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Kweder H, Eidi H. Vitamin D deficiency in elderly: Risk factors and drugs impact on vitamin D status. Avicenna J Med 2021; 8:139-146. [PMID: 30319955 PMCID: PMC6178567 DOI: 10.4103/ajm.ajm_20_18] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Introduction: Vitamin D (VD) deficiency is a major public health problem worldwide. In spite of its high prevalence, particularly among elderly people, VD deficiency is still underestimated by many physicians. Increasingly, VD deficiency is associated with several known geriatric syndromes. Methods: The study sample consisted of 125 patients, aged 75 years and older, admitted to the acute geriatric unit. The plausible association between the serum 25-hydroxyvitamin D [25(OH)D] level and patient age, sex, body mass index, renal function, cholecystectomy history, and the prescribed drugs had been investigated. The Fisher's exact test was used to conduct the statistical analysis of data. Results: Surprisingly, furosemide treatment was correlated with normal 25(OH)D levels and an increased incidence of secondary hyperparathyroidism. Unlike the other four parameters mentioned above, our data showed that only the patient sex exhibited a significant association with 25(OH)D level as elderly males suffered from a serious VD deficiency as compared to elderly females. Conclusion: Old age is an independent risk factor for VD deficiency. The supplementary dose of VD should be precisely defined to achieve the optimal serum 25(OH)D level in elderly people. The definition of the normal serum 25(OH)D threshold in elderly furosemide-treated patients is worth of further studies.
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Affiliation(s)
- Hasan Kweder
- Department of Geriatric Medicine, Hospital of Pierre Oudot, Bourgoin-Jallieu City, Isère Department, Region of Auvergne-Rhône-Alpes, France
| | - Housam Eidi
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
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2
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Jeong MY, Lin YH, Wennersten SA, Demos-Davies KM, Cavasin MA, Mahaffey JH, Monzani V, Saripalli C, Mascagni P, Reece TB, Ambardekar AV, Granzier HL, Dinarello CA, McKinsey TA. Histone deacetylase activity governs diastolic dysfunction through a nongenomic mechanism. Sci Transl Med 2019; 10:10/427/eaao0144. [PMID: 29437146 DOI: 10.1126/scitranslmed.aao0144] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/07/2017] [Accepted: 01/05/2018] [Indexed: 12/21/2022]
Abstract
There are no approved drugs for the treatment of heart failure with preserved ejection fraction (HFpEF), which is characterized by left ventricular (LV) diastolic dysfunction. We demonstrate that ITF2357 (givinostat), a clinical-stage inhibitor of histone deacetylase (HDAC) catalytic activity, is efficacious in two distinct murine models of diastolic dysfunction with preserved EF. ITF2357 blocked LV diastolic dysfunction due to hypertension in Dahl salt-sensitive (DSS) rats and suppressed aging-induced diastolic dysfunction in normotensive mice. HDAC inhibitor-mediated efficacy was not due to lowering blood pressure or inhibiting cellular and molecular events commonly associated with diastolic dysfunction, including cardiac fibrosis, cardiac hypertrophy, or changes in cardiac titin and myosin isoform expression. Instead, ex vivo studies revealed impairment of cardiac myofibril relaxation as a previously unrecognized, myocyte-autonomous mechanism for diastolic dysfunction, which can be ameliorated by HDAC inhibition. Translating these findings to humans, cardiac myofibrils from patients with diastolic dysfunction and preserved EF also exhibited compromised relaxation. These data suggest that agents such as HDAC inhibitors, which potentiate cardiac myofibril relaxation, hold promise for the treatment of HFpEF in humans.
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Affiliation(s)
- Mark Y Jeong
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Ying H Lin
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Sara A Wennersten
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Kimberly M Demos-Davies
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Maria A Cavasin
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Jennifer H Mahaffey
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | | | - Chandrasekhar Saripalli
- Department of Cellular and Molecular Medicine and Sarver Molecular Cardiovascular Research Program, University of Arizona, Tucson, AZ 85724, USA
| | | | - T Brett Reece
- Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Amrut V Ambardekar
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Henk L Granzier
- Department of Cellular and Molecular Medicine and Sarver Molecular Cardiovascular Research Program, University of Arizona, Tucson, AZ 85724, USA
| | - Charles A Dinarello
- Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Timothy A McKinsey
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA. .,Consortium for Fibrosis Research & Translation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
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3
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Abstract
More than 50% of patients with clinical heart failure have a preserved ejection fraction. Despite mortality that is similar to or slightly lower than heart failure with reduced ejection fraction, trials to date have not shown a therapy that imparts a mortality benefit in heart failure with preserved ejection fraction (HFpEF). HFpEF represents a heterogeneous disorder with a complex pathophysiologic basis, and this may contribute to the negative results in clinical trials. Geographic variations in both patient selection and adherence to study medications confound the interpretation of the trial results. Mineralocorticoid receptor antagonists may be useful in selected patients.
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Affiliation(s)
- Ajith Nair
- Department of Medicine, Section of Cardiology, Baylor College of Medicine, 6620 Main Street, 12th Floor, Suite 1225, Houston, TX 77030, USA
| | - Anita Deswal
- Department of Medicine, Section of Cardiology, Baylor College of Medicine and Michael E. DeBakey VA Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030, USA.
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4
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Rojas SV, Hanke JS, Avsar M, Ahrens PR, Deutschmann O, Tümler KA, Uribarri A, Rojas-Hernández S, Sánchez PL, González-Santos JM, Haverich A, Schmitto JD. Asistencia ventricular izquierda como terapia de destino: ¿la cirugía mínimamente invasiva es una alternativa segura? Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.03.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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5
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Ohuchi H. Where Is the "Optimal" Fontan Hemodynamics? Korean Circ J 2017; 47:842-857. [PMID: 29035429 PMCID: PMC5711675 DOI: 10.4070/kcj.2017.0105] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 06/23/2017] [Indexed: 12/25/2022] Open
Abstract
Fontan circulation is generally characterized by high central venous pressure, low cardiac output, and slightly low arterial oxygen saturation, and it is quite different from normal biventricular physiology. Therefore, when a patient with congenital heart disease is selected as a candidate for this type of circulation, the ultimate goals of therapy consist of 2 components. One is a smooth adjustment to the new circulation, and the other is long-term circulatory stabilization after adjustment. When either of these goals is not achieved, the patient is categorized as having "failed" Fontan circulation, and the prognosis is dismal. For the first goal of smooth adjustment, a lot of effort has been made to establish criteria for patient selection and intensive management immediately after the Fontan operation. For the second goal of long-term circulatory stabilization, there is limited evidence of successful strategies for long-term hemodynamic stabilization. Furthermore, there have been no data on optimal hemodynamics in Fontan circulation that could be used as a reference for patient management. Although small clinical trials and case reports are available, the results cannot be generalized to the majority of Fontan survivors. We recently reported the clinical and hemodynamic characteristics of early and late failing Fontan survivors and their association with all-cause mortality. This knowledge could provide insight into the complex Fontan pathophysiology and might help establish a management strategy for long-term hemodynamic stabilization.
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Affiliation(s)
- Hideo Ohuchi
- Departments of Pediatric Cardiology and Adult Congenital Heart Disease, National Cerebral and Cardiovascular Center, Suita, Japan.
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6
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Rojas SV, Hanke JS, Avsar M, Ahrens PR, Deutschmann O, Tümler KA, Uribarri A, Rojas-Hernández S, Sánchez PL, González-Santos JM, Haverich A, Schmitto JD. Left Ventricular Assist Device Therapy for Destination Therapy: Is Less Invasive Surgery a Safe Alternative? ACTA ACUST UNITED AC 2017. [PMID: 28645834 DOI: 10.1016/j.rec.2017.03.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION AND OBJECTIVES The number of older patients with congestive heart failure has dramatically increased. Because of stagnating cardiac transplantation, there is a need for an alternative therapy, which would solve the problem of insufficient donor organ supply. Left ventricular assist devices (LVADs) have recently become more commonly used as destination therapy (DT). Assuming that older patients show a higher risk-profile for LVAD surgery, it is expected that the increasing use of less invasive surgery (LIS) LVAD implantation will improve postoperative outcomes. Thus, this study aimed to assess the outcomes of LIS-LVAD implantation in DT patients. METHODS We performed a prospective analysis of 2-year outcomes in 46 consecutive end-stage heart failure patients older than 60 years, who underwent LVAD implantation (HVAD, HeartWare) for DT in our institution between 2011 and 2013. The patients were divided into 2 groups according to the surgical implantation technique: LIS (n = 20) vs conventional (n = 26). RESULTS There was no statistically significant difference in 2-year survival rates between the 2 groups, but the LIS group showed a tendency to improved patient outcome in 85.0% vs 69.2% (P = .302). Moreover, the incidence of postoperative bleeding was minor in LIS patients (0% in the LIS group vs 26.9% in the conventional surgery group, P < .05), who also showed lower rates of postoperative extended inotropic support (15.0% in the LIS group vs 46.2% in the conventional surgery group, P < .05). CONCLUSIONS Our data indicate that DT patients with LIS-LVAD implantation showed a lower incidence of postoperative bleeding, a reduced need for inotropic support, and a tendency to lower mortality compared with patients treated with the conventional surgical technique.
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Affiliation(s)
- Sebastian V Rojas
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
| | - Jasmin S Hanke
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Murat Avsar
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Philipp R Ahrens
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Ove Deutschmann
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Kirstin A Tümler
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Aitor Uribarri
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany; Departamento de Cardiología, Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain
| | | | - Pedro L Sánchez
- Departamento de Cardiología, Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain
| | - José M González-Santos
- Departamento de Cirugía Cardiaca, Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain
| | - Axel Haverich
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Jan D Schmitto
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
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7
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Sargento L, Simões AV, Longo S, Lousada N, Palma Dos Reis R. Red blood cell distribution width is a survival predictor beyond anemia and Nt-ProBNP in stable optimally medicated heart failure with reduced ejection fraction outpatients. Clin Hemorheol Microcirc 2017; 65:185-194. [PMID: 27716652 DOI: 10.3233/ch-16155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND RDW is an automatic value obtained with the blood count, and represents the erythrocytes dimension variation. OBJECTIVE To evaluate in optimally medicated outpatients with heart failure with reduced ejection fraction (HFrEF) the RDW prognostic value regarding survival in a multivariable model including anemia and Nt-ProBNP. METHODS 233 consecutive outpatients, LVEF <40%, clinically stable were followed-up for 3-years in an HF Unit. End-point was all-cause death. The RDW categorized according to the tertiles (T1 = <13.9; T2 14-15.2; T3> = 15.3). Anemia classified according to the WHO criteria. Cox survival model adjusted for clinical profile, optimal therapeutic, renal function, Nt-ProBNP, etiology, atrial fibrillation, and anemia. RESULTS (1) The 3-years death rate was 33.5%, and increased with the RDW tertiles (17.3%; 25%; 61.1%; p < 0.001). (2) The ROC curve for death associated with RDW (AUC 0.73; p < 0.001); (3) The adjusted death risk increased with the tertiles (Hazard-ratio '[HR] = 1.61; IC 95% 1.09-2.39; p = 0.017). RDW> = 15.3 had greater adjusted death risk than T1 (HR = 2.18; 95% CI 0.99-4.8; p = 0.05) and T1+T2 (HR = 1.54; 95% CI 1.13-2.09; p = 0.006). CONCLUSION RDW determined in optimally medicated outpatients with HFrEF, during dry-state, is a strong, cheap, and independent predictor of long-term survival.
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8
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Nunes SS, Feric N, Pahnke A, Miklas JW, Li M, Coles J, Gagliardi M, Keller G, Radisic M. Human Stem Cell-Derived Cardiac Model of Chronic Drug Exposure. ACS Biomater Sci Eng 2016; 3:1911-1921. [DOI: 10.1021/acsbiomaterials.5b00496] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Sara S. Nunes
- Toronto
General Research Institute, University Health Network, 101 College
Street Toronto, Ontario, Canada M5G 1L7
- Heart & Stroke/Richard Lewar Centre of Excellence, University of Toronto, 101 College Street, MaRS Third Floor, Room 902, Toronto, Ontario, Canada M5G 1L7
- Institute
of Biomaterials and Biomedical Engineering, University of Toronto, 164 College St, RS 407, Toronto, Ontario, Canada M5S 3G9
| | - Nicole Feric
- Institute
of Biomaterials and Biomedical Engineering, University of Toronto, 164 College St, RS 407, Toronto, Ontario, Canada M5S 3G9
| | - Aric Pahnke
- Heart & Stroke/Richard Lewar Centre of Excellence, University of Toronto, 101 College Street, MaRS Third Floor, Room 902, Toronto, Ontario, Canada M5G 1L7
- Department
of Chemical Engineering and Applied Chemistry, University of Toronto, 200 College Street, Toronto, Ontario, Canada M5S 1A1
| | - Jason W. Miklas
- Institute
of Biomaterials and Biomedical Engineering, University of Toronto, 164 College St, RS 407, Toronto, Ontario, Canada M5S 3G9
| | - Mark Li
- Heart & Stroke/Richard Lewar Centre of Excellence, University of Toronto, 101 College Street, MaRS Third Floor, Room 902, Toronto, Ontario, Canada M5G 1L7
- Institute
of Biomaterials and Biomedical Engineering, University of Toronto, 164 College St, RS 407, Toronto, Ontario, Canada M5S 3G9
| | - John Coles
- Hospital of Sick Children, 555
University Avenue, Toronto, Ontario, Canada M5G 1X8
| | - Mark Gagliardi
- McEwen
Centre for Regenerative Medicine, University Health Network, MaRS
Centre, Toronto Medical Discovery Tower, 101 College Street, eighth
floor, room 701 Toronto, Ontario, Canada M5G 1L7
| | - Gordon Keller
- McEwen
Centre for Regenerative Medicine, University Health Network, MaRS
Centre, Toronto Medical Discovery Tower, 101 College Street, eighth
floor, room 701 Toronto, Ontario, Canada M5G 1L7
| | - Milica Radisic
- Toronto
General Research Institute, University Health Network, 101 College
Street Toronto, Ontario, Canada M5G 1L7
- Heart & Stroke/Richard Lewar Centre of Excellence, University of Toronto, 101 College Street, MaRS Third Floor, Room 902, Toronto, Ontario, Canada M5G 1L7
- Institute
of Biomaterials and Biomedical Engineering, University of Toronto, 164 College St, RS 407, Toronto, Ontario, Canada M5S 3G9
- Department
of Chemical Engineering and Applied Chemistry, University of Toronto, 200 College Street, Toronto, Ontario, Canada M5S 1A1
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9
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Huang YL, Hu ZD, Liu SJ, Sun Y, Qin Q, Qin BD, Zhang WW, Zhang JR, Zhong RQ, Deng AM. Prognostic value of red blood cell distribution width for patients with heart failure: a systematic review and meta-analysis of cohort studies. PLoS One 2014; 9:e104861. [PMID: 25133510 PMCID: PMC4136732 DOI: 10.1371/journal.pone.0104861] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 07/13/2014] [Indexed: 12/30/2022] Open
Abstract
Aims Multiple studies have investigated the prognostic role of red blood cell distribution width (RDW) for patients with heart failure (HF), but the results have been inconsistent. The aim of the present study was to estimate the impact of RDW on the prognosis of HF by performing a systematic review and meta-analysis. Methods and Results The Embase, PubMed, and Web of Science databases were searched up to November 16, 2013 to identify eligible cohort studies. The quality of each study was assessed using the Newcastle-Ottawa Scale (NOS). The association between RDW, either on admission or at discharge, and HF outcomes (all-cause mortality [ACM], heart transplantation, cardiovascular mortality, and rehospitalization, etc.) were reviewed. The overall hazard ratio (HR) for the effect of RDW on ACM was pooled using a random-effects model, and the publication bias was evaluated using funnel plots and Eggers' tests. Seventeen studies, with a total of 18288 HF patients, were included for systematic review. All eligible studies indicated that RDW on admission and RDW at discharge, as well as its change during treatment, were of prognostic significance for HF patients. The HR for the effect of a 1% increase in baseline RDW on ACM was 1.10 (95% confidence interval: 1.07–1.13), based on pooling of nine studies that provided related data. However, publication bias was observed among these studies. Conclusions HF patients with higher RDW may have poorer prognosis than those with lower RDW. Further studies are needed to explore the potential mechanisms underlying this association.
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Affiliation(s)
- Yuan-Lan Huang
- Department of Laboratory Medicine, NO. 455 Hospital of People's Liberation Army, Shanghai, P. R. China
- Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China
- Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Zhi-De Hu
- Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China
- Department of Laboratory Medicine, General Hospital of Ji'nan Military Region of People's Liberation Army, Ji'nan, Shandong Province, P. R. China
| | - Shi-Jian Liu
- Department of Biobank and Biostatistics, Pediatric Translational Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China,
| | - Yi Sun
- Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Qin Qin
- Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Bao-Dong Qin
- Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Wei-Wei Zhang
- Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Jian-Rong Zhang
- Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Ren-Qian Zhong
- Department of Laboratory Diagnosis, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China
- * E-mail: (AMD); (RQZ)
| | - An-Mei Deng
- Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China
- * E-mail: (AMD); (RQZ)
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10
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Bernstein D. Introduction to the series: challenges and opportunities in pediatric heart failure and transplantation. Circulation 2014; 129:112-4. [PMID: 24396014 DOI: 10.1161/circulationaha.113.006102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Daniel Bernstein
- Department of Pediatrics and the Stanford Cardiovascular Institute, Stanford University, Stanford, CA
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11
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Conti V, Russomanno G, Corbi G, Izzo V, Vecchione C, Filippelli A. Adrenoreceptors and nitric oxide in the cardiovascular system. Front Physiol 2013; 4:321. [PMID: 24223559 PMCID: PMC3818479 DOI: 10.3389/fphys.2013.00321] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 10/16/2013] [Indexed: 02/03/2023] Open
Abstract
Nitric Oxide (NO) is a small molecule that continues to attract much attention from the scientific community. Since its discovery, it has been evident that NO has a crucial role in the modulation of vascular tone. Moreover, NO is involved in multiple signal transduction pathways thus contributing to the regulation of many cellular functions. NO effects can be either dependent or independent on cGMP, and rely also upon several mechanisms such as the amount of NO, the compartmentalization of the enzymes responsible for its biosynthesis (NOS), and the local redox conditions. Several evidences highlighted the correlation among adrenoreceptors activity, vascular redox status and NO bioavailability. It was suggested a possible crosstalk between NO and oxidative stress hallmarks in the endothelium function and adaptation, and in sympathetic vasoconstriction control. Adrenergic vasoconstriction is a balance between a direct vasoconstrictive effect on smooth muscle and an indirect vasorelaxant action caused by α2- and β-adrenergic endothelial receptor-triggered NO release. An increased oxidative stress and a reduction of NO bioavailability shifts this equilibrium causing the enhanced vascular adrenergic responsiveness observed in hypertension. The activity of NOS contributes to manage the adrenergic pathway, thus supporting the idea that the endothelium might control or facilitate β-adrenergic effects on the vessels and the polymorphic variants in β2-receptors and NOS isoforms could influence aging, some pathological conditions and individual responses to drugs. This seems to be dependent, almost in part, on differences in the control of vascular tone exerted by NO. Given its involvement in such important mechanisms, the NO pathway is implicated in aging process and in both cardiovascular and non-cardiovascular conditions. Thus, it is essential to pinpoint NO involvement in the regulation of vascular tone for the effective clinical/therapeutic management of cardiovascular diseases (CVD).
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Affiliation(s)
- Valeria Conti
- Department of Medicine and Surgery, University of Salerno Baronissi, Italy
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12
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Ahmet I, Tae HJ, Brines M, Cerami A, Lakatta EG, Talan MI. Chronic administration of small nonerythropoietic peptide sequence of erythropoietin effectively ameliorates the progression of postmyocardial infarction-dilated cardiomyopathy. J Pharmacol Exp Ther 2013; 345:446-56. [PMID: 23584743 DOI: 10.1124/jpet.113.202945] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The cardioprotective properties of erythropoietin (EPO) in preclinical studies are well documented, but erythropoietic and prothrombotic properties of EPO preclude its use in chronic heart failure (CHF). We tested the effect of long-term treatment with a small peptide sequence within the EPO molecule, helix B surface peptide (HBSP), that possesses tissue-protective, but not erythropoietic properties of EPO, on mortality and cardiac remodeling in postmyocardial infarction-dilated cardiomyopathy in rats. Starting 2 weeks after permanent left coronary artery ligation, rats received i.p. injections of HBSP (60 µg/kg) or saline two times per week for 10 months. Treatment did not elicit an immune response, and did not affect the hematocrit. Compared with untreated rats, HBSP treatment reduced mortality by 50% (P < 0.05). Repeated echocardiography demonstrated remarkable attenuation of left ventricular dilatation (end-diastolic volume: 41 versus 86%; end-systolic volume: 44 versus 135%; P < 0.05), left ventricle functional deterioration (ejection fraction: -4 versus -63%; P < 0.05), and myocardial infarction (MI) expansion (3 versus 38%; P < 0.05). A hemodynamic assessment at study termination demonstrated normal preload independent stroke work (63 ± 5 versus 40 ± 4; P < 0.05) and arterioventricular coupling (1.2 ± 0.2 versus 2.7 ± 0.7; P < 0.05). Histologic analysis revealed reduced apoptosis (P < 0.05) and fibrosis (P < 0.05), increased cardiomyocyte density (P < 0.05), and increased number of cardiomyocytes in myocardium among HBSP-treated rats. The results indicate that HBSP effectively reduces mortality, ameliorates the MI expansion and CHF progression, and preserves systolic reserve in the rat post-MI model. There is also a possibility that HBSP promoted the increase of the myocytes number in the myocardial wall remote from the infarct. Thus, HBSP peptide merits consideration for clinical testing.
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Affiliation(s)
- Ismayil Ahmet
- Laboratory of Cardiovascular Sciences, National Institute on Aging/National Institutes of Health, Baltimore, Maryland, USA
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13
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Rosa-Garrido M, Karbassi E, Monte E, Vondriska TM. Regulation of chromatin structure in the cardiovascular system. Circ J 2013; 77:1389-98. [PMID: 23575346 DOI: 10.1253/circj.cj-13-0176] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
It has been appreciated for some time that cardiovascular disease involves large-scale transcriptional changes in various cell types. What has become increasingly clear only in the past few years, however, is the role of chromatin remodeling in cardiovascular phenotypes in normal physiology, as well as in development and disease. This review summarizes the state of the chromatin field in terms of distinct mechanisms to regulate chromatin structure in vivo, identifying when these modes of regulation have been demonstrated in cardiovascular tissues. We describe areas in which a better understanding of chromatin structure is leading to new insights into the fundamental biology of cardiovascular disease.
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Affiliation(s)
- Manuel Rosa-Garrido
- Department of Anesthesiology, David Geffen School of Medicine, UCLA, Los Angeles, CA 90095, USA
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14
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Abstract
Heart failure (HF) is a vicious circle in which an original insult leading to mechanical cardiac dysfunction initiates multiple morphological, biochemical and molecular pathological alterations referred to as cardiac remodelling. Remodelling leads to further deterioration of cardiac function and functional reserve. Interrupting or reversing cardiac remodelling is a major therapeutic goal of HF therapies. The role of molecules and molecular pathways in cardiac remodelling and HF has been extensively studied. Multiple approaches are now used or investigated in HF therapy, including pharmacological therapy, device therapy, gene therapy, cell therapy and biological therapy targeting cytokines and growth factors. This review explores the molecular targets and molecular bases of current and prospective therapies in HF.
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Affiliation(s)
- Elie R Chemaly
- Cardiovascular Research Center, Mount Sinai School of Medicine, New York, NY 10029, USA
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15
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Affiliation(s)
- Koichiro Kuwahara
- Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine
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Salata C, Ferreira-Machado SC, Mencalha AL, de Andrade CBV, de Campos VMA, Mandarim-de-Lacerda CA, deAlmeida CE. Chemotherapy and radiation regimens to breast cancer treatment induce changes in mRNA levels of renin–angiotensin system related genes in cardiac tissue. J Renin Angiotensin Aldosterone Syst 2012; 14:330-6. [DOI: 10.1177/1470320312465218] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Camila Salata
- Laboratório de Ciências Radiológicas, Departamento de Biofísica e Biometria, UERJ, Rio de Janeiro, Brazil
- Laboratório de Morfometria e Morfologia Cardiovascular, Instituto de Biologia, UERJ, Rio de Janeiro, Brazil
| | - Samara Cristina Ferreira-Machado
- Laboratório de Ciências Radiológicas, Departamento de Biofísica e Biometria, UERJ, Rio de Janeiro, Brazil
- Departamento de Biologia Geral – GBG, UFF, Niterói, Brazil
| | | | - Cherley Borba Vieira de Andrade
- Laboratório de Ciências Radiológicas, Departamento de Biofísica e Biometria, UERJ, Rio de Janeiro, Brazil
- Laboratório de Ultraestrutura e Biologia Tecidual, Departamento de Histologia, UERJ, Rio de Janeiro, Brazil
| | | | | | - Carlos Eduardo deAlmeida
- Laboratório de Ciências Radiológicas, Departamento de Biofísica e Biometria, UERJ, Rio de Janeiro, Brazil
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Taratukhin EO. Enalapril: new possibilities. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2012. [DOI: 10.15829/1728-8800-2012-5-71-73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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