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Akinterinwa OE, Singh M, Vemuri S, Tyagi SC. A Need to Preserve Ejection Fraction during Heart Failure. Int J Mol Sci 2024; 25:8780. [PMID: 39201469 PMCID: PMC11354382 DOI: 10.3390/ijms25168780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/20/2024] [Accepted: 08/07/2024] [Indexed: 09/02/2024] Open
Abstract
Heart failure (HF) is a significant global healthcare burden with increasing prevalence and high morbidity and mortality rates. The diagnosis and management of HF are closely tied to ejection fraction (EF), a crucial parameter for evaluating disease severity and determining treatment plans. This paper emphasizes the urgent need to maintain EF during heart failure, highlighting the distinct phenotypes of HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). It discusses the complexities of HFrEF pathophysiology and its negative impact on patient outcomes, stressing the importance of ongoing research and the development of effective therapeutic interventions to slow down the progression from preserved to reduced ejection fraction. Additionally, it explores the potential role of renal denervation in preserving ejection fraction and its implications for HFrEF management. This comprehensive review aims to offer valuable insights into the critical role of EF preservation in enhancing outcomes for patients with heart failure.
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Affiliation(s)
- Oluwaseun E. Akinterinwa
- Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Mahavir Singh
- Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA
- Center for Predictive Medicine (CPM) for Biodefense and Emerging Infectious Diseases, University of Louisville, Louisville, KY 40202, USA
| | - Sreevatsa Vemuri
- Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Suresh C. Tyagi
- Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA
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Doiron JE, Li Z, Yu X, LaPenna KB, Quiriarte H, Allerton TD, Koul K, Malek A, Shah SJ, Sharp TE, Goodchild TT, Kapusta DR, Lefer DJ. Early Renal Denervation Attenuates Cardiac Dysfunction in Heart Failure With Preserved Ejection Fraction. J Am Heart Assoc 2024; 13:e032646. [PMID: 38353216 PMCID: PMC11010115 DOI: 10.1161/jaha.123.032646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/08/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND The renal sympathetic nervous system modulates systemic blood pressure, cardiac performance, and renal function. Pathological increases in renal sympathetic nerve activity contribute to the pathogenesis of heart failure with preserved ejection fraction (HFpEF). We investigated the effects of renal sympathetic denervation performed at early or late stages of HFpEF progression. METHODS AND RESULTS Male ZSF1 obese rats were subjected to radiofrequency renal denervation (RF-RDN) or sham procedure at either 8 weeks or 20 weeks of age and assessed for cardiovascular function, exercise capacity, and cardiorenal fibrosis. Renal norepinephrine and renal nerve tyrosine hydroxylase staining were performed to quantify denervation following RF-RDN. In addition, renal injury, oxidative stress, inflammation, and profibrotic biomarkers were evaluated to determine pathways associated with RDN. RF-RDN significantly reduced renal norepinephrine and tyrosine hydroxylase content in both study cohorts. RF-RDN therapy performed at 8 weeks of age attenuated cardiac dysfunction, reduced cardiorenal fibrosis, and improved endothelial-dependent vascular reactivity. These improvements were associated with reductions in renal injury markers, expression of renal NLR family pyrin domain containing 3/interleukin 1β, and expression of profibrotic mediators. RF-RDN failed to exert beneficial effects when administered in the 20-week-old HFpEF cohort. CONCLUSIONS Our data demonstrate that early RF-RDN therapy protects against HFpEF disease progression in part due to the attenuation of renal fibrosis and inflammation. In contrast, the renoprotective and left ventricular functional improvements were lost when RF-RDN was performed in later HFpEF progression. These results suggest that RDN may be a viable treatment option for HFpEF during the early stages of this systemic inflammatory disease.
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Affiliation(s)
- Jake E. Doiron
- Department of Pharmacology and Experimental TherapeuticsLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - Zhen Li
- Department of Cardiac SurgerySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCAUSA
| | - Xiaoman Yu
- Department of Cardiac SurgerySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCAUSA
| | - Kyle B. LaPenna
- Department of Pharmacology and Experimental TherapeuticsLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - Heather Quiriarte
- Department of Vascular MetabolismPennington Biomedical Research CenterBaton RougeLAUSA
| | - Timothy D. Allerton
- Department of Vascular MetabolismPennington Biomedical Research CenterBaton RougeLAUSA
| | - Kashyap Koul
- School of MedicineLouisiana State University Health Sciences Center New OrleansNew OrleansLAUSA
| | - Andrew Malek
- School of MedicineLouisiana State University Health Sciences Center New OrleansNew OrleansLAUSA
| | - Sanjiv J. Shah
- Division of Cardiology, Department of Medicine and Bluhm Cardiovascular InstituteNorthwestern University Feinberg School of MedicineChicagoILUSA
| | - Thomas E. Sharp
- Department of Molecular Pharmacology and Physiology, Morsani College of MedicineUniversity of South FloridaTampaFLUSA
- USF Health Heart InstituteTampaFLUSA
| | - Traci T. Goodchild
- Department of Cardiac SurgerySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCAUSA
| | - Daniel R. Kapusta
- Department of Pharmacology and Experimental TherapeuticsLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - David J. Lefer
- Department of Cardiac SurgerySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCAUSA
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Hamaoka T, Leuenberger UA, Drew RC, Murray M, Blaha C, Luck JC, Sinoway LI, Cui J. Glucose metabolism and autonomic function in healthy individuals and patients with type 2 diabetes mellitus at rest and during exercise. Exp Physiol 2024; 109:214-226. [PMID: 38050866 PMCID: PMC10841625 DOI: 10.1113/ep091444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023]
Abstract
Autonomic dysfunction is a common complication of type 2 diabetes mellitus (T2DM). However, the character of dysfunction varies in different reports. Differences in measurement methodology and complications might have influenced the inconsistent results. We sought to evaluate comprehensively the relationship between abnormal glucose metabolism and autonomic function at rest and the response to exercise in healthy individuals and T2DM patients. We hypothesized that both sympathetic and parasympathetic indices would decrease with the progression of abnormal glucose metabolism in individuals with few complications related to high sympathetic tone. Twenty healthy individuals and 11 T2DM patients without clinically evident cardiovascular disease other than controlled hypertension were examined. Resting muscle sympathetic nerve activity (MSNA), heart rate variability, spontaneous cardiovagal baroreflex sensitivity (CBRS), sympathetic baroreflex sensitivity and the MSNA response to handgrip exercise were measured. Resting MSNA was lower in patients with T2DM than in healthy control subjects (P = 0.011). Resting MSNA was negatively correlated with haemoglobin A1c in all subjects (R = -0.45, P = 0.024). The parasympathetic components of heart rate variability and CBRS were negatively correlated with glycaemic/insulin indices in all subjects and even in the control group only (all, P < 0.05). In all subjects, the MSNA response to exercise was positively correlated with fasting blood glucose (R = 0.69, P < 0.001). Resting sympathetic activity and parasympathetic modulation of heart rate were decreased in relationship to abnormal glucose metabolism. Meanwhile, the sympathetic responses to handgrip were preserved in diabetics. The responses were correlated with glucose/insulin parameters throughout diabetic and control subjects. These results suggest the importance of a comprehensive assessment of autonomic function in T2DM.
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Affiliation(s)
- Takuto Hamaoka
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Urs A. Leuenberger
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Rachel C. Drew
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
- Department of Exercise and Health SciencesUniversity of Massachusetts BostonBostonMassachusettsUSA
| | - Matthew Murray
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Cheryl Blaha
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Jonathan Carter Luck
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Lawrence I. Sinoway
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
| | - Jian Cui
- Penn State Heart and Vascular InstitutePennsylvania State University College of MedicineHersheyPennsylvaniaUSA
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Patel M, Braun J, Lambert G, Kameneva T, Keatch C, Lambert E. Central mechanisms in sympathetic nervous dysregulation in obesity. J Neurophysiol 2023; 130:1414-1424. [PMID: 37910522 DOI: 10.1152/jn.00254.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/16/2023] [Accepted: 10/26/2023] [Indexed: 11/03/2023] Open
Abstract
Cardiovascular and metabolic complications associated with excess adiposity are linked to chronic activation of the sympathetic nervous system, resulting in a high risk of mortality among obese individuals. Obesity-related positive energy balance underlies the progression of hypertension, end-organ damage, and insulin resistance, driven by increased sympathetic tone throughout the body. It is, therefore, important to understand the central network that drives and maintains sustained activation of the sympathetic nervous system in the obese state. Experimental and clinical studies have identified structural changes and altered dynamics in both grey and white matter regions in obesity. Aberrant activation in certain brain regions has been associated with altered reward circuitry and metabolic pathways including leptin and insulin signaling along with adiposity-driven systemic and central inflammation. The impact of these pathways on the brain via overactivity of the sympathetic nervous system has gained interest in the past decade. Primarily, the brainstem, hypothalamus, amygdala, hippocampus, and cortical structures including the insular, orbitofrontal, temporal, cingulate, and prefrontal cortices have been identified in this context. Although the central network involving these structures is much more intricate, this review highlights recent evidence identifying these regions in sympathetic overactivity in obesity.
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Affiliation(s)
- Mariya Patel
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Joe Braun
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Gavin Lambert
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Tatiana Kameneva
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, Australia
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Melbourne, Victoria, Australia
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Victoria, Australia
| | - Charlotte Keatch
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Elisabeth Lambert
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, Australia
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5
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Vaganova AN, Shemyakova TS, Lenskaia KV, Rodionov RN, Steenblock C, Gainetdinov RR. Trace Amine-Associated Receptors and Monoamine-Mediated Regulation of Insulin Secretion in Pancreatic Islets. Biomolecules 2023; 13:1618. [PMID: 38002300 PMCID: PMC10669413 DOI: 10.3390/biom13111618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Currently, metabolic syndrome treatment includes predominantly pharmacological symptom relief and complex lifestyle changes. Trace amines and their receptor systems modulate signaling pathways of dopamine, norepinephrine, and serotonin, which are involved in the pathogenesis of this disorder. Trace amine-associated receptor 1 (TAAR1) is expressed in endocrine organs, and it was revealed that TAAR1 may regulate insulin secretion in pancreatic islet β-cells. For instance, accumulating data demonstrate the positive effect of TAAR1 agonists on the dynamics of metabolic syndrome progression and MetS-associated disease development. The role of other TAARs (TAAR2, TAAR5, TAAR6, TAAR8, and TAAR9) in the islet's function is much less studied. In this review, we summarize the evidence of TAARs' contribution to the metabolic syndrome pathogenesis and regulation of insulin secretion in pancreatic islets. Additionally, by the analysis of public transcriptomic data, we demonstrate that TAAR1 and other TAAR receptors are expressed in the pancreatic islets. We also explore associations between the expression of TAARs mRNA and other genes in studied samples and demonstrate the deregulation of TAARs' functional associations in patients with metabolic diseases compared to healthy donors.
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Affiliation(s)
- Anastasia N. Vaganova
- Institute of Translational Biomedicine, St. Petersburg State University, 199034 St. Petersburg, Russia; (A.N.V.); (T.S.S.)
- St. Petersburg State University Hospital, St. Petersburg State University, 199034 St. Petersburg, Russia
| | - Taisiia S. Shemyakova
- Institute of Translational Biomedicine, St. Petersburg State University, 199034 St. Petersburg, Russia; (A.N.V.); (T.S.S.)
| | - Karina V. Lenskaia
- Department of Medicine, St. Petersburg State University, Universitetskaya nab. 7/9, 199034 St. Petersburg, Russia;
| | - Roman N. Rodionov
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (R.N.R.); (C.S.)
| | - Charlotte Steenblock
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; (R.N.R.); (C.S.)
| | - Raul R. Gainetdinov
- Institute of Translational Biomedicine, St. Petersburg State University, 199034 St. Petersburg, Russia; (A.N.V.); (T.S.S.)
- St. Petersburg State University Hospital, St. Petersburg State University, 199034 St. Petersburg, Russia
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Bunsawat K, Skow RJ, Kaur J, Wray DW. Neural control of the circulation during exercise in heart failure with reduced and preserved ejection fraction. Am J Physiol Heart Circ Physiol 2023; 325:H998-H1011. [PMID: 37682236 PMCID: PMC10907034 DOI: 10.1152/ajpheart.00214.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/23/2023] [Accepted: 09/06/2023] [Indexed: 09/09/2023]
Abstract
Patients with heart failure with reduced (HFrEF) and preserved ejection fraction (HFpEF) exhibit severe exercise intolerance that may be due, in part, to inappropriate cardiovascular and hemodynamic adjustments to exercise. Several neural mechanisms and locally released vasoactive substances work in concert through complex interactions to ensure proper adjustments to meet the metabolic demands of the contracting skeletal muscle. Specifically, accumulating evidence suggests that disease-related alterations in neural mechanisms (e.g., central command, exercise pressor reflex, arterial baroreflex, and cardiopulmonary baroreflex) contribute to heightened sympathetic activation and impaired ability to attenuate sympathetic vasoconstrictor responsiveness that may contribute to reduced skeletal muscle blood flow and severe exercise intolerance in patients with HFrEF. In contrast, little is known regarding these important aspects of physiology in patients with HFpEF, though emerging data reveal heightened sympathetic activation and attenuated skeletal muscle blood flow during exercise in this patient population that may be attributable to dysregulated neural control of the circulation. The overall goal of this review is to provide a brief overview of the current understanding of disease-related alterations in the integrative neural cardiovascular responses to exercise in both HFrEF and HFpEF phenotypes, with a focus on sympathetic nervous system regulation during exercise.
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Affiliation(s)
- Kanokwan Bunsawat
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States
| | - Rachel J Skow
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas, United States
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Jasdeep Kaur
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, United States
| | - D Walter Wray
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
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7
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Kharazmi F, Hosseini-Dastgerdi H, Pourshanazari AA, Nematbakhsh M. The denervation or activation of renal sympathetic nerve and renal blood flow. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2023; 28:76. [PMID: 38152073 PMCID: PMC10751519 DOI: 10.4103/jrms.jrms_216_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/09/2023] [Accepted: 07/17/2023] [Indexed: 12/29/2023]
Abstract
The denervation or activation of the sympathetic nerve in the kidney can affect renal hemodynamics. The sympathetic nervous system regulates the physiological functions of the kidneys. Stimulation of sympathetic efferent nerves affects various parameters related to renal hemodynamics, including sodium excretion, renin secretion, and renal blood flow (RBF). Hence, renal sympathetic fibers may also play an essential role in regulating systemic vascular resistance and controlling blood pressure. In the absence of renal nerves, the hemodynamics response to stimuli is negligible or absent. The effect of renal sympathetic denervation on RBF is dependent on several factors such as interspecies differences, the basic level of nerve activity in the vessels or local density of adrenergic receptor in the vascular bed. The role of renal denervation has been investigated therapeutically in hypertension and related disorders. Hence, the dynamic impact of renal nerves on RBF enables using RBF dynamic criteria as a marker for renal denervation therapy.
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Affiliation(s)
- Fatemeh Kharazmi
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hajaralsadat Hosseini-Dastgerdi
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mehdi Nematbakhsh
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran
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Wang Z, Zhu D, Zhu X, Liu D, Cao Q, Pan T, Zhang Q, Gu X, Li L, Teng G. Interventional metabology: A review of bariatric arterial embolization and endovascular denervation for treating metabolic disorders. J Diabetes 2023; 15:665-673. [PMID: 37438984 PMCID: PMC10415876 DOI: 10.1111/1753-0407.13437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 05/12/2023] [Accepted: 06/06/2023] [Indexed: 07/14/2023] Open
Abstract
The rising prevalence of metabolic disorders such as obesity and type 2 diabetes mellitus (T2DM) poses a major challenge to global health. Existing therapeutic approaches have limitations, and there is a need for new, safe, and less invasive treatments. Interventional metabolic therapy is a new addition to the treatment arsenal for metabolic disorders. This review focuses on two interventional techniques: bariatric arterial embolization (BAE) and endovascular denervation (EDN). BAE involves embolizing specific arteries feeding ghrelin-producing cells to suppress appetite and promote weight loss. EDN targets nerves that regulate metabolic organs to improve glycemic control in T2DM patients. We describe the current state of these techniques, their mechanisms of action, and the available safety and effectiveness data. We also propose a new territory called "Interventional Metabology" to encompass these and other interventional approaches to treating metabolic disorders.
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Affiliation(s)
- Zhi Wang
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, School of MedicineSoutheast UniversityNanjingChina
| | - Dan‐Qi Zhu
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, School of MedicineSoutheast UniversityNanjingChina
| | - Xiang‐Yun Zhu
- Department of Endocrinology, Zhongda Hospital, School of MedicineSoutheast UniversityNanjingChina
- Institute of PancreasSoutheast UniversityNanjingChina
| | - De‐Chen Liu
- Department of Endocrinology, Zhongda Hospital, School of MedicineSoutheast UniversityNanjingChina
- Institute of PancreasSoutheast UniversityNanjingChina
| | - Qing‐Yue Cao
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, School of MedicineSoutheast UniversityNanjingChina
| | - Tao Pan
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, School of MedicineSoutheast UniversityNanjingChina
| | - Qi Zhang
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, School of MedicineSoutheast UniversityNanjingChina
| | - Xiao‐Chun Gu
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, School of MedicineSoutheast UniversityNanjingChina
| | - Ling Li
- Department of Endocrinology, Zhongda Hospital, School of MedicineSoutheast UniversityNanjingChina
- Institute of PancreasSoutheast UniversityNanjingChina
| | - Gao‐Jun Teng
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, School of MedicineSoutheast UniversityNanjingChina
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Lawrence S, Mueller BR, Kwon P, Robinson-Papp J. Phenotyping autonomic neuropathy using principal component analysis. Auton Neurosci 2023; 245:103056. [PMID: 36525943 PMCID: PMC9899306 DOI: 10.1016/j.autneu.2022.103056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/12/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
To identify autonomic neuropathy (AN) phenotypes, we used principal component analysis on data from participants (N = 209) who underwent standardized autonomic testing including quantitative sudomotor axon reflex testing, and heart rate and blood pressure at rest and during tilt, Valsalva, and standardized deep breathing. The analysis identified seven clusters: 1) normal, 2) hyperadrenergic features without AN, 3) mild AN with hyperadrenergic features, 4) moderate AN, 5) mild AN with hypoadrenergic features, 6) borderline AN with hypoadrenergic features, 7) mild balanced deficits across parasympathetic, sympathetic and sudomotor domains. These findings demonstrate a complex relationship between adrenergic and other aspects of autonomic function.
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Affiliation(s)
- Steven Lawrence
- Vilcek Institute of Graduate Biomedical Sciences, NYU Grossman School of Medicine, USA
| | - Bridget R Mueller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, USA
| | - Patrick Kwon
- Department of Neurology, NYU Grossman School of Medicine, USA
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Cheung T, Lam JYT, Fong KH, Ho YS, Ho A, Cheng CPW, Sittlington J, Xiang YT, Li TMH. The Effectiveness of Electrical Vestibular Stimulation (VeNS) on Symptoms of Anxiety: Study Protocol of a Randomized, Double-Blinded, Sham-Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4218. [PMID: 36901227 PMCID: PMC10002296 DOI: 10.3390/ijerph20054218] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
The prevalence of symptoms of anxiety is increasing, especially during the COVID-19 pandemic. A home use transdermal neurostimulation device might help to minimize the severity of anxiety disorder. To the best of our knowledge, there is no clinical trial using transdermal neurostimulation to treat individuals with symptoms of anxiety in Asia. This gives us the impetus to execute the first study which aims at evaluating the efficacy of Electrical Vestibular Stimulation (VeNS) on anxiety in Hong Kong. This study proposes a two-armed, double-blinded, randomized, sham-controlled trial including the active VeNS and sham VeNS group. Both groups will be measured at baseline (T1), immediately after the intervention (T2), and at the 1-month (T3) and 3-month follow-up (T4). A total of 66 community-dwelling adults aged 18 to 60 with anxiety symptoms will be recruited in this study. All subjects will be computer randomised into either the active VeNS group or the sham VeNS group in a 1:1 ratio. All subjects in each group will receive twenty 30 min VeNS sessions during weekdays, which will be completed in a 4-week period. Baseline measurements and post-VeNS evaluation of the psychological outcomes (i.e., anxiety, insomnia, and quality of life) will also be conducted on all participants. The 1-month and 3-month follow-up period will be used to assess the long-term sustainability of the VeNS intervention. For statistical analysis, ANOVA with repeated measures will be used to analyze data. Missing data were managed with multiple mutations. The level of significance will be set to p < 0.05. Results of this study will be used to determine whether this VeNS device can be considered as a self-help technological device to reduce perceived anxiety in the general population in the community setting. This clinical Trial was registered with the Clinical Trial government, identifier: NCT04999709.
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Affiliation(s)
- Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- The Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Joyce Yuen Ting Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Kwan Hin Fong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yuen Shan Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Alex Ho
- Integrated Services for Persons with Disabilities, Christian Family Service Centre, Hong Kong SAR, China A
| | | | - Julie Sittlington
- School of Biomedical Sciences, Ulster University, Coleraine BT52 1SA, UK
| | - Yu-Tao Xiang
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Tim Man Ho Li
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
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11
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Heusser K, Tank J, Diedrich A, Fischer A, Heise T, Jordan J. Limited evidence for sympathetic neural overactivation in older patients with type 2 diabetes mellitus. Front Neurosci 2023; 16:1107752. [PMID: 36711125 PMCID: PMC9878600 DOI: 10.3389/fnins.2022.1107752] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 12/30/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction Mechanistic studies suggested that excess sympathetic activity promotes arterial hypertension while worsening insulin sensitivity. Older patients with type 2 diabetes are at particularly high cardiovascular and metabolic risk. However, data on sympathetic activity in this population is scarce. Methods We studied 61 patients with type 2 diabetes mellitus (22 women, 60.9 ± 1.4 years; 39 men, 60.9 ± 1.4 years). They had to have diabetes for at least 2 years, a hemoglobin A1c of 6.5-10%, a body-mass-index of 20-40 kg/m2, and had to be treated with stable doses of metformin only. We recorded ECG, finger and brachial blood pressure, and muscle sympathetic nerve activity (MSNA). Results MSNA was 37.5 ± 2.5 bursts/min in women and 39.0 ± 2.0 bursts/min in men (p = 0.55). MSNA expressed as burst incidence was 52.7 ± 2.0 bursts/100 beats in women and 59.2 ± 3.1 bursts/100 beats in men (p = 0.21). Five out of 39 men (12.8%) and two out of 22 women (9.1%) exhibited resting MSNA measurements above the 95th percentile for sex and age. In the pooled analysis, MSNA was not significantly correlated with systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, body composition, or HbA1c (r 2 < 0.02, p > 0.26 for all). Discussion We conclude that relatively few older patients with type 2 diabetes mellitus exhibit increased MSNA. The large interindividual variability in MSNA cannot be explained by gender, blood pressure, body mass index, or glycemic control.
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Affiliation(s)
- Karsten Heusser
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Jens Tank
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - André Diedrich
- Vanderbilt Autonomic Dysfunction Center, Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States,Department of Biomedical Engineering, School of Engineering, Vanderbilt University, Nashville, TN, United States
| | - Annelie Fischer
- Profil Institut für Stoffwechselforschung GmbH, Neuss, Germany
| | - Tim Heise
- Profil Institut für Stoffwechselforschung GmbH, Neuss, Germany
| | - Jens Jordan
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany,Medical Faculty, University of Cologne, Cologne, Germany,*Correspondence: Jens Jordan,
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12
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Seravalle G, Vanoli J, Molisano C, Merati V, Grassi G. Heart rate thresholds for cardiovascular risk and sympathetic activation in the metabolic syndrome. Acta Diabetol 2022; 59:1429-1435. [PMID: 35904642 PMCID: PMC9519654 DOI: 10.1007/s00592-022-01945-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/14/2022] [Indexed: 12/03/2022]
Abstract
AIMS We examined whether to what extent resting heart rate (HR) values are capable to reflect in the metabolic syndrome (MS) a different degree of sympathetic activation. We also thought to determine at which HR cutoff values the sympathetic nervous system becomes more activated in the MS. METHODS In 70 MS patients aged 55.5 ± 1.8 (mean ± SEM) years we evaluated muscle sympathetic nerve traffic (MSNA, microneurography) and venous plasma norepinephrine (NE, HPLC assay), subdividing the study population in three different subgroups according to resting clinic and 24-h HR values (< 70, 70-79 and ≥ 80 beats/min). RESULTS MS patients with clinic HR values ≥ 80 beats/min displayed MSNA and NE values significantly increased when compared to those found in MS with HR between 70 and 79 beats/min or below 70 beats/min (MSNA: 55.2 ± 0.9 vs 44.6 ± 0.6 and 39.2 ± 0.6 bursts/min, P < 0.01, NE: 403.9 ± 6.9 vs 330.1 ± 4.3 and 258.3 ± 6.8 pg/ml, respectively, P < 0.01). A similar behavior was observed for 24-h HR. In the group as a whole both MSNA and plasma NE showed highly significant direct relationships with clinic HR, the correlation being similar for MSNA and NE (r = 0.89 and r = 0.91, P < 0.01 for both) Similar significant relationships were also found between 24-h HR values and MSNA or NE. CONCLUSIONS In the MS HR values ≥ 80 beats/min are associated with an increased sympathetic activation, both when assessed by direct recording of MSNA and when evaluated as plasma NE. The sympathetic overdrive parallels for magnitude the HR elevations, this being the case for both clinic and 24-h HR.
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Affiliation(s)
- Gino Seravalle
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Italy
| | - Jennifer Vanoli
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Italy
| | - Concetta Molisano
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Italy
| | - Valeria Merati
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Italy
| | - Guido Grassi
- Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Italy.
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13
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Shen L, Dashwood MR, Casale C, Orie NN, Evans IM, Sufi P, Gray R, Mohamed-Ali V. Depot- and diabetes-specific differences in norepinephrine-mediated adipose tissue angiogenesis, vascular tone, collagen deposition and morphology in obesity. Life Sci 2022; 305:120756. [PMID: 35780713 DOI: 10.1016/j.lfs.2022.120756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/18/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022]
Abstract
AIMS Norepinephrine (NE) is a known regulator of adipose tissue (AT) metabolism, angiogenesis, vasoconstriction and fibrosis. This may be through autocrine/paracrine effects on local resistance vessel function and morphology. The aims of this study were to investigate, in human subcutaneous and omental adipose tissue (SAT and OAT): NE synthesis, angiogenesis, NE-mediated arteriolar vasoconstriction, the induction of collagen gene expression and its deposition in non-diabetic versus diabetic obese subjects. MATERIALS AND METHODS SAT and OAT from obese patients were used to investigate tissue NE content, tyrosine hydroxylase (TH) density, angiogenesis including capillary density, angiogenic capacity and angiogenic gene expression, NE-mediated arteriolar vasoconstriction and collagen deposition. KEY FINDINGS In the non-diabetic group, NE concentration, TH immunoreactivity, angiogenesis and maximal vasoconstriction were significantly higher in OAT compared to SAT (p < 0.05). However, arterioles from OAT showed lower NE sensitivity compared to SAT (10-8 M to 10-7.5 M, p < 0.05). A depot-specific difference in collagen deposition was also observed, being greater in OAT than SAT. In the diabetic group, no significant depot-specific differences were seen in NE synthesis, angiogenesis, vasoconstriction or collagen deposition. SAT arterioles showed significantly lower sensitivity to NE (10-8 M to 10-7.5 M, p < 0.05) compared to the non-diabetic group. SIGNIFICANCE SAT depot in non-diabetic obese patients exhibited relatively low NE synthesis, angiogenesis, tissue fibrosis and high vasoreactivity, due to preserved NE sensitivity. The local NE synthesis in OAT and diabetes desensitizes NE-induced vasoconstriction, and may also explain the greater tissue angiogenesis and fibrosis in these depots.
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Affiliation(s)
- Lei Shen
- Rayne Building, University College London, London, UK.
| | | | - Carlo Casale
- Rayne Building, University College London, London, UK
| | - Nelson N Orie
- Royal Free Campus, University College London, London, UK; Anti-Doping Lab Qatar, Doha, Qatar
| | - Ian M Evans
- Cancer Stem Cell Team, Institute of Cancer Research, London, UK
| | | | - Rosaire Gray
- Rayne Building, University College London, London, UK; Whittington Hospital, London, UK
| | - Vidya Mohamed-Ali
- Royal Free Campus, University College London, London, UK; Anti-Doping Lab Qatar, Doha, Qatar
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14
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McMillan NJ, Soares RN, Harper JL, Shariffi B, Moreno-Cabañas A, Curry TB, Manrique-Acevedo C, Padilla J, Limberg JK. Role of the arterial baroreflex in the sympathetic response to hyperinsulinemia in adult humans. Am J Physiol Endocrinol Metab 2022; 322:E355-E365. [PMID: 35187960 PMCID: PMC8993537 DOI: 10.1152/ajpendo.00391.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/28/2022] [Accepted: 02/14/2022] [Indexed: 11/22/2022]
Abstract
Muscle sympathetic nerve activity (MSNA) increases during hyperinsulinemia, primarily attributed to central nervous system effects. Whether peripheral vasodilation induced by insulin further contributes to increased MSNA via arterial baroreflex-mediated mechanisms requires further investigation. Accordingly, we examined baroreflex modulation of the MSNA response to hyperinsulinemia. We hypothesized that rescuing peripheral resistance with coinfusion of the vasoconstrictor phenylephrine would attenuate the MSNA response to hyperinsulinemia. We further hypothesized that the insulin-mediated increase in MSNA would be recapitulated with another vasodilator (sodium nitroprusside, SNP). In 33 young healthy adults (28 M/5F), MSNA (microneurography) and arterial blood pressure (BP, Finometer/brachial catheter) were measured, and total peripheral resistance (TPR, ModelFlow) and baroreflex sensitivity were calculated at rest and during intravenous infusion of insulin (n = 20) or SNP (n = 13). A subset of participants receiving insulin (n = 7) was coinfused with phenylephrine. Insulin infusion decreased TPR (P = 0.01) and increased MSNA (P < 0.01), with no effect on arterial baroreflex sensitivity or BP (P > 0.05). Coinfusion with phenylephrine returned TPR and MSNA to baseline, with no effect on arterial baroreflex sensitivity (P > 0.05). Similar to insulin, SNP decreased TPR (P < 0.02) and increased MSNA (P < 0.01), with no effect on arterial baroreflex sensitivity (P > 0.12). Acute hyperinsulinemia shifts the baroreflex stimulus-response curve to higher MSNA without changing sensitivity, likely due to insulin's peripheral vasodilatory effects. Results show that peripheral vasodilation induced by insulin contributes to increased MSNA during hyperinsulinemia.NEW & NOTEWORTHY We hypothesized that elevation in muscle sympathetic nervous system activity (MSNA) during hyperinsulinemia is mediated by its peripheral vasodilator effect on the arterial baroreflex. Using three separate protocols in humans, we observed increases in both MSNA and cardiac output during hyperinsulinemia, which we attributed to the baroreflex response to peripheral vasodilation induced by insulin. Results show that peripheral vasodilation induced by insulin contributes to increased MSNA during hyperinsulinemia.
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Affiliation(s)
- Neil J McMillan
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Rogerio N Soares
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
| | - Jennifer L Harper
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Brian Shariffi
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
| | - Alfonso Moreno-Cabañas
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain
| | - Timothy B Curry
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Camila Manrique-Acevedo
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Missouri, Columbia, Missouri
- Research Services, Harry S. Truman Memorial Veterans Hospital, Columbia, Missouri
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
| | - Jacqueline K Limberg
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri
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15
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Limberg JK, Soares RN, Padilla J. Role of the Autonomic Nervous System in the Hemodynamic Response to Hyperinsulinemia-Implications for Obesity and Insulin Resistance. Curr Diab Rep 2022; 22:169-175. [PMID: 35247145 PMCID: PMC9012695 DOI: 10.1007/s11892-022-01456-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/30/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Herein, we summarize recent advances which provide new insights into the role of the autonomic nervous system in the control of blood flow and blood pressure during hyperinsulinemia. We also highlight remaining gaps in knowledge as it pertains to the translation of findings to relevant human chronic conditions such as obesity, insulin resistance, and type 2 diabetes. RECENT FINDINGS Our findings in insulin-sensitive adults show that increases in muscle sympathetic nerve activity with hyperinsulinemia do not result in greater sympathetically mediated vasoconstriction in the peripheral circulation. Both an attenuation of α-adrenergic-receptor vasoconstriction and augmented β-adrenergic vasodilation in the setting of high insulin likely explain these findings. In the absence of an increase in sympathetically mediated restraint of peripheral vasodilation during hyperinsulinemia, blood pressure is supported by increases in cardiac output in insulin-sensitive individuals. We highlight a dynamic interplay between central and peripheral mechanisms during hyperinsulinemia to increase sympathetic nervous system activity and maintain blood pressure in insulin-sensitive adults. Whether these results translate to the insulin-resistant condition and implications for long-term cardiovascular regulation warrants further exploration.
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Affiliation(s)
- Jacqueline K Limberg
- Department of Nutrition and Exercise Physiology, University of Missouri, 204 Gwynn Hall, Columbia, MO, 65211, USA.
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA.
| | - Rogerio N Soares
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, 204 Gwynn Hall, Columbia, MO, 65211, USA
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA
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16
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Mirzadeh Z, Faber CL, Schwartz MW. Central Nervous System Control of Glucose Homeostasis: A Therapeutic Target for Type 2 Diabetes? Annu Rev Pharmacol Toxicol 2022; 62:55-84. [PMID: 34990204 PMCID: PMC8900291 DOI: 10.1146/annurev-pharmtox-052220-010446] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Historically, pancreatic islet beta cells have been viewed as principal regulators of glycemia, with type 2 diabetes (T2D) resulting when insulin secretion fails to compensate for peripheral tissue insulin resistance. However, glycemia is also regulated by insulin-independent mechanisms that are dysregulated in T2D. Based on evidence supporting its role both in adaptive coupling of insulin secretion to changes in insulin sensitivity and in the regulation of insulin-independent glucose disposal, the central nervous system (CNS) has emerged as a fundamental player in glucose homeostasis. Here, we review and expand upon an integrative model wherein the CNS, together with the islet, establishes and maintains the defended level of glycemia. We discuss the implications of this model for understanding both normal glucose homeostasis and T2D pathogenesis and highlight centrally targeted therapeutic approaches with the potential to restore normoglycemia to patients with T2D.
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Affiliation(s)
- Zaman Mirzadeh
- Ivy Brain Tumor Center, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona 85013, USA;
| | - Chelsea L Faber
- Ivy Brain Tumor Center, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona 85013, USA;
- UW Medicine Diabetes Institute, Department of Medicine, University of Washington, Seattle, Washington 98109, USA;
| | - Michael W Schwartz
- UW Medicine Diabetes Institute, Department of Medicine, University of Washington, Seattle, Washington 98109, USA;
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17
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Nelson MAM, Efird JT, Kew KA, Katunga LA, Monroe TB, Doorn JA, Beatty CN, Shi Q, Akhter SA, Alwair H, Robidoux J, Anderson EJ. Enhanced Catecholamine Flux and Impaired Carbonyl Metabolism Disrupt Cardiac Mitochondrial Oxidative Phosphorylation in Diabetes Patients. Antioxid Redox Signal 2021; 35:235-251. [PMID: 33066717 PMCID: PMC8262387 DOI: 10.1089/ars.2020.8122] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Aims: Catecholamine metabolism via monoamine oxidase (MAO) contributes to cardiac injury in models of ischemia and diabetes, but the pathogenic mechanisms involved are unclear. MAO deaminates norepinephrine (NE) and dopamine to produce H2O2 and highly reactive "catecholaldehydes," which may be toxic to mitochondria due to the localization of MAO to the outer mitochondrial membrane. We performed a comprehensive analysis of catecholamine metabolism and its impact on mitochondrial energetics in atrial myocardium obtained from patients with and without type 2 diabetes. Results: Content and maximal activity of MAO-A and MAO-B were higher in the myocardium of patients with diabetes and they were associated with body mass index. Metabolomic analysis of atrial tissue from these patients showed decreased catecholamine levels in the myocardium, supporting an increased flux through MAOs. Catecholaldehyde-modified protein adducts were more abundant in myocardial tissue extracts from patients with diabetes and were confirmed to be MAO dependent. NE treatment suppressed mitochondrial ATP production in permeabilized myofibers from patients with diabetes in an MAO-dependent manner. Aldehyde dehydrogenase (ALDH) activity was substantially decreased in atrial myocardium from these patients, and metabolomics confirmed lower levels of ALDH-catalyzed catecholamine metabolites. Proteomic analysis of catechol-modified proteins in isolated cardiac mitochondria from these patients identified >300 mitochondrial proteins to be potential targets of these unique carbonyls. Innovation and Conclusion: These findings illustrate a unique form of carbonyl toxicity driven by MAO-mediated metabolism of catecholamines, and they reveal pathogenic factors underlying cardiometabolic disease. Importantly, they suggest that pharmacotherapies targeting aldehyde stress and catecholamine metabolism in heart may be beneficial in patients with diabetes and cardiac disease. Antioxid. Redox Signal. 35, 235-251.
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Affiliation(s)
- Margaret-Ann M Nelson
- Department of Pharmacology & Toxicology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Jimmy T Efird
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Kimberly A Kew
- Department of Biochemistry and Molecular Biology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Lalage A Katunga
- Department of Pharmacology & Toxicology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - T Blake Monroe
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, Iowa, USA
| | - Jonathan A Doorn
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, Iowa, USA
| | - Cherese N Beatty
- Department of Pharmacology & Toxicology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Qian Shi
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Shahab A Akhter
- Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, Greenville, North Carolina, USA
| | - Hazaim Alwair
- Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina Heart Institute, Greenville, North Carolina, USA
| | - Jacques Robidoux
- Department of Pharmacology & Toxicology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Ethan J Anderson
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, Iowa, USA.,Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa, USA
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Abstract
OBJECTIVE The microneurographic technique has shown that sympathetic overactivity may characterize patients with the metabolic syndrome. However, technical and methodological limitations of the studies prevented to draw definite conclusions. The present meta-analysis evaluated 16 microneurographic studies including 650 individuals, 444 metabolic syndrome patients and 206 healthy controls, respectively. The analysis was primarily based on muscle sympathetic nerve traffic (MSNA) quantified by microneurography in metabolic syndrome. METHODS Assessment was extended to the relationships of MSNA with an indirect neuroadrenergic marker, such as heart rate (HR), anthropometric variables, as BMI, waist-hip ratio and metabolic profile. RESULTS Metabolic syndrome individuals displayed MSNA values (means ± SEM) significantly greater than controls (58.6 ± 4.8 versus 41.6 ± 4.1 bursts/100 heart beats, P < 0.01). This result was independent on the concomitant presence of sleep apnea and drug treatment. MSNA was directly and significantly related to clinic SBP (r = 0.91, P < 0.01) but not to BMI (r = 0.17, P = NS), whereas no significant relationship was found between MSNA and metabolic variables included in the definition of metabolic syndrome. No significant correlation was found between MSNA and HR. CONCLUSION These data provide evidence that metabolic syndrome is characterized by a marked increase (about 30%) in MSNA. They also show that among the variables included in metabolic syndrome definition and related to the sympathetic overdrive blood pressure appears to be the most important one, at variance from what described in obesity in which metabolic and anthropometric factors play a major role. Finally in metabolic syndrome HR does not appear to represent a faithful mirror of the occurring sympathetic activation.
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Robeva R, Nedyalkova M, Kirilov G, Elenkova A, Zacharieva S, Kudłak B, Jatkowska N, Simeonov V. Multivariate Statistical Approach for Nephrines in Women with Obesity. Molecules 2021; 26:1393. [PMID: 33807567 PMCID: PMC7961883 DOI: 10.3390/molecules26051393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/19/2021] [Accepted: 03/02/2021] [Indexed: 12/22/2022] Open
Abstract
Catecholamines are physiological regulators of carbohydrate and lipid metabolism during stress, but their chronic influence on metabolic changes in obese patients is still not clarified. The present study aimed to establish the associations between the catecholamine metabolites and metabolic syndrome (MS) components in obese women as well as to reveal the possible hidden subgroups of patients through hierarchical cluster analysis and principal component analysis. The 24-h urine excretion of metanephrine and normetanephrine was investigated in 150 obese women (54 non diabetic without MS, 70 non-diabetic with MS and 26 with type 2 diabetes). The interrelations between carbohydrate disturbances, metabolic syndrome components and stress response hormones were studied. Exploratory data analysis was used to determine different patterns of similarities among the patients. Normetanephrine concentrations were significantly increased in postmenopausal patients and in women with morbid obesity, type 2 diabetes, and hypertension but not with prediabetes. Both metanephrine and normetanephrine levels were positively associated with glucose concentrations one hour after glucose load irrespectively of the insulin levels. The exploratory data analysis showed different risk subgroups among the investigated obese women. The development of predictive tools that include not only traditional metabolic risk factors, but also markers of stress response systems might help for specific risk estimation in obesity patients.
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Affiliation(s)
- Ralitsa Robeva
- Department of Endocrinology, Faculty of Medicine, Medical University—Sofia, USHATE “Acad. Iv. Penchev”, 2, Zdrave Str., 1431 Sofia, Bulgaria; (R.R.); (G.K.); (A.E.); (S.Z.)
| | - Miroslava Nedyalkova
- Department of Inorganic Chemistry, Faculty of Chemistry and Pharmacy, University of Sofia “St. Kl. Ohridski”, 1164 Sofia, Bulgaria
| | - Georgi Kirilov
- Department of Endocrinology, Faculty of Medicine, Medical University—Sofia, USHATE “Acad. Iv. Penchev”, 2, Zdrave Str., 1431 Sofia, Bulgaria; (R.R.); (G.K.); (A.E.); (S.Z.)
| | - Atanaska Elenkova
- Department of Endocrinology, Faculty of Medicine, Medical University—Sofia, USHATE “Acad. Iv. Penchev”, 2, Zdrave Str., 1431 Sofia, Bulgaria; (R.R.); (G.K.); (A.E.); (S.Z.)
| | - Sabina Zacharieva
- Department of Endocrinology, Faculty of Medicine, Medical University—Sofia, USHATE “Acad. Iv. Penchev”, 2, Zdrave Str., 1431 Sofia, Bulgaria; (R.R.); (G.K.); (A.E.); (S.Z.)
| | - Błażej Kudłak
- Department of Analytical Chemistry, Faculty of Chemistry, Gdańsk University of Technology, 11/12 Narutowicza, 80-233 Gdańsk, Poland; (B.K.); (N.J.)
| | - Natalia Jatkowska
- Department of Analytical Chemistry, Faculty of Chemistry, Gdańsk University of Technology, 11/12 Narutowicza, 80-233 Gdańsk, Poland; (B.K.); (N.J.)
| | - Vasil Simeonov
- Department of Analytical Chemistry, Faculty of Chemistry and Pharmacy, University of Sofia “St. Kl. Ohridski”, 1164 Sofia, Bulgaria;
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20
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Santin Y, Resta J, Parini A, Mialet-Perez J. Monoamine oxidases in age-associated diseases: New perspectives for old enzymes. Ageing Res Rev 2021; 66:101256. [PMID: 33434685 DOI: 10.1016/j.arr.2021.101256] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/04/2020] [Accepted: 01/05/2021] [Indexed: 12/19/2022]
Abstract
Population aging is one of the most significant social changes of the twenty-first century. This increase in longevity is associated with a higher prevalence of chronic diseases, further rising healthcare costs. At the molecular level, cellular senescence has been identified as a major process in age-associated diseases, as accumulation of senescent cells with aging leads to progressive organ dysfunction. Of particular importance, mitochondrial oxidative stress and consequent organelle alterations have been pointed out as key players in the aging process, by both inducing and maintaining cellular senescence. Monoamine oxidases (MAOs), a class of enzymes that catalyze the degradation of catecholamines and biogenic amines, have been increasingly recognized as major producers of mitochondrial ROS. Although well-known in the brain, evidence showing that MAOs are also expressed in a variety of peripheral organs stimulated a growing interest in the extra-cerebral roles of these enzymes. Besides, the fact that MAO-A and/or MAO-B are frequently upregulated in aged or dysfunctional organs has uncovered new perspectives on their roles in pathological aging. In this review, we will give an overview of the major results on the regulation and function of MAOs in aging and age-related diseases, paying a special attention to the mechanisms linked to the increased degradation of MAO substrates or related to MAO-dependent ROS formation.
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Affiliation(s)
- Yohan Santin
- Institute of Metabolic and Cardiovascular Diseases (I2MC), INSERM, Université de Toulouse, Toulouse, France
| | - Jessica Resta
- Institute of Metabolic and Cardiovascular Diseases (I2MC), INSERM, Université de Toulouse, Toulouse, France
| | - Angelo Parini
- Institute of Metabolic and Cardiovascular Diseases (I2MC), INSERM, Université de Toulouse, Toulouse, France
| | - Jeanne Mialet-Perez
- Institute of Metabolic and Cardiovascular Diseases (I2MC), INSERM, Université de Toulouse, Toulouse, France.
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Luo S, Ezrokhi M, Cominos N, Tsai TH, Stoelzel CR, Trubitsyna Y, Cincotta AH. Experimental dopaminergic neuron lesion at the area of the biological clock pacemaker, suprachiasmatic nuclei (SCN) induces metabolic syndrome in rats. Diabetol Metab Syndr 2021; 13:11. [PMID: 33485386 PMCID: PMC7825247 DOI: 10.1186/s13098-021-00630-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/13/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The daily peak in dopaminergic neuronal activity at the area of the biological clock (hypothalamic suprachiasmatic nuclei [SCN]) is diminished in obese/insulin resistant vs lean/insulin sensitive animals. The impact of targeted lesioning of dopamine (DA) neurons specifically at the area surrounding (and that communicate with) the SCN (but not within the SCN itself) upon glucose metabolism, adipose and liver lipid gene expression, and cardiovascular biology in normal laboratory animals has not been investigated and was the focus of this study. METHODS Female Sprague-Dawley rats received either DA neuron neurotoxic lesion by bilateral intra-cannula injection of 6-hydroxydopamine (2-4 μg/side) or vehicle treatment at the area surrounding the SCN at 20 min post protriptyline ip injection (20 mg/kg) to protect against damage to noradrenergic and serotonergic neurons. RESULTS At 16 weeks post-lesion relative to vehicle treatment, peri-SCN area DA neuron lesioning increased weight gain (34.8%, P < 0.005), parametrial and retroperitoneal fat weight (45% and 90% respectively, P < 0.05), fasting plasma insulin, leptin and norepinephrine levels (180%, 71%, and 40% respectively, P < 0.05), glucose tolerance test area under the curve (AUC) insulin (112.5%, P < 0.05), and insulin resistance (44%-Matsuda Index, P < 0.05) without altering food consumption during the test period. Such lesion also induced the expression of several lipid synthesis genes in adipose and liver and the adipose lipolytic gene, hormone sensitive lipase in adipose (P < 0.05 for all). Liver monocyte chemoattractant protein 1 (a proinflammatory protein associated with metabolic syndrome) gene expression was also significantly elevated in peri-SCN area dopaminergic lesioned rats. Peri-SCN area dopaminergic neuron lesioned rats were also hypertensive (systolic BP rose from 157 ± 5 to 175 ± 5 mmHg, P < 0.01; diastolic BP rose from 109 ± 4 to 120 ± 3 mmHg, P < 0.05 and heart rate increase from 368 ± 12 to 406 ± 12 BPM, P < 0.05) and had elevated plasma norepinephrine levels (40% increased, P < 0.05) relative to controls. CONCLUSIONS These findings indicate that reduced dopaminergic neuronal activity in neurons at the area of and communicating with the SCN contributes significantly to increased sympathetic tone and the development of metabolic syndrome, without effect on feeding.
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Affiliation(s)
- Shuqin Luo
- VeroScience LLC, 1334 Main Road, Tiverton, RI, 02878, USA
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22
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Moreira NJD, Dos Santos F, Moreira ED, Farah D, de Souza LE, da Silva MB, Moraes-Silva IC, Lincevicius GS, Caldini EG, Irigoyen MCC. Acute renal denervation normalizes aortic function and decreases blood pressure in spontaneously hypertensive rats. Sci Rep 2020; 10:21826. [PMID: 33311525 PMCID: PMC7733454 DOI: 10.1038/s41598-020-78674-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 11/03/2020] [Indexed: 11/09/2022] Open
Abstract
Mechanisms involved in the acute responses to renal denervation (RDN) have yet to be fully understood. We assessed urinary volume, autonomic control and aorta vascular reactivity after acute RDN. Male normotensive Wistar rats and spontaneously hypertensive rats (SHR) were divided into normotensive + RDN (ND) or sham surgery (NS), and hypertensive + RDN (HD) or sham surgery (HS). Metabolic parameters and hemodynamic measurements were recorded 72h and 4 days after intervention, respectively. Aortic rings were studied 7 days post RDN in an isometric myograph. Concentration–response curves to phenylephrine, sodium nitroprusside and acetylcholine (10–10–10−5 M) were performed. Two-way ANOVA was used for group comparisons and differences reported when p < 0.05. Results are presented as mean ± SEM. Urinary volume was 112% higher in HD vs. HS (HS = 14.94 ± 2.5 mL; HD = 31.69 ± 2.2 mL) and remained unchanged in normotensive rats. Systolic BP was lower in HD rats (HS = 201 ± 12 vs. HD = 172 ± 3 mmHg) without changes in normotensive group. HD group showed increased HF and LF modulation (HS = 5.8 ± 0.7 ms2vs. HD = 13.4 ± 1.4 ms2; HS = 3.5 ± 0.7 ms2vs. HD = 10.5 ± 1.7 ms2, respectively). RDN normalized vascular reactivity in HD rats and increased phenylephrine response in ND rats. Acute fall in BP induced by RDN is associated with increased urinary volume, which in turn may also have contributed to functional changes of the aorta.
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Affiliation(s)
- Nathalia Juocys Dias Moreira
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (InCor-FMUSP), São Paulo, Brazil.,Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM - UNIFESP), São Paulo, Brazil
| | - Fernando Dos Santos
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (InCor-FMUSP), São Paulo, Brazil
| | - Edson Dias Moreira
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (InCor-FMUSP), São Paulo, Brazil
| | - Daniela Farah
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (InCor-FMUSP), São Paulo, Brazil.,Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM - UNIFESP), São Paulo, Brazil
| | - Leandro Eziquiel de Souza
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (InCor-FMUSP), São Paulo, Brazil
| | - Maikon Barbosa da Silva
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (InCor-FMUSP), São Paulo, Brazil
| | - Ivana Cinthya Moraes-Silva
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (InCor-FMUSP), São Paulo, Brazil
| | - Gisele Silvério Lincevicius
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (InCor-FMUSP), São Paulo, Brazil.,Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM - UNIFESP), São Paulo, Brazil
| | - Elia Garcia Caldini
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
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Malik V, Mishima R, D Elliott A, H Lau D, Sanders P. The "Road" to Atrial Fibrillation: The Role of the Cardiac Autonomic Nervous System. J Atr Fibrillation 2020; 13:2400. [PMID: 33024501 DOI: 10.4022/jafib.2400] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/16/2020] [Accepted: 03/18/2020] [Indexed: 01/04/2023]
Abstract
At the population level, there is a parallel escalation in the healthcare burden of both, atrial fibrillation (AF) as well its risk factors. Compounding this relationship, AF is associated with escalating burden at an individual level, due its self-perpetuating and progressive nature. The mechanisms by which these risk factors interact to produce atrial remodelling and subsequent AF are unclear. This intersection is critical to the development of strategies to combat this disease at both the individual and population-level. It is well known that AF can manifest from disturbances in autonomic activity. At the population level, there is growing data to suggest a role of the autonomic nervous system in the future incidence of AF. Here, we provide an overview of the association of cardiac autonomic dysfunction with the incidence of AF, review the role of the autonomic nervous system (ANS) as an intermediary between risk factors and the development of AF and finally, we discuss the bidirectional relationship between AF and cardiac autonomic nervous system dysfunction; to determine whether this is implicated in the progression of AF.
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Affiliation(s)
- Varun Malik
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Ricardo Mishima
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Adrian D Elliott
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Dennis H Lau
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Prashanthan Sanders
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
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24
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Zilliox LA, Russell JW. Is there cardiac autonomic neuropathy in prediabetes? Auton Neurosci 2020; 229:102722. [PMID: 33011523 DOI: 10.1016/j.autneu.2020.102722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 06/09/2020] [Accepted: 08/24/2020] [Indexed: 02/09/2023]
Abstract
Although there is considerably more data showing an association between type 2 diabetes mellitus (T2DM) and autonomic neuropathy, accumulating evidence indicates that cardiovascular autonomic neuropathy (CAN) is common in persons with impaired glucose tolerance (IGT). Furthermore, CAN may occur early after a metabolic insult and obesity, especially among mean, and seems to play an important role in the early pathogenesis of CAN. Autonomic symptoms are common in subjects with IGT. In addition to defects in CAN, in subjects with IGT, there is impaired sudomotor function and abnormalities of endothelial peripheral vasoreactivity. At the present time, the only interventions that may be effective in preventing or reversing IGT associated autonomic neuropathy are lifestyle improvement. These include a tailored diet and exercise program. Other approaches that may be beneficial include modulation of oxidative stress and improvement of metabolic regulation in subjects with IGT. Interventions are most likely to be effective early in the course of disease and therefore it is extremely important to have early diagnosis of IGT and autonomic neuropathy.
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Affiliation(s)
- Lindsay A Zilliox
- Department of Neurology, University of Maryland and Maryland VA Healthcare System, Baltimore, MD, United States of America
| | - James W Russell
- Department of Neurology, University of Maryland and Maryland VA Healthcare System, Baltimore, MD, United States of America.
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25
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Wang Y, Rijal B, Xu M, Li Z, An Y, Zhang F, Lu C. Renal denervation improves vascular endothelial dysfunction by inducing autophagy via AMPK/mTOR signaling activation in a rat model of type 2 diabetes mellitus with insulin resistance. Acta Diabetol 2020; 57:1227-1243. [PMID: 32488498 DOI: 10.1007/s00592-020-01532-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 03/31/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Recent clinical and animal studies have shown that renal denervation (RDN) improves insulin sensitivity and endothelial dysfunction. However, the specific mechanism remains incompletely understood. The purpose of this study is to investigate the effects of RDN on endothelial dysfunction of type 2 diabetes mellitus (T2DM) rat models with insulin resistance and to explore the underlying molecular mechanisms. METHODS Male Sprague-Dawley rats were fed with or without high-fat diet allocated in different groups, combined with low-dose streptozotocin which induces a rat model to develop T2DM with insulin resistance. RDN was conducted 1 week after the rat models fully developed T2DM. The animals were sub-divided into four groups randomly: control group (CON, n = 6), diabetic group (T2DM, n = 6), diabetic with sham surgery group (Sham, n = 6) and diabetic with RDN group (RDN, n = 6). Rats in all groups were studied at baseline, both preoperatively and 4 weeks after RDN, respectively. Western blot was used to detect the expression of angiotensin-converting enzyme 2 (ACE2) protein and the expression of autophagy-related proteins Beclin1, LC3 and p62 and autophagy signaling pathway AMPK/mTOR proteins and apoptosis-related protein caspase-3 in the aorta endothelial cells. In addition, the effects of ACE2 on autophagy of human umbilical vein insulin resistance endothelial cell culture in vitro were also studied. RESULTS RDN decreased plasma and renal tissue norepinephrine levels. The Von Willebrand factor level was also decreased, while the plasma level of nitric oxide (NO) was significantly increased after RDN. Compared with the T2DM group and the Sham group, the endothelium-dependent and endothelium-independent diastolic function of the RDN group was improved significantly, the expression of Beclin1, LC3, ACE2 and eNOS proteins was higher, and the level of p62 protein was decreased. Furthermore, we found that RDN can activate the expression of p-AMPK and inhibit the expression of p-mTOR. In cell culture experiment, ACE2 activated p-AMPK and inhibited p-mTOR, thus promoting autophagy. CONCLUSIONS RDN may not only increase the expression of ACE2 in the vascular endothelium, but also can via ACE2 activate p-AMPK and inhibit p-mTOR, thus promoting autophagy and improving endothelial dysfunction.
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MESH Headings
- AMP-Activated Protein Kinases/metabolism
- Animals
- Autophagy/physiology
- Denervation/methods
- Diabetes Mellitus, Experimental/complications
- Diabetes Mellitus, Experimental/pathology
- Diabetes Mellitus, Experimental/physiopathology
- Diabetes Mellitus, Experimental/surgery
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/pathology
- Diabetes Mellitus, Type 2/physiopathology
- Diabetes Mellitus, Type 2/surgery
- Endothelium, Vascular/metabolism
- Endothelium, Vascular/physiopathology
- Insulin Resistance
- Kidney/innervation
- Kidney/metabolism
- Kidney/surgery
- Male
- Rats
- Rats, Sprague-Dawley
- Signal Transduction/physiology
- TOR Serine-Threonine Kinases/metabolism
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Affiliation(s)
- Yong Wang
- First Central Clinical College of Tianjin Medical University, Tianjin, China
- Department of Cardiology, The First People's Hospital of Shangqiu, Shangqiu, Henan, China
| | - Bikash Rijal
- First Central Clinical College of Tianjin Medical University, Tianjin, China
| | - Mengping Xu
- Department of Cardiology, Tianjin First Central Hospital, Tianjin, China
| | - Zhuqing Li
- School of Medicine, Nankai University, Tianjin, China
| | - Yunan An
- First Central Clinical College of Tianjin Medical University, Tianjin, China
| | - Feng Zhang
- Department of Cardiology, Tianjin First Central Hospital, Tianjin, China
| | - Chengzhi Lu
- Department of Cardiology, Tianjin First Central Hospital, Tianjin, China.
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Majeed F, Yar T. "Comparison of cardiovascular autonomic activity (heart rate variability and baroreceptor sensitivity) in young healthy females during fasting and hyperglycaemia". Diabetes Metab Syndr 2020; 14:1511-1518. [PMID: 32795743 DOI: 10.1016/j.dsx.2020.07.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/11/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIM The present study compared cardiovascular autonomic activity and reactivity during fasting (FS) and hyperglycemia (HS) states in young healthy females. METHODS This case crossover study was conducted on 30 females recruited by convenient sampling. Blood glucose levels were measured in FS and after oral glucose load i.e., HS. Finger arterial blood pressure (BP) and ECG were recorded constantly to monitor baroreceptor sensitivity (BRS) and heart rate variability (HRV). Autonomic reactivity was tested with deep breathing (DB), Valsalva manoeuvre (VM), and head-up-tilt (HUT) test under FS and HS. HRV parameters not normally distributed were natural log (ln) transformed. RESULTS Significantly reduced Valsalva ratio and higher heart rate and BP were observed in HS that continued during HUT (P < 0.05). The lnSDNN (standard deviation of normal-to-normal intervals) and lnRMSSD (root mean square of successive differences) were significantly lower (p < 0.05) in HS during HUT. After HUT, lnRMSSD remained lower (P = 0.031), whereas lnLF/HF (low frequency/high frequency power) ratio (P = 0.042) and LFnu (normalized units) (P = 0.024) were higher in HS. BRS was significantly lower in supine position in HS compared to FS and further reduced in HUT position in both FS and HS (P < 0.05). CONCLUSION Compared to FS, the HS exhibited heightened sympathetic activity with attenuation of parasympathetic activity and this phenomenon was further accentuated by HUT. BRS was more sensitive indicator of autonomic effects of hyperglycemia in resting state. In addition to standard tests, autonomic reactivity in vulnerable young subjects could be useful to detect autonomic imbalance at an early stage.
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Affiliation(s)
- Farrukh Majeed
- Department of Physiology College of Medicine Imam Abulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Talay Yar
- Department of Physiology College of Medicine Imam Abulrahman Bin Faisal University, Dammam, Saudi Arabia.
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27
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Gueguen C, Burke SL, Barzel B, Eikelis N, Watson AMD, Jha JC, Jackson KL, Sata Y, Lim K, Lambert GW, Jandeleit-Dahm KAM, Cooper ME, Thomas MC, Head GA. Empagliflozin modulates renal sympathetic and heart rate baroreflexes in a rabbit model of diabetes. Diabetologia 2020; 63:1424-1434. [PMID: 32372207 DOI: 10.1007/s00125-020-05145-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 03/10/2020] [Indexed: 10/24/2022]
Abstract
AIMS/HYPOTHESIS We determined whether empagliflozin altered renal sympathetic nerve activity (RSNA) and baroreflexes in a diabetes model in conscious rabbits. METHODS Diabetes was induced by alloxan, and RSNA, mean arterial pressure (MAP) and heart rate were measured before and after 1 week of treatment with empagliflozin, insulin, the diuretic acetazolamide or the ACE inhibitor perindopril, or no treatment, in conscious rabbits. RESULTS Four weeks after alloxan administration, blood glucose was threefold and MAP 9% higher than non-diabetic controls (p < 0.05). One week of treatment with empagliflozin produced a stable fall in blood glucose (-43%) and increased water intake (+49%) but did not change RSNA, MAP or heart rate compared with untreated diabetic rabbits. The maximum RSNA to hypotension was augmented by 75% (p < 0.01) in diabetic rabbits but the heart rate baroreflex was unaltered. Empagliflozin and acetazolamide reduced the augmentation of the RSNA baroreflex (p < 0.05) to be similar to the non-diabetic group. Noradrenaline (norepinephrine) spillover was similar in untreated diabetic and non-diabetic rabbits but twofold greater in empagliflozin- and acetazolamide-treated rabbits (p < 0.05). CONCLUSIONS/INTERPRETATION As empagliflozin can restore diabetes-induced augmented sympathetic reflexes, this may be beneficial in diabetic patients. A similar action of the diuretic acetazolamide suggests that the mechanism may involve increased sodium and water excretion. Graphical abstract.
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Affiliation(s)
- Cindy Gueguen
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia
| | - Sandra L Burke
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia
| | - Benjamin Barzel
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia
| | - Nina Eikelis
- Iverson Health Innovation Research Institute and School of Health Science, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Anna M D Watson
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Jay C Jha
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Kristy L Jackson
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia
| | - Yusuke Sata
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Kyungjoon Lim
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia
- Department of Physiology, Anatomy & Microbiology, La Trobe University, Melbourne, VIC, Australia
| | - Gavin W Lambert
- Iverson Health Innovation Research Institute and School of Health Science, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Karin A M Jandeleit-Dahm
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Diabetic Nephropathy Research Group, Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibnitz Center for Diabetes Research, Heinrich Heine University, Düsseldorf, Germany
| | - Mark E Cooper
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Merlin C Thomas
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Geoffrey A Head
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia.
- Department of Pharmacology, Monash University, Melbourne, VIC, Australia.
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28
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Baqar S, Kong YW, Chen AX, O'Callaghan C, MacIsaac RJ, Bouterakos M, Lambert GW, Jerums G, Lambert EE, Ekinci EI. Effect of Salt Supplementation on Sympathetic Activity and Endothelial Function in Salt-Sensitive Type 2 Diabetes. J Clin Endocrinol Metab 2020; 105:5639695. [PMID: 31761946 DOI: 10.1210/clinem/dgz219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 11/23/2019] [Indexed: 12/22/2022]
Abstract
CONTEXT Lower sodium intake is paradoxically associated with higher mortality in type 2 diabetes (T2D). OBJECTIVE To determine whether sympathetic nervous system (SNS) activation and endothelial dysfunction contribute to these observations, we examined the effect of salt supplementation on these systems in people with T2D with habitual low sodium. We hypothesized that salt supplementation would lower SNS activity and improve endothelial function compared to placebo. DESIGN We conducted a randomized, double-blinded, placebo-controlled crossover trial. SETTING The study took place in a tertiary referral diabetes outpatient clinic. PARTICIPANTS Twenty-two people with T2D with habitual low sodium intake (24-hour urine sodium <150 mmol/24h) were included. INTERVENTION Salt supplementation (100 mmol NaCl/24h) or placebo for 3 weeks was administered. MAIN OUTCOME MEASURES The primary outcome of SNS activity and endothelial function was assessed as follows: Microneurography assessed muscle sympathetic nerve activity (MSNA), pulse amplitude tonometry assessed endothelial function via reactive hyperemic index (RHI), and arterial stiffness was assessed via augmentation index (AI). Secondary outcomes included cardiac baroreflex, serum aldosterone, ambulatory blood pressure monitoring (ABPM), heart rate variability (HRV), and salt sensitivity. RESULTS Compared to placebo, salt supplementation increased MSNA (burst frequency P = .047, burst incidence P = .016); however, RHI (P = .24), AI (P = .201), ABPM (systolic P = .09, diastolic P = .14), and HRV were unaffected. Salt supplementation improved baroreflex (slope P = .026) and lowered aldosterone (P = .004), and in salt-resistant individuals there was a trend toward improved RHI (P = .07). CONCLUSIONS In people with T2D and low habitual sodium intake, salt supplementation increased SNS activity without altering endothelial function or blood pressure but improved baroreflex function, a predictor of cardiac mortality. Salt-resistant individuals trended toward improved endothelial function with salt supplementation.
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Affiliation(s)
- Sara Baqar
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Yee Wen Kong
- Department of Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Angela X Chen
- Department of Medicine, Austin Health, Heidelberg, Victoria, Australia
| | | | - Richard J MacIsaac
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
- Department of Endocrinology & Diabetes, St Vincent's Hospital Melbourne and The University of Melbourne, Fitzroy, Victoria, Australia
| | - Maree Bouterakos
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Gavin W Lambert
- Human Neurotransmitters Laboratory, Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia
- Iverson Health Innovation Research Institute and Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - George Jerums
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Elisabeth E Lambert
- Human Neurotransmitters Laboratory, Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia
- Iverson Health Innovation Research Institute and Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Elif I Ekinci
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
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29
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Sari CI, Eikelis N, Head GA, Schlaich M, Meikle P, Lambert G, Lambert E. Android Fat Deposition and Its Association With Cardiovascular Risk Factors in Overweight Young Males. Front Physiol 2019; 10:1162. [PMID: 31620011 PMCID: PMC6759693 DOI: 10.3389/fphys.2019.01162] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/28/2019] [Indexed: 11/16/2022] Open
Abstract
Objective Excess adiposity increases the risk of type-2 diabetes and cardiovascular disease development. Beyond the simple level of adiposity, the pattern of fat distribution may influence these risks. We sought to examine if higher android fat distribution was associated with different hemodynamic, metabolic or vascular profile compared to a lower accumulation of android fat deposits in young overweight males. Methods Forty-six participants underwent dual-energy X-ray absorptiometry and were stratified into two groups. Group 1: low level of android fat (<9.5%) and group 2: high level of android fat (>9.5%). Assessments comprised measures of plasma lipid and glucose profile, blood pressure, endothelial function [reactive hyperemia index (RHI)] and muscle sympathetic nerve activity (MSNA). Results There were no differences in weight, BMI, total body fat and lean mass between the two groups. Glucose tolerance and insulin resistance (fasting plasma insulin) were impaired in group 2 (p < 0.05). Levels of plasma triglycerides and 5 lipid species were higher in group 2 (p < 0.05). Endothelial function was less in group 2 (RHI: 1.64 vs. 2.26, p = 0.003) and heart rate was higher (76 vs. 67 bpm, p = 0.004). No difference occurred in MSNA nor blood pressure between the 2 groups. Conclusion Preferential fat accumulation in the android compartment is associated with increased cardiovascular and metabolic risk via alteration of endothelial function.
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Affiliation(s)
- Carolina Ika Sari
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Nina Eikelis
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Iverson Health Innovation Research Institute, School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Geoffrey A Head
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Markus Schlaich
- Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit, The University of Western Australia, Perth, WA, Australia
| | - Peter Meikle
- Metabolomics Laboratories, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Gavin Lambert
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Iverson Health Innovation Research Institute, School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Elisabeth Lambert
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Iverson Health Innovation Research Institute, School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia
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30
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Waldron NH, Fudim M, Mathew JP, Piccini JP. Neuromodulation for the Treatment of Heart Rhythm Disorders. JACC Basic Transl Sci 2019; 4:546-562. [PMID: 31468010 PMCID: PMC6712352 DOI: 10.1016/j.jacbts.2019.02.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/22/2019] [Accepted: 02/22/2019] [Indexed: 12/13/2022]
Abstract
Derangement of autonomic nervous signaling is an important contributor to cardiac arrhythmogenesis. Modulation of autonomic nervous signaling holds significant promise for the prevention and treatment of cardiac arrhythmias. Further clinical investigation is necessary to establish the efficacy and safety of autonomic modulatory therapies in reducing cardiac arrhythmias.
There is an increasing recognition of the importance of interactions between the heart and the autonomic nervous system in the pathophysiology of arrhythmias. These interactions play a role in both the initiation and maintenance of arrhythmias and are important in both atrial and ventricular arrhythmia. Given the importance of the autonomic nervous system in the pathophysiology of arrhythmias, there has been notable effort in the field to improve existing therapies and pioneer additional interventions directed at cardiac-autonomic targets. The interventions are targeted to multiple and different anatomic targets across the neurocardiac axis. The purpose of this review is to provide an overview of the rationale for neuromodulation in the treatment of arrhythmias and to review the specific treatments under evaluation and development for the treatment of both atrial fibrillation and ventricular arrhythmias.
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Key Words
- AERP, atrial effective refractory period
- AF, atrial fibrillation
- AGP, autonomic ganglionic plexus
- ANS, autonomic nervous system
- CABG, coronary artery bypass grafting
- HRV, heart rate variability
- ICD, implantable cardioverter-defibrillator
- LLVNS, low-level vagal nerve stimulation
- OSA, obstructive sleep apnea
- POAF, post-operative atrial fibrillation
- PVI, pulmonary vein isolation
- RDN, renal denervation
- SCS, spinal cord stimulation
- SGB, stellate ganglion blockade
- SNS, sympathetic nervous system
- VF, ventricular fibrillation
- VNS, vagal nerve stimulation
- VT, ventricular tachycardia
- arrhythmia
- atrial fibrillation
- autonomic nervous system
- ganglionated plexi
- neuromodulation
- ventricular arrhythmias
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Affiliation(s)
- Nathan H Waldron
- Department of Anesthesia, Duke University Medical Center, Durham, North Carolina.,Duke Clinical Research Institute, Durham, North Carolina
| | - Marat Fudim
- Duke Clinical Research Institute, Durham, North Carolina.,Electrophysiology Section, Duke University Medical Center, Durham, North Carolina
| | - Joseph P Mathew
- Department of Anesthesia, Duke University Medical Center, Durham, North Carolina.,Duke Clinical Research Institute, Durham, North Carolina
| | - Jonathan P Piccini
- Duke Clinical Research Institute, Durham, North Carolina.,Electrophysiology Section, Duke University Medical Center, Durham, North Carolina
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Grassi G, Biffi A, Seravalle G, Trevano FQ, Dell'Oro R, Corrao G, Mancia G. Sympathetic Neural Overdrive in the Obese and Overweight State. Hypertension 2019; 74:349-358. [PMID: 31203727 DOI: 10.1161/hypertensionaha.119.12885] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Nerve traffic recordings (muscle sympathetic nerve traffic [MSNA]) have shown that sympathetic activation may occur in obesity. However, the small sample size of the available studies, presence of comorbidities, heterogeneity of the subjects examined represented major weaknesses not allowing to draw definite conclusions. This is the case for the overweight state. The present meta-analysis evaluated 1438 obese or overweight subjects recruited in 45 microneurographic studies. The analysis was primarily based on MSNA quantification in obesity and overweight, excluding as concomitant conditions hypertension, metabolic syndrome, and other comorbidities. Assessment was extended to the relationships of MSNA with other neuroadrenergic markers, such as plasma norepinephrine and heart rate, anthropometric variables, as body mass index, waist-to-hip ratio, presence/absence of obstructive sleep apnea, and metabolic profile. Compared with normoweights MSNA was significantly greater in overweight and more in obese individuals (37.0±4.1 versus 43.2±3.5 and 50.4±5.0 burts/100 heartbeats, P<0.01). This was the case even in the absence of obstructive sleep apnea. MSNA was significantly directly related to body mass index and waist-to-hip ratio ( r=0.41 and r=0.64, P<0.04 and <0.01, respectively), clinic blood pressure ( r=0.68, P<0.01), total cholesterol, LDL (low-density lipoprotein) cholesterol, and triglycerides ( r=0.91, r=0.94, and r=0.80, respectively, P<0.01) but unrelated to plasma insulin, glucose, and homeostatic model assessment for insulin resistance. No significant correlation was found between MSNA, heart rate, and norepinephrine. Thus, obesity and overweight are characterized by sympathetic overactivity which mirrors the severity of the clinical condition and reflects metabolic alterations, with the exclusion of glucose/insulin profile. Neither heart rate nor norepinephrine appear to represent faithful markers of the muscle sympathetic overdrive.
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Affiliation(s)
- Guido Grassi
- From the Clinica Medica, Department of Medicine and Surgery (G.G., F.Q.T., R.D.).,University of Milano-Bicocca (G.G.)
| | - Annalisa Biffi
- National Centre for Healthcare Research and Pharmacoepidemiology (A.B., G.C.).,Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods (A.B., G.D.)
| | | | - Fosca Quarti Trevano
- From the Clinica Medica, Department of Medicine and Surgery (G.G., F.Q.T., R.D.)
| | - Raffaella Dell'Oro
- From the Clinica Medica, Department of Medicine and Surgery (G.G., F.Q.T., R.D.)
| | - Giovanni Corrao
- National Centre for Healthcare Research and Pharmacoepidemiology (A.B., G.C.).,Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods (A.B., G.D.)
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Young BE, Holwerda SW, Vranish JR, Keller DM, Fadel PJ. Sympathetic Transduction in Type 2 Diabetes Mellitus. Hypertension 2019; 74:201-207. [PMID: 31188673 DOI: 10.1161/hypertensionaha.119.12928] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Approximately 60% of patients with type 2 diabetes mellitus (T2D) develop hypertension. Recent work also indicates greater blood pressure (BP) excursions throughout the day in T2D. Collectively, these findings suggest altered BP control in T2D. Although muscle sympathetic nerve activity (MSNA) recordings in T2D have provided equivocal results, quantification of MSNA alone does not account for ensuing vasoconstriction and BP responses elicited by MSNA. Thus, we tested the hypothesis that patients with T2D exhibit enhanced sympathetic transduction to BP. MSNA (microneurography) and beat-to-beat BP (Finometer) were measured at rest in 21 T2D and 13 age-matched and body mass index-matched control subjects and, signal-averaging was performed to quantify the mean arterial pressure and total vascular conductance responses to spontaneous bursts of MSNA. The peak mean arterial pressure and total vascular conductance responses to spontaneous MSNA were similar between T2D and control (both P>0.05). However, further analysis, separating T2D into those taking statins (n=13, T2D +statin) and not taking statins (n=8, T2D -statin), indicated that T2D -statin patients (4.2±0.6 mm Hg) exhibited greater peak mean arterial pressure responses compared with both T2D +statin patients (2.5±0.3 mm Hg, P=0.01) and control (control: 2.8±0.3 mm Hg, P=0.02). Likewise, nadir total vascular conductance responses to spontaneous MSNA bursts were greater in T2D -statin patients (T2D -statin: -3.3±0.6 mL/(min·mm Hg), T2D +statin: -1.6±0.3 mL/(min·mm Hg), P=0.03; control -2.2±0.3 mL/(min·mm Hg), P=0.08). Notably, T2D +statin patients exhibited similar peak mean arterial pressure and total vascular conductance responses to MSNA compared with control. Collectively, these findings demonstrate, for the first time, that patients with T2D exhibit augmented sympathetic transduction and this effect seems to be offset by statin therapy.
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Affiliation(s)
- Benjamin E Young
- From the Department of Kinesiology, University of Texas at Arlington (B.E.Y., D.M.K., P.J.F.)
| | - Seth W Holwerda
- Department of Health and Human Physiology, University of Iowa (S.W.H.)
| | - Jennifer R Vranish
- Department of Integrative Physiology and Health Science, Alma College, MI (J.R.V.)
| | - David M Keller
- From the Department of Kinesiology, University of Texas at Arlington (B.E.Y., D.M.K., P.J.F.)
| | - Paul J Fadel
- From the Department of Kinesiology, University of Texas at Arlington (B.E.Y., D.M.K., P.J.F.)
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Kochetkov AI, Ostroumova OD, Starodubova AV, Оstroumova ТМ, Bondarenko DA. Association between Sympathetic Nervous System Activation, Obesity and Insulin Resistance. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2019. [DOI: 10.20996/1819-6446-2019-15-2-230-243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- A. I. Kochetkov
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University
| | - O. D. Ostroumova
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University; I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. V. Starodubova
- Federal Research Centre for Nutrition, Biotechnology and Food Safety; Pirogov Russian National Research Medical University
| | - Т. М. Оstroumova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - D. A. Bondarenko
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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Abstract
Diabetic kidney disease commonly is associated with an increased risk of cardiovascular disease. There are traditional common risk factors for both conditions including hypertension and poor glycemic control. However, it is likely that there are other pathophysiological mechanisms that explain the clinical phenomenon of increased cardiovascular disease in diabetic patients with chronic kidney and vice versa. Current management of both conditions includes aggressive glucose and blood pressure control. The protective role of treating dyslipidemia has been shown for cardiovascular disease, but the results for renal disease are not as clear. The advent of new classes of glucose-lowering agents such as sodium glucose co-transporter2 inhibitors and glucagon-like peptide-1 agonists has resulted in impressive effects on both cardiovascular and renal disease in diabetes. However, how these drugs act independently of glucose lowering to confer both kidney and cardiovascular protection has not been fully elucidated. Nevertheless, these new treatments provide optimism for reducing both microvascular and macrovascular complications in diabetes, which represent the major causes of morbidity and premature mortality in this condition.
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Affiliation(s)
- Muhammad Maqbool
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia
| | - Mark E Cooper
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia
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Baqar S, Straznicky NE, Lambert G, Kong YW, Dixon JB, Jerums G, Ekinci EI, Lambert E. Comparison of endothelial function and sympathetic nervous system activity along the glucose continuum in individuals with differing metabolic risk profiles and low dietary sodium intake. BMJ Open Diabetes Res Care 2019; 7:e000606. [PMID: 31114697 PMCID: PMC6501854 DOI: 10.1136/bmjdrc-2018-000606] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/01/2018] [Accepted: 12/22/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Low sodium intake may trigger sympathetic nervous system (SNS) activation and endothelial dysfunction. Studies have not explored these associations along the glucose continuum. Accordingly, we compared endothelial function and SNS activity in individuals with low sodium intake and differing categories of metabolic risk along the glucose continuum. We hypothesized that low sodium intake is associated with (1) impairment of endothelial function and (2) higher SNS activity in individuals with higher metabolic risk. RESEARCH DESIGN AND METHODS In this prospective observational study, participants (n=54) with low sodium intake (single 24 hours urine sodium excretion <150 mmol/24 hours) were categorized based on oral glucose tolerance testing as: normal glucose tolerance (NGT, n=10), impaired glucose tolerance (IGT, n=15), treatment naive type 2 diabetes (T2D-) (n=12) or treated type 2 diabetes (T2D+) (n=17). We assessed endothelial function using pulse amplitude tonometry (PAT) derived reactive hyperemic index and PAT ratio; arterial stiffness via augmentation index; muscle sympathetic nerve activity (MSNA) using microneurography; cardiac baroreflex; heart rate; blood pressure; glycosylated hemoglobin A1c (HbA1c) and lipid profile. RESULTS Mean (SD) sodium excretion was 110.6 (26) mmol/24 hours. Compared with NGT, IGT and T2D-, the T2D+ group had lower MSNA (p=0.005), PAT ratio (p=0.04) and baroreflex sensitivity (p=0.0002) and an augmented heart rate (p=0.02). The T2D+ group had appropriate mean (SD) glycemic (HbA1c 7.2 (1.72)%), total cholesterol (4.2 (1.0) mmol/L), low-density lipoprotein (2.2 (1.0) mmol/L) and blood pressure (systolic 136 (13), diastolic 78 (12)) (mm Hg) control. CONCLUSIONS Individuals with T2D+ have impaired endothelial and baroreflex function, despite low sodium intake, appropriately managed cardiometabolic risk factors and lower SNS activity, compared with others along the glucose continuum. Whether low sodium intake is associated with modulation of the sympathovascular profile in T2D requires further investigation.
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Affiliation(s)
- Sara Baqar
- Endocrinology, Austin Health, Heidelberg, Victoria, Australia
| | - Nora E Straznicky
- Department of Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Gavin Lambert
- Faculty of Health, Arts and Design, Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Yee Wen Kong
- Endocrinology, Austin Health, Heidelberg, Victoria, Australia
| | - John B Dixon
- Vascular and Hypertension, Obesity Research, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - George Jerums
- Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
| | - Elif Ilhan Ekinci
- Endocrinology, Austin Health, Heidelberg, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Elisabeth Lambert
- Faculty of Health, Arts and Design, Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, Australia
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Nascimento AR, Gomes F, Machado MV, Gonçalves-de-Albuquerque C, Bousquet P, Tibiriçá E. I 1-imidazoline receptor-mediated cardiovascular and metabolic effects in high-fat diet-induced metabolic syndrome in rats. Auton Neurosci 2018; 217:18-25. [PMID: 30704971 DOI: 10.1016/j.autneu.2018.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/09/2018] [Accepted: 12/21/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The objective of this study was to investigate the effects of a new I1-imidazoline receptor-selective pyrroline compound on the hemodynamic, metabolic and microvascular alterations in a high-fat diet (HFD)-induced model of metabolic syndrome in rats. METHODS In total, twenty adult male Wistar rats were fed a high-fat diet (HFD, n = 20) for 20 weeks. Thereafter, the rats received a new pyrroline compound selective for I1-imidazoline receptors (LNP599; 10 mg/kg/day) or vehicle (n = 10/group) orally by gavage for 4 weeks. Functional microcirculation was assessed using intravital video microscopy, and structural microcirculation was evaluated using histochemical analysis. RESULTS LNP599 induced concomitant reductions in the SBP, HR and plasma catecholamine levels. The animals treated with this new antihypertensive compound also presented an improvement in body weight and the metabolic parameters related to metabolic syndrome, such as the glucose and lipid profiles. These effects were accompanied by a reversal of the functional and structural capillary rarefaction in the skeletal muscle. CONCLUSIONS The modulation of the sympathetic nervous system by a selective agonist for I1-imidazoline receptors improves the hemodynamic and metabolic parameters in an experimental model of metabolic syndrome. LNP599 can also contribute to the restoration of microcirculatory parameters.
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Affiliation(s)
- Alessandro R Nascimento
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil; Faculty of Medicine of the University of Strasbourg, Strasbourg, France.
| | - Fabiana Gomes
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil
| | - Marcus V Machado
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil
| | | | - Pascal Bousquet
- Faculty of Medicine of the University of Strasbourg, Strasbourg, France
| | - Eduardo Tibiriçá
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil
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Kim YK, Nam KI, Song J. The Glymphatic System in Diabetes-Induced Dementia. Front Neurol 2018; 9:867. [PMID: 30429819 PMCID: PMC6220044 DOI: 10.3389/fneur.2018.00867] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 09/26/2018] [Indexed: 12/14/2022] Open
Abstract
The glymphatic system has emerged as an important player in central nervous system (CNS) diseases, by regulating the vasculature impairment, effectively controlling the clearance of toxic peptides, modulating activity of astrocytes, and being involved in the circulation of neurotransmitters in the brain. Recently, several studies have indicated decreased activity of the glymphatic pathway under diabetes conditions such as in insulin resistance and hyperglycemia. Furthermore, diabetes leads to the disruption of the blood-brain barrier and decrease of apolipoprotein E (APOE) expression and the secretion of norepinephrine in the brain, involving the impairment of the glymphatic pathway and ultimately resulting in cognitive decline. Considering the increased prevalence of diabetes-induced dementia worldwide, the relationship between the glymphatic pathway and diabetes-induced dementia should be investigated and the mechanisms underlying their relationship should be discussed to promote the development of an effective therapeutic approach in the near future. Here, we have reviewed recent evidence for the relationship between glymphatic pathway dysfunction and diabetes. We highlight that the enhancement of the glymphatic system function during sleep may be beneficial to the attenuation of neuropathology in diabetes-induced dementia. Moreover, we suggest that improving glymphatic system activity may be a potential therapeutic strategy for the prevention of diabetes-induced dementia.
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Affiliation(s)
- Young-Kook Kim
- Department of Biochemistry, Chonnam National University Medical School, Gwangju, South Korea.,Department of Biomedical Sciences, Center for Creative Biomedical Scientists, Chonnam National University, Gwangju, South Korea
| | - Kwang Il Nam
- Department of Anatomy, Chonnam National University Medical School, Gwangju, South Korea
| | - Juhyun Song
- Department of Biomedical Sciences, Center for Creative Biomedical Scientists, Chonnam National University, Gwangju, South Korea.,Department of Anatomy, Chonnam National University Medical School, Gwangju, South Korea
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Mialet-Perez J, Santin Y, Parini A. Monoamine oxidase-A, serotonin and norepinephrine: synergistic players in cardiac physiology and pathology. J Neural Transm (Vienna) 2018; 125:1627-1634. [DOI: 10.1007/s00702-018-1908-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 07/13/2018] [Indexed: 10/28/2022]
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Cao L, Graham SL, Pilowsky PM. Carbohydrate ingestion induces differential autonomic dysregulation in normal-tension glaucoma and primary open angle glaucoma. PLoS One 2018; 13:e0198432. [PMID: 29879162 PMCID: PMC5991678 DOI: 10.1371/journal.pone.0198432] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 05/20/2018] [Indexed: 12/25/2022] Open
Abstract
Background It is reported that glaucoma may be associated with vascular dysregulation. Normal tension glaucoma (NTG) and primary open angle glaucoma (POAG), which feature different intraocular pressure levels, may manifest differential features of systemic autonomic dysregulation. Methods and results We investigated autonomic regulation to carbohydrate ingestion and postural change in 37 glaucoma patients (19 NTG and 18 POAG) and 36 controls. Subjects were age and gender-matched, normotensive, and had normal comparable insulin sensitivity. Continuous finger arterial pressure and ECG was recorded in supine and standing positions before and after carbohydrate ingestion. Low frequency (LF, 0.04–0.15Hz) and high frequency (HF, 0.15–0.4Hz) spectral power of heart rate and systolic blood pressure variability (HRV and SBPV) were calculated to estimate sympathovagal function. Overall comparison glaucoma (N = 37) and controls (N = 36) showed an increased sympathetic excitation, vagal withdrawal and unstable mean arterial pressure after carbohydrate ingestion in glaucoma patients. Glaucoma severity by retinal nerve fibre layer (RNFL) thickness is positively correlated to autonomic responses (HRV LF power and HF power in normalised units (nu), and HRV LF/HF ratio) after carbohydrate ingestion. Early (30 minutes) following carbohydrate ingestion, SBP LF power and HRV parameters remained unchanged in controls; while POAG showed abnormal autonomic responses, with a paradoxical vagal enhancement (increased HRV HF power in nu) and sympathetic inhibition (decreased HRV LF power nu and HRV LF/HF ratio), and associated hypotension. Later (60–120 minutes) following carbohydrate ingestion, HRV parameters remained unaltered in controls; whereas NTG manifested vagal withdrawal (reduced HRV HF power nu) and sympathetic hyper-responsiveness (increased HRV LF power nu and HRV LF/HF ratio), despite increased SBP LF power in both controls and NTG. Both NTG and POAG exhibited attenuated autonomic responses to postural stress. Conclusions NTG and POAG both manifest some systemic autonomic cardiovascular dysregulation. However, the two forms of glaucoma respond differentially to carbohydrate ingestion, irrespective of insulin resistance.
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Affiliation(s)
- Lei Cao
- The Heart Research Institute, The University of Sydney, Newtown, NSW, Australia
| | - Stuart L. Graham
- Australian School of Advanced Medicine, Macquarie University, North Ryde, NSW, Australia
| | - Paul M. Pilowsky
- The Heart Research Institute, The University of Sydney, Newtown, NSW, Australia
- * E-mail:
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Hu B, Zhang J, Wang J, He B, Wang D, Zhang W, Zhou X, Li H. Responses of PKCε to cardiac overloads on myocardial sympathetic innervation and NET expression. Auton Neurosci 2017; 210:24-33. [PMID: 29195789 DOI: 10.1016/j.autneu.2017.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/06/2017] [Accepted: 11/22/2017] [Indexed: 01/17/2023]
Abstract
Protein kinase C (PKC) is a key mediator of many diverse physiological and pathological responses. PKC activation play an important regulatory role of cardiac function. The present study was performed to investigate whether there were differential activations of the PKCε and how the activation coupled with norepinephrine transporter (NET) surface expression, sympathetic innervation pattern and extracellular matrix remodeling in different cardiac hemodynamic overloads induced by abdominal aortic constriction or aortocaval fistula. At 8weeks after the operations, heart failure were induced, accompanied with myocardial hypertrophy, which was more pronounced in pressure overload (POL) than that of volume overload (VOL) rats, left ventricular dysfunction and increased plasma norepinephrine (NE). In POL rats there was an increase in myocardial collagen deposition, in contrast, the amount decreased in VOL as compared with the sham rats. POL remarkably upregulated PKCε membrane-cytosol ratio and downregulated NET membrane fraction, whereas, in VOL induced opposite changes. Accompanied with the PKCε activation, nerve sprouting, evidenced by myocardial GAP43 protein increased, and different nerve phenotypes were found, in POL tyrosine hydroxylase (TH) positive nerve density increased with NET and choline acetyltransferase (ChAT) immunoreactivity density decreased, in contrast, in VOL NET and ChAT increased, TH did not change. The overloads did not induce alteration of NET mRNA expression, but resulted in different myocardial β1-AR mRNA expression, in POL β1-AR mRNAwas significantly downregulated, while in VOL rats unaltered. Conclusion, the present results suggested that the different cardiac hemodynamic overload could differentially activate a common signaling, PKCε intermediate and thereby generate biological diversity.
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Affiliation(s)
- Bing Hu
- Xiqing Hospital, Tianjin, China
| | - Jing Zhang
- Pingjin Hospital, Logistics University of CAPF, China
| | - Jing Wang
- Pingjin Hospital, Logistics University of CAPF, China
| | - Bing He
- Tianjin Key Laboratory for Biomarkers of Occupation and Environmental Hazard, China
| | - Deshun Wang
- Pingjin Hospital, Logistics University of CAPF, China
| | | | - Xin Zhou
- Pingjin Hospital, Logistics University of CAPF, China; Institute of Cardiovascular disease of CAPF, China; Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, China
| | - He Li
- Pingjin Hospital, Logistics University of CAPF, China; Institute of Cardiovascular disease of CAPF, China; Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, China.
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Schlaich MP. Renal Sympathetic Denervation: A Viable Option for Treating Resistant Hypertension. Am J Hypertens 2017; 30:847-856. [PMID: 28338871 DOI: 10.1093/ajh/hpx033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 02/12/2017] [Indexed: 01/20/2023] Open
Abstract
Accumulating evidence from mainly uncontrolled clinical studies with various types of ablation catheters have shown that renal denervation (RDN) can be applied safely and is effective in lowering blood pressure (BP) in patients with treatment-resistant hypertension. Sustained BP lowering has been documented up to 3 years. Furthermore, RDN has been associated with regression of target organ damage, such as left ventricular hypertrophy, arterial stiffness, and others. Several studies indicate potential benefit in other common clinical conditions associated with increased sympathetic tone including chronic kidney disease and heart failure. However, the recently published Symplicity HTN-3 study, the largest and most rigorously designed sham-controlled clinical trial, while confirming the safety of the procedure, failed to demonstrate a BP lowering effect beyond that of a sham procedure in patients with resistant hypertension. Efforts to unravel the reasons for the discrepant results from Symplicity HTN-3 have focused on a range of potential confounders including anatomical and procedural aspects. Indeed, data from post-hoc analyses indicate that sufficient RDN may not have been achieved in the majority of patients in Symplicity HTN-3. Furthermore, recent evidence from human postmortem and functional animal studies revealed new insights into the anatomical distribution of renal nerves and their accessibility by intravascular approaches. Initial results from recent clinical trials integrating these important findings indeed seem to confirm that RDN remains a viable option for the treatment of hypertension. Thorough further investigations will be key to determine the true potential of RDN in clinical conditions characterized by increased sympathetic drive.
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Affiliation(s)
- Markus P Schlaich
- Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia
- Cardiology Department, Royal Perth Hospital, Perth, Western Australia, Australia
- Neurovascular Hypertension and Kidney Disease Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
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Chen DLT, Brown R, Liess C, Poljak A, Xu A, Zhang J, Trenell M, Jenkins A, Chisholm D, Samocha-Bonet D, Macefield VG, Greenfield JR. Muscle Sympathetic Nerve Activity Is Associated with Liver Insulin Sensitivity in Obese Non-Diabetic Men. Front Physiol 2017; 8:101. [PMID: 28293196 PMCID: PMC5328983 DOI: 10.3389/fphys.2017.00101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 02/07/2017] [Indexed: 12/14/2022] Open
Abstract
Introduction: Muscle sympathetic nerve activity (MSNA) may play a role in insulin resistance in obesity. However, the direction and nature of the relationship between MSNA and insulin resistance in obesity remain unclear. We hypothesized that resting MSNA would correlate inversely with both muscle and liver insulin sensitivity and that it would be higher in insulin-resistant vs. insulin-sensitive subjects. Materials and methods: Forty-five non-diabetic obese subjects were studied. As no significant relationships were found in women, the data presented in on 22 men aged 48 ± 12 years. Two-step (15 and 80 mU/m2/min) hyperinsulinaemic-euglycaemic clamps were performed using deuterated glucose to determine liver and muscle insulin sensitivity. Clinical and metabolic parameters were assessed. MSNA was measured via a microelectrode inserted percutaneously into the common peroneal nerve. Results: MSNA burst frequency correlated inversely with liver insulin sensitivity (r = -0.53, P = 0.02) and positively with the hepatokines C-reactive protein (CRP) and fibroblast growth factor (FGF)-19 (r = 0.57, P = 0.006, and r = -0.47, P = 0.03, respectively). MSNA burst frequency was lower in Liversen compared to Liverres (27 ± 5 vs. 38 ± 2 bursts per minute; P = 0.03). Muscle insulin sensitivity was unrelated to MSNA. Discussion: Sympathetic neural activation is related to liver insulin sensitivity and circulating hepatokines CRP and FGF-19 in non-diabetic obese men. These results suggest a potential hepato-endocrine-autonomic axis. Future studies are needed to clarify the influence of MSNA on liver insulin sensitivity in men.
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Affiliation(s)
- Daniel L. T. Chen
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
| | - Rachael Brown
- School of Medicine, University of Western SydneySydney, NSW, Australia
- Neuroscience Research AustraliaSydney, NSW, Australia
| | - Carsten Liess
- Philips HealthcareLuebeckertordamm, Hamburg, Germany
| | - Anne Poljak
- Bioanalytical Mass Spectrometry Facility, UNSW SydneySydney, NSW, Australia
- School of Medical Sciences, UNSW SydneySydney, NSW, Australia
| | - Aimin Xu
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong KongHong Kong, Hong Kong
| | - Jialiang Zhang
- State Key Laboratory of Pharmaceutical Biotechnology, University of Hong KongHong Kong, Hong Kong
| | | | - Arthur Jenkins
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
- School of Health Science, University of WollongongWollongong, NSW, Australia
| | - Donald Chisholm
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
| | - Dorit Samocha-Bonet
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
- School of Medical Sciences, UNSW SydneySydney, NSW, Australia
| | - Vaughan G. Macefield
- School of Medicine, University of Western SydneySydney, NSW, Australia
- Neuroscience Research AustraliaSydney, NSW, Australia
| | - Jerry R. Greenfield
- Diabetes and Metabolism Division, Garvan Institute of Medical ResearchSydney, NSW, Australia
- Department of Endocrinology and Diabetes Center, St. Vincent's HospitalSydney, NSW, Australia
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Li X, Dunn J, Salins D, Zhou G, Zhou W, Schüssler-Fiorenza Rose SM, Perelman D, Colbert E, Runge R, Rego S, Sonecha R, Datta S, McLaughlin T, Snyder MP. Digital Health: Tracking Physiomes and Activity Using Wearable Biosensors Reveals Useful Health-Related Information. PLoS Biol 2017; 15:e2001402. [PMID: 28081144 PMCID: PMC5230763 DOI: 10.1371/journal.pbio.2001402] [Citation(s) in RCA: 200] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 12/05/2016] [Indexed: 02/06/2023] Open
Abstract
A new wave of portable biosensors allows frequent measurement of health-related physiology. We investigated the use of these devices to monitor human physiological changes during various activities and their role in managing health and diagnosing and analyzing disease. By recording over 250,000 daily measurements for up to 43 individuals, we found personalized circadian differences in physiological parameters, replicating previous physiological findings. Interestingly, we found striking changes in particular environments, such as airline flights (decreased peripheral capillary oxygen saturation [SpO2] and increased radiation exposure). These events are associated with physiological macro-phenotypes such as fatigue, providing a strong association between reduced pressure/oxygen and fatigue on high-altitude flights. Importantly, we combined biosensor information with frequent medical measurements and made two important observations: First, wearable devices were useful in identification of early signs of Lyme disease and inflammatory responses; we used this information to develop a personalized, activity-based normalization framework to identify abnormal physiological signals from longitudinal data for facile disease detection. Second, wearables distinguish physiological differences between insulin-sensitive and -resistant individuals. Overall, these results indicate that portable biosensors provide useful information for monitoring personal activities and physiology and are likely to play an important role in managing health and enabling affordable health care access to groups traditionally limited by socioeconomic class or remote geography.
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Affiliation(s)
- Xiao Li
- Department of Genetics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Jessilyn Dunn
- Department of Genetics, Stanford University School of Medicine, Stanford, California, United States of America
- Mobilize Center, Stanford University, Palo Alto, California, United States of America
| | - Denis Salins
- Department of Genetics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Gao Zhou
- Department of Genetics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Wenyu Zhou
- Department of Genetics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Sophia Miryam Schüssler-Fiorenza Rose
- Spinal Cord Injury Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, United States of America
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, United States of America
| | - Dalia Perelman
- Division of Endocrinology, Stanford University School of Medicine, Stanford, California, United States of America
| | - Elizabeth Colbert
- Spinal Cord Injury Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, United States of America
| | - Ryan Runge
- Department of Genetics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Shannon Rego
- Spinal Cord Injury Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, United States of America
| | - Ria Sonecha
- Department of Genetics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Somalee Datta
- Department of Genetics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Tracey McLaughlin
- Division of Endocrinology, Stanford University School of Medicine, Stanford, California, United States of America
| | - Michael P. Snyder
- Department of Genetics, Stanford University School of Medicine, Stanford, California, United States of America
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Nestel PJ, Khan AA, Straznicky NE, Mellett NA, Jayawardana K, Mundra PA, Lambert GW, Meikle PJ. Markers of sympathetic nervous system activity associate with complex plasma lipids in metabolic syndrome subjects. Atherosclerosis 2016; 256:21-28. [PMID: 27940403 DOI: 10.1016/j.atherosclerosis.2016.11.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 11/21/2016] [Accepted: 11/30/2016] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND AIMS Plasma sphingolipids including ceramides, and gangliosides are associated with insulin resistance (IR) through effects on insulin signalling and glucose metabolism. Our studies of subjects with metabolic syndrome (MetS) showed close relationships between IR and sympathetic nervous system (SNS) activity including arterial norepinephrine (NE). We have therefore investigated possible associations of IR and SNS activity with complex lipids that are involved in both insulin sensitivity and neurotransmission. METHODS We performed a cross-sectional assessment of 23 lipid classes/subclasses (total 339 lipid species) by tandem mass spectrometry in 94 overweight untreated subjects with IR (quantified by HOMA-IR, Matsuda index and plasma insulin). RESULTS Independently of IR parameters, several circulating complex lipids associated significantly with arterial NE and NEFA (non-esterified fatty acids) and marginally with heart rate (HR). After accounting for BMI, HOMA-IR, systolic BP, age, gender, and correction for multiple comparisons, these associations were significant (p < 0.05): NE with ceramide, phosphatidylcholine, alkyl- and alkenylphosphatidylcholine and free cholesterol; NEFA with mono- di- and trihexosylceramide, GM3 ganglioside, sphingomyelin, phosphatidylcholine, alkyl- and alkenylphosphatidylcholine, phosphatidylinositol and free cholesterol; HR marginally (p = or <0.1>0.05) with ceramide, GM3 ganglioside, sphingomyelin, lysophosphatidylcholine, phosphatidylinositol, lysophosphatidylinositol and free cholesterol. Multiple subspecies of these lipids significantly associated with NE and NEFA. None of the IR biomarkers associated significantly with lipid classes/subclasses after correction for multiple comparisons. CONCLUSIONS This is the first demonstration that arterial norepinephrine and NEFA, that reflect both SNS activity and IR, associate significantly with circulating complex lipids independently of IR, suggesting a role for such lipids in neural mechanisms operating in MetS.
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Affiliation(s)
- Paul J Nestel
- Baker IDI Heart & Diabetes Institute, Melbourne, Australia.
| | - Anmar A Khan
- Baker IDI Heart & Diabetes Institute, Melbourne, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Faculty of Medical Sciences, Unm Al-Qura University, Makkah, Saudi Arabia
| | | | | | | | | | | | - Peter J Meikle
- Baker IDI Heart & Diabetes Institute, Melbourne, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Sorrentino A, Borghetti G, Zhou Y, Cannata A, Meo M, Signore S, Anversa P, Leri A, Goichberg P, Qanud K, Jacobson JT, Hintze TH, Rota M. Hyperglycemia induces defective Ca2+ homeostasis in cardiomyocytes. Am J Physiol Heart Circ Physiol 2016; 312:H150-H161. [PMID: 27881388 DOI: 10.1152/ajpheart.00737.2016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 11/21/2016] [Accepted: 11/21/2016] [Indexed: 01/03/2023]
Abstract
Diabetes and other metabolic conditions characterized by elevated blood glucose constitute important risk factors for cardiovascular disease. Hyperglycemia targets myocardial cells rendering ineffective mechanical properties of the heart, but cellular alterations dictating the progressive deterioration of cardiac function with metabolic disorders remain to be clarified. In the current study, we examined the effects of hyperglycemia on cardiac function and myocyte physiology by employing mice with high blood glucose induced by administration of streptozotocin, a compound toxic to insulin-producing β-cells. We found that hyperglycemia initially delayed the electrical recovery of the heart, whereas cardiac function became defective only after ~2 mo with this condition and gradually worsened with time. Prolonged hyperglycemia was associated with increased chamber dilation, thinning of the left ventricle (LV), and myocyte loss. Cardiomyocytes from hyperglycemic mice exhibited defective Ca2+ transients before the appearance of LV systolic defects. Alterations in Ca2+ transients involved enhanced spontaneous Ca2+ releases from the sarcoplasmic reticulum (SR), reduced cytoplasmic Ca2+ clearance, and declined SR Ca2+ load. These defects have important consequences on myocyte contraction, relaxation, and mechanisms of rate adaptation. Collectively, our data indicate that hyperglycemia alters intracellular Ca2+ homeostasis in cardiomyocytes, hindering contractile activity and contributing to the manifestation of the diabetic cardiomyopathy. NEW & NOTEWORTHY We have investigated the effects of hyperglycemia on cardiomyocyte physiology and ventricular function. Our results indicate that defective Ca2+ handling is a critical component of the progressive deterioration of cardiac performance of the diabetic heart.
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Affiliation(s)
- Andrea Sorrentino
- Departments of Anesthesia and Medicine and Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Giulia Borghetti
- Departments of Anesthesia and Medicine and Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Yu Zhou
- Departments of Anesthesia and Medicine and Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Antonio Cannata
- Departments of Anesthesia and Medicine and Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Marianna Meo
- Departments of Anesthesia and Medicine and Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sergio Signore
- Departments of Anesthesia and Medicine and Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Piero Anversa
- Departments of Anesthesia and Medicine and Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Fondazione Cardiocentro Ticino, University of Zurich, Lugano, Switzerland
| | - Annarosa Leri
- Departments of Anesthesia and Medicine and Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Fondazione Cardiocentro Ticino, University of Zurich, Lugano, Switzerland
| | - Polina Goichberg
- Departments of Anesthesia and Medicine and Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Khaled Qanud
- Department of Physiology, New York Medical College, Valhalla, New York; and
| | - Jason T Jacobson
- Department of Physiology, New York Medical College, Valhalla, New York; and.,Department of Cardiology, Westchester Medical Center, Valhalla, New York
| | - Thomas H Hintze
- Department of Physiology, New York Medical College, Valhalla, New York; and
| | - Marcello Rota
- Departments of Anesthesia and Medicine and Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; .,Department of Physiology, New York Medical College, Valhalla, New York; and
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48
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Straznicky NE, Guo L, Corcoran SJ, Esler MD, Phillips SE, Sari CI, Grima MT, Karapanagiotidis S, Wong CY, Eikelis N, Mariani JA, Kobayashi D, Dixon JB, Lambert GW, Lambert EA. Norepinephrine transporter expression is inversely associated with glycaemic indices: a pilot study in metabolically diverse persons with overweight and obesity. Obes Sci Pract 2016; 2:13-23. [PMID: 27812376 PMCID: PMC5066670 DOI: 10.1002/osp4.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 10/04/2015] [Accepted: 10/09/2015] [Indexed: 01/20/2023] Open
Abstract
Objective The objective of this study was to examine the cross‐sectional relationship between the expression of norepinephrine transporter (NET), the protein responsible for neuronal uptake‐1, and indices of glycaemia and hyperinsulinaemia, in overweight and obese individuals. Methods Thirteen non‐medicated, non‐smoking subjects, aged 58 ± 1 years (mean ± standard error of the mean), body mass index (BMI) 31.4 ± 1.0 kg m−2, with wide‐ranging plasma glucose and haemoglobin A1c (HbA1c, range 5.1% to 6.5%) participated. They underwent forearm vein biopsy to access sympathetic nerves for the quantification of NET by Western blot, oral glucose tolerance test (OGTT), euglycaemic hyperinsulinaemic clamp, echocardiography and assessments of whole‐body norepinephrine kinetics and muscle sympathetic nerve activity. Results Norepinephrine transporter expression was inversely associated with fasting plasma glucose (r = −0.62, P = 0.02), glucose area under the curve during OGTT (AUC0–120, r = −0.65, P = 0.02) and HbA1c (r = −0.67, P = 0.01), and positively associated with steady‐state glucose utilization during euglycaemic clamp (r = 0.58, P = 0.04). Moreover, NET expression was inversely related to left ventricular posterior wall dimensions (r = −0.64, P = 0.02) and heart rate (r = −0.55, P = 0.05). Indices of hyperinsulinaemia were not associated with NET expression. In stepwise linear regression analysis adjusted for age, body mass index and blood pressure, HbA1c was an independent inverse predictor of NET expression, explaining 45% of its variance. Conclusions Hyperglycaemia is associated with reduced peripheral NET expression. Further studies are required to identify the direction of causality.
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Affiliation(s)
- N E Straznicky
- Human Neurotransmitters Laboratory Baker IDI Heart & Diabetes Institute Melbourne Australia
| | - L Guo
- Human Neurotransmitters Laboratory Baker IDI Heart & Diabetes Institute Melbourne Australia
| | - S J Corcoran
- Human Neurotransmitters Laboratory Baker IDI Heart & Diabetes Institute Melbourne Australia
| | - M D Esler
- Human Neurotransmitters Laboratory Baker IDI Heart & Diabetes Institute Melbourne Australia
| | - S E Phillips
- Human Neurotransmitters Laboratory Baker IDI Heart & Diabetes Institute Melbourne Australia
| | - C I Sari
- Human Neurotransmitters Laboratory Baker IDI Heart & Diabetes Institute Melbourne Australia
| | - M T Grima
- Human Neurotransmitters Laboratory Baker IDI Heart & Diabetes Institute Melbourne Australia
| | - S Karapanagiotidis
- Alfred Baker Medical Unit Baker IDI Heart & Diabetes Institute Melbourne Australia
| | - C Y Wong
- Alfred Baker Medical Unit Baker IDI Heart & Diabetes Institute Melbourne Australia; Cardiology, Western Health University of Melbourne Melbourne Australia
| | - N Eikelis
- Human Neurotransmitters Laboratory Baker IDI Heart & Diabetes Institute Melbourne Australia
| | - J A Mariani
- Heart Failure Research Group Baker IDI Heart & Diabetes Institute Melbourne Australia; Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Australia
| | - D Kobayashi
- Human Neurotransmitters Laboratory Baker IDI Heart & Diabetes Institute Melbourne Australia
| | - J B Dixon
- Human Neurotransmitters Laboratory Baker IDI Heart & Diabetes Institute Melbourne Australia; Primary Health Care Monash University Melbourne Australia
| | - G W Lambert
- Human Neurotransmitters Laboratory Baker IDI Heart & Diabetes Institute Melbourne Australia; Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Australia
| | - E A Lambert
- Human Neurotransmitters Laboratory Baker IDI Heart & Diabetes Institute Melbourne Australia; Departments of Physiology Monash University Melbourne Australia; Departments of Physiology University of Melbourne Melbourne Australia
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Tsuneki H, Kon K, Ito H, Yamazaki M, Takahara S, Toyooka N, Ishii Y, Sasahara M, Wada T, Yanagisawa M, Sakurai T, Sasaoka T. Timed Inhibition of Orexin System by Suvorexant Improved Sleep and Glucose Metabolism in Type 2 Diabetic db/db Mice. Endocrinology 2016; 157:4146-4157. [PMID: 27631554 DOI: 10.1210/en.2016-1404] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Sleep disturbances are associated with type 2 diabetes; therefore, the amelioration of sleep may improve metabolic disorders. To investigate this possibility, we here examined the effects of suvorexant, an antiinsomnia drug targeting the orexin system, on sleep and glucose metabolism in type 2 diabetic mice. Diabetic db/db mice had a longer wakefulness time during the resting period, as compared with nondiabetic db/m+ control mice. The single or 7-day administration of suvorexant at lights-on (ie, the beginning of the resting phase) increased nonrapid eye movement sleep time during the resting phase and, as a consequence, reduced awake time. The daily resting-phase administration of suvorexant for 2-4 weeks improved impaired glucose tolerance in db/db mice without affecting body weight gain, food intake, systemic insulin sensitivity, or serum insulin, and glucagon levels. No changes were detected in the markers of lipid metabolism and inflammation, such as the hepatic triglyceride content and Tnf-α mRNA levels in liver and adipose tissues. The improving effect of suvorexant on glucose tolerance was associated with a reduction in the expression levels of hepatic gluconeogenic factors, including phosphoenolpyruvate carboxykinase and peroxisome proliferator-activated receptor-γ coactivator-1α in the liver in the resting phase. In contrast, the daily awake-phase administration of suvorexant had no beneficial effect on glucose metabolism. These results suggest that the suvorexant-induced increase of sleep time at the resting phase improved hepatic glucose metabolism in db/db mice. Our results provide insight into the development of novel pharmacological interventions for type 2 diabetes that target the orexin-operated sleep/wake regulatory system.
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Affiliation(s)
- Hiroshi Tsuneki
- Departments of Clinical Pharmacology (H.T., K.K., T.W., T.Sas.) and Anesthesiology (H.I., M.Yam.), Graduate School of Science and Technology, and Graduate School of Innovative Life Science (S.T., N.T.), and Department of Pathology (Y.I., M.S.), University of Toyama, Toyama 930-0194, Japan; and International Institute for Integrative Sleep Medicine (WPI-IIIS) (M.Yan., T.Sak.), University of Tsukuba, Tsukuba 305-8575, Japan
| | - Kanta Kon
- Departments of Clinical Pharmacology (H.T., K.K., T.W., T.Sas.) and Anesthesiology (H.I., M.Yam.), Graduate School of Science and Technology, and Graduate School of Innovative Life Science (S.T., N.T.), and Department of Pathology (Y.I., M.S.), University of Toyama, Toyama 930-0194, Japan; and International Institute for Integrative Sleep Medicine (WPI-IIIS) (M.Yan., T.Sak.), University of Tsukuba, Tsukuba 305-8575, Japan
| | - Hisakatsu Ito
- Departments of Clinical Pharmacology (H.T., K.K., T.W., T.Sas.) and Anesthesiology (H.I., M.Yam.), Graduate School of Science and Technology, and Graduate School of Innovative Life Science (S.T., N.T.), and Department of Pathology (Y.I., M.S.), University of Toyama, Toyama 930-0194, Japan; and International Institute for Integrative Sleep Medicine (WPI-IIIS) (M.Yan., T.Sak.), University of Tsukuba, Tsukuba 305-8575, Japan
| | - Mitsuaki Yamazaki
- Departments of Clinical Pharmacology (H.T., K.K., T.W., T.Sas.) and Anesthesiology (H.I., M.Yam.), Graduate School of Science and Technology, and Graduate School of Innovative Life Science (S.T., N.T.), and Department of Pathology (Y.I., M.S.), University of Toyama, Toyama 930-0194, Japan; and International Institute for Integrative Sleep Medicine (WPI-IIIS) (M.Yan., T.Sak.), University of Tsukuba, Tsukuba 305-8575, Japan
| | - Satoyuki Takahara
- Departments of Clinical Pharmacology (H.T., K.K., T.W., T.Sas.) and Anesthesiology (H.I., M.Yam.), Graduate School of Science and Technology, and Graduate School of Innovative Life Science (S.T., N.T.), and Department of Pathology (Y.I., M.S.), University of Toyama, Toyama 930-0194, Japan; and International Institute for Integrative Sleep Medicine (WPI-IIIS) (M.Yan., T.Sak.), University of Tsukuba, Tsukuba 305-8575, Japan
| | - Naoki Toyooka
- Departments of Clinical Pharmacology (H.T., K.K., T.W., T.Sas.) and Anesthesiology (H.I., M.Yam.), Graduate School of Science and Technology, and Graduate School of Innovative Life Science (S.T., N.T.), and Department of Pathology (Y.I., M.S.), University of Toyama, Toyama 930-0194, Japan; and International Institute for Integrative Sleep Medicine (WPI-IIIS) (M.Yan., T.Sak.), University of Tsukuba, Tsukuba 305-8575, Japan
| | - Yoko Ishii
- Departments of Clinical Pharmacology (H.T., K.K., T.W., T.Sas.) and Anesthesiology (H.I., M.Yam.), Graduate School of Science and Technology, and Graduate School of Innovative Life Science (S.T., N.T.), and Department of Pathology (Y.I., M.S.), University of Toyama, Toyama 930-0194, Japan; and International Institute for Integrative Sleep Medicine (WPI-IIIS) (M.Yan., T.Sak.), University of Tsukuba, Tsukuba 305-8575, Japan
| | - Masakiyo Sasahara
- Departments of Clinical Pharmacology (H.T., K.K., T.W., T.Sas.) and Anesthesiology (H.I., M.Yam.), Graduate School of Science and Technology, and Graduate School of Innovative Life Science (S.T., N.T.), and Department of Pathology (Y.I., M.S.), University of Toyama, Toyama 930-0194, Japan; and International Institute for Integrative Sleep Medicine (WPI-IIIS) (M.Yan., T.Sak.), University of Tsukuba, Tsukuba 305-8575, Japan
| | - Tsutomu Wada
- Departments of Clinical Pharmacology (H.T., K.K., T.W., T.Sas.) and Anesthesiology (H.I., M.Yam.), Graduate School of Science and Technology, and Graduate School of Innovative Life Science (S.T., N.T.), and Department of Pathology (Y.I., M.S.), University of Toyama, Toyama 930-0194, Japan; and International Institute for Integrative Sleep Medicine (WPI-IIIS) (M.Yan., T.Sak.), University of Tsukuba, Tsukuba 305-8575, Japan
| | - Masashi Yanagisawa
- Departments of Clinical Pharmacology (H.T., K.K., T.W., T.Sas.) and Anesthesiology (H.I., M.Yam.), Graduate School of Science and Technology, and Graduate School of Innovative Life Science (S.T., N.T.), and Department of Pathology (Y.I., M.S.), University of Toyama, Toyama 930-0194, Japan; and International Institute for Integrative Sleep Medicine (WPI-IIIS) (M.Yan., T.Sak.), University of Tsukuba, Tsukuba 305-8575, Japan
| | - Takeshi Sakurai
- Departments of Clinical Pharmacology (H.T., K.K., T.W., T.Sas.) and Anesthesiology (H.I., M.Yam.), Graduate School of Science and Technology, and Graduate School of Innovative Life Science (S.T., N.T.), and Department of Pathology (Y.I., M.S.), University of Toyama, Toyama 930-0194, Japan; and International Institute for Integrative Sleep Medicine (WPI-IIIS) (M.Yan., T.Sak.), University of Tsukuba, Tsukuba 305-8575, Japan
| | - Toshiyasu Sasaoka
- Departments of Clinical Pharmacology (H.T., K.K., T.W., T.Sas.) and Anesthesiology (H.I., M.Yam.), Graduate School of Science and Technology, and Graduate School of Innovative Life Science (S.T., N.T.), and Department of Pathology (Y.I., M.S.), University of Toyama, Toyama 930-0194, Japan; and International Institute for Integrative Sleep Medicine (WPI-IIIS) (M.Yan., T.Sak.), University of Tsukuba, Tsukuba 305-8575, Japan
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Santulli G, Iaccarino G. Adrenergic signaling in heart failure and cardiovascular aging. Maturitas 2016; 93:65-72. [PMID: 27062709 PMCID: PMC5036981 DOI: 10.1016/j.maturitas.2016.03.022] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 03/23/2016] [Accepted: 03/25/2016] [Indexed: 12/15/2022]
Abstract
Both cardiovascular disease and aging are associated with changes in the sympathetic nervous system. Indeed, mounting evidence indicates that adrenergic receptors are functionally involved in numerous processes underlying both aging and cardiovascular disorders, in particular heart failure. This article will review the pathophysiological role of the sympathetic nervous system in heart failure and cardiovascular aging.
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Affiliation(s)
- Gaetano Santulli
- College of Physicians & Surgeons, Columbia University Medical Center, New York, NY, USA.
| | - Guido Iaccarino
- Division of Internal Medicine, Department of Medicine and Surgery, University of Salerno, Italy.
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