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Haligheri G, Johnson T, Kathol M, Kuzava L, Goth N, Staggs VS, Donnelly JE, Ptomey LT, Forsha D. Early cardiac dysfunction in obese adolescents with Down syndrome or autism. Cardiol Young 2023; 33:1678-1685. [PMID: 36184834 DOI: 10.1017/s1047951122003158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Obesity in adolescents with intellectual and developmental disabilities) occurs at twice the frequency as their typically developing peers. Typically developing adolescents with obesity have abnormal cardiac function (as measured by strain echocardiography) and cardiac mass, but the effects of obesity on cardiac health in adolescents with Down syndrome or autism spectrum disorder are unknown. The purpose of this study was to evaluate the impact of body mass index on cardiac function in adolescents with Down syndrome or autism. METHODS Adolescents (age 12-21 years) with Down syndrome (n = 28), autism (n = 33), and age-/sex-matched typically developing controls (n = 15) received an echocardiogram optimised for strain analysis at a single timepoint. Measures of ventricular function, mass, and size were collected. Regression modelling evaluated the impact of body mass index and intellectual and developmental disabilities diagnosis on these cardiac measures. RESULTS In regression modelling, an elevated body mass index z-score was associated with diminished systolic biventricular function by global strain (left ventricular longitudinal strain β 0.87, P < 0.001; left ventricular circumferential strain β 0.57, p 0.003; right ventricular longitudinal strain β 0.63, P < 0.001). Diminished left ventricular diastolic function by early diastolic strain rate was also associated with elevated body mass index (global longitudinal end-diastolic strain rate β -0.7, P < 0.001). No association was found between traditional (non-strain) measures of systolic and diastolic ventricular function and body mass index z-score. CONCLUSIONS Obesity in adolescents with Down syndrome or autism negatively impacts cardiac function as measured by echocardiographic strain analysis that was not detected by traditional parameters.
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Affiliation(s)
- Geetha Haligheri
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
- University of Missouri - Kansas City, Department of Pediatrics, Kansas City, MO, USA
| | - Tyler Johnson
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
| | - Melanie Kathol
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
| | - Laura Kuzava
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
| | - Natalie Goth
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
| | - Vincent S Staggs
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
| | | | | | - Dan Forsha
- Children's Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
- University of Missouri - Kansas City, Department of Pediatrics, Kansas City, MO, USA
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Changes in Nutritional State and Cardiovascular Parameters in Alimentary Obese Children after a Month-Long Stay in Children's Treatment Center. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111610. [PMID: 36360338 PMCID: PMC9688163 DOI: 10.3390/children9111610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
Childhood and adolescent obesity has become an important public health issue, as it leads to higher risk of cardio−metabolic, orthopedic, and psychological comorbidities. The aim of this study was to evaluate the changes in nutritional state and cardiovascular system parameters in obese children. Sixty respondents aged 9−17 years with alimentary obesity participated in this research. Anthropometric parameters (body weight (BWT), body mass index (BMI), percentage of body fat (%), waist and hip circumference (WC and HC), waist−hip ratio (WHR)) and cardiovascular parameters (systolic and diastolic blood pressure (SP and DP), cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), pulse wave velocity and its variability (PWV and PWVV), and parameters of pulse wave analysis) were measured. Every respondent went through two sets of measurements, the first (I.) after their admission to the children’s hospital and the second (II.) at the end of their one-month-long therapeutic stay. Statistically significant differences between measurements I. and II. were observed in the following parameters: BWT (p < 0.01), BMI (p < 0.01), WC (p < 0.01), HC (p < 0.01), DP (p < 0.01), PWV (p < 0.05), and ABI (p < 0.01). The results of this study show that obesity has a mostly negative impact on the cardiovascular health of affected children, with likely negative results in their adulthood.
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3
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Causative Mechanisms of Childhood and Adolescent Obesity Leading to Adult Cardiometabolic Disease: A Literature Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app112311565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The past few decades have shown a worrisome increase in the prevalence of obesity and its related illnesses. This increasing burden has a noteworthy impact on overall worldwide mortality and morbidity, with significant economic implications as well. The same trend is apparent regarding pediatric obesity. This is a particularly concerning aspect when considering the well-established link between cardiovascular disease and obesity, and the fact that childhood obesity frequently leads to adult obesity. Moreover, most obese adults have a history of excess weight starting in childhood. In addition, given the cumulative character of both time and severity of exposure to obesity as a risk factor for associated diseases, the repercussions of obesity prevalence and related morbidity could be exponential in time. The purpose of this review is to outline key aspects regarding the current knowledge on childhood and adolescent obesity as a cardiometabolic risk factor, as well as the most common etiological pathways involved in the development of weight excess and associated cardiovascular and metabolic diseases.
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Strzelczyk J, Kalinowski P, Zieniewicz K, Szmigielski C, Byra M, Styczyński G. The Influence of Surgical Weight Reduction on Left Atrial Strain. Obes Surg 2021; 31:5243-5250. [PMID: 34550536 PMCID: PMC8595175 DOI: 10.1007/s11695-021-05710-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 12/11/2022]
Abstract
Background Obesity increases and surgical weight reduction decreases the risk of atrial fibrillation (AF) and heart failure (HF). We hypothesized that surgically induced weight loss may favorably affect left atrial (LA) mechanical function measured by longitudinal strain, which has recently emerged as an independent imaging biomarker of increased AF and HF risk. Methods We retrospectively evaluated echocardiograms performed before and 12.2 ± 2.2 months after bariatric surgery in 65 patients with severe obesity (mean age 39 [36; 47] years, 72% of females) with no known cardiac disease or arrhythmia. The LA mechanical function was measured by the longitudinal strain using the semi-automatic speckle tracking method. Results After surgery, body mass index decreased from 43.72 ± 4.34 to 30.04 ± 4.33 kg/m2. We observed a significant improvement in all components of the LA strain. LA reservoir strain (LASR) and LA conduit strain (LASCD) significantly increased (35.7% vs 38.95%, p = 0.0005 and − 19.6% vs − 24.4%, p < 0.0001) and LA contraction strain (LASCT) significantly decreased (− 16% vs − 14%, p = 0.0075). There was a significant correlation between an increase in LASR and LASCD and the improvement in parameters of left ventricular diastolic and longitudinal systolic function (increase in E’ and MAPSE). Another significant correlation was identified between the decrease in LASCT and an improvement in LA function (decrease in A’). Conclusions The left atrial mechanical function improves after bariatric surgery. It is partially explained by the beneficial effect of weight reduction on the left ventricular diastolic and longitudinal systolic function. This effect may contribute to decreased risk of AF and HF after bariatric surgery. Graphical abstract ![]()
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Affiliation(s)
- Jakub Strzelczyk
- Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Stefana Banacha Street 1A, 02-097, Warsaw, Poland.
| | - Piotr Kalinowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Stefana Banacha Street 1A, 02-097, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Stefana Banacha Street 1A, 02-097, Warsaw, Poland
| | - Cezary Szmigielski
- Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Stefana Banacha Street 1A, 02-097, Warsaw, Poland
| | - Michał Byra
- Department of Ultrasound, Institute of Fundamental Technological Research, Polish Academy of Sciences, Adolfa Pawińskiego Street 5B, 02-106, Warsaw, Poland
| | - Grzegorz Styczyński
- Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Stefana Banacha Street 1A, 02-097, Warsaw, Poland
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Heiskanen JS, Ruohonen S, Rovio SP, Pahkala K, Kytö V, Kähönen M, Lehtimäki T, Viikari JSA, Juonala M, Laitinen T, Tossavainen P, Jokinen E, Hutri-Kähönen N, Raitakari OT. Cardiovascular Risk Factors in Childhood and Left Ventricular Diastolic Function in Adulthood. Pediatrics 2021; 147:peds.2020-016691. [PMID: 33558307 DOI: 10.1542/peds.2020-016691] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Cardiovascular risk factors, such as obesity, blood pressure, and physical inactivity, have been identified as modifiable determinants of left ventricular (LV) diastolic function in adulthood. However, the links between childhood cardiovascular risk factor burden and adulthood LV diastolic function are unknown. To address this lack of knowledge, we aimed to identify childhood risk factors associated with LV diastolic function in the participants of the Cardiovascular Risk in Young Finns Study. METHODS Study participants (N = 1871; 45.9% men; aged 34-49 years) were examined repeatedly between the years 1980 and 2011. We determined the cumulative risk exposure in childhood (age 6-18 years) as the area under the curve for systolic blood pressure, adiposity (defined by using skinfold and waist circumference measurements), physical activity, serum insulin, triglycerides, total cholesterol, and high- and low-density lipoprotein cholesterols. Adulthood LV diastolic function was defined by using E/é ratio. RESULTS Elevated systolic blood pressure and increased adiposity in childhood were associated with worse adulthood LV diastolic function, whereas higher physical activity level in childhood was associated with better adulthood LV diastolic function (P < .001 for all). The associations of childhood adiposity and physical activity with adulthood LV diastolic function remained significant (both P < .05) but were diluted when the analyses were adjusted for adulthood systolic blood pressure, adiposity, and physical activity. The association between childhood systolic blood pressure and adult LV diastolic function was diluted to nonsignificant (P = .56). CONCLUSIONS Adiposity status and the level of physical activity in childhood are independently associated with LV diastolic function in adulthood.
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Affiliation(s)
- Jarkko S Heiskanen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; .,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Saku Ruohonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Orion Pharma, Turku, Finland
| | - Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Ville Kytö
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Heart Center, Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Päivi Tossavainen
- Department of Pediatrics, PEDEGO Research Unit and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Eero Jokinen
- Department of Paediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Nina Hutri-Kähönen
- Department of Paediatrics, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; and
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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6
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Zhang Y, Zhao M, Bovet P, Xi B. Association of abdominal obesity and high blood pressure with left ventricular hypertrophy and geometric remodeling in Chinese children. Nutr Metab Cardiovasc Dis 2021; 31:306-313. [PMID: 33500107 DOI: 10.1016/j.numecd.2020.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/03/2020] [Accepted: 09/07/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Many studies have examined the association between overweight or obesity assessed by body mass index and left ventricular hypertrophy (LVH) in children or adolescents, but only few studies have assessed the relation with abdominal obesity in children. This study aimed to assess the association of abdominal obesity assessed by waist circumference (WC), high blood pressure (BP) and their joint effect on LVH and left ventricular (LV) geometric remodeling in Chinese children. METHODS AND RESULTS Data were from a cross-sectional survey of 1319 Chinese children aged 6-11 years who had undergone cardiac ultrasound. Compared with normal WC, the adjusted odds ratios (ORs) for abdominal obesity were 6.78 (95% confidence interval [CI] 3.77-12.16) for LVH, 2.80 (1.55-5.05) for CR, 5.43 (2.84-10.39) for EH, and 20.05 (4.46-90.08) for CH, respectively. Compared with children with both normal WC and normal BP, the adjusted ORs for those with abdominal obesity and normal BP were 6.98 (3.71-13.10) for LVH, 2.87 (1.47-5.60) for CR, 5.52 (2.70-11.26) for EH, and 15.20 (4.51-78.13) for CH. The adjusted ORs for those with abdominal obesity and high BP were 7.12 (3.27-15.50) for LVH, 4.71 (2.04-10.85) for CR, 7.49 (3.23-17.40) for EH, and 8.65 (1.32-56.89) for CH. The ORs for those with high BP and normal WC were not significant for these cardiac outcomes (P > 0.05). CONCLUSIONS LVH and LV geometric remodeling were associated more strongly with abdominal obesity than with high BP in Chinese children, stressing the need to prevent childhood abdominal obesity for reducing cardiac risk.
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Affiliation(s)
- Yunfei Zhang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Pascal Bovet
- University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
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7
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Yang D, Liu HQ, Liu FY, Tang N, Guo Z, Ma SQ, An P, Wang MY, Wu HM, Yang Z, Fan D, Tang QZ. The Roles of Noncardiomyocytes in Cardiac Remodeling. Int J Biol Sci 2020; 16:2414-2429. [PMID: 32760209 PMCID: PMC7378633 DOI: 10.7150/ijbs.47180] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 06/16/2020] [Indexed: 02/07/2023] Open
Abstract
Cardiac remodeling is a common characteristic of almost all forms of heart disease, including cardiac infarction, valvular diseases, hypertension, arrhythmia, dilated cardiomyopathy and other conditions. It is not merely a simple outcome induced by an increase in the workload of cardiomyocytes (CMs). The remodeling process is accompanied by abnormalities of cardiac structure as well as disturbance of cardiac function, and emerging evidence suggests that a wide range of cells in the heart participate in the initiation and development of cardiac remodeling. Other than CMs, there are numerous noncardiomyocytes (non-CMs) that regulate the process of cardiac remodeling, such as cardiac fibroblasts and immune cells (including macrophages, lymphocytes, neutrophils, and mast cells). In this review, we summarize recent knowledge regarding the definition and significant effects of various non-CMs in the pathogenesis of cardiac remodeling, with a particular emphasis on the involved signaling mechanisms. In addition, we discuss the properties of non-CMs, which serve as targets of many cardiovascular drugs that reduce adverse cardiac remodeling.
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Affiliation(s)
- Dan Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, RP China
- Cardiovascular Research Institute of Wuhan University, Wuhan 430060, RP China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, RP China
| | - Han-Qing Liu
- Department of Thyroid and Breast, Renmin Hospital of Wuhan University, Wuhan 430060, RP China
| | - Fang-Yuan Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, RP China
- Cardiovascular Research Institute of Wuhan University, Wuhan 430060, RP China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, RP China
| | - Nan Tang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, RP China
- Cardiovascular Research Institute of Wuhan University, Wuhan 430060, RP China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, RP China
| | - Zhen Guo
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, RP China
- Cardiovascular Research Institute of Wuhan University, Wuhan 430060, RP China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, RP China
| | - Shu-Qing Ma
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, RP China
- Cardiovascular Research Institute of Wuhan University, Wuhan 430060, RP China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, RP China
| | - Peng An
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, RP China
- Cardiovascular Research Institute of Wuhan University, Wuhan 430060, RP China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, RP China
| | - Ming-Yu Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, RP China
- Cardiovascular Research Institute of Wuhan University, Wuhan 430060, RP China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, RP China
| | - Hai-Ming Wu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, RP China
- Cardiovascular Research Institute of Wuhan University, Wuhan 430060, RP China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, RP China
| | - Zheng Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, RP China
- Cardiovascular Research Institute of Wuhan University, Wuhan 430060, RP China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, RP China
| | - Di Fan
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, RP China
- Cardiovascular Research Institute of Wuhan University, Wuhan 430060, RP China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, RP China
| | - Qi-Zhu Tang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, RP China
- Cardiovascular Research Institute of Wuhan University, Wuhan 430060, RP China
- Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan 430060, RP China
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Hu WS, Ting WJ, Tamilselvi S, Day CH, Wang T, Chiang WD, Viswanadha VP, Yeh YL, Lin WT, Huang CY. Oral administration of alcalase potato protein hydrolysate-APPH attenuates high fat diet-induced cardiac complications via TGF-β/GSN axis in aging rats. ENVIRONMENTAL TOXICOLOGY 2019; 34:5-12. [PMID: 30240538 DOI: 10.1002/tox.22651] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 08/23/2018] [Accepted: 08/25/2018] [Indexed: 06/08/2023]
Abstract
Consumption of high fat diet (HFD) is associated with increased cardiovascular risk factors among elderly people. Aging and obesity induced-cardiac remodeling includes hypertrophy and fibrosis. Gelsolin (GSN) induces cardiac hypertrophy and TGF-β, a key cytokine, which induces fibrosis. The relationship between TGF-β and GSN in aging induced cardiac remodeling is still unknown. We evaluated the expressions of TGF-β and GSN in HFD fed 22 months old aging SD rats, followed by the administration of either probucol or alcalase potato protein hydrolysate (APPH). Western blotting and Masson trichrome staining showed that APPH (45 and 75 mg/kg/day) and probucol (500 mg/kg/day) treatments significantly reduced the aging and HFD-induced hypertrophy and fibrosis. Echocardiograph showed that the performance of the hearts was improved in APPH, and probucol treated HFD aging rats. Serum from all rats was collected and H9c2 cells were cultured with collected serums separately. The GSN dependent hypertrophy was inhibited with an exogenous TGF-β in H9c2 cells cultured in HFD+ APPH treated serum. Thus, we propose that along with its role in cardiac fibrosis, TGF-β also acts as an upstream activator of GSN dependent hypertrophy. Hence, TGF-β in serum could be a promising therapeutic target for cardiac remodeling in aging and/or obese subjects.
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Affiliation(s)
- Wei Syun Hu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University, Hospital, Taichung, Taiwan
| | - Wei Jen Ting
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
| | - Shanmugam Tamilselvi
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
| | | | - Ting Wang
- Department of hospitality management, College of Agriculture, Tunghai University, Taichung, Taiwan
| | - Wen-Dee Chiang
- Department of Food science, College of Agriculture, Tunghai University, Taichung, Taiwan
| | | | - Yu Lan Yeh
- Department of pathology, Changhua Christian Hospital, Changhua, Taiwan
- Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
| | - Wan Teng Lin
- Department of hospitality management, College of Agriculture, Tunghai University, Taichung, Taiwan
| | - Chih Yang Huang
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
- Graduate Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan
- Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan
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9
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Zhang P, Li D, Su Y, Wang X, Sun J, Xu Y, Sun J. Assessment of myocardial strain in children with risk factors for atherosclerosis with use of 3D speckle tracking echocardiography. Echocardiography 2018; 35:487-493. [PMID: 29399870 DOI: 10.1111/echo.13806] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Peixu Zhang
- Department of Neurology; First Hospital; Jilin University; Changchun China
| | - Dongqing Li
- Department of Gynecologic Oncology; The Tumor Hospital; Changchun China
| | - Yanzhuo Su
- Department of Gastrointestinal Colorectal and Anal Surgery; China-Japan Union Hospital of Jilin University; Changchun China
| | - Xiaona Wang
- Department of Pediatric cardiology; First Hospital; Jilin University; Changchun China
| | - Jianping Sun
- Department of Pediatric cardiology; First Hospital; Jilin University; Changchun China
| | - Yang Xu
- Department of Pediatric cardiology; First Hospital; Jilin University; Changchun China
| | - Jinghui Sun
- Department of Pediatric cardiology; First Hospital; Jilin University; Changchun China
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10
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Jing L, Pulenthiran A, Nevius CD, Mejia-Spiegeler A, Suever JD, Wehner GJ, Kirchner HL, Haggerty CM, Fornwalt BK. Impaired right ventricular contractile function in childhood obesity and its association with right and left ventricular changes: a cine DENSE cardiac magnetic resonance study. J Cardiovasc Magn Reson 2017; 19:49. [PMID: 28659144 PMCID: PMC5490166 DOI: 10.1186/s12968-017-0363-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 05/17/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Pediatric obesity is a growing public health problem, which is associated with increased risk of cardiovascular disease and premature death. Left ventricular (LV) remodeling (increased myocardial mass and thickness) and contractile dysfunction (impaired longitudinal strain) have been documented in obese children, but little attention has been paid to the right ventricle (RV). We hypothesized that obese/overweight children would have evidence of RV remodeling and contractile dysfunction. METHODS One hundred and three children, ages 8-18 years, were prospectively recruited and underwent cardiovascular magnetic resonance (CMR), including both standard cine imaging and displacement encoding with stimulated echoes (DENSE) imaging, which allowed for quantification of RV geometry and function/mechanics. RV free wall longitudinal strain was quantified from the end-systolic four-chamber DENSE image. Linear regression was used to quantify correlations of RV strain with LV strain and measurements of body composition (adjusted for sex and height). Analysis of variance was used to study the relationship between RV strain and LV remodeling types (concentric remodeling, eccentric/concentric hypertrophy). RESULTS The RV was sufficiently visualized with DENSE in 70 (68%) subjects, comprising 36 healthy weight (13.6 ± 2.7 years) and 34 (12.1 ± 2.9 years) obese/overweight children. Obese/overweight children had a 22% larger RV mass index (8.2 ± 0.9 vs 6.7 ± 1.1 g/m2.7, p < 0.001) compared to healthy controls. RV free wall longitudinal strain was impaired in obese/overweight children (-16 ± 4% vs -19 ± 5%, p = 0.02). Ten (14%) out of 70 children had LV concentric hypertrophy, and these children had the most impaired RV longitudinal strain compared to those with normal LV geometry (-13 ± 4% vs -19 ± 5%, p = 0.002). RV longitudinal strain was correlated with LV longitudinal strain (r = 0.34, p = 0.004), systolic blood pressure (r = 0.33, p = 0.006), as well as BMI z-score (r = 0.28, p = 0.02), waist (r = 0.31, p = 0.01), hip (r = 0.40, p = 0.004) and abdominal (r = 0.38, p = 0.002) circumference, height and sex adjusted. CONCLUSIONS Obese/overweight children have evidence of RV remodeling (increased RV mass) and RV contractile dysfunction (impaired free wall longitudinal strain). Moreover, RV longitudinal strain correlates with LV longitudinal strain, and children with LV concentric hypertrophy show the most impaired RV function. These results suggest there may be a common mechanism underlying both remodeling and dysfunction of the left and right ventricles in obese/overweight children.
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MESH Headings
- Adolescent
- Child
- Female
- Humans
- Hypertrophy, Left Ventricular/diagnostic imaging
- Hypertrophy, Left Ventricular/etiology
- Hypertrophy, Left Ventricular/physiopathology
- Image Interpretation, Computer-Assisted
- Kentucky
- Linear Models
- Magnetic Resonance Imaging, Cine
- Male
- Myocardial Contraction
- Observer Variation
- Pediatric Obesity/complications
- Pediatric Obesity/diagnosis
- Pediatric Obesity/physiopathology
- Pennsylvania
- Predictive Value of Tests
- Prospective Studies
- Reproducibility of Results
- Ventricular Dysfunction, Left/diagnostic imaging
- Ventricular Dysfunction, Left/etiology
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Dysfunction, Right/diagnostic imaging
- Ventricular Dysfunction, Right/etiology
- Ventricular Dysfunction, Right/physiopathology
- Ventricular Function, Left
- Ventricular Function, Right
- Ventricular Remodeling
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Affiliation(s)
- Linyuan Jing
- Department of Imaging Science and Innovation, Geisinger Health System, 100 North Academy Avenue, Danville, 17822-4400 PA USA
- Biomedical and Translational Informatics Institute, Geisinger Health System, Danville, PA USA
| | - Arichanah Pulenthiran
- Department of Imaging Science and Innovation, Geisinger Health System, 100 North Academy Avenue, Danville, 17822-4400 PA USA
- Biomedical and Translational Informatics Institute, Geisinger Health System, Danville, PA USA
| | - Christopher D. Nevius
- Department of Imaging Science and Innovation, Geisinger Health System, 100 North Academy Avenue, Danville, 17822-4400 PA USA
- Biomedical and Translational Informatics Institute, Geisinger Health System, Danville, PA USA
| | - Abba Mejia-Spiegeler
- Department of Imaging Science and Innovation, Geisinger Health System, 100 North Academy Avenue, Danville, 17822-4400 PA USA
- Biomedical and Translational Informatics Institute, Geisinger Health System, Danville, PA USA
| | - Jonathan D. Suever
- Department of Imaging Science and Innovation, Geisinger Health System, 100 North Academy Avenue, Danville, 17822-4400 PA USA
- Biomedical and Translational Informatics Institute, Geisinger Health System, Danville, PA USA
| | - Gregory J. Wehner
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY USA
| | - H. Lester Kirchner
- Biomedical and Translational Informatics Institute, Geisinger Health System, Danville, PA USA
| | - Christopher M. Haggerty
- Department of Imaging Science and Innovation, Geisinger Health System, 100 North Academy Avenue, Danville, 17822-4400 PA USA
- Biomedical and Translational Informatics Institute, Geisinger Health System, Danville, PA USA
| | - Brandon K. Fornwalt
- Department of Imaging Science and Innovation, Geisinger Health System, 100 North Academy Avenue, Danville, 17822-4400 PA USA
- Biomedical and Translational Informatics Institute, Geisinger Health System, Danville, PA USA
- Department of Radiology, Geisinger Health System, Danville, PA USA
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