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Wu X, Yang F, Sun L. Computed tomography myocardial perfusion imaging of patients with left ventricular hypertrophy in hypertension: A retrospective study. Clin Exp Hypertens 2023; 45:2159426. [PMID: 36594488 DOI: 10.1080/10641963.2022.2159426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Left ventricular hypertrophy (LVH) is a strong predictor of adverse cardiovascular outcomes including heart failure. This study evaluated characteristics and the influencing factors of computed tomography myocardial perfusion imaging (CT-MPI) of patients with LVH in hypertension. METHODS A total of 65 patients with stable chest pain and confirmed coronary stenosis <50% by coronary computed tomography angiography (cCTA) from September 2019 to February 2021 were recruited. According to the results of echocardiography, patients were divided into the LVH group (n = 33) and control group (patients without LVH, n = 32). The general data of all study subjects were collected, and the body mass index (BMI) and body surface area (BSA) were calculated. Myocardial blood flow (MBF), myocardial blood volume (MBV), and echocardiographic parameters were recorded. Spearman correlation analyses were conducted to analyze the relationship between MBF, MBV, and echocardiographic parameters. RESULTS The LVH group had significantly higher left ventricular end diastolic distance (LVEDd), septal wall thickness diastole (SWTd), and post wall thickness diastole (PWTd) than the control group, resulting in higher left ventricular mass index (LVMI) (P < .05). The LVH group showed significantly lower MBF than the control group (P < .05), but there was no significant difference in MBV between two groups (P > .05). Spearman correlation analysis demonstrated that MBF was negatively correlated with SWTd and LVMI (P < .05). CONCLUSIONS CT-MPI, as a new noninvasive modality to evaluate myocardial perfusion in hypertensive patients, revealed that MBF is reduced in patients with LVH, while MBV remains unchanged. In hypertensive patients, decreased MBF is significantly correlated with increased LVMI.
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Affiliation(s)
- Xia Wu
- Department of Cardiac Rehabilitation, Daqing Oilfield General Hospital, Daqing City, China
| | - Fei Yang
- Department of Geriatrics, Daqing Oilfield General Hospital, Daqing City, China
| | - Lili Sun
- Department of Geriatrics, Daqing Oilfield General Hospital, Daqing City, China
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2
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Eftekhari A, Westra J, Stegehuis V, Holm NR, van de Hoef TP, Kirkeeide RL, Piek JJ, Lance Gould K, Johnson NP, Christiansen EH. Prognostic value of microvascular resistance and its association to fractional flow reserve: a DEFINE-FLOW substudy. Open Heart 2022; 9:e001981. [PMID: 35410913 PMCID: PMC9003618 DOI: 10.1136/openhrt-2022-001981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/24/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the prognostic value of hyperemic microvascular resistance (HMR) and its relationship with hyperemic stenosis resistance (HSR) index and fractional flow reserve (FFR) in stable coronary artery disease. METHODS This is a substudy of the DEFINE-FLOW cohort (NCT02328820), which evaluated the prognosis of lesions (n=456) after combined FFR and coronary flow reserve (CFR) assessment in a prospective, non-blinded, non-randomised, multicentre study in 12 centres in Europe and Japan. Participants (n=430) were evaluated by wire-based measurement of coronary pressure, flow and vascular resistance (ComboWire XT, Phillips Volcano, San Diego, California, USA). RESULTS Mean FFR and CFR were 0.82±0.10 and 2.2±0.6, respectively. When divided according to FFR and CFR thresholds (above and below 0.80 and 2.0, respectively), HMR was highest in lesions with FFR>0.80 and CFR<2.0 (n=99) compared with lesions with FFR≤0.80 and CFR≥2.0 (n=68) (2.92±1.2 vs 1.91±0.64 mm Hg/cm/s, p<0.001). The FFR value was proportional to the ratio between HMR and the HMR+HSR (total resistance), 95% limits of agreement (-0.032; 0.019), bias (-0.003±0.02) and correlation (r2=0.98, p<0.0001). Cox regression model using HMR as continuous parameter for target vessel failure showed an HR of 1.51, 95% CI (0.9 to 2.4), p=0.10. CONCLUSIONS Increased HMR was not associated with a higher rate of adverse clinical events, in this population of mainly stable patients. FFR can be equally well expressed as HMR/HMR+HSR, thereby providing an alternative conceptual formulation linking epicardial severity with microvascular resistance. TRIAL REGISTRATION NUMBER NCT02328820.
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Affiliation(s)
- Ashkan Eftekhari
- Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark
- Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Jelmer Westra
- Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Valérie Stegehuis
- Amsterdam UMC, University of Amsterdam, Heart Center,Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Niels Ramsing Holm
- Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Tim P van de Hoef
- Amsterdam UMC, University of Amsterdam, Heart Center,Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Richard L Kirkeeide
- Weatherhead PET Center, Division of Cardiology, Department of Medicine, McGovern Medical School at UTHealth and Memorial Hermann Hospital, Houston, Texas, USA
| | - Jan J Piek
- Amsterdam UMC, University of Amsterdam, Heart Center,Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - K Lance Gould
- Weatherhead PET Center, Division of Cardiology, Department of Medicine, McGovern Medical School at UTHealth and Memorial Hermann Hospital, Houston, Texas, USA
| | - Nils P Johnson
- Weatherhead PET Center, Division of Cardiology, Department of Medicine, McGovern Medical School at UTHealth and Memorial Hermann Hospital, Houston, Texas, USA
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Winston TS, Chen C, Suddhapas K, Tarris BA, Elattar S, Sun S, Zhang T, Ma Z. Controlling Mesenchyme Tissue Remodeling via Spatial Arrangement of Mechanical Constraints. Front Bioeng Biotechnol 2022; 10:833595. [PMID: 35252142 PMCID: PMC8896258 DOI: 10.3389/fbioe.2022.833595] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 01/26/2022] [Indexed: 11/25/2022] Open
Abstract
Tissue morphogenetic remodeling plays an important role in tissue repair and homeostasis and is often governed by mechanical stresses. In this study, we integrated an in vitro mesenchymal tissue experimental model with a volumetric contraction-based computational model to investigate how geometrical designs of tissue mechanical constraints affect the tissue remodeling processes. Both experimental data and simulation results verified that the standing posts resisted the bulk contraction of the tissues, leading to tissue thinning around the posts as gap extension and inward remodeling at the edges as tissue compaction. We changed the geometrical designs for the engineered mesenchymal tissues with different shapes of posts arrangements (triangle vs. square), different side lengths (6 mm vs. 8 mm), and insertion of a center post. Both experimental data and simulation results showed similar trends of tissue morphological changes of significant increase of gap extension and deflection compaction with larger tissues. Additionally, insertion of center post changed the mechanical stress distribution within the tissues and stabilized the tissue remodeling. This experimental-computational integrated model can be considered as a promising initiative for future mechanistic understanding of the relationship between mechanical design and tissue remodeling, which could possibly provide design rationale for tissue stability and manufacturing.
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Affiliation(s)
- Tackla S. Winston
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY, United States
- BioInspired Syracuse Institute for Materials and Living Systems, Syracuse University, Syracuse, NY, United States
| | - Chao Chen
- BioInspired Syracuse Institute for Materials and Living Systems, Syracuse University, Syracuse, NY, United States
- Department of Mechanical and Aerospace Engineering, Syracuse University, Syracuse, NY, United States
| | - Kantaphon Suddhapas
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY, United States
- BioInspired Syracuse Institute for Materials and Living Systems, Syracuse University, Syracuse, NY, United States
| | - Bearett A. Tarris
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY, United States
- BioInspired Syracuse Institute for Materials and Living Systems, Syracuse University, Syracuse, NY, United States
| | - Saif Elattar
- Department of Chemical and Petroleum Engineering, University of Kansas, Lawrence, KS, United States
| | - Shiyang Sun
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY, United States
- BioInspired Syracuse Institute for Materials and Living Systems, Syracuse University, Syracuse, NY, United States
| | - Teng Zhang
- BioInspired Syracuse Institute for Materials and Living Systems, Syracuse University, Syracuse, NY, United States
- Department of Mechanical and Aerospace Engineering, Syracuse University, Syracuse, NY, United States
- *Correspondence: Teng Zhang, ; Zhen Ma,
| | - Zhen Ma
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY, United States
- BioInspired Syracuse Institute for Materials and Living Systems, Syracuse University, Syracuse, NY, United States
- *Correspondence: Teng Zhang, ; Zhen Ma,
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Liu D, Luo H, Qiao C. SHP-1/STAT3 Interaction Is Related to Luteolin-Induced Myocardial Ischemia Protection. Inflammation 2021; 45:88-99. [PMID: 34460026 PMCID: PMC8403691 DOI: 10.1007/s10753-021-01530-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/28/2021] [Indexed: 01/06/2023]
Abstract
Prevention and management of myocardial ischemia/reperfusion (I/R) injury is a key step in coronary heart disease surgery. Luteolin is a falconoid compound that has an antioxidant effect, but its mechanism in I/R injury in vivo and in vitro is still under explored. This study attempted to reveal the role of luteolin (Lut) in I/R through mediation of the Src homology 2 domain-containing protein tyrosine phosphatase 1 (SHP-1)/Signal transducer and activator of transcription 3 (STAT3) pathway. To establish I/R rat models, the left anterior descending artery (LAD) was ligated for 30 min and re-perfused for 1 h in Lut-pretreated or nude rats. Comparisons between infarct area, cardiac dysfunction, and myocardial cell death and inflammatory reaction were performed in I/R-induced rats. Hypoxia/reoxygenation (H/R) cell models were established by stimulating H9c2 cells with 95% nitrogen and 5% carbon dioxide. Simultaneously, H/R-related cell death and inflammatory reactions were investigated following Lut treatment. The target protein of Lut was identified using western blotting. Pro-inflammatory cytokines were also measured in serum or Lut-pretreated cell culture medium. The results revealed that compared with the I/R group, Lut treatment could significantly decrease myocardial infarction (MI) area, increase left ventricular ejection fraction (LVEF), and decrease cell death and pro-inflammatory cytokines in the serum. Decreased apoptosis and inflammatory cytokines were also observed in H/R cells after Lut treatment. Lut treatment downregulated SHP-1 expression and subsequently upregulated STAT3 phosphorylation in both I/R rat heart tissue and H9c2 cells. The findings of the current study suggest that Lut can protect the heart and reduce MI area, cell apoptosis rate, and inflammatory level in I/R models.
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Affiliation(s)
- Donghai Liu
- Cardiovascular Surgery II, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Hong Luo
- Cardiovascular Surgery II, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Chenhui Qiao
- Cardiovascular Surgery II, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China. .,Cardiovascular Surgery II, The First Affiliated Hospital of Zhengzhou University, Henan, 450052, Zhengzhou, China.
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5
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Zhang Y, Wernly B, Cao X, Mustafa SJ, Tang Y, Zhou Z. Adenosine and adenosine receptor-mediated action in coronary microcirculation. Basic Res Cardiol 2021; 116:22. [PMID: 33755785 PMCID: PMC7987637 DOI: 10.1007/s00395-021-00859-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 03/08/2021] [Indexed: 12/20/2022]
Abstract
Adenosine is an ubiquitous extracellular signaling molecule and plays a fundamental role in the regulation of coronary microcirculation through activation of adenosine receptors (ARs). Adenosine is regulated by various enzymes and nucleoside transporters for its balance between intra- and extracellular compartments. Adenosine-mediated coronary microvascular tone and reactive hyperemia are through receptors mainly involving A2AR activation on both endothelial and smooth muscle cells, but also involving interaction among other ARs. Activation of ARs further stimulates downstream targets of H2O2, KATP, KV and KCa2+ channels leading to coronary vasodilation. An altered adenosine-ARs signaling in coronary microcirculation has been observed in several cardiovascular diseases including hypertension, diabetes, atherosclerosis and ischemic heart disease. Adenosine as a metabolite and its receptors have been studied for its both therapeutic and diagnostic abilities. The present review summarizes important aspects of adenosine metabolism and AR-mediated actions in the coronary microcirculation.
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Affiliation(s)
- Ying Zhang
- The International Collaborative Centre On Big Science Plan for Purinergic Signalling, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Bernhard Wernly
- Department of Anaesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | - Xin Cao
- The International Collaborative Centre On Big Science Plan for Purinergic Signalling, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - S Jamal Mustafa
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, USA
| | - Yong Tang
- The International Collaborative Centre On Big Science Plan for Purinergic Signalling, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Chronobiology Key Laboratory of Sichuan Province, Chengdu, China
| | - Zhichao Zhou
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, 17176, Stockholm, Sweden.
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Monori-Kiss A, Antal P, Szekeres M, Varbiro S, Fees A, Szekacs B, Nadasy GL. Morphological remodeling of the intramural coronary resistance artery network geometry in chronically Angiotensin II infused hypertensive female rats. Heliyon 2020; 6:e03807. [PMID: 32368650 PMCID: PMC7184174 DOI: 10.1016/j.heliyon.2020.e03807] [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: 09/13/2019] [Revised: 03/03/2020] [Accepted: 04/16/2020] [Indexed: 11/30/2022] Open
Abstract
Segmental remodeling of resistance arteries, inhibition of angiogenetic processes, their rarefaction by AngiotensinII and hypertension are accepted facts. Less is known about alterations in resistance artery network geometry potentially induced by them. Female rats were infused with 100 ng/kg/min AngiotensinII with osmotic minipumps for four weeks that raised mean arterial blood pressure from 98 ± 3 to 125 ± 7 mmHg. Geometry of the left coronary artery system was studied on plastic casts and on in situ microsurgically prepared, saline infused video-microscoped networks (n = 13 and 11 controls and hypertensives, respectively). Parallel running branches, broken course of larger branches, multiple branchings and branch crossings have been identified (13 and 74 such deformities, in control and hypertensive networks, respectively, p < 0.01). Bifurcation angles increased with increasing asymmetry of daughter branches but not in hypertensives. Dividing the whole network (theoretically) into several hundreds of 50μm long ring units, ring frequency peaked at 200μm diameter in normal networks. This peak diminished and was replaced by a peak at 300μm in hypertensives (p < 0.01). In controls, diameter of vascular units decreased at a fairly even rate with flow distance from the orifice. The 350, 200, 150μm diameter units were found with highest frequencies at flow distances around 2.5, 5.5 and 7.5mm, respectively. This regular pattern disintegrated in hypertensives. Higher blood flow routes were needed to cover the same distance from the orifice (p < 0.01). Shrinkage and diminishment of many parallel connected 200μm segments, concomitant enlargement of many larger segments accompanied with morphological deformities can be expected to contribute to elevated vascular resistance.
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Affiliation(s)
- Anna Monori-Kiss
- Institute of Translational Medicine, Semmelweis University, 37-47 Tuzolto Str, H-1094, Budapest, Hungary
| | - Peter Antal
- Institute of Translational Medicine, Semmelweis University, 37-47 Tuzolto Str, H-1094, Budapest, Hungary
| | - Maria Szekeres
- Department of Physiology, Semmelweis University, 37-47 Tuzolto Str, H-1094, Budapest, Hungary.,Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, 17 Vas Str, H-1088, Budapest, Hungary
| | - Szabolcs Varbiro
- Department of Obstetrics and Gynecology, Semmelweis University, 78a Ulloi Str, H-1082, Budapest, Hungary
| | - Alexander Fees
- Department of Physiology, Semmelweis University, 37-47 Tuzolto Str, H-1094, Budapest, Hungary
| | - Bela Szekacs
- II. Department of Internal Medicine, Section of Geriatrics, Semmelweis University, 20-22 Halmi Str, H-1115, Budapest, Hungary
| | - Gyorgy L Nadasy
- Department of Physiology, Semmelweis University, 37-47 Tuzolto Str, H-1094, Budapest, Hungary
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7
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Wei B, Lin Q, Ji Y, Zhao Y, Ding L, Zhou W, Zhang L, Gao C, Zhao W. Luteolin ameliorates rat myocardial ischaemia-reperfusion injury through activation of peroxiredoxin II. Br J Pharmacol 2018; 175:3315-3332. [PMID: 29782637 PMCID: PMC6057904 DOI: 10.1111/bph.14367] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 04/08/2018] [Accepted: 05/04/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND PURPOSE Antioxidants provide a promising therapeutic effect for the cardiovascular disease. Luteolin, a polyphenolic bioflavonoid, is known to confer cardioprotection, although the underlying mechanisms, especially the role of luteolin on the antioxidant enzymes, such as the peroxiredoxin family, remain unknown. EXPERIMENTAL APPROACH We measured the effects of luteolin on myocardial ischaemia/reperfusion (MI/R) injury in vivo (Sprague-Dawley rats) and in vitro, together with the underlying mechanisms, with a focus on signalling by peroxiredoxins. H9c2 cells were used to assess the changes in peroxiredoxins and the other antioxidant enzymes. Oxidative stress, cardiac function, LDH release, ROS and infarct size were also assayed. KEY RESULTS Luteolin exerted significant cardioprotective effects in vivo and in vitro via improving cardiac function, increasing the expression of anti-apoptotic protein Bcl-2 and decreasing the pro-apoptotic protein Bax and active caspases 3 and 9, associated with MI/R. Mechanistically, luteolin markedly enhanced expression of peroxiredoxin II, without significant effects on other forms of peroxiredoxin, catalase or SOD1. Molecular docking showed that luteolin could indeed bind to the enzymic active pocket of peroxiredoxin II. Furthermore, down-regulation of peroxiredoxin II by peroxiredoxin II-antisense, administered by adenovirus infection of H9c2 cardiomyocytes, and inhibition of peroxiredoxin II in vivo significantly reversed the cardioprotective effects of luteolin. CONCLUSIONS AND IMPLICATIONS Our findings, for the first time, demonstrate that luteolin protects against MI/R injury through promoting signalling through the endogenous antioxidant enzyme, peroxiredoxin II, indicating the important beneficial role of this antioxidant system in the heart.
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Affiliation(s)
- Bo Wei
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Co‐innovation Center of Henan Province for New Drug R & D and Preclinical Safety, School of Pharmace utical SciencesZhengzhou UniversityZhengzhouHenanChina
| | - Qiao Lin
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Co‐innovation Center of Henan Province for New Drug R & D and Preclinical Safety, School of Pharmace utical SciencesZhengzhou UniversityZhengzhouHenanChina
| | - Ya‐Ge Ji
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Co‐innovation Center of Henan Province for New Drug R & D and Preclinical Safety, School of Pharmace utical SciencesZhengzhou UniversityZhengzhouHenanChina
| | - Yi‐Can Zhao
- Department of Internal Medicine‐CardiologyThe Second Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanP.R. China
| | - Li‐Na Ding
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Co‐innovation Center of Henan Province for New Drug R & D and Preclinical Safety, School of Pharmace utical SciencesZhengzhou UniversityZhengzhouHenanChina
| | - Wen‐Juan Zhou
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Co‐innovation Center of Henan Province for New Drug R & D and Preclinical Safety, School of Pharmace utical SciencesZhengzhou UniversityZhengzhouHenanChina
| | - Li‐Hua Zhang
- Department of Internal Medicine‐CardiologyThe Second Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanP.R. China
| | - Chuan‐Yu Gao
- Department of Internal Medicine‐CardiologyHenan Provincial People's Hospital of Zhengzhou UniversityZhengzhouHenanP.R. China
| | - Wen Zhao
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education of China, Co‐innovation Center of Henan Province for New Drug R & D and Preclinical Safety, School of Pharmace utical SciencesZhengzhou UniversityZhengzhouHenanChina
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Ou Y, Zhao Z, Tsauo J, Jiang L, Yang Y, Chen M. An Unusual Case of Takotsubo Syndrome With Hyperaldosteronism as the Potential Cause. J Clin Endocrinol Metab 2018; 103:12-15. [PMID: 29095987 DOI: 10.1210/jc.2017-01117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 10/26/2017] [Indexed: 02/05/2023]
Abstract
CONTEXT Catecholamine-related factors are the most popular explanation for the occurrence of Takotsubo syndrome. An aldosterone-related mechanism, however, has not been proposed. CASE DESCRIPTION A 45-year-old male patient presenting with ST-segment elevation myocardial infarction was diagnosed with primary aldosteronism, severe hypokalemia, and Takotsubo syndrome. After excluding the known conditions of apical ballooning and the factors of vasospasm, primary aldosteronism is considered as the major contributor to the development of Takotsubo syndrome. The potential mechanisms are discussed. CONCLUSIONS The case suggests a possible hyperaldosteronism-induced and vasoconstriction-mediated mechanism in the development of Takotsubo syndrome.
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Affiliation(s)
- Yuanweixiang Ou
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Zhengang Zhao
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jiayyu Tsauo
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Licheng Jiang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yong Yang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Mao Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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Cardiac Progenitor Cell Recruitment Drives Fetal Cardiac Regeneration by Enhanced Angiogenesis. Ann Thorac Surg 2017; 104:1968-1975. [DOI: 10.1016/j.athoracsur.2017.05.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 04/24/2017] [Accepted: 05/15/2017] [Indexed: 12/15/2022]
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10
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Effect of Bioactive Compound of Aronia melanocarpa on Cardiovascular System in Experimental Hypertension. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:8156594. [PMID: 29333212 PMCID: PMC5733212 DOI: 10.1155/2017/8156594] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 10/10/2017] [Accepted: 10/18/2017] [Indexed: 02/04/2023]
Abstract
Aronia melanocarpa has attracted scientific interest due to its dense contents of different polyphenols. We aimed to analyse effects of Aronia melanocarpa (AME) extract on blood pressure (BP), lipid peroxidation, cytokine level, total NOS activity in the left ventricle (LV), and aorta of L-NAME-induced hypertensive rats. 12-week-old male WKY rats were assigned to the control group and groups treated with AME extract (57.90 mg/kg/day), L-NAME (40 mg/kg/day), or combination of L-NAME (40 mg/kg/day) and AME (57.90 mg/kg/day) in tap water for 3 weeks. NOS activity, eNOS protein expression, and conjugated diene (CD) concentration were determined in the LV and aorta. After 3 weeks of L-NAME treatment, BP was increased by 28% and concomitant treatment with AME reduced it by 21%. NOS activity of the LV and aorta in the L-NAME group was decreased by about 40%, while AME increased it almost on the control level. AME-induced eNOS upregulation may contribute to increase NOS activity. Moreover, AME decreased CD concentration in the LV and aorta and TNF-α and IL-6 production in the plasma were increased by L-NAME treatment. In conclusion, our results showed that active substances of Aronia melanocarpa may have a positive effect on blood pressure, NOS activity, and proinflammatory processes in L-NAME-induced hypertension.
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Mu F, Duan J, Bian H, Yin Y, Zhu Y, Wei G, Guan Y, Wang Y, Guo C, Wen A, Yang Y, Xi M. Cardioprotective effects and mechanism of Radix Salviae miltiorrhizae and Lignum Dalbergiae odoriferae on rat myocardial ischemia/reperfusion injury. Mol Med Rep 2017; 16:1759-1770. [PMID: 28656200 PMCID: PMC5562082 DOI: 10.3892/mmr.2017.6821] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 04/25/2017] [Indexed: 01/03/2023] Open
Abstract
Radix Salviae miltiorrhizae (SM) and Lignum Dalbergiae odoriferae (DO) are traditional Chinese medicinal herbs used to treat ischemic heart disease and other cardiovascular diseases; however, to the best of our knowledge, there are currently few studies regarding their effects. The present study aimed to investigate the cardioprotective effects of SM and DO during myocardial ischemia/reperfusion (MI/R) injury in rats, and explore the molecular mechanisms that underlie their actions. In the present study, Sprague-Dawley rats were pretreated with SM, the aqueous extract of DO (DOA) and the volatile oil of DO (DOO), either as a monotherapy or in combination for 7 days. Subsequently, the rats were subjected to 30 min of ischemia followed by 180 min of reperfusion. Traditional pharmacodynamic evaluation and metabonomics based on gas chromatography/time-of-flight mass spectrometry were used to identify the therapeutic effects of these traditional Chinese medicines. The results revealed that SM, DOA and DOO monotherapies ameliorated cardiac function, and this effect was strengthened further when used in combined therapies. Among the combined treatments, SM + DOO exhibited the greatest potential (P<0.05) to improve electrocardiogram results and heart rate, reduce the heart weight index and myocardial infarct size, and decrease the levels of creatine kinase-MB and lactate dehydrogenase. In addition, metabonomics-based findings, including the principal component analysis and partial least squares discriminant analysis score plot of the metabolic state in rat serum, provided confirmation for the aforementioned results, verifying that SM + DOO exerted synergistic therapeutic efficacies to exhibit a greater effect on rats with MI/R injury when compared with the other pretreatment groups. Furthermore, the most effective duration of SM + DOO treatment was 30 min and the least effective duration was 180 min. Treatment with SM + DOO also significantly (P<0.01) reduced the number of terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling-positive cells, tumor necrosis factor-α andinterleukin-6 expression, and malondialdehyde content, and increased the serum and tissue activity of superoxide dismutase. These results indicated that the combined effects of SM + DOO may be more effective compared with the single pretreatments against MI/R injury in rats. This effect may be achieved partly through anti-apoptotic, antioxidant and anti-inflammatory activities. Therefore, SM + DOO may be considered an effective and promising novel strategy for the prophylaxis and treatment of ischemic heart disease.
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Affiliation(s)
- Fei Mu
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Jialin Duan
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Haixu Bian
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Ying Yin
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Yanrong Zhu
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Guo Wei
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Yue Guan
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Yanhua Wang
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Chao Guo
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Aidong Wen
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Yong Yang
- Department of Pharmacy, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, P.R. China
| | - Miaomiao Xi
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
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Nehrhoff I, Ripoll J, Samaniego R, Desco M, Gómez-Gaviro MV. Looking inside the heart: a see-through view of the vascular tree. BIOMEDICAL OPTICS EXPRESS 2017; 8:3110-3118. [PMID: 28663930 PMCID: PMC5480453 DOI: 10.1364/boe.8.003110] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 05/20/2017] [Accepted: 05/21/2017] [Indexed: 06/07/2023]
Abstract
The ability to acquire 3D images of the heart and its vasculature at cellular resolution facilitates a more detailed study of many heart diseases. Here, we describe a novel technique to image in 3D the heart vasculature by combining the CUBIC clearing protocol combined with in vivo administration of fluorescent-labeled lectin. The use of these techniques in combination with Selective Plane Illumination Microscopy (SPIM) made it possible to obtain high resolution 3D images of the cardiac vascular tree. This methodological approach may enhance the visualization of 3D images of the cardiac vasculature remodeling associated with coronary disease.
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Affiliation(s)
- Imke Nehrhoff
- Instituto de Investigación Sanitaria Gregorio Marañón, (IiSGM), Madrid, Spain
| | - Jorge Ripoll
- Instituto de Investigación Sanitaria Gregorio Marañón, (IiSGM), Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain
| | - Rafael Samaniego
- Unidad de Microscopía Confocal, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Manuel Desco
- Instituto de Investigación Sanitaria Gregorio Marañón, (IiSGM), Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Spain
| | - Maria Victoria Gómez-Gaviro
- Instituto de Investigación Sanitaria Gregorio Marañón, (IiSGM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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13
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Treatment with tumor necrosis factor inhibitors restores coronary microvascular function in young patients with severe psoriasis. Atherosclerosis 2016; 251:25-30. [DOI: 10.1016/j.atherosclerosis.2016.05.036] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 05/01/2016] [Accepted: 05/20/2016] [Indexed: 02/07/2023]
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14
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Akl MR, Nagpal P, Ayoub NM, Tai B, Prabhu SA, Capac CM, Gliksman M, Goy A, Suh KS. Molecular and clinical significance of fibroblast growth factor 2 (FGF2 /bFGF) in malignancies of solid and hematological cancers for personalized therapies. Oncotarget 2016; 7:44735-44762. [PMID: 27007053 PMCID: PMC5190132 DOI: 10.18632/oncotarget.8203] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 03/10/2016] [Indexed: 12/30/2022] Open
Abstract
Fibroblast growth factor (FGF) signaling is essential for normal and cancer biology. Mammalian FGF family members participate in multiple signaling pathways by binding to heparan sulfate and FGF receptors (FGFR) with varying affinities. FGF2 is the prototype member of the FGF family and interacts with its receptor to mediate receptor dimerization, phosphorylation, and activation of signaling pathways, such as Ras-MAPK and PI3K pathways. Excessive mitogenic signaling through the FGF/FGFR axis may induce carcinogenic effects by promoting cancer progression and increasing the angiogenic potential, which can lead to metastatic tumor phenotypes. Dysregulated FGF/FGFR signaling is associated with aggressive cancer phenotypes, enhanced chemotherapy resistance and poor clinical outcomes. In vitro experimental settings have indicated that extracellular FGF2 affects proliferation, drug sensitivity, and apoptosis of cancer cells. Therapeutically targeting FGF2 and FGFR has been extensively assessed in multiple preclinical studies and numerous drugs and treatment options have been tested in clinical trials. Diagnostic assays are used to quantify FGF2, FGFRs, and downstream signaling molecules to better select a target patient population for higher efficacy of cancer therapies. This review focuses on the prognostic significance of FGF2 in cancer with emphasis on therapeutic intervention strategies for solid and hematological malignancies.
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Affiliation(s)
- Mohamed R. Akl
- Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Poonam Nagpal
- Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Nehad M. Ayoub
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Betty Tai
- Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Sathyen A. Prabhu
- Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Catherine M. Capac
- Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Matthew Gliksman
- Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Andre Goy
- Lymphoma Division, The John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | - K. Stephen Suh
- Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
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15
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Sinclair MD, Lee J, Cookson AN, Rivolo S, Hyde ER, Smith NP. Measurement and modeling of coronary blood flow. WILEY INTERDISCIPLINARY REVIEWS-SYSTEMS BIOLOGY AND MEDICINE 2015; 7:335-56. [PMID: 26123867 DOI: 10.1002/wsbm.1309] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 05/19/2015] [Accepted: 05/21/2015] [Indexed: 01/10/2023]
Abstract
Ischemic heart disease that comprises both coronary artery disease and microvascular disease is the single greatest cause of death globally. In this context, enhancing our understanding of the interaction of coronary structure and function is not only fundamental for advancing basic physiology but also crucial for identifying new targets for treating these diseases. A central challenge for understanding coronary blood flow is that coronary structure and function exhibit different behaviors across a range of spatial and temporal scales. While experimental studies have sought to understand this feature by isolating specific mechanisms, in tandem, computational modeling is increasingly also providing a unique framework to integrate mechanistic behaviors across different scales. In addition, clinical methods for assessing coronary disease severity are continuously being informed and updated by findings in basic physiology. Coupling these technologies, computational modeling of the coronary circulation is emerging as a bridge between the experimental and clinical domains, providing a framework to integrate imaging and measurements from multiple sources with mathematical descriptions of governing physical laws. State-of-the-art computational modeling is being used to combine mechanistic models with data to provide new insight into coronary physiology, optimization of medical technologies, and new applications to guide clinical practice.
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Affiliation(s)
- Matthew D Sinclair
- Division of Imaging Sciences and Biomedical Engineering, British Heart Foundation (BHF) Centre of Excellence, King's College London, London, UK
| | - Jack Lee
- Division of Imaging Sciences and Biomedical Engineering, British Heart Foundation (BHF) Centre of Excellence, King's College London, London, UK
| | - Andrew N Cookson
- Division of Imaging Sciences and Biomedical Engineering, British Heart Foundation (BHF) Centre of Excellence, King's College London, London, UK
| | - Simone Rivolo
- Division of Imaging Sciences and Biomedical Engineering, British Heart Foundation (BHF) Centre of Excellence, King's College London, London, UK
| | - Eoin R Hyde
- Division of Imaging Sciences and Biomedical Engineering, British Heart Foundation (BHF) Centre of Excellence, King's College London, London, UK
| | - Nicolas P Smith
- Division of Imaging Sciences and Biomedical Engineering, British Heart Foundation (BHF) Centre of Excellence, King's College London, London, UK.,Department of Engineering, University of Auckland, Auckland, New Zealand
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Yu D, Li M, Tian Y, Liu J, Shang J. Luteolin inhibits ROS-activated MAPK pathway in myocardial ischemia/reperfusion injury. Life Sci 2014; 122:15-25. [PMID: 25476833 DOI: 10.1016/j.lfs.2014.11.014] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 11/03/2014] [Accepted: 11/08/2014] [Indexed: 11/25/2022]
Abstract
AIMS Luteolin is a falconoid compound that has an antioxidant effect, but its contribution to ROS-activated MAPK pathways in ischemia/reperfusion injury is seldom reported. Here, we have confirmed that it exhibits an antioxidant effect in myocardial ischemia/reperfusion injury (MIRI) by inhibiting ROS-activated MAPK pathways. MAIN METHODS We exposed rat hearts into the left anterior descending coronary artery (LAD) ligation for 30min followed by 1h of reperfusion. Observations were carried out using electrocardiography; detection of hemodynamic parameters; and testing levels of lactate dehydrogenase (LDH), creatine kinase (CK), total superoxide dismutase (T-SOD), and malondialdehyde (MDA). Mitogen-activated protein kinase (MAPK) pathway was measured by western blot and transmission electron microscopy was applied to observe the myocardial ultrastructure. Rat H9c2 cell in 95% N2 and 5% CO2 stimulated the MIRI. Oxidation system mRNA levels were measured by real-time PCR; mitochondrial membrane potential and apoptosis were measured by confocal microscopy and flow cytometry; western blot analysis was used to assay caspase-3, -8, and -9 and MAPK pathway protein expression; the MAPK pathway was inhibited using SB203580 (p38 MAPK inhibitor) and SP600125 (c-Jun NH2-terminal kinase inhibitor) before H9c2 cells were exposed to hypoxia/reoxygenation injury to show the modulation of the changes in ROS generation, cell viability and apoptosis. KEY FINDINGS In vivo, luteolin can ameliorate the impaired mitochondrial morphology, regulating the MAPK pathway to protect MIRI. In vitro, luteolin can affect the oxidation system, mitochondrial membrane potential and MAPK pathway to anti-apoptosis. SIGNIFICANCE These results reveal a ROS-MAPK mediated mechanism and mitochondrial pathway through which luteolin can protect myocardial ischemia/reperfusion injury.
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Affiliation(s)
- Dongsheng Yu
- Center for Drug Screening & State Key Laboratory of Natural Medicines, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, PR China
| | - Mengwen Li
- Center for Drug Screening & State Key Laboratory of Natural Medicines, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, PR China
| | - Youqing Tian
- Lianyungang TCM Branch, Jiangsu Union Technical Institute, Lianyungang 222007, PR China
| | - Jun Liu
- Center for Drug Screening & State Key Laboratory of Natural Medicines, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, PR China
| | - Jing Shang
- Center for Drug Screening & State Key Laboratory of Natural Medicines, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, PR China; Qinghai Key Laboratory of Tibetan Medicine Pharmacology and Safety Evaluation, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining 810008, PR China.
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17
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Aldrighi JM, Tsutsui JM, Kowastch I, Ribeiro AL, Scapinelli A, Tamanaha S, Oliveira RM, Mathias W. Effects of Insulin Resistance on Myocardial Blood Flow and Arterial Peripheral Circulation in Patients with Polycystic Ovary Syndrome. Echocardiography 2014; 32:1277-84. [PMID: 25412756 DOI: 10.1111/echo.12849] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is associated with increased risk for cardiovascular disease. We sought to evaluate the effects of insulin resistance (IR) on myocardial microcirculation and peripheral artery function in patients with PCOS. METHODS We studied 55 women (28 with PCOS without IR, 18 with PCOS and IR and 11 normal controls) who underwent laboratorial analysis, high-resolution vascular ultrasound and real time myocardial contrast echocardiography (RTMCE). Intima-media thickness (IMT) and brachial artery flow-mediated dilation (FMD) were evaluated by vascular ultrasound. The replenishment velocity (β), plateau of acoustic intensity (A) and myocardial blood flow reserve (MBFR) were determined by quantitative dipyridamole stress RTMCE. RESULTS β reserve in group PCOS + IR was lower than control (2.34 ± 0.55 vs. 3.60 ± 0.6; P < 0.001) and than PCOS without IR (2.34 ± 0.55 vs. 3.17 ± 0.65; P < 0.001). MBFR in patients with PCOS without IR did not differ from those of control (4.59 ± 1.59 vs. 5.30 ± 1.64; P = 0.22) or from patients with PCOS + IR (4.59 ± 1.59 vs. 3.70 ± 1.47; P = 0.07). When comparing with control group, patients with PCOS + IR had lower MBFR (5.30 ± 1.64 vs. 3.70 ± 1.47; P = 0.01). No significant differences were found between control, PCOS without IR and PCOS + IR for FMD (0.18 ± 0.05, 0.15 ± 0.04 and 0.13 ± 0.07; P =NS) or IMT (0.48 ± 0.05, 0.47 ± 0.05 and 0.49 ± 0.07; P = NS). CONCLUSION Women with PCOS and IR had depressed β and MBFR as demonstrated by quantitative RTMCE, but no alteration in endothelial dysfunction or IMT. PCOS without IR showed isolated depression in β reserve, probably an earlier marker of myocardial flow abnormality.
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Affiliation(s)
- José M Aldrighi
- Department of Obstetrics and Gynecology, School of Medical Sciences of Santa Casa, São Paulo, Brazil
| | - Jeane M Tsutsui
- Heart Institute (InCor), University of Sao Paulo Medical School and Fleury Group, São Paulo, Brazil
| | - Ingrid Kowastch
- Heart Institute (InCor), University of Sao Paulo Medical School and Fleury Group, São Paulo, Brazil
| | - Alessandra L Ribeiro
- Department of Obstetrics and Gynecology, School of Medical Sciences of Santa Casa, São Paulo, Brazil
| | - Alessandro Scapinelli
- Department of Obstetrics and Gynecology, School of Medical Sciences of Santa Casa, São Paulo, Brazil
| | - Sonia Tamanaha
- Department of Obstetrics and Gynecology, School of Medical Sciences of Santa Casa, São Paulo, Brazil
| | - Ricardo M Oliveira
- Department of Obstetrics and Gynecology, School of Medical Sciences of Santa Casa, São Paulo, Brazil
| | - Wilson Mathias
- Heart Institute (InCor), University of Sao Paulo Medical School and Fleury Group, São Paulo, Brazil
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18
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The involvement of a polyphenol-rich extract of black chokeberry in oxidative stress on experimental arterial hypertension. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:912769. [PMID: 23533529 PMCID: PMC3600185 DOI: 10.1155/2013/912769] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Accepted: 01/29/2013] [Indexed: 12/30/2022]
Abstract
The aim of this study is to characterize the content of Aronia melanocarpa Elliott (black chokeberry) extract and also to estimate the influence of polyphenolic compounds contained in chokeberries on oxidative stress, on an L-NAME-induced experimental model of arterial hypertension. The rat blood pressure values were recorded using a CODA Noninvasive Blood Pressure System. HPLC/DAD coupled with ElectroSpray Ionization-Mass Spectrometry allowed identification of five phenolic compounds in berries ethanolic extract as follows: chlorogenic acid, kuromanin, rutin, hyperoside, and quercetin. The serous activity of glutathione-peroxidase (GSH-Px) has significantly lower values in the hypertensive (AHT) group as compared to the group protected by polyphenols (AHT + P). The total antioxidant capacity (TAC) values are lower in the AHT group and they are significantly higher in the AHT + P group. All the measured blood pressure components revealed a biostatistically significant blood pressure drop between the AHT group and the AHT + P group. The results reveal the normalization of the reduced glutathion (GSH) concentration as well as a considerable reduction in the malondialdehyde (MDA) serum concentration in the AHT + P group. Ethanolic extract of black chokeberry fruits not only has a potential value as a prophylactic agent but also may function as a nutritional supplement in the management of arterial hypertension.
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Broyd CJ, Sen S, Mikhail GW, Francis DP, Mayet J, Davies JE. Myocardial ischemia in aortic stenosis: insights from arterial pulse-wave dynamics after percutaneous aortic valve replacement. Trends Cardiovasc Med 2013; 23:185-91. [PMID: 23395429 DOI: 10.1016/j.tcm.2012.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 12/01/2012] [Accepted: 12/03/2012] [Indexed: 01/09/2023]
Abstract
Wave-intensity analysis is a technique that can qualify both the direction and magnitude of the forces accelerating and decelerating coronary blood flow and is derived from simultaneously acquired measures of coronary pressure and velocity using invasive intracoronary wires. Using this technique during TAVI, the dominant force (or 'wave') acting to increase the coronary blood flow which originates from microvascular relaxation is shown to be elevated in severe aortic stenosis and decreased post-implantation. Additionally, with increasing heart rate a progressive fall in the magnitude of this wave is noted and after TAVI this effect is reversed (returning towards the physiological norm). The potential causes of myocardial ischemia in aortic stenosis are clearly multi-factorial but this observation suggests a decoupling between the aorta and myocardium in aortic stenosis, the effects of which are magnified during increased heart rate.
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Affiliation(s)
- Christopher J Broyd
- International Centre for Circulatory Health, National Heart and Lung Institute, 59-61 North Wharf Road, London W2 1LA, UK.
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20
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Lario FC, Miname MH, Tsutsui JM, Santos RD, Kowatsch I, Sbano JC, Ramires JA, Filho RK, Mathias W. Atorvastatin Treatment Improves Myocardial and Peripheral Blood Flow in Familial Hypercholesterolemia Subjects without Evidence of Coronary Atherosclerosis. Echocardiography 2012; 30:64-71. [DOI: 10.1111/j.1540-8175.2012.01810.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Fabio C. Lario
- Echocardiography Laboratory; Heart Institute (InCor)-University of São Paulo Medical School; São Paulo; Brazil
| | - Marcio H. Miname
- Dislipidemia Department; Heart Institute (InCor)-University of São Paulo Medical School; São Paulo; Brazil
| | - Jeane M. Tsutsui
- Fleury Group; Echocardiography Laboratory; Heart Institute (InCor)-University of São Paulo Medical School; São Paulo; Brazil
| | - Raul D. Santos
- Dislipidemia Department; Heart Institute (InCor)-University of São Paulo Medical School; São Paulo; Brazil
| | - Ingrid Kowatsch
- Echocardiography Laboratory; Heart Institute (InCor)-University of São Paulo Medical School; São Paulo; Brazil
| | - João C.N. Sbano
- Echocardiography Laboratory; Heart Institute (InCor)-University of São Paulo Medical School; São Paulo; Brazil
| | - Jose A.F. Ramires
- Dislipidemia Department; Heart Institute (InCor)-University of São Paulo Medical School; São Paulo; Brazil
| | - Roberto Kalil Filho
- Echocardiography Laboratory; Heart Institute (InCor)-University of São Paulo Medical School; São Paulo; Brazil
| | - Wilson Mathias
- Echocardiography Laboratory; Heart Institute (InCor)-University of São Paulo Medical School; São Paulo; Brazil
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Comprehensive phenotyping of salt-induced hypertensive heart disease in living mice using cardiac magnetic resonance. Eur Radiol 2012; 23:332-8. [PMID: 22836163 DOI: 10.1007/s00330-012-2598-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 06/18/2012] [Accepted: 06/28/2012] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To characterise the effects of high-salt diet (HSD) on left ventricular (LV) mass, systolic function and coronary reserve in living mice using cardiac magnetic resonance imaging (MRI). METHODS Thirty C57BL/6 1-month-old female mice were fed either a control (n = 15) or an HSD (n = 15). After 3 months, LV volumes, ejection fraction and mass were assessed using time-resolved three-dimensional (3D) black-blood manganese-enhanced MRI, and coronary flow velocity reserve (CFVR) was assessed using dynamic MR angiography at rest and during adenosine-induced hyperaemia. Hearts were excised to assess LV wet mass and micro-vascular remodelling at histology. RESULTS Micro-vascular remodelling was found at histology in all investigated hearts from the HSD group and none from the control group. No difference between the HSD and control groups was found in terms of heart weight, LV volumes and ejection fraction. Heart to body weight ratio was higher in the HSD group (4.39 ± 0.24 vs 4.02 ± 0.16 mg/g, P < 0.001), because of lower body weight (22.3 ± 0.9 vs 24.0 ± 1.4 g, P < 0.001). CFVR was lower in the HSD group (1.73 ± 0.11 vs 1.94 ± 0.12, P < 0.001). CONCLUSIONS Phenotyping of hypertensive heart disease is feasible in living mice using dynamic MR angiography and time-resolved 3D black-blood manganese-enhanced MRI. HSD is associated with early impairment of coronary reserve, before the onset of significant hypertrophy.
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Compensatory remodeling of coronary microvasculature maintains shear stress in porcine left-ventricular hypertrophy. J Hypertens 2012; 30:608-16. [PMID: 22252479 DOI: 10.1097/hjh.0b013e32834f44dd] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hypertension-induced left-ventricular hypertrophy (LVH) is generally accompanied with coronary neovascularization. The extent of vascular growth or rarefaction depends on many factors (e.g. age, duration of hypertension, degree of hypertrophy). Here, we hypothesize that there is a compensatory vascular growth that maintains uniform wall shear stress (WSS) in perfusion arterioles (diameters of 8-60 μm) in LVH of young porcine. METHOD To test this hypothesis, we investigated LVH in young porcine after 5 weeks of supravalvular aortic stenosis (3 months of age). The morphometry (diameters, lengths, number and connectivity of vessels) of the entire left circumflex (LCx) arterial tree was determined and a hemodynamic network analysis was used to calculate the distribution of pressure, flow and WSS throughout the tree in the control and LVH groups. RESULTS It was found that the number of vessels and the weight of left ventricle (LV) in hypertrophy increased 1.5 and 1.2 times, respectively, and the length of the LCx main trunk increased by 3 cm (36% increase), as compared with those in control group. There were similar myocardial blood flows of 0.87 ± 0.24 and 0.94 ± 0.38 ml/min per g in control and LVH hearts, respectively. The compensatory remodeling in early LVH restores WSS in the smaller perfusion arterioles, but not in the larger epicardial branches. CONCLUSION The present findings quantify the structural and functional remodeling in the entire LCx arterial tree in response to LVH, which reflect heterogeneity in vascular morphometry and hemodynamics from small to large vessels. These conclusions enhance our understanding of compensatory vascular remodeling in LVH of pediatric heart.
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Sangaralingham SJ, Ritman EL, McKie PM, Ichiki T, Lerman A, Scott CG, Martin FL, Harders GE, Bellavia D, Burnett JC. Cardiac micro-computed tomography imaging of the aging coronary vasculature. Circ Cardiovasc Imaging 2012; 5:518-24. [PMID: 22679058 DOI: 10.1161/circimaging.112.973057] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Alterations at the level of the coronary circulation with aging may play an important role in the evolution of age-associated changes in left ventricular (LV) fibrosis and function. However these age-associated changes in the coronary vasculature remain poorly defined primarily due to the lack of high resolution imaging technologies. The current study was designed to utilize cardiac micro-computed tomography (micro-CT) technology as a novel imaging strategy, to define the 3-dimensional coronary circulation in the young and aged heart and its relationship to LV fibrosis and function. METHODS AND RESULTS Young (2 months old; n=10) and aged (20 months old; n=10) Fischer rats underwent cardiac micro-CT imaging as well as echocardiography, blood pressure, and fibrosis analysis. Importantly, when indexed to LV mass, which increased with age, the total and intramyocardial vessel volumes were lower, whereas the epicardial vessel volume, with and without indexing to LV mass, was significantly higher in the aged hearts compared with the young hearts. Moreover, the aged hearts had a significantly lower percentage of intramyocardial vessel volume and a significantly higher percentage of epicardial vessel volume, when normalized to the total vessel volume, compared with the young hearts. Further, the aged hearts had significant LV fibrosis and mild LV dysfunction compared with the young hearts. CONCLUSIONS This micro-CT imaging study reports the reduction in normalized intramyocardial vessel volume within the aged heart, in association with increased epicardial vessel volume, in the setting of increased LV fibrosis, and mild LV dysfunction.
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Affiliation(s)
- S Jeson Sangaralingham
- Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
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Reversal of experimental renovascular hypertension restores coronary microvascular function and architecture. Am J Hypertens 2011; 24:458-65. [PMID: 21233798 DOI: 10.1038/ajh.2010.259] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Hypertension (HTN) may lead to left ventricular hypertrophy and vascular dysfunction, which are independent factors for adverse cardiovascular outcomes. We hypothesized that decreased blood pressure by percutaneous transluminal renal angioplasty (PTRA) would improve the function and architecture of coronary microvessels, in association with decreased inflammation and fibrosis. METHODS Three groups of pigs were studied: normal, HTN, and HTN+PTRA. After 6 weeks of renovascular HTN, induced by placing a local-irritant coil in the renal artery, pigs underwent PTRA or sham. Four weeks later multidetector-computed tomography (CT) was used to assess systolic, diastolic, and microvascular function, and responses to adenosine. Microvascular architecture, oxygen sensors, inflammation, and fibrosis were then explored in cardiac tissue. RESULTS PTRA successfully decreased blood pressure and left ventricular hypertrophy. Basal fractional vascular volume (FVV) was similar among the groups, but its response to adenosine was significantly attenuated in HTN, whereas microvascular permeability (MP) and response to adenosine were greater than normal. Both were restored by PTRA. These were accompanied by increased myocardial expression of hypoxia-inducible factor (HIF)-1α, inflammation, and microvascular remodeling, including increased density of epicardial microvessels (20-200 µm), as well as cardiac diastolic dysfunction, all of which improved by reversal of HTN. However, PTRA only partially decreased myocardial fibrosis. CONCLUSIONS Reversal of early renovascular HTN improved coronary microvascular function and architecture and reversed myocardial hypertrophy and diastolic dysfunction, in association with decreased levels of myocardial ischemia and inflammation markers, underscoring the benefits of blood pressure normalization for preservation of cardiovascular function and structure.
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Mannheim D, Herrmann J, Bonetti PO, Lavi R, Lerman LO, Lerman A. Simvastatin preserves diastolic function in experimental hypercholesterolemia independently of its lipid lowering effect. Atherosclerosis 2011; 216:283-91. [PMID: 21414623 DOI: 10.1016/j.atherosclerosis.2011.02.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 01/31/2011] [Accepted: 02/17/2011] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Isolated diastolic dysfunction is present in 40% of heart failure patients. It has been attributed to myocardial fibrosis and related to cardiovascular risk factor exposure. We hypothesized that simvastatin will improve these dynamics in experimental hypercholesterolemia (HC). METHODS Three groups of pigs were studied after 12 weeks of normal (N) diet, HC diet, or HC diet with simvastatin (80 mg/day) treatment. Cardiac function was assessed by electron beam computed tomography (EBCT) and percentage of myocardium occupied by microvessels (myocardial vascular fraction) was calculated by micro-CT. Collagen content was determined by Sirius red staining and confirmed by a quantitative, hydroxyoproline-based assay. RESULTS Compared with N, LDL serum concentration was higher in HC and HC+simvastatin (1.0±0.1 vs. 7.9±1.7 and 9.6±1.2 mmol/L, p<0.05 for both). Cardiac early diastolic filling was reduced in HC compared with N (102.4±11.3 vs. 151.1±12.1 mL/s; p<0.05) but restored in HC+simvastatin (176.8±21.3 mL/s, p<0.05 vs. HC). Compared with N, myocardial vascular fraction was higher in HC but not in HC+simvastatin (1.98±0.84 vs. 4.48±0.31 and 2.95±0.95%; p<0.05 for HC vs. N). Myocardial collagen content was higher in HC than in HC+simvastatin and N (4.72±1.03 vs. 1.62±0.12 and 1.21±0.24% area staining; p<0.05 for HC vs. N), which was attributable mainly to an increase in collagen III (2.90±0.48 vs. 1.62±0.12 and 1.21±0.24% area staining; p<0.05 for HC vs. N). CONCLUSIONS Simvastatin is able to prevent diastolic dysfunction in experimental HC independent of its lipid lowering effect. This beneficial effect is, at least partially, due to a decrease in myocardial fibrosis and angiogenesis.
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Affiliation(s)
- Dallit Mannheim
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA
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Kirschbaum SW, Nieman K, Springeling T, Weustink AC, Ramcharitar S, Mieghem CV, Rossi A, Duckers E, Serruys PW, Boersma E, de Feyter PJ, van Geuns RJM. Non-Invasive Diagnostic Workup of Patients With Suspected Stable Angina by Combined Computed Tomography Coronary Angiography and Magnetic Resonance Perfusion Imaging. Circ J 2011; 75:1678-84. [DOI: 10.1253/circj.cj-10-1154] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Sharon W. Kirschbaum
- Department of Cardiology, Erasmus University Medical Center
- Department of Radiology, Erasmus University Medical Center
| | - Koen Nieman
- Department of Cardiology, Erasmus University Medical Center
- Department of Radiology, Erasmus University Medical Center
| | - Tirza Springeling
- Department of Cardiology, Erasmus University Medical Center
- Department of Radiology, Erasmus University Medical Center
| | - Annick C. Weustink
- Department of Cardiology, Erasmus University Medical Center
- Department of Radiology, Erasmus University Medical Center
| | | | | | - Alexia Rossi
- Department of Radiology, Erasmus University Medical Center
| | - Eric Duckers
- Department of Cardiology, Erasmus University Medical Center
| | | | - Eric Boersma
- Department of Cardiology, Erasmus University Medical Center
| | - Pim J. de Feyter
- Department of Cardiology, Erasmus University Medical Center
- Department of Radiology, Erasmus University Medical Center
| | - Robert-Jan M. van Geuns
- Department of Cardiology, Erasmus University Medical Center
- Department of Radiology, Erasmus University Medical Center
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Urbieta Caceres VH, Lin J, Zhu XY, Favreau FD, Gibson ME, Crane JA, Lerman A, Lerman LO. Early experimental hypertension preserves the myocardial microvasculature but aggravates cardiac injury distal to chronic coronary artery obstruction. Am J Physiol Heart Circ Physiol 2010; 300:H693-701. [PMID: 21131477 DOI: 10.1152/ajpheart.00516.2010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Coronary artery disease is a leading cause of death. Hypertension (HT) increases the incidence of cardiac events, but its effect on cardiac adaptation to coexisting coronary artery stenosis (CAS) is unclear. We hypothesized that concurrent HT modulates microvascular function in chronic CAS and aggravates microvascular remodeling and myocardial injury. Four groups of pigs (n=6 each) were studied: normal, CAS, HT, and CAS+HT. CAS and HT were induced by placing local irritant coils in the left circumflex coronary artery and renal artery, respectively. Six weeks later multidetector computerized tomography (CT) was used to assess systolic and diastolic function, microvascular permeability, myocardial perfusion, and responses to adenosine in the "area at risk." Microvascular architecture, inflammation, and fibrosis were then explored in cardiac tissue. Basal myocardial perfusion was similarly decreased in CAS and CAS+HT, but its response to adenosine was significantly more attenuated in CAS. Microvascular permeability in CAS+HT was greater than in CAS and was accompanied by amplified myocardial inflammation, fibrosis, and microvascular remodeling, as well as cardiac systolic and diastolic dysfunction. On the other hand, compared with normal, micro-CT-derived microvascular (20-200 μm) transmural density decreased in CAS but not in HT or CAS+HT. We conclude that the coexistence of early renovascular HT exacerbated myocardial fibrosis and vascular remodeling distal to CAS. These changes were not mediated by loss of myocardial microvessels, which were relatively preserved, but possibly by exacerbated myocardial inflammation and fibrosis. HT modulates cardiac adaptive responses to CAS and bears cardiac functional consequences.
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Iliescu R, Chade AR. Progressive renal vascular proliferation and injury in obese Zucker rats. Microcirculation 2010; 17:250-8. [PMID: 20536738 DOI: 10.1111/j.1549-8719.2010.00020.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Obesity, an independent risk factor for chronic kidney disease, may induce renal injury by promoting inflammation. Inflammatory cytokines can induce neovascularization in different organs, including the kidneys. However, whether obesity triggers renal neovascularization and, if so, its effect on renal function has never been investigated. METHODS Blood pressure, proteinuria, and glomerular filtration rate (GFR) were measured in vivo. Renal microvascular (MV) architecture was studied by 3D micro-CT in lean and obese Zucker rats (LZR and OZR, n = 7/group) at 12, 22, and 32 weeks of age. Renal inflammation was assessed by quantifying interleukin (IL)-6, tumor necrosis factor (TNF)-alpha, and ED-1 expression, as renal fibrosis in trichrome-stained cross-sections. RESULTS Mild inflammation and lower GFR was only observed in younger OZR, without renal fibrosis or changes in MV density. Interestingly, renal MV density increased in OZR at 32 weeks of age, accompanied by pronounced increase in renal IL-6 and TNF-alpha, ED-1+ cells, proteinuria, decreased GFR, and fibrosis. CONCLUSIONS This study shows increased renal cortical vascularization in experimental obesity, suggesting neovascularization as an evolving process as obesity progresses. Increased renal vascularization, possibly triggered by inflammation, may reflect an initially compensatory mechanism in obesity. However, increased inflammation and inflammatory-induced neovascularization may further promote renal injury as obesity advances.
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Affiliation(s)
- Radu Iliescu
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi 39216-4505, USA
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Lin J, Zhu X, Chade AR, Jordan KL, Lavi R, Daghini E, Gibson ME, Guglielmotti A, Lerman A, Lerman LO. Monocyte chemoattractant proteins mediate myocardial microvascular dysfunction in swine renovascular hypertension. Arterioscler Thromb Vasc Biol 2009; 29:1810-6. [PMID: 19628782 DOI: 10.1161/atvbaha.109.190546] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Monocyte chemoattractant proteins (MCPs) play an important role in mediating inflammatory processes. Hypertension (HTN) is associated with inflammation as well as impaired cardiac microcirculatory function and structure, but the contribution of MCPs to these alterations remained unclear. This study tested the hypothesis that MCPs regulate cardiac microvascular function and structure in experimental HTN. METHODS AND RESULTS Pigs (n=6 per group) were studied after 10 weeks of normal, renovascular HTN, or renovascular HTN+ bindarit (MCPs inhibitor, 50 mg/kg/d PO). Left ventricular (LV) function, myocardial microvascular permeability, and fractional vascular volume were assessed by fast computed tomography before and after adenosine infusion (400 microg/kg/min). Myocardial fibrosis, inflammation, and microvascular remodeling were determined ex vivo. Hypertension was not altered by bindarit, but LV hypertrophy and diastolic function were improved. In response to adenosine, myocardial microvascular permeability increased in HTN (from 0.0083+/-0.0009 to 0.0103+/-0.0011 AU, P=0.038 versus baseline) and fractional vascular volume decreased, whereas both remained unchanged in normal and HTN+bindarit pigs. HTN upregulated endothelin-1 expression, myocardial inflammation, and microvascular wall thickening, which were inhibited by bindarit. CONCLUSIONS MCPs partly mediate myocardial inflammation, fibrosis, vascular remodeling, and impaired vascular integrity induced by hypertension. Inhibition of MCPs could potentially be a therapeutic target in hypertensive cardiomyopathy.
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Affiliation(s)
- Jing Lin
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA
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Zhu XY, Daghini E, Chade AR, Versari D, Krier JD, Textor KB, Lerman A, Lerman LO. Myocardial microvascular function during acute coronary artery stenosis: effect of hypertension and hypercholesterolaemia. Cardiovasc Res 2009; 83:371-80. [PMID: 19423617 DOI: 10.1093/cvr/cvp140] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Coronary collateral arteries (CCA) reduce cardiovascular events. We tested the hypothesis that new microvessels that proliferate in early atherosclerosis may be associated with myocardial protection during acute subtotal coronary artery obstruction (CAO). METHODS AND RESULTS Acute left anterior descending CAO was induced by a balloon catheter in pigs after 12 weeks of high-cholesterol (HC) diet, renovascular hypertension (HTN), or normal control. Cardiac structure, myocardial perfusion, and functional response to iv adenosine and CAO were studied in vivo using electron beam computed tomography (CT). The intra-myocardial microvessels were subsequently evaluated ex vivo using micro-CT, and myocardial expression of growth factors using immunoblotting. Basal myocardial perfusion and microvascular permeability were similar among the groups, whereas their responses to adenosine were attenuated in HC and HTN. A significant decline in myocardial perfusion in normal pigs during acute CAO was attenuated in HC and abolished in HTN. CAO also elicited an increase in normal anterior wall microvascular permeability (+202 +/- 59%, P < 0.05), which was attenuated in HC and HTN (+55 +/- 9 and +31 +/- 8%, respectively, P < 0.05 vs. normal). Microvascular (<200 microm) spatial density was significantly elevated in HC and HTN, accompanied by increased myocardial growth factor expression. CONCLUSION This study demonstrates that early exposure to the cardiovascular risk factors HC and HTN protects the heart from decreases in myocardial perfusion during acute subtotal CAO. This protective effect is associated with and potentially mediated by pre-emptive development of intra-myocardial microvessels that might serve as recruitable CCA.
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Affiliation(s)
- Xiang-Yang Zhu
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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MyD88-dependent nuclear factor-κB activation is involved in fibrinogen-induced hypertrophic response of cardiomyocytes. J Hypertens 2009; 27:1084-93. [DOI: 10.1097/hjh.0b013e3283293c93] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Larsen JR, Smerup M, Hasenkam JM, Christensen SD, Sivesgaard K, Torp P, Sloth E. Hypertrophied hearts: what of sevoflurane cardioprotection? Acta Anaesthesiol Scand 2009; 53:496-504. [PMID: 19317865 DOI: 10.1111/j.1399-6576.2008.01889.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Recent studies have demonstrated that inhalation anaesthetics, like sevoflurane, confer cardioprotection both experimentally and clinically. However, coexisting cardiac disease might diminish anaesthetic cardioprotection and could partly explain why the clinical results of cardioprotection with anaesthetics remain controversial--in contrast to solid experimental evidence. Concomitant left ventricular hypertrophy is found in some cardiac surgery patients and could change cardioprotection efficacy. Hypertrophy could potentially render the heart less susceptible to sevoflurane cardioprotection and more susceptible to ischaemic injury. We investigated whether hypertrophy blocks sevoflurane cardioprotection, and whether tolerance to ischaemia is altered by left ventricular hypertrophy, in an established experimental animal model of ischaemia-reperfusion. METHODS Anaesthetized juvenile pigs (n=7-12/group) were subjected to 45 min distal coronary artery balloon occlusion, followed by 120 min of reperfusion. Controls were given pentobarbital, while sevoflurane cardioprotection was achieved by 3.2% inhalation throughout the experiment. Chronic banding of the ascending aorta resulted in left ventricular hypertrophy development in two further groups and these animals underwent identical ischaemia-reperfusion protocols, with or without sevoflurane cardioprotection. Myocardial infarct sizes were compared post-mortem. RESULTS The mean myocardial infarct size (% of area-at-risk) was reduced from mean 55.0 (13.6%) (+/-SD) in controls to 17.5 (13.2%) by sevoflurane (P=0.001). Sevoflurane reduced the infarct size in hypertrophied hearts to 14.6 (10.4%) (P=0.001); however, in hypertrophic controls, infarcts were reduced to 34.2 (10.2%) (P=0.001). CONCLUSION Sevoflurane abrogated ischaemic injury to similar levels in both normal and left ventricular hypertrophied hearts.
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Affiliation(s)
- J R Larsen
- Institute of Experimental Clinical Medicine, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, Aarhus N, Denmark.
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Evaluation of angiogenesis using micro-computed tomography in a xenograft mouse model of lung cancer. Neoplasia 2009; 11:48-56. [PMID: 19107231 DOI: 10.1593/neo.81036] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Revised: 10/05/2008] [Accepted: 10/07/2008] [Indexed: 11/18/2022]
Abstract
Quantitative evaluation of lung tumor angiogenesis using immunohistochemical techniques has been limited by difficulties in generating reproducible data. To analyze intrapulmonary tumor angiogenesis, we used high-resolution micro-computed tomography (micro-CT) of lung tumors of mice inoculated with mouse Lewis lung carcinoma (LLC1) or human adenocarcinoma (A549) cell lines. The lung vasculature was filled with the radiopaque silicone rubber, Microfil, through the jugular vein (in vivo application) or pulmonary artery (ex vivo application). In addition, human adenocarcinoma lung tumor-bearing mice treated site-specifically with humanized monoclonal antibody (bevacizumab) against vascular endothelial growth factor. Quantitative analysis of lung tumor microvessels imaged with micro-CT showed that more vessels (mainly small, <0.02 mm(2)) were filled using the in vivo (5.4%) compared with the ex vivo (2.1%) method. Furthermore, bevacizumab-treated lung tumor-bearing mice showed significantly reduced lung tumor volume and lung tumor angiogenesis compared with untreated mice as assessed by micro-CT. Interestingly, microvascularization of mainly the smaller vessels (<0.02 mm(2)) was reduced after bevacizumab treatment. This observation with micro-CT was nicely correlated with immunohistochemical measurement of microvessels. Therefore, micro-CT is a novel method for investigating lung tumor angiogenesis, and this might be considered as an additional complementary tool for precise quantification of angiogenesis.
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Primak AN, Dong Y, Dzyubak OP, Jorgensen SM, McCollough CH, Ritman EL. A technical solution to avoid partial scan artifacts in cardiac MDCT. Med Phys 2008; 34:4726-37. [PMID: 18196800 DOI: 10.1118/1.2805476] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Quantitative evaluation of cardiac image data obtained using multidetector row computed tomography (CT) is compromised by partial scan reconstructions, which improve the temporal resolution but significantly increase image-to-image CT number variations for a fixed region of interest compared to full reconstruction images. The feasibility of a new approach to solve this problem is assessed. An anthropomorphic cardiac phantom and an anesthetized pig were scanned on a dual-source CT scanner using both full and partial scan acquisition modes under different conditions. Additional scans were conducted with the electrocardiogram (ECG) signal being in synchrony with the gantry rotation. In the animal study, a simple x-ray detector was used to generate a signal once per gantry rotation. This signal was then used to pace the pig's heart. Phantom studies demonstrated that partial scan artifacts are strongly dependent on the rotational symmetry of angular projections, which is determined by the object shape and composition and its position with respect to the isocenter. The degree of partial scan artifacts also depends on the location of the region of interest with respect to highly attenuating materials (bones, iodine, etc.) within the object. Single-source partial scan images (165 ms temporal resolution) were significantly less affected by partial scan artifacts compared to dual-source partial scan images (82 ms temporal resolution). When the ECG signal was in synchrony with the gantry rotation, the same cardiac phase always corresponded to the same positions of the x-ray tube(s) and, hence, the same scattering and beam hardening geometry. As a result, the range of image-to-image CT number variations for partial scan reconstruction images acquired in synchronized mode was decreased to that achieved using full reconstruction image data. The success of the new approach, which synchronizes the ECG signal with the position of the x-ray tube(s), was demonstrated both in the phantom and animal experiments.
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Affiliation(s)
- A N Primak
- CT Clinical Innovation Center, Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
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Abstract
The microcirculation is a complex and integrated system, transporting oxygen and nutrients to the cells. The key component of this system is the endothelium, contributing to the local balance between pro and anti-inflammatory mediators, hemostatic balance, as well as vascular permeability and cell proliferation. A constant shear stress maintains vascular endothelium homeostasis while perturbed shear stress leads to changes in secretion of vasodilator and vasoconstrictor agents. Increased oxidative stress is a major pathogenetic mechanism of endothelial dysfunction by decreasing NO bioavailability, promoting inflammation and participating in activation of intracellular signals cascade, so influencing ion channels activation, signal transduction pathways, cytoskeleton remodelling, intercellular communication and ultimately gene expression. Targeting the microvascular inflammation and oxidative stress is a fascinating approach for novel therapies in order to decrease morbidity and mortality of chronic and acute diseases.
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Affiliation(s)
- E Crimi
- Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
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Daghini E, Zhu XY, Versari D, Bentley MD, Napoli C, Lerman A, Lerman LO. Antioxidant vitamins induce angiogenesis in the normal pig kidney. Am J Physiol Renal Physiol 2007; 293:F371-81. [PMID: 17429028 DOI: 10.1152/ajprenal.00475.2006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The effects of chronic supplementation with antioxidant vitamins on angiogenesis are controversial. The aim of the present study was to evaluate in kidneys of normal pigs the effect of chronic supplementation with vitamins E and C, at doses that are effective in reducing oxidative stress and attenuating angiogenesis under pathological conditions. Domestic pigs were randomized to receive a 12-wk normal diet without ( n = 6) or with antioxidant vitamins supplementation (1g/day vitamin C, 100 IU·kg−1·day−1 vitamin E; n = 6). Electron beam computed tomography (CT) was used to evaluate renal cortical vascular function in vivo, and micro-CT was to assess the spatial density and average diameter of cortical microvessels (diameter <500 μm) ex vivo. Oxidative stress and expressions of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor (HIF)-1α were evaluated in renal tissue. The effects of increasing concentrations of the same vitamins on redox status and angiogenesis were also evaluated in human umbilical vascular endothelial cells (HUVEC). Compared with normal pigs, the density of cortical transmural microvessels was significantly greater in vitamin-supplemented pigs (149.0 ± 11.7 vs. 333.8 ± 48.1 vessel/cm2, P < 0.05), whereas the cortical perfusion response to ACh was impaired. This was accompanied by a significant increase in tissue oxidative stress and levels of VEGF and HIF-1α. A low dose of antioxidant decreased, whereas a high dose increased, HUVEC oxidative stress and angiogenesis, which was partly mediated by hydrogen peroxide. Antioxidant vitamin supplementation can increase tissue oxidative redox and microvascular proliferation in the normal kidney, probably due to a biphasic effect that depends on basal redox balance.
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Affiliation(s)
- Elena Daghini
- Division of Nephrology and Hypertension, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
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Zhu XY, Bentley MD, Chade AR, Ritman EL, Lerman A, Lerman LO. Early changes in coronary artery wall structure detected by microcomputed tomography in experimental hypercholesterolemia. Am J Physiol Heart Circ Physiol 2007; 293:H1997-2003. [PMID: 17573460 DOI: 10.1152/ajpheart.00362.2007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Changes in the structure of the artery wall commence shortly after exposure to cardiovascular risk factors, such as hypercholesterolemia (HC), but may be difficult to detect. The ability to study vascular wall structure could be helpful in evaluation of the factors that instigate atherosclerosis and its pathomechanisms. The present study tested the hypothesis that early morphological changes in coronary arteries of hypercholesterolemic (HC) pigs can be detected using the novel X-ray contrast agent OsO(4) and three-dimensional micro-computed tomography (CT). Two groups of pigs were studied after they were fed a normal or an HC (2% cholesterol) diet for 12 wk. Hearts were harvested, coronary arteries were injected with 1% OsO(4) solution, and cardiac samples (6-mum-thick) were scanned by micro-CT. Layers of the epicardial coronary artery wall, early lesions, and perivascular OsO(4) accumulation were determined. Leakage of OsO(4) from myocardial microvessels was used to assess vascular permeability, which was correlated with immunoreactivity of vascular endothelial growth factor in corresponding histological cross sections. OsO(4) enhanced the visualization of coronary artery wall layers and facilitated detection of early lesions in HC in longitudinal tomographic sections of vascular segments. Increased density of perivascular OsO(4) in HC was correlated with increased vascular endothelial growth factor expression and suggested increased microvascular permeability. The use of OsO(4) as a contrast agent in micro-CT allows three-dimensional visualization of coronary artery wall structure, early lesion formation, and changes in vascular permeability. Therefore, this technique can be a useful tool in atherosclerosis research.
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Affiliation(s)
- Xiang-Yang Zhu
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
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Barmeyer AA, Stork A, Muellerleile K, Tiburtius C, Schofer AK, Heitzer TA, Hofmann T, Adam G, Meinertz T, Lund GK. Contrast-enhanced Cardiac MR Imaging in the Detection of Reduced Coronary Flow Velocity Reserve. Radiology 2007; 243:377-85. [PMID: 17456867 DOI: 10.1148/radiol.2432060331] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively evaluate the accuracy of contrast material-enhanced cardiac magnetic resonance (MR) imaging for determining impaired coronary flow velocity reserve (CFR) by using Doppler flow measurement as the reference standard. MATERIALS AND METHODS The study was approved by the institutional ethics committee, and all patients gave written informed consent. Eligible patients underwent contrast-enhanced cardiac MR imaging and invasive measurement of CFR. For contrast-enhanced MR imaging, a three-section single-shot saturation recovery gradient-recalled echo sequence with steady-state free precession was used. Sections were divided into six segments. For each segment, a transmural and subendocardial myocardial perfusion reserve index (MPRI) was calculated by using the upslope of the signal intensity-time curve during the first pass of contrast material at rest and during adenosine infusion (140 microg per kilogram body weight per minute). MPRIs of vascular regions were compared with the corresponding CFR. Receiver operating characteristic (ROC) analysis was performed to find the number of segments needed for best diagnostic accuracy of MPRI and to find a cutoff value for MPRI in the detection of a reduced CFR. RESULTS Thirty-five patients were evaluated (male-to-female ratio, 27:8; mean age +/- standard deviation, 63.5 years +/- 8.2; mean body mass index, 28.8 kg/m(2) +/- 3.8), and 43 vascular regions were analyzed. A linear correlation was found between the MPRI and CFR (r = 0.44, P < .05). The MPRI was significantly lower in vascular regions with a CFR of less than 2.00 than in regions with a CFR of 2.00 or greater (P < .05). Detection of a CFR of less than 2.00 was more accurate with subendocardial MPRI measurements than with transmural measurements. The mean subendocardial MPRI of the segments with the three lowest MPRIs of a vascular region showed the best diagnostic performance in the detection of a CFR of less than 2.00 (area under the ROC curve, 0.85; sensitivity, 84%; specificity, 75%) by using a cutoff value of 1.21. CONCLUSION The diagnostic accuracy of subendocardial perfusion analysis in contrast-enhanced cardiac MR imaging is higher than that of transmural analysis.
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Affiliation(s)
- Achim A Barmeyer
- Clinic of Cardiology/Angiology, Heart Center, University Hospital Hamburg-Eppendorf, Martini-strasse 52, 20246 Hamburg, Germany.
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Zhu XY, Daghini E, Chade AR, Napoli C, Ritman EL, Lerman A, Lerman LO. Simvastatin prevents coronary microvascular remodeling in renovascular hypertensive pigs. J Am Soc Nephrol 2007; 18:1209-17. [PMID: 17344424 DOI: 10.1681/asn.2006090976] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Patients with hypertension and chronic kidney disease are at risk for cardiovascular diseases, possibly related to inflammation. Statins have beneficial anti-inflammatory effects on vascular structure regardless of cholesterol reduction. It was hypothesized that alterations in myocardial microvascular structure in swine renovascular hypertension (RVH) would be improved by simvastatin treatment. Three groups of pigs were studied after 12 wk: normal (n = 7), RVH (n = 7), or RVH+simvastatin (RVH+S; 80 mg/d; n = 6). Left ventricular muscle mass and myocardial perfusion were determined in vivo using electron beam computed tomography, and myocardial samples then were scanned ex vivo using micro-computed tomography for measurement of the spatial density of myocardial microvessels (80 to 500 microm) in situ. Capillary density and myocardial expression of inflammatory and growth factors were determined in myocardial tissue. The effects of simvastatin on inflammation-induced tube formation were evaluated in vitro in human umbilical vein endothelial cells that were exposed to TNF-alpha. RVH and RVH+S had similarly increased arterial pressure and serum creatinine. However, left ventricular hypertrophy was prevented by simvastatin, and myocardial perfusion was increased. Compared with normal, RVH showed increased spatial density of microvessels (169.6 +/- 21 versus 107.7 +/- 15.2 vessels/cm(2); P < 0.05), which was decreased in RVH+S (72.5 +/- 14.9 vessels/cm(2)), whereas capillary density remained similar to normal. RVH also increased myocardial expression of inflammatory and growth factors, which were reversed by simvastatin. Furthermore, simvastatin attenuated TNF-alpha-induced angiogenesis in vitro. Simvastatin prevents myocardial microvascular remodeling and hypertrophy in experimental RVH independent of lipid lowering. This protective effect is partly mediated by blunted expression as well as angiogenic activity of inflammatory cytokines.
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Affiliation(s)
- Xiang-Yang Zhu
- Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA
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Mannheim D, Versari D, Daghini E, Gössl M, Galili O, Chade A, Rajkumar VS, Ritman EL, Lerman LO, Lerman A. Impaired myocardial perfusion reserve in experimental hypercholesterolemia is independent of myocardial neovascularization. Am J Physiol Heart Circ Physiol 2007; 292:H2449-58. [PMID: 17208989 DOI: 10.1152/ajpheart.01215.2006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Our objective was to investigate the functional role of hypercholesterolemia-associated myocardial neovascularization in early atherosclerosis using the antiangiogenic thalidomide. Experimental atherosclerosis is characterized by myocardial neovascularization, associated with a decrease in myocardial perfusion response to challenge, coronary endothelial dysfunction, and high oxidative stress. However, the functional significance of these neovessels is not known. Three groups of pigs (n = 6 each) were studied after 12 wk of normal or hypercholesterolemic diet without (HC) or with thalidomide (HC + Thal). Myocardial perfusion and permeability were assessed at baseline and in response to cardiac challenge, using electron beam computed tomography, and coronary endothelial function was assessed using organ chambers. Myocardial samples were scanned ex vivo with a three-dimensional microscopic computed tomography scanner, and the spatial density of the myocardial microvessels was quantified. Growth factors and oxidative stress were measured in the myocardial tissue. As a results of these procedures, myocardial perfusion response to adenosine and dobutamine was blunted in both HC and HC + Thal pigs compared with normal pigs (P < 0.05, HC and HC + Thal vs. normal) as was the coronary endothelial function. Myocardial permeability response to adenosine was increased in both HC and HC + Thal pigs compared with normal pigs (P < 0.05, HC and HC + Thal vs. normal, and HC + Thal vs. HC). The microvascular density was increased in HC pigs compared with normal pigs but normalized in HC + Thal pigs (P < 0.001 HC vs. normal and HC + Thal). HC + Thal pigs showed decreased expression of Flk-1 and basic FGF but increased expression of VEGF compared with normal and HC pigs. Oxidative stress was increased in both HC and HC + Thal pigs compared with normal pigs. In conclusion, chronic administration of thalidomide attenuates myocardial neovascularization in experimental HC pigs without affecting myocardial perfusion response to stimulation. This suggests that the myocardial neovascularization may not contribute to the attenuated myocardial perfusion response in hypercholesterolemia.
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Affiliation(s)
- Dallit Mannheim
- Division of Cardiovascular Diseases, Mayo Clinic Rochester, 200 First Street SW, Rochester, MN 55905, USA
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