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Marcucci R, Mannini L, Andrei V, Bandinelli B, Gori AM, Fatucchi S, Giglioli C, Romano SM, Piazzai C, Marchionni N, Cecchi E. Transient stress-related hyperviscosity and endothelial dysfunction in Takotsubo syndrome: a time course study. Heart Vessels 2022; 37:1776-1784. [PMID: 35451602 DOI: 10.1007/s00380-022-02071-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/31/2022] [Indexed: 11/04/2022]
Abstract
Takotsubo syndrome (TTS) is an acute and usually reversible heart failure syndrome, frequently associated with emotional or physical stress. Its pathophysiology remains largely unclear, although several mechanisms related to catecholaminergic storm have been proposed. In this study we analyzed during the acute phase of TTS and at follow-up both hemorheological parameters and biomarkers of endothelial damage, whose time course has never been fully explored. In 50 TTS women, we analyzed several hemorheological parameters [whole blood viscosity (WBV) at 0.512 s-1 and at 94.5 s-1, plasma viscosity (PLV), erythrocyte deformability and aggregation index] as well as biomarkers of endothelial dysfunction [von Willebrand Factor (vWF), Plasminogen activator inhibitor-1 and factor VIII levels] during the acute phase and after a median 6 months follow-up. These variables were also assessed in 50 age-matched healthy women. Respect to follow-up, in the acute phase of TTS we observed higher values of white blood cell count, fibrinogen, WBV at low and high shear rates, PLV, erythrocyte aggregation index and lower values of erythrocyte elongation index. Moreover, all biomarkers of endothelial dysfunction resulted significantly higher in the acute phase. During follow-up WBV at 94.5 s-1, erythrocyte elongation index and vWF resulted significantly altered with respect to controls. The results of this study confirm the role of hyperviscosity and endothelial dysfunction in TTS pathophysiology. Moreover, they suggest the persistence of alterations of erythrocyte deformability and endothelial dysfunction even beyond the acute phase that could be the target of therapeutic strategies also during follow-up.
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Affiliation(s)
- Rossella Marcucci
- Department of Cardiac Thoracic and Vascular Medicine, Center for Atherothrombotic Diseases, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.,Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Lucia Mannini
- Department of Cardiac Thoracic and Vascular Medicine, Center for Atherothrombotic Diseases, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Valentina Andrei
- General Cardiology Unit, Department of Cardiac Thoracic and Vascular Medicine, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni, 85, 50141, Florence, Italy
| | - Brunella Bandinelli
- Department of Cardiac Thoracic and Vascular Medicine, Center for Atherothrombotic Diseases, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Anna Maria Gori
- Department of Cardiac Thoracic and Vascular Medicine, Center for Atherothrombotic Diseases, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.,Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Serena Fatucchi
- General Cardiology Unit, Department of Cardiac Thoracic and Vascular Medicine, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni, 85, 50141, Florence, Italy
| | - Cristina Giglioli
- General Cardiology Unit, Department of Cardiac Thoracic and Vascular Medicine, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni, 85, 50141, Florence, Italy
| | - Salvatore Mario Romano
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.,General Cardiology Unit, Department of Cardiac Thoracic and Vascular Medicine, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni, 85, 50141, Florence, Italy
| | - Chiara Piazzai
- General Cardiology Unit, Department of Cardiac Thoracic and Vascular Medicine, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni, 85, 50141, Florence, Italy
| | - Niccolo' Marchionni
- General Cardiology Unit, Department of Cardiac Thoracic and Vascular Medicine, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni, 85, 50141, Florence, Italy
| | - Emanuele Cecchi
- General Cardiology Unit, Department of Cardiac Thoracic and Vascular Medicine, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni, 85, 50141, Florence, Italy.
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Brun JF, Varlet-Marie E, Myzia J, Raynaud de Mauverger E, Pretorius E. Metabolic Influences Modulating Erythrocyte Deformability and Eryptosis. Metabolites 2021; 12:4. [PMID: 35050126 PMCID: PMC8778269 DOI: 10.3390/metabo12010004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 12/17/2022] Open
Abstract
Many factors in the surrounding environment have been reported to influence erythrocyte deformability. It is likely that some influences represent reversible changes in erythrocyte rigidity that may be involved in physiological regulation, while others represent the early stages of eryptosis, i.e., the red cell self-programmed death. For example, erythrocyte rigidification during exercise is probably a reversible physiological mechanism, while the alterations of red blood cells (RBCs) observed in pathological conditions (inflammation, type 2 diabetes, and sickle-cell disease) are more likely to lead to eryptosis. The splenic clearance of rigid erythrocytes is the major regulator of RBC deformability. The physicochemical characteristics of the surrounding environment (thermal injury, pH, osmolality, oxidative stress, and plasma protein profile) also play a major role. However, there are many other factors that influence RBC deformability and eryptosis. In this comprehensive review, we discuss the various elements and circulating molecules that might influence RBCs and modify their deformability: purinergic signaling, gasotransmitters such as nitric oxide (NO), divalent cations (magnesium, zinc, and Fe2+), lactate, ketone bodies, blood lipids, and several circulating hormones. Meal composition (caloric and carbohydrate intake) also modifies RBC deformability. Therefore, RBC deformability appears to be under the influence of many factors. This suggests that several homeostatic regulatory loops adapt the red cell rigidity to the physiological conditions in order to cope with the need for oxygen or fuel delivery to tissues. Furthermore, many conditions appear to irreversibly damage red cells, resulting in their destruction and removal from the blood. These two categories of modifications to erythrocyte deformability should thus be differentiated.
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Affiliation(s)
- Jean-Frédéric Brun
- UMR CNRS 9214-Inserm U1046 Physiologie et Médecine Expérimentale du Cœur et des Muscles-PHYMEDEXP, Unité D’explorations Métaboliques (CERAMM), Département de Physiologie Clinique, Université de Montpellier, Hôpital Lapeyronie-CHRU de Montpellier, 34295 Montpellier, France; (J.M.); (E.R.d.M.)
| | - Emmanuelle Varlet-Marie
- UMR CNRS 5247-Institut des Biomolécules Max Mousseron (IBMM), Laboratoire du Département de Physicochimie et Biophysique, UFR des Sciences Pharmaceutiques et Biologiques, Université de Montpellier, 34090 Montpellier, France;
| | - Justine Myzia
- UMR CNRS 9214-Inserm U1046 Physiologie et Médecine Expérimentale du Cœur et des Muscles-PHYMEDEXP, Unité D’explorations Métaboliques (CERAMM), Département de Physiologie Clinique, Université de Montpellier, Hôpital Lapeyronie-CHRU de Montpellier, 34295 Montpellier, France; (J.M.); (E.R.d.M.)
| | - Eric Raynaud de Mauverger
- UMR CNRS 9214-Inserm U1046 Physiologie et Médecine Expérimentale du Cœur et des Muscles-PHYMEDEXP, Unité D’explorations Métaboliques (CERAMM), Département de Physiologie Clinique, Université de Montpellier, Hôpital Lapeyronie-CHRU de Montpellier, 34295 Montpellier, France; (J.M.); (E.R.d.M.)
| | - Etheresia Pretorius
- Department of Physiological Sciences, Stellenbosch University, Stellenbosch, Private Bag X1 MATIELAND, Stellenbosch 7602, South Africa;
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Wang Y, Zhao R, Wan QY, Shen XD, Wu XT, Chen J. Effects of omega-3 polyunsaturated fatty acid supplementation in patients with obesity awaiting bariatric surgery. Surg Obes Relat Dis 2021; 17:1226-1228. [PMID: 33691993 DOI: 10.1016/j.soard.2021.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/28/2021] [Accepted: 01/30/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Yong Wang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Rui Zhao
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qian-Yi Wan
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xiao-Ding Shen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xiao-Ting Wu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Chen
- Healthcare-associated Infection Control Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
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