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Bu F, Wang J, Chen J, Zhang Q, Lin X, Zhang R, Bai H, Hua Y, Wang H, Huang M, Huang Y, Lin Y, Hu X, Zheng L, Wang Q. HCC-1 Accelerates Atherosclerosis by Inducing Endothelial Cell and Macrophage Pyroptosis and Serves as an Early Diagnostic Biomarker. Arterioscler Thromb Vasc Biol 2024; 44:2088-2107. [PMID: 39087347 DOI: 10.1161/atvbaha.124.321007] [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: 03/26/2024] [Accepted: 06/18/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND HCC-1 (hemofiltrate CC chemokine-1), a CC-type chemokine, exerts function to change intracellular calcium concentration, induce leukocyte, and manipulate enzyme release especially in monocytes. It has been reported that HCC-1 can predict the persistent acute kidney injury or suppress hepatocellular carcinoma by modulating cell cycle and promoting apoptosis; however, the effect of HCC-1 on atherosclerosis is poorly understood. Here, we aimed to clarify the function and mechanism of HCC-1 in atherosclerosis and whether it could serve as a novel biomarker for the diagnosis of atherosclerosis. METHODS HCC-1 expression in serum, atherosclerotic plaques, and normal arterial tissue from patients with atherosclerosis and control group was assessed by ELISA, immunohistochemistry and confocal microscope, and bioinformatic analysis. The atherosclerotic model of HCC-1 overexpressing and control mice was generated by tail vein injection of adeno-associated virus serotype 9-HCC-1 on an ApoE-/- background. Cell adhesion, polarization, and pyroptosis were evaluated in vitro. The relationship between HCC-1 concentration in serum and atherosclerosis was analyzed in patients with atherosclerosis. RESULTS HCC-1 expression was positively correlated with the occurrence and stable-unstable switch of atherosclerosis under bioinformatic analysis, which is further supported by the results of increased HCC-1 expression in atherosclerosis patients both in serum and atherosclerotic plaque. adeno-associated virus serotype 9-HCC-1 mice had higher levels of inflammatory factors, increased macrophage accumulation and pyroptotic rate in plaque, and decreased atherosclerotic plaque stability. In vitro, HCC-1 promoted monocyte adhesion and M1 polarization and induced inflammation and pyroptosis both in endothelial cells and macrophages. CONCLUSIONS HCC-1 expression was increased in patients with atherosclerosis, and HCC-1 overexpression accelerated atherosclerotic burden via an enhancement in monocyte recruitment, M1 polarization, and pyroptosis both in endothelial cells and macrophages. Our findings suggested that HCC-1 may serve as an early biomarker for the diagnosis of atherosclerosis, with the capacity to reflect the degree of stenosis.
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Affiliation(s)
- Fan Bu
- Center for Clinical Laboratory, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China (F.B., J.C., Y. Hua, M.H., Y.L., Q.W.)
| | - Junhui Wang
- Hematology (J.W.), Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Juanjiang Chen
- Center for Clinical Laboratory, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China (F.B., J.C., Y. Hua, M.H., Y.L., Q.W.)
| | - Qi Zhang
- Departments of Laboratory Medicine (Q.Z., X.L., R.Z., H.B., H.W., Y. Huang, X.H., L.Z.), Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Xiaomin Lin
- Departments of Laboratory Medicine (Q.Z., X.L., R.Z., H.B., H.W., Y. Huang, X.H., L.Z.), Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Ruyi Zhang
- Departments of Laboratory Medicine (Q.Z., X.L., R.Z., H.B., H.W., Y. Huang, X.H., L.Z.), Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Huanlan Bai
- Departments of Laboratory Medicine (Q.Z., X.L., R.Z., H.B., H.W., Y. Huang, X.H., L.Z.), Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Yuneng Hua
- Center for Clinical Laboratory, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China (F.B., J.C., Y. Hua, M.H., Y.L., Q.W.)
| | - Haifang Wang
- Departments of Laboratory Medicine (Q.Z., X.L., R.Z., H.B., H.W., Y. Huang, X.H., L.Z.), Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Mei Huang
- Center for Clinical Laboratory, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China (F.B., J.C., Y. Hua, M.H., Y.L., Q.W.)
| | - Yiyi Huang
- Departments of Laboratory Medicine (Q.Z., X.L., R.Z., H.B., H.W., Y. Huang, X.H., L.Z.), Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Yuling Lin
- Center for Clinical Laboratory, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China (F.B., J.C., Y. Hua, M.H., Y.L., Q.W.)
| | - Xiumei Hu
- Departments of Laboratory Medicine (Q.Z., X.L., R.Z., H.B., H.W., Y. Huang, X.H., L.Z.), Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Lei Zheng
- Departments of Laboratory Medicine (Q.Z., X.L., R.Z., H.B., H.W., Y. Huang, X.H., L.Z.), Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Qian Wang
- Center for Clinical Laboratory, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China (F.B., J.C., Y. Hua, M.H., Y.L., Q.W.)
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Liu B, Zeng H, Su H, Williams QA, Besanson J, Chen Y, Chen JX. Endothelial Cell-Specific Prolyl Hydroxylase-2 Deficiency Augments Angiotensin II-Induced Arterial Stiffness and Cardiac Pericyte Recruitment in Mice. J Am Heart Assoc 2024; 13:e035769. [PMID: 39056332 DOI: 10.1161/jaha.124.035769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Endothelial prolyl hydroxylase-2 (PHD2) is essential for pulmonary remodeling and hypertension. In the present study, we investigated the role of endothelial PHD2 in angiotensin II-mediated arterial stiffness, pericyte recruitment, and cardiac fibrosis. METHODS AND RESULTS Chondroitin sulfate proteoglycan 4 tracing reporter chondroitin sulfate proteoglycan 4- red fluorescent protein (DsRed) transgenic mice were crossed with PHD2flox/flox (PHD2f/f) mice and endothelial-specific knockout of PHD2 (PHD2ECKO) mice. Transgenic PHD2f/f (TgPHD2f/f) mice and TgPHD2ECKO mice were infused with angiotensin II for 4 weeks. Arterial thickness, stiffness, and histological and immunofluorescence of pericytes and fibrosis were measured. Infusion of TgPHD2f/f mice with angiotensin II resulted in a time-dependent increase in pulse-wave velocity. Angiotensin II-induced pulse-wave velocity was further elevated in the TgPHD2ECKO mice. TgPHD2ECKO also reduced coronary flow reserve compared with TgPHD2f/f mice infused with angiotensin II. Mechanistically, knockout of endothelial PHD2 promoted aortic arginase activity and angiotensin II-induced aortic thickness together with increased transforming growth factor-β1 and ICAM-1/VCAM-1 expression in coronary arteries. TgPHD2f/f mice infused with angiotensin II for 4 weeks exhibited a significant increase in cardiac fibrosis and hypertrophy, which was further developed in the TgPHD2ECKO mice. Chondroitin sulfate proteoglycan 4 pericyte was traced by DsRed+ staining and angiotensin II infusion displayed a significant increase of DsRed+ pericytes in the heart, as well as a deficiency of endothelial PHD2, which further promoted angiotensin II-induced pericyte increase. DsRed+ pericytes were costained with fibroblast-specific protein 1 and α-smooth muscle actin for measuring pericyte-myofibroblast cell transition. The knockout of endothelial PHD2 increased the amount of DsRed+/fibroblast-specific protein 1+ and DsRed+/α-smooth muscle actin+ cells induced by angiotensin II infusion. CONCLUSIONS Knockout of endothelial PHD2 enhanced angiotensin II-induced cardiac fibrosis by mechanisms involving increasing arterial stiffness and pericyte-myofibroblast cell transitions.
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Affiliation(s)
- Bo Liu
- Department of Pharmacology and Toxicology University of Mississippi Medical Center, School of Medicine Jackson MS
| | - Heng Zeng
- Department of Pharmacology and Toxicology University of Mississippi Medical Center, School of Medicine Jackson MS
| | - Han Su
- Department of Pharmacology and Toxicology University of Mississippi Medical Center, School of Medicine Jackson MS
| | - Quinesha A Williams
- Department of Pharmacology and Toxicology University of Mississippi Medical Center, School of Medicine Jackson MS
| | - Jessie Besanson
- Department of Pharmacology and Toxicology University of Mississippi Medical Center, School of Medicine Jackson MS
| | - Yingjie Chen
- Department of Physiology and Biophysics University of Mississippi Medical Center, School of Medicine Jackson MS
| | - Jian-Xiong Chen
- Department of Pharmacology and Toxicology University of Mississippi Medical Center, School of Medicine Jackson MS
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3
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Liu YF, Tian Y, Chen XF, Zhang C, Huang L. Role of osteokines in atherosclerosis. Cell Biochem Funct 2024; 42:e4107. [PMID: 39154288 DOI: 10.1002/cbf.4107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/03/2024] [Accepted: 08/04/2024] [Indexed: 08/19/2024]
Abstract
Despite their diverse physiologies and roles, the heart, skeletal muscles, and smooth muscles all derive from a common embryonic source as bones. Moreover, bone tissue, skeletal and smooth muscles, and the heart share conserved signaling pathways. The maintenance of skeletal health is precisely regulated by osteocytes, osteoblasts, and osteoclasts through coordinated secretion of bone-derived factors known as osteokines. Increasing evidence suggests the involvement of osteokines in regulating atherosclerotic vascular disease. Therefore, this review aims to examine the evidence for the role of osteokines in atherosclerosis development and progression comprehensively. Specifically discussed are extensively studied osteokines in atherosclerosis such as osteocalcin, osteopontin, osteoprotegerin, and fibroblast growth factor 23. Additionally, we highlighted the effects of exercise on modulating these key regulators derived from bone tissue metabolism. We believe that gaining an enhanced understanding of how osteocalcin contributes to the process of atherosclerosis will enable us to develop targeted and comprehensive therapeutic strategies against diseases associated with its progression.
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Affiliation(s)
- Yi-Fan Liu
- Institute of Translational Medicine, School of Basic Medical, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Yuan Tian
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan province, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
| | - Xiao-Fang Chen
- Institute of Translational Medicine, School of Basic Medical, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Chi Zhang
- Institute of Cardiovascular Disease, Key Lab for Arteriosclerology of Hunan province, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
| | - Liang Huang
- Institute of Translational Medicine, School of Basic Medical, Hengyang Medical School, University of South China, Hengyang, Hunan, China
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4
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Ellis JA, Doron O, Schneider JR, Higbie CM, Kulason KO, Khatri D, Langer DJ. Technical aspects and operative nuances using a high-definition 4K-3-dimensional exoscope for carotid endarterectomy surgery. Br J Neurosurg 2024; 38:857-862. [PMID: 34608831 DOI: 10.1080/02688697.2021.1982865] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/19/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Carotid endarterectomy (CEA) is effective in treating carotid artery stenosis to prevent stroke. Historically, this operation has been performed utilizing loupe magnification with or without the operating microscope (OM). However, there remains a need for continued improvement in operative visualization and surgical ergonomics. Recently, newly developed digital 'exoscope' has provided the surgeon with unique lighting and magnification as well as improvements in surgical ergonomics and working angle. We sought to review our cumulative experience using a novel 4K high-definition (4K-HD) 3-dimensional (3D) exoscope (EX) for CEA surgery. METHODS All CEA surgery cases at our institution between 2013 and 2019 using the 4K-HD 3D EX were reviewed. Operative parameters, patient outcome and operator's assessment of the EX compared to OM-assisted cases was conducted. RESULTS 28 patients were treated, 10 of which were operated using the EX. All procedures were performed without perioperative complications, or significant differences in operative parameters (blood loss <20 cm3 and 164 ± 49.5 minutes) compared to OM-assisted cases. Operators reported improved level of comfort performing 'high' bifurcation surgery and improved visualization and posture during inspection of the distal ICA lumen as primary advantages of EX-assisted CEA over OM-assisted CEA. CONCLUSIONS The ORBEYE EX, albeit a learning curve necessitating a short period of the OR team, provided safety and outcome comparable to OM-assisted surgery. Potential advantages noted were improved visualization and ergonomics specifically for when extreme working angles were required. Our experience suggests that the exoscope may become a valuable alternative to standard magnification tools in CEA surgery.
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Affiliation(s)
- Jason A Ellis
- Department of Neurosurgery, Lenox Hill Hospital, Donald and Zucker School of Medicine, Northwell Health, New York, NY, USA
| | - Omer Doron
- Department of Neurosurgery, Lenox Hill Hospital, Donald and Zucker School of Medicine, Northwell Health, New York, NY, USA
| | - Julia R Schneider
- Department of Neurosurgery, Lenox Hill Hospital, Donald and Zucker School of Medicine, Northwell Health, New York, NY, USA
| | - Catherine M Higbie
- Department of Neurosurgery, Lenox Hill Hospital, Donald and Zucker School of Medicine, Northwell Health, New York, NY, USA
| | - Kay O Kulason
- Department of Neurosurgery, Lenox Hill Hospital, Donald and Zucker School of Medicine, Northwell Health, New York, NY, USA
| | - Deepak Khatri
- Department of Neurosurgery, Lenox Hill Hospital, Donald and Zucker School of Medicine, Northwell Health, New York, NY, USA
| | - David J Langer
- Department of Neurosurgery, Lenox Hill Hospital, Donald and Zucker School of Medicine, Northwell Health, New York, NY, USA
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5
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Xie Z, Zeinstra N, Kirby MA, Le NM, Murry CE, Zheng Y, Wang RK. Quantifying Microvascular Structure in Healthy and Infarcted Rat Hearts Using Optical Coherence Tomography Angiography. IEEE TRANSACTIONS ON MEDICAL IMAGING 2024; 43:2878-2887. [PMID: 38568757 DOI: 10.1109/tmi.2024.3381934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Myocardial infarction (MI) is a life-threatening medical emergency resulting in coronary microvascular dysregulation and heart muscle damage. One of the primary characteristics of MI is capillary loss, which plays a significant role in the progression of this cardiovascular condition. In this study, we utilized optical coherence tomography angiography (OCTA) to image coronary microcirculation in fixed rat hearts, aiming to analyze coronary microvascular impairment post-infarction. Various angiographic metrics are presented to quantify vascular features, including the vessel area density, vessel complexity index, vessel tortuosity index, and flow impairment. Pathological differences identified from OCTA analysis are corroborated with histological analysis. The quantitative assessments reveal a significant decrease in microvascular density in the capillary-sized vessels and an enlargement for the arteriole/venule-sized vessels. Further, microvascular tortuosity and complexity exhibit an increase after myocardial infarction. The results underscore the feasibility of using OCTA to offer qualitative microvascular details and quantitative metrics, providing insights into coronary vascular network remodeling during disease progression and response to therapy.
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6
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Rosano GMC, Stolfo D, Anderson L, Abdelhamid M, Adamo M, Bauersachs J, Bayes-Genis A, Böhm M, Chioncel O, Filippatos G, Hill L, Lainscak M, Lambrinou E, Maas AHEM, Massouh AR, Moura B, Petrie MC, Rakisheva A, Ray R, Savarese G, Skouri H, Van Linthout S, Vitale C, Volterrani M, Metra M, Coats AJS. Differences in presentation, diagnosis and management of heart failure in women. A scientific statement of the Heart Failure Association of the ESC. Eur J Heart Fail 2024; 26:1669-1686. [PMID: 38783694 DOI: 10.1002/ejhf.3284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/11/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Despite the progress in the care of individuals with heart failure (HF), important sex disparities in knowledge and management remain, covering all the aspects of the syndrome, from aetiology and pathophysiology to treatment. Important distinctions in phenotypic presentation are widely known, but the mechanisms behind these differences are only partially defined. The impact of sex-specific conditions in the predisposition to HF has gained progressive interest in the HF community. Under-recruitment of women in large randomized clinical trials has continued in the more recent studies despite epidemiological data no longer reporting any substantial difference in the lifetime risk and prognosis between sexes. Target dose of medications and criteria for device eligibility are derived from studies with a large predominance of men, whereas specific information in women is lacking. The present scientific statement encompasses the whole scenario of available evidence on sex-disparities in HF and aims to define the most challenging and urgent residual gaps in the evidence for the scientific and clinical HF communities.
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Affiliation(s)
- Giuseppe M C Rosano
- Chair of Pharmacology, Department of Human Sciences and Promotion of Quality of Life, San Raffaele University of Rome, Rome, Italy
- Cardiology, San Raffaele Cassino Hospital, Cassino, Italy
| | - Davide Stolfo
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lisa Anderson
- Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St. George's University of London and St George's University Hospitals NHS Foundation Trust, London, UK
| | - Magdy Abdelhamid
- Department of Cardiovascular Medicine, Faculty of Medicine, Kasr Al Ainy, Cairo University, Giza, Egypt
| | - Marianna Adamo
- ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Antoni Bayes-Genis
- Heart Institute, Hospital Universitari Germans Trias i Poujol, CIBERCV, Badalona, Spain
| | - Michael Böhm
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Saarland University, Homburg/Saar, Germany
| | - Ovidiu Chioncel
- University of Medicine Carol Davila, Bucharest, Romania
- Emergency Institute for Cardiovascular Diseases 'Prof. C.C. Iliescu', Bucharest, Romania
| | - Gerasimos Filippatos
- National & Kapodistrian University of Athens School of Medicine, Athens University Hospital Attikon, Chaidari, Greece
| | - Loreena Hill
- School of Nursing and Midwifery, Queen's University, Belfast, UK
| | - Mitja Lainscak
- Division of Cardiology, General Hospital Murska Sobota, Rakičan, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Angela H E M Maas
- Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Angela R Massouh
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Brenda Moura
- Armed Forces Hospital, Porto, Portugal
- Faculty of Medicine of University of Porto, Porto, Portugal
| | - Mark C Petrie
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Amina Rakisheva
- City Cardiological Center, Almaty Kazakhstan Qonaev city hospital, Almaty Region, Kazakhstan
| | - Robin Ray
- Department of Cardiology, St George's Hospital, London, UK
| | - Gianluigi Savarese
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Heart and Vascular and Neuro Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Hadi Skouri
- Division of Cardiology, Sheikh Shakhbout Medical city, Abu Dhabi, UAE
| | - Sophie Van Linthout
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner site Berlin, Berlin, Germany
| | | | - Maurizio Volterrani
- Department of Human Science and Promotion of Quality of Life, San Raffaele Open University, Rome, Italy
- Cardio-Pulmonary Department, IRCCS San Raffaele, Rome, Italy
| | - Marco Metra
- ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
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7
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Li Y, Fan Y, Ye S, Xu L, Wang G, Lu Y, Huang S, Zhang Y. Biomedical application of microalgal-biomaterials hybrid system. Biotechnol J 2024; 19:e2400325. [PMID: 39167555 DOI: 10.1002/biot.202400325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/14/2024] [Accepted: 07/16/2024] [Indexed: 08/23/2024]
Abstract
Microalgae are a group of microorganisms containing chlorophyll A, which are highly photosynthetic and rich in nutrients. And they can produce multiple bioactive substances (peptides, proteins, polysaccharides, and fatty acids) for biomedical applications. Despite the unique advantages of microalgae-based biotherapy, the insufficient treatment efficiency limits its further application. With the development of nanotechnology, the combination of microalgae and biomaterials can improve therapeutic efficacies, which has attracted increasing attention. In this microalgal-biomaterials hybrid system, biomaterials with excellent optical and magnetic properties play an important role in biological therapy. Microalgae, as a natural vehicle, can increase oxygen content and alleviate hypoxia in diseased areas, further enhancing therapeutic effects. In this review, the synergistic therapeutic effects of microalgal-biomaterials hybrid system in different diseases (cancer, myocardial infarction, ischemia stroke, chronic infection, and intestinal diseases) are comprehensively summarized.
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Affiliation(s)
- Yize Li
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
| | - Yali Fan
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
| | - Shuo Ye
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
| | - Lingyun Xu
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
| | - Gezhen Wang
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
| | - Yuli Lu
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
| | - Suxiang Huang
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
| | - Yingying Zhang
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
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8
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Ruan J, Kang M, Nirwane A, Yao Y. A dispensable role of mural cell-derived laminin- α5 in intracerebral hemorrhage. J Cereb Blood Flow Metab 2024:271678X241264083. [PMID: 39053486 DOI: 10.1177/0271678x241264083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Although most laminin isoforms are neuroprotective in stroke, mural cell-derived laminin-α5 plays a detrimental role in an ischemia-reperfusion model. To determine whether this deleterious effect is an intrinsic feature of mural cell-derived laminin-α5 or unique to ischemic stroke, we performed loss-of-function studies using middle-aged mice with laminin-α5 deficiency in mural cells (α5-PKO) in an intracerebral hemorrhage (ICH) model. Control and α5-PKO mice exhibited comparable changes in all parameters examined, including hematoma size, neuronal death, neurological function, blood-brain barrier integrity, and reactive gliosis. These findings highlight a minimal role of mural cell-derived laminin-α5 in ICH. Together with the detrimental role of mural cell-derived laminin-α5 in ischemic stroke, these negative results in ICH model suggest that mural cell-derived laminin-α5 may exert distinct functions in different diseases.
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Affiliation(s)
- Jingsong Ruan
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Minkyung Kang
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Abhijit Nirwane
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Yao Yao
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
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9
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Li X, Zhou X, Gao L. Diabetes and Heart Failure: A Literature Review, Reflection and Outlook. Biomedicines 2024; 12:1572. [PMID: 39062145 PMCID: PMC11274420 DOI: 10.3390/biomedicines12071572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/08/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
Heart failure (HF) is a complex clinical syndrome caused by structural or functional dysfunction of the ventricular filling or blood supply. Diabetes mellitus (DM) is an independent predictor of mortality for HF. The increase in prevalence, co-morbidity and hospitalization rates of both DM and HF has further fueled the possibility of overlapping disease pathology between the two. For decades, antidiabetic drugs that are known to definitively increase the risk of HF are the thiazolidinediones (TZDs) and saxagliptin in the dipeptidyl peptidase-4 (DPP-4) inhibitor, and insulin, which causes sodium and water retention, and whether metformin is effective or safe for HF is not clear. Notably, sodium-glucose transporter 2 (SGLT2) inhibitors and partial glucagon-like peptide-1 receptor agonists (GLP-1 RA) all achieved positive results for HF endpoints, with SGLT2 inhibitors in particular significantly reducing the composite endpoint of cardiovascular mortality and hospitalization for heart failure (HHF). Further understanding of the mutual pathophysiological mechanisms between HF and DM may facilitate the detection of novel therapeutic targets to improve the clinical outcome. This review focuses on the association between HF and DM, emphasizing the efficacy and safety of antidiabetic drugs and HF treatment. In addition, recent therapeutic advances in HF and the important mechanisms by which SGLT2 inhibitors/mineralocorticoid receptor antagonist (MRA)/vericiguat contribute to the benefits of HF are summarized.
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Affiliation(s)
| | | | - Ling Gao
- Department of Endocrinology, Renmin Hospital, Wuhan University, Wuhan 430060, China; (X.L.); (X.Z.)
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10
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Rehan R, Virk S, Wong CCY, Passam F, Layland J, Keech A, Yong A, White HD, Fearon W, Ng M. Intracoronary thrombolysis in ST-elevation myocardial infarction: a systematic review and meta-analysis. Heart 2024; 110:988-996. [PMID: 38925881 PMCID: PMC11287581 DOI: 10.1136/heartjnl-2024-324078] [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: 02/29/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Despite restoration of epicardial blood flow in acute ST-elevation myocardial infarction (STEMI), inadequate microcirculatory perfusion is common and portends a poor prognosis. Intracoronary (IC) thrombolytic therapy can reduce microvascular thrombotic burden; however, contemporary studies have produced conflicting outcomes. OBJECTIVES This meta-analysis aims to evaluate the efficacy and safety of adjunctive IC thrombolytic therapy at the time of primary percutaneous coronary intervention (PCI) among patients with STEMI. METHODS Comprehensive literature search of six electronic databases identified relevant randomised controlled trials. The primary outcome was major adverse cardiac events (MACE). The pooled risk ratio (RR) and weighted mean difference (WMD) with a 95% CI were calculated. RESULTS 12 studies with 1915 patients were included. IC thrombolysis was associated with a significantly lower incidence of MACE (RR=0.65, 95% CI 0.51 to 0.82, I2=0%, p<0.0004) and improved left ventricular ejection fraction (WMD=1.87; 95% CI 1.07 to 2.67; I2=25%; p<0.0001). Subgroup analysis demonstrated a significant reduction in MACE for trials using non-fibrin (RR=0.39, 95% CI 0.20 to 0.78, I2=0%, p=0.007) and moderately fibrin-specific thrombolytic agents (RR=0.62, 95% CI 0.47 to 0.83, I2=0%, p=0.001). No significant reduction was observed in studies using highly fibrin-specific thrombolytic agents (RR=1.10, 95% CI 0.62 to 1.96, I2=0%, p=0.75). Furthermore, there were no significant differences in mortality (RR=0.91; 95% CI 0.48 to 1.71; I2=0%; p=0.77) or bleeding events (major bleeding, RR=1.24; 95% CI 0.47 to 3.28; I2=0%; p=0.67; minor bleeding, RR=1.47; 95% CI 0.90 to 2.40; I2=0%; p=0.12). CONCLUSION Adjunctive IC thrombolysis at the time of primary PCI in patients with STEMI improves clinical and myocardial perfusion parameters without an increased rate of bleeding. Further research is needed to optimise the selection of thrombolytic agents and treatment protocols.
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Affiliation(s)
- Rajan Rehan
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Concord Hospital, Concord, New South Wales, Australia
| | - Sohaib Virk
- Systematic Reviews, CORE Group, Sydney, New South Wales, Australia
| | - Christopher C Y Wong
- Cardiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Stanford Hospital, Stanford, California, USA
| | - Freda Passam
- Department of Hematology, University of Sydney, Sydney, New South Wales, Australia
| | | | - Anthony Keech
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Andy Yong
- Cardiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Harvey D White
- Cardiology Department, Green Lane Cardiovascular Service and Green Lane Cardiovascular Research Unit, Auckland City Hospital, Auckland, New Zealand
| | | | - Martin Ng
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Department of Cardiology, The University of Sydney, Sydney, New South Wales, Australia
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11
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Hoarau D, Ramos I, Termoz A, Fernandez V, Rambure M, Allemann SS, Derex L, Haesebaert J, Schott AM, Viprey M. Determinants of adherence to post-stroke/transient ischemic attack secondary prevention medications: A cohort study. Eur J Neurol 2024:e16395. [PMID: 38953278 DOI: 10.1111/ene.16395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/26/2024] [Accepted: 06/10/2024] [Indexed: 07/03/2024]
Abstract
BACKGROUND Adherence to post-stroke secondary prevention medications mitigates recurrence risk. This study aimed to measure adherence to secondary prevention medications during 3 years post-ischemic stroke/transient ischemic attack, using prescription and dispensing data, and identify factors associated with suboptimal adherence. METHODS This multicenter, prospective, cohort study involved patients from the STROKE 69 cohort, which included all consecutive patients with suspected acute stroke admitted between November 2015 and December 2016 to any emergency department or stroke center in the Rhône area in France. Prescription data for antihypertensive agents, antidiabetic agents, lipid-lowering drugs, and antithrombotics were collected. Dispensing data were provided by the French regional reimbursement database. Adherence was calculated using the continuous medication acquisition index. Associations between suboptimal adherence and potential influencing factors across the World Health Organization's five dimensions were explored through univariate and multivariate analyses. RESULTS From 1512 eligible patients, 365 were included. Optimal adherence to overall treatment (≥90%) was observed in 61%, 62%, and 65% of patients in the first, second, and third years, respectively. Education level (high school diploma or higher: OR = 3.24, 95% CI [1.49; 7.36]) and depression (Hospital Anxiety and Depression Scale-Depression scores 8-10: OR = 1.90, 95% CI [1.05; 3.44]) were significantly associated with suboptimal adherence. CONCLUSIONS Overall adherence to secondary prevention medications was fairly good. Having an initial diagnosis of transient ischemic attack, a high level of education, or depression was associated with increased odds of suboptimal adherence, while having a history of heart rhythm disorder was associated with lower odds.
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Affiliation(s)
- Damien Hoarau
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France
| | - Inès Ramos
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Anne Termoz
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France
| | | | - Marie Rambure
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France
| | - Samuel S Allemann
- Pharmaceutical Care Research Group, University of Basel, Basel, Switzerland
| | - Laurent Derex
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Comprehensive Stroke Center, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Bron, France
| | - Julie Haesebaert
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France
| | - Anne-Marie Schott
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France
| | - Marie Viprey
- Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France
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12
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Anker SD, Friede T, von Bardeleben RS, Butler J, Khan MS, Diek M, Heinrich J, Geyer M, Placzek M, Ferrari R, Abraham WT, Alfieri O, Auricchio A, Bayes-Genis A, Cleland JGF, Filippatos G, Gustafsson F, Haverkamp W, Kelm M, Kuck KH, Landmesser U, Maggioni AP, Metra M, Ninios V, Petrie MC, Rassaf T, Ruschitzka F, Schäfer U, Schulze PC, Spargias K, Vahanian A, Zamorano JL, Zeiher A, Karakas M, Koehler F, Lainscak M, Öner A, Mezilis N, Theofilogiannakos EK, Ninios I, Chrissoheris M, Kourkoveli P, Papadopoulos K, Smolka G, Wojakowski W, Reczuch K, Pinto FJ, Zmudka K, Kalarus Z, Adamo M, Santiago-Vacas E, Ruf TF, Gross M, Tongers J, Hasenfuß G, Schillinger W, Ponikowski P. Percutaneous repair of moderate-to-severe or severe functional mitral regurgitation in patients with symptomatic heart failure: Baseline characteristics of patients in the RESHAPE-HF2 trial and comparison to COAPT and MITRA-FR trials. Eur J Heart Fail 2024; 26:1608-1615. [PMID: 38847420 DOI: 10.1002/ejhf.3286] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 04/24/2024] [Accepted: 04/30/2024] [Indexed: 07/26/2024] Open
Abstract
AIM The RESHAPE-HF2 trial is designed to assess the efficacy and safety of the MitraClip device system for the treatment of clinically important functional mitral regurgitation (FMR) in patients with heart failure (HF). This report describes the baseline characteristics of patients enrolled in the RESHAPE-HF2 trial compared to those enrolled in the COAPT and MITRA-FR trials. METHODS AND RESULTS The RESHAPE-HF2 study is an investigator-initiated, prospective, randomized, multicentre trial including patients with symptomatic HF, a left ventricular ejection fraction (LVEF) between 20% and 50% with moderate-to-severe or severe FMR, for whom isolated mitral valve surgery was not recommended. Patients were randomized 1:1 to a strategy of delivering or withholding MitraClip. Of 506 patients randomized, the mean age of the patients was 70 ± 10 years, and 99 of them (20%) were women. The median EuroSCORE II was 5.3 (2.8-9.0) and median plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) was 2745 (1407-5385) pg/ml. Most patients were prescribed beta-blockers (96%), diuretics (96%), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitors (82%) and mineralocorticoid receptor antagonists (82%). The use of sodium-glucose cotransporter 2 inhibitors was rare (7%). Cardiac resynchronization therapy (CRT) devices had been previously implanted in 29% of patients. Mean LVEF, left ventricular end-diastolic volume and effective regurgitant orifice area (EROA) were 31 ± 8%, 211 ± 76 ml and 0.25 ± 0.08 cm2, respectively, whereas 44% of patients had mitral regurgitation severity of grade 4+. Compared to patients enrolled in COAPT and MITRA-FR, those enrolled in RESHAPE-HF2 were less likely to have mitral regurgitation grade 4+ and, on average, HAD lower EROA, and plasma NT-proBNP and higher estimated glomerular filtration rate, but otherwise had similar age, comorbidities, CRT therapy and LVEF. CONCLUSION Patients enrolled in RESHAPE-HF2 represent a third distinct population where MitraClip was tested in, that is one mainly comprising of patients with moderate-to-severe FMR instead of only severe FMR, as enrolled in the COAPT and MITRA-FR trials. The results of RESHAPE-HF2 will provide crucial insights regarding broader application of the transcatheter edge-to-edge repair procedure in clinical practice.
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Affiliation(s)
- Stefan D Anker
- Department of Cardiology (CVK) of German Heart Center Charité; Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charité Universitätsmedizin, Berlin, Germany
- Department of Cardiology and Pneumology, University Medical Centre Göttingen, Georg August University of Göttingen, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Tim Friede
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany
| | | | - Javed Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
| | | | - Monika Diek
- Department of Cardiology (CVK) of German Heart Center Charité; Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charité Universitätsmedizin, Berlin, Germany
- Department of Cardiology and Pneumology, University Medical Centre Göttingen, Georg August University of Göttingen, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Jutta Heinrich
- Clinical Trial Unit, University Medical Center Göttingen, Göttingen, Germany
| | - Martin Geyer
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Marius Placzek
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany
| | - Roberto Ferrari
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - William T Abraham
- Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH, USA
| | - Ottavio Alfieri
- Cardiac Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Angelo Auricchio
- Department of Cardiology, Cardiocentro Ticino Institute-EOC, Lugano, Switzerland
| | - Antoni Bayes-Genis
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - John G F Cleland
- School of Cardiovascular and Metabolic Health, University of Glasgow, British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow, UK
| | - Gerasimos Filippatos
- Department of Cardiology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Finn Gustafsson
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Wilhelm Haverkamp
- Department of Cardiology (CVK) of German Heart Center Charité; Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charité Universitätsmedizin, Berlin, Germany
| | - Malte Kelm
- Department of Cardiology, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- CARID, Cardiovascular Research Institute, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany
| | - Karl-Heinz Kuck
- Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Ulf Landmesser
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Benjamin Franklin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Marco Metra
- Institute of Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Vlasis Ninios
- European Interbalkan Medical Center, Thessaloniki, Greece
| | - Mark C Petrie
- School of Cardiovascular and Metabolic Health, University of Glasgow, British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow, UK
| | - Tienush Rassaf
- West German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Frank Ruschitzka
- Department of Cardiology, University Heart Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - P Christian Schulze
- Department of Internal Medicine I, Cardiology, University Hospital Jena, Jena, Germany
| | | | - Alec Vahanian
- UFR Medecine, Université de Paris-Cité, site Bichat, GH Bichat, Paris, France
| | - Jose Luis Zamorano
- Department of Cardiology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- CIBERCV, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Andreas Zeiher
- Institute for Cardiovascular Regeneration, Goethe University Frankfurt, Frankfurt am Main, Germany
- German Center of Cardiovascular Research (DZHK), Partner Site Rhein-Main, Frankfurt am Main, Germany
| | - Mahir Karakas
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Friedrich Koehler
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Deutsches Herzzentrum der Charité (DHZC), Department of Cardiology, Angiology and Intensive Care Medicine, Campus Charité Mitte, Berlin, Germany
- Center for Cardiovascular Telemedicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Mitja Lainscak
- Division of Cardiology, General Hospital Murska Sobota, Murska Sobota, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Alper Öner
- Department of Cardiology, Rostock University Medical Centre, Rostock, Germany
| | - Nikolaos Mezilis
- Department of Cardiology, St Luke's Hospital, Thessaloniki, Greece
| | | | - Ilias Ninios
- European Interbalkan Medical Center, Thessaloniki, Greece
| | | | | | - Konstantinos Papadopoulos
- European Interbalkan Medical Center, Thessaloniki, Greece
- Department of Transcatheter Heart Valves, HYGEIA Hospital, Athens, Greece
| | - Grzegorz Smolka
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Wojciech Wojakowski
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Reczuch
- Institute of Heart Diseases, Medical University and University Hospital, Wroclaw, Poland
| | - Fausto J Pinto
- Centro Academico de Medicina de Lisboa, CCUL@RISE, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Krzysztof Zmudka
- Clinic of Interventional Cardiology, John Paul II Hospital, Kraków, Poland
| | - Zbigniew Kalarus
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia, Katowice, Poland
| | - Marianna Adamo
- Institute of Cardiology, ASST Spedali Civili and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | | | - Tobias Friedrich Ruf
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Michael Gross
- Department of Medicine, Heart and Vascular Center, Division of Cardiology and Vascular Medicine, Johanniter Hospital Stendal, Stendal, Germany
| | - Joern Tongers
- Mid-German Heart Center, Department of Cardiology, Angiology and Intensive Care Medicine, University Hospital Halle/Saale, Halle, Germany
| | - Gerd Hasenfuß
- Department of Cardiology and Pneumology, University Medical Centre Göttingen, Georg August University of Göttingen, Göttingen, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Wolfgang Schillinger
- Department of Cardiology and Pneumology, University Medical Centre Göttingen, Georg August University of Göttingen, Göttingen, Germany
- Heart Center, Department of Cardiology, Georg-August-University Göttingen, Göttingen, Germany
| | - Piotr Ponikowski
- Centro Academico de Medicina de Lisboa, CCUL@RISE, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
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13
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Wang L, Liu Y, Shi W, Liu X, Qin M. Value of the monocyte-to-high-density lipoprotein cholesterol ratio in refining the detection of prevalent heart failure: Insights from the NHANES 1999-2018. Lipids 2024; 59:93-100. [PMID: 38637329 DOI: 10.1002/lipd.12395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 03/07/2024] [Accepted: 03/21/2024] [Indexed: 04/20/2024]
Abstract
The monocyte-to-high-density lipoprotein cholesterol ratio (MHR) is a novel marker that can help estimate the degree of atherosclerosis by considering inflammation and lipid abnormalities. This study aimed to assess the association between the MHR and prevalent heart failure (HF) and to explore the value of the MHR in detecting prevalent HF in the general US population. Our study included 25,374 participants from the National Health and Nutrition Examination Survey (1999-2018). Among the participants, 749 (2.95%) reported a history of HF, and the HF group had a significantly higher MHR than the non-HF group. Adjusted analyses revealed that each standard deviation increase in the MHR was associated with a 27.8% increase in the risk of HF. The association between the MHR and prevalent HF was linear across the entire MHR range. Adding the MHR to conventional cardiovascular risk factors significantly improved the area under the curve (0.875; p < 0.001), continuous net reclassification index (0.187; p < 0.001), and integrated discrimination index (0.004; p < 0.001). Our study suggests a potential association between the MHR and HF risk, and the findings enhance HF risk stratification and provide novel insights into the interplay between the coronary atherosclerotic burden and HF in clinical settings.
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Affiliation(s)
- Letian Wang
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
- Department of Cardiology, Shanghai Chest Hospital, Shanghai, China
| | - Yang Liu
- Department of Cardiology, Shanghai Chest Hospital, Shanghai, China
| | - Wenrui Shi
- Department of Cardiology, Shanghai Chest Hospital, Shanghai, China
- Shanghai Jiaotong University, Shanghai, China
| | - Xu Liu
- Department of Cardiology, Shanghai Chest Hospital, Shanghai, China
| | - Mu Qin
- Department of Cardiology, Shanghai Chest Hospital, Shanghai, China
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14
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Xiao W, Yuan JL, Chen Y, Ma G, Zhang C, Sun L, Hong C, Ye T. Development and validation of a prediction model for heart failure in patients with heart valvular regurgitation. ESC Heart Fail 2024. [PMID: 38923827 DOI: 10.1002/ehf2.14899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/06/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024] Open
Abstract
AIMS Patients with heart valvular regurgitation is increasing; early screening of potential patients developing heart failure (HF) is crucial. METHODS From 1 November 2019 to 31 October 2023, a total of 509 patients with heart valvular regurgitation hospitalized in the Department of Cardiovascular Disease of the First Affiliated Hospital of Guangzhou University of Traditional Medicine were enrolled. Three hundred fifty-six cases were selected as the training set for modelling, and 153 cases were selected as the validation set for the internal validation of the model. RESULTS A predictive model of heart failure with the following nine risk factors was developed: atrial fibrillation (AF), pulmonary infection (PI), coronary artery disease (CAD), creatinine (CREA), low-density lipoprotein cholesterol (LDL-C), d-dimer (DDi), left ventricular end-diastolic diameter (LVEDd), mitral regurgitation (MR) and aortic regurgitation (AR). The model was evaluated by the C-index [the training set: area under curve (AUC) 0.937, 95% confidence interval (CI) 0.911-0.963; the validation set: AUC 0.928, 95% CI 0.890-0.967]. Hosmer-Lemeshow test (the training set: χ2 10.908, P = 0.207; the validation set: χ2 4.896, P = 0.769) revealed that both the training and validation sets performed well in terms of model differentiation and calibration. Decision curve analysis showed that both the training and validation sets have higher net benefits, indicating that the model has good utility. Ten-fold cross-validation showed that the training set has high similarities with the validation set, which means that the model has good stability. CONCLUSIONS The occurrence of heart failure in patients with valvular regurgitation has a significant correlation with AF, PI, CAD, CREA, LDL-C, DDi, LVEDd, MR and AR. Based on these risk factors, a prediction model for heart failure was developed and validated, which showed good differentiation and utility, high accuracy and stability, providing a method for predicting heart failure.
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Affiliation(s)
- WenKang Xiao
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jia-Lin Yuan
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - YunYi Chen
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - GuiPing Ma
- Department of Cardiovascular Disease, Beijing University of Chinese Medicine Shenzhen Hospital, Shenzhen, China
| | | | - Le Sun
- Department of Rheumatology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - ChuangXiong Hong
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Taochun Ye
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Clinical Research Academy of Chinese Medicine, Guangzhou, China
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15
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Zhou X, Liu H, Feng F, Kang GJ, Liu M, Guo Y, Dudley SC. Macrophage IL-1β mediates atrial fibrillation risk in diabetic mice. JCI Insight 2024; 9:e171102. [PMID: 38889387 DOI: 10.1172/jci.insight.171102] [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: 04/03/2023] [Accepted: 06/14/2024] [Indexed: 06/20/2024] Open
Abstract
Diabetes mellitus (DM) is an independent risk factor for atrial fibrillation (AF). The mechanisms underlying DM-associated AF are unclear. AF and DM are both related to inflammation. We investigated whether DM-associated inflammation contributed to AF risk. Mice were fed with high-fat diet to induce type II DM and were subjected to IL-1β antibodies, macrophage depletion by clodronate liposomes, a mitochondrial antioxidant (mitoTEMPO), or a cardiac ryanodine receptor 2 (RyR2) stabilizer (S107). All tests were performed at 36-38 weeks of age. DM mice presented with increased AF inducibility, enhanced mitochondrial reactive oxygen species (mitoROS) generation, and activated innate immunity in the atria, as evidenced by enhanced monocyte chemoattractant protein-1 (MCP-1) expression, macrophage infiltration, and IL-1β levels. Signs of aberrant RyR2 Ca2+ leak were observed in the atria of DM mice. IL-1β neutralization, macrophage depletion, and exposure to mitoTEMPO and S107 significantly ameliorated the AF vulnerability in DM mice. Atrial overexpression of MCP-1 increased AF occurrence in normal mice through the same mechanistic signaling cascade as observed in DM mice. In conclusion, macrophage-mediated IL-1β contributed to DM-associated AF risk through mitoROS modulation of RyR2 Ca2+ leak.
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16
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Xu JJ, Dai J, Xie QH, Du PC, Li C, Zhou H. Effect of Luhong formula on the cardiac rehabilitation of patients with chronic heart failure. World J Clin Cases 2024; 12:3027-3034. [PMID: 38898832 PMCID: PMC11185362 DOI: 10.12998/wjcc.v12.i17.3027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND Current treatments for chronic heart failure (CHF) are therapeutically ineffective. The optimization of treatments for this disease needs to be explored and analyzed. AIM To analyze the effect of using Luhong Formula in the cardiac rehabilitation of patients with CHF and its influence on cardiopulmonary function (CPF) and prognosis. METHODS In total, 160 patients with CHF admitted between June 2022 and June 2023 were selected, including 75 receiving perindopril (control group) and 85 receiving Luhong Formula (research group). We conducted comparative analyses on the curative effects of traditional Chinese medicine (TCM) syndromes and cardiac function, CPF [oxygen consumption at the anaerobic threshold (VO2 AT) and at peak exercise (peak VO2)], echocardiographic indexes [left atrial volume index (LAVI), left ventricular muscle mass index (LVMI), left ventricular ejection fraction (LVEF)], and prognosis [major adverse cardiovascular events (MACEs) at 6 months follow-up]. RESULTS The research group showed markedly higher curative effects of TCM syndromes and cardiac function than the control group. In addition, post-treatment VO2 AT, peak VO2, LVMI and LVEF in the research group were significantly higher, whereas LAVI was significantly lower, than those of the control group. Furthermore, fewer patients in the research group developed MACEs at the 6-month follow-up. CONCLUSION Luhong Formula is more therapeutically effective than perindopril for the cardiac rehabilitation of patients with CHF, specifically in enhancing CPF and prognosis.
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Affiliation(s)
- Ji-Jie Xu
- Department of Cardiology & Cardiovascular Research Institute, Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201999, China
| | - Jian Dai
- Department of Cardiology & Cardiovascular Research Institute, Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201999, China
| | - Qi-Hai Xie
- Department of Cardiology & Cardiovascular Research Institute, Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201999, China
| | - Pei-Chao Du
- Department of Cardiology & Cardiovascular Research Institute, Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201999, China
| | - Cha Li
- Department of Cardiology & Cardiovascular Research Institute, Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201999, China
| | - Hua Zhou
- Department of Cardiology & Cardiovascular Research Institute, Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201999, China
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Elsner C, Bettin S, Tilz R, Häckl D. Economic Considerations of Cardiovascular Implantable Electronic Devices for The Treatment of Heart Failure. Curr Heart Fail Rep 2024; 21:186-193. [PMID: 38662154 DOI: 10.1007/s11897-024-00664-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE OF REVIEW Heart failure (HF) is a major public health problem worldwide, affecting more than 64 million people [1]. The complex and severe nature of HF presents challenges in providing cost-effective care as patients often require multiple hospitalizations and treatments. This review of relevant studies with focus on the last 10 years summarizes the health and economic implications of various HF treatment options in Europe and beyond. Although the main cost drivers in HF treatment are clinical (re)admission and decompensation of HF, an assessment of the economic impacts of various other device therapy options for HF care are included in this review. This includes: cardiovascular implantable electronic devices (CIEDs) such as cardiac-resynchronisation-therapy devices that include pacemaking (CRT-P), cardiac-resynchronisation-therapy devices that include defibrillation (CRT-D), implantable cardioverter/defibrillators (ICDs) and various types of pacemakers. The impact of (semi)automated (tele)monitoring as a relevant factor for increasing both the quality and economic impact of care is also taken into consideration. Quality of life adjusted life years (QALYs) are used in the overall context as a composite metric reflecting quantity and quality of life as a standardized measurement of incremental cost-effectiveness ratios (ICER) of different device-based HF interventions. RECENT FINDINGS In terms of the total cost of different devices, CRT-Ds were found in several studies to be more expensive than all other devices in regards to runtime and maintenance costs including (re)implantation. In the case of CRT combined with an implantable cardioverter-defibrillator (CRT-D) versus ICD alone, CRT-D was found to be the most cost-effective treatment in research work over the past 10 years. Further comparison between CRT-D vs. CRT-P does not show an economic advantage of CRT-D as a minority of patients require shock therapy. Furthermore, a positive health economic effect and higher survival rate is seen in CRT-P full ventricular stimulation vs. right heart only stimulation. Telemedical care has been found to provide a positive health economic impact for selected patient groups-even reducing patient mortality. For heart failure both in ICD and CRT-D subgroups the given telemonitoring benefit seems to be greater in higher-risk populations with a worse HF prognosis. In patients with HF, all CIED therapies are in the range of commonly accepted cost-effectiveness. QALY and ICER calculations provide a more nuanced understanding of the economic impact these therapies create in the healthcare landscape. For severe cases of HF, CRT-D with telemedical care seems to be the better option from a health economic standpoint, as therapy is more expensive, but costs per QALY range below the commonly accepted threshold.
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Affiliation(s)
- Christian Elsner
- Center for Artificial Intelligence, University Hospital Schleswig-Holstein, Lübeck, Germany.
| | - Simon Bettin
- Department for ENT, University of Lübeck, Lübeck, Germany
| | - Roland Tilz
- German Center for Cardiovascular Research (DZHK), Partner Site, Lübeck, Germany
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18
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Oommen SG, Man RK, Talluri K, Nizam M, Kohir T, Aviles MA, Nino M, Jaisankar LG, Jaura J, Wannakuwatte RA, Tom L, Abraham J, Siddiqui HF. Heart Failure With Improved Ejection Fraction: Prevalence, Predictors, and Guideline-Directed Medical Therapy. Cureus 2024; 16:e61790. [PMID: 38975458 PMCID: PMC11227107 DOI: 10.7759/cureus.61790] [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] [Accepted: 06/06/2024] [Indexed: 07/09/2024] Open
Abstract
Recently, a new category of heart failure with improved ejection fraction (HFimpEF) has emerged in the classification system. This is defined as the subgroup of patients with heart failure with reduced ejection fraction (HFrEF) whose left ventricular ejection fraction has recovered partially or completely, with no specific cut-off values established yet in the guidelines. In our review, we aim to provide an overview of prevalence, predictors, mechanism of remodeling, and management strategies regarding HFimpEF. These patients constitute a sizeable cohort among patients with reduced ejection fraction. Certain patient characteristics including younger age and female gender, absence of comorbid conditions, low levels of biomarkers, and non-ischemic etiology were identified as positive predictors. The heart undergoes significant maladaptive changes post failure leading to adverse remodeling influenced etiology and duration. Goal-directed medical therapy including beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin II receptor blockers (ARBs) have notably improved cardiac function by inducing reverse remodeling. Despite a more favorable prognosis compared to HFrEF, patients with improved ejection fraction (EF) still face clinical events and reduced quality of life, and remain at risk of adverse outcomes. Although the evidence is scarce, it is advisable to continue treatment modalities despite improvement in EF, including device therapies, to prevent relapse and clinical deterioration. It is imperative to conduct further research to understand the mechanism leading to EF amelioration and establish guidelines to identify and direct management strategies.
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Affiliation(s)
- Sheethal G Oommen
- Psychiatry, Grigore T. Popa University of Medicine and Pharmacy, Iași, ROU
| | - Ruzhual K Man
- Research, Lady Hardinge Medical College, Mumbai, IND
| | - Keerthi Talluri
- Department of Medicine, Ganni Subba Lakshmi Medical College, Rajahmundry, IND
| | - Maryam Nizam
- Emergency Department, Valaichennai Base Hospital, Valaichennai, LKA
| | - Tejashwini Kohir
- Department of Medicine, Ganni Subba Lakshmi Medical College, Rajahmundry, IND
| | | | | | | | - Jashan Jaura
- General Practice, Max Super Speciality Hospital, Bathinda, Bathinda, IND
| | | | - Leo Tom
- Internal Medicine, Kowdoor Sadananda Hegde Medical Academy, Mangalore, IND
| | - Jeby Abraham
- General Medicine, Yenepoya Medical College, Mangalore, IND
| | - Humza F Siddiqui
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
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Zhang X, Zhang Q, Zhang Q, Wang H, Yin Y, Li H, Huang Q, Guo C, Zhong J, Zhou T, Chen Y, Chen Z, Shan Q, Hu R. Tetrahydrofolate Attenuates Cognitive Impairment after Hemorrhagic Stroke by Promoting Hippocampal Neurogenesis via PTEN Signaling. eNeuro 2024; 11:ENEURO.0021-24.2024. [PMID: 38729764 PMCID: PMC11149488 DOI: 10.1523/eneuro.0021-24.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/28/2024] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
Intracerebral hemorrhage (ICH), the most common subtype of hemorrhagic stroke, leads to cognitive impairment and imposes significant psychological burdens on patients. Hippocampal neurogenesis has been shown to play an essential role in cognitive function. Our previous study has shown that tetrahydrofolate (THF) promotes the proliferation of neural stem cells (NSCs). However, the effect of THF on cognition after ICH and the underlying mechanisms remain unclear. Here, we demonstrated that administration of THF could restore cognition after ICH. Using Nestin-GFP mice, we further revealed that THF enhanced the proliferation of hippocampal NSCs and neurogenesis after ICH. Mechanistically, we found that THF could prevent ICH-induced elevated level of PTEN and decreased expressions of phosphorylated AKT and mTOR. Furthermore, conditional deletion of PTEN in NSCs of the hippocampus attenuated the inhibitory effect of ICH on the proliferation of NSCs and abnormal neurogenesis. Taken together, these results provide molecular insights into ICH-induced cognitive impairment and suggest translational clinical therapeutic strategy for hemorrhagic stroke.
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Affiliation(s)
- Xuyang Zhang
- Department of Neurosurgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Qingzhu Zhang
- Department of Neurosurgery, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Qian Zhang
- Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Haomiao Wang
- Department of Neurosurgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Yi Yin
- Department of Neurosurgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Huanhuan Li
- Department of Neurosurgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Qianying Huang
- Clinical Medical Research Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Chao Guo
- Department of Neurosurgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Jun Zhong
- Department of Neurosurgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Tengyuan Zhou
- Department of Neurosurgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Yujie Chen
- Department of Neurosurgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Zhi Chen
- Department of Neurosurgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Qiao Shan
- Department of Neurosurgery, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Rong Hu
- Department of Neurosurgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
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20
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Li W, Wang S, Liu L, Chen J, Lan J, Ding J, Chen Z, Yuan S, Qi Z, Wei M, Ji X. Normobaric Hyperoxia Combined With Endovascular Treatment Based on Temporal Gradient: A Dose-Escalation Study. Stroke 2024; 55:1468-1476. [PMID: 38747162 DOI: 10.1161/strokeaha.123.046106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/28/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Normobaric hyperoxia (NBO) has neuroprotective effects in acute ischemic stroke. Thus, we aimed to identify the optimal NBO treatment duration combined with endovascular treatment. METHODS This is a single-center, randomized controlled, open-label, blinded-end point dose-escalation clinical trial. Patients with acute ischemic stroke who had an indication for endovascular treatment at Tianjin Huanhu Hospital were randomly assigned to 4 groups (1:1 ratio) based on NBO therapy duration: (1) control group (1 L/min oxygen for 4 hours); (2) NBO-2h group (10 L/min for 2 hours); (3) NBO-4h group (10 L/min for 4 hours); and (4) NBO-6h group (10 L/min for 6 hours). The primary outcome was cerebral infarction volume at 72 hours after randomization using an intention-to-treat analysis model. The primary safety outcome was the 90-day mortality rate. RESULTS Between June 2022 and September 2023, 100 patients were randomly assigned to the following groups: control group (n=25), NBO-2h group (n=25), NBO-4h group (n=25), and NBO-6h group (n=25). The 72-hour cerebral infarct volumes were 39.4±34.3 mL, 30.6±30.1 mL, 19.7±15.4 mL, and 22.6±22.4 mL, respectively (P=0.013). The NBO-4h and NBO-6h groups both showed statistically significant differences (adjusted P values: 0.011 and 0.027, respectively) compared with the control group. Compared with the control group, both the NBO-4h and NBO-6h groups showed significant differences (P<0.05) in the National Institutes of Health Stroke Scale scores at 24 hours, 72 hours, and 7 days, as well as in the change of the National Institutes of Health Stroke Scale scores from baseline to 24 hours. Additionally, there were no significant differences among the 4 groups in terms of 90-day mortality rate, symptomatic intracranial hemorrhage, early neurological deterioration, or severe adverse events. CONCLUSIONS The effectiveness of NBO therapy was associated with oxygen administration duration. Among patients with acute ischemic stroke who underwent endovascular treatment, NBO therapy for 4 and 6 hours was found to be more effective. Larger-scale multicenter studies are needed to validate these findings. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT05404373.
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Affiliation(s)
- Weili Li
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China (W.L.)
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders (W.L., J.L., M.W., X.J.)
| | - Sifei Wang
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, China (S.W.)
- Department of Neurosurgery, Tianjin Huanhu Hospital, China (S.W., M.W.)
| | - Lan Liu
- School of Statistics, University of Minnesota at Twin Cities, Minneapolis (L.L.)
| | | | - Jing Lan
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders (W.L., J.L., M.W., X.J.)
| | - Jiayue Ding
- Department of Neurology, Tianjin Medical University General Hospital, China (J.D.)
| | - Zhiying Chen
- Department of Neurology, Jiujiang University Affiliated Hospital, China (Z.C.)
| | - Shuhua Yuan
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital (S.Y., Z.Q.), Capital Medical University, Beijing, China
| | - Zhifeng Qi
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital (S.Y., Z.Q.), Capital Medical University, Beijing, China
| | - Ming Wei
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders (W.L., J.L., M.W., X.J.)
- Department of Neurosurgery, Tianjin Huanhu Hospital, China (S.W., M.W.)
| | - Xunming Ji
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders (W.L., J.L., M.W., X.J.)
- Department of Neurosurgery, Xuanwu Hospital (X.J.), Capital Medical University, Beijing, China
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21
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Yang D, Jian Z, Tang C, Chen Z, Zhou Z, Zheng L, Peng X. Zebrafish Congenital Heart Disease Models: Opportunities and Challenges. Int J Mol Sci 2024; 25:5943. [PMID: 38892128 PMCID: PMC11172925 DOI: 10.3390/ijms25115943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/18/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Congenital heart defects (CHDs) are common human birth defects. Genetic mutations potentially cause the exhibition of various pathological phenotypes associated with CHDs, occurring alone or as part of certain syndromes. Zebrafish, a model organism with a strong molecular conservation similar to humans, is commonly used in studies on cardiovascular diseases owing to its advantageous features, such as a similarity to human electrophysiology, transparent embryos and larvae for observation, and suitability for forward and reverse genetics technology, to create various economical and easily controlled zebrafish CHD models. In this review, we outline the pros and cons of zebrafish CHD models created by genetic mutations associated with single defects and syndromes and the underlying pathogenic mechanism of CHDs discovered in these models. The challenges of zebrafish CHD models generated through gene editing are also discussed, since the cardiac phenotypes resulting from a single-candidate pathological gene mutation in zebrafish might not mirror the corresponding human phenotypes. The comprehensive review of these zebrafish CHD models will facilitate the understanding of the pathogenic mechanisms of CHDs and offer new opportunities for their treatments and intervention strategies.
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22
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Bao M, Li H, Li J. Circulating trimethylamine N-oxide is correlated with high coronary artery atherosclerotic burden in individuals with newly diagnosed coronary heart disease. BMC Cardiovasc Disord 2024; 24:265. [PMID: 38773380 PMCID: PMC11106919 DOI: 10.1186/s12872-024-03937-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 05/13/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Trimethylamine N-oxide (TMAO) is a metabolite derived from the gut microbiota and has been reported to be correlated with cardiovascular diseases. Although TMAO is associated with the severity of coronary artery disease in subjects with coronary heart disease (CHD) history. However, the correlation between TMAO and the atherosclerotic burden in newly diagnosed cases of CHD is unknown. METHODS In this hospital-based study, we enrolled 429 individuals newly diagnosed with CHD undergoing coronary angiography. Plasma TMAO was assessed before coronary angiography. SYNTAX score was computed during coronary angiography to estimate the coronary artery atherosclerotic burden. Both linear and logistic regression analyses were conducted to explore the correlation between plasma TMAO levels and SYNTAX score in newly diagnosed CHD population. RESULTS The TMAO in patients with SYNTAX ≥ 33 and subjects with SYNTAX < 23 were 6.10 (interquartile range [IQR]: 3.53 to 9.15) µmol/L and 4.90 [IQR: 3.25 to 7.68] µmol/L, respectively. Linear regression adjusting for traditional risk factors showed TMAO level was positively correlated with SYNTAX score (β = 0.179; p = 0.006) in CHD population. When TMAO was added to models with traditional risk factors, the predictive value improved significantly, with the receiver operating characteristic curve (AUC) increased from 0.7312 to 0.7502 (p = 0.003). Stratified analysis showed that the correlations did not hold true for subjects who were non-smoker or with histories of diabetes. None of the stratifying factors significantly altered the correlation (all p for interaction < 0.05). CONCLUSIONS We found a positive linear correlation between plasma TMAO and SYNTAX score among newly diagnosed CHD individuals in Chinese population.
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Affiliation(s)
- Minghui Bao
- Department of Cardiology, Peking University First Hospital, Peking University, Xi Shiku Street No. 8, Xicheng District, Beijing, 100034, China.
| | - Haotong Li
- National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Peking University, Xi Shiku Street No. 8, Xicheng District, Beijing, 100034, China
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23
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Bagheri M, Bombin A, Shi M, Murthy VL, Shah R, Mosley JD, Ferguson JF. Genotype-based "virtual" metabolomics in a clinical biobank identifies novel metabolite-disease associations. Front Genet 2024; 15:1392622. [PMID: 38812968 PMCID: PMC11133605 DOI: 10.3389/fgene.2024.1392622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/03/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction: Circulating metabolites act as biomarkers of dysregulated metabolism and may inform disease pathophysiology. A portion of the inter-individual variability in circulating metabolites is influenced by common genetic variation. We evaluated whether a genetics-based "virtual" metabolomics approach can identify novel metabolite-disease associations. Methods: We examined the association between polygenic scores for 724 metabolites with 1,247 clinical phenotypes in the BioVU DNA biobank, comprising 57,735 European ancestry and 15,754 African ancestry participants. We applied Mendelian randomization (MR) to probe significant relationships and validated significant MR associations using independent GWAS of candidate phenotypes. Results and Discussion: We found significant associations between 336 metabolites and 168 phenotypes in European ancestry and 107 metabolites and 56 phenotypes in African ancestry. Of these metabolite-disease pairs, MR analyses confirmed associations between 73 metabolites and 53 phenotypes in European ancestry. Of 22 metabolitephenotype pairs evaluated for replication in independent GWAS, 16 were significant (false discovery rate p < 0.05). These included associations between bilirubin and X-21796 with cholelithiasis, phosphatidylcholine (16:0/22:5n3,18:1/20:4) and arachidonate with inflammatory bowel disease and Crohn's disease, and campesterol with coronary artery disease and myocardial infarction. These associations may represent biomarkers or potentially targetable mediators of disease risk.
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Affiliation(s)
- Minoo Bagheri
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Andrei Bombin
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Mingjian Shi
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Venkatesh L. Murthy
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Ravi Shah
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Jonathan D. Mosley
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Jane F. Ferguson
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
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Norouzkhani N, Afshari S, Sadatmadani SF, Mollaqasem MM, Mosadeghi S, Ghadri H, Fazlizade S, Alizadeh K, Akbari Javar P, Amiri H, Foroughi E, Ansari A, Mousazadeh K, Davany BA, Akhtari kohnehshahri A, Alizadeh A, Dadkhah PA, Poudineh M. Therapeutic potential of berries in age-related neurological disorders. Front Pharmacol 2024; 15:1348127. [PMID: 38783949 PMCID: PMC11112503 DOI: 10.3389/fphar.2024.1348127] [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: 01/13/2024] [Accepted: 04/10/2024] [Indexed: 05/25/2024] Open
Abstract
Aging significantly impacts several age-related neurological problems, such as stroke, brain tumors, oxidative stress, neurodegenerative diseases (Alzheimer's, Parkinson's, and dementia), neuroinflammation, and neurotoxicity. Current treatments for these conditions often come with side effects like hallucinations, dyskinesia, nausea, diarrhea, and gastrointestinal distress. Given the widespread availability and cultural acceptance of natural remedies, research is exploring the potential effectiveness of plants in common medicines. The ancient medical system used many botanical drugs and medicinal plants to treat a wide range of diseases, including age-related neurological problems. According to current clinical investigations, berries improve motor and cognitive functions and protect against age-related neurodegenerative diseases. Additionally, berries may influence signaling pathways critical to neurotransmission, cell survival, inflammation regulation, and neuroplasticity. The abundance of phytochemicals in berries is believed to contribute to these potentially neuroprotective effects. This review aimed to explore the potential benefits of berries as a source of natural neuroprotective agents for age-related neurological disorders.
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Affiliation(s)
- Narges Norouzkhani
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shaghayegh Afshari
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | | | - Shakila Mosadeghi
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hani Ghadri
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Safa Fazlizade
- Student Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Keyvan Alizadeh
- Student Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Pouyan Akbari Javar
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Hamidreza Amiri
- Student Research Committee, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Elaheh Foroughi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arina Ansari
- Student Research Committee, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Kourosh Mousazadeh
- School of Medicine, Islamic Azad University, Tehran Medical Branch, Tehran, Iran
| | | | - Ata Akhtari kohnehshahri
- Student Research Committee, Faculty of Medicine, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
| | - Alaleh Alizadeh
- Student Research Committee, Faculty of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Parisa Alsadat Dadkhah
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohadeseh Poudineh
- Student Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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Shah S, Christianson AL, Meganathan K, Leonard AC, Crews DC, Rubinstein J, Mitsnefes MM, Schauer DP, Thakar CV. Sex Differences in Cardiovascular Outcomes in Patients With Kidney Failure. J Am Heart Assoc 2024; 13:e029691. [PMID: 38700013 PMCID: PMC11179932 DOI: 10.1161/jaha.123.029691] [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: 05/02/2023] [Accepted: 03/29/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Cardiovascular disease is the leading cause of mortality in patients with kidney failure, and their risk of cardiovascular events is 10 to 20 times higher as compared with the general population. METHODS AND RESULTS We evaluated 508 822 patients who initiated dialysis between January 1, 2005 and December 31, 2014 using the United States Renal Data System with linked Medicare claims. We determined hospitalization rates for cardiovascular events, defined by acute coronary syndrome, heart failure, and stroke. We examined the association of sex with outcome of cardiovascular events, cardiovascular death, and all-cause death using adjusted time-to-event models. The mean age was 70±12 years and 44.7% were women. The cardiovascular event rate was 232 per thousand person-years (95% CI, 231-233), with a higher rate in women than in men (248 per thousand person-years [95% CI, 247-250] versus 219 per thousand person-years [95% CI, 217-220]). Women had a 14% higher risk of cardiovascular events than men (hazard ratio [HR], 1.14 [95% CI, 1.13-1.16]). Women had a 16% higher risk of heart failure (HR, 1.16 [95% CI, 1.15-1.18]), a 31% higher risk of stroke (HR, 1.31 [95% CI, 1.28-1.34]), and no difference in risk of acute coronary syndrome (HR, 1.01 [95% CI, 0.99-1.03]). Women had a lower risk of cardiovascular death (HR, 0.89 [95% CI, 0.88-0.90]) and a lower risk of all-cause death than men (HR, 0.96 [95% CI, 0.95-0.97]). CONCLUSIONS Among patients undergoing dialysis, women have a higher risk of cardiovascular events of heart failure and stroke than men. Women have a lower adjusted risk of cardiovascular mortality and all-cause mortality.
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Affiliation(s)
- Silvi Shah
- Division of Nephrology and Hypertension, Department of Internal MedicineUniversity of CincinnatiCincinnatiOHUSA
| | | | | | - Anthony C. Leonard
- Department of Environmental HealthUniversity of CincinnatiCincinnatiOHUSA
| | - Deidra C. Crews
- Division of Nephrology, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Jack Rubinstein
- Division of Cardiology, Department of Internal MedicineUniversity of CincinnatiCincinnatiOHUSA
| | - Mark M. Mitsnefes
- Division of Nephrology and HypertensionCincinnati Children’s Hospital Medical CenterCincinnatiOHUSA
| | - Daniel P. Schauer
- Division of General Internal Medicine and Center for Clinical EffectivenessUniversity of CincinnatiCincinnatiOHUSA
| | - Charuhas V. Thakar
- Division of Nephrology and Hypertension, Department of Internal MedicineUniversity of CincinnatiCincinnatiOHUSA
- Wellcome‐Wolfson Institute of Experimental MedicineSchool of Medicine, Dentistry and Biomedical SciencesNorthern IrelandUnited Kingdom
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Wang Y, Yang Q, Liu Y, Zheng G, Fan F, Tian H, Zhang X. Psychosomatic mechanisms of heart failure symptoms on quality of life in patients with chronic heart failure: A multi-centre cross-sectional study. J Clin Nurs 2024; 33:1839-1848. [PMID: 38044710 DOI: 10.1111/jocn.16955] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/29/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Abstract
AIMS To determine the contributions of different kinds of symptoms to the quality of life and mediating effect of psychological and physical symptoms between heart failure symptoms and quality of life. DESIGN A multi-centre cross-sectional study. METHODS 2006 chronic heart failure patients from four cities were recruited in China from January 2021 to December 2022. Patients' symptoms and quality of life were self-reported, and data were analysed using correlation analysis, dominance analysis and mediating effects analysis. RESULTS The dominance analysis revealed that the overall mean contributions of heart failure, psychological and physical symptoms were .083, .085 and .111; 29.5%, 30.2% and 39.5% of the known variance. And heart failure symptoms could negatively affect quality of life through psychological and physical symptoms, accounting for 28.39% and 22.95% of the total effect. Heart failure symptoms could also affect quality of life through the chain-mediated effect of physical and psychological symptoms, accounting for 16.74%. CONCLUSIONS Physiological symptoms had the strongest effect on quality of life and heart failure symptoms had the weakest. Most of the effect for heart failure symptoms on quality of life in chronic heart failure patients was mediated by psychological and physiological symptoms. RELEVANCE TO CLINICAL PRACTICE It is important to design non-pharmacological intervention plans for the enhancement of physical and psychological symptoms' management skills, to reduce the adverse impact of heart failure symptoms on quality of life. REPORTING METHOD Study methods and results reported in adherence to the STROBE checklist. NO PATIENT OR PUBLIC CONTRIBUTION No patients or members of the public were involved in the study.
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Affiliation(s)
- Yu Wang
- Department of Nursing, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Qiaofang Yang
- Department of Nursing, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Yancun Liu
- Structural Heart Disease Wards, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Gaigai Zheng
- Heart Failure Wards, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Fanghui Fan
- Coronary Care Unit, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Huan Tian
- Heart Failure Wards, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Xin Zhang
- Henan International Travel Health Care Center, Zhengzhou, China
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Yuan C, Yang H, Lan W, Yang J, Tang Y. Nicotinamide ribose ameliorates myocardial ischemia/reperfusion injury by regulating autophagy and regulating oxidative stress. Exp Ther Med 2024; 27:187. [PMID: 38533432 PMCID: PMC10964731 DOI: 10.3892/etm.2024.12475] [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: 09/12/2023] [Accepted: 02/08/2024] [Indexed: 03/28/2024] Open
Abstract
Nicotinamide riboside (NR) has been reported to play a protective role in myocardial ischemia-reperfusion (I/R) injury when used in association with other drugs; however, the individual effect of NR is unknown. In the present study Evan's blue/triphenyl tetrazolium chloride staining, hematoxylin and eosin staining, echocardiography, western blotting, reverse transcription-quantitative PCR, and the detection of myocardial injury-associated markers and oxidative stress metabolites were used to explore the ability of NR to alleviate cardiac I/R injury and the relevant mechanisms of action. In a mouse model of I/R injury, dietary supplementation with NR reduced the area of myocardial ischemic infarction, alleviated pathological myocardial changes, decreased inflammatory cell infiltration and attenuated the levels of mitochondrial reactive oxygen species (ROS) and creatine kinase myocardial band (CK-MB). In addition, echocardiography suggested that NR alleviated the functional damage of the myocardium caused by I/R injury. In H9c2 cells, NR pretreatment reduced the levels of lactate dehydrogenase, CK-MB, malondialdehyde, superoxide dismutase and ROS, and reduced cell mortality after the induction of hypoxia/reoxygenation (H/R) injury. In addition, the results indicated NR activated sirt 1 via the upregulation of nicotinamide adenine dinucleotide (NAD+) and protected the cells against autophagy. The sirt 1 inhibitor EX527 significantly attenuated the ability of NR to inhibit autophagy, but had no significant effect on the ROS content of the H9c2 cells. In summary, the present study suggests that NR protects against autophagy by increasing the NAD+ content in the body via the sirt 1 pathway, although the sirt 1 pathway does not affect oxidative stress.
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Affiliation(s)
- Chen Yuan
- The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, P.R. China
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330000, P.R. China
- East China Institute of Digital Medical Engineering, Shangrao, Jiangxi 334100, P.R. China
| | - Heng Yang
- The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, P.R. China
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330000, P.R. China
| | - Wanqi Lan
- The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, P.R. China
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330000, P.R. China
| | - Juesheng Yang
- The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, P.R. China
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330000, P.R. China
| | - Yanhua Tang
- The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, P.R. China
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330000, P.R. China
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Saeed M, Sabanci R, Ghnaima H, Watat K, Shaban D, Nader G, Banga S, Wilcox M. Navigating Asymptomatic Mitral Regurgitation: Diagnostic Dilemmas and Treatment Strategies. Cureus 2024; 16:e61191. [PMID: 38939291 PMCID: PMC11210828 DOI: 10.7759/cureus.61191] [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] [Accepted: 05/27/2024] [Indexed: 06/29/2024] Open
Abstract
This case report explores the complexities involved in the diagnosis and management of asymptomatic mitral regurgitation (MR) in a 64-year-old male presenting with an incidental systolic murmur. Torrential MR with flail mitral valve (MV) segments was identified through comprehensive imaging and clinical evaluation, including echocardiography and catheterization. The discussion highlights the nuances of surgical timing, emphasizing the importance of tailored approaches based on left ventricular (LV) function and dilation. This report sheds light on the evolving landscape of managing asymptomatic MR, underscoring the need for balancing surveillance with proactive intervention to optimize patient outcomes.
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Affiliation(s)
- Moiz Saeed
- Internal Medicine, Michigan State University, East Lansing, USA
| | - Rand Sabanci
- Internal Medicine, Michigan State University, East Lansing, USA
| | - Harith Ghnaima
- Internal Medicine, Michigan State University, East Lansing, USA
| | - Kevin Watat
- Internal Medicine, Michigan State University College of Human Medicine, East Lansing, USA
| | - Dina Shaban
- Internal Medicine, Michigan State University College of Human Medicine, East Lansing, USA
| | - Georgette Nader
- Internal Medicine, BronxCare Health System, New York, USA
- Internal Medicine, Michigan State Sparrow Hospital, Lansing, USA
| | - Sandeep Banga
- Cardiology, Michigan State University, East Lansing, USA
| | - Matthew Wilcox
- Cardiology, Sparrow Thoracic and Cardiovascular Institute, Lansing, USA
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Wang W, Huang XX, Jiang RH, Zhou J, Shi HB, Xu XQ, Wu FY. Gadolinium Retention and Nephrotoxicity in a Mouse Model of Acute Ischemic Stroke: Linear Versus Macrocyclic Agents. J Magn Reson Imaging 2024; 59:1852-1861. [PMID: 37548106 DOI: 10.1002/jmri.28931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Gadolinium (Gd)-based contrast agents (GBCAs) have been widely used for acute ischemic stroke (AIS) patients. GBCAs or AIS alone may cause the adverse effects on kidney tissue, respectively. However, whether GBCAs and AIS would generate a synergistic negative effect remains undefined. PURPOSE To evaluate synergistic negative effects of AIS and GBCAs on renal tissues in a mouse model of AIS, and to compare the differences of these negative effects between linear and macrocyclic GBCAs. STUDY TYPE Animal study. ANIMAL MODEL Seventy-two healthy mice underwent transient middle cerebral artery occlusion (tMCAO) and sham operation to establish AIS and sham model (N = 36/model). 5.0 mmol/kg GBCAs (gadopentetate or gadobutrol) or 250 μL saline were performed at 4.5 hours and 1 day after model establishing (N = 12/group). ASSESSMENT Inductively coupled plasma mass spectrometry (ICP-MS) was performed to detect Gd concentrations. Serum biochemical analyzer was performed to measure the serum creatinine (Scr), uric acid (UA), and blood urea nitrogen (BUN). Pathological staining was performed to observe tubular injury, cell apoptosis, mesangial hyperplasia, and interstitial fibrosis. STATISTICAL TESTS Two-way analysis of variances with post hoc Sidak's tests and independent-samples t-tests were performed. A P-value <0.05 was considered statistically significant. RESULTS AIS groups showed higher Gd concentration than sham group on day 1 p.i. regardless of gadopentetate or gadobutrol used. Increased total Gd concentration was also found in AIS + gadopentetate group compared with the sham group on day 28 p.i. Significantly higher rates for renal dysfunction, higher tubular injury scores, and higher numbers of apoptotic cells on days 1 or 28 p.i. were found for AIS mice injected with GBCA. AIS + gadopentetate group displayed more severe renal damage than the AIS + gadobutrol group. DATA CONCLUSION AIS and GBCAs may cause increased total Gd accumulation and nephrotoxicity in a mouse, especially linear GBCAs were used. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 4.
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Affiliation(s)
- Wei Wang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xin-Xin Huang
- Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Run-Hao Jiang
- Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiang Zhou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hai-Bin Shi
- Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Bahr F, Ricke-Hoch M, Ponimaskin E, Müller F. Serotonin Receptors in Myocardial Infarction: Friend or Foe? ACS Chem Neurosci 2024; 15:1619-1634. [PMID: 38573542 PMCID: PMC11027101 DOI: 10.1021/acschemneuro.4c00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
Acute myocardial infarction (AMI) is one of the leading causes of death worldwide and treatment costs pose a major burden on the global health care system. Despite the variety of treatment options, individual recovery can be still poor and the mortality rate, especially in the first few years after the event, remains high. Therefore, intense research is currently focused on identifying novel target molecules to improve the outcome following AMI. One of the potentially interesting targets is the serotonergic system (5-HT system), not at least because of its connection to mental disorders. It is known that patients suffering from AMI have an increased risk of developing depression and vice versa. This implicates that the 5-HT system can be affected in response to AMI and might thus represent a target structure for patients' treatment. This review aims to highlight the importance of the 5-HT system after AMI by describing the role of individual serotonin receptors (5-HTR) in the regulation of physiological and pathophysiological responses. It particularly focuses on the signaling pathways of the serotonin receptors 1, 2, 4, and 7, which are expressed in the cardiovascular system, during disease onset, and the following remodeling process. This overview also emphasizes the importance of the 5-HT system in AMI etiology and highlights 5-HTRs as potential treatment targets.
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Affiliation(s)
- F.S. Bahr
- Cellular
Neurophysiology, Hannover Medical School, 30625 Hannover, Germany
| | - M. Ricke-Hoch
- Cardiology
and Angiology, Hannover Medical School, 30625 Hannover, Germany
| | - E. Ponimaskin
- Cellular
Neurophysiology, Hannover Medical School, 30625 Hannover, Germany
| | - F.E. Müller
- Cellular
Neurophysiology, Hannover Medical School, 30625 Hannover, Germany
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Aziz YN, Sucharew H, Reeves MJ, Broderick JP. Factors Associated With Premature Termination of Hyperacute Stroke Trials: A Review. J Am Heart Assoc 2024; 13:e034115. [PMID: 38606770 PMCID: PMC11262524 DOI: 10.1161/jaha.124.034115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/12/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND We performed a review of acute stroke trials to determine features associated with premature termination of trial enrollment, defined by the authors as not meeting preplanned sample size. METHODS AND RESULTS MEDLINE was searched for randomized clinical stroke trials published in 9 major clinical journals between 2013 and 2022. We included randomized clinical trials that were phase 2 or 3 with a preplanned sample size ≥100 and a time-to-treatment within 24 hours of onset for transient ischemic attack, ischemic stroke, or intracerebral hemorrhage. Data were abstracted on trial features including trial design, inclusion criteria, imaging, location and number of sites, masking, treatment complexity, control group (standard therapy, placebo), industry involvement, and preplanned stopping rules (futility and efficacy). Least absolute shrinkage and selection operator regression was used to select the most important factors associated with premature termination; then, a multivariable logistic regression was fit including only the least absolute shrinkage and selection operator selected variables. Of 1475 studies assessed, 98 trials met eligibility criteria. Forty-five (46%) trials were prematurely terminated, of which 27% were stopped for benefit/efficacy, 20% for lack of money/slow enrollment, 18% for futility, 16% for newly available evidence, 17% for other reasons, and 4% due to harm. Complex trials (adjusted odds ratio [aOR], 2.76 [95% CI, 1.13-7.49]), presence of a futility rule (aOR, 4.43 [95% CI, 1.62-17.91]), and exclusion of prestroke dependency (none/slight disability only; aOR, 2.19 [95% CI, 0.84-6.72] versus dependency allowed) were identified as the strongest predictors. CONCLUSIONS Nearly half of acute stroke trials were terminated prematurely. Broadening inclusion criteria and simplifying trial design may decrease the likelihood of unplanned termination, whereas planned futility analyses may appropriately terminate trials early, saving money and resources.
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Affiliation(s)
- Yasmin N. Aziz
- Department of Neurology and Rehabilitation MedicineUniversity of CincinnatiCincinnatiOHUSA
| | - Heidi Sucharew
- Department of Emergency MedicineUniversity of CincinnatiCincinnatiOHUSA
| | - Mathew J. Reeves
- Department of Epidemiology and BiostatisticsMichigan State UniversityEast LansingMIUSA
| | - Joseph P. Broderick
- Department of Neurology and Rehabilitation MedicineUniversity of CincinnatiCincinnatiOHUSA
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Izadpanah P, Dehghanzadeh T, Attar A, Hosseinpour A, Rahimikashkooli N. Hemoglobin A 1c levels and 1-year mortality in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention. Future Cardiol 2024; 20:117-122. [PMID: 38602426 PMCID: PMC11216615 DOI: 10.2217/fca-2023-0121] [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: 10/04/2023] [Accepted: 03/06/2024] [Indexed: 04/12/2024] Open
Abstract
Background: In this study, we investigated whether different levels of hemoglobin A1c (HbA1c) are associated with different short-term and 1-year mortality rates among diabetic patients undergoing percutaneous coronary intervention. Patients & methods: Clinical events including in-hospital, 1-month and 1-year mortality were compared between three groups based on HbA1c levels of patients (I: ≤5.6%, II: 5.7-6.4%, III: ≥6.5%). Results: Among 165 diabetic individuals, patients with abnormal HbA1c levels (≥6.5%) experienced significantly higher hospitalization days (7.65 ± 1.64 days) compared with those with normal HbA1c (4.94 ± 0.97 days) (p < 0.0001). In-hospital mortality was significantly higher in group III (14.5%) and II (5.5%) compared with group I (0%) (p = 0.008). Conclusion: HbA1c levels may be a reliable predictor of short-term clinical events in diabetic patients.
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Affiliation(s)
- Peyman Izadpanah
- Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz 7164954937, Iran
| | - Tara Dehghanzadeh
- School of Medicine, Shiraz University of Medical Sciences, Shiraz 7134845794, Iran
| | - Armin Attar
- Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz 7164954937, Iran
| | - Alireza Hosseinpour
- School of Medicine, Shiraz University of Medical Sciences, Shiraz 7134845794, Iran
| | - Nima Rahimikashkooli
- Internal Medicine Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz 7193613311, Iran
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Xiong J, Sun Y, Huang H, Liu Y, Ling F, Wei Y, Zheng Q, Qi W, Liang F. The Causal Relationship between Angina Pectoris and Gout Based on Two Sample Mendelian Randomization. Pain Res Manag 2024; 2024:4564596. [PMID: 38633818 PMCID: PMC11022507 DOI: 10.1155/2024/4564596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/23/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024]
Abstract
Purpose Two-sample Mendelian randomization (MR) was conducted to assess the causal relationship between angina pectoris and gout. Material and Methods. Based on genome-wide association studies, single nucleotide polymorphisms (SNPs) that were closely associated with gout were selected from the UK Biobank-Neale Lab (ukb-a-107) as genetic instrumental variables. Considering that gout is characterized by elevated blood uric acid levels, SNPs related to blood uric acid levels were screened from BioBank Japan (bbj-a-57) as auxiliary gene instrumental variables. SNPs closely associated with angina pectoris onset were screened from the FINN dataset (finn-b-I9_ANGINA) as outcome variables. Two-sample MR was conducted, with inverse variance weighting (IVW) of the random effects model as the primary result, along with the weighted median method (WME) and the MR-Egger regression method. To further confirm the causal relationship between angina and gout incidence, a meta-analysis was conducted on the IVW results of the ukb-a-107 and bbj-a-57. Results The odds ratios and 95% confidence intervals of the IVW, WME, and MR-Egger results of ukb-a-107 were (OR = 33.72; 95% CI: 2.07∼550.38), (OR = 57.94; 95% CI: 2.75∼1219.82), and (OR = 96.38; 95% CI: 0.6∼15556.93), respectively. The P values of IVW and WME were 0.014 and 0.014 (both <0.05), respectively, indicating that the development of angina pectoris was significantly associated with the incidence of gout. The odds ratios and 95% confidence intervals of the IVW, WME, and MR-Egger about bbj-a-57 were (OR = 1.20; 95% CI: 1.07∼1.34), (OR = 1.19; 95% CI: 1.02∼1.38), and (OR = 1.30; 95% CI; 1.06∼1.60), respectively. The P values of IVW, WME and MR-Egger were 0.001, 0.027 and 0.017 (all <0.05), respectively, indicating a significant correlation between angina and blood uric acid levels. Scatter plots of ukb-a-107 and bbj-a-57 showed that the causal association estimates of the IVW, MR-Egger, and weighted median methods were similar and that the MR results were accurate. Funnel plots and the MR-Egger intercept of ukb-a-107 and bbj-a-57 showed the absence of horizontal pleiotropy. The leave-out sensitivity analysis results of ukb-a-107 and bbj-a-57 are stable. The meta-analysis of IVW results for ukb-a-107 and bbj-a-57 showed (OR = 1.20; 95% CI: 1.07-1.34, P=0.02), confirming that gout characterized by high blood uric acid levels significantly increases the risk of angina attacks. Conclusions This MR study found a clear causal relationship between angina pectoris and gout, which increases the risk of angina pectoris.
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Affiliation(s)
- Jian Xiong
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Yuxin Sun
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Hui Huang
- Guangxi University of Traditional Chinese Medicine, Nanning, Guangxi 530001, China
| | - Yu Liu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Fayang Ling
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Yin Wei
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Qianhua Zheng
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Wenchuan Qi
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Fanrong Liang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
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Esmaeili H, Patino-Guerrero A, Nelson RA, Karamanova N, M Fisher T, Zhu W, Perreault F, Migrino RQ, Nikkhah M. Engineered Gold and Silica Nanoparticle-Incorporated Hydrogel Scaffolds for Human Stem Cell-Derived Cardiac Tissue Engineering. ACS Biomater Sci Eng 2024; 10:2351-2366. [PMID: 38323834 PMCID: PMC11075803 DOI: 10.1021/acsbiomaterials.3c01256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Electrically conductive biomaterials and nanomaterials have demonstrated great potential in the development of functional and mature cardiac tissues. In particular, gold nanomaterials have emerged as promising candidates due to their biocompatibility and ease of fabrication for cardiac tissue engineering utilizing rat- or stem cell-derived cardiomyocytes (CMs). However, despite significant advancements, it is still not clear whether the enhancement in cardiac tissue function is primarily due to the electroconductivity features of gold nanoparticles or the structural changes of the scaffold resulting from the addition of these nanoparticles. To address this question, we developed nanoengineered hydrogel scaffolds comprising gelatin methacrylate (GelMA) embedded with either electrically conductive gold nanorods (GNRs) or nonconductive silica nanoparticles (SNPs). This enabled us to simultaneously assess the roles of electrically conductive and nonconductive nanomaterials in the functionality and fate of human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). Our studies revealed that both GNR- and SNP-incorporated hydrogel scaffolds exhibited excellent biocompatibility and similar cardiac cell attachment. Although the expression of sarcomere alpha-actinin did not significantly differ among the conditions, a more organized sarcomere structure was observed within the GNR-embedded hydrogels compared to the nonconductive nanoengineered scaffolds. Furthermore, electrical coupling was notably improved in GNR-embedded scaffolds, as evidenced by the synchronous calcium flux and enhanced calcium transient intensity. While we did not observe a significant difference in the gene expression profile of human cardiac tissues formed on the conductive GNR- and nonconductive SNP-incorporated hydrogels, we noticed marginal improvements in the expression of some calcium and structural genes in the nanomaterial-embedded hydrogel groups as compared to the control condition. Given that the cardiac tissues formed atop the nonconductive SNP-based scaffolds (used as the control for conductivity) also displayed similar levels of gene expression as compared to the conductive hydrogels, it suggests that the electrical conductivity of nanomaterials (i.e., GNRs) may not be the sole factor influencing the function and fate of hiPSC-derived cardiac tissues when cells are cultured atop the scaffolds. Overall, our findings provide additional insights into the role of electrically conductive gold nanoparticles in regulating the functionalities of hiPSC-CMs.
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Affiliation(s)
- Hamid Esmaeili
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona 85287, United States
| | - Alejandra Patino-Guerrero
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona 85287, United States
- Department of Cardiovascular Diseases, Physiology and Biomedical Engineering, Center for Regenerative Medicine, Mayo Clinic, Scottsdale, Arizona 85259, United States
| | - Ronald A Nelson
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona 85287, United States
| | - Nina Karamanova
- Phoenix Veterans Affairs Health Care System, Phoenix, Arizona 85022, United States
| | - Taylor M Fisher
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, Arizona 85287, United States
| | - Wuqiang Zhu
- Department of Cardiovascular Diseases, Physiology and Biomedical Engineering, Center for Regenerative Medicine, Mayo Clinic, Scottsdale, Arizona 85259, United States
| | - François Perreault
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, Arizona 85287, United States
| | - Raymond Q Migrino
- Phoenix Veterans Affairs Health Care System, Phoenix, Arizona 85022, United States
- University of Arizona College of Medicine, Phoenix, Arizona 85004, United States
| | - Mehdi Nikkhah
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona 85287, United States
- Biodesign Virginia G. Piper Center for Personalized Diagnosis, Arizona State University, Tempe, Arizona 85287, United States
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Carmin CN, Ownby RL, Fontanella C, Steelesmith D, Binkley PF. Impact of Mental Health Treatment on Outcomes in Patients With Heart Failure and Ischemic Heart Disease. J Am Heart Assoc 2024; 13:e031117. [PMID: 38506666 PMCID: PMC11179768 DOI: 10.1161/jaha.123.031117] [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: 05/22/2023] [Accepted: 01/12/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND There is conflicting evidence as to the impact of mental health treatment on outcomes in patients with heart disease. The aim of this study was to examine whether individuals who received mental health treatment for anxiety or depression after being hospitalized for ischemic disorders or heart failure had a reduced frequency of rehospitalizations, emergency department visits, or mortality compared with those who did not receive treatment. METHODS AND RESULTS A population-based, retrospective, cohort design was used to examine the association between psychotherapy or antidepressant medication prescription and health service utilization and mortality in patients with coronary artery disease or heart failure and comorbid anxiety or depression. Those receiving versus not receiving mental health treatment were compared based on the frequency of rehospitalization, emergency department visits, and mortality. The study sample included 1563 patients who had a mean age of 50.1 years. Individuals who received both forms of mental health treatment for anxiety or depression were 75% less likely to be rehospitalized, 74% less likely to have an emergency department visit, and 66% less likely to die from any cause. CONCLUSIONS Mental health treatment for anxiety or depression has a significant impact on outcomes in patients with cardiovascular disease consisting of reduced hospitalizations, emergency department visits, and in some conditions improved survival.
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Affiliation(s)
- Cheryl N. Carmin
- Department of Psychiatry and Behavioral HealthThe Ohio State University Wexner Medical CenterColumbusOHUSA
| | - Raymond L. Ownby
- Department of Psychiatry and Behavioral MedicineNova Southeastern UniversityFort LauderdaleFLUSA
| | - Cynthia Fontanella
- Department of Psychiatry and Behavioral HealthThe Ohio State University Wexner Medical CenterColumbusOHUSA
| | - Danielle Steelesmith
- Department of Psychiatry and Behavioral HealthThe Ohio State University Wexner Medical CenterColumbusOHUSA
| | - Philip F. Binkley
- Department of Psychiatry and Behavioral HealthThe Ohio State University Wexner Medical CenterColumbusOHUSA
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Jujić A, Molvin J, Holm Isholth H, Dieden A, Korduner J, Zaghi A, Nezami Z, Bergmann A, Schomburg L, Magnusson M. Association between low selenoprotein P concentrations and anaemia in hospitalized heart failure patients. ESC Heart Fail 2024; 11:877-882. [PMID: 38200550 DOI: 10.1002/ehf2.14651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/22/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024] Open
Abstract
AIMS Heart failure (HF) patients with anaemia tend to have a worse outcome, with increased hospitalization rates, decreased exercise tolerance, and higher mortality compared to those without anaemia. Limited research exists on the association between selenium deficiency and anaemia specifically in HF patients, despite previous findings of a correlation in different populations. The BIOSTAT-CHF study demonstrated that higher selenium levels in HF patients were associated to a lower risk of anaemia and iron deficiency. This study investigates the relationship between selenoprotein P (SELENOP) concentrations, a major contributor and functional biomarker of selenium transport, and anaemia, Hb levels, and iron status in hospitalized HF patients. METHODS AND RESULTS SELENOP was analysed in 320 hospitalized HF subjects, with complete data available for 310 subjects. The relationships between continuous SELENOP concentrations and 1) Hb concentrations, 2) anaemia (Hb < 115 g/L (women), <130 g/L (men)), and 3) iron status (as measured by transferrin receptor 1 (TfR1) which increases in iron deficiency) were evaluated using multivariable logistic and linear regression models. Additionally, SELENOP concentrations in the lowest quartile were related to anaemia, haemoglobin, and iron state in multivariable logistic and linear models. The mean age of the study population was 75.0 ± 11.6 years, and 30% were women. Anaemia was present in 133 subjects (42.9%). SELENOP concentrations were positively correlated with haemoglobin concentrations (0.238; P < 0.001) and negatively with TfR1 concentrations (-0.238, P < 0.001). In multivariable regression models, higher SELENOP concentrations were associated with higher Hb concentrations (B = 3.23; P = 0.002) and lower TfR1 concentrations (B = -0.20; P < 0.001). Furthermore, SELENOP deficiency was associated with lower Hb concentrations (B = -7.64: P = 0.001), higher TfR1 concentrations (B = 0.31; P = 0.003), and higher odds of anaemia in HF patients (odds ratio 2.17; 95% confidence interval 1.23-3.82; P = 0.008). CONCLUSIONS In hospitalized heart failure patients, lower concentrations of SELENOP were associated with higher prevalence of anaemia.
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Affiliation(s)
- Amra Jujić
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Cardiology, Lund University, Skane University Hospital, Malmö, Sweden
| | - John Molvin
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Cardiology, Lund University, Skane University Hospital, Malmö, Sweden
| | - Hannes Holm Isholth
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Cardiology, Lund University, Skane University Hospital, Malmö, Sweden
| | - Anna Dieden
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Biomedical Science, Malmö University, Malmö, Sweden
- Biofilms-Reseach Centre for Biointerfaces, Malmö University, Malmö, Sweden
| | - Johan Korduner
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Amir Zaghi
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Zainu Nezami
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | | | - Martin Magnusson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Cardiology, Lund University, Skane University Hospital, Malmö, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
- Hypertension in Africa Research Team (HART), North West University Potchefstroom, Potchefstroom, South Africa
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Anthony N, Hassan A, Ghani U, Rahim O, Ghulam M, James N, Ashfaq Z, Ali S, Siddiqui A. Age-Related Patterns of Symptoms and Risk Factors in Acute Coronary Syndrome (ACS): A Study Based on Cardiology Patients' Records at Rehman Medical Institute, Peshawar. Cureus 2024; 16:e58426. [PMID: 38765358 PMCID: PMC11098971 DOI: 10.7759/cureus.58426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction Acute Coronary Syndrome (ACS) is a critical condition characterized by reduced blood flow to the heart and includes various conditions such as ST-elevation myocardial infarction, non-ST elevation myocardial infarction, and unstable angina. Objectives The aim of this study was to investigate age-related patterns of symptoms and risk factors in ACS patients and to evaluate how diagnostic test results differ among various age groups of ACS patients. Methodology This retrospective study was conducted from May to November of 2023 on patients with acute coronary syndrome admitted to the cardiology ward of Rehman Medical Institute (RMI), Peshawar. The sample size was 137 ACS-diagnosed patients based on the inclusion and exclusion criteria. After getting ethical approval from the institutional ethical approval board, data were collected for the entire year of 2022 based on proforma with the variables demographic data, troponin I level, presented symptoms, and associated co-morbidities of the patients. The inclusion criteria were patients of all genders, patients diagnosed with Acute Coronary Syndrome (ACS), and patients whose records were available in the cardiology department of Rehman Medical Institute. Results The results show that ACS is more prevalent in the age group of 50-69 years (p=0.037) and is significantly more common in males (p=0.019). Chest pain emerged as the predominant symptom, with a significant association of p=0.029 between chest pain and patients of ACS in the age group 30-49 years. While raised troponin I levels were prevalent across all age groups. Moreover, specific risk factors such as diabetes mellitus, hypertension, and family history of CAD showed the significance of p= 0.04, p=0.006, and p=0.021, respectively, with the age group 50-69 years old. Conclusion This study highlights the importance of considering age and gender in ACS management and provides insights into age-related patterns of symptoms and risk factors, which can contribute to optimizing preventive strategies and improving patient care. Further research is needed to explore the underlying mechanisms and assess long-term outcomes in different age groups.
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Affiliation(s)
- Nouman Anthony
- General Medicine, Rehman Medical Institue, Peshawar, PAK
| | - Amir Hassan
- Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Peshawar, PAK
| | - Usman Ghani
- Cardiology, Northwest General, Peshawar, PAK
| | - Omar Rahim
- Internal Medicine, Naseer Teaching Hospital, Peshawar, PAK
| | - Moula Ghulam
- Medicine, Rehman Medical Institute, Peshawar, PAK
| | - Neha James
- General Medicine, Rehman Medical Institute, Peshawar, PAK
| | | | - Saad Ali
- Medicine, Rehman Medical Institute, Peshawar, PAK
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Martins Dos Santos H, Pereira GS, de Oliveira LC, Da Silva PK, Gonçalves Lima M, Faria CDCDM, Silva SM. Biopsychosocial factors associated with the state of disability after hemiparesis in the chronic phase of stroke: exploratory analysis based on the International Classification of Functioning, Disability and Health. Disabil Rehabil 2024; 46:1366-1373. [PMID: 37029629 DOI: 10.1080/09638288.2023.2196444] [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: 07/12/2022] [Accepted: 03/24/2023] [Indexed: 04/09/2023]
Abstract
OBJECTIVE To identify the main biopsychosocial factors associated with disability level after stroke using the International Classification of Functioning, Disability and Health (ICF) model. METHODS A cross-sectional study was conducted with chronic stroke survivors. Disability was assessed using the World Health Disability Assessment Schedule 2.0. The independent variables were: Body functions: emotional functioning and whether the dominant upper limb was affected. For the Activities & Participation component, satisfaction regarding the execution of activities and participation were assessed using the SATIS-Stroke, as well as the locomotion ability for adults (ABILOCO), manual ability (ABILHAND) and the return to work. For environmental factors, income and facilitators and obstacles were assessed using the Measure of the Quality of the Environment (MQE). Personal factors: age and sex. Multiple Linear Regression was employed. RESULTS Limited locomotor ability (β = -0.281; t = -3.231 p = 0.002), dissatisfaction regarding activities and participation (β = -0.273; t = -3.070 p = 0.003), and the non-return to work (β = 0.162; t = 2.085 p = 0.04) were associated with disability. CONCLUSION The reduction in locomotor ability, dissatisfaction regarding activities and participation and the non-return to work were associated with disability in the chronic phase following a stroke.
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Affiliation(s)
| | - Gabriela Santos Pereira
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Leia Cordeiro de Oliveira
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Paula Karina Da Silva
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Michael Gonçalves Lima
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | | | - Soraia Micaela Silva
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
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Wang B, Liu J, Zhao L. Association of congestive heart failure with mortality in individuals with rheumatoid arthritis: a cohort study. Clin Rheumatol 2024; 43:1287-1297. [PMID: 38378912 DOI: 10.1007/s10067-024-06878-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/05/2024] [Accepted: 01/16/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE Rheumatoid arthritis (RA) is a risk factor for congestive heart failure (CHF). Evidence is lacking regarding the relationship between CHF and mortality among American adults with RA. We aimed to investigate the relationship between CHF and mortality in patients with RA. METHODS We extracted the corresponding data from the National Health and Nutrition Examination Survey (NHANES) database and calculated the hazard ratios (HR) and 95% CIs between CHF and mortality from all causes, cardiovascular disease (CVD), and cancer by using a Cox proportional risk model. RESULTS A total of 2045 participants with a mean age of 60.32 ± 13.96 years were included; 57.60% were female. During a median follow-up period of 109 months, there were 602 deaths. After adjusting for potential confounders, compared with participants who are non-CHF, those with CHF had 60% (HR 1.60, 95% CI 1.27-2.01) and 110% (1.45, 1.45 to 3.06) higher all-cause mortality and CVD mortality, respectively. Furthermore, a significant association between CHF and all-cause mortality can also be observed in female individuals and those aged 65 and above. There was no significant association between CHF and cancer mortality. CONCLUSIONS In this cohort study of US adults with RA, CHF was significantly associated with an increased risk of all-cause or CVD-related death. This finding underscores the importance of CHF in the management of patients with RA and may provide future information on maintaining the health status of patients with RA. Key messages • The study findings demonstrate a significant increase in overall mortality and cardiovascular mortality among individuals with RA who develop CHF. • This knowledge can assist healthcare professionals in identifying high-risk patients who could benefit from targeted monitoring and early intervention to prevent or manage CHF.
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Affiliation(s)
- Bo Wang
- Department of Orthopaedics, Lanzhou University Second Hospital, #82 Cuiyingmen, Lanzhou, Gansu, People's Republic of China, 730000
- Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China
- Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Jinmin Liu
- Department of Orthopaedics, Lanzhou University Second Hospital, #82 Cuiyingmen, Lanzhou, Gansu, People's Republic of China, 730000
- Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China
- Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Lianggong Zhao
- Department of Orthopaedics, Lanzhou University Second Hospital, #82 Cuiyingmen, Lanzhou, Gansu, People's Republic of China, 730000.
- Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China.
- Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China.
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Agbonlahor O, DeJarnett N, Hart JL, Bhatnagar A, McLeish AC, Walker KL. Racial/Ethnic Discrimination and Cardiometabolic Diseases: A Systematic Review. J Racial Ethn Health Disparities 2024; 11:783-807. [PMID: 36976513 PMCID: PMC10044132 DOI: 10.1007/s40615-023-01561-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Racial discrimination has been identified as a risk factor for cardiometabolic diseases, the leading cause of morbidity and mortality among racial/ethnic minority groups; however, there is no synthesis of current knowledge on the association between discrimination and cardiometabolic diseases. The objective of this systematic review was to summarize evidence linking racial/ethnic discrimination and cardiometabolic diseases. METHODS The review was conducted based on studies identified via electronic searches of 5 databases (PubMed, Google Scholar, WorldWideScience.org, ResearchGate and Microsoft Academic) using terms related to discrimination and cardiometabolic disease. RESULTS Of the 123 eligible studies included in the review, 87 were cross-sectional, 25 longitudinal, 8 quasi-experimental, 2 randomized controlled trials and 1 case-control. Cardiometabolic disease outcomes discussed were hypertension (n = 46), cardiovascular disease (n = 40), obesity (n = 12), diabetes (n = 11), metabolic syndrome (n = 9), and chronic kidney disease (n = 5). Although a variety of discrimination measures was employed across the studies, the Everyday Discrimination Scale was used most often (32.5%). African Americans/Blacks were the most frequently studied racial/ethnic group (53.1%), and American Indians the least (0.02%). Significant associations between racial/ethnic discrimination and cardiometabolic disease were found in 73.2% of the studies. DISCUSSION Racial/ethnic discrimination is positively associated with increased risk of cardiometabolic disease and higher levels of cardiometabolic biomarkers. Identifying racial/ethnic discrimination as a potential key contributor to the health inequities associated with cardiometabolic diseases is important for addressing the significant burden borne by racial/ethnic minorities.
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Affiliation(s)
- Osayande Agbonlahor
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
| | - Natasha DeJarnett
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- Division of Environmental Medicine, School of Medicine, University of Louisville, Louisville, KY USA
| | - Joy L. Hart
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- Division of Environmental Medicine, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
| | - Alison C. McLeish
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY USA
| | - Kandi L. Walker
- Department of Communication, University of Louisville, Louisville, KY USA
- Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY USA
- American Heart Association Tobacco Center for Regulatory Science, Dallas, TX USA
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Xueying C, Hua Z, Lujing Z, Ruomeng L, Wen D, Anyong C, Ronghua G, Ying G, Shufang Z, Guoliang Y, Lixin L, Shijun W, Shaohui Z, Lijun G. Which patients with coronary artery disease should include oral nitrates on their discharge medication list? Acta Cardiol 2024; 79:136-148. [PMID: 37961760 DOI: 10.1080/00015385.2023.2271763] [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: 06/07/2023] [Accepted: 10/11/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Which patients with coronary artery disease (CAD) should have oral nitrates on their discharge medication list after coronary angiography (CAG)? To assess the relationship between oral nitrates included in the discharge medication list and major adverse cardiovascular events (MACEs) among CAD patients, we designed this retrospective cohort study. METHODS A total of 2979 CAD patients hospitalised in the Department of Cardiology, Affiliated Hospital of Jining Medical University from May 2013 to October 2015 were enrolled, grouped according to whether oral nitrates were included at discharge after CAG, and followed up for MACEs for a mean of 4.42 years after discharge. The primary endpoint was MACEs. Multivariate Cox proportional hazards models were used to analyses potential confounding factors. Stratified analysis was used to observe the relationship between oral nitrates and MACEs by different covariates. RESULTS The median follow-up time was 4.61 years, and 296 (9.94%) patients experienced MACEs. Multivariate Cox proportional hazards model analysis showed no association between oral nitrates on the discharge medication list and the occurrence of MACEs among patients with CAD (p > 0.05) after adjusting for some covariates, such as SYNTAX score (hazard ratio (HR): 1.18, 95% confidence interval (CI): 0.90-1.55, p = 0.2420). Stratified analysis revealed a higher incidence of MACEs among hypertensive patients prescribed oral nitrates at discharge (HR: 1.67, 95% confidence CI: 1.13-2.46, p = 0.0046). However, prescribing nitrates at discharge for patients with low uric acid levels increased the incidence of MACEs, which showed a possible trend towards significance (HR: 1.44, 95% CI: 0.99-2.09, p = 0.0525). CONCLUSION There was no association between oral nitrates included in the discharge medication list and the development of MACEs among patients with CAD after adjusting for some covariates, such as SYNTAX score. Oral nitrates after discharge for CAD patients combined with hypertension increased the occurrence of MACEs. Oral nitrates after discharge for CAD patients combined with low uric acid levels may increase theoccurrence of MACEs, and close monitoring for any adverse events is recommended.
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Affiliation(s)
- Chen Xueying
- Department of Cardiology, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
- Postdoctoral Mobile Station of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Zhang Hua
- Colleague of Clinical Medicine, Jining Medical University, Jining, Shandong, China
| | - Zhao Lujing
- Department of Cardiology, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Li Ruomeng
- Emergency Care Unit, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Dai Wen
- Department of Cardiology, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Chen Anyong
- Department of Cardiology, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Gao Ronghua
- Department of Cardiology, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Guo Ying
- Department of Cardiology, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Zhang Shufang
- Department of Cardiology, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Yang Guoliang
- Department of Cardiology, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Liu Lixin
- Department of Cardiology, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Wang Shijun
- Postdoctoral Mobile Station of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Zhang Shaohui
- Department of Cardiology, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Gan Lijun
- Department of Cardiology, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
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Locatelli G, Iovino P, Pasta A, Jurgens CY, Vellone E, Riegel B. Cluster analysis of heart failure patients based on their psychological and physical symptoms and predictive analysis of cluster membership. J Adv Nurs 2024; 80:1380-1392. [PMID: 37788062 DOI: 10.1111/jan.15890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/16/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023]
Abstract
AIM Patients with heart failure experience multiple co-occurring symptoms that lower their quality of life and increase hospitalization and mortality rates. So far, no heart failure symptom cluster study recruited patients from community settings or focused on symptoms predicting most clinical outcomes. Considering physical and psychological symptoms together allows understanding how they burden patients in different combinations. Moreover, studies predicting symptom cluster membership using variables other than symptoms are lacking. We aimed to (a) cluster heart failure patients based on physical and psychological symptoms and (b) predict symptom cluster membership using sociodemographic/clinical variables. DESIGN Secondary analysis of MOTIVATE-HF trial, which recruited 510 heart failure patients from a hospital, an outpatient and a community setting in Italy. METHODS Cluster analysis was performed based on the two scores of the Hospital Anxiety-Depression scale and two scores of the Heart-Failure Somatic Perception Scale predicting most clinical outcomes. ANOVA and chi-square test were used to compare patients' characteristics among clusters. For the predictive analysis, we split the data into a training set and a test set and trained three classification models on the former to predict patients' symptom cluster membership based on 11 clinical/sociodemographic variables. Permutation analysis investigated which variables best predicted cluster membership. RESULTS Four clusters were identified based on the intensity and combination of psychological and physical symptoms: mixed distress (high psychological, low physical symptoms), high distress, low distress and moderate distress. Clinical and sociodemographic differences were found among clusters. NYHA-class (New York Heart Association) and sleep quality were the most important variables in predicting symptom cluster membership. CONCLUSIONS These results can support the development of tailored symptom management intervention and the investigation of symptom clusters' effect on patient outcomes. The promising results of the predictive analysis suggest that such benefits may be obtained even when direct access to symptoms-related data is absent. IMPLICATIONS These results may be particularly useful to clinicians, patients and researchers because they highlight the importance of addressing clusters of symptoms, instead of individual symptoms, to facilitate symptom detection and management. Knowing which variables best predict symptom cluster membership can allow to obtain such benefits even when direct access to symptoms-data is absent. IMPACT Four clusters of heart failure patients characterized by different intensity and combination of psychological and physical symptoms were identified. NYHA class and sleep quality appeared important variables in predicting symptom cluster membership. REPORTING METHOD The authors have adhered to the EQUATOR guidelines STROBE to report observational cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION Patients were included only for collecting their data.
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Affiliation(s)
- Giulia Locatelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, New South Wales, Sydney, Australia
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, Italy
| | - Alessandro Pasta
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Corrine Y Jurgens
- Connell School of Nursing, Boston College, Massachusetts, Boston, USA
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Department of Nursing and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
| | - Barbara Riegel
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, New South Wales, Sydney, Australia
- School of Nursing, University of Pennsylvania, Pennsylvania, Philadelphia, USA
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Shi W, Zhang Q, Lu Y, Liu J, Ma X, Xie Z, Zhang G, Chang M, Tian Y. Association of single nucleotide polymorphisms in ITLN1 gene with ischemic stroke risk in Xi'an population, Shaanxi province. PeerJ 2024; 12:e16934. [PMID: 38529304 PMCID: PMC10962333 DOI: 10.7717/peerj.16934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/22/2024] [Indexed: 03/27/2024] Open
Abstract
Background Ischemic stroke (IS) is the main cause of death and adult disability. However, the pathogenesis of this complicated disease is unknown. The present study aimed to assess the relationship between ITLN1 single nucleotide polymorphisms (SNPs) and the susceptibility to IS in Xi'an population, Shaanxi province. Methods In this study, we designed polymerase chain reaction (PCR) primers located at -3,308 bp upstream of the transcription initiation site within promoter region of the ITLN1 gene. The target fragment was amplified by PCR and identified by agarose gel electrophoresis. Sanger sequencing was then performed in the samples extracted from a cohort comprising 1,272 participants (636 controls and 636 cases), and the obtained sequences were compared with the reference sequences available on the National Center for Biotechnology Information (NCBI) website to detect SNPs in the ITLN1 gene promoter region. Logistic regression analysis was employed to assess the relationship between ITLN1 polymorphisms and IS risk, with adjustments for age and gender. Significant positive results were tested by false-positive report probability (FPRP) and false discovery rate (FDR). The interaction among noteworthy SNPs and their predictive relationship with IS risk were explored using the Multi-Factor Dimensionality Reduction (MDR) software. Results The results of Sanger sequencing were compared with the reference sequences on the NCBI website, and we found 14 SNPs in ITLN1 gene promoter satisfied Hardy-Weinberg equilibrium (HWE). Logistic regression analysis showed that ITLN1 was associated with a decreased risk of IS (rs6427553: Homozygous C/C: adjusted OR: 0.69, 95% CI [0.48-0.97]; Log-additive: adjusted OR: 0.83, 95% CI [0.70-0.98]; rs7411035: Homozygous G/G: adjusted OR: 0.66, 95% CI [0.47-0.94]; Dominant G/T-G/G: adjusted OR: 0.78, 95% CI [0.62-0.98]; Log-additive: adjusted OR: 0.81, 95% CI [0.69-0.96]; rs4656958: Heterozygous G/A: adjusted OR: 0.74, 95% CI [0.59-0.94]; Homozygous A/A: adjusted OR: 0.51, 95% CI [0.31-0.84]; Dominant G/A-A/A: adjusted OR: 0.71, 95% CI [0.57-0.89]; Recessive A/A: adjusted OR: 0.59, 95% CI [0.36-0.96]; Log-additive: adjusted OR: 0.73, 95% CI [0.61-0.88]), especially in people aged less than 60 years and males. Conclusions In short, our study revealed a correlation between ITLN1 variants (rs6427553, rs7411035 and rs4656958) and IS risk in Xi'an population, Shaanxi province, laying a foundation for ITLN1 gene as a potential biomarker for predicting susceptibility to IS.
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Affiliation(s)
- Wenzhen Shi
- Clinical Medical Research Center, Xi’an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi’an No.3 Hospital, Xi’an, China
| | - Qi Zhang
- Clinical Medical Research Center, Xi’an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi’an No.3 Hospital, Xi’an, China
| | - Ying Lu
- Department of Neurology, the Affiliated Hospital of Northwest University, Xi’an No.3 Hospital, Xi’an, China
| | - Jie Liu
- Clinical Medical Research Center, Xi’an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi’an No.3 Hospital, Xi’an, China
| | - Xiaojuan Ma
- Clinical Medical Research Center, Xi’an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi’an No.3 Hospital, Xi’an, China
| | - Zhen Xie
- Xi’an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, The College of Life Sciences and Medicine, Northwest University, Xi’an, China
| | - Gejuan Zhang
- Department of Neurology, the Affiliated Hospital of Northwest University, Xi’an No.3 Hospital, Xi’an, China
| | - Mingze Chang
- Department of Neurology, the Affiliated Hospital of Northwest University, Xi’an No.3 Hospital, Xi’an, China
| | - Ye Tian
- Department of Neurology, the Affiliated Hospital of Northwest University, Xi’an No.3 Hospital, Xi’an, China
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Cullins MJ, Connor NP. Differential impact of unilateral stroke on the bihemispheric motor cortex representation of the jaw and tongue muscles in young and aged rats. Front Neurol 2024; 15:1332916. [PMID: 38572491 PMCID: PMC10987714 DOI: 10.3389/fneur.2024.1332916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/04/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Dysphagia commonly occurs after stroke, yet the mechanisms of post-stroke corticobulbar plasticity are not well understood. While cortical activity associated with swallowing actions is bihemispheric, prior research has suggested that plasticity of the intact cortex may drive recovery of swallowing after unilateral stroke. Age may be an important factor as it is an independent predictor of dysphagia after stroke and neuroplasticity may be reduced with age. Based on previous clinical studies, we hypothesized that cranial muscle activating volumes may be expanded in the intact hemisphere and would contribute to swallowing function. We also hypothesized that older age would be associated with limited map expansion and reduced function. As such, our goal was to determine the impact of stroke and age on corticobulbar plasticity by examining the jaw and tongue muscle activating volumes within the bilateral sensorimotor cortices. Methods Using the middle cerebral artery occlusion rat stroke model, intracortical microstimulation (ICMS) was used to map regions of sensorimotor cortex that activate tongue and jaw muscles in both hemispheres. Young adult (7 months) and aged (30 months) male F344 × BN rats underwent a stroke or sham-control surgery, followed by ICMS mapping 8 weeks later. Videofluoroscopy was used to assess oral-motor functions. Results Increased activating volume of the sensorimotor cortex within the intact hemisphere was found only for jaw muscles, whereas significant stroke-related differences in tongue activating cortical volume were limited to the infarcted hemisphere. These stroke-related differences were correlated with infarct size, such that larger infarcts were associated with increased jaw representation in the intact hemisphere and decreased tongue representation in the infarcted hemisphere. We found that both age and stroke were independently associated with swallowing differences, weight loss, and increased corticomotor thresholds. Laterality of tongue and jaw representations in the sham-control group revealed variability between individuals and between muscles within individuals. Conclusion Our findings suggest the role of the intact and infarcted hemispheres in the recovery of oral motor function may differ between the tongue and jaw muscles, which may have important implications for rehabilitation, especially hemisphere-specific neuromodulatory approaches. This study addressed the natural course of recovery after stroke; future work should expand to focus on rehabilitation.
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Affiliation(s)
- Miranda J. Cullins
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
| | - Nadine P. Connor
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
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Fraser JF, Pahwa S, Maniskas M, Michas C, Martinez M, Pennypacker KR, Dornbos D. Now that the door is open: an update on ischemic stroke pharmacotherapeutics for the neurointerventionalist. J Neurointerv Surg 2024; 16:425-428. [PMID: 37258227 DOI: 10.1136/jnis-2022-019293] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/22/2023] [Indexed: 06/02/2023]
Abstract
The last 10 years have seen a major shift in management of large vessel ischemic stroke with changes towards ever-expanding use of reperfusion therapies (intravenous thrombolysis and mechanical thrombectomy). These strategies 'open the door' to acute therapeutics for ischemic tissue, and we should investigate novel therapeutic approaches to enhance survival of recently reperfused brain. Key insights into new approaches have been provided through translational research models and preclinical paradigms, and through detailed research on ischemic mechanisms. Additional recent clinical trials offer exciting salvos into this new strategy of pairing reperfusion with neuroprotective therapy. This pairing strategy can be employed using drugs that have shown neuroprotective efficacy; neurointerventionalists can administer these during or immediately after reperfusion therapy. This represents a crucial moment when we emphasize reperfusion, and have the technological capability along with the clinical trial experience to lead the way in multiprong approaches to stroke treatment.
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Affiliation(s)
- Justin F Fraser
- Department of Neurological Surgery, University of Kentucky, Lexington, Kentucky, USA
- Department of Neurology, University of Kentucky, Lexington, Kentucky, USA
- Department of Radiology, University of Kentucky, Lexington, Kentucky, USA
| | - Shivani Pahwa
- Department of Neurological Surgery, University of Kentucky, Lexington, Kentucky, USA
- Department of Radiology, University of Kentucky, Lexington, Kentucky, USA
| | - Michael Maniskas
- Department of Neurology, The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, USA
| | - Christopher Michas
- Department of Neurological Surgery, University of Kentucky, Lexington, Kentucky, USA
| | - Mesha Martinez
- Department of Neurointerventional Radiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Keith R Pennypacker
- Department of Neurology, University of Kentucky, Lexington, Kentucky, USA
- University of Kentucky, Lexington, Kentucky, USA
| | - David Dornbos
- Department of Neurological Surgery, University of Kentucky, Lexington, Kentucky, USA
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Foschi M, D’Anna L, Gabriele C, Conversi F, Gabriele F, De Santis F, Orlandi B, De Santis F, Ornello R, Sacco S. Sex Differences in the Epidemiology of Intracerebral Hemorrhage Over 10 Years in a Population-Based Stroke Registry. J Am Heart Assoc 2024; 13:e032595. [PMID: 38410943 PMCID: PMC10944030 DOI: 10.1161/jaha.123.032595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/14/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND We investigated incidence and outcome of spontaneous intracerebral hemorrhage (ICH) in a population-based stroke registry and provided data to inform on the figures of the disease in women and in men. METHODS AND RESULTS Our prospective population-based registry included patients with first-ever ICH occurring from January 2011 to December 2020. Incidence rates were standardized to the 2011 Italian and European population, and incidence rate ratios were calculated. Multivariate hazard ratios for 30-day and 1-year fatality were estimated with Cox regression, including components of the ICH score and sex. We included 748 first-ever ICHs (41.3% women). Women were significantly older than men at ICH onset (78.9±12.6 versus 73.2±13.6 years; P<0.001) and showed higher clinical severity on presentation (median National Institutes of Health Stroke Scale score, 11 [interquartile range, 6-20] versus 9 [interquartile range, 4-15], respectively; P=0.016). The crude annual incidence rate was 20.2 (95% CI, 18.0-22.6) per 100 000 person-years in women and 30.2 (95% CI, 27.4-33.2) per 100 000 person-years in men); incidence was lower in women versus men (incidence rate ratio, 0.67 [95% CI, 0.58-0.78]; P<0.001) and did not change over time in both sexes (P for trend=0.073 and 0.904, respectively). Unadjusted comparison showed higher 1-year case-fatality rates in women versus men (48.5% versus 40.1%; P=0.026). After adjusting for components of the ICH score, female sex lost significance as a predictor of mortality. CONCLUSIONS We found lower ICH incidence in women than in men. However, women showed a higher 1-year case-fatality rate versus men, which was likely related to older age at ICH onset and higher clinical severity. Identification of factors explaining the reported differences is important to develop targeted interventions.
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Affiliation(s)
- Matteo Foschi
- Department of Biotechnological and Applied Clinical SciencesUniversity of L’AquilaL’AquilaItaly
| | - Lucio D’Anna
- Department of Stroke and Neuroscience, Charing Cross HospitalImperial College London National Health Service Healthcare TrustLondonUK
- Department of Brain SciencesImperial College LondonLondonUK
| | - Claudia Gabriele
- Department of Life, Health and Environmental SciencesUniversity of L’AquilaL’AquilaItaly
| | - Francesco Conversi
- Department of Biotechnological and Applied Clinical SciencesUniversity of L’AquilaL’AquilaItaly
| | - Francesca Gabriele
- Department of Biotechnological and Applied Clinical SciencesUniversity of L’AquilaL’AquilaItaly
| | - Federica De Santis
- Department of Neurology and Stroke Unit of Avezzano‐SulmonaL’AquilaItaly
| | - Berardino Orlandi
- Department of Neurology and Stroke Unit of Avezzano‐SulmonaL’AquilaItaly
| | - Federico De Santis
- Department of Biotechnological and Applied Clinical SciencesUniversity of L’AquilaL’AquilaItaly
| | - Raffaele Ornello
- Department of Biotechnological and Applied Clinical SciencesUniversity of L’AquilaL’AquilaItaly
| | - Simona Sacco
- Department of Biotechnological and Applied Clinical SciencesUniversity of L’AquilaL’AquilaItaly
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Shah S, Chaple D, Masand VH, Zaki MEA, Al-Hussain SA, Shah A, Arora S, Jawarkar R, Tauqeer M. In silico study to recognize novel angiotensin-converting-enzyme-I inhibitors by 2D-QSAR and constraint-based molecular simulations. J Biomol Struct Dyn 2024; 42:2211-2230. [PMID: 37128759 DOI: 10.1080/07391102.2023.2203261] [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: 11/08/2022] [Accepted: 04/10/2023] [Indexed: 05/03/2023]
Abstract
Cardiovascular diseases (CVD) such as heart failure, stroke, and hypertension affect 64.3 million people worldwide and are responsible for 30% of all deaths. Primary inhibition of the angiotensin-converting enzyme (ACE) is significant in the management of CVD. In the present study, the genetic algorithm-multiple linear regressions (GA-MLR) method is used to generate highly predictive and statistically significant (R2 = 0.70-0.75, Q2LOO=0.67-0.73, Q2LMO=0.66-0.72, CCCex=0.70-0.78) quantitative structure-activity relationships (QSAR) models conferring to OECD requirements using a dataset of 255 structurally diverse and experimentally validated ACE inhibitors. The models contain simply illustratable Padel, Estate, and PyDescriptors that correlate structural scaffold requisite for ACE inhibition. Also, constraint-based molecular docking reveals an interaction profile between ligands and enzymes which is then correlated with the essential structural features associated with the QSAR models. The QSAR-based virtual screening was utilized to find novel lead molecules from a designed database of 102 thiadiazole derivatives. The Applicability domain (AD), Molecular Docking, Molecular dynamics, and ADMET analysis suggest two compound D24 and D40 are inflexibly linked to the protein binding site and follows drug-likeness properties.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Sapan Shah
- Department of Pharmaceutical Chemistry, Priyadarshini J. L. College of Pharmacy, Nagpur, Maharashtra, India
| | - Dinesh Chaple
- Department of Pharmaceutical Chemistry, Priyadarshini J. L. College of Pharmacy, Nagpur, Maharashtra, India
| | - Vijay H Masand
- Department of Chemistry, Vidya Bharati Mahavidyalaya, Amravati, Maharashtra, India
| | - Magdi E A Zaki
- Department of Chemistry, Faculty of Science, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Sami A Al-Hussain
- Department of Chemistry, Faculty of Science, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Ashish Shah
- Department of Pharmacy, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Sumit Arora
- Department of Pharmacognosy, Gurunanak College of Pharmacy, Nagpur, Maharashtra, India
| | - Rahul Jawarkar
- Department of Medicinal Chemistry and Drug Discovery, Dr. Rajendra Gode Institute of Pharmacy, Amravati, India
| | - Mohammad Tauqeer
- Department of Pharmacognosy, Dr. Arun Motghare College of Pharmacy, Kosra-Kondha, Maharashtra, India
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Pei C, He C, Li H, Li X, Huang W, Liu J, Yin J. Clinical and imaging markers for the prognosis of acute ischemic stroke. Front Neurol 2024; 15:1345914. [PMID: 38487321 PMCID: PMC10937465 DOI: 10.3389/fneur.2024.1345914] [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: 11/28/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
Background and purpose Significant differences in the outcomes observed in patients with acute ischemic stroke (AIS) have led to research investigations for identifying the predictors. In this retrospective study, we aimed to investigate the relationship of different clinical and imaging factors with the prognosis of AIS. Materials and methods All clinical and imaging metrics were compared between the good and poor prognosis groups according to the modified Rankin Scale (mRS) score at 90 days after discharge. Clinical factors included gender, age, NIHSS scores at admission, and other medical history risk factors. Imaging markers included the lesion's size and location, diffusion, and perfusion metrics of infarction core and peripheral regions, and the state of collateral circulation. Spearman's correlations were analyzed for age and imaging markers between the different groups. The Chi-square test and Cramer's V coefficient analysis were performed for gender, collateral circulation status, NIHSS score, and other stroke risk factors. Results A total of 89 patients with AIS were divided into the good (mRS score ≤ 2) and poor prognosis groups (mRS score ≥ 3). There were differences in NIHSS score at the admission; relative MK (rMK), relative MD (rMD), relative CBF (rCBF) of the infarction core; relative mean transit time (rMTT), relative time to peak (rTTP), and relative CBF (rCBF) of peripheral regions; and collateral circulation status between the two groups (p < 0.05). Among them, the rMK of infarction lesions had the strongest correlation with the mRS score at 90 days after discharge (r = 0.545, p < 0.001). Conclusion Perfusion and diffusion metrics could reflect the microstructure and blood flow characteristics of the lesion, which were the key factors for the salvage ability and prognosis of the infarction tissue. The characteristics of the infarction core and peripheral regions have different effects on the outcomes. Diffusion of infarction core has strong relations with the prognosis, whereas the time metrics (MTT, TTP) were more important for peripheral regions. MK had a more significant association with prognosis than MD. These factors were the primary markers influencing the prognosis of cerebral infarction patients.
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Affiliation(s)
- Chenyang Pei
- Tianjin Medical University, Tianjin, China
- Department of Radiology, Haikou People's Hospital, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, Hainan, China
| | - Che He
- Medical Imaging Center, The First People's Hospital of Qujing, Qujing, Yunnan, China
| | - Han Li
- Tianjin Medical University, Tianjin, China
| | - Xiangying Li
- Department of Radiology, Haikou People's Hospital, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, Hainan, China
| | - Weihui Huang
- Department of Neurology, Tianjin First Central Hospital, Tianjin, China
| | - Jun Liu
- Department of Radiology, Tianjin Fourth Central Hospital, Tianjin, China
| | - Jianzhong Yin
- Department of Radiology, Haikou People's Hospital, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, Hainan, China
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Islam MM, Oyarzun-Gonzalez X, Bose-Brill S, Donneyong MM. Supplemental Nutrition Assistance Program and Adherence to Antihypertensive Medications. JAMA Netw Open 2024; 7:e2356619. [PMID: 38393731 PMCID: PMC10891466 DOI: 10.1001/jamanetworkopen.2023.56619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/22/2023] [Indexed: 02/25/2024] Open
Abstract
Importance Nonadherence to antihypertensive medications is associated with uncontrolled blood pressure, higher mortality rates, and increased health care costs, and food insecurity is one of the modifiable medication nonadherence risk factors. The Supplemental Nutrition Assistance Program (SNAP), a social intervention program for addressing food insecurity, may help improve adherence to antihypertensive medications. Objective To evaluate whether receipt of SNAP benefits can modify the consequences of food insecurity on nonadherence to antihypertensive medications. Design, Setting, and Participants A retrospective cohort study design was used to assemble a cohort of antihypertensive medication users from the linked Medical Expenditure Panel Survey (MEPS)-National Health Interview Survey (NHIS) dataset for 2016 to 2017. The MEPS is a national longitudinal survey on verified self-reported prescribed medication use and health care access measures, and the NHIS is an annual cross-sectional survey of US households that collects comprehensive health information, health behavior, and sociodemographic data, including receipt of SNAP benefits. Receipt of SNAP benefits in the past 12 months and food insecurity status in the past 30 days were assessed through standard questionnaires during the study period. Data analysis was performed from March to December 2021. Exposure Status of SNAP benefit receipt. Main Outcomes and Measures The main outcome, nonadherence to antihypertensive medication refill adherence (MRA), was defined using the MEPS data as the total days' supply divided by 365 days for each antihypertensive medication class. Patients were considered nonadherent if their overall MRA was less than 80%. Food insecurity status in the 30 days prior to the survey was modeled as the effect modifier. Inverse probability of treatment (IPT) weighting was used to control for measured confounding effects of baseline covariates. A probit model was used, weighted by the product of the computed IPT weights and MEPS weights, to estimate the population average treatment effects (PATEs) of SNAP benefit receipt on nonadherence. A stratified analysis approach was used to assess for potential effect modification by food insecurity status. Results This analysis involved 6692 antihypertensive medication users, of whom 1203 (12.8%) reported receiving SNAP benefits and 1338 (14.8%) were considered as food insecure. The mean (SD) age was 63.0 (13.3) years; 3632 (51.3%) of the participants were women and 3060 (45.7%) were men. Although SNAP was not associated with nonadherence to antihypertensive medications in the overall population, it was associated with a 13.6-percentage point reduction in nonadherence (PATE, -13.6 [95% CI, -25.0 to -2.3]) among the food-insecure subgroup but not among their food-secure counterparts. Conclusions and Relevance This analysis of a national observational dataset suggests that patients with hypertension who receive SNAP benefits may be less likely to become nonadherent to antihypertensive medication, especially if they are experiencing food insecurity. Further examination of the role of SNAP as a potential intervention for preventing nonadherence to antihypertensive medications through prospectively designed interventional studies or natural experiment study designs is needed.
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Affiliation(s)
- Md. Mohaimenul Islam
- Outcomes and Translational Sciences, College of Pharmacy, The Ohio State University, Columbus
| | - Ximena Oyarzun-Gonzalez
- Outcomes and Translational Sciences, College of Pharmacy, The Ohio State University, Columbus
| | - Seuli Bose-Brill
- Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus
| | - Macarius M. Donneyong
- Outcomes and Translational Sciences, College of Pharmacy, The Ohio State University, Columbus
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Babygeetha A, Devineni D. Social Support and Adherence to Self-Care Behavior Among Patients With Coronary Heart Disease and Heart Failure: A Systematic Review. EUROPES JOURNAL OF PSYCHOLOGY 2024; 20:63-77. [PMID: 38487598 PMCID: PMC10936663 DOI: 10.5964/ejop.12131] [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: 06/07/2023] [Accepted: 08/19/2023] [Indexed: 03/17/2024]
Abstract
Cardiovascular diseases stand out as the foremost cause of mortality on a global scale and encompass conditions that require long term self-care. Coronary heart disease and heart failure are two cardiovascular conditions that require significant lifestyle modifications. Adherence to self-care is a multifaceted phenomenon, and is influenced by various factors that include social, economic, disease-related and healthcare system-related factors. A key factor in adherence to self-care in chronic illnesses is social support. To explore this relationship between social support and adherence to self-care, a systematic review was carried out across Scopus, EBSCO host and ProQuest from October 2022 to February 2023 using predefined search criteria. Studies from inception to February 2023 were considered for the review, ultimately incorporating a total of 11 studies. Six studies had an adult population with coronary heart disease while the remaining five had adults with heart failure. All the studies reported a significant positive correlation between social support and adherence to self-care. Our findings revealed that social support plays a significant role in promoting self-care, emphasizing the need for a holistic understanding of self-care to develop effective interventions. Along with self-report measures, objective measures should be used to assess adherence accurately. There is a need for scales that assess all aspects of self-care, as well as the development of new interventions and teaching strategies to facilitate the individual's self-care journey. In addition, family members and trusted resources should be involved in encouraging self-care, and interventions should target both patients and their family members.
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Affiliation(s)
- Athira Babygeetha
- Department of Applied Psychology, Pondicherry University, Puducherry, India
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