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Zhang K, Yuan Z, Wang S, Zhao S, Cui H, Lai Y. The abnormalities of free fatty acid metabolism in patients with hypertrophic cardiomyopathy, a single-center retrospective observational study. BMC Cardiovasc Disord 2024; 24:312. [PMID: 38902636 PMCID: PMC11188237 DOI: 10.1186/s12872-024-03925-9] [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: 12/26/2023] [Accepted: 05/06/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Previous studies have shown the importance of energy deficiency and malfunctioning mitochondria in the pathophysiology of hypertrophic cardiomyopathy (HCM). There has been a little research into the relationship between plasma free fatty acids (FFA), one of the heart's main energy sources, and HCM. We evaluated its clinical importance in HCM to see if there was a link between plasma FFA metabolism and HCM. METHODS In a single-center retrospective observational study, we investigated 420 HCM patients diagnosed at Beijing Anzhen Hospital between January 1, 2018, and December 31, 2022. Meanwhile, 1372 individuals without HCM (non-HCM) were recruited. 391 non-HCM patients were chosen as controls via a propensity score matching (PSM) study with a 1:1 ratio. RESULTS FFA in HCM patients showed statistically significant correlations with creatinine (r = 0.115, p = 0.023), estimated GFR (r=-0.130, p = 0.010), BNP (r = 0.152, p = 0.007), LVEF (r=-0.227, p < 0.001), LVFS (r=-0.160, p = 0.002), and LAD (r = 0.112, p = 0.028). Higher FFA levels were found in HCM patients who had atrial fibrillation and NYHY functional classes III or IV (p = 0.015 and p = 0.022, respectively). In HCM patients, multiple linear regression analysis revealed that BNP and LVEF had independent relationships with increasing FFA (Standardized = 0.139, p = 0.013 and =-0.196, p < 0.001, respectively). CONCLUSIONS Among HCM patients, the plasma FFA concentration was lower, and those with AF and NYHY functional class III or IV had higher FFA levels, and LVEF and BNP were independently associated with increasing FFA. The findings of the study should help inspire future efforts to better understand how energy deficiency contributes to hypertrophic cardiomyopathy (HCM) development.
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Affiliation(s)
- Ke Zhang
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Chaoyang District, Chaoyang District, Box: 100011, Beijing, China
- Beijing Anzhen Hospital, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Ministry of Education, Beijing, 100029, China
| | - Zhongyu Yuan
- Beijing Anzhen Hospital, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Ministry of Education, Beijing, 100029, China
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Shengwei Wang
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Chaoyang District, Chaoyang District, Box: 100011, Beijing, China
- Beijing Anzhen Hospital, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Ministry of Education, Beijing, 100029, China
| | - Shifeng Zhao
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Chaoyang District, Chaoyang District, Box: 100011, Beijing, China
- Beijing Anzhen Hospital, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Ministry of Education, Beijing, 100029, China
| | - Hao Cui
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Chaoyang District, Chaoyang District, Box: 100011, Beijing, China
- Beijing Anzhen Hospital, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Ministry of Education, Beijing, 100029, China
| | - Yongqiang Lai
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No.2 Anzhen Road, Chaoyang District, Chaoyang District, Box: 100011, Beijing, China.
- Beijing Anzhen Hospital, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Ministry of Education, Beijing, 100029, China.
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2
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Gao S, Liu XP, Li TT, Chen L, Feng YP, Wang YK, Yin YJ, Little PJ, Wu XQ, Xu SW, Jiang XD. Animal models of heart failure with preserved ejection fraction (HFpEF): from metabolic pathobiology to drug discovery. Acta Pharmacol Sin 2024; 45:23-35. [PMID: 37644131 PMCID: PMC10770177 DOI: 10.1038/s41401-023-01152-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
Heart failure (HF) with preserved ejection fraction (HFpEF) is currently a preeminent challenge for cardiovascular medicine. It has a poor prognosis, increasing mortality, and is escalating in prevalence worldwide. Despite accounting for over 50% of all HF patients, the mechanistic underpinnings driving HFpEF are poorly understood, thus impeding the discovery and development of mechanism-based therapies. HFpEF is a disease syndrome driven by diverse comorbidities, including hypertension, diabetes and obesity, pulmonary hypertension, aging, and atrial fibrillation. There is a lack of high-fidelity animal models that faithfully recapitulate the HFpEF phenotype, owing primarily to the disease heterogeneity, which has hampered our understanding of the complex pathophysiology of HFpEF. This review provides an updated overview of the currently available animal models of HFpEF and discusses their characteristics from the perspective of energy metabolism. Interventional strategies for efficiently utilizing energy substrates in preclinical HFpEF models are also discussed.
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Affiliation(s)
- Si Gao
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China
| | - Xue-Ping Liu
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China
| | - Ting-Ting Li
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China
| | - Li Chen
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China
| | - Yi-Ping Feng
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China
| | - Yu-Kun Wang
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China
| | - Yan-Jun Yin
- School of Pharmacy, Bengbu Medical College, Bengbu, 233000, China
| | - Peter J Little
- School of Pharmacy, University of Queensland, Pharmacy Australia Centre of Excellence, Woolloongabba, QLD, 4102, Australia
| | - Xiao-Qian Wu
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, 511436, China.
| | - Suo-Wen Xu
- Department of Endocrinology, First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China.
| | - Xu-Dong Jiang
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China.
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3
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Kumar M, Haghighi K, Koch S, Rubinstein J, Stillitano F, Hajjar RJ, Kranias EG, Sadayappan S. Myofilament Alterations Associated with Human R14del-Phospholamban Cardiomyopathy. Int J Mol Sci 2023; 24:2675. [PMID: 36768995 PMCID: PMC9917359 DOI: 10.3390/ijms24032675] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/23/2023] [Accepted: 01/27/2023] [Indexed: 02/01/2023] Open
Abstract
Phospholamban (PLN) is a major regulator of cardiac contractility, and human mutations in this gene give rise to inherited cardiomyopathies. The deletion of Arginine 14 is the most-prevalent cardiomyopathy-related mutation, and it has been linked to arrhythmogenesis and early death. Studies in PLN-humanized mutant mice indicated an increased propensity to arrhythmias, but the underlying cellular mechanisms associated with R14del-PLN cardiac dysfunction in the absence of any apparent structural remodeling remain unclear. The present study addressed the specific role of myofilaments in the setting of R14del-PLN and the long-term effects of R14del-PLN in the heart. Maximal force was depressed in skinned cardiomyocytes from both left and right ventricles, but this effect was more pronounced in the right ventricle of R14del-PLN mice. In addition, the Ca2+ sensitivity of myofilaments was increased in both ventricles of mutant mice. However, the depressive effects of R14del-PLN on contractile parameters could be reversed with the positive inotropic drug omecamtiv mecarbil, a myosin activator. At 12 months of age, corresponding to the mean symptomatic age of R14del-PLN patients, contractile parameters and Ca2+ transients were significantly depressed in the right ventricular R14del-PLN cardiomyocytes. Echocardiography did not reveal any alterations in cardiac function or remodeling, although histological and electron microscopy analyses indicated subtle alterations in mutant hearts. These findings suggest that both aberrant myocyte calcium cycling and aberrant contractility remain specific to the right ventricle in the long term. In addition, altered myofilament activity is an early characteristic of R14del-PLN mutant hearts and the positive inotropic drug omecamtiv mecarbil may be beneficial in treating R14del-PLN cardiomyopathy.
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Affiliation(s)
- Mohit Kumar
- Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Kobra Haghighi
- Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Sheryl Koch
- Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Jack Rubinstein
- Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Francesca Stillitano
- Division Heart and Lung, Department of Cardiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Roger J. Hajjar
- Phospholamban Heart Foundation, Postbus 66, 1775 ZH Middenmeer, The Netherlands
| | - Evangelia G. Kranias
- Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Sakthivel Sadayappan
- Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
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Joseph LC, Avula UMR, Wan EY, Reyes MV, Lakkadi KR, Subramanyam P, Nakanishi K, Homma S, Muchir A, Pajvani UB, Thorp EB, Reiken SR, Marks AR, Colecraft HM, Morrow JP. Dietary Saturated Fat Promotes Arrhythmia by Activating NOX2 (NADPH Oxidase 2). Circ Arrhythm Electrophysiol 2019; 12:e007573. [PMID: 31665913 PMCID: PMC7004280 DOI: 10.1161/circep.119.007573] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 09/10/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Obesity and diets high in saturated fat increase the risk of arrhythmias and sudden cardiac death. However, the molecular mechanisms are not well understood. We hypothesized that an increase in dietary saturated fat could lead to abnormalities of calcium homeostasis and heart rhythm by a NOX2 (NADPH oxidase 2)-dependent mechanism. METHODS We investigated this hypothesis by feeding mice high-fat diets. In vivo heart rhythm telemetry, optical mapping, and isolated cardiac myocyte imaging were used to quantify arrhythmias, repolarization, calcium transients, and intracellular calcium sparks. RESULTS We found that saturated fat activates NOX (NADPH oxidase), whereas polyunsaturated fat does not. The high saturated fat diet increased repolarization heterogeneity and ventricular tachycardia inducibility in perfused hearts. Pharmacological inhibition or genetic deletion of NOX2 prevented arrhythmogenic abnormalities in vivo during high statured fat diet and resulted in less inducible ventricular tachycardia. High saturated fat diet activates CaMK (Ca2+/calmodulin-dependent protein kinase) in the heart, which contributes to abnormal calcium handling, promoting arrhythmia. CONCLUSIONS We conclude that NOX2 deletion or pharmacological inhibition prevents the arrhythmogenic effects of a high saturated fat diet, in part mediated by activation of CaMK. This work reveals a molecular mechanism linking cardiac metabolism to arrhythmia and suggests that NOX2 inhibitors could be a novel therapy for heart rhythm abnormalities caused by cardiac lipid overload.
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Affiliation(s)
- Leroy C. Joseph
- Department of Medicine, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Uma Mahesh R. Avula
- Department of Medicine, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Elaine Y. Wan
- Department of Medicine, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Michael V. Reyes
- Department of Medicine, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Kundanika R. Lakkadi
- Department of Medicine, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Prakash Subramanyam
- Department of Physiology and Cellular Biophysics, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Koki Nakanishi
- Department of Medicine, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Shunichi Homma
- Department of Medicine, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Antoine Muchir
- Center of Research in Myology, UPMC-Inserm UMR974, CNRS FRE3617, Institut de Myologie, G.H. Pitie Salpetriere, Paris, France
| | - Utpal B. Pajvani
- Department of Medicine, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Edward B. Thorp
- Departments of Pathology and Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Steven R. Reiken
- Department of Physiology and Cellular Biophysics, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Andrew R. Marks
- Department of Physiology and Cellular Biophysics, College of Physicians and Surgeons of Columbia University, New York, NY
| | - Henry M. Colecraft
- Department of Physiology and Cellular Biophysics, College of Physicians and Surgeons of Columbia University, New York, NY
| | - John P. Morrow
- Department of Medicine, College of Physicians and Surgeons of Columbia University, New York, NY
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5
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Deus AF, Vileigas DF, Silva DCT, Tomasi LC, Campos DHS, Okoshi K, Padovani CR, Cicogna AC. Cardiac function and intracellular Ca2+ handling proteins are not impaired by high-saturated-fat diet-induced obesity. ACTA ACUST UNITED AC 2019; 52:e8085. [PMID: 31141087 PMCID: PMC6542093 DOI: 10.1590/1414-431x20198085] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 04/02/2019] [Indexed: 11/22/2022]
Abstract
Obesity is often associated with changes in cardiac function; however, the mechanisms responsible for functional abnormalities have not yet been fully clarified. Considering the lack of information regarding high-saturated-fat diet-induced obesity, heart function, and the proteins involved in myocardial calcium (Ca2+) handling, the aim of this study was to test the hypothesis that this dietary model of obesity leads to cardiac dysfunction resulting from alterations in the regulatory proteins of intracellular Ca2+ homeostasis. Male Wistar rats were distributed into two groups: control (C, n=18; standard diet) and obese (Ob, n=19; high-saturated-fat diet), which were fed for 33 weeks. Cardiac structure and function were evaluated using echocardiographic and isolated papillary muscle analyses. Myocardial protein expressions of sarcoplasmic reticulum Ca2+-ATPase, phospholamban (PLB), PLB serine-16 phosphorylation, PLB threonine-17 phosphorylation, ryanodine receptor, calsequestrin, Na+/Ca2+ exchanger, and L-type Ca2+ channel were assessed by western blot. Obese rats presented 104% increase in the adiposity index (C: 4.5±1.4 vs Ob: 9.2±1.5%) and obesity-related comorbidities compared to control rats. The left atrium diameter (C: 5.0±0.4 vs Ob: 5.5±0.5 mm) and posterior wall shortening velocity (C: 36.7±3.4 vs Ob: 41.8±3.8 mm/s) were higher in the obese group than in the control. The papillary muscle function was similar between the groups at baseline and after inotropic and lusitropic maneuvers. Obesity did not lead to changes in myocardial Ca2+ handling proteins expression. In conclusion, the hypothesis was not confirmed, since the high-saturated-fat diet-induced obese rats did not present cardiac dysfunction or impaired intracellular Ca2+ handling proteins.
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Affiliation(s)
- A F Deus
- Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - D F Vileigas
- Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - D C T Silva
- Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - L C Tomasi
- Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - D H S Campos
- Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - K Okoshi
- Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - C R Padovani
- Departamento de Bioestatística, Instituto de Biociências de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - A C Cicogna
- Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
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Nakamura M, Sadoshima J. Cardiomyopathy in obesity, insulin resistance and diabetes. J Physiol 2019; 598:2977-2993. [PMID: 30869158 DOI: 10.1113/jp276747] [Citation(s) in RCA: 136] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 02/25/2019] [Indexed: 12/17/2022] Open
Abstract
The prevalence of obesity, insulin resistance and diabetes is increasing rapidly. Most patients with these disorders have hypertriglyceridaemia and increased plasma levels of fatty acids, which are taken up and stored in lipid droplets in the heart. Intramyocardial lipids that exceed the capacity for storage and oxidation can be lipotoxic and induce non-ischaemic and non-hypertensive cardiomyopathy, termed diabetic or lipotoxic cardiomyopathy. The clinical features of diabetic cardiomyopathy are cardiac hypertrophy and diastolic dysfunction, which lead to heart failure, especially heart failure with preserved ejection fraction. Although the pathogenesis of the cardiomyopathy is multifactorial, diabetic dyslipidaemia and intramyocardial lipid accumulation are the key pathological features, triggering cellular signalling and modifications of proteins and lipids via generation of toxic metabolic intermediates. Most clinical studies have shown no beneficial effect of anti-diabetic agents and statins on outcomes in heart failure patients without atherosclerotic diseases, indicating the importance of identifying underlying mechanisms and early interventions for diabetic cardiomyopathy. Here, we summarize the molecular mechanisms of diabetic cardiomyopathy, with a special emphasis on cardiac lipotoxicity, and discuss the role of peroxisome proliferator-activated receptor α and dysregulated fatty acid metabolism as potential therapeutic targets.
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Affiliation(s)
- Michinari Nakamura
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers New Jersey Medical School, 185 South Orange Ave, Newark, NJ, 07103, USA
| | - Junichi Sadoshima
- Department of Cell Biology and Molecular Medicine, Cardiovascular Research Institute, Rutgers New Jersey Medical School, 185 South Orange Ave, Newark, NJ, 07103, USA
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7
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Sánchez A, Contreras C, Climent B, Gutiérrez A, Muñoz M, García-Sacristán A, López M, Rivera L, Prieto D. Impaired Ca 2+ handling in resistance arteries from genetically obese Zucker rats: Role of the PI3K, ERK1/2 and PKC signaling pathways. Biochem Pharmacol 2018; 152:114-128. [PMID: 29574066 DOI: 10.1016/j.bcp.2018.03.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/20/2018] [Indexed: 01/12/2023]
Abstract
The impact of obesity on vascular smooth muscle (VSM) Ca2+ handling and vasoconstriction, and its regulation by the phosphatidylinositol 3-kinase (PI3K), mitogen activated protein kinase (MAPK) and protein kinase C (PKC) were assessed in mesenteric arteries (MA) from obese Zucker rats (OZR). Simultaneous measurements of intracellular Ca2+ ([Ca2+]i) and tension were performed in MA from OZR and compared to lean Zucker rats (LZR), and the effects of selective inhibitors of PI3K, ERK-MAPK kinase and PKC were assessed on the functional responses of VSM voltage-dependent L-type Ca2+ channels (CaV1.2). Increases in [Ca2+]i induced by α1-adrenoceptor activation and high K+ depolarization were not different in arteries from LZR and OZR although vasoconstriction was enhanced in OZR. Blockade of the ryanodine receptor (RyR) and of Ca2+ release from the sarcoplasmic reticulum (SR) markedly reduced depolarization-induced Ca2+ responses in arteries from lean but not obese rats, suggesting impaired Ca2+-induced Ca2+ release (CICR) from SR in arteries from OZR. Enhanced Ca2+ influx after treatment with ryanodine was abolished by nifedipine and coupled to up-regulation of CaV1.2 channels in arteries from OZR. Increased activation of ERK-MAPK and up-regulation of PI3Kδ, PKCβ and δ isoforms were associated to larger inhibitory effects of PI3K, MAPK and PKC blockers on VSM L-type channel Ca2+ entry in OZR. Changes in arterial Ca2+ handling in obesity involve SR Ca2+ store dysfunction and enhanced VSM Ca2+ entry through L-type channels, linked to a compensatory up-regulation of CaV1.2 proteins and increased activity of the ERK-MAPK, PI3Kδ and PKCβ and δ, signaling pathways.
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Affiliation(s)
- Ana Sánchez
- Department of Physiology, School of Pharmacy, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Cristina Contreras
- NeurObesity Group, Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela 15782, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), 15706, Spain
| | - Belén Climent
- Department of Physiology, School of Pharmacy, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Alejandro Gutiérrez
- Department of Physiology, School of Pharmacy, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Mercedes Muñoz
- Department of Physiology, School of Pharmacy, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Albino García-Sacristán
- Department of Physiology, School of Pharmacy, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Miguel López
- NeurObesity Group, Department of Physiology, CIMUS, University of Santiago de Compostela-Instituto de Investigación Sanitaria, Santiago de Compostela 15782, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), 15706, Spain
| | - Luis Rivera
- Department of Physiology, School of Pharmacy, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Dolores Prieto
- Department of Physiology, School of Pharmacy, Universidad Complutense de Madrid, 28040 Madrid, Spain.
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8
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Valero-Muñoz M, Sam F. Reply. JACC Basic Transl Sci 2018; 3:158-159. [PMID: 30062201 PMCID: PMC6059000 DOI: 10.1016/j.jacbts.2018.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Flora Sam
- Whitaker Cardiovascular Institute, Cardiovascular Medicine Section, Boston University School of Medicine, 700 Albany Street, W507, Boston, Massachusetts 02118
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9
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Sikkel MB, Francis DP, Howard J, Gordon F, Rowlands C, Peters NS, Lyon AR, Harding SE, MacLeod KT. Hierarchical statistical techniques are necessary to draw reliable conclusions from analysis of isolated cardiomyocyte studies. Cardiovasc Res 2017; 113:1743-1752. [PMID: 29016722 PMCID: PMC5852514 DOI: 10.1093/cvr/cvx151] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/27/2017] [Accepted: 08/29/2017] [Indexed: 02/01/2023] Open
Abstract
AIMS It is generally accepted that post-MI heart failure (HF) changes a variety of aspects of sarcoplasmic reticular Ca2+ fluxes but for some aspects there is disagreement over whether there is an increase or decrease. The commonest statistical approach is to treat data collected from each cell as independent, even though they are really clustered with multiple likely similar cells from each heart. In this study, we test whether this statistical assumption of independence can lead the investigator to draw conclusions that would be considered erroneous if the analysis handled clustering with specific statistical techniques (hierarchical tests). METHODS AND RESULTS Ca2+ transients were recorded in cells loaded with Fura-2AM and sparks were recorded in cells loaded with Fluo-4AM. Data were analysed twice, once with the common statistical approach (assumption of independence) and once with hierarchical statistical methodologies designed to allow for any clustering. The statistical tests found that there was significant hierarchical clustering. This caused the common statistical approach to underestimate the standard error and report artificially small P values. For example, this would have led to the erroneous conclusion that time to 50% peak transient amplitude was significantly prolonged in HF. Spark analysis showed clustering, both within each cell and also within each rat, for morphological variables. This means that a three-level hierarchical model is sometimes required for such measures. Standard statistical methodologies, if used instead, erroneously suggest that spark amplitude is significantly greater in HF and spark duration is reduced in HF. CONCLUSION Ca2+ fluxes in isolated cardiomyocytes show so much clustering that the common statistical approach that assumes independence of each data point will frequently give the false appearance of statistically significant changes. Hierarchical statistical methodologies need a little more effort, but are necessary for reliable conclusions. We present cost-free simple tools for performing these analyses.
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Affiliation(s)
- Markus B Sikkel
- Myocardial Function Section, Fourth Floor, Imperial Centre for Translational and Experimental Medicine, National Heart and Lung Institute, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
- Department of Electrophysiology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Darrel P Francis
- Myocardial Function Section, Fourth Floor, Imperial Centre for Translational and Experimental Medicine, National Heart and Lung Institute, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
| | - James Howard
- Myocardial Function Section, Fourth Floor, Imperial Centre for Translational and Experimental Medicine, National Heart and Lung Institute, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
| | - Fabiana Gordon
- Statistics Advisory Service, Imperial College London, London, UK
| | - Christina Rowlands
- Myocardial Function Section, Fourth Floor, Imperial Centre for Translational and Experimental Medicine, National Heart and Lung Institute, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
| | - Nicholas S Peters
- Myocardial Function Section, Fourth Floor, Imperial Centre for Translational and Experimental Medicine, National Heart and Lung Institute, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
- Department of Electrophysiology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Alexander R Lyon
- Myocardial Function Section, Fourth Floor, Imperial Centre for Translational and Experimental Medicine, National Heart and Lung Institute, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
- Department of Cardiology, Royal Brompton Hospital, London, UK
| | - Sian E Harding
- Myocardial Function Section, Fourth Floor, Imperial Centre for Translational and Experimental Medicine, National Heart and Lung Institute, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
| | - Kenneth T MacLeod
- Myocardial Function Section, Fourth Floor, Imperial Centre for Translational and Experimental Medicine, National Heart and Lung Institute, Imperial College London, Hammersmith Campus, Du Cane Road, London, UK
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Xie S, Deng Y, Pan YY, Wang ZH, Ren J, Guo XL, Yuan X, Shang J, Liu HG. Melatonin protects against chronic intermittent hypoxia-induced cardiac hypertrophy by modulating autophagy through the 5′ adenosine monophosphate-activated protein kinase pathway. Biochem Biophys Res Commun 2015; 464:975-981. [DOI: 10.1016/j.bbrc.2015.06.149] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 06/22/2015] [Indexed: 12/19/2022]
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11
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Lu XL, Tong YF, Liu Y, Xu YL, Yang H, Zhang GY, Li XH, Zhang HG. Gαq protein carboxyl terminus imitation polypeptide GCIP-27 improves cardiac function in chronic heart failure rats. PLoS One 2015; 10:e0121007. [PMID: 25822412 PMCID: PMC4379177 DOI: 10.1371/journal.pone.0121007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 02/03/2015] [Indexed: 11/24/2022] Open
Abstract
Background Gαq protein carboxyl terminus imitation polypeptide (GCIP)-27 has been shown to alleviate pathological cardiomyocyte hypertrophy induced by various factors. Pathological cardiac hypertrophy increases the morbidity and mortality of cardiovascular diseases while it compensates for poor heart function. This study was designed to investigate the effects of GCIP-27 on heart function in rats with heart failure induced by doxorubicin. Methods and Results Forty-eight rats were randomly divided into the following six groups receiving vehicle (control), doxorubicin (Dox), losartan (6 mg/kg, i.g.) and three doses of GCIP-27 (10, 30, 90 μg/kg; i.p., bid), respectively. Heart failure was induced by Dox, which was administered at a 20 mg/kg cumulative dose. After 10 weeks of treatment, we observed that GCIP-27 (30, 90 μg/kg) significantly increased ejection fraction, fraction shortening, stroke volume and sarcoplasmic reticulum Ca2+ ATPase activity of Dox-treated hearts. Additionally, GCIP-27 decreased myocardial injury, heart weight index and left ventricular weight index, fibrosis and serum cardiac troponin-I concentration in Dox-treated mice. Immunohistochemistry, western blotting and real-time PCR experiments indicated that GCIP-27 (10–90 μg/kg) could markedly upregulate the protein expression of myocardial α-myosin heavy chain (MHC), Bcl-2, protein kinase C (PKC) ε and phosphorylated extracellular signal-regulated kinase (p-ERK) 1/2 as well as the mRNA expression of α-MHC, but downregulated the expression of β-MHC, Bax and PKC βII, and the mRNA expression levels of β-MHC in Dox-treated mice. It was also found that GCIP-27 (30, 90 μg/L) decreased cell size and protein content of cardiomyocytes significantly in vitro by comparison of Dox group. Conclusions GCIP-27 could effectively ameliorate heart failure development induced by Dox. PKC–ERK1/2 signaling might represent the underlying mechanism of the beneficial effects of GCIP-27.
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Affiliation(s)
- Xiao Lan Lu
- Department of Pharmacology, College of Pharmacy, Third Military Medical University, Chongqing 400038, China
- Department of Clinical Laboratory, First Affiliated Hospital of North Sichuan Medical College, Sichuan Nanchong 637000, China
| | - Yang Fei Tong
- Department of Pharmacology, College of Pharmacy, Third Military Medical University, Chongqing 400038, China
| | - Ya Liu
- Institute of Materia Medica and Department of Pharmaceutics, College of Pharmacy, Third Military Medical University, Chongqing 40038, China
| | - Ya Li Xu
- Department of Ultrasound, Second Affiliated Hospital, Third Military Medical University, Chongqing 400037, China
| | - Hua Yang
- Department of Pharmacology, College of Pharmacy, Third Military Medical University, Chongqing 400038, China
| | - Guo Yuan Zhang
- Department of Clinical Laboratory, First Affiliated Hospital of North Sichuan Medical College, Sichuan Nanchong 637000, China
| | - Xiao-Hui Li
- Institute of Materia Medica and Department of Pharmaceutics, College of Pharmacy, Third Military Medical University, Chongqing 40038, China
| | - Hai-Gang Zhang
- Department of Pharmacology, College of Pharmacy, Third Military Medical University, Chongqing 400038, China
- * E-mail:
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12
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Littlejohns B, Lin H, Angelini GD, Halestrap AP, Suleiman MS. Switching back to normal diet following high-fat diet feeding reduces cardiac vulnerability to ischaemia and reperfusion injury. Cell Physiol Biochem 2014; 34:1090-100. [PMID: 25228294 PMCID: PMC4464011 DOI: 10.1159/000366323] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2014] [Indexed: 02/01/2023] Open
Abstract
Background We have recently shown that hearts of mice fed high-fat diet exhibit increased vulnerability to ischaemia and reperfusion (I/R) in parallel to changes in catalase protein expression, mitochondrial morphology and intracellular diastolic Ca2+. Aims To determine whether switching from high-fat back to normal diet alters vulnerability to I/R and to investigate cardiac cellular remodelling in relation to the mechanism(s) underlying I/R injury. Methods and Results Male C57BL/6J mice were fed a high-fat diet for 19-22 weeks; after which a subset of mice was switched back to normal diet for 4-6 weeks. Hearts from mice switched back to normal diet were more resistant to reperfusion injury compared to hearts from mice fed only high-fat diet. This was associated with a significant reversal in catalase expression (western blotting) and recovery of size and density of mitochondria (electron microscopy). In contrast, switching back to normal diet did not alter cardiomyocyte contractility or Ca2+ transients compared to high-fat diet. Conclusion This study shows for the first time that switching the diet from high-fat back to normal reduces vulnerability to I/R. This effect is associated with changes in catalase levels and mitochondrial morphology without altering cardiomyocyte contractility or Ca2+ transients.
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Affiliation(s)
- Ben Littlejohns
- Bristol Heart Institute, School of Clinical Sciences, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
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13
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Berthiaume JM, Azam SM, Hoit BD, Chandler MP. Cardioprotective effects of dietary lipids evident in the time-dependent alterations of cardiac function and gene expression following myocardial infarction. Physiol Rep 2014; 2:2/5/e12019. [PMID: 24844640 PMCID: PMC4098746 DOI: 10.14814/phy2.12019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
We have previously shown that prolonged high–saturated fat feeding (SAT) for 8 weeks after myocardial infarction (MI) improves ventricular function and prevents the metabolic remodeling commonly observed in heart failure. The current study was designed to delineate the interplay between markers of energy metabolism and indices of cardiac remodeling with 2 and 4 weeks of post‐MI SAT in male Wistar rats. By 2 weeks, less remodeling was noted in MI‐SAT evidenced by diminished chamber dilation and greater ejection fraction assessed by echocardiography and hemodynamic measures. In addition, gene expression of energy metabolism targets involved in FA uptake, oxidation, and glucose oxidation regulation was increased in MI‐SAT with respect to MI alone, although no change in PDH phosphorylation was observed. The regulatory kinase, phosphoinositide 3 kinase (Pi3k), was strongly induced by 2 weeks in the MI‐SAT group, although AKT protein content (a primary downstream target of PI3K that affects metabolism) was decreased by both MI and SAT alone, indicating early involvement of cellular signaling pathways in lipid‐mediated cardioprotection. Our results demonstrate that cardioprotection occurs acutely with SAT following MI, with improvement in indices of both cardiac function and fatty acid oxidation, suggesting a mechanistic role for energy metabolism in the beneficial effects of high dietary fat following cardiac injury. e12019 A diet rich in saturated fats is cardioprotective after myocardial infarction. The cardioprotective effect is noted by 2 weeks and includes functional and genomic changes indicative of a relationship with preservation of metabolic flexibility.
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Affiliation(s)
- Jessica M Berthiaume
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, Ohio
| | - Salaman M Azam
- Department of Medicine, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio
| | - Brian D Hoit
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, Ohio Department of Medicine, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio
| | - Margaret P Chandler
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, Ohio
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14
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Mourmoura E, Chaté V, Couturier K, Laillet B, Vial G, Rigaudiere JP, Morio B, Malpuech-Brugère C, Azarnoush K, Demaison L. Body adiposity dictates different mechanisms of increased coronary reactivity related to improved in vivo cardiac function. Cardiovasc Diabetol 2014; 13:54. [PMID: 24572210 PMCID: PMC3996056 DOI: 10.1186/1475-2840-13-54] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 02/19/2014] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Saturated fatty acid-rich high fat (HF) diets trigger abdominal adiposity, insulin resistance, type 2 diabetes and cardiac dysfunction. This study was aimed at evaluating the effects of nascent obesity on the cardiac function of animals fed a high-fat diet and at analyzing the mechanisms by which these alterations occurred at the level of coronary reserve. MATERIALS AND METHODS Rats were fed a control (C) or a HF diet containing high proportions of saturated fatty acids for 3 months. Thereafter, their cardiac function was evaluated in vivo using a pressure probe inserted into the cavity of the left ventricle. Their heart was isolated, perfused iso-volumetrically according to the Langendorff mode and the coronary reserve was evaluated by determining the endothelial-dependent (EDV) and endothelial-independent (EIV) vasodilatations in the absence and presence of endothelial nitric oxide synthase and cyclooxygenase inhibitors (L-NAME and indomethacin). The fatty acid composition of cardiac phospholipids was then evaluated. RESULTS Although all the HF-fed rats increased their abdominal adiposity, some of them did not gain body weight (HF- group) compared to the C group whereas other ones had a higher body weight (HF+). All HF rats displayed a higher in vivo cardiac activity associated with an increased EDV. In the HF- group, the improved EDV was due to an increase in the endothelial cell vasodilatation activity whereas in the HF+ group, the enhanced EDV resulted from an improved sensitivity of coronary smooth muscle cells to nitric oxide. Furthermore, in the HF- group the main pathway implicated in the EDV was the NOS pathway while in the HF+ group the COX pathway. CONCLUSIONS Nascent obesity-induced improvement of cardiac function may be supported by an enhanced coronary reserve occurring via different mechanisms. These mechanisms implicate either the endothelial cells activity or the smooth muscle cells sensitivity depending on the body adiposity of the animals.
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Affiliation(s)
- Evangelia Mourmoura
- Université Joseph Fourier, Laboratoire de Bioénergétique Fondamentale et Appliquée, BP 53, Grenoble F-38041, France
- U1055 INSERM, Grenoble F-38041, France
| | - Valérie Chaté
- Université Joseph Fourier, Laboratoire de Bioénergétique Fondamentale et Appliquée, BP 53, Grenoble F-38041, France
- U1055 INSERM, Grenoble F-38041, France
| | - Karine Couturier
- Université Joseph Fourier, Laboratoire de Bioénergétique Fondamentale et Appliquée, BP 53, Grenoble F-38041, France
- U1055 INSERM, Grenoble F-38041, France
| | - Brigitte Laillet
- INRA, UMR 1019 Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
- Clermont Université, Université d’Auvergne, UMR 1019 Nutrition Humaine, Clermont-Ferrand, France
| | - Guillaume Vial
- INSERM UMR-1060, Laboratoire CarMeN, Université Lyon 1, INRA USC1362, INSA de Lyon, Facultés de médecine Rockefeller et Charles Merieux Lyon-Sud, Lyon F-69003, France
| | - Jean-Paul Rigaudiere
- INRA, UMR 1019 Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
- Clermont Université, Université d’Auvergne, UMR 1019 Nutrition Humaine, Clermont-Ferrand, France
| | - Béatrice Morio
- INSERM UMR-1060, Laboratoire CarMeN, Université Lyon 1, INRA USC1362, INSA de Lyon, Facultés de médecine Rockefeller et Charles Merieux Lyon-Sud, Lyon F-69003, France
| | - Corinne Malpuech-Brugère
- INRA, UMR 1019 Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
- Clermont Université, Université d’Auvergne, UMR 1019 Nutrition Humaine, Clermont-Ferrand, France
| | - Kasra Azarnoush
- Heart surgery Department, G. Montpied Hospital, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Luc Demaison
- Université Joseph Fourier, Laboratoire de Bioénergétique Fondamentale et Appliquée, BP 53, Grenoble F-38041, France
- U1055 INSERM, Grenoble F-38041, France
- INRA, UMR 1019 Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
- Clermont Université, Université d’Auvergne, UMR 1019 Nutrition Humaine, Clermont-Ferrand, France
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15
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Wende AR, Symons JD, Abel ED. Mechanisms of lipotoxicity in the cardiovascular system. Curr Hypertens Rep 2013; 14:517-31. [PMID: 23054891 DOI: 10.1007/s11906-012-0307-2] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cardiovascular diseases account for approximately one third of all deaths globally. Obese and diabetic patients have a high likelihood of dying from complications associated with cardiovascular dysfunction. Obesity and diabetes increase circulating lipids that upon tissue uptake, may be stored as triglyceride, or may be metabolized in other pathways, leading to the generation of toxic intermediates. Excess lipid utilization or activation of signaling pathways by lipid metabolites may disrupt cellular homeostasis and contribute to cell death, defining the concept of lipotoxicity. Lipotoxicity occurs in multiple organs, including cardiac and vascular tissues, and a number of specific mechanisms have been proposed to explain lipotoxic tissue injury. In addition, recent data suggests that increased tissue lipids may also be protective in certain contexts. This review will highlight recent progress toward elucidating the relationship between nutrient oversupply, lipotoxicity, and cardiovascular dysfunction. The review will focus in two sections on the vasculature and cardiomyocytes respectively.
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Affiliation(s)
- Adam R Wende
- Program in Molecular Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Utah School of Medicine, Salt Lake City, 84112, USA
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16
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Karlstädt A, Fliegner D, Kararigas G, Ruderisch HS, Regitz-Zagrosek V, Holzhütter HG. CardioNet: a human metabolic network suited for the study of cardiomyocyte metabolism. BMC SYSTEMS BIOLOGY 2012; 6:114. [PMID: 22929619 PMCID: PMC3568067 DOI: 10.1186/1752-0509-6-114] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Accepted: 08/16/2012] [Indexed: 02/08/2023]
Abstract
Background Availability of oxygen and nutrients in the coronary circulation is a crucial determinant of cardiac performance. Nutrient composition of coronary blood may significantly vary in specific physiological and pathological conditions, for example, administration of special diets, long-term starvation, physical exercise or diabetes. Quantitative analysis of cardiac metabolism from a systems biology perspective may help to a better understanding of the relationship between nutrient supply and efficiency of metabolic processes required for an adequate cardiac output. Results Here we present CardioNet, the first large-scale reconstruction of the metabolic network of the human cardiomyocyte comprising 1793 metabolic reactions, including 560 transport processes in six compartments. We use flux-balance analysis to demonstrate the capability of the network to accomplish a set of 368 metabolic functions required for maintaining the structural and functional integrity of the cell. Taking the maintenance of ATP, biosynthesis of ceramide, cardiolipin and further important phospholipids as examples, we analyse how a changed supply of glucose, lactate, fatty acids and ketone bodies may influence the efficiency of these essential processes. Conclusions CardioNet is a functionally validated metabolic network of the human cardiomyocyte that enables theorectical studies of cellular metabolic processes crucial for the accomplishment of an adequate cardiac output.
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Affiliation(s)
- Anja Karlstädt
- Institute of Biochemistry, Charité-Universitätsmedizin Berlin, Charitéplatz 1/Virchowweg 6, 10117 Berlin, Germany.
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