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Minina EN, Stepura EE. Aspects of myocardial heterogeneity in assessment its remodeling. RUDN JOURNAL OF MEDICINE 2022. [DOI: 10.22363/2313-0245-2022-26-4-451-460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The influence of sports activity on the cardiovascular system is accompanied by physiological adaptation of the organism. Intense physical activity, far exceeding the body’s capabilities, can lead to structural changes or remodeling of the athlete’s myocardium. The review is devoted to the study of myocardial heterogeneity and is aimed at attracting attention of physicians, physiologists, biologists, researchers and developers of ECG computer analysis programs to prognostically significant indicators. Based on the mechanisms of electrical heterogeneity of the ventricular myocardium, the review considers the results of clinical studies by Russian and foreign specialists. The high predictive capabilities of indicators for the detection of fatal and non-fatal cardiovascular events and sudden cardiac death are discussed. It was found that the speed indicators of the electrical activity of the heart are the earliest marker of cardiac arrhythmias and conduction disorders. Risk factors - arterial hypertension, smoking, hypercholesterolemia and overweight - are associated with a decrease in the rate of electrical activity of the heart and an increase in myocardial heterogeneity. The data presented allow us to conclude that myocardial electrical heterogeneity is a prognostically significant indicator for the detection of fatal and non-fatal cardiovascular events; it is widely discussed in foreign literature, but is not used by domestic specialists.
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Varró A, Tomek J, Nagy N, Virág L, Passini E, Rodriguez B, Baczkó I. Cardiac transmembrane ion channels and action potentials: cellular physiology and arrhythmogenic behavior. Physiol Rev 2020; 101:1083-1176. [PMID: 33118864 DOI: 10.1152/physrev.00024.2019] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Cardiac arrhythmias are among the leading causes of mortality. They often arise from alterations in the electrophysiological properties of cardiac cells and their underlying ionic mechanisms. It is therefore critical to further unravel the pathophysiology of the ionic basis of human cardiac electrophysiology in health and disease. In the first part of this review, current knowledge on the differences in ion channel expression and properties of the ionic processes that determine the morphology and properties of cardiac action potentials and calcium dynamics from cardiomyocytes in different regions of the heart are described. Then the cellular mechanisms promoting arrhythmias in congenital or acquired conditions of ion channel function (electrical remodeling) are discussed. The focus is on human-relevant findings obtained with clinical, experimental, and computational studies, given that interspecies differences make the extrapolation from animal experiments to human clinical settings difficult. Deepening the understanding of the diverse pathophysiology of human cellular electrophysiology will help in developing novel and effective antiarrhythmic strategies for specific subpopulations and disease conditions.
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Affiliation(s)
- András Varró
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary.,MTA-SZTE Cardiovascular Pharmacology Research Group, Hungarian Academy of Sciences, Szeged, Hungary
| | - Jakub Tomek
- Department of Computer Science, British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, United Kingdom
| | - Norbert Nagy
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary.,MTA-SZTE Cardiovascular Pharmacology Research Group, Hungarian Academy of Sciences, Szeged, Hungary
| | - László Virág
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Elisa Passini
- Department of Computer Science, British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, United Kingdom
| | - Blanca Rodriguez
- Department of Computer Science, British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, United Kingdom
| | - István Baczkó
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
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Boldt KR, Rios JL, Joumaa V, Herzog W. Force properties of skinned cardiac muscle following increasing volumes of aerobic exercise in rats. J Appl Physiol (1985) 2018; 125:495-503. [PMID: 29722623 PMCID: PMC6139514 DOI: 10.1152/japplphysiol.00631.2017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 04/19/2018] [Accepted: 04/30/2018] [Indexed: 11/22/2022] Open
Abstract
The positive effects of chronic endurance exercise training on health and performance have been well documented. These positive effects have been evaluated primarily at the structural level, and work has begun to evaluate mechanical adaptations of the myocardium. However, it remains poorly understood how the volume of exercise training affects cardiac adaptation. To gain some understanding, we subjected 3-mo-old Sprague-Dawley rats ( n = 23) to treadmill running for 11 wk at one of three exercise volumes (moderate, high, and extra high). Following training, hearts were excised and mechanical testing was completed on skinned trabecular fiber bundles. Performance on a maximal fitness test was dose dependent on training volume, where greater levels of training led to greater performance. No differences were observed between animals from any group for maximal active stress and passive stress at a sarcomere length of 2.2 µm. Heart mass and passive stress at sarcomere lengths beyond 2.4 µm increased in a dose-dependent manner for animals in the control and moderate- and high-duration groups. However, hearts from animals in the extra high-duration group presented with inhibited responses for heart mass and passive stress, despite performing greatest on a graded treadmill fitness test. These results suggest that heart mass and passive stress adapt in a dose-dependent manner, until exercise becomes excessive and adaptation is inhibited. Our findings are in agreement with the beneficial role exercise has in cardiac adaptation. However, excessive exercise comes with risks of maladaptation, which must be weighed against the desire to increase performance. NEW & NOTEWORTHY For the first time, we present findings on cardiac trabecular muscle passive stiffness and show the effect of excessive exercise on the heart. We demonstrated that heart mass increases with exercise until a maximum, after which greater exercise volume results in inhibited adaptation. At paraphysiological lengths, passive stiffness increases with exercise but to a lesser degree with excessive training. Despite greater performance on graded exercise tests, animals in the highest trained group exhibited possible maladaptation.
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Affiliation(s)
- Kevin R Boldt
- Human Performance Laboratory, University of Calgary , Calgary, Alberta , Canada
- Faculty of Kinesiology, University of Calgary , Calgary, Alberta , Canada
| | - Jaqueline L Rios
- Human Performance Laboratory, University of Calgary , Calgary, Alberta , Canada
- Faculty of Kinesiology, University of Calgary , Calgary, Alberta , Canada
| | - Venus Joumaa
- Human Performance Laboratory, University of Calgary , Calgary, Alberta , Canada
- Faculty of Kinesiology, University of Calgary , Calgary, Alberta , Canada
| | - Walter Herzog
- Human Performance Laboratory, University of Calgary , Calgary, Alberta , Canada
- Faculty of Kinesiology, University of Calgary , Calgary, Alberta , Canada
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Blagrove RC, Bruinvels G, Read P. Early Sport Specialization and Intensive Training in Adolescent Female Athletes: Risks and Recommendations. Strength Cond J 2017. [DOI: 10.1519/ssc.0000000000000315] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Crouse SF, White S, Erwin JP, Meade TH, Martin SE, Oliver JM, Joubert DP, Lambert BS, Bramhall JP, Gill K, Weir D. Echocardiographic and Blood Pressure Characteristics of First-Year Collegiate American-Style Football Players. Am J Cardiol 2016; 117:131-4. [PMID: 26554673 DOI: 10.1016/j.amjcard.2015.09.049] [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] [Received: 08/01/2015] [Revised: 09/25/2015] [Accepted: 09/25/2015] [Indexed: 10/22/2022]
Abstract
Echocardiographic (echo) and blood pressure (BP) reference values may help identify athletes at cardiovascular risk, yet benchmarks are inadequate for collegiate American-style football (ASF) players. Our purpose was to describe echo characteristics and BP values in collegiate ASF athletes compared with normal. First-year players (n = 80, age = 18 ± 1 years, height = 186 ± 7 cm, weight = 100.1 ± 22.0 kg, body mass index = 28.7 ± 5.0), body surface area [BSA] = 2.24 ± 0.25; percentage fat = 16.5 ± 9.7%) were measured for systolic and diastolic BP, and underwent echo procedures by a certified sonographer. Data analyses included simple statistics, Pearson r, frequencies in normal ranges, and t test; α = 0.05. Selected echo measurements (and indexed by BSA) were: left ventricular (LV) internal diameter diastole = 5.3 ± 0.5 cm (2.4 ± 0.3); left atrial diameter = 3.9 ± 0.5 cm (1.8 ± 0.2): LV end-diastolic volume = 138 ± 30 ml (62 ± 11); septal wall thickness = 1.0 ± 0.2 cm (0.5 ± 0.1); LV posterior wall thickness = 1.0 ± 0.1 cm (0.5 ± 0.1), LV mass = 212 ± 46 g (95 ± 18); and relative wall thickness = 0.39 ± 0.07. Correlations between BSA and echo variables were significant (r = 0.26 to 0.50). Indexing by BSA reduced percentages above reference ranges from 36% to 7%. Septal wall thickness index was significantly greater in black (0.5 ± 0.1) than nonblack (0.4 ± 0.1) athletes. Fifty-nine athletes were hypertensive or prehypertensive, and diastolic BP was significantly greater in black (76 ± 10 mm Hg) compared with nonblack athletes (71 ± 8 mm Hg). ASF athletes demonstrated LV wall thicknesses and cavity sizes consistent with sport-training hypertrophy but which were unremarkable when indexed by BSA. Ethnicity generally did not influence echo variables. No ASF players were identified with cardiac dysfunction or disease.
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Sweeting J, Ingles J, Ball K, Semsarian C. Challenges of exercise recommendations and sports participation in genetic heart disease patients. ACTA ACUST UNITED AC 2015; 8:178-86. [PMID: 25691687 DOI: 10.1161/circgenetics.114.000784] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Joanna Sweeting
- From the Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Newtown, NSW, Australia (J.S., J.I., C.S.); Sydney Medical School, University of Sydney, Sydney, NSW, Australia (J.S., J.I., C.S.); Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia (K.B.); and Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia (C.S.)
| | - Jodie Ingles
- From the Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Newtown, NSW, Australia (J.S., J.I., C.S.); Sydney Medical School, University of Sydney, Sydney, NSW, Australia (J.S., J.I., C.S.); Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia (K.B.); and Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia (C.S.)
| | - Kylie Ball
- From the Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Newtown, NSW, Australia (J.S., J.I., C.S.); Sydney Medical School, University of Sydney, Sydney, NSW, Australia (J.S., J.I., C.S.); Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia (K.B.); and Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia (C.S.)
| | - Christopher Semsarian
- From the Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Newtown, NSW, Australia (J.S., J.I., C.S.); Sydney Medical School, University of Sydney, Sydney, NSW, Australia (J.S., J.I., C.S.); Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia (K.B.); and Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia (C.S.).
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Al-Asoom LI, Al-Shaikh BA, Bamosa AO, El-Bahai MN. Comparison of Nigella sativa- and exercise-induced models of cardiac hypertrophy: structural and electrophysiological features. Cardiovasc Toxicol 2015; 14:208-13. [PMID: 24448711 DOI: 10.1007/s12012-014-9244-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Exercise training is employed as supplementary therapeutic intervention for heart failure, due to its ability to induce physiological cardiac hypertrophy. In parallel, supplementation with Nigella sativa (N. sativa) was found to enhance myocardial function and induce cardiac hypertrophy. In this study, we aim to compare the morphological and electrophysiological changes associated with these patterns of cardiac hypertrophy and the possible changes upon administration of N. sativa to exercise-trained animals. Fifty-six adult Wistar rats were divided into: control, Nigella-treated (N), exercise-trained (E), and Nigella-treated-exercise-trained (NE) rats. Daily 800 mg/kg N. sativa was administered orally to N and NE. E and NE ran on treadmill, 2 h/day. At the end of 8 weeks ECG, body weight (BW), heart weight (HW), and left ventricular weight (LVW) were recorded. Hematoxylin and Eosin and periodic acid-Schiff sections were prepared to study the histology of left ventricles and to measure diameter of cardiomyocytes (Cdia). HW/BW, LVW/BW, and mean Cdia were significantly higher in all experimental animals compared to the controls. Histology showed normal cardiomyocytes with no fibrosis. ECG showed significantly lower heart rates, higher QRS amplitude, and ventricular specific potential in NE group compared to control group. Supplementation of N. sativa demonstrated a synergistic effect with exercise training as Nigella-exercise-induced cardiac hypertrophy had lower heart rate and well-matched electrical activity of the heart to its mass. Therefore, this model of cardiac hypertrophy might be introduced as a new therapeutic strategy for treatment for heart failure with superior advantages to exercise training.
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Affiliation(s)
- Lubna Ibrahim Al-Asoom
- Department of Physiology, College of Medicine, University of Dammam, P. O. Box 2114, Ad Dammām, Saudi Arabia,
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Montano MM, Desjardins CL, Doughman YQ, Hsieh YH, Hu Y, Bensinger HM, Wang C, Stelzer JE, Dick TE, Hoit BD, Chandler MP, Yu X, Watanabe M. Inducible re-expression of HEXIM1 causes physiological cardiac hypertrophy in the adult mouse. Cardiovasc Res 2013; 99:74-82. [PMID: 23585471 PMCID: PMC3687752 DOI: 10.1093/cvr/cvt086] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 03/28/2013] [Accepted: 04/01/2013] [Indexed: 01/06/2023] Open
Abstract
AIMS The transcription factor hexamethylene-bis-acetamide-inducible protein 1 (HEXIM1) regulates myocardial vascularization and growth during cardiogenesis. Our aim was to determine whether HEXIM1 also has a beneficial role in modulating vascularization, myocardial growth, and function within the adult heart. METHODS AND RESULTS To achieve our objective, we created and investigated a mouse line wherein HEXIM1 was re-expressed in adult cardiomyocytes to levels found in the foetal heart. Our findings support a beneficial role for HEXIM1 through increased vascularization, myocardial growth, and increased ejection fraction within the adult heart. HEXIM1 re-expression induces angiogenesis, that is, essential for physiological hypertrophy and maintenance of cardiac function. The ability of HEXIM1 to co-ordinate processes associated with physiological hypertrophy may be attributed to HEXIM1 regulation of other transcription factors (HIF-1-α, c-Myc, GATA4, and PPAR-α) that, in turn, control many genes involved in myocardial vascularization, growth, and metabolism. Moreover, the mechanism for HEXIM1-induced physiological hypertrophy appears to be distinct from that involving the PI3K/AKT pathway. CONCLUSION HEXIM1 re-expression results in the induction of angiogenesis that allows for the co-ordination of tissue growth and angiogenesis during physiological hypertrophy.
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Affiliation(s)
- Monica M. Montano
- Department of Pharmacology, Case Western Reserve University School of Medicine, H.G. Wood Bldg. W307, 2109 Adelbert Road, Cleveland, OH 44106, USA
| | - Candida L. Desjardins
- Department of Biomedical Engineering, Case Western Reserve University School of Engineering, Cleveland, OH 44106, USA
| | - Yong Qui Doughman
- Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USA
- Department of Genetics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USA
- Department of Anatomy, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - Yee-Hsee Hsieh
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Yanduan Hu
- Department of Pharmacology, Case Western Reserve University School of Medicine, H.G. Wood Bldg. W307, 2109 Adelbert Road, Cleveland, OH 44106, USA
| | - Heather M. Bensinger
- Department of Pharmacology, Case Western Reserve University School of Medicine, H.G. Wood Bldg. W307, 2109 Adelbert Road, Cleveland, OH 44106, USA
| | - Connie Wang
- Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USA
- Department of Genetics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USA
- Department of Anatomy, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - Julian E. Stelzer
- Department of Physiology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Thomas E. Dick
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Brian D. Hoit
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Margaret P. Chandler
- Department of Physiology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Xin Yu
- Department of Biomedical Engineering, Case Western Reserve University School of Engineering, Cleveland, OH 44106, USA
| | - Michiko Watanabe
- Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USA
- Department of Genetics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USA
- Department of Anatomy, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USA
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Smith DL, Barr DA, Kales SN. Extreme sacrifice: sudden cardiac death in the US Fire Service. EXTREME PHYSIOLOGY & MEDICINE 2013; 2:6. [PMID: 23849605 PMCID: PMC3710100 DOI: 10.1186/2046-7648-2-6] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 11/30/2012] [Indexed: 01/19/2023]
Abstract
Firefighting is a hazardous profession which has claimed on average the lives of 105 US firefighters per year for the past decade. The leading cause of line-of-duty mortality is sudden cardiac death, which accounts for approximately 45% of all firefighter duty-related fatalities. Strenuous physical activity, emotional stress, and environmental pollutants all strain the cardiovascular system, and each can increase the risk of sudden cardiac events in susceptible individuals. Sudden cardiac death is more likely to occur during or shortly after emergency duties such as fire suppression, despite the fact that these duties comprise a relatively small proportion of firefighters' annual duties. Additionally, cardiac events are more likely to occur in firefighters who possess an excess of traditional risk factors for cardiovascular disease along with underlying atherosclerosis and/or structural heart disease. In this review, we propose a theoretical model for the interaction between underlying cardiovascular disease in firefighters and the multifactorial physiological strain of firefighting.
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Affiliation(s)
- Denise L Smith
- Health and Exercise Sciences, Skidmore College, 815 North Broadway, Saratoga Springs, NY 12866, USA
- University of Illinois Fire Service Institute, 11 Gerty Drive, Champaign, IL 61820, USA
| | - David A Barr
- Health and Exercise Sciences, Skidmore College, 815 North Broadway, Saratoga Springs, NY 12866, USA
| | - Stefanos N Kales
- Harvard School of Public Health, Harvard Medical School, Occupational Medicine, Cambridge Hospital, Macht Building Suite 427, 1493 Cambridge Street, Cambridge, MA, 02139, USA
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Current world literature. Curr Opin Cardiol 2011; 27:62-5. [PMID: 22146379 DOI: 10.1097/hco.0b013e32834f4ed9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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