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Dziadosz D, Daniłowicz-Szymanowicz L, Wejner-Mik P, Budnik M, Brzezińska B, Duchnowski P, Golińska-Grzybała K, Jaworski K, Jedliński I, Kamela M, Kasprzak J, Kowalczyk-Domagała M, Kurnicka K, Kustrzycka-Kratochwil D, Mickiewicz K, Możeńska O, Oko-Sarnowska Z, Plewka M, Polewczyk A, Uziębło-Życzkowska B, Wierzbowska-Drabik K, Wachnicka-Truty R, Wołoszyn-Horák E, Szymański P, Gackowski A, Mizia-Stec K. What Do We Know So Far About Ventricular Arrhythmias and Sudden Cardiac Death Prediction in the Mitral Valve Prolapse Population? Could Biomarkers Help Us Predict Their Occurrence? Curr Cardiol Rep 2024; 26:245-268. [PMID: 38507154 PMCID: PMC11136782 DOI: 10.1007/s11886-024-02030-9] [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] [Accepted: 02/22/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE OF THE REVIEW To summarize currently available data on the topic of mitral valve prolapse (MVP) and its correlation to the occurrence of atrial and ventricular arrhythmias. To assess the prognostic value of several diagnostic methods such as transthoracic echocardiography, transesophageal echocardiography, cardiac magnetic resonance, cardiac computed tomography, electrocardiography, and electrophysiology concerning arrhythmic episodes. To explore intra and extracellular biochemistry of the cardiovascular system and its biomarkers as diagnostic tools to predict rhythm disturbances in the MVP population. RECENT FINDINGS MVP is a common and mainly benign valvular disorder. It affects 2-3% of the general population. MVP is a heterogeneous and highly variable phenomenon with three structural phenotypes: myxomatous degeneration, fibroelastic deficiency, and forme fruste. Exercise intolerance, supraventricular tachycardia, and chest discomfort are the symptoms that are often paired with psychosomatic components. Though MVP is thought to be benign, the association between isolated MVP without mitral regurgitation (MR) or left ventricle dysfunction, with ventricular arrhythmia (VA) and sudden cardiac death (SCD) has been observed. The incidence of SCD in the MVP population is around 0.6% per year, which is 6 times higher than the occurrence of SCD in the general population. Often asymptomatic MVP population poses a challenge to screen for VA and prevent SCD. Therefore, it is crucial to carefully assess the risk of VA and SCD in patients with MVP with the use of various tools such as diagnostic imaging and biochemical and genetic screening.
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Affiliation(s)
- D Dziadosz
- 1st Department of Cardiology, Faculty of Medicine, Medical University of Silesia, Katowice, Poland
- Centre of European Reference Network of Heart Diseases - ERN GUARD-HEART, 47 Ziołowa St, 40-635, Katowice, Poland
| | - L Daniłowicz-Szymanowicz
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - P Wejner-Mik
- 1st Department of Cardiology, Medical University of Lodz, Bieganski Hospital, Łódź, Poland
| | - M Budnik
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Central Clinical Hospital, 1a Banacha St, 02-97, Warsaw, Poland
| | - B Brzezińska
- Department of Cardiology, T. Marciniak Hospital, Wrocław, Poland
| | - P Duchnowski
- Cardinal Wyszynski National Institute of Cardiology, 04-628, Warsaw, Poland
| | - K Golińska-Grzybała
- Dept of Coronary Disease and Heart Failure, Noninvasive Cardiovascular Laboratory, Medical College, Jagiellonian University, St. John Paul II Hospital, Cracow, Poland
| | - K Jaworski
- Department of Coronary Artery Disease and Cardiac Rehabilitation, National Institute of Cardiology, Warsaw, Poland
| | - I Jedliński
- Medicor, Powstańców Wielkopolskich 4, 61-895, Poznań, Poland
| | - M Kamela
- Department of Cardiology, Hospital of the Ministry of Interior and Administration, Rzeszów, Poland
| | - J Kasprzak
- 1st Department of Cardiology, Medical University of Lodz, Bieganski Hospital, Łódź, Poland
| | - M Kowalczyk-Domagała
- Pediatric Cardiology Department, The Children's Memorial Health Institute, Warsaw, Poland
| | - K Kurnicka
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Infant Jesus Clinical Hospital, Lindleya str. 4, 02-005, Warsaw, Poland
| | - D Kustrzycka-Kratochwil
- Department of Cardiology, Center for Heart Diseases, 4th Military Clinical Hospital, Weigla 5, 50-981, Wrocław, Poland
| | - K Mickiewicz
- Department of Cardiology, Medical University of Bialystok, 15-276, Białystok, Poland
| | - O Możeńska
- JO Medical Center, Quo Vadis 1/U6, 02-495, Warsaw, Poland
| | - Z Oko-Sarnowska
- Department of Cardiology, Poznań University of Medical Sciences, Wielkopolskie, 60-355, Poznań, Poland
| | - M Plewka
- Department of Interventional Cardiology and Cardiac Arrhythmias, Military Medical Academy Memorial Teaching Hospital of the Medical University of Lodz, Łódź, Poland
| | - A Polewczyk
- Department of Physiology, Pathophysiology and Clinical Immunology, Institute of Medical Sciences, Jan Kochanowski University, Żeromskiego 5, 25-369, Kielce, Poland
- Department of Cardiac Surgery, Świętokrzyskie Cardiology Center, Grunwaldzka 45, 25-736, Kielce, Poland
| | - B Uziębło-Życzkowska
- Department of Cardiology and Internal Diseases, Military Institute of Medicine - National Research Institute, Warsaw, Poland
| | - K Wierzbowska-Drabik
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Lodz, Łódź, Poland
| | - R Wachnicka-Truty
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdynia, Poland
| | - E Wołoszyn-Horák
- Second Department of Cardiology. Specialist Hospital in Zabrze, Medical University of Silesia, Curie-Sklodowskiej str. 10, Zabrze, Poland
| | - P Szymański
- Center of Clinical Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland
| | - A Gackowski
- Dept of Coronary Disease and Heart Failure, Noninvasive Cardiovascular Laboratory, Medical College, Jagiellonian University, St. John Paul II Hospital, Cracow, Poland
| | - K Mizia-Stec
- 1st Department of Cardiology, Faculty of Medicine, Medical University of Silesia, Katowice, Poland.
- Centre of European Reference Network of Heart Diseases - ERN GUARD-HEART, 47 Ziołowa St, 40-635, Katowice, Poland.
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Andayeshgar B, Abdali-Mohammadi F, Sepahvand M, Almasi A, Salari N. Arrhythmia detection by the graph convolution network and a proposed structure for communication between cardiac leads. BMC Med Res Methodol 2024; 24:96. [PMID: 38678178 PMCID: PMC11055258 DOI: 10.1186/s12874-024-02223-4] [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: 07/07/2023] [Accepted: 04/17/2024] [Indexed: 04/29/2024] Open
Abstract
One of the most common causes of death worldwide is heart disease, including arrhythmia. Today, sciences such as artificial intelligence and medical statistics are looking for methods and models for correct and automatic diagnosis of cardiac arrhythmia. In pursuit of increasing the accuracy of automated methods, many studies have been conducted. However, in none of the previous articles, the relationship and structure between the heart leads have not been included in the model. It seems that the structure of ECG data can help develop the accuracy of arrhythmia detection. Therefore, in this study, a new structure of Electrocardiogram (ECG) data was introduced, and the Graph Convolution Network (GCN), which has the possibility of learning the structure, was used to develop the accuracy of cardiac arrhythmia diagnosis. Considering the relationship between the heart leads and clusters based on different ECG poles, a new structure was introduced. In this structure, the Mutual Information(MI) index was used to evaluate the relationship between the leads, and weight was given based on the poles of the leads. Weighted Mutual Information (WMI) matrices (new structure) were formed by R software. Finally, the 15-layer GCN network was adjusted by this structure and the arrhythmia of people was detected and classified by it. To evaluate the performance of the proposed new network, sensitivity, precision, specificity, accuracy, and confusion matrix indices were used. Also, the accuracy of GCN networks was compared by three different structures, including WMI, MI, and Identity. Chapman's 12-lead ECG Dataset was used in this study. The results showed that the values of sensitivity, precision, specificity, and accuracy of the GCN-WMI network with 15 intermediate layers were equal to 98.74%, 99.08%, 99.97% & 99.82%, respectively. This new proposed network was more accurate than the Graph Convolution Network-Mutual Information (GCN-MI) with an accuracy equal to 99.71% and GCN-Id with an accuracy equal to 92.68%. Therefore, utilizing this network, the types of arrhythmia were recognized and classified. Also, the new network proposed by the Graph Convolution Network-Weighted Mutual Information (GCN-WMI) was more accurate than those conducted in other studies on the same data set (Chapman). Based on the obtained results, the structure proposed in this study increased the accuracy of cardiac arrhythmia diagnosis and classification on the Chapman data set. Achieving such accuracy for arrhythmia diagnosis is a great achievement in clinical sciences.
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Affiliation(s)
- Bahare Andayeshgar
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, 6715847141, Iran
| | - Fardin Abdali-Mohammadi
- Department of Computer Engineering and Information Technology, Razi University, Kermanshah, 6714967346, Iran
| | - Majid Sepahvand
- Department of Computer Engineering and Information Technology, Razi University, Kermanshah, 6714967346, Iran
| | - Afshin Almasi
- Clinical Research Development Center, Mohammad Kermanshahi, and Farabi Hospitals, Imam Khomeini, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, 6715847141, Iran.
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, 6715847141, Iran.
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Hong H, Kim J, Min H, Kim YW, Kim TY. Association of B-Type Natriuretic Peptide Level with Clinical Outcome in Out-of-Hospital Cardiac Arrest in Emergency Department Patients. Diagnostics (Basel) 2023; 13:2522. [PMID: 37568885 PMCID: PMC10417783 DOI: 10.3390/diagnostics13152522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/16/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVES B-type natriuretic peptide (BNP) is used for outcome assessment of various diseases. We designed this study to investigate whether BNP, which has been proven useful in the risk stratification of sudden cardiac arrest (SCA) of cardiac etiology, can also prove to be a valuable prognostic tool for SCA also included with non-cardiac etiology. In this study, we aim to investigate the relationship between measured BNP levels and clinical outcomes in SCA, regardless of the cause of SCA. METHODS This retrospective multicenter observational study was performed in two tertiary university hospitals and one general hospital between January 2015 and December 2020. The total number of SCA patients was 1625. The patients with out-of-hospital cardiac arrest over 19 years old and acquired laboratory data, including BNP at emergency department (ED) arrival, were included. BNP was measured during advanced Cardiovascular Life Support (ACLS). The exclusion criteria were age under 18 years, traumatic arrest, and without BNP. RESULTS The median BNP was 171.8 (range; 5-5000) pg/mL in the return of Spontaneous Circulation (ROSC), higher than No-ROSC (p = 0.007). The median BNP concentration was 99.7 (range; 5-3040.68) pg/mL in the survival to discharge, which was significantly lower than the death group (p = 0.012). The odds ratio of survival to discharge decreased proportionally to the BNP level. The odds ratio of neurologic outcome was not correlated with the BNP level. CONCLUSION In patients with SCA of all origins, low BNP concentration measured during ACLS correlated with an increased ratio of survival to discharge. However, BNP measured during ACLS was not found to be an independent factor.
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Affiliation(s)
- Heejin Hong
- Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, 27, Dongguk-ro, Ilsandong-gu, Goyang 10326, Republic of Korea
| | - Jihyun Kim
- Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, 27, Dongguk-ro, Ilsandong-gu, Goyang 10326, Republic of Korea
| | - Hana Min
- Department of Emergency Medicine, National Health Insurance Service Ilsan Hospital, 100, Ilsan-ro, Ilsandong-gu, Goyang 10444, Republic of Korea
| | - Yong Won Kim
- Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, 27, Dongguk-ro, Ilsandong-gu, Goyang 10326, Republic of Korea
| | - Tae-Youn Kim
- Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, 27, Dongguk-ro, Ilsandong-gu, Goyang 10326, Republic of Korea
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Left Ventricular Hypertrophy and Ventricular Tachyarrhythmia: The Role of Biomarkers. Int J Mol Sci 2023; 24:ijms24043881. [PMID: 36835293 PMCID: PMC9958550 DOI: 10.3390/ijms24043881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023] Open
Abstract
Left ventricular hypertrophy (LVH) refers to a complex rebuilding of the left ventricle that can gradually lead to serious complications-heart failure and life-threatening ventricular arrhythmias. LVH is defined as an increase in the size of the left ventricle (i.e., anatomically), therefore the basic diagnosis detecting the increase in the LV size is the domain of imaging methods such as echocardiography and cardiac magnetic resonance. However, to evaluate the functional status indicating the gradual deterioration of the left ventricular myocardium, additional methods are available approaching the complex process of hypertrophic remodeling. The novel molecular and genetic biomarkers provide insights on the underlying processes, representing a potential basis for targeted therapy. This review summarizes the spectrum of the main biomarkers employed in the LVH valuation.
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Li X, Guo D, Zhou W, Hu Y, Zhou H, Chen Y. The Potential Prognostic, Diagnostic and Therapeutic Targets for Recurrent Arrhythmias in Patients with Coronary Restenosis and Reocclusions After Coronary Stenting. Curr Pharm Des 2022; 28:3500-3512. [PMID: 36424794 DOI: 10.2174/1381612829666221124110445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 10/07/2022] [Accepted: 10/13/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The interplay of oxidative stress, proinflammatory microparticles, and proinflammatory cytokines in recurrent arrhythmias is unknown in elderly patients with coronary restenosis and reocclusions after coronary stenting. OBJECTIVE This research sought to investigate the potential diagnostic and therapeutic targets for recurrent arrhythmias in patients with coronary restenosis and reocclusions after coronary stenting. METHODS We examined whether oxidative stress, proinflammatory microparticles, and proinflammatory cytokines could have effects that lead to recurrent arrhythmias in elderly patients with coronary restenosis and reocclusions. We measured the levels of malondialdehyde (MDA), CD31 + endothelial microparticle (CD31 EMP), CD62E + endothelial microparticle (CD62E + EMP), high-sensitivity C-reactive protein (hs-CRP), interleukin- 1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α), as well as oxidized low-density lipoprotein (OX-LDL), and assessed the effects of relationship between oxidative stress, proinflammatory microparticles, and proinflammatory cytokines on recurrent atrial and ventricular arrhythmias in elderly patients with coronary restenosis and reocclusions after coronary stenting. RESULTS The levels of CD31 + EMP, CD62E + EMP, MDA, hs-CRP, IL-1β, IL-6, IL-8, TNF-α and OX-LDL were found to be increased significantly in coronary restenosis + recurrent atrial arrhythmia group compared to without coronary restenosis and coronary restenosis + without recurrent atrial arrhythmia groups, respectively (P < 0.001). Patients in the coronary reocclusion + recurrent ventricular arrhythmia group also exhibited significantly increased levels of CD31 + EMP, CD62E + EMP, MDA, hs-CRP, IL-1β, IL-6, IL-8, TNF-α and OXLDL compared to without coronary reocclusion and coronary reocclusion + without recurrent ventricular arrhythmia groups, respectively (P < 0.001). CONCLUSION Proinflammatory microparticles, proinflammatory cytokines, and oxidative stress might act as potential targets for recurrent arrhythmias in patients with coronary restenosis and reocclusions after coronary stenting.
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Affiliation(s)
- Xia Li
- Department of Geriatrics, Second People's Hospital of Huai'an, Xiamen Road Branch Hospital, The Affiliated Huaian Hospital of Xuzhou Medical University, Huai'an 223002, China
| | - Dianxuan Guo
- Department of Geriatrics, Second People's Hospital of Huai'an, Xiamen Road Branch Hospital, The Affiliated Huaian Hospital of Xuzhou Medical University, Huai'an 223002, China
| | - Wenhang Zhou
- Department of Geriatrics, Second People's Hospital of Huai'an, Xiamen Road Branch Hospital, The Affiliated Huaian Hospital of Xuzhou Medical University, Huai'an 223002, China
| | - Youdong Hu
- Department of Geriatrics, Second People's Hospital of Huai'an, Xiamen Road Branch Hospital, The Affiliated Huaian Hospital of Xuzhou Medical University, Huai'an 223002, China
| | - Hualan Zhou
- Department of Geriatrics, Second People's Hospital of Huai'an, Xiamen Road Branch Hospital, The Affiliated Huaian Hospital of Xuzhou Medical University, Huai'an 223002, China
| | - Ying Chen
- Department of Geriatrics, Second People's Hospital of Huai'an, Xiamen Road Branch Hospital, The Affiliated Huaian Hospital of Xuzhou Medical University, Huai'an 223002, China
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Cardiac Troponin I Reveals Diagnostic and Prognostic Superiority to Aminoterminal Pro-B-Type Natriuretic Peptide in Sepsis and Septic Shock. J Clin Med 2022; 11:jcm11216592. [PMID: 36362826 PMCID: PMC9658155 DOI: 10.3390/jcm11216592] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/21/2022] [Accepted: 10/28/2022] [Indexed: 11/09/2022] Open
Abstract
Data regarding the prognostic value of cardiac biomarkers in patients suffering from sepsis or septic shock is scarce. Studies investigating the prognostic role of cardiac biomarkers in patients with sepsis and septic shock were commonly published prior to the sepsis-3 criteria and were often not restricted to septic patients only, too. This study investigated the diagnostic and prognostic value of the aminoterminal pro-B-type Natriuretic Peptide (NT-pro BNP) and cardiac troponin I (cTNI) in patients with sepsis and septic shock. Consecutive patients with sepsis and septic shock were included from 2019 to 2021. Blood samples were retrieved from the day of disease onset (i.e., day 1), day 2 and 3. Firstly, the diagnostic value of the NT-pro BNP and cTNI to diagnose sepsis or septic shock was tested. Secondly, the prognostic value of the NT-pro BNP and cTNI was examined with regard to the 30-day all-cause mortality. The statistical analyses included univariable t-tests, Spearman’s correlations, C-statistics, Kaplan–Meier analyses and Cox proportional regression analyses. A total of 162 patients were included prospectively, of which 57% had a sepsis and 43% a septic shock. The overall rate of all-cause mortality at 30 days was 53%. With an area under the curve (AUC) of 0.658 on day 1 and 0.885 on day 3, cTNI expressed a better diagnostic value than NT-pro BNP, especially on day 3 (ΔAUCd3 = 0.404; p = 0.022). Furthermore, cTNI displayed a moderate but slightly better prognostic value than NT-pro BNP on all examined days (AUC for cTNI, d1 = 0.635; 95% CI 0.541–0.729; p = 0.007 vs. AUC for NT-pro BNP, d1 = 0.582; 95% CI 0.477–0.687; p = 0.132). In conclusion, cTNI was a reliable diagnostic parameter for the diagnosis of sepsis and septic shock, as well as a reliable prognostic tool with regard to 30-day all-cause mortality in patients suffering from sepsis and septic shock.
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Soysal AU, Yalin K. Biomarkers to Predict Sudden Cardiac Death. Biomark Med 2022. [DOI: 10.2174/9789815040463122010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
Sudden cardiac death (SCD) is a common disorder and an unsolved issue for
health care providers. Despite several risk factors for SCD, some cases experience SCD
as an initial presentation of cardiovascular disease. Prediction of individuals at
increased risk for SCD is important for implementing community-based approaches
and individual-based therapies with high costs, such as implantable defibrillators. This
chapter discusses the potential role of biomarkers in predicting SCD in different
cardiovascular diseases.
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Affiliation(s)
- Ali Uğur Soysal
- Department of Cardiology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa,
Istanbul, Turkey
| | - Kivanc Yalin
- Department of Cardiology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa,
Istanbul, Turkey
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Andayeshgar B, Abdali-Mohammadi F, Sepahvand M, Daneshkhah A, Almasi A, Salari N. Developing Graph Convolutional Networks and Mutual Information for Arrhythmic Diagnosis Based on Multichannel ECG Signals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10707. [PMID: 36078423 PMCID: PMC9518156 DOI: 10.3390/ijerph191710707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Cardiovascular diseases, like arrhythmia, as the leading causes of death in the world, can be automatically diagnosed using an electrocardiogram (ECG). The ECG-based diagnostic has notably resulted in reducing human errors. The main aim of this study is to increase the accuracy of arrhythmia diagnosis and classify various types of arrhythmias in individuals (suffering from cardiovascular diseases) using a novel graph convolutional network (GCN) benefitting from mutual information (MI) indices extracted from the ECG leads. In this research, for the first time, the relationships of 12 ECG leads measured using MI as an adjacency matrix were illustrated by the developed GCN and included in the ECG-based diagnostic method. Cross-validation methods were applied to select both training and testing groups. The proposed methodology was validated in practice by applying it to the large ECG database, recently published by Chapman University. The GCN-MI structure with 15 layers was selected as the best model for the selected database, which illustrates a very high accuracy in classifying different types of rhythms. The classification indicators of sensitivity, precision, specificity, and accuracy for classifying heart rhythm type, using GCN-MI, were computed as 98.45%, 97.89%, 99.85%, and 99.71%, respectively. The results of the present study and its comparison with other studies showed that considering the MI index to measure the relationship between cardiac leads has led to the improvement of GCN performance for detecting and classifying the type of arrhythmias, in comparison to the existing methods. For example, the above classification indicators for the GCN with the identity adjacency matrix (or GCN-Id) were reported to be 68.24%, 72.83%, 95.24%, and 92.68%, respectively.
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Affiliation(s)
- Bahare Andayeshgar
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Fardin Abdali-Mohammadi
- Department of Computer Engineering and Information Technology, Razi University, Kermanshah 6714967346, Iran
| | - Majid Sepahvand
- Department of Computer Engineering and Information Technology, Razi University, Kermanshah 6714967346, Iran
| | - Alireza Daneshkhah
- Research Centre for Computational Science and Mathematical Modelling, Coventry University, Coventry CV1 2JH, UK
| | - Afshin Almasi
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
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Prognostic Value of Cardiac Troponin I in Patients with Ventricular Tachyarrhythmias. J Clin Med 2022; 11:jcm11112987. [PMID: 35683378 PMCID: PMC9181556 DOI: 10.3390/jcm11112987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 01/07/2023] Open
Abstract
Besides the diagnostic role in acute myocardial infarction, cardiac troponin I levels (cTNI) may be increased in various other clinical conditions, including heart failure, valvular heart disease and sepsis. However, limited data are available regarding the prognostic role of cTNI in the setting of ventricular tachyarrhythmias. Therefore, the present study sought to assess the prognostic impact of cTNI in patients with ventricular tachyarrhythmias (i.e., ventricular tachycardia (VT) and fibrillation (VF)) on admission. A large retrospective registry was used, including all consecutive patients presenting with ventricular tachyarrhythmias from 2002 to 2015. The prognostic impact of elevated cTNI levels was investigated for 30-day all-cause mortality (i.e., primary endpoint) using Kaplan–Meier, receiver operating characteristic (ROC), multivariable Cox regression analyses and propensity score matching. From a total of 1104 patients with ventricular tachyarrhythmias and available cTNI levels on admission, 46% were admitted with VT and 54% with VF. At 30 days, high cTNI was associated with the primary endpoint (40% vs. 22%; log rank p = 0.001; HR = 2.004; 95% CI 1.603–2.505; p = 0.001), which was still evident after multivariable adjustment and propensity score matching (30% vs. 18%; log rank p = 0.003; HR = 1.729; 95% CI 1.184–2.525; p = 0.005). Significant discrimination of the primary endpoint was especially evident in VT patients (area under the curve (AUC) 0.734; 95% CI 0.645–0.823; p = 0.001). In contrast, secondary endpoints, including all-cause mortality at 30 months and a composite arrhythmic endpoint, were not affected by cTNI levels. The risk of cardiac rehospitalization was lower in patients with high cTNI, which was no longer observed after propensity score matching. In conclusion, high cTNI levels were associated with increased risk of all-cause mortality at 30 days in patients presenting with ventricular tachyarrhythmias.
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Kohajda Z, Virág L, Hornyik T, Husti Z, Sztojkov-Ivanov A, Nagy N, Horváth A, Varga R, Prorok J, Szlovák J, Tóth N, Gazdag P, Topal L, Naveed M, Árpádffy-Lovas T, Pászti B, Magyar T, Koncz I, Déri S, Demeter-Haludka V, Aigner Z, Ördög B, Patfalusi M, Tálosi L, Tiszlavicz L, Földesi I, Jost N, Baczkó I, Varró A. In vivo and cellular antiarrhythmic and cardiac electrophysiological effects of desethylamiodarone in dog cardiac preparations. Br J Pharmacol 2022; 179:3382-3402. [PMID: 35106755 DOI: 10.1111/bph.15812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE The aim of the present study was to study the antiarrhythmic effects and cellular mechanisms of desethylamiodarone (DEA), the main metabolite of amiodarone (AMIO), following acute and chronic 4-week oral treatments (25-50 mg·kg-1 ·day-1 ). EXPERIMENTAL APPROACH The antiarrhythmic effects of acute iv. (10 mg·kg-1 ) and chronic oral (4 weeks, 25 mg·kg-1 ·day-1 ) administration of DEA were assessed in carbachol and tachypacing-induced dog atrial fibrillation models. Action potentials were recorded from atrial and right ventricular tissue following acute (10 μM) and chronic (p.o. 4 weeks, 50 mg·kg-1 ·day-1 ) DEA application using the conventional microelectrode technique. Ionic currents were measured by the whole cell configuration of the patch clamp technique in isolated left ventricular myocytes. Pharmacokinetic studies were performed following a single intravenous dose (25 mg·kg-1 ) of AMIO and DEA intravenously and orally. In chronic (91-day) toxicological investigations, DEA and AMIO were administered in the oral dose of 25 mg·kg-1 ·day-1 ). KEY RESULTS DEA exerted marked antiarrhythmic effects in both canine atrial fibrillation models. Both acute and chronic DEA administration prolonged action potential duration in atrial and ventricular muscle without any changes detected in Purkinje fibres. DEA decreased the amplitude of several outward potassium currents such as IKr , IKs , IK1 , Ito , and IKACh , while the ICaL and late INa inward currents were also significantly depressed. Better drug bioavailability and higher volume of distribution for DEA were observed compared to AMIO. No neutropenia and less severe pulmonary fibrosis was found following DEA compared to that of AMIO administration. CONCLUSION AND IMPLICATIONS Chronic DEA treatment in animal experiments has marked antiarrhythmic and electrophysiological effects with better pharmacokinetics and lower toxicity than its parent compound. These results suggest that the active metabolite, DEA, should be considered for clinical trials as a possible new, more favourable option for the treatment of cardiac arrhythmias including atrial fibrillation.
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Affiliation(s)
- Zsófia Kohajda
- ELKH-SZTE Research Group for Cardiovascular Pharmacology, Eötvös Loránd Research Network, Szeged, Hungary
| | - László Virág
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - Tibor Hornyik
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Zoltán Husti
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Anita Sztojkov-Ivanov
- Department of Pharmacodynamics and Biopharmacy, University of Szeged, Szeged, Hungary
| | - Norbert Nagy
- ELKH-SZTE Research Group for Cardiovascular Pharmacology, Eötvös Loránd Research Network, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - András Horváth
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Richárd Varga
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - János Prorok
- ELKH-SZTE Research Group for Cardiovascular Pharmacology, Eötvös Loránd Research Network, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Jozefina Szlovák
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Noémi Tóth
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Péter Gazdag
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Leila Topal
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Muhammad Naveed
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Tamás Árpádffy-Lovas
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Bence Pászti
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Tibor Magyar
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - István Koncz
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Szilvia Déri
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | | | - Zoltán Aigner
- Institute of Pharmaceutical Technology and Regulatory Affairs, University of Szeged, Szeged, Hungary
| | - Balázs Ördög
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary
| | - Márta Patfalusi
- Department of Toxicology, ATRC Aurigon Toxicological Research Center Ltd., Dunakeszi, Hungary
| | - László Tálosi
- Department of Pharmacognosy, Faculty of Pharmacy, University of Szeged, Szeged, Hungary
| | - László Tiszlavicz
- Department of Pathology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Imre Földesi
- Department of Laboratory Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Norbert Jost
- ELKH-SZTE Research Group for Cardiovascular Pharmacology, Eötvös Loránd Research Network, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - István Baczkó
- Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - András Varró
- ELKH-SZTE Research Group for Cardiovascular Pharmacology, Eötvös Loránd Research Network, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, University of Szeged, Szeged, Hungary.,Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
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11
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Tian M, Xue J, Dai C, Jiang E, Zhu B, Pang H. CircSLC8A1 and circNFIX can be used as auxiliary diagnostic markers for sudden cardiac death caused by acute ischemic heart disease. Sci Rep 2021; 11:4695. [PMID: 33633191 PMCID: PMC7907149 DOI: 10.1038/s41598-021-84056-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 02/11/2021] [Indexed: 12/16/2022] Open
Abstract
Sudden cardiac death (SCD) caused by acute ischemic heart disease (IHD) is a major cause of sudden death worldwide. Circular RNAs (circRNAs) are abundant in the heart and play important roles in cardiovascular diseases, but the role of circRNAs as biomarkers in the forensic diagnosis of SCD caused by acute IHD remains poorly characterized. To investigate the potential of two heart-enriched circRNAs, circNFIX and circSLC8A1, we explored the expression of these two circRNAs in different kinds of commonly used IHD models, and further verified their expressions in forensic autopsy cases. The results from both the IHD rat and H9c2 cell models revealed that circSlc8a1 level was upregulated, while the circNfix level was elevated in the early stage of ischemia and subsequently downregulated. The time-dependent expression patterns of the two circRNAs suggested their potential as SCD biomarkers. In autopsy cases, the results showed that the expression of these two circRNAs in the myocardium with acute IHD-related SCDs corresponded to the observations in the ischemic models. Further analysis related to myocardial ischemia indicated that circSLC8A1 showed high sensitivity and specificity for myocardial infarction and was positively correlated with creatine kinase MB in pericardial fluid. Downregulated circNFIX level could indicate the ischemic myocardial damage, and it was negatively correlated with the coronary artery stenosis grade. The combination of circSLC8A1 and circNFIX had better performance to discriminate IHD-related SCDs. The results suggested that circSLC8A1 and circNFIX may be used as auxiliary diagnostic markers for SCD caused by acute IHD in forensic medicine.
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Affiliation(s)
- Meihui Tian
- Department of Forensic Genetics and Biology, School of Forensic Medicine, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, P.R. China
| | - Jiajia Xue
- Department of Forensic Pathology, School of Forensic Medicine, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, P.R. China
| | - Cuiyun Dai
- Department of Forensic Genetics and Biology, School of Forensic Medicine, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, P.R. China
| | - Enzhu Jiang
- Department of Forensic Genetics and Biology, School of Forensic Medicine, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, P.R. China
| | - Baoli Zhu
- Department of Forensic Pathology, School of Forensic Medicine, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, P.R. China
| | - Hao Pang
- Department of Forensic Genetics and Biology, School of Forensic Medicine, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, P.R. China.
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12
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Circular RNAs in Sudden Cardiac Death Related Diseases: Novel Biomarker for Clinical and Forensic Diagnosis. Molecules 2021; 26:molecules26041155. [PMID: 33670057 PMCID: PMC7926443 DOI: 10.3390/molecules26041155] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/17/2022] Open
Abstract
The prevention and diagnosis of sudden cardiac death (SCD) are among the most important keystones and challenges in clinical and forensic practice. However, the diagnostic value of the current biomarkers remains unresolved issues. Therefore, novel diagnostic biomarkers are urgently required to identify patients with early-stage cardiovascular diseases (CVD), and to assist in the postmortem diagnosis of SCD cases without typical cardiac damage. An increasing number of studies show that circular RNAs (circRNAs) have stable expressions in myocardial tissue, and their time- and tissue-specific expression levels might reflect the pathophysiological status of the heart, which makes them potential CVD biomarkers. In this article, we briefly introduced the biogenesis and functional characteristics of circRNAs. Moreover, we described the roles of circRNAs in multiple SCD-related diseases, including coronary artery disease (CAD), myocardial ischemia or infarction, arrhythmia, cardiomyopathy, and myocarditis, and discussed the application prospects and challenges of circRNAs as a novel biomarker in the clinical and forensic diagnosis of SCD.
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13
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Anan R, Watanabe H, Takahama H, Mori W. Ventricular tachycardia in patients undergoing 24-h Holter monitoring as preoperative evaluation for noncardiac surgery. Heart Vessels 2021; 36:1047-1055. [PMID: 33475765 DOI: 10.1007/s00380-021-01779-1] [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: 10/05/2020] [Accepted: 01/08/2021] [Indexed: 11/29/2022]
Abstract
The incidence of ventricular tachycardia (VT) in preoperative evaluation for noncardiac surgery in general hospitals has not been established. The aim of this study was to determine the incidence of VT, characteristics of patients with VT, characteristics of VT, and significance of VT in patients undergoing 24-h Holter monitoring as preoperative evaluation for noncardiac surgery. In 601 patients, VT was detected in 46 patients (7.7%). In patients with VT, left ventricular ejection fraction (LVEF) was lower (62.6 ± 9.3% vs. 66.6 ± 8.9%, p = 0.003), and B-type natriuretic peptide (BNP) was higher compared with patients without VT (median, 52.5 pg/mL vs. 32.8 pg/mL, p = 0.02). The maximum number of consecutive beats of VT was more frequent in the patients with LVEF < 50% than in the patients with LVEF ≥ 50% (median, 11.5 beats vs. 3.0 beats, p = 0.01). Forty patients (87%) underwent scheduled surgery without major complications.
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Affiliation(s)
- Ryuichiro Anan
- Department of Cardiology, National Hospital Organization Miyakonojo Medical Center, 5033-1 Iwayoshi-cho, Miyakonojo, 885-0014, Japan. .,Institute for Clinical Research, National Hospital Organization Miyakonojo Medical Center, 5033-1 Iwayoshi-cho, Miyakonojo, 885-0014, Japan.
| | - Hideaki Watanabe
- Clinical Laboratory Department, National Hospital Organization Miyakonojo Medical Center, 5033-1 Iwayoshi-cho, Miyakonojo, 885-0014, Japan
| | - Hitomi Takahama
- Clinical Laboratory Department, National Hospital Organization Miyakonojo Medical Center, 5033-1 Iwayoshi-cho, Miyakonojo, 885-0014, Japan
| | - Wakako Mori
- Clinical Laboratory Department, National Hospital Organization Miyakonojo Medical Center, 5033-1 Iwayoshi-cho, Miyakonojo, 885-0014, Japan
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14
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Rodríguez-Sánchez E, Navarro-García JA, González-Lafuente L, Aceves-Ripoll J, Vázquez-Sánchez S, Poveda J, Mercado-García E, Corbacho-Alonso N, Calvo-Bonacho E, Fernández-Velasco M, Álvarez-Llamas G, Barderas MG, Ruilope LM, Ruiz-Hurtado G. Oxidized Low-Density Lipoprotein Associates with Ventricular Stress in Young Adults and Triggers Intracellular Ca 2+ Alterations in Adult Ventricular Cardiomyocytes. Antioxidants (Basel) 2020; 9:antiox9121213. [PMID: 33271910 PMCID: PMC7761043 DOI: 10.3390/antiox9121213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022] Open
Abstract
Oxidized low-density lipoprotein (oxLDL) is associated with cardiac damage and causes injury to multiple cell types. We aimed to investigate the role of oxLDL in ventricular stress. We first examined the association between circulating oxLDL and N-terminal pro-brain natriuretic peptide (NT-proBNP), a marker of myocardial stress, in young subjects (30-50 years) with or without stable coronary artery disease (SCAD). oxLDL and NT-proBNP were significantly higher in subjects at high cardiovascular risk (CVR) than in subjects at low CVR and were associated independently of traditional CVR factors and C-reactive protein. Furthermore, the levels of oxLDL and NT-proBNP were significantly lower in subjects with SCAD than in peers at high CVR. To determine the intracellular mechanisms involved in the cardiac effects of oxLDL, we analyzed the in vitro effect of oxLDL on intracellular Ca2+ handling in adult rat ventricular cardiomyocytes using confocal microscopy. Acute challenge of adult ventricular cardiomyocytes to oxLDL reduced systolic Ca2+ transients and sarcoplasmic reticulum Ca2+ load. Moreover, diastolic spontaneous Ca2+ leak increased significantly after acute exposure to oxLDL. Thus, we demonstrate that oxLDL associates with NT-proBNP in young subjects, and can directly induce Ca2+ mishandling in adult ventricular cardiomyoyctes, predisposing cardiomyocytes to cardiac dysfunction and arrhythmogenicity.
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Affiliation(s)
- Elena Rodríguez-Sánchez
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - José Alberto Navarro-García
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Laura González-Lafuente
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Jennifer Aceves-Ripoll
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Sara Vázquez-Sánchez
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Jonay Poveda
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Elisa Mercado-García
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Nerea Corbacho-Alonso
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, SESCAM, 45004 Toledo, Spain; (N.C.-A.); (M.G.B.)
| | | | - María Fernández-Velasco
- IdiPAZ Institute for Health Research/Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, CIBER-CV, 28029 Madrid, Spain;
| | | | - María G. Barderas
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, SESCAM, 45004 Toledo, Spain; (N.C.-A.); (M.G.B.)
| | - Luis M. Ruilope
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
- Hypertension Unit, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- CIBER-CV, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- European University of Madrid, Madrid, Spain
| | - Gema Ruiz-Hurtado
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
- Hypertension Unit, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- CIBER-CV, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- Correspondence: ; Tel.: +34-91-390-8001
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15
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Radu S, Floria M. Ventricular arrhythmic risk prediction: simpler is easier. Minerva Cardioangiol 2020; 68:556-558. [PMID: 33059406 DOI: 10.23736/s0026-4725.20.05389-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Mariana Floria
- Grigore T. Popa University, Iasi, Romania.,Department of Internal Medicine, Iacob Czihac Military Emergency Hospital, Iasi, Romania
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16
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Varga RS, Hornyik T, Husti Z, Kohajda Z, Krajsovszky G, Nagy N, Jost N, Virág L, Tálosi L, Mátyus P, Varró A, Baczkó I. Antiarrhythmic and cardiac electrophysiological effects of SZV-270, a novel compound with combined Class I/B and Class III effects, in rabbits and dogs. Can J Physiol Pharmacol 2020; 99:89-101. [PMID: 32970956 DOI: 10.1139/cjpp-2020-0412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Cardiovascular diseases are the leading causes of mortality. Sudden cardiac death is most commonly caused by ventricular fibrillation (VF). Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a major cause of stroke and heart failure. Pharmacological management of VF and AF remains suboptimal due to limited efficacy of antiarrhythmic drugs and their ventricular proarrhythmic adverse effects. In this study, the antiarrhythmic and cardiac cellular electrophysiological effects of SZV-270, a novel compound, were investigated in rabbit and canine models. SZV-270 significantly reduced the incidence of VF in rabbits subjected to coronary artery occlusion/reperfusion and reduced the incidence of burst-induced AF in a tachypaced conscious canine model of AF. SZV-270 prolonged the frequency-corrected QT interval, lengthened action potential duration and effective refractory period in ventricular and atrial preparations, blocked I Kr in isolated cardiomyocytes (Class III effects), and reduced the maximum rate of depolarization (V max) at cycle lengths smaller than 1000 ms in ventricular preparations (Class I/B effect). Importantly, SZV-270 did not provoke Torsades de Pointes arrhythmia in an anesthetized rabbit proarrhythmia model characterized by impaired repolarization reserve. In conclusion, SZV-270 with its combined Class I/B and III effects can prevent reentry arrhythmias with reduced risk of provoking drug-induced Torsades de Pointes.
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Affiliation(s)
- Richárd S Varga
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - Tibor Hornyik
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - Zoltán Husti
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - Zsófia Kohajda
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary
| | - Gábor Krajsovszky
- Department of Organic Chemistry, Semmelweis University, Budapest, Hungary
| | - Norbert Nagy
- MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary
| | - Norbert Jost
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - László Virág
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - László Tálosi
- Department of Pharmacognosy, Faculty of Pharmacy, University of Szeged, Szeged, Hungary
| | - Péter Mátyus
- Department of Organic Chemistry, Semmelweis University, Budapest, Hungary
| | - András Varró
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary.,MTA-SZTE Research Group of Cardiovascular Pharmacology, Hungarian Academy of Sciences, Szeged, Hungary
| | - István Baczkó
- Department of Pharmacology and Pharmacotherapy, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
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