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Hosseini SA, Karampourian A, Shamsizadeh M, Mohammadi Y. Application of Haddon strategy training on self-care behavior and disease consequences in heart failure. JOURNAL OF VASCULAR NURSING 2023. [DOI: 10.1016/j.jvn.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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2
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Leaky Gut and the Ingredients That Help Treat It: A Review. Molecules 2023; 28:molecules28020619. [PMID: 36677677 PMCID: PMC9862683 DOI: 10.3390/molecules28020619] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/31/2022] [Accepted: 01/01/2023] [Indexed: 01/11/2023] Open
Abstract
The human body is in daily contact with potentially toxic and infectious substances in the gastrointestinal tract (GIT). The GIT has the most significant load of antigens. The GIT can protect the intestinal integrity by allowing the passage of beneficial agents and blocking the path of harmful substances. Under normal conditions, a healthy intestinal barrier prevents toxic elements from entering the blood stream. However, factors such as stress, an unhealthy diet, excessive alcohol, antibiotics, and drug consumption can compromise the composition of the intestinal microbiota and the homeostasis of the intestinal barrier function of the intestine, leading to increased intestinal permeability. Intestinal hyperpermeability can allow the entry of harmful agents through the junctions of the intestinal epithelium, which pass into the bloodstream and affect various organs and systems. Thus, leaky gut syndrome and intestinal barrier dysfunction are associated with intestinal diseases, such as inflammatory bowel disease and irritable bowel syndrome, as well as extra-intestinal diseases, including heart diseases, obesity, type 1 diabetes mellitus, and celiac disease. Given the relationship between intestinal permeability and numerous conditions, it is convenient to seek an excellent strategy to avoid or reduce the increase in intestinal permeability. The impact of dietary nutrients on barrier function can be crucial for designing new strategies for patients with the pathogenesis of leaky gut-related diseases associated with epithelial barrier dysfunctions. In this review article, the role of functional ingredients is suggested as mediators of leaky gut-related disorders.
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Kamra K, Karpuk N, Adam R, Zucker IH, Schultz HD, Wang HJ. Time-dependent alteration in the chemoreflex post-acute lung injury. Front Physiol 2022; 13:1009607. [PMID: 36338487 PMCID: PMC9630356 DOI: 10.3389/fphys.2022.1009607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/04/2022] [Indexed: 11/30/2022] Open
Abstract
Acute lung injury (ALI) induces inflammation that disrupts the normal alveolar-capillary endothelial barrier which impairs gas exchange to induce hypoxemia that reflexively increases respiration. The neural mechanisms underlying the respiratory dysfunction during ALI are not fully understood. The purpose of this study was to investigate the role of the chemoreflex in mediating abnormal ventilation during acute (early) and recovery (late) stages of ALI. We hypothesized that the increase in respiratory rate (fR) during post-ALI is mediated by a sensitized chemoreflex. ALI was induced in male Sprague-Dawley rats using a single intra-tracheal injection of bleomycin (Bleo: low-dose = 1.25 mg/Kg or high-dose = 2.5 mg/Kg) (day 1) and respiratory variables- fR, Vt (Tidal Volume), and VE (Minute Ventilation) in response to 10% hypoxia (10% O2, 0% CO2) and 5% hypercapnia/21% normoxia (21% O2, 5% CO2) were measured weekly from W0-W4 using whole-body plethysmography (WBP). Our data indicate sensitization (∆fR = 93 ± 31 bpm, p < 0.0001) of the chemoreflex at W1 post-ALI in response to hypoxic/hypercapnic gas challenge in the low-dose bleo (moderate ALI) group and a blunted chemoreflex (∆fR = -0.97 ± 42 bpm, p < 0.0001) at W1 post-ALI in the high-dose bleo (severe ALI) group. During recovery from ALI, at W3-W4, both low-dose and high-dose groups exhibited a sensitized chemoreflex in response to hypoxia and normoxic-hypercapnia. We then hypothesized that the blunted chemoreflex at W1 post-ALI in the high-dose bleo group could be due to near maximal tonic activation of chemoreceptors, called the "ceiling effect". To test this possibility, 90% hyperoxia (90% O2, 0% CO2) was given to bleo treated rats to inhibit the chemoreflex. Our results showed no changes in fR, suggesting absence of the tonic chemoreflex activation in response to hypoxia at W1 post-ALI. These data suggest that during the acute stage of moderate (low-dose bleo) and severe (high-dose bleo) ALI, chemoreflex activity trends to be slightly sensitized and blunted, respectively while it becomes significantly sensitized during the recovery stage. Future studies are required to examine the molecular/cellular mechanisms underlying the time-course changes in chemoreflex sensitivity post-ALI.
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Affiliation(s)
- Kajal Kamra
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, United States,Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE, United States
| | - Nikolay Karpuk
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE, United States
| | - Ryan Adam
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, United States
| | - Irving H. Zucker
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, United States
| | - Harold D. Schultz
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, United States
| | - Han-Jun Wang
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, United States,Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE, United States,*Correspondence: Han-Jun Wang,
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Jovanović JĐ, Antonijević M, Vojinović R, Filipović ND, Marković Z. In silico study of inhibitory capacity of sacubitril/valsartan toward neprilysin and angiotensin receptor. RSC Adv 2022; 12:29719-29726. [PMID: 36321085 PMCID: PMC9575392 DOI: 10.1039/d2ra04226f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/11/2022] [Indexed: 01/24/2023] Open
Abstract
Heart failure (HF) is a life-threatening condition that occurs when the heart cannot pump enough blood and oxygen to meet the body's needs. It affects mostly the elderly, commonly from the male population, especially those with obesity, diabetes, or some other chronic condition. It can be treated with different medications, and promising results were shown by a relatively new medicament called Entresto. Results obtained from molecular docking and molecular dynamics simulations to examine the inhibitory capacity of Entresto are presented in this study. Parameters obtained by the molecular docking simulations show that both parts of Entresto (sacubitril (SAC) and valsartan (VAL)) interact with targeted proteins, and inhibit their physiological function. Simulations of molecular dynamics revealed some interesting inhibitory patterns. SAC was discovered to produce structural alterations in neprilysin by binding to it, reducing neprilysin's physiological activity. In addition to blocking the active site, SAC binding causes the enzyme's structure to become less compact over time, causing changes in its biochemical characteristics and preventing the enzyme from performing its biological function. Similar to SAC, VAL also causes deviations in the structure of angiotensin receptors. The angiotensin receptor GPCR (G-protein-coupled receptors) is immersed in the lipid bilayer, and changes in the tertiary structure are only visible through RMSD and RMSF, not by examining R g. In this regard, MD simulations validated the results of molecular docking simulations, demonstrating that both SAC and VAL had inhibitory potential towards the neprilysin and angiotensin receptors, respectively.
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Affiliation(s)
- Jelena Đorović Jovanović
- Department of Science, Institute for Information Technologies, University of Kragujevac Jovana Cvijića bb 34000 Kragujevac Republic of Serbia
| | - Marko Antonijević
- Department of Science, Institute for Information Technologies, University of Kragujevac Jovana Cvijića bb 34000 Kragujevac Republic of Serbia
| | - Radiša Vojinović
- Faculty of Medical Sciences, University of Kragujevac Svetozara Markovića 69 34000 Kragujevc Republic of Serbia
| | - Nenad D Filipović
- Faculty of Engineering, University of Kragujevac Sestre Janjić 6 34000 Kragujevac Republic of Serbia
| | - Zoran Marković
- Department of Science, Institute for Information Technologies, University of Kragujevac Jovana Cvijića bb 34000 Kragujevac Republic of Serbia
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Dogheim GM, Amralla MT, Werida RH. Role of neopterin as an inflammatory biomarker in congestive heart failure with insights on effect of drug therapies on its level. Inflammopharmacology 2022; 30:1617-1622. [PMID: 35876931 PMCID: PMC9499907 DOI: 10.1007/s10787-022-01028-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 06/23/2022] [Indexed: 11/06/2022]
Abstract
Inflammation has a major role in the pathogenesis of heart failure (HF). It triggers a cascade that leads to the release of pro-inflammatory cytokines which in turn cause cardiac hypertrophy, fibrosis, apoptosis, negative inotorpy and leukocyte recruitment which worsen the condition. Neopterin is an inflammatory biomarker which is released as a response to macrophage activation. Levels of neopterin are elevated in conditions which has an immunological component such as autoimmune disease, viral and bacterial infections and malignancy. Neopterin levels were found to be elevated in patients with HF. This is due to the fact that inflammation takes place during the development of the condition. Studies demonstrated that neopterin can be used as a biomarker for diagnosing HF, determining severity of the disease and monitoring its progression. Neopterin levels were higher in patients with New York Heart Association classification (NYHA) III–IV more than class I–II. Moreover, neopterin levels correlated well with morbidity and mortality. It has been suggested that neopterin be monitored levels to determine effectiveness of HF treatment options.
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Affiliation(s)
- Gaidaa M Dogheim
- Pharmacy Practice Department, Faculty of Pharmacy, Alexandria University, Al Mesallah Sharq, Qism Bab Sharqi, Alexandria Governorate, Alexandria, 21500, Egypt.
| | - Mohamed T Amralla
- Bachelor Degree, Faculty of Pharmacy, Alexandria University, Alexandria, 21500, Egypt
| | - Rehab H Werida
- Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Damanhour University, Damanhour, 22514, Egypt
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Krishnan A, Sharma H, Yuan D, Trollope AF, Chilton L. The Role of Epicardial Adipose Tissue in the Development of Atrial Fibrillation, Coronary Artery Disease and Chronic Heart Failure in the Context of Obesity and Type 2 Diabetes Mellitus: A Narrative Review. J Cardiovasc Dev Dis 2022; 9:jcdd9070217. [PMID: 35877579 PMCID: PMC9318726 DOI: 10.3390/jcdd9070217] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 12/07/2022] Open
Abstract
Cardiovascular diseases (CVDs) are a significant burden globally and are especially prevalent in obese and/or diabetic populations. Epicardial adipose tissue (EAT) surrounding the heart has been implicated in the development of CVDs as EAT can shift from a protective to a maladaptive phenotype in diseased states. In diabetic and obese patients, an elevated EAT mass both secretes pro-fibrotic/pro-inflammatory adipokines and forms intramyocardial fibrofatty infiltrates. This narrative review considers the proposed pathophysiological roles of EAT in CVDs. Diabetes is associated with a disordered energy utilization in the heart, which promotes intramyocardial fat and structural remodeling. Fibrofatty infiltrates are associated with abnormal cardiomyocyte calcium handling and repolarization, increasing the probability of afterdepolarizations. The inflammatory phenotype also promotes lateralization of connexin (Cx) proteins, undermining unidirectional conduction. These changes are associated with conduction heterogeneity, together creating a substrate for atrial fibrillation (AF). EAT is also strongly implicated in coronary artery disease (CAD); inflammatory adipokines from peri-vascular fat can modulate intra-luminal homeostasis through an “outside-to-inside” mechanism. EAT is also a significant source of sympathetic neurotransmitters, which promote progressive diastolic dysfunction with eventual cardiac failure. Further investigations on the behavior of EAT in diabetic/obese patients with CVD could help elucidate the pathogenesis and uncover potential therapeutic targets.
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Affiliation(s)
- Anirudh Krishnan
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia; (A.K.); (H.S.); (D.Y.)
| | - Harman Sharma
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia; (A.K.); (H.S.); (D.Y.)
| | - Daniel Yuan
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia; (A.K.); (H.S.); (D.Y.)
| | - Alexandra F. Trollope
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia;
| | - Lisa Chilton
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Correspondence:
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Xie J, Li L. Letter regarding 'Acute and short-term efficacy of sauna treatment on cardiovascular function: a meta-analysis'. Eur J Cardiovasc Nurs 2021; 20:728-729. [PMID: 34329398 DOI: 10.1093/eurjcn/zvab049] [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: 11/14/2022]
Affiliation(s)
- Jian Xie
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Cardiovascular Institute, Shuangyong Street No.6, Nanning, Guangxi 53000, China
| | - Lang Li
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Cardiovascular Institute, Shuangyong Street No.6, Nanning, Guangxi 53000, China
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Wang Y, Chen Y, Yang M, Chen C. Effects of ginsenoside Rb1 on serum brain natriuretic peptide level and caspase-3 protein expression in cardiomyocytes of rats with chronic heart failure. Pharmacogn Mag 2021. [DOI: 10.4103/pm.pm_561_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Firouzabadi N, Dashti M, Dehshahri A, Bahramali E. Biomarkers of IL-33 and sST2 and Lack of Association with Carvedilol Therapy in Heart Failure. Clin Pharmacol 2020; 12:53-58. [PMID: 32607003 PMCID: PMC7305854 DOI: 10.2147/cpaa.s256290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/29/2020] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE The IL-33/ST2 pathway plays a fundamental role in the cardiovascular system and can be considered as a new therapeutic strategy for the treatment or prevention of cardiovascular diseases. ST2, as an interleukin (IL)-1 receptor family member, has transmembrane (ST2L) and soluble (sST2) isoforms. sST2 neutralizes IL-33 and thereby inhibits the cardioprotective role of IL-33/ST2L signaling pathway. Increase in sST2 level is associated with weak cardiac output and can be a predictor of mortality in heart failure (HF). Thereby, we hypothesized that there may be a relationship between the cardioprotective effects of carvedilol and sST2 and IL-3 in HF patients. METHODS sST2 and IL-33 were measured in serum of 66 individuals; 22 healthy volunteers and 44 suffering from HF; among whom 25 patients received carvedilol and the other 19 patients did not receive any β-blockers. RESULTS Lack of association between serum levels of IL-33 and sST2 was observed between HF patients and healthy individuals (2.4466 ± 0.69 vs 2.6748 ± 0.33 and 3416.6 ± 1089.1 vs 2971.6 ± 792.5, respectively). Our results indicated no significant difference between sST2 and IL-33 levels in HF patients who did not receive beta-blockers and patients receiving carvedilol (P=0.59 and P=0.97). CONCLUSION Our results showed a lack of association between serum levels of IL-33 and sST2 and HF. Moreover, the results do not confirm the cardioprotective mechanism of carvedilol by means of IL-33/sST2 pathway.
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Affiliation(s)
- Negar Firouzabadi
- Department of Pharmacology and Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Maryam Dashti
- Department of Pharmacology and Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Dehshahri
- Department of Pharmaceutical Biotechnology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ehsan Bahramali
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Torres WM, Barlow SC, Moore A, Freeburg LA, Hoenes A, Doviak H, Zile MR, Shazly T, Spinale FG. Changes in Myocardial Microstructure and Mechanics With Progressive Left Ventricular Pressure Overload. JACC Basic Transl Sci 2020; 5:463-480. [PMID: 32478208 PMCID: PMC7251228 DOI: 10.1016/j.jacbts.2020.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 01/08/2023]
Abstract
This study assessed the regional changes in myocardial geometry, microstructure, mechanical behavior, and properties that occur in response to progressive left ventricular pressure overload (LVPO) in a large animal model. Using an index of local biomechanical function at early onset of LVPO allowed for prediction of the magnitude of left ventricular chamber stiffness (Kc) and left atrial area at LVPO late timepoints. Our study found that LV myocardial collagen content alone was insufficient to identify mechanisms for LV myocardial stiffness with progression to heart failure with preserved ejection fraction (HFpEF). Serial assessment of regional biomechanical function might hold value in monitoring the natural history and progression of HFpEF, which would allow evaluation of novel therapeutic approaches.
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Key Words
- Ct, cycle time
- EDV, end-diastolic volume
- EF, ejection fraction
- ESV, end-systolic volume
- HF, heart failure
- HFpEF, heart failure with preserved ejection fraction
- HFrEF, heart failure with reduced ejection fraction
- IVRT, isovolumic relaxation time
- LA, left atrial
- LV, left ventricular
- LVPO, left ventricular pressure overload
- NT-proBNP, N-terminal pro-brain natriuretic peptide
- PCR, polymerase chain reaction
- PRSW, pre-load recruitable stroke work
- SHG, second harmonic generation
- STE, speckle tracking echocardiography
- echocardiography
- heart failure
- pressure overload
- qPCR, quantitative real-time PCR
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Affiliation(s)
- William M. Torres
- College of Engineering and Computing, University of South Carolina, Columbia, South Carolina
- Cardiovascular Translational Research Center, University of South Carolina School of Medicine and the Columbia Veteran Affairs Healthcare Center, Columbia, South Carolina
| | - Shayne C. Barlow
- Cardiovascular Translational Research Center, University of South Carolina School of Medicine and the Columbia Veteran Affairs Healthcare Center, Columbia, South Carolina
| | - Amber Moore
- Cardiovascular Translational Research Center, University of South Carolina School of Medicine and the Columbia Veteran Affairs Healthcare Center, Columbia, South Carolina
| | - Lisa A. Freeburg
- Cardiovascular Translational Research Center, University of South Carolina School of Medicine and the Columbia Veteran Affairs Healthcare Center, Columbia, South Carolina
| | - Abigail Hoenes
- Cardiovascular Translational Research Center, University of South Carolina School of Medicine and the Columbia Veteran Affairs Healthcare Center, Columbia, South Carolina
| | - Heather Doviak
- Cardiovascular Translational Research Center, University of South Carolina School of Medicine and the Columbia Veteran Affairs Healthcare Center, Columbia, South Carolina
| | - Michael R. Zile
- Medical University of South Carolina and RHJ Department of Veterans Affairs Medical Center, Charleston, South Carolina
| | - Tarek Shazly
- College of Engineering and Computing, University of South Carolina, Columbia, South Carolina
| | - Francis G. Spinale
- College of Engineering and Computing, University of South Carolina, Columbia, South Carolina
- Cardiovascular Translational Research Center, University of South Carolina School of Medicine and the Columbia Veteran Affairs Healthcare Center, Columbia, South Carolina
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Sun D, Zhang F, Ma T, Zhang Y, Liang Z. Atorvastatin alleviates left ventricular remodeling in isoproterenol-induced chronic heart failure in rats by regulating the RhoA/Rho kinase signaling pathway. Pharmacol Rep 2020; 72:903-911. [PMID: 32144744 DOI: 10.1007/s43440-020-00085-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/13/2020] [Accepted: 02/21/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Chronic heart failure (CHF) is characterized by left ventricular dysfunction and altered autonomic control of cardiac function. This study aimed to investigate the effects of atorvastatin on left ventricular remodeling (LVR) and cardiac function in rats with isoproterenol-induced CHF and the possible mechanism. METHODS An isoproterenol-induced CHF model was established in rata, which were subsequently treated with atorvastatin. Echocardiography, hemodynamic, and left ventricular mass indexes were assessed. The mRNA expression of RhoA, Rho kinase, and endothelial nitric oxide synthase (eNOS) was determined by RT-qPCR. The protein expression of myosin-binding subunit (MBS), MBS-P, eNOS, phosphorylated-eNOS, RhoA, and Rho kinase was measured by Western blot analysis. The relative activity of NADPH oxidase, ROS, and NO was assessed by ELISA. RESULTS Isoproterenol-induced CHF rats treated with atorvastatin exhibited decreased left ventricular end-systolic dimension, left ventricular end-diastolic dimension, left ventricular end-diastolic pressure, left ventricular mass index, maximum fall rate of change in left ventricular pressure, heart rate (p < 0.001), expression of RhoA, Rho kinase, MBS and MBS-P (p < 0.01), and relative activity of NADPH oxidase, ROS and NO (p < 0.05) and increased left ventricular short axis fractional shortening, left ventricular end-systolic pressure, maximum rise rate of change in left ventricular pressure (p < 0.001) and expression of eNOS, and phosphorylated-eNOS ser1177 (all p < 0.05) compared with those of rats with isoproterenol-induced CHF. CONCLUSION We demonstrated that atorvastatin inhibits LVR and improves cardiac function in rats with isoproterenol-induced CHF through inhibition of the RhoA/Rho kinase signaling pathway.
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Affiliation(s)
- Dingjun Sun
- Department of Cardiology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital (Haikou People's Hospital), Haikou, 570208, People's Republic of China
| | - Fuwei Zhang
- Department of Cardiology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital (Haikou People's Hospital), Haikou, 570208, People's Republic of China
| | - Tianyi Ma
- Department of Cardiology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital (Haikou People's Hospital), Haikou, 570208, People's Republic of China
| | - Yixue Zhang
- Department of Cardiology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital (Haikou People's Hospital), Haikou, 570208, People's Republic of China
| | - Zhongshu Liang
- Department of Cardiology, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, People's Republic of China.
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Wang Y, Ma X. Relationship between changes of electrocardiogram indexes in chronic heart failure with arrhythmia and serum PIIINP and BNP. Exp Ther Med 2020; 19:591-596. [PMID: 31897101 PMCID: PMC6923753 DOI: 10.3892/etm.2019.8269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 11/20/2019] [Indexed: 01/01/2023] Open
Abstract
Relationship between changes of electrocardiogram (ECG) indexes in chronic heart failure (CHF) with arrhythmia and serum type III procollagen amino-terminal peptide (PIIINP) and brain natriuretic peptide (BNP) were evaluated. From December 2017 to December 2018, 101 patients with heart failure (HF) were collected. Among them, 48 patients with HF and slow arrhythmia were in group A, and 53 cases of HF with non-slow arrhythmia were sin group B, including 33 males and 20 females. BNP was detected by chemiluminescence and PIIINP was detected by immunoassay. The changes of ECG indexes in the two groups, the correlation between serum PIIINP and BNP and NYHA classification of cardiac function, and the correlation between ECG indexes and PIIINP and BNP were detected. ROC curve analysis of BNP and PIIINP in the diagnosis of slow HF was carried out. Serum PIIINP and BNP in group A were significantly higher than those in group B (P<0.05). The levels of PIIINP and BNP in serum of NYHA patients with different cardiac functions, and those in serum of patients with class III were significantly higher than those of group II (P<0.05), while significantly lower than those of group IV (P<0.05). The heart rate and Q-T interval in group A were significantly higher than those in group B (P<0.05). The P-R interval and QES wave group in group A were significantly lower than those in group B (P<0.05). BNP had a positive correlation with Hr and G-T, and was negatively correlated with P-R and QRS; PIIINP was positively correlated with Hr and G-T, and had a negative correlation with P-R, QRS and BNP; PIIINP had positive correlation with NYHA; ECG indexes were correlated with BNP and PIIINP, and had diagnostic value for CHF. Using ECG indexes to predict BNP and PIIINP levels was conducive to the diagnosis of CHF.
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Affiliation(s)
- Yue Wang
- Electrocardiogram Room, Yantai Yuhuangding Hospital, Yantai, Shandong 264000, P.R. China
| | - Xiaoke Ma
- Departnent of Laboratory Medicine, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong 264000, P.R. China
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Wang Z, Chen L, Zhang J, Yin Y, Li D. Multi-view ensemble learning with empirical kernel for heart failure mortality prediction. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2020; 36:e3273. [PMID: 31680466 DOI: 10.1002/cnm.3273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/30/2019] [Accepted: 09/30/2019] [Indexed: 06/10/2023]
Abstract
Heart failure (HF) refers to the heart's inability to pump sufficient blood to maintain the body's needs, which has a very serious impact on human health. In recent years, the prevalence of HF has remained high. This paper proposes a multi-view ensemble learning algorithm based on empirical kernel mapping called MVE-EK, which predicts the mortality of patient through hospital records. Multi-view ensemble learning can take advantage of the consistency and complementarity of different views. The MVE-EK first divides the patient's features into multiple views and then divides the samples of each view to multiple subsets through under sampling, which can reduce the imbalance rate of the original dataset and obtain some relatively balanced subsets. Each subset is mapped into kernel space by empirical kernel mapping, which can map samples from linearly inseparable spaces to linearly separable spaces. Finally, the multi-view ensemble learning is performed by the designed loss of acquaintance between views. The effectiveness of the algorithm is verified on the three datasets of HF patient in the real world. The performance of the algorithm is better than other comparison algorithms. The datasets are collected from Shanghai Shuguang Hospital and involve 10 203 hospitalization records for 4682 HF patients between March 2009 and April 2016. The prediction information provided by the algorithm can assist the clinician in providing a more personalized treatment plan for patients with HF.
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Affiliation(s)
- Zhe Wang
- Key Laboratory of Advanced Control and Optimization for Chemical Processes, Ministry of Education, East China University of Science and Technology, Shanghai, People's Republic of China
- Department of Computer Science and Engineering, East China University of Science and Technology, Shanghai, People's Republic of China
| | - Lilong Chen
- Key Laboratory of Advanced Control and Optimization for Chemical Processes, Ministry of Education, East China University of Science and Technology, Shanghai, People's Republic of China
- Department of Computer Science and Engineering, East China University of Science and Technology, Shanghai, People's Republic of China
| | - Jing Zhang
- Department of Computer Science and Engineering, East China University of Science and Technology, Shanghai, People's Republic of China
| | - Yichao Yin
- Information Center, Shanghai Shuguang Hospital, Shanghai, People's Republic of China
| | - Dongdong Li
- Department of Computer Science and Engineering, East China University of Science and Technology, Shanghai, People's Republic of China
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Yuan T, Chen Y, Zhou X, Lin X, Zhang Q. Effectiveness and safety of Danshen injection on heart failure: Protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e15636. [PMID: 31145280 PMCID: PMC6709174 DOI: 10.1097/md.0000000000015636] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 04/18/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Danshen injection (DSI) is a traditional Chinese medicine preparation extracted from Danshen (Salvia miltiorrhiza), which has the functions of promoting blood circulation and removing blood stasis. Heart failure (HF) is a complex cardiovascular disease, always leading to frequent onset and hospitalization, decreased quality of life, increased mortality, etc. Many clinical studies demonstrate that DSI has a good treatment on HF. We will provide a protocol to evaluate the effectiveness and safety of DSI for HF. METHODS We will systematically search 3 English databases (PubMed, Excerpta Medica database [EMBASE], the Cochrane Central Register of Controlled Trials [Cochrane Library]) and 4 Chinese databases (Chinese National Knowledge Infrastructure [CNKI], Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database [CBM]) for randomised controlled trials (RCT) of DSI for HF. Left ventricular ejection fraction (LVEF), ejection fraction, left ventricular end diastolic dimension (LVEDD), and six-minute walk distance (SWD) will be set as the primary outcome measures. The secondary outcome measures will include NT-pro BNP, quality of life and adverse reaction. All data will be analysed by using Stata 14.0 software and TSA v0.9 software. We will use I test statistics to assess the heterogeneity of included studies, and Begg's funnel plots and Egger's test to assess publication bias. Methodological quality will be assessed through a Cochrane risk of bias tool for randomized controlled trials (RCTs). RESULT This study will provide a high quality evidence for DSI on HF. CONCLUSION This protocol will provide a reliable evidence to evaluate the effectiveness and safety of DSI on HF. REGISTRATION PROS-PERO CRD42019125274.
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Affiliation(s)
- Tianhui Yuan
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine
| | - Yi Chen
- Guangzhou University of Chinese Medicine, Guangzhou
| | - Xiaoqi Zhou
- Guangzhou University of Chinese Medicine, Guangzhou
| | - Xueying Lin
- Guangzhou University of Chinese Medicine, Guangzhou
| | - Qingsong Zhang
- Shenzhen Baoan Traditional Chinese Medicine Hospital Group, Guangdong Sheng, China
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15
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Zhao Y, Gu Z, Zhao X, Wang L, Gao M. Association of CTLA4 and NFKB1 polymorphisms with chronic heart failure: a case-control study in the Chinese population. EUR J INFLAMM 2019. [DOI: 10.1177/2058739219852851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Previous works have demonstrated the involvement of cytotoxic T-lymphocyte antigen 4 (CTLA-4) and nuclear factor kappa B (NF-κB) in maintaining the normal physiology of the heart. Polymorphisms in genes encoding these proteins may affect their normal functions, which could subsequently lead to chronic heart failure (CHF). In this work, we examined the association of CTLA4 and NFKB1 polymorphisms with CHF in a Chinese population. The −318C>T and +49A>G polymorphisms of CTLA4 and −94 insertion/deletion ATTG polymorphism of NFKB1 were genotyped on 538 patients with CHF and 1076 healthy controls. Our data indicate that the CTLA4 +49A>G and NFKB1 polymorphisms could confer susceptibility to CHF among Chinese. A significantly increased CHF risk was observed for the mutant CTLA4 +49GG genotype ( P = 0.0093), and both heterozygous ATTG1/ATTG2 ( P = 0.0142) and mutant ATTG2/ATTG2 ( P = 0.0018) genotypes of NFKB1. Our data suggest that there is a potential use of these polymorphisms for early genetic screening for CHF.
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Affiliation(s)
- Yue Zhao
- Department of Cardiovascular, First People’s Hospital, Baiyin, China
| | - Zhenying Gu
- Fu Ping Township Public Health Center, Baiyin, China
| | - Xiaoge Zhao
- Key Laboratory of Environment and Genes Related to Diseases, Medical School of Xi’an Jiaotong University, Xi’an, China
| | - Liqin Wang
- Department of Cardiovascular, Xi’an Medical College, Xi’an, China
| | - Meizhu Gao
- Department of Cardiovascular, First People’s Hospital, Baiyin, China
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16
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Ghafarian F, Pashirzad M, Khazaei M, Rezayi M, Hassanian SM, Ferns GA, Avan A. The clinical impact of exosomes in cardiovascular disorders: From basic science to clinical application. J Cell Physiol 2018; 234:12226-12236. [PMID: 30536994 DOI: 10.1002/jcp.27964] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 11/19/2018] [Indexed: 12/13/2022]
Abstract
Cardiovascular disease (CVD) is the major cause of death globally; therefore, there is a need for the identification of a valid biomarker that accurately predicts the risk of developing CVD, and novel therapeutic approaches for its treatment. Exosomes are very small extracellular vesicles containing protein, lipid, transcription factors, messenger RNAs, noncoding RNA, and nucleic acid contents that are important players in intercellular communication, and that act via long-range signals or cell-to-cell contact. The discovery of exosomes provides potential strategies for the diagnosis and treatment of CVD. In the current review, we have explored the potential impact of exosomes on cardiovascular physiology, and their therapeutic potential in cardiovascular disorders with an emphasis on the existing preclinical studies.
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Affiliation(s)
- Farzaneh Ghafarian
- Department of Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehran Pashirzad
- Department of Medical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Khazaei
- Department of Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Rezayi
- Department of Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mahdi Hassanian
- Department of Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Department of Division of Medical Education, Falmer, Brighton, Sussex, UK
| | - Amir Avan
- Department of Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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17
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Yan X, Jiao K, Song X. Shen’ge powder decreases the cardiomyocyte hypertrophy in chronic heart failure by activating the Rho protein/Rho‐associated coiledcoil forming protein kinase signaling pathway. J Cell Biochem 2018; 120:3038-3045. [PMID: 30474257 DOI: 10.1002/jcb.27386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/09/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Xinpeng Yan
- Department of Traditional Chinese Medicine Shengli Oilfield Central Hospital Dongying Shandong PR China
| | - Kai Jiao
- Department of Cardiology Shengli Oilfield Central Hospital Dongying Shandong PR China
| | - Xiaozheng Song
- Department of Cardiology Shengli Oilfield Central Hospital Dongying Shandong PR China
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18
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Effects of levocarnitine on cardiac function, urinary albumin, hs-CRP, BNP, and troponin in patients with coronary heart disease and heart failure. Hellenic J Cardiol 2018; 61:99-102. [PMID: 30195728 DOI: 10.1016/j.hjc.2018.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 08/29/2018] [Accepted: 08/31/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the effects of levocarnitine on cardiac function, urinary albumin (ALB), high-sensitivity C-reactive protein (hs-CRP), brain natriuretic peptide (BNP), and troponin in patients with coronary heart disease (CHD) and heart failure (HF). METHODS In total, 246 patients with CHD-caused HF were selected and randomly divided into Group A and Group B. A fully automatic biochemical analyzer was used to measure the levels of ALB, hs-CRP, BNP, and troponin in both groups of patients, and the expression levels of LVDD and LVEF were detected by cardiac color ultrasonography. Patients in Group B were intravenously injected with 3.0 g of levocarnitine, once per day. After 14 days, changes in levels of ALB, hs-CRP, BNP, troponin, LVDD, and LVEF in Group A patients were detected. RESULTS The effective cure rates of patients in both groups were 65.8% and 81.3%, respectively, and there was a statistically significant difference between the two groups (p < 0.05). After administration of levocarnitine, all indicators showed decreasing trends, but the LVEF level increased. Among them, patients treated with levocarnitine showed the most evident decrease in LVEF. Decrease in BNP was the largest (p < 0.05). Additionally, there was no statistical difference in incidence rate between the two groups (5.8% vs. 2.5%, p = 0.222). CONCLUSION Levocarnitine can effectively improve ALB, hs-CRP, BNP, troponin, and LVDD levels to improve cardiac function rating and thus improve cardiac function.
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Tian J, Xue J, Hu X, Han Q, Zhang Y. CHF-PROM: validation of a patient-reported outcome measure for patients with chronic heart failure. Health Qual Life Outcomes 2018; 16:51. [PMID: 29554963 PMCID: PMC5859646 DOI: 10.1186/s12955-018-0874-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 02/27/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Due to a lack of an appropriate disease-specific patient-reported outcome (PRO) instrument for chronic heart failure including its social support and treatment aspects in China, this study was performed to develop a patient-reported outcome measure (PROM) for patients with chronic heart failure and evaluate its reliability, validity, and feasibility. METHODS According to the standard PROM guidelines established by the Food and Drug Administration, an item pool was formed by reviewing a large amount of relevant literature and interviewing patients with chronic heart failure about their main symptoms. Thus, the primary scale was created after adjusting the items and language with the help of patients and experts in the field. Next, 155 patients from 8 hospitals in different districts were recruited for a pilot survey using questionnaires containing these items. The patients' responses were analyzed using the classical test theory and item response theory to select high-quality items and determine the subdomains of the scale. This was followed by a formal investigation in the same eight hospitals. In total, 360 patients and 100 healthy subjects were included to evaluate the reliability, validity, and feasibility of the items. Through this process, the final scale was established. RESULTS The final scale comprised 12 subdomains with 57 items related to physical, psychological, social, and therapeutic areas. The data analysis results of the formal investigation showed that the PROM for chronic heart failure had good reliability, validity, and feasibility. Reliability was verified by Cronbach's alpha coefficient, which was 0.913 for the total scale, 0.903 for the physical domain, 0.941 for the psychological domain, 0.827 for the social domain, and 0.839 for the therapeutic domain. The construct validity results met the relative criteria of confirmatory factor analysis. Discriminant validity was represented by score comparisons of nine subdomains. The response rate and the effective rate of return of the CHF-PROM were 98.94% and 98.92%, respectively. CONCLUSIONS The final scale coincides with the theoretical framework and better reflects the overall quality of life of patients with chronic heart failure. This scale can be used as a valid instrument to evaluate clinical treatment and clinical trials of chronic heart failure.
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Affiliation(s)
- Jing Tian
- Department of Cardiology, The 1st Hospital of Shanxi Medical University, 85 South Jiefang Road, Taiyuan, Shanxi Province 030001 China
| | - Jiangping Xue
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, Shanxi Province 030001 China
| | - Xiaojuan Hu
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, Shanxi Province 030001 China
| | - Qinghua Han
- Department of Cardiology, The 1st Hospital of Shanxi Medical University, 85 South Jiefang Road, Taiyuan, Shanxi Province 030001 China
| | - Yanbo Zhang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, Shanxi Province 030001 China
- Shanxi Medical University molecular imaging precision medicine Collaborative Innovation Center, Taiyuan, Shanxi Province 030001 China
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20
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Jiang Y, Wang J, Wang Y, Ke X, Zhang C, Yang R. Self-emulsifying drug delivery system improves preventive effect of curcuminoids on chronic heart failure in rats. Saudi Pharm J 2018; 26:528-534. [PMID: 29844725 PMCID: PMC5961756 DOI: 10.1016/j.jsps.2018.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 02/03/2018] [Indexed: 11/28/2022] Open
Abstract
Several studies have reported the preventive or therapeutic effect of curcuminoids on chronic heart failure (CHF), but their application was limited due to low solubility and bioavailability. Our previous study indicates that self-emulsifying drug delivery system (SEDDS) improves the solubility and bioavailability of curcuminoids. Thus, the aim of this work was to investigate whether SEDDS could improve preventive effect of curcuminoids on CHF in rats. CHF model was were established by coronary artery ligation. Ninety rats were randomly and averagely divided into sham, model, low- or high-dose suspension or SEDDS of curcuminoids (66.68 or 266.68 mg/kg) groups. Hemodynamic indices were recorded by multipurpose polygraph. Serum oxidative indices, B-type natriuretic peptide (BNP) and heart weight index were determined by kits and electronic balance. Myocardial infarct area, ventricular dilatation degree and collagen volume fraction of myocardial interstitium were analyzed by Masson staining, picric acid and sirius red staining, light microscopy and image analysis system. Myocardial histopathology was observed by hematoxylin and eosin staining, Masson staining and light microscopy. Reduction of ventricular pump function, increase of BNP level and heart weight index, myocardial lipid peroxidation damage, myocardial infarction, myocardial fibrosis, and cardiac enlargement were detected or observed in model group relative to those in sham group. After treatment with suspension or SEDDS of curcuminoids, the above-mentioned pathological changes were obviously reversed relative to those in model group. Meanwhile, the ameliorative effect of SEDDS of curcuminoids was markedly better than that of suspension of curcuminoids. This work provides a valuable reference from pharmacodynamics for development of curcuminoids pharmaceutics.
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Affiliation(s)
- Yunbin Jiang
- College of Pharmaceutical Sciences and Chinese Medicine, Southwest University, Chongqing 400715, China
| | - Junzhi Wang
- Hubei Key Laboratory of Natural Products Research and Development, College of Biological and Pharmaceutical Sciences, China Three Gorges University, Yichang 443002, China
| | - Yunhong Wang
- Institute of Chinese Medicine Preparation, Chongqing Academy of Chinese Materia Medica, Chongqing 400065, China
| | - Xiumei Ke
- Jiujiang Key Laboratory of Translational Medicine, Basic Medical College, Jiujiang University, Jiujiang 33200, China
| | - Chuanhui Zhang
- Institute of Chinese Medicine Preparation, Chongqing Academy of Chinese Materia Medica, Chongqing 400065, China
| | - Rongping Yang
- College of Pharmaceutical Sciences and Chinese Medicine, Southwest University, Chongqing 400715, China
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Lewis R, Hackfort BT, Schultz HD. Chronic Heart Failure Abolishes Circadian Rhythms in Resting and Chemoreflex Breathing. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1071:129-136. [PMID: 30357743 DOI: 10.1007/978-3-319-91137-3_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Physiological systems often display 24 h rhythms that vary with the light/dark cycle. Disruption of circadian physiological rhythms have been linked to the progression of various cardiovascular diseases, and advances in the understanding of these rhythms have led to novel interventions and improved clinical outcomes. Although respiratory function has been known to vary between the light and dark periods, circadian rhythms in breathing have been understudied in clinical conditions. In the current study, we have begun to assess light/dark variations in respiration in chronic heart failure (CHF), a condition associated with abnormal resting and chemoreflex breathing as well as exercise intolerance. CHF was induced using coronary artery ligation and verified using echocardiography. Sham animals underwent a thoracotomy without coronary artery ligation. Tidal volume, respiratory frequency, and minute ventilation were all determined by whole body plethysmography under resting conditions and in response to chemoreflex challenges during the light and dark periods. Light/dark differences in voluntary exercise were assessed using a running wheel. The sham control group showed light/dark differences in resting and chemoreflex breathing, as well as arterial pressure, and these effects were eliminated in the CHF group. Both groups completed more rotations on the running wheel during the dark period compared to during the light period. The data suggest that CHF disrupts cardiovascular and respiratory circadian rhythms.
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Affiliation(s)
- Robert Lewis
- A.T. Still University School of Osteopathic Medicine, Mesa, AZ, USA.
| | - Bryan T Hackfort
- Department of Cellular and Integrative Physiology at the University of Nebraska Medical Center, Omaha, NE, USA
| | - Harold D Schultz
- Department of Cellular and Integrative Physiology at the University of Nebraska Medical Center, Omaha, NE, USA
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Ding H, Jayasena R, Maiorana A, Dowling A, Chen SH, Karunanithi M, Layland J, Edwards I. Innovative Telemonitoring Enhanced Care Programme for Chronic Heart Failure (ITEC-CHF) to improve guideline compliance and collaborative care: protocol of a multicentre randomised controlled trial. BMJ Open 2017; 7:e017550. [PMID: 28993389 PMCID: PMC5640081 DOI: 10.1136/bmjopen-2017-017550] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/28/2017] [Accepted: 09/06/2017] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Chronic heart failure (CHF) is a life-threatening chronic disease characterised by periodic exacerbations and recurrent hospitalisations. In the management of CHF, patient compliance with evidence-based clinical guidelines is essential, but remains difficult practically. The objective of this study is to examine whether an Innovative Telemonitoring Enhanced Care Programme for CHF (ITEC-CHF) improves patients' compliance, and associated health and economic outcomes. METHODS AND ANALYSIS An open multicentre randomised controlled trial has been designed. Patients will be recruited and randomised to receive either ITEC-CHF (n=150) or usual care CHF (n=150) for at least 6 months. ITEC-CHF combines usual care and an additional telemonitoring service including remote weight monitoring, structured telephone support and nurse-led collaborative care. The primary outcomes are the compliance rates with the best-practice guidelines for daily weight monitoring. The secondary outcomes include the compliance with other guideline recommendations (health maintenance, medication, diet and exercise), health (health-related quality of life, risk factors, functional capacity and psychological states) and economic outcomes related to the use of healthcare resources such as hospital readmissions and general practitioner/emergency department visits. ETHICS AND DISSEMINATION The clinical trial has been approved by Peninsula Health Human Research Ethics Committee (HREC Reference: HREC/14/PH/27), Royal Perth Hospital Human Research Ethics Committee (Reference: 15-081) and the Curtin University Human Research Ethics Committee (Reference: HR 181/2014). We will disseminate the final results to the public via conferences and journal publications. A final study report will also be provided to the ethics committees. TRIAL REGISTRATION NUMBER Registered with Australian New Zealand Clinical Trial Registry (ACTRN12614000916640).
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Affiliation(s)
- Hang Ding
- The Australian e-Health Research Centre, CSIRO, Brisbane, QLD, Australia
| | - Rajiv Jayasena
- The Australian e-Health Research Centre, CSIRO, Melbourne, VIC, Australia
| | - Andrew Maiorana
- Allied Health Department and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, WA, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Alison Dowling
- Integrated Care & Dental, Peninsula Health, Melbourne, VIC, Australia
| | - Sheau Huey Chen
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Mohan Karunanithi
- The Australian e-Health Research Centre, CSIRO, Brisbane, QLD, Australia
| | - Jamie Layland
- Department of Cardiology, Peninsula Health, Melbourne, VIC, Australia
| | - Iain Edwards
- Integrated Care & Dental, Peninsula Health, Melbourne, VIC, Australia
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Helix B Surface Peptide Protects Cardiomyocytes Against Hypoxia/Reoxygenation-induced Apoptosis Through Mitochondrial Pathways. J Cardiovasc Pharmacol 2017; 67:418-26. [PMID: 26828322 DOI: 10.1097/fjc.0000000000000367] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Helix B surface peptide (HBSP), a newly developed tissue-protective erythropoietin derivative, has beneficial effects on myocardial ischemia. This study aimed to investigate the cardio-protective effects of HBSP against hypoxia/reoxygenation (H/R) injury and its possible mechanism. METHODS A rat-derived cardiomyocyte cell line (H9C2 cells) were established and pretreated with HBSP. The pretreated primary cultures were subjected to H/R and monitored for cell viability using the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide assay. Intracellular reactive oxygen species (ROS) levels, apoptosis, and mitochondrial membrane potential (ΔΨm) were detected by flow cytometry. The expression of cytochrome C and Bcl-2 family proteins, as well as the activities of caspases 3 and 9 were determined by Western blot analysis and a colorimetric method, respectively. RESULTS HBSP reduced apoptotic cells in cardiomyocytes subjected to H/R. In HBSP-treated cardiomyocytes, the H/R-induced mitochondrial ROS production, ΔΨm collapse, and cytochrome C release from mitochondria to the cytosol significantly decreased. Moreover, HBSP inhibited the activation of caspases 9 and 3, as well as the alteration of Bcl-2 family proteins, which were induced by H/R. CONCLUSIONS These results indicated that HBSP has protective effects against H/R-induced apoptosis by regulating the mitochondrial pathway. This mechanism involves inhibiting mitochondrial ROS generation, inhibiting caspase-3 activity, reducing ΔΨm collapse, reducing cytochrome release, and balancing anti and proapoptotic Bcl-2 family proteins.
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Nesiritide Therapy Is Associated With Better Clinical Outcomes Than Dobutamine Therapy in Heart Failure. Am J Ther 2017; 24:e181-e188. [PMID: 26164026 DOI: 10.1097/mjt.0000000000000278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
To evaluate the therapeutic effects of dobutamine and nesiritide in the treatment of heart failure (HF), a meta-analysis of published studies was conducted. Computerized bibliographic databases in Chinese and English languages were carefully searched to identify the relevant literature. A total of 6 cohort studies were enrolled in current meta-analysis for statistical analyses. The effect of dobutamine and nesiritide in patients with HF was estimated by odds ratios (ORs) and 95% confidence interval (CI). Our results revealed a significantly higher survival rate in nesiritide-treated patients, compared with those treated with dobutamine (OR = 1.97; 95% CI, 1.43-2.71; P < 0.001). In addition, a lower readmission rate was also associated with the nesiritide-treated group in comparison with the dobutamine-treated group (OR = 1.96; 95% CI, 1.39-2.78; P < 0.001). A stratified analysis revealed that the subgroup of patients with HF treated with nesiritide showed higher survival outcomes than those patients with HF treated with dobutamine when follow-up period was greater than 6 months (OR = 1.70; 95% CI, 1.21-2.38; P = 0.002) but not under 6 months (P > 0.05). This indicated that nesiritide treatment had longer term benefits as well. Interestingly, based on the reason for readmission, a subgroup analysis of the HF subgroup and the "all-cause" subgroup showed that higher readmission rates were associated with dobutamine treatment in both subgroups (HF: OR = 2.71; 95% CI, = 1.51-4.83; P = 0.001; all-cause: OR = 1.64; 95% CI, 1.06-2.53; P = 0.026; respectively). Our results suggest that nesiritide therapy is associated with a lower in-hospital mortality rates and decreased readmission rates compared with dobutamine treatment in patients with HF.
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Wang S, Long CL, Chen J, Cui WY, Zhang YF, Zhang H, Wang H. Pharmacological evidence: a new therapeutic approach to the treatment of chronic heart failure through SUR2B/Kir6.1 channel in endothelial cells. Acta Pharmacol Sin 2017; 38:41-55. [PMID: 27890915 PMCID: PMC5220542 DOI: 10.1038/aps.2016.118] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 09/13/2016] [Indexed: 12/20/2022] Open
Abstract
Both iptakalim (Ipt) and natakalim (Nat) activate the SUR2B/Kir6.1 channel, an ATP-sensitive potassium channel (KATP) subtype, with high selectivity. In this study we investigated the therapeutic effects of Ipt and Nat against isoproterenol-induced chronic heart failure (ISO-CHF) in rats, and demonstrated a new therapeutic approach to the treatment of CHF through activation of the SUR2B/Kir6.1 channel in endothelial cells. In ISO-CHF rats, oral administration of Nat (1, 3, 9 mg·kg-1·d-1) or Ipt (3 mg·kg-1·d-1) for 60 days significantly improved cardiac dysfunction, reversed cardiac remodeling, significantly attenuated the pathological increases in BNP levels, and improved endothelial dysfunction by adjusting the balance between endothelin and NO systems. The therapeutic effects of Nat were prevented by the selective KATP blocker glibenclamine (Gli, 50 mg·kg-1·d-1), confirming that these effects were mediated through activation of the SUR2B/Kir6.1 channel in endothelial cells. The molecular mechanisms underlying the therapeutic effects of Nat were further addressed using proteomic methods. We identified 724 proteins in the plasma of ISO-CHF rats; 55 proteins were related to Nat. These differentially expressed proteins were mainly involved in single-organism processes and the regulation of biological quality relative to CHF, including proteasome (Psm) and ATP protein clusters. We screened out PRKAR2β, GAS6/eNOS/NO and NO/PKG/VASP pathways involved in the amelioration of CHF among the 24 enriched pathways. We further confirmed 6 protein candidates, including PRKAR2β, GAS6 and VASP, which were involved in the endothelial mechanisms, and ATP, TIMP3 and AGT, which contributed to its cardiovascular actions. This study demonstrates a new pharmacological approach to the treatment of CHF through activation of the SUR2B/Kir6.1 channel in endothelial cells, and that the eNOS/VASP pathways are involved in its signaling mechanisms.
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Affiliation(s)
- Shang Wang
- Cardiovascular Drug Research Center, Institute of Health and Environmental Medicine, Academy of Military Medical Sciences, Beijing 100850, China
| | - Chao-liang Long
- Cardiovascular Drug Research Center, Institute of Health and Environmental Medicine, Academy of Military Medical Sciences, Beijing 100850, China
| | - Jun Chen
- Cardiovascular Drug Research Center, Institute of Health and Environmental Medicine, Academy of Military Medical Sciences, Beijing 100850, China
| | - Wen-yu Cui
- Cardiovascular Drug Research Center, Thadweik Academy of Medicine, Beijing 100039, China
| | - Yan-fang Zhang
- Cardiovascular Drug Research Center, Institute of Health and Environmental Medicine, Academy of Military Medical Sciences, Beijing 100850, China
| | - Hao Zhang
- Cardiovascular Drug Research Center, Institute of Health and Environmental Medicine, Academy of Military Medical Sciences, Beijing 100850, China
| | - Hai Wang
- Cardiovascular Drug Research Center, Institute of Health and Environmental Medicine, Academy of Military Medical Sciences, Beijing 100850, China
- Cardiovascular Drug Research Center, Thadweik Academy of Medicine, Beijing 100039, China
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Sane R, Aklujkar A, Patil A, Mandole R. Effect of heart failure reversal treatment as add-on therapy in patients with chronic heart failure: A randomized, open-label study. Indian Heart J 2016. [PMID: 28648417 PMCID: PMC5485380 DOI: 10.1016/j.ihj.2016.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The present study was designed to evaluate effect of heart failure reversal therapy (HFRT) using herbal procedure (panchakarma) and allied therapies, as add-on to standard CHF treatment (SCT) in chronic heart failure (CHF) patients. METHODS This open-label, randomized study conducted in CHF patients (aged: 25-65 years, ejection fraction: 30-65%), had 3-phases: 1-week screening, 6-week treatment (randomized [1:1] to HFRT+SCT or SCT-alone) and follow-up (12-week). Twice weekly HFRT (60-75min) consisting of snehana (external oleation), swedana (passive heat therapy), hrudaydhara (concoction dripping treatment) and basti (enema) was administered. Primary endpoints included evaluation of change in metabolic equivalents of task (MET) and peak oxygen uptake (VO2peak) from baseline, at end of 6-week treatment and follow-up at week-18 (non-parametric rank ANCOVA analysis). Safety and quality of life (QoL) was assessed. RESULTS Seventy CHF patients (n=35, each treatment-arm; mean [SD] age: 53.0 [8.6], 80% men) were enrolled in the study. All patients completed treatment phase. Add-on HFRT caused a significant increase in METs (least square mean difference [LSMD], 6-week: 1.536, p=0.0002; 18-week: -1.254, p=0.0089) and VO2peak (LSMD, 6-week: -5.52, p=0.0002; 18-week: -4.517, p=0.0089) as compared with SCT-alone. Results were suggestive of improved functional capacity in patients with HFRT (QoL; Mean [SD] HFRT+SCT vs. SCT-alone; 6-week: -0.44 [0.34] vs. -0.06 [0.25], p<0.0001 and 18-week: -0.53 [0.35] vs. -0.29 [0.26], p=0.0013). Seven treatment-emergent adverse events (mild severity) were reported in HFRT-arm. CONCLUSION Findings of this study highlight therapeutic efficacy of add-on HFRT vs. SCT-alone in CHF patients. The non-invasive HFRT showed no safety concerns.
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Affiliation(s)
| | | | - Atul Patil
- Shree Saibaba Heart Institute and Research Center, Nashik, India
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Zhang S, Wang Z. Effect of recombinant human brain natriuretic peptide (rhBNP) versus nitroglycerin in patients with heart failure: A systematic review and meta-analysis. Medicine (Baltimore) 2016; 95:e4757. [PMID: 27858837 PMCID: PMC5591085 DOI: 10.1097/md.0000000000004757] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This study was the first to evaluate the therapeutic outcomes of recombinant human brain natriuretic peptide (rhBNP) versus nitroglycerin (NIT) in patients with heart failure (HF). METHODS The electronic databases were systematically searched to identify available studies. The pooled odds ratios (ORs) and their 95% confidence intervals (95% CIs) were analyzed to assess the mortality, readmission, hypotension, and renal dysfunction in the comparison of rhBNP and NIT therapies. RESULTS Final 5 randomized controlled trials (RCTs) involving 782 patients with HF were carried out in our study. The pooled OR of mortality, readmission, and hypotension showed that no significant difference was found in both drugs (P > 0.05), with the absence of heterogeneity. The incidence of renal dysfunction was not significant difference in both groups (P = 0.85). The pooled OR from 2 studies of Asian population using multivariate analysis demonstrated that the use of rhBNP was correlated with a significantly decreased risk of renal dysfunction (I = 0.0%, OR = 0.19, P = 0.001). Possible publication bias was not detected using Egger's test (P > 0.05). CONCLUSIONS The results suggested that rhBNP and NIT therapies were not significant difference in mortality, readmission, and hypotension. The use of rhBNP may become a useful predictor of renal dysfunction in Asian patients with HF. Additional studies are needed for Caucasian population with HF.
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Affiliation(s)
- Sijie Zhang
- Department of Cardiology, The Fourth Hospital of Hebei Medical University
| | - Zhiqian Wang
- Department of Cardiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China
- Correspondence: Zhiqian Wang, Department of Cardiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China (e-mail: )
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Wang XC, Zhu DM, Shan YX. Dobutamine Therapy is Associated with Worse Clinical Outcomes Compared with Nesiritide Therapy for Acute Decompensated Heart Failure: A Systematic Review and Meta-Analysis. Am J Cardiovasc Drugs 2015; 15:429-37. [PMID: 26123415 DOI: 10.1007/s40256-015-0134-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Inotropes and natriuretic peptides are essential components of current therapeutic options for acute decompensated heart failure (ADHF). This systematic review examines the therapeutic effectiveness of dobutamine and brain natriuretic peptide, nesiritide, in reducing mortality and readmission rates for ADHF treatment. METHODS Published studies related to dobutamine and nesiritide therapy in ADHF were identified via an exhaustive search of scientific literature databases. The identified studies, published between 2002 and 2012, were carefully screened based on our predefined inclusion criteria. Selected studies were pooled, and odds ratios (ORs) and 95% confidence intervals (95% CI) for each outcome were calculated. Subgroup analysis was conducted to assess the influence of ethnicity on the study outcome. RESULTS Seven cohort studies were selected for this meta-analysis. These seven studies included 959 ADHF patients who underwent nesiritide treatment and 1748 ADHF patients who received dobutamine therapy. Our meta-analysis revealed a significantly lower survival rate in dobutamine-treated patients compared with nesiritide-treated patients (OR 0.48, 95% CI 0.36-0.63, P < 0.001). Additionally, a markedly higher readmission rate was associated with dobutamine treatment compared with nesiritide treatment (OR 0.52, 95% CI 0.36-0.73, P < 0.001). A stratified analysis based on ethnicity revealed a significantly lower survival in dobutamine-treated ADHF patients in Caucasian and mixed populations compared with nesiritide treatment (Caucasian: OR 0.60, 95% CI 0.38-0.94, P = 0.024; Mixed: OR 0.38, 95% CI 0.26-0.56, P < 0.001). However, a similar association was not detected in Asian populations (P = 0.738). Further, dobutamine-treated ADHF patients displayed higher readmission rates than did nesiritide-treated patients in both Caucasian and mixed-race populations (all P < 0.05). CONCLUSIONS Our study suggests that dobutamine therapy is associated with poorer outcomes, with higher in-hospital mortality rates and increased readmission rates compared with nesiritide therapy in ADHF patients. Thus, current treatment strategies need to be redesigned for better outcomes.
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Affiliation(s)
- Xiao-Chen Wang
- Department of Thoracic and Cardiac Surgery, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
- Department of Thoracic and Cardiac Surgery, The Affiliated Jiangyin Hospital of Southest University Medical College, Jiangyin, People's Republic of China
| | - Dong-Min Zhu
- Department of Cardiology, Nursing College of Nanjing Medical University, Nanjing, People's Republic of China
- Department of Cardiology, The Affiliated Jiangyin Hospital of Southest University Medical College, Jiangyin, Jiangyin, People's Republic of China
| | - Yu-Xuan Shan
- Department of Cardiology, Linfen People's Hospital, No. 17, Liberation Road, Linfen, 041000, People's Republic of China.
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Lv MY, Deng SL, Long XF. Retraction. rhBNP therapy can improve clinical outcomes and reduce in-hospital mortality compared with dobutamine in heart failure patients: a meta-analysis. Br J Clin Pharmacol 2015; 81:174-85. [PMID: 26382927 DOI: 10.1111/bcp.12788] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/11/2015] [Accepted: 09/15/2015] [Indexed: 12/27/2022] Open
Abstract
AIMS A meta-analysis was performed to compare the therapeutic outcomes in patients treated for heart failure (HF) with recombinant human brain natriuretic peptide (rhBNP) and dobutamine. METHODS PubMed, Embase and the Chinese Biomedical Database were exhaustively searched to identify studies relevant to this meta-analysis. Eight cohort studies were found suitable for inclusion. Data regarding trial validity, methodological processes and clinical outcomes were extracted. RESULTS Patients treated with rhBNP showed statistically significant reduction of in-hospital mortality and re-admission rates compared with the dobutamine treated patient group (both P < 0.05). Further, the rhBNP treated patient group showed higher survival outcomes, compared with dobutamine treated patients, when the post-treatment follow-up period was longer than 6 months (P < 0.05). Stratified analysis based on ethnicity showed a dramatic decrease of in-hospital mortality among mixed race HF patients receiving rhBNP treatment (P < 0.05), but such decreases were not statistically significant in Asian and Caucasian populations (both P > 0.05). On the other hand, re-admission rates were significantly lower in rhBNP treated Caucasian and mixed race populations (both P < 0.05). Notably, in rhBNP treated group, dose levels of 0.015 and 0.03 incrementally lowered the re-admission rates, displaying dose effect, and the re-admission rates at both rhBNP doses were significantly lower than the dobutamine treated group (both P < 0.05). CONCLUSIONS Our meta-analysis results suggested that rhBNP therapy is associated with lower in-hospital mortality and re-admission rates in HF patients compared to the dobutamine regimen. Nevertheless, large scale prospective, randomized trials are necessary to confirm these findings.
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Affiliation(s)
- Ming-Yi Lv
- Department of Internal Medicine, ICU, Affiliated Zhongshan Hospital of Dalian University, Dalian, 116000, Liaoning Province, P.R. China
| | - Shu-Ling Deng
- Department of Internal Medicine, ICU, Affiliated Zhongshan Hospital of Dalian University, Dalian, 116000, Liaoning Province, P.R. China
| | - Xiao-Feng Long
- Department of Internal Medicine, ICU, Affiliated Zhongshan Hospital of Dalian University, Dalian, 116000, Liaoning Province, P.R. China
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Raymer B, Ebner D. Small molecule and peptide therapies for chronic heart failure: a patent review (2011 - 2014). Expert Opin Ther Pat 2015; 25:1175-90. [PMID: 26173447 DOI: 10.1517/13543776.2015.1061997] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Chronic heart failure (CHF) is the long-term inability of the heart to meet circulatory demands under normal conditions. Effects of CHF can include increased blood volume, increased vascular resistance and compromised contractility leading to fluid retention, dyspnea and fatigue. Current standard of care for chronic systolic heart failure is directed towards managing hypoperfusion through the renin-angiotensin-aldosterone and sympathetic nervous systems. Treatment may also involve reversal of maladaptive cardiac remodeling and prevention of life-threatening arrhythmias. AREAS COVERED This review highlights small molecule and peptidic agents for the treatment of CHF with patents published between 2011 and 2014. Targets are subdivided into inotropic agents, ventricular remodeling, diuretics and the renin-angiotensin-aldosterone system. EXPERT OPINION CHF represents a large, unmet medical need where improved therapies are needed. The renin-angiotensin-aldosterone system pathway continues to be a major source of new therapies for CHF with new inotropic therapies emerging. Promising initial clinical results for a few approaches combined with the expectation of additional clinical results in the near future make this an exciting time in the pursuit of new treatments for CHF.
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Affiliation(s)
- Brian Raymer
- a Cardiovascular, Metabolic, and Endocrine Diseases Chemistry, Pfizer Worldwide Research and Development , Cambridge, MA, USA +1 617 551 3414 ; +1 617 551 3082 ;
| | - David Ebner
- a Cardiovascular, Metabolic, and Endocrine Diseases Chemistry, Pfizer Worldwide Research and Development , Cambridge, MA, USA +1 617 551 3414 ; +1 617 551 3082 ;
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Effects of Qili Qiangxin Capsule on AQP2, V2R, and AT1R in Rats with Chronic Heart Failure. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:639450. [PMID: 26074997 PMCID: PMC4449905 DOI: 10.1155/2015/639450] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 07/21/2014] [Accepted: 08/11/2014] [Indexed: 11/17/2022]
Abstract
Qili qiangxin capsule (QL), a traditional Chinese herbal compound, has been proved to be effective and safe for the treatment of chronic heart failure (CHF). Upregulation of aquaporin-2 (AQP2) accounts for the water retention in CHF. The aim of the present study was to evaluate the effects of QL on the expression of AQP2 in rats with CHF induced by acute myocardial infarction and to investigate the underlying mechanisms. The urine output of all rats was quantified and collected every day at the first week and the 4th week after administration of QL or Valsartan. The expression of AQP2, vasopressin type 2 receptor (V2R), and angiotensin II type 1 receptor (AT1R) were examined after treatment for 4 weeks. Urinary output increased significantly after administration of QL. Importantly, the protein expression of AQP2 and AQP2 phosphorylated at serine 256 (pS256-AQP2) was downregulated after administration of QL and Valsartan to CHF rats. Furthermore, QL reduced plasma arginine vasopressin (AVP) and angiotensin II (AngII) level and downregulated V2R and AT1R protein expression. Thus, QL exerts its diuretic effect and improves cardiac function in CHF rats by reversing the increases in both AQP2 and pS256-AQP2 expression. The possible mechanisms may involve inhibition of V2R and AT1R.
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Maleckar MM, Lines GT, Koivumäki JT, Cordeiro JM, Calloe K. NS5806 partially restores action potential duration but fails to ameliorate calcium transient dysfunction in a computational model of canine heart failure. Europace 2014; 16 Suppl 4:iv46-iv55. [PMID: 25362170 DOI: 10.1093/europace/euu252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS The study investigates how increased Ito, as mediated by the activator NS5806, affects excitation-contraction coupling in chronic heart failure (HF). We hypothesized that restoring spike-and-dome morphology of the action potential (AP) to a healthy phenotype would be insufficient to restore the intracellular Ca(2) (+) transient (CaT), due to HF-induced remodelling of Ca(2+) handling. METHODS AND RESULTS An existing mathematical model of the canine ventricular myocyte was modified to incorporate recent experimental data from healthy and failing myocytes, resulting in models of both healthy and HF epicardial, midmyocardial, and endocardial cell variants. Affects of NS5806 were also included in HF models through its direct interaction with Kv4.3 and Kv1.4. Single-cell simulations performed in all models (control, HF, and HF + drug) and variants (epi, mid, and endo) assessed AP morphology and underlying ionic processes with a focus on calcium transients (CaT), how these were altered in HF across the ventricular wall, and the subsequent effects of varying compound concentration in HF. Heart failure model variants recapitulated a characteristic increase in AP duration (APD) in the disease. The qualitative effects of application of half-maximal effective concentration (EC50) of NS5806 on APs and CaT are heterogeneous and non-linear. Deepening in the AP notch with drug is a direct effect of the activation of Ito; both Ito and consequent alteration of IK1 kinetics cause decrease in AP plateau potential. Decreased APD50 and APD90 are both due to altered IK1. Analysis revealed that drug effects depend on transmurality. Ca(2+) transient morphology changes-increased amplitude and shorter time to peak-are due to direct increase in ICa,L and indirect larger SR Ca(2+) release subsequent to Ito activation. CONCLUSIONS Downstream effects of a compound acting exclusively on sarcolemmal ion channels are difficult to predict. Remediation of APD to pre-failing state does not ameliorate dysfunction in CaT; however, restoration of notch depth appears to impart modest benefit and a likelihood of therapeutic value in modulating early repolarization.
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Affiliation(s)
- Mary M Maleckar
- Simula Research Laboratory, Center for Cardiological Innovation and Center for Biomedical Computing, PO Box 134, Lysaker 1325, Norway
| | - Glenn T Lines
- Simula Research Laboratory, Center for Cardiological Innovation and Center for Biomedical Computing, PO Box 134, Lysaker 1325, Norway Department of Informatics, University of Oslo, PO Box 1072, Oslo 0316, Norway
| | - Jussi T Koivumäki
- Simula Research Laboratory, Center for Cardiological Innovation and Center for Biomedical Computing, PO Box 134, Lysaker 1325, Norway
| | - Jonathan M Cordeiro
- Department of Experimental Cardiology, Masonic Medical Research Laboratory, 2150 Bleecker St., Utica, NY 13501, USA
| | - Kirstine Calloe
- Department of Veterinary Clinical and Animal Science, University of Copenhagen, Rm. 151, Dyrlægevej 100, Frederiksberg 1870, Denmark
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Schultz HD, Marcus NJ, Del Rio R. Role of the carotid body in the pathophysiology of heart failure. Curr Hypertens Rep 2014; 15:356-62. [PMID: 23824499 DOI: 10.1007/s11906-013-0368-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Important recent advances implicate a role of the carotid body (CB) chemoreflex in sympathetic and breathing dysregulation in several cardio-respiratory diseases, drawing renewed interest in its potential implications for clinical treatment. Evidence from both chronic heart failure (CHF) patients and animal models indicates that the CB chemoreflex is enhanced in CHF, and contributes to the tonic elevation in sympathetic nerve activity (SNA) and periodic breathing associated with the disease. Although this maladaptive change likely derives from altered function at all levels of the reflex arc, a change in afferent function of the CB is likely to be a main driving force. This review will focus on recent advances in our understanding of the pathophysiological mechanisms that alter CB function in CHF and their potential translational impact on treatment of chronic heart failure (CHF).
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Affiliation(s)
- Harold D Schultz
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE 68198-5850, USA.
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Gregori M, Tocci G, Giammarioli B, Befani A, Ciavarella GM, Ferrucci A, Paneni F. Abnormal Regulation of Renin Angiotensin Aldosterone System Is Associated With Right Ventricular Dysfunction in Hypertension. Can J Cardiol 2014; 30:188-94. [DOI: 10.1016/j.cjca.2013.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 11/03/2013] [Accepted: 11/04/2013] [Indexed: 10/26/2022] Open
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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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Pantos C, Mourouzis I, Cokkinos DV. Thyroid hormone and cardiac repair/regeneration: from Prometheus myth to reality? Can J Physiol Pharmacol 2012; 90:977-87. [PMID: 22762197 DOI: 10.1139/y2012-031] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Nature's models of repair and (or) regeneration provide substantial evidence that a natural healing process may exist in the heart. The potential for repair and (or) regeneration has been evolutionarily conserved in mammals, and seems to be restricted to the early developmental stages. This window of regeneration is reactivated during the disease state in which fetal gene reprogramming occurs in response to stress. Analogies exist between the damaged and developing heart, indicating that a regulatory network that drives embryonic heart development may control aspects of heart repair and (or) regeneration. In this context, thyroid hormone (TH), which is a critical regulator of the maturation of the myocardium, appears to have a reparative role later in adult life. Changes in TH - thyroid hormone receptor (TR) homeostasis govern the return of the injured myocardium to the fetal phenotype. Accordingly, TH can induce cardiac repair and (or) regeneration by reactivating developmental gene programming. As a proof of concept in humans, TH is found to be an independent determinant of functional recovery and mortality after myocardial infarction. The potential of TH to regenerate and (or) repair the ischemic myocardium is now awaited to be tested in clinical trials.
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Fujita B, Franz M, Goebel B, Fritzenwanger M, Figulla HR, Kuethe F, Ferrari M, Jung C. Prognostic relevance of heart rate at rest for survival and the quality of life in patients with dilated cardiomyopathy. Clin Res Cardiol 2012; 101:701-7. [DOI: 10.1007/s00392-012-0447-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 03/15/2012] [Indexed: 11/28/2022]
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Garcia S, Spitznagel MB, Cohen R, Raz N, Sweet L, Colbert L, Josephson R, Hughes J, Rosneck J, Gunstad J. Depression is associated with cognitive dysfunction in older adults with heart failure. Cardiovasc Psychiatry Neurol 2011; 2011:368324. [PMID: 22195274 PMCID: PMC3238358 DOI: 10.1155/2011/368324] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 11/15/2011] [Accepted: 11/18/2011] [Indexed: 12/21/2022] Open
Abstract
Persons with heart failure (HF) frequently exhibit cognitive impairment with deficits in attention and memory. Depression is common in HF though its possible contribution to cognitive impairment is unknown. Cognitive dysfunction and depression may share common mechanisms in HF, as both are associated with similar abnormalities on neuroimaging. A total of 116 participants with HF (68.53 ± 9.30 years) completed a neuropsychological battery and self-report measures of depression. Regression models showed depression incrementally and independently predicted test performance in all cognitive domains. Follow-up partial correlations revealed that greater depressive symptoms were associated with poorer performance on tests of attention, executive function, psychomotor speed, and language. These results indicate that depressive symptoms are associated with poorer cognitive performance in HF though further work is needed to clarify mechanisms for this association and possible cognitive benefits of treating depression in persons with HF.
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Affiliation(s)
- Sarah Garcia
- Department of Psychology, Kent State University, 221 Kent Hall Addition, Kent, OH 44242, USA
| | - Mary Beth Spitznagel
- Department of Psychology, Kent State University, 221 Kent Hall Addition, Kent, OH 44242, USA
- Department of Psychiatry, Summa Health System, Akron, OH 44304, USA
| | - Ronald Cohen
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912, USA
| | - Naftali Raz
- Institute of Gerontology, Wayne State University, Detroit, MI 48202, USA
| | - Lawrence Sweet
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912, USA
| | - Lisa Colbert
- Department of Kinesiology, University of Wisconsin, Madison, WI 53706, USA
| | - Richard Josephson
- Harrington-McLaughlin Heart and Vascular Institute, University Hospitals Case Medical Center and Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Joel Hughes
- Department of Psychology, Kent State University, 221 Kent Hall Addition, Kent, OH 44242, USA
- Department of Psychiatry, Summa Health System, Akron, OH 44304, USA
| | - Jim Rosneck
- Department of Psychiatry, Summa Health System, Akron, OH 44304, USA
| | - John Gunstad
- Department of Psychology, Kent State University, 221 Kent Hall Addition, Kent, OH 44242, USA
- Department of Psychiatry, Summa Health System, Akron, OH 44304, USA
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