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Crotti L, Spazzolini C, Nyegaard M, Overgaard MT, Kotta MC, Dagradi F, Sala L, Aiba T, Ayers MD, Baban A, Barc J, Beach CM, Behr ER, Bos JM, Cerrone M, Covi P, Cuneo B, Denjoy I, Donner B, Elbert A, Eliasson H, Etheridge SP, Fukuyama M, Girolami F, Hamilton R, Horie M, Iascone M, Jaimez JJ, Jensen HK, Kannankeril PJ, Kaski JP, Makita N, Muñoz-Esparza C, Odland HH, Ohno S, Papagiannis J, Porretta AP, Prandstetter C, Probst V, Robyns T, Rosenthal E, Rosés-Noguer F, Sekarski N, Singh A, Spentzou G, Stute F, Tfelt-Hansen J, Till J, Tobert KE, Vinocur JM, Webster G, Wilde AAM, Wolf CM, Ackerman MJ, Schwartz PJ. Clinical presentation of calmodulin mutations: the International Calmodulinopathy Registry. Eur Heart J 2023; 44:3357-3370. [PMID: 37528649 PMCID: PMC10499544 DOI: 10.1093/eurheartj/ehad418] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/14/2023] [Accepted: 06/13/2023] [Indexed: 08/03/2023] Open
Abstract
AIMS Calmodulinopathy due to mutations in any of the three CALM genes (CALM1-3) causes life-threatening arrhythmia syndromes, especially in young individuals. The International Calmodulinopathy Registry (ICalmR) aims to define and link the increasing complexity of the clinical presentation to the underlying molecular mechanisms. METHODS AND RESULTS The ICalmR is an international, collaborative, observational study, assembling and analysing clinical and genetic data on CALM-positive patients. The ICalmR has enrolled 140 subjects (median age 10.8 years [interquartile range 5-19]), 97 index cases and 43 family members. CALM-LQTS and CALM-CPVT are the prevalent phenotypes. Primary neurological manifestations, unrelated to post-anoxic sequelae, manifested in 20 patients. Calmodulinopathy remains associated with a high arrhythmic event rate (symptomatic patients, n = 103, 74%). However, compared with the original 2019 cohort, there was a reduced frequency and severity of all cardiac events (61% vs. 85%; P = .001) and sudden death (9% vs. 27%; P = .008). Data on therapy do not allow definitive recommendations. Cardiac structural abnormalities, either cardiomyopathy or congenital heart defects, are present in 30% of patients, mainly CALM-LQTS, and lethal cases of heart failure have occurred. The number of familial cases and of families with strikingly different phenotypes is increasing. CONCLUSION Calmodulinopathy has pleiotropic presentations, from channelopathy to syndromic forms. Clinical severity ranges from the early onset of life-threatening arrhythmias to the absence of symptoms, and the percentage of milder and familial forms is increasing. There are no hard data to guide therapy, and current management includes pharmacological and surgical antiadrenergic interventions with sodium channel blockers often accompanied by an implantable cardioverter-defibrillator.
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Affiliation(s)
- Lia Crotti
- Istituto Auxologico Italiano IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Via Pier Lombardo 22, 20135 Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126 Milan, Italy
| | - Carla Spazzolini
- Istituto Auxologico Italiano IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Via Pier Lombardo 22, 20135 Milan, Italy
| | - Mette Nyegaard
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Michael T Overgaard
- Department of Chemistry and Bioscience, Aalborg University, Aalborg, Denmark
| | - Maria-Christina Kotta
- Istituto Auxologico Italiano IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Via Pier Lombardo 22, 20135 Milan, Italy
| | - Federica Dagradi
- Istituto Auxologico Italiano IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Via Pier Lombardo 22, 20135 Milan, Italy
| | - Luca Sala
- Istituto Auxologico Italiano IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Via Pier Lombardo 22, 20135 Milan, Italy
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
| | - Takeshi Aiba
- Division of Arrhythmia, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Mark D Ayers
- Department of Pediatrics, Division of Pediatric Cardiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Anwar Baban
- Member of the European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart: ERN GUARD-Heart
- Pediatric Cardiology and Arrhythmia/Syncope Units, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Julien Barc
- Université de Nantes, CHU Nantes, CNRS, INSERM, L’institut du Thorax, Nantes, France
| | - Cheyenne M Beach
- Pediatric Cardiology, Yale School of Medicine, New Haven, CT, USA
| | - Elijah R Behr
- Cardiology Section, Institute of Molecular and Clinical Sciences, St George’s University of London and Cardiovascular Clinical Academic Group, St George’s University Hospitals NHS Foundation Trust, UK
| | - J Martijn Bos
- Departments of Cardiovascular Medicine, Pediatric and Adolescent Medicine, and Molecular Pharmacology & Experimental Therapeutics, Division of Heart Rhythm Services and Pediatric Cardiology, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Marina Cerrone
- Inherited Arrhythmias Clinic, Leon H. Charney Division of Cardiology, NYU Grossmann School of Medicine, New York, NY, USA
| | - Peter Covi
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Bettina Cuneo
- Department of Pediatrics, Section of Cardiology, University of Denver School of Medicine, Aurora, CO, USA
| | - Isabelle Denjoy
- Centre de Référence Maladies Cardiaques Héréditaires Filière Cardiogen, Département de Rythmologie, Groupe Hospitalier Bichat-Claude Bernard, Paris, France
| | - Birgit Donner
- Kardiologie, Universitäts-Kinderspital beider Basel (UKBB), Basel, Switzerland
| | - Adrienne Elbert
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Håkan Eliasson
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Pediatric Cardiology C8:34, Karolinska University Hospital, Stockholm, Sweden
| | - Susan P Etheridge
- Department of Pediatrics, Division of Pediatric Cardiology, University of Utah and Primary Children’s Hospital, Salt Lake City, UT, USA
| | - Megumi Fukuyama
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Shiga, Japan
| | | | - Robert Hamilton
- Division of Cardiology, The Hospital for Sick Children (SickKids), Toronto, ON, Canada
| | - Minoru Horie
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Maria Iascone
- Laboratorio di Genetica Medica, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Juan Jiménez Jaimez
- Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario IBS Granada, Spain
| | - Henrik Kjærulf Jensen
- Department of Cardiology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, K-8200 Aarhus N, Denmark
| | - Prince J Kannankeril
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Juan P Kaski
- Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Science, University College London, Zayed Centre for Research into Rare Disease in Childhood, London, UK
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, UK
| | - Naomasa Makita
- National Cerebral and Cardiovascular Center, Suita, Japan
- Sapporo Teishinkai Hospital, Sapporo, Japan
| | - Carmen Muñoz-Esparza
- Member of the European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart: ERN GUARD-Heart
- Inherited Cardiac Disease Unit, Hospital Universitario Virgen Arrixaca, Murcia, Spain
| | - Hans H Odland
- Department of Cardiology and Pediatric Cardiology, Section for Arrhythmias, Oslo University Hospital, Oslo, Norway
| | - Seiko Ohno
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - John Papagiannis
- Pediatric and Adult Congenital Heart Disease, Onassis Cardiac Surgery Center, Athens, Greece
| | - Alessandra Pia Porretta
- Unité des Troubles du Rythme, Service de Cardiologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Christopher Prandstetter
- Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Department of Pediatric Cardiology, Kepler University Hospital, Linz, Austria
| | - Vincent Probst
- Service de Cardiologie, L’institut du Thorax, CHU Nantes, Nantes, France
| | - Tomas Robyns
- Member of the European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart: ERN GUARD-Heart
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Eric Rosenthal
- Evelina London Children’s Hospital, St Thomas’ Hospital, London, UK
| | - Ferran Rosés-Noguer
- Member of the European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart: ERN GUARD-Heart
- Lead Paediatric Cardiology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Royal Brompton Hospital NHS Guy’s and St Thomas Foundation Trust, London, UK
| | - Nicole Sekarski
- Unité de Cardiologie Pédiatrique, Département Médico-Chirurgical de Pédiatrie, CHUV | Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Anoop Singh
- Department of Pediatrics, Medical College of Wisconsin, Wauwatosa, WI, USA
| | | | - Fridrike Stute
- Department of Pediatric Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - Jacob Tfelt-Hansen
- Member of the European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart: ERN GUARD-Heart
- Section of Genetics, Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Denmark
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jan Till
- Royal Brompton Hospital NHS Guy’s and St Thomas Foundation Trust, London, UK
| | - Kathryn E Tobert
- Departments of Cardiovascular Medicine, Pediatric and Adolescent Medicine, and Molecular Pharmacology & Experimental Therapeutics, Division of Heart Rhythm Services and Pediatric Cardiology, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | | | - Gregory Webster
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Arthur A M Wilde
- Member of the European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart: ERN GUARD-Heart
- Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, The Netherlands
| | - Cordula M Wolf
- Center for Rare Congenital Heart Diseases, Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Center Munich, Technical University Munich, School of Medicine & Health, Munich, Germany
| | - Michael J Ackerman
- Departments of Cardiovascular Medicine, Pediatric and Adolescent Medicine, and Molecular Pharmacology & Experimental Therapeutics, Division of Heart Rhythm Services and Pediatric Cardiology, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Peter J Schwartz
- Istituto Auxologico Italiano IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Via Pier Lombardo 22, 20135 Milan, Italy
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Current Knowledge and Recent Advances of Right Ventricular Molecular Biology and Metabolism from Congenital Heart Disease to Chronic Pulmonary Hypertension. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1981568. [PMID: 29581963 PMCID: PMC5822779 DOI: 10.1155/2018/1981568] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 12/20/2017] [Indexed: 11/18/2022]
Abstract
Studies about pulmonary hypertension and congenital heart diseases have introduced the concept of right ventricular remodeling leading these pathologies to a similar outcome: right ventricular failure. However right ventricular remodeling is also a physiological process that enables the normal fetal right ventricle to adapt at birth and gain its adult phenotype. The healthy mature right ventricle is exposed to low pulmonary vascular resistances and is compliant. However, in the setting of chronic pressure overload, as in pulmonary hypertension, or volume overload, as in congenital heart diseases, the right ventricle reverts back to a fetal phenotype to sustain its function. Mechanisms include angiogenic changes and concomitant increased metabolic activity to maintain energy production. Eventually, the remodeled right ventricle cannot resist the increased afterload, leading to right ventricular failure. After comparing the fetal and adult healthy right ventricles, we sought to review the main metabolic and cellular changes occurring in the setting of PH and CHD. Their association with RV function and potential impact on clinical practice will also be discussed.
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Bond AR, Iacobazzi D, Abdul-Ghani S, Ghorbel M, Heesom K, Wilson M, Gillett C, George SJ, Caputo M, Suleiman S, Tulloh RMR. Changes in contractile protein expression are linked to ventricular stiffness in infants with pulmonary hypertension or right ventricular hypertrophy due to congenital heart disease. Open Heart 2018; 5:e000716. [PMID: 29344379 PMCID: PMC5761287 DOI: 10.1136/openhrt-2017-000716] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 11/15/2017] [Accepted: 11/18/2017] [Indexed: 12/12/2022] Open
Abstract
Background The right ventricle (RV) is not designed to sustain high pressure leading to failure. There are no current medications to help RV contraction, so further information is required on adaption of the RV to such hypertension. Methods The Right Ventricle in Children (RVENCH) study assessed infants with congenital heart disease undergoing cardiac surgery with hypertensive RV. Clinical and echocardiographic data were recorded, and samples of RV were taken from matched infants, analysed for proteomics and compared between pathologies and with clinical and echocardiographic outcome data. Results Those with tetralogy of Fallot (TOF) were significantly more cyanosed than those with ventricular septal defect (median oxygen saturation 83% vs 98%, P=0.0038), had significantly stiffer RV (tricuspid E wave/A wave ratio 1.95 vs 0.84, P=0.009) and had most had restrictive physiology. Gene ontology in TOF, with enrichment analysis, demonstrated significant increase in proteins of contractile mechanisms and those of calmodulin, actin binding and others associated with contractility than inventricular septal defect. Structural proteins were also found to be higher in association with sarcomeric function: Z-disc, M-Band and thin-filament proteins. Remaining proteins associated with actin binding, calcium signalling and myocyte cytoskeletal development. Phosphopeptide enrichment led to higher levels of calcium signalling proteins in TOF. Conclusion This is the first demonstration that those with an RV, which is stiff and hypertensive in TOF, have a range of altered proteins, often in calcium signalling pathways. Information about these alterations might guide treatment options both in terms of individualised therapy or inotropic support for the Right ventricle when hypertensive due to pulmoanry hypertension or congenital heart disease.
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Affiliation(s)
- Andrew R Bond
- Clinical Sciences, Bristol Heart Institute, Bristol Royal Infirmary, Bristol, UK
| | - Dominga Iacobazzi
- Clinical Sciences, Bristol Heart Institute, Bristol Royal Infirmary, Bristol, UK
| | - Safa Abdul-Ghani
- Clinical Sciences, Bristol Heart Institute, Bristol Royal Infirmary, Bristol, UK
| | - Mohammed Ghorbel
- Clinical Sciences, Bristol Heart Institute, Bristol Royal Infirmary, Bristol, UK
| | - Kate Heesom
- Proteomics Facility, University of Bristol, Bristol, UK
| | | | | | - Sarah J George
- Clinical Sciences, Bristol Heart Institute, Bristol Royal Infirmary, Bristol, UK
| | - Massimo Caputo
- Clinical Sciences, Bristol Heart Institute, Bristol Royal Infirmary, Bristol, UK.,Department of Congenital Heart Disease, King David Building, Bristol, UK
| | - Saadeh Suleiman
- Clinical Sciences, Bristol Heart Institute, Bristol Royal Infirmary, Bristol, UK
| | - Robert M R Tulloh
- Clinical Sciences, Bristol Heart Institute, Bristol Royal Infirmary, Bristol, UK.,Department of Congenital Heart Disease, King David Building, Bristol, UK
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Wu Y, Xu J, Chen J, Zou M, Rusidanmu A, Yang R. Blocking transferrin receptor inhibits the growth of lung adenocarcinoma cells in vitro. Thorac Cancer 2017; 9:253-261. [PMID: 29286585 PMCID: PMC5792724 DOI: 10.1111/1759-7714.12572] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 11/08/2017] [Accepted: 11/08/2017] [Indexed: 12/19/2022] Open
Abstract
Background Transferrin receptor (TfR) is expressed in most lung cancers and is an indicator of poor prognosis in certain groups of patients. In this study, we blocked cell surface TfR to inhibit lung adenocarcinoma (LAC) cell growth in vitro and investigated the associated molecular mechanisms to determine a potential therapeutic target in human LAC. Methods RNA interference and antibody blocking techniques were used to block the function of TfR in LAC cells, and cell proliferation assays were used to detect the results. Affymetrix microarray analysis was conducted using H1299 cells in which TfR was blocked with an antibody to investigate the molecular mechanisms involved. Results The cell proliferation assay demonstrated that H1299 cell proliferation was significantly inhibited after small interfering RNA knockdown or blocking of TfR. Mechanistic studies found that 100 genes were altered more than two‐fold after TfR was blocked and that blocking TfR was accompanied by decreased expression of the oncogene KRAS. Conclusion Our data provide evidence that blocking TfR could significantly inhibit LAC proliferation by targeting the oncogene KRAS; therefore, TfR may be a therapeutic target for LAC. In addition, our results suggest a new method for blocking the signal from the oncogene KRAS by targeting TfR in LAC.
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Affiliation(s)
- Yihe Wu
- Department of Thoracic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jinming Xu
- Department of Thoracic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jinbo Chen
- College of Medicine, Zhejiang University, Hangzhou, China
| | - Meirong Zou
- College of Medicine, Zhejiang University, Hangzhou, China
| | - Aizemaiti Rusidanmu
- Department of Thoracic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Rong Yang
- Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Huang P, Shen Z, Yu W, Huang Y, Tang C, Du J, Jin H. Hydrogen Sulfide Inhibits High-Salt Diet-Induced Myocardial Oxidative Stress and Myocardial Hypertrophy in Dahl Rats. Front Pharmacol 2017; 8:128. [PMID: 28360857 PMCID: PMC5352693 DOI: 10.3389/fphar.2017.00128] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 03/01/2017] [Indexed: 12/27/2022] Open
Abstract
The study aimed to examine the protective effect of hydrogen sulfide (H2S) on high-salt-induced oxidative stress and myocardial hypertrophy in salt-sensitive (Dahl) rats. Thirty male Dahl rats and 40 SD rats were included in the study. They were randomly divided into Dahl control (Dahl + NS), Dahl high salt (Dahl + HS), Dahl + HS + NaHS, SD + NS, SD + HS, SD + HS + NaHS, and SD + HS + hydroxylamine (HA). Rats in Dahl + NS and SD + NS groups were given chow with 0.5% NaCl and 0.9% normal saline intraperitoneally daily. Myocardial structure, α-myosin heavy chain (α-MHC) and β-myosin heavy chain (β-MHC) expressions were determined. Endogenous myocardial H2S pathway and oxidative stress in myocardial tissues were tested. Myocardial H2S pathway was downregulated with myocardial hypertrophy featured by increased heart weight/body weight and cardiomyocytes cross-sectional area, decreased α-MHC and increased β-MHC expressions in Dahl rats with high-salt diet (all P < 0.01), and oxidative stress in myocardial tissues was significantly activated, demonstrated by the increased contents of hydroxyl radical, malondialdehyde and oxidized glutathione and decreased total antioxidant capacity, carbon monoxide, catalase, glutathione, glutathione peroxidase, superoxide dismutase (SOD) activities and decreased SOD1 and SOD2 protein expressions (P < 0.05, P < 0.01). However, H2S reduced myocardial hypertrophy with decreased heart weight/body weight and cardiomyocytes cross-sectional area, increased α-MHC, decreased β-MHC expressions and inhibited oxidative stress in myocardial tissues of Dahl rats with high-salt diet. However, no significant difference was found in H2S pathway, myocardial structure, α-MHC and β-MHC protein and oxidative status in myocardial tissues among SD + NS, SD + HS, and SD + HS + NaHS groups. HA, an inhibitor of cystathionine β-synthase, inhibited myocardial H2S pathway (P < 0.01), and stimulated myocardial hypertrophy and oxidative stress in SD rats with high-salt diet. Hence, H2S inhibited myocardial hypertrophy in high salt-stimulated Dahl rats in association with the enhancement of antioxidant capacity, thereby inhibiting oxidative stress in myocardial tissues.
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Affiliation(s)
- Pan Huang
- Department of Pediatrics, Peking University First Hospital Beijing, China
| | - Zhizhou Shen
- Department of Pediatrics, Peking University First Hospital Beijing, China
| | - Wen Yu
- Department of Pediatrics, Peking University First Hospital Beijing, China
| | - Yaqian Huang
- Department of Pediatrics, Peking University First Hospital Beijing, China
| | - Chaoshu Tang
- Department of Physiology and Pathophysiology, Peking University Health Science Centre Beijing, China
| | - Junbao Du
- Department of Pediatrics, Peking University First HospitalBeijing, China; Key Laboratory of Molecular Cardiology, Ministry of Education, Peking UniversityBeijing, China
| | - Hongfang Jin
- Department of Pediatrics, Peking University First Hospital Beijing, China
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Iacobazzi D, Suleiman MS, Ghorbel M, George SJ, Caputo M, Tulloh RM. Cellular and molecular basis of RV hypertrophy in congenital heart disease. Heart 2015; 102:12-7. [PMID: 26516182 PMCID: PMC4717403 DOI: 10.1136/heartjnl-2015-308348] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 09/11/2015] [Indexed: 01/13/2023] Open
Abstract
RV hypertrophy (RVH) is one of the triggers of RV failure in congenital heart disease (CHD). Therefore, improving our understanding of the cellular and molecular basis of this pathology will help in developing strategic therapeutic interventions to enhance patient benefit in the future. This review describes the potential mechanisms that underlie the transition from RVH to RV failure. In particular, it addresses structural and functional remodelling that encompass contractile dysfunction, metabolic changes, shifts in gene expression and extracellular matrix remodelling. Both ischaemic stress and reactive oxygen species production are implicated in triggering these changes and will be discussed. Finally, RV remodelling in response to various CHDs as well as the potential role of biomarkers will be addressed.
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Affiliation(s)
- D Iacobazzi
- School of Clinical Sciences, Bristol Royal Infirmary, Bristol, UK
| | - M-S Suleiman
- School of Clinical Sciences, Bristol Royal Infirmary, Bristol, UK
| | - M Ghorbel
- School of Clinical Sciences, Bristol Royal Infirmary, Bristol, UK
| | - S J George
- School of Clinical Sciences, Bristol Royal Infirmary, Bristol, UK
| | - M Caputo
- School of Clinical Sciences, Bristol Royal Infirmary, Bristol, UK Department of Congenital Heart Disease, Bristol Royal Hospital for Children, Bristol, UK
| | - R M Tulloh
- School of Clinical Sciences, Bristol Royal Infirmary, Bristol, UK Department of Congenital Heart Disease, Bristol Royal Hospital for Children, Bristol, UK
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Boczek NJ, Ye D, Jin F, Tester DJ, Huseby A, Bos JM, Johnson AJ, Kanter R, Ackerman MJ. Identification and Functional Characterization of a Novel CACNA1C-Mediated Cardiac Disorder Characterized by Prolonged QT Intervals With Hypertrophic Cardiomyopathy, Congenital Heart Defects, and Sudden Cardiac Death. Circ Arrhythm Electrophysiol 2015; 8:1122-32. [PMID: 26253506 PMCID: PMC5094060 DOI: 10.1161/circep.115.002745] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 07/23/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND A portion of sudden cardiac deaths can be attributed to structural heart diseases, such as hypertrophic cardiomyopathy (HCM) or cardiac channelopathies such as long-QT syndrome (LQTS); however, the underlying molecular mechanisms are distinct. Here, we identify a novel CACNA1C missense mutation with mixed loss-of-function/gain-of-function responsible for a complex phenotype of LQTS, HCM, sudden cardiac death, and congenital heart defects. METHODS AND RESULTS Whole exome sequencing in combination with Ingenuity variant analysis was completed on 3 affected individuals and 1 unaffected individual from a large pedigree with concomitant LQTS, HCM, and congenital heart defects and identified a novel CACNA1C mutation, p.Arg518Cys, as the most likely candidate mutation. Mutational analysis of exon 12 of CACNA1C was completed on 5 additional patients with a similar phenotype of LQTS plus a personal or family history of HCM-like phenotypes and identified 2 additional pedigrees with mutations at the same position, p.Arg518Cys/His. Whole cell patch clamp technique was used to assess the electrophysiological effects of the identified mutations in CaV1.2 and revealed a complex phenotype, including loss of current density and inactivation in combination with increased window and late current. CONCLUSIONS Through whole exome sequencing and expanded cohort screening, we identified a novel genetic substrate p.Arg518Cys/His-CACNA1C, in patients with a complex phenotype including LQTS, HCM, and congenital heart defects annotated as cardiac-only Timothy syndrome. Our electrophysiological studies, identification of mutations at the same amino acid position in multiple pedigrees, and cosegregation with disease in these pedigrees provide evidence that p.Arg518Cys/His is the pathogenic substrate for the observed phenotype.
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Affiliation(s)
- Nicole J Boczek
- From the Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (N.J.B., D.Y., D.J.T., J.M.B., M.J.A.), Division of Immunology and Neurology (F.J., A.H., A.J.J.), and Departments of Medicine (Division of Cardiovascular Diseases) and Pediatrics (Division of Pediatric Cardiology) (M.J.A.), Mayo Clinic, Rochester, MN; Division of Cardiology, Nicklaus Children's Hospital, Miami, FL (R.K.)
| | - Dan Ye
- From the Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (N.J.B., D.Y., D.J.T., J.M.B., M.J.A.), Division of Immunology and Neurology (F.J., A.H., A.J.J.), and Departments of Medicine (Division of Cardiovascular Diseases) and Pediatrics (Division of Pediatric Cardiology) (M.J.A.), Mayo Clinic, Rochester, MN; Division of Cardiology, Nicklaus Children's Hospital, Miami, FL (R.K.)
| | - Fang Jin
- From the Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (N.J.B., D.Y., D.J.T., J.M.B., M.J.A.), Division of Immunology and Neurology (F.J., A.H., A.J.J.), and Departments of Medicine (Division of Cardiovascular Diseases) and Pediatrics (Division of Pediatric Cardiology) (M.J.A.), Mayo Clinic, Rochester, MN; Division of Cardiology, Nicklaus Children's Hospital, Miami, FL (R.K.)
| | - David J Tester
- From the Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (N.J.B., D.Y., D.J.T., J.M.B., M.J.A.), Division of Immunology and Neurology (F.J., A.H., A.J.J.), and Departments of Medicine (Division of Cardiovascular Diseases) and Pediatrics (Division of Pediatric Cardiology) (M.J.A.), Mayo Clinic, Rochester, MN; Division of Cardiology, Nicklaus Children's Hospital, Miami, FL (R.K.)
| | - April Huseby
- From the Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (N.J.B., D.Y., D.J.T., J.M.B., M.J.A.), Division of Immunology and Neurology (F.J., A.H., A.J.J.), and Departments of Medicine (Division of Cardiovascular Diseases) and Pediatrics (Division of Pediatric Cardiology) (M.J.A.), Mayo Clinic, Rochester, MN; Division of Cardiology, Nicklaus Children's Hospital, Miami, FL (R.K.)
| | - J Martijn Bos
- From the Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (N.J.B., D.Y., D.J.T., J.M.B., M.J.A.), Division of Immunology and Neurology (F.J., A.H., A.J.J.), and Departments of Medicine (Division of Cardiovascular Diseases) and Pediatrics (Division of Pediatric Cardiology) (M.J.A.), Mayo Clinic, Rochester, MN; Division of Cardiology, Nicklaus Children's Hospital, Miami, FL (R.K.)
| | - Aaron J Johnson
- From the Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (N.J.B., D.Y., D.J.T., J.M.B., M.J.A.), Division of Immunology and Neurology (F.J., A.H., A.J.J.), and Departments of Medicine (Division of Cardiovascular Diseases) and Pediatrics (Division of Pediatric Cardiology) (M.J.A.), Mayo Clinic, Rochester, MN; Division of Cardiology, Nicklaus Children's Hospital, Miami, FL (R.K.)
| | - Ronald Kanter
- From the Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (N.J.B., D.Y., D.J.T., J.M.B., M.J.A.), Division of Immunology and Neurology (F.J., A.H., A.J.J.), and Departments of Medicine (Division of Cardiovascular Diseases) and Pediatrics (Division of Pediatric Cardiology) (M.J.A.), Mayo Clinic, Rochester, MN; Division of Cardiology, Nicklaus Children's Hospital, Miami, FL (R.K.)
| | - Michael J Ackerman
- From the Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory (N.J.B., D.Y., D.J.T., J.M.B., M.J.A.), Division of Immunology and Neurology (F.J., A.H., A.J.J.), and Departments of Medicine (Division of Cardiovascular Diseases) and Pediatrics (Division of Pediatric Cardiology) (M.J.A.), Mayo Clinic, Rochester, MN; Division of Cardiology, Nicklaus Children's Hospital, Miami, FL (R.K.).
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Identification of Region-Specific Myocardial Gene Expression Patterns in a Chronic Swine Model of Repaired Tetralogy of Fallot. PLoS One 2015; 10:e0134146. [PMID: 26252659 PMCID: PMC4529093 DOI: 10.1371/journal.pone.0134146] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 07/06/2015] [Indexed: 12/20/2022] Open
Abstract
Surgical repair of Tetralogy of Fallot (TOF) is highly successful but may be complicated in adulthood by arrhythmias, sudden death, and right ventricular or biventricular dysfunction. To better understand the molecular and cellular mechanisms of these delayed cardiac events, a chronic animal model of postoperative TOF was studied using microarrays to perform cardiac transcriptomic studies. The experimental study included 12 piglets (7 rTOF and 5 controls) that underwent surgery at age 2 months and were further studied after 23 (+/- 1) weeks of postoperative recovery. Two distinct regions (endocardium and epicardium) from both ventricles were analyzed. Expression levels from each localization were compared in order to decipher mechanisms and signaling pathways leading to ventricular dysfunction and arrhythmias in surgically repaired TOF. Several genes were confirmed to participate in ventricular remodeling and cardiac failure and some new candidate genes were described. In particular, these data pointed out FRZB as a heart failure marker. Moreover, calcium handling and contractile function genes (SLN, ACTC1, PLCD4, PLCZ), potential arrhythmia-related genes (MYO5B, KCNA5), and cytoskeleton and cellular organization-related genes (XIRP2, COL8A1, KCNA6) were among the most deregulated genes in rTOF ventricles. To our knowledge, this is the first comprehensive report on global gene expression profiling in the heart of a long-term swine model of repaired TOF.
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Heart failure in congenital heart disease: the role of genes and hemodynamics. Pflugers Arch 2014; 466:1025-35. [DOI: 10.1007/s00424-014-1447-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 01/07/2014] [Indexed: 12/28/2022]
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