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Dong G. Development and Challenges of Pre-Heart Failure with Preserved Ejection Fraction. Rev Cardiovasc Med 2023; 24:274. [PMID: 39076392 PMCID: PMC11270127 DOI: 10.31083/j.rcm2409274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2024] Open
Abstract
Pre-heart failure with preserved ejection fraction (Pre-HFpEF) is a critical link to the development of heart failure with preserved ejection fraction (HFpEF). Early recognition and early intervention of pre-HFpEF will halt the progression of HFpEF. This article addresses the concept proposal, development, and evolution of pre-HFpEF, the mechanisms and risks of pre-HFpEF, the screening methods to recognize pre-HFpEF, and the treatment of pre-HFpEF. Despite the challenges, we believe more focus on the topic will resolve more problems.
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Affiliation(s)
- Guoju Dong
- Department of Cardiovascular Internal Medicine, Xiyuan Hospital, Chinese
Academy of Traditional Chinese Medicine, 100091 Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan
Hospital, Chinese Academy of Traditional Chinese Medicine, 100091 Beijing, China
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The relevance of left ventricular functions to clinical and metabolic characteristics of prepubertal children with obesity. Cardiol Young 2022; 32:1246-1253. [PMID: 34585656 DOI: 10.1017/s1047951121003991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Paediatric obesity is a worldwide health burden, with growing evidence linking obesity to myocardial function impairments. The study aims to evaluate left ventricular functions among prepubertal obese children to obesity-related clinical and metabolic parameters. METHODS Between June 2019 and March 2020, 40 prepubertal children with obesity were recruited and compared to 40 healthy controls. Patients were assessed for body mass index z scores, waist circumference, body adiposity by bioimpedance analysis, and obesity-related laboratory tests, for example, serum chemerin. Left ventricular functions were assessed using variable echocardiographic modalities, such as M-mode, tissue Doppler, and two-dimensional speckle tracking. RESULTS Mean patients' age was 9.25 ± 1.05 years. Left ventricular mass index, E/E', and myocardial performance index were significantly increased in obese children than controls. Although M-mode-derived ejection fraction was comparable in both groups, two-dimensional speckle tracking-derived ejection fraction, global longitudinal strain, and global circumferential strain were significantly lower in cases than controls. Left ventricular mass index displayed a positive correlation with body mass index z score (p = 0.003), fat mass index (p = 0.037), and trunk fat mass (p = 0.021). Global longitudinal strain was negatively correlated with body mass index z score (p = 0.015) and fat mass index (p = 0.016). Serum chemerin was positively correlated with myocardial performance index (p = 0.01). CONCLUSION Alterations of left ventricular myocardial functions in prepubertal obese children could be detected using different echocardiographic modalities. Chemerin, body mass index z score, fat mass index, and trunk fat mass were correlated with subclinical left ventricular myocardial dysfunction parameters before puberty. Our results reinforce early and strict management of childhood obesity upon detection of changes in anthropometric and body adiposity indices.
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Sowithayasakul P, Buschmann LK, Boekhoff S, Müller HL. Cardiac remodeling in patients with childhood-onset craniopharyngioma-results of HIT-Endo and KRANIOPHARYNGEOM 2000/2007. Eur J Pediatr 2021; 180:1593-1602. [PMID: 33459867 PMCID: PMC8032608 DOI: 10.1007/s00431-020-03915-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 12/14/2020] [Accepted: 12/21/2020] [Indexed: 12/21/2022]
Abstract
Hypothalamic obesity caused by childhood-onset craniopharyngioma results in long-term cardiovascular morbidity. Knowledge about clinical markers and risk factors for cardiovascular morbidity is scarce. A cross-sectional study on transthoracic echocardiographic parameters was performed to determine the associations with clinical and anthropometric parameters in 36 craniopharyngioma patients. BMI correlated with the thickness of interventricular septum in diastole (IVSd) (r = 0.604, p < 0.001) and left ventricular posterior wall thickness in diastole (LVPWd) (r = 0.460, p = 0.011). In multivariate analyses on risk factors for cardiac remodeling, sex hormone replacement therapy, BMI, and male gender were positively correlated with increased left ventricular internal diameter in diastole (LVIDd), R2 = 0.596, F = 10.323, p < 0.001. BMI and insulin resistance were selected as significant independent determinants of IVSd, produced R2 = 0.655, F = 29.441, p < 0.001. Due to a wide range of disease duration, 17 pediatric and 19 adult patients were analyzed separately. In the adult subgroup (age at study ≥ 18 years), BMI correlated with IVSd (r = 0.707, p = 0.003), LVPWd (r = 0.592, p = 0.020), and LVIDd (r = 0.571, p = 0.026). In the pediatric subgroup (age at study < 18 years), no correlation between transthoracic echocardiography (TTE) parameters and BMI was observed. Only LVIDd correlated with disease duration (r = 0.645, p < 0.001). All cardiac functions were within the normal range, indicating no association with functional impairments.Conclusion: Cardiac remodeling in patients with craniopharyngioma correlated with the degree of hypothalamic obesity, disease duration, sex hormone replacement therapy, male gender, and insulin resistance. As echocardiography has limited sensitivity in patients with obesity, further research on more sensitive techniques for cardiac diagnostics in craniopharyngioma patients is warranted. What is Known: •Long-term prognosis in survivors of craniopharyngioma is impaired by obesity and cardiovascular disease. •Associations between echocardiographic findings and clinical and anthropometric parameters after craniopharyngioma are not yet analyzed. What is New: •In patients with childhood-onset craniopharyngioma, cardiac remodeling was associated with hypothalamic obesity, duration of disease, male gender sex hormone replacement, and insulin resistance. •Due to reduced echocardiographic sensitivity caused by obesity-related technical limitations, more sensitive cardiac diagnostics should be considered.
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Affiliation(s)
- Panjarat Sowithayasakul
- Department of Pediatrics and Pediatric Hematology/Oncology, University Children’s Hospital, Carl von Ossietzky University Oldenburg, Klinikum Oldenburg AöR, 26133 Oldenburg, Germany ,Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, Bangkok, 26120 Thailand
| | - Leona Katharin Buschmann
- Department of Pediatrics and Pediatric Hematology/Oncology, University Children’s Hospital, Carl von Ossietzky University Oldenburg, Klinikum Oldenburg AöR, 26133 Oldenburg, Germany
| | - Svenja Boekhoff
- Department of Pediatrics and Pediatric Hematology/Oncology, University Children’s Hospital, Carl von Ossietzky University Oldenburg, Klinikum Oldenburg AöR, 26133 Oldenburg, Germany
| | - Hermann L. Müller
- Department of Pediatrics and Pediatric Hematology/Oncology, University Children’s Hospital, Carl von Ossietzky University Oldenburg, Klinikum Oldenburg AöR, 26133 Oldenburg, Germany
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Ponce S, Allison MA, Swett K, Cai J, Desai AA, Hurwitz BE, Ni A, Schneiderman N, Shah SJ, Spevack DM, Talavera GA, Rodriguez CJ. The associations between anthropometric measurements and left ventricular structure and function: the Echo-SOL Study. Obes Sci Pract 2018; 4:387-395. [PMID: 30151233 PMCID: PMC6105700 DOI: 10.1002/osp4.279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 04/13/2018] [Accepted: 04/26/2018] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The objective of this study is to determine associations between anthropometry and echocardiographic measures of cardiac structure and function in Hispanic/Latinos. METHODS A total of 1,824 participants from ECHO-SOL were included. We evaluated associations between echocardiographic measures of left ventricular structure and function and anthropometric measures using multivariable-adjusted linear and logistic regression models adjusting for traditional cardiovascular risk factors. RESULTS The mean age was 56 ± 0.17 years, 57% were women. The mean body mass index (BMI) was 30 ± 9.4 kg m-2, waist circumference (WC) was 100 ± 18 cm, and waist-to-hip ratio (WHR) was 0.93 ± 0.15. Adjusted analysis showed that 5-unit increment in BMI and 5-cm increase in WC was associated with 3.4 ± 0.6 and 1.05 ± 0.05 g m-2.7 (p < 0.05 for both) higher left ventricular (LV) mass index, respectively. Similarly, 0.1-unit increment in WHR was associated with 2.0 ± 0.16 g m-2.7 higher LV mass index (p < 0.01). WHR was associated with 0.22 ± 0.08% decrease in ejection fraction (p < 0.05). Concomitantly, 5-unit increment in BMI and WC was associated with increased odds of abnormal LV geometry (odds ratio 1.40 and 1.16, p = 0.03 and <0.01, respectively); 0.1-unit increment in WHR was associated with increased odds of abnormal LV geometry (odds ratio 1.51, p < 0.01). CONCLUSIONS Among Hispanic/Latinos, higher anthropometric measures were associated with adverse cardiac structure and function.
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Affiliation(s)
- S. Ponce
- Family Medicine and Public Health DepartmentUniversity of California San DiegoLa JollaCAUSA
| | - M. A. Allison
- Family Medicine and Public Health DepartmentUniversity of California San DiegoLa JollaCAUSA
| | - K. Swett
- Biostatistics DepartmentUniversity of North CarolinaChapel HillNCUSA
| | - J. Cai
- Biostatistics DepartmentUniversity of North CarolinaChapel HillNCUSA
| | - A. A. Desai
- Department of MedicineUniversity of ArizonaTucsonAZUSA
| | - B. E. Hurwitz
- Department of PsychologyUniversity of MiamiCoral GablesFLUSA
| | - A. Ni
- Biostatistics DepartmentUniversity of North CarolinaChapel HillNCUSA
| | - N. Schneiderman
- Department of PsychologyUniversity of MiamiCoral GablesFLUSA
| | - S. J. Shah
- Department of MedicineNorthwestern UniversityEvanstonILUSA
| | - D. M. Spevack
- Department of MedicineAlbert Einstein College of MedicineBronxNYUSA
| | - G. A. Talavera
- Graduate School of Public HealthSan Diego State UniversitySan DiegoCAUSA
| | - C. J. Rodriguez
- Epidemiology and PreventionWake Forest UniversityWinston‐SalemNCUSA
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Bruce EB, Sakarya Y, Kirichenko N, Toklu HZ, Sumners C, Morgan D, Tümer N, Scarpace PJ, Carter CS. ACE2 activator diminazene aceturate reduces adiposity but preserves lean mass in young and old rats. Exp Gerontol 2018; 111:133-140. [PMID: 30006298 DOI: 10.1016/j.exger.2018.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/11/2018] [Accepted: 07/10/2018] [Indexed: 12/17/2022]
Abstract
The obesity epidemic is multi-generational and is particularly debilitating in the aging population, necessitating the use of pharmaceutical interventions. Recent evidence suggests that increasing the activity of the angiotensin converting enzyme-2 [ACE2]/angiotensin-(1-7)[Ang-(1-7)]/Mas receptor (MasR) axis in obese animal models leads to significant reductions in body weight. It was hypothesized that activation of ACE2 via diminazene aceturate (DIZE) will significantly reduce body weight of rats fed a high fat diet. Young and old (4 and 23 months, respectively) male Fisher 344 × Brown Norway rats were fed 60% high fat diet for one week, and subsequently given either 15 mg/kg/day DIZE s.c. or vehicle for three weeks. DIZE treatment resulted in a significant reduction of food intake and body weight in both young and old animals. However, that decrease was so dramatic in the older animals that they all nearly stopped eating. Interestingly, the TD-NMR assessments revealed that the weight-loss was primarily a result of decreased body fat percentage, with a relative preservation of lean mass. Tissue weights confirm the significant loss of white adipose tissue (WAT), with no change in muscle weights. Gene expression and serum ACE2 activity analyses implied that increased activation of the ACE2/Ang-(1-7)/MasR axis plays a role in reducing fat mass. Collectively, our results suggest that DIZE may be a useful tool in the study of obesity; however, caution is recommended when using this compound in older animals due to severe anorectic effects, although there is a mechanism by which muscle is preserved.
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Affiliation(s)
- Erin B Bruce
- Department of Pharmacology and Therapeutics, University of Florida, Gainesville, FL, United States of America
| | - Yasemin Sakarya
- Department of Pharmacology and Therapeutics, University of Florida, Gainesville, FL, United States of America
| | - Nataliya Kirichenko
- Department of Pharmacology and Therapeutics, University of Florida, Gainesville, FL, United States of America
| | - Hale Z Toklu
- Department of Pharmacology and Therapeutics, University of Florida, Gainesville, FL, United States of America
| | - Colin Sumners
- Department of Physiology and Functional Genomics, University of Florida, Gainesville, FL, United States of America
| | - Drake Morgan
- Department of Psychiatry, University of Florida, Gainesville, FL, United States of America
| | - Nihal Tümer
- Department of Pharmacology and Therapeutics, University of Florida, Gainesville, FL, United States of America
| | - Philip J Scarpace
- Department of Pharmacology and Therapeutics, University of Florida, Gainesville, FL, United States of America
| | - Christy S Carter
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States of America.
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Fernandes T, Casaes L, Soci Ú, Silveira A, Gomes J, Barretti D, Roque F, Oliveira E. Exercise Training Restores the Cardiac Microrna-16 Levels Preventing Microvascular Rarefaction in Obese Zucker Rats. Obes Facts 2018; 11:15-24. [PMID: 29402872 PMCID: PMC5869535 DOI: 10.1159/000454835] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 11/23/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To evaluate the effects of aerobic exercise training (AET) on cardiac miRNA-16 levels and its target gene VEGF related to microvascular rarefaction in obese Zucker rats (OZR). METHODS OZR (n = 11) and lean (L; n = 10) male rats were assigned into 4 groups: OZR, trained OZR (OZRT), L and trained L (LT). Swimming exercise training lasted 60 min, 1×/day/10 weeks, with 4% body weight workload. Cardiac angiogenesis was assessed by histological analysis (periodic acid-Schiff) by calculating the capillary/fiber ratio. The protein expressions of VEGF, VEGFR2, and CD31 were evaluated by western blot. The expression of miRNA-16 was evaluated by real-time PCR. RESULTS Heart rate decreased in the trained groups compared to sedentary groups. The cardiac capillary/fiber ratio was reduced in OZR compared to L, LT and OZRT groups, indicating that aerobic exercise training (AET) was capable of reversing the microvascular rarefaction in the obese animals. miRNA-16 expression was increased in OZR compared to L, LT and OZRT. In contrast, its target, VEGF protein expression was 24% lower in OZR compared to L group, which has been normalized in OZRT group. VEGFR2 protein expression was increased in trained groups compared to their controls. CD31, a endothelial cells marker, showed increased expression in OZRT compared to OZR, indicating greater vascularization in OZRT group. CONCLUSION AET induced cardiac angiogenesis in obese animals. This revascularization is associated with a decrease in miRNA-16 expression permissive for increased VEGF protein expression, suggesting a mechanism for potential therapeutic application in vascular diseases.
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Affiliation(s)
| | | | | | | | | | | | | | - Edilamar Oliveira
- *Edilamar Menezes Oliveira, PhD, Laboratory of Biochemistry and Molecular Biology of the Exercise, School of Physical Education and Sport - University of Sao Paulo, Av Prof. Mello Moraes, 65, Butanta, SP 05508-900 Sao Paulo, Brazil,
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Liao PH, Kuo WW, Kuo CH, Yeh YL, Shen CY, Chen YH, Chen RJ, Padma VV, Chen YH, Huang CY. Lactobacillus reuteri GMNL-263 reduces hyperlipidaemia and the heart failure process in high-calorie diet-fed induced heart dysfunction in rats. J Funct Foods 2016. [DOI: 10.1016/j.jff.2015.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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