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Chowdhury SM, Atz AM, Graham EM, Bandisode VM, Rhodes JF, Nutting AC, Taylor C, Savage A, Hassid M, Kavarana M, Menick D. Low Ventricular Stiffness Is Associated With Suboptimal Outcomes in Patients With a Single Right Ventricle After the Fontan Operation: A Novel Phenotype. J Am Heart Assoc 2024; 13:e035601. [PMID: 39189484 DOI: 10.1161/jaha.124.035601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 07/09/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Despite a rigorous screening process, including cardiac catheterization, a subset of patients with a single right ventricle (SRV) demonstrates suboptimal short-term outcomes after the Fontan operation. The goal of this study was to perform a comprehensive assessment of diastolic function in pre-Fontan patients with an SRV using invasive reference-standard measures and determine their associations with post-Fontan outcomes. METHODS AND RESULTS Children aged 2 to 6 years with SRV physiology undergoing pre-Fontan heart catheterization were recruited prospectively. Patients were divided into those who had an optimal or suboptimal outcome. A suboptimal outcome was defined as length of stay ≥14 days or heart transplant/cardiac death in first year after Fontan. Patients underwent pressure-volume loop analysis using reference-standard methods. The measure of ventricular stiffness, β, was obtained via preload reduction. Cardiac magnetic resonance imaging for extracellular volume and serum draws for matrix metalloproteinase activity were performed. Of 19 patients with an SRV, 9 (47%) had a suboptimal outcome. Mean age was 4.2±0.7 years. Patients with suboptimal outcomes had lower ventricular stiffness (0.021 [0.009-0.049] versus 0.090 [0.031-0.118] mL-1; P=0.02), lower extracellular volume (25% [28%-32%] versus 31% [28%-33%]; P=0.02), and lower matrix metalloproteinase-2 (90 [79-104] versus 108 [79-128] ng/mL; P=0.01) compared with patients with optimal outcomes. The only invasive measure that had an association with suboptimal outcome was β (P=0.038). CONCLUSIONS Patients with an SRV with suboptimal outcome after the Fontan operation had lower ventricular stiffness and evidence of maladaptive extracellular matrix metabolism compared with patients with optimal outcome. This appears to be a novel phenotype that may have important clinical implications and requires further study.
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Affiliation(s)
- Shahryar M Chowdhury
- Department of Pediatrics, Division of Cardiology Medical University of South Carolina Charleston SC USA
| | - Andrew M Atz
- Department of Pediatrics, Division of Cardiology Medical University of South Carolina Charleston SC USA
| | - Eric M Graham
- Department of Pediatrics, Division of Cardiology Medical University of South Carolina Charleston SC USA
| | - Varsha M Bandisode
- Department of Pediatrics, Division of Cardiology Medical University of South Carolina Charleston SC USA
| | - John F Rhodes
- Department of Pediatrics, Division of Cardiology Medical University of South Carolina Charleston SC USA
| | - Arni C Nutting
- Department of Pediatrics, Division of Cardiology Medical University of South Carolina Charleston SC USA
| | - Carolyn Taylor
- Department of Pediatrics, Division of Cardiology Medical University of South Carolina Charleston SC USA
| | - Andrew Savage
- Department of Pediatrics, Division of Cardiology Medical University of South Carolina Charleston SC USA
| | - Marc Hassid
- Department of Anesthesia Medical University of South Carolina Charleston SC USA
| | - Minoo Kavarana
- Department of Surgery Medical University of South Carolina Charleston SC USA
| | - Donald Menick
- Department of Medicine, Division of Cardiology Medical University of South Carolina Charleston SC USA
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Kato S, Himeno Y, Amano A. Mathematical analysis of left ventricular elastance with respect to afterload change during ejection phase. PLoS Comput Biol 2024; 20:e1011974. [PMID: 38635493 PMCID: PMC11025827 DOI: 10.1371/journal.pcbi.1011974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/07/2024] [Indexed: 04/20/2024] Open
Abstract
Since the left ventricle (LV) has pressure (Plv) and volume (Vlv), we can define LV elastance from the ratio between Plv and Vlv, termed as "instantaneous elastance." On the other hand, end-systolic elastance (Emax) is known to be a good index of LV contractility, which is measured by the slope of several end-systolic Plv-Vlv points obtained by using different loads. The word Emax originates from the assumption that LV elastance increases during the ejection phase and attains its maximum at the end-systole. From this concept, we can define another elastance determined by the slope of isochronous Plv-Vlv points, that is Plv-Vlv points at a certain time after the ejection onset time by using different loads. We refer to this elastance as "load-dependent elastance." To reveal the relation between these two elastances, we used a hemodynamic model that included a detailed ventricular myocyte contraction model. From the simulation results, we found that the isochronous Plv-Vlv points lay in one line and that the line slope corresponding to the load-dependent elastance slightly decreased during the ejection phase, which is quite different from the instantaneous elastance. Subsequently, we analyzed the mechanism determining these elastances from the model equations. We found that instantaneous elastance is directly related to contraction force generated by the ventricular myocyte, but the load-dependent elastance is determined by two factors: one is the transient characteristics of the cardiac cell, i.e., the velocity-dependent force drops characteristics in instantaneous shortening. The other is the force-velocity relation of the cardiac cell. We also found that the linear isochronous pressure-volume relation is based on the approximately linear relation between the time derivative of the cellular contraction force and the cellular shortening velocity that results from the combined characteristics of LV and aortic compliances.
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Affiliation(s)
- Shiro Kato
- Department of Bioinformatics, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Yukiko Himeno
- Department of Bioinformatics, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Akira Amano
- Department of Bioinformatics, Ritsumeikan University, Kusatsu, Shiga, Japan
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Gao S, Liu XP, Li TT, Chen L, Feng YP, Wang YK, Yin YJ, Little PJ, Wu XQ, Xu SW, Jiang XD. Animal models of heart failure with preserved ejection fraction (HFpEF): from metabolic pathobiology to drug discovery. Acta Pharmacol Sin 2024; 45:23-35. [PMID: 37644131 PMCID: PMC10770177 DOI: 10.1038/s41401-023-01152-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
Heart failure (HF) with preserved ejection fraction (HFpEF) is currently a preeminent challenge for cardiovascular medicine. It has a poor prognosis, increasing mortality, and is escalating in prevalence worldwide. Despite accounting for over 50% of all HF patients, the mechanistic underpinnings driving HFpEF are poorly understood, thus impeding the discovery and development of mechanism-based therapies. HFpEF is a disease syndrome driven by diverse comorbidities, including hypertension, diabetes and obesity, pulmonary hypertension, aging, and atrial fibrillation. There is a lack of high-fidelity animal models that faithfully recapitulate the HFpEF phenotype, owing primarily to the disease heterogeneity, which has hampered our understanding of the complex pathophysiology of HFpEF. This review provides an updated overview of the currently available animal models of HFpEF and discusses their characteristics from the perspective of energy metabolism. Interventional strategies for efficiently utilizing energy substrates in preclinical HFpEF models are also discussed.
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Affiliation(s)
- Si Gao
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China
| | - Xue-Ping Liu
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China
| | - Ting-Ting Li
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China
| | - Li Chen
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China
| | - Yi-Ping Feng
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China
| | - Yu-Kun Wang
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China
| | - Yan-Jun Yin
- School of Pharmacy, Bengbu Medical College, Bengbu, 233000, China
| | - Peter J Little
- School of Pharmacy, University of Queensland, Pharmacy Australia Centre of Excellence, Woolloongabba, QLD, 4102, Australia
| | - Xiao-Qian Wu
- Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, 511436, China.
| | - Suo-Wen Xu
- Department of Endocrinology, First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China.
| | - Xu-Dong Jiang
- Department of Pharmacy, School of Medicine, Guangxi University of Science and Technology, Liuzhou, 545005, China.
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Yang H, Zhu J, Fu H, Shuai W. Dapansutrile Ameliorates Atrial Inflammation and Vulnerability to Atrial Fibrillation in HFpEF Rats. Heart Lung Circ 2024; 33:65-77. [PMID: 38040503 DOI: 10.1016/j.hlc.2023.09.017] [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: 05/22/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Numerous studies have demonstrated that NLRP3 inflammasomes are key players in the progression of atrial fibrillation (AF) in heart failure with preserved ejection fraction (HFpEF). This study aimed to analyse the effect of pharmacological inhibition of NLRP3 inflammasomes using dapansutrile (DAPA), an oral NLRP3-specific inhibitor. METHODS Dahl salt-sensitive rats were fed a high-salt diet (HSD, 8% NaCl) to induce HFpEF. Either DAPA (200 mg/kg/day) or saline was administered daily via gavage for 4 weeks. Electrophysiological studies were performed to assess the AF inducibility. Confocal fluorescence microscopy and western blot analysis were used to study calcium handling. RESULTS The DAPA-treated HFpEF rats were less prone to AF induction by programmed electrical stimulation. Atrial fibrosis and inflammation were attenuated in DAPA-treated HFpEF hearts. Dapansutrile treatment showed an increase in the Ca2+ transient sarcoplasmic reticulum-Ca2+ load, and protein expression of SERCA2; NCX1 and phosphorylation of PLB at Thr17 were decreased following DAPA treatment. The increased frequency of spontaneous Ca2+ spark in the HFpEF rats was related to the hyperphosphorylation of RyR2 at Ser2814, which was blunted in DAPA treatment. Dapansutrile treatment also decreased the phosphorylation of CaMKII expression in the HFpEF rats. Mechanistically, DAPA exerts an anti-arrhythmic effect, mainly by inhibiting activation of the NLRP3 inflammasome. CONCLUSION These data provide evidence that the beneficial cardiac effects of DAPA are associated with reduced atrial inflammation and improved CaMKII-dependent Ca2+-handling abnormalities via blunting activation of the NLRP3 inflammasome, and DAPA may be beneficial in a rat model of HFpEF-induced AF.
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Affiliation(s)
- Hongjie Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Jun Zhu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Hui Fu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Wei Shuai
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China.
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Seropian IM, Cassaglia P, Miksztowicz V, González GE. Unraveling the role of galectin-3 in cardiac pathology and physiology. Front Physiol 2023; 14:1304735. [PMID: 38170009 PMCID: PMC10759241 DOI: 10.3389/fphys.2023.1304735] [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: 10/12/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
Galectin-3 (Gal-3) is a carbohydrate-binding protein with multiple functions. Gal-3 regulates cell growth, proliferation, and apoptosis by orchestrating cell-cell and cell-matrix interactions. It is implicated in the development and progression of cardiovascular disease, and its expression is increased in patients with heart failure. In atherosclerosis, Gal-3 promotes monocyte recruitment to the arterial wall boosting inflammation and atheroma. In acute myocardial infarction (AMI), the expression of Gal-3 increases in infarcted and remote zones from the beginning of AMI, and plays a critical role in macrophage infiltration, differentiation to M1 phenotype, inflammation and interstitial fibrosis through collagen synthesis. Genetic deficiency of Gal-3 delays wound healing, impairs cardiac remodeling and function after AMI. On the contrary, Gal-3 deficiency shows opposite results with improved remodeling and function in other cardiomyopathies and in hypertension. Pharmacologic inhibition with non-selective inhibitors is also protective in cardiac disease. Finally, we recently showed that Gal-3 participates in normal aging. However, genetic absence of Gal-3 in aged mice exacerbates pathological hypertrophy and increases fibrosis, as opposed to reduced fibrosis shown in cardiac disease. Despite some gaps in understanding its precise mechanisms of action, Gal-3 represents a potential therapeutic target for the treatment of cardiovascular diseases and the management of cardiac aging. In this review, we summarize the current knowledge regarding the role of Gal-3 in the pathophysiology of heart failure, atherosclerosis, hypertension, myocarditis, and ischemic heart disease. Furthermore, we describe the physiological role of Gal-3 in cardiac aging.
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Affiliation(s)
- Ignacio M. Seropian
- Laboratorio de Patología Cardiovascular Experimental e Hipertensión Arterial, Instituto de Investigaciones Biomédicas (UCA-CONICET), Facultad de Ciencias Médicas Universidad Católica Argentina, Buenos Aires, Argentina
- Servicio de Hemodinamia, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Pablo Cassaglia
- Departamento de Patología, Instituto de Salud Comunitaria, Universidad Nacional de Hurlingham, Buenos Aires, Argentina
| | - Verónica Miksztowicz
- Laboratorio de Patología Cardiovascular Experimental e Hipertensión Arterial, Instituto de Investigaciones Biomédicas (UCA-CONICET), Facultad de Ciencias Médicas Universidad Católica Argentina, Buenos Aires, Argentina
| | - Germán E. González
- Laboratorio de Patología Cardiovascular Experimental e Hipertensión Arterial, Instituto de Investigaciones Biomédicas (UCA-CONICET), Facultad de Ciencias Médicas Universidad Católica Argentina, Buenos Aires, Argentina
- Departamento de Patología, Instituto de Salud Comunitaria, Universidad Nacional de Hurlingham, Buenos Aires, Argentina
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Hu SY, Zhou Y, Zhong SJ, Yang M, Huang SM, Li L, Li XC, Hu ZX. Shenmai Injection Improves Hypertensive Heart Failure by Inhibiting Myocardial Fibrosis via TGF-β 1/Smad Pathway Regulation. Chin J Integr Med 2023; 29:119-126. [PMID: 35840852 DOI: 10.1007/s11655-022-2899-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To study effects of Shenmai Injection on hypertensive heart failure and its mechanism for inhibiting myocardial fibrosis. METHODS Salt-sensitive (Dahl/SS) rats were fed with normal diet (0.3% NaCl) and the high-salt diet (8% NaCl) to observe the changes in blood pressure and heart function, as the control group and the model group. Salt-insensitive rats (SS-13BN) were fed with the high-salt diet (8% NaCl) as the negative control group. After modeling, the model rats were randomly divided into heart failure (HF) group, Shenmai Injection (SMI) group and pirfenidone (PFD) group by a random number table, with 6 rats in each group. They were given sterilized water, SMI and pirfenidone, respectively. Blood pressure, cardiac function, fibrosis and related molecular expression were detected by sphygmomanometer, echocardiogram, enzyme linked immunosorbent assay (ELISA), hematoxylin-eosin staining, Masson staining, immunofluorescence and qPCR analysis. RESULTS After high-salt feeding, compared with the control and negative control group, in the model group the blood pressure increased significantly, the left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were significantly reduced, and the serum NT-proBNP concentration increased significantly (all P<0.05); furthermore, the arrangement of myocardial cells was disordered, the edema was severe, and the degree of myocardial fibrosis was also significantly increased (P<0.05); the protein and mRNA expressions of collagen type I (Col I) were up-regulated (P<0.05), and the mRNA expressions of transforming growth factor β 1 (TGF- β 1), Smad2 and Smad3 were significantly up-regulated (P<0.05). Compared with HF group, after intervention of Shenmai Injection, LVEF and LVFS increased, myocardial morphology was improved, collagen volume fraction decreased significantly (P<0.05), and the mRNA expressions of Col I, TGF- β 1, Smad2 and Smad3, as well as Col I protein expression, were all significantly down-regulated (all P<0.05). CONCLUSION Myocardial fibrosis is the main pathological manifestation of hypertensive heart failure, and Shenmai Injection could inhibit myocardial fibrosis and effectively improve heart failure by regulating TGF-β 1/Smad signaling pathway.
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Affiliation(s)
- Si-Yuan Hu
- School of Sports Art, Hunan University of Chinese Medicine, Changsha, 410208, China.,College of Health Science, Wuhan Sports University, Wuhan, 430079, China
| | - Yao Zhou
- Department of Medicine, Hunan Traditional Chinese Medical College, Zhuzhou, Hunan Province, 412012, China
| | - Sen-Jie Zhong
- Graduate School, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Meng Yang
- Graduate School, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Shu-Min Huang
- Graduate School, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Lin Li
- Graduate School, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Xin-Chun Li
- Graduate School, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Zhi-Xi Hu
- Institute of Chinese Medicine Diagnosis, Hunan University of Chinese Medicine, Changsha, 410208, China.
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Urbanek K, Cappetta D, Bellocchio G, Coppola MA, Imbrici P, Telesca M, Donniacuo M, Riemma MA, Mele E, Cianflone E, Naviglio S, Conte E, Camerino GM, Mele M, Bucci M, Castaldo G, De Luca A, Rossi F, Berrino L, Liantonio A, De Angelis A. Dapagliflozin protects the kidney in a non-diabetic model of cardiorenal syndrome. Pharmacol Res 2023; 188:106659. [PMID: 36646190 DOI: 10.1016/j.phrs.2023.106659] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
Cardiorenal syndrome encompasses a spectrum of disorders involving heart and kidney dysfunction, and sharing common risk factors, such as hypertension and diabetes. Clinical studies have shown that patients with and without diabetes may benefit from using sodium-glucose cotransporter 2 inhibitors to reduce the risk of heart failure and ameliorate renal endpoints. Because the underlying mechanisms remain elusive, we investigated the effects of dapagliflozin on the progression of renal damage, using a model of non-diabetic cardiorenal disease. Dahl salt-sensitive rats were fed a high-salt diet for five weeks and then randomized to dapagliflozin or vehicle for the following six weeks. After treatment with dapagliflozin, renal function resulted ameliorated as shown by decrease of albuminuria and urine albumin-to-creatinine ratio. Functional benefit was accompanied by a decreased accumulation of extracellular matrix and a reduced number of sclerotic glomeruli. Dapagliflozin significantly reduced expression of inflammatory and endothelial activation markers such as NF-κB and e-selectin. Upregulation of pro-oxidant-releasing NADPH oxidases 2 and 4 as well as downregulation of antioxidant enzymes were also counteracted by drug treatment. Our findings also evidenced the modulation of both classic and non-classic renin-angiotensin-aldosterone system (RAAS), and effects of dapagliflozin on gene expression of ion channels/transporters involved in renal homeostasis. Thus, in a non-diabetic model of cardiorenal syndrome, dapagliflozin provides renal protection by modulating inflammatory response, endothelial activation, fibrosis, oxidative stress, local RAAS and ion channels.
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Affiliation(s)
- Konrad Urbanek
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Via A. Pansini 5, 80131 Naples, Italy; CEINGE-Advanced Biotechnologies, Via G. Salvatore 486, 80131 Naples, Italy
| | - Donato Cappetta
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138 Naples, Italy; Department of Biological and Environmental Sciences and Technologies, University of Salento, Via Lecce-Monteroni, Monteroni di Lecce, 73047 Lecce, Italy
| | - Gabriella Bellocchio
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138 Naples, Italy
| | - Maria Antonietta Coppola
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", Via Orabona 4, 70125 Bari, Italy
| | - Paola Imbrici
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", Via Orabona 4, 70125 Bari, Italy
| | - Marialucia Telesca
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138 Naples, Italy
| | - Maria Donniacuo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138 Naples, Italy
| | - Maria Antonietta Riemma
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138 Naples, Italy
| | - Elena Mele
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138 Naples, Italy
| | - Eleonora Cianflone
- Department of Medical and Surgical Sciences, Magna Graecia University, Viale Europa, 88100 Catanzaro, Italy
| | - Silvio Naviglio
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138 Naples, Italy
| | - Elena Conte
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", Via Orabona 4, 70125 Bari, Italy
| | - Giulia Maria Camerino
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", Via Orabona 4, 70125 Bari, Italy
| | - Marco Mele
- University Hospital Policlinico Riuniti, Viale Pinto 1, 71100 Foggia, Italy
| | - Mariarosaria Bucci
- Department of Pharmacy, University of Naples "Federico II", Via A. Pansini 5, 80131 Naples, Italy
| | - Giuseppe Castaldo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Via A. Pansini 5, 80131 Naples, Italy; CEINGE-Advanced Biotechnologies, Via G. Salvatore 486, 80131 Naples, Italy
| | - Annamaria De Luca
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", Via Orabona 4, 70125 Bari, Italy
| | - Francesco Rossi
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138 Naples, Italy
| | - Liberato Berrino
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138 Naples, Italy
| | - Antonella Liantonio
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", Via Orabona 4, 70125 Bari, Italy
| | - Antonella De Angelis
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via Costantinopoli 16, 80138 Naples, Italy.
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Potential Impact of Non-Steroidal Mineralocorticoid Receptor Antagonists in Cardiovascular Disease. Int J Mol Sci 2023; 24:ijms24031922. [PMID: 36768246 PMCID: PMC9915890 DOI: 10.3390/ijms24031922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Inappropriate mineralocorticoid receptor (MR) activation in different cardiovascular cell types has deleterious effects on cardiac remodeling and function. Therefore, MR inhibition is a crucial pharmacological strategy to overcome cardiovascular dysfunction. Despite efficient blockade of MR with steroidal MR antagonists (MRAs), their clinical application is unsatisfactory due to the adverse effects. Newer non-steroidal MRAs with greater potency could be suitable for clinical application, especially in patients with type 2 diabetes mellitus and chronic kidney disease. Although clinical evidence has shown the beneficial effects of non-steroidal MRAs on cardiovascular outcomes in patients with heart failure with reduced ejection fraction, clinical trials are ongoing to evaluate the efficacy of heart failure with preserved ejection fraction. Therefore, comparative pharmacological characterization of non-steroidal MRAs over classic steroidal MRAs is crucial. Here, we summarize the pre-clinical evidence of non-steroidal MRAs, which suggests an improvement in cardiac dysfunction, as well as the underlying molecular mechanisms in animal models mimicking different clinical conditions. In addition, we discuss up-to-date information from clinical trials regarding the beneficial effects of non-steroidal MRAs on meaningful cardiovascular outcomes. Both pre-clinical and clinical evidence support treatment with non-steroidal MRAs in patients with cardiovascular disease.
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9
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Xu H, Gao K, Liu C, Li T, Ding Y, Ma J. Pathological mechanism of heart failure with preserved ejection fraction in rats based on iTRAQ technology. PeerJ 2023; 11:e15280. [PMID: 37159835 PMCID: PMC10163871 DOI: 10.7717/peerj.15280] [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: 02/15/2023] [Accepted: 04/03/2023] [Indexed: 05/11/2023] Open
Abstract
Objective Heart failure with preserved ejection fraction (HFpEF) is a public health problem worldwide. Treatments for the patients with HFpEF are not satisfactory because there is no unified understanding of the pathological mechanism of HFpEF. This study aims at investigating the potential pathological mechanism for the effective diagnosis and treatment of HFpEF. Methods Ten adult male Dahl salt sensitive rats (180-200 g) were divided into control and model groups. The rats in model group were fed with high salt diet (8% NaCl) to induce HFpEF for this comparative study. Behavioral changes, biochemical parameters, and histopathological changes of the rats were detected. iTRAQ technology combined with bioinformatics analysis was employed to study the differentially expressed proteins (DEPs) and their enrichment in signaling pathways. Results Echocardiography detection showed decreased LVEF, indicating impaired cardiac function (P < 0.01), increased LVPWd, indicating ventricular wall hypertrophy (P < 0.05), prolonged duration of IVRT and decreased E/A ratio, indicating diastolic dysfunction (P < 0.05) of the rats in model group. 563 DEPs were identified in the rats of both groups, with 243 up-regulated and 320 down-regulated. The expression of PPAR signaling pathway in the rats of model group was down-regulated, with PPARα most significantly decreased (91.2%) (P < 0.01), PPARγ obviously decreased (63.60%) (P < 0.05), and PPARβ/δ decreased (45.33%) (P < 0.05). The DEPs enriched in PPAR signaling pathway were mainly related to such biological processes as fatty acid beta-oxidation, such cellular components as peroxisome, and such molecular functions as lipid binding. Conclusions NaCl high salt diet is one of the factors to increase the incidence of HFpEF in rats. PPARα, PPARγ and PPAR β/δ might be the targets of HFpEF. The findings may provide a theoretical basis for the treatment of HFpEF in clinical practice.
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Affiliation(s)
- Hang Xu
- Department of Traditional Chinese Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Kai Gao
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Chao Liu
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Tian Li
- School of Basic Medicine, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Yi Ding
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Jing Ma
- Department of Traditional Chinese Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
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10
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Ibrahim ESH, Sosa A, Brown SA, An D, Klawikowski S, Baker J, Bergom C. Myocardial Contractility Pattern Characterization in Radiation-Induced Cardiotoxicity Using Magnetic Resonance Imaging: A Pilot Study with ContractiX. Tomography 2022; 9:36-49. [PMID: 36648991 PMCID: PMC9844312 DOI: 10.3390/tomography9010004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/13/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
Radiation therapy (RT) plays an integral role in treating thoracic cancers, despite the risk of radiation-induced cardiotoxicity. We hypothesize that our newly developed magnetic resonance imaging (MRI)-based contractility index (ContractiX) is a sensitive marker for early detection of RT-induced cardiotoxicity in a preclinical rat model of thoracic cancer RT. Adult salt-sensitive rats received image-guided heart RT and were imaged with MRI at 8 weeks and 10 weeks post-RT or sham. The MRI exam included cine and tagging sequences to measure left-ventricular ejection fraction (LVEF), mass, myocardial strain, and ContractiX. Furthermore, ventricular torsion, diastolic strain rate, and mechanical dyssynchrony were measured. Statistical analyses were performed between the sham, 8 weeks post-RT, and 10 weeks post-RT MRI parameters. The results showed that both LVEF and myocardial mass increased post-RT. Peak systolic strain and ContractiX significantly decreased post-RT, with a more relative reduction in ContractiX compared to strain. ContractiX showed an inverse nonlinear relationship with LVEF and continuously decreased with time post-RT. While early diastolic strain rate and mechanical dyssynchrony significantly changed post-RT, ventricular torsion changes were not significant post-RT. In conclusion, ContractiX measured via non-contrast MRI is a sensitive early marker for the detection of subclinical cardiac dysfunction post-RT, and it is superior to other MRI cardiac measures.
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Affiliation(s)
- El-Sayed H. Ibrahim
- Department of Radiology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
- Correspondence:
| | - Antonio Sosa
- Department of Radiology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Sherry-Ann Brown
- Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Dayeong An
- Department of Biomedical Engineering, Marquette University, 1250 W Wisconsin Ave, Milwaukee, WI 53233, USA
| | - Slade Klawikowski
- Department of Radiation Oncology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - John Baker
- Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Carmen Bergom
- Department of Radiation Oncology, Washington University, 1 Brookings Dr, St. Louis, MO 63130, USA
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11
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Ferrari LF, Rey C, Ramirez A, Dziuba A, Zickella J, Zickella M, Raff H, Taylor NE. Characterization of the Dahl salt-sensitive rat as a rodent model of inherited, widespread, persistent pain. Sci Rep 2022; 12:19348. [PMID: 36369350 PMCID: PMC9652451 DOI: 10.1038/s41598-022-24094-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022] Open
Abstract
Animal models are essential for studying the pathophysiology of chronic pain disorders and as screening tools for new therapies. However, most models available do not reproduce key characteristics of clinical persistent pain. This has limited their ability to accurately predict which new medicines will be clinically effective. Here, we characterize the Dahl salt-sensitive (SS) rat strain as the first rodent model of inherited widespread hyperalgesia. We show that this strain exhibits physiological phenotypes known to contribute to chronic pain, such as neuroinflammation, defective endogenous pain modulation, dysfunctional hypothalamic-pituitary-adrenal axis, increased oxidative stress and immune cell activation. When compared with Sprague Dawley and Brown Norway rats, SS rats have lower nociceptive thresholds due to increased inflammatory mediator concentrations, lower corticosterone levels, and high oxidative stress. Treatment with dexamethasone, the reactive oxygen species scavenger tempol, or the glial inhibitor minocycline attenuated the pain sensitivity in SS rats without affecting the other strains while indomethacin and gabapentin provided less robust pain relief. Moreover, SS rats presented impaired diffuse noxious inhibitory controls and an exacerbated response to the proalgesic mediator PGE2, features of generalized pain conditions. These data establish this strain as a novel model of spontaneous, widespread hyperalgesia that can be used to identify biomarkers for chronic pain diagnosis and treatment.
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Affiliation(s)
- Luiz F. Ferrari
- grid.223827.e0000 0001 2193 0096Department of Anesthesiology, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT 84108 USA
| | - Charles Rey
- grid.223827.e0000 0001 2193 0096Department of Anesthesiology, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT 84108 USA
| | - Anna Ramirez
- grid.223827.e0000 0001 2193 0096Department of Anesthesiology, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT 84108 USA
| | - Adam Dziuba
- grid.223827.e0000 0001 2193 0096Department of Anesthesiology, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT 84108 USA
| | - Jacqueline Zickella
- grid.223827.e0000 0001 2193 0096Department of Anesthesiology, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT 84108 USA
| | - Michael Zickella
- grid.223827.e0000 0001 2193 0096Department of Anesthesiology, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT 84108 USA
| | - Hershel Raff
- grid.427152.7Endocrine Research Laboratory, Aurora St. Luke’s Medical Center, Advocate Aurora Research Institute, Milwaukee, WI 53215 USA ,grid.30760.320000 0001 2111 8460Department of Medicine (Endocrinology and Molecular Medicine), Medical College of Wisconsin, Milwaukee, WI 53226 USA
| | - Norman E. Taylor
- grid.223827.e0000 0001 2193 0096Department of Anesthesiology, University of Utah School of Medicine, 383 Colorow Drive, Salt Lake City, UT 84108 USA
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12
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Ma S, He LL, Zhang GR, Zuo QJ, Wang ZL, Zhai JL, Zhang TT, Wang Y, Ma HJ, Guo YF. Canagliflozin mitigates ferroptosis and ameliorates heart failure in rats with preserved ejection fraction. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2022; 395:945-962. [PMID: 35476142 PMCID: PMC9276585 DOI: 10.1007/s00210-022-02243-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/13/2022] [Indexed: 02/07/2023]
Abstract
Recently, hypoglycemic drugs belonging to sodium-glucose cotransporter 2 inhibitors (SGLT2i) have generated significant interest due to their clear cardiovascular benefits for heart failure with preserved ejection fraction (HFpEF) since there are no effective drugs that may improve clinical outcomes for these patients over a prolonged period. But, the underlying mechanisms remain unclear, particularly its effects on ferroptosis, a newly defined mechanism of iron-dependent non-apoptotic cell death during heart failure (HF). Here, with proteomics, we demonstrated that ferroptosis might be a key mechanism in a rat model of high-salt diet-induced HFpEF, characterized by iron overloading and lipid peroxidation, which was blocked following treatment with canagliflozin. Data are available via ProteomeXchange with identifier PXD029031. The ferroptosis was evaluated with the levels of acyl-CoA synthetase long-chain family member 4, glutathione peroxidase 4, ferritin heavy chain 1, transferrin receptor, Ferroportin 1, iron, glutathione, malondialdehyde, and 4-hydroxy-trans-2-nonenal. These findings highlight the fact that targeting ferroptosis may serve as a cardioprotective strategy for HFpEF prevention and suggest that canagliflozin may exert its cardiovascular benefits partly via its mitigation of ferroptosis.
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Affiliation(s)
- Sai Ma
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Internal Medicine, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Li-Li He
- Department of Geriatric Cardiology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Guo-Rui Zhang
- Department of Cardiology, The Third Hospital of Shijiazhuang City Affiliated to Hebei Medical University, Shijiazhuang, Hebei, China
| | - Qing-Juan Zuo
- Department of Geriatric Cardiology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Zhong-Li Wang
- Department of Physical Examination Center, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Jian-Long Zhai
- Department of Cardiology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Ting-Ting Zhang
- Department of Geriatric Cardiology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Yan Wang
- Department of Geriatric Cardiology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Hui-Juan Ma
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Yi-Fang Guo
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China.
- Department of Geriatric Cardiology, Hebei General Hospital, Shijiazhuang, Hebei, China.
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13
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Shen S, Duan J, Hu J, Qi Y, Kang L, Wang K, Chen J, Wu X, Xu B, Gu R. Colchicine alleviates inflammation and improves diastolic dysfunction in heart failure rats with preserved ejection fraction. Eur J Pharmacol 2022; 929:175126. [PMID: 35779623 DOI: 10.1016/j.ejphar.2022.175126] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/09/2022] [Accepted: 06/24/2022] [Indexed: 01/23/2023]
Abstract
PURPOSE Several studies have reported that colchicine attenuates cardiac inflammation and improves cardiac function in myocardial infarction and atrial fibrillation. However, no study has investigated its effect on heart failure with preserved ejection fraction (HFpEF). Hence, this study aimed to assess its efficacy in a high salt diet (HSD)-induced HFpEF rat model. METHODS A rat hypertension-induced HFpEF model was created by treating Dahl/SS salt-sensitive rats with an HSD for 6 weeks. Colchicine was given via gavage daily as treatment. Cardiac function and inflammation were assessed using echocardiography, histology, and ELISA. Furthermore, the expression levels of NLRP3 and NF-κB signaling pathways were examined. RESULTS Treatment with colchicine increased survival and attenuated cardiac dysfunction, as indicated by decreased echocardiographic E/A ratio and longer exercise endurance along with reduced ventricular fibrosis and remodeling in HSD-induced Dahl rats. The treatment also reduced cardiac oxidative stress and inflammatory cell infiltration, as inferred from lower mRNA expressions of TNFα and CCL2 as well as protein expressions of NLRP3 and NF-κB pathways. CONCLUSION The findings signify that colchicine plays a crucial role in alleviating systemic inflammation and NLRP3 inflammation activation as well as in attenuating cardiac dysfunction and fibrosis in HSD-induced HFpEF model. Colchicine, therefore, holds therapeutic potential for further clinical applications.
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Affiliation(s)
- Song Shen
- Department of Cardiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, PR China
| | - Junfeng Duan
- Department of Cardiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, PR China
| | - Jiaxin Hu
- Department of Cardiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, PR China
| | - Yu Qi
- Department of Cardiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, PR China
| | - Lina Kang
- Department of Cardiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, PR China
| | - Kun Wang
- Department of Cardiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, PR China
| | - Jianzhou Chen
- Department of Cardiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, PR China
| | - Xiang Wu
- Department of Cardiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, PR China
| | - Biao Xu
- Department of Cardiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, PR China.
| | - Rong Gu
- Department of Cardiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, PR China.
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14
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He L, Ma S, Zuo Q, Zhang G, Wang Z, Zhang T, Zhai J, Guo Y. An Effective Sodium-Dependent Glucose Transporter 2 Inhibition, Canagliflozin, Prevents Development of Hypertensive Heart Failure in Dahl Salt-Sensitive Rats. Front Pharmacol 2022; 13:856386. [PMID: 35370704 PMCID: PMC8964360 DOI: 10.3389/fphar.2022.856386] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022] Open
Abstract
Background: The aim of the study was to investigate the protective effect of canagliflozin (CANA) on myocardial metabolism and heart under stress overload and to further explore its possible molecular mechanism. Methods: High-salt diet was used to induce heart failure with preserved ejection fraction (HFpEF), and then, the physical and physiological indicators were measured. The cardiac function was evaluated by echocardiography and related indicators. Masson trichrome staining, wheat germ agglutinin, and immunohistochemical staining were conducted for histology analysis. Meanwhile, oxidative stress and cardiac ATP production were also determined. PCR and Western blotting were used for quantitative detection of related genes and proteins. Comprehensive metabolomics and proteomics were employed for metabolic analysis and protein expression analysis. Results: In this study, CANA showed diuretic, hypotensive, weight loss, and increased intake of food and water. Dahl salt-sensitive (DSS) rats fed with a diet containing 8% NaCl AIN-76A developed left ventricular remodeling and diastolic dysfunction caused by hypertension. After CANA treatment, cardiac hypertrophy and fibrosis were reduced, and the left ventricular diastolic function was improved. Metabolomics and proteomics data confirmed that CANA reduced myocardial glucose metabolism and increased fatty acid metabolism and ketogenesis in DSS rats, normalizing myocardial metabolism and reducing the myocardial oxidative stress. Mechanistically, CANA upregulated p-adenosine 5′-monophosphate-activated protein kinase (p-AMPK) and sirtuin 1 (SIRT1) and significantly induced the expression of peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1a). Conclusion: CANA can improve myocardial hypertrophy, fibrosis, and left ventricular diastolic dysfunction induced by hypertension in DSS rats, possibly through the activation of the AMPK/SIRT1/PGC-1a pathway to regulate energy metabolism and oxidative stress.
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Affiliation(s)
- Lili He
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, China.,Department of Geriatric Cardiology, Hebei General Hospital, Shijiazhuang, China
| | - Sai Ma
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, China.,Department of Internal Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Qingjuan Zuo
- Department of Geriatric Cardiology, Hebei General Hospital, Shijiazhuang, China
| | - Guorui Zhang
- Department of Cardiology, The Third Hospital of Shijiazhuang City Affiliated to Hebei Medical University, Shijiazhuang, China
| | - Zhongli Wang
- Department of Physical Examination Center, Hebei General Hospital, Shijiazhuang, China
| | - Tingting Zhang
- Department of Geriatric Cardiology, Hebei General Hospital, Shijiazhuang, China
| | - Jianlong Zhai
- Department of Cardiology, Hebei General Hospital, Shijiazhuang, China
| | - Yifang Guo
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, China.,Department of Geriatric Cardiology, Hebei General Hospital, Shijiazhuang, China
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15
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Zhao Z, Liu J, Hu Y, Zhang X, Cao L, Dong Z, Li L, Hu Z. Bacterial diversity in the intestinal mucosa of heart failure rats treated with Sini Decoction. BMC Complement Med Ther 2022; 22:93. [PMID: 35354453 PMCID: PMC8969309 DOI: 10.1186/s12906-022-03575-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Sini Decoction (SND), a classic Chinese medicine prescription, has been proved to have a good effect on heart failure (HF), whereas its underlying mechanism is still unclear. In order to explore the therapeutic mechanism of SND, we combined with 16S rRNA gene sequencing to analyze the composition of gut microflora in rats with HF. Material and methods Twenty Sprague–Dawley (SD) rats were divided into four groups (n = 5): normal group, model group, SND treatment group (SNT group), and metoprolol (Met) treatment group (Meto group). All the rats except the normal group were intraperitoneally injected with doxorubicin (concentration 2 mg/mL, dose 0.15 mL/100 g) once a week to induce HF. After successfully modeling, SND and Met were gavaged to rats, respectively. After the treatment period, blood was collected for hematological analyses, myocardial tissue and colon tissues were collected for Hematoxylin–Eosin (H&E) staining, and mucosal scrapings were collected for Illumina Miseq high-throughput sequencing. Results Echocardiographic results suggested that both left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) in Model rats decreased compared with normal rats. The results of H&E staining showed that compared with the model group, the structures of myocardial tissue and colon tissue in the SNT group and Meto group showed a recovery trend. Alpha results showed that the model group had higher species diversity and richness compared with the normal group. After treatment, the richness and diversity of intestinal bacteria in the SNT group were significantly restored, and Met also showed the effect of adjusting bacterial diversity, but its effect on bacterial richness was not ideal. At the Family level, we found that the number of several bacteria associated with HF in the model group increased significantly. Excitingly, SND and Met had shown positive effects in restoring these HF-associated bacteria. Similarly, the results of Linear discriminant analysis (LDA) showed that both SND and Met could reduce the accumulation of bacteria in the model group caused by HF. Conclusion Collectively, SND can improve HF by regulating the intestinal flora. This will provide new ideas for the clinical treatment of patients with HF. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-022-03575-4.
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Affiliation(s)
- Zhenyu Zhao
- Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Jiahao Liu
- Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Yanzhi Hu
- Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Xining Zhang
- Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Liqin Cao
- Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Zhenhua Dong
- Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Lin Li
- Institute of Traditional Chinese Medicine Diagnostics, Hunan University of Chinese Medicine, Changsha, Hunan, China. .,The Domestic First-Class Discipline Construction Project of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China.
| | - Zhixi Hu
- Institute of Traditional Chinese Medicine Diagnostics, Hunan University of Chinese Medicine, Changsha, Hunan, China. .,The Domestic First-Class Discipline Construction Project of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China.
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16
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Stock JM, Chelimsky G, Edwards DG, Farquhar WB. Dietary sodium and health: How much is too much for those with orthostatic disorders? Auton Neurosci 2022; 238:102947. [PMID: 35131651 PMCID: PMC9296699 DOI: 10.1016/j.autneu.2022.102947] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 11/09/2021] [Accepted: 01/16/2022] [Indexed: 10/19/2022]
Abstract
High dietary salt (NaCl) increases blood pressure (BP) and can adversely impact multiple target organs including the vasculature, heart, kidneys, brain, autonomic nervous system, skin, eyes, and bone. However, patients with orthostatic disorders are told to increase their NaCl intake to help alleviate symptoms. While there is evidence to support the short-term benefits of increasing NaCl intake in these patients, there are few studies assessing the benefits and side effects of long-term high dietary NaCl. The evidence reviewed suggests that high NaCl can adversely impact multiple target organs, often independent of BP. However, few of these studies have been performed in patients with orthostatic disorders. We conclude that the recommendation to increase dietary NaCl in patients with orthostatic disorders should be done with care, keeping in mind the adverse impact on dietary NaCl in people without orthostatic disorders. Modest, rather than robust, increases in NaCl intake may be sufficient to alleviate symptoms but also minimize any long-term negative effects.
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Affiliation(s)
- Joseph M Stock
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
| | - Gisela Chelimsky
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - David G Edwards
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
| | - William B Farquhar
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America.
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17
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Kobak KA, Zarzycka W, Chiao YA. Age and Sex Differences in Heart Failure With Preserved Ejection Fraction. FRONTIERS IN AGING 2022; 3:811436. [PMID: 35821846 PMCID: PMC9261310 DOI: 10.3389/fragi.2022.811436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/13/2022] [Indexed: 11/29/2022]
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a multi-organ disorder that represents about 50% of total heart failure (HF) cases and is the most common form of HF in the elderly. Because of its increasing prevalence caused by the aging population, high mortality and morbidity, and very limited therapeutic options, HFpEF is considered as one of the greatest unmet medical needs in cardiovascular medicine. Despite its complex pathophysiology, numerous preclinical models have been established in rodents and in large animals to study HFpEF pathophysiology. Although age and sex differences are well described in HFpEF population, there are knowledge gaps in sex- and age-specific differences in established preclinical models. In this review, we summarize various strategies that have been used to develop HFpEF models and discuss the knowledge gaps in sex and age differences in HFpEF.
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18
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Ishida A, Isotani A, Fujisawa M, Del Saz EG, Okumiya K, Kimura Y, Manuaba IIB, Rantetampang AL, Ohya Y, Matsubayashi K. Effects of a Low-Salt and High-Potassium Diet on Arterial Stiffness and Left Ventricular Function in Indigenous Papuans. J Am Heart Assoc 2021; 10:e021789. [PMID: 34873920 PMCID: PMC9075252 DOI: 10.1161/jaha.121.021789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background A sodium‐restricted diet represents a potential non‐pharmacological strategy for improving blood pressure, arterial stiffness, and left ventricular (LV) diastolic function. We investigated age‐related differences in LV structure and function and the relationship between LV function and central hemodynamics in an indigenous Papuan population, who maintain a traditional lifestyle, including a low‐salt and high‐potassium diet. Methods and Results We measured LV dimensions, transmitral blood flow, and mitral annular tissue velocities through echocardiography and Doppler imaging. Blood pressure and brachial‐ankle pulse wave velocity were measured using an automatic device (Omron). Central blood pressure and wave reflection parameters were estimated via oscillometry (Mobil‐O‐Graph, using European calibrations). A total of 82 native Papuans (median age, 42 years; 38 women; no blood pressure treatment) were enrolled. Age‐related difference in brachial systolic pressure was modest but significant, and brachial‐ankle pulse wave velocity significantly increased with age; however, LV mass index remained unchanged. LV ejection fraction and global longitudinal strain were preserved; mitral A‐wave velocity and average E/e´ increased; and e´ and E/A decreased with age. Brachial‐ankle pulse wave velocity and spot urine Na/K were positively and independently correlated with E/e´. Age and heart rate were inversely associated with E/A. In conclusion, LV systolic function was preserved; however, LV diastolic function decreased with age in Papuans. Moreover, age‐related arterial stiffening, but not wave reflections, was inversely related to LV diastolic function. Conclusions Our results suggest that arterial and LV stiffness may not be altered by sodium restriction. Longitudinal studies are warranted to elucidate the effects of diet on arterial and LV function.
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Affiliation(s)
- Akio Ishida
- Department of Cardiovascular Medicine, Nephrology and Neurology Graduate School of Medicine University of the Ryukyus Okinawa Japan
| | - Akihiro Isotani
- Department of Cardiology Kokura Memorial Hospital Kitakyusyu Japan
| | | | | | | | - Yumi Kimura
- Graduate School of Human Sciences Osaka University Osaka Japan
| | | | | | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology Graduate School of Medicine University of the Ryukyus Okinawa Japan
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19
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Frisk M, Le C, Shen X, Røe ÅT, Hou Y, Manfra O, Silva GJJ, van Hout I, Norden ES, Aronsen JM, Laasmaa M, Espe EKS, Zouein FA, Lambert RR, Dahl CP, Sjaastad I, Lunde IG, Coffey S, Cataliotti A, Gullestad L, Tønnessen T, Jones PP, Altara R, Louch WE. Etiology-Dependent Impairment of Diastolic Cardiomyocyte Calcium Homeostasis in Heart Failure With Preserved Ejection Fraction. J Am Coll Cardiol 2021; 77:405-419. [PMID: 33509397 PMCID: PMC7840890 DOI: 10.1016/j.jacc.2020.11.044] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/26/2020] [Accepted: 11/16/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Whereas heart failure with reduced ejection fraction (HFrEF) is associated with ventricular dilation and markedly reduced systolic function, heart failure with preserved ejection fraction (HFpEF) patients exhibit concentric hypertrophy and diastolic dysfunction. Impaired cardiomyocyte Ca2+ homeostasis in HFrEF has been linked to disruption of membrane invaginations called t-tubules, but it is unknown if such changes occur in HFpEF. OBJECTIVES This study examined whether distinct cardiomyocyte phenotypes underlie the heart failure entities of HFrEF and HFpEF. METHODS T-tubule structure was investigated in left ventricular biopsies obtained from HFrEF and HFpEF patients, whereas cardiomyocyte Ca2+ homeostasis was studied in rat models of these conditions. RESULTS HFpEF patients exhibited increased t-tubule density in comparison with control subjects. Super-resolution imaging revealed that higher t-tubule density resulted from both tubule dilation and proliferation. In contrast, t-tubule density was reduced in patients with HFrEF. Augmented collagen deposition within t-tubules was observed in HFrEF but not HFpEF hearts. A causative link between mechanical stress and t-tubule disruption was supported by markedly elevated ventricular wall stress in HFrEF patients. In HFrEF rats, t-tubule loss was linked to impaired systolic Ca2+ homeostasis, although diastolic Ca2+ removal was also reduced. In contrast, Ca2+ transient magnitude and release kinetics were largely maintained in HFpEF rats. However, diastolic Ca2+ impairments, including reduced sarco/endoplasmic reticulum Ca2+-ATPase activity, were specifically observed in diabetic HFpEF but not in ischemic or hypertensive models. CONCLUSIONS Although t-tubule disruption and impaired cardiomyocyte Ca2+ release are hallmarks of HFrEF, such changes are not prominent in HFpEF. Impaired diastolic Ca2+ homeostasis occurs in both conditions, but in HFpEF, this mechanism for diastolic dysfunction is etiology-dependent.
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Affiliation(s)
- Michael Frisk
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway. https://twitter.com/IEMRLouch
| | - Christopher Le
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Xin Shen
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Åsmund T Røe
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Yufeng Hou
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Ornella Manfra
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Gustavo J J Silva
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Isabelle van Hout
- Department of Physiology, HeartOtago, University of Otago, Otago, New Zealand
| | - Einar S Norden
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway; Bjørknes College, Oslo, Norway
| | - J Magnus Aronsen
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Martin Laasmaa
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Emil K S Espe
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Fouad A Zouein
- Department of Pharmacology and Toxicology, American University of Beirut Medical Center, Faculty of Medicine, Riad El-Solh, Beirut, Lebanon
| | - Regis R Lambert
- Department of Physiology, HeartOtago, University of Otago, Otago, New Zealand
| | - Christen P Dahl
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Research Institute for Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Ivar Sjaastad
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway; Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Ida G Lunde
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Sean Coffey
- Department of Medicine and HeartOtago, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Alessandro Cataliotti
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Lars Gullestad
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Research Institute for Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Theis Tønnessen
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway; Department of Cardiothoracic Surgery, Oslo University Hospital Ullevål, Oslo, Norway
| | - Peter P Jones
- Department of Physiology, HeartOtago, University of Otago, Otago, New Zealand
| | - Raffaele Altara
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway. https://twitter.com/IEMRLouch
| | - William E Louch
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway; K.G. Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
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20
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Fusco-Allison G, Li DK, Hunter B, Jackson D, Bannon PG, Lal S, O'Sullivan JF. Optimizing the discovery and assessment of therapeutic targets in heart failure with preserved ejection fraction. ESC Heart Fail 2021; 8:3643-3655. [PMID: 34342166 PMCID: PMC8497375 DOI: 10.1002/ehf2.13504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 06/02/2021] [Accepted: 06/21/2021] [Indexed: 01/09/2023] Open
Abstract
There is an urgent need for models that faithfully replicate heart failure with preserved ejection fraction (HFpEF), now recognized as the most common form of heart failure in the world. In vitro approaches have several shortcomings, most notably the immature nature of stem cell‐derived human cardiomyocytes [induced pluripotent stem cells (iPSC)] and the relatively short lifespan of primary cardiomyocytes. Three‐dimensional ‘organoids’ incorporating mature iPSCs with other cell types such as endothelial cells and fibroblasts are a significant advance, but lack the complexity of true myocardium. Animal models can replicate many features of human HFpEF, and rodent models are the most common, and recent attempts to incorporate haemodynamic, metabolic, and ageing contributions are encouraging. Differences relating to species, physiology, heart rate, and heart size are major limitations for rodent models. Porcine models mitigate many of these shortcomings and approximate human physiology more closely, but cost and time considerations limit their potential for widespread use. Ex vivo analysis of failing hearts from animal models offer intriguing possibilities regarding cardiac substrate utilisation, but are ultimately subject to the same constrains as the animal models from which the hearts are obtained. Ex vivo approaches using human myocardial biopsies can uncover new insights into pathobiology leveraging myocardial energetics, substrate turnover, molecular changes, and systolic/diastolic function. In collaboration with a skilled cardiothoracic surgeon, left ventricular endomyocardial biopsies can be obtained at the time of valvular surgery in HFpEF patients. Critically, these tissues maintain their disease phenotype, preserving inter‐relationship of myocardial cells and extracellular matrix. This review highlights a novel approach, where ultra‐thin myocardial tissue slices from human HFpEF hearts can be used to assess changes in myocardial structure and function. We discuss current approaches to modelling HFpEF, describe in detail the novel tissue slice model, expand on exciting opportunities this model provides, and outline ways to improve this model further.
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Affiliation(s)
- Gabrielle Fusco-Allison
- Precision Cardiovascular Laboratory, The University of Sydney, Sydney, New South Wales, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.,Heart Research Institute, Newtown, Sydney, New South Wales, Australia.,Central Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Desmond K Li
- Precision Cardiovascular Laboratory, The University of Sydney, Sydney, New South Wales, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.,Heart Research Institute, Newtown, Sydney, New South Wales, Australia.,Central Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Benjamin Hunter
- Precision Cardiovascular Laboratory, The University of Sydney, Sydney, New South Wales, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.,School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Central Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Dan Jackson
- Precision Cardiovascular Laboratory, The University of Sydney, Sydney, New South Wales, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.,Central Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Paul G Bannon
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sean Lal
- Precision Cardiovascular Laboratory, The University of Sydney, Sydney, New South Wales, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.,School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Central Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - John F O'Sullivan
- Precision Cardiovascular Laboratory, The University of Sydney, Sydney, New South Wales, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.,Heart Research Institute, Newtown, Sydney, New South Wales, Australia.,Central Clinical School, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.,Faculty of Medicine, TU Dresden, Dresden, Germany
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21
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Abdellatif M, Trummer-Herbst V, Koser F, Durand S, Adão R, Vasques-Nóvoa F, Freundt JK, Voglhuber J, Pricolo MR, Kasa M, Türk C, Aprahamian F, Herrero-Galán E, Hofer SJ, Pendl T, Rech L, Kargl J, Anto-Michel N, Ljubojevic-Holzer S, Schipke J, Brandenberger C, Auer M, Schreiber R, Koyani CN, Heinemann A, Zirlik A, Schmidt A, von Lewinski D, Scherr D, Rainer PP, von Maltzahn J, Mühlfeld C, Krüger M, Frank S, Madeo F, Eisenberg T, Prokesch A, Leite-Moreira AF, Lourenço AP, Alegre-Cebollada J, Kiechl S, Linke WA, Kroemer G, Sedej S. Nicotinamide for the treatment of heart failure with preserved ejection fraction. Sci Transl Med 2021; 13:13/580/eabd7064. [PMID: 33568522 DOI: 10.1126/scitranslmed.abd7064] [Citation(s) in RCA: 114] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 11/05/2020] [Accepted: 01/12/2021] [Indexed: 12/17/2022]
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a highly prevalent and intractable form of cardiac decompensation commonly associated with diastolic dysfunction. Here, we show that diastolic dysfunction in patients with HFpEF is associated with a cardiac deficit in nicotinamide adenine dinucleotide (NAD+). Elevating NAD+ by oral supplementation of its precursor, nicotinamide, improved diastolic dysfunction induced by aging (in 2-year-old C57BL/6J mice), hypertension (in Dahl salt-sensitive rats), or cardiometabolic syndrome (in ZSF1 obese rats). This effect was mediated partly through alleviated systemic comorbidities and enhanced myocardial bioenergetics. Simultaneously, nicotinamide directly improved cardiomyocyte passive stiffness and calcium-dependent active relaxation through increased deacetylation of titin and the sarcoplasmic reticulum calcium adenosine triphosphatase 2a, respectively. In a long-term human cohort study, high dietary intake of naturally occurring NAD+ precursors was associated with lower blood pressure and reduced risk of cardiac mortality. Collectively, these results suggest NAD+ precursors, and especially nicotinamide, as potential therapeutic agents to treat diastolic dysfunction and HFpEF in humans.
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Affiliation(s)
- Mahmoud Abdellatif
- Department of Cardiology, Medical University of Graz, Graz 8036, Austria
| | | | - Franziska Koser
- Institute of Physiology II, University of Münster, Münster 48149, Germany
| | - Sylvère Durand
- Metabolomics and Cell Biology Platforms, Institut Gustave Roussy, Villejuif 94805, France.,Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, INSERM U1138, Institut Universitaire de France, Paris 75006, France
| | - Rui Adão
- Department of Cardiology, Medical University of Graz, Graz 8036, Austria.,Department of Surgery and Physiology, Cardiovascular Research and Development Centre (UnIC), Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
| | - Francisco Vasques-Nóvoa
- Department of Surgery and Physiology, Cardiovascular Research and Development Centre (UnIC), Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
| | - Johanna K Freundt
- Institute of Physiology II, University of Münster, Münster 48149, Germany
| | - Julia Voglhuber
- Department of Cardiology, Medical University of Graz, Graz 8036, Austria.,BioTechMed Graz, Graz 8010, Austria
| | | | - Michael Kasa
- Department of Cardiology, Medical University of Graz, Graz 8036, Austria
| | - Clara Türk
- Institute for Genetics, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, Cologne 50931, Germany.,Center for Molecular Medicine (CMMC), University of Cologne, Cologne 50931, Germany
| | - Fanny Aprahamian
- Metabolomics and Cell Biology Platforms, Institut Gustave Roussy, Villejuif 94805, France.,Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, INSERM U1138, Institut Universitaire de France, Paris 75006, France
| | - Elías Herrero-Galán
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid 28029, Spain
| | - Sebastian J Hofer
- Institute of Molecular Biosciences, University of Graz, NAWI Graz, Graz 8010, Austria
| | - Tobias Pendl
- Institute of Molecular Biosciences, University of Graz, NAWI Graz, Graz 8010, Austria
| | - Lavinia Rech
- Department of Cardiology, Medical University of Graz, Graz 8036, Austria
| | - Julia Kargl
- Otto Loewi Research Center, Division of Pharmacology, Medical University of Graz, Graz 8010, Austria
| | | | - Senka Ljubojevic-Holzer
- Department of Cardiology, Medical University of Graz, Graz 8036, Austria.,BioTechMed Graz, Graz 8010, Austria
| | - Julia Schipke
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover 30625, Germany
| | - Christina Brandenberger
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover 30625, Germany
| | - Martina Auer
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Graz 8010, Austria.,Division of Cell Biology, Histology and Embryology, Medical University of Graz, Graz 8010, Austria
| | - Renate Schreiber
- Institute of Molecular Biosciences, University of Graz, NAWI Graz, Graz 8010, Austria
| | - Chintan N Koyani
- Department of Cardiology, Medical University of Graz, Graz 8036, Austria
| | - Akos Heinemann
- Otto Loewi Research Center, Division of Pharmacology, Medical University of Graz, Graz 8010, Austria
| | - Andreas Zirlik
- Department of Cardiology, Medical University of Graz, Graz 8036, Austria
| | - Albrecht Schmidt
- Department of Cardiology, Medical University of Graz, Graz 8036, Austria
| | - Dirk von Lewinski
- Department of Cardiology, Medical University of Graz, Graz 8036, Austria
| | - Daniel Scherr
- Department of Cardiology, Medical University of Graz, Graz 8036, Austria
| | - Peter P Rainer
- Department of Cardiology, Medical University of Graz, Graz 8036, Austria.,BioTechMed Graz, Graz 8010, Austria
| | | | - Christian Mühlfeld
- Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover 30625, Germany
| | - Marcus Krüger
- Institute for Genetics, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, Cologne 50931, Germany.,Center for Molecular Medicine (CMMC), University of Cologne, Cologne 50931, Germany
| | - Saša Frank
- BioTechMed Graz, Graz 8010, Austria.,Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Graz 8010, Austria
| | - Frank Madeo
- BioTechMed Graz, Graz 8010, Austria.,Institute of Molecular Biosciences, University of Graz, NAWI Graz, Graz 8010, Austria
| | - Tobias Eisenberg
- BioTechMed Graz, Graz 8010, Austria.,Institute of Molecular Biosciences, University of Graz, NAWI Graz, Graz 8010, Austria
| | - Andreas Prokesch
- BioTechMed Graz, Graz 8010, Austria.,Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Graz 8010, Austria.,Division of Cell Biology, Histology and Embryology, Medical University of Graz, Graz 8010, Austria
| | - Adelino F Leite-Moreira
- Department of Surgery and Physiology, Cardiovascular Research and Development Centre (UnIC), Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
| | - André P Lourenço
- Department of Surgery and Physiology, Cardiovascular Research and Development Centre (UnIC), Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
| | | | - Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Innsbruck 6020, Austria.,VASCage, Research Centre for Promoting Vascular Health in the Ageing Community, Innsbruck 6020, Austria
| | - Wolfgang A Linke
- Institute of Physiology II, University of Münster, Münster 48149, Germany
| | - Guido Kroemer
- Metabolomics and Cell Biology Platforms, Institut Gustave Roussy, Villejuif 94805, France. .,Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, INSERM U1138, Institut Universitaire de France, Paris 75006, France.,Pôle de Biologie, Hôpital Européen Georges Pompidou, AP-HP, Paris 75015, France.,Suzhou Institute for Systems Medicine, Chinese Academy of Sciences, Suzhou 215000, China.,Karolinska Institute, Department of Women's and Children's Health, Karolinska University Hospital, Solna 17164, Sweden
| | - Simon Sedej
- Department of Cardiology, Medical University of Graz, Graz 8036, Austria. .,BioTechMed Graz, Graz 8010, Austria.,Faculty of Medicine, University of Maribor, Maribor 2000, Slovenia
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22
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Changes of gut microbiome composition and metabolites associated with hypertensive heart failure rats. BMC Microbiol 2021; 21:141. [PMID: 33952214 PMCID: PMC8097775 DOI: 10.1186/s12866-021-02202-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 04/19/2021] [Indexed: 12/14/2022] Open
Abstract
Background The potential role of the gut microbiome (GM) in heart failure (HF) had recently been revealed. However, the underlying mechanisms of the GM and fecal metabolome in HF have not been characterized. The Dahl salt-sensitive rat model of hypertensive heart failure (H-HF) was used to study the clinical symptoms and characteristics. To elucidate the pathogenesis of HF, we combined 16S rRNA gene sequencing and metabolomics to analyze gut microbial compositions and fecal metabolomic profiles of rats with H-HF. Results PCoA of beta diversity shown that the gut microbiome composition profiles among the three groups were separated. Gut microbial composition was significantly altered in H-HF rats, the ratio of Firmicutes to Bacteroidetes(F/B) increased and the abundance of Muribaculaceae, Lachnospiraceae, and Lactobacillaceae decreased. Significantly altered levels of 17 genera and 35 metabolites were identified as the potential biomarker of H-HF. Correlation analysis revealed that specific altered genera were strongly correlated with changed fecal metabolites. The reduction in short-chain fatty acids (SCFA)-producing bacteria and trimethylamine N-oxide (TMAO) might be a notable characteristic for H-HF. Conclusions This is the first study to characterize the fecal microbiome of hypertensive heart failure by integrating 16S rRNA gene sequencing and LC–MS-based metabolomics approaches. Collectively, the results suggesting changes of gut microbiome composition and metabolites are associated with hypertensive heart failure rats. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-021-02202-5.
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23
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Han P, Zhang R, Wagner S, Xie Y, Cingolani E, Marban E, Christodoulou AG, Li D. Electrocardiogram-less, free-breathing myocardial extracellular volume fraction mapping in small animals at high heart rates using motion-resolved cardiovascular magnetic reesonance multitasking: a feasibility study in a heart failure with preserved ejection fraction rat model. J Cardiovasc Magn Reson 2021; 23:8. [PMID: 33568177 PMCID: PMC7877086 DOI: 10.1186/s12968-020-00699-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 12/10/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Extracellular volume fraction (ECV) quantification with cardiovascular magnetic resonance (CMR) T1 mapping is a powerful tool for the characterization of focal or diffuse myocardial fibrosis. However, it is technically challenging to acquire high-quality T1 and ECV maps in small animals for preclinical research because of high heart rates and high respiration rates. In this work, we developed an electrocardiogram (ECG)-less, free-breathing ECV mapping method using motion-resolved CMR Multitasking on a 9.4 T small animal CMR system. The feasibility of characterizing diffuse myocardial fibrosis was tested in a rat heart failure model with preserved ejection fraction (HFpEF). METHODS High-salt fed rats diagnosed with HFpEF (n = 9) and control rats (n = 9) were imaged with the proposed ECV Multitasking technique. A 25-min exam, including two 4-min T1 Multitasking scans before and after gadolinium injection, were performed on each rat. It allows a cardiac temporal resolution of 20 ms for a heart rate of ~ 300 bpm. Myocardial ECV was calculated from the hematocrit (HCT) and fitted T1 values of the myocardium and the blood pool. Masson's trichrome stain was used to measure the extent of fibrosis. Welch's t-test was performed between control and HFpEF groups. RESULTS ECV was significantly higher in the HFpEF group (22.4% ± 2.5% vs. 18.0% ± 2.1%, P = 0.0010). A moderate correlation between the ECV and the extent of fibrosis was found (R = 0.59, P = 0.0098). CONCLUSIONS Motion-resolved ECV Multitasking CMR can quantify ECV in the rat myocardium at high heart rates without ECG triggering or respiratory gating. Elevated ECV found in the HFpEF group is consistent with previous human studies and well correlated with histological data. This technique has the potential to be a viable imaging tool for myocardial tissue characterization in small animal models.
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Affiliation(s)
- Pei Han
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA USA
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Rui Zhang
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
- Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shawn Wagner
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Eugenio Cingolani
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Eduardo Marban
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Anthony G. Christodoulou
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA USA
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Debiao Li
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA USA
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
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24
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Hemodynamic and Functional Impact of Epicardial Adipose Tissue in Heart Failure With Preserved Ejection Fraction. JACC-HEART FAILURE 2020; 8:657-666. [PMID: 32653449 DOI: 10.1016/j.jchf.2020.04.016] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study determined the impact of excess epicardial adipose tissue (EAT) in patients with the obese phenotype of heart failure with preserved ejection fraction (HFpEF). BACKGROUND Patients with HFpEF and an elevated body mass index differ from nonobese patients, but beyond generalized obesity, fat distribution may be more important. Increases in EAT are associated with excess visceral adiposity, inflammation, and cardiac fibrosis, and EAT has been speculated to play an important role in the pathophysiology of HFpEF, but no study has directly evaluated this question. METHODS Patients with HFpEF and obesity (n = 169) underwent invasive hemodynamic exercise testing with expired gas analysis and echocardiography. Increased EAT was defined by echocardiography (EAT thickness ≥9 mm). RESULTS Compared with obese patients without increased EAT (HFpEFEAT-, n = 92), obese patients with HFpEF with increased EAT (HFpEFEAT+; n = 77) displayed a higher left ventricular eccentricity index, indicating increased pericardial restraint, but similar resting biventricular structure and function. In contrast, hemodynamics were more abnormal in patients with HFpEFEAT+, with higher right atrial, pulmonary artery, and pulmonary capillary wedge pressures at rest and during exercise compared with those of patients with HFpEFEAT-. Peak oxygen consumption (VO2) was reduced in both groups but was 20% lower in patients with HFpEFEAT+ (p < 0.01). CONCLUSIONS Among patients with the obese phenotype of HFpEF, the presence of increased EAT is associated with more profound hemodynamic derangements at rest and exercise, including greater elevation in cardiac filling pressures, more severe pulmonary hypertension, and greater pericardial restraint, culminating in poorer exercise capacity. Further study is needed to understand the biology and treatment of excessive EAT in patients with HFpEF.
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25
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Brener MI, Uriel N, Burkhoff D. Left Ventricular Volume Reduction and Reshaping as a Treatment Option for Heart Failure. STRUCTURAL HEART 2020. [DOI: 10.1080/24748706.2020.1777359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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26
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Morphometric, Hemodynamic, and Multi-Omics Analyses in Heart Failure Rats with Preserved Ejection Fraction. Int J Mol Sci 2020; 21:ijms21093362. [PMID: 32397533 PMCID: PMC7247709 DOI: 10.3390/ijms21093362] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/29/2020] [Accepted: 05/07/2020] [Indexed: 12/30/2022] Open
Abstract
(1) Background: There are no successive treatments for heart failure with preserved ejection fraction (HFpEF) because of complex interactions between environmental, histological, and genetic risk factors. The objective of the study is to investigate changes in cardiomyocytes and molecular networks associated with HFpEF. (2) Methods: Dahl salt-sensitive (DSS) rats developed HFpEF when fed with a high-salt (HS) diet for 7 weeks, which was confirmed by in vivo and ex vivo measurements. Shotgun proteomics, microarray, Western blot, and quantitative RT-PCR analyses were further carried out to investigate cellular and molecular mechanisms. (3) Results: Rats with HFpEF showed diastolic dysfunction, impaired systolic function, and prolonged repolarization of myocytes, owing to an increase in cell size and apoptosis of myocytes. Heatmap of multi-omics further showed significant differences between rats with HFpEF and controls. Gene Set Enrichment Analysis (GSEA) of multi-omics revealed genetic risk factors involved in cardiac muscle contraction, proteasome, B cell receptor signaling, and p53 signaling pathway. Gene Ontology (GO) analysis of multi-omics showed the inflammatory response and mitochondrial fission as top biological processes that may deteriorate myocyte stiffening. GO analysis of protein-to-protein network indicated cytoskeleton protein, cell fraction, enzyme binding, and ATP binding as the top enriched molecular functions. Western blot validated upregulated Mff and Itga9 and downregulated Map1lc3a in the HS group, which likely contributed to accumulation of aberrant mitochondria to increase ROS and elevation of myocyte stiffness, and subsequent contractile dysfunction and myocardial apoptosis. (4) Conclusions: Multi-omics analysis revealed multiple pathways associated with HFpEF. This study shows insight into molecular mechanisms for the development of HFpEF and may provide potential targets for the treatment of HFpEF.
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27
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Bing F, Wang X, Shen W, Li L, Niu P, Chen Y, Zhang W, Tan W, Huo Y. Inhalation of Ultrafine Zinc Particles Impaired Cardiovascular Functions in Hypertension-Induced Heart Failure Rats With Preserved Ejection Fraction. Front Bioeng Biotechnol 2020; 8:13. [PMID: 32039193 PMCID: PMC6993201 DOI: 10.3389/fbioe.2020.00013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/08/2020] [Indexed: 12/30/2022] Open
Abstract
Although it is possible for inhalation of ultrafine particles to impair human health, its effect is not clear in patients with HFpEF. This study investigated cardiac and hemodynamic changes in hypertension-induced rats of HFpEF after inhaling ultrafine zinc particles for a while. Multiple experimental measurements were carried out in DSS rats fed with high salt (HS) and low salt (LS) diets as well as HS diet with the inhalation of ultrafine zinc particles (defined as HP). Cardiac strain and strain rate were quantified by the speckle tracking echocardiography. The pressure and flow waves were recorded in the carotid artery and abdominal aorta and analyzed by the models of Windkessel and Womersley types. HS and HP rats were found to show lower strains on endocardium and epicardium than LS rats. The inhalation of ultrafine zinc particles further reduced the strain in the longitudinal direction on the endocardium of rats with HFpEF, but had relatively small effects on the epicardium. The inhalation of ultrafine zinc particles resulted in the increase of systemic resistance and the decrease of total vascular compliance as well as the increased PWV and induced more severe vascular stiffening in rats with HFpEF. In summary, the inhalation of ultrafine zinc particles deteriorated local myocardial dysfunctions in the LV and the hemodynamic environment in peripheral arteries in rats of HFpEF. This study is of importance to understand the mechanisms of cardiovascular impairments owing to air pollution.
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Affiliation(s)
- Fangbo Bing
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Xuan Wang
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Wenzeng Shen
- College of Medicine, Hebei University, Baoding, China
| | - Li Li
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Pei Niu
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Ying Chen
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China.,Shenzhen Graduate School, Peking University, Shenzhen, China
| | - Wenxi Zhang
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Wenchang Tan
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China.,Shenzhen Graduate School, Peking University, Shenzhen, China.,PKU-HKUST Shenzhen-Hong Kong Institution, Shenzhen, China
| | - Yunlong Huo
- PKU-HKUST Shenzhen-Hong Kong Institution, Shenzhen, China.,Institute of Mechanobiology and Medical Engineering, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
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28
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Byrne NJ, Matsumura N, Maayah ZH, Ferdaoussi M, Takahara S, Darwesh AM, Levasseur JL, Jahng JWS, Vos D, Parajuli N, El-Kadi AOS, Braam B, Young ME, Verma S, Light PE, Sweeney G, Seubert JM, Dyck JRB. Empagliflozin Blunts Worsening Cardiac Dysfunction Associated With Reduced NLRP3 (Nucleotide-Binding Domain-Like Receptor Protein 3) Inflammasome Activation in Heart Failure. Circ Heart Fail 2020; 13:e006277. [PMID: 31957470 DOI: 10.1161/circheartfailure.119.006277] [Citation(s) in RCA: 135] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although empagliflozin was shown to profoundly reduce cardiovascular events in diabetic patients and blunt the decline in cardiac function in nondiabetic mice with established heart failure (HF), the mechanism of action remains unknown. METHODS AND RESULTS We treated 2 rodent models of HF with 10 mg/kg per day empagliflozin and measured activation of the NLRP3 (nucleotide-binding domain-like receptor protein 3) inflammasome in the heart. We show for the first time that beneficial effects of empagliflozin in HF with reduced ejection fraction (HF with reduced ejection fraction [HFrEF]; n=30-34) occur in the absence of changes in circulating ketone bodies, cardiac ketone oxidation, or increased cardiac ATP production. Of note, empagliflozin attenuated activation of the NLRP3 inflammasome and expression of associated markers of sterile inflammation in hearts from mice with HFrEF, implicating reduced cardiac inflammation as a mechanism of empagliflozin that contributes to sustained function in HFrEF in the absence of diabetes mellitus. In addition, we validate that the beneficial cardiac effects of empagliflozin in HF with preserved ejection fraction (HFpEF; n=9-10) are similarly associated with reduced activation of the NLRP3 inflammasome. Lastly, the ability of empagliflozin to reduce inflammation was completely blunted by a calcium (Ca2+) ionophore, suggesting that empagliflozin exerts its benefit upon restoring optimal cytoplasmic Ca2+ levels in the heart. CONCLUSIONS These data provide evidence that the beneficial cardiac effects of empagliflozin are associated with reduced cardiac inflammation via blunting activation of the NLRP3 inflammasome in a Ca2+-dependent manner and hence may be beneficial in treating HF even in the absence of diabetes mellitus.
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Affiliation(s)
- Nikole J Byrne
- Cardiovascular Research Centre, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., D.V., N.P., P.E.L., J.M.S., J.R.B.D.), University of Alberta, Edmonton, Canada.,Alberta Diabetes Institute, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., N.P., P.E.L., J.R.B.D.), University of Alberta, Edmonton, Canada.,Department of Pediatrics, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.R.B.D.), University of Alberta, Edmonton, Canada
| | - Nobutoshi Matsumura
- Cardiovascular Research Centre, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., D.V., N.P., P.E.L., J.M.S., J.R.B.D.), University of Alberta, Edmonton, Canada.,Alberta Diabetes Institute, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., N.P., P.E.L., J.R.B.D.), University of Alberta, Edmonton, Canada.,Department of Pediatrics, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.R.B.D.), University of Alberta, Edmonton, Canada.,Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan (N.M., S.T., A.M.D.)
| | - Zaid H Maayah
- Cardiovascular Research Centre, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., D.V., N.P., P.E.L., J.M.S., J.R.B.D.), University of Alberta, Edmonton, Canada.,Alberta Diabetes Institute, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., N.P., P.E.L., J.R.B.D.), University of Alberta, Edmonton, Canada.,Department of Pediatrics, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.R.B.D.), University of Alberta, Edmonton, Canada
| | - Mourad Ferdaoussi
- Cardiovascular Research Centre, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., D.V., N.P., P.E.L., J.M.S., J.R.B.D.), University of Alberta, Edmonton, Canada.,Alberta Diabetes Institute, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., N.P., P.E.L., J.R.B.D.), University of Alberta, Edmonton, Canada.,Department of Pediatrics, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.R.B.D.), University of Alberta, Edmonton, Canada
| | - Shingo Takahara
- Cardiovascular Research Centre, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., D.V., N.P., P.E.L., J.M.S., J.R.B.D.), University of Alberta, Edmonton, Canada.,Alberta Diabetes Institute, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., N.P., P.E.L., J.R.B.D.), University of Alberta, Edmonton, Canada.,Department of Pediatrics, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.R.B.D.), University of Alberta, Edmonton, Canada.,Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan (N.M., S.T., A.M.D.)
| | - Ahmed M Darwesh
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan (N.M., S.T., A.M.D.)
| | - Jody L Levasseur
- Cardiovascular Research Centre, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., D.V., N.P., P.E.L., J.M.S., J.R.B.D.), University of Alberta, Edmonton, Canada.,Alberta Diabetes Institute, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., N.P., P.E.L., J.R.B.D.), University of Alberta, Edmonton, Canada
| | | | - Dyonne Vos
- Cardiovascular Research Centre, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., D.V., N.P., P.E.L., J.M.S., J.R.B.D.), University of Alberta, Edmonton, Canada
| | - Nirmal Parajuli
- Cardiovascular Research Centre, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., D.V., N.P., P.E.L., J.M.S., J.R.B.D.), University of Alberta, Edmonton, Canada.,Alberta Diabetes Institute, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., N.P., P.E.L., J.R.B.D.), University of Alberta, Edmonton, Canada.,Division of Biomedical Science, Sanford School of Medicine, University of South Dakota, Vermillion (N.P.)
| | - Ayman O S El-Kadi
- Faculty of Pharmacy and Pharmaceutical Sciences (A.O.S.E.-K., J.M.S.), University of Alberta, Edmonton, Canada
| | - Branko Braam
- Division of Nephrology, Faculty of Medicine and Dentistry (B.B.), University of Alberta, Edmonton, Canada.,Department of Medicine, Faculty of Medicine and Dentistry (B.B.), University of Alberta, Edmonton, Canada
| | - Martin E Young
- Department of Medicine, University of Alabama at Birmingham (M.E.Y.)
| | - Subodh Verma
- Division of Cardiac Surgery, St. Michael's Hospital, University of Toronto, Canada (S.V.)
| | - Peter E Light
- Cardiovascular Research Centre, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., D.V., N.P., P.E.L., J.M.S., J.R.B.D.), University of Alberta, Edmonton, Canada.,Alberta Diabetes Institute, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., N.P., P.E.L., J.R.B.D.), University of Alberta, Edmonton, Canada.,Department of Pharmacology, Faculty of Medicine and Dentistry (P.E.L., J.M.S.), University of Alberta, Edmonton, Canada
| | - Gary Sweeney
- Deparment of Biology, York University, Toronto, Canada (J.W.S.J., G.S.)
| | - John M Seubert
- Cardiovascular Research Centre, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., D.V., N.P., P.E.L., J.M.S., J.R.B.D.), University of Alberta, Edmonton, Canada.,Department of Pharmacology, Faculty of Medicine and Dentistry (P.E.L., J.M.S.), University of Alberta, Edmonton, Canada.,Faculty of Pharmacy and Pharmaceutical Sciences (A.O.S.E.-K., J.M.S.), University of Alberta, Edmonton, Canada
| | - Jason R B Dyck
- Cardiovascular Research Centre, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., D.V., N.P., P.E.L., J.M.S., J.R.B.D.), University of Alberta, Edmonton, Canada.,Alberta Diabetes Institute, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.L.L., N.P., P.E.L., J.R.B.D.), University of Alberta, Edmonton, Canada.,Department of Pediatrics, Faculty of Medicine and Dentistry (N.J.B., N.M., Z.H.M., M.F., S.T., J.R.B.D.), University of Alberta, Edmonton, Canada
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29
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Bugyei-Twum A, Ford C, Civitarese R, Seegobin J, Advani SL, Desjardins JF, Kabir G, Zhang Y, Mitchell M, Switzer J, Thai K, Shen V, Abadeh A, Singh KK, Billia F, Advani A, Gilbert RE, Connelly KA. Sirtuin 1 activation attenuates cardiac fibrosis in a rodent pressure overload model by modifying Smad2/3 transactivation. Cardiovasc Res 2019; 114:1629-1641. [PMID: 29800064 DOI: 10.1093/cvr/cvy131] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/17/2018] [Indexed: 12/14/2022] Open
Abstract
Aims Transforming growth factor β1 (TGF-β1) is a prosclerotic cytokine involved in cardiac remodelling leading to heart failure (HF). Acetylation/de-acetylation of specific lysine residues in Smad2/3 has been shown to regulate TGF-β signalling by altering its transcriptional activity. Recently, the lysine de-acetylase sirtuin 1 (SIRT1) has been shown to have a cardioprotective effect; however, SIRT1 expression and activity are paradoxically reduced in HF. Herein, we investigate whether pharmacological activation of SIRT1 would induce cardioprotection in a pressure overload model and assess the impact of SIRT1 activation on TGF-β signalling and the fibrotic response. Methods and results Eight weeks old male C57BL/6 mice were randomized to undergo sham surgery or transverse aortic constriction (TAC) to induce pressure overload. Post-surgery, animals were further randomized to receive SRT1720 or vehicle treatment. Echocardiography, pressure-volume loops, and histological analysis revealed an impairment in cardiac function and deleterious left ventricular remodelling in TAC-operated animals that was improved with SRT1720 treatment. Genetic ablation and cell culture studies using a Smad-binding response element revealed SIRT1 to be a specific target of SRT1720 and identified Smad2/3 as a SIRT1 specific substrate. Conclusion Overall, our data demonstrate that Smad2/3 is a specific SIRT1 target and suggests that pharmacological activation of SIRT1 may be a novel therapeutic strategy to prevent/reverse HF via modifying Smad activity.
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Affiliation(s)
- Antoinette Bugyei-Twum
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, Ontario, Canada
| | - Christopher Ford
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Robert Civitarese
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Jessica Seegobin
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Suzanne L Advani
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Jean-Francois Desjardins
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Golam Kabir
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Yanling Zhang
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Melissa Mitchell
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Jennifer Switzer
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Kerri Thai
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Vanessa Shen
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Armin Abadeh
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Krishna K Singh
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Filio Billia
- Division of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Advani
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Richard E Gilbert
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada
| | - Kim A Connelly
- Division of Cardiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, Ontario, Canada
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30
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Cardiac wall mechanics analysis in hypertension-induced heart failure rats with preserved ejection fraction. J Biomech 2019; 98:109428. [PMID: 31653505 DOI: 10.1016/j.jbiomech.2019.109428] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/07/2019] [Accepted: 10/13/2019] [Indexed: 11/21/2022]
Abstract
Although cardiac wall mechanics is of importance for understanding heart failure with preserved ejection fraction (HFpEF), there is a lack of relevant mechanics studies. The aim of this study was to analyze the changes in stress and strain in the left ventricle (LV) in hypertension-induced HFpEF rats. Based on experimental measurements in DSS rats fed with high-salt (HS) and low-salt (LS) diets, LV stress and strain were computed throughout the cardiac cycle using Continuity software. HS-feeding increased myofiber stress and strain along both the transmural and longitudinal directions at the end-diastolic state but resulted in a lower absolute value of strain and relatively unchanged stress at the end-systolic state. Moreover, the end-diastolic stress and strain decreased with increasing radial position from the endocardial towards the epicardial walls despite negligible changes along the longitudinal direction. The changes in LV wall mechanics characterized the elevated diastolic LV stiffness and slow LV relaxation in HS-fed rats of HFpEF. These findings denote that a vicious cycle of increased stress and strain and diastolic dysfunction can prompt the development of HFpEF.
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31
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Shea CM, Price GM, Liu G, Sarno R, Buys ES, Currie MG, Masferrer JL. Soluble guanylate cyclase stimulator praliciguat attenuates inflammation, fibrosis, and end-organ damage in the Dahl model of cardiorenal failure. Am J Physiol Renal Physiol 2019; 318:F148-F159. [PMID: 31608671 DOI: 10.1152/ajprenal.00247.2019] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Reduced nitric oxide (NO) and a decrease in cGMP signaling mediated by soluble guanylate cyclase (sGC) has been linked to the development of several cardiorenal diseases. Stimulation of sGC is a potential means for enhancing cGMP production in conditions of reduced NO bioavailability. The purpose of our studies was to determine the effects of praliciguat, a clinical-stage sGC stimulator, in a model of cardiorenal failure. Dahl salt-sensitive rats fed a high-salt diet to induce hypertension and organ damage were treated with the sGC stimulator praliciguat to determine its effects on hemodynamics, biomarkers of inflammation, fibrosis, tissue function, and organ damage. Praliciguat treatment reduced blood pressure, improved cardiorenal damage, and attenuated the increase in circulating markers of inflammation and fibrosis. Notably, praliciguat affected markers of renal damage at a dose that had minimal effect on blood pressure. In addition, liver fibrosis and circulating markers of tissue damage were attenuated in praliciguat-treated rats. Stimulation of the NO-sGC-cGMP pathway by praliciguat attenuated or normalized indicators of chronic inflammation, fibrosis, and tissue dysfunction in the Dahl salt-sensitive rat model. Stimulation of sGC by praliciguat may present an effective mechanism for treating diseases linked to NO deficiency, particularly those associated with cardiac and renal failure. Praliciguat is currently being evaluated in patients with diabetic nephropathy and heart failure with preserved ejection fraction.
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Affiliation(s)
| | | | - Guang Liu
- Cyclerion Therapeutics, Cambridge, Massachusetts
| | - Renee Sarno
- Cyclerion Therapeutics, Cambridge, Massachusetts
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32
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Jeong MY, Lin YH, Wennersten SA, Demos-Davies KM, Cavasin MA, Mahaffey JH, Monzani V, Saripalli C, Mascagni P, Reece TB, Ambardekar AV, Granzier HL, Dinarello CA, McKinsey TA. Histone deacetylase activity governs diastolic dysfunction through a nongenomic mechanism. Sci Transl Med 2019; 10:10/427/eaao0144. [PMID: 29437146 DOI: 10.1126/scitranslmed.aao0144] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/07/2017] [Accepted: 01/05/2018] [Indexed: 12/21/2022]
Abstract
There are no approved drugs for the treatment of heart failure with preserved ejection fraction (HFpEF), which is characterized by left ventricular (LV) diastolic dysfunction. We demonstrate that ITF2357 (givinostat), a clinical-stage inhibitor of histone deacetylase (HDAC) catalytic activity, is efficacious in two distinct murine models of diastolic dysfunction with preserved EF. ITF2357 blocked LV diastolic dysfunction due to hypertension in Dahl salt-sensitive (DSS) rats and suppressed aging-induced diastolic dysfunction in normotensive mice. HDAC inhibitor-mediated efficacy was not due to lowering blood pressure or inhibiting cellular and molecular events commonly associated with diastolic dysfunction, including cardiac fibrosis, cardiac hypertrophy, or changes in cardiac titin and myosin isoform expression. Instead, ex vivo studies revealed impairment of cardiac myofibril relaxation as a previously unrecognized, myocyte-autonomous mechanism for diastolic dysfunction, which can be ameliorated by HDAC inhibition. Translating these findings to humans, cardiac myofibrils from patients with diastolic dysfunction and preserved EF also exhibited compromised relaxation. These data suggest that agents such as HDAC inhibitors, which potentiate cardiac myofibril relaxation, hold promise for the treatment of HFpEF in humans.
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Affiliation(s)
- Mark Y Jeong
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Ying H Lin
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Sara A Wennersten
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Kimberly M Demos-Davies
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Maria A Cavasin
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Jennifer H Mahaffey
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | | | - Chandrasekhar Saripalli
- Department of Cellular and Molecular Medicine and Sarver Molecular Cardiovascular Research Program, University of Arizona, Tucson, AZ 85724, USA
| | | | - T Brett Reece
- Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Amrut V Ambardekar
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Henk L Granzier
- Department of Cellular and Molecular Medicine and Sarver Molecular Cardiovascular Research Program, University of Arizona, Tucson, AZ 85724, USA
| | - Charles A Dinarello
- Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Timothy A McKinsey
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA. .,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
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33
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Cho JH, Zhang R, Aynaszyan S, Holm K, Goldhaber JI, Marbán E, Cingolani E. Ventricular Arrhythmias Underlie Sudden Death in Rats With Heart Failure and Preserved Ejection Fraction. Circ Arrhythm Electrophysiol 2019; 11:e006452. [PMID: 30030266 DOI: 10.1161/circep.118.006452] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/21/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Heart failure (HF) with preserved ejection fraction (HFpEF) is increasingly common clinically, now rivaling or exceeding HF with reduced ejection fraction . Sudden death is the leading mode of exodus in patients with HFpEF, but the underlying causes are largely unknown. Using ambulatory recordings in a rat model, we test the hypothesis that ventricular arrhythmias (VA) underlie sudden death in HFpEF. METHODS Dahl salt-sensitive rats (7 weeks of age) were fed a high-salt diet to induce HFpEF (n=13) or a normal-salt diet (controls, n=9). Transthoracic echocardiography was performed to check systolic and diastolic function at 14 to 18 weeks of age. Telemetric electrocardiographic recordings were analyzed for QT interval duration, burden of premature ventricular contractions, spontaneous VA, and heart rate variability. Survival was monitored twice daily. RESULTS High-salt-fed rats with clear diastolic dysfunction, preserved ejection fraction, and HF signs were diagnosed with HFpEF at 14 to 15 weeks of age. QT and QTc intervals were prolonged in HFpEF rats compared with controls. Heart rate variability was reduced in HFpEF rats compared with controls. Spontaneous VA were more prevalent in HFpEF rats (6/13=46.1% versus 0/9=0% in controls; P<0.05), and sudden death was observed in 4 of 13 HFpEF rats. Three of the 4 sudden deaths were associated with VA as the terminal rhythm. CONCLUSIONS In this rat model with phenotypically verified HFpEF, sudden death was common and generally associated with VA. Further clinical studies are warranted to determine whether these insights translate to sudden death in HFpEF patients.
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Affiliation(s)
- Jae Hyung Cho
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Rui Zhang
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - Kevin Holm
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - Eduardo Marbán
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Eugenio Cingolani
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA.
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34
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Lai YC, Wang L, Gladwin MT. Insights into the pulmonary vascular complications of heart failure with preserved ejection fraction. J Physiol 2018; 597:1143-1156. [PMID: 30549058 DOI: 10.1113/jp275858] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 11/19/2018] [Indexed: 12/21/2022] Open
Abstract
Pulmonary hypertension in the setting of heart failure with preserved ejection fraction (PH-HFpEF) is a growing public health problem that is increasing in prevalence. While PH-HFpEF is defined by a high mean pulmonary artery pressure, high left ventricular end-diastolic pressure and a normal ejection fraction, some HFpEF patients develop PH in the presence of pulmonary vascular remodelling with a high transpulmonary pressure gradient or pulmonary vascular resistance. Ageing, increased left atrial pressure and stiffness, mitral regurgitation, as well as features of metabolic syndrome, which include obesity, diabetes and hypertension, are recognized as risk factors for PH-HFpEF. Qualitative studies have documented that patients with PH-HFpEF develop more severe symptoms than those with HFpEF and are associated with more significant exercise intolerance, frequent hospitalizations, right heart failure and reduced survival. Currently, there are no effective therapies for PH-HFpEF, although a number of candidate drugs are being evaluated, including soluble guanylate cyclase stimulators, phosphodiesterase type 5 inhibitors, sodium nitrite and endothelin receptor antagonists. In this review we attempt to provide an updated overview of recent findings pertaining to the pulmonary vascular complications in HFpEF in terms of clinical definitions, epidemiology and pathophysiology. Mechanisms leading to pulmonary vascular remodelling in HFpEF, a summary of pre-clinical models of HFpEF and PH-HFpEF, and new candidate therapeutic strategies for the treatment of PH-HFpEF are summarized.
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Affiliation(s)
- Yen-Chun Lai
- Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Longfei Wang
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, USA.,The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mark T Gladwin
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, USA.,Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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35
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Cho JH, Kilfoil PJ, Zhang R, Solymani RE, Bresee C, Kang EM, Luther K, Rogers RG, de Couto G, Goldhaber JI, Marbán E, Cingolani E. Reverse electrical remodeling in rats with heart failure and preserved ejection fraction. JCI Insight 2018; 3:121123. [PMID: 30282820 PMCID: PMC6237473 DOI: 10.1172/jci.insight.121123] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 08/21/2018] [Indexed: 01/06/2023] Open
Abstract
Sudden death is the most common mode of exodus in patients with heart failure and preserved ejection fraction (HFpEF). Cardiosphere-derived cells (CDCs) reduce inflammation and fibrosis in a rat model of HFpEF, improving diastolic function and prolonging survival. We tested the hypothesis that CDCs decrease ventricular arrhythmias (VAs) and thereby possibly contribute to prolonged survival. Dahl salt-sensitive rats were fed a high-salt diet to induce HFpEF. Allogeneic rat CDCs (or phosphate-buffered saline as placebo) were injected in rats with echo-verified HFpEF. CDC-injected HFpEF rats were less prone to VA induction by programmed electrical stimulation. Action potential duration (APD) was shortened, and APD homogeneity was increased by CDC injection. Transient outward potassium current density was upregulated in cardiomyocytes from CDC rats relative to placebo, as were the underlying transcript (Kcnd3) and protein (Kv4.3) levels. Fibrosis was attenuated in CDC-treated hearts, and survival was increased. Sudden death risk also trended down, albeit nonsignificantly. CDC therapy decreased VA in HFpEF rats by shortening APD, improving APD homogeneity, and decreasing fibrosis. Unlike other stem/progenitor cells, which often exacerbate arrhythmias, CDCs reverse electrical remodeling and suppress arrhythmogenesis in HFpEF.
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MESH Headings
- Action Potentials
- Animals
- Arrhythmias, Cardiac/etiology
- Arrhythmias, Cardiac/mortality
- Arrhythmias, Cardiac/prevention & control
- Death, Sudden, Cardiac/etiology
- Death, Sudden, Cardiac/prevention & control
- Disease Models, Animal
- Echocardiography
- Electrocardiography
- Heart Failure/etiology
- Heart Failure/mortality
- Heart Ventricles/diagnostic imaging
- Heart Ventricles/physiopathology
- Humans
- Male
- Myoblasts, Cardiac/transplantation
- Myocytes, Cardiac/metabolism
- Myocytes, Cardiac/pathology
- Rats
- Rats, Inbred Dahl
- Shal Potassium Channels/metabolism
- Sodium, Dietary/adverse effects
- Stroke Volume
- Transplantation, Homologous
- Ventricular Remodeling
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Affiliation(s)
- Jae Hyung Cho
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Peter J. Kilfoil
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Rui Zhang
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Ryan E. Solymani
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Catherine Bresee
- Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Elliot M. Kang
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Kristin Luther
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Russell G. Rogers
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Geoffrey de Couto
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Joshua I. Goldhaber
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Eduardo Marbán
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Eugenio Cingolani
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Miller DL, Lu X, Dou C, Zhu YI, Fuller R, Fields K, Fabiilli ML, Owens GE, Gordon D, Kripfgans OD. Ultrasonic Cavitation-Enabled Treatment for Therapy of Hypertrophic Cardiomyopathy: Proof of Principle. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:1439-1450. [PMID: 29681423 PMCID: PMC5960614 DOI: 10.1016/j.ultrasmedbio.2018.03.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 03/09/2018] [Accepted: 03/14/2018] [Indexed: 05/08/2023]
Abstract
Ultrasound myocardial cavitation-enabled treatment was applied to the SS-16BN rat model of hypertrophic cardiomyopathy for proof of the principle underlying myocardial reduction therapy. A focused ultrasound transducer was targeted using 10-MHz imaging (10 S, GE Vivid 7) to the left ventricular wall of anesthetized rats in a warmed water bath. Pulse bursts of 4-MPa peak rarefactional pressure amplitude were intermittently triggered 1:8 heartbeats during a 10-min infusion of a microbubble suspension. Methylprednisolone was given to reduce initial inflammation, and Losartan was given to reduce fibrosis in the healing tissue. At 28 d post therapy, myocardial cavitation-enabled treatment significantly reduced the targeted wall thickness by 16.2% (p <0.01) relative to shams, with myocardial strain rate and endocardial displacement reduced by 34% and 29%, respectively, which are sufficient for therapeutic treatment. Premature electrocardiogram complexes and plasma troponin measurements were found to identify optimal and suboptimal treatment cohorts and would aid in achieving the desired impact. With clinical translation, myocardial cavitation-enabled treatment should fill the need for a new non-invasive hypertrophic cardiomyopathy therapy option.
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Affiliation(s)
| | - Xiaofang Lu
- University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Chunyan Dou
- University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Yiying I Zhu
- University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Rachael Fuller
- University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Kristina Fields
- University of Michigan Health System, Ann Arbor, Michigan, USA
| | | | - Gabe E Owens
- University of Michigan Health System, Ann Arbor, Michigan, USA
| | - David Gordon
- University of Michigan Health System, Ann Arbor, Michigan, USA
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Platt MJ, Huber JS, Romanova N, Brunt KR, Simpson JA. Pathophysiological Mapping of Experimental Heart Failure: Left and Right Ventricular Remodeling in Transverse Aortic Constriction Is Temporally, Kinetically and Structurally Distinct. Front Physiol 2018; 9:472. [PMID: 29867532 PMCID: PMC5962732 DOI: 10.3389/fphys.2018.00472] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/16/2018] [Indexed: 12/16/2022] Open
Abstract
A growing proportion of heart failure (HF) patients present with impairments in both ventricles. Experimental pressure-overload (i.e., transverse aortic constriction, TAC) induces left ventricle (LV) hypertrophy and failure, as well as right ventricle (RV) dysfunction. However, little is known about the coordinated progression of biventricular dysfunction that occurs in TAC. Here we investigated the time course of systolic and diastolic function in both the LV and RV concurrently to improve our understanding of the chronology of events in TAC. Hemodynamic, histological, and morphometric assessments were obtained from the LV and RV at 2, 4, 9, and 18 weeks post-surgery. Results: Systolic pressures peaked in both ventricles at 4 weeks, thereafter steadily declining in the LV, while remaining elevated in the RV. The LV and RV followed different structural and functional timelines, suggesting the patterns in one ventricle are independent from the opposing ventricle. RV hypertrophy/fibrosis and pulmonary arterial remodeling confirmed a progressive right-sided pathology. We further identified both compensation and decompensation in the LV with persistent concentric hypertrophy in both phases. Finally, diastolic impairments in both ventricles manifested as an intricate progression of multiple parameters that were not in agreement until overt systolic failure was evident. Conclusion: We establish pulmonary hypertension was secondary to LV dysfunction, confirming TAC is a model of type II pulmonary hypertension. This study also challenges some common assumptions in experimental HF (e.g., the relationship between fibrosis and filling pressure) while addressing a knowledge gap with respect to temporality of RV remodeling in pressure-overload.
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Affiliation(s)
- Mathew J. Platt
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, ON, Canada
- IMPART Team Canada Investigator Network, Saint John, NB, Canada
| | - Jason S. Huber
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, ON, Canada
- IMPART Team Canada Investigator Network, Saint John, NB, Canada
| | - Nadya Romanova
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, ON, Canada
- IMPART Team Canada Investigator Network, Saint John, NB, Canada
| | - Keith R. Brunt
- IMPART Team Canada Investigator Network, Saint John, NB, Canada
- Department of Pharmacology, Dalhousie Medicine New Brunswick, Saint John, NB, Canada
| | - Jeremy A. Simpson
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, ON, Canada
- IMPART Team Canada Investigator Network, Saint John, NB, Canada
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Fillmore N, Levasseur JL, Fukushima A, Wagg CS, Wang W, Dyck JRB, Lopaschuk GD. Uncoupling of glycolysis from glucose oxidation accompanies the development of heart failure with preserved ejection fraction. Mol Med 2018; 24:3. [PMID: 30134787 PMCID: PMC6016884 DOI: 10.1186/s10020-018-0005-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 02/13/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Alterations in cardiac energy metabolism contribute to the development and severity of heart failure (HF). In severe HF, overall mitochondrial oxidative metabolism is significantly decreased resulting in a reduced energy reserve. However, despite the high prevalence of HF with preserved ejection fraction (HFpEF) in our society, it is not clear what changes in cardiac energy metabolism occur in HFpEF, and whether alterations in energy metabolism contribute to the development of contractile dysfunction. METHODS We directly assessed overall energy metabolism during the development of HFpEF in Dahl salt-sensitive rats fed a high salt diet (HSD) for 3, 6 and 9 weeks. RESULTS Over the course of 9 weeks, the HSD caused a progressive decrease in diastolic function (assessed by echocardiography assessment of E'/A'). This was accompanied by a progressive increase in cardiac glycolysis rates (assessed in isolated working hearts obtained at 3, 6, and 9 weeks of HSD). In contrast, the subsequent oxidation of pyruvate from glycolysis (glucose oxidation) was not altered, resulting in an uncoupling of glucose metabolism and a significant increase in proton production. Increased glucose transporter (GLUT)1 expression accompanied this elevation in glycolysis. Decreases in cardiac fatty acid oxidation and overall adenosine triphosphate (ATP) production rates were not observed in early HF, but both significantly decreased as HF progressed to HF with reduced EF (i.e. 9 weeks of HSD). CONCLUSIONS Overall, we show that increased glycolysis is the earliest energy metabolic change that occurs during HFpEF development. The resultant increased proton production from uncoupling of glycolysis and glucose oxidation may contribute to the development of HFpEF.
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Affiliation(s)
- Natasha Fillmore
- Cardiovascular Research Centre, Mazankowski Alberta Heart Institute University of Alberta, Edmonton, Canada
| | - Jody L Levasseur
- Cardiovascular Research Centre, Mazankowski Alberta Heart Institute University of Alberta, Edmonton, Canada
| | - Arata Fukushima
- Cardiovascular Research Centre, Mazankowski Alberta Heart Institute University of Alberta, Edmonton, Canada
| | - Cory S Wagg
- Cardiovascular Research Centre, Mazankowski Alberta Heart Institute University of Alberta, Edmonton, Canada
| | - Wei Wang
- Cardiovascular Research Centre, Mazankowski Alberta Heart Institute University of Alberta, Edmonton, Canada
| | - Jason R B Dyck
- Cardiovascular Research Centre, Mazankowski Alberta Heart Institute University of Alberta, Edmonton, Canada
| | - Gary D Lopaschuk
- Cardiovascular Research Centre, Mazankowski Alberta Heart Institute University of Alberta, Edmonton, Canada.
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Masuda K. [4. Preparation of Heart Disease Models and Evaluation of Pathology Using Ultrasound Imaging]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2018; 74:200-207. [PMID: 29459548 DOI: 10.6009/jjrt.2018_jsrt_74.2.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kasumi Masuda
- Division of Functional Diagnostics, Osaka University Graduate School of Medicine
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40
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Ludvigsen S, Mancusi C, Kildal S, de Simone G, Gerdts E, Ytrehus K. Cardiac adaptation to hypertension in adult female Dahl salt-sensitive rats is dependent on ovarian function, but loss of ovarian function does not predict early maladaptation. Physiol Rep 2018; 6:e13593. [PMID: 29417743 PMCID: PMC5803524 DOI: 10.14814/phy2.13593] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 12/19/2017] [Accepted: 12/20/2017] [Indexed: 01/25/2023] Open
Abstract
Aim of study was to examine experimentally the adult female hypertensive heart in order to determine the role of ovary function in the response of the heart to salt-dependent hypertension. Dahl salt-sensitive rats, age 12 weeks, with/without ovariectomy were fed a standard (0.3% NaCl) or high-salt diet (8%) for 16 weeks. Mean arterial blood pressure monitored noninvasively in conscious state increased significantly by high salt. Echocardiography was performed at baseline and endpoint. Heart function and molecular changes were evaluated at endpoint by left ventricle catheterization, by sirius red staining for collagen and by gene expression using quantitative RT-PCR for selected genes. At endpoint, significant concentric hypertrophy was present with high salt. Increase in relative wall thickening with high salt compared to normal diet was more pronounced with intact ovaries (0.33 ± 0.02 and 0.57 ± 0.04 vs. 0.29 ± 0.00 and 0.46 ± 0.03) as was the reduction in midwall fractional shortening (20 ± 0.6 and 14 ± 2 vs. 19 ± 0.9 and 18 ± 1). Ovariectomy increased stroke volume and decreased the ratio of mitral peak velocity of early filling (E) to early diastolic mitral annular velocity (E') (E/E' ratio) when compared to hearts from intact rats. High salt increased expression of collagen I and III genes and perivascular collagen in the heart slightly, but % interstitial collagen by sirius red staining remained unchanged in intact rats and decreased significantly by ovariectomy. Added volume load but not deterioration of function or structure characterized the nonfailing hypertensive heart of salt-sensitive females ovariectomized at mature age when compared to corresponding intact females.
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Affiliation(s)
- Stian Ludvigsen
- Cardiovascular Research GroupDepartment of Medical BiologyUiT – The Arctic University of NorwayTromsøNorway
| | - Costantino Mancusi
- Hypertension Research CenterFederico II University of NaplesNaplesItaly
- Department of Clinical ScienceUniversity of BergenBergenNorway
| | - Simon Kildal
- Cardiovascular Research GroupDepartment of Medical BiologyUiT – The Arctic University of NorwayTromsøNorway
| | | | - Eva Gerdts
- Department of Clinical ScienceUniversity of BergenBergenNorway
| | - Kirsti Ytrehus
- Cardiovascular Research GroupDepartment of Medical BiologyUiT – The Arctic University of NorwayTromsøNorway
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41
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Lourenço AP, Leite-Moreira AF, Balligand JL, Bauersachs J, Dawson D, de Boer RA, de Windt LJ, Falcão-Pires I, Fontes-Carvalho R, Franz S, Giacca M, Hilfiker-Kleiner D, Hirsch E, Maack C, Mayr M, Pieske B, Thum T, Tocchetti CG, Brutsaert DL, Heymans S. An integrative translational approach to study heart failure with preserved ejection fraction: a position paper from the Working Group on Myocardial Function of the European Society of Cardiology. Eur J Heart Fail 2017; 20:216-227. [DOI: 10.1002/ejhf.1059] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 09/08/2017] [Accepted: 10/01/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
- Andre P. Lourenço
- Department of Surgery and Physiology & Cardiovascular Research Centre, Faculty of Medicine; University of Porto; Portugal
| | - Adelino F. Leite-Moreira
- Department of Surgery and Physiology & Cardiovascular Research Centre, Faculty of Medicine; University of Porto; Portugal
| | - Jean-Luc Balligand
- Pole of Pharmacology and Therapeutics, Institut de Recherche Experimentale et Clinique (IREC), and Clinique Universitaire Saint-Luc; Université catholique de Louvain; Brussels Belgium
| | - Johann Bauersachs
- Klinik fuer Kardiologie und Angiologie Medizinische Hochschule; Hannover Germany
| | - Dana Dawson
- Reader in Cardiovascular Medicine and Honorary Consultant Cardiologist, University of Aberdeen; UK
| | | | - Leon J. de Windt
- Department of Cardiology, CARIM School for Cardiovascular Diseases Faculty of Health, Medicine and Life Sciences; Maastricht University; The Netherlands
| | - Inês Falcão-Pires
- Department of Surgery and Physiology & Cardiovascular Research Centre, Faculty of Medicine; University of Porto; Portugal
| | - Ricardo Fontes-Carvalho
- Department of Surgery and Physiology & Cardiovascular Research Centre, Faculty of Medicine; University of Porto; Portugal
| | - Stefan Franz
- University Hospital Halle; Department of Internal Medicine III; Halle, Saale Germany
| | - Mauro Giacca
- Molecular Medicine Laboratory, International Centre for Genetic Engineering and Biotechnology (ICGEB) & Department of Medical, Surgical and Health Sciences; University of Trieste; Trieste Italy
| | | | - Emilio Hirsch
- Department of Molecular Biotechnology and Health Sciences; University of Turin; Torino Italy
| | - Christoph Maack
- Klinik für Innere Medizin III; Universitätsklinikum des Saarlandes; Homburg Germany
| | - Manuel Mayr
- The James Black Centre and King's British Heart Foundation Centre, King's College; University of London; London UK
| | - Burkert Pieske
- Department of Cardiology, Charité, Campus Virchow & German Centre for Cardiovascular Research (DZHK), Charite & Berlin Institute of Health, Berlin; Germany & Department of Cardiology, University of Graz; Graz Austria
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (IMTTS), IFB-Tx, & REBIRTH Excellence Cluster, Hannover Medical School, Hannover, Germany, and National Heart and Lung Institute; Imperial College London; UK
| | - Carlo G. Tocchetti
- Department of Translational Medical Sciences, Division of Internal Medicine; Federico II University; Naples Italy
| | | | - Stephane Heymans
- Department of Cardiology, Maastricht University Medical Center & CARIM; Maastricht University; Maastricht The Netherlands
- Cardiovascular Sciences; University of Leuven; Belgium
- Netherlands Heart Institute; Utrecht The Netherlands
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Oishi S, Suzuki N, Hasui Y, Homma T, Obana M, Nagayama T, Fujio Y. Sustained Activation of Guanylate Cyclase-A with TDT, a Natriuretic Peptide Derivative, Exhibits Cardiorenal Protection in Dahl Salt-Sensitive Hypertensive Rats. J Pharmacol Exp Ther 2017; 363:402-410. [PMID: 29021382 DOI: 10.1124/jpet.117.244459] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 10/02/2017] [Indexed: 11/22/2022] Open
Abstract
Heart failure often presents with prognosis-relevant impaired renal function. To investigate whether the chronic activation of guanylate cyclase-A (GC-A) protects both heart and kidney, we examined the effects of TDT, a neprilysin (NEP)-resistant natriuretic peptide (NP) derivative, on cardiac and renal dysfunction in Dahl salt-sensitive hypertensive (DS) rats. Pretreatment with NEP or NEP inhibitor did not influence GC-A activation by TDT both in vitro and in vivo, resulting in a long-acting profile of TDT compared with native human atrial NP (hANP). The repeated administration of TDT to DS rats suppressed the progress of cardiac hypertrophy, systolic/diastolic dysfunction, and proteinuria in a dose-dependent manner. Compared with vehicle and hANP, salt diet-induced podocyte injury was reduced by TDT, as analyzed by urinary podocalyxin concentration, renal expression of nephrin mRNA, and glomerular expression of desmin protein. Since glomerular TRPC6 plays detrimental roles in podocyte homeostasis, we examined the renal expression of TRPC6 in DS rats and found that salt diet upregulated the expression of TRPC6. Importantly, TRPC6 induction was significantly decreased in TDT-treated rats, compared with vehicle and hANP. Consistently, in primary-culture podocytes from DS rats, TDT inhibited ATP-induced calcium influx, similar to TRPC inhibitor SKF96365. Finally, TDT-mediated protection of podocytes was abolished by protein kinase G inhibitor KT5823. In conclusion, TDT treatment attenuated heart and kidney dysfunction, accompanied by podocyte protection through inhibition of TRPC6. Thus, long-acting NPs could be a new avenue for treatment of heart failure.
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Affiliation(s)
- Shohei Oishi
- Laboratory of Clinical Science and Biomedicine, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan (S.O., M.O., Y.F.); End-Organ Disease Laboratories (S.O., Y.H., T.H.), Rare Disease & LCM Laboratories (T.N.), and Research Function (N.S.), Daiichi Sankyo Co., Ltd, Tokyo, Japan
| | - Naoko Suzuki
- Laboratory of Clinical Science and Biomedicine, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan (S.O., M.O., Y.F.); End-Organ Disease Laboratories (S.O., Y.H., T.H.), Rare Disease & LCM Laboratories (T.N.), and Research Function (N.S.), Daiichi Sankyo Co., Ltd, Tokyo, Japan
| | - Yuri Hasui
- Laboratory of Clinical Science and Biomedicine, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan (S.O., M.O., Y.F.); End-Organ Disease Laboratories (S.O., Y.H., T.H.), Rare Disease & LCM Laboratories (T.N.), and Research Function (N.S.), Daiichi Sankyo Co., Ltd, Tokyo, Japan
| | - Tsuyoshi Homma
- Laboratory of Clinical Science and Biomedicine, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan (S.O., M.O., Y.F.); End-Organ Disease Laboratories (S.O., Y.H., T.H.), Rare Disease & LCM Laboratories (T.N.), and Research Function (N.S.), Daiichi Sankyo Co., Ltd, Tokyo, Japan
| | - Masanori Obana
- Laboratory of Clinical Science and Biomedicine, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan (S.O., M.O., Y.F.); End-Organ Disease Laboratories (S.O., Y.H., T.H.), Rare Disease & LCM Laboratories (T.N.), and Research Function (N.S.), Daiichi Sankyo Co., Ltd, Tokyo, Japan
| | - Takahiro Nagayama
- Laboratory of Clinical Science and Biomedicine, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan (S.O., M.O., Y.F.); End-Organ Disease Laboratories (S.O., Y.H., T.H.), Rare Disease & LCM Laboratories (T.N.), and Research Function (N.S.), Daiichi Sankyo Co., Ltd, Tokyo, Japan
| | - Yasushi Fujio
- Laboratory of Clinical Science and Biomedicine, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan (S.O., M.O., Y.F.); End-Organ Disease Laboratories (S.O., Y.H., T.H.), Rare Disease & LCM Laboratories (T.N.), and Research Function (N.S.), Daiichi Sankyo Co., Ltd, Tokyo, Japan
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Cho JH, Zhang R, Kilfoil PJ, Gallet R, de Couto G, Bresee C, Goldhaber JI, Marbán E, Cingolani E. Delayed Repolarization Underlies Ventricular Arrhythmias in Rats With Heart Failure and Preserved Ejection Fraction. Circulation 2017; 136:2037-2050. [PMID: 28974519 DOI: 10.1161/circulationaha.117.028202] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 09/07/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Heart failure with preserved ejection fraction (HFpEF) represents approximately half of heart failure, and its incidence continues to increase. The leading cause of mortality in HFpEF is sudden death, but little is known about the underlying mechanisms. METHODS Dahl salt-sensitive rats were fed a high-salt diet (8% NaCl) from 7 weeks of age to induce HFpEF (n=38). Rats fed a normal-salt diet (0.3% NaCl) served as controls (n=13). Echocardiograms were performed to assess systolic and diastolic function from 14 weeks of age. HFpEF-verified and control rats underwent programmed electrical stimulation. Corrected QT interval was measured by surface ECG. The mechanisms of ventricular arrhythmias (VA) were probed by optical mapping, whole-cell patch clamp to measure action potential duration and ionic currents, and quantitative polymerase chain reaction and Western blotting to investigate changes in ion channel expression. RESULTS After 7 weeks of a high-salt diet, 31 of 38 rats showed diastolic dysfunction and preserved ejection fraction along with signs of heart failure and hence were diagnosed with HFpEF. Programmed electric stimulation demonstrated increased susceptibility to VA in HFpEF rats (P<0.001 versus controls). The arrhythmogenicity index was increased (P<0.001) and the corrected QT interval on ECG was prolonged (P<0.001) in HFpEF rats. Optical mapping of HFpEF hearts demonstrated prolonged action potentials (P<0.05) and multiple reentry circuits during induced VA. Single-cell recordings of cardiomyocytes isolated from HFpEF rats confirmed a delay of repolarization (P=0.001) and revealed downregulation of transient outward potassium current (Ito; P<0.05). The rapid components of the delayed rectifier potassium current (IKr) and the inward rectifier potassium current (IK1) were also downregulated (P<0.05), but the current densities were much lower than for Ito. In accordance with the reduction of Ito, both Kcnd3 transcript and Kv4.3 protein levels were decreased in HFpEF rat hearts. CONCLUSIONS Susceptibility to VA was markedly increased in rats with HFpEF. Underlying abnormalities include QT prolongation, delayed repolarization from downregulation of potassium currents, and multiple reentry circuits during VA. Our findings are consistent with the hypothesis that potassium current downregulation leads to abnormal repolarization in HFpEF, which in turn predisposes to VA and sudden cardiac death.
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Affiliation(s)
- Jae Hyung Cho
- Cedars-Sinai Heart Institute, Los Angeles, CA (J.H.C., R.Z., P.J.K., G.d.C., J.I.G., E.M., E.C.)
| | - Rui Zhang
- Cedars-Sinai Heart Institute, Los Angeles, CA (J.H.C., R.Z., P.J.K., G.d.C., J.I.G., E.M., E.C.)
| | - Peter J Kilfoil
- Cedars-Sinai Heart Institute, Los Angeles, CA (J.H.C., R.Z., P.J.K., G.d.C., J.I.G., E.M., E.C.)
| | - Romain Gallet
- Henri Mondor University Hospital, Créteil, France (R.G.)
| | - Geoffrey de Couto
- Cedars-Sinai Heart Institute, Los Angeles, CA (J.H.C., R.Z., P.J.K., G.d.C., J.I.G., E.M., E.C.)
| | - Catherine Bresee
- Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, CA (C.B.)
| | - Joshua I Goldhaber
- Cedars-Sinai Heart Institute, Los Angeles, CA (J.H.C., R.Z., P.J.K., G.d.C., J.I.G., E.M., E.C.)
| | - Eduardo Marbán
- Cedars-Sinai Heart Institute, Los Angeles, CA (J.H.C., R.Z., P.J.K., G.d.C., J.I.G., E.M., E.C.)
| | - Eugenio Cingolani
- Cedars-Sinai Heart Institute, Los Angeles, CA (J.H.C., R.Z., P.J.K., G.d.C., J.I.G., E.M., E.C.)
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Tam MC, Lee R, Cascino TM, Konerman MC, Hummel SL. Current Perspectives on Systemic Hypertension in Heart Failure with Preserved Ejection Fraction. Curr Hypertens Rep 2017; 19:12. [PMID: 28233237 DOI: 10.1007/s11906-017-0709-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a prevalent but incompletely understood syndrome. Traditional models of HFpEF pathophysiology revolve around systemic HTN and other causes of increased left ventricular afterload leading to left ventricular hypertrophy (LVH) and diastolic dysfunction. However, emerging models attribute the development of HFpEF to systemic proinflammatory changes secondary to common comorbidities which include HTN. Alterations in passive ventricular stiffness, ventricular-arterial coupling, peripheral microvascular function, systolic reserve, and chronotropic response occur. As a result, HFpEF is heterogeneous in nature, making it difficult to prescribe uniform therapies to all patients. Nonetheless, treating systemic HTN remains a cornerstone of HFpEF management. Antihypertensive therapies have been linked to LVH regression and improvement in diastolic dysfunction. However, to date, no therapies have definitive mortality benefit in HFpEF. Non-pharmacologic management for HTN, including dietary modification, exercise, and treating sleep disordered breathing, may provide some morbidity benefit in the HFpEF population. Future research is need to identify effective treatments, perhaps in more specific subgroups, and focus may need to shift from reducing mortality to improving exercise capacity and symptoms. Tailoring antihypertensive therapies to specific phenotypes of HFpEF may be an important component of this strategy.
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Affiliation(s)
- Marty C Tam
- Frankel Cardiovascular Center, University of Michigan Health System, Ann Arbor, MI, USA
| | - Ran Lee
- Frankel Cardiovascular Center, University of Michigan Health System, Ann Arbor, MI, USA
| | - Thomas M Cascino
- Frankel Cardiovascular Center, University of Michigan Health System, Ann Arbor, MI, USA
| | - Matthew C Konerman
- Frankel Cardiovascular Center, University of Michigan Health System, Ann Arbor, MI, USA
| | - Scott L Hummel
- Frankel Cardiovascular Center, University of Michigan Health System, Ann Arbor, MI, USA. .,Ann Arbor Veterans Affairs Health System, 1500 E. Medical Center Drive, 2383 CVC/SPC 5853, Ann Arbor, MI, 48109, USA.
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Prat V, Rozec B, Gauthier C, Lauzier B. Human heart failure with preserved ejection versus feline cardiomyopathy: what can we learn from both veterinary and human medicine? Heart Fail Rev 2017; 22:783-794. [DOI: 10.1007/s10741-017-9645-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Behdadfar S, Navarro L, Sundnes J, Maleckar MM, Avril S. Importance of material parameters and strain energy function on the wall stresses in the left ventricle. Comput Methods Biomech Biomed Engin 2017; 20:1223-1232. [DOI: 10.1080/10255842.2017.1347160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sareh Behdadfar
- Ecole Nationale Supérieure des Mines, CIS-EMSE, Institut national de la santé et de la recherche médicale, INSERM:UMR1059, SAINBIOSE, Saint-Etienne, France
| | - Laurent Navarro
- Ecole Nationale Supérieure des Mines, CIS-EMSE, Institut national de la santé et de la recherche médicale, INSERM:UMR1059, SAINBIOSE, Saint-Etienne, France
| | - Joakim Sundnes
- Computational Cardiac Modeling Department, Simula Research Laboratory, Fornebu, Norway
| | - Molly M. Maleckar
- Computational Cardiac Modeling Department, Simula Research Laboratory, Fornebu, Norway
- Modeling at the Allen Institute for Cell Science, Allen Institute, Seattle, WA, USA
| | - Stéphane Avril
- Ecole Nationale Supérieure des Mines, CIS-EMSE, Institut national de la santé et de la recherche médicale, INSERM:UMR1059, SAINBIOSE, Saint-Etienne, France
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Obokata M, Reddy YNV, Pislaru SV, Melenovsky V, Borlaug BA. Evidence Supporting the Existence of a Distinct Obese Phenotype of Heart Failure With Preserved Ejection Fraction. Circulation 2017; 136:6-19. [PMID: 28381470 DOI: 10.1161/circulationaha.116.026807] [Citation(s) in RCA: 687] [Impact Index Per Article: 98.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/24/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Heart failure (HF) with preserved ejection fraction (HFpEF) is a heterogeneous syndrome. Phenotyping patients into pathophysiologically homogeneous groups may enable better targeting of treatment. Obesity is common in HFpEF and has many cardiovascular effects, suggesting that it may be a viable candidate for phenotyping. We compared cardiovascular structure, function, and reserve capacity in subjects with obese HFpEF, those with nonobese HFpEF, and control subjects. METHODS Subjects with obese HFpEF (body mass index ≥35 kg/m2; n=99), nonobese HFpEF (body mass index <30 kg/m2; n=96), and nonobese control subjects free of HF (n=71) underwent detailed clinical assessment, echocardiography, and invasive hemodynamic exercise testing. RESULTS Compared with both subjects with nonobese HFpEF and control subjects, subjects with obese HFpEF displayed increased plasma volume (3907 mL [3563-4333 mL] versus 2772 mL [2555-3133 mL], and 2680 mL [2380-3006 mL]; P<0.0001), more concentric left ventricular remodeling, greater right ventricular dilatation (base, 34±7 versus 31±6 and 30±6 mm, P=0.0005; length, 66±7 versus 61±7 and 61±7 mm, P<0.0001), more right ventricular dysfunction, increased epicardial fat thickness (10±2 versus 7±2 and 6±2 mm; P<0.0001), and greater total epicardial heart volume (945 mL [831-1105 mL] versus 797 mL [643-979 mL] and 632 mL [517-768 mL]; P<0.0001), despite lower N-terminal pro-B-type natriuretic peptide levels. Pulmonary capillary wedge pressure was correlated with body mass and plasma volume in obese HFpEF (r=0.22 and 0.27, both P<0.05) but not in nonobese HFpEF (P≥0.3). The increase in heart volumes in obese HFpEF was associated with greater pericardial restraint and heightened ventricular interdependence, reflected by increased ratio of right- to left-sided heart filling pressures (0.64±0.17 versus 0.56±0.19 and 0.53±0.20; P=0.0004), higher pulmonary venous pressure relative to left ventricular transmural pressure, and greater left ventricular eccentricity index (1.10±0.19 versus 0.99±0.06 and 0.97±0.12; P<0.0001). Interdependence was enhanced as pulmonary artery pressure load increased (P for interaction <0.05). Compared with those with nonobese HFpEF and control subjects, obese patients with HFpEF displayed worse exercise capacity (peak oxygen consumption, 7.7±2.3 versus 10.0±3.4 and12.9±4.0 mL/min·kg; P<0.0001), higher biventricular filling pressures with exercise, and depressed pulmonary artery vasodilator reserve. CONCLUSIONS Obesity-related HFpEF is a genuine form of cardiac failure and a clinically relevant phenotype that may require specific treatments.
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Affiliation(s)
- Masaru Obokata
- From Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (M.O., Y.N.V.R., S.V.P., V.M., B.A.B.); and Institute for Clinical and Experimental Medicine-IKEM, Prague, Czech Republic (V.M.)
| | - Yogesh N V Reddy
- From Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (M.O., Y.N.V.R., S.V.P., V.M., B.A.B.); and Institute for Clinical and Experimental Medicine-IKEM, Prague, Czech Republic (V.M.)
| | - Sorin V Pislaru
- From Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (M.O., Y.N.V.R., S.V.P., V.M., B.A.B.); and Institute for Clinical and Experimental Medicine-IKEM, Prague, Czech Republic (V.M.)
| | - Vojtech Melenovsky
- From Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (M.O., Y.N.V.R., S.V.P., V.M., B.A.B.); and Institute for Clinical and Experimental Medicine-IKEM, Prague, Czech Republic (V.M.)
| | - Barry A Borlaug
- From Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (M.O., Y.N.V.R., S.V.P., V.M., B.A.B.); and Institute for Clinical and Experimental Medicine-IKEM, Prague, Czech Republic (V.M.).
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Lee YT, Lin HY, Chan YWF, Li KHC, To OTL, Yan BP, Liu T, Li G, Wong WT, Keung W, Tse G. Mouse models of atherosclerosis: a historical perspective and recent advances. Lipids Health Dis 2017; 16:12. [PMID: 28095860 PMCID: PMC5240327 DOI: 10.1186/s12944-016-0402-5] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 12/27/2016] [Indexed: 12/20/2022] Open
Abstract
Atherosclerosis represents a significant cause of morbidity and mortality in both the developed and developing countries. Animal models of atherosclerosis have served as valuable tools for providing insights on its aetiology, pathophysiology and complications. They can be used for invasive interrogation of physiological function and provide a platform for testing the efficacy and safety of different pharmacological therapies. Compared to studies using human subjects, animal models have the advantages of being easier to manage, with controllable diet and environmental risk factors. Moreover, pathophysiological changes can be induced either genetically or pharmacologically to study the harmful effects of these interventions. There is no single ideal animal model, as different systems are suitable for different research objectives. A good understanding of the similarities and differences to humans enables effective extrapolation of data for translational application. In this article, we will examine the different mouse models for the study and elucidation of the pathophysiological mechanisms underlying atherosclerosis. We also review recent advances in the field, such as the role of oxidative stress in promoting endoplasmic reticulum stress, mitochondrial dysfunction and mitochondrial DNA damage, which can result in vascular inflammation and atherosclerosis. Finally, novel therapeutic approaches to reduce vascular damage caused by chronic inflammation using microRNA and nano-medicine technology, are discussed.
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Affiliation(s)
- Yee Ting Lee
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, SAR People’s Republic of China
| | - Hiu Yu Lin
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, SAR People’s Republic of China
| | | | | | - Olivia Tsz Ling To
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
| | - Bryan P Yan
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, 300211 People’s Republic of China
| | - Guangping Li
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, 300211 People’s Republic of China
| | - Wing Tak Wong
- School of Life Sciences, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
| | - Wendy Keung
- Stem Cell & Regenerative Medicine Consortium, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, SAR People’s Republic of China
| | - Gary Tse
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
- Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, SAR People’s Republic of China
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Cardioprotection and lifespan extension by the natural polyamine spermidine. Nat Med 2016; 22:1428-1438. [PMID: 27841876 DOI: 10.1038/nm.4222] [Citation(s) in RCA: 751] [Impact Index Per Article: 93.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 09/24/2016] [Indexed: 12/13/2022]
Abstract
Aging is associated with an increased risk of cardiovascular disease and death. Here we show that oral supplementation of the natural polyamine spermidine extends the lifespan of mice and exerts cardioprotective effects, reducing cardiac hypertrophy and preserving diastolic function in old mice. Spermidine feeding enhanced cardiac autophagy, mitophagy and mitochondrial respiration, and it also improved the mechano-elastical properties of cardiomyocytes in vivo, coinciding with increased titin phosphorylation and suppressed subclinical inflammation. Spermidine feeding failed to provide cardioprotection in mice that lack the autophagy-related protein Atg5 in cardiomyocytes. In Dahl salt-sensitive rats that were fed a high-salt diet, a model for hypertension-induced congestive heart failure, spermidine feeding reduced systemic blood pressure, increased titin phosphorylation and prevented cardiac hypertrophy and a decline in diastolic function, thus delaying the progression to heart failure. In humans, high levels of dietary spermidine, as assessed from food questionnaires, correlated with reduced blood pressure and a lower incidence of cardiovascular disease. Our results suggest a new and feasible strategy for protection against cardiovascular disease.
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Mazumder R, Schroeder S, Mo X, Clymer BD, White RD, Kolipaka A. In vivo quantification of myocardial stiffness in hypertensive porcine hearts using MR elastography. J Magn Reson Imaging 2016; 45:813-820. [PMID: 27564862 DOI: 10.1002/jmri.25423] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 07/29/2016] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To determine alteration in left ventricular (LV) myocardial stiffness (MS) with hypertension (HTN). Cardiac MR elastography (MRE) was used to estimate MS in HTN induced pigs and MRE-derived MS measurements were compared against LV pressure, thickness and circumferential strain. MATERIALS AND METHODS Renal-wrapping surgery was performed to induce HTN in eight pigs. LV catheterization (to measure pressure) and cardiac MRI (1.5 Tesla; gradient echo-MRE and tagging) was performed pre-surgery at baseline (Bx), and post-surgery at month 1 (M1) and month 2 (M2). Images were analyzed to estimate LV-MS, thickness, and circumferential strain across the cardiac cycle. The associations between end-diastolic (ED) and end-systolic (ES) MS and (i) mean LV pressure; (ii) ED and ES thickness, respectively; and (iii) circumferential strain were evaluated using Spearman's correlation method. RESULTS From Bx to M2, mean pressure, MRE-derived stiffness, and thickness increased while circumferential strain decreased significantly (slope test, P ≤ 0.05). Both ED and ES MS had significant positive correlation with (i) mean pressure (ED MS: ρ = 0.56; P = 0.005 and ES MS: ρ = 0.45; P = 0.03); (ii) ED thickness ( ρ = 0.73; P < 0.0001) and ES thickness ( ρ = 0.84; P < 0.0001), respectively; but demonstrated a negative trend with circumferential strain (ED MS: ρ = 0.31 and ES MS: ρ = 0.37). CONCLUSION This study demonstrated that, in a HTN porcine model, MRE-derived MS increased with increase in pressure and thickness. LEVEL OF EVIDENCE 1 J. Magn. Reson. Imaging 2017;45:813-820.
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Affiliation(s)
- Ria Mazumder
- Department of Electrical and Computer Engineering, 205 Dreese Laboratories, The Ohio State University, Columbus, Ohio, USA.,Department of Radiology, Room 460, The Ohio State University, Columbus, Ohio, USA.,Department of Biomedical Engineering, 265 Kirkbride Hall, Walnut Street, Widener University, Chester, PA
| | - Samuel Schroeder
- Department of Radiology, Room 460, The Ohio State University, Columbus, Ohio, USA.,Department of Mechanical Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Xiaokui Mo
- Center for Biostatistics, Department of Biomedical Informatics, Room 320D, Lincoln Tower, Columbus, Ohio, USA
| | - Bradley D Clymer
- Department of Electrical and Computer Engineering, 205 Dreese Laboratories, The Ohio State University, Columbus, Ohio, USA
| | - Richard D White
- Department of Radiology, Room 460, The Ohio State University, Columbus, Ohio, USA.,Department of Internal Medicine-Division of Cardiovascular Medicine, 244 Davis Heart & Lung Research Institute, The Ohio State University, Columbus, Ohio, USA
| | - Arunark Kolipaka
- Department of Radiology, Room 460, The Ohio State University, Columbus, Ohio, USA.,Department of Internal Medicine-Division of Cardiovascular Medicine, 244 Davis Heart & Lung Research Institute, The Ohio State University, Columbus, Ohio, USA
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