dapagliflozin use in all eligible hHF patients is associated with a significant reduction in direct costs. Our data support that, in addition to the improvements in HF-related outcomes, dapagliflozin may have a significant economic impact on healthcare costs in Portuguese hospitals.
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Affiliation(s)
- Dulce Brito
- Department of Cardiology, Centro Hospitalar Universitário Lisboa Norte, CAML, Lisboa, Portugal; CCUL@RISE, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.
| | - Cândida Fonseca
- Serviço de Medicina Interna Centro Hospitalar de Lisboa Ocidental, Clínica de Insuficiência Cardíaca, Hospital de S. Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Fátima Franco
- Serviço de Cardiologia, Unidade de Tratamento de Insuficiência Cardíaca Avançada (UTICA), Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Vanessa Lopes
- Serviço de Cardiologia, Unidade de Tratamento de Insuficiência Cardíaca Avançada (UTICA), Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Sara Gonçalves
- Integrated Unit in Heart Failure (UNIICA), Cardiology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - Rui Baptista
- Cardiology Department, Unidade Local de Saúde Entre o Douro e Vouga, Santa Maria da Feira, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; University of Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal; Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Joana Sequeira
- Department of Internal Medicine, Unidade Local de Saúde Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Irene Marques
- Department of Internal Medicine, Unidade Local de Saúde de Santo António, Porto, Portugal; Unidade Multidisciplinar de Investigação Biomédica (UMIB), Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal; 3ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal; CAC ICBAS-CHP - Centro Académico Clínico Instituto de Ciências Biomédicas Abel Salazar - Unidade Local de Saúde Santo António, Porto, Portugal
| | - Rita Rego
- Department of Internal Medicine, Unidade Local de Saúde de Santo António, Porto, Portugal
| | - Joana Pimenta
- Serviço de Medicina Interna, Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal
| | - José Silva-Cardoso
- Department of Medicine, Faculdade de Medicina, Universidade do Porto, Porto, Portugal; Department of Cardiology, Centro Hospitalar Universitário de São João, Porto, Portugal; CINTESIS - Center for Health Technology and Services Research, Faculdade de Medicina, Universidade do Porto, Porto, Portugal; CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
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25
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Qayyum AA, Frljak S, Juhl M, Poglajen G, Zemljičl G, Cerar A, Litman T, Ekblond A, Haack-Sørensen M, Højgaard LD, Kastrup J, Vrtovec B. Mesenchymal stromal cells to treat patients with non-ischaemic heart failure: Results from SCIENCE II pilot study. ESC Heart Fail 2024. [PMID: 39039797 DOI: 10.1002/ehf2.14925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 06/02/2024] [Accepted: 06/14/2024] [Indexed: 07/24/2024] Open
Abstract
AIMS Allogeneic stem cell therapy is more logistically suitable compared with autologous cell therapy for large-scale patient treatment. We aim to investigate the clinical safety and efficacy profile of the allogeneic adipose tissue derived mesenchymal stromal cell product (CSCC_ASC) as an add-on therapy in patients with chronic non-ischaemic heart failure with reduced left ventricular ejection fraction (HFrEF) < 40%. METHODS AND RESULTS This is a single-centre investigator-initiated randomized phase I/II study with direct intra-myocardial injections of 100 million allogeneic CSCC_ASC. A total of 30 HFrEF patients with New York Heart Association (NYHA) class ≥II despite optimal anticongestive heart failure medication and plasma NT-proBNP > 300 pg/mL (>35 pmol/L) were included and randomized 2:1 to CSCC_ASC or standard care. The primary endpoint left ventricular end systolic volume (LVESV) and other echo related parameters were analysed by an investigator blinded for treatment allocation. No difference in serious adverse events was observed between groups. LVESV decreased significantly from baseline to 6 months follow-up in the ASC group (153.7 ± 53.2 mL and 128.7 ± 45.6 mL, P < 0.001) and remained unchanged in the standard care group (180.4 ± 39.4 mL and 186.7 ± 48.9 mL, P = 0.652). There was a significant difference between the groups in LVESV change (31.3 ± 11.0 mL, P = 0.009). The difference from baseline to follow-up between the two groups in left ventricular end diastolic volume (LVEDV) was 18.7 ± 12.4 mL, P = 0.146 and in left ventricular ejection fraction (LVEF) -7.8 ± 2.1%, P = 0.001. Considering the baseline values of LVESV, LVEDV and LVEF as covariates, the difference between groups for change from baseline to follow-up resulted in a P-value of 0.056, 0.076, and 0.738, respectively. NYHA class and self-reported health did also improve significantly in the ASC group compared with the standard care group (0.7 ± 0.2, P = 0.001 and -12.8 ± 5.3, P = 0.025; respectively). There was no difference in NT-proBNP (-371 ± 455 pmol/L, P = 0.422) or in 6 min walk test (12 ± 31 m, P = 0.695) between groups. CONCLUSIONS Intramyocardial injections of allogeneic CSCC_ASC in patients with chronic non-ischaemic HFrEF was safe and improved LVESV, LVEF, NYHA class, and self-reported health compared with standard care group.
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Affiliation(s)
- Abbas Ali Qayyum
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Sabina Frljak
- Advanced Heart Failure and Transplantation Centre, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Morten Juhl
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Gregor Poglajen
- Advanced Heart Failure and Transplantation Centre, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Gregor Zemljičl
- Advanced Heart Failure and Transplantation Centre, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Andraz Cerar
- Advanced Heart Failure and Transplantation Centre, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Thomas Litman
- Department of Immunology and Microbiology, LEO Foundation Skin Immunology Research Center, University of Copenhagen, Copenhagen, Denmark
| | - Annette Ekblond
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Mandana Haack-Sørensen
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lisbeth Drozd Højgaard
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jens Kastrup
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bojan Vrtovec
- Advanced Heart Failure and Transplantation Centre, University Medical Centre Ljubljana, Ljubljana, Slovenia
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26
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Merkel ED, Behon A, Masszi R, Schwertner WR, Kuthi L, Veres B, Osztheimer I, Papp R, Molnár L, Zima E, Gellér L, Kosztin A, Merkely B. Obesity paradox in patients with reduced ejection fraction eligible for device implantation - an observational study. ESC Heart Fail 2024. [PMID: 39031161 DOI: 10.1002/ehf2.14961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/02/2024] [Accepted: 04/19/2024] [Indexed: 07/22/2024] Open
Abstract
AIMS Patients with obesity have an overall higher cardiovascular risk, at the same time obesity could be associated with a better outcome in a certain subgroup of patients, a phenomenon known as the obesity paradox. Data are scarce in candidates for cardiac resynchronization therapy (CRT). We aimed to investigate the association between body mass index (BMI) and all-cause mortality in patients eligible for CRT. METHODS Altogether 1,585 patients underwent cardiac resynchronization therapy between 2000-2020 and were categorized based on their BMI, 459 (29%) patients with normal weight (BMI < 25 kg/m2), 641 (40%) patients with overweight (BMI 25- < 30 kg/m2) and 485 (31%) with obesity (BMI ≥ 30 kg/m2). The primary endpoint was all-cause mortality, heart transplantation, and left ventricular assist device implantation. We assessed periprocedural complications and 6-month echocardiographic response. RESULTS Normal-weight patients were older compared to patients with overweight or obesity (70 years vs. 69 years vs. 68 years; P ‹0.001), respectively. Sex distribution, ischaemic aetiology, and CRT-D implantation rates were similar in the three patient groups. Diabetes mellitus (BMI < 25 kg/m2 26% vs. BMI 25- < 30 kg/m2 37% vs. BMI ≥ 30 kg/m2 48%; P ‹0.001) and hypertension (BMI < 25 kg/m2 71% vs. BMI 25- < 30 kg/m2 74% vs. BMI ≥ 30 kg/m2 82%; P ‹0.001) were more frequent in patients with overweight and obesity. During the mean follow-up time of 5.1 years, 973 (61%) reached the primary endpoint, 66% in the BMI < 25 kg/m2 group, 61% in the BMI 25- < 30 kg/m2 group and 58% in the BMI ≥ 30 kg/m2 group (log-rank P‹0.05). Patients with obesity showed mortality benefit over normal-weight patients (HR 0.78; 95%CI 0.66-0.92; P = 0.003). The obesity paradox was present in patients free from diabetes, atrial fibrillation, and ischemic events. Periprocedural complication rates did not differ in the three groups (BMI < 25 kg/m2 25% vs. BMI 25- < 30 kg/m2 28% vs. BMI ≥ 30 kg/m2 26%; P = 0.48). Left ventricular ejection fraction improved significantly in all patient groups (BMI < 25 kg/m2 median∆ $$ \Delta $$ -LVEF 7% vs. BMI 25- < 30 kg/m2 median∆ $$ \Delta $$ -LVEF 7.5% vs. BMI ≥ 30 kg/m2 median∆ $$ \Delta $$ -LVEF 6%; P < 0.0001) with a similar proportion of developing reverse remodeling (BMI < 25 kg/m2 58% vs. BMI 25- < 30 kg/m2 61% vs. BMI ≥ 30 kg/m2 57%; P = 0.48); P = 0.75). CONCLUSIONS The obesity paradox was present in our HF cohort at long-term, patients underwent CRT implantation with obesity and free of comorbidities showed mortality benefit compared to normal weight patients. Patients with obesity showed similar echocardiographic response and safety outcomes compared to normal weight patients.
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Affiliation(s)
- Eperke D Merkel
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Anett Behon
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Richard Masszi
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | | | - Luca Kuthi
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Boglárka Veres
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | | | - Roland Papp
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Levente Molnár
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Endre Zima
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - László Gellér
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | | | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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Izraiq M, AlBalbissi K, Alawaisheh R, Toubasi A, Ahmed YB, Mahmoud M, Khraim KI, AL-Ithawi M, Mansour OM, Hamati A, Khraisat FA, Abu-Hantash H. Comparative Analysis of Heart Failure with Preserved Vs Reduced Ejection Fraction: Patient Characteristics, Outcomes, Mortality Prediction, and Machine Learning Model Development in the JoHFR. Int J Gen Med 2024; 17:3083-3091. [PMID: 39049833 PMCID: PMC11268376 DOI: 10.2147/ijgm.s465388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024] Open
Abstract
Background Heart failure (HF) is a global health challenge affecting millions, with significant variations in patient characteristics and outcomes based on ejection fraction. This study aimed to differentiate between HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) with respect to patient characteristics, risk factors, comorbidities, and clinical outcomes, incorporating advanced machine learning models for mortality prediction. Methodology The study included 1861 HF patients from 21 centers in Jordan, categorized into HFrEF (EF <40%) and HFpEF (EF ≥ 50%) groups. Data were collected from 2021 to 2023, and machine learning models were employed for mortality prediction. Results Among the participants, 29.7% had HFpEF and 70.3% HFrEF. Significant differences were noted in demographics and comorbidities, with a higher prevalence of males, younger age, smoking, and familial history of premature ASCVD in the HFrEF group. HFpEF patients were typically older, with higher rates of diabetes, hypertension, and obesity. Machine learning analysis, mainly using the Random Forest Classifier, demonstrated significant predictive capability for mortality with an accuracy of 0.9002 and an AUC of 0.7556. Other models, including Logistic Regression, SVM, and XGBoost, also showed promising results. Length of hospital stay, need for mechanical ventilation, and number of hospital admissions were the top predictors of mortality in our study. Conclusion The study underscores the heterogeneity in patient profiles between HFrEF and HFpEF. Integrating machine learning models offers valuable insights into mortality risk prediction in HF patients, highlighting the potential of advanced analytics in improving patient care and outcomes.
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Affiliation(s)
- Mahmoud Izraiq
- Cardiology Section, Internal Medicine Department, Specialty Hospital, Amman, Jordan
| | - Kais AlBalbissi
- Cardiology Section, Internal Medicine Department, Jordan University Hospital, Amman, Jordan
| | - Raed Alawaisheh
- Cardiology Section, Internal Medicine Department, Specialty Hospital, Amman, Jordan
| | - Ahmad Toubasi
- Cardiology Section, Internal Medicine Department, Jordan University Hospital, Amman, Jordan
| | - Yaman B Ahmed
- Cardiology Section, Internal Medicine Department, King Abdullah University Hospital, Irbid, Jordan
| | - Marah Mahmoud
- Cardiology Section, Internal Medicine Department, Specialty Hospital, Amman, Jordan
| | - Karam I Khraim
- Cardiology Section, Internal Medicine Department, Specialty Hospital, Amman, Jordan
| | - Mohammed AL-Ithawi
- Cardiology Section, Internal Medicine Department, Specialty Hospital, Amman, Jordan
| | | | - Anoud Hamati
- Cardiology Section, Internal Medicine Department, Specialty Hospital, Amman, Jordan
| | - Farah A Khraisat
- Cardiology Section, Internal Medicine Department, Jordan University Hospital, Amman, Jordan
| | - Hadi Abu-Hantash
- Department of Cardiology, Amman Surgical Hospital, Amman, Jordan
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Kikoïne J, Nowacka A, Schukraft S, Abdurashidova T, Yerly P, Tozzi P, Ltaief Z, Rosner L, Hullin R, Kirsch M. Clinical outcomes of HeartMate 3 left ventricular assist device support with a Bridge to Transplant vs a Destination Therapy strategy: a single-centre retrospective cohort. Swiss Med Wkly 2024; 154:3529. [PMID: 39137373 DOI: 10.57187/s.3529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Abstract
INTRODUCTION Real-world outcomes with the HeartMate 3 left ventricular assist device (LVAD) depending on whether it's a bridge to transplantation (BTT) or destination therapy (DT) are poorly studied. We aimed to compare the profile and clinical outcomes of patients supported with HeartMate 3 according to a BTT or a DT pre-implantation strategy. METHODS All patients consecutively implanted with HeartMate 3 at our centre (University Hospital of Lausanne, Switzerland) in 2015-2022 were analysed in a retrospective observational study. Indications for HeartMate 3 implantation were advanced heart failure despite optimal medical treatment. Patients were treated with a vitamin K antagonist anticoagulant combined with antiplatelet therapy after HeartMate 3 implantation and were followed up monthly at our institution. RESULTS Among 71 patients implanted with HeartMate 3 between 2015 and 2022, 51 (71.8%) were implanted as a BTT and 20 (28.2%) as DT. Their median age was 58 (IQR: 52-69) years and 84% of patients were classified as INTERMACS profiles 2-4. The median follow-up duration was 18.3 (IQR: 7.5-33.9) months. Patients in the DT group were older than those in the BTT group (p <0.001) and had more chronic renal failure (p <0.001). They also had a lower 5-year survival rate (mean ± standard error: 87.3 ± 5.6% vs 49.4 ± 15.1%) and more adverse events such as renal dysfunction requiring temporary perioperative dialysis (p = 0.08) or bleeding (p = 0.06). CONCLUSION Although patients supported with HeartMate 3 have favourable survival, those with LVAD-DT have poorer outcomes. There is a need to better select patients eligible for LVAD-DT in order to limit the burden of adverse events and improve their prognosis.
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Affiliation(s)
- John Kikoïne
- Department of Cardiology, University Hospital, Lausanne, Switzerland
| | - Anna Nowacka
- Department of Cardiac Surgery, University Hospital, Lausanne, Switzerland
| | - Sara Schukraft
- Department of Cardiology, University Hospital, Lausanne, Switzerland
| | | | - Patrick Yerly
- Department of Cardiology, University Hospital, Lausanne, Switzerland
| | - Piergiorgio Tozzi
- Department of Cardiac Surgery, University Hospital, Lausanne, Switzerland
| | - Zied Ltaief
- Department of Intensive Care Medicine, University Hospital, Lausanne, Switzerland
| | - Lorenzo Rosner
- Department of Anaesthesiology, University Hospital, Lausanne, Switzerland
| | - Roger Hullin
- Department of Cardiology, University Hospital, Lausanne, Switzerland
| | - Matthias Kirsch
- Department of Cardiac Surgery, University Hospital, Lausanne, Switzerland
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Zhou T, Pan J, Yan C, Yuan J, Song H, Han Y. Unveiling shared biomarkers and therapeutic targets between systemic lupus erythematosus and heart failure through bioinformatics analysis. Front Med (Lausanne) 2024; 11:1402010. [PMID: 38912340 PMCID: PMC11190381 DOI: 10.3389/fmed.2024.1402010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 05/21/2024] [Indexed: 06/25/2024] Open
Abstract
Background Systemic lupus erythematosus (SLE) is frequently accompanied by various complications, with cardiovascular diseases being particularly concerning due to their high mortality rate. Although there is clinical evidence suggesting a potential correlation between SLE and heart failure (HF), the underlying shared mechanism is not fully understood. Therefore, it is imperative to explore the potential mechanisms and shared therapeutic targets between SLE and HF. Methods The SLE and HF datasets were downloaded from the NCBI Gene Expression Omnibus database. Differentially expressed genes (DEGs) in both SLE and HF were performed using "limma" R package. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genes (KEGG) analyses were conducted to analyze the enriched functions and pathways of DEGs in both SLE and HF datasets. Protein-Protein Interaction network (PPI) and the molecular complex detection (MCODE) plugins in the Cytoscape software were performed to identify the shared hub genes between SLE and HF datasets. R package "limma" was utilized to validate the expression of hub genes based on SLE (GSE122459) and HF (GSE196656) datasets. CIBERSORT algorithm was utilized to analyze the immune cell infiltration of SLE and HF samples based on SLE (GSE112087) and HF (GSE116250) datasets. A weighted gene co-expression network analysis (WGCNA) network was established to further validate the hub genes based on HF dataset (GSE116250). Molecular biology techniques were conducted to validate the hub genes. Results 999 shared DGEs were identified between SLE and HF datasets, which were mainly enriched in pathways related to Th17 cell differentiation. 5 shared hub genes among the common DGEs between SLE and HF datasets were screened and validated, including HSP90AB1, NEDD8, RPLP0, UBB, and UBC. Additionally, 5 hub genes were identified in the central part of the MEbrown module, showing the strongest correlation with dilated cardiomyopathy. HSP90AB1 and UBC were upregulated in failing hearts compared to non-failing hearts, while UBB, NEDD8, and RPLP0 did not show significant changes. Conclusion HSP90AB1 and UBC are closely related to the co-pathogenesis of SLE and HF mediated by immune cell infiltration. They serve as promising molecular markers and potential therapeutic targets for the treatment of SLE combined with HF.
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Affiliation(s)
- Ting Zhou
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Jing Pan
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Chenghui Yan
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Jing Yuan
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Haixu Song
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Yaling Han
- State Key Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
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Van Nguyen T, Nguyen HTK, Wong WJ, Ahmad F, Nguyen TN. The prescription of beta-blockers in older patients with heart failure with reduced ejection fraction: an observational study in Vietnam. Sci Rep 2024; 14:12923. [PMID: 38839862 PMCID: PMC11153617 DOI: 10.1038/s41598-024-63479-w] [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: 08/25/2023] [Accepted: 05/29/2024] [Indexed: 06/07/2024] Open
Abstract
This study in older hospitalized patients with heart failure with reduced ejection fraction (HFrEF) aimed to examine the prevalence of beta-blocker prescription and its associated factors. A total of 190 participants were recruited from July 2019 to July 2020. The inclusion criteria included: (1) aged ≥ 60 years, (2) having a diagnosis of chronic HFrEF in the medical records, (3) hospitalized for at least 48 h. The participants had a mean age of 75.5 ± 9.1, and 46.8% were female. Of these, 55.3% were prescribed beta-blockers during admission. To explore the factors associated with beta-blocker prescription, multivariable logistic regression analysis was applied and the results were presented as odds ratios (OR) and 95% confidence intervals (CI). On multivariate logistic regression models, higher NYHA classes (OR 0.49, 95%CI 0.26-0.94), chronic obstructive pulmonary disease (OR 0.17, 95% CI 0.04-0.85), chronic kidney disease (OR 0.40, 95% CI 0.19-0.83), and heart rate under 65 (OR 0.34, 95% CI 0.12-0.98) were associated with a reduced likelihood of prescription. In this study, we found a low rate of beta-blocker prescriptions, with only around half of the participants being prescribed beta-blockers. Further studies are needed to examine the reasons for the under-prescription of beta-blockers, and to evaluate the long-term benefits of beta-blockers in elderly patients with HFrEF in this population.
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Affiliation(s)
- Tan Van Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
- Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam.
| | - Hoa T K Nguyen
- Department of Geriatrics and Gerontology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Wei Jin Wong
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Fahed Ahmad
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Tu Ngoc Nguyen
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
- The George Institute of Global Health, UNSW, Sydney, Australia.
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Boonyapiphat T, Tangkittikasem T, Torpongpun A, Senthong V, Jiampo P. Real-World Clinical Burden of Newly Diagnosed Heart failure in Thai Patients. Cardiol Ther 2024; 13:415-430. [PMID: 38709436 PMCID: PMC11093927 DOI: 10.1007/s40119-024-00366-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/18/2024] [Indexed: 05/07/2024] Open
Abstract
INTRODUCTION There are limited data on the burden of newly diagnosed patients with heart failure (HF) in Thailand. Thus, this study aimed to fully understand the hospitalization, rehospitalization, mortality rates, demographics and characteristics, and quality of care in these patients. METHOD A retrospective review of all eligible adult patients' medical records from 2018 and 2019 was conducted at five hospitals. The patients were newly diagnosed with HF, as indicated by the International Classification of Diseases (ICD)-10 code "I50." Descriptive statistics was used to investigate patients' hospital burden and clinical outcome data. RESULTS There were 1134 patients newly diagnosed with HF, classified as HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and HF with mildly reduced ejection fraction (HFmrEF) (44.0, 40.0, and 16.0%, respectively). The male-to-female ratios in HFmrEF and HFpEF were similar. In contrast, the proportion of men with HFrEF was greater. The mean age of all patients was 66.0 years. The hospitalization rate was 1.3. Rehospitalization rates for HF-related issues were 0.1, 0.2, 0.4, and 0.5 at 30 days, 60 days, 180 days, and 1 year, respectively. The percentage of deaths from all causes among these patients was 9.8%, while the percentage of deaths from cardiovascular-related causes was 8.5%. Only a small proportion of patients received a target dose of guideline-directed medical therapy (GDMT). CONCLUSIONS The study revealed that the characteristics, hospitalization rate for HF, and in-hospital mortality rate among newly diagnosed patients with HF were higher compared to similar studies conducted in Thailand and other countries. Moreover, a high quality of care is needed to improve the morbidity and mortality associated with HF in Thailand.
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Affiliation(s)
| | | | | | - Vichai Senthong
- Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Mueang, Khon Kaen, Thailand
| | - Panyapat Jiampo
- Bhumibol Adulyadej Hospital, 171 Phahonyothin Road, Khlong Thanon Subdistrict, Sai Mai District, Bangkok, 10220, Thailand.
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Elsner C, Bettin S, Tilz R, Häckl D. Economic Considerations of Cardiovascular Implantable Electronic Devices for The Treatment of Heart Failure. Curr Heart Fail Rep 2024; 21:186-193. [PMID: 38662154 DOI: 10.1007/s11897-024-00664-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE OF REVIEW Heart failure (HF) is a major public health problem worldwide, affecting more than 64 million people [1]. The complex and severe nature of HF presents challenges in providing cost-effective care as patients often require multiple hospitalizations and treatments. This review of relevant studies with focus on the last 10 years summarizes the health and economic implications of various HF treatment options in Europe and beyond. Although the main cost drivers in HF treatment are clinical (re)admission and decompensation of HF, an assessment of the economic impacts of various other device therapy options for HF care are included in this review. This includes: cardiovascular implantable electronic devices (CIEDs) such as cardiac-resynchronisation-therapy devices that include pacemaking (CRT-P), cardiac-resynchronisation-therapy devices that include defibrillation (CRT-D), implantable cardioverter/defibrillators (ICDs) and various types of pacemakers. The impact of (semi)automated (tele)monitoring as a relevant factor for increasing both the quality and economic impact of care is also taken into consideration. Quality of life adjusted life years (QALYs) are used in the overall context as a composite metric reflecting quantity and quality of life as a standardized measurement of incremental cost-effectiveness ratios (ICER) of different device-based HF interventions. RECENT FINDINGS In terms of the total cost of different devices, CRT-Ds were found in several studies to be more expensive than all other devices in regards to runtime and maintenance costs including (re)implantation. In the case of CRT combined with an implantable cardioverter-defibrillator (CRT-D) versus ICD alone, CRT-D was found to be the most cost-effective treatment in research work over the past 10 years. Further comparison between CRT-D vs. CRT-P does not show an economic advantage of CRT-D as a minority of patients require shock therapy. Furthermore, a positive health economic effect and higher survival rate is seen in CRT-P full ventricular stimulation vs. right heart only stimulation. Telemedical care has been found to provide a positive health economic impact for selected patient groups-even reducing patient mortality. For heart failure both in ICD and CRT-D subgroups the given telemonitoring benefit seems to be greater in higher-risk populations with a worse HF prognosis. In patients with HF, all CIED therapies are in the range of commonly accepted cost-effectiveness. QALY and ICER calculations provide a more nuanced understanding of the economic impact these therapies create in the healthcare landscape. For severe cases of HF, CRT-D with telemedical care seems to be the better option from a health economic standpoint, as therapy is more expensive, but costs per QALY range below the commonly accepted threshold.
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Affiliation(s)
- Christian Elsner
- Center for Artificial Intelligence, University Hospital Schleswig-Holstein, Lübeck, Germany.
| | - Simon Bettin
- Department for ENT, University of Lübeck, Lübeck, Germany
| | - Roland Tilz
- German Center for Cardiovascular Research (DZHK), Partner Site, Lübeck, Germany
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Jiampo P, Tangkittikasem T, Boonyapiphat T, Senthong V, Torpongpun A. Real-World Heart Failure Burden in Thai Patients. Cardiol Ther 2024; 13:281-297. [PMID: 38326588 PMCID: PMC11093949 DOI: 10.1007/s40119-024-00355-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 01/17/2024] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION Heart failure (HF) is one of the leading causes of hospitalization worldwide. In Thailand, data on HF burden remains limited. This study aimed to describe comprehensive evidence detailing the HF prevalence, hospital admission rates, in-hospital mortality, and overall mortality rates at the hospital level. METHOD All eligible adult patients' medical records from 2018 and 2019 were analyzed retrospectively at five hospitals in different regions. The patients were diagnosed with HF, as indicated by the International Classification of Diseases (ICD)-10 code I50. Descriptive statistics were used to examine the hospital burden as well as patients' clinical and outcome data. RESULTS A total of 7384 patients with HF were identified from five tertiary hospitals. Around half of the patients were male. The mean age was 67 years, and the main health insurance scheme was the Universal Coverage Scheme. The prevalence of HF was 0.1% in 2018 and 0.2% in 2019. Heart failure with preserved ejection fraction (HFpEF) was the most common type of HF in both visits, followed by heart failure with reduced ejection fraction (HFrEF) and heart failure with mildly reduced ejection fraction (HFmrEF). The proportion of HF hospitalizations was 1.2% in 2018 and 1.5% in 2019. The proportion of HF rehospitalizations versus hospitalizations in patients with HF was 22.7% in 2018 and 23.9% in 2019. The risk of rehospitalization was highest at 180 days after hospital discharge (87.8%). Among the patients with HF, the proportion of all-cause mortality was 9.1% in 2018 and 8.0% in 2019. Most of the deaths occurred within 30 days after hospitalization. CONCLUSION Our study demonstrated that the burden of HF in terms of hospitalization and in-hospital mortality was notably high when compared to similar studies conducted in Thailand and other countries.
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Affiliation(s)
- Panyapat Jiampo
- Bhumibol Adulyadej Hospital, Sai Mai District, Bangkok, Thailand
| | | | | | - Vichai Senthong
- Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Mueang, Khon Kaen, Thailand
| | - Artit Torpongpun
- Chonburi Hospital, 69 Moo 2, Sukhumvit Road, Ban Suan, Mueang Chon Buri, Chon Buri, 20000, Thailand.
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Ren Y, Zhao X. Bone marrow mesenchymal stem cells-derived exosomal lncRNA GAS5 mitigates heart failure by inhibiting UL3/Hippo pathway-mediated ferroptosis. Eur J Med Res 2024; 29:303. [PMID: 38812041 PMCID: PMC11137962 DOI: 10.1186/s40001-024-01880-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: 03/28/2024] [Accepted: 05/03/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Exosomes (Exos) are involved in the therapeutic effects of bone marrow mesenchymal stem cells (BMSCs) on heart failure (HF). We investigated the molecular mechanisms underlying the involvement of BMSC-Exos in ferroptosis on HF. METHODS A rat model of HF and cellular model of hypoxia were established. BMSC-Exos were injected into model rats or co-cultured with model cells. In model rats, the cardiac function (echocardiography), oxidative stress (commercial kits), pathological damage (HE staining), fibrosis (MASSON staining), iron deposition (Prussian blue staining), and cell apoptosis (TUNEL staining) were examined. Viability (cell counting kit-8; CCK-8), cell cycle (flow cytometry), oxidative stress, and Fe2+ levels were detected in the model cells. GAS5, UL3, YAP, and TAZ expression were detected using qRT-PCR, western blotting, and immunohistochemistry analyses. RESULTS BMSC-Exos restored cardiac function and inhibited oxidative stress, apoptosis, pathological damage, fibrosis, and iron deposition in myocardial tissues of HF rats. In hypoxic cells, BMSC-Exos increased cell viability, decreased the number of G1 phase cells, decreased Fe2+ levels, and inhibited oxidative stress. Ferrostatin-1 (a ferroptosis inhibitor) exhibited a synergistic effect with BMSC-Exos. Additionally, GAS5 was upregulated in BMSC-Exos, further upregulating its target UL3 and Hippo pathway effectors (YAP and TAZ). The relieving effects of BMSC-Exos on HF or hypoxia-induced injury were enhanced by GAS5 overexpression, but weakened by UL3 silencing or verteporfin (a YAP inhibitor). CONCLUSIONS GAS5-harbouring BMSC-Exos inhibited ferroptosis by regulating the UL3/Hippo pathway, contributing to HF remission in vivo and in vitro.
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Affiliation(s)
- Yu Ren
- Department of Scientific Research, Inner Mongolia People's Hospital, Hohhot, 010017, China
| | - Xingsheng Zhao
- Department of Cardiology, Inner Mongolia People's Hospital, No.20 Zhao Wuda Road, Hohhot, 010017, China.
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Lazăr-Höcher AI, Cozma D, Cirin L, Cozgarea A, Faur-Grigori AA, Catană R, Tudose DG, Târtea G, Crișan S, Gaiță D, Luca CT, Văcărescu C. A Comparative Analysis of Apical Rocking and Septal Flash: Two Views of the Same Systole? J Clin Med 2024; 13:3109. [PMID: 38892820 PMCID: PMC11172686 DOI: 10.3390/jcm13113109] [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: 03/28/2024] [Revised: 05/11/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Heart failure (HF) is a complex medical condition characterized by both electrical and mechanical dyssynchrony. Both dyssynchrony mechanisms are intricately linked together, but the current guidelines for cardiac resynchronization therapy (CRT) rely only on the electrical dyssynchrony criteria, such as the QRS complex duration. This possible inconsistency may result in undertreating eligible individuals who could benefit from CRT due to their mechanical dyssynchrony, even if they fail to fulfill the electrical criteria. The main objective of this literature review is to provide a comprehensive analysis of the practical value of echocardiography for the assessment of left ventricular (LV) dyssynchrony using parameters such as septal flash and apical rocking, which have proven their relevance in patient selection for CRT. The secondary objectives aim to offer an overview of the relationship between septal flash and apical rocking, to emphasize the primary drawbacks and benefits of using echocardiography for evaluation of septal flash and apical rocking, and to offer insights into potential clinical applications and future research directions in this area. Conclusion: there is an opportunity to render resynchronization therapy more effective for every individual; septal flash and apical rocking could be a very useful and straightforward echocardiography resource.
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Affiliation(s)
- Alexandra-Iulia Lazăr-Höcher
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.-I.L.-H.); (L.C.); (A.C.)
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania; (A.-A.F.-G.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
| | - Dragoș Cozma
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania; (A.-A.F.-G.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Liviu Cirin
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.-I.L.-H.); (L.C.); (A.C.)
| | - Andreea Cozgarea
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.-I.L.-H.); (L.C.); (A.C.)
- County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
| | - Adelina-Andreea Faur-Grigori
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania; (A.-A.F.-G.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
| | - Rafael Catană
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
| | - Dănuț George Tudose
- Institute of Cardiovascular Diseases C.C. Iliescu, Fundeni Clinical Institute, 258 Fundeni Street, 022328 Bucharest, Romania;
| | - Georgică Târtea
- Department of Physiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Simina Crișan
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania; (A.-A.F.-G.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Dan Gaiță
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania; (A.-A.F.-G.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Constantin-Tudor Luca
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania; (A.-A.F.-G.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Cristina Văcărescu
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania; (A.-A.F.-G.); (S.C.); (D.G.); (C.-T.L.); (C.V.)
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
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Li J, Song Y, Chen F. Evaluating the impact of Sacubitril/valsartan on diastolic function in patients with heart failure: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e37965. [PMID: 38728489 PMCID: PMC11081558 DOI: 10.1097/md.0000000000037965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Heart failure is a common and severe condition, often complicated by diastolic dysfunction. Current standard therapies such as ACEIs and ARBs have limited efficacy in managing diastolic function. Sacubitril/Valsartan, an emerging therapy, warrants rigorous investigation to elucidate its impact on diastolic function in heart failure patients. METHODS This systematic review and meta-analysis were conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and utilized the PICO schema. Searches were performed on 4 databases-PubMed, Embase, Web of Science, and Cochrane Library-without temporal restrictions. Inclusion and exclusion criteria were strictly defined, and quality assessments were conducted using the Cochrane Collaboration Risk of Bias tool. Both fixed-effects and random-effects models were used for statistical analysis, depending on inter-study heterogeneity assessed by I2 statistics and Chi-square tests. RESULTS Out of 1129 identified publications, 8 studies met the criteria and were included in the meta-analysis. These studies consisted of both randomized controlled trials and cohort studies and featured diverse global populations. Significant reductions were found in the echocardiographic parameter E/e' ratio and LAVi upon treatment with Sacubitril/Valsartan compared to standard therapies, with mean differences of -1.38 and -4.62, respectively, both with P values < .01. CONCLUSIONS This meta-analysis demonstrates that Sacubitril/Valsartan significantly improves diastolic function parameters in heart failure patients compared to standard treatments. These findings underscore the potential benefits of Sacubitril/Valsartan in the management of heart failure, particularly for patients with diastolic dysfunction.
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Affiliation(s)
- Jinfu Li
- Department of Internal Medicine III, Fujian Dehua County Hospital, Quanzhou, Fujian Province, China
| | - Yanbin Song
- Department of Cardiology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
- Department of Cardiology, the Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Fengyun Chen
- Department of Cardiovascular Medicine, Central Hospital Affiliated to Chongqing University of Technology, Chongqing, China
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An C, Li Z, Chen Y, Huang S, Yang F, Hu Y, Xu T, Zhang C, Ge S. The cGAS-STING pathway in cardiovascular diseases: from basic research to clinical perspectives. Cell Biosci 2024; 14:58. [PMID: 38720328 PMCID: PMC11080250 DOI: 10.1186/s13578-024-01242-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
The cyclic guanosine monophosphate (GMP)-adenosine monophosphate (AMP) synthase-stimulator of interferon genes (cGAS-STING) signaling pathway, an important component of the innate immune system, is involved in the development of several diseases. Ectopic DNA-induced inflammatory responses are involved in several pathological processes. Repeated damage to tissues and metabolic organelles releases a large number of damage-associated molecular patterns (mitochondrial DNA, nuclear DNA, and exogenous DNA). The DNA fragments released into the cytoplasm are sensed by the sensor cGAS to initiate immune responses through the bridging protein STING. Many recent studies have revealed a regulatory role of the cGAS-STING signaling pathway in cardiovascular diseases (CVDs) such as myocardial infarction, heart failure, atherosclerosis, and aortic dissection/aneurysm. Furthermore, increasing evidence suggests that inhibiting the cGAS-STING signaling pathway can significantly inhibit myocardial hypertrophy and inflammatory cell infiltration. Therefore, this review is intended to identify risk factors for activating the cGAS-STING pathway to reduce risks and to simultaneously further elucidate the biological function of this pathway in the cardiovascular field, as well as its potential as a therapeutic target.
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Affiliation(s)
- Cheng An
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Hefei, 230032, Anhui, China
| | - Zhen Li
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yao Chen
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Hefei, 230032, Anhui, China
| | - Shaojun Huang
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Hefei, 230032, Anhui, China
| | - Fan Yang
- Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Ying Hu
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, Jiangsu, China
| | - Tao Xu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, Anhui, China
| | - Chengxin Zhang
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Hefei, 230032, Anhui, China.
| | - Shenglin Ge
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Hefei, 230032, Anhui, China.
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Li T, Yang H, Guo L, Shi Z, Hu W. Dietary antioxidant intake is associated with heart failure: Results from the NHANES 2003-2019. Heart Lung 2024; 65:101-108. [PMID: 38457967 DOI: 10.1016/j.hrtlng.2024.02.008] [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: 12/07/2023] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Growing evidence has shown that antioxidant diets protect against heart failure (HF). However, the association between the composite dietary antioxidant index (CDAI), an important measure of overall antioxidants in the diet, and HF has received little attention. OBJECTIVE The purpose of this study was to examine the relationship between the CDAI and HF. METHODS A secondary cross-sectional analysis of the 2003 to 2019 National Health and Nutrition Examination Survey (NHANES) was performed. Weighted multivariable logistic regression was used to test the association between the CDAI and HF in four different models, with subgroup analysis and an interaction test subsequently performed. RESULTS A total of 37,390 participants were included. The HF groups had lower CDAI levels than those in the non-HF group (0.29 ± 0.04 vs. -0.74 ± 0.16, p < 0.0001). After adjusting for demographic characteristics, lifestyle factors, and disease history, a negative association was found between the CDAI and HF (OR: 0.97, 95 % CI: 0.94, 1.00). There was an inverse trend whereby increasing the CDAI was associated with decreasing the odds of HF (p for trend < 0.001). The subgroup analysis and interaction test showed no significant dependence on demographic characteristics, lifestyle factors, and disease history with regard to this association (all p for interaction > 0.05). CONCLUSION The CDAI was inversely associated with HF in US adults, with higher CDAI levels possibly being associated with a lower incidence of HF, suggesting that dietary antioxidants may help prevent HF.
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Affiliation(s)
- Tao Li
- Department of Pathophysiology, Medical College, Jiaying University, Meizhou, China
| | - Huangdan Yang
- Department of Nursing, Medical College, Jiaying University Meizhou, China
| | - Lijuan Guo
- Department of Nursing, Medical College, Jiaying University Meizhou, China
| | - Zeya Shi
- Department of Nursing, Hunan Provincial People's Hospital Changsha, China
| | - Wanqin Hu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong SAR, China.
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de Oliveira MT, Baptista R, Chavez-Leal SA, Bonatto MG. Heart failure management with β-blockers: can we do better? Curr Med Res Opin 2024; 40:43-54. [PMID: 38597068 DOI: 10.1080/03007995.2024.2318002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/08/2024] [Indexed: 04/11/2024]
Abstract
Heart failure (HF) is associated with disabling symptoms, poor quality of life, and a poor prognosis with substantial excess mortality in the years following diagnosis. Overactivation of the sympathetic nervous system is a key feature of the pathophysiology of HF and is an important driver of the process of adverse remodelling of the left ventricular wall that contributes to cardiac failure. Drugs which suppress the activity of the renin-angiotensin-aldosterone system, including β-blockers, are foundation therapies for the management of heart failure with reduced ejection fraction (HFrEF) and despite a lack of specific outcomes trials, are also widely used by cardiologist in patients with HF with preserved ejection fraction (HFpEF). Today, expert opinion has moved away from recommending that treatment for HF should be guided solely by the LVEF and interventions should rather address signs and symptoms of HF (e.g. oedema and tachycardia), the severity of HF, and concomitant conditions. β-blockers improve HF symptoms and functional status in HF and these agents have demonstrated improved survival, as well as a reduced risk of other important clinical outcomes such as hospitalisation for heart failure, in randomised, placebo-controlled outcomes trials. In HFpEF, β-blockers are anti-ischemic and lower blood pressure and heart rate. Moreover, β-blockers also reduce mortality in the setting of HF occurring alongside common comorbid conditions, such as diabetes, CKD (of any severity), and COPD. Higher doses of β-blockers are associated with better clinical outcomes in populations with HF, so that ensuring adequate titration of therapy to their maximal (or maximally tolerated) doses is important for ensuring optimal outcomes for people with HF. In principle, a patient with HF could have combined treatment with a β-blocker, renin-angiotensin-aldosterone system inhibitor/neprilysin inhibitor, mineralocorticoid receptor antagonist, and a SGLT2 inhibitor, according to tolerability.
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Affiliation(s)
- Mucio Tavares de Oliveira
- Heart Institute, Day Hospital and Infusion Center, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Infusion Center and Day Hospital at Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil
| | - Rui Baptista
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
- Cardiology Department, Centro Hospitalar Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | | | - Marcely Gimenes Bonatto
- Department of Heart Failure and Heart Transplant, Hospital Santa Casa de Misericórdia de, Curitiba, Brazil
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40
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Maryam, Varghese TP, B T. Unraveling the complex pathophysiology of heart failure: insights into the role of renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system (SNS). Curr Probl Cardiol 2024; 49:102411. [PMID: 38246316 DOI: 10.1016/j.cpcardiol.2024.102411] [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: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 01/23/2024]
Abstract
Heart failure (HF) is a widespread disease with significantly elevated mortality, morbidity, and hospitalization rates. Dysregulation of the sympathetic nervous system (SNS) and renin-angiotensin-aldosterone system (RAAS) are both postulated to be significant regulators of cardiovascular function, thereby playing a pivotal role in its pathophysiology. The RAAS is a sophisticated hormonal system that controls electrolyte homeostasis, fluid balance, and blood pressure. Angiotensin II, which operates to constrict blood vessels and raise blood pressure, is its principal effector molecule. The RAAS is frequently hyperactive in HF, which increases fluid retention and worsens cardiac function. The SNS is frequently hyperactive in heart failure, which increases the workload on the heart and worsens symptoms. This review will discuss what is currently known about the pathophysiology of heart failure, specifically in the context of RAAS and the SNS, in-depth to emphasize the knowledge gap that necessitates more research.
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Affiliation(s)
- Maryam
- Department of Pharmacy Practice, Deccan School of Pharmacy, Nampally, Hyderabad, Telangana, India; Department of Pharmacy Practice, Yenepoya Pharmacy College & Research centre, Yenepoya (Deemed to be University), Ayush campus, Naringana, Deralakatte, Mangalore, Karnataka, India
| | - Treesa P Varghese
- Department of Pharmacy Practice, Yenepoya Pharmacy College & Research centre, Yenepoya (Deemed to be University), Ayush campus, Naringana, Deralakatte, Mangalore, Karnataka, India.
| | - Tazneem B
- Department of Pharmacy Practice, Deccan School of Pharmacy, Nampally, Hyderabad, Telangana, India; Department of Pharmacy Practice, Yenepoya Pharmacy College & Research centre, Yenepoya (Deemed to be University), Ayush campus, Naringana, Deralakatte, Mangalore, Karnataka, India
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Lassen M, Seven E, Søholm H, Hassager C, Møller JE, Køber NV, Lindholm MG. Heart Failure with Preserved vs. Reduced Ejection Fraction: Patient Characteristics, In-hospital Treatment and Mortality-DanAHF, a Nationwide Prospective Study. J Cardiovasc Transl Res 2024; 17:265-274. [PMID: 37052785 DOI: 10.1007/s12265-023-10385-7] [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: 01/16/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023]
Abstract
This study aims to describe baseline characteristics and in-hospital management of a patient cohort hospitalized with acute heart failure (AHF). Adult patients in Denmark admitted with a medical diagnosis during a 7-day period were reviewed for symptoms and clinical findings suggestive of AHF. HFpEF was defined as LVEF ≥ 45%. Of 5194 patients, 290 (6%) had AHF. Sixty-two percent (n = 179) was diagnosed with HFpEF. Compared to HFrEF patients, HFpEF patients were more often women (48% vs. 31%, p = 0.004), less likely to have ischemic heart disease (31% vs. 53%, p = 0.002) and a pacemaker/ICD (7% vs. 21%, p < 0.001/1% vs. 8%, p < 0.001). Fewer HFpEF patients received intravenous diuretics (43% vs. 73%, p < 0.001) and inotropes (2% vs. 7%, p = 0.02), while more HFpEF patients received nitro-glycerine (59% vs. 44%, p = 0.02). Intubation/NIV, ICU admission, and revascularization were used similarly. Hospitalization was shorter for HFpEF patients (4 vs. 6 days, p < 0.001), with no significant difference in survival to discharge (96% vs. 91%, p = 0.07). Of AHF admissions, nearly two-thirds was due to HFpEF. Compared to HFrEF, HFpEF patients had a lower cardiac comorbidity and a 2-day shorter hospitalization.
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Affiliation(s)
- Maria Lassen
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.
- Department of Anaesthesiology and Intensive Care, Bispebjerg Hospital, Copenhagen, Denmark.
| | - Ekim Seven
- Department of Cardiology, Hvidovre Hospital, Copenhagen, Denmark
| | - Helle Søholm
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
| | - Christian Hassager
- Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Jacob Eifer Møller
- Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
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Miger K, Overgaard Olesen AS, Grand J, Fabricius-Bjerre A, Sajadieh A, Høst N, Køber N, Abild A, Pedersen L, Lawaetz Schultz HH, Torp-Pedersen C, Ploug Boesen M, Thune JJ, Nielsen OW. Computed tomography or chest X-ray to assess pulmonary congestion in dyspnoeic patients with acute heart failure. ESC Heart Fail 2024; 11:1163-1173. [PMID: 38279517 DOI: 10.1002/ehf2.14688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/22/2023] [Accepted: 01/08/2024] [Indexed: 01/28/2024] Open
Abstract
AIMS While computed tomography (CT) is widely acknowledged as superior to chest radiographs for acute diagnostics, its efficacy in diagnosing acute heart failure (AHF) remains unexplored. This prospective study included consecutive patients with dyspnoea undergoing simultaneous low-dose chest CT (LDCT) and chest radiographs. Here, we aimed to determine if LDCT is superior to chest radiographs to confirm pulmonary congestion in dyspnoeic patients with suspected AHF. METHODS AND RESULTS An observational, prospective study, including dyspnoeic patients from the emergency department. All patients underwent concurrent clinical examination, laboratory tests, echocardiogram, chest radiographs, and LDCT. The primary efficacy measure to compare the two radiological methods was conditional odds ratio (cOR). The primary outcome was adjudicated AHF, ascertained by comprehensive expert consensus. The secondary outcome, echo-bnp AHF, was an objective AHF diagnosis based on echocardiographic cardiac dysfunction, elevated cardiac filling pressure, loop diuretic administration, and NT-pro brain natriuretic peptide > 300 pg/mL. Of 228 dyspnoeic patients, 64 patients (28%) had adjudicated AHF, and 79 patients (35%) had echo-bnp AHF. Patients with AHF were older (78 years vs. 73 years), had lower left ventricular ejection fraction (36% vs. 55%), had higher elevated left ventricular filling pressures (98% vs. 18%), and had higher NT-pro brain natriuretic peptide levels (3628 pg/mL vs. 470 pg/mL). The odds to diagnose adjudicated AHF and echo-bnp AHF were up to four times greater using LDCT (cOR: 3.89 [2.15, 7.06] and cOR: 2.52 [1.45, 4.38], respectively). For each radiologic sign of pulmonary congestion, the LDCT provided superior or equivalent results as the chest radiographs, and the interrater agreement was higher using LDCT (kappa 0.88 [95% CI: 0.81, 0.95] vs. 0.73 [95% CI: 0.63, 0.82]). As first-line imaging modality, LDCT will find one additional adjudicated AHF in 12.5 patients and prevent one false-positive in 20 patients. Similar results were demonstrated for echo-bnp AHF. CONCLUSIONS In consecutive dyspnoeic patients admitted to the emergency department, LDCT is significantly better than chest radiographs in detecting pulmonary congestion.
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Affiliation(s)
- Kristina Miger
- Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne Sophie Overgaard Olesen
- Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Johannes Grand
- Department of Cardiology, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark
| | - Andreas Fabricius-Bjerre
- Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Ahmad Sajadieh
- Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Nis Høst
- Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Nanna Køber
- Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Annemette Abild
- Department of Radiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Lars Pedersen
- Department of Pulmonary Medicine and Infectious Diseases, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Hans Henrik Lawaetz Schultz
- Department of Pulmonary Medicine and Infectious Diseases, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Copenhagen University Hospital - North Zealand, Hilleroed, Denmark
- Department of Cardiology, Aalborg University Hospital, North Denmark Region, Denmark
| | - Mikael Ploug Boesen
- Department of Radiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jens Jakob Thune
- Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Olav W Nielsen
- Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Dai Q, Zhao S, Li W, Liu K, Tao X, Liu C, Yao H, Mu F, Chen S, Li J, Wei P, Gao F, Xi M. Pharmacodynamics and Mechanism of Astragali Radix and Anemarrhenae Rhizoma in Treating Chronic Heart Failure by Inhibiting Complement Activation. Rejuvenation Res 2024; 27:61-74. [PMID: 38386515 DOI: 10.1089/rej.2023.0068] [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] [Indexed: 02/24/2024] Open
Abstract
Astragali radix (AR) and anemarrhenae rhizoma (AAR) are used clinically in Chinese medicine for the treatment of chronic heart failure (CHF), but the exact therapeutic mechanism is unclear. In this study, a total of 60 male C57BL/6 mice were divided into 5 groups, namely sham, model, AR, AAR, and AR-AAR. In the sham group, the chest was opened without ligation. In the other groups, the chest was opened and the transverse aorta was ligated to construct the transverse aortic constriction model. After 8 weeks of feeding, mice were given medicines by gavage for 4 weeks. Left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were detected by echocardiography. Heart weight index (HWI) and wheat germ agglutinin staining were used to evaluate cardiac hypertrophy. Hematoxylin-eosin staining was used to observe the pathological morphology of myocardial tissue. Masson staining was used to evaluate myocardial fibrosis. The content of serum brain natriuretic peptide (BNP) was detected by enzyme-linked immunosorbent assay kit. The content of serum immunoglobulin G (IgG) was detected by immunoturbidimetry. The mechanism of AR-AAR in the treatment of CHF was explored by proteomics. Western blot was used to detect the protein expressions of complement component 1s (C1s), complement component 9 (C9), and terminal complement complex 5b-9 (C5b-9). The results show that AR-AAR inhibits the expression of complement proteins C1s, C9, and C5b-9 by inhibiting the production of IgG antibodies from B cell activation, which further inhibits the complement activation, attenuates myocardial fibrosis, reduces HWI and cardiomyocyte cross-sectional area, improves cardiomyocyte injury, reduces serum BNP release, elevates LVEF and LVFS, improves cardiac function, and exerts myocardial protection.
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Affiliation(s)
- Qi Dai
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang, China
- TANK Medicinal Biology Institute of Xi'an, Xi'an, China
| | - Shi Zhao
- TANK Medicinal Biology Institute of Xi'an, Xi'an, China
| | - Weihong Li
- TANK Medicinal Biology Institute of Xi'an, Xi'an, China
- College of Life Sciences, Northwestern University, Xi'an, China
| | - Kedi Liu
- TANK Medicinal Biology Institute of Xi'an, Xi'an, China
| | - Xingru Tao
- TANK Medicinal Biology Institute of Xi'an, Xi'an, China
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Chengzhao Liu
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang, China
- TANK Medicinal Biology Institute of Xi'an, Xi'an, China
| | - Hong Yao
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang, China
- TANK Medicinal Biology Institute of Xi'an, Xi'an, China
| | - Fei Mu
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Sha Chen
- YouYi Clinical Laboratories of Shaanxi, Xi'an, China
| | - Jing Li
- YouYi Clinical Laboratories of Shaanxi, Xi'an, China
| | - Peifeng Wei
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang, China
- National Drug Clinical Trial Institute, The Second Affiliated Hospital, Shaanxi University of Chinese Medicine, Xi'an, China
| | - Feng Gao
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Miaomiao Xi
- TANK Medicinal Biology Institute of Xi'an, Xi'an, China
- National Drug Clinical Trial Institute, The Second Affiliated Hospital, Shaanxi University of Chinese Medicine, Xi'an, China
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Zheng J, Cen K, Zhang J, Zhang H, Zhao M, Hou X. Uric acid levels and heart failure: A mendelian randomization study. Nutr Metab Cardiovasc Dis 2024; 34:1008-1013. [PMID: 38413359 DOI: 10.1016/j.numecd.2023.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/18/2023] [Accepted: 12/24/2023] [Indexed: 02/29/2024]
Abstract
BACKGROUND AND AIMS Uric acid, the end-product of purine metabolism within the human body, has been the subject of studies exploring its potential association with cardiovascular and cerebrovascular diseases. However, the precise relationship between uric acid levels and heart failure remains elusive. METHODS AND RESULTS In this particular study, aggregated data from genome-wide association studies on uric acid and heart failure were utilized to perform a two-sample Mendelian randomization (MR) analysis utilizing R software. The aim was to uncover any causal link between these variables. The primary outcome was assessed using inverse variance weighted (IVW) methodology, while sensitivity analyses employed MR-Egger, weighted median (WME), and MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) techniques. IVW results revealed a possible causal relationship between elevated uric acid levels and an increased risk of heart failure (OR: 1.09, 95 % CI: 1.01-1.17, P < 0.05). Encouragingly, the directions provided by MR-Egger and WME aligned with IVW findings, and no anomalies were detected in the remaining sensitivity analyses. CONCLUSION These outcomes indicate the stability of the results of the study, thereby suggesting that heightened uric acid levels may contribute to an augmented risk of heart failure.
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Affiliation(s)
- Jiaqi Zheng
- School of Public Health, Shenyang Medical College, Shenyang, 110034, China
| | - Kaiwen Cen
- School of Public Health, Shenyang Medical College, Shenyang, 110034, China
| | - Jiajun Zhang
- School of Public Health, Shenyang Medical College, Shenyang, 110034, China
| | - Huan Zhang
- Officers' Ward Department, General Hospital of Northern Theater Command, Shenyang, 110034, China
| | - Mingguang Zhao
- Department of Neurosurgery, General Hospital of Northern Theater Command, Shenyang, 110034, China
| | - Xiaowen Hou
- School of Public Health, Shenyang Medical College, Shenyang, 110034, China.
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Johal A, Udongwo N, Imburgio S, Mararenko A, Akhlaq H, Dandu S, Abe T, Almendral J, Heaton J, Hansalia R. Negative effects of COVID-19 on the implantation rate of cardiac resynchronization therapy with defibrillator device. J Arrhythm 2024; 40:237-246. [PMID: 38586844 PMCID: PMC10995599 DOI: 10.1002/joa3.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/29/2023] [Accepted: 01/06/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction COVID-19 drastically impacted the landscape of the United States' medical system. Limited data is available on the nationwide implantation trends in Cardiac Resynchronization Therapy Defibrillator (CRT-D) devices before and during the pandemic. We aimed to explore the impact of the COVID-19 pandemic on CRT-D insertion rates and adverse outcomes related to delays in care. Methods and Results We conducted a retrospective cross-sectional analysis using the National Inpatient Sample database between 2017 and 2020. Variables were identified using their ICD-10 codes. Inclusion criteria: age ≥ 18 years, presenting for a nonelective admission, primary diagnosis of hypertensive heart disease, hypertensive heart, chronic kidney disease, or heart failure, and underwent insertion of a CRT-D. Between 2017 and 2020, CRT-D devices were inserted during 23,635 admissions. On average, 6198 devices were implanted yearly from 2017 to 2019, with only 5040 devices being implanted in 2020. Additionally, reduced implantation rates were noted for every cohort of hospital size, location, and teaching status during this year. The year 2020 also had the highest average death rate at 1.39%, but this difference was statistically insignificant (adjusted Wald test p = .767), and COVID-19 was not associated with an increased risk of inpatient mortality (OR 0.22, 95% CI 0.03-1.82, p = .162). Conclusion The COVID-19 pandemic has affected all facets of the healthcare system, especially surgical volume rates. CRT-D procedures significantly decreased in 2020. This is the first retrospective study highlighting the trend of reduced rates of CRT-D implantation as a response to the COVID-19 pandemic.
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Affiliation(s)
- Anmol Johal
- Department of MedicineJersey Shore University Medical CenterNeptune CityNew JerseyUSA
| | - Ndausung Udongwo
- Department of MedicineJersey Shore University Medical CenterNeptune CityNew JerseyUSA
| | - Steven Imburgio
- Department of MedicineJersey Shore University Medical CenterNeptune CityNew JerseyUSA
| | - Anton Mararenko
- Department of MedicineJersey Shore University Medical CenterNeptune CityNew JerseyUSA
| | - Hira Akhlaq
- Department of MedicineJersey Shore University Medical CenterNeptune CityNew JerseyUSA
| | - Sowmya Dandu
- Department of MedicineJersey Shore University Medical CenterNeptune CityNew JerseyUSA
| | - Temidayo Abe
- Department of CardiologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Jesus Almendral
- Department of CardiologyJersey Shore University Medical CenterNeptune CityNew JerseyUSA
| | - Joseph Heaton
- Department of MedicineJersey Shore University Medical CenterNeptune CityNew JerseyUSA
| | - Riple Hansalia
- Department of CardiologyJersey Shore University Medical CenterNeptune CityNew JerseyUSA
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46
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Kong R, Li S. Effects of childhood obesity on heart failure and its associated risk factors in the European population: A Mendelian randomization study. Nutr Metab Cardiovasc Dis 2024; 34:1080-1087. [PMID: 38233270 DOI: 10.1016/j.numecd.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/10/2023] [Accepted: 11/30/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND AND AIMS Observational studies have shown that obesity considerably affects the cardiovascular system. Thus we conducted this Mendelian randomization (MR) analysis to evaluate the causal effect of childhood obesity on heart failure (HF) and its risk factors. METHODS AND RESULTS We obtained genetic instruments from genome-wide association studies (GWAS) that investigated childhood obesity, HF, type 2 diabetes mellitus (T2DM), atrial fibrillation (AF), coronary artery disease (CAD), myocardial infarction (MI), chronic kidney disease (CKD), valvular heart disease, myocarditis, hypertrophic cardiomyopathy, and hyperthyroidism. Inverse variance weighting (IVW), weighted median analysis, MR-Egger, and MR-pleiotropy residual sum and outlier (MR-PRESSO) were employed for MR analyses. In addition, the leave-one-out sensitivity test, MR-PRESSO global test, and Cochran's Q test were used for sensitivity analyses. Genetic evaluations showed that childhood obesity increases the risk of HF (odds ratio [OR] = 1.11, 95%CI: 1.05-1.17, p = 1.26 × 10-4), T2DM (OR = 1.17, 95%CI: 1.12-1.23, p = 8.80 × 10-12), AF (OR = 1.08, 95%CI: 1.05-1.12, p = 2.66 × 10-7), MI (OR = 1.08, 95%CI: 1.04-1.13, p = 3.35 × 10-4), and CAD (OR = 1.08, 95%CI: 1.03-1.13, p = 1.48 × 10-3). We found no association between childhood obesity and CKD, valvular heart disease, myocarditis, hypertrophic cardiomyopathy, or hyperthyroidism. Sensitivity analysis and Bonferroni's correction showed consistent results. CONCLUSIONS Our study provides new evidence for the relationship between childhood obesity and HF and its risk factors. The results indicate that individuals with a history of childhood obesity require more clinical attention to prevent the development of HF.
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Affiliation(s)
- Renjing Kong
- Department of Geriatrics, The Second Xiangya Hospital, Institute of Aging and Age-Related Disease Research, Central South University, Changsha, Hunan 410011, China
| | - Shuang Li
- Department of Geriatrics, The Second Xiangya Hospital, Institute of Aging and Age-Related Disease Research, Central South University, Changsha, Hunan 410011, China.
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Magaldi M, Nogue E, Molinari N, De Luca N, Dupuy AM, Leclercq F, Pasquie JL, Roubille C, Mercier G, Cristol JP, Roubille F. Predicting One-Year Mortality after Discharge Using Acute Heart Failure Score (AHFS). J Clin Med 2024; 13:2018. [PMID: 38610783 PMCID: PMC11012877 DOI: 10.3390/jcm13072018] [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: 02/23/2024] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Acute heart failure (AHF) represents a leading cause of unscheduled hospital stays, frequent rehospitalisations, and mortality worldwide. The aim of our study was to develop a bedside prognostic tool, a multivariable predictive risk score, that is useful in daily practice, thus providing an early prognostic evaluation at admission and an accurate risk stratification after discharge in patients with AHF. Methods: This study is a subanalysis of the STADE HF study, which is a single-centre, prospective, randomised controlled trial enrolling 123 patients admitted to hospital for AHF. Here, 117 patients were included in the analysis, due to data exhaustivity. Regression analysis was performed to determine predictive variables for one-year mortality and/or rehospitalisation after discharge. Results: During the first year after discharge, 23 patients died. After modellisation, the variables considered to be of prognostic relevance in terms of mortality were (1) non-ischaemic aetiology of HF, (2) elevated creatinine levels at admission, (3) moderate/severe mitral regurgitation, and (4) prior HF hospitalisation. We designed a linear model based on these four independent predictive variables, and it showed a good ability to score and predict patient mortality with an AUC of 0.84 (95%CI: 0.76-0.92), thus denoting a high discriminative ability. A risk score equation was developed. During the first year after discharge, we observed as well that 41 patients died or were rehospitalised; hence, while searching for a model that could predict worsening health conditions (i.e., death and/or rehospitalisation), only two predictive variables were identified: non-ischaemic HF aetiology and previous HF hospitalisation (also included in the one-year mortality model). This second modellisation showed a more discrete discriminative ability with an AUC of 0.67 (95% C.I. 0.59-0.77). Conclusions: The proposed risk score and model, based on readily available predictive variables, are promising and useful tools to assess, respectively, the one-year mortality risk and the one-year mortality and/or rehospitalisations in patients hospitalised for AHF and to assist clinicians in the management of patients with HF aiming at improving their prognosis.
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Affiliation(s)
- Mariarosaria Magaldi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80138 Naples, Italy; (M.M.)
- Cardiology Department, Montpellier University Hospital, Inserm U1046, CNRS UMR 9214, PhyMedExp, 34295 Montpellier, France (J.-L.P.)
| | - Erika Nogue
- Clinical Research and Epidemiology Unit, University Hospital of Montpellier, Montpellier University, 34090 Montpellier, France
| | - Nicolas Molinari
- Institute of Epidemiology and Public Health, INSERM, INRIA, CHU Montpellier, University of Montpellier, 34090 Montpellier, France
| | - Nicola De Luca
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80138 Naples, Italy; (M.M.)
| | - Anne-Marie Dupuy
- Département de Biochimie et Hormonologie, Centre de Ressources Biologiques, CHU de Montpellier, 34295 Montpellier, France;
| | - Florence Leclercq
- Cardiology Department, Montpellier University Hospital, Inserm U1046, CNRS UMR 9214, PhyMedExp, 34295 Montpellier, France (J.-L.P.)
| | - Jean-Luc Pasquie
- Cardiology Department, Montpellier University Hospital, Inserm U1046, CNRS UMR 9214, PhyMedExp, 34295 Montpellier, France (J.-L.P.)
| | - Camille Roubille
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, CEDEX 5, 34090 Montpellier, France
- Department of Internal Medicine PhyMedExp CHU Montpellier, Montpellier University, 34090 Montpellier, France
| | - Grégoire Mercier
- Department of Statistics, Montpellier University Hospital, CEDEX 5, 34090 Montpellier, France;
| | - Jean-Paul Cristol
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, CEDEX 5, 34090 Montpellier, France
- Laboratory of Biochemistry, Montpellier University Hospital, CEDEX 5, 34090 Montpellier, France
| | - François Roubille
- Cardiology Department, Montpellier University Hospital, Inserm U1046, CNRS UMR 9214, PhyMedExp, 34295 Montpellier, France (J.-L.P.)
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, CEDEX 5, 34090 Montpellier, France
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Zhang QL, Chen XH, Zhou SJ, Lei YQ, Chen Q, Cao H. Relationship between heart failure and intestinal inflammation in infants with congenital heart disease. BMC Microbiol 2024; 24:98. [PMID: 38528458 DOI: 10.1186/s12866-024-03229-0] [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: 07/28/2023] [Accepted: 02/21/2024] [Indexed: 03/27/2024] Open
Abstract
OBJECTIVE The association between heart failure (HF) and intestinal inflammation caused by a disturbed intestinal microbiota in infants with congenital heart disease (CHD) was investigated. METHODS Twenty infants with HF and CHD who were admitted to our hospital between October 2021 and March 2022 were included in this study. Twenty age- and sex-matched infants without HF at our hospital were selected as the control group. Faecal samples were obtained from each participant and analysed by enzyme-linked immunoassay and 16 S rDNA sequencing to assess intestinal inflammatory factors and the microbiota. RESULTS The levels of intestinal inflammatory factors, including IL-1β, IL-4, IL-6, IL-17 A and TNF-α, were greatly increased, while the levels of IL-10 were significantly decreased in the HF group compared to the control group (p < 0.05). The intestinal microbial diversity of patients in the HF group was markedly lower than that in the control group (p < 0.05). The abundance of Enterococcus was significantly increased in the HF group compared to the control group (p < 0.05), but the abundance of Bifidobacterium was significantly decreased in the HF group compared to the control group (p < 0.05). The diversity of the intestinal microbiota was negatively correlated with the levels of IL-1β, IL-4, IL-6 and TNF-α in the intestinal tract but was positively correlated with that of IL-10. The abundance of Enterococcus was positively associated with the levels of IL-1β, IL-4, IL-6 and TNF-α in the intestinal tract but was negatively correlated with that of IL-10. NT-proBNP was positively associated with the levels of IL-1β, IL-4, IL-6 and TNF-α in the HF group but was negatively correlated with that of IL-10. The heart function score was positively associated with the levels of IL-1β, IL-4, IL-6 and TNF-α in the HF group but was negatively correlated with that of IL-10. CONCLUSIONS Infants with CHD-related HF had a disordered intestinal microbiota, decreased diversity of intestinal microbes, increased levels of pathogenic bacteria and decreased levels of beneficial bacteria. The increased abundance of Enterococcus and the significant decrease in the diversity of the intestinal microbiota may exacerbate the intestinal inflammatory response, which may be associated with the progression of HF.
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Affiliation(s)
- Qi-Liang Zhang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
- Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
| | - Xiu-Hua Chen
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
- Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Si-Jia Zhou
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
- Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Yu-Qing Lei
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
- Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
- Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
- Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
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Chen XJ, Liu SY, Li SM, Feng JK, Hu Y, Cheng XZ, Hou CZ, Xu Y, Hu M, Feng L, Xiao L. The recent advance and prospect of natural source compounds for the treatment of heart failure. Heliyon 2024; 10:e27110. [PMID: 38444481 PMCID: PMC10912389 DOI: 10.1016/j.heliyon.2024.e27110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/15/2024] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
Heart failure is a continuously developing syndrome of cardiac insufficiency caused by diseases, which becomes a major disease endangering human health as well as one of the main causes of death in patients with cardiovascular diseases. The occurrence of heart failure is related to hemodynamic abnormalities, neuroendocrine hormones, myocardial damage, myocardial remodeling etc, lead to the clinical manifestations including dyspnea, fatigue and fluid retention with complex pathophysiological mechanisms. Currently available drugs such as cardiac glycoside, diuretic, angiotensin-converting enzyme inhibitor, vasodilator and β receptor blocker etc are widely used for the treatment of heart failure. In particular, natural products and related active ingredients have the characteristics of mild efficacy, low toxicity, multi-target comprehensive efficacy, and have obvious advantages in restoring cardiac function, reducing energy disorder and improving quality of life. In this review, we mainly focus on the recent advance including mechanisms and active ingredients of natural products for the treatment of heart failure, which will provide the inspiration for the development of more potent clinical drugs against heart failure.
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Affiliation(s)
- Xing-Juan Chen
- China Academy of Chinese Medical Sciences Guang’anmen Hospital, Beijing, 100053, China
| | - Si-Yuan Liu
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Si-Ming Li
- China Academy of Chinese Medical Sciences Guang’anmen Hospital, Beijing, 100053, China
| | | | - Ying Hu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
| | - Xiao-Zhen Cheng
- China Academy of Chinese Medical Sciences Guang’anmen Hospital, Beijing, 100053, China
| | - Cheng-Zhi Hou
- China Academy of Chinese Medical Sciences Guang’anmen Hospital, Beijing, 100053, China
| | - Yun Xu
- China Academy of Chinese Medical Sciences Guang’anmen Hospital, Beijing, 100053, China
| | - Mu Hu
- Peking University International Hospital, Beijing, 102206, China
| | - Ling Feng
- China Academy of Chinese Medical Sciences Guang’anmen Hospital, Beijing, 100053, China
| | - Lu Xiao
- China Academy of Chinese Medical Sciences Guang’anmen Hospital, Beijing, 100053, China
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50
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Kwaśny A, Uchmanowicz I, Juárez-Vela R, Młynarska A, Łokieć K, Czapla M. Sex-related differences in the impact of nutritional status on in-hospital mortality in heart failure: a retrospective cohort study. Eur J Cardiovasc Nurs 2024; 23:176-187. [PMID: 37226867 DOI: 10.1093/eurjcn/zvad050] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
AIMS A nutritional status is related to the length of hospitalization and in-hospital mortality of patients with heart failure (HF). The aim of this study is to assess the prognostic impact of nutritional status and body mass index (BMI) on in-hospital mortality among patients with HF relative to their sex. METHODS AND RESULTS We conducted a retrospective study and analysis of 809 medical records of patients admitted to the Institute of Heart Disease of the University Clinical Hospital in Wroclaw (Poland). Women were statistically significantly older than men (74.67 ± 11.15 vs. 66.76 ± 17.78; P < 0.001). In unadjusted model, significant predictors of the odds of in-hospital mortality for men were underweight (OR = 14.81, P = 0.001) and the risk of malnutrition (OR = 8.979, P < 0.001). In the case of women, none of the traits analysed was significant. In age-adjusted model, significant independent predictors of the odds of in-hospital mortality in the case of men were BMI < 18.5 (OR = 15.423, P = 0.001) and risk of malnutrition (OR = 5.557, P = 0.002). In the case of women, none of the nutritional status traits analysed were significant. In multivariable-adjusted model in men, significant independent predictors of the odds of in-hospital mortality were BMI < 18.5 (OR = 15.978, P = 0.007) compared with having normal body weight and the risk of malnutrition (OR = 4.686, P = 0.015). In the case of women, none of the nutritional status traits analysed were significant. CONCLUSION Both underweight and the risk of malnutrition are direct predictors of the odds of in-hospital mortality in men, but not in women. The study did not find a relationship between nutritional status and in-hospital mortality in women.
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Affiliation(s)
- Adrian Kwaśny
- Institute of Dietetics, The Academy of Business and Health Science, 90-361 Lodz, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, ul. Bartla 5, 51-618 Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, ul. Borowska 213, 50-556 Wroclaw, Poland
| | - Raúl Juárez-Vela
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain
| | - Agnieszka Młynarska
- Department Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, 40-635 Katowice, Poland
| | - Katarzyna Łokieć
- Department of Propaedeutic of Civilization Diseases, Medical University of Lodz, 90-419 Lodz, Poland
| | - Michał Czapla
- Institute of Heart Diseases, University Hospital, ul. Borowska 213, 50-556 Wroclaw, Poland
- Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain
- Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland
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