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Triska J, Uretsky BF, Pitt B, Birnbaum Y. Closing the Digitalis Divide: Back to the Basics of Randomized Controlled Trials. Cardiovasc Drugs Ther 2023; 37:807-813. [PMID: 34748147 DOI: 10.1007/s10557-021-07287-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Publishe d decades after several randomized controlled trials (RCT) demonstrating decreased hospitalizations and no effect on all-cause mortality with digoxin use, a series of meta-analyses linking digoxin treatment and mortality have contributed to a narrower application of this medication for the management of heart failure (HF) and atrial fibrillation (AF). Given the conflicting data from the earlier RCTs and more recent meta-analyses, there is a growing polarization among providers for and against the use of digoxin in managing these conditions. METHODS To help close this divide, we provide a perspective on the literature with special attention to the quality of both older and more recent studies on this subject. RESULTS The data from the highest quality studies we have, RCTs, suggest that digoxin use in patients with HF and/or AF is associated with improvement in several areas of outcomes including functional capacity, symptom management, reduced hospitalizations, fewer deaths due to HF, and treatment of refractory chronic heart failure with rEF, and may even have overall mortality benefit when serum digoxin concentrations are within therapeutic range. These effects are more pronounced in patients with EF < 25% and NYHA Class II-IV and at highest risk for hospitalization. CONCLUSION As the risk of confounding factors was minimized by the study design, the likelihood that positive outcomes were identified with digoxin use increased. Clinicians and researchers need further adequately designed and powered RCTs exploring the connection between digoxin therapy and mortality, hospitalizations, and symptom management.
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Affiliation(s)
- J Triska
- Internal Medicine Residency, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
| | - B F Uretsky
- University of Arkansas for Medical Sciences, Central Arkansas Veterans Health System, Little Rock, AR, 72205, USA
| | - B Pitt
- University of Michigan School of Medicine, Ann Arbor, MI, 48109, USA
| | - Y Birnbaum
- John S. Dunn Chair in Cardiology Research and Education, The Department of Medicine, Section of Cardiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
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Pitt B, Bhatt DL, Schotzinger RJ, Pacyniak E, Jowett J, Lee JS. A safety and pharmacodynamic study of the highly selective aldosterone synthase inhibitor PB6440 in the cynomolgus monkey. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Aldosterone is an important mediator of hypertension, particularly resistant hypertension, heart failure, and chronic kidney disease. PB6440 is a potent inhibitor of aldosterone synthase (CYP11B2) with high selectivity over the closely related enzyme CYP11B1. In previous studies in cynomolgus monkeys, PB6440 exhibited excellent oral bioavailability and a marked suppression of aldosterone synthesis at doses as low as 1 mg/kg/day. Importantly, no effect was observed on cortisol production nor significant changes noted in plasma concentrations of the steroid precursors 11-deoxycortisol or deoxycorticosterone (DOC), which are dependent on CYP11B1 activity. The purpose of the current study was to assess the safety and pharmacodynamics of higher doses of PB6440 in the cynomolgus monkey in order to determine a therapeutic index prior to initiation of studies in humans.
Methods
Male and female cynomolgus monkeys (2/sex/dose group) were administered 0, 10, 30 or 100 mg/kg PB6440 once-daily for 14 days by oral gavage. Assessment of safety was based on mortality, clinical observations, body weights, and clinical and anatomic pathology. Blood samples were also collected for pharmacodynamic analysis, including aldosterone, cortisol, 11-deoxycortisol, DOC, and ACTH.
Results
PB6440 was well tolerated at all doses. There were no deaths and no reports of clinical observations at any dose level. Mild decreases in body weight were observed in PB6440-treated animals, which were likely due to the diuretic effects of the compound. PB6440 caused an increase in adrenal weights which was associated with hypertrophy of the adrenal zona fasciculata, a finding which has previously been observed with other aldosterone synthase inhibitors. PB6440 led to marked declines in basal aldosterone levels of −97%, −97% and −98% from baseline at 10, 30 and 100 mg/kg/day, respectively, at 24-hours following the final dose. Despite these clear declines in circulating aldosterone levels, no meaningful changes in cortisol, 11-deoxycortisol, DOC, or ACTH levels were observed, supporting lack of CYP11B1 inhibition. PB6440 led to expected decreases in plasma sodium (up to 7 nmol/L at the high dose). No effect on plasma potassium levels were observed at any dose level.
Conclusions
PB6440 was well tolerated in the cynomolgus monkey at doses that are much higher than needed for potent aldosterone suppression based on previous studies. At the highest dose level tested (100 mg/kg), which led to a 98% reduction in basal aldosterone levels, no evidence of significant CYP11B1 inhibition was observed. The absence of an increase in plasma potassium in the presence of a plasma sodium decline merits further study. Thus, PB6440 is a highly selective novel aldosterone synthase inhibitor for the potential treatment of hypertension, heart failure, and chronic kidney disease in humans.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): PhaseBio Pharmaceuticals Inc.
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Affiliation(s)
- B Pitt
- University of Michigan School of Medicine , Ann Arbor , United States of America
| | - D L Bhatt
- Brigham and Women'S Hospital, Harvard Medical School , Boston , United States of America
| | | | - E Pacyniak
- Selenity Therapeutics , Durham , United States of America
| | - J Jowett
- PhaseBio Pharmaceuticals Inc. , Malvern , United States of America
| | - J S Lee
- PhaseBio Pharmaceuticals Inc. , Malvern , United States of America
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Agarwal R, Pitt B, Rossing P, Anker SD, Filippatos G, Ruilope LM, Kovesdy CP, Tuttle K, Vaduganathan M, Wanner C, Bansilal S, Gebel M, Joseph A, Lawatscheck R, Bakris G. In patients with type 2 diabetes chronic kidney disease is a modifiable cardiovascular risk factor. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Chronic kidney disease (CKD) in patients with type 2 diabetes (T2D) is associated with an increased risk of cardiovascular (CV) events. The modifiability of CKD-associated CV risk in patients with T2D across a spectrum of CKD stages remains unknown.
Purpose
To test whether CKD, as defined jointly by estimated glomerular filtration rate (eGFR) and albuminuria (urine albumin-to-creatinine ratio [UACR]), is a modifiable CV risk factor in patients with T2D. Furthermore, to estimate the population-wide reduction in first CV events in the US if all eligible patients were treated with finerenone.
Methods
We estimated the incidence rates of CV events (composite of CV death, non-fatal stroke, non-fatal myocardial infarction, or hospitalisation for heart failure) over a median follow-up of 3.0 years in 13,026 patients with CKD and T2D, treated with finerenone or placebo, in a joint analysis by eGFR and UACR categories. Patients were from FIDELITY, a prespecified pooled analysis of two phase III trials, and had an eGFR ≥25 ml/min/1.73 m2 and UACR 30–5000 mg/g at screening.The potential impact of finerenone treatment on the US population was evaluated by simulating the number of first CV events that could be prevented per year with finerenone, using incidence rates from FIDELITY and prevalence rates of CKD in patients with T2D from the National Health and Nutrition Examination Survey (NHANES).
Results
Lower eGFR and higher UACR categories were associated with higher incidences of CV events in finerenone and placebo recipients (Figure). Finerenone reduced CV risk versus placebo (hazard ratio 0.86; 95% CI 0.78–0.95; p=0.0018) without evidence of moderation of risk reduction by combined eGFR and UACR categories (p interaction = 0.66; Figure 1). Using NHANES, a total of 6.4 million treatment-eligible individuals with CKD and T2D were identified; 75% had CKD with an eGFR ≥60 ml/min/1.73 m2 and 25% had CKD with an eGFR <60 ml/min/1.73 m2. Simulations using this NHANES population projected that 1 year of finerenone treatment could prevent 38,359 CV events in US patients with CKD and T2D, with 66% of events prevented in patients with eGFR ≥60 ml/min/1.73 m2.
Conclusions
Higher albuminuria and lower eGFR are associated with increased CV risk in patients with T2D. Across a range of eGFR and albuminuria categories, CV risk is modifiable. Therefore, CKD is a modifiable CV risk factor in part mediated by mineralocorticoid receptor overactivation. UACR screening to identify patients with T2D and albuminuria with an eGFR ≥60 ml/min/1.73 m2 is likely to provide a significant opportunity for population benefits.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Bayer AG
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Affiliation(s)
- R Agarwal
- Richard L. Roudebush VA Medical Center and Indiana University , Indianapolis , United States of America
| | - B Pitt
- University of Michigan, Department of Medicine , Ann Arbor , United States of America
| | - P Rossing
- Steno Diabetes Center Copenhagen , Gentofte , Denmark
| | - S D Anker
- Berlin Institute of Health Center for Regenerative Therapies, Department of Cardiology (CVK) , Berlin , Germany
| | - G Filippatos
- National & Kapodistrian University of Athens, School of Medicine, Department of Cardiology, Attikon University Hospital , Athens , Greece
| | - L M Ruilope
- Institute of Research imas12, Cardiorenal Translational Laboratory and Hypertension Unit , Madrid , Spain
| | - C P Kovesdy
- University of Tennessee, Division of Nephrology, Department of Medicine , Memphis , United States of America
| | - K Tuttle
- Providence Medical Research Center, Providence Health Care , Seattle , United States of America
| | - M Vaduganathan
- Harvard Medical School, Cardiovascular Division, Brigham and Women's Hospital , Boston , United States of America
| | - C Wanner
- University Hospital of Wurzburg, Division of Nephrology , Wurzburg , Germany
| | - S Bansilal
- Bayer Corporation, US Medical Affairs , New Jersey , United States Minor Outlying Islands
| | - M Gebel
- Bayer AG, Research and Development, Integrated Analysis Statistics , Wuppertal , Germany
| | | | - R Lawatscheck
- Bayer AG, Medical Affairs & Pharmacovigilance, Pharmaceuticals , Berlin , Germany
| | - G Bakris
- University of Chicago Medicine, Department of Medicine , Chicago , United States of America
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Rossing P, Agarwal R, Anker S, Filippatos G, Pitt B, Ruilope L, Joseph A, Gebel M, Kolkhof P, Nowack C, Bakris G. POS-350 FINERENONE IN MILD TO SEVERE CHRONIC KIDNEY DISEASE AND TYPE 2 DIABETES: THE FIDELITY PRESPECIFIED POOLED ANALYSIS. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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5
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Delbeck M, Joseph A, Pitt B, Kolkhof P. Antifibrotic and anti-inflammatory effects of the selective nonsteroidal MR antagonist finerenone in preclinical pulmonary fibrosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients with idiopathic pulmonary fibrosis (IPF) are at increased risk of developing coronary artery disease (CAD) with a median survival of 3.5 years after diagnosis. Cardiac and pulmonary fibrosis share several common signaling pathways including TGF-β-related collagen synthesis. Pirfenidone and nintedanib were the first approved medical antifibrotic IPF therapies that inhibit TGF-β–related collagen synthesis or multiple receptor tyrosine kinases, respectively. However, the role of mineralocorticoid receptor blockade in IPF is less well understood.
Purpose
To test the hypothesis that the selective nonsteroidal MR antagonist finerenone has antifibrotic and anti-inflammatory activity in preclinical IPF.
Methods
Anti-fibrotic/anti-inflammatory efficacy was investigated in two different mouse models of pulmonary fibrosis. Lung fibrosis was induced by either intranasal application of bleomycin (1 mg/kg) or intratracheal application of silica particles (2.5 mg/mouse). Bleomycin-treated C57BL6 mice (8 weeks old male, n=10–15/group) were administered once daily orally from day 7 to 21 with vehicle (ethanol/solutol/water), finerenone (10 mg/kg) or nintedanib (60 mg/kg) in vehicle. Silica-treated C57BL6 mice (8 weeks old male, n=10–12/group) were administered once daily orally from day 7 to 30 with vehicle (ethanol/solutol/water), finerenone (1 or 10 mg/kg) or nintedanib (100 mg/kg) in vehicle, or with pirfenidone (800mg/kg/d) via chow. At day 21 and 30 respectively, histological examination of pulmonary fibrosis using immunohistochemistry (COL1A1 positive tissue area in %) and Ashcroft score as well as profibrotic and pro-inflammatory cytokine and COL1A1 protein level (ELISA) analysis in lung homogenate were performed.
Results
Bleomycin caused a significant increase in lung COL1A1 positive tissue area and Ashcroft Score and silica-induced lung pathology additionally showed elevated IL-1beta, IL-6, IL-10, IL-12p70, TNFalpha and COL1A1 protein levels in lung tissue. Therapeutic treatment with finerenone as well as nintedanib from day 7–21 significantly reduced the percentage of lung COL1A1 positive tissue and Ashcroft score in the bleomycin mice model without a significant difference between treatment groups. Furthermore, finerenone significantly reduced lung COL1A1 as well as IL-1beta, IL-6, IL-10, IL-12p70 and TNFalpha protein levels in lung homogenate after a therapeutic treatment from day 7–30 in the silica mice model, whereas nintedanib showed only a reduction in lung COL1A1 and IL-10 levels and treatment with pirfenidone was without significant effects. There was a significant difference in the reduction of lung IL-12p70 and TNFalpha protein levels between finerenone 10 mg/kg and nintedanib as well as pirfenidone treatment.
Conclusion
Nonsteroidal MR antagonism by finerenone showed anti-fibrotic/anti-inflammatory efficacy in two animal models of pulmonary fibrosis and may impact the progressive course of fibrotic diseases.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): BAYER AG
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Affiliation(s)
- M Delbeck
- BAYER AG, R&D, Cardiology Research, Wuppertal, Germany
| | - A Joseph
- BAYER AG, R&D, Clinical Development, Berlin, Germany
| | - B Pitt
- University of Michigan, Ann Arbor, United States of America
| | - P Kolkhof
- BAYER AG, R&D, Cardiology Research, Wuppertal, Germany
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Hui S, Sharma A, Docherty K, McMurray J, Pitt B, Dickstein K, Pfeffer M, Girerd N, Rossignol P, Ferreira J, Zannad F. Non-fatal cardiovascular events preceding sudden cardiac death in patients with an acute myocardial infarction complicated by heart failure: insights from the High-Risk-Myocardial-Infarction database. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Sudden cardiac death (SCD) is responsible for 20–40% of mortality following acute myocardial infarction (AMI). The risk of SCD is even higher among patients with AMI complicated by heart failure (HF) (either clinically apparent HF or left ventricular dysfunction). The temporal relationship between an AMI complicated by HF and subsequent SCD and the association of non-fatal cardiovascular (CV) events following AMI with SCD has yet to be described.
Purpose
Among patients with AMI complicated by HF, we evaluated the probability and temporal association of subsequent non-fatal cardiovascular (CV) events (HF hospitalization, recurrent MI, or stroke) and SCD.
Methods
The High-Risk Myocardial Infarction (HRMI) database contains 28,771 patients with signs of HF or reduced LV ejection fraction (<40%) after AMI. Among patients with an AMI complicated by HF, we used adjudicated cause of death from the HRMI Database to identify: 1) the temporal distribution of SCD among patients following an index AMI; 2) the probability of having SCD following a non-fatal CV event following the index AMI.
Results
Median follow-up was 1.9 years. Mean age was 65.0±11.5 years and 70% were male. The incidence of CV death was 7.9 per 100 patient-year [py] and for SCD was 3.1 per 100py (40% of CV deaths). SCD rates were highest in the early period (<90 days) after AMI and decreased over time. Recurrent MI preceded 9.6% of SCD after a median time of 145 days; HF hospitalization preceded 17.0% of SCD after a median 144 days; and stroke preceded 2.7% of SCD after a median of 138 days (vs. non-sudden CV death: MI 46.6% at 1 days, HF hospitalization: 30.9% at 67 days, stroke 12.9% at 9 days). The incidence of SCD preceded by HF hospitalization was significantly higher than SCD without preceding HF hospitalization.
Conclusion
Among patients with AMI complicated by HF, SCD predominantly occurred in the early “high-risk” period after AMI; SCD rates decreased afterwards. Patients with non-fatal HF hospitalizations during follow-up may have a higher subsequent SCD risk. Preventing HF onset after MI may help decreasing SCD.
Proportion of sudden cardiac death
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): Lucien Award, McGill University
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Affiliation(s)
- S Hui
- McGill University Health Centre, Division of Cardiology, Montreal, Canada
| | - A Sharma
- McGill University Health Centre, Division of Cardiology, Montreal, Canada
| | - K Docherty
- University of Glasgow, BHF Cardiovascular Research Centre, Glasgow, United Kingdom
| | - J.J.V McMurray
- University of Glasgow, BHF Cardiovascular Research Centre, Glasgow, United Kingdom
| | - B Pitt
- University of Michigan, Medicine, Ann Arbor, United States of America
| | - K Dickstein
- Stavanger University Hospital, Cardiology, Stavanger, Norway
| | - M.A Pfeffer
- Brigham and Women'S Hospital, Harvard Medical School, Division of Cardiovascular Medicine, Boston, United States of America
| | - N Girerd
- University Hospital of Brabois, Centre d'Investigation Clinique 1433 Plurithématique, Nancy, France
| | - P Rossignol
- University Hospital of Brabois, Centre d'Investigation Clinique 1433 Plurithématique, Nancy, France
| | - J.P Ferreira
- University Hospital of Brabois, Centre d'Investigation Clinique 1433 Plurithématique, Nancy, France
| | - F Zannad
- University Hospital of Brabois, Centre d'Investigation Clinique 1433 Plurithématique, Nancy, France
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De Marco C, Claggett B, De Denus S, Huynh T, Desai AS, Sirois MG, Jarolim P, Solomon SD, Pitt B, Rouleau JL, Pfeffer MA, O'meara E. P6350Impact of diabetes on serum biomarkers in heart failure with preserved ejection fraction: insights from the spironolactone for heart failure with preserved ejection fraction (TOPCAT) trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and purpose
Diabetes mellitus (DM) is common in heart failure with preserved ejection fraction (HFpEF). Patients with DM and HF with reduced ejection fraction have higher levels of prognostic biomarkers relative to non-diabetics. We sought to examine differences in biomarkers at baseline and over time in patients with HFpEF with and without DM (non-DM).
Methods
The Americas cohort of the TOPCAT trial included 248 subjects with baseline measurements of serum biomarkers and follow-up measures 12 months later. Subjects were identified as non-DM or DM at baseline. Baseline values were compared using non-parametric tests and 12-month changes were compared via linear regression after log-transformation and adjustment for baseline biomarker value, age, gender, randomization strata, and randomized treatment.
Results
At baseline, DM patients had significantly lower eGFR and higher hsCRP, PIIINP, TIMP1, and Gal-3 levels versus non-DM patients (Table). In addition, there was a significantly larger increase over time in levels of hs-TnT, a marker of myocyte death, in DM vs. non-DM patients (p=0.016).
Baseline and 12-Month Biomarkers Baseline % Change at 12 Months Non-DM (n=132) DM (n=116) p Non-DM (n=110) DM (n=94) p eGFR (mL/min/1.73m2) 67 [57, 77] 57 [46, 73] 0.003 −14% (−17, −10) −14% (−18, −10) 0.34 hsCRP (mg/L) 2.4 [1.1, 5.6] 3.1 [1.6, 7.5] 0.046 1% (−5, 3) −11% (−27, 7) 0.54 NT-proBNP (pg/mL) 624 [338, 1235] 629 [278, 1429] 0.80 −2% (−12, 10) −5% (−21, 13) 0.48 hs-TNT (ng/mL) 5.7 [3.1, 12.4] 7.1 [3.7, 14.2] 0.17 −1% (−14, 13) 11% (−3, 27) 0.016 Soluble ST2 (ng/mL) 28 [22, 32] 28 [21, 35] 0.36 −1% (−7, 5) −4% (−9, 2) 0.60 Aldosterone (ng/L) 149 [120, 202] 142 [113, 174] 0.09 17% (9, 26) 23% (14, 33) 0.76 PICP (ng/mL) 137 [101, 169] 127 [102, 155] 0.29 5% (−5, 17) 1% (−9, 12) 0.07 CITP (ng/mL) 1.6 [1.0, 2.8] 1.6 [0.9, 3.0] 0.93 −25% (−37, 10) −23% (−36, −8) 0.87 PIIINP (ng/mL) 23 [16, 30] 28 [21, 36] <0.001 5% (−4, 15) 5% (−3, 14) 0.12 TIMP-1 (ng/mL) 188 [170, 212] 212 [183, 245] <0.001 −1% (−4, 2) −2% (−5, 2) 0.59 Galectin-3 (ng/mL) 20 [16, 23] 22 [18, 28] <0.001 6% (3, 10) 9% (4, 14) 0.52 eGFR, estimated glomerular filtration rate; hsCRP, high-sensitivity CRP; NT-proBNP, N-terminal pro-B-type natriuretic peptide; hs-TnT, high-sensitivity troponin T; PICP, pro-collagen type I carboxy-terminal peptide; CITP, collage type I; PIIINP=pro-collagen type III amino-terminal peptide; TIMP-1=tissue inhibitor of MMP-1.
Conclusions
In comparison to patients without DM, those with DM had poorer renal function and higher baseline levels of markers of myocardial stretch, myocyte death, and pro-fibrotic biomarkers. Further, hs-TnT increased over 12 months only in patients with DM.
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Affiliation(s)
- C De Marco
- Montreal Heart Institute, Department of Medicine, Montreal, Canada
| | - B Claggett
- Brigham and Womens Hospital, Cardiovascular Division, Boston, United States of America
| | - S De Denus
- Montreal Heart Institute, Department of Pharmacy, Montreal, Canada
| | - T Huynh
- McGill University Health Centre, Division of Cardiology, Montreal, Canada
| | - A S Desai
- Brigham and Womens Hospital, Cardiovascular Division, Boston, United States of America
| | - M G Sirois
- Montreal Heart Institute, Department of Medicine, Montreal, Canada
| | - P Jarolim
- Brigham and Womens Hospital, Boston, United States of America
| | - S D Solomon
- Brigham and Womens Hospital, Cardiovascular Division, Boston, United States of America
| | - B Pitt
- University of Michigan, Department of Medicine, Ann Arbor, United States of America
| | - J L Rouleau
- Montreal Heart Institute, Department of Medicine, Montreal, Canada
| | - M A Pfeffer
- Brigham and Womens Hospital, Cardiovascular Division, Boston, United States of America
| | - E O'meara
- Montreal Heart Institute, Department of Medicine, Montreal, Canada
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Tyurina YY, Shrivastava I, Tyurin VA, Mao G, Dar HH, Watkins S, Epperly M, Bahar I, Shvedova AA, Pitt B, Wenzel SE, Mallampalli RK, Sadovsky Y, Gabrilovich D, Greenberger JS, Bayır H, Kagan VE. "Only a Life Lived for Others Is Worth Living": Redox Signaling by Oxygenated Phospholipids in Cell Fate Decisions. Antioxid Redox Signal 2018; 29:1333-1358. [PMID: 28835115 PMCID: PMC6157439 DOI: 10.1089/ars.2017.7124] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 08/10/2017] [Accepted: 08/18/2017] [Indexed: 12/19/2022]
Abstract
SIGNIFICANCE Oxygenated polyunsaturated lipids are known to play multi-functional roles as essential signals coordinating metabolism and physiology. Among them are well-studied eicosanoids and docosanoids that are generated via phospholipase A2 hydrolysis of membrane phospholipids and subsequent oxygenation of free polyunsaturated fatty acids (PUFA) by cyclooxygenases and lipoxygenases. Recent Advances: There is an emerging understanding that oxygenated PUFA-phospholipids also represent a rich signaling language with yet-to-be-deciphered details of the execution machinery-oxygenating enzymes, regulators, and receptors. Both free and esterified oxygenated PUFA signals are generated in cells, and their cross-talk and inter-conversion through the de-acylation/re-acylation reactions is not sufficiently explored. CRITICAL ISSUES Here, we review recent data related to oxygenated phospholipids as important damage signals that trigger programmed cell death pathways to eliminate irreparably injured cells and preserve the health of multicellular environments. We discuss the mechanisms underlying the trans-membrane redistribution and generation of oxygenated cardiolipins in mitochondria by cytochrome c as pro-apoptotic signals. We also consider the role of oxygenated phosphatidylethanolamines as proximate pro-ferroptotic signals. FUTURE DIRECTIONS We highlight the importance of sequential processes of phospholipid oxygenation and signaling in disease contexts as opportunities to use their regulatory mechanisms for the identification of new therapeutic targets.
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Affiliation(s)
- Yulia Y. Tyurina
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Indira Shrivastava
- Department of Computational and Systems Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Vladimir A. Tyurin
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Gaowei Mao
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Haider H. Dar
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Simon Watkins
- Department of Cell Biology and Physiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael Epperly
- Radiation Oncology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ivet Bahar
- Department of Computational and Systems Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anna A. Shvedova
- Exposure Assessment Branch/NIOSH/CDC, West Virginia University, Morgantown, West Virginia
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, West Virginia
| | - Bruce Pitt
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sally E. Wenzel
- Department of Medicine, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Asthma Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rama K. Mallampalli
- Department of Medicine, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Medicine, Acute Lung Injury Center of Excellence, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Yoel Sadovsky
- Magee Women's Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | - Hülya Bayır
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Valerian E. Kagan
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Chemistry, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
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Ferreira JP, Abreu P, McMurray JJV, Van Veldhuisen DJ, Swedberg K, Pocock S, Vincent J, Lins K, Pitt B, Zannad F. P910Beware of making dose comparisons for efficacy in post-hoc analyses of achieved dose in up-titrating studies: lessons from the EMPHASIS trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J P Ferreira
- Clinical Investigation Centre Pierre Drouin (CIC-P), Nancy, France
| | - P Abreu
- Cardiovascular Research Foundation, New York, United States of America
| | - J J V McMurray
- Cardiovascular Research Centre of Glasgow, Glasgow, United Kingdom
| | | | | | - S Pocock
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - J Vincent
- Cardiovascular Research Foundation, New York, United States of America
| | - K Lins
- Cardiovascular Research Foundation, New York, United States of America
| | - B Pitt
- University of Michigan, Ann Arbor, United States of America
| | - F Zannad
- Clinical Investigation Centre Pierre Drouin (CIC-P), Nancy, France
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Beldhuis IE, Myhre PL, Claggett B, Damman K, Fang JC, Lewis EF, O'Meara E, Pitt B, Shah SJ, Voors AA, Pfeffer MA, Solomon SD, Desai AS. P6508Balance of risk and benefit of spironolactone according to renal function in heart failure patients with preserved ejection fraction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- I E Beldhuis
- Brigham and Women's Hospital, Cardiovascular Division, Boston, United States of America
| | - P L Myhre
- Brigham and Women's Hospital, Cardiovascular Division, Boston, United States of America
| | - B Claggett
- Brigham and Women's Hospital, Cardiovascular Division, Boston, United States of America
| | - K Damman
- University Medical Center Groningen, Department of Cardiology, Groningen, Netherlands
| | - J C Fang
- University of Utah School of Medicine, Salt Lake City, United States of America
| | - E F Lewis
- Brigham and Women's Hospital, Cardiovascular Division, Boston, United States of America
| | - E O'Meara
- Montreal Heart Institute, Montreal, Canada
| | - B Pitt
- University of Michigan School of Medicine, Ann Arbor, United States of America
| | - S J Shah
- Northwestern University Medical Center, Division of Cardiology, Chicago, United States of America
| | - A A Voors
- University Medical Center Groningen, Department of Cardiology, Groningen, Netherlands
| | - M A Pfeffer
- Brigham and Women's Hospital, Cardiovascular Division, Boston, United States of America
| | - S D Solomon
- Brigham and Women's Hospital, Cardiovascular Division, Boston, United States of America
| | - A S Desai
- Brigham and Women's Hospital, Cardiovascular Division, Boston, United States of America
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11
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Rossello X, Ariti C, Pocock SJ, McMurray JJV, Van Veldhuisen DJ, Swedberg K, Pitt B, Zannad F. 203Impact of mineralocorticoid receptor antagonists on sudden cardiac death in patients with heart failure and left ventricular systolic dysfunction: a meta-analysis of three randomized controlled trials. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- X Rossello
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - C Ariti
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - S J Pocock
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - K Swedberg
- University of Gothenburg, Gothenburg, Sweden
| | - B Pitt
- University of Michigan, Michigan, United States of America
| | - F Zannad
- University of Lorraine, Nancy, France
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12
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Hayes-Larson E, Hirsch-Moverman Y, Saito S, Frederix K, Pitt B, Maama-Maime L, Howard AA. Depressive symptoms and hazardous/harmful alcohol use are prevalent and correlate with stigma among TB-HIV patients in Lesotho. Int J Tuberc Lung Dis 2018; 21:34-41. [PMID: 29025483 DOI: 10.5588/ijtld.17.0062] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Limited data exist on the prevalence and correlates, including stigma, of mental health conditions, including depressive symptoms and alcohol use, among patients co-infected with tuberculosis (TB) and the human immunodeficiency virus (HIV) in sub-Saharan Africa, despite their negative impact on health outcomes. OBJECTIVE To assess the prevalence and correlates of depressive symptoms and hazardous/harmful alcohol use among TB-HIV patients in the Start TB patients on ART and Retain on Treatment (START) study. DESIGN START, a mixed-methods cluster-randomized trial, evaluated a combination intervention package vs. standard of care (SOC) to improve treatment outcomes in TB-HIV co-infected patients in Lesotho. Moderate/severe depressive symptoms and hazardous/harmful alcohol use were measured using baseline questionnaire data collected from April 2013 to March 2015. Demographic, psychosocial, and TB- and HIV-related knowledge and attitudes, including stigma, were assessed for association with both conditions using generalized linear mixed models. RESULTS Among 371 participants, 29.8% reported moderate/severe depressive symptoms, and 24.7% reported hazardous/harmful alcohol use; 7% reported both. Depressive symptoms were significantly associated with less education, more difficulty understanding written medical information, non-disclosure of TB, greater TB stigma, and the SOC study arm. Hazardous/harmful alcohol use was significantly associated with male sex, as well as greater TB and external HIV stigma. CONCLUSION Prevalence of depressive symptoms and hazardous/harmful alcohol use were high, suggesting a need for routine screening for, and treatment of, mental health disorders in TB-HIV patients.
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Affiliation(s)
- E Hayes-Larson
- ICAP, Mailman School of Public Health, Columbia University, New York, New York, USA; Department of Epidemiology Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Y Hirsch-Moverman
- ICAP, Mailman School of Public Health, Columbia University, New York, New York, USA; Department of Epidemiology Mailman School of Public Health, Columbia University, New York, New York, USA
| | - S Saito
- ICAP, Mailman School of Public Health, Columbia University, New York, New York, USA; Department of Epidemiology Mailman School of Public Health, Columbia University, New York, New York, USA
| | - K Frederix
- ICAP, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - B Pitt
- ICAP, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - L Maama-Maime
- National Tuberculosis Control Programme, Lesotho Ministry of Health, Maseru Lesotho
| | - A A Howard
- ICAP, Mailman School of Public Health, Columbia University, New York, New York, USA; Department of Epidemiology Mailman School of Public Health, Columbia University, New York, New York, USA
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13
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O'Connor DE, Frederix K, Saito S, Maama LB, Hirsch-Moverman Y, Pitt B, Hayes-Larson E, Lebelo L, Shale M, Howard AA. Pulmonary tuberculosis diagnostic practices among people living with the human immunodeficiency virus in Lesotho. Int J Tuberc Lung Dis 2018; 21:1133-1138. [PMID: 28911357 DOI: 10.5588/ijtld.17.0297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Twelve health facilities in Berea District, Lesotho, that participated in the Start TB Patients on ART and Retain on Treatment (START) Study, a mixed-methods cluster-randomized trial evaluating a combination intervention package to improve early initiation of antiretroviral therapy (ART) and anti-tuberculosis treatment success among patients with tuberculosis (TB) and human immunodeficiency virus (HIV). OBJECTIVE To assess TB and HIV diagnostic practices among TB-HIV patients. DESIGN A standardized survey assessed services at each facility at baseline. Routine clinical data were abstracted for all newly registered adult TB-HIV patients during the study period. Descriptive statistics were used to assess TB diagnostic practices, timing of the HIV diagnosis, and ART status at TB treatment initiation. RESULTS Between April 2013 and March 2015, 1233 TB-HIV patients were enrolled. Among 1215 patients with available data, 87.2% had pulmonary TB, of which 34.8% were bacteriologically confirmed, 40.9% tested negative and 24.3% were not tested. Among 1138 patients with available data, 53.3% had an existing HIV diagnosis, of whom 39.3% were ART-naïve. CONCLUSIONS The majority of pulmonary TB patients were clinically diagnosed, and many were unaware of their HIV status or were ART-naïve despite known status. The Test and Treat Strategy holds promise to prevent TB and reduce TB-related mortality among people living with HIV; however, enhanced TB diagnostic capacity and improved HIV case detection are urgently needed.
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Affiliation(s)
- D E O'Connor
- ICAP at Columbia University, Mailman School of Public Health, New York, New York, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - K Frederix
- ICAP at Columbia University, Maseru, Lesotho
| | - S Saito
- ICAP at Columbia University, Mailman School of Public Health, New York, New York, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - L B Maama
- National Tuberculosis Program, Lesotho Ministry of Health, Maseru, Lesotho
| | - Y Hirsch-Moverman
- ICAP at Columbia University, Mailman School of Public Health, New York, New York, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - B Pitt
- ICAP at Columbia University, Maseru, Lesotho
| | - E Hayes-Larson
- ICAP at Columbia University, Mailman School of Public Health, New York, New York, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - L Lebelo
- ICAP at Columbia University, Maseru, Lesotho
| | - M Shale
- ICAP at Columbia University, Maseru, Lesotho
| | - A A Howard
- ICAP at Columbia University, Mailman School of Public Health, New York, New York, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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14
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Affiliation(s)
- B Pitt
- Academic Unit, Psychiatry of Old Age, St Charles' Hospital, London
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15
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Abstract
OBJECTIVE We present an ultra-sensitive, minimally-invasive method for quantifying cotinine in dried blood spot (DBS) samples as a biomarker of exposure to tobacco smoke that can be collected using a simple heel or finger prick to obtain blood samples. METHODS Cotinine levels were measured in matched plasma and reconstituted DBS samples from smokers and nonsmokers to evaluate assay parameters. In addition, we applied this new method to finger-prick DBS samples that were collected from infants, children and young adults ages 1-21 to estimate exposure to tobacco smoke. Partitioning of cotinine across red blood cells and haematocrit effects were investigated. RESULTS Cotinine levels measured in matched plasma and reconstituted DBS samples from smokers and nonsmokers were found to be highly correlated (R2=0.94), with 100% sensitivity and 94% specificity to differentiate reported smokers from nonsmokers. With this method, the LOQ is <0.25 ng/mL using a single 3.2 mm punch of a DBS, and haematocrit effects are negligible. CONCLUSIONS This sensitive, high-throughput and minimally-invasive method for quantifying cotinine in DBS samples provides a simple and cost effective means for estimating exposure to tobacco smoke in population based studies, and has particular advantages in studies involving infants and children.
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Affiliation(s)
- Daniel Ladror
- a Department of Preventive Medicine, Feinberg School of Medicine , Northwestern University , Chicago , IL , USA
| | - Bruce Pitt
- b Department of Environmental and Occupational Health, Graduate School of Public Health , University of Pittsburgh , Pittsburgh , PA , USA
| | - William Funk
- a Department of Preventive Medicine, Feinberg School of Medicine , Northwestern University , Chicago , IL , USA
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16
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Biering-Sorensen T, Shah S, Anand I, Sweitzer N, Claggett B, Pitt B, Pfeffer M, Solomon S, Shah A. P6178Prognostic importance of pulmonary pressure in heart failure with preserved ejection fraction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Pitt B, Rossignol P. Impact of Hyperkalemia and Worsening Renal Function on the Use of Renin Angiotensin Aldosterone System Inhibitors in Chronic Heart Failure With Reduced Ejection Fraction. Clin Pharmacol Ther 2017; 102:389-391. [DOI: 10.1002/cpt.746] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/09/2017] [Accepted: 05/15/2017] [Indexed: 11/11/2022]
Affiliation(s)
- B Pitt
- University of Michigan School of Medicine; Ann Arbor Michigan USA
| | - P Rossignol
- Inserm, Centre d'Investigations Cliniques-Plurithématique 14-33, Inserm U1116, CHRU, Nancy; Université de Lorraine, and F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists); Nancy France
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18
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Olivier A, Girerd N, Michel JB, Ketelslegers JM, Fay R, Vincent J, Bramlage P, Pitt B, Zannad F, Rossignol P. Combined baseline and one-month changes in big endothelin-1 and brain natriuretic peptide plasma concentrations predict clinical outcomes in patients with left ventricular dysfunction after acute myocardial infarction: Insights from the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) study. Int J Cardiol 2017; 241:344-350. [PMID: 28284500 DOI: 10.1016/j.ijcard.2017.02.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 01/14/2017] [Accepted: 02/03/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Increased levels of neuro-hormonal biomarkers predict poor prognosis in patients with acute myocardial infarction (AMI) complicated by left ventricular systolic dysfunction (LVSD). The predictive value of repeated (one-month interval) brain natriuretic peptides (BNP) and big-endothelin 1 (BigET-1) measurements were investigated in patients with LVSD after AMI. METHODS In a sub-study of the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS trial), BNP and BigET-1 were measured at baseline and at 1month in 476 patients. RESULTS When included in the same Cox regression model, baseline BNP (p=0.0003) and BigET-1 (p=0.026) as well as the relative changes (after 1month) from baseline in BNP (p=0.049) and BigET-1 (p=0.045) were predictive of the composite of cardiovascular death or hospitalization for worsening heart failure. Adding baseline and changes in BigET-1 to baseline and changes in BNP led to a significant increase in prognostic reclassification as assessed by integrated discrimination improvement index (5.0%, p=0.01 for the primary endpoint). CONCLUSIONS Both increased baseline and changes after one month in BigET-1 concentrations were shown to be associated with adverse clinical outcomes, independently from BNP baseline levels and one month changes, in patients after recent AMI complicated with LVSD. This novel result may be of clinical interest since such combined biomarker assessment could improve risk stratification and open new avenues for biomarker-guided targeted therapies. KEY MESSAGES In the present study, we report for the first time in a population of patients with reduced LVEF after AMI and signs or symptoms of congestive HF, that increased baseline values of BNP and BigET-1 as well as a further rise of these markers over the first month after AMI, were independently predictive of future cardiovascular events. This approach may therefore be of clinical interest with the potential of improving risk stratification after AMI with reduced LVEF while further opening new avenues for biomarker-guided targeted therapies.
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Affiliation(s)
- A Olivier
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France; Department of Cardiovascular Disease, Institut Lorrain du Coeur et des Vaisseaux, Nancy University Hospital, Nancy, France.
| | - N Girerd
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France
| | - J B Michel
- Inserm, UMRS 1148 University Paris Diderot, Paris, France
| | | | - R Fay
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France
| | | | - P Bramlage
- Institute for Cardiovascular Pharmacology and Epidemiology, Mahlow, Germany
| | - B Pitt
- University of Michigan, School of Medicine, Ann Arbor, MI, USA
| | - F Zannad
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France; Department of Cardiovascular Disease, Institut Lorrain du Coeur et des Vaisseaux, Nancy University Hospital, Nancy, France
| | - P Rossignol
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France
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Colunga Blanco S, Gonzalez Matos C, Angelis A, Dinis PG, Chinali M, Toth A, Andreassi MG, Rodriguez Munoz D, Reid AB, Park JH, Shetye A, Novo G, De Marchi SF, Cikes M, Smarz K, Illatopa V, Peluso D, Wellnhofer E, De La Rosa Riestra A, Sattarzadeh Badkoubeh R, Mandour Ali M, Azoz A, Pontone G, Krljanac G, Acar R, Nucifora G, Sirtautas A, Roos ST, Qasem MS, Marini C, Fabiani I, Gillis K, Bandera F, Borowiec A, Lim YJ, Chalbia TE, Santos M, Gao SA, Zilberszac R, Farrag AAM, Palmiero G, Aruta P, De Diego Soler O, Fasano D, Tamborini G, Ancona F, Raafat DM, Marchel M, De Gregorio C, Gommans DHF, Godinho AR, Mielczarek M, Bandera F, Kubik M, Cho JY, Tarando F, Lourenco Marmelo BF, Reis L, Domingues K, Krestjyaninov MV, Mesquita J, Ikonomidis I, Ferferieva V, Peluso D, Peluso D, King GJ, D'ascenzi F, Ferrera Duran C, Sormani P, Gonzalez Fernandez O, Tereshina O, Cambronero Cortinas E, Kupczynska K, Carvalho JF, Shivalkar B, Aghamohammadzadeh R, Cifra B, Cifra B, Bandera F, Kuznetsov VA, Van Zalen JJ, Kochanowski J, Goebel B, Ladeiras-Lopes R, Goebel B, Karvandi M, Karvandi M, Alonso Salinas G, Unkun T, Ranjbar S, Hubert A, Enescu OA, Liccardo M, Cameli M, Ako E, Lembo M, Goffredo C, Enache R, Novo G, Wdowiak-Okrojek K, Nemes A, Nemes A, Di Salvo G, Capotosto L, Caravaca P, Maceira Gonzalez AM, Iriart X, Jug B, Garcia Campos A, Capin Sampedro E, Corros Vicente C, Martin Fernandez M, Leon Arguero V, Fidalgo Arguelles A, Velasco Alonso E, Lopez Iglesias F, De La Hera Galarza JM, Chaparro-Munoz M, Recio-Mayoral A, Vlachopoulos C, Ioakeimidis N, Felekos I, Abdelrasoul M, Aznaouridis K, Chrysohoou C, Rousakis G, Aggeli K, Tousoulis D, Faustino AC, Paiva L, Fernandes A, Costa M, Cachulo MC, Goncalves L, Emma F, Rinelli G, Esposito C, Franceschini A, Doyon A, Raimondi F, Schaefer F, Pongiglione G, Mateucci MC, Vago H, Juhasz C, Janosa C, Oprea V, Balint OH, Temesvari A, Simor T, Kadar K, Merkely B, Bruno RM, Borghini A, Stea F, Gargani L, Mercuri A, Sicari R, Picano E, Lozano Granero C, Carbonell San Roman A, Moya Mur JL, Fernandez-Golfin C, Moreno Planas J, Fernandez Santos S, Casas Rojo E, Hernandez-Madrid A, Zamorano Gomez JL, Pearce K, Gamlin W, Miller C, Schmitt M, Seong IW, Kim KH, Kim MJ, Jung HO, Sohn IS, Park SM, Cho GY, Choi JO, Park SW, Nazir SA, Khan JN, Singh A, Kanagala P, Squire I, Mccann GP, Di Lisi D, Meschisi MC, Brunco V, Badalamenti G, Bronte E, Russo A, Novo S, Von Tscharner M, Urheim S, Aakhus S, Seiler C, Schmalholz S, Biering-Sorensen T, Cheng S, Oparil S, Izzo J, Pitt B, Solomon SD, Zaborska B, Jaxa-Chamiec T, Tysarowski M, Budaj A, Cordova F, Aguirre O, Sanabria S, Ortega J, Romeo G, Perazzolo Marra M, Tona F, Famoso G, Pigatto E, Cozzi F, Iliceto S, Badano LP, Kriatselis C, Gerds-Li JH, Kropf M, Pieske B, Graefe M, Martinez Santos P, Batlle Lopez E, Vilacosta I, Sanchez Sauce B, Espana Barrio E, Jimenez Valtierra J, Campuzano Ruiz R, Alonso Bello J, Martin Rios MD, Farrashi M, Abtahi H, Sadeghi H, Sadeghipour P, Tavoosi A, Abdel Rahman TA, Mohamed LA, Maghraby HM, Kora IM, Abdel Hameed FR, Ali MN, Al Shehri A, Youssef A, Gad A, Alsharqi M, Alsaikhan L, Andreini D, Rota C, Guglielmo M, Mushtaq S, Baggiano A, Beltrama V, Solbiati A, Guaricci AI, Pepi M, Trifunovic D, Sobic Saranovic D, Savic L, Grozdic Milojevic I, Asanin M, Srdic M, Petrovic M, Zlaic N, Mrdovic I, Dogan C, Izci S, Gecmen C, Unkun T, Cap M, Erdogan E, Onal C, Yilmaz F, Ozdemir N, Muser D, Tioni C, Zanuttini D, Morocutti G, Spedicato L, Bernardi G, Proclemer A, Pranevicius R, Zapustas N, Briedis K, Valuckiene Z, Jurkevicius R, Juffermans LJM, Enait V, Van Royen N, Van Rossum AC, Kamp O, Khalaf HASSEN, Hitham SAKER, Osama AS, Abazid RAMI, Guall RAHIM, Durdan SHAFAT, Mohammed ZYAD, Stella S, Rosa I, Ancona F, Spartera M, Italia L, Latib A, Colombo A, Margonato A, Agricola E, Scatena C, Mazzanti C, Conte L, Pugliese N, Barletta V, Bortolotti U, Naccarato AG, Di Bello V, Bala G, Roosens B, Hernot S, Remory I, Droogmans S, Cosyns B, Generati G, Labate V, Donghi V, Pellegrino M, Carbone F, Alfonzetti E, Guazzi M, Dabrowski R, Kowalik I, Firek B, Chwyczko T, Szwed H, Kawamura A, Kawano S, Zaroui A, Ben Said R, Ben Halima M, Kheder N, Farhati A, Mourali S, Mechmech R, Leite L, Martins R, Baptista R, Barbosa A, Ribeiro N, Oliveira A, Castro G, Pego M, Polte CL, Lagerstrand K, Johnsson ÅA, Janulewicz M, Bech-Hanssen O, Gabriel H, Wisser W, Maurer G, Rosenhek R, El Aroussy W, Abdel Ghany M, Al Adeeb K, Ascione L, Carlomagno G, Sordelli C, Ferro A, Ascione R, Severino S, Caso P, Muraru D, Janei C, Haertel Miglioranza M, Cavalli G, Romeo G, Peluso D, Cucchini U, Iliceto S, Badano L, Armario Bel X, Garcia-Garcia C, Ferrer Sistach E, Rueda Sobella F, Oliveras Vila T, Labata Salvador C, Serra Flores J, Lopez-Ayerbe J, Bayes-Genis A, Conte E, Gonella A, Morena L, Civelli D, Losardo L, Margaria F, Riva L, Tanga M, Carminati C, Muratori M, Gripari P, Ghulam Ali S, Fusini L, Vignati C, Bartorelli AL, Alamanni F, Pepi M, Rosa I, Stella S, Marini C, Spartera M, Latib A, Montorfano M, Colombo A, Margonato A, Agricola E, Ismaiel A, Ali N, Amry S, Serafin A, Kochanowski J, Filipiak KJ, Opolski G, Speranza G, Ando' G, Magaudda L, Cramer GE, Bakker J, Michels M, Dieker HJ, Fouraux MA, Marcelis CLM, Timmermans J, Brouwer MA, Kofflard MJM, Vasconcelos M, Araujo V, Almeida P, Sousa C, Macedo F, Cardoso JS, Maciel MJ, Voilliot D, Huttin O, Venner C, Olivier A, Villemin T, Deballon R, Manenti V, Juilliere Y, Selton-Suty C, Generati G, Pellegrino M, Labate V, Carbone F, Alfonzetti E, Guazzi M, Dabrowska-Kugacka A, Dorniak K, Lewicka E, Szalewska D, Kutniewska-Kubik M, Raczak G, Kim KH, Yoon HJ, Park HJ, Ahn Y, Jeong MH, Cho JG, Park JC, Kim JH, Galli E, Habib G, Schnell F, Lederlin M, Daubert JC, Mabo P, Donal E, Faria R, Magalhaes P, Marques N, Domingues K, Lourenco C, Almeida AR, Teles L, Picarra B, Azevedo O, Lourenco C, Oliveira M, Magalhaes P, Domingues K, Marmelo B, Almeida A, Picarra B, Faria R, Marques N, Bento D, Lourenco C, Magalhaes P, Cruz I, Marmelo B, Reis L, Picarra B, Faria R, Azevedo O, Gimaev RH, Melnikova MA, Olezov NV, Ruzov VI, Goncalves P, Almeida MS, Branco P, Carvalho MS, Dores H, Gaspar MA, Sousa H, Andrade MJ, Mendes M, Makavos G, Varoudi M, Papadavid E, Andreadou I, Gravanis K, Liarakos N, Pavlidis G, Rigopoulos D, Lekakis J, Deluyker D, Bito V, Pigatto E, Romeo G, Muraru D, Cozzi F, Punzi L, Iliceto S, Badano LP, Pigatto E, Romeo G, Muraru D, Cozzi F, Iliceto S, Badano LP, Neilan T, Coen K, Gannon S, Bennet K, Clarke JG, Solari M, Cameli M, Focardi M, Corrado D, Bonifazi M, Henein M, Mondillo S, Gomez-Escalonilla C, De Agustin A, Egido J, Islas F, Simal P, Gomez De Diego JJ, Luaces M, Macaya C, Perez De Isla L, Zancanella M, Rusconi C, Musca F, Santambrogio G, De Chiara B, Vallerio P, Cairoli R, Giannattasio G, Moreo A, Alvarez Ortega C, Mori Junco R, Caro Codon J, Meras Colunga P, Ponz De Antonio I, Lopez Fernandez T, Valbuena Lopez S, Moreno Yanguela M, Lopez-Sendon JL, Surkova E, Bonanad-Lozano C, Lopez-Lereu MP, Monmeneu-Menadas JV, Gavara J, De Dios E, Paya-Chaume A, Escribano-Alarcon D, Chorro-Gasco FJ, Bodi-Peris V, Michalski BW, Miskowiec D, Kasprzak JD, Lipiec P, Morgado G, Caldeira D, Cruz I, Joao I, Almeida AR, Lopes L, Fazendas P, Cotrim C, Pereira H, De Block C, Buys D, Salgado R, Vrints C, Van Gaal L, Mctear C, Irwin RB, Dragulescu A, Friedberg M, Mertens L, Dragulescu A, Friedberg M, Mertens L, Carbone F, Generati G, Pellegrino M, Labate V, Alfonzetti E, Guazzi M, Krinochkin DV, Yaroslavskaya EI, Zaharova EH, Pushkarev GS, Sugihara C, Patel NR, Sulke AN, Lloyd GW, Piatkowski R, Scislo P, Grabowski M, Marchel M, Opolski G, Roland H, Hamadanchi A, Otto S, Jung C, Lauten A, Figulla HC, Poerner TC, Sampaio F, Fonseca P, Fontes-Carvalho R, Pinho M, Campos AS, Castro P, Fonseca C, Ribeiro J, Gama V, Heck R, Hamdanchi A, Otto S, Jung C, Lauten A, Figulla HR, Poerner TC, Ranjbar S, Ghaffaripour Jahromi M, Ranjbar S, Hinojar R, Fernandez Golfin C, Esteban A, Pascual-Izco M, Garcia-Martin A, Casas Rojo E, Jimenez-Nacher JJ, Zamorano JL, Gecmen C, Cap M, Izci S, Erdogan E, Onal C, Acar R, Bakal RB, Kaymaz C, Ozdemir N, Karvandi M, Ghaffaripour Jahromi M, Galand V, Schnell F, Matelot D, Martins R, Leclercq C, Carre F, Suran BC, Margulescu AD, Rimbas RC, Siliste C, Vinereanu D, Nocerino P, Urso AC, Borrino A, Carbone C, Follero P, Ciardiello C, Prato L, Salzano G, Marino F, Ruspetti A, Sparla S, Di Tommaso C, Loiacono F, Focardi M, D'ascenzi F, Henein M, Mondillo S, Porter J, Walker M, Lo Iudice F, Esposito R, Santoro C, Cocozza S, Izzo R, De Luca N, De Simone G, Trimarco B, Galderisi M, Gervasi F, Patti G, Mega S, Bono M, Di Sciascio G, Buture A, Badea R, Platon P, Ghiorghiu I, Jurcut R, Coman IM, Popescu BA, Ginghina C, Lunetta M, Spoto MS, Lo Vi AM, Pensabene G, Meschisi MC, Carita P, Coppola G, Novo S, Assennato P, Shim A, Wejner-Mik P, Kasprzak JD, Lipiec P, Havasi K, Domsik P, Kalapos A, Forster T, Piros GA, Domsik P, Kalapos A, Lengyel C, Orosz A, Forster T, Bulbul Z, Issa Z, Al Sehly A, Pergola V, Oufi S, Conde Y, Cimino E, Rinaldi E, Ashurov R, Ricci S, Pergolini M, Vitarelli A, Lujan Valencia JE, Chaparro M, Garcia-Guerrero A, Cristo Ropero MJ, Izquierdo Bajo A, Madrona L, Recio-Mayoral A, Monmeneu JV, Igual B, Lopez Lereu P, Garcia MP, Selmi W, Jalal Z, Thambo JB, Kosuta D, Fras Z. Poster session 5The imaging examinationP1097Correlation between visual and quantitative assessment of left ventricle: intra- and inter-observer agreementP1099Incremental prognostic value of late gadolinium-enhanced by cardiac magnetic resonance in patients with heart failureAnatomy and physiology of the heart and great vesselsP1100Left ventricular geometry and diastolic performance in erectile dysfunction patients; a topic of differential arterial stiffness influenceAssessment of diameters, volumes and massP1101Impact of the percutaneous closure of atrial septal defect on the right heart "remodeling"P1102Left Ventricular Mass Indexation in Infants, Children and Adolescents: a Simplified Approach for the Identification of Left Ventricular Hypertrophy in Clinical PracticeP1103Impact of trabecules while quantifying cardiac magnetic resonance exams in patients with systemic right ventricleP1104Detection of subclinical atherosclerosis by carotid intima-media thickness: correlation with leukocytes telomere shorteningAssessments of haemodynamicsP1105Flow redirection towards the left ventricular outflow tract: vortex formation is not affected by variations in atrio-ventricular delayAssessment of systolic functionP1106Reproducibility and feasibility of cardiac MRI feature tracking in Fabry diseaseP1107Normal left ventricular strain values by two-dimensional strain echocardiography; result of normal (normal echocardiographic dimensions and functions in korean people) studyP1108Test-retest repeatability of global strain following st-elevation myocardial infarction - a comparison of tagging and feature trackingP1109Cardiotoxicity induced by tyrosine kinase inhibitors in patients with gastrointestinal stromal tumors (GIST)P1110Finite strain ellipses for the analysis of left ventricular principal strain directions using 3d speckle tracking echocardiographyP1111Antihypertensive therapy reduces time to peak longitudinal strainP1112Right ventricular systolic function as a marker of prognosis after inferior myocardial infarction - 5-year follow-upP1113Is artery pulmonary dilatation related with right but also early left ventricle dysfunction in pulmonary artery hypertension?P1114Right ventricular mechanics changes according to pressure overload increasing, a 2D-speckle tracking echocardiographic evaluationAssessment of diastolic functionP1115Paired comparison of left atrial strain from P-wave to P-wave and R-wave to R-waveP1116Diagnostic role of Tissue Doppler Imaging echocardiographic criteria in obese heart failure with preserved ejection fraction patientsP1117Evaluation of diastolic function of right ventricle in idiopathic pulmonary arterial hypertensionP1118Severity and predictors of diastolic dysfunction in a non-hypertensive non-ischemic cohort of Egyptian patients with documented systemic autoimmune disease; pilot reportP1119correlation between ST segment shift and cardiac diastolic function in patients with acute myocardial infarctionIschemic heart diseaseP1120Computed tomography coronary angiography verSus sTRess cArdiac magneTic rEsonance for the manaGement of sYmptomatic revascularized patients: a cost effectiveness study (STRATEGY study)P1121Utility of transmural myocardial mechanic for early infarct size prediction after primary percutaneous coronary intervention in STEMI patientsP1122Progressive Improvements of the echocardiographic deformation parameters in ST Elevation Myocardial Infarction after five years follow-upP1123Long-term prognostic value of left ventricular dyssynchrony as assessed by cardiac magnetic resonance feature-tracking imaging after a first st-segment elevation myocardial infarctionP1124Differences in mitral annulus remodeling in acute anterior ST elevation and acute inferior ST elevation myocardial infarctionP1125Reduction of microvascular injury using a novel theragnostic ultrasound strategy: a first in men feasibility and safety studyP1126Impact of focused echocardiography in clinical decision of patient presented with st elevation myocardial infarction underwent primary angioplastyHeart valve DiseasesP1127Aortic valve area calculation in aortic stenosis: a comparison among conventional and 3D-transesophageal echocardiography and computed tomographyP1128Myocardial fibrosis and microRNA-21 expression in patients with severe aortic valve stenosis and preserved ejection fraction: a 2D speckle tracking echocardiography, tissutal and plasmatic studyP1129Quantification of calcium amount in a new experimental model: a comparison between calibrated integrated backscatter of ultrasound and computed tomographyP1130Altered diffusion capacity in aortic stenosis: role of the right heartP1131Osteoprotegerin predicts all-cause mortality in calcific aortic stenosis patients with preserved left ventricle ejection fraction in long term observationP1132Mitral regurgitation as a risk factor for pulmonary hypertension in patients with aortic stenosisP1133The relationship between the level of plasma B-type natriuretic peptide and mitral stenosisP1134Aortic regurgitation, left ventricle mechanics and vascular load: a single centre 2d derived-speckle tracking studyP1135Feasibility and reproducibility issues limit the usefulness of quantitative colour Doppler parameters in the assessment of chronic aortic and mitral regurgitation severityP1136Predictors of postoperative outcome in degenerative mitral regurgitationP1137Left ventricular mechanical dyssynchrony in patients with severe mitral regurgitation of rheumatic etiology; three dimensional echocardiography studyP1138Functional mitral regurgitation and left atrial dysfunction concur in determining pulmonary hypertension and functional status in subjects with left ventricular systolic dysfunctionP11393D echocardiography allows more effective quantitative assessment of the severity of functional tricuspid regurgitation than conventional 2D/Doppler echocardiographyP1140Prosthetic valve thrombosis: still a severe disease? 10-years experience in a university hospitalP1141Validity of echocardiography in the hospital course of patients with feverP1142Do baseline 3DTEE characteristics of mitral valve apparatus predict long term result in patients undergoing percutaneous valve repair for degenerative regurgitation?P1143Influence of baseline aortic regurgitation on mitral regurgitation change after transcatheter aortic valve replacement for aortic stenosisP1144Prevalence of echocardiography detected significant valvular regurge in subclinical rheumatic carditis in assiut childrenCardiomyopathiesP1145Can we early detect left ventricular systolic dysfunction in patients with Duchenne muscular dystrophy using global longitudinal strain assessment?P1146Prevalence of isolated papillary muscle hypertrophy in young competitive athletesP1147Troponin release after exercise in patients with hypertrophic cardiomyopathy: associations with clinical and mr imaging characteristicsP1148Atrial fibrillation in hypertrophic cardiomyopathy: can we score the risk?P1149Impact of hypertrophy on multiple layer longitudinal deformation in hypertrophy cardiomyopathy and cardiac amyloidosis compared to controlsP1150Functional evaluation in hypertrophic cardiomyopathy combining cardiopulmonary exercise testing combined with exercise-echocardiographyP1151Refinement of the old diagnostic criteria of left ventricular noncompaction cardiomyopathy (LVNC) based on cardiac magnetic resonance (CMR)P1152Differences of clinical characteristics and outcomes between acute myocarditis with preserved and reduced left ventricular systolic functionP1153Value of longitudinal strain for distinguishing left ventricular non-compaction from idiopathic dilated cardiomyopathyP1154Speed of recovery of left ventricular function is not related to the prognosis of Takotsubo cardiomyopathy. A Portuguese multicentre studyP1155Predictors of in-hospital left ventricular systolic function recovery after admission with takotsubo cardiomyopathy. Portuguese multicentre studyP1156Mid-ventricular takotsubo detected by initial echocardiogram associates with recurrence of takotsubo cardiomyopathy - a portuguese multicentre studySystemic diseases and other conditionsP1157Relations between left ventricle remodelling and expression of angiotensin 2 AT2R1 geneP1158Impact of renal denervation on long-term blood pressure variability and surrogate markers of target organ damage in individuals with drug-resistant arterial hypertensionP1159Greater improvement of coronary artery function, left ventricular deformation and twisting by IL12/23 compared to TNF-a inhibition in psoriasisP1160Advanced glycation end products play a role in adverse LV remodeling following MIP1161Incidence of subclinical myocardial dysfunction in patients with systemic sclerosis and normal left ventricular systolic and diastolic functionP1162Left atrial remodeling and dysfunction occur early in patients with systemic sclerosis and normal left ventricular functionP1163Intrinsic vortex formation : a unique performance indicatorP1164P-wave morphology is unaffected by training-induced biatrial dilatation: a prospective, longitudinal study in healthy athletesP1165Usefulness of transthoracic echocardiography in diagnosis of young patients with ischemic strokeP1166Primary cardiac lymphoma: role of echocardiography in the clinical managementP1167Abnormal echocardiographic findings in cancer patients before chemotherapyMasses, tumors and sources of embolismP1168Three-dimensional transesophageal echocardiography of the left atrial appendage reduces rate of postpone electrical cardioversionP1169Detection of ventricular thrombus by cmr after reperfused st-segment elevation myocardial infarction correlated with echocardiographyP1170Clinical and transthoracic echocardiographic predictors of left atrial appendage thrombus in patients with atrial fibrillationStress echocardiographyP1171Pharmacological stress echocardiography complications: a 4-year single center experienceP1172Myocardial functional and perfusion reserve in type I diabetesP1173Feasibility of incorporating 3D Dobutamine stress echocardiography into routine clinical practiceP1174Right ventricular isovolumic acceleration at rest and during exercise in children after heart transplantP1175Right ventricular systolic and diastolic response to exercise in children after heart transplant -a bicycle exercise studyP1176Determinants of functional capacity in heart failure patients with reduced ejection fractionP1177Handgrip stress echocardiography with emotional component compared to conventional isometric exercise in coronary artery disease diagnosisP1178The relationship between resting transthoracic echocardiography and exercise capacity in patients with paroxysmal atrial fibrillationP1179Correlation between NT-proBNP and selected echocardiography parameters at rest and after exercise in patients with functional ischemic mitral regurgitation qualified for cardiosurgical treatmentReal-time three-dimensional TEEP1180Vena contracta area for severity grading in functional and degenerative mitral regurgitation: A study based on transesophageal 3D colour Doppler in 419 patientsP1181Proximal flow convergence by 3D echocardiography in the evaluation of mitral valve area in rheumatic mitral stenosisP1182Quantification of valve dimensions by transesophageal 3D echocardiography in patients with functional and degenerative mitral regurgitationTissue Doppler and speckle trackingP1183Automatic calculation of left ventricular volume changes over a cardiac cycle from echocardiography images by nonlinear dimensionality reductionP1184Effect of the mitral valve repairs on the left ventricular blood flow formationP1185Quantification of left atrial strain using cardiovascular magnetic resonance. a comparison between hypertrophic cardiomyopathy and healthy controlsP1186The role of early systolic lengthening in patients with non-ST elevation acute coronary syndrome and its relation to syntax scoreP1187Different standard two dimensional strain methods to quantity left ventricular mechanicsP1188Atrial function and electrocardiography caracteristics in sportsmen with or without paroxysmal atrial fibrillationP1189Right ventricular outflow premature contractions induce regional left ventricular dysfunctionP1190Ultrasound guided venous access for pacemaker and defibrillators. Randomized TrialP1191Atrial function analysis correlates with symptoms and quality of life of heart failure patientsP1192The use of tissue doppler echocardiography in myocardial iron overload in patients with thalassaemia majorP1193Independent association between pulse pressure and left ventricular global longitudinal strainP1194Global and regional longitudinal strain identifies the presence of coronary artery disease in patients with suspected reduction of coronary flow reserve and absence of wall motion abnormalitiesP1195Prognostic value of invasive and noninvasive parameters of right ventricular function in patients with pulmonary arterial hypertension receiving specific vasodilator therapyP1196Myocardial deformation analysis to improve arrhythmic risk stratificationP1197Quantitative assessment of regional systolic and diastolic function parameters for detecting prior transient ischemia in normokinetic segmentsP1198Left atrial function in patients with corrected tetralogy of Fallot - a three-dimensional speckle-tracking echocardiographic studyP1199Left atrial ejection force correlates with left atrial strain and volume-based functional properties as assessed by three-dimensional speckle tracking echocardiographyP1200Acute angulation of the aortic arch late after the arterial switch operation for transposition of the great arteries: impact on cardiac mechanicsP1201Circumferential deformation of the ascending thoracic aorta in hypertensive patients by three-dimensional speckle tracking echocardiographyCardiac Magnetic ResonanceP1202The incremental value of cardiac magnetic resonance on diagnosis myocardial infarction and non-obstructed coronary arteriesP1204Reference ranges of global and regional myocardial T1 values derived from MOLLI and shMOLLI at 3TComputed Tomography & Nuclear CardiologyP1205Deformation of the left atrial appendage after percutaneous closure with the Amplatzer cardiac plugP1206Prognostic impact of non-obstructive coronary artery disease on coronary computed tomographic angiography: A single-center study. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pitt B. Clinical application of myocardial imaging with radioisotopes in the evaluation and management of patients with coronary artery disease. Adv Cardiol 2015; 26:30-7. [PMID: 217248 DOI: 10.1159/000402386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Mantell JE, DiCarlo AL, Remien RH, Zerbe A, Morris D, Pitt B, Nkonyana JP, Abrams EJ, El-Sadr W. 'There's no place like home': perceptions of home-based HIV testing in Lesotho. Health Educ Res 2014; 29:456-469. [PMID: 24599266 PMCID: PMC4021194 DOI: 10.1093/her/cyu004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 01/23/2014] [Indexed: 05/31/2023]
Abstract
HIV testing has the potential to reduce HIV transmission by identifying and counseling individuals with HIV, reducing risk behaviors, linking persons with HIV to care and earlier treatment, and reducing perinatal transmission. In Lesotho, a high HIV prevalence country in which a large proportion of the population has never tested for HIV, home-based testing (HBT) may be an important strategy to increase HIV testing. We identified factors influencing acceptability of HIV prevention strategies among a convenience sample of 200 pregnant or post-partum Basotho women and 30 Basotho men. We first conducted cross-sectional surveys, followed by key informant interviews with all 30 men and focus group discussions with a sub-set of 62 women. In total, 82% of women reported positive perceptions of HBT; women and men viewed HBT as a potential way to increase testing among men and saw the home as a comfortable, supportive environment for testing and counseling couples and families together. Potential barriers to HBT uptake included concerns about confidentiality, privacy, coercion to test, conflict within the family and fear of HIV/AIDS-associated stigma. Participants emphasized community mobilization and education as important elements of HBT.
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Affiliation(s)
- J E Mantell
- Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100.
| | - A L DiCarlo
- Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100.Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100
| | - R H Remien
- Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100
| | - A Zerbe
- Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100
| | - D Morris
- Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100
| | - B Pitt
- Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100
| | - J P Nkonyana
- Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100
| | - E J Abrams
- Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100
| | - W El-Sadr
- Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100
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Eschalier R, McMurray J, Swedberg K, Veldhuisen van D, Krum H, Pocock S, Shi H, Vincent J, Rossignol P, Zannad F, Pitt B. SAFETY AND EFFICACY OF EPLERENONE IN PATIENTS AT HIGH RISK FOR HYPERKALEMIA AND/OR WORSENING RENAL FUNCTION. ANALYSES OF THE EMPHASIS-HF STUDY SUBGROUPS (EPLERENONE IN MILD PATIENTS HOSPITALIZATION AND SURVIVAL STUDY IN HEART FAILURE). Racionalʹnaâ farmakoterapiâ v kardiologii 2014. [DOI: 10.20996/1819-6446-2014-10-1-106-115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Ritz E, Pitt B. Mineralocorticoid receptor blockade-a novel approach to fight hyperkalaemia in chronic kidney disease. Clin Kidney J 2013; 6:464-8. [PMID: 26120440 PMCID: PMC4438399 DOI: 10.1093/ckj/sft084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 06/28/2013] [Indexed: 01/06/2023] Open
Abstract
Hyperkalaemia continues to be a major hazard of mineralocorticoid receptor blockade in an effort to retard the progression of chronic kidney disease (CKD). In cardiac patients on mineralocorticoid receptor blockade, RLY-5016 which captures K+ in the colon has been effective in reducing the risk of hyperkalaemia. This compound might be useful in CKD as well.
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Affiliation(s)
- E Ritz
- Nierenzentrum , University of Heidelberg , Heidelberg , Germany
| | - B Pitt
- Internal Medicine and Cardiovascular Disease , University of Michigan Medical School , Ann Arbor, MI , USA
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Girerd N, Collier T, Pocock S, Krum H, Mcmurray J, Swedberg K, Van Veldhuisen D, Vincent J, Pitt B, Zannad F. Clinical benefits of Eplerenone in patients with systolic NYHA II heart failure when initiated shortly after hospital discharge. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Boyle S, Latini R, Jhund P, MacDonald M, Petrie M, Pitt B, Maggioni A, Chang W, Lewsey J, Solomon S, McMurray J. Dual Renin–angiotensin System Blockade with Aliskiren in Patients with Heart Failure, with or without Diabetes Mellitus: Insights from ALOFT. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pitt B. Increased cardiovascular risk associated with non-cardiac chest pain in patients with a prior psychiatric hospitalization: an opportunity and challenge for both the psychiatrist and the cardiologist. Eur Heart J 2012; 33:692-4. [DOI: 10.1093/eurheartj/ehr390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pitt B. Plasma aldosterone levels in patients with coronary artery disease without heart failure or myocardial infarction: implications for pathophsiology, prognosis, and therapy. Eur Heart J 2011; 33:162-4. [DOI: 10.1093/eurheartj/ehr276] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ehrmann D, Deldin P, Pitt B. Is sleep apnea a potential link between major depressive disorder and cardiovascular disease? Int J Cardiol 2011; 147:1-3. [DOI: 10.1016/j.ijcard.2010.10.106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Accepted: 10/23/2010] [Indexed: 11/25/2022]
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Gamble C, Talbott E, Youk A, Holguin F, Pitt B, Silveira L, Bleecker E, Busse W, Calhoun W, Castro M, Chung KF, Erzurum S, Israel E, Wenzel S. Racial differences in biologic predictors of severe asthma: Data from the Severe Asthma Research Program. J Allergy Clin Immunol 2010; 126:1149-56.e1. [PMID: 21051082 DOI: 10.1016/j.jaci.2010.08.049] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Revised: 08/24/2010] [Accepted: 08/26/2010] [Indexed: 11/28/2022]
Abstract
BACKGROUND Biologic factors are known to contribute to asthma severity. It is unknown whether these factors differentially contribute to asthma severity in black compared with white subjects. OBJECTIVE We sought to assess the extent to which racial disparities between black and white subjects with severe asthma are attributable to physiologic, immunoinflammatory, and sociodemographic variables. METHODS Black and white asthmatic adults enrolled in a cross-sectional study focused on severe asthma were evaluated. Severe asthma was identified by using the American Thoracic Society definition. After initial univariable analyses, unconditional logistic regression models were used to estimate the probability of having severe asthma for black and white subjects. RESULTS Differences in severe asthma in black compared with white subjects were observed. In univariable analysis IgE level was not associated with severe asthma in black or white subjects, whereas in multivariable analysis IgE level was significantly associated with severe asthma for black subjects (P = .014) but not for white subjects. The odds of having severe asthma more than doubled for black subjects with 2 or more family members with asthma (P = .026), whereas the odds of severe asthma for white participants with a strong family history of asthma decreased by almost half (P = .05). Atopy was negatively associated with severe asthma in both races in univariable analysis but remained significant only in black subjects, whereas comorbidities were associated with severe asthma in white subjects. CONCLUSION Biologic factors were distinctly associated with severe asthma only in black subjects. Studies that incorporate comprehensive evaluation of biologic factors associated with asthma might lead to the development of therapies that target biologic abnormalities in black subjects.
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Polk AA, Maul TM, McKeel DT, Snyder TA, Lehocky CA, Pitt B, Stolz DB, Federspiel WJ, Wagner WR. A biohybrid artificial lung prototype with active mixing of endothelialized microporous hollow fibers. Biotechnol Bioeng 2010; 106:490-500. [PMID: 20091735 DOI: 10.1002/bit.22675] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Acute respiratory distress syndrome (ARDS) affects nearly 150,000 patients per year in the US, and is associated with high mortality ( approximately 40%) and suboptimal options for patient care. Mechanical ventilation and extracorporeal membrane oxygenation are limited to short-term use due to ventilator-induced lung injury and poor biocompatibility, respectively. In this report, we describe the development of a biohybrid lung prototype, employing a rotating endothelialized microporous hollow fiber (MHF) bundle to improve blood biocompatibility while MHF mixing could contribute to gas transfer efficiency. MHFs were surface modified with radio frequency glow discharge (RFGD) and protein adsorption to promote endothelial cell (EC) attachment and growth. The MHF bundles were placed in the biohybrid lung prototype and rotated up to 1,500 revolutions per minute (rpm) using speed ramping protocols to condition ECs to remain adherent on the fibers. Oxygen transfer, thrombotic deposition, and EC p-selectin expression were evaluated as indicators of biohybrid lung functionality and biocompatibility. A fixed aliquot of blood in contact with MHF bundles rotated at either 250 or 750 rpm reached saturating pO(2) levels more quickly with increased rpm, supporting the concept that fiber rotation would positively contribute to oxygen transfer. The presence of ECs had no effect on the rate of oxygen transfer at lower fiber rpm, but did provide some resistance with increased rpm when the overall rate of mass transfer was higher due to active mixing. RFGD followed by fibronectin adsorption on MHFs facilitated near confluent EC coverage with minimal p-selectin expression under both normoxic and hyperoxic conditions. Indeed, even subconfluent EC coverage on MHFs significantly reduced thrombotic deposition adding further support that endothelialization enhances, blood biocompatibility. Overall these findings demonstrate a proof-of-concept that a rotating endothelialized MHF bundle enhances gas transfer and biocompatibility, potentially producing safer, more efficient artificial lungs.
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Affiliation(s)
- Alexa A Polk
- The McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pennsylvania 15213, USA
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Lotze M, Tang D, Buchser W, Liang X, DeVera M, Plevy S, John E, Pitt B, Basse P, Butterfield L, Kalinski P, Zeh H, Lotfi R, Rubartelli A. E14 Damage associated molecular pattern molecules (DAMPs) redox and autophagy. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s1873-9954(10)70018-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tyurin VA, Tyurina YY, Jung MY, Tungekar MA, Wasserloos KJ, Bayir H, Greenberger JS, Kochanek PM, Shvedova AA, Pitt B, Kagan VE. Mass-spectrometric analysis of hydroperoxy- and hydroxy-derivatives of cardiolipin and phosphatidylserine in cells and tissues induced by pro-apoptotic and pro-inflammatory stimuli. J Chromatogr B Analyt Technol Biomed Life Sci 2009; 877:2863-72. [PMID: 19328050 PMCID: PMC2723191 DOI: 10.1016/j.jchromb.2009.03.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 03/04/2009] [Accepted: 03/06/2009] [Indexed: 10/21/2022]
Abstract
Oxidation of two anionic phospholipids--cardiolipin (CL) in mitochondria and phosphatidylserine (PS) in extramitochondrial compartments--is important signaling event, particularly during the execution of programmed cell death and clearance of apoptotic cells. Quantitative analysis of CL and PS oxidation products is central to understanding their molecular mechanisms of action. We combined the identification of diverse phospholipid molecular species by ESI-MS with quantitative assessments of lipid hydroperoxides using a fluorescence HPLC-based protocol. We characterized CL and PS oxidation products formed in a model system (cyt c/H(2)O(2)), in apoptotic cells (neurons, pulmonary artery endothelial cells) and mouse lung under inflammatory/oxidative stress conditions (hyperoxia, inhalation of single walled carbon nanotubes). Our results demonstrate the usefulness of this approach for quantitative assessments, identification of individual molecular species and structural characterization of anionic phospholipids that are involved in oxidative modification in cells and tissues.
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Affiliation(s)
- Vladimir A. Tyurin
- Center for Free Radical and Antioxidant Health, University of Pittsburgh, Pittsburgh PA
- Departments of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh PA
| | - Yulia Y. Tyurina
- Center for Free Radical and Antioxidant Health, University of Pittsburgh, Pittsburgh PA
- Departments of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh PA
| | - Mi-Yeon Jung
- Center for Free Radical and Antioxidant Health, University of Pittsburgh, Pittsburgh PA
- Departments of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh PA
| | - Muhammad A. Tungekar
- Center for Free Radical and Antioxidant Health, University of Pittsburgh, Pittsburgh PA
- Departments of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh PA
| | - Karla J. Wasserloos
- Departments of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh PA
| | - Hülya Bayir
- Center for Free Radical and Antioxidant Health, University of Pittsburgh, Pittsburgh PA
- Departments of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh PA
- Critical Care Medicine, University of Pittsburgh, Pittsburgh PA
| | | | | | | | - Bruce Pitt
- Departments of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh PA
| | - Valerian E. Kagan
- Center for Free Radical and Antioxidant Health, University of Pittsburgh, Pittsburgh PA
- Departments of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh PA
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Freel EM, Tsorlalis IK, Lewsey JD, Latini R, Maggioni AP, Solomon S, Pitt B, Connell JMC, McMurray JJV. Aldosterone status associated with insulin resistance in patients with heart failure--data from the ALOFT study. Heart 2009; 95:1920-4. [PMID: 19713201 DOI: 10.1136/hrt.2009.173344] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Aldosterone has a key role in the pathophysiology of heart failure. In around 50% of such patients, aldosterone "escapes" from inhibition by drugs that interrupt the renin-angiotensin axis; such patients have a worse clinical outcome. Insulin resistance is a risk factor in heart failure and cardiovascular disease. The relation between aldosterone status and insulin sensitivity was investigated in a cohort of heart failure patients. METHODS 302 patients with New York Heart Association (NYHA) class II-IV heart failure on conventional therapy were randomised in the ALiskiren Observation of heart Failure Treatment study (ALOFT), designed to test the safety of a directly acting renin inhibitor. Plasma aldosterone and 24-hour urinary aldosterone excretion, as well as fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were measured. Subjects with aldosterone escape and high urinary aldosterone were identified according to previously accepted definitions. RESULTS 20% of subjects demonstrated aldosterone escape and 34% had high urinary aldosterone levels. At baseline, there was a positive correlation between fasting insulin and plasma (r = 0.22 p<0.01) and urinary aldosterone(r = 0.19 p<0.03). Aldosterone escape and high urinary aldosterone subjects both demonstrated higher levels of fasting insulin (p<0.008, p<0.03), HOMA-IR (p<0.06, p<0.03) and insulin-glucose ratios (p<0.006, p<0.06) when compared to low aldosterone counterparts. All associations remained significant when adjusted for potential confounders. CONCLUSIONS This study demonstrates a novel direct relation between aldosterone status and insulin resistance in heart failure. This observation merits further study and may identify an additional mechanism that contributes to the adverse clinical outcome associated with aldosterone escape.
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Affiliation(s)
- E M Freel
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow G12 8TA, UK.
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Li J, Wilson A, Gao X, Kuruba R, Liu Y, Poloyac S, Pitt B, Xie W, Li S. Coordinated regulation of dimethylarginine dimethylaminohydrolase-1 and cationic amino acid transporter-1 by farnesoid X receptor in mouse liver and kidney and its implication in the control of blood levels of asymmetric dimethylarginine. J Pharmacol Exp Ther 2009; 331:234-43. [PMID: 19605523 DOI: 10.1124/jpet.109.153510] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Asymmetric dimethylarginine (ADMA) is a potent endogenous inhibitor of endothelial nitric-oxide synthase (eNOS), and increased plasma concentrations of ADMA have been regarded as a risk factor for a number of cardiovascular diseases. Circulating ADMA is largely taken up by liver and kidney via system y(+) carriers of the cationic amino acid (CAT) family and subsequently metabolized by dimethylarginine dimethylaminohydrolases (DDAHs). As such, agents targeted at enhancing ADMA metabolism may prove to be useful in the prevention and/or treatment of various types of cardiovascular disease. Farnesoid X receptor (FXR) is a member of the nuclear receptor superfamily and plays an important role in the maintenance of cholesterol and bile acid homeostasis. We report here that treatment of mice with an FXR agonist 3-(2,6-dichlorophenyl)-4-(3'-carboxy-2-chlorostilben-4-yl)oxymethyl-5-isopropylisoxazole; GW4064) led to increased expression of DDAH-1 and CAT-1 in both liver and kidney. In cultured human hepatocytes and kidney proximal tubular epithelial cells, GW4064 increased CAT-1 expression, and this was associated with a significant increase in the cellular uptake of ADMA. Promoter analyses suggest that CAT-1 is a likely target of FXR, and a functional FXR response element was found in the promoter region of CAT-1 gene. These data suggest that FXR may play an important role in regulating blood levels of ADMA via coordinated regulation of DDAH-1 and CAT-1 in liver and kidney.
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Affiliation(s)
- Jiang Li
- Center for Pharmacogenetics, Department of Pharmaceutical Sciences, University of Pittsburgh, PA 15261, USA
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Kagan VE, Bayir HA, Belikova NA, Kapralov O, Tyurina YY, Tyurin VA, Jiang J, Stoyanovsky DA, Wipf P, Kochanek PM, Greenberger JS, Pitt B, Shvedova AA, Borisenko G. Cytochrome c/cardiolipin relations in mitochondria: a kiss of death. Free Radic Biol Med 2009; 46:1439-53. [PMID: 19285551 PMCID: PMC2732771 DOI: 10.1016/j.freeradbiomed.2009.03.004] [Citation(s) in RCA: 322] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Revised: 03/02/2009] [Accepted: 03/04/2009] [Indexed: 12/16/2022]
Abstract
Recently, phospholipid peroxidation products gained a reputation as key regulatory molecules and participants in oxidative signaling pathways. During apoptosis, a mitochondria-specific phospholipid, cardiolipin (CL), interacts with cytochrome c (cyt c) to form a peroxidase complex that catalyzes CL oxidation; this process plays a pivotal role in the mitochondrial stage of the execution of the cell death program. This review is focused on redox mechanisms and essential structural features of cyt c's conversion into a CL-specific peroxidase that represent an interesting and maybe still unique example of a functionally significant ligand change in hemoproteins. Furthermore, specific characteristics of CL in mitochondria--its asymmetric transmembrane distribution and mechanisms of collapse, the regulation of its synthesis, remodeling, and fatty acid composition--are given significant consideration. Finally, new concepts in drug discovery based on the design of mitochondria-targeted inhibitors of cyt c/CL peroxidase and CL peroxidation with antiapoptotic effects are presented.
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Affiliation(s)
- Valerian E Kagan
- Center for Free Radical and Antioxidant Health, Pittsburgh, PA 15219, USA.
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Pitt B. RAAS inhibition/blockade in patients with cardiovascular disease: implications of recent large-scale randomised trials for clinical practice. Heart 2009; 95:1205-8. [DOI: 10.1136/hrt.2009.167080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kirlin PC, Pitt B, Lucchesi BR. Intravenous prenalterol in acute and chronic heart failure. Acta Med Scand Suppl 2009; 659:263-86. [PMID: 6127894 DOI: 10.1111/j.0954-6820.1982.tb00852.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Pepine CJ, Schlaifer JD, Mancini GB, Pitt B, O'Neill BJ, Haber HE. Influence of smoking status on progression of endothelial dysfunction. TREND Investigators. Trial on Reversing Endothelial Dysfunction. Clin Cardiol 2009; 21:331-4. [PMID: 9595215 PMCID: PMC6655863 DOI: 10.1002/clc.4960210506] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Cigarette smoking is a major risk factor for developing coronary artery disease and is associated with increased coronary morbidity and mortality in patients with established atherosclerosis. This report describes the influence of smoking on coronary endothelial function in normotensive patients with coronary artery disease, but without left ventricular dysfunction, severe hypercholesterolemia, or insulin-dependent diabetes mellitus. METHODS Placebo-treated patients (n = 54) from a larger study assessing coronary endothelial function were classified at baseline as smokers or nonsmokers for this subgroup analysis. Patients underwent coronary angiography at baseline and again after 6-month follow-up. RESULTS At baseline, there was a trend for a greater decrease in target segment diameter (n = 54) in smokers compared with nonsmokers (-17.2 +/- 5.3% vs. -8.0 +/- 2.5%, acetylcholine 10(-4) mol/l). All measured coronary artery segments (n = 202) showed similar responses (-7.3 +/- 2.7% vs. -3.8 +/- 1.3%, acetylcholine 10(-4) mmol/l, for smokers vs. nonsmokers, respectively). After 6 months, smokers showed an even greater vasoconstrictor response to acetylcholine whereas nonsmokers did not (-21.7 +/- 5.3% vs. -8.3 +/- 2.5%, acetylcholine 10(-4) mmol/l). The vasodilatory response to nitroglycerin was similar in smokers and nonsmokers. CONCLUSIONS In current smokers, a marked decline in endothelium-dependent vasomotor response was observed over a 6-month period.
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Affiliation(s)
- C J Pepine
- Department of Medicine, University of Florida, Gainesville, USA
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Abstract
Therapy with an angiotensin-converting enzyme (ACE) inhibitor is established for reducing excessive blood pressure, reducing mortality in patients with congestive heart failure (CHF), preventing the development of CHF in patients with asymptomatic left ventricular (LV) dysfunction, and preventing death and CHF when initiated early after the onset of acute myocardial infarction (MI). Although these benefits have been attributed largely to hemodynamic mechanisms, recent preclinical and clinical evidence reveal ACE inhibition as potent in preventing ischemic events and in blocking an array of ischemic processes, including atherogenesis. A major contributor to this new evidence is the large, placebo-controlled Heart Outcomes Prevention Evaluation (HOPE) trial, which found that the ACE inhibitor ramipril ( 10 mg daily) prevented MI and other ischemic events in patients with a broad range of cardiovascular (CV) risks (including coronary artery disease, stroke, peripheral vascular disease, or diabetes plus one additional risk factor) but no LV dysfunction or history of heart failure at baseline. The data from the HOPE trial suggest a greatly expanded role for ramipril in the prevention and management of CV disease.
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Affiliation(s)
- B Pitt
- Cardiology Division, University of Michigan Medical Center, Ann Arbor 48109-0366, USA
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Abstract
BACKGROUND The Epleronone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) trial demonstrated that selective aldosterone blockade with eplerenone significantly reduced total mortality by 15%, combined cardiovascular (CV) mortality/CV hospitalization by 13%, CV mortality by 17% and sudden cardiac death by 21%, vs. placebo when added to standard care in patients with left ventricular systolic dysfunction (LVSD) and signs of congestive heart failure (CHF) following acute myocardial infarction (AMI). We retrospectively evaluated the effect of eplerenone vs. placebo in a subset of 1483 diabetic patients with LVSD and signs of CHF following AMI. METHODS Diabetic status was determined from medical histories at screening. Analyses were based on time to first occurrence of an event. Results were based on a Cox's proportional hazards regression model stratified by region with treatment, subgroup and treatment-by-subgroup interaction as factors. The 95% confidence intervals for the risk ratios were based on the Wald's test. RESULTS Treatment with eplerenone in diabetic patients with CHF following AMI reduced the risk of the primary endpoint, a composite of CV mortality or CV hospitalization, by 17% (p = 0.031). The absolute risk reduction of the primary endpoint was greater in the diabetic cohort (5.1%) than in the non-diabetic cohort (3%). Hyperkalaemia occurred more often with eplerenone than with placebo (5.6 vs. 3%, p = 0.015). Among the diabetic cohorts, the prespecified endpoint of 'any CV disorder' occurred in 28% of the eplerenone group and 35% of the placebo group (p = 0.007). CONCLUSION Eplerenone treatment may reduce adverse CV events in diabetic patients with LVSD and signs of CHF following AMI.
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Affiliation(s)
- J H O'Keefe
- University of Missouri-Kansas City School of Medicine, Mid-America Heart Institute, St Luke's Hospital, Kansas City, MO 64111, USA.
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Pitt B. The measurement of plasma aldosterone in patients post-myocardial infarction. Eur Heart J 2008; 29:2451-2. [DOI: 10.1093/eurheartj/ehn425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kagan V, Tyurina Y, Wasserlos K, Stewart R, Stitt M, Kaynar M, Pitt B. OXIDATIVE LIPIDOMICS OF HYPEROXIC LUNG INJURY. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70229-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bauer EM, Pitt B, St. Croix CM. Zinc mediated vasoconstriction in the isolated perfused rat lung. FASEB J 2008. [DOI: 10.1096/fasebj.22.1_supplement.1174.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Eileen Maria Bauer
- Environmental and Occupational HealthUniversity of PittsburghPittsburghPA
| | - Bruce Pitt
- Environmental and Occupational HealthUniversity of PittsburghPittsburghPA
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