1
|
Wang J, Du H, Sun Q, Wan W, Zhang H. The promotion of sestrin2/AMPK signaling by HIF-1α overexpression enhances the damage caused by acute myocardial infarction. BMC Cardiovasc Disord 2023; 23:571. [PMID: 37986153 PMCID: PMC10662688 DOI: 10.1186/s12872-023-03604-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVE Acute myocardial infarction (AMI), is a serious form of coronary heart disease. The present study sought to investigate the impact of HIF-1α on AMI, along with its fundamental mechanism. METHODS Sprague-Dawley (SD) rats were used to conduct an AMI model. 2,3,5-triphenyl-2H-tetrazolium chloride (TTC) staining was used examine the region of myocardial infract area at various time intervals. Protein expression levels were detected using western blotting. The rats were randomly divided into sham, model, negative control (NC), HIF-1α overexpression (HIF-1α-OE), and HIF-1α-OE+ si-sestrin2 groups. We examined the impact of HIF-1α overexpression on AMI rats using Haematoxylin-Eosin (H&E) staining, TTC staining, enzyme-linked immunosorbent assay (ELISA), TdT-mediated dUTP Nick-End Labeling (TUNEL) assay, and immunohistochemistry (IHC) staining. RESULTS According to the TTC findings, the region affected by myocardial infarction reached its peak at day 14. Based on the results from the western blot analysis, the levels of HIF-1α and sestrin2 were found the minimum on day 28. Subsequently, we discovered that the overexpression of HIF-1α rescued the cardiac function parameters, improved the morphology of myocardial tissue, and mitigated inflammation. Furthermore, the overexpression of HIF-1α led to a reduction in the levels of MDA and an increase in the levels of SOD. Moreover, the overexpression of HIF-1α resulted in a decrease in cellular apoptosis. This result was confirmed by the expression levels of Bcl-2 and Bax. Nevertheless, the defensive impact of elevated HIF-1α expression was somewhat counteracted by the suppression of sestrin2. In terms of mechanism, the overexpression of HIF-1α enhanced the levels of sestrin2 and the protein adenosine monophosphate activated kinase (AMPK). CONCLUSION Our research suggests that the overexpression of HIF-1α may rescue the damage to myocardial tissue, and this effect is associated with the sestrin2/AMPK signaling pathway. Our study provides a novel comprehension of the protective effects of HIF-1α overexpression on AMI.
Collapse
Affiliation(s)
- Jie Wang
- Cardiac Intensive Care Unit, Yantaishan Hospital, Yantai, Shandong, China
| | - Honglei Du
- Department of Cardiology, Yantai Yeda Hospital, No.23-1, the Yellow River Road, Yantai economic and Technological Development Zone, Yantai, Shandong, 264006, China
| | - Qing Sun
- Department of Cardiology, Yantaishan Hospital, Yantai, China
| | - Weiping Wan
- Department of Ultrasound, Yantaishan Hospital, Yantai, Shandong, China
| | - Haifeng Zhang
- Department of Cardiology, Yantai Yeda Hospital, No.23-1, the Yellow River Road, Yantai economic and Technological Development Zone, Yantai, Shandong, 264006, China.
| |
Collapse
|
2
|
Wu C, Gao X, Li L, Jing Q, Li W, Xu H, Zhang W, Li S, Zhao Y, Wang Y, Li W, Wu Y, Hu F, Jin C, Qiao S, Yang J, Yang Y. Role of ST-Segment Resolution Alone and in Combination With TIMI Flow After Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction. J Am Heart Assoc 2023:e029670. [PMID: 37449560 PMCID: PMC10382099 DOI: 10.1161/jaha.123.029670] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023]
Abstract
Background To evaluate the role of ST-segment resolution (STR) alone and in combination with Thrombolysis in Myocardial Infarction (TIMI) flow in reperfusion evaluation after primary percutaneous coronary intervention (PPCI) for ST-segment-elevation myocardial infarction by investigating the long-term prognostic impact. Methods and Results From January 2013 through September 2014, we studied 5966 patients with ST-segment-elevation myocardial infarction enrolled in the CAMI (China Acute Myocardial Infarction) registry with available data of STR evaluated at 120 minutes after PPCI. Successful STR included STR ≥50% and complete STR (ST-segment back to the equipotential line). After PPCI, the TIMI flow was assessed. The primary outcome was 2-year all-cause mortality. STR < 50%, STR ≥50%, and complete STR occurred in 20.6%, 64.3%, and 15.1% of patients, respectively. By multivariable analysis, STR ≥50% (5.6%; adjusted hazard ratio [HR], 0.45 [95% CI, 0.36-0.56]) and complete STR (5.1%; adjusted HR, 0.48 [95% CI, 0.34-0.67]) were significantly associated with lower 2-year mortality than STR <50% (11.7%). Successful STR was an independent predictor of 2-year mortality across the spectrum of clinical variables. After combining TIMI flow with STR, different 2-year mortality was observed in subgroups, with the lowest in successful STR and TIMI 3 flow, intermediate when either of these measures was reduced, and highest when both were abnormal. Conclusions Post-PPCI STR is a robust long-term prognosticator for ST-segment-elevation myocardial infarction, whereas the integrated analysis of STR plus TIMI flow yields incremental prognostic information beyond either measure alone, supporting it as a convenient and reliable surrogate end point for defining successful PPCI. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01874691.
Collapse
Affiliation(s)
- Chao Wu
- Department of Cardiology, Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Beijing China
| | - Xiaojin Gao
- Department of Cardiology, Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Beijing China
| | - Ling Li
- Medical Research and Biometrics Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Beijing China
| | - Quanmin Jing
- Department of Cardiology General Hospital of Shenyang Military Region Shenyang China
| | - Weimin Li
- Department of Cardiology The First Affiliated Hospital of Harbin Medical University Harbin China
| | - Haiyan Xu
- Department of Cardiology, Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Beijing China
| | - Wenbo Zhang
- Department of Epidemiology University Medical Center Groningen Groningen the Netherlands
| | - Sidong Li
- Division of Life Sciences and Medicine University of Science and Technology of China Hefei China
| | - Yanyan Zhao
- Medical Research and Biometrics Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Beijing China
| | - Yang Wang
- Medical Research and Biometrics Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Beijing China
| | - Wei Li
- Medical Research and Biometrics Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Beijing China
| | - Yongjian Wu
- Department of Cardiology, Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Beijing China
| | - Fenghuan Hu
- Department of Cardiology, Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Beijing China
| | - Chen Jin
- Department of Cardiology, Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Beijing China
| | - Shubin Qiao
- Department of Cardiology, Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Beijing China
| | - Jingang Yang
- Department of Cardiology, Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Beijing China
| | - Yuejin Yang
- Department of Cardiology, Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease National Center for Cardiovascular Diseases Beijing China
| |
Collapse
|
3
|
Chang K, Ahn Y, Lim S, Yang JH, Lee KY, Choo EH, Kim HK, Nam CW, Kim W, Hwang JY, Rha SW, Kim HS, Cho MC, Jang Y, Jeong MH. 2021 Korean Society of Myocardial Infarction Expert Consensus Document on Revascularization for Acute Myocardial Infarction. Korean Circ J 2021; 51:289-307. [PMID: 33821579 PMCID: PMC8022023 DOI: 10.4070/kcj.2021.0043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/03/2021] [Indexed: 01/30/2023] Open
Abstract
Acute myocardial infarction (AMI) is a fatal manifestation of ischemic heart disease and remains a major public health concern worldwide despite advances in its diagnosis and management. The characteristics of patients with AMI, as well as its disease patterns, have gradually changed over time in Korea, and the outcomes of revascularization have improved dramatically. Several characteristics associated with the revascularization of Korean patients differ from those of patients in other countries. The sophisticated state of AMI revascularization in Korea has led to the need for a Korean expert consensus. The Task Force on Expert Consensus Document of the Korean Society of Myocardial Infarction has comprehensively reviewed the outcomes of large clinical trials and current practical guidelines, as well as studies on Korean patients with AMI. Based on these comprehensive reviews, the members of the task force summarize the major guidelines and recent publications, and propose an expert consensus for revascularization in patients with AMI.
Collapse
Affiliation(s)
- Kiyuk Chang
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Youngkeun Ahn
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Sungmin Lim
- Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong Hoon Yang
- Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwan Yong Lee
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Ho Choo
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Kuk Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Chang Wook Nam
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Korea
| | - Weon Kim
- Division of Cardiovascular, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Korea
| | - Jin Yong Hwang
- Division of Cardiology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Seung Woon Rha
- Divison of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Hyo Soo Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Myeong Chan Cho
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Yangsoo Jang
- Divison of Cardiology, Department of Internal Medicine, Severance Hospital, Seoul, Korea
| | - Myung Ho Jeong
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea.
| |
Collapse
|
4
|
Na D, Aijie H, Bo L, Zhilin M, Long Y. Gambogic acid exerts cardioprotective effects in a rat model of acute myocardial infarction through inhibition of inflammation, iNOS and NF-κB/p38 pathway. Exp Ther Med 2017; 15:1742-1748. [PMID: 29434760 DOI: 10.3892/etm.2017.5599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 09/05/2017] [Indexed: 01/18/2023] Open
Abstract
Gamboge, the dried resin secreted by Garcinia maingayii (gambogic tree), was previously demonstrated to exert anti-inflammatory effects. The present study examined the effects of gambogic acid, the major active constituent of gamboge, on myocardial infarction (MI) and inflammation in a rat model and explored the possible underlying mechanisms. The results demonstrated that gambogic acid inhibited the ratio of heart weight to body weight and myocardial damage (via lactate dehydrogenase and cardiac troponin T) in rats with MI. Gambogic acid suppressed the activation of interleukin (IL)-6 and tumor necrosis factor-α, and increased IL-10 levels in MI rats. Furthermore, gambogic acid reduced inducible nitric oxide synthase (iNOS), matrix metalloproteinase (MMP)-2, MMP-9, intercellular adhesion molecule-1 (ICAM-1), nuclear factor (NF)-κB/p65 and phosphorylated p38 protein in ischemic myocardial tissue of MI rats. In conclusion, gambogic acid exerted anti-inflammatory effects in MI rats by targeting the iNOS, MMPs, ICAM-1, NF-κB and p38 pathways. Gambogic acid may protect against MI-induced inflammation in rats, which may be associated with the activation of the NF-κB/p38 pathway.
Collapse
Affiliation(s)
- Duan Na
- Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning 110016, P.R. China
| | - Hou Aijie
- Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning 110016, P.R. China
| | - Luan Bo
- Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning 110016, P.R. China
| | - Miao Zhilin
- Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning 110016, P.R. China
| | - Yuan Long
- Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning 110016, P.R. China
| |
Collapse
|
5
|
Park KH, Jeong MH, Ahn Y, Jung SS, Kim MH, Yang HM, Yoon J, Rha SW, Park KS, Han KR, Cho BR, Cha KS, Kim BO, Hyon MS, Shin WY, Choe H, Bae JW, Kim HY. The impact of vascular access for in-hospital major bleeding in patients with acute coronary syndrome at moderate- to very high-bleeding risk. J Korean Med Sci 2013; 28:1307-15. [PMID: 24015035 PMCID: PMC3763104 DOI: 10.3346/jkms.2013.28.9.1307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Accepted: 07/11/2013] [Indexed: 11/20/2022] Open
Abstract
The aim of our study was to determine the impact of vascular access on in-hospital major bleeding (IHMB) in acute coronary syndrome (ACS). We analyzed 995 patients with non-ST elevation myocardial infarction and unstable angina at the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) moderate- to very high-bleeding risk scores in trans-radial intervention (TRI) retrospective registry from 16 centers in Korea. A total of 402 patients received TRI and 593 patients did trans-femoral intervention (TFI). The primary end-point was IHMB as defined in the CRUSADE. There were no significant differences in in-hospital and 1-yr mortality rates between two groups. However, TRI had lower incidences of IHMB and blood transfusion than TFI (6.0% vs 9.4%, P = 0.048; 4.5% vs 9.4%, P = 0.003). The patients suffered from IHMB had higher incidences of in-hospital and 1-yr mortality than those free from IHMB (3.1% vs 15.0%, P < 0.001; 7.2% vs 30.0%, P < 0.001). TRI was an independent negative predictor of IHMB (odds ratio, 0.305; 95% confidence interval, 0.109-0.851; P = 0.003). In conclusions, IHMB is still significantly correlated with in-hospital and 1-yr mortality. Our study suggests that compared to TFI, TRI could reduce IHMB in patients with ACS at moderate- to very high-bleeding risk.
Collapse
Affiliation(s)
- Keun-Ho Park
- Chonnam National University Hospital, Gwangju, Korea
| | | | - Youngkeun Ahn
- Chonnam National University Hospital, Gwangju, Korea
| | | | | | | | | | | | | | - Kyoo Rok Han
- Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | | | | | - Byung Ok Kim
- Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Min Soo Hyon
- Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Won-Yong Shin
- Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Hyunmin Choe
- Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Jang-Whan Bae
- Chungbuk National University Hospital, Cheongju, Korea
| | - Hee Yeol Kim
- The Catholic University of Korea Bucheon St. Mary's Hospital, Bucheon, Korea
| | | |
Collapse
|
6
|
Leonardi S, Armstrong PW, Schulte PJ, Ohman EM, Newby LK. Implementation of standardized assessment and reporting of myocardial infarction in contemporary randomized controlled trials: a systematic review. Eur Heart J 2013; 34:894-902d. [PMID: 23355654 DOI: 10.1093/eurheartj/eht003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Myocardial infarction (MI) is a key endpoint in randomized controlled trials (RCTs), but heterogeneous definitions limit comparisons across RCTs or meta-analyses. The 2000 European Society of Cardiology/American College of Cardiology MI redefinition and the 2007 universal MI definition consensus documents made recommendations to address this issue. In cardiovascular randomized trials, we evaluated the impact of implementation of three key recommendations from these reports-troponin use to define MI; separate reporting of spontaneous and procedure-related MI; and infarct size reporting. We searched ClinicalTrials.gov and MEDLINE databases for cardiovascular RCTs with more than 500 patients in which enrolment began between September 2000 and July 2012 and that listed MI in the primary endpoint. We searched English-language publications with primary results or design papers. Of 3222 studies screened, 96 (3.0%) met our criteria. We extracted enrolment start date, number of patients and MI events, follow-up duration, and coronary revascularization rate. Data extraction quality was assessed by duplicated extractions. Of 96 RCTs, 80 had a primary results publication, comprising 608 091 patients and 43 621 endpoint MIs. Myocardial infarction represented 45.3% (95% confidence interval, 40.2-50.4) of events in the primary composite endpoint. Troponin defined MI in 57% (53/93) of trials with an MI definition available. Of these RCTs, three used troponin only if creatine kinase-MB was unavailable, six used troponin to define peri-procedural MI, seven specified the 99th percentile as the MI decision limit, and three reported spontaneous and procedure-related MI separately. None reported biomarker-based infarct size, but five reported MI as multiples of the assay upper limit of normal. Although MI is a major component of cardiovascular RCT primary endpoints, standardized MI reporting and implementation of consensus document recommendations for MI definition are limited. Developing appropriate strategies for uniform implementation is required.
Collapse
Affiliation(s)
- Sergio Leonardi
- Duke University Medical Center, The Duke Clinical Research Institute, P.O. Box 17969, Durham, NC 27715-7969, USA
| | | | | | | | | |
Collapse
|