1
|
Bernatova I, Bartekova M. Molecular Aspects of Cardiometabolic Diseases: From Etiopathogenesis to Potential Therapeutic Targets. Int J Mol Sci 2024; 25:5841. [PMID: 38892029 PMCID: PMC11172306 DOI: 10.3390/ijms25115841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Cardiometabolic diseases (CMDs) encompass a range of prevalent, often preventable, non-communicable illnesses, including myocardial infarction, stroke, cardiac insufficiency, arterial hypertension, obesity, type 2 diabetes mellitus, insulin resistance, chronic renal dysfunction, non-alcoholic fatty liver disease, and rare metabolic disorders [...].
Collapse
Affiliation(s)
- Iveta Bernatova
- Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Sienkiewiczova 1, 81371 Bratislava, Slovakia
| | - Monika Bartekova
- Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, 9 Dubravska cesta, 84104 Bratislava, Slovakia
| |
Collapse
|
2
|
Tsigkou V, Oikonomou E, Anastasiou A, Lampsas S, Zakynthinos GE, Kalogeras K, Katsioupa M, Kapsali M, Kourampi I, Pesiridis T, Marinos G, Vavuranakis MA, Tousoulis D, Vavuranakis M, Siasos G. Molecular Mechanisms and Therapeutic Implications of Endothelial Dysfunction in Patients with Heart Failure. Int J Mol Sci 2023; 24:ijms24054321. [PMID: 36901752 PMCID: PMC10001590 DOI: 10.3390/ijms24054321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023] Open
Abstract
Heart failure is a complex medical syndrome that is attributed to a number of risk factors; nevertheless, its clinical presentation is quite similar among the different etiologies. Heart failure displays a rapidly increasing prevalence due to the aging of the population and the success of medical treatment and devices. The pathophysiology of heart failure comprises several mechanisms, such as activation of neurohormonal systems, oxidative stress, dysfunctional calcium handling, impaired energy utilization, mitochondrial dysfunction, and inflammation, which are also implicated in the development of endothelial dysfunction. Heart failure with reduced ejection fraction is usually the result of myocardial loss, which progressively ends in myocardial remodeling. On the other hand, heart failure with preserved ejection fraction is common in patients with comorbidities such as diabetes mellitus, obesity, and hypertension, which trigger the creation of a micro-environment of chronic, ongoing inflammation. Interestingly, endothelial dysfunction of both peripheral vessels and coronary epicardial vessels and microcirculation is a common characteristic of both categories of heart failure and has been associated with worse cardiovascular outcomes. Indeed, exercise training and several heart failure drug categories display favorable effects against endothelial dysfunction apart from their established direct myocardial benefit.
Collapse
Affiliation(s)
- Vasiliki Tsigkou
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
- Correspondence: ; Tel.: +30-69-4770-1299
| | - Artemis Anastasiou
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Stamatios Lampsas
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - George E. Zakynthinos
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Konstantinos Kalogeras
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Maria Katsioupa
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Maria Kapsali
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Islam Kourampi
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Theodoros Pesiridis
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Georgios Marinos
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Michael-Andrew Vavuranakis
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Dimitris Tousoulis
- 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration General Hospital, 11527 Athens, Greece
| | - Manolis Vavuranakis
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Sotiria Chest Disease Hospital, 11527 Athens, Greece
- Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| |
Collapse
|
3
|
Prognostic value of reactive hyperemia index using peripheral artery tonometry in patients with heart failure. Sci Rep 2023; 13:125. [PMID: 36599885 PMCID: PMC9812967 DOI: 10.1038/s41598-023-27454-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023] Open
Abstract
Given the high prevalence and poor prognosis of heart failure (HF), finding prognostic factors for patients with HF is crucial. This study investigated the prognostic value of reactive hyperemia index (RHI), a measure of endothelial function, in HF. A total of 90 HF patients (mean age, 63.7 ± 13.2 years; female, 25.6%) with a history of hospitalization for HF treatment were prospectively enrolled. RHI was measured using digital arterial tonometry in a stable condition. Clinical events, including all-cause death and HF admission, were assessed. During the median follow-up of 3.66 years (interquartile range, 0.91-4.94 years), 26 clinical events (28.9%) occurred. Although there were no significant differences in risk factors and laboratory findings according to the occurrence of clinical events, the RHI value was significantly lower in patients with clinical events than in those without (1.21 ± 0.34 vs. 1.68 ± 0.48; P < 0.001). Kaplan-Meier survival analysis showed that a lower RHI value (< 1.48) was associated with a significantly higher incidence rate of clinical events (log-rank P < 0.001). In multivariable cox regression analysis, a low RHI value (< 1.48) was associated with an increased risk of clinical events (hazard ratio, 14.09; 95% confidence interval, 3.61-54.99; P < 0.001) even after controlling for potential confounders. Our study showed that reduced RHI was associated with an increased risk of adverse clinical outcomes in HF. This suggests that endothelial dysfunction may be an important prognostic marker in patients with HF.
Collapse
|
4
|
Dardi P, dos Reis Costa D, Assunção H, Rossoni L. Venous endothelial function in cardiovascular disease. Biosci Rep 2022; 42:BSR20220285. [PMID: 36281946 PMCID: PMC9685499 DOI: 10.1042/bsr20220285] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 09/29/2023] Open
Abstract
The essential role of the endothelium in vascular homeostasis is associated with the release of endothelium-dependent relaxing and contractile factors (EDRF and EDCF, respectively). Different from arteries, where these factors are widely studied, the vasoactive factors derived from the venous endothelium have been given less attention. There is evidence for a role of the nitric oxide (NO), endothelium-dependent hyperpolarization (EDH) mechanism, and cyclooxygenase (COX)-derived metabolites as EDRFs; while the EDCFs need to be better evaluated since no consensus has been reached about their identity in venous vessels. The imbalance between the synthesis, bioavailability, and/or action of EDRFs and/or EDCFs results in a pathological process known as endothelial dysfunction, which leads to reduced vasodilation and/or increased vasoconstriction. In the venous system, endothelial dysfunction is relevant since reduced venodilation may increase venous tone and decrease venous compliance, thus enhancing mean circulatory filling pressure, which maintains or modify cardiac workload contributing to the etiology of cardiovascular diseases. Interestingly, some alterations in venous function appear at the early stages (or even before) the establishment of these diseases. However, if the venous endothelium dysfunction is involved in these alterations is not yet fully understood and requires further studies. In this sense, the present study aims to review the current knowledge on venous endothelial function and dysfunction, and the general state of the venous tone in two important cardiovascular diseases of high incidence and morbimortality worldwide: hypertension and heart failure.
Collapse
Affiliation(s)
- Patrizia Dardi
- Laboratory of Vascular Physiology, Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, Brazil
| | | | - Henrique Charlanti Reis Assunção
- Laboratory of Vascular Physiology, Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, Brazil
| | - Luciana Venturini Rossoni
- Laboratory of Vascular Physiology, Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, Brazil
| |
Collapse
|
5
|
Rammos C, Manzke A, Lortz J, Messiha D, Petrikhovich O, Jánosi RA, Steinmetz M, Rassaf T. Mechanical atherothrombectomy improves endothelial function through plaque burden reduction in PAD. VASA 2022; 51:377-385. [DOI: 10.1024/0301-1526/a001034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Summary: Background: Endothelial dysfunction defines outcomes and serves as a surrogate parameter for the progression of cardiovascular disease. For symptomatic peripheral artery disease (PAD) endovascular treatment is the primary revascularization strategy, which affects endothelial function. Interventional mechanical atherothrombectomy (MATH) provides advantages when treating complex atherosclerotic and thrombotic lesions. We now aimed to determine the impact and mechanisms of MATH on endothelial function. Patients and methods: Endothelial function was determined using flow-mediated dilation (FMD) before and after lower limb intervention with a six-month follow-up in the target and control vessel in 15 PAD MATH+DCB treated patients and compared to 15 non-Math controls. In a further cohort of 20 patients the impact of MATH and DCB on vascular structure and virtual histology was assessed through intravascular ultrasound (IVUS) and compared to DCB treatment alone. Results: Improved endothelial function after 6 months was observed in both groups for the target and nontarget vessel. When comparing the changes from baseline endothelial function, treatment with MATH+DCB was superior to DCB treatment in the target vessel. IVUS revealed a greater improvement in luminal area and plaque burden reduction after MATH treatment. Virtual histology disclosed MATH-associated changes in plaque composition evidenced by alterations in fibrous volume and reductions in superficial calcium. Conclusions: We demonstrate an improved endothelial function after MATH treatment as compared to DCB treatment. The improved vessel function is evidenced by MATH-related plaque burden reduction, improved luminal gain and a decrease in superficial calcification. Clinicaltrials.gov: NCT04092972.
Collapse
Affiliation(s)
- Christos Rammos
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Anna Manzke
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Daniel Messiha
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Olga Petrikhovich
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Rolf Alexander Jánosi
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
6
|
Maroofi A, Moro T, Agrimi J, Safari F. Cognitive decline in heart failure: Biomolecular mechanisms and benefits of exercise. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166511. [PMID: 35932891 DOI: 10.1016/j.bbadis.2022.166511] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 11/24/2022]
Abstract
By definition, heart failure (HF) is a human pathological condition affecting the structure and function of all organs in the body, and the brain is not an exception to that. Failure of the heart to pump enough blood centrally and peripherally is at the foundation of HF patients' inability to attend even the most ordinary daily activities and progressive deterioration of their cognitive capacity. What is more, between heart and brain exists a bidirectional relationship that goes well beyond hemodynamics and concerns bioelectric and endocrine signaling. This increasingly consolidated evidence makes the scenario even more complex. Studies have mainly chased how HF impairs cognition without focusing much on preventive measures, notably cardio-cerebral health proxies. Here, we aim to provide a brief account of known and hypothetical factors that may explain how exercise can help obviate cognitive dysfunction associated with HF in its different forms. As we shall see, there is a stringent need for a deeper grasp of such mechanisms. Indeed, gaining this new knowledge will automatically shed new light on the inner workings of HF itself, thus resulting in more effective prevention and treatment of this escalating syndrome.
Collapse
Affiliation(s)
- Abdulbaset Maroofi
- Department of Exercise Physiology, Faculty of Physical Education & Sport Sciences, University of Guilan, Rasht, Iran
| | - Tatiana Moro
- Department of Biomedical Sciences, University of Padua, 35131 Padua, Italy
| | - Jacopo Agrimi
- Department of Biomedical Sciences, University of Padua, 35131 Padua, Italy.
| | - Fatemeh Safari
- Department of Physiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| |
Collapse
|
7
|
Saenz-Medina J, Muñoz M, Rodriguez C, Sanchez A, Contreras C, Carballido-Rodríguez J, Prieto D. Endothelial Dysfunction: An Intermediate Clinical Feature between Urolithiasis and Cardiovascular Diseases. Int J Mol Sci 2022; 23:ijms23020912. [PMID: 35055099 PMCID: PMC8778796 DOI: 10.3390/ijms23020912] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 02/08/2023] Open
Abstract
UNLABELLED An epidemiological relationship between urolithiasis and cardiovascular diseases has extensively been reported. Endothelial dysfunction is an early pathogenic event in cardiovascular diseases and has been associated with oxidative stress and low chronic inflammation in hypertension, coronary heart disease, stroke or the vascular complications of diabetes and obesity. The aim of this study is to summarize the current knowledge about the pathogenic mechanisms of urolithiasis in relation to the development of endothelial dysfunction and cardiovascular morbidities. METHODS A non-systematic review has been performed mixing the terms "urolithiasis", "kidney stone" or "nephrolithiasis" with "cardiovascular disease", "myocardial infarction", "stroke", or "endothelial dysfunction". RESULTS Patients with nephrolithiasis develop a higher incidence of cardiovascular disease with a relative risk estimated between 1.20 and 1.24 and also develop a higher vascular disease risk scores. Analyses of subgroups have rendered inconclusive results regarding gender or age. Endothelial dysfunction has also been strongly associated with urolithiasis in clinical studies, although no systemic serum markers of endothelial dysfunction, inflammation or oxidative stress could be clearly related. Analysis of urine composition of lithiasic patients also detected a higher expression of proteins related to cardiovascular disease. Experimental models of hyperoxaluria have also found elevation of serum endothelial dysfunction markers. CONCLUSIONS Endothelial dysfunction has been strongly associated with urolithiasis and based on the experimental evidence, should be considered as an intermediate and changeable feature between urolithiasis and cardiovascular diseases. Oxidative stress, a key pathogenic factor in the development of endothelial dysfunction has been also pointed out as an important factor of lithogenesis. Special attention must be paid to cardiovascular morbidities associated with urolithiasis in order to take advantage of pleiotropic effects of statins, angiotensin receptor blockers and allopurinol.
Collapse
Affiliation(s)
- Javier Saenz-Medina
- Department of Urology, Puerta de Hierro-Majadahonda University Hospital, 28222 Majadahonda, Spain
- Department of Medical Specialities and Public Health, Faculty of Health Sciences, King Juan Carlos University, 28933 Móstoles, Spain
- Correspondence:
| | - Mercedes Muñoz
- Department of Physiology, Pharmacy Faculty, Complutense University, 28040 Madrid, Spain; (M.M.); (C.R.); (A.S.); (C.C.); (D.P.)
| | - Claudia Rodriguez
- Department of Physiology, Pharmacy Faculty, Complutense University, 28040 Madrid, Spain; (M.M.); (C.R.); (A.S.); (C.C.); (D.P.)
| | - Ana Sanchez
- Department of Physiology, Pharmacy Faculty, Complutense University, 28040 Madrid, Spain; (M.M.); (C.R.); (A.S.); (C.C.); (D.P.)
| | - Cristina Contreras
- Department of Physiology, Pharmacy Faculty, Complutense University, 28040 Madrid, Spain; (M.M.); (C.R.); (A.S.); (C.C.); (D.P.)
| | - Joaquín Carballido-Rodríguez
- Department of Urology, Puerta de Hierro-Majadahonda University Hospital, Autonoma University, 08193 Bellaterra, Spain;
| | - Dolores Prieto
- Department of Physiology, Pharmacy Faculty, Complutense University, 28040 Madrid, Spain; (M.M.); (C.R.); (A.S.); (C.C.); (D.P.)
| |
Collapse
|
8
|
Charry D, Xu J, Tanaka H, Heffernan KS, Richardson MR, Churilla JR. Total brachial artery reactivity and incident heart failure and heart failure subtypes: multi-ethnic study of atherosclerosis. Heart Vessels 2021; 37:411-418. [PMID: 34436657 DOI: 10.1007/s00380-021-01933-9] [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] [Received: 05/28/2021] [Accepted: 08/20/2021] [Indexed: 10/20/2022]
Abstract
Endothelial dysfunction may be a phenotypic expression of heart failure (HF). Total brachial artery reactivity (TBAR) is a non-invasive measurement of endothelial function that has been associated with increased risk of cardiovascular outcomes. Limited information is currently available on the impact of TBAR on incident HF and its subtypes. The aim of this study was to investigate whether TBAR is associated with overall incident HF, and the two HF subtypes, HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) in a community-based study. The sample included 5499 participants (45-84 years of age) from the Multi-Ethnic Study of Atherosclerosis who were free of cardiovascular disease at baseline. Brachial artery was imaged via ultrasound after five minutes of cuff occlusion at the right forearm. TBAR was calculated as the difference between maximum and minimum brachial artery diameters following cuff release, divided by the minimum diameter multiplied by 100%. A dichotomous TBAR variable was created based on the median value (below or above 7.9%). Participants with EF ≤ 40% were considered HFrEF and those with EF ≥ 50% were considered HFpEF. Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). Over a mean follow-up period of 12.5 years, incident HF was diagnosed in 250 participants: 98 classified as HFrEF, 106 as HFpEF, and 46 with unknown or borderline EF (41-49%). Crude analysis revealed that those with TBAR below the median had a significantly greater risk of HF (HR 1.46; 95% CI 1.13-1.88, p < 0.01) and HFrEF (HR 1.61; 95% CI 1.07-2.43, p < 0.05). Following adjustment for known HF risk factors (e.g., age, sex, race, blood pressure), the strength of these relationships was attenuated. Borderline significant results were revealed in those with HFpEF (HR 1.43; 95% CI 0.97-2.12, p = 0.06). Kaplan-Meier curves suggest significantly lower risks of developing HF and HFrEF in those with TBAR above the median (log-rank p ≤ 0.05 for both). When examined as a continuous variable, with a cut point of 50% for EF, every 1-standard deviation (9.7%) increase in TBAR resulted in a 19 and 29% decrease in risk of HF (p < 0.05) and HFrEF (p = 0.05), respectively. Lower TBAR values were associated with higher rates of incident HF and HFrEF, suggesting a possible role of endothelial dysfunction in HF pathogenesis. The impact of other known HF risk factors may mediate this relationship, thus further research is warranted.
Collapse
Affiliation(s)
- Daniela Charry
- Department of Clinical and Applied Movement Sciences, Brooks College of Health, University of North Florida, 1 UNF Drive/Bldg 39, Jacksonville, FL, 32224-2673, USA.
| | - Jasper Xu
- Department of Health Administration, Brooks College of Health, University of North Florida, 1 UNF Drive/Bldg 39, Jacksonville, FL, 32224-2673, USA
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, San Jacinto Blvd/Bellmont Hall 822F, 2109, Austin, TX, 78712, USA
| | - Kevin S Heffernan
- Department of Exercise Science, Syracuse University, 900 South Crouse Ave/210B Women's Building, Syracuse, NY, 13244, USA
| | - M Ryan Richardson
- Department of Clinical and Applied Movement Sciences, Brooks College of Health, University of North Florida, 1 UNF Drive/Bldg 39, Jacksonville, FL, 32224-2673, USA
| | - James R Churilla
- Department of Clinical and Applied Movement Sciences, Brooks College of Health, University of North Florida, 1 UNF Drive/Bldg 39, Jacksonville, FL, 32224-2673, USA
| |
Collapse
|
9
|
Rammos C, Steinmetz M, Johnstone M, Manzke A, Lortz J, Petrikhovich O, Hendgen-Cotta U, Jánosi RA, Rassaf T. The impact of percutaneous peripheral interventions on endothelial function. VASA 2021; 50:423-430. [PMID: 34233505 DOI: 10.1024/0301-1526/a000963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Treatment of symptomatic peripheral artery disease (PAD) through endovascular interventions is the primary revascularization strategy. Interventions restore perfusion but may cause severe injury to the vascular endothelium, which regulates vascular tone. Endothelial dysfunction is involved in the progression of cardiovascular disease, with higher incidences of vascular events. We aimed to determine the impact of percutaneous interventions on change in endothelial function. Patients and methods: Endothelial function was determined using flow-mediated dilation (FMD) before, the day after lower limb intervention with paclitaxel-coated balloons or stent guided interventions and after a six-month follow-up in the target limb, control limb and the systemic circulation in 42 PAD patients aged 70.2±9 years and 66% men. Additionally, macro- and microvascular function were assessed. Results: In PAD patients aged 70.2±9 years and 66% men, we observed an immediate enhancement of macro-, microvascular and endothelial function after endovascular treatment (FMD of superficial femoral artery (SFA) 3.7±0.2% to 4.1±0.1%, n=42, p=0.02), a sustained long-term improvement after 6-months (FMD SFA 3.7±0.2% to 4.2±0.1%, n=42, p=0.01), and moreover an improved systemic endothelial function (FMD brachial artery 4.3±0.1% to 4.7±0.2, n=42, p=0.01) following peripheral interventions. Subgroup analysis however revealed that following paclitaxel-based percutaneous intervention, the paclitaxel dosage applied was inversely related to the chronic improvement in local endothelial function (r=-0.6, n=22, p=0.005) without evidence for systemic effects (r=-0.25, p=0.27). Conclusions: We demonstrate an improved local and systemic endothelial function after treatment of atherosclerotic peripheral disease with a distinguished response after endovascular intervention with higher dosage of applied paclitaxel restraining the benefits. Further studies have to determine the optimal interventional strategy with respect to different treatment modalities to maintain vessel functions.
Collapse
Affiliation(s)
- Christos Rammos
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Martin Steinmetz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Mirjam Johnstone
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Anna Manzke
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Olga Petrikhovich
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Ulrike Hendgen-Cotta
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Rolf A Jánosi
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Germany
| |
Collapse
|
10
|
Young A, Garcia M, Sullivan SM, Liu C, Moazzami K, Ko YA, Shah AJ, Kim JH, Pearce B, Uphoff I, Bremner JD, Raggi P, Quyyumi A, Vaccarino V. Impaired Peripheral Microvascular Function and Risk of Major Adverse Cardiovascular Events in Patients With Coronary Artery Disease. Arterioscler Thromb Vasc Biol 2021; 41:1801-1809. [PMID: 33730873 PMCID: PMC8062308 DOI: 10.1161/atvbaha.121.316083] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- An Young
- Department of Epidemiology (A.Y., MG., S.M.S., C.L., K.M., A.J.S., B.P., I.U., V.V.), Rollins School of Public Health, Emory University, Atlanta, GA.,Emory Clinical Cardiovascular Research Institute, Division of Cardiology (A.Y., M.G., K.M., A.J.S., J.H.K., A.Q., V.V.), Emory University School of Medicine, Atlanta, GA
| | - Mariana Garcia
- Department of Epidemiology (A.Y., MG., S.M.S., C.L., K.M., A.J.S., B.P., I.U., V.V.), Rollins School of Public Health, Emory University, Atlanta, GA.,Emory Clinical Cardiovascular Research Institute, Division of Cardiology (A.Y., M.G., K.M., A.J.S., J.H.K., A.Q., V.V.), Emory University School of Medicine, Atlanta, GA
| | - Samaah M Sullivan
- Department of Epidemiology (A.Y., MG., S.M.S., C.L., K.M., A.J.S., B.P., I.U., V.V.), Rollins School of Public Health, Emory University, Atlanta, GA
| | - Chang Liu
- Department of Epidemiology (A.Y., MG., S.M.S., C.L., K.M., A.J.S., B.P., I.U., V.V.), Rollins School of Public Health, Emory University, Atlanta, GA
| | - Kasra Moazzami
- Department of Epidemiology (A.Y., MG., S.M.S., C.L., K.M., A.J.S., B.P., I.U., V.V.), Rollins School of Public Health, Emory University, Atlanta, GA.,Emory Clinical Cardiovascular Research Institute, Division of Cardiology (A.Y., M.G., K.M., A.J.S., J.H.K., A.Q., V.V.), Emory University School of Medicine, Atlanta, GA
| | - Yi-An Ko
- Biostatistics and Bioinformatics (Y.-A.K.), Rollins School of Public Health, Emory University, Atlanta, GA
| | - Amit J Shah
- Department of Epidemiology (A.Y., MG., S.M.S., C.L., K.M., A.J.S., B.P., I.U., V.V.), Rollins School of Public Health, Emory University, Atlanta, GA.,Emory Clinical Cardiovascular Research Institute, Division of Cardiology (A.Y., M.G., K.M., A.J.S., J.H.K., A.Q., V.V.), Emory University School of Medicine, Atlanta, GA.,Atlanta VA Medical Center (A.J.S., J.D.B.)
| | - Jeong Hwan Kim
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology (A.Y., M.G., K.M., A.J.S., J.H.K., A.Q., V.V.), Emory University School of Medicine, Atlanta, GA
| | - Brad Pearce
- Department of Epidemiology (A.Y., MG., S.M.S., C.L., K.M., A.J.S., B.P., I.U., V.V.), Rollins School of Public Health, Emory University, Atlanta, GA
| | - Irina Uphoff
- Department of Epidemiology (A.Y., MG., S.M.S., C.L., K.M., A.J.S., B.P., I.U., V.V.), Rollins School of Public Health, Emory University, Atlanta, GA
| | - J Douglas Bremner
- Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA.,Atlanta VA Medical Center (A.J.S., J.D.B.)
| | - Paolo Raggi
- Mazankowski Alberta Heart Institute, University of Alberta, Canada (P.R.)
| | - Arshed Quyyumi
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology (A.Y., M.G., K.M., A.J.S., J.H.K., A.Q., V.V.), Emory University School of Medicine, Atlanta, GA
| | - Viola Vaccarino
- Department of Epidemiology (A.Y., MG., S.M.S., C.L., K.M., A.J.S., B.P., I.U., V.V.), Rollins School of Public Health, Emory University, Atlanta, GA.,Emory Clinical Cardiovascular Research Institute, Division of Cardiology (A.Y., M.G., K.M., A.J.S., J.H.K., A.Q., V.V.), Emory University School of Medicine, Atlanta, GA
| |
Collapse
|
11
|
Shahriar MH, Chowdhury MAH, Ahmed S, Eunus M, Kader SB, Begum BA, Islam T, Sarwar G, Al Shams R, Raqib R, Alam DS, Parvez F, Ahsan H, Yunus M. Exposure to household air pollutants and endothelial dysfunction in rural Bangladesh: A cross-sectional study. Environ Epidemiol 2021; 5:e132. [PMID: 33870008 PMCID: PMC8043736 DOI: 10.1097/ee9.0000000000000132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 01/05/2021] [Indexed: 11/26/2022] Open
Abstract
More than one third of world's population use biomass fuel for cooking that has been linked to an array of adverse health hazards including cardiovascular mortality and morbidity. As part of Bangladesh Global Environmental and Occupational Health (GEO Health) project, we assessed whether household air pollution (HAP) was associated with dysfunction in microvascular circulation (measured by reactive hyperemia index [RHI]). METHODS We measured exposure to HAP (particulate matter [PM2.5], carbon monoxide [CO], and black carbon [BC]) for 48 hours of 200 healthy nonsmoker adult females who used biomass fuel for cooking. Exposure to PM2.5 and BC were measured using personal monitor, RTI MicroPEM (RTI International, NC) with an internal filter that had been both pre- and post-weighed to capture the deposited pollutants concentration. Lascar CO logger was used to measure CO. Endothelial function was measured by forearm blood flow dilatation response to brachial artery occlusion using RHI based on peripheral artery tonometry. A low RHI score (<1.67) indicates impaired endothelial function. RESULTS Average 48 hours personal exposure to PM2.5 and BC were 144.15 μg/m3 (SD 61.26) and 6.35 μg/m3 (SD 2.18), respectively. Interquartile range for CO was 0.73 ppm (0.62-1.35 ppm). Mean logarithm of RHI (LnRHI) was 0.57 in current data. No statistically significant association was observed for LnRHI with PM2.5 (odds ratio [OR] = 0.97; 95% confidence interval [CI] = 0.92, 1.01; P = 0.16), BC (OR = 0.85; 95% CI = 0.72, 1.01; P = 0.07), and CO (OR = 0.89; 95% CI = 0.64, 1.25; P = 0.53) after adjusting for potential covariates. CONCLUSIONS In conclusion, HAP was not associated with endothelial dysfunction among nonsmoking females in rural Bangladesh who used biomass fuel for cooking for years.
Collapse
Affiliation(s)
- Mohammad Hasan Shahriar
- Department of Public Health Sciences, Biological Science Division, The University of Chicago, Chicago, Illinois
- UChicago Research Bangladesh, Dhaka, Bangladesh
| | - Muhammad Ashique Haider Chowdhury
- Department of Public Health Sciences, Biological Science Division, The University of Chicago, Chicago, Illinois
- icddr,b, Dhaka, Bangladesh
| | - Shyfuddin Ahmed
- icddr,b, Dhaka, Bangladesh
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
| | | | | | | | | | | | | | | | - Dewan S. Alam
- School of Kinesiology and Health Sciences, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Faruque Parvez
- Mailman School of Public Health, Columbia University, New York, New York
| | - Habibul Ahsan
- Department of Public Health Sciences, Biological Science Division, The University of Chicago, Chicago, Illinois
- UChicago Research Bangladesh, Dhaka, Bangladesh
- Mailman School of Public Health, Columbia University, New York, New York
- Institute for Population and Precision Health, The University of Chicago, Chicago, Illinois
| | | |
Collapse
|
12
|
Lin AY, Dinatolo E, Metra M, Sbolli M, Dasseni N, Butler J, Greenberg BH. Thromboembolism in Heart Failure Patients in Sinus Rhythm: Epidemiology, Pathophysiology, Clinical Trials, and Future Direction. JACC-HEART FAILURE 2021; 9:243-253. [PMID: 33714744 DOI: 10.1016/j.jchf.2021.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/05/2021] [Indexed: 12/11/2022]
Abstract
Despite advances in medical and device therapy, patients with heart failure remain at high risk for morbidity and mortality. Experimental and clinical studies have shown an association between heart failure and a hypercoagulable state, and that patients with heart failure experience an increased incidence of stroke and other thromboembolic events, regardless of whether they are in atrial fibrillation. Although oral anticoagulation is recommended when atrial fibrillation is present, the benefits of this therapy in patients with heart failure in sinus rhythm are uncertain. Older randomized controlled trials comparing warfarin with antiplatelet therapy were, for the most part, underpowered and failed to show convincing benefits of warfarin therapy in this population. Several recent studies that assessed the effects of low-dose direct-acting oral anticoagulant therapy in patients with coronary artery disease in sinus rhythm either included or specifically targeted patients with heart failure. Post hoc analysis of their results showed that this treatment strategy was associated with improved outcomes in patients with acute coronary syndrome or stable coronary artery disease and also a significant reduction in thromboembolic events, including ischemic stroke. This review presents the rationale for anticoagulant therapy in patients with heart failure in sinus rhythm, discusses gaps in our knowledge base, offers suggestions for when anticoagulation might be considered, and identifies potential directions for future research.
Collapse
Affiliation(s)
- Andrew Y Lin
- Department of Cardiology, UC San Diego Health System, La Jolla, California, USA
| | - Elisabetta Dinatolo
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University and Civil Hospital of Brescia, Brescia, Italy
| | - Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University and Civil Hospital of Brescia, Brescia, Italy
| | - Marco Sbolli
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University and Civil Hospital of Brescia, Brescia, Italy
| | - Nicolò Dasseni
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University and Civil Hospital of Brescia, Brescia, Italy
| | - Javed Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Barry H Greenberg
- Department of Cardiology, UC San Diego Health System, La Jolla, California, USA.
| |
Collapse
|
13
|
Daiber A, Andreadou I, Oelze M, Davidson SM, Hausenloy DJ. Discovery of new therapeutic redox targets for cardioprotection against ischemia/reperfusion injury and heart failure. Free Radic Biol Med 2021; 163:325-343. [PMID: 33359685 DOI: 10.1016/j.freeradbiomed.2020.12.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/10/2020] [Accepted: 12/16/2020] [Indexed: 02/06/2023]
Abstract
Global epidemiological studies reported a shift from maternal/infectious communicable diseases to chronic non-communicable diseases and a major part is attributable to atherosclerosis and metabolic disorders. Accordingly, ischemic heart disease was identified as a leading risk factor for global mortality and morbidity with a prevalence of 128 million people. Almost 9 million premature deaths can be attributed to ischemic heart disease and subsequent acute myocardial infarction and heart failure, also representing a substantial socioeconomic burden. As evidenced by typical oxidative stress markers such as lipid peroxidation products or oxidized DNA/RNA bases, the formation of reactive oxygen species by various sources (NADPH oxidases, xanthine oxidase and mitochondrial resperatory chain) plays a central role for the severity of ischemia/reperfusion damage. The underlying mechanisms comprise direct oxidative damage but also adverse redox-regulation of kinase and calcium signaling, inflammation and cardiac remodeling among others. These processes and the role of reactive oxygen species are discussed in the present review. We also present and discuss potential targets for redox-based therapies that are either already established in the clinics (e.g. guanylyl cyclase activators and stimulators) or at least successfully tested in preclinical models of myocardial infarction and heart failure (mitochondria-targeted antioxidants). However, reactive oxygen species have not only detrimental effects but are also involved in essential cellular signaling and may even act protective as seen by ischemic pre- and post-conditioning or eustress - which makes redox therapy quite challenging.
Collapse
Affiliation(s)
- Andreas Daiber
- Department of Cardiology 1, Molecular Cardiology, University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany; Partner Site Rhine-Main, German Center for Cardiovascular Research (DZHK), Langenbeckstr. 1, 55131, Mainz, Germany.
| | - Ioanna Andreadou
- Laboratory of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens, 15771, Athens, Greece
| | - Matthias Oelze
- Department of Cardiology 1, Molecular Cardiology, University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Sean M Davidson
- The Hatter Cardiovascular Institute, 67 Chenies Mews, London, WC1E 6HX, United Kingdom
| | - Derek J Hausenloy
- The Hatter Cardiovascular Institute, 67 Chenies Mews, London, WC1E 6HX, United Kingdom; Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore; National Heart Research Institute Singapore, National Heart Centre, Singapore; Yong Loo Lin School of Medicine, National University Singapore, Singapore; Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taiwan.
| |
Collapse
|
14
|
Molitor M, Rudi WS, Garlapati V, Finger S, Schüler R, Kossmann S, Lagrange J, Nguyen TS, Wild J, Knopp T, Karbach SH, Knorr M, Ruf W, Münzel T, Wenzel P. Nox2+ myeloid cells drive vascular inflammation and endothelial dysfunction in heart failure after myocardial infarction via angiotensin II receptor type 1. Cardiovasc Res 2021; 117:162-177. [PMID: 32077922 DOI: 10.1093/cvr/cvaa042] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/31/2020] [Accepted: 02/14/2020] [Indexed: 12/20/2022] Open
Abstract
AIMS Heart failure (HF) ensuing myocardial infarction (MI) is characterized by the initiation of a systemic inflammatory response. We aimed to elucidate the impact of myelomonocytic cells and their activation by angiotensin II on vascular endothelial function in a mouse model of HF after MI. METHODS AND RESULTS HF was induced in male C57BL/6J mice by permanent ligation of the left anterior descending coronary artery. Compared to sham, HF mice had significantly impaired endothelial function accompanied by enhanced mobilization of Sca-1+c-Kit+ haematopoietic stem cells and Sca-1-c-Kit+ common myeloid and granulocyte-macrophage progenitors in the bone marrow as well as increased vascular infiltration of CD11b+Ly6G-Ly6Chigh monocytes and accumulation of CD11b+ F4/80+ macrophages, assessed by flow cytometry. Using mice with Cre-inducible expression of diphtheria toxin receptor in myeloid cells, we selectively depleted lysozyme M+ myelomonocytic cells for 10 days starting 28 days after MI. While the cardiac phenotype remained unaltered until 38 days post-MI, myeloid cell depletion attenuated vascular accumulation of Nox2+CD45+ cells, endothelial dysfunction, oxidative stress, and vascular expression of adhesion molecules and angiotensin II receptor type 1 (AT1R). Pharmacological blockade of this receptor for 4 weeks did not significantly alter cardiac function, but mimicked the effects of myeloid cell depletion: telmisartan (20 mg/kg/day, fed to C57BL/6J mice) diminished bone marrow myelopoesis and myeloid reactive oxygen species production, attenuated endothelial leucocyte rolling and vascular accumulation of CD11b+Ly6G-Ly6Chigh monocytes and macrophages, resulting in improved vascular function with less abundance of Nox2+CD45+ cells. CONCLUSION Endothelial dysfunction in HF ensuing MI is mediated by inflammatory Nox2+ myeloid cells infiltrating the vessel wall that can be targeted by AT1R blockade.
Collapse
Affiliation(s)
- Michael Molitor
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Department of Cardiology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Germany
| | - Wolf-Stephan Rudi
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Department of Cardiology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Germany
| | - Venkata Garlapati
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Germany
| | - Stefanie Finger
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Rebecca Schüler
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Institute for Molecular Medicine, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Sabine Kossmann
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- The Heart Research Institute, 7 Eliza Street, Newtown, NSW 2042, Australia
| | - Jeremy Lagrange
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Thanh Son Nguyen
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Johannes Wild
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Department of Cardiology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Germany
| | - Tanja Knopp
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Institute for Molecular Medicine, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Susanne H Karbach
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Department of Cardiology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Germany
| | - Maike Knorr
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Department of Cardiology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Wolfram Ruf
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Germany
- Scripps Research Institute, La Jolla, CA, USA
| | - Thomas Münzel
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Department of Cardiology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Germany
| | - Philip Wenzel
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Department of Cardiology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Germany
| |
Collapse
|
15
|
Bosso G, Valvano A, Apuzzi V, Mercurio V, Di Simone V, Cittadini A, Napoli R, Oliviero U. Peripheral Vascular Function in Dilated Cardiomyopathy of Different Etiology. Angiology 2020; 71:726-733. [DOI: 10.1177/0003319720932803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Vascular function in dilated cardiomyopathy of different etiology has been poorly investigated. Moreover, reference values of flow-mediated dilation (FMD) in chronic heart failure (CHF) need to be updated according to the new standardized protocols. We characterized the vascular impairment in different stages of post-ischemic dilated cardiomyopathy (PI-DC) or idiopathic dilated cardiomyopathy (I-DC). Eighty consecutive outpatients with CHF in different New York Heart Association (NYHA) classes (45 PI-DC, 35 I-DC) and 50 control subjects underwent FMD and brachial distensibility coefficient measurement. Patients with CHF showed a marked impairment in FMD compared with controls that worsened from classes NYHA I-II to III-IV, independently of etiology ( P < .05). New York Heart Association I-II PI-DC patients showed a worse FMD compared with NYHA I-II I-DC patients ( P < .05). Brachial distensibility coefficient values were significantly lower in patients with CHF compared with controls ( P < .001) without differences between PI-DC and I-DC. In conclusion, advanced CHF is characterized by vascular impairment that is independent of etiology. In the early stages of CHF, endothelial dysfunction is more severe in patients with PI-DC compared with I-DC probably due to the high cardiovascular risk profile. In I-DC, vascular function impairment is independent of cardiovascular risk factors and could participate in the pathogenesis of I-DC.
Collapse
Affiliation(s)
- Giorgio Bosso
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Antonio Valvano
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Valentina Apuzzi
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Valentina Mercurio
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Valeria Di Simone
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Raffaele Napoli
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| | - Ugo Oliviero
- Department of Translational Medical Sciences, Federico II University School of Medicine, Naples, Italy
| |
Collapse
|
16
|
Walker J, Cattaneo M, Badimon L, Agnelli G, Chan AT, Lanas A, Rocca B, Rothwell P, Patrignani P, Langley R, Vilahur G, Cosentino F. Highlights from the 2019 International Aspirin Foundation Scientific Conference, Rome, 28 June 2019: benefits and risks of antithrombotic therapy for cardiovascular disease prevention. Ecancermedicalscience 2020; 14:998. [PMID: 32153653 PMCID: PMC7032943 DOI: 10.3332/ecancer.2020.998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Indexed: 12/16/2022] Open
Abstract
At the 2019 International Aspirin Foundation Scientific Conference 'Benefits and Risks of Antithrombotic Therapy for Cardiovascular Disease Prevention', held in Rome, Italy, international experts sought to discuss and debate the optimal antithrombotic strategy for the secondary prevention of cardiovascular disease (CVD) and to seek agreement around dosing and target populations for aspirin use in primary disease prevention. Getting the best evidence to support real-life decisions in the clinic can be complex, and individualising management in order to balance both the risks and benefits of different disease prevention strategies appears to be the best approach. It is hoped that future decision-making tools and biomarkers will help direct treatments at those most likely to benefit.
Collapse
Affiliation(s)
- Jaqui Walker
- International Aspirin Foundation, 34 Bower Mount Road, Maidstone, Kent ME16 8AU, UK
| | - Marco Cattaneo
- Medicina 2, ASST Santi Paolo e Carlo, Milan, Italy - Dipartimento di Science della Salute, Università degli studi di Milano, 20122 Milan, Italy
| | - Lina Badimon
- Cardiovascular Program-ICCC, IR-Hospital de la Santa Creu, I Sant Pau and CiberCV, 08041 Barcelona, Spain
| | - Giancarlo Agnelli
- Internal Vascular and Emergency Medicine-Stroke Unit, University of Perugia, 06123 Perugia, Italy
| | - Andrew T Chan
- Clinical and Translational Epidemiology Unit, Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School
| | - Angel Lanas
- University of Zaragoza, 50009 Zaragoza, Spain
| | - Bianca Rocca
- Institute of Pharmacology, Catholic University School of Medicine, Rome, Italy
| | - Peter Rothwell
- Centre for the Prevention of Stroke and Dementia and Professor of Clinical Neurology, Oxford, UK
| | - Paola Patrignani
- Department of Neuroscience, Imaging and Clinical Sciences, and CeSI-MeT, 'G.d'Annunizio' University, School of Medicine, Chieti, Italy
| | - Ruth Langley
- MRC Clinical Trials Unit at UCL, WC1V 6LJ London, UK
| | - Gemma Vilahur
- Cardiovascular Program ICCC-Research Institute Hospital de la Santa Creu I Sant Pau, IIB-Sant Pau, 08041 Barcelona, Spain and CiberCV, Institute Carlos III, 28903 Madrid, Spain
| | - Francesco Cosentino
- Unit of Cardiology, Department of Medicine, Karolinska University Hospital, 171 76 Stockholm, Sweden
| |
Collapse
|
17
|
Acute exposure to nocturnal train noise induces endothelial dysfunction and pro-thromboinflammatory changes of the plasma proteome in healthy subjects. Basic Res Cardiol 2019; 114:46. [PMID: 31664594 PMCID: PMC6817813 DOI: 10.1007/s00395-019-0753-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/04/2019] [Indexed: 12/17/2022]
Abstract
Nocturnal train noise exposure has been associated with hypertension and myocardial infarction. It remains unclear whether acute nighttime train exposure may induce subclinical atherosclerosis, such as endothelial dysfunction and other functional and/or biochemical changes. Thus, we aimed to expose healthy subjects to nocturnal train noise and to assess endothelial function, changes in plasma protein levels and clinical parameters. In a randomized crossover study, we exposed 70 healthy volunteers to either background or two different simulated train noise scenarios in their homes during three nights. After each night, participants visited the study center for measurement of vascular function and assessment of other biomedical and biochemical parameters. The three nighttime noise scenarios were exposure to either background noise (control), 30 or 60 train noise events (Noise30 or Noise60), with average sound pressure levels of 33, 52 and 54 dB(A), respectively. Flow-mediated dilation (FMD) of the brachial artery was 11.23 ± 4.68% for control, compared to 8.71 ± 3.83% for Noise30 and 8.47 ± 3.73% for Noise60 (p < 0.001 vs. control). Sleep quality was impaired after both Noise30 and Noise60 nights (p < 0.001 vs. control). Targeted proteomic analysis showed substantial changes of plasma proteins after the Noise60 night, mainly centered on redox, pro-thrombotic and proinflammatory pathways. Exposure to simulated nocturnal train noise impaired endothelial function. The proteomic changes point toward a proinflammatory and pro-thrombotic phenotype in response to nocturnal train noise and provide a molecular basis to explain the increased cardiovascular risk observed in epidemiological noise studies.
Collapse
|
18
|
Budzyń M, Gryszczyńka B, Boruczkowski M, Kaczmarek M, Begier-Krasińska B, Osińska A, Bukowska A, Iskra M, Kasprzak MP. The Potential Role of Circulating Endothelial Cells and Endothelial Progenitor Cells in the Prediction of Left Ventricular Hypertrophy in Hypertensive Patients. Front Physiol 2019; 10:1005. [PMID: 31447695 PMCID: PMC6696897 DOI: 10.3389/fphys.2019.01005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 07/19/2019] [Indexed: 01/20/2023] Open
Abstract
Background The main aim of present study is to evaluate the potential role of circulating endothelial cells (CECs) and endothelial progenitor cells (CEPCs) – representing specific markers of endothelial damage, in the prediction of left ventricular hypertrophy (LVH) in hypertensive patients categorized into two groups; mild (MH) and resistant hypertension (RH). Materials and Methods Thirty patients with MH and 28 subjects with RH were involved in the study. In both groups, patients were divided into an LVH and non-LVH group. The control group included 33 age and sex-matched normotensive volunteers. Physical examination, laboratory tests and echocardiography were conducted. Results In both the MH and RH group, patients with as well as without LVH demonstrated a higher number of CECs and a lower ratio of CEPCs/CECs as compared to the healthy control. Multiple linear regression analysis showed a positive association of CEPCs with left ventricular mass (LVM) and left ventricular mass index (LVMI), independently of other confounders. Conclusion Our results suggest that endothelial injury observed as an elevated CECs number and its impaired regeneration, reflected by a lowered CEPCs/CECs ratio, precede LVH occurrence and may play a significant role in LVH development regardless of the clinical severity of hypertension. Moreover, independent correlation of CEPCs with echocardiographic (ECG) incidences of LVH suggests their potential use as a screening biomarker to stratify the risk of LVH development.
Collapse
Affiliation(s)
- Magdalena Budzyń
- Department of General Chemistry, Chair of Chemistry and Clinical Biochemistry, Poznań University of Medical Sciences, Poznań, Poland
| | - Bogna Gryszczyńka
- Department of General Chemistry, Chair of Chemistry and Clinical Biochemistry, Poznań University of Medical Sciences, Poznań, Poland
| | - Maciej Boruczkowski
- Department of Clinical Immunology, Poznań University of Medical Sciences, Poznań, Poland
| | - Mariusz Kaczmarek
- Department of Clinical Immunology, Poznań University of Medical Sciences, Poznań, Poland
| | - Beata Begier-Krasińska
- Department of Hypertensiology, Angiology, and Internal Diseases, Poznań University of Medical Sciences, Poznań, Poland
| | - Angelika Osińska
- Department of Hypertensiology, Angiology, and Internal Diseases, Poznań University of Medical Sciences, Poznań, Poland
| | - Alicja Bukowska
- Medical Analysis Laboratory, Regional Blood Center, Poznań, Poland
| | - Maria Iskra
- Department of General Chemistry, Chair of Chemistry and Clinical Biochemistry, Poznań University of Medical Sciences, Poznań, Poland
| | - Magdalena Paulina Kasprzak
- Department of General Chemistry, Chair of Chemistry and Clinical Biochemistry, Poznań University of Medical Sciences, Poznań, Poland
| |
Collapse
|
19
|
Endothelial Dysfunction in Chronic Heart Failure: Assessment, Findings, Significance, and Potential Therapeutic Targets. Int J Mol Sci 2019; 20:ijms20133198. [PMID: 31261886 PMCID: PMC6651535 DOI: 10.3390/ijms20133198] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/13/2019] [Accepted: 06/25/2019] [Indexed: 12/11/2022] Open
Abstract
Chronic heart failure (CHF) is a complex syndrome that results from structural and functional disturbances that affect the ability of the heart to supply oxygen to tissues. It largely affects and reduces the patient's quality of life, socio-economic status, and imposes great costs on health care systems worldwide. Endothelial dysfunction (ED) is a newly discovered phenomenon that contributes greatly to the pathophysiology of numerous cardiovascular conditions and commonly co-exists with chronic heart failure. However, the literature lacks clarity as to which heart failure patients might be affected, its significance in CHF patients, and its reversibility with pharmacological and non-pharmacological means. This review will emphasize all these points and summarize them for future researchers interested in vascular pathophysiology in this particular patient population. It will help to direct future studies for better characterization of these two phenomena for the potential discovery of therapeutic targets that might reduce future morbidity and mortality in this "at risk" population.
Collapse
|
20
|
Arterial Hypertension and Interleukins: Potential Therapeutic Target or Future Diagnostic Marker? Int J Hypertens 2019; 2019:3159283. [PMID: 31186952 PMCID: PMC6521461 DOI: 10.1155/2019/3159283] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 03/26/2019] [Indexed: 02/06/2023] Open
Abstract
Hypertension as a multifactorial pathology is one of the most important cardiovascular risk factors, affecting up to 30-40% of the general population. Complex immune responses are involved in the inflammatory mechanism of hypertension, with evidence pointing to increased inflammatory mediators even in prehypertensive patients. Increased vascular permeability, thrombogenesis, and fibrosis, effects that are associated with sustained hypertension, could be attributed to chronic inflammation. Chronic inflammation triggers endothelial dysfunction via increased production of ROS through proinflammatory cytokines. Increased serum level of proinflammatory cytokines such as IL-1β, IL-6, IL-8, IL-17, IL-23, TGFβ, and TNFα in hypertensive patients has been associated with either increased blood pressure values and/or end-organ damage. Moreover, some cytokines (i.e., IL-6) seem to determine a hypertensive response to angiotensin II, regardless of blood pressure values. Understanding hypertension as an inflammatory-based pathology gives way to new therapeutic targets. As such, conventional cardiovascular drugs (statins, calcium channels blockers, and ACEIs/ARBs) have shown additional anti-inflammatory effects that could be linked to their blood pressure lowering properties. Moreover, anti-inflammatory drugs (mycophenolate mofetil) have been shown to decrease blood pressure in hypertensive patients or prevent its development in normotensive individuals. Further research is needed to evaluate whether drugs targeting hypertensive-linked proinflammatory cytokines, such as monoclonal antibodies, could become a new therapeutic option in treating arterial hypertension.
Collapse
|
21
|
Moscarelli M, Devito F, Fattouch K, Lancellotti P, Ciccone MM, Rizzo P, Gaudino M, Marchese A, Angelini G, Speziale G. The effect of surgical versus transcatheter aortic valve replacement on endothelial function. An observational study. Int J Surg 2019; 63:1-7. [DOI: 10.1016/j.ijsu.2019.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/17/2019] [Accepted: 01/19/2019] [Indexed: 12/19/2022]
|
22
|
Toba H, Lindsey ML. Extracellular matrix roles in cardiorenal fibrosis: Potential therapeutic targets for CVD and CKD in the elderly. Pharmacol Ther 2019; 193:99-120. [PMID: 30149103 PMCID: PMC6309764 DOI: 10.1016/j.pharmthera.2018.08.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Whereas hypertension, diabetes, and dyslipidemia are age-related risk factors for cardiovascular disease (CVD) and chronic kidney disease (CKD), aging alone is an independent risk factor. With advancing age, the heart and kidney gradually but significantly undergo inflammation and subsequent fibrosis, which eventually results in an irreversible decline in organ physiology. Through cardiorenal network interactions, cardiac dysfunction leads to and responds to renal injury, and both facilitate aging effects. Thus, a comprehensive strategy is needed to evaluate the cardiorenal aging network. Common hallmarks shared across systems include extracellular matrix (ECM) accumulation, along with upregulation of matrix metalloproteinases (MMPs) including MMP-9. The wide range of MMP-9 substrates, including ECM components and inflammatory cytokines, implicates MMP-9 in a variety of pathological and age-related processes. In particular, there is strong evidence that inflammatory cell-derived MMP-9 exacerbates cardiorenal aging. This review explores the potential therapeutic targets against CVD and CKD in the elderly, focusing on ECM and MMP roles.
Collapse
Affiliation(s)
- Hiroe Toba
- Department of Clinical Pharmacology, Division of Pathological Sciences, Kyoto Pharmaceutical University, Kyoto, Japan.
| | - Merry L Lindsey
- Mississippi Center for Heart Research, Department of Physiology and Biophysics, University of Mississippi Medical Center, and Research Service, G.V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, MS, USA.
| |
Collapse
|
23
|
Alem MM, Alshehri AM, Cahusac PMB, Walters MR. Effect of Xanthine Oxidase Inhibition on Arterial Stiffness in Patients With Chronic Heart Failure. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2018; 12:1179546818779584. [PMID: 29899669 PMCID: PMC5992797 DOI: 10.1177/1179546818779584] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 04/30/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND The xanthine oxidase inhibitor allopurinol improves endothelial function in different populations, including patients with chronic heart failure (CHF). Its effect on arterial stiffness parameters is less clear. We investigated the effect of short-term low-dose allopurinol therapy on arterial stiffness in Saudi patients with stable mild-moderate CHF. METHODS A prospective, randomized, double-blind, placebo-controlled study was performed on 73 patients with mild-moderate CHF. In all, 36 patients were randomized to allopurinol 300 mg daily for 3 months, while 37 patients were randomized to placebo. Arterial stiffness parameters, aortic pulse wave velocity (Ao-PWV) and heart rate corrected augmentation index (c-AIx), were assessed before and after treatment along with serum uric acid. RESULTS A total of 66 patients completed the study. Both groups were matched for age, sex, severity of heart failure, and arterial stiffness. Compared with placebo, allopurinol recipients had a significant fall in uric acid concentration from 6.31 ± 1.4 (SD) mg/dL to 3.81 ± 1.2 (P < .001). Despite that, there was no significant change in arterial stiffness parameters between allopurinol and placebo groups. Post-treatment Ao-PWV was 9.79 ± 2.6 m/s in the allopurinol group and 10.07 ± 3.4 m/s in the placebo group, P = .723. Post-treatment c-AIx was 24.0% ± 9.1% and 22.0% ± 9.9%, respectively, P = .403. CONCLUSIONS We have shown that allopurinol significantly reduced uric acid concentration in Saudi patients with CHF but was not associated with a change in arterial stiffness. Our cohort of patients had worse arterial stiffness values at baseline, which might make them more resistant to change using our study regimen.The study has been registered with the International Standard Randomized Controlled Trial Number registry with an identifier number of ISRCTN58980230.
Collapse
Affiliation(s)
- Manal M Alem
- Department of Pharmacology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Abdullah M Alshehri
- Internal Medicine Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Peter MB Cahusac
- Department of Pharmacology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Comparative Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Matthew R Walters
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| |
Collapse
|
24
|
Yin J, Xia W, Zhang Y, Ding G, Chen L, Yang G, Huang S, Jia Z, Zhang A. Role of dihydroartemisinin in regulating prostaglandin E2 synthesis cascade and inflammation in endothelial cells. Heart Vessels 2018; 33:1411-1422. [DOI: 10.1007/s00380-018-1190-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 05/18/2018] [Indexed: 10/16/2022]
|
25
|
Daiber A, Steven S, Weber A, Shuvaev VV, Muzykantov VR, Laher I, Li H, Lamas S, Münzel T. Targeting vascular (endothelial) dysfunction. Br J Pharmacol 2017; 174:1591-1619. [PMID: 27187006 PMCID: PMC5446575 DOI: 10.1111/bph.13517] [Citation(s) in RCA: 304] [Impact Index Per Article: 43.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 04/28/2016] [Accepted: 05/09/2016] [Indexed: 12/18/2022] Open
Abstract
Cardiovascular diseases are major contributors to global deaths and disability-adjusted life years, with hypertension a significant risk factor for all causes of death. The endothelium that lines the inner wall of the vasculature regulates essential haemostatic functions, such as vascular tone, circulation of blood cells, inflammation and platelet activity. Endothelial dysfunction is an early predictor of atherosclerosis and future cardiovascular events. We review the prognostic value of obtaining measurements of endothelial function, the clinical techniques for its determination, the mechanisms leading to endothelial dysfunction and the therapeutic treatment of endothelial dysfunction. Since vascular oxidative stress and inflammation are major determinants of endothelial function, we have also addressed current antioxidant and anti-inflammatory therapies. In the light of recent data that dispute the prognostic value of endothelial function in healthy human cohorts, we also discuss alternative diagnostic parameters such as vascular stiffness index and intima/media thickness ratio. We also suggest that assessing vascular function, including that of smooth muscle and even perivascular adipose tissue, may be an appropriate parameter for clinical investigations. LINKED ARTICLES This article is part of a themed section on Redox Biology and Oxidative Stress in Health and Disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.12/issuetoc.
Collapse
Affiliation(s)
- Andreas Daiber
- Center of CardiologyMedical Center of the Johannes Gutenberg UniversityMainzGermany
- German Center for Cardiovascular Research (DZHK)Partner Site Rhine‐MainMainzGermany
| | - Sebastian Steven
- Center of CardiologyMedical Center of the Johannes Gutenberg UniversityMainzGermany
- Center of Thrombosis and HemostasisMedical Center of the Johannes Gutenberg UniversityMainzGermany
| | - Alina Weber
- Center of CardiologyMedical Center of the Johannes Gutenberg UniversityMainzGermany
| | - Vladimir V. Shuvaev
- Department of Systems Pharmacology & Translational Therapeutics, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Vladimir R. Muzykantov
- Department of Systems Pharmacology & Translational Therapeutics, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Ismail Laher
- Department of Pharmacology and Therapeutics, Faculty of MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Huige Li
- German Center for Cardiovascular Research (DZHK)Partner Site Rhine‐MainMainzGermany
- Department of PharmacologyMedical Center of the Johannes Gutenberg UniversityMainzGermany
| | - Santiago Lamas
- Department of Cell Biology and ImmunologyCentro de Biología Molecular "Severo Ochoa" (CSIC‐UAM)MadridSpain
| | - Thomas Münzel
- Center of CardiologyMedical Center of the Johannes Gutenberg UniversityMainzGermany
- German Center for Cardiovascular Research (DZHK)Partner Site Rhine‐MainMainzGermany
| |
Collapse
|
26
|
Visualization of endothelial barrier damage prior to formation of atherosclerotic plaques. Histochem Cell Biol 2017; 148:117-127. [PMID: 28343238 DOI: 10.1007/s00418-017-1562-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2017] [Indexed: 01/09/2023]
Abstract
En-face fat staining is frequently used to visualize atherosclerotic lesions. This method, however, is not suitable to visualize endothelial barrier damage prior to microscopically detectable morphological alterations of the arterial wall such as sub-endothelial lipid deposition. To enable the investigation of early endothelial barrier damage and in particular the initial steps of atherosclerosis, a new method has to fulfill three requirements: (i) easy and fast to perform, (ii) low cost of applicability without requirement for highly sophisticated technical equipment, and (iii) reliable reproducibility of valid results. To this end, we used intracardial Evans blue dye injection after washout of blood and measured dye deposition within the aortic wall as a parameter of endothelial barrier leakiness, which is recognized as one of the earliest signs of atherosclerotic plaque formation. These analyses were performed in ApoE -/-, LDL receptor -/- and Cc1 -/- mouse models which have been reported to develop aortic plaques with or without high cholesterol diet. Our data show that sub-endothelial dye deposition is a reliable and reproducible readout parameter to assess endothelial barrier damage. Along these lines, measurements of aortic intima areas with Evans blue deposition in relation to total intima circumference enabled quantitative assessments of the results. Our technique enables the imaging of endothelial barrier damage prior to detectable aortic lipid deposition and plaque development. Thus, it will facilitate the detection of the initial vascular pathogenetic processes that lead to cardiovascular diseases. It will also enable the testing of new drugs and therapeutic procedures to prevent these disorders.
Collapse
|
27
|
De Keulenaer GW, Segers VFM, Zannad F, Brutsaert DL. The future of pleiotropic therapy in heart failure. Lessons from the benefits of exercise training on endothelial function. Eur J Heart Fail 2017; 19:603-614. [PMID: 28105791 DOI: 10.1002/ejhf.735] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/15/2016] [Accepted: 11/24/2016] [Indexed: 12/14/2022] Open
Abstract
A novel generation of drugs is introduced in the treatment of heart failure (HF). These drugs, including phosphodiesterase-5 inhibitors, guanylate cyclase stimulators and activators, share the feature that their action is either endothelial-mediated or substitutes for endothelial pathways, in particular the nitric oxide-cyclic guanosine monophosphate pathway, thereby influencing homeostatic balances in virtually each organ system in a pleiotropic fashion. Unfortunately, recent clinical trials with some of these drugs have shown disappointing results, at least in the setting of HF with a preserved ejection fraction. This suggests that their clinical use may require approaches that diverge from traditional pharmacological approaches, the latter often titrated on the effects of drugs on haemodynamic parameters or single biomarkers. In this paper we preconize that HF drugs with an endothelial profile should be applied conform to principles of endothelial physiology and systems pharmacology. This type of drug therapy should be viewed as a systems physio-pharmacological intervention and its clinical use accustomed to systems pharmacological principles, comparable to the systemic endothelial-mediated benefits induced by exercise training in HF. We will review the actions of these drugs and define criteria to which trials with these drugs should comply in order to increase chances of success.
Collapse
Affiliation(s)
- Gilles W De Keulenaer
- Laboratory of Physiopharmacology, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.,Department of Cardiology, Middelheim Hospital, Antwerp, Belgium
| | - Vincent F M Segers
- Laboratory of Physiopharmacology, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.,Department of Cardiology, University Hospital Antwerp, Edegem, Belgium
| | - Faiez Zannad
- CHU Nancy, Pôle de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandoeuvre-lès-Nancy, France
| | - Dirk L Brutsaert
- Laboratory of Physiopharmacology, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.,Department of Cardiology, University Hospital Antwerp, Edegem, Belgium
| |
Collapse
|
28
|
Habedank D, Schefold JC, Bernhardt C, Karhausen T, Doehner W, Anker SD, Reinke P. Vasodilation and Exercise Capacity in Patients with End-Stage Renal Disease: A Prospective Proof-of-Concept Study. Cardiorenal Med 2016; 7:50-59. [PMID: 27994602 DOI: 10.1159/000449174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 08/06/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Previous data have pointed to the fact that vascular function is significantly impaired in patients with end-stage renal disease (ESRD). We aimed to better characterise vasodilation and exercise capacity in both ESRD and chronic heart failure (CHF) patients. METHODS A total of 30 ESRD patients (23 male; mean age 45.7 ± 9.9 years) were included in a prospective proof-of-concept study at a tertiary care academic centre. The patients underwent forearm venous plethysmography with post-ischaemic peak blood flow (PF) and flow-dependent flow (FDF) testing as well as cardiopulmonary exercise testing during the morning of the day following the last haemodialysis. After matching for age, gender, and body mass index, the data were compared to 30 patients with CHF and 20 age-matched healthy controls. RESULTS PF in ESRD patients was reduced when compared to that in CHF patients (12.5 ± 4.2 vs. 15.6 ± 6.9 ml/100 ml/min; p = 0.048) and healthy controls (26.4 ± 9.3 ml/100 ml/min; p < 0.001). When compared to controls, FDF was significantly reduced in ESRD patients (7.6 ± 3.1 vs. 6.0 ± 2.5 ml/100 ml/min; p = 0.03), but not in CHF patients, whereas resting blood flow did not differ between the ESRD, CHF, and healthy control groups. In contrast to indices of vasodilative capacity, maximum exercise capacity (peakVO2) was higher in ESRD when compared to CHF patients (23.8 ± 7.3 vs. 18.8 ± 5.2 ml/min/kg), but significantly impaired when compared to controls (32.8 ± 6.7 ml/min/kg; p < 0.001). CONCLUSION In this proof-of-concept study, exercise capacity was relatively preserved, while vasodilative capacity was substantially impaired in ESRD patients. Additional studies are warranted to examine the underlying mechanisms and potential clinical implications of our findings.
Collapse
Affiliation(s)
- Dirk Habedank
- Medizinische Klinik Kardiologie, DRK-Kliniken Berlin-Köpenick, Berlin, Germany
| | - Joerg C Schefold
- Department of Nephrology and Intensive Care Medicine, Berlin, Germany; Department of Intensive Care Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Carolin Bernhardt
- Department of Cardiology, Applied Cachexia Research, Berlin, Germany
| | - Tim Karhausen
- Department of Cardiology, Applied Cachexia Research, Berlin, Germany
| | - Wolfram Doehner
- Department of Cardiology, Applied Cachexia Research, Berlin, Germany; Stroke Research Centre, Charité Campus Virchow-Klinikum, Berlin, Germany
| | - Stefan D Anker
- Department of Cardiology, Applied Cachexia Research, Berlin, Germany; Department of Cardiology and Pneumology, Innovative Clinical Trials, University of Göttingen, Göttingen, Germany
| | - Petra Reinke
- Department of Nephrology and Intensive Care Medicine, Berlin, Germany
| |
Collapse
|
29
|
Yurdagul A, Orr AW. Blood Brothers: Hemodynamics and Cell-Matrix Interactions in Endothelial Function. Antioxid Redox Signal 2016; 25:415-34. [PMID: 26715135 PMCID: PMC5011636 DOI: 10.1089/ars.2015.6525] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 11/25/2015] [Accepted: 12/23/2015] [Indexed: 12/29/2022]
Abstract
SIGNIFICANCE Alterations in endothelial function contribute to a variety of vascular diseases. In pathological conditions, the endothelium shows a reduced ability to regulate vasodilation (endothelial dysfunction) and a conversion toward a proinflammatory and leaky phenotype (endothelial activation). At the interface between the vessel wall and blood, the endothelium exists in a complex microenvironment and must translate changes in these environmental signals to alterations in vessel function. Mechanical stimulation and endothelial cell interactions with the vascular matrix, as well as a host of soluble factors, coordinately contribute to this dynamic regulation. RECENT ADVANCES Blood hemodynamics play an established role in the regulation of endothelial function. However, a growing body of work suggests that subendothelial matrix composition similarly and coordinately regulates endothelial cell phenotype such that blood flow affects matrix remodeling, which affects the endothelial response to flow. CRITICAL ISSUES Hemodynamics and soluble factors likely affect endothelial matrix remodeling through multiple mechanisms, including transforming growth factor β signaling and alterations in cell-matrix receptors, such as the integrins. Likewise, differential integrin signaling following matrix remodeling appears to regulate several key flow-induced responses, including nitric oxide production, regulation of oxidant stress, and activation of proinflammatory signaling and gene expression. Microvascular remodeling responses, such as angiogenesis and arteriogenesis, may also show coordinated regulation by flow and matrix. FUTURE DIRECTIONS Identifying the mechanisms regulating the dynamic interplay between hemodynamics and matrix remodeling and their contribution to the pathogenesis of cardiovascular disease remains an important research area with therapeutic implications across a variety of conditions. Antioxid. Redox Signal. 25, 415-434.
Collapse
Affiliation(s)
- Arif Yurdagul
- Department of Cell Biology and Anatomy, Louisiana State University Health Sciences Center–Shreveport, Shreveport, Louisiana
| | - A. Wayne Orr
- Department of Cell Biology and Anatomy, Louisiana State University Health Sciences Center–Shreveport, Shreveport, Louisiana
- Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center–Shreveport, Shreveport, Louisiana
| |
Collapse
|
30
|
Calegari L, Mozzaquattro BB, Rossato DD, Quagliotto E, Ferreira JB, Rasia-Filho A, Dal Lago P. Exercise training attenuates the pressor response evoked by peripheral chemoreflex in rats with heart failure. Can J Physiol Pharmacol 2016; 94:979-86. [PMID: 27295522 DOI: 10.1139/cjpp-2015-0518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The effects of exercise training (ExT) on the pressor response elicited by potassium cyanide (KCN) in the rat model of ischemia-induced heart failure (HF) are unknown. We evaluated the effects of ExT on chemoreflex sensitivity and its interaction with baroreflex in rats with HF. Wistar rats were divided into four groups: trained HF (Tr-HF), sedentary HF (Sed-HF), trained sham (Tr-Sham), and sedentary sham (Sed-Sham). Trained animals underwent to a treadmill running protocol for 8 weeks (60 m/day, 5 days/week, 16 m/min). After ExT, arterial pressure (AP), baroreflex sensitivity (BRS), peripheral chemoreflex (KCN: 100 μg/kg body mass), and cardiac function were evaluated. The results demonstrate that ExT induces an improvement in BRS and attenuates the pressor response to KCN relative to the Sed-HF group (P < 0.05). The improvement in BRS was associated with a reduction in the pressor response following ExT in HF rats (P < 0.05). Moreover, ExT induced a reduction in left ventricular end-diastolic pressure and pulmonary congestion compared with the Sed-HF group (P < 0.05). The pressor response to KCN in the hypotensive state is decreased in sedentary HF rats. These results suggest that ExT improves cardiac function and BRS and attenuates the pressor response evoked by KCN in HF rats.
Collapse
Affiliation(s)
- Leonardo Calegari
- a Laboratory of Physiology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,b Faculty of Physical Education and Physical Therapy, University of Passo Fundo, Brazil
| | - Bruna B Mozzaquattro
- a Laboratory of Physiology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Edson Quagliotto
- a Laboratory of Physiology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Janaina B Ferreira
- d Hypertension Unit, Heart Institute (InCor), University of São Paulo, Brazil
| | - Alberto Rasia-Filho
- a Laboratory of Physiology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Pedro Dal Lago
- a Laboratory of Physiology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,e Department of Physical Therapy, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| |
Collapse
|
31
|
Association between Body Mass Index, Asymmetric Dimethylarginine and Risk of Cardiovascular Events and Mortality in Norwegian Patients with Suspected Stable Angina Pectoris. PLoS One 2016; 11:e0152029. [PMID: 27003294 PMCID: PMC4803210 DOI: 10.1371/journal.pone.0152029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 03/08/2016] [Indexed: 02/07/2023] Open
Abstract
Background Asymmetric dimethylarginine (ADMA) is associated with increased risk of atherosclerotic cardiovascular disease and mortality through inhibition of nitrogen oxide (NO) synthesis. As positive correlations between serum concentrations of NO and body mass index (BMI) have been observed, we aimed to explore whether the potential associations between plasma ADMA levels and the risk of acute myocardial infarction (AMI) and mortality were modified by BMI. Methods Multivariable Cox proportional hazard models were used to estimate the hazard ratios (HR) for AMI, cardiovascular death and all-cause mortality according to baseline plasma ADMA levels in 4122 patients with suspected stable angina pectoris. Analyses were subsequently repeated in patients with BMI below (low BMI) or above (high BMI) median. Results A total of 2982 patients (72%) were men. Median (range) age, plasma ADMA level and BMI were 62 (21–88) years, 0.54 (0.10–1.25) μmol/L and 26.3 (18.5–54.3) kg/m2, respectively. During a mean (standard deviation) follow-up time of 4.7 (1.4) years, 337 (8%) patients suffered from an AMI, 300 (7%) died, whereof 165 (55%) due to cardiovascular disease. Each 0.1 μmol/L increment in plasma ADMA level was associated with an increased risk of AMI (HR (95% CI) 1.21 (1.08, 1.35) and cardiovascular death 1.30 (1.13, 1.49) in participants with low BMI only. Interactions were significant for AMI (p = 0.04) and CV death (p = 0.03). BMI did not modify the association between plasma ADMA levels and all-cause mortality. Conclusion Plasma ADMA levels were associated with risk of AMI and cardiovascular death among patients with low BMI only.
Collapse
|
32
|
Rammos C, Zeus T, Balzer J, Kubatz L, Hendgen-Cotta UB, Veulemans V, Hellhammer K, Totzeck M, Luedike P, Kelm M, Rassaf T. Percutaneous Mitral Valve Repair in Mitral Regurgitation Reduces Cell-Free Hemoglobin and Improves Endothelial Function. PLoS One 2016; 11:e0151203. [PMID: 26986059 PMCID: PMC4795750 DOI: 10.1371/journal.pone.0151203] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 02/23/2016] [Indexed: 11/18/2022] Open
Abstract
Background and Objective Endothelial dysfunction is predictive for cardiovascular events and may be caused by decreased bioavailability of nitric oxide (NO). NO is scavenged by cell-free hemoglobin with reduction of bioavailable NO up to 70% subsequently deteriorating vascular function. While patients with mitral regurgitation (MR) suffer from an impaired prognosis, mechanisms relating to coexistent vascular dysfunctions have not been described yet. Therapy of MR using a percutaneous mitral valve repair (PMVR) approach has been shown to lead to significant clinical benefits. We here sought to investigate the role of endothelial function in MR and the potential impact of PMVR. Methods and Results Twenty-seven patients with moderate-to-severe MR treated with the MitraClip® device were enrolled in an open-label single-center observational study. Patients underwent clinical assessment, conventional echocardiography, and determination of endothelial function by measuring flow-mediated dilation (FMD) of the brachial artery using high-resolution ultrasound at baseline and at 3-month follow-up. Patients with MR demonstrated decompartmentalized hemoglobin and reduced endothelial function (cell-free plasma hemoglobin in heme 28.9±3.8 μM, FMD 3.9±0.9%). Three months post-procedure, PMVR improved ejection fraction (from 41±3% to 46±3%, p = 0.03) and NYHA functional class (from 3.0±0.1 to 1.9±1.7, p<0.001). PMVR was associated with a decrease in cell free plasma hemoglobin (22.3±2.4 μM, p = 0.02) and improved endothelial functions (FMD 4.8±1.0%, p<0.0001). Conclusion We demonstrate here that plasma from patients with MR contains significant amounts of cell-free hemoglobin, which is accompanied by endothelial dysfunction. PMVR therapy is associated with an improved hemoglobin decompartmentalization and vascular function.
Collapse
Affiliation(s)
- Christos Rammos
- University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Tobias Zeus
- University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Jan Balzer
- University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Laura Kubatz
- University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Ulrike B. Hendgen-Cotta
- University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Verena Veulemans
- University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Katharina Hellhammer
- University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Matthias Totzeck
- University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Peter Luedike
- University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Malte Kelm
- University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Tienush Rassaf
- University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstrasse 5, 40225, Düsseldorf, Germany
- * E-mail:
| |
Collapse
|
33
|
Links between atherosclerotic and periodontal disease. Exp Mol Pathol 2016; 100:220-35. [DOI: 10.1016/j.yexmp.2016.01.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 01/08/2016] [Indexed: 02/06/2023]
|
34
|
Tzanis G, Manetos C, Dimopoulos S, Vasileiadis I, Malliaras K, Kaldara E, Karatzanos E, Nanas S. Attenuated Microcirculatory Response to Maximal Exercise in Patients With Chronic Heart Failure. J Cardiopulm Rehabil Prev 2016; 36:33-7. [PMID: 26468631 DOI: 10.1097/hcr.0000000000000145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE Exercise training programs improve microcirculatory alternations in patients with chronic heart failure (CHF). However less is known about the acute effect of maximum exercise on the skeletal muscle microcirculation. We aimed to assess the effect of acute exercise on peripheral microcirculation of patients with CHF, as assessed by near-infrared spectroscopy with vascular occlusion technique. METHODS Tissue oxygenation was evaluated in 8 stable patients with CHF (7 males; mean age, 60 ± 9 years; body mass index, 26.3 ± 3.8 kg/m) and 8 healthy subjects (matched for age, sex, and body mass index) before and after cardiopulmonary exercise testing. Tissue oxygen saturation (StO2), StO2peak, oxygen consumption rate, and endothelial function (reperfusion rate), before and after maximum exercise, were assessed. RESULTS Patients with CHF had lower StO2 and reperfusion rate compared with healthy subjects (71.4% ± 9.8% vs 81.0% ± 5.4% and 9 ± 1 %/min vs 13.9 ± 5.8%/min, respectively; P < .05) at rest. Oxygen consumption rate increased after exercise in patients with CHF and healthy subjects (from -31.7 ± 8.2 to -43.7 ± 12.7 and from -35.7 ± 6.7 to -42.4 ± 6.4, respectively; P < .05). StO2 decreased significantly after maximal exercise in patients with CHF (from 71.4 ± 9.8 to 65.2 ± 12.7; P < .05), whereas it returned to the preexercise values in healthy subjects (from 81.0 ± 5.4 to 80.3 ± 7.0). There was a significant between-group difference (P < .05). CONCLUSIONS Patients with CHF present microcirculatory alternations. Acute exercise exerts an effect on microcirculation in peripheral, nonexercising muscles, with altered response in patients with CHF compared with healthy subjects.
Collapse
Affiliation(s)
- Georgios Tzanis
- 1st Critical Care Medicine Department (Drs Tzanis, Manetos, Dimopoulos, Vasileiadis, Karatzanos, and Nanas), Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, Evgenidion Hospital, NKUA, Athens, Greece; and 3rd Cardiology Department (Drs Malliaras and Kaldara), NKUA, Athens, Greece
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Schmitt A, Carra MC, Boutouyrie P, Bouchard P. Periodontitis and arterial stiffness: a systematic review and meta-analysis. J Clin Periodontol 2015; 42:977-87. [PMID: 26465940 DOI: 10.1111/jcpe.12467] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2015] [Indexed: 01/11/2023]
Abstract
INTRODUCTION AND AIMS Patients with periodontitis have a higher risk of cardiovascular diseases, although a causal relationship between these conditions remains unclear. Arterial stiffness is considered a marker of arteriosclerosis and a risk factor for cardiovascular diseases. A systematic review of the literature on clinical studies using pulse wave velocity (PWV) to assess arterial stiffness in patients with periodontitis was carried out to answer the following questions: (i) Do patients with periodontitis have impaired arterial stiffness compared to non-periodontal diseased subjects? (ii) Is periodontal treatment effective as a means to improve arterial stiffness in patients with periodontitis? LITERATURE REVIEW Literature search was done on different databases up to September 2014. All clinical studies (excluding case reports) using PWV in patients with periodontitis were retrieved for a full-text evaluation. A total of 10 studies were included. Patients with periodontitis have increased arterial stiffness compared to controls (PWV mean difference 0.85 m/s; 95% confidence interval: 0.53-1.16; p<0.00001). The only two interventional studies showed contradictory results on the effects of periodontal treatment on PWV. CONCLUSION Patients with periodontitis appear to have higher values of PWV compared to controls. The effect of periodontal treatment on arterial stiffness remains unclear.
Collapse
Affiliation(s)
- Audrey Schmitt
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Université Paris 7 - Denis Diderot, U.F.R. of Odontology, Paris, France
| | - Maria Clotilde Carra
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Université Paris 7 - Denis Diderot, U.F.R. of Odontology, Paris, France
| | - Pierre Boutouyrie
- Department of Pharmacology, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France.,INSERM U970, Université Paris Descartes, Paris, France
| | - Philippe Bouchard
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Université Paris 7 - Denis Diderot, U.F.R. of Odontology, Paris, France.,EA 2496, Université Paris Descartes, Paris, France
| |
Collapse
|
36
|
Langbein H, Brunssen C, Hofmann A, Cimalla P, Brux M, Bornstein SR, Deussen A, Koch E, Morawietz H. NADPH oxidase 4 protects against development of endothelial dysfunction and atherosclerosis in LDL receptor deficient mice. Eur Heart J 2015; 37:1753-61. [PMID: 26578199 PMCID: PMC4900759 DOI: 10.1093/eurheartj/ehv564] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 10/04/2015] [Indexed: 12/27/2022] Open
Abstract
Aims Endothelial dysfunction is an early step in the development of atherosclerosis. Increased formation of superoxide anions by NADPH oxidase Nox1, 2, and 5 reduces nitric oxide availability and can promote endothelial dysfunction. In contrast, recent evidence supports a vasoprotective role of H2O2 produced by main endothelial isoform Nox4. Therefore, we analysed the impact of genetic deletion of Nox4 on endothelial dysfunction and atherosclerosis in the low-density lipoprotein receptor (Ldlr) knockout model. Methods and results Ex vivo analysis of endothelial function by Mulvany myograph showed impaired endothelial function in thoracic aorta of Nox4−/−/Ldlr−/− mice. Further progression of endothelial dysfunction due to high-fat diet increased atherosclerotic plaque burden and galectin-3 staining in Nox4−/−/Ldlr−/− mice compared with Ldlr−/− mice. Under physiological conditions, loss of Nox4 does not influence aortic vascular function. In this setting, loss of Nox4-derived H2O2 production could be partially compensated for by nNOS upregulation. Using an innovative optical coherence tomography approach, we were able to analyse endothelial function by flow-mediated vasodilation in the murine saphenous artery in vivo. This new approach revealed an altered flow-mediated dilation in Nox4−/− mice, indicating a role for Nox4 under physiological conditions in peripheral arteries in vivo. Conclusions Nox4 plays an important role in maintaining endothelial function under physiological and pathological conditions. Loss of Nox4-derived H2O2 could be partially compensated for by nNOS upregulation, but severe endothelial dysfunction is not reversible. This leads to increased atherosclerosis under atherosclerotic prone conditions.
Collapse
Affiliation(s)
- Heike Langbein
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Coy Brunssen
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Anja Hofmann
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Peter Cimalla
- Department of Anesthesiology and Intensive Care Medicine, Clinical Sensoring and Monitoring, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany
| | - Melanie Brux
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Stefan R Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany
| | - Andreas Deussen
- Institute of Physiology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Edmund Koch
- Department of Anesthesiology and Intensive Care Medicine, Clinical Sensoring and Monitoring, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany
| | - Henning Morawietz
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| |
Collapse
|
37
|
Wenzel P, Rossmann H, Müller C, Kossmann S, Oelze M, Schulz A, Arnold N, Simsek C, Lagrange J, Klemz R, Schönfelder T, Brandt M, Karbach SH, Knorr M, Finger S, Neukirch C, Häuser F, Beutel ME, Kröller-Schön S, Schulz E, Schnabel RB, Lackner K, Wild PS, Zeller T, Daiber A, Blankenberg S, Münzel T. Heme oxygenase-1 suppresses a pro-inflammatory phenotype in monocytes and determines endothelial function and arterial hypertension in mice and humans. Eur Heart J 2015; 36:3437-46. [PMID: 26516175 DOI: 10.1093/eurheartj/ehv544] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 09/22/2015] [Indexed: 01/22/2023] Open
Abstract
AIMS Heme oxygenase-1 (HO-1) confers protection to the vasculature and suppresses inflammatory properties of monocytes and macrophages. It is unclear how HO-1 determines the extent of vascular dysfunction in mice and humans. METHODS AND RESULTS Decreased HO-1 activity and expression was paralleled by increased aortic expression and activity of the nicotinamide dinucleotide phosphate oxidase Nox2 in HO-1 deficient Hmox1⁻/⁻ and Hmox1(⁺/⁻) compared with Hmox1⁺/⁺ mice. When subjected to angiotensin II-infusion, streptozotocin-induced diabetes mellitus and aging, HO-1 deficient mice showed increased vascular dysfunction inversely correlated with HO activity. In a primary prevention population-based cohort, we assessed length polymorphisms of the HMOX1 promoter region and established a bipolar frequency pattern of allele length (long vs. short repeats) in 4937 individuals. Monocytic HMOX1 mRNA expression was positively correlated with flow-mediated dilation and inversely with CD14 mRNA expression indicating pro-inflammatory monocytes in 733 hypertensive individuals of this cohort. Hmox1⁻/⁻ mice showed drastically increased expression of the chemokine receptor CCR2 in monocytes and the aorta. Angiotensin II-infused Hmox1⁻/⁻ mice had amplified endothelial inflammation in vivo, significantly increased aortic infiltration of pro-inflammatory CD11b⁺ Ly6C(hi) monocytes and Ly6G⁺ neutrophils and were marked by Ly6C(hi) monocytosis in the circulation and an increased blood pressure response. Finally, individuals with unfavourable HMOX1 gene promoter length had increased prevalence of arterial hypertension and reduced cumulative survival after a median follow-up of 7.23 years. CONCLUSIONS Heme oxygenase-1 is a regulator of vascular function in hypertension via determining the phenotype of inflammatory circulating and infiltrating monocytes with possible implications for all-cause mortality.
Collapse
Affiliation(s)
- Philip Wenzel
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany Center for Thrombosis and Hemostasis Mainz, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany German Center for Cardiovascular Research (DZHK), Partner Site RhineMain, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Heidi Rossmann
- Department of Laboratory Medicine, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Christian Müller
- University Heart Center, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Germany
| | - Sabine Kossmann
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany Center for Thrombosis and Hemostasis Mainz, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Matthias Oelze
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Andreas Schulz
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Natalie Arnold
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Canan Simsek
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Jeremy Lagrange
- Center for Thrombosis and Hemostasis Mainz, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Roman Klemz
- Laboratory of Chronobiology, Charité University Medical Center Berlin, Hessische Str. 3-4, 10115 Berlin, Germany
| | - Tanja Schönfelder
- Center for Thrombosis and Hemostasis Mainz, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Moritz Brandt
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Susanne H Karbach
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Maike Knorr
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Stefanie Finger
- Center for Thrombosis and Hemostasis Mainz, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Carolin Neukirch
- Department of Laboratory Medicine, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Friederike Häuser
- Department of Laboratory Medicine, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Swenja Kröller-Schön
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Eberhard Schulz
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Renate B Schnabel
- University Heart Center, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Germany
| | - Karl Lackner
- Department of Laboratory Medicine, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Philipp S Wild
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany Center for Thrombosis and Hemostasis Mainz, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany German Center for Cardiovascular Research (DZHK), Partner Site RhineMain, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Tanja Zeller
- University Heart Center, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Germany
| | - Andreas Daiber
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Stefan Blankenberg
- University Heart Center, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Germany
| | - Thomas Münzel
- Department of Medicine 2, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany German Center for Cardiovascular Research (DZHK), Partner Site RhineMain, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| |
Collapse
|
38
|
Cardona A, Kondapally Seshasai SR, Davey J, Arrebola-Moreno AL, Ambrosio G, Kaski JC, Ray KK. A meta-analysis of published studies of endothelial dysfunction does not support its routine clinical use. Int J Clin Pract 2015; 69:649-58. [PMID: 25728053 DOI: 10.1111/ijcp.12630] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Endothelial dysfunction is a marker of future cardiovascular disease (CVD) risk, yet epidemiological studies have yielded inconsistent results. We therefore studied the association between endothelial dysfunction and CVD under diverse circumstances. METHODS AND RESULTS Literature-based meta-analysis of prospective observational studies with ≥ 12 months of follow-up published in Medline and having information on endothelial function and CVD outcomes. Tabular data on participant characteristics, endothelial function assessments and incident CVD outcomes were abstracted from individual studies. Random-effects meta-analysis was used to quantify pooled associations, and I(2) statistic to evaluate between-study heterogeneity. Potential sources of heterogeneity were explored by subgroup analyses and meta-regression. Thirty five studies involving 17,206 participants met the inclusion criteria. During more than 80,000 person-years of observation, up to 2755 CVD events were accrued, yielding a pooled relative risk (RR) of 1.25 (95% confidence interval 1.15-1.35) for CVD comparing top (i.e. more severe) vs. bottom (less severe) third of endothelial dysfunction. There was significant between-study heterogeneity and evidence of publication bias. RRs varied importantly according to the method used to ascertain endothelial function, and were higher among older individuals and among participants with risk factors for CVD or established CVD at baseline. CONCLUSIONS Although endothelial dysfunction is an important determinant of cardiovascular outcomes in people with pre-existing CVD, current evidence base does not support its use as a potentially useful measurement for risk stratification in people at lower risk of CVD.
Collapse
Affiliation(s)
- A Cardona
- Cardiovascular and Cell Sciences Research Institute, St. George's, University of London, London, UK
- Division of Cardiology, University of Perugia School of Medicine, Perugia, Italy
| | - S R Kondapally Seshasai
- Cardiovascular and Cell Sciences Research Institute, St. George's, University of London, London, UK
| | - J Davey
- Cardiovascular and Cell Sciences Research Institute, St. George's, University of London, London, UK
| | - A L Arrebola-Moreno
- Cardiovascular and Cell Sciences Research Institute, St. George's, University of London, London, UK
- Division of Cardiology, University Hospital Virgen de Las Nieve, Granada, Spain
| | - G Ambrosio
- Division of Cardiology, University of Perugia School of Medicine, Perugia, Italy
| | - J C Kaski
- Cardiovascular and Cell Sciences Research Institute, St. George's, University of London, London, UK
| | - K K Ray
- Cardiovascular and Cell Sciences Research Institute, St. George's, University of London, London, UK
| |
Collapse
|
39
|
Rajapakse NW, Nanayakkara S, Kaye DM. Pathogenesis and treatment of the cardiorenal syndrome: Implications of L-arginine-nitric oxide pathway impairment. Pharmacol Ther 2015; 154:1-12. [PMID: 25989232 DOI: 10.1016/j.pharmthera.2015.05.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 05/07/2015] [Indexed: 01/11/2023]
Abstract
A highly complex interplay exists between the heart and kidney in the setting of both normal and abnormal physiology. In the context of heart failure, a pathophysiological condition termed the cardiorenal syndrome (CRS) exists whereby dysfunction in the heart or kidney can accelerate pathology in the other organ. The mechanisms that underpin CRS are complex, and include neuro-hormonal activation, oxidative stress and endothelial dysfunction. The endothelium plays a central role in the regulation of both cardiac and renal function, and as such impairments in endothelial function can lead to dysfunction of both these organs. In particular, reduced bioavailability of nitric oxide (NO) is a key pathophysiologic component of endothelial dysfunction. The synthesis of NO by the endothelium is critically dependent on the plasmalemmal transport of its substrate, L-arginine, via the cationic amino acid transporter-1 (CAT1). Impaired L-arginine-NO pathway activity has been demonstrated individually in heart and renal failure. Recent findings suggest abnormalities of the L-arginine-NO pathway also play a role in the pathogenesis of CRS and thus this pathway may represent a potential new target for the treatment of heart and renal failure.
Collapse
Affiliation(s)
- Niwanthi W Rajapakse
- Heart Failure Research Group, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Physiology, Monash University, Melbourne, Australia.
| | | | - David M Kaye
- Heart Failure Research Group, Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne Australia; Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia
| |
Collapse
|
40
|
Konradi J, Mollenhauer M, Baldus S, Klinke A. Redox-sensitive mechanisms underlying vascular dysfunction in heart failure. Free Radic Res 2015; 49:721-42. [DOI: 10.3109/10715762.2015.1027200] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
41
|
Levosimendan displays anti-inflammatory effects and decreases MPO bioavailability in patients with severe heart failure. Sci Rep 2015; 5:9704. [PMID: 25867530 PMCID: PMC4394753 DOI: 10.1038/srep09704] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 03/06/2015] [Indexed: 11/09/2022] Open
Abstract
Treatment of decompensated heart failure often includes administration of levosimendan. Myeloperoxidase (MPO) is released during polymorphonuclear neutrophil (PMN) degranulation, and mediates dysregulation of vascular tone in heart failure. We evaluated the effects of levosimendan-treatment on MPO in patients with acute decompensation of chronic heart failure over a one week course. Plasma MPO levels were significantly decreased after levosimendan treatment (from 252.1 ± 31.1 pmol/l at baseline to 215.02 ± 27.96 pmol/l at 6 h, p < 0.05). Ex vivo incubation of whole blood with levosimendan decreased MPO release after PMN-stimulation (8.2 ± 1.4-fold increase at baseline vs. 6.0 ± 1.1-fold increase with levosimendan). MPO levels also significantly correlated with diastolic blood pressure over the time course. In a multivariate linear model, the main contributor to systolic, diastolic and mean blood pressure was level of PMN elastase. MPO contributed only in heparin-treated patients, suggesting a more significant role for endothelial-bound MPO than for circulating MPO or elastase with respect to blood pressure regulation. We here provide the first evidence that levosimendan treatment inhibits MPO release by PMNs in decompensated heart failure patients. This mechanism may regulate endothelial function and vascular tone in heart failure patients.
Collapse
|
42
|
Amabile N, Boulanger CM, Caussin C. Unexpected benefits of TAVI: a therapy for the heart and the vessels. EUROINTERVENTION 2015; 10:1375-7. [DOI: 10.4244/eijy14m11_05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
43
|
Abstract
This review summarizes the current methods for the functional assessment of vascular damage (e.g., assessment of endothelial function, measurement of pulse wave velocity, and pressure wave analysis) and describes the association between vascular dysfunction and chronic cardio-renal syndrome. Vascular dysfunction may contribute to the development and progression of heart failure. Additionally, vascular dysfunction, especially increased arterial stiffness and abnormal pressure wave reflection and central hemodynamics, has been reported to accelerate renal function decline. Furthermore, renal dysfunction worsens vascular pathophysiological abnormalities. Therefore, the functional assessment of vascular damage may be useful in the management of cardio-renal syndrome.
Collapse
|
44
|
Brachial flow-mediated dilation predicts subclinical target organ damage progression in essential hypertensive patients. J Hypertens 2014; 32:2393-400; discussion 2400. [DOI: 10.1097/hjh.0000000000000337] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
45
|
Cell-sheet therapy with omentopexy promotes arteriogenesis and improves coronary circulation physiology in failing heart. Mol Ther 2014; 23:374-86. [PMID: 25421595 DOI: 10.1038/mt.2014.225] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 11/16/2014] [Indexed: 12/25/2022] Open
Abstract
Cell-sheet transplantation induces angiogenesis for chronic myocardial infarction (MI), though insufficient capillary maturation and paucity of arteriogenesis may limit its therapeutic effects. Omentum has been used clinically to promote revascularization and healing of ischemic tissues. We hypothesized that cell-sheet transplantation covered with an omentum-flap would effectively establish mature blood vessels and improve coronary microcirculation physiology, enhancing the therapeutic effects of cell-sheet therapy. Rats were divided into four groups after coronary ligation; skeletal myoblast cell-sheet plus omentum-flap (combined), cell-sheet only, omentum-flap only, and sham operation. At 4 weeks after the treatment, the combined group showed attenuated cardiac hypertrophy and fibrosis, and a greater amount of functionally (CD31(+)/lectin(+)) and structurally (CD31(+)/α-SMA(+)) mature blood vessels, along with myocardial upregulation of relevant genes. Synchrotron-based microangiography revealed that the combined procedure increased vascularization in resistance arterial vessels with better dilatory responses to endothelium-dependent agents. Serial (13)N-ammonia PET showed better global coronary flow reserve in the combined group, mainly attributed to improvement in the basal left ventricle. Consequently, the combined group had sustained improvements in cardiac function parameters and better functional capacity. Cell-sheet transplantation with an omentum-flap better promoted arteriogenesis and improved coronary microcirculation physiology in ischemic myocardium, leading to potent functional recovery in the failing heart.
Collapse
|
46
|
Shantsila E, Wrigley BJ, Blann AD, Gill PS, Lip GY. A contemporary view on endothelial function in heart failure. Eur J Heart Fail 2014; 14:873-81. [DOI: 10.1093/eurjhf/hfs066] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Eduard Shantsila
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital; Birmingham B18 7QH UK
| | - Benjamin J. Wrigley
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital; Birmingham B18 7QH UK
| | - Andrew D. Blann
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital; Birmingham B18 7QH UK
| | - Paramjit S. Gill
- Primary Care Clinical Sciences; University of Birmingham; Birmingham UK
| | - Gregory Y.H. Lip
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital; Birmingham B18 7QH UK
| |
Collapse
|
47
|
Green DJ, Dawson EA, Groenewoud HM, Jones H, Thijssen DH. Is Flow-Mediated Dilation Nitric Oxide Mediated? Hypertension 2014; 63:376-82. [DOI: 10.1161/hypertensionaha.113.02044] [Citation(s) in RCA: 230] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Flow-mediated dilation (FMD) is a noninvasive index of endothelial function and vascular health in humans. Studies examining the role of nitric oxide (NO) are not conclusive. In this article, we quantified the contribution of NO in FMD of conduit arteries and explored the effect of the protocol (ie, distal cuff, ≈5-minute ischemia) and method of analysis (ie, automated and continuous edge detection) on the NO dependency of this test. A systematic review and 3-stage meta-analysis of published crossover studies that measured FMD under local infusion of saline or the NO synthase blocker
N
G
monomethyl-L-arginine (L-NMMA) was undertaken. Twenty studies met the inclusion criteria for stage 1 (374 individual comparisons). The meta-analyzed outcome was the difference in FMD between infusion of saline (ie, FMD
saline
) and NO synthase blocker (ie, FMD
L-NMMA
). Overall, FMD
saline
was 8.2% (95% confidence interval [CI], 6.8%–9.6%) compared with FMD
L-NMMA
of 3.7% (95% CI, 3.1%–4.3%;
P
<0.001). Stage 2 analysis focused on studies that used the most commonly adopted approach in healthy volunteers (ie, distal cuff placement, ≈5-minute occlusion), which similarly revealed a significant NO contribution to FMD (FMD
saline
, 6.5% [95% CI, 5.7%–7.3%]; FMD
L-NMMA
, 0.9% [95% CI, 0.5%–1.3%];
P
<0.001). Stage 3 meta-analyzed the studies that adopted the commonly adopted approach and automated, continuous method of analysis, which also revealed a significant contribution of NO to the FMD (FMD
saline
, 6.9% [95% CI, 6.0%–7.8%]; FMD
L-NMMA
, 2.4% [95% CI, 1.1%–3.7%];
P
<0.001). This comprehensive analysis demonstrates that FMD of conduit arteries in humans is, at least in part, mediated by NO.
Collapse
Affiliation(s)
- Daniel J. Green
- From the Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom (D.J.G., E.A.D., H.J., D.H.J.T.); School of Sports Science, Exercise and Health, The University of Western Australia, Crawley Perth, Western Australia (D.J.G.); and Departments of Health Evidence (H.M.M.G.) and Physiology (D.H.J.T.), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ellen A. Dawson
- From the Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom (D.J.G., E.A.D., H.J., D.H.J.T.); School of Sports Science, Exercise and Health, The University of Western Australia, Crawley Perth, Western Australia (D.J.G.); and Departments of Health Evidence (H.M.M.G.) and Physiology (D.H.J.T.), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hans M.M. Groenewoud
- From the Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom (D.J.G., E.A.D., H.J., D.H.J.T.); School of Sports Science, Exercise and Health, The University of Western Australia, Crawley Perth, Western Australia (D.J.G.); and Departments of Health Evidence (H.M.M.G.) and Physiology (D.H.J.T.), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Helen Jones
- From the Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom (D.J.G., E.A.D., H.J., D.H.J.T.); School of Sports Science, Exercise and Health, The University of Western Australia, Crawley Perth, Western Australia (D.J.G.); and Departments of Health Evidence (H.M.M.G.) and Physiology (D.H.J.T.), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dick H.J. Thijssen
- From the Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom (D.J.G., E.A.D., H.J., D.H.J.T.); School of Sports Science, Exercise and Health, The University of Western Australia, Crawley Perth, Western Australia (D.J.G.); and Departments of Health Evidence (H.M.M.G.) and Physiology (D.H.J.T.), Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
48
|
Rabelo ER, Ruschel K, Moreno H, Rubira M, Consolim-Colombo FM, Irigoyen MC, Rohde LE. Venous endothelial function in heart failure: Comparison with healthy controls and effect of clinical compensation. Eur J Heart Fail 2014; 10:758-64. [DOI: 10.1016/j.ejheart.2008.06.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Revised: 05/02/2008] [Accepted: 06/09/2008] [Indexed: 11/28/2022] Open
Affiliation(s)
- Eneida R. Rabelo
- Cardiovascular Division of Hospital de Clínicas de Porto Alegre, The Post-Graduation Programs in Biology?Physiology and Cardiology?Cardiovascular Sciences; Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil, The Heart Institute (InCor); São Paulo SP Brazil
| | - Karen Ruschel
- Cardiovascular Division of Hospital de Clínicas de Porto Alegre, The Post-Graduation Programs in Biology?Physiology and Cardiology?Cardiovascular Sciences; Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil, The Heart Institute (InCor); São Paulo SP Brazil
| | - Heitor Moreno
- Cardiovascular Division of Hospital de Clínicas de Porto Alegre, The Post-Graduation Programs in Biology?Physiology and Cardiology?Cardiovascular Sciences; Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil, The Heart Institute (InCor); São Paulo SP Brazil
| | - Marcelo Rubira
- Cardiovascular Division of Hospital de Clínicas de Porto Alegre, The Post-Graduation Programs in Biology?Physiology and Cardiology?Cardiovascular Sciences; Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil, The Heart Institute (InCor); São Paulo SP Brazil
| | - Fernanda M. Consolim-Colombo
- Cardiovascular Division of Hospital de Clínicas de Porto Alegre, The Post-Graduation Programs in Biology?Physiology and Cardiology?Cardiovascular Sciences; Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil, The Heart Institute (InCor); São Paulo SP Brazil
| | - Maria Cláudia Irigoyen
- Cardiovascular Division of Hospital de Clínicas de Porto Alegre, The Post-Graduation Programs in Biology?Physiology and Cardiology?Cardiovascular Sciences; Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil, The Heart Institute (InCor); São Paulo SP Brazil
| | - Luis E. Rohde
- Cardiovascular Division of Hospital de Clínicas de Porto Alegre, The Post-Graduation Programs in Biology?Physiology and Cardiology?Cardiovascular Sciences; Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil, The Heart Institute (InCor); São Paulo SP Brazil
| |
Collapse
|
49
|
Periodontitis is associated with endothelial dysfunction in a general population: a cross-sectional study. PLoS One 2013; 8:e84603. [PMID: 24386401 PMCID: PMC3873439 DOI: 10.1371/journal.pone.0084603] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 11/16/2013] [Indexed: 01/22/2023] Open
Abstract
A large body of evidence underlines an association between periodontal disease and cardiovascular disease. In contrast, data on its relation with endothelial dysfunction as a marker of early subclinical atherosclerosis is inconclusive and limited to patient-cohort studies. We therefore investigated the association between periodontal disease and flow-mediated dilation of the brachial artery (FMD) as a measure of endothelial dysfunction in a general population, and also addressed a possible mediation via inflammation. The study population comprised 1,234 subjects (50.5% men) aged 25–85 years from the 5-year follow-up of the Study of Health in Pomerania, a population-based cohort study. Clinical attachment loss (CAL) and pocket probing depth (PPD) as measures of periodontal disease were assessed half-mouth at four sites per tooth. Subjects were classified according to the periodontitis case definition proposed by Tonetti and Claffey (2005). Measurements of FMD and nitroglycerin-mediated dilation (NMD) were performed using standardized ultrasound techniques. High-sensitive C-reactive protein, fibrinogen and leukocyte count were measured. Fully adjusted multivariate linear regression analyses revealed significant associations of the percentage of sites with PPD ≥6 mm with FMD (ptrend=0.048), with subjects within the highest category having a 0.74% higher FMD compared to subjects within the lowest category (p<0.05). Consistently, FMD values increased significantly across categories of the percentage of sites with CAL ≥6 mm (ptrend=0.01) and the periodontitis case definition (ptrend=0.006). Restrictions to subjects without antihypertensive or statin medication or current non-smokers confirmed previous results. Systemic inflammation did not seem to mediate the relation. Both PPD and CAL were not consistently associated with NMD. In contrast to previous studies, high levels of periodontal disease were significantly associated with high FMD values. This association was not mediated via systemic inflammation. This study revives the discussion on whether and how periodontitis contributes to endothelial dysfunction.
Collapse
|
50
|
Tousoulis D, Oikonomou E, Siasos G, Stefanadis C. Statins in heart failure--With preserved and reduced ejection fraction. An update. Pharmacol Ther 2013; 141:79-91. [PMID: 24022031 DOI: 10.1016/j.pharmthera.2013.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 08/12/2013] [Indexed: 12/26/2022]
Abstract
HMG-CoA reductase inhibitors or statins beyond their lipid lowering properties and mevalonate inhibition exert also their actions through a multiplicity of mechanisms. In heart failure (HF) the inhibition of isoprenoid intermediates and small GTPases, which control cellular function such as cell shape, secretion and proliferation, is of clinical significance. Statins share also the peroxisome proliferator-activated receptor pathway and inactivate extracellular-signal-regulated kinase phosphorylation suppressing inflammatory cascade. By down-regulating Rho/Rho kinase signaling pathways, statins increase the stability of eNOS mRNA and induce activation of eNOS through phosphatidylinositol 3-kinase/Akt/eNOS pathway restoring endothelial function. Statins change also myocardial action potential plateau by modulation of Kv1.5 and Kv4.3 channel activity and inhibit sympathetic nerve activity suppressing arrhythmogenesis. Less documented evidence proposes also that statins have anti-hypertrophic effects - through p21ras/mitogen activated protein kinase pathway - which modulate synthesis of matrix metalloproteinases and procollagen 1 expression affecting interstitial fibrosis and diastolic dysfunction. Clinical studies have partly confirmed the experimental findings and despite current guidelines new evidence supports the notion that statins can be beneficial in some cases of HF. In subjects with diastolic HF, moderately impaired systolic function, low b-type natriuretic peptide levels, exacerbated inflammatory response and mild interstitial fibrosis evidence supports that statins can favorably affect the outcome. Under the lights of this evidence in this review article we discuss the current knowledge on the mechanisms of statins' actions and we link current experimental and clinical data to further understand the possible impact of statins' treatment on HF syndrome.
Collapse
Affiliation(s)
- Dimitris Tousoulis
- 1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece.
| | - Evangelos Oikonomou
- 1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece
| | - Gerasimos Siasos
- 1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece
| | - Christodoulos Stefanadis
- 1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece
| |
Collapse
|