1
|
Niu Y, Zhou T, Zhang S, Li W, Wang K, Dong N, Wu Q. Corin deficiency impairs cardiac function in mouse models of heart failure. Front Cardiovasc Med 2023; 10:1164524. [PMID: 37636304 PMCID: PMC10450958 DOI: 10.3389/fcvm.2023.1164524] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 08/01/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Corin is a protease in the natriuretic peptide system. Deleterious CORIN variants are associated with hypertension and heart disease. It remains unclear if and to what extent corin deficiency may contribute to heart failure (HF). Methods Corin knockout (KO) mice were used as a model. Cardiac function was assessed by echocardiography and tissue analysis in Corin KO mice at different ages or subjected to transverse aortic constriction (TAC), which increased pressure overload. Heart and lung tissues were analyzed for cardiac hypertrophy and lung edema using wheat germ agglutinin, Sirius red, Masson's trichrome, and Prussian blue staining. Recombinant corin was tested for its effect on cardiac function in the TAC-operated Corin KO mice. Selected gene expression in the heart was examined by RT-PCR. ELISA was used to analyze factors in plasma. Results Corin KO mice had progressive cardiac dysfunction with cardiac hypertrophy and fibrosis after 9 months of age, likely due to chronic hypertension. When Corin KO mice were subjected to TAC at 10-12 weeks of age, cardiac function decreased more rapidly than in similarly treated wild-type mice. When the TAC-operated Corin KO mice were treated with recombinant corin protein, cardiac dysfunction, hypertrophy, and fibrosis were ameliorated. The corin treatment also decreased the gene expression associated with cardiac hypertrophy and fibrosis, increased plasma cGMP levels, lowered plasma levels of N-terminal pro-atrial natriuretic peptide, angiotensin II, and aldosterone, and lessened lung edema in the Corin KO mice subjected to TAC. Conclusion Corin deficiency impairs cardiac function and exacerbates HF development in mice. Corin protein may be used to reduce cardiac hypertrophy and fibrosis, suppress the renin-angiotensin-aldosterone system, and improve cardiac function in HF.
Collapse
Affiliation(s)
- Yayan Niu
- Cyrus Tang Hematology Center, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Prevention, Medical School, Soochow University, Suzhou, China
| | - Tiantian Zhou
- Cyrus Tang Hematology Center, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Prevention, Medical School, Soochow University, Suzhou, China
| | - Shengnan Zhang
- Cyrus Tang Hematology Center, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Prevention, Medical School, Soochow University, Suzhou, China
- NHC Key Laboratory of Thrombosis and Hemostasis, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Wenguo Li
- Cyrus Tang Hematology Center, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Prevention, Medical School, Soochow University, Suzhou, China
| | - Kun Wang
- Cyrus Tang Hematology Center, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Prevention, Medical School, Soochow University, Suzhou, China
| | - Ningzheng Dong
- Cyrus Tang Hematology Center, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Prevention, Medical School, Soochow University, Suzhou, China
- NHC Key Laboratory of Thrombosis and Hemostasis, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qingyu Wu
- Cyrus Tang Hematology Center, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Prevention, Medical School, Soochow University, Suzhou, China
| |
Collapse
|
2
|
Wu Q. Natriuretic Peptide Signaling in Uterine Biology and Preeclampsia. Int J Mol Sci 2023; 24:12309. [PMID: 37569683 PMCID: PMC10418983 DOI: 10.3390/ijms241512309] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Endometrial decidualization is a uterine process essential for spiral artery remodeling, embryo implantation, and trophoblast invasion. Defects in endometrial decidualization and spiral artery remodeling are important contributing factors in preeclampsia, a major disorder in pregnancy. Atrial natriuretic peptide (ANP) is a cardiac hormone that regulates blood volume and pressure. ANP is also generated in non-cardiac tissues, such as the uterus and placenta. In recent human genome-wide association studies, multiple loci with genes involved in natriuretic peptide signaling are associated with gestational hypertension and preeclampsia. In cellular experiments and mouse models, uterine ANP has been shown to stimulate endometrial decidualization, increase TNF-related apoptosis-inducing ligand expression and secretion, and enhance apoptosis in arterial smooth muscle cells and endothelial cells. In placental trophoblasts, ANP stimulates adenosine 5'-monophosphate-activated protein kinase and the mammalian target of rapamycin complex 1 signaling, leading to autophagy inhibition and protein kinase N3 upregulation, thereby increasing trophoblast invasiveness. ANP deficiency impairs endometrial decidualization and spiral artery remodeling, causing a preeclampsia-like phenotype in mice. These findings indicate the importance of natriuretic peptide signaling in pregnancy. This review discusses the role of ANP in uterine biology and potential implications of impaired ANP signaling in preeclampsia.
Collapse
Affiliation(s)
- Qingyu Wu
- Cyrus Tang Hematology Center, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Prevention, Soochow University, Suzhou 215123, China
| |
Collapse
|
3
|
Malandish A, Ghadamyari N, Karimi A, Naderi M. The role of exercise training on cardiovascular peptides in patients with heart failure: A systematic review and meta-analysis. Curr Res Physiol 2022; 5:270-286. [PMID: 35800138 PMCID: PMC9253836 DOI: 10.1016/j.crphys.2022.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/25/2022] [Accepted: 06/20/2022] [Indexed: 12/19/2022] Open
Abstract
Background The purpose of this systematic review & meta-analysis was to determine the roles of aerobic, resistance or concurrent exercises vs. control (CON) group on B-type natriuretic peptide (BNP) and N-terminal-pro hormone BNP (NT-proBNP) in patients with heart failure. Methods The electronic databases of PubMed, Scopus, Web of Science, and Google Scholar were searched up to May 2022 for aerobic vs. CON, resistance vs. CON, and concurrent vs. CON studies on circulating (serum or plasma) levels of BNP and NT-proBNP in patients with heart failure. Non-randomized or randomized controlled trial studies were included. Standardized mean difference (SMD) and 95% confidence intervals (95% CIs) were calculated. This systematic review & meta-analysis was registered in PROSPERO at the University of York with the registration number [CRD42021271632]. Results A total of 28 articles (37 intervention arms), 26 aerobic intervention arms, 3 resistance intervention arms, and 8 concurrent intervention arms were included. A total of 2563 participants (exercise groups = 1350 and CON groups = 1213) were included. Exercise training significantly decreased NT-proBNP marker [-0.229 (SMD and 95% CI: 0.386 to -0.071), p = 0.005], irrespective of overweight/obesity status. Analysis of subgroup by type of exercise training revealed that there was a significant reduction in the NT-proBNP marker for aerobic exercise group compared to the CON group [-0.336 (SMD and 95% CI: 0.555 to -0.105), p = 0.004], whereas concurrent exercise did not show significant changes in the NT-proBNP marker [-0.134 (SMD and 95% CI: 0.350 to 0.083), p = 0.227]. In addition, exercise training did not significantly change the BNP marker [-0.122 (SMD and 95% CI: 0.322 to 0.079), p = 0.235]. Conclusions The results suggested that exercise training, especially aerobic exercise can be improved the NT-proBNP concentrations in patients with HF (irrespective of overweight/obesity status), which may be a sign of positive physiological adaptations to aerobic exercise.
Collapse
Affiliation(s)
- Abbas Malandish
- Ph.D of Exercise Physiology, Department of Exercise Physiology, Faculty of Sport Sciences, Urmia University, Urmia, Iran
| | - Niloufar Ghadamyari
- Ph.D Stu. of Exercise Physiology, Department of Exercise Physiology, Faculty of Sport Health Sciences, Ankara University, Ankara, Turkey
| | - Asma Karimi
- M.Sc of Applied Exercise Physiology, Department of Exercise Physiology, Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - Mahdi Naderi
- M.Sc of Exercise Physiology, Department of Exercise Physiology, Faculty of Sport Sciences, Kharazmi University, Tehran, Iran
| |
Collapse
|
4
|
Hamid Al-Sultan RM, Abdulsalaam Al-Sultan A, Hayawi MA, Aldahham BJM, Saleh MY, Mohammed HA. The effect of subclinical thyroid dysfunction on B- type natriuretic peptide level. BIONATURA 2022. [DOI: 10.21931/rb/2022.07.02.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Thyroid hormones (THs) have a significant effect on the cardiovascular system. THs increase myocardium stretch, leading to the release of B-type Natriuretic Peptide (BNP), which is considered a diagnostic biomarker of heart failure (HF). Thyroid dysfunctions (subclinical hypothyroidism; SCH and subclinical hyperthyroidism; SCHyper) stimulate several changes in the heart by causing either diastolic or systolic left ventricular dysfunctions leading to HF. This study aims to measure the changes of B- type NP levels in cases of subclinical hypo and hyperthyroidism. The present study aims to measure the changes in B-type Natriuretic Peptide (BNP) levels in subclinical hypo and hyperthyroidism (SCH and SCHyper). A theoretical study was also conducted using a docking program to find the effectiveness of some drugs in inhibiting or promoting B-type Natriuretic Peptide (BNP).
A case study was conducted in a private clinic, Mosul- Iraq, from (April 1st – Sep 1) 2021, with 25 healthy participants with normal functioning thyroids as a control group (EU). A newly diagnosed 25 SCH and 17 SCHyper patients participated in this study, considering that none of them have thyroid dysfunctions taking medicine, hypertension, heart diseases, renal failure, and pregnant women. They all were checked for Thyroid Function Tests (TFTs), Free Triiodothyronine (FT3), Free Thyroxin (FT4) and Thyroid Stimulating Hormone (TSH). The plasma level of BNP was measured in all participants of the three groups. The results showed that the plasma level of BNP was higher in SCHyper patients (10.97 pg/ml) as compared to that of SCH patients (8.09 pg/ml) and EU subjects (8.27 pg/ml). Hereby, we could state that subclinical hyperthyroidism, SCHyper, triggers BNP release. Therefore, it should be kept in mind that any high BNP levels due to SCHyper should be considered a reliable diagnostic biomarker of heart failure (HF).
Keywords. Thyroid hormone(TH), Subclinical hypothyroidism(SCH), Subclinical hyperthyroidism(SCHyper), Chronic heart disease(CHD), Heart failure(HF), B-type natriuretic peptide(BNP), Docking Study.
Collapse
Affiliation(s)
| | - Ammar Abdulsalaam Al-Sultan
- Head & founder of the department of cardiac surgery Mosul Center for Cardiology and Cardiac surgery, Directorate of Health , Nineveh, Ministry of Health
| | - Mohammed A. Hayawi
- Department of Basic Science, College of Nursing , University of Mosul , Mosul, Iraq
| | - Bilal J M Aldahham
- Department of Applied Chemistry, College of Applied Sciences-Hit, University Of Anbar, Hit 31007, Anbar, Iraq
| | - Mohanad Y. Saleh
- Department of Chemistry, College of Education for pure Science, University of Mosul, Mosul, Iraq
| | - Hazim A. Mohammed
- Department of Biochemistry, College of Medicine, University of Mosul, Mosul, Iraq
| |
Collapse
|
5
|
Corin: A Key Mediator in Sodium Homeostasis, Vascular Remodeling, and Heart Failure. BIOLOGY 2022; 11:biology11050717. [PMID: 35625445 PMCID: PMC9138375 DOI: 10.3390/biology11050717] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/01/2022] [Accepted: 05/05/2022] [Indexed: 12/11/2022]
Abstract
Simple Summary Atrial natriuretic peptide (ANP) is an important hormone that regulates many physiological and pathological processes, including electrolyte and body fluid balance, blood volume and pressure, cardiac channel activity and function, inflammatory response, lipid metabolism, and vascular remodeling. Corin is a transmembrane serine protease that activates ANP. Variants in the CORIN gene are associated with cardiovascular disease, including hypertension, cardiac hypertrophy, atrial fibrillation, heart failure, and preeclampsia. The current data indicate a key role of corin-mediated ANP production and signaling in the maintenance of cardiovascular homeostasis. In this review, we discuss the latest findings regarding the molecular and cellular mechanisms underlying the role of corin in sodium homeostasis, uterine spiral artery remodeling, and heart failure. Abstract Atrial natriuretic peptide (ANP) is a crucial element of the cardiac endocrine function that promotes natriuresis, diuresis, and vasodilation, thereby protecting normal blood pressure and cardiac function. Corin is a type II transmembrane serine protease that is highly expressed in the heart, where it converts the ANP precursor to mature ANP. Corin deficiency prevents ANP activation and causes hypertension and heart disease. In addition to the heart, corin is expressed in other tissues, including those of the kidney, skin, and uterus, where corin-mediated ANP production and signaling act locally to promote sodium excretion and vascular remodeling. These results indicate that corin and ANP function in many tissues via endocrine and autocrine mechanisms. In heart failure patients, impaired natriuretic peptide processing is a common pathological mechanism that contributes to sodium and body fluid retention. In this review, we discuss most recent findings regarding the role of corin in non-cardiac tissues, including the kidney and skin, in regulating sodium homeostasis and body fluid excretion. Moreover, we describe the molecular mechanisms underlying corin and ANP function in supporting orderly cellular events in uterine spiral artery remodeling. Finally, we assess the potential of corin-based approaches to enhance natriuretic peptide production and activity as a treatment of heart failure.
Collapse
|
6
|
Niu Y, Zhang S, Gu X, Zhou T, Li F, Liu M, Wu Q, Dong N. Recombinant Soluble Corin Improves Cardiac Function in Mouse Models of Heart Failure. J Am Heart Assoc 2021; 10:e019961. [PMID: 33759549 PMCID: PMC8174325 DOI: 10.1161/jaha.120.019961] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Corin is a transmembrane protease that activates ANP and BNP (atrial and B‐type natriuretic peptides). Impaired corin expression and function are associated with heart failure. In this study, we characterized a soluble form of corin (sCorin) and examined its effects on cardiac morphology and function in mouse heart failure models. Methods and Results sCorin, consisting of the full‐length extracellular fragment of human corin with an engineered activation site, was expressed in Chinese hamster ovary cells, purified from the conditioned medium with affinity chromatography, and characterized in pro‐ANP processing assays in vitro and pharmacokinetic studies in mice. Effects of sCorin on mouse models of heart failure induced by left coronary artery ligation and transverse aortic constriction were assessed by ELISA analysis of plasma markers, histologic examination, and echocardiography. We showed that purified and activated sCorin converted pro‐ANP to ANP that stimulated cGMP production in cultured cells. In mice, intravenously and intraperitoneally administered sCorin had plasma half‐lives of 3.5±0.1 and 8.3±0.3 hour, respectively. In the mouse heart failure models, intraperitoneal injection of sCorin increased plasma ANP, BNP, and cGMP levels; lowered plasma levels of NT‐proANP (N‐terminal‐pro‐ANP), angiotensin II, and aldosterone; reduced cardiac hypertrophy and fibrosis; and improved cardiac function. Conclusions We show that sCorin treatment enhanced natriuretic peptide processing and activity, suppressed the renin‐angiotensin‐aldosterone system, and improved cardiac morphology and function in mice with failing hearts.
Collapse
Affiliation(s)
- Yayan Niu
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China.,MOH Key Laboratory of Thrombosis and Hemostasis Jiangsu Institute of HematologySoochow University Suzhou China
| | - Shengnan Zhang
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China.,MOH Key Laboratory of Thrombosis and Hemostasis Jiangsu Institute of HematologySoochow University Suzhou China
| | - Xiabing Gu
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China.,MOH Key Laboratory of Thrombosis and Hemostasis Jiangsu Institute of HematologySoochow University Suzhou China
| | - Tiantian Zhou
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China
| | - Feng Li
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China.,MOH Key Laboratory of Thrombosis and Hemostasis Jiangsu Institute of HematologySoochow University Suzhou China
| | - Meng Liu
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China
| | - Qingyu Wu
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China.,Cardiovascular & Metabolic Sciences Lerner Research InstituteCleveland Clinic Cleveland OH
| | - Ningzheng Dong
- Cyrus Tang Hematology Center Collaborative Innovation Center of Hematology State Key Laboratory of Radiation Medicine and Prevention The First Affiliated HospitalMedical CollegeSoochow University Suzhou China.,MOH Key Laboratory of Thrombosis and Hemostasis Jiangsu Institute of HematologySoochow University Suzhou China
| |
Collapse
|
7
|
Dahiya T, Yadav S, Yadav N, Mann A, Sharma M, Rana J. Monitoring of BNP cardiac biomarker with major emphasis on biosensing methods: A review. SENSORS INTERNATIONAL 2021. [DOI: 10.1016/j.sintl.2021.100103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
8
|
Hohn A, Baumann A, Pietroschinsky E, Franklin J, Illerhaus A, Buchwald D, Hinkelbein J, Zahn PK, Annecke T. Hemoadsorption: effective in reducing circulating fragments of the endothelial glycocalyx during cardiopulmonary bypass in patients undergoing on-pump cardiac surgery? Minerva Anestesiol 2020; 87:35-42. [PMID: 32643361 DOI: 10.23736/s0375-9393.20.14525-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The vascular endothelial glycocalyx is susceptible to ischemia and hypoxia. Released soluble components of the endothelial glycocalyx (EG) have been identified as potential damage associated molecular patterns (DAMPs) able to enhance an ongoing inflammatory response. Shedding of the EG has been associated with released atrial-natriuretic peptide (ANP) during cardiac surgery procedures. A novel hemoadsorption technique (CytoSorb®) has been shown to effectively remove molecules up to 55 kDa unspecifically from circulation. It is not known whether ANP or glycocalyx components can be removed successfully by this technique. METHODS In 15 patients undergoing on-pump cardiac surgery, the hemoadsorption device was integrated in the cardiopulmonary bypass (CPB) circuit. Pre- and post-adsorber concentrations of ANP, heparan sulphate (HEP), syndecan-1 (SYN) and hyaluronan (HYA) were measured at 10 (T1), 30 (T2), and 60 (T3) minutes after aortic cross-clamping and complete CPB. RESULTS Hemoadsorption significantly reduced mean HEP concentrations (-157.5 [333.4] ng/mL; P<0.001) post adsorber. For ANP and SYN no statistically significant changes were detected whereas mean [SD] HYA concentrations even increased significantly (+21.6 [43.0] ng/mL; P<0.001) post adsorber. CONCLUSIONS In this study representing a real-life scenario, we could demonstrate that the novel hemoadsorption device (CytoSorb®) was able to effectively adsorb HEP from the circulation if integrated in a CPB circuit. However, blood concentrations of HYA, SYN, and ANP could not be reduced during CPB in our investigation.
Collapse
Affiliation(s)
- Andreas Hohn
- Faculty of Medicine, University of Cologne, Cologne, Germany - .,Department of Anesthesiology and Intensive Care Medicine, Cologne University Hospital, Cologne, Germany - .,Department of Anesthesiology and Intensive Care Medicine, Kliniken Maria Hilf GmbH, Moenchengladbach, Germany -
| | - Andreas Baumann
- Department of Anesthesiology, Intensive Care, Palliative Care and Pain Medicine, BG University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Eva Pietroschinsky
- Faculty of Medicine, University of Cologne, Cologne, Germany.,Department of Anesthesiology and Intensive Care Medicine, Cologne University Hospital, Cologne, Germany
| | - Jeremy Franklin
- Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
| | - Anja Illerhaus
- Faculty of Medicine, University of Cologne, Cologne, Germany.,Department of Dermatology, Cologne University Hospital, Cologne, Germany
| | - Dirk Buchwald
- Department of Cardiac and Thoracic Surgery, BG University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Jochen Hinkelbein
- Faculty of Medicine, University of Cologne, Cologne, Germany.,Department of Anesthesiology and Intensive Care Medicine, Cologne University Hospital, Cologne, Germany
| | - Peter K Zahn
- Department of Anesthesiology, Intensive Care, Palliative Care and Pain Medicine, BG University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
| | - Thorsten Annecke
- Faculty of Medicine, University of Cologne, Cologne, Germany.,Department of Anesthesiology and Intensive Care Medicine, Cologne University Hospital, Cologne, Germany.,Department of Anesthesiology and Intensive Care Medicine, Kliniken der Stadt Köln GmbH, University of Witten Herdecke, Cologne, Germany
| |
Collapse
|
9
|
Functional Role of Natriuretic Peptides in Risk Assessment and Prognosis of Patients with Mitral Regurgitation. J Clin Med 2020; 9:jcm9051348. [PMID: 32380651 PMCID: PMC7290430 DOI: 10.3390/jcm9051348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 04/29/2020] [Accepted: 05/01/2020] [Indexed: 12/24/2022] Open
Abstract
The management of mitral valve regurgitation (MR), a common valve disease, represents a challenge in clinical practice, since the indication for either surgical or percutaneous valve replacement or repair are guided by symptoms and by echocardiographic parameters which are not always feasible. In this complex scenario, the use of natriuretic peptide (NP) levels would serve as an additive diagnostic and prognostic tool. These biomarkers contribute to monitoring the progression of the valve disease, even before the development of hemodynamic consequences in a preclinical stage of myocardial damage. They may contribute to more accurate risk stratification by identifying patients who are more likely to experience death from cardiovascular causes, heart failure, and cardiac hospitalizations, thus requiring surgical management rather than a conservative approach. This article provides a comprehensive overview of the available evidence on the role of NPs in the management, risk evaluation, and prognostic assessment of patients with MR both before and after surgical or percutaneous valve repair. Despite largely positive evidence, a series of controversial findings exist on this relevant topic. Recent clinical trials failed to assess the role of NPs following the interventional procedure. Future larger studies are required to enable the introduction of NP levels into the guidelines for the management of MR.
Collapse
|
10
|
Hu J, Qian W, Yu Z, Xu T, Ju L, Hua Q, Wang Y, Ling JJ, Lv H. Increased Neutrophil Respiratory Burst Predicts the Risk of Coronary Artery Lesion in Kawasaki Disease. Front Pediatr 2020; 8:391. [PMID: 32850525 PMCID: PMC7399066 DOI: 10.3389/fped.2020.00391] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Kawasaki diseases (KD) is a febrile systemic vasculitis in infants associated with coronary aneurysm. The etiology of KD remains unclear. Human neutrophils have great capacity to cause tissue damage in inflammatory diseases via their inappropriate activation to release reactive oxygen species (ROS). Brain natriuretic peptide (BNP) is a substantial modulator of neutrophil activation to regulate ROS production. It is increasingly released from the myocardium in heart failure and myocardial inflammatory states. Objective: The purpose of this study was to explore the potential role of neutrophil respiratory burst in the pathogenesis of coronary artery lesions (CAL) in KD. Materials and Methods: A total of 78 children were enrolled. Of all the cases, 20 cases are healthy control (HC), 20 are with coronary artery lesion (CAL), and 38 are with non-coronary artery lesion (NCAL). The activation ratio of neutrophils was evaluated by flow cytometry. In addition, plasma levels of BNP were detected. Results: Our results showed that the activation ratio of neutrophils in KD with CAL is significantly higher than the other two groups (HC and NCAL). Besides, the plasma levels of BNP in KD (with or without CAL) were higher than that in HC. Conclusions: These findings suggested that neutrophil respiratory burst may play a significant role in the pathogenesis of CAL, and predicts the risk of CAL in Kawasaki disease.
Collapse
Affiliation(s)
- Jing Hu
- Children's Hospital of Soochow University, Suzhou, China.,Wuxi Children's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Wei Qian
- Wuxi Children's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Zhiwei Yu
- Wuxi Children's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Tao Xu
- Wuxi Children's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Liang Ju
- Wuxi Children's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Qi Hua
- Wuxi Children's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Yan Wang
- Wuxi Children's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Jing Jing Ling
- Wuxi Children's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Haitao Lv
- Children's Hospital of Soochow University, Suzhou, China
| |
Collapse
|
11
|
Kumari M, Kovach T, Sheehy B, Zabell A, Morales R, Moodley SJ, Shah YG, Maroo PV, Maroo AP, Tang WHW. Circulating NT-proBNP but not soluble corin levels were associated with preeclampsia in pregnancy-associated hypertension. Clin Biochem 2019; 67:12-15. [PMID: 30890412 DOI: 10.1016/j.clinbiochem.2019.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 02/25/2019] [Accepted: 03/16/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Corin is a serine protease known to convert B-type natriuretic peptide (BNP) prohormone into BNP and its amino-terminal fragment (NT-proBNP). In mice lacking corin, high blood pressure and proteinuria were found at late gestational stages, with associated delayed trophoblast invasion and impaired spiral artery remodeling in the uterus. We hypothesize that both NT-proBNP and soluble corin elevation predict the presence of preeclampsia in pregnant patients with hypertension. METHODS We prospectively enrolled 149 pregnant women with a history of chronic hypertension or gestational hypertension presenting at a tertiary-care hospital. We compared plasma NT-proBNP and soluble corin concentrations based on their preeclamptic status. RESULTS In our study cohort, 62 patients with preeclampsia had lower gestational age than 87 patients without preeclampsia (33.3 ± 3 versus 36.6 ± 3 weeks; P < .001), otherwise the baseline characteristics were similar. We observed higher NT-proBNP concentrations in patients with preeclampsia compared to those without preeclampsia (304.3 [96.34, 570.4] vs. 60.8 [35.61, 136.8] ng/L, P < .001), with no differences between chronic and gestational hypertension. However, the concentration of corin was not statistically different between the two groups (1756 [1214, 2133] vs. 1571 [1171, 1961] ng/L, P = .1087). ROC curve analysis demonstrated stronger predictive value of NT-proBNP compared to soluble corin in predicting the presence of preeclampsia in our study population (AUC 0.7406 vs. 0.5789, P < .0001). CONCLUSION While corin may contribute to mechanistic underpinnings of the development of preeclampsia in animal models, soluble corin likely has no diagnostic role in human pregnancies for preeclampsia beyond natriuretic peptide levels.
Collapse
Affiliation(s)
- Meera Kumari
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States of America
| | - Tracy Kovach
- Center for Clinical Genomics, Cleveland Clinic, Cleveland, OH, United States of America
| | - Brendan Sheehy
- Kettering Medical Center, Kettering, OH, United States of America
| | - Allyson Zabell
- Northeast Ohio Medical University, Rootstown, OH, United States of America
| | - Rommel Morales
- Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, OH, United States of America
| | - Sangithan Jules Moodley
- Obstetrics and Gynecology, Fairview General Hospital, Fairview Park, OH, United States of America
| | - Yogesh G Shah
- Obstetrics and Gynecology, Fairview General Hospital, Fairview Park, OH, United States of America
| | - Praful V Maroo
- Department of Cardiovascular Medicine, Fairview General Hospital, Fairview Park, OH, United States of America
| | - Anjli P Maroo
- Department of Cardiovascular Medicine, Fairview General Hospital, Fairview Park, OH, United States of America
| | - W H Wilson Tang
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States of America; Center for Clinical Genomics, Cleveland Clinic, Cleveland, OH, United States of America; Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America.
| |
Collapse
|
12
|
Verstreken S, Delrue L, Goethals M, Bartunek J, Vanderheyden M. Natriuretic Peptide Processing in Patients with and Without Left Ventricular Dysfunction. Int Heart J 2018; 60:115-120. [PMID: 30518715 DOI: 10.1536/ihj.18-012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study aimed to examine the relationship between corin expression and circulating brain natriuretic peptide in patients with left ventricular (LV) dysfunction.Circulating levels of B-type natriuretic peptide (BNP) can be an indicator of LV dysfunction. The 32-amino-acid BNP is cleaved by corin, a cardiac serine protease, from its108-amino-acid pro-brain natriuretic peptide (proBNP) precursor.This study included 25 patients with idiopathic dilated cardiomyopathy (DCMP) and LV dysfunction and 44 heart transplant recipients with normal LV function who underwent diagnostic left and right heart catheterization. Blood samples were used to determine the ratio of plasma proBNP/BNP levels, and LV endomyocardial biopsies were used to determine the expression of NPPB, which encode BNP and corin, respectively, by quantitative reverse transcription-polymerase chain reaction.Patients with DCMP revealed worse hemodynamic profiles and higher plasma proBNP and BNP levels than those of the transplant recipients. Myocardial NPPB expression was higher and CORIN expression was lower in the DCMP patients than in the transplant recipients. CORIN expression significantly correlated with NPPB expression (r = -0.585; P < 0.001), ejection fraction (EF; r = 0.694; P < 0.01), LV end-diastolic pressure (r = -0.373; P < 0.05), and indexed end-diastolic LV volume (r = -0.452; P < 0.001). In addition, the plasma proBNP/BNP levels inversely correlated with the CORIN expression (r = -0.362; P < 0.005).Decreased myocardial CORIN expression and the corresponding higher levels of circulating unprocessed proBNP in DCMP may partly account for the relative BNP resistance observed in patients with LV dysfunction.
Collapse
Affiliation(s)
| | - Leen Delrue
- Cardiovascular Center, Onze Lieve Vrouw Ziekenhuis
| | | | | | | |
Collapse
|
13
|
Xiao P, Li H, Li X, Song D. Analytical barriers in clinical B-type natriuretic peptide measurement and the promising analytical methods based on mass spectrometry technology. ACTA ACUST UNITED AC 2018; 57:954-966. [DOI: 10.1515/cclm-2018-0956] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 10/22/2018] [Indexed: 12/28/2022]
Abstract
Abstract
B-type natriuretic peptide (BNP) is a circulating biomarker that is mainly applied in heart failure (HF) diagnosis and to monitor disease progression. Because some identical amino acid sequences occur in the precursor and metabolites of BNP, undesirable cross-reactions are common in immunoassays. This review first summarizes current analytical methods, such as immunoassay- and mass spectrometry (MS)-based approaches, including the accuracy of measurement and the inconsistency of the results. Second, the review presents some promising approaches to resolve the current barriers in clinical BNP measurement, such as how to decrease cross-reactions and increase the measurement consistency. Specific approaches include research on novel BNP assays with higher-specificity chemical antibodies, the development of International System of Units (SI)-traceable reference materials, and the development of structure characterization methods based on state-of-the-art ambient and ion mobility MS technologies. The factors that could affect MS analysis are also discussed, such as biological sample cleanup and peptide ionization efficiency. The purpose of this review is to explore and identify the main problems in BNP clinical measurement and to present three types of approaches to resolve these problems, namely, materials, methods and instruments. Although novel approaches are proposed here, in practice, it is worth noting that the BNP-related peptides including unprocessed proBNP were all measured in clinical BNP assays. Therefore, approaches that aimed to measure a specific BNP or proBNP might be an effective way for the standardization of a particular BNP form measurement, instead of the standardization of “total” immunoreactive BNP assays in clinical at present.
Collapse
Affiliation(s)
- Peng Xiao
- Division of Chemical Metrology and Analytical Science , National Institute of Metrology , Beijing 100029 , P.R. China , Phone: +86-10-64228896, Fax: +86-10-64271639
| | - Hongmei Li
- Division of Chemical Metrology and Analytical Science , National Institute of Metrology , Beijing 100029 , P.R. China , Phone: +86-10-64228896, Fax: +86-10-64271639
| | - Xianjiang Li
- Division of Chemical Metrology and Analytical Science , National Institute of Metrology , Beijing , P.R. China
| | - Dewei Song
- Division of Chemical Metrology and Analytical Science , National Institute of Metrology , Beijing , P.R. China
| |
Collapse
|
14
|
Yang SF, Chou RH, Li SY, Huang SS, Huang PH. Serum Corin Level Is Associated With Subsequent Decline in Renal Function in Patients With Suspected Coronary Artery Disease. J Am Heart Assoc 2018; 7:JAHA.117.008157. [PMID: 29728370 PMCID: PMC6015333 DOI: 10.1161/jaha.117.008157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Higher circulatory corin in patients with cardiac diseases is associated with improved cardiovascular outcomes, and chronic cardiac dysfunction is a well-known cause of progressive renal dysfunction. This study aimed to determine the role of serum corin in predicting short-term and long-term renal outcomes after contrast exposure in patients with suspected coronary artery disease. METHODS AND RESULTS Four hundred one patients who had received coronary angiography were enrolled. Serum corin levels were determined before administration of contrast media. Contrast-induced nephropathy was defined as a rise in serum creatinine of 0.5 mg/dL or a 25% increase from baseline within 48 hours after the procedure. Progressive renal dysfunction was defined as >50% decrease in estimated glomerular filtration rate after discharge. All patients were followed up for at least 1 year or until the occurrence of death after coronary angiography. Overall, contrast-induced nephropathy occurred in 23 (5.7%) patients. During a median follow-up of 529 days, 44 (11.0%) cases had subsequent decline in renal function. After adjustment for demographic characteristics, kidney function, traditional risk factors, and medications, lower corin level was found to be independently associated with higher risk for progressive renal dysfunction (hazard ratio, 0.23; 95% confidence interval, 0.12-0.44) but not for contrast-induced nephropathy. This inverse correlation remained evident in patients with underlying chronic kidney disease, coronary artery disease, or heart failure. CONCLUSIONS Lower baseline serum corin was associated with higher risk of renal function decline in patients undergoing coronary angiography. Further studies are needed to verify these results.
Collapse
Affiliation(s)
- Shang-Feng Yang
- Division of Nephrology, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ruey-Hsing Chou
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Szu-Yuan Li
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shao-Sung Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan .,Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan .,Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
15
|
Triposkiadis F, Pieske B, Butler J, Parissis J, Giamouzis G, Skoularigis J, Brutsaert D, Boudoulas H. Global left atrial failure in heart failure. Eur J Heart Fail 2016; 18:1307-1320. [DOI: 10.1002/ejhf.645] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 07/21/2016] [Accepted: 07/24/2016] [Indexed: 01/08/2023] Open
Affiliation(s)
- Filippos Triposkiadis
- Department of Cardiology; Larissa University Hospital; PO Box 1425 411 10 Larissa Greece
| | - Burkert Pieske
- Department of Internal Medicine and Cardiology, Charité University Medicine Berlin-Campus Virchow Klinikum, and Department of Internal Medicine and Cardiology, German Heart Centre; Berlin Centre for Heart Failure; Berlin Germany
| | - Javed Butler
- Cardiology Division, School of Medicine; Stony Brook University; Stony Brook NY USA
| | - John Parissis
- Department of Cardiology; Athens University Hospital Attikon; Athens Greece
| | - Gregory Giamouzis
- Department of Cardiology; Larissa University Hospital; PO Box 1425 411 10 Larissa Greece
| | - John Skoularigis
- Department of Cardiology; Larissa University Hospital; PO Box 1425 411 10 Larissa Greece
| | - Dirk Brutsaert
- Laboratory of Physiopharmacology (Building T2); University of Antwerp; Universiteitsplein 1 Antwerp 2610 Belgium
| | - Harisios Boudoulas
- Ohio State University; Columbus Ohio USA
- Biomedical Research Foundation Academy of Athens; Athens, and Aristotelian University of Thessaloniki; Thessaloniki Greece
| |
Collapse
|
16
|
Logeart D, Baudet M. Du BNP au ST2 : quels biomarqueurs utiliser en pratique? Presse Med 2016; 45:877-884. [DOI: 10.1016/j.lpm.2016.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 06/05/2016] [Indexed: 12/01/2022] Open
|
17
|
Ameling S, Bhardwaj G, Hammer E, Beug D, Steil L, Reinke Y, Weitmann K, Grube M, Trimpert C, Klingel K, Kandolf R, Hoffmann W, Nauck M, Dörr M, Empen K, Felix SB, Völker U. Changes of myocardial gene expression and protein composition in patients with dilated cardiomyopathy after immunoadsorption with subsequent immunoglobulin substitution. Basic Res Cardiol 2016; 111:53. [PMID: 27412778 PMCID: PMC7101709 DOI: 10.1007/s00395-016-0569-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 06/16/2016] [Indexed: 12/18/2022]
Abstract
Immunoadsorption with subsequent immunoglobulin substitution (IA/IgG) represents a therapeutic approach for patients with dilated cardiomyopathy (DCM). Here, we studied which molecular cardiac alterations are initiated after this treatment. Transcription profiling of endomyocardial biopsies with Affymetrix whole genome arrays was performed on 33 paired samples of DCM patients collected before and 6 months after IA/IgG. Therapy-related effects on myocardial protein levels were analysed by label-free proteome profiling for a subset of 23 DCM patients. Data were analysed regarding therapy-associated differences in gene expression and protein levels by comparing responders (defined by improvement of left ventricular ejection fraction ≥20 % relative and ≥5 % absolute) and non-responders. Responders to IA/IgG showed a decrease in serum N-terminal proBNP levels in comparison with baseline which was accompanied by a decreased expression of heart failure markers, such as angiotensin converting enzyme 2 or periostin. However, despite clinical improvement even in responders, IA/IgG did not trigger general inversion of DCM-associated molecular alterations in myocardial tissue. Transcriptome profiling revealed reduced gene expression for connective tissue growth factor, fibronectin, and collagen type I in responders. In contrast, in non-responders after IA/IgG, fibrosis-associated genes and proteins showed elevated levels, whereas values were reduced or maintained in responders. Thus, improvement of LV function after IA/IgG seems to be related to a reduced gene expression of heart failure markers and pro-fibrotic molecules as well as reduced fibrosis progression.
Collapse
Affiliation(s)
- Sabine Ameling
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Friedrich-Ludwig-Jahn-Straße 15a, 17475, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Gourav Bhardwaj
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Friedrich-Ludwig-Jahn-Straße 15a, 17475, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Elke Hammer
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Friedrich-Ludwig-Jahn-Straße 15a, 17475, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Daniel Beug
- Department of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Leif Steil
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Friedrich-Ludwig-Jahn-Straße 15a, 17475, Greifswald, Germany
| | - Yvonne Reinke
- Department of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Kerstin Weitmann
- Institute for Community Medicine, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Markus Grube
- Department of Pharmacology, Centre of Drug Absorption and Transport (C_DAT), University Medicine Greifswald, Felix-Hausdorff-Str. 3, 17487, Greifswald, Germany
| | - Christiane Trimpert
- Department of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Karin Klingel
- Department of Molecular Pathology, University Hospital Tübingen, Liebermeisterstr. 8, 72076, Tübingen, Germany
| | - Reinhard Kandolf
- Department of Molecular Pathology, University Hospital Tübingen, Liebermeisterstr. 8, 72076, Tübingen, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Klaus Empen
- Department of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Stephan B Felix
- Department of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany. .,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany.
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Friedrich-Ludwig-Jahn-Straße 15a, 17475, Greifswald, Germany. .,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany.
| |
Collapse
|
18
|
Lee NS, Daniels LB. Current Understanding of the Compensatory Actions of Cardiac Natriuretic Peptides in Cardiac Failure: A Clinical Perspective. Card Fail Rev 2016; 2:14-19. [PMID: 28848655 PMCID: PMC5565993 DOI: 10.15420/cfr.2016:4:2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/22/2016] [Indexed: 12/11/2022] Open
Abstract
Natriuretic peptides play a crucial role in maintaining cardiovascular homeostasis. Among their properties are vasodilation, natriuresis, diuresis, and inhibition of cardiac remodeling. As heart failure progresses, however, natriuretic peptides fail to compensate. Knowledge of their processing and signaling pathways has guided the development of pharmacological therapies aimed at bolstering their effects. The drugs that have achieved the most clinical success have also stirred the most controversy. Nesiritide, the synthetic B-type natriuretic peptide, yielded significant symptomatic relief and improved haemodynamics but its use was plagued with questions surrounding its possibly harmful impact on renal function. More recently, compounds containing inhibitors of neprilysin, the enzyme responsible for degrading natriuretic peptides, have demonstrated morbidity and mortality benefit, but have also been linked to possible negative side effects. Clearly, potentiating the actions of natriuretic peptides for the benefit of patients is not as simple as just raising their serum concentration. This article reviews the current understanding of the compensatory actions of cardiac natriuretic peptides in heart failure and how this knowledge is revolutionizing heart failure therapy.
Collapse
Affiliation(s)
- Noel S Lee
- Division of Cardiovascular Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Lori B Daniels
- Division of Cardiovascular Medicine, University of California, San Diego, La Jolla, CA, USA
| |
Collapse
|
19
|
Kramer F, Dinh W. Molecular and Digital Biomarker Supported Decision Making in Clinical Studies in Cardiovascular Indications. Arch Pharm (Weinheim) 2016; 349:399-409. [DOI: 10.1002/ardp.201600055] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 03/21/2016] [Accepted: 03/23/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Frank Kramer
- Clinical Sciences - Experimental Medicine; BAYER Pharma AG; Wuppertal Germany
| | - Wilfried Dinh
- Clinical Sciences - Experimental Medicine; BAYER Pharma AG; Wuppertal Germany
| |
Collapse
|
20
|
Wöhrle J, Karakas M, Trepte U, Seeger J, Gonska B, Koenig W, Rottbauer W. Midregional-proAtrial Natriuretic Peptide and High Sensitive Troponin T Strongly Predict Adverse Outcome in Patients Undergoing Percutaneous Repair of Mitral Valve Regurgitation. PLoS One 2015; 10:e0137464. [PMID: 26368980 PMCID: PMC4569129 DOI: 10.1371/journal.pone.0137464] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 08/17/2015] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND It is not known whether biomarkers of hemodynamic stress, myocardial necrosis, and renal function might predict adverse outcome in patients undergoing percutaneous repair of severe mitral valve insufficiency. Thus, we aimed to assess the predictive value of various established and emerging biomarkers for major adverse cardiovascular events (MACE) in these patients. METHODS Thirty-four patients with symptomatic severe mitral valve insufficiency with a mean STS-Score for mortality of 12.6% and a mean logistic EuroSCORE of 19.7% undergoing MitraClip therapy were prospectively included in this study. Plasma concentrations of mid regional-proatrial natriuretic peptide (MR-proANP), Cystatin C, high-sensitive C-reactive protein (hsCRP), high-sensitive troponin T (hsTnT), N-terminal B-type natriuretic peptide (NT-proBNP), galectin-3, and soluble ST-2 (interleukin 1 receptor-like 1) were measured directly before procedure. MACE was defined as cardiovascular death and hospitalization for heart failure (HF). RESULTS During a median follow-up of 211 days (interquartile range 133 to 333 days), 9 patients (26.5%) experienced MACE (death: 7 patients, rehospitalization for HF: 2 patients). Thirty day MACE-rate was 5.9% (death: 2 patients, no rehospitalization for HF). Baseline concentrations of hsTnT (Median 92.6 vs 25.2 ng/L), NT-proBNP (Median 11251 vs 1974 pg/mL) and MR-proANP (Median 755.6 vs 318.3 pmol/L, all p<0.001) were clearly higher in those experiencing an event vs event-free patients, while other clinical variables including STS-Score and logistic EuroSCORE did not differ significantly. In Kaplan-Meier analyses, NT-proBNP and in particular hsTnT and MR-proANP above the median discriminated between those experiencing an event vs event-free patients. This was further corroborated by C-statistics where areas under the ROC curve for prediction of MACE using the respective median values were 0.960 for MR-proANP, 0.907 for NT-proBNP, and 0.822 for hsTnT. CONCLUSIONS MR-proANP and hsTnT strongly predict cardiovascular death and rehospitalization for HF in patients undergoing percutaneous repair of mitral valve insufficiency. Both markers might be useful components in new scoring systems to better predict short- and potentially long-term mortality and morbidity after MitraClip procedure.
Collapse
Affiliation(s)
- Jochen Wöhrle
- Department of Internal Medicine II–Cardiology, University of Ulm Medical Center, Ulm, Germany
| | - Mahir Karakas
- Department of Internal Medicine II–Cardiology, University of Ulm Medical Center, Ulm, Germany
| | - Ulrike Trepte
- Department of Internal Medicine II–Cardiology, University of Ulm Medical Center, Ulm, Germany
| | - Julia Seeger
- Department of Internal Medicine II–Cardiology, University of Ulm Medical Center, Ulm, Germany
| | - Birgid Gonska
- Department of Internal Medicine II–Cardiology, University of Ulm Medical Center, Ulm, Germany
| | - Wolfgang Koenig
- Department of Internal Medicine II–Cardiology, University of Ulm Medical Center, Ulm, Germany
| | - Wolfgang Rottbauer
- Department of Internal Medicine II–Cardiology, University of Ulm Medical Center, Ulm, Germany
| |
Collapse
|
21
|
Central nervous system circuits modified in heart failure: pathophysiology and therapeutic implications. Heart Fail Rev 2015; 19:759-79. [PMID: 24573960 DOI: 10.1007/s10741-014-9427-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The pathophysiology of heart failure (HF) is characterized by an abnormal activation of neurohumoral systems, including the sympathetic nervous and the renin-angiotensin-aldosterone systems, which have long-term deleterious effects on the disease progression. Perpetuation of this neurohumoral activation is partially dependent of central nervous system (CNS) pathways, mainly involving the paraventricular nucleus of the hypothalamus and some regions of the brainstem. Modifications in these integrative CNS circuits result in the attenuation of sympathoinhibitory and exacerbation of sympathoexcitatory pathways. In addition to the regulation of sympathetic outflow, these central pathways coordinate a complex network of agents with an established pathophysiological relevance in HF such as angiotensin, aldosterone, and proinflammatory cytokines. Central pathways could be potential targets in HF therapy since the current mainstay of HF pharmacotherapy aims primarily at antagonizing the peripheral mechanisms. Thus, in the present review, we describe the role of CNS pathways in HF pathophysiology and as potential novel therapeutic targets.
Collapse
|
22
|
Song W, Wang H, Wu Q. Atrial natriuretic peptide in cardiovascular biology and disease (NPPA). Gene 2015; 569:1-6. [PMID: 26074089 DOI: 10.1016/j.gene.2015.06.029] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Revised: 05/18/2015] [Accepted: 06/09/2015] [Indexed: 12/11/2022]
Abstract
Atrial natriuretic peptide (ANP) is a cardiac hormone that regulates salt-water balance and blood pressure by promoting renal sodium and water excretion and stimulating vasodilation. ANP also has an anti-hypertrophic function in the heart, which is independent of its systemic blood pressure-lowering effect. In mice, ANP deficiency causes salt-sensitive hypertension and cardiac hypertrophy. Recent studies have shown that ANP plays an important role in regulating vascular remodeling and energy metabolism. Variants in the human NPPA gene, encoding the ANP precursor, are associated with hypertension, stroke, coronary artery disease, heart failure (HF) and obesity. ANP and related peptides are used as biomarkers for heart disease. Recombinant proteins and small molecules that enhance the ANP pathway have been developed to treat patients with HF. In this review, we discuss the role of ANP in cardiovascular biology and disease.
Collapse
Affiliation(s)
- Wei Song
- Departments of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Hao Wang
- Departments of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; Department of Chemistry, Cleveland State University, Cleveland, OH 44155, USA
| | - Qingyu Wu
- Departments of Molecular Cardiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; Department of Chemistry, Cleveland State University, Cleveland, OH 44155, USA; Cyrus Tang Hematology Center, Soochow University, Suzhou 215123, China.
| |
Collapse
|
23
|
Merz WM, Gembruch U. Old tool - new application: NT-proBNP in fetal medicine. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2014; 44:377-385. [PMID: 24919683 DOI: 10.1002/uog.13443] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 05/29/2014] [Accepted: 06/05/2014] [Indexed: 06/03/2023]
Affiliation(s)
- W M Merz
- Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany
| | | |
Collapse
|
24
|
Abstract
Corin is a serine protease originally isolated from the heart. Functional studies show that corin is the long-sought enzyme responsible for activating cardiac natriuretic peptides. In mice, lack of corin prevents natriuretic peptide processing, causing salt-sensitive hypertension. In humans, corin variants and mutations that reduce corin activity have been identified in patients with hypertension and heart failure. Decreased plasma levels of corin antigen and activity have been reported in patients with heart failure and coronary artery disease. Low levels of urinary corin also have been found in patients with chronic kidney disease. Most recent studies show that corin also acts in the uterus to promote spiral artery remodeling and prevent pregnancy-induced hypertension. Here, we review the role of corin in natriuretic peptide processing and cardiovascular diseases such as hypertension, heart disease, pre-eclampsia, and chronic kidney disease.
Collapse
|
25
|
Karakas M, Jaensch A, Breitling LP, Brenner H, Koenig W, Rothenbacher D. Prognostic value of midregional pro-A-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide in patients with stable coronary heart disease followed over 8 years. Clin Chem 2014; 60:1441-9. [PMID: 25139456 DOI: 10.1373/clinchem.2013.220202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Pathophysiological studies suggest that A-type natriuretic peptides (ANPs) might provide valuable information beyond B-type natriuretic peptides (BNPs) about cardiac dysfunction in patients with coronary heart disease (CHD). We aimed to assess the predictive value of midregional pro-A-type natriuretic peptide (MR-proANP) for recurrent cardiovascular disease (CVD) events in stable CHD patients for whom information on N-terminal proBNP (NT-proBNP) was already available. METHODS Plasma concentrations of MR-proANP and NT-proBNP were measured at baseline in a cohort of 1048 patients aged 30-70 years with CHD who were participating in an in-hospital rehabilitation program. Main outcome measures were cardiovascular mortality, nonfatal myocardial infarction, and nonfatal stroke. RESULTS During a median follow-up of 8.1 years, 150 patients (incidence 21.1 per 1000 patient-years) experienced a secondary CVD event. MR-proANP was associated with a hazard ratio (HR) of 1.89 (95% CI, 1.01-3.57) when the top quartile was compared to the bottom quartile in the fully adjusted model (P for trend = 0.011). For NT-proBNP the respective HR was 2.22 (95% CI, 1.19-4.14) with a P for trend = 0.001. Finally, MR-proANP improved various model performance measures, including c-statistics and reclassification metrics, but without being superior to NT-proBNP. CONCLUSIONS Although we found an independent association of MR-proANP as well as NT-proBNP when used as single markers with recurrent CVD events after adjustment for established risk factors, the results of a simultaneous assessment of both markers indicated that MR-proANP fails to provide additional prognostic information to NT-proBNP in the population studied.
Collapse
Affiliation(s)
- Mahir Karakas
- Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Lutz P Breitling
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Wolfgang Koenig
- Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany;
| | - Dietrich Rothenbacher
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| |
Collapse
|
26
|
Abstract
In this review three major issues of sodium homeostasis are addressed. Specifically, volume-dependent (salt-sensitive) hypertension, sodium chloride content of maintenance fluid and clinical evaluation of hyponatremia are discussed. Regarding volume-dependent hypertension the endocrine/paracrine systems mediating renal sodium retention, the relationship between salt intake, plasma sodium levels and blood pressure, as well as data on the dissociation of sodium and volume regulation are presented. The concept of perinatal programming of salt-preference is also mentioned. Some theoretical and practical aspects of fluid therapy are summarized with particular reference to using hypotonic sodium chloride solution for maintenance fluid as opposed to the currently proposed isotonic sodium chloride solution. Furthermore, the incidence, the aetiological classification and central nervous system complications of hyponatremia are presented, too. In addition, clinical and pathophysical features of hyponatremic encephalophathy and osmotic demyelinisation are given. The adaptive reactions of the brain to hypotonic stress are also described with particular emphasis on the role of brain-specific water channel proteins (aquaporin-4) and the benzamil-inhibitable sodium channels. In view of the outmost clinical significance of hyponatremia, the principles of efficient and safe therapeutic approaches are outlined. Orv. Hetil., 2013, 154, 1488–1497.
Collapse
Affiliation(s)
- Endre Sulyok
- Pécsi Tudományegyetem Egészségtudományi Kar Pécs Vörösmarty u. 4. 7621
| |
Collapse
|
27
|
Affiliation(s)
- Doan T.M. Ngo
- From the Cardiology Unit, The Queen Elizabeth Hospital and Department of Medicine, University of Adelaide South Australia 5011, Australia
| | - John D. Horowitz
- From the Cardiology Unit, The Queen Elizabeth Hospital and Department of Medicine, University of Adelaide South Australia 5011, Australia
| | - Aaron L. Sverdlov
- From the Cardiology Unit, The Queen Elizabeth Hospital and Department of Medicine, University of Adelaide South Australia 5011, Australia
| |
Collapse
|
28
|
MS-based approaches to unravel the molecular complexity of proprotein-derived biomarkers and support their quantification: the examples of B-type natriuretic peptide and apelin peptides. Bioanalysis 2012; 4:2851-63. [DOI: 10.4155/bio.12.259] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The specific forms of described protein biomarkers that occur in human blood are not yet fully established. Even though B-type natriuretic peptide (BNP) and N-terminal proBNP are now well known markers of heart failure and other cardiac disorders, several studies yielded highly controversial results reporting various truncated, multimerized or modified forms in human blood. Similar discrepancies were observed for other biomarkers also originating from proproteins, such as the apelin peptides. The drawback of most of these studies is that they used methods with low resolving power, such as immunoassays after HPLC separation. MS-based techniques may be able to avoid such flaws. In this review, we discuss the usefulness of MS-based approaches for the characterization of circulating forms of peptide biomarkers that originate from a given proprotein. Two particular examples are discussed in detail: BNP-related peptides and some more putative biomarkers of heart failure, the apelin peptides.
Collapse
|
29
|
Chen JH, Michiue T, Ishikawa T, Maeda H. Pathophysiology of sudden cardiac death as demonstrated by molecular pathology of natriuretic peptides in the myocardium. Forensic Sci Int 2012; 223:342-8. [DOI: 10.1016/j.forsciint.2012.10.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Revised: 07/13/2012] [Accepted: 10/08/2012] [Indexed: 11/17/2022]
|
30
|
Abstract
BACKGROUND N-terminal pro-B-type natriuretic peptide (ntproBNP) is an established marker of heart failure in adult cardiology. We analyzed nt-proBNP in the circulation of fetuses with increased volume load secondary to anemia and investigated the effect of treatment on nt-proBNP concentration. METHODS Fetuses undergoing intrauterine transfusion (IUT) were examined. nt-proBNP was measured before IUT and correlated with hemoglobin concentrations, ultrasonographic findings, and Doppler measurements of the peak systolic velocity of the middle cerebral artery (MCA-PSV). RESULTS A total of 27 patients (7 with hydrops) and 78 controls were examined. nt-proBNP was markedly elevated in anemia (P < 0.001). Concentrations were highest in hydropic fetuses (P < 0.03); no differences were present in hemoglobin and MCA-PSV values between hydropic and nonhydropic cases. In fetuses undergoing multiple IUTs nt-proBNP normalized after the third IUT, whereas hemoglobin and MCA-PSV remained abnormal. CONCLUSION Levels of circulating nt-proBNP correlate well with the degree of myocardial workload in the hyperdynamic state of fetal anemia. We hypothesize that normalization of nt-proBNP after serial transfusions is an indicator of myocardial adjustment to chronic anemia. nt-proBNP measurement may be useful in the management of fetal anemia, particularly in cases at risk of hydrops and fetuses requiring multiple transfusions.
Collapse
|
31
|
Cui H, Huo G, Liu L, Fan L, Ye P, Cao J, Bai Y, Wang F, Hu Y. Association of cardiac and renal function with extreme N-terminal fragment pro-B-type natriuretic peptide levels in elderly patients. BMC Cardiovasc Disord 2012; 12:57. [PMID: 22834778 PMCID: PMC3422193 DOI: 10.1186/1471-2261-12-57] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 07/26/2012] [Indexed: 11/23/2022] Open
Abstract
Background The data are inconsistent regarding whether extreme N-terminal fragment pro-B-type natriuretic peptide (NT pro-BNP) levels are associated with impaired renal function. Furthermore, the relationship between extreme NT pro-BNP levels and cardiac and renal function in elderly patients has not been reported. The aim of the present study was to examine a hypothesis that extreme NT pro-BNP levels may be associated with impaired cardiac and renal function in elderly patients. Methods We retrospectively analyzed the data of demographic, clinical, and echocardiographic features on 152 consecutive elderly patients aged more than 80 years old (average age, 83.65 ± 3.58 years) with NT pro-BNP levels ≥ 3000 pg/ml. The participants were divided into two categories according to their NT pro-BNP levels: (1) 3000–10000 pg/mL and (2) >10000 pg /mL. Results The number of patients with impaired renal function (P = 0.019) and the mortality (P < 0.001) in the period of inpatient was higher in the group with NT pro-BNP > 10000 pg /mL. The levels of serum creatinine and creatine kinase MB (CK-MB) in the group of NT pro-BNP > 10000 pg / mL were higher than those in the group of NT pro-BNP = 3000-10000 pg/mL (P = 0.001 and P = 0.023, respectively). Furthermore, no significant difference in the distribution by NYHA class in different NT pro-BNP levels was observed. Multiple linear regression analyses demonstrated that with NT pro-BNP levels as the dependent variable, NT pro-BNP levels were positively correlated with CK-MB (β = 0.182, P = 0.024) and creatinine levels (β = 0.281, P = 0.001). The area under the receiver-operating characteristic (ROC) curve of NT pro-BNP levels and clinical diagnosis of impaired renal function was 0.596 and reached significant difference (95%CI:0.503-0.688, P = 0.044). Conclusion These data suggest that the extreme elevation of NT pro-BNP levels (≥3000 pg/ml) is mainly determined by impaired renal function in elderly patients above 80 years. Extreme NT pro-BNP levels may be useful for assessing the severity of impaired renal function.
Collapse
Affiliation(s)
- Hua Cui
- Second Geriatric Cardiology Division, Chinese PLA General Hospital, No 28 Fuxing Road, Beijing 100853, P.R. China
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Marcadores biológicos: ¿qué aportan los péptidos natriuréticos? HIPERTENSION Y RIESGO VASCULAR 2012. [DOI: 10.1016/j.hipert.2012.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
33
|
Molecular pathology of natriuretic peptides in the myocardium with special regard to fatal intoxication, hypothermia, and hyperthermia. Int J Legal Med 2012; 126:747-56. [DOI: 10.1007/s00414-012-0732-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 06/12/2012] [Indexed: 11/30/2022]
|
34
|
Iqbal N, Wentworth B, Choudhary R, Landa ADLP, Kipper B, Fard A, Maisel AS. Cardiac biomarkers: new tools for heart failure management. Cardiovasc Diagn Ther 2012; 2:147-64. [PMID: 24282708 PMCID: PMC3839143 DOI: 10.3978/j.issn.2223-3652.2012.06.03] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Accepted: 06/08/2012] [Indexed: 12/14/2022]
Abstract
The last decade has seen exciting advances in the field of biomarkers used in managing patients with heart failure (HF). Biomarker research has broadened our knowledge base, shedding more light on the underlying pathophysiological mechanisms occurring in patients with both acute and chronic HF. The criterion required by an ideal cardiovascular biomarker has been progressively changing to an era of sensitive assays that can be used to guide treatment. Recent technological advances have made it possible to rapidly measure even minute amounts of these proteins by means of higher sensitivity assays. With a high prevalence of comorbidities associated with HF, an integrated approach utilizing multiple biomarkers have shown promise in predicting mortality, better risk stratification and reducing re-hospitalizations, thus lowering health-care costs. This review provides a brief insight into recent advances in the field of biomarkers currently used in the diagnosis and prognosis of patients with acute and chronic HF.
Collapse
Affiliation(s)
- Navaid Iqbal
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Bailey Wentworth
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Rajiv Choudhary
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | | | - Benjamin Kipper
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Arrash Fard
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Alan S. Maisel
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
- Department of Medicine, University of California at San Diego, La Jolla, CA, USA
| |
Collapse
|
35
|
Coutinho T, Turner ST, Mosley TH, Kullo IJ. Biomarkers associated with pulse pressure in African-Americans and non-Hispanic whites. Am J Hypertens 2012; 25:145-51. [PMID: 22012208 PMCID: PMC3707798 DOI: 10.1038/ajh.2011.193] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Pulse pressure (an indirect measure of arterial stiffness) is a robust predictor of cardiovascular events, but its pathophysiology remains poorly understood. To gain insight into the pathophysiology of arterial stiffness we conducted an exploratory investigation of the associations of 47 circulating biomarkers in etiologic pathways of arteriosclerosis with brachial artery pulse pressure. METHODS Participants included 1,193 African-Americans and 1,145 non-Hispanic whites belonging to hypertensive sibships. Blood pressure (BP) was measured with a random-zero sphygmomanometer. Multivariable linear regression was employed to assess the associations of biomarkers with pulse pressure after adjustment for age, sex, conventional risk factors, mean arterial pressure, heart rate, and use of aspirin, statins, estrogens, and antihypertensives. Statistical significance was set at P ≤ 0.001 (Bonferroni correction for multiple testing). RESULTS Log N-terminal probrain natriuretic peptide (NT-proBNP) (African-Americans: β = 2.11 ± 0.52, non-Hispanic whites: β = 2.65 ± 0.55), log midregional proatrial natriuretic peptide (African-Americans: β = 4.83 ± 0.70, non-Hispanic whites: β = 3.70 ± 0.67), and log osteoprotegerin (African-Americans: β = 4.64 ± 1.02, non-Hispanic whites: β = 4.19 ± 0.99) were independently associated with pulse pressure (P < 0.001 for all) in both ethnicities. Log C-reactive protein (CRP) (β = 1.56 ± 0.35), log midregional proadrenomedullin (MR-proADM) (β = 5.53 ± 1.19) and log matrix metalloproteinase-2 (β = 3.89 ± 1.06) were associated with greater pulse pressure in African-Americans only (P ≤ 0.001 for all), whereas higher fibrinogen was associated with pulse pressure in non-Hispanic whites only (β = 0.02 ± 0.004. P < 0.001). CONCLUSIONS Our results suggest that hemodynamic stress, vascular inflammation and calcification, and matrix remodeling may have a role in the pathogenesis and/or adverse consequences of increased pulse pressure.
Collapse
Affiliation(s)
- Thais Coutinho
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Stephen T. Turner
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | - Thomas H. Mosley
- Department of Medicine (Geriatrics), University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Iftikhar J. Kullo
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
36
|
Corin in clinical laboratory diagnostics. Clin Chim Acta 2011; 413:378-83. [PMID: 22093942 DOI: 10.1016/j.cca.2011.10.032] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 10/21/2011] [Accepted: 10/25/2011] [Indexed: 12/11/2022]
Abstract
Corin is a transmembrane serine protease identified in the heart, where it converts natriuretic peptides from inactive precursors to mature active forms. Studies in animal models and patients with hypertension and heart disease demonstrate that corin is critical in maintaining normal blood pressure and cardiac function. Like many proteolytic enzymes, corin expression and activity are regulated. Cell biology experiments indicate that transcriptional control, intracellular protein trafficking, cell surface targeting, zymogen activation and ectodomain shedding are important mechanisms in regulating corin expression and activity in the heart. More recently, soluble corin was detected in human blood and its levels were found to be reduced in patients with heart failure (HF). These findings indicate that corin deficiency may be involved in the pathogenesis of HF and suggest that soluble corin may be used as a biomarker for the disease. In this review, we describe the function and regulation of corin and discuss recent studies of soluble corin in human blood and its potential use as a biomarker for HF.
Collapse
|
37
|
Polak J, Kotrc M, Wedellova Z, Jabor A, Malek I, Kautzner J, Kazdova L, Melenovsky V. Lipolytic effects of B-type natriuretic peptide 1-32 in adipose tissue of heart failure patients compared with healthy controls. J Am Coll Cardiol 2011; 58:1119-25. [PMID: 21884948 DOI: 10.1016/j.jacc.2011.05.042] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 05/03/2011] [Accepted: 05/31/2011] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Our goal was to examine the role of B-type natriuretic peptide (BNP) in lipolysis regulation in heart failure (HF) patients. BACKGROUND Enhanced adipose tissue lipolysis can contribute to myocardial lipid overload, insulin resistance, and cachexia in advanced HF. Natriuretic peptides were recently recognized to stimulate lipolysis in healthy subjects. METHODS Ten nondiabetic HF patients (New York Heart Association functional class III, 50% nonischemic etiology) and 13 healthy subjects (control subjects) of similar age, sex, and body composition underwent a microdialysis study of subcutaneous abdominal adipose tissue. Four microdialysis probes were simultaneously perfused with 0.1 μM BNP(1-32,) 10 μM BNP(1-32), 10 μM norepinephrine (NE) or Ringer's solution. Outgoing dialysate glycerol concentration (DGC) was measured as an index of lipolysis. RESULTS Spontaneous lipolysis was higher in HF patients compared with control subjects (DGC: 189 ± 37 μmol/l vs. 152 ± 35 μmol/l, p < 0.01). Response to NE was similar (p = 0.35) in HF patients and control subjects (DGC increase of 1.7 ± 0.2-fold vs. 1.7 ± 0.4-fold). BNP(1-32) 10 μM markedly increased lipolysis in both HF patients and control subjects (DGC increase of 2.8 ± 0.5-fold vs. 3.2 ± 0.3-fold), whereas the response to 0.1 μM BNP(1-32) was more pronounced in HF patients (p = 0.02). In HF patients, spontaneous lipolysis positively correlated with insulin resistance and the response to BNP(1-32) negatively correlated with adiposity. CONCLUSIONS BNP(1-32) exerts strong lipolytic effects in humans. Despite marked elevation of plasma immunoreactive BNP, the responsiveness of adipose tissue to BNP(1-32) is not attenuated in HF, possibly reflecting a deficiency of endogenous bioactive BNP. Lipolytic effects of BNP can contribute to excessive fatty acid mobilization in advanced HF.
Collapse
Affiliation(s)
- Jan Polak
- Department of Cardiology, Institute of Clinical and Experimental Medicine, IKEM, Videnska 1958/9, Prague, Czech Republic
| | | | | | | | | | | | | | | |
Collapse
|
38
|
Effects of anticoagulants on human plasma soluble corin levels measured by ELISA. Clin Chim Acta 2010; 411:1998-2003. [PMID: 20800586 DOI: 10.1016/j.cca.2010.08.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2010] [Revised: 08/15/2010] [Accepted: 08/16/2010] [Indexed: 01/04/2023]
Abstract
BACKGROUND Recently, soluble corin was detected in human plasma. In patients with heart failure, plasma corin levels were lower than that of normal controls. In this study, we analyzed experimental conditions for measuring plasma or serum corin by an immunoassay. METHODS Serum and plasma corin levels were measured by ELISA. Effects of different anticoagulants (EDTA, heparin and sodium citrate) on plasma corin levels were examined. RESULTS Corin levels in serum were similar to that in plasma with heparin (950±305 vs. 929±301 pg/ml, n=40, p=0.73), but were significantly higher than those in plasma with sodium citrate (735±237 pg/ml, p<0.01) or EDTA (716±261 pg/ml, p<0.001). Native and recombinant human corin proteins were stable in human plasma with EDTA at 4°C or underwent freezing-and-thawing. In 348 healthy Chinese individuals, plasma corin levels ranged from 216 to 1663 pg/ml. The levels were higher in males than that in females (842±283 vs. 569±192 pg/ml, p<0.001). CONCLUSION Soluble corin was stable in plasma samples. Plasma soluble corin levels vary depending on anticoagulants used. Samples containing heparin had significantly higher levels of corin than that in samples with EDTA or sodium citrate.
Collapse
|
39
|
Shrestha K, Troughton RW, Borowski AG, Yandle TG, Richards AM, Klein AL, Tang WHW. Plasma corin levels provide minimal prognostic utility incremental to natriuretic peptides in chronic systolic heart failure. J Card Fail 2010; 16:621-7. [PMID: 20670840 DOI: 10.1016/j.cardfail.2010.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Revised: 03/05/2010] [Accepted: 03/24/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Corin is a serine protease that cleaves pro-atrial and pro-B-type natriuretic peptides into biologically active hormones. The relationship between soluble plasma corin levels, plasma natriuretic peptide levels, myocardial structure and performance, and long-term clinical outcomes in the setting of chronic systolic heart failure has not been described. METHODS AND RESULTS In 126 patients with chronic systolic heart failure (left ventricular ejection fraction <or=35%, New York Heart Association functional Class I-IV), we measured plasma corin and natriuretic peptide levels and performed comprehensive echocardiography with assessment of cardiac structure and performance. Adverse clinical events (all-cause mortality, cardiac transplantation, or heart failure hospitalization) were prospectively tracked for a median of 38 months. Plasma corin levels modestly correlated with echocardiographic indices of cardiac structure, including left ventricular mass index (r = 0.30, P = .003) and interventricular septum width (r = 0.22, P = .013). However, plasma corin levels did not correlate with age, arterial pressures, estimated glomerular filtration rate, echocardiographic indices of systolic or diastolic function, or plasma natriuretic peptide levels. In Cox proportional hazards analysis, higher plasma corin levels did not predict reduced risk of adverse clinical events (hazard ratio 0.91; 95% confidence interval 0.67-1.24, P = .52), and did not provide incremental prognostic value to natriuretic peptide levels. CONCLUSION In our cohort of ambulatory patients with chronic systolic heart failure, soluble plasma corin levels did not provide prognostic utility incremental to that of natriuretic peptides.
Collapse
Affiliation(s)
- Kevin Shrestha
- Department of Cardiovascular Medicine, the Cleveland Clinic, Cleveland, Ohio 44195, USA
| | | | | | | | | | | | | |
Collapse
|