1
|
Xie Q, Liu C, Liu F, Zhang X, Zhang Z, An X, Yang Y, Li X. Predictive Effect of Alternative Insulin Resistance Indexes on Adverse Cardiovascular Events in Patients with Metabolic Syndrome with Heart Failure. Diabetes Metab Syndr Obes 2024; 17:2347-2356. [PMID: 38881693 PMCID: PMC11178087 DOI: 10.2147/dmso.s457598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 05/20/2024] [Indexed: 06/18/2024] Open
Abstract
Purpose Metabolic Syndrome (MS) greatly increases the risk of heart disease and Heart Failure(HF). Insulin Resistance (IR) is considered to be the key to the pathophysiology of MS. The purpose of this study was to evaluate the predictive effect of different alternative indicators of IR on adverse cardiovascular events in patients with MS complicated with HF. Methods Patients with HF who were diagnosed with MS in the heart center of the first affiliated Hospital of Xinjiang Medical University were selected continuously. The baseline data of the patients in the group were compared. The diagnostic value of alternative indexes of IR was evaluated by the working characteristic curve of subjects. The relationship between different alternative indicators of IR and survival rate was evaluated by survival curve. COX regression was used to analyze the effects of different alternative indicators of IR on the risk of end-point events. Results The levels of TyG, TyG-BMI, TyG-WC, TG/HDL-C and METS-IR were significantly increased in patients with Major Adverse Cardiovascular Events (MACEs). Among the five alternative indexes of IR, METS-IR had the highest AUC (0.691, 95% CI:0.657-0.752, P < 0.001) in predicting MACEs. No matter which alternative index of IR was used, the survival rate of MACEs in High group was significantly decreased. TyG, TyG-BMI, TyG-WC, TG/HDL-C and METS-IR can independently predict the occurrence of MACEs events, even if some confounding factors are adjusted. Conclusion Our study shows that alternative indicators of IR, especially METS-IR, are independently associated with adverse cardiovascular events in patients with MS and HF.
Collapse
Affiliation(s)
- Qian Xie
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China
| | - Chang Liu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China
| | - Fen Liu
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China
| | - Xuehe Zhang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China
| | - Zhiyang Zhang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China
| | - Xin An
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China
| | - Yining Yang
- Department of Cardiology, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi, People's Republic of China
- Xinjiang Key Laboratory of Cardiovascular Homeostasis and Regeneration Research, Urumqi, People's Republic of China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, People's Republic of China
- Key Laboratory of Cardiovascular Disease Research, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China
| | - Xiaomei Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China
| |
Collapse
|
2
|
Fukumoto Y. Impact of female sexual dysfunction on cardiovascular diseases. Eur J Prev Cardiol 2024; 31:780-781. [PMID: 38365264 DOI: 10.1093/eurjpc/zwae051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Affiliation(s)
- Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, 830-0011 Kurume, Japan
| |
Collapse
|
3
|
Chung G, Kim HJ. Lifestyle and Health Behaviors Associated with Metabolic Syndrome and Cardiovascular Disease. Metab Syndr Relat Disord 2024; 22:105-113. [PMID: 38011536 DOI: 10.1089/met.2023.0152] [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] [Indexed: 11/29/2023] Open
Abstract
Background: As the prevalence of cardiovascular disease increases, the socioeconomic burden is expected to increase further. This study aimed to investigate lifestyle and health behaviors related to metabolic syndrome (MetS), myocardial infarction (MI), and stroke prevalence in men and women 50-79 years of age to assess clustering of risk factors. Methods: This study used raw data from the eighth Korea National Health and Nutrition Examination Survey (KNHANES) in 2021. Collected data were analyzed using SPSS 29.0 program. Complex Samples General Linear Model procedure and Complex Samples Logistic Regression procedure were performed. Results: Body mass index of more than 25.0 kg/m2, being a woman, having a middle school education or less, reporting a lower middle economic status, and performing exercise for less than 150 min a week were associated with MetS prevalence. Stress was associated with MI prevalence in men and women. Depression was associated with stroke prevalence in men. Conclusions: This study found that an education on obesity control in men and women is needed to reduce the prevalence of MetS. To reduce the prevalence of MI, stress management is required for men and women. To decrease stroke prevalence, depression management is needed for men.
Collapse
Affiliation(s)
- Goeun Chung
- Department of Public Health Medical Service, Jeju National University Hospital, Jeju, Republic of Korea
| | - Hye-Jin Kim
- Department of Nursing, College of Medicine, University of Ulsan, Ulsan, Republic of Korea
| |
Collapse
|
4
|
Ruiz-García A, Serrano-Cumplido A, Escobar-Cervantes C, Arranz-Martínez E, Turégano-Yedro M, Pallarés-Carratalá V. Heart Failure Prevalence Rates and Its Association with Other Cardiovascular Diseases and Chronic Kidney Disease: SIMETAP-HF Study. J Clin Med 2023; 12:4924. [PMID: 37568326 PMCID: PMC10419820 DOI: 10.3390/jcm12154924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Heart failure (HF) is a major health problem that causes high mortality and hospitalization rates. This study aims to determine the HF prevalence rates in populations aged both ≥18 years and ≥50 years and to assess its association with cardiovascular diseases and chronic kidney disease. METHODS A cross-sectional observational study was conducted in a primary care setting, with a population-based random sample of 6588 people aged 18.0-102.8 years. Crude and adjusted prevalence rates of HF were calculated. The associations of renal and cardiometabolic factors with HF were assessed in both populations using univariate, bivariate and multivariate analysis. RESULTS The HF crude prevalence rates were 2.8% (95%CI: 2.4-3.2) in adults (≥18 years), and 4.6% (95%CI: 4.0-5.3) in the population aged ≥ 50 years, without significant differences between males and females in both populations. The age- and sex-adjusted prevalence rates were 2.1% (male: 1.9%; female: 2.3%) in the overall adult population, and 4.5% (male: 4.2%; female: 4.8%) in the population aged ≥ 50 years, reaching 10.0% in the population aged ≥ 70 years. Atrial fibrillation, hypertension, low estimated glomerular filtration rate (eGFR), coronary heart disease (CHD), stroke, sedentary lifestyle, and diabetes were independently associated with HF in both populations. A total of 95.7% (95%CI: 92.7-98.6) of the population with HF had an elevated cardiovascular risk. CONCLUSIONS This study reports that HF prevalence increases from 4.5% in the population over 50 years to 10% in the population over 70 years. The main clinical conditions that are HF-related are sedentary lifestyle, atrial fibrillation, hypertension, diabetes, low eGFR, stroke, and CHD.
Collapse
Affiliation(s)
- Antonio Ruiz-García
- Pinto Primary Care Center, Lipids and Cardiovascular Prevention Unit, University Health Centre, 28320 Madrid, Spain;
- Department of Medicine, European University of Madrid, 28005 Madrid, Spain
| | | | | | | | | | - Vicente Pallarés-Carratalá
- Health Surveillance Unit, Mutual Insurance Union, 12004 Castellon, Spain
- Department of Medicine, Jaume I University, 12006 Castellon, Spain
| |
Collapse
|
5
|
Sun J, Shimozono K, Adachi H, Nohara S, Shibata T, Sugiyama Y, Fukumoto Y. Trends in the Prevalence of Cancer in Cardiovascular Diseases: A Single Center Retrospective Study, 2011-2018. Kurume Med J 2023; 67:147-161. [PMID: 36464275 DOI: 10.2739/kurumemedj.ms674007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Recent progress of cancer therapy has increased the number of cancer survivors, in whom cardiovascular diseases (CVDs) have become a big concern. This study aimed to clarify the prevalence of various types of CVDs in cancer patients, using the database of the Cardiovascular Medicine in Kurume University Hospital. METHODS AND RESULTS This retrospective cohort study enrolled 11,093 hospitalized patients in Cardiovascular Medicine, Kurume University Hospital from April 2011 to March 2019. Among 11,093 enrolled patients, there were 992 CVDs patients with cancer (8.94%). The five most prevalent forms of cancer were colon cancer, prostate cancer, hepatocellular carcinoma, lung cancer, and gastric cancer. Although there was no statistical significance, the comorbidity of breast cancer gradually increased during the study period (2011-2018). In all CVDs, prostate cancer, lung cancer, and uterine cancer tended to increase as comorbidities, while hepatocellular carcinoma and tongue cancer tended to decrease during the observational period. The absolute number of patients with cancer increased in all CVDs, including coronary artery diseases, heart failure, arrhythmia, and pulmonary hypertension. CONCLUSIONS The present study demonstrates that the prevalence of cancer in hospitalized CVDs patients was around 10%, and is showing a tendency to increase. Thus, cancer may have substantial impacts on CVDs treatment.
Collapse
Affiliation(s)
- Jiahui Sun
- Division of Cardiovascular Medicine, Department of Internal Medicine
| | | | - Hisashi Adachi
- Department of Community Medicine, Kurume University School of Medicine
| | - Shoichiro Nohara
- Division of Cardiovascular Medicine, Department of Internal Medicine
| | - Tatsuhiro Shibata
- Division of Cardiovascular Medicine, Department of Internal Medicine
| | - Yoichi Sugiyama
- Division of Cardiovascular Medicine, Department of Internal Medicine
| | | |
Collapse
|
6
|
Ittermann T, Dörr M, Markus MRP, Nauck M, Jürgens C, Schipf S, Schmidt CO, Völzke H, Richter A. Variability of biomarkers used for the classification of metabolic syndrome: A repeated measurements study. Nutr Metab Cardiovasc Dis 2022; 32:1693-1702. [PMID: 35469729 DOI: 10.1016/j.numecd.2022.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS The definition of the metabolic syndrome consists of five components. The underlying measurements are subject to intra-individual variability. This repeated measurements study investigated the impact of intra-individual measurement variability on the stability of the diagnosis of metabolic syndrome over 12 months. METHODS AND RESULTS Twenty-five employees of the University Medicine Greifswald aged 22-70 years were examined once a month over one year. Examinations included blood sampling and anthropometric and blood pressure measurements. Laboratory measurements included glucose, cholesterol (high-density lipoprotein [HDL], and low-density lipoprotein [LDL]), and triglycerides. The metabolic syndrome was defined according to the International Diabetes Federation modified for non-fasting blood samples. Variations in continuous metabolic markers were assessed using coefficients of variation (CV) and intra-class correlation coefficients (ICC). Overall eight participants (32%) were categorized at least once within 12 months as having a metabolic syndrome; in none of those metabolic syndrome was found consistently over the study follow-ups. The Cohen's Kappa for metabolic syndrome was 0.57. CV was highest for triglycerides (27.5%) followed by glucose (10.1%), LDL- (9.5%), and HDL-cholesterol (8.6%). ICC's were lowest for glucose (0.51), triglycerides (0.65), systolic (0.68), and diastolic blood pressure (0.69). CONCLUSION We showed that the measurement of biomarkers defining the metabolic syndrome is a time-varying condition with implications for the concept of the metabolic syndrome. To account for this uncertainty in prevalence studies we propose to identify uncertain cases according to the current definition of the metabolic syndrome. For analysing associations we recommend to apply probabilistic sensitivity analyses.
Collapse
Affiliation(s)
- Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner site Greifswald, Greifswald, Germany.
| | - Marcus Dörr
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner site Greifswald, Greifswald, Germany
| | - Marcello R P Markus
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner site Greifswald, Greifswald, Germany; German Center for Diabetes Research (DZD), Partner site Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner site Greifswald, Greifswald, Germany
| | - Clemens Jürgens
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - Sabine Schipf
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - Carsten O Schmidt
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner site Greifswald, Greifswald, Germany
| | - Adrian Richter
- Institute for Community Medicine, University Medicine Greifswald, Germany
| |
Collapse
|
7
|
Badin JK, Eggenberger C, Rodenbeck SD, Hashmi ZA, Wang IW, Garcia JP, Alloosh M, Sturek M. Intracellular Ca 2+ Dysregulation in Coronary Smooth Muscle Is Similar in Coronary Disease of Humans and Ossabaw Miniature Swine. J Cardiovasc Transl Res 2022; 15:167-178. [PMID: 34286469 PMCID: PMC10620470 DOI: 10.1007/s12265-021-10153-5] [Citation(s) in RCA: 2] [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: 12/30/2020] [Accepted: 07/02/2021] [Indexed: 12/31/2022]
Abstract
Intracellular free Ca2+ ([Ca2+]i) dysregulation occurs in coronary smooth muscle (CSM) in atherosclerotic coronary artery disease (CAD) of metabolic syndrome (MetS) swine. Our goal was to determine how CAD severity, arterial structure, and MetS risk factors associate with [Ca2+]i dysregulation in human CAD compared to changes in Ossabaw miniature swine. CSM cells were dispersed from coronary arteries of explanted hearts from transplant recipients and from lean and MetS swine with CAD. CSM [Ca2+]i elicited by Ca2+ influx and sarcoplasmic reticulum (SR) Ca2+ release and sequestration was measured with fura-2. Increased [Ca2+]i signaling was associated with advanced age and a greater media area in human CAD. Decreased [Ca2+]i signaling was associated with a greater number of risk factors and a higher plaque burden in human and swine CAD. Similar [Ca2+]i dysregulation exhibited in human and Ossabaw swine CSM provides strong evidence for the translational relevance of this large animal model.
Collapse
Affiliation(s)
- Jill K Badin
- Department of Anatomy, Cell Biology, & Physiology, Indiana University School of Medicine, 635 Barnhill Dr., Medical Sciences, Room 385, Indianapolis, IN, 46202, USA
| | - Caleb Eggenberger
- Department of Anatomy, Cell Biology, & Physiology, Indiana University School of Medicine, 635 Barnhill Dr., Medical Sciences, Room 385, Indianapolis, IN, 46202, USA
- Marian University College of Osteopathic Medicine, Indianapolis, IN, 46222, USA
| | - Stacey Dineen Rodenbeck
- Department of Anatomy, Cell Biology, & Physiology, Indiana University School of Medicine, 635 Barnhill Dr., Medical Sciences, Room 385, Indianapolis, IN, 46202, USA
- Department of Biology, Harding University, Searcy, AR, 72149, USA
| | - Zubair A Hashmi
- Cardiothoracic Transplantation Surgery, Indiana University - Methodist Hospital, Indianapolis, IN, 46202, USA
| | - I-Wen Wang
- Cardiothoracic Transplantation Surgery, Indiana University - Methodist Hospital, Indianapolis, IN, 46202, USA
| | - Jose P Garcia
- Cardiothoracic Transplantation Surgery, Indiana University - Methodist Hospital, Indianapolis, IN, 46202, USA
| | - Mouhamad Alloosh
- Department of Anatomy, Cell Biology, & Physiology, Indiana University School of Medicine, 635 Barnhill Dr., Medical Sciences, Room 385, Indianapolis, IN, 46202, USA
| | - Michael Sturek
- Department of Anatomy, Cell Biology, & Physiology, Indiana University School of Medicine, 635 Barnhill Dr., Medical Sciences, Room 385, Indianapolis, IN, 46202, USA.
| |
Collapse
|
8
|
Zhou Y, Fu L, Sun J, Zhu Z, Xing Z, Zhou S, Tai S, Wang Y. Association Between Metabolic Syndrome and an Increased Risk of Hospitalization for Heart Failure in Population of HFpEF. Front Cardiovasc Med 2021; 8:698117. [PMID: 34595217 PMCID: PMC8476762 DOI: 10.3389/fcvm.2021.698117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/04/2021] [Indexed: 01/14/2023] Open
Abstract
Background: The association between metabolic syndrome and the development of heart failure (HF) with preserved ejection fraction (HFpEF) has not been completely clarified. Aim: To evaluate the association between metabolic syndrome and the risk of HF hospitalization for patients with HFpEF. Methods: Patient data were obtained from the American cohort of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial database. Data for the primary outcome (hospitalization for HF) and secondary outcomes (all-cause mortality, cardiovascular mortality, and all-cause hospitalization) were collected, and hazard ratios (HRs) for the patients with and without metabolic syndrome were analyzed by applying a multivariable Cox proportional hazard model. Results: Among the 1,548 total participants, 1,197 had metabolic syndrome. The patients with metabolic syndrome exhibited worse heart function and a lower quality of life than those without metabolic syndrome. During the 3.3 years of follow-up, 351 patients were hospitalized for HF. After a multivariable adjustment, the risk of hospitalization for HF and all-cause hospitalization (adjusted HR = 1.42, 95% CI: 1.01–2.00; p = 0.042 and adjusted HR = 1.27; 95% CI: 1.04–1.54; p = 0.017, respectively) were independently associated with HFpEF for the patients with metabolic syndrome. In addition, the risks of HF hospitalization and all-cause hospitalization among 267 propensity score-matched patients were higher for patients with metabolic syndrome (HR = 1.53, 95% CI = 1.05–2.23, and p = 0.025 and HR = 1.34, 95% CI = 1.08–1.67, and p = 0.009, respectively). Conclusion: The risks of HF hospitalization and all-cause hospitalization were higher for patients with HFpEF having metabolic syndrome than for those without metabolic syndrome.
Collapse
Affiliation(s)
- Ying Zhou
- Department of Blood Transfusion, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Liyao Fu
- Department of Blood Transfusion, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jiaxing Sun
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhaowei Zhu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhenhua Xing
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shenghua Zhou
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shi Tai
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yongjun Wang
- Department of Blood Transfusion, The Second Xiangya Hospital of Central South University, Changsha, China
| |
Collapse
|
9
|
Chiu LS, Pedley A, Massaro J, Benjamin EJ, Mitchell GF, McManus DD, Aragam J, Vasan RS, Cheng S, Long MT. The association of non-alcoholic fatty liver disease and cardiac structure and function-Framingham Heart Study. Liver Int 2020; 40:2445-2454. [PMID: 32654390 PMCID: PMC7669676 DOI: 10.1111/liv.14600] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease confers increased risk for cardiovascular disease, including heart failure (HF), for reasons that remain unclear. Possible pathways could involve an association of liver fat with cardiac structural or functional abnormalities even after accounting for body size. METHODS We analysed N = 2356 Framingham Heart Study participants (age 52 ± 12 years, 52% women) who underwent echocardiography and standardized computed tomography measures of liver fat. RESULTS In cross-sectional multivariable regression models adjusted for age, gender, cohort and cardiovascular risk factors, liver fat was positively associated with left ventricular (LV) mass (β = 1.45; 95% confidence interval (CI): 0.01, 2.88), LV wall thickness (β = 0.01; 95% CI: 0.00, 0.02), mass volume ratio (β = 0.02; 95% CI 0.01, 0.03), mitral peak velocity (E) (β = 0.83; 95% CI 0.31, 1.36) and LV filling pressure (E/e' ratio) (β = 0.16; 95% CI 0.09, 0.23); and inversely associated with global systolic longitudinal strain (β = 0.20, 95% CI 0.07, 0.33), diastolic annular velocity (e') (β = -0.12; 95% CI - 0.22, -0.03), and E/A ratio (β = -0.01; 95% CI - 0.02, -0.00). After additional adjustment for body mass index (BMI), statistical significance was attenuated for all associations except for that of greater liver fat with increased LV filling pressure, a possible precursor to HF (β = 0.11; 95% CI 0.03, 0.18). CONCLUSION Increased liver fat was associated with multiple subclinical cardiac dysfunction measures, with most of associations mediated by obesity. Interestingly, the association of liver fat and LV filling pressure was only partially mediated by BMI, suggesting a possible direct effect of liver fat on LV filling pressure. Further confirmatory studies are needed.
Collapse
Affiliation(s)
- Laura S. Chiu
- Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, MA
| | | | - Joseph Massaro
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study, Framingham, MA.,Department of Mathematics and Statistics, Boston University, Boston, MA, United States
| | - Emelia J. Benjamin
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study, Framingham, MA.,Section of Cardiovascular Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA,Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | | | - David D. McManus
- Cardiology Division, Department of Medicine and the Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worchester, MA
| | - Jayashri Aragam
- Cardiovascular Division, VA Boston Healthcare System, West Roxbury, MA,Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Ramachandran S. Vasan
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study, Framingham, MA.,Section of Cardiovascular Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA,Department of Epidemiology, Boston University School of Public Health, Boston, MA,Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston Medical Center, Boston, MA
| | - Susan Cheng
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Michelle T. Long
- Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, MA
| |
Collapse
|
10
|
Arcopinto M, Schiavo A, Salzano A, Bossone E, D'Assante R, Marsico F, Demelo-Rodriguez P, Baliga RR, Cittadini A, Marra AM. Metabolic Syndrome in Heart Failure: Friend or Foe? Heart Fail Clin 2019; 15:349-358. [PMID: 31079693 DOI: 10.1016/j.hfc.2019.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The interplay between metabolic syndrome (MetS) and heart failure (HF) is intricate. Population studies show that MetS confers an increased risk to develop HF and this effect is mediated by insulin resistance (IR). However, obesity, a key component in MetS and common partner of IR, is protective in patients with established HF, although IR confers an increased risk of dying by HF. Such phenomenon, known as "obesity paradox," accounts for the complexity of the HF-MetS relationship. Because IR impacts more on outcomes than MetS itself, the former may be considered the actual target for MetS in HF patients.
Collapse
Affiliation(s)
- Michele Arcopinto
- Department of Translational Medical Sciences, "Federico II" University, Via Pansini 5, 80131 Naples, Italy
| | - Alessandra Schiavo
- Department of Translational Medical Sciences, "Federico II" University, Via Pansini 5, 80131 Naples, Italy
| | - Andrea Salzano
- Department of Translational Medical Sciences, "Federico II" University, Via Pansini 5, 80131 Naples, Italy; Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, UK
| | - Eduardo Bossone
- Cardiology Division, A Cardarelli Hospital, Via Antonio Cardarelli 9, 80131 Naples, Italy
| | - Roberta D'Assante
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) SDN, Via Gianturco 113, 80142 Naples, Italy
| | - Fabio Marsico
- Department of Advanced Biomedical Sciences, Section of Cardiology, Federico II University of Naples, Via Pansini 5, 80131 Naples, Italy; Center for Congenital Heart Disease, University Hospital "Inselspital," University of Bern, Bern, Switzerland
| | - Pablo Demelo-Rodriguez
- Venous Thromboembolism Unit, Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Calle del Dr. Esquerdo, 46, 28007 Madrid, Spain; School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Ragavendra R Baliga
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Davis Heart and Lung Research Institute, 473 W 12th Avenue, Columbus, OH 43210, USA
| | - Antonio Cittadini
- Department of Translational Medical Sciences, "Federico II" University, Via Pansini 5, 80131 Naples, Italy; Interdisciplinary Research Centre in Biomedical Materials (CRIB), Via Pansini 5, 80131 Naples, Italy
| | - Alberto M Marra
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) SDN, Via Gianturco 113, 80142 Naples, Italy.
| |
Collapse
|
11
|
Bozkurt B, Aguilar D, Deswal A, Dunbar SB, Francis GS, Horwich T, Jessup M, Kosiborod M, Pritchett AM, Ramasubbu K, Rosendorff C, Yancy C. Contributory Risk and Management of Comorbidities of Hypertension, Obesity, Diabetes Mellitus, Hyperlipidemia, and Metabolic Syndrome in Chronic Heart Failure: A Scientific Statement From the American Heart Association. Circulation 2016; 134:e535-e578. [DOI: 10.1161/cir.0000000000000450] [Citation(s) in RCA: 182] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
12
|
Tadaki S, Sakata Y, Miura Y, Miyata S, Asakura M, Shimada K, Yamamoto T, Fukumoto Y, Kadokami T, Yasuda S, Miura T, Ando SI, Yano M, Kitakaze M, Daida H, Shimokawa H. Prognostic Impacts of Metabolic Syndrome in Patients With Chronic Heart Failure - A Multicenter Prospective Cohort Study. Circ J 2016; 80:677-88. [PMID: 26794282 DOI: 10.1253/circj.cj-15-0942] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) is involved in the increased risk of atherosclerotic cardiovascular diseases. We have previously reported that the prevalence of MetS is more than 2-fold greater in patients with chronic heart failure (CHF) than in the general population in Japan. However, the prognostic impact of MetS in CHF patients remains to be elucidated. METHODS AND RESULTS In the present nationwide, large-scale clinical study in Japan, we enrolled 4,762 patients with Stage C/D CHF. The prevalence of MetS by the definition of the Japanese Committee for the Diagnostic Criteria in 2005 was 41.3% (50.6% in males, 21.5% in females). MetS was characterized by higher prevalence of males, obesity and lifestyle-related comorbidities, including glucose intolerance, dyslipidemia and hypertension. Multivariate Cox hazard analysis showed that MetS was associated with increased incidence of the composite of all-cause death and atherosclerotic events in males (hazard ratio [HR] 1.28; 95% confidence interval [CI] 1.06-1.54, P=0.011) but not in females (HR 1.23, 95% CI 0.87-1.75, P=0.241). Among the components of MetS, over waist circumference and glucose intolerance were significantly associated with increased incidence of the composite endpoint (HR 1.23, P=0.038, and HR 1.29, P<0.001, respectively) in males but not in females. CONCLUSIONS The results indicate that MetS only has a negative prognostic impact in male CHF patients. (Circ J 2016; 80: 677-688).
Collapse
Affiliation(s)
- Soichiro Tadaki
- Department of Cardiovascular Medicine and Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Vaduganathan M, Michel A, Hall K, Mulligan C, Nodari S, Shah SJ, Senni M, Triggiani M, Butler J, Gheorghiade M. Spectrum of epidemiological and clinical findings in patients with heart failure with preserved ejection fraction stratified by study design: a systematic review. Eur J Heart Fail 2015; 18:54-65. [PMID: 26634799 DOI: 10.1002/ejhf.442] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 10/03/2015] [Accepted: 10/09/2015] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Heart failure with preserved ejection fraction (HFpEF) represents a major global and economic burden, but its epidemiological, clinical, and outcome data have varied according to study design. METHODS AND RESULTS We conducted a systematic review of published HFpEF clinical trials and observational studies (community-based studies and registries) from August 1998 to July 2013 using PubMed and EMBASE databases. Two independent investigators manually screened and extracted relevant data. We included 62 articles (19 describing clinical trials, 12 describing community-based observational studies, and 31 describing registries). The ejection fraction (EF) cut-off values ranged widely for HFpEF from >40% to >55%. However, differences in EF cut-offs were not clearly associated with incidence and prevalence data across studies. Of all patients with heart failure in community studies, 33-84% had HFpEF, which tended to be higher than reported in registries. The HFpEF patients in included studies were primarily older, white (>70%) patients with hypertension (∼50-90%) and coronary artery disease (up to 60%). All-cause mortality and all-cause hospitalizations ranged from 13% to 23% (26-50 months follow-up) and 55% to 67% (37-50 months follow-up), respectively, in clinical trials; cardiovascular causes accounted for 70% of both outcomes. All-cause mortality tended to be higher in registries than in clinical trials and community-based observational studies up to 5 years into follow-up. CONCLUSIONS Important differences in EF thresholds, epidemiological indices, clinical profiles, treatment patterns, and outcomes exist across contemporary HFpEF clinical trials, observational studies, and registries. Precision in definition and inclusion of more uniform populations may facilitate improved profiling of HFpEF patients.
Collapse
Affiliation(s)
- Muthiah Vaduganathan
- Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA, USA
| | | | - Kathryn Hall
- Research Evaluation Unit, Oxford PharmaGenesis, Oxford, UK
| | | | - Savina Nodari
- Department of Experimental and Applied Medicine - Section of Cardiovascular Diseases, University of Brescia, Brescia, Italy
| | - Sanjiv J Shah
- Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, 201 East Huron, Galter 3-150, Chicago, IL, USA
| | - Michele Senni
- Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovannni XXIII, Bergamo, Italy
| | - Marco Triggiani
- Department of Experimental and Applied Medicine - Section of Cardiovascular Diseases, University of Brescia, Brescia, Italy
| | - Javed Butler
- Division of Cardiology, Stony Brook University, Stony Brook, NY, USA
| | - Mihai Gheorghiade
- Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, 201 East Huron, Galter 3-150, Chicago, IL, USA
| |
Collapse
|
14
|
Chang SN, Juang JJM, Tsai CT, Ko JT, Lien WP. A Novel Integrated Score Index of Echocardiographic Indices for the Evaluation of Left Ventricular Diastolic Function. PLoS One 2015; 10:e0142175. [PMID: 26555598 PMCID: PMC4640516 DOI: 10.1371/journal.pone.0142175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 10/19/2015] [Indexed: 12/31/2022] Open
Abstract
Background We propose a novel integrated score index, which could be used to quantify and grade left ventricular (LV) diastolic function. Methods We enrolled 629 participants [393 healthy subjects, 145 with hypertension (HTN), 24 with hypertrophic cardiomyopathy (HCM), and 67 with coronary artery disease (CAD)]. This score index was with a score of 1 for an E/A ratio < 1, a score of 1 for a septal e’/a’ ratio ≤ 0.8, a score of 2 for a lateral e’/a’ ratio ≤ 1, a score of 2 for a septal E/e’ ratio ≥10–15, a score of 3 for a lateral E/e’ ratio ≥8–15, and a score of 1 for a deceleration time >240 ms. The sum of each score was considered as the final value in this scoring method (either a septal or a lateral E/e’ ratio > 15 was given a total score of 10, regardless of the other measurements). Results After analysis, the AUROC of this integrated score index for predicting any diastolic dysfunction (discriminated by the American Society of Echocardiography guidelines) was 0.962, and the AUROC of the method from the logistic regression was 0.970. The mean values of the score index for the groups were 3.81 ± 0.12 in healthy, 6.48 ± 0.19 in HTN, 7.35 ± 0.46 in HCM, and 6.62 ± 0.29 in CAD. Using the score index, the healthy subjects obtained lower scores compared with those of HTN (p = 0.00), HCM (p = 0.00), and CAD (p = 0.00). Therefore, this score index could discriminate patients with diseases with impaired diastolic function from the healthy subjects when the total sum of the score was equal to or greater than 4. Conclusions If the presently used methods cannot allow the clear diagnosis of LV diastolic dysfunction, this integrated score index might be helpful for discriminating diseases with impaired diastolic function.
Collapse
Affiliation(s)
- Sheng-Nan Chang
- National Taiwan University College of Medicine, Graduate Institute of Clinical Medicine, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Dou-Liu City, Taiwan
| | - Jimmy Jyh-Ming Juang
- Cardiovascular Center, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Ti Tsai
- National Taiwan University College of Medicine, Graduate Institute of Clinical Medicine, Taipei, Taiwan
- Cardiovascular Center, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | | | - Wen-Pin Lien
- Cardiovascular Center, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail: ;
| |
Collapse
|
15
|
New insight into improvement of cardiovascular outcomes with intensive glycemic control in patients with metabolic syndrome and type 2 diabetes mellitus included. Cell Biochem Biophys 2014; 71:9-15. [PMID: 25113641 DOI: 10.1007/s12013-014-0175-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The epidemiology of metabolic syndrome (MetS) is very concerning since this is a widespread chronic disease in adult and elderly population. Different epidemiological studies confirmed strong relationship between type 2 diabetes mellitus (DM2) inclusive MetS and the occurrence of microvascular and macrovascular complications in these patients. Therefore, we are discussing molecular mechanisms and pathways recently introduced and intensively researched. These molecules have been held responsible for direct and indirect correlative trends important in the assessment of potential benefit of intensive glycemic control. Novel substances may improve patient's outcome in recent future regarding cardiovascular complications though their acting mechanisms have not been completely elucidated. We are reviewing whether it would intensive glycemic control be a reasonable approach in patients with MetS when DM2 is included and which recommendations are currently widely applied. The aim was therefore to emphasize current need for further investigations in the field since the utility of intensive glycemic control in all DM/MetS patients as mean for reduction of cardiovascular complications still remains controversial.
Collapse
|
16
|
Chang HR, Hsieh JC, Hsu BG, Wang LY, Chen MYC, Wang JH. Inverse association of N-terminal pro-B-type natriuretic peptide with metabolic syndrome in patients with congestive heart failure. PLoS One 2013; 8:e79096. [PMID: 24265747 PMCID: PMC3827135 DOI: 10.1371/journal.pone.0079096] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 09/17/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Metabolic syndrome has been shown to be associated with lower levels of plasma N-terminal pro-B-type natriuretic peptide (Nt-proBNP) in the general population. We sought to elucidate the relationship between Nt-proBNP and components of metabolic syndrome in patients with congestive heart failure (CHF). METHODS Fasting blood samples were obtained from 93 patients in our institution. Plasma levels of Nt-proBNP and other biochemical data were measured. The New York Heart Association (NYHA) classification system (I-IV) was used to define the functional capacity of CHF. Metabolic syndrome and its components were defined using diagnostic criteria from the International Diabetes Federation. RESULTS Forty-nine patients (52.7%) had CHF. There was a positive correlation between plasma Nt-proBNP levels and NYHA functional capacity in CHF patients. Plasma Nt-proBNP levels increased significantly with each increasing NYHA class of the disease. The prevalence of metabolic syndrome in CHF patients was higher than that in patients without CHF. Most importantly, we found that plasma Nt-proBNP levels were lower in CHF patients with metabolic syndrome attributable to inverse relationships between plasma Nt-proBNP and body mass index (β = -0.297), plasma triglyceride (β = -0.286) and homeostasis model assessment of insulin resistance (HOMA-IR; β = -0.346). Fasting glucose to insulin ratio (FGIR, an insulin sensitivity index) was positively associated with plasma Nt-proBNP levels (β = 0.491), and was the independent predictor of plasma Nt-proBNP levels in CHF patients. CONCLUSIONS Plasma Nt-proBNP levels are inversely associated with metabolic syndrome in CHF patients. Reduced plasma Nt-proBNP levels in CHF patients may lead to impaired lipolysis and metabolic function, and may contribute to the development of metabolic syndrome in CHF patients.
Collapse
Affiliation(s)
- Huai-Ren Chang
- Division of Cardiology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Jen-Che Hsieh
- Division of Cardiology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Bang-Gee Hsu
- Division of Nephrology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Ling-Yi Wang
- Institute of Epidemiology & Preventive Medicine, College of Pulbic Health, National Taiwan University, Taipei, Taiwan
| | - Michael Yu-Chih Chen
- Division of Cardiology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Ji-Hung Wang
- Division of Cardiology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| |
Collapse
|
17
|
Fukumoto Y. Impact of left ventricular ejection fraction in Japanese heart failure patients. J Cardiol 2013; 62:203-4. [PMID: 23827048 DOI: 10.1016/j.jjcc.2013.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 05/31/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Yoshihiro Fukumoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
| |
Collapse
|
18
|
Wang JH, Lee CJ, Hsieh JC, Chen YC, Hsu BG. Inverse association of long-acting natriuretic peptide with metabolic syndrome in congestive heart failure patients. Diabetol Metab Syndr 2013; 5:19. [PMID: 23566312 PMCID: PMC3635959 DOI: 10.1186/1758-5996-5-19] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 04/01/2013] [Indexed: 12/05/2022] Open
Abstract
AIMS Long-acting natriuretic peptide (LANP) is one of the peptide hormones in atrial natriuretic peptide (ANP) pro-hormone. Low levels of natriuretic peptide may lead to reduced lipolysis and excessive weight gain in obese patients. The aim of this study was to investigate the relationship between fasting serum LANP level and the metabolic syndrome (MetS) among congestive heart failure (CHF) patients. METHODS Fasting blood samples were obtained from 186 patients with normal renal function in cardiac clinic outpatients. CHF defined by the American College of Cardiology Foundation and the American Heart Association 2005 Guidelines. MetS and its components were defined using diagnostic criteria from the International Diabetes Federation. RESULTS Ninety-eight patients (52.7%) had CHF. There was a tendency of increased fasting LANP levels as the NYHA CHF functional classes increased (p = 0.002). Forty-six of the CHF patients (46.9%) had MetS. Fasting LANP level negatively correlated with MetS among CHF patients (p < 0.001). Univariate linear regression analysis showed that BUN (p = 0.026) positively correlated with fasting serum LANP levels, while body weight (p = 0.009), BMI (p = 0.004), homeostasis model assessment of insulin resistance (HOMA-IR; p = 0.024) and HOMA-β (p = 0.001) negatively correlated with fasting serum LANP levels among the CHF patients. Multivariate forward stepwise linear regression analysis of the significant variables showed that the HOMA-β (R2 change = 0.292, p < 0.001) and HOMA-IR (R2 change = 0.081, p = 0.019) were independent predictors of fasting serum LANP levels in CHF patients. CONCLUSIONS LANP level is significantly reduced in CHF patients affected by MetS. HOMA-β and HOMA-IR were independent predictors of serum LANP levels in CHF patients.
Collapse
Affiliation(s)
- Ji-Hung Wang
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Division of Cardiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Chung-Jen Lee
- Department of Nursing, Tzu Chi College of Technology, Hualien, Taiwan
| | - Jen-Che Hsieh
- Division of Cardiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Yu-Chih Chen
- Division of Cardiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Bang-Gee Hsu
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Division of Nephrology, Buddhist Tzu Chi General Hospital, No. 707, Section 3, Chung-Yang Raod, Hualien, Taiwan
| |
Collapse
|
19
|
Miura Y, Fukumoto Y, Miura T, Shimada K, Asakura M, Kadokami T, Ando SI, Miyata S, Sakata Y, Daida H, Matsuzaki M, Yasuda S, Kitakaze M, Shimokawa H. Impact of Physical Activity on Cardiovascular Events in Patients With Chronic Heart Failure. Circ J 2013; 77:2963-72. [DOI: 10.1253/circj.cj-13-0746] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yutaka Miura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Yoshihiro Fukumoto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Toshiro Miura
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
| | - Kazunori Shimada
- Department of Cardiovascular Medicine, Juntendo University School of Medicine
| | - Masanori Asakura
- Cardiovascular Division of Internal Medicine, National Cerebral and Cardiovascular Center
| | | | - Shin-ichi Ando
- Division of Cardiovascular Medicine, Saiseikai Futsukaichi Hospital
| | - Satoshi Miyata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University School of Medicine
| | - Masunori Matsuzaki
- Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine
| | - Satoshi Yasuda
- Cardiovascular Division of Internal Medicine, National Cerebral and Cardiovascular Center
| | - Masafumi Kitakaze
- Cardiovascular Division of Internal Medicine, National Cerebral and Cardiovascular Center
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| |
Collapse
|
20
|
Dai Z, Aoki T, Fukumoto Y, Shimokawa H. Coronary perivascular fibrosis is associated with impairment of coronary blood flow in patients with non-ischemic heart failure. J Cardiol 2012; 60:416-21. [PMID: 22867802 DOI: 10.1016/j.jjcc.2012.06.009] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Revised: 05/19/2012] [Accepted: 06/20/2012] [Indexed: 01/19/2023]
Abstract
BACKGROUND Although myocardial interstitial fibrosis has been considered to play a pathogenic role in chronic heart failure (HF), the role of perivascular fibrosis, another form of fibrosis, remains to be elucidated. METHODS We examined 64 consecutive patients with non-ischemic HF caused by hypertrophic cardiomyopathy (HCM, n=16), hypertensive heart disease (HHD, n=11), or dilated cardiomyopathy (DCM, n=37), diagnosed by both cardiac catheterization and endomyocardial biopsy (right ventricular side of the interventricular septum) in the Tohoku University Hospital between January 2001 and April 2009. We calculated the collagen volume fraction (CVF) and perivascular fibrosis ratio (PFR) in biopsy samples and also examined Thrombolysis in Myocardial Infarction (TIMI) frame count to evaluate coronary blood flow. RESULTS There was no significant correlation between CVF and PFR (r(2)=0.0007). Although CVF was comparable among HCM, HHD, and DCM (1.11 ± 1.04, 1.89 ± 1.61, and 1.41 ± 1.48, respectively), PFR was significantly higher in HCM than in DCM (1.78 ± 1.09 vs. 1.23 ± 0.44, p<0.05). PFR was not correlated with cardiac function parameters, such as left ventricular (LV) ejection fraction, cardiac output, LV end-diastolic pressure, LV end-diastolic volume, aortic pressure, or pulmonary artery pressure. However, PFR was significantly correlated with coronary flow in the left anterior descending coronary artery (as evaluated by TIMI frame count) (r(2)=0.3351, p<0.0001, in all-cases combined population), but not with that in the left circumflex or right coronary artery. This correlation remained significant in a logistic regression model tested in 7 variables (body mass index, PVR, CVF, presence of hypertension, dyslipidemia, diabetes mellitus, and atrial fibrillation). CONCLUSIONS These results indicate that coronary perivascular fibrosis is associated with the impairment of coronary blood flow although not associated with interstitial fibrosis or cardiac function, suggesting that it can be a new therapeutic target to improve coronary microcirculation.
Collapse
Affiliation(s)
- Zhehao Dai
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | | |
Collapse
|
21
|
Lee S, Do HJ, Kang SM, Chung JH, Park E, Shin MJ. Plasma phospholipid fatty acid composition and estimated desaturase activity in heart failure patients with metabolic syndrome. J Clin Biochem Nutr 2012; 51:150-5. [PMID: 22962535 PMCID: PMC3432827 DOI: 10.3164/jcbn.11-12] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Accepted: 01/26/2012] [Indexed: 01/24/2023] Open
Abstract
Metabolic syndrome is one of the major factors to increase the incidence of heart failure. In our study, we compared plasma fatty acid compositions among heart failure patients with and without Metabolic syndrome. Fatty acid (FA) composition of plasma phospholipids was analyzed and the activities of desaturase were estimated as the ratio of substrate and product fatty acids in 85 stable heart failure patients. Fatty acid and estimated desaturase activities were further examined for their associations with Metabolic syndrome components. Heart failure patients with Metabolic syndrome showed significant changes in fatty acid composition in comparison to those without Metabolic syndrome, which had a decreased proportion of lauric acid (C12:0) and an increased proportion of dihomo-γ-linolenic acid (C20:3n-6). Also, estimated desaturase activities (D5D and D6D) were closely related to Metabolic syndrome condition among heart failure patients. The content of dihomo-γ-linolenic acid showed positive correlations with BMI, waist circumference, and plasma triglyceride levels. D6D were positively associated with plasma triglyceride levels, whereas D5D showed a negative correlation with plasma triglyceride levels and waist circumferences. The content of dihomo-γ-linolenic acid as well as estimated D6D and D5D were altered in heart failure patients with Metabolic syndrome.
Collapse
Affiliation(s)
- Seungmin Lee
- Department of Food and Nutrition and Institute of Health Science, Korea University, Seoul, Republic of Korea
| | | | | | | | | | | |
Collapse
|
22
|
Abstract
Acute decompensated heart failure (ADHF) is a major public health problem throughout the world and its importance is continuing to grow. This article reviews the epidemiology of ADHF and the profile of patients suffering from this condition. It describes factors used in assessing prognosis and presents treatment options. Although no currently available treatments have been shown to favorably affect long-term outcomes, there are a variety of strategies and approaches to management that are expected to reduce morbidity and mortality following discharge after ADHF hospitalization. In particular, the clinician is alerted to the need to identify factors that trigger decompensation as well as to optimize treatments for chronic heart failure. The importance of the transition from hospital to the outpatient setting is described. Particular attention should be focused on providing health education to the patient and their family at an appropriate level of medical literacy as well as ensuring early follow-up evaluation after hospital discharge.
Collapse
Affiliation(s)
- Barry Greenberg
- Advanced Heart Failure Treatment Program, Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California at San Diego, CA 92093, USA.
| |
Collapse
|
23
|
Damnjanović I, Veličković-Radovanović R, Kocić R, Zlatković-Guberinić S, Sokolović D, Đinđić N, Conić I. INFLUENCE OF BETA-BLOCKERS ON INSULIN RESISTANCE IN PATIENTS WITH DIABETES MELLITUS TYPE 2. ACTA MEDICA MEDIANAE 2011. [DOI: 10.5633/amm.2011.0404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
24
|
Schmelzer C, Kitano M, Hosoe K, Döring F. Ubiquinol affects the expression of genes involved in PPARα signalling and lipid metabolism without changes in methylation of CpG promoter islands in the liver of mice. J Clin Biochem Nutr 2011; 50:119-26. [PMID: 22448092 PMCID: PMC3303474 DOI: 10.3164/jcbn.11-19] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2011] [Accepted: 05/21/2011] [Indexed: 01/25/2023] Open
Abstract
Coenzyme Q10 is an essential cofactor in the respiratory chain and serves as a potent antioxidant in biological membranes. Recent studies in vitro and in vivo provide evidence that Coenzyme Q10 is involved in inflammatory processes and lipid metabolism via gene expression. To study these effects at the epigenomic level, C57BL6J mice were supplemented for one week with reduced Coenzyme Q10 (ubiquinol). Afterwards, gene expression signatures and DNA promoter methylation patterns of selected genes were analysed. Genome-wide transcript profiling in the liver identified 1112 up-regulated and 571 down-regulated transcripts as differentially regulated between ubiquinol-treated and control animals. Text mining and GeneOntology analysis revealed that the ”top 20” ubiquinol-regulated genes play a role in lipid metabolism and are functionally connected by the PPARα signalling pathway. With regard to the ubiquinol-induced changes in gene expression of about +3.14-fold (p≤0.05), +2.18-fold (p≤0.01), and −2.13-fold (p≤0.05) for ABCA1, ACYP1, and ACSL1 genes, respectively, hepatic DNA methylation analysis of 282 (sense orientation) and 271 (antisense) CpG units in the respective promoter islands revealed no significant effect of ubiquinol. In conclusion, ubiquinol affects the expression of genes involved in PPARα signalling and lipid metabolism without changing the promoter DNA methylation status in the liver of mice.
Collapse
Affiliation(s)
- Constance Schmelzer
- Leibniz Institute for Farm Animal Biology (FBN), Research Unit Nutritional Physiology "Oskar Kellner", Dummerstorf, Germany
| | | | | | | |
Collapse
|
25
|
Kawada T, Otsuka T, Endo T, Kon Y. Prevalence of the metabolic syndrome and its relationship with diabetes mellitus by aging. Aging Male 2011; 14:203-6. [PMID: 21718089 DOI: 10.3109/13685538.2011.565092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION It is important to make a prompt diagnosis of metabolic syndrome (MetS) in order to prevent the development of cardio-/cerebro- vascular diseases and diabetes mellitus (DM). The authors estimated the risk of development of DM by the presence/absence of MetS and age groups. METHODS A cross-sectional study of subjects undergoing intensive health examination was conducted (3149 men aged 30-69 years). Diagnosis of MetS was based on the criteria of the National Cholesterol Education Program Expert Panel (NCEP). RESULTS The prevalence of DM occurring in association with MetS increased with age; it was 11.9% in subjects with MetS in their 30s, it was 19.8% in subjects with MetS in their 60s. The prevalence of DM among subjects who had one or two components of MetS also increased with age. There was a significant progressive increase of the odds ratio in subjects in their 30s, 40s, 50s and 60s who were judged as having MetS; significant increase of the odds ratio was seen in subjects in their 60s, even in those who were not judged as having MetS. CONCLUSIONS Subjects with MetS show a high prevalence of DM, and the prevalence increased with age in the subjects.
Collapse
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan.
| | | | | | | |
Collapse
|
26
|
|
27
|
Matsue Y, Suzuki M, Nakamura R, Abe M, Ono M, Yoshida S, Seya M, Iwatsuka R, Mizukami A, Setoguchi M, Nagahori W, Ohno M, Matsumura A, Hashimoto Y. Prevalence and Prognostic Implications of Pre-Diabetic State in Patients With Heart Failure. Circ J 2011; 75:2833-9. [DOI: 10.1253/circj.cj-11-0754] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yuya Matsue
- Division of Cardiology, Department of Medicine, Kameda Medical Center
| | - Makoto Suzuki
- Division of Cardiology, Department of Medicine, Kameda Medical Center
| | - Rena Nakamura
- Division of Cardiology, Department of Medicine, Kameda Medical Center
| | - Masami Abe
- Division of Cardiology, Department of Medicine, Kameda Medical Center
| | - Maki Ono
- Division of Cardiology, Department of Medicine, Kameda Medical Center
| | - Seigo Yoshida
- Division of Cardiology, Department of Medicine, Kameda Medical Center
| | - Mie Seya
- Division of Cardiology, Department of Medicine, Kameda Medical Center
| | - Ryota Iwatsuka
- Division of Cardiology, Department of Medicine, Kameda Medical Center
| | - Akira Mizukami
- Division of Cardiology, Department of Medicine, Kameda Medical Center
| | | | - Wataru Nagahori
- Division of Cardiology, Department of Medicine, Kameda Medical Center
| | - Masakazu Ohno
- Division of Cardiology, Department of Medicine, Kameda Medical Center
| | - Akihiko Matsumura
- Division of Cardiology, Department of Medicine, Kameda Medical Center
| | - Yuji Hashimoto
- Division of Cardiology, Department of Medicine, Kameda Medical Center
| |
Collapse
|
28
|
Shiba N, Nochioka K, Miura M, Kohno H, Shimokawa H, on behalf of the CHART-2 Investigators. Trend of Westernization of Etiology and Clinical Characteristics of Heart Failure Patients in Japan - First Report From the CHART-2 Study -. Circ J 2011; 75:823-33. [DOI: 10.1253/circj.cj-11-0135] [Citation(s) in RCA: 172] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Nobuyuki Shiba
- Departments of Cardiovascular Medicine and Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Kotaro Nochioka
- Departments of Cardiovascular Medicine and Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Masanobu Miura
- Departments of Cardiovascular Medicine and Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Haruka Kohno
- Departments of Cardiovascular Medicine and Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Hiroaki Shimokawa
- Departments of Cardiovascular Medicine and Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | | |
Collapse
|
29
|
|