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Al Sayed ZR, Pereira C, Le Borgne R, Viaris de Lesegno C, Jouve C, Pénard E, Mallet A, Masurkar N, Loussouarn G, Verbavatz JM, Lamaze C, Trégouët DA, Hulot JS. CAVIN1-Mediated hERG Dynamics: A Novel Mechanism Underlying the Interindividual Variability in Drug-Induced Long QT. Circulation 2024. [PMID: 38682330 DOI: 10.1161/circulationaha.123.063917] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/21/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Drug-induced QT prolongation (diLQT) is a feared side effect that could expose susceptible individuals to fatal arrhythmias. The occurrence of diLQT is primarily attributed to unintended drug interactions with cardiac ion channels, notably the hERG (human ether-a-go-go-related gene) channels that generate the delayed-rectifier potassium current (IKr) and thereby regulate the late repolarization phase. There is an important interindividual susceptibility to develop diLQT, which is of unknown origin but can be reproduced in patient-specific induced pluripotent stem cell-derived cardiomyocytes (iPS-CMs). We aimed to investigate the dynamics of hERG channels in response to sotalol and to identify regulators of the susceptibility to developing diLQT. METHODS We measured electrophysiological activity and cellular distribution of hERG channels after hERG blocker treatment in iPS-CMs derived from patients with highest sensitivity (HS) or lowest sensitivity (LS) to sotalol administration in vivo (ie, on the basis of the measure of the maximal change in QT interval 3 hours after administration). Specific small interfering RNAs and CAVIN1-T2A-GFP adenovirus were used to manipulate CAVIN1 expression. RESULTS Whereas HS and LS iPS-CMs showed similar electrophysiological characteristics at baseline, the late repolarization phase was prolonged and IKr significantly decreased after exposure of HS iPS-CMs to low sotalol concentrations. IKr reduction was caused by a rapid translocation of hERG channel from the membrane to the cytoskeleton-associated fractions upon sotalol application. CAVIN1, essential for caveolae biogenesis, was 2× more highly expressed in HS iPS-CMs, and its knockdown by small interfering RNA reduced their sensitivity to sotalol. CAVIN1 overexpression in LS iPS-CMs using adenovirus showed reciprocal effects. We found that treatment with sotalol promoted translocation of the hERG channel from the plasma membrane to the cytoskeleton fractions in a process dependent on CAVIN1 (caveolae associated protein 1) expression. CAVIN1 silencing reduced the number of caveolae at the membrane and abrogated the translocation of hERG channel in sotalol-treated HS iPS-CMs. CAVIN1 also controlled cardiomyocyte responses to other hERG blockers, such as E4031, vandetanib, and clarithromycin. CONCLUSIONS Our study identifies unbridled turnover of the potassium channel hERG as a mechanism supporting the interindividual susceptibility underlying diLQT development and demonstrates how this phenomenon is finely tuned by CAVIN1.
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Affiliation(s)
- Zeina R Al Sayed
- PARCC, INSERM, Université Paris Cité, Paris, France. (Z.R.A.S., C.P., C.J., N.M., J.-S.H.)
| | - Céline Pereira
- PARCC, INSERM, Université Paris Cité, Paris, France. (Z.R.A.S., C.P., C.J., N.M., J.-S.H.)
| | - Rémi Le Borgne
- Institut Jacques Monod, CNRS, Université Paris Cité, Paris, France. (R.L.B., J.-M.V.)
| | | | - Charlène Jouve
- PARCC, INSERM, Université Paris Cité, Paris, France. (Z.R.A.S., C.P., C.J., N.M., J.-S.H.)
| | - Esthel Pénard
- Ultrastructural BioImaging Core Facility (UBI), C2RT, Institut Pasteur, Université Paris Cité, Paris, France. (E.P., A.M.)
| | - Adeline Mallet
- Ultrastructural BioImaging Core Facility (UBI), C2RT, Institut Pasteur, Université Paris Cité, Paris, France. (E.P., A.M.)
| | - Nihar Masurkar
- PARCC, INSERM, Université Paris Cité, Paris, France. (Z.R.A.S., C.P., C.J., N.M., J.-S.H.)
| | - Gildas Loussouarn
- Université de Nantes, CNRS, INSERM, l'Institut du Thorax, Nantes, France (G.L.)
| | - Jean-Marc Verbavatz
- Institut Jacques Monod, CNRS, Université Paris Cité, Paris, France. (R.L.B., J.-M.V.)
| | - Christophe Lamaze
- INSERM U1143, CNRS UMR 3666, PSL Research University, Institut Curie, Paris, France (C.V.d.L., C.L.)
| | - David-Alexandre Trégouët
- INSERM UMR_S 1219, Bordeaux Population Health Research Center, University of Bordeaux, France (D.-A.T.)
| | - Jean-Sébastien Hulot
- PARCC, INSERM, Université Paris Cité, Paris, France. (Z.R.A.S., C.P., C.J., N.M., J.-S.H.)
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France (J.-S.H.)
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Hulot JS, Janiak P, Boutinaud P, Boutouyrie P, Chézalviel-Guilbert F, Christophe JJ, Cohen A, Damy T, Djadi-Prat J, Firat H, Hervé PY, Isnard R, Jondeau G, Mousseaux E, Pernot M, Prot P, Tyl B, Soulat G, Logeart D. Rationale and design of the PACIFIC-PRESERVED (PhenomApping, ClassIFication and Innovation for Cardiac dysfunction in patients with heart failure and PRESERVED left ventricular ejection fraction) study. Arch Cardiovasc Dis 2024:S1875-2136(24)00057-3. [PMID: 38644067 DOI: 10.1016/j.acvd.2024.02.011] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome that is poorly defined, reflecting an incomplete understanding of its pathophysiology. AIM To redefine the phenotypic spectrum of HFpEF. METHODS The PACIFIC-PRESERVED study is a prospective multicentre cohort study designed to perform multidimensional deep phenotyping of patients diagnosed with HFpEF (left ventricular ejection fraction≥50%), patients with heart failure with reduced ejection fraction (left ventricular ejection fraction≤40%) and subjects without overt heart failure (3:2:1 ratio). The study proposes prospective investigations in patients during a 1-day hospital stay: physical examination; electrocardiogram; performance-based tests; blood samples; cardiac magnetic resonance imaging; transthoracic echocardiography (rest and low-level exercise); myocardial shear wave elastography; chest computed tomography; and non-invasive measurement of arterial stiffness. Dyspnoea, depression, general health and quality of life will be assessed by dedicated questionnaires. A biobank will be established. After the hospital stay, patients are asked to wear a connected garment (with digital sensors) to collect electrocardiography, pulmonary and activity variables in real-life conditions (for up to 14 days). Data will be centralized for machine-learning-based analyses, with the aim of reclassifying HFpEF into more distinct subgroups, improving understanding of the disease mechanisms and identifying new biological pathways and molecular targets. The study will also serve as a platform to enable the development of innovative technologies and strategies for the diagnosis and stratification of patients with HFpEF. CONCLUSIONS PACIFIC-PRESERVED is a prospective multicentre phenomapping study, using novel analytical techniques, which will provide a unique data resource to better define HFpEF and identify new clinically meaningful subgroups of patients.
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Affiliation(s)
- Jean-Sébastien Hulot
- Université Paris Cité, INSERM, PARCC, 75015 Paris, France; CIC1418 and DMU CARTE, Hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France.
| | | | | | - Pierre Boutouyrie
- Université Paris Cité, INSERM, PARCC, 75015 Paris, France; Pharmacology and DMU CARTE, Hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France
| | | | | | - Ariel Cohen
- Cardiology, Hôpital Saint-Antoine, AP-HP, ICAN 1166, Sorbonne Université, 75012 Paris, France
| | - Thibaud Damy
- Cardiology, Hôpital Henri-Mondor, AP-HP, 94000 Créteil, France
| | - Juliette Djadi-Prat
- Clinical Research Unit, Hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France
| | | | | | - Richard Isnard
- Cardiology, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | | | - Elie Mousseaux
- Université Paris Cité, INSERM, PARCC, 75015 Paris, France; Cardiac Imaging Radiology, Hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France
| | - Mathieu Pernot
- Physics for Medicine Paris, INSERM U1273, ESPCI Paris, PSL University, CNRS FRE 2031, 75015 Paris, France
| | | | | | - Gilles Soulat
- Université Paris Cité, INSERM, PARCC, 75015 Paris, France; Cardiac Imaging Radiology, Hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France
| | - Damien Logeart
- Cardiology, Hôpital Lariboisière, AP-HP, 75018 Paris, France
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Carette C, Okamba-Belle D, Hirlemann M, Wack M, Domenge O, Jannot AS, Czernichow S, Rives-Lange C, Fayol A, Hulot JS. Systematic brain natriuretic peptide (BNP) measurement for cardiac screening in patients with severe obesity: the OLECOEUR study. Obes Facts 2024:000538766. [PMID: 38583425 DOI: 10.1159/000538766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 04/05/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Heart failure (HF) diagnosis is difficult in patients with obesity due to cardiovascular and pulmonary comorbidities associated with physical deconditioning that all lead to dyspnea. Methods The OLECOEUR study screens prospectively for HF using systematic brain natriuretic peptide (BNP) measurement in ambulatory patients with obesity from one Nutrition department (Paris, France). Clinical, biological and echocardiogram data were extracted from electronic medical records. Results We included 1506 patients middle aged (mean age: 47.2 ± 14.6 years old) with severe obesity (mean BMI: 40.4 ± 6.6 kg/m²). Patients with BNP ≥ 35 pg/ml presented left heart remodeling including thicker interventricular septum (10.4 ± 2.0 vs. 9.6 ± 1.8 mm; P=0.0008), higher left ventricle mass (89.9 ± 24.3 vs. 77.2 ± 20.0 g/m2; P=0.0009) and significant modifications of both left and right atria in line with a higher proportion of prior atrial fibrillation. Markers of right heart remodeling on echocardiography were also significantly higher (pulmonary artery systolic pressure: 33.3 ± 17.3 vs. 24.5 ± 6.3 mmHg; P=0.0002). Conclusion The OLECOEUR study shows left and right subclinical heart remodeling in patients with obesity screened for HF with systematic dosage of BNP with usual cut-off at 35 pg/ml.
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Seguret M, Davidson P, Robben S, Jouve C, Pereira C, Lelong Q, Deshayes L, Cerveau C, Le Berre M, Rodrigues Ribeiro RS, Hulot JS. A versatile high-throughput assay based on 3D ring-shaped cardiac tissues generated from human induced pluripotent stem cell-derived cardiomyocytes. eLife 2024; 12:RP87739. [PMID: 38578976 PMCID: PMC11001295 DOI: 10.7554/elife.87739] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024] Open
Abstract
We developed a 96-well plate assay which allows fast, reproducible, and high-throughput generation of 3D cardiac rings around a deformable optically transparent hydrogel (polyethylene glycol [PEG]) pillar of known stiffness. Human induced pluripotent stem cell-derived cardiomyocytes, mixed with normal human adult dermal fibroblasts in an optimized 3:1 ratio, self-organized to form ring-shaped cardiac constructs. Immunostaining showed that the fibroblasts form a basal layer in contact with the glass, stabilizing the muscular fiber above. Tissues started contracting around the pillar at D1 and their fractional shortening increased until D7, reaching a plateau at 25±1%, that was maintained up to 14 days. The average stress, calculated from the compaction of the central pillar during contractions, was 1.4±0.4 mN/mm2. The cardiac constructs recapitulated expected inotropic responses to calcium and various drugs (isoproterenol, verapamil) as well as the arrhythmogenic effects of dofetilide. This versatile high-throughput assay allows multiple in situ mechanical and structural readouts.
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Sakhi H, Soulat G, Craiem D, Gencer U, Lamy J, Stipechi V, Puscas T, Hulot JS, Hagege A, Mousseaux E. Association of Impaired Left Ventricular Mitral Filling from 4D Flow Cardiac MRI and Prognosis of Hypertrophic Cardiomyopathy. Radiol Cardiothorac Imaging 2024; 6:e230198. [PMID: 38512023 DOI: 10.1148/ryct.230198] [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] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Purpose To investigate whether the peak early filling rate normalized to the filling volume (PEFR/FV) estimated from four-dimensional (4D) flow cardiac MRI may be used to assess impaired left ventricular (LV) filling and predict clinical outcomes in individuals with hypertrophic cardiomyopathy (HCM). Materials and Methods Cardiac MRI with a 4D flow sequence and late gadolinium enhancement (LGE), as well as echocardiography, was performed in 88 individuals: 44 participants with HCM from a French prospective registry (ClinicalTrials.gov; NCT01091480) and 44 healthy volunteers matched for age and sex. In participants with HCM, a composite primary end point was assessed at follow-up, including unexplained syncope, new-onset atrial fibrillation, hospitalization for congestive heart failure, ischemic stroke, sustained ventricular arrhythmia, septal reduction therapy, and cardiac death. A Cox proportional hazard model was used to analyze associations with the primary end point. Results PEFR/FV was significantly lower in the HCM group (mean age, 51.8 years ± 18.5 [SD]; 29 male participants) compared with healthy volunteers (mean, 3.35 sec-1 ± 0.99 [0.90-5.20] vs 4.42 sec-1 ± 1.68 [2.74-11.86]; P < .001) and correlated with both B-type natriuretic peptide (BNP) level (r = -0.31; P < .001) and the ratio of pulsed Doppler early transmitral inflow to Doppler tissue imaging annulus velocities (E/E'; r = -0.54; P < .001). At a median follow-up of 2.3 years (IQR, 1.7-3.3 years), the primary end point occurred in 14 (32%) participants. A PEFR/FV of 2.61 sec-1 or less was significantly associated with occurrence of the primary end point (hazard ratio, 9.46 [95% CI: 2.61, 45.17; P < .001] to 15.21 [95% CI: 3.51, 80.22; P < .001]), independently of age, BNP level, E/E', LGE extent, and LV and left atrial strain according to successive bivariate models. Conclusion In HCM, LV filling evaluated with 4D flow cardiac MRI correlated with Doppler and biologic indexes of diastolic dysfunction and predicted clinical outcomes. Keywords: Diastolic Function, Left Ventricular Filling, Hypertrophic Cardiomyopathy, Cardiac MRI, 4D Flow Sequence Clinical trial registration no. NCT01091480 Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Hichem Sakhi
- From the Department of Radiology, AP-HP, Hôpital Européen Georges-Pompidou, 20-40 rue Leblanc, 75015 Paris, France (H.S., G.S., U.G., J.L., T.P., J.S.H., A.H., E.M.); Institut National de la Santé et de la Recherche Médicale, PARCC, Paris, France (G.S., U.G., J.L., J.S.H., A.H., E.M.); Université de Paris-Cité, Paris, France (G.S., J.S.H., A.H., E.M.); and Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina (D.C., V.S.)
| | - Gilles Soulat
- From the Department of Radiology, AP-HP, Hôpital Européen Georges-Pompidou, 20-40 rue Leblanc, 75015 Paris, France (H.S., G.S., U.G., J.L., T.P., J.S.H., A.H., E.M.); Institut National de la Santé et de la Recherche Médicale, PARCC, Paris, France (G.S., U.G., J.L., J.S.H., A.H., E.M.); Université de Paris-Cité, Paris, France (G.S., J.S.H., A.H., E.M.); and Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina (D.C., V.S.)
| | - Damian Craiem
- From the Department of Radiology, AP-HP, Hôpital Européen Georges-Pompidou, 20-40 rue Leblanc, 75015 Paris, France (H.S., G.S., U.G., J.L., T.P., J.S.H., A.H., E.M.); Institut National de la Santé et de la Recherche Médicale, PARCC, Paris, France (G.S., U.G., J.L., J.S.H., A.H., E.M.); Université de Paris-Cité, Paris, France (G.S., J.S.H., A.H., E.M.); and Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina (D.C., V.S.)
| | - Umit Gencer
- From the Department of Radiology, AP-HP, Hôpital Européen Georges-Pompidou, 20-40 rue Leblanc, 75015 Paris, France (H.S., G.S., U.G., J.L., T.P., J.S.H., A.H., E.M.); Institut National de la Santé et de la Recherche Médicale, PARCC, Paris, France (G.S., U.G., J.L., J.S.H., A.H., E.M.); Université de Paris-Cité, Paris, France (G.S., J.S.H., A.H., E.M.); and Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina (D.C., V.S.)
| | - Jérôme Lamy
- From the Department of Radiology, AP-HP, Hôpital Européen Georges-Pompidou, 20-40 rue Leblanc, 75015 Paris, France (H.S., G.S., U.G., J.L., T.P., J.S.H., A.H., E.M.); Institut National de la Santé et de la Recherche Médicale, PARCC, Paris, France (G.S., U.G., J.L., J.S.H., A.H., E.M.); Université de Paris-Cité, Paris, France (G.S., J.S.H., A.H., E.M.); and Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina (D.C., V.S.)
| | - Valentina Stipechi
- From the Department of Radiology, AP-HP, Hôpital Européen Georges-Pompidou, 20-40 rue Leblanc, 75015 Paris, France (H.S., G.S., U.G., J.L., T.P., J.S.H., A.H., E.M.); Institut National de la Santé et de la Recherche Médicale, PARCC, Paris, France (G.S., U.G., J.L., J.S.H., A.H., E.M.); Université de Paris-Cité, Paris, France (G.S., J.S.H., A.H., E.M.); and Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina (D.C., V.S.)
| | - Tania Puscas
- From the Department of Radiology, AP-HP, Hôpital Européen Georges-Pompidou, 20-40 rue Leblanc, 75015 Paris, France (H.S., G.S., U.G., J.L., T.P., J.S.H., A.H., E.M.); Institut National de la Santé et de la Recherche Médicale, PARCC, Paris, France (G.S., U.G., J.L., J.S.H., A.H., E.M.); Université de Paris-Cité, Paris, France (G.S., J.S.H., A.H., E.M.); and Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina (D.C., V.S.)
| | - Jean-Sébastien Hulot
- From the Department of Radiology, AP-HP, Hôpital Européen Georges-Pompidou, 20-40 rue Leblanc, 75015 Paris, France (H.S., G.S., U.G., J.L., T.P., J.S.H., A.H., E.M.); Institut National de la Santé et de la Recherche Médicale, PARCC, Paris, France (G.S., U.G., J.L., J.S.H., A.H., E.M.); Université de Paris-Cité, Paris, France (G.S., J.S.H., A.H., E.M.); and Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina (D.C., V.S.)
| | - Albert Hagege
- From the Department of Radiology, AP-HP, Hôpital Européen Georges-Pompidou, 20-40 rue Leblanc, 75015 Paris, France (H.S., G.S., U.G., J.L., T.P., J.S.H., A.H., E.M.); Institut National de la Santé et de la Recherche Médicale, PARCC, Paris, France (G.S., U.G., J.L., J.S.H., A.H., E.M.); Université de Paris-Cité, Paris, France (G.S., J.S.H., A.H., E.M.); and Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina (D.C., V.S.)
| | - Elie Mousseaux
- From the Department of Radiology, AP-HP, Hôpital Européen Georges-Pompidou, 20-40 rue Leblanc, 75015 Paris, France (H.S., G.S., U.G., J.L., T.P., J.S.H., A.H., E.M.); Institut National de la Santé et de la Recherche Médicale, PARCC, Paris, France (G.S., U.G., J.L., J.S.H., A.H., E.M.); Université de Paris-Cité, Paris, France (G.S., J.S.H., A.H., E.M.); and Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina (D.C., V.S.)
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Domengé O, Fayol A, Ladouceur M, Wahbi K, Amar L, Carette C, Hagège A, Hulot JS. Trends in prevalence of major etiologies leading to heart failure in young patients: An integrative review. Trends Cardiovasc Med 2024; 34:80-88. [PMID: 36155830 DOI: 10.1016/j.tcm.2022.09.005] [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] [Received: 04/20/2022] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 10/14/2022]
Abstract
The prevalence of Heart failure (HF) is increasing with the aging of the population but it is estimated that 10% of HF patients are younger than 50 years-old. HF development in this population is characterized with a fast-growing prevalence, and important disparities according to underlying etiologies or gender. These observations highlight the need to identify specific and preventable factors in these patients, a topic that is under-studied. Here we provide an overview of trends in prevalence of major etiologies leading to HF in young subjects, including genetic factors associated with cardiomyopathies, premature vascular dysfunction and related ischemia, metabolic stress, cardio-toxic responses to different agents, and myocarditis. We also highlight the increasing influence of major risk factors that are driving HF in younger patients, such as obesity, diabetes or arterial hypertension.
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Affiliation(s)
- Orianne Domengé
- Université de Paris, INSERM, PARCC, Paris F-75006, France; CIC1418 and DMU CARTE, AP-HP: Assistance Publique - Hopitaux de Paris, PARCC, Hôpital Européen Georges-Pompidou, 56 Rue Leblanc, Paris F-75015, France
| | - Antoine Fayol
- Université de Paris, INSERM, PARCC, Paris F-75006, France; CIC1418 and DMU CARTE, AP-HP: Assistance Publique - Hopitaux de Paris, PARCC, Hôpital Européen Georges-Pompidou, 56 Rue Leblanc, Paris F-75015, France
| | - Magalie Ladouceur
- Université de Paris, INSERM, PARCC, Paris F-75006, France; Adult Congenital Heart Disease Unit, Department of Cardiology, AP-HP, Hôpital Européen Georges Pompidou and Necker Hospital, Paris, France
| | - Karim Wahbi
- Cardiology Department, Centre de Référence de Pathologie Neuromusculaire, AP-HP, Hôpital Cochin, Paris, France
| | - Laurence Amar
- Université de Paris, INSERM, PARCC, Paris F-75006, France; Hypertension Department and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris F-75015, France
| | - Claire Carette
- CIC1418 and DMU CARTE, AP-HP: Assistance Publique - Hopitaux de Paris, PARCC, Hôpital Européen Georges-Pompidou, 56 Rue Leblanc, Paris F-75015, France; Service de nutrition, Centre Spécialisé Obésité, AP-HP, Hôpital Européen Georges-Pompidou, Paris F-75015, France
| | - Albert Hagège
- Department of Cardiology and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris F-75015, France
| | - Jean-Sébastien Hulot
- Université de Paris, INSERM, PARCC, Paris F-75006, France; CIC1418 and DMU CARTE, AP-HP: Assistance Publique - Hopitaux de Paris, PARCC, Hôpital Européen Georges-Pompidou, 56 Rue Leblanc, Paris F-75015, France.
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7
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Berthelot E, Eliahou L, Jagu A, Damy T, Hanon O, Hulot JS, Meune C, Roig C, Roubille F, Sabouret P, Logeart D, Mewton N. [Natriuretic peptides in the diagnosis and monitoring of heart failure]. Rev Prat 2024; 74:185-193. [PMID: 38415425] [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] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
NATRIURETIC PEPTIDES IN THE DIAGNOSIS AND MONITORING OF CARDIAC FAILURE. Heart failure (HF) is a serious and common disease requiring a prompt diagnosis for appropriate management. Natriuretic peptides, such as BNP and NT-proBNP, play a crucial role in diagnosing HF due to their s pecificity and reproducibility. It is important to measuring natriuretic peptides, especially in cases of acute dyspnea, to differentiate cardiac causes from others. Specific thresholds are recommended, with high values strongly suggest HF, while normal levels rule out the diagnosis. Clinical characteristics, such as age, renal function, atrial fibrillation, obesity, and gender, influence natriuretic peptides levels and should be considered in interpretation. For diabetic, hypertensive, and obese patients, early screening for HF through natriuretic peptides measurement is crucial. Furthermore, these natriuretic peptides are useful for monitoring chronic heart failure patients. They assist in confirming decompensation, titrating treatment, evaluating treatment response, and establishing prognosis. However, it's essential to choose a single biomarker (BNP or NT-proBNP) to avoid confusion.
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Affiliation(s)
| | - Ludivine Eliahou
- Centre national de référence pour le syndrome de Marfan et les maladies apparentées, VASCERN HTAD European Reference Centre, AP-HP, hôpital Bichat-Claude-Bernard, Paris, France. Service de cardiologie, AP-HP, hôpital Bichat-Claude-Bernard, Paris, France
| | - Annabelle Jagu
- Service de cardiologie, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - Thibaud Damy
- Service de cardiologie, Center for Cardiac Amyloidosis, GRC Amyloid Research Institute, DHU A-TVB, AP-HP CHU Henri-Mondor et université Paris-Est Créteil, France
| | - Olivier Hanon
- EA4468 université de Paris, service de gériatrie, hôpital Broca, AP-HP, Hôpitaux universitaires Paris Centre, France
| | | | - Christophe Meune
- Service de cardiologie, hôpital Avicenne, AP-HP, université de Paris, Paris, France
| | - Clemence Roig
- Service de cardiologie, Institut mutualiste Montsouris, Paris, France
| | - François Roubille
- INSERM U661, Montpellier, France. hôpital Arnaud-de-Villeneuve, université de Montpellier-1 et 2, Montpellier, France
| | - Pierre Sabouret
- Département de cardiologie médicale de l'Institut de cardiologie de Paris et Collège national des cardiologues français, hôpital La Pitié-Salpêtrière, université La Sorbonne, Paris, France
| | - Damien Logeart
- Service de cardiologie, AP-HP, hôpital Lariboisière, Paris, France, université de Paris, Paris, France
| | - Nathan Mewton
- Hôpital cardiovasculaire Louis-Pradel, centre d'investigation clinique INSERM 1407, service insuffisance cardiaque, Hospices civils de Lyon ; université Claude-Bernard Lyon-1, INSERM U1060 CarMeN, Lyon, France
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8
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Hulot JS, Kupatt C. Inhalable Therapies for the Heart: Take the "Lung" Way Home? J Am Coll Cardiol 2024; 83:60-62. [PMID: 38171711 DOI: 10.1016/j.jacc.2023.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 01/05/2024]
Affiliation(s)
- Jean-Sébastien Hulot
- Université de Paris, INSERM, PARCC, Paris, France; CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France.
| | - Christian Kupatt
- Klinik und Poliklinik für Innere Medizin I, Klinikum rechts der Isar, Technical University Munich, Munich, Germany; German Center for Cardiovascular Research, Munich Heart Alliance, Munich, Germany
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9
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Vermersch E, Neuvendel S, Jouve C, Ruiz-Velasco A, Pereira C, Seguret M, Cattin-Messaoudi ME, Lotfi S, Dorval T, Berson P, Hulot JS. hsa-miR-548v controls the viscoelastic properties of human cardiomyocytes and improves their relaxation rates. JCI Insight 2024; 9:e161356. [PMID: 38165745 DOI: 10.1172/jci.insight.161356] [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] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 12/19/2023] [Indexed: 01/04/2024] Open
Abstract
The impairment of left ventricular (LV) diastolic function with an inadequate increase in myocardial relaxation velocity directly results in lower LV compliance, increased LV filling pressures, and heart failure symptoms. The development of agents facilitating the relaxation of human cardiomyocytes requires a better understanding of the underlying regulatory mechanisms. We performed a high-content microscopy-based screening in human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) using a library of 2,565 human miRNA mimics and measured relaxation kinetics via high-computing analyses of motion movies. We identified hsa-miR-548v, a primate-specific miRNA, as the miRNA producing the largest increase in relaxation velocities. This positive lusitropic effect was reproduced in engineered cardiac tissues generated with healthy and BRAF T599R mutant hiPSC-CMs and was independent of changes in calcium transients. Consistent with improvements in viscoelastic responses to mechanical stretch, RNA-Seq showed that hsa-miR-548v downregulated multiple targets, especially components of the mechanosensing machinery. The exogenous administration of hsa-miR-548v in hiPSC-CMs notably resulted in a significant reduction of ANKRD1/CARP1 expression and localization at the sarcomeric I-band. This study suggests that the sarcomere I-band is a critical control center regulating the ability of cardiomyocytes to relax and is a target for improving relaxation and diastolic dysfunction.
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Affiliation(s)
- Eva Vermersch
- Université Paris Cité, Inserm, PARCC, F-75015 Paris, France
- Institut de recherches Servier, In vitro Pharmacology unit, and
| | | | - Charlène Jouve
- Université Paris Cité, Inserm, PARCC, F-75015 Paris, France
| | | | - Céline Pereira
- Université Paris Cité, Inserm, PARCC, F-75015 Paris, France
| | - Magali Seguret
- Université Paris Cité, Inserm, PARCC, F-75015 Paris, France
| | | | - Sofia Lotfi
- Institut de recherches Servier, In vitro Pharmacology unit, and
| | - Thierry Dorval
- Institut de recherches Servier, In vitro Pharmacology unit, and
| | - Pascal Berson
- Institut de recherches Servier, Cardiovascular and Metabolism Therapeutic Area, Croissy-sur-seine, France
| | - Jean-Sébastien Hulot
- Université Paris Cité, Inserm, PARCC, F-75015 Paris, France
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, F-75015, Paris, France
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10
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Raboudi A, Hervé PY, Allanic M, Boutinaud P, Christophe JJ, Firat H, Mousseaux E, Pernot M, Prot P, Sartorius-Carvajal A, Chézalviel-Guilbert F, Hulot JS. The PACIFIC ontology for heterogeneous data management in cardiology. J Biomed Inform 2024; 149:104579. [PMID: 38135173 DOI: 10.1016/j.jbi.2023.104579] [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] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023]
Abstract
With the emergence of health data warehouses and major initiatives to collect and analyze multi-modal and multisource data, data organization becomes central. In the PACIFIC-PRESERVED (PhenomApping, ClassIFication, and Innovation for Cardiac Dysfunction - Heart Failure with PRESERVED LVEF Study, NCT04189029) study, a data driven research project aiming at redefining and profiling the Heart Failure with preserved Ejection Fraction (HFpEF), an ontology was developed by different data experts in cardiology to enable better data management in a complex study context (multisource, multiformat, multimodality, multipartners). The PACIFIC ontology provides a cardiac data management framework for the phenomapping of patients. It was built upon the BMS-LM (Biomedical Study -Lifecycle Management) core ontology and framework, proposed in a previous work to ensure data organization and provenance throughout the study lifecycle (specification, acquisition, analysis, publication). The BMS-LM design pattern was applied to the PACIFIC multisource variables. In addition, data was structured using a subset of MeSH headings for diseases, technical procedures, or biological processes, and using the Uberon ontology anatomical entities. A total of 1372 variables were organized and enriched with annotations and description from existing ontologies and taxonomies such as LOINC to enable later semantic interoperability. Both, data structuring using the BMS-LM framework, and its mapping with published standards, foster interoperability of multimodal cardiac phenomapping datasets.
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Affiliation(s)
- Amel Raboudi
- Fealinx, 37 rue Adam Ledoux 92400, Courbevoie, France.
| | | | | | | | | | | | - Elie Mousseaux
- Université Paris Cité, INSERM, PARCC, F-75015, Paris, France; Department of Radiology, AP-HP, Hôpital Européen Georges-Pompidou, F-75015 Paris, France.
| | - Mathieu Pernot
- Physics for Medicine Paris, INSERM U1273, ESPCI Paris, PSL University, CNRS FRE 2031, Paris, France.
| | - Pierre Prot
- BioSerenity, ICM iPeps, F-75013, Paris, France.
| | | | | | - Jean-Sébastien Hulot
- Université Paris Cité, INSERM, PARCC, F-75015, Paris, France; CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, F-75015, Paris, France.
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11
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Poulet G, Hulot JS, Blanchard A, Bergerot D, Xiao W, Ginot F, Boutonnet-Rodat A, Justine A, Beinse G, Geromel V, Pellegrina L, Azizi M, Laurent-Puig P, Benhaim L, Taly V. Circadian rhythm and circulating cell-free DNA release on healthy subjects. Sci Rep 2023; 13:21675. [PMID: 38065990 PMCID: PMC10709451 DOI: 10.1038/s41598-023-47851-w] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/19/2023] [Indexed: 12/18/2023] Open
Abstract
In the last decade, clinical studies have investigated the clinical relevance of circulating cell-free-DNA (ccfDNA) as a diagnostic and prognosis tool in various diseases including cancers. However, limited knowledge on ccfDNA biology restrains its full development in the clinical practice. To improve our understanding, we evaluated the impact of the circadian rhythm on ccfDNA release in healthy subjects over a 24-h period. 10 healthy female subjects underwent blood sampling at 8am and 20 healthy male subjects underwent serial blood sampling (8:00 AM, 9:00 AM, 12:00 PM, 4:00 PM, 8:00 PM, 12:00 AM, 4 AM (+ 1 Day) and 8 AM (+ 1 Day)). We performed digital droplet-based PCR (ddPCR) assays to target 2 DNA fragments (69 & 243 bp) located in the KRAS gene to determine the ccfDNA concentration and fragmentation profile. As control, half of the samples were re-analyzed by capillary miniaturized electrophoresis (BIAbooster system). Overall, we did not detect any influence of the circadian rhythm on ccfDNA release. Instead, we observed a decrease in the ccfDNA concentration after meal ingestion, suggesting either a post-prandial effect or a technical detection bias due to a higher plasma load in lipids and triglycerides. We also noticed a potential effect of gender, weight and creatinine levels on ccfDNA concentration.
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Affiliation(s)
- Geoffroy Poulet
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France
- Eurofins-Biomnis, Gerland, Lyon, France
| | - Jean-Sébastien Hulot
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, 75015, Paris, France
| | - Anne Blanchard
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, 75015, Paris, France
| | - Damien Bergerot
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, 75015, Paris, France
| | - Wenjin Xiao
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France
| | | | | | - Abdelli Justine
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France
| | - Guillaume Beinse
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France
| | | | | | - Michel Azizi
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, 75015, Paris, France
| | - Pierre Laurent-Puig
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France
- Biochemistry Department - Unit of Pharmacogenetic and Molecular Oncology, Hôpital Européen Georges Pompidou (HEGP), Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
| | - Leonor Benhaim
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France.
- Department of Visceral and Surgical Oncology, Gustave Roussy, Villejuif, France.
| | - Valerie Taly
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France.
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12
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Liu L, Jouve C, Henry J, Berrandou TE, Hulot JS, Georges A, Bouatia-Naji N. Genomic, Transcriptomic, and Proteomic Depiction of Induced Pluripotent Stem Cells-Derived Smooth Muscle Cells As Emerging Cellular Models for Arterial Diseases. Hypertension 2023; 80:740-753. [PMID: 36655574 DOI: 10.1161/hypertensionaha.122.19733] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Vascular smooth muscle cells (SMCs) plasticity is a central mechanism in cardiovascular health and disease. We aimed at providing cellular phenotyping, epigenomic and proteomic depiction of SMCs derived from induced pluripotent stem cells and evaluating their potential as cellular models in the context of complex diseases. METHODS Human induced pluripotent stem cell lines were differentiated using RepSox (R-SMCs) or PDGF-BB (platelet-derived growth factor-BB) and TGF-β (transforming growth factor beta; TP-SMCs), during a 24-day long protocol. RNA-Seq and assay for transposase accessible chromatin-Seq were performed at 6 time points of differentiation, and mass spectrometry was used to quantify proteins. RESULTS Both induced pluripotent stem cell differentiation protocols generated SMCs with positive expression of SMC markers. TP-SMCs exhibited greater proliferation capacity, migration and lower calcium release in response to contractile stimuli, compared with R-SMCs. Genes involved in the contractile function of arteries were highly expressed in R-SMCs compared with TP-SMCs or primary SMCs. R-SMCs and coronary artery transcriptomic profiles were highly similar, characterized by high expression of genes involved in blood pressure regulation and coronary artery disease. We identified FOXF1 and HAND1 as key drivers of RepSox specific program. Extracellular matrix content contained more proteins involved in wound repair in TP-SMCs and higher secretion of basal membrane constituents in R-SMCs. Open chromatin regions of R-SMCs and TP-SMCs were significantly enriched for variants associated with blood pressure and coronary artery disease. CONCLUSIONS Both induced pluripotent stem cell-derived SMCs models present complementary cellular phenotypes of high relevance to SMC plasticity. These cellular models present high potential to study functional regulation at genetic risk loci of main arterial diseases.
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Affiliation(s)
- Lu Liu
- Université Paris Cité, Inserm, PARCC, Paris, France (L.L., C.J., J.H., T.-E.B., J.-S.H., A.G., N.B.-N.)
| | - Charlène Jouve
- Université Paris Cité, Inserm, PARCC, Paris, France (L.L., C.J., J.H., T.-E.B., J.-S.H., A.G., N.B.-N.)
| | - Joséphine Henry
- Université Paris Cité, Inserm, PARCC, Paris, France (L.L., C.J., J.H., T.-E.B., J.-S.H., A.G., N.B.-N.)
| | - Takiy-Eddine Berrandou
- Université Paris Cité, Inserm, PARCC, Paris, France (L.L., C.J., J.H., T.-E.B., J.-S.H., A.G., N.B.-N.)
| | - Jean-Sébastien Hulot
- Université Paris Cité, Inserm, PARCC, Paris, France (L.L., C.J., J.H., T.-E.B., J.-S.H., A.G., N.B.-N.)
| | - Adrien Georges
- Université Paris Cité, Inserm, PARCC, Paris, France (L.L., C.J., J.H., T.-E.B., J.-S.H., A.G., N.B.-N.)
| | - Nabila Bouatia-Naji
- Université Paris Cité, Inserm, PARCC, Paris, France (L.L., C.J., J.H., T.-E.B., J.-S.H., A.G., N.B.-N.)
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13
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Masurkar N, Bouvet M, Logeart D, Jouve C, Dramé F, Claude O, Roux M, Delacroix C, Bergerot D, Mercadier JJ, Sirol M, Gellen B, Livrozet M, Fayol A, Robidel E, Trégouët DA, Marazzi G, Sassoon D, Valente M, Hulot JS. Novel Cardiokine GDF3 Predicts Adverse Fibrotic Remodeling After Myocardial Infarction. Circulation 2023; 147:498-511. [PMID: 36484260 DOI: 10.1161/circulationaha.121.056272] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Myocardial infarction (MI) induces a repair response that ultimately generates a stable fibrotic scar. Although the scar prevents cardiac rupture, an excessive profibrotic response impairs optimal recovery by promoting the development of noncontractile fibrotic areas. The mechanisms that lead to cardiac fibrosis are diverse and incompletely characterized. We explored whether the expansion of cardiac fibroblasts after MI can be regulated through a paracrine action of cardiac stromal cells. METHODS We performed a bioinformatic secretome analysis of cardiac stromal PW1+ cells isolated from normal and post-MI mouse hearts to identify novel secreted proteins. Functional assays were used to screen secreted proteins that promote fibroblast proliferation. The expressions of candidates were subsequently analyzed in mouse and human hearts and plasmas. The relationship between levels of circulating protein candidates and adverse post-MI cardiac remodeling was examined in a cohort of 80 patients with a first ST-segment-elevation MI and serial cardiac magnetic resonance imaging evaluations. RESULTS Cardiac stromal PW1+ cells undergo a change in paracrine behavior after MI, and the conditioned media from these cells induced a significant increase in the proliferation of fibroblasts. We identified a total of 12 candidates as secreted proteins overexpressed by cardiac PW1+ cells after MI. Among these factors, GDF3 (growth differentiation factor 3), a member of the TGF-β (transforming growth factor-β) family, was markedly upregulated in the ischemic hearts. Conditioned media specifically enriched with GDF3 induced fibroblast proliferation at a high level by stimulation of activin-receptor-like kinases. In line with the secretory nature of this protein, we next found that GDF3 can be detected in mice and human plasma samples, with a significant increase in the days after MI. In humans, higher GDF3 circulating levels (measured in the plasma at day 4 after MI) were significantly associated with an increased risk of adverse remodeling 6 months after MI (adjusted odds ratio, 1.76 [1.03-3.00]; P=0.037), including lower left ventricular ejection fraction and a higher proportion of akinetic segments. CONCLUSIONS Our findings define a mechanism for the profibrotic action of cardiac stromal cells through secreted cardiokines, such as GDF3, a candidate marker of adverse fibrotic remodeling after MI. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT01113268.
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Affiliation(s)
- Nihar Masurkar
- Paris Cardiovascular Research Center, INSERM (N.M., M.B., C.J., F.D., O.C., C.D., E.R., G.M., D.S., M.V., J.-S.H.), Université de Paris, Cité' France
| | - Marion Bouvet
- Paris Cardiovascular Research Center, INSERM (N.M., M.B., C.J., F.D., O.C., C.D., E.R., G.M., D.S., M.V., J.-S.H.), Université de Paris, Cité' France
| | - Damien Logeart
- Hôpital Lariboisière (D.L., M.S.), Université de Paris, Cité' France
| | - Charlène Jouve
- Paris Cardiovascular Research Center, INSERM (N.M., M.B., C.J., F.D., O.C., C.D., E.R., G.M., D.S., M.V., J.-S.H.), Université de Paris, Cité' France
| | - Fatou Dramé
- Paris Cardiovascular Research Center, INSERM (N.M., M.B., C.J., F.D., O.C., C.D., E.R., G.M., D.S., M.V., J.-S.H.), Université de Paris, Cité' France
| | - Olivier Claude
- Paris Cardiovascular Research Center, INSERM (N.M., M.B., C.J., F.D., O.C., C.D., E.R., G.M., D.S., M.V., J.-S.H.), Université de Paris, Cité' France
| | - Maguelonne Roux
- Sorbonne Université, UPMC Univ Paris 06, INSERM, Institute of Cardio Metabolism and Nutrition, France (M.R.)
| | - Clément Delacroix
- Paris Cardiovascular Research Center, INSERM (N.M., M.B., C.J., F.D., O.C., C.D., E.R., G.M., D.S., M.V., J.-S.H.), Université de Paris, Cité' France
| | - Damien Bergerot
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France (D.B., M.L., A.F., J.-S.H.)
| | - Jean-Jacques Mercadier
- Signalisation and Cardiovascular Pathophysiology - Univ. Paris-Sud, INSERM, Université Paris-Saclay, Châtenay-Malabry, France (J.-J.M.)
| | - Marc Sirol
- Hôpital Lariboisière (D.L., M.S.), Université de Paris, Cité' France
| | - Barnabas Gellen
- ELSAN, Polyclinique de Poitiers, Service de Cardiologie, France (B.G.)
| | - Marine Livrozet
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France (D.B., M.L., A.F., J.-S.H.)
| | - Antoine Fayol
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France (D.B., M.L., A.F., J.-S.H.)
| | - Estelle Robidel
- Paris Cardiovascular Research Center, INSERM (N.M., M.B., C.J., F.D., O.C., C.D., E.R., G.M., D.S., M.V., J.-S.H.), Université de Paris, Cité' France
| | - David-Alexandre Trégouët
- INSERM UMR_S 1219, Bordeaux Population Health Research Center, University of Bordeaux, France (D.-A.T.)
| | - Giovanna Marazzi
- Paris Cardiovascular Research Center, INSERM (N.M., M.B., C.J., F.D., O.C., C.D., E.R., G.M., D.S., M.V., J.-S.H.), Université de Paris, Cité' France
| | - David Sassoon
- Paris Cardiovascular Research Center, INSERM (N.M., M.B., C.J., F.D., O.C., C.D., E.R., G.M., D.S., M.V., J.-S.H.), Université de Paris, Cité' France
| | - Mariana Valente
- Paris Cardiovascular Research Center, INSERM (N.M., M.B., C.J., F.D., O.C., C.D., E.R., G.M., D.S., M.V., J.-S.H.), Université de Paris, Cité' France
| | - Jean-Sébastien Hulot
- Paris Cardiovascular Research Center, INSERM (N.M., M.B., C.J., F.D., O.C., C.D., E.R., G.M., D.S., M.V., J.-S.H.), Université de Paris, Cité' France.,CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France (D.B., M.L., A.F., J.-S.H.)
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14
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van der Velden J, Asselbergs FW, Bakkers J, Batkai S, Bertrand L, Bezzina CR, Bot I, Brundel BJJM, Carrier L, Chamuleau S, Ciccarelli M, Dawson D, Davidson SM, Dendorfer A, Duncker DJ, Eschenhagen T, Fabritz L, Falcão-Pires I, Ferdinandy P, Giacca M, Girao H, Gollmann-Tepeköylü C, Gyongyosi M, Guzik TJ, Hamdani N, Heymans S, Hilfiker A, Hilfiker-Kleiner D, Hoekstra AG, Hulot JS, Kuster DWD, van Laake LW, Lecour S, Leiner T, Linke WA, Lumens J, Lutgens E, Madonna R, Maegdefessel L, Mayr M, van der Meer P, Passier R, Perbellini F, Perrino C, Pesce M, Priori S, Remme CA, Rosenhahn B, Schotten U, Schulz R, Sipido KR, Sluijter JPG, van Steenbeek F, Steffens S, Terracciano CM, Tocchetti CG, Vlasman P, Yeung KK, Zacchigna S, Zwaagman D, Thum T. Animal models and animal-free innovations for cardiovascular research: current status and routes to be explored. Consensus document of the ESC Working Group on Myocardial Function and the ESC Working Group on Cellular Biology of the Heart. Cardiovasc Res 2022; 118:3016-3051. [PMID: 34999816 PMCID: PMC9732557 DOI: 10.1093/cvr/cvab370] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [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: 02/07/2021] [Accepted: 01/05/2022] [Indexed: 01/09/2023] Open
Abstract
Cardiovascular diseases represent a major cause of morbidity and mortality, necessitating research to improve diagnostics, and to discover and test novel preventive and curative therapies, all of which warrant experimental models that recapitulate human disease. The translation of basic science results to clinical practice is a challenging task, in particular for complex conditions such as cardiovascular diseases, which often result from multiple risk factors and comorbidities. This difficulty might lead some individuals to question the value of animal research, citing the translational 'valley of death', which largely reflects the fact that studies in rodents are difficult to translate to humans. This is also influenced by the fact that new, human-derived in vitro models can recapitulate aspects of disease processes. However, it would be a mistake to think that animal models do not represent a vital step in the translational pathway as they do provide important pathophysiological insights into disease mechanisms particularly on an organ and systemic level. While stem cell-derived human models have the potential to become key in testing toxicity and effectiveness of new drugs, we need to be realistic, and carefully validate all new human-like disease models. In this position paper, we highlight recent advances in trying to reduce the number of animals for cardiovascular research ranging from stem cell-derived models to in situ modelling of heart properties, bioinformatic models based on large datasets, and state-of-the-art animal models, which show clinically relevant characteristics observed in patients with a cardiovascular disease. We aim to provide a guide to help researchers in their experimental design to translate bench findings to clinical routine taking the replacement, reduction, and refinement (3R) as a guiding concept.
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Grants
- R01 HL150359 NHLBI NIH HHS
- RG/16/14/32397 British Heart Foundation
- FS/18/37/33642 British Heart Foundation
- PG/17/64/33205 British Heart Foundation
- PG/15/88/31780 British Heart Foundation
- FS/RTF/20/30009, NH/19/1/34595, PG/18/35/33786, CS/17/4/32960, PG/15/88/31780, and PG/17/64/33205 British Heart Foundation
- NC/T001488/1 National Centre for the Replacement, Refinement and Reduction of Animals in Research
- PG/18/44/33790 British Heart Foundation
- CH/16/3/32406 British Heart Foundation
- FS/RTF/20/30009 British Heart Foundation
- NWO-ZonMW
- ZonMW and Heart Foundation for the translational research program
- Dutch Cardiovascular Alliance (DCVA)
- Leducq Foundation
- Dutch Research Council
- Association of Collaborating Health Foundations (SGF)
- UCL Hospitals NIHR Biomedical Research Centre, and the DCVA
- Netherlands CardioVascular Research Initiative CVON
- Stichting Hartekind and the Dutch Research Counsel (NWO) (OCENW.GROOT.2019.029)
- National Fund for Scientific Research, Belgium and Action de Recherche Concertée de la Communauté Wallonie-Bruxelles, Belgium
- Netherlands CardioVascular Research Initiative CVON (PREDICT2 and CONCOR-genes projects), the Leducq Foundation
- ERA PerMed (PROCEED study)
- Netherlands Cardiovascular Research Initiative
- Dutch Heart Foundation
- German Centre of Cardiovascular Research (DZHH)
- Chest Heart and Stroke Scotland
- Tenovus Scotland
- Friends of Anchor and Grampian NHS-Endowments
- National Institute for Health Research University College London Hospitals Biomedical Research Centre
- German Centre for Cardiovascular Research
- European Research Council (ERC-AG IndivuHeart), the Deutsche Forschungsgemeinschaft
- European Union Horizon 2020 (REANIMA and TRAINHEART)
- German Ministry of Education and Research (BMBF)
- Centre for Cardiovascular Research (DZHK)
- European Union Horizon 2020
- DFG
- National Research, Development and Innovation Office of Hungary
- Research Excellence Program—TKP; National Heart Program
- Austrian Science Fund
- European Union Commission’s Seventh Framework programme
- CVON2016-Early HFPEF
- CVON She-PREDICTS
- CVON Arena-PRIME
- European Union’s Horizon 2020 research and innovation programme
- Deutsche Forschungsgemeinschaft
- Volkswagenstiftung
- French National Research Agency
- ERA-Net-CVD
- Fédération Française de Cardiologie, the Fondation pour la Recherche Médicale
- French PIA Project
- University Research Federation against heart failure
- Netherlands Heart Foundation
- Dekker Senior Clinical Scientist
- Health Holland TKI-LSH
- TUe/UMCU/UU Alliance Fund
- south African National Foundation
- Cancer Association of South Africa and Winetech
- Netherlands Heart Foundation/Applied & Engineering Sciences
- Dutch Technology Foundation
- Pie Medical Imaging
- Netherlands Organisation for Scientific Research
- Dr. Dekker Program
- Netherlands CardioVascular Research Initiative: the Dutch Heart Foundation
- Dutch Federation of University Medical Centres
- Netherlands Organization for Health Research and Development and the Royal Netherlands Academy of Sciences for the GENIUS-II project
- Netherlands Organization for Scientific Research (NWO) (VICI grant); the European Research Council
- Incyte s.r.l. and from Ministero dell’Istruzione, Università e Ricerca Scientifica
- German Center for Cardiovascular Research (Junior Research Group & Translational Research Project), the European Research Council (ERC Starting Grant NORVAS),
- Swedish Heart-Lung-Foundation
- Swedish Research Council
- National Institutes of Health
- Bavarian State Ministry of Health and Care through the research project DigiMed Bayern
- ERC
- ERA-CVD
- Dutch Heart Foundation, ZonMw
- the NWO Gravitation project
- Ministero dell'Istruzione, Università e Ricerca Scientifica
- Regione Lombardia
- Netherlands Organisation for Health Research and Development
- ITN Network Personalize AF: Personalized Therapies for Atrial Fibrillation: a translational network
- MAESTRIA: Machine Learning Artificial Intelligence Early Detection Stroke Atrial Fibrillation
- REPAIR: Restoring cardiac mechanical function by polymeric artificial muscular tissue
- Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)
- European Union H2020 program to the project TECHNOBEAT
- EVICARE
- BRAV3
- ZonMw
- German Centre for Cardiovascular Research (DZHK)
- British Heart Foundation Centre for Cardiac Regeneration
- British Heart Foundation studentship
- NC3Rs
- Interreg ITA-AUS project InCARDIO
- Italian Association for Cancer Research
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Affiliation(s)
- Jolanda van der Velden
- Amsterdam UMC, Vrije Universiteit, Physiology, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
- Netherlands Heart Institute, Utrecht, The Netherlands
| | - Folkert W Asselbergs
- Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Faculty of Population Health Sciences, Institute of Cardiovascular Science and Institute of Health Informatics, University College London, London, UK
| | - Jeroen Bakkers
- Hubrecht Institute-KNAW and University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Sandor Batkai
- Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies, Hannover, Germany
| | - Luc Bertrand
- Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies, Hannover, Germany
| | - Connie R Bezzina
- Université catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Pole of Cardiovascular Research, Brussels, Belgium
| | - Ilze Bot
- Heart Center, Department of Experimental Cardiology, Amsterdam UMC, Location Academic Medical Center, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, The Netherlands
- Division of BioTherapeutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Bianca J J M Brundel
- Amsterdam UMC, Vrije Universiteit, Physiology, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
| | - Lucie Carrier
- Institute of Experimental Pharmacology and Toxicology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Steven Chamuleau
- Amsterdam UMC, Heart Center, Cardiology, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Odontology, University of Salerno, Fisciano (SA), Italy
| | - Dana Dawson
- Department of Cardiology, Aberdeen Cardiovascular and Diabetes Centre, Aberdeen Royal Infirmary and University of Aberdeen, Aberdeen, UK
| | - Sean M Davidson
- The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London WC1E 6HX, UK
| | - Andreas Dendorfer
- Walter-Brendel-Centre of Experimental Medicine, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Dirk J Duncker
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Thomas Eschenhagen
- Institute of Experimental Pharmacology and Toxicology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Larissa Fabritz
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
- University Center of Cardiovascular Sciences and Department of Cardiology, University Heart Center Hamburg, Germany and Institute of Cardiovascular Sciences, University of Birmingham, UK
| | - Ines Falcão-Pires
- UnIC - Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal
| | - Péter Ferdinandy
- Cardiometabolic Research Group and MTA-SE System Pharmacology Research Group, Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
- Pharmahungary Group, Szeged, Hungary
| | - Mauro Giacca
- Department of Medicine, Surgery and Health Sciences and Cardiovascular Department, Centre for Translational Cardiology, Azienda Sanitaria Universitaria Integrata Trieste, Trieste, Italy
- International Center for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
- King’s British Heart Foundation Centre, King’s College London, London, UK
| | - Henrique Girao
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology, Faculty of Medicine, Coimbra, Portugal
- Clinical Academic Centre of Coimbra, Coimbra, Portugal
| | | | - Mariann Gyongyosi
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Tomasz J Guzik
- Instutute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Jagiellonian University, Collegium Medicum, Kraków, Poland
| | - Nazha Hamdani
- Division Cardiology, Molecular and Experimental Cardiology, Ruhr University Bochum, Bochum, Germany
- Institute of Physiology, Ruhr University Bochum, Bochum, Germany
| | - Stephane Heymans
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Andres Hilfiker
- Department for Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Denise Hilfiker-Kleiner
- Department for Cardiology and Angiology, Hannover Medical School, Hannover, Germany
- Department of Cardiovascular Complications in Pregnancy and in Oncologic Therapies, Comprehensive Cancer Centre, Philipps-Universität Marburg, Germany
| | - Alfons G Hoekstra
- Computational Science Lab, Informatics Institute, Faculty of Science, University of Amsterdam, Amsterdam, the Netherlands
| | - Jean-Sébastien Hulot
- Université de Paris, INSERM, PARCC, F-75015 Paris, France
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, F-75015 Paris, France
| | - Diederik W D Kuster
- Amsterdam UMC, Vrije Universiteit, Physiology, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
| | - Linda W van Laake
- Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Sandrine Lecour
- Department of Medicine, Hatter Institute for Cardiovascular Research in Africa and Cape Heart Institute, University of Cape Town, Cape Town, South Africa
| | - Tim Leiner
- Department of Radiology, Utrecht University Medical Center, Utrecht, the Netherlands
| | - Wolfgang A Linke
- Institute of Physiology II, University of Muenster, Robert-Koch-Str. 27B, 48149 Muenster, Germany
| | - Joost Lumens
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Esther Lutgens
- Experimental Vascular Biology Division, Department of Medical Biochemistry, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Institute for Cardiovascular Prevention, Ludwig-Maximilians-Universität München (LMU), Munich, Germany
- DZHK, Partner Site Munich Heart Alliance, Munich, Germany
| | - Rosalinda Madonna
- Department of Pathology, Cardiology Division, University of Pisa, 56124 Pisa, Italy
- Department of Internal Medicine, Cardiology Division, University of Texas Medical School in Houston, Houston, TX, USA
| | - Lars Maegdefessel
- DZHK, Partner Site Munich Heart Alliance, Munich, Germany
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Manuel Mayr
- King’s British Heart Foundation Centre, King’s College London, London, UK
| | - Peter van der Meer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Robert Passier
- Department of Applied Stem Cell Technologies, TechMed Centre, University of Twente, 7500AE Enschede, The Netherlands
- Department of Anatomy and Embryology, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands
| | - Filippo Perbellini
- Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies, Hannover, Germany
| | - Cinzia Perrino
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Maurizio Pesce
- Unità di Ingegneria Tissutale Cardiovascolare, Centro cardiologico Monzino, IRCCS, Milan, Italy
| | - Silvia Priori
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri, Pavia, Italy
- University of Pavia, Pavia, Italy
| | - Carol Ann Remme
- Université catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Pole of Cardiovascular Research, Brussels, Belgium
| | - Bodo Rosenhahn
- Institute for information Processing, Leibniz University of Hanover, 30167 Hannover, Germany
| | - Ulrich Schotten
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Rainer Schulz
- Institute of Physiology, Justus Liebig University Giessen, Giessen, Germany
| | - Karin R Sipido
- Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Joost P G Sluijter
- Experimental Cardiology Laboratory, Department of Cardiology, Regenerative Medicine Center Utrecht, Circulatory Health Laboratory, Utrecht University, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank van Steenbeek
- Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Sabine Steffens
- Institute for Cardiovascular Prevention, Ludwig-Maximilians-Universität München (LMU), Munich, Germany
- DZHK, Partner Site Munich Heart Alliance, Munich, Germany
| | | | - Carlo Gabriele Tocchetti
- Cardio-Oncology Unit, Department of Translational Medical Sciences, Center for Basic and Clinical Immunology Research (CISI), Interdepartmental Center for Clinical and Translational Research (CIRCET), Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University, Naples, Italy
| | - Patricia Vlasman
- Amsterdam UMC, Vrije Universiteit, Physiology, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
| | - Kak Khee Yeung
- Amsterdam UMC, Vrije Universiteit, Surgery, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
| | - Serena Zacchigna
- Department of Medicine, Surgery and Health Sciences and Cardiovascular Department, Centre for Translational Cardiology, Azienda Sanitaria Universitaria Integrata Trieste, Trieste, Italy
- International Center for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Dayenne Zwaagman
- Amsterdam UMC, Heart Center, Cardiology, Amsterdam Cardiovascular Science, Amsterdam, The Netherlands
| | - Thomas Thum
- Hannover Medical School, Institute of Molecular and Translational Therapeutic Strategies, Hannover, Germany
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
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15
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Lecoeur E, Domengé O, Fayol A, Jannot AS, Hulot JS. Epidemiology of heart failure in young adults: a French nationwide cohort study. Eur Heart J 2022; 44:383-392. [PMID: 36452998 PMCID: PMC9890267 DOI: 10.1093/eurheartj/ehac651] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/24/2022] [Accepted: 10/30/2022] [Indexed: 12/05/2022] Open
Abstract
AIMS Heart failure (HF) in young adults is uncommon, and changes in its incidence and prognosis in recent years are poorly described. METHODS AND RESULTS The incidence and prognosis of HF in young adults (1850 years) were characterized using nationwide medico-administrative data from the French National Hospitalization Database (period 20132018). A total of 1,486 877 patients hospitalized for incident HF were identified, including 70 075 (4.7) patients aged 1850 years (estimated incidence of 0.44 for this age group). During the study period, the overall incidence of HF tended to decrease in the overall population but significantly increased by 0.041 in young adults (P 0.001). This increase was notably observed among young men (from 0.51 to 0.59, P 0.001), particularly those aged 3650 years. In these young men, ischaemic heart disease (IHD) was the most frequently reported cause of HF, whereas non-ischaemic HF was mainly observed in patients 35 years old. In contrast to non-ischaemic HF, the incidence of IHD increased over the study period, which suggests that IHD-related HF is progressively affecting younger patients. Concordantly, young HF patients presented with high rates of traditional IHD risk factors, including obesity, smoking, hypertension, dyslipidaemia, or diabetes. Lastly, the rates of re-hospitalization (for HF or for any cause) within two years after the first HF event and in-hospital mortality were high in all groups, indicating a poor-prognosis population. CONCLUSION Strategies for the prevention of HF risk factors should be strongly considered for patients under 50 years old.
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Affiliation(s)
- Emmanuel Lecoeur
- Department of Medical Informatics and Public Health, Hôpital Européen Georges-Pompidou, F-75015, Paris, France
| | - Orianne Domengé
- Université de Paris Cité, INSERM, PARCC, Heart failure translational laboratory, F-75015, Paris, France,CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, F-75015, Paris, France
| | - Antoine Fayol
- Université de Paris Cité, INSERM, PARCC, Heart failure translational laboratory, F-75015, Paris, France,CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, F-75015, Paris, France
| | - Anne-Sophie Jannot
- Department of Medical Informatics and Public Health, Hôpital Européen Georges-Pompidou, F-75015, Paris, France
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16
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Lee CR, Luzum JA, Sangkuhl K, Gammal RS, Sabatine MS, Stein CM, Kisor DF, Limdi NA, Lee YM, Scott SA, Hulot JS, Roden DM, Gaedigk A, Caudle KE, Klein TE, Johnson JA, Shuldiner AR. Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2C19 Genotype and Clopidogrel Therapy: 2022 Update. Clin Pharmacol Ther 2022; 112:959-967. [PMID: 35034351 PMCID: PMC9287492 DOI: 10.1002/cpt.2526] [Citation(s) in RCA: 130] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/22/2021] [Indexed: 11/06/2022]
Abstract
CYP2C19 catalyzes the bioactivation of the antiplatelet prodrug clopidogrel, and CYP2C19 genotype impacts clopidogrel active metabolite formation. CYP2C19 intermediate and poor metabolizers who receive clopidogrel experience reduced platelet inhibition and increased risk for major adverse cardiovascular and cerebrovascular events. This guideline is an update to the 2013 Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for the use of clopidogrel based on CYP2C19 genotype and includes expanded indications for CYP2C19 genotype-guided antiplatelet therapy, increased strength of recommendation for CYP2C19 intermediate metabolizers, updated CYP2C19 genotype to phenotype translation, and evidence from an expanded literature review (updates at www.cpicpgx.org).
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Affiliation(s)
- Craig R. Lee
- Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Jasmine A. Luzum
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, USA
| | - Katrin Sangkuhl
- Department of Biomedical Data Science, Stanford University, Stanford, CA, USA
| | - Roseann S. Gammal
- Department of Pharmacy Practice, Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Marc S. Sabatine
- Thrombolysis in Myocardial Infarction Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - C. Michael Stein
- Division of Clinical Pharmacology, Departments of Medicine and Pharmacology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - David F. Kisor
- Department of Pharmaceutical Sciences, Manchester University, Fort Wayne, IN, USA
| | - Nita A Limdi
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yee Ming Lee
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA
| | - Stuart A. Scott
- Department of Pathology, Stanford University, Stanford, CA, USA; Clinical Genomics Laboratory, Stanford Health Care, Palo Alto, CA, USA
| | - Jean-Sébastien Hulot
- Université de Paris, CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, F-75015, Paris, France
| | - Dan M. Roden
- Departments of Medicine and Pharmacology, Office of Personalized Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Andrea Gaedigk
- Division of Clinical Pharmacology, Toxicology & Therapeutic Innovation, Children’s Mercy Kansas City and University of Missouri Kansas City School of Medicine, Kansas City, MO, USA
| | - Kelly E. Caudle
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Teri E. Klein
- Department of Biomedical Data Science, Stanford University, Stanford, CA, USA
| | - Julie A. Johnson
- Department of Pharmacotherapy and Translational Research, and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Alan R. Shuldiner
- Department of Medicine, and Program for Genomic and Personalized Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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17
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Collet JP, Rahoual G, Hulot JS. Clonal Hematopoiesis in Cardiogenic Shock. J Am Coll Cardiol 2022; 80:1557-1559. [DOI: 10.1016/j.jacc.2022.09.002] [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] [Received: 08/25/2022] [Accepted: 09/01/2022] [Indexed: 11/05/2022]
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18
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Georges A, Liu L, Berrandou T, Jouve C, Hulot JS, Bouatia-Naji N. Epigenetic and phenotypic characterization of iPSCs-derived smooth muscle cells: towards a cellular model for complex arterial diseases. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.192] [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
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): European Research Council
Introduction
Smooth muscle cells (SMCs) capacity to switch between proliferative (synthetic) and quiescent (contractile) phenotypes is a widely studied mechanism in cardiovascular disease. Primary SMCs tend to lose many physiological features in culture, which makes the study of their contractile function challenging. Recently, an optimized protocol of induced pluripotent stem cells (iPSCs) differentiation into contractile SMCs was described.
Purpose
We aimed at obtaining a deep characterization of cellular phenotypes during the differentiation into synthetic or contractile SMCs, and evaluate these cellular models in the context of complex cardiovascular diseases.
Methods
We differentiated 4 human iPSC lines (2 males, 2 females) towards either contractile (Repsox induced) or synthetic (PDGF-BB/TGF-β induced) SMC phenotypes using a 24-days protocol (Figure). We performed RNA-Seq and assay for transposase accessible chromatin (ATAC)-Seq at 6 time points of differentiation. We compared gene expression and open chromatin profiles between them and to existing datasets of primary human SMCs and artery tissues. We characterized the extracellular matrix (matrisome) generated by SMCs using mass spectrometry.
Results
iPSCs derived SMCs showed expected morphology and positive expression of SMC markers. Synthetic SMCs exhibited greater capacity of proliferation, migration, lower contractility and calcium release capacity, compared to contractile SMCs. RNA-Seq results showed that multiple disease-associated genes involved in the contractile function of arteries, including smooth-muscle myosin heavy chain (MYH11), myosin light chain kinase (MYLK) and angiotensin type 1 receptor (AGTR1) genes, were highly expressed in contractile compared to synthetic SMCs. Interestingly, multiple genes coding for extracellular matrix components were also enriched in contractile SMCs. Matrisome characterization confirmed that contractile SMCs generated a rich extracellular matrix, compared to synthetic cells. Analysis of transcriptomic and open chromatin profiles suggests contractile SMCs retained a higher level of activity for transcription factors involved in vascular smooth muscle development. Synthetic SMCs however presented open chromatin profiles similar to cultured primary SMCs. Open chromatin regions of contractile SMCs were highly enriched for variants associated with vascular diseases such as hypertension and intracranial aneurysm, whereas synthetic SMCs were more enriched for variants associated to peripheral artery disease and aortic aneurysm.
Conclusions
Differentiation of SMCs from iPSCs using two complementary protocols provides valid cellular models suitable for the study of a variety of vascular diseases. Utilization of these cells in combination with genome-editing tools is a promising approach to the study of complex regulatory mechanisms at genetic risk loci while considering phenotypic variability of arterial cellular components.
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Affiliation(s)
- A Georges
- Paris Cardiovascular Research Center (PARCC) , Paris , France
| | - L Liu
- Paris Cardiovascular Research Center (PARCC) , Paris , France
| | - T Berrandou
- Paris Cardiovascular Research Center (PARCC) , Paris , France
| | - C Jouve
- Paris Cardiovascular Research Center (PARCC) , Paris , France
| | - JS Hulot
- Paris Cardiovascular Research Center (PARCC) , Paris , France
| | - N Bouatia-Naji
- Paris Cardiovascular Research Center (PARCC) , Paris , France
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19
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Delacroix C, Dramé F, Sassoon D, Valente M, Hulot JS. Pharmacological blockade of αV integrin (CD51) reduces the development of pressure-overload-induced cardiac fibrosis. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.04.146] [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: 10/17/2022]
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20
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Seguret M, Jouve C, Al Sayed ZR, Pereira C, Wahbi K, Muchir A, Bonne G, Hulot JS. CRISPR/Cas9 genome editing for a correction of LMNA p.H222P mutation using human-induced pluripotent stem cells (hiPSCs). Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.04.072] [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: 10/17/2022]
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21
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Jouve C, Al Sayed ZR, Seguret M, Pereira C, Vermersch E, Hulot JS. Cardiomyocytes derived from human-induced pluripotent stem cell culture in rod-shaped micropattern. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.04.057] [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: 11/24/2022]
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22
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Delacroix C, Hulot JS. [Integrins in cardiac fibrosis]. Med Sci (Paris) 2022; 38:438-444. [PMID: 35608466 DOI: 10.1051/medsci/2022055] [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: 11/15/2022] Open
Abstract
For the last 20 years, integrins have been a therapeutic target of interest in the treatment of fibrotic diseases, particularly regarding the integrins of the αV family. Initially developed as anti-cancer drugs but with modest benefits, inhibitors of integrins (such as the anti-αV cilengitide) have shown interesting anti-fibrotic effects in different organs including the heart. Cardiac fibrosis is defined as an accumulation of stiff extracellular matrix in the myocardium, and ultimately leads to heart failure, one of the leading causes of mortality worldwide. Understanding the determinants of cardiac fibrosis and the involvement of integrins is a major matter of public health. This review presents the current knowledge on the different types of cardiac fibrosis and their etiologies, and report on first data supporting specific integrin inhibition therapy as a novel anti-fibrotic strategy, in particular to treat cardiac fibrosis.
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Affiliation(s)
- Clément Delacroix
- Paris Centre de recherche cardiovasculaire (PARCC), Inserm U.970, 56 rue Leblanc, 75015 Paris, France
| | - Jean-Sébastien Hulot
- Paris Centre de recherche cardiovasculaire (PARCC), Inserm U.970, 56 rue Leblanc, 75015 Paris, France
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Mariette X, Hermine O, Tharaux PL, Resche-Rigon M, Porcher R, Ravaud P, Bureau S, Dougados M, Tibi A, Azoulay E, Cadranel J, Emmerich J, Fartoukh M, Guidet B, Humbert M, Lacombe K, Mahevas M, Pene F, Pourchet-Martinez V, Schlemmer F, Yazdanpanah Y, Baron G, Perrodeau E, Vanhoye D, Kedzia C, Demerville L, Gysembergh-Houal A, Bourgoin A, Dalibey S, Raked N, Mameri L, Alary S, Hamiria S, Bariz T, Semri H, Hai DM, Benafla M, Belloul M, Vauboin P, Flamand S, Pacheco C, Walter-Petrich A, Stan E, Benarab S, Nyanou C, Montlahuc C, Biard L, Charreteur R, Dupré C, Cardet K, Lehmann B, Baghli K, Madelaine C, D'Ortenzio E, Puéchal O, Semaille C, Savale L, Harrois A, Figueiredo S, Duranteau J, Anguel N, Pavot A, Monnet X, Richard C, Teboul JL, Durand P, Tissieres P, Jevnikar M, Montani D, Bulifon S, Jaïs X, Sitbon O, Pavy S, Noel N, Lambotte O, Escaut L, Jauréguiberry S, Baudry E, Verny C, Noaillon M, Lefèvre E, Zaidan M, Le Tiec CLT, Verstuyft C, Roques AM, Grimaldi L, Molinari D, Leprun G, Fourreau A, Cylly L, Virlouvet M, Meftali R, Fabre S, Licois M, Mamoune A, Boudali Y, Georgin-Lavialle S, Senet P, Pialoux G, Soria A, Parrot A, François H, Rozensztajn N, Blin E, Choinier P, Camuset J, Rech JS, Canellas A, Rolland-Debord C, Lemarié N, Belaube N, Nadal M, Siguier M, Petit-Hoang C, Chas J, Drouet E, Lemoine M, Phibel A, Aunay L, Bertrand E, Ravato S, Vayssettes M, Adda A, Wilpotte C, Thibaut P, Fillon J, Debrix I, Fellahi S, Bastard JP, Lefèvre G, Fallet V, Gottenberg JE, Hansmann Y, Andres E, Bayer S, Becker G, Blanc F, Brin S, Castelain V, Chatelus E, Chatron E, Collange O, Danion F, De Blay F, Demonsant E, Diemunsch P, Diemunsch S, Felten R, Goichot B, Greigert V, Guffroy A, Heger B, Hutt A, Kaeuffer C, Kassegne L, Korganow AS, Le Borgne P, Lefebvre N, Martin T, Mertes PM, Metzger C, Meyer N, Nisand G, Noll E, Oberlin M, Ohlmann-Caillard S, Poindron V, Pottecher J, Ruch Y, Sublon C, Tayebi H, Weill F, Mekinian A, Abisror N, Jachiet V, Chopin D, Fain O, Garnier M, Krause le Garrec J, Morgand M, Pacanowski J, Urbina T, McAvoy C, Pereira M, Aratus G, Berard L, Simon T, Daguenel-Nguyen A, Antignac M, Leplay C, Arlet JB, Diehl JL, Bellenfant F, Blanchard A, Buffet A, Cholley B, Fayol A, Flamarion E, Godier A, Gorget T, Hamada SR, Hauw-Berlemont C, Hulot JS, Lebeaux D, Livrozet M, Michon A, Neuschwander A, Penet MA, Planquette B, Ranque B, Sanchez O, Volle G, Briois S, Cornic M, Elisee V, Jesuthasan D, Djadi-Prat J, Jouany P, Junquera R, Henriques M, Kebir A, Lehir I, Meunier J, Patin F, Paquet V, Tréhan A, Vigna V, Sabatier B, Bergerot D, Jouve C, Knosp C, Lenoir O, Mahtal N, Resmini L, Lescure FX, Ghosn J, BACHELARD A, BIRONNE T, BORIE R, BOUNHIOL A, BOUSSARD C, CHAUFFiER J, CHALAL S, CHALAL L, CHANSOMBAT M, CRESPIN P, CRESTANI B, DACONCEICAO O, DECONINCK L, DIEUDE P, DOSSIER A, DUBERT M, DUCROCQ G, FUENTES A, GERVAIS A, GILBERT M, ISERNIA V, ISMAEL S, JOLY V, JULIA Z, LARIVEN S, LE GAC S, LE PLUART D, LOUNI F, NDIAYE A, PAPO T, PARISEY M, PHUNG B, POURBAIX A, RACHLINE A, RIOUX C, SAUTEREAU A, STEG G, TARHINI H, VALAYER S, VALLOIS D, VERMES P, VOLPE T, Nguyen Y, Honsel V, Weiss E, Codorniu A, Zarrouk V, De Lastours V, Uzzan M, Olivier O, Rossi G, Gamany N, Rahli R, Louis Z, Boutboul D, Galicier L, Amara Y, Archer G, Benattia A, Bergeron A, Bondeelle L, De Castro N, Clément M, Darmont M, Denis B, Dupin C, Feredj E, Feyeux D, Joseph A, Lengliné E, Le Guen P, Liégeon G, Lorillon G, Mabrouki A, Mariotte E, Martin de Frémont G, Mirouse A, Molina JM, Peffault de Latour R, Oksenhendler E, Saussereau J, Tazi A, Tudesq JJ, Zafrani L, Brindele I, Bugnet E, Celli Lebras K, Chabert J, Djaghout L, Fauvaux C, Jegu AL, Kozaliewicz E, Meunier M, Tremorin MT, Davoine C, Madeleine I, Caillat-Zucman S, Delaugerre C, Morin F, SENE D, BURLACU R, CHOUSTERMAN B, MEGARBANE B, RICHETTE P, RIVELINE JP, FRAZIER A, VICAUT E, BERTON L, HADJAM T, VASQUEZ-IBARRA MA, JOURDAINE C, JACOB A, SMATI J, RENAUD S, MANIVET P, PERNIN C, SUAREZ L, Semerano L, ABAD S, Benainous R, Bloch Queyrat C, Bonnet N, Brahmi S, Cailhol J, Cohen Y, Comparon C, Cordel H, Dhote R, Dournon N, Duchemann B, Ebstein N, Giroux-Leprieur B, Goupil de Bouille J, Jacolot A, Nunes H, Oziel J, Rathouin V, Rigal M, Roulot D, Tantet C, Uzunhan Y, COSTEDOAT-CHALUMEAU N, Ait Hamou Z, Benghanem S, BLANCHE P, CANOUI E, CARLIER N, CHAIGNE B, CONTEJEAN A, DUNOGUE B, DUPLAND P, DUREL - MAURISSE A, GAUZIT R, JAUBERT P, Joumaa H, Jozwiak M, KERNEIS S, LACHATRE M, Lafoeste H, LEGENDRE P, LUONG NGUYEN LB, MAREY J, MORBIEU C, MOUTHON L, NGUYEN L, Palmieri LJ, REGENT A, SZWEBEL TA, TERRIER B, GUERIN C, ZERBIT J, CHEREF K, CHITOUR K, CISSE MS, CLARKE A, CLAVERE G, DUSANTER I, GAUDEFROY C, JALLOULI M, KOLTA S, LE BOURLOUT C, MARIN N, MENAGE N, MOORES A, PEIGNEY I, PIERRON C, SALEH-MGHIR S, VALLET M, MICHEL M, MELICA G, LELIEVRE JD, FOIS E, LIM P, MATIGNON M, GUILLAUD C, THIEMELE A, SCHMITZ D, BOUHRIS M, BELAZOUZ S, LANGUILLE L, MEKONTSO-DESSAPS A, SADAOUI T, Mayaux J, Cacoub P, Corvol JC, Louapre C, Sambin S, Mariani LL, Karachi C, Tubach F, Estellat C, Gimeno L, Martin K, Bah A, Keo V, Ouamri S, Messaoudi Y, Yelles N, Faye P, Cavelot S, Larcheveque C, Annonay L, Benhida J, Zahrate-Ghoul A, Hammal S, Belilita R, Lecronier M, Beurton A, Haudebourg L, Deleris R, Le Marec J, Virolle S, Nemlaghi S, Bureau C, Mora P, De Sarcus M, Clovet O, Duceau B, Grisot PH, Pari MH, Arzoine J, Clarac U, Faure M, Delemazure J, Decavele M, Morawiec E, Demoule A, Dres M, Vautier M, Allenbach Y, Benveniste O, Leroux G, Rigolet A, Guillaume-Jugnot P, Domont F, Desbois AC, Comarmond C, Champtiaux N, Toquet S, Ghembaza A, Vieira M, Maalouf G, Boleto G, Ferfar Y, Charbonnier F, AGUILAR C, ALBY-LAURENT F, ALYANAKIAN MA, BAKOUBOULA P, BROISSAND C, BURGER C, CAMPOS-VEGA C, CHAVAROT N, CHOUPEAUX L, FOURNIER B, GRANVILLE S, ISSORAT E, ROUZAUD C, VIMPERE D, Geri G, Derridj N, Sguiouar N, Meddah H, Djadel M, Chambrin-Lauvray H, Duclos-Vallée JC, Saliba F, Sacleux SC, Koumis I, Michot JM, Stoclin A, Colomba E, Pommeret F, Willekens C, Sakkal M, Da Silva R, Dejean V, Mekid Y, Ben-Mabrouk I, Pradon C, Drouard L, Camara-Clayette V, Morel A, Garcia G, Mohebbi A, Berbour F, Dehais M, Pouliquen AL, Klasen A, Soyez-Herkert L, London J, Keroumi Y, Guillot E, Grailles G, El Amine Y, Defrancq F, Fodil H, Bouras C, Dautel D, Gambier N, Dieye T, Razurel A, Bienvenu B, Lancon V, Lecomte L, Beziriganyan K, Asselate B, Allanic L, Kiouris E, Legros MH, Lemagner C, Martel P, Provitolo V, Ackermann F, Le Marchand M, Clan Hew Wai A, Fremont D, Coupez E, Adda M, Duée F, Bernard L, Gros A, Henry E, Courtin C, Pattyn A, Guinot PG, Bardou M, Maurer A, Jambon J, Cransac A, Pernot C, Mourvillier B, Servettaz A, Deslée G, Wynckel A, Benoit P, Marquis E, Roux D, Gernez C, Yelnik C, Poissy J, Nizard M, Denies F, Gros H, Mourad JJ, Sacco E, Renet S. Sarilumab in adults hospitalised with moderate-to-severe COVID-19 pneumonia (CORIMUNO-SARI-1): An open-label randomised controlled trial. The Lancet Rheumatology 2022; 4:e24-e32. [PMID: 34812424 PMCID: PMC8598187 DOI: 10.1016/s2665-9913(21)00315-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Patients with COVID-19 pneumonia can have increased inflammation and elevated cytokines, including interleukin (IL)-6, which might be deleterious. Thus, sarilumab, a high-affinity anti-IL-6 receptor antibody, might improve the outcome of patients with moderate-to-severe COVID-19 pneumonia. Methods We did a multicentric, open-label, Bayesian randomised, adaptive, phase 2/3 clinical trial, nested within the CORIMUNO-19 cohort, to test a superiority hypothesis. Patients 18 years or older hospitalised with COVID-19 in six French centres, requiring at least 3L/min of oxygen but without ventilation assistance and a WHO Clinical Progression Scale [CPS] score of 5 were enrolled. Patients were randomly assigned (1:1) via a web-based system, according to a randomisation list stratified on centre and with blocks randomly selected among 2 and 4, to receive usual care plus 400 mg of sarilumab intravenously on day 1 and on day 3 if clinically indicated (sarilumab group) or usual care alone (usual care group). Primary outcomes were the proportion of patients with WHO-CPS scores greater than 5 on the 10-point scale on day 4 and survival without invasive or non-invasive ventilation at day 14. This completed trial is closed to new participants and is registered with ClinicalTrials.gov, NCT04324073. Findings 165 patients were recruited from March 27 to April 6, 2020, and 148 patients were randomised (68 patients to the sarilumab group and 80 to the usual care group) and followed up for 90 days. Median age was 61·7 years [IQR 53·0–71·1] in the sarilumab group and 62·8 years [56·0–71·7] in the usual care group. In the sarilumab group 49 (72%) of 68 were men and in the usual care group 59 (78%) of 76 were men. Four patients in the usual care group withdrew consent and were not analysed. 18 (26%) of 68 patients in the sarilumab group had a WHO-CPS score greater than 5 at day 4 versus 20 (26%) of 76 in the usual care group (median posterior absolute risk difference 0·2%; 90% credible interval [CrI] −11·7 to 12·2), with a posterior probability of absolute risk difference greater than 0 of 48·9%. At day 14, 25 (37%) patients in the sarilumab and 26 (34%) patients in the usual care group needed ventilation or died, (median posterior hazard ratio [HR] 1·10; 90% CrI 0·69–1·74) with a posterior probability HR greater than 1 of 37·4%. Serious adverse events occurred in 27 (40%) patients in the sarilumab group and 28 (37%) patients in the usual care group (p=0·73). Interpretation Sarilumab treatment did not improve early outcomes in patients with moderate-to-severe COVID-19 pneumonia. Further studies are warranted to evaluate the effect of sarilumab on long-term survival. Funding Assistance publique—Hôpitaux de Paris
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Cracowski JL, Hulot JS, Laporte S, Charvériat M, Roustit M, Deplanque D, Girodet PO. Clinical pharmacology: Current innovations and future challenges. Fundam Clin Pharmacol 2021; 36:456-467. [PMID: 34954839 DOI: 10.1111/fcp.12747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/08/2021] [Accepted: 12/18/2021] [Indexed: 11/28/2022]
Abstract
Clinical pharmacology is the study of drugs in humans, from first-in-human studies to randomized controlled trials (RCTs) and benefit-risk ratio assessment in large populations. The objective of this review is to present the recent innovations that may revolutionize the development of drugs in the future. On behalf of the French Society of Pharmacology and Therapeutics, we provide recommendations to address those future challenges in clinical pharmacology. Whatever the future will be, robust preliminary data on drug mechanism of action and rigorous study design will remain crucial prior to the start of pharmacological studies in human. At the present time, RCTs remains the gold standard to evaluate the efficacy of human drugs, although alternative designs (pragmatic trials, platform trials, etc.) are emerging. Innovations in healthy volunteers' studies and the contribution of new technologies such as artificial intelligence, machine learning and internet-based trials have the potential to improve drug development. In the field of precision medicine, new disease phenotypes and endotypes will probably help to identify new pharmacological targets, responders to therapies and patients at risk for drug adverse events. In such a moving landscape, the development of translational research through academic and private partnership, transparent sharing of clinical trial data and enhanced interactions between drug experts, patients and the general public are priority areas for action.
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Affiliation(s)
- Jean-Luc Cracowski
- Univ. Grenoble Alpes, U1042, INSERM, Grenoble, France.,CHU de Grenoble, Service de Pharmacologie - Pharmacosurveillance, CIC1406, Centre Régional de Pharmacovigilance, Grenoble, France
| | - Jean-Sébastien Hulot
- Université de Paris, INSERM, PARCC, Paris, France.,CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Silvy Laporte
- Univ. Jean-Monnet, Saint-Etienne, UMR1059, Saint-Etienne, France.,CHU de Saint-Etienne, Unité de recherche clinique, Innovation et pharmacologie, Saint-Etienne, France
| | | | - Matthieu Roustit
- Univ. Grenoble Alpes, U1042, INSERM, Grenoble, France.,CHU de Grenoble, Service de Pharmacologie - Pharmacosurveillance, CIC1406, Centre Régional de Pharmacovigilance, Grenoble, France
| | - Dominique Deplanque
- Univ. Lille, Inserm, CHU Lille, U1172 - Degenerative & vascular cognitive disorders, Lille, France.,Univ. Lille, Inserm, CHU Lille, CIC 1403 - Clinical Investigation Center, Lille, France
| | - Pierre-Olivier Girodet
- Univ. Bordeaux, CIC1401, U1045, INSERM, Bordeaux, France.,CHU de Bordeaux, CIC1401, Service de Pharmacologie Médicale, Bordeaux, France
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E, Bakakos A, Bakar NA, Bal A, Balakrishnan M, Balan V, Bani-Sadr F, Barbalho R, Barbosa NY, Barclay WS, Barnett SU, Barnikel M, Barrasa H, Barrelet A, Barrigoto C, Bartoli M, Bartone C, Baruch J, Bashir M, Basmaci R, Basri MFH, Bastos D, Battaglini D, Bauer J, Bautista Rincon DF, Bazan Dow D, Bedossa A, Bee KH, Behilill S, Beishuizen A, Beljantsev A, Bellemare D, Beltrame A, Beltrão BA, Beluze M, Benech N, Benjiman LE, Benkerrou D, Bennett S, Bento L, Berdal JE, Bergeaud D, Bergin H, Bernal Sobrino JL, Bertoli G, Bertolino L, Bessis S, Betz A, Bevilcaqua S, Bezulier K, Bhatt A, Bhavsar K, Bianchi I, Bianco C, Bidin FN, Bikram Singh M, Bin Humaid F, Bin Kamarudin MN, Bissuel F, Biston P, Bitker L, Blanco-Schweizer P, Blier C, Bloos F, Blot M, Blumberg L, Boccia F, Bodenes L, Bogaarts A, Bogaert D, Boivin AH, Bolze PA, Bompart F, Bonfasius A, Borges D, Borie R, Bosse HM, Botelho-Nevers E, Bouadma L, Bouchaud O, Bouchez S, Bouhmani D, Bouhour D, Bouiller K, Bouillet L, Bouisse C, Boureau AS, Bourke J, Bouscambert M, Bousquet A, Bouziotis J, Boxma B, Boyer-Besseyre M, Boylan M, Bozza FA, Brack M, Braconnier A, Braga C, Brandenburger T, Brás Monteiro F, Brazzi L, Breen D, Breen P, Breen P, Brett S, Brickell K, Broadley T, Browne A, Browne S, Brozzi N, Brusse-Keizer M, Buchtele N, Buesaquillo C, Bugaeva P, Buisson M, Burhan E, Burrell A, Bustos IG, Butnaru D, Cabie A, Cabral S, Caceres E, Cadoz C, Callahan M, Calligy K, Calvache JA, Cam J, Campana V, Campbell P, Campisi J, Canepa C, Cantero M, Caraux-Paz P, Cárcel S, Cardellino CS, Cardoso F, Cardoso F, Cardoso N, Cardoso S, Carelli S, Carlier N, Carmoi T, Carney G, Carpenter C, Carqueja I, Carret MC, Carrier FM, Carroll I, Carson G, Carton E, Casanova ML, Cascão M, Casey S, Casimiro J, Cassandra B, Castañeda S, Castanheira N, Castor-Alexandre G, Castrillón H, Castro I, Catarino A, Catherine FX, Cattaneo P, Cavalin R, Cavalli GG, Cavayas A, Ceccato A, Cervantes-Gonzalez M, Chair A, Chakveatze C, Chan A, Chand M, Chantalat Auger C, Chapplain JM, Chas J, Chaudary M, Chávez Iñiguez JS, Chen A, Chen YS, Cheng MP, Cheret A, Chiarabini T, Chica J, Chidambaram SK, Chin-Tho L, Chirouze C, Chiumello D, Cho HJ, Cho SM, Cholley B, Chopin MC, Chow TS, Chow YP, Chua HJ, Chua J, Cidade JP, Cisneros Herreros JM, Citarella BW, Ciullo A, Clarke E, Clarke J, Claure Del Granado R, Clohisey S, Cobb JP, Coca N, Codan C, Cody C, Coelho A, Coles M, Colin G, Collins M, Colombo SM, Combs P, Connolly J, Connor M, Conrad A, Contreras S, Conway E, Cooke GS, Copland M, Cordel H, Corley A, Cormican S, Cornelis S, Cornet AD, Corpuz AJ, Cortegiani A, Corvaisier G, Costigan E, Couffignal C, Couffin-Cadiergues S, Courtois R, Cousse S, Cregan R, Crepy D'Orleans C, Croonen S, Crowl G, Crump J, Cruz C, Cruz Berm JL, Cruz Rojo J, Csete M, Cucino A, Cullen A, Cullen C, Cummings M, Curley G, Curlier E, Curran C, Custodio P, da Silva Filipe A, Da Silveira C, Dabaliz AA, Dagens A, Dahly D, Dalton H, Dalton J, Daly S, D'Amico F, Daneman N, 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Duplaix M, Durante-Mangoni E, Durham III L, Dussol B, Duthoit J, Duval X, Dyrhol-Riise AM, Ean SC, Echeverria-Villalobos M, Egan S, Eira C, El Sanharawi M, Elapavaluru S, Elharrar B, Ellerbroek J, Eloy P, Elshazly T, Elyazar I, Enderle I, Endo T, Eng CC, Engelmann I, Enouf V, Epaulard O, Escher M, Esperatti M, Esperou H, Esposito-Farese M, Estevão J, Etienne M, Ettalhaoui N, Everding AG, Evers M, Fabre I, Fabre M, Faheem A, Fahy A, Fairfield CJ, Fakar Z, Faria P, Farooq A, Farrar JJ, Farshait N, Fateena H, Fatoni AZ, Faure K, Favory R, Fayed M, Feely N, Feeney L, Fernandes J, Fernandes M, Fernandes S, Ferrand FX, Ferrand Devouge E, Ferrão J, Ferraz M, Ferreira B, Ferreira S, Ferrer-Roca R, Ferriere N, Ficko C, Figueiredo-Mello C, Fiorda J, Flament T, Flateau C, Fletcher T, Florio LL, Flynn B, Flynn D, Foley C, Foley J, Fomin V, Fonseca T, Fontela P, Forsyth S, Foster D, Foti G, Fourn E, Fowler RA, Fraher DM, Franch-Llasat D, Fraser C, Fraser JF, Freire MV, Freitas Ribeiro A, Friedrich C, Fritz R, Fry S, Fuentes N, Fukuda M, Gaborieau V, Gaci R, Gagliardi M, Gagnard JC, Gagné N, Gagneux-Brunon A, Gaião S, Gail Skeie L, Gallagher P, Gallego Curto E, Gamble C, Gani Y, Garan A, Garcia R, García Barrio N, Garcia-Diaz J, Garcia-Gallo E, Garimella N, Garot D, Garrait V, Gauli B, Gault N, Gavin A, Gavrylov A, Gaymard A, Gebauer J, Geraud E, Gerbaud Morlaes L, Germano N, ghisulal PK, Ghosn J, Giani M, Giaquinto C, Gibson J, Gigante T, Gilg M, Gilroy E, Giordano G, Girvan M, Gissot V, Gitahi J, Giwangkancana G, Glikman D, Glybochko P, Gnall E, Goco G, Goehringer F, Goepel S, Goffard JC, Goh JY, Golob J, Gomes R, Gomez K, Gómez-Junyent J, Gominet M, Gonzalez A, Gordon P, Gordon A, Gorenne I, Goubert L, Goujard C, Goulenok T, Grable M, Graf J, Grandin EW, Granier P, Grasselli G, Grazioli L, Green CA, Greene C, Greenhalf W, Greffe S, Grieco DL, Griffee M, Griffiths F, Grigoras I, Groenendijk A, Grosse Lordemann A, Gruner H, Gu Y, Guarracino F, Guedj J, Guego M, Guellec D, 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Ivulich D, Jaafar D, Jaafoura S, Jabot J, Jackson C, Jamieson N, Jaquet P, Jassat W, Jaud-Fischer C, Jaureguiberry S, Javidfar J, Jawad I, Jaworsky D, Jayakumar D, Jego F, Jelani AM, Jenum S, Jimbo-Sotomayor R, Job VDP, Joe OY, Jorge García RN, Joseph C, Joseph M, Joshi S, Jourdain M, Jouvet P, June J, Jung A, Jung H, Juzar D, Kafif O, Kaguelidou F, Kaisbain N, Kaleesvran T, Kali S, Kalicinska A, Kalomoiri S, Kamal S, Kamaluddin MAA, Kamaruddin ZAC, Kamarudin N, Kandamby DH, Kandel C, Kang KY, Kant R, Kanwal D, Kanyawati D, Karki B, Karpayah P, Karsies T, Kartsonaki C, Kasugai D, Kataria A, Katz K, Kaur A, Kaur Johal S, Kawasaki T, Kay C, Keane H, Keating S, Kellam P, Kelly A, Kelly A, Kelly C, Kelly N, Kelly S, Kelly Y, Kelsey M, Kennedy R, Kennon K, Kernan M, Kerroumi Y, Keshav S, Kestelyn E, Khalid I, Khalid O, Khalil A, Khan C, Khan I, Khanal S, Kho ME, Khoo D, Khoo R, Khoo S, Khoso N, Kiat KH, Kida Y, Kiiza P, Kildal AB, Kim JB, Kimmoun A, Kindgen-Milles D, King A, Kitamura N, Klenerman P, Klont R, Kloumann Bekken G, Knight S, Kobbe R, Kodippily C, Kohns Vasconcelos M, Koirala S, Komatsu M, Korten V, Kosgei C, Kpangon A, Krawczyk K, Krishnan S, Krishnan V, Kruglova O, Kumar A, Kumar D, Kumar G, Kumar M, Kumar Vecham P, Kuriakose D, Kurtzman E, Kusumastuti NP, Kutsogiannis D, Kutsyna G, Kyriakoulis K, Lachatre M, Lacoste M, Laffey JG, Lagrange M, Laine F, Lairez O, Lakhey S, Lalueza A, Lambert M, Lamontagne F, Langelot-Richard M, Langlois V, Lantang EY, Lanza M, Laouénan C, Laribi S, Lariviere D, Lasry S, Latif N, Launay O, Laureillard D, Lavie-Badie Y, Law A, Lawrence C, Lawrence T, Le M, Le Bihan C, Le Bris C, Le Falher G, Le Fevre L, Le Hingrat Q, Le Maréchal M, Le Mestre S, Le Moal G, Le Moing V, Le Nagard H, Le Turnier P, Leal E, Leal Santos M, Lee BH, Lee HG, Lee J, Lee SH, Lee TC, Lee YL, Leeming G, Lefebvre B, Lefebvre L, Lefevre B, LeGac S, Lelievre JD, Lellouche F, Lemaignen A, Lemee V, Lemeur A, Lemmink G, Lene HS, Lennon J, León R, Leone M, Leone M, Lepiller Q, Lescure FX, Lesens O, Lesouhaitier M, Lester-Grant A, Levy B, Levy Y, Levy-Marchal C, Lewandowska K, L'Her E, Li Bassi G, Liang J, Liaquat A, Liegeon G, Lim KC, Lim WS, Lima C, Lina B, Lina L, Lind A, Lingas G, Lion-Daolio S, Lissauer S, Liu K, Livrozet M, Lizotte P, Loforte A, Lolong N, Loon LC, Lopes D, Lopez-Colon D, Loschner AL, Loubet P, Loufti B, Louis G, Lourenco S, Lovelace-Macon L, Low LL, Lowik M, Loy JS, Lucet JC, Lumbreras Bermejo C, Luna CM, Lungu O, Luong L, Luque N, Luton D, Lwin N, Lyons R, Maasikas O, Mabiala O, MacDonald S, MacDonald S, Machado M, Macheda G, Macias Sanchez J, Madhok J, Maestro de la Calle G, Mahieu R, Mahy S, Maia AR, Maier LS, Maillet M, Maitre T, Malfertheiner M, Malik N, Mallon P, Maltez F, Malvy D, Manda V, Mandei JM, Mandelbrot L, Manetta F, Mangal K, Mankikian J, Manning E, Manuel A, Maria Sant`Ana Malaque C, Marino D, Marino F, Markowicz S, Maroun Eid C, Marques A, Marquis C, Marsh B, Marsh L, Marshal M, Marshall J, Martelli CT, Martin DA, Martin E, Martin-Blondel G, Martinelli A, Martin-Loeches I, Martinot M, Martin-Quiros A, Martins A, Martins J, Martins N, Martins Rego C, Martucci G, Martynenko O, Marwali EM, Marzukie M, Masa Jimenez JF, Maslove D, Maslove D, Mason P, Mason S, Masood S, Masood S, Mat Nor B, Matan M, Mateus Fernandes H, Mathew M, Mathieu D, Mattei M, Matulevics R, Maulin L, Maxwell M, Maynar J, Mazzoni T, Mc Sweeney L, McAndrew L, McArthur C, McCarthy A, McCarthy A, McCloskey C, McConnochie R, McDermott S, McDonald SE, McElroy A, McElwee S, McEneany V, McEvoy N, McGeer A, McKay C, McKeown J, McLean KA, McNally P, McNicholas B, McPartlan E, Meaney E, Mear-Passard C, Mechlin M, Meher M, Mehkri O, Mele F, Melo L, Memon K, Mendes JJ, Menkiti O, Menon K, Mentré F, Mentzer AJ, Mercier E, Mercier N, Merckx A, Mergeay-Fabre M, Mergler B, Merson L, Mesquita A, Metwally O, Meybeck A, Meyer D, Meynert AM, Meysonnier V, Meziane A, Mezidi M, Michelagnoli G, Michelanglei C, Michelet I, Mihelis E, Mihnovit V, Miranda-Maldonado H, Misnan NA, Mohamed NNE, Mohamed TJ, Moin A, Molina D, Molinos E, Molloy B, Mone M, Monteiro A, Montes C, Montrucchio G, Moore S, Moore SC, Morales Cely L, Moro L, Morocho Tutillo DR, Morton B, Motherway C, Motos A, Mouquet H, Mouton Perrot C, Moyet J, Mudara C, Mufti AK, Muh NY, Muhamad D, Mullaert J, Muller F, Müller KE, Munblit D, Muneeb S, Munir N, Munshi L, Murphy A, Murphy A, Murphy L, Murris M, Murthy S, Musaab H, Muyandy G, Myrodia DM, N N, Nagpal D, Nagrebetsky A, Narasimhan M, Narayanan N, Nasim Khan R, Nazerali-Maitland A, Neant N, Neb H, Nekliudov NA, Nelwan E, Neto R, Neumann E, Neves B, Ng PY, Nghi A, Nguyen D, Ni Choileain O, Ni Leathlobhair N, Nichol A, Nitayavardhana P, Nonas S, Noordin NAM, Noret M, Norharizam NFI, Norman L, Notari A, Noursadeghi M, Nowicka K, Nowinski A, Nseir S, Nunez JI, Nurnaningsih N, Nyamankolly E, O Brien F, O'Callaghan A, Occhipinti G, OConnor D, O'Donnell M, Ogston T, Ogura T, Oh TH, O'Halloran S, O'Hearn K, Ohshimo S, Oldakowska A, Oliveira J, Oliveira L, Olliaro PL, O'Neil C, Ong DS, Ong JY, Oosthuyzen W, Opavsky A, Openshaw P, Orakzai S, Orozco-Chamorro CM, Orquera A, Ortoleva J, Osatnik J, O'Shea L, O'Sullivan M, Othman SZ, Ouamara N, Ouissa R, Owyang C, Oziol E, Pabasara HMU, Pagadoy M, Pages J, Palacios A, Palacios M, Palmarini M, Panarello G, Panda PK, Paneru H, Pang LH, Panigada M, Pansu N, Papadopoulos A, Parke R, Parker M, Parra B, Parrini V, Pasha T, Pasquier J, Pastene B, Patauner F, Patel J, Pathmanathan MD, Patrão L, Patricio P, Patrier J, Patterson L, Pattnaik R, Paul C, Paul M, Paulos J, Paxton WA, Payen JF, Peariasamy K, Pedrera Jiménez M, Peek GJ, Peelman F, Peiffer-Smadja N, Peigne V, Pejkovska M, Pelosi P, Peltan ID, Pereira R, Perez D, Periel L, Perpoint T, Pesenti A, Pestre V, Petrou L, Petrov-Sanchez V, Pettersen FO, Peytavin G, Pharand S, Piagnerelli M, Picard W, Picone O, Piero MD, Pierobon C, Piersma D, Pimentel C, Pinto R, Pires C, Pironneau I, Piroth L, Pius R, Piva S, Plantier L, Plotkin D, Png HS, Poissy J, Pokeerbux R, Pokorska-Spiewak M, Poli S, Pollakis G, Ponscarme D, Popielska J, Post AM, Postma DF, Povoa P, Póvoas D, Powis J, Prapa S, Preau S, Prebensen C, Preiser JC, Prinssen A, Pritchard MG, Priyadarshani GDD, Proença L, Pudota S, Puéchal O, Pujo Semedi B, Pulicken M, Puntoni M, Purcell G, Quesada L, Quinones-Cardona V, Quirós González V, Quist-Paulsen E, Quraishi M, Rabaa M, Rabaud C, Rabindrarajan E, Rafael A, Rafiq M, Ragazzo G, Rahman AKHA, Rahman RA, Rahutullah A, Rainieri F, Rajahram GS, Rajapakse N, Ralib A, Ramakrishnan N, Ramanathan K, Ramli AA, Rammaert B, Ramos GV, Rana A, Rangappa R, Ranjan R, Rapp C, Rashan A, Rashan T, Rasheed G, Rasmin M, Rätsep I, Rau C, Ravi T, Raza A, Real A, Rebaudet S, Redl S, Reeve B, Rehan A, Rehman A, Reid L, Reid L, Reikvam DH, Reis R, Rello J, Remppis J, Remy M, Ren H, Renk H, Resende L, Resseguier AS, Revest M, Rewa O, Reyes LF, Reyes T, Ribeiro MI, Richardson D, Richardson D, Richier L, Ridzuan SNAA, Riera J, Rios AL, Rishu A, Rispal P, Risso K, Rivera Nuñez MA, Rizer N, Robb D, Robba C, Roberto A, Roberts S, Robertson DL, Robineau O, Roche-Campo F, Rodari P, Rodeia S, Rodriguez Abreu J, Roessler B, Roger C, Roger PM, Roilides E, Rojek A, Romaru J, Roncon-Albuquerque Jr R, Roriz M, Rosa-Calatrava M, Rose M, Rosenberger D, Rossanese A, Rossetti M, Rossignol B, Rossignol P, Rousset S, Roy C, Roze B, Rusmawatiningtyas D, Russell CD, Ryan M, Ryan M, Ryckaert S, Rygh Holten A, Saba I, Sadaf S, Sadat M, Sahraei V, Saint-Gilles M, Sakiyalak P, Salahuddin N, Salazar L, Saleem J, Saleem J, Sales G, Sallaberry S, Salmon Gandonniere C, Salvator H, Sanchez O, Sánchez Choez X, Sanchez de Oliveira K, Sanchez-Miralles A, Sancho-Shimizu V, Sandhu G, Sandhu Z, Sandrine PF, Sandulescu O, Santos M, Sarfo-Mensah S, Sarmento Banheiro B, Sarmiento ICE, Sarton B, Satyapriya S, Satyawati R, Saviciute E, Savio R, Savvidou P, Saw YT, Schaffer J, Schermer T, Scherpereel A, Schneider M, Schroll S, Schwameis M, Schwartz G, Scott JT, Scott-Brown J, Sedillot N, Seitz T, Selvanayagam J, Selvarajoo M, Semaille C, Semple MG, Senian RB, Senneville E, Sepulveda C, Sequeira F, Sequeira T, Serpa Neto A, Serrano Balazote P, Shadowitz E, Shahidan SA, Shahnaz Hasan M, Shamsah M, Shankar A, Sharjeel S, Sharma P, Shaw CA, Shaw V, Shi H, Shiban N, Shiekh M, Shiga T, Shime N, Shimizu H, Shimizu K, Shimizu N, Shindo N, Shrapnel S, Shum HP, Si Mohammed N, Siang NY, Sibiude J, Siddiqui A, Sigfrid L, Sillaots P, Silva C, Silva MJ, Silva R, Sim Lim Heng B, Sin WC, Singh BC, Singh P, Sitompul PA, Sivam K, Skogen V, Smith S, Smood B, Smyth C, Smyth M, Smyth M, Snacken M, So D, Soh TV, Solis M, Solomon J, Solomon T, Somers E, Sommet A, Song MJ, Song R, Song T, Song Chia J, Sonntagbauer M, Soom AM, Sotto A, Soum E, Sousa AC, Sousa M, Sousa Uva M, Souza-Dantas V, Sperry A, Spinuzza E, Sri Darshana BPSR, Sriskandan S, Stabler S, Staudinger T, Stecher SS, Steinsvik T, Stienstra Y, Stiksrud B, Stolz E, Stone A, Streinu-Cercel A, Streinu-Cercel A, Strudwick S, Stuart A, Stuart D, Subekti D, Suen G, Suen JY, Sukumar P, Sultana A, Summers C, Supic D, Suppiah D, Surovcová M, Suwarti S, Svistunov AA, Syahrin S, Syrigos K, Sztajnbok J, Szuldrzynski K, Tabrizi S, Taccone FS, Tagherset L, Taib SM, Talarek E, Taleb S, Talsma J, Tampubolon ML, Tan KK, Tan LV, Tan YC, Tanaka C, Tanaka H, Tanaka T, Taniguchi H, Tanveer H, Taqdees H, Taqi A, Tardivon C, Tattevin P, Taufik MA, Tawfik H, Tedder RS, Tee TY, Teixeira J, Tejada S, Tellier MC, Teoh SK, Teotonio V, Téoulé F, Terpstra P, Terrier O, Terzi N, Tessier-Grenier H, Tey A, Thabit AAM, Tham ZD, Thangavelu S, Thibault V, Thiberville SD, Thill B, Thirumanickam J, Thompson S, Thomson D, Thomson EC, Thurai SRT, Thuy DB, Thwaites RS, Tierney P, Tieroshyn V, Timashev PS, Timsit JF, Tirupakuzhi Vijayaraghavan BK, Tissot N, Toh JZY, Toki M, Tolppa T, Tonby K, Tonnii SL, Torres A, Torres M, Torres Santos-Olmo RM, Torres-Zevallos H, Towers M, Trapani T, Traynor D, Treoux T, Trieu HT, Tripathy S, Tromeur C, Trontzas I, Trouillon T, Truong J, Tual C, Tubiana S, Tuite H, Turmel JM, Turtle LC, Tveita A, Twardowski P, Uchiyama M, Udayanga PGI, Udy A, Ullrich R, Umer Z, Uribe A, Usman A, Vajdovics C, Val-Flores L, Valle AL, Valran A, Van de Velde S, van den Berge M, van der Feltz M, van der Valk P, Van Der Vekens N, Van der Voort P, Van Der Werf S, van Dyk M, van Gulik L, Van Hattem J, van Lelyveld S, van Netten C, Van Twillert G, van Veen I, Vanel N, Vanoverschelde H, Varghese P, Varrone M, Vasudayan SR, Vauchy C, Vaughan H, Veeran S, Veislinger A, Vencken S, Ventura S, Verbon A, Vidal JE, Vieira C, Vijayan D, Villanueva JA, Villar J, Villeneuve PM, Villoldo A, Vinh Chau NV, Visseaux B, Visser H, Vitiello C, Vonkeman H, Vuotto F, Wahab NH, Wahab SA, Wahid NA, Wainstein M, Wan Muhd Shukeri WF, Wang CH, Webb SA, Wei J, Weil K, Wen TP, Wesselius S, West TE, Wham M, Whelan B, White N, Wicky PH, Wiedemann A, Wijaya SO, Wille K, Willems S, Williams V, Wils EJ, Wing Yiu N, Wong C, Wong TF, Wong XC, Wong YS, Xian GE, Xian LS, Xuan KP, Xynogalas I, Yacoub S, Yakop SRBM, Yamazaki M, Yazdanpanah Y, Yee Liang Hing N, Yelnik C, Yeoh CH, Yerkovich S, Yokoyama T, Yonis H, Yousif O, Yuliarto S, Zaaqoq A, Zabbe M, Zacharowski K, Zahid M, Zahran M, Zaidan NZB, Zambon M, Zambrano M, Zanella A, Zawadka K, Zaynah N, Zayyad H, Zoufaly A, Zucman D. The value of open-source clinical science in pandemic response: lessons from ISARIC. Lancet Infect Dis 2021; 21:1623-1624. [PMID: 34619109 PMCID: PMC8489876 DOI: 10.1016/s1473-3099(21)00565-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/16/2021] [Indexed: 12/31/2022]
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Fayol A, Wack M, Livrozet M, Carves JB, Domengé O, Vermersch E, Mirabel M, Karras A, Le Guen J, Blanchard A, Azizi M, Amar L, Bories MC, Mousseaux E, Carette C, Puymirat E, Hagège A, Jannot AS, Hulot JS. Aetiological classification and prognosis in patients with heart failure with preserved ejection fraction. ESC Heart Fail 2021; 9:519-530. [PMID: 34841727 PMCID: PMC8788026 DOI: 10.1002/ehf2.13717] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/31/2021] [Indexed: 12/18/2022] Open
Abstract
AIMS Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome with various causes that may influence prognosis. METHODS AND RESULTS We extracted the electronic medical records for 2180 consecutive patients hospitalized between 2016 and 2019 for decompensated heart failure. Using a text mining algorithm looking for a left ventricular ejection fraction ≥50% and plasma brain natriuretic peptide level >100 pg/mL, we identified 928 HFpEF patients. We screened for a prevailing cause of HFpEF according to European guidelines and found that 418 (45.0%) patients had secondary HFpEF due to either myocardial (n = 125, 13.5%) or loading condition abnormalities (n = 293, 31.5%), while the remaining 510 (55.0%) patients had idiopathic HFpEF. We assessed the association between the causes of HFpEF and survival collected up to 31 December 2020 using Cox proportional hazards analysis. Even though patients with idiopathic HFpEF were older, frequently female, and had frequent co-morbidities and a higher crude mortality rate compared with secondary HFpEF patients, their prognosis was similar after adjustment for age and sex. Unsupervised clustering analysis revealed three main phenogroups with different distribution of idiopathic vs. secondary HFpEF. The phenogroup with the highest proportion of idiopathic HFpEF (69%) had (i) an excess rate of non-cardiac co-morbidities including chronic obstructive pulmonary disease (31%) or obesity (41%) and (ii) a better prognosis compared with the two other phenogroups enriched with secondary HFpEF. CONCLUSIONS Aetiological classification provides clinical and prognostic information and may be useful to better decipher the clinical heterogeneity of HFpEF.
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Affiliation(s)
- Antoine Fayol
- Université de Paris, INSERM, PARCC, Paris, F-75006, France.,CIC1418 and DMU CARTE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Maxime Wack
- Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Inserm, Paris, France.,Departement d'Informatique Hospitalière, DMU PRIME, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Marine Livrozet
- Université de Paris, INSERM, PARCC, Paris, F-75006, France.,CIC1418 and DMU CARTE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Jean-Baptiste Carves
- CIC1418 and DMU CARTE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | | | - Eva Vermersch
- Université de Paris, INSERM, PARCC, Paris, F-75006, France
| | | | - Alexandre Karras
- Université de Paris, INSERM, PARCC, Paris, F-75006, France.,Department of Nephrology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Julien Le Guen
- Department of Geriatry, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Anne Blanchard
- Université de Paris, INSERM, PARCC, Paris, F-75006, France.,CIC1418 and DMU CARTE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Michel Azizi
- Université de Paris, INSERM, PARCC, Paris, F-75006, France.,Hypertension Department and DMU CARTE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Laurence Amar
- Université de Paris, INSERM, PARCC, Paris, F-75006, France.,Hypertension Department and DMU CARTE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Marie-Cécile Bories
- Université de Paris, INSERM, PARCC, Paris, F-75006, France.,Department of Cardiology and DMU CARTE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, F-75015, France
| | - Elie Mousseaux
- Université de Paris, INSERM, PARCC, Paris, F-75006, France.,Department of Radiology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Claire Carette
- CIC1418 and DMU CARTE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France.,Department of Nutrition, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Etienne Puymirat
- Université de Paris, INSERM, PARCC, Paris, F-75006, France.,Department of Cardiology and DMU CARTE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, F-75015, France
| | - Albert Hagège
- Université de Paris, INSERM, PARCC, Paris, F-75006, France.,Department of Cardiology and DMU CARTE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, F-75015, France
| | - Anne-Sophie Jannot
- Centre de Recherche des Cordeliers, Sorbonne Université, Université de Paris, Inserm, Paris, France.,Departement d'Informatique Hospitalière, DMU PRIME, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Jean-Sébastien Hulot
- Université de Paris, INSERM, PARCC, Paris, F-75006, France.,CIC1418 and DMU CARTE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
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Hulot JS, Clopton P. When Natural Peptides Meet Artificial Intelligence to Improve Risk Prediction. J Am Coll Cardiol 2021; 78:1632-1634. [PMID: 34649701 DOI: 10.1016/j.jacc.2021.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Jean-Sébastien Hulot
- Université de Paris, INSERM, PARCC, Paris, France; CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France.
| | - Paul Clopton
- Stanford University School of Medicine, Stanford, California, USA
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Affiliation(s)
- Jean-Sébastien Hulot
- Université de Paris, INSERM, PARCC, Paris, France; CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France.
| | - Marine Livrozet
- Université de Paris, INSERM, PARCC, Paris, France; CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
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Sabouret P, Attias D, Beauvais C, Berthelot E, Bouleti C, Gibault Genty G, Galat A, Hanon O, Hulot JS, Isnard R, Jourdain P, Lamblin N, Lebreton G, Lellouche N, Logeart D, Meune C, Pezel T, Damy T. Diagnosis and management of heart failure from hospital admission to discharge: A practical expert guidance. Ann Cardiol Angeiol (Paris) 2021; 71:41-52. [PMID: 34274113 DOI: 10.1016/j.ancard.2021.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/07/2021] [Indexed: 10/20/2022]
Abstract
Heart failure (HF) has high event rates, mortality, and is challenging to manage in clinical practice. Clinical management is complicated by complex therapeutic strategies in a population with a high prevalence of comorbidity and general frailty. In the last four years, an abundance of research has become available to support multidisciplinary management of heart failure from within the hospital through to discharge and primary care as well as supporting diagnosis and comorbidity management. Within the hospital setting, recent evidence supports sacubitril-valsartan combination in frail, deteriorating or de novo patients with LVEF≤40%. Furthermore, new strategies such as SGLT2 inhibitors and vericiguat provide further benefit for patients with decompensating HF. Studies with tafamidis report major clinical benefits specifically for patients with ATTR cardiac amyloidosis, a remaining underdiagnosed and undertreated disease. New evidence for medical interventions supports his bundle pacing to reduce QRS width and improve haemodynamics as well as ICD defibrillation for non-ischemic cardiomyopathy. The Mitraclip reduces hospitalisations and mortality in patients with symptomatic, secondary mitral regurgitation and ablation reduces mortality and hospitalisations in patients with paroxysmal and persistent atrial fibrillation. In end-stage HF, the 2018 French Heart Allocation policy should improve access to heart transplants for stable, ambulatory patients and, mechanical circulatory support should be considered to avoid deteriorating on the waiting list. In the community, new evidence supports that improving discharge education, treatment and patient support improves outcomes. The authors believe that this review fills the gap between the guidelines and clinical practice and provides practical recommendations to improve HF management.
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Affiliation(s)
- P Sabouret
- Heart Institute, Cardiology department, La Pitié Salpetrière Hospital, Sorbonne University, Paris, France
| | - D Attias
- Cardiology department, Centre Cardiologique du Nord, Saint-Denis, France
| | - C Beauvais
- Cardiology department, La Riboisière Hospital, Inserm UMRS 942, University of Paris, Paris, France
| | - E Berthelot
- Cardiology department, Kremlin Bicêtre Hospital, Paris-Saclay University, Le Kremlin Bicêtre, France
| | - C Bouleti
- Cardiology department, Poitiers University Hospital, CIC INSERM 1402, Poitiers, France
| | - G Gibault Genty
- Cardiology department, André Mignot Hospital, Le Chesnay, France
| | - A Galat
- Cardiology department, University Hospital Henri Mondor, UPEC, Créteil, France
| | - O Hanon
- Geriatrics Department, Hospital Broca, Paris Descartes University, Paris, France
| | - J S Hulot
- Pharmacology Department, Georges-Pompidou European Hospital, INSERM, PARCC, CIC1418 Paris-Descartes University, Paris, France
| | - R Isnard
- Heart Institute, Cardiology department, La Pitié Salpetrière Hospital, Sorbonne University, Paris, France
| | - P Jourdain
- Cardiology department, Kremlin Bicêtre Hospital, Paris-Saclay University, Le Kremlin Bicêtre, France
| | - N Lamblin
- Cardiology Department, University Hospital, Lille, France
| | - G Lebreton
- Heart Institute, Cardiac Surgery department, La Pitié Salpêtrière Hospital, Sorbonne University, Paris, France
| | - N Lellouche
- Cardiology department, University Hospital Henri Mondor, UPEC, Créteil, France
| | - D Logeart
- Cardiology department, La Riboisière Hospital, Inserm UMRS 942, University of Paris, Paris, France
| | - C Meune
- Department of Cardiology, Avicenne Hospital, Paris 13 University, Bobigny, France
| | - T Pezel
- Cardiology department, La Riboisière Hospital, Inserm UMRS 942, University of Paris, Paris, France
| | - T Damy
- Cardiology department, University Hospital Henri Mondor, UPEC, Créteil, France.
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30
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Mousseaux E, Fayol A, Danchin N, Soulat G, Charpentier E, Livrozet M, Carves JB, Tea V, Salem FB, Chamandi C, Hulot JS, Puymirat E. Association between coronary artery calcifications and 6-month mortality in hospitalized patients with COVID-19. Diagn Interv Imaging 2021; 102:717-725. [PMID: 34312110 PMCID: PMC8275480 DOI: 10.1016/j.diii.2021.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/14/2022]
Abstract
Purpose The purpose of this study was to evaluate the association between coronary artery calcium (CAC) visual score and 6-month mortality in patients with coronavirus disease 2019 (COVID-19). Material and methods A single-center prospective observational cohort was conducted in 169 COVID-19 consecutive hospitalized patients between March 13 and April 1, 2020, and follow-up for 6-months. A four-level visual CAC scoring was assessed by analyzing images obtained after the first routine non-ECG-gated CT performed to detect COVID-19 pneumonia. Results Among 169 confirmed COVID-19 patients (118 men, 51 women; mean age, 65.6 ± 18.8 [SD] years; age range: 30–95 years) 63 (37%) presented with either moderate (n = 26, 15.3%) or heavy (n = 37, 21.8%) CAC detected by CT and 20 (11.8%) had history of cardiovascular disease requiring specific preventive treatment. At six months, mortality rate (45/169; 26.6%) increased with magnitude of CAC and was 7/64 (10.9%), 11/42 (26.2%), 10/26 (38.5%), 17/37 (45.9%) for no-CAC, mild-CAC, moderate-CAC and heavy-CAC groups, respectively (P = 0.001). Compared to the no CAC group, risk of death increased after adjustment with magnitude of CAC (HR: 2.23, 95% CI: 0.73–6.87, P = 0.16; HR: 2.78, 95% CI: 0.85–9.07, P0.09; HR: 5.38, 95% CI: 1.57–18.40, P = 0.007; in mild CAC, moderate and heavy CAC groups, respectively). In patients without previous coronary artery disease (154/169; 91%), mortality increased from 10.9% to 45.8% (P = 0.001) according to the magnitude of CAC categories. After adjustment, presence of moderate or heavy CAC was associated with higher mortality (HR: 2.26, 95% CI: 1.09–4.69, P = 0.03). Conclusion By using non-ECG-gated CT during the initial pulmonary assessment of COVID-19, heavy CAC is independently associated with 6-month mortality in patients hospitalized for severe COVID-19 pneumonia.
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Affiliation(s)
- Elie Mousseaux
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Department of Radiology, Assistance Publique-Hôpitaux des Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 75015 Paris, France; Institut National de la Santé et de la Recherche Médicale, PARCC, UMR970, 75015 Paris, France.
| | - Antoine Fayol
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Institut National de la Santé et de la Recherche Médicale, PARCC, UMR970, 75015 Paris, France; CIC1418 and DMU CARTE, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 75015 Paris, France
| | - Nicolas Danchin
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 75015 Paris, France
| | - Gilles Soulat
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Department of Radiology, Assistance Publique-Hôpitaux des Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 75015 Paris, France; Institut National de la Santé et de la Recherche Médicale, PARCC, UMR970, 75015 Paris, France
| | - Etienne Charpentier
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Department of Radiology, Assistance Publique-Hôpitaux des Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 75015 Paris, France
| | - Marine Livrozet
- Université de Paris, Faculté de Médecine, 75006 Paris, France; CIC1418 and DMU CARTE, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 75015 Paris, France
| | - Jean-Baptiste Carves
- Université de Paris, Faculté de Médecine, 75006 Paris, France; CIC1418 and DMU CARTE, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 75015 Paris, France
| | - Victoria Tea
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Institut National de la Santé et de la Recherche Médicale, PARCC, UMR970, 75015 Paris, France
| | - Fares Ben Salem
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Department of Radiology, Assistance Publique-Hôpitaux des Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 75015 Paris, France
| | - Chekrallah Chamandi
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Institut National de la Santé et de la Recherche Médicale, PARCC, UMR970, 75015 Paris, France
| | - Jean-Sébastien Hulot
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Institut National de la Santé et de la Recherche Médicale, PARCC, UMR970, 75015 Paris, France; CIC1418 and DMU CARTE, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 75015 Paris, France
| | - Etienne Puymirat
- Université de Paris, Faculté de Médecine, 75006 Paris, France; Institut National de la Santé et de la Recherche Médicale, PARCC, UMR970, 75015 Paris, France; Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 75015 Paris, France
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31
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Russick J, Foy PE, Josseaume N, Meylan M, Hamouda NB, Kirilovsky A, Sissy CE, Tartour E, Smadja DM, Karras A, Hulot JS, Livrozet M, Fayol A, Arlet JB, Diehl JL, Dragon-Durey MA, Pagès F, Cremer I. Immune Signature Linked to COVID-19 Severity: A SARS-Score for Personalized Medicine. Front Immunol 2021; 12:701273. [PMID: 34322128 PMCID: PMC8312547 DOI: 10.3389/fimmu.2021.701273] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/28/2021] [Indexed: 12/15/2022] Open
Abstract
SARS-CoV-2 infection leads to a highly variable clinical evolution, ranging from asymptomatic to severe disease with acute respiratory distress syndrome, requiring intensive care units (ICU) admission. The optimal management of hospitalized patients has become a worldwide concern and identification of immune biomarkers predictive of the clinical outcome for hospitalized patients remains a major challenge. Immunophenotyping and transcriptomic analysis of hospitalized COVID-19 patients at admission allow identifying the two categories of patients. Inflammation, high neutrophil activation, dysfunctional monocytic response and a strongly impaired adaptive immune response was observed in patients who will experience the more severe form of the disease. This observation was validated in an independent cohort of patients. Using in silico analysis on drug signature database, we identify differential therapeutics that specifically correspond to each group of patients. From this signature, we propose a score-the SARS-Score-composed of easily quantifiable biomarkers, to classify hospitalized patients upon arrival to adapt treatment according to their immune profile.
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Affiliation(s)
- Jules Russick
- Centre de Recherche des Cordeliers, Sorbonne Universite, Inserm, Universite de Paris, Team Inflammation, Complement and Cancer, Paris, France
| | - Pierre-Emmanuel Foy
- Centre de Recherche des Cordeliers, Sorbonne Universite, Inserm, Universite de Paris, Team Inflammation, Complement and Cancer, Paris, France
| | - Nathalie Josseaume
- Centre de Recherche des Cordeliers, Sorbonne Universite, Inserm, Universite de Paris, Team Inflammation, Complement and Cancer, Paris, France
| | - Maxime Meylan
- Centre de Recherche des Cordeliers, Sorbonne Universite, Inserm, Universite de Paris, Team Inflammation, Complement and Cancer, Paris, France
| | - Nadine Ben Hamouda
- Hopital Europeen Georges Pompidou, AP-HP, Paris, Universite de Paris, Paris, France
- Centre de Recherche des Cordeliers, Sorbonne Universite, Inserm, Universite de Paris, Team Integrative Cancer Immunology F-75006, Paris, France
- Sorbonne Universite, Paris, France
| | - Amos Kirilovsky
- Hopital Europeen Georges Pompidou, AP-HP, Paris, Universite de Paris, Paris, France
- Centre de Recherche des Cordeliers, Sorbonne Universite, Inserm, Universite de Paris, Team Integrative Cancer Immunology F-75006, Paris, France
- Sorbonne Universite, Paris, France
| | - Carine El Sissy
- Hopital Europeen Georges Pompidou, AP-HP, Paris, Universite de Paris, Paris, France
- Centre de Recherche des Cordeliers, Sorbonne Universite, Inserm, Universite de Paris, Team Integrative Cancer Immunology F-75006, Paris, France
- Sorbonne Universite, Paris, France
| | - Eric Tartour
- Department of Immunology, Hôpital Europeen Georges Pompidou, AP-HP, Paris, France
| | - David M. Smadja
- Université de Paris, Innovative Therapies in Hemostasis, INSERM, Hematology Department and Biosurgical Research Lab, (Carpentier Foundation) Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), Paris, France
- F-CRIN INNOVTE, Saint-Étienne, France
| | - Alexandre Karras
- Department of Nephrology, Hopital Europeen Georges Pompidou, AP-HP, Paris, France
- Department of Nephrology, Universite de Paris, Paris, France
| | - Jean-Sébastien Hulot
- Université de Paris, INSERM, PARCC, Paris, France
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Marine Livrozet
- Université de Paris, INSERM, PARCC, Paris, France
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Antoine Fayol
- Université de Paris, INSERM, PARCC, Paris, France
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Jean-Benoit Arlet
- Department of Nephrology, Universite de Paris, Paris, France
- Department of Internal Medicine, Hopital Europeen Georges Pompidou, AP-HP, Paris, France
| | - Jean-Luc Diehl
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France
- Intensive Care Unit and Biosurgical Research Lab (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, Paris, France
| | - Marie-Agnès Dragon-Durey
- Centre de Recherche des Cordeliers, Sorbonne Universite, Inserm, Universite de Paris, Team Inflammation, Complement and Cancer, Paris, France
- Hopital Europeen Georges Pompidou, AP-HP, Paris, Universite de Paris, Paris, France
- Centre de Recherche des Cordeliers, Sorbonne Universite, Inserm, Universite de Paris, Team Integrative Cancer Immunology F-75006, Paris, France
- Sorbonne Universite, Paris, France
| | - Franck Pagès
- Hopital Europeen Georges Pompidou, AP-HP, Paris, Universite de Paris, Paris, France
- Centre de Recherche des Cordeliers, Sorbonne Universite, Inserm, Universite de Paris, Team Integrative Cancer Immunology F-75006, Paris, France
- Sorbonne Universite, Paris, France
| | - Isabelle Cremer
- Centre de Recherche des Cordeliers, Sorbonne Universite, Inserm, Universite de Paris, Team Inflammation, Complement and Cancer, Paris, France
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32
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Hulot JS, Trochu JN, Donal E, Galinier M, Logeart D, De Groote P, Juillière Y. Vericiguat for the treatment of heart failure: mechanism of action and pharmacological properties compared with other emerging therapeutic options. Expert Opin Pharmacother 2021; 22:1847-1855. [PMID: 34074190 DOI: 10.1080/14656566.2021.1937121] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
INTRODUCTION The significant morbidity and mortality in patients with heart failure (HF), notably in the most advanced forms of the disease, justify the need for novel therapeutic options. In the last year, the soluble guanylate cyclase (sGC) stimulator, vericiguat, has drawn the attention of the medical community following the report of reduced clinical outcomes in patients with worsening chronic HF (WCHF). AREAS COVERED The authors review the available data on the mechanism of action of vericiguat (cyclic guanosine monophosphate (cGMP) pathway), its clinical development program, its role in HF management, and its future positioning in the therapeutic recommendations. EXPERT OPINION cGMP deficiency has deleterious effects on the heart and contributes to the progression of HF. Different molecules, including nitric oxide (NO) donors, phosphodiesterase inhibitors, and natriuretic peptides analogues, target the NO-sCG-cGMP pathway but have yielded conflicting results in HF patients. Vericiguat acts as a sGC stimulator thus targeting the NO-sGC-cGMP pathway by a different mechanism that complements the current pharmacotherapy for HF. Vericiguat has shown an additional statistical add-on therapy efficacy by reducing morbi-mortality in patients with WCHF. A better evaluation of HF severity might be an important determinant to guide the use of vericiguat among the available therapies.
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Affiliation(s)
- Jean-Sébastien Hulot
- Université de Paris, INSERM, PARCC, Paris, France.,CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Jean-Noël Trochu
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du Thorax, Nantes, France
| | - Erwan Donal
- LTSI INSERM U1099, Service de Cardiologie et Maladies Vasculaires, Centre Hospitalier Universitaire de Rennes, Université Rennes, Rennes, France
| | - Michel Galinier
- Department of Cardiology, Toulouse-Rangueil University Hospital, Toulouse University School of Medicine, Toulouse, France
| | - Damien Logeart
- Department of Cardiology, Lariboisière Hospital, Paris, France.,Université de Paris, Paris, France
| | - Pascal De Groote
- CHU Lille, Service de Cardiologie, France.,INSERM U1167, Institut Pasteur de Lille, Lille, France
| | - Yves Juillière
- Centre Hospitalier Universitaire de Nancy Brabois, Vandoeuvre Lès Nancy, France
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33
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Dragon-Durey MA, Chen X, Kirilovsky A, Ben Hamouda N, El Sissy C, Russick J, Charpentier E, Binois Y, Marliot F, Meylan M, Granier C, Pere H, Saldmann A, Rance B, Jannot AS, Baron S, Chebbi M, Fayol A, Josseaume N, Rives-Lange C, Tharaux PL, Cholley B, Diehl JL, Arlet JB, Azizi M, Karras A, Czernichow S, Smadja DM, Hulot JS, Cremer I, Tartour E, Mousseaux E, Pagès F. Differential association between inflammatory cytokines and multiorgan dysfunction in COVID-19 patients with obesity. PLoS One 2021; 16:e0252026. [PMID: 34038475 PMCID: PMC8153504 DOI: 10.1371/journal.pone.0252026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/08/2021] [Indexed: 01/08/2023] Open
Abstract
To investigate the mechanisms underlying the SARS-CoV-2 infection severity observed in patients with obesity, we performed a prospective study of 51 patients evaluating the impact of multiple immune parameters during 2 weeks after admission, on vital organs' functions according to body mass index (BMI) categories. High-dimensional flow cytometric characterization of immune cell subsets was performed at admission, 30 systemic cytokines/chemokines levels were sequentially measured, thirteen endothelial markers were determined at admission and at the zenith of the cytokines. Computed tomography scans on admission were quantified for lung damage and hepatic steatosis (n = 23). Abnormal BMI (> 25) observed in 72.6% of patients, was associated with a higher rate of intensive care unit hospitalization (p = 0.044). SARS-CoV-2 RNAaemia, peripheral immune cell subsets and cytokines/chemokines were similar among BMI groups. A significant association between inflammatory cytokines and liver, renal, and endothelial dysfunctions was observed only in patients with obesity (BMI > 30). In contrast, early signs of lung damage (ground-glass opacity) correlated with Th1/M1/inflammatory cytokines only in normal weight patients. Later lesions of pulmonary consolidation correlated with BMI but were independent of cytokine levels. Our study reveals distinct physiopathological mechanisms associated with SARS-CoV-2 infection in patients with obesity that may have important clinical implications.
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Affiliation(s)
- Marie-Agnès Dragon-Durey
- Laboratory of Immunology
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- INSERM UMRS 1138, Cordeliers Research Center, Team Inflammation, Complement, and Cancer, Paris, France
- Sorbonne Université, Cordeliers Research Center, Paris, France
| | - Xiaoyi Chen
- Sorbonne Université, Cordeliers Research Center, Paris, France
- INSERM UMRS 1138, Cordeliers Research Center, Team Information Sciences to Support Personalized Medicine, Paris, France
- Laboratory of Information Sciences to support Personalized Medicine, Paris, France
| | - Amos Kirilovsky
- Sorbonne Université, Cordeliers Research Center, Paris, France
- INSERM UMRS 1138, Cordeliers Research Center, Team Integrative Cancer Immunology, Paris, France
| | - Nadine Ben Hamouda
- Laboratory of Immunology
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Carine El Sissy
- Laboratory of Immunology
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Sorbonne Université, Cordeliers Research Center, Paris, France
- INSERM UMRS 1138, Cordeliers Research Center, Team Integrative Cancer Immunology, Paris, France
| | - Jules Russick
- INSERM UMRS 1138, Cordeliers Research Center, Team Inflammation, Complement, and Cancer, Paris, France
- Sorbonne Université, Cordeliers Research Center, Paris, France
| | - Etienne Charpentier
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Department of Radiology
| | - Yannick Binois
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Department of Nephrology
| | - Florence Marliot
- Laboratory of Immunology
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Sorbonne Université, Cordeliers Research Center, Paris, France
- INSERM UMRS 1138, Cordeliers Research Center, Team Integrative Cancer Immunology, Paris, France
| | - Maxime Meylan
- INSERM UMRS 1138, Cordeliers Research Center, Team Inflammation, Complement, and Cancer, Paris, France
- Sorbonne Université, Cordeliers Research Center, Paris, France
| | - Clémence Granier
- Laboratory of Immunology
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- INSERM, Paris Cardiovascular Center / PARCC, UMR 970, Paris, France
| | - Hélène Pere
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- INSERM, Paris Cardiovascular Center / PARCC, UMR 970, Paris, France
- Laboratory of Virology
| | - Antonin Saldmann
- Laboratory of Immunology
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- INSERM, Paris Cardiovascular Center / PARCC, UMR 970, Paris, France
| | - Bastien Rance
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- INSERM UMRS 1138, Cordeliers Research Center, Team Information Sciences to Support Personalized Medicine, Paris, France
- Laboratory of Information Sciences to support Personalized Medicine, Paris, France
- Biostatistics and Public Health Department
| | - Anne Sophie Jannot
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- INSERM UMRS 1138, Cordeliers Research Center, Team Information Sciences to Support Personalized Medicine, Paris, France
- Laboratory of Information Sciences to support Personalized Medicine, Paris, France
- Biostatistics and Public Health Department
| | - Stéphanie Baron
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Department of Physiology
| | - Mouna Chebbi
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Department of Physiology
| | - Antoine Fayol
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Clinic Investigation Center 1418
| | - Nathalie Josseaume
- INSERM UMRS 1138, Cordeliers Research Center, Team Inflammation, Complement, and Cancer, Paris, France
- Sorbonne Université, Cordeliers Research Center, Paris, France
| | - Claire Rives-Lange
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Department of Nutrition
| | - Pierre-Louis Tharaux
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- INSERM, Paris Cardiovascular Center / PARCC, UMR 970, Paris, France
| | - Bernard Cholley
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Department of Intensive Medicine, Reanimation
| | - Jean-Luc Diehl
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Department of Intensive Medicine, Reanimation
- INSERM UMR-S1140, Team Innovative Therapies in Haemostasis, Paris, France
| | - Jean-Benoît Arlet
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Department of Internal Medicine
| | - Michel Azizi
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Department of Vascular Medicine
| | - Alexandre Karras
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Department of Nephrology
| | - Sébastien Czernichow
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Department of Nutrition
| | - David M. Smadja
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- INSERM UMR-S1140, Team Innovative Therapies in Haemostasis, Paris, France
- Department of Hematology
| | - Jean-Sébastien Hulot
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- INSERM, Paris Cardiovascular Center / PARCC, UMR 970, Paris, France
- Clinic Investigation Center 1418
| | - Isabelle Cremer
- INSERM UMRS 1138, Cordeliers Research Center, Team Inflammation, Complement, and Cancer, Paris, France
- Sorbonne Université, Cordeliers Research Center, Paris, France
| | - Eric Tartour
- Laboratory of Immunology
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- INSERM, Paris Cardiovascular Center / PARCC, UMR 970, Paris, France
| | - Elie Mousseaux
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Department of Radiology
| | - Franck Pagès
- Laboratory of Immunology
- Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Université de Paris, Paris, France
- Sorbonne Université, Cordeliers Research Center, Paris, France
- INSERM UMRS 1138, Cordeliers Research Center, Team Integrative Cancer Immunology, Paris, France
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Seguret M, Vermersch E, Jouve C, Hulot JS. Cardiac Organoids to Model and Heal Heart Failure and Cardiomyopathies. Biomedicines 2021; 9:563. [PMID: 34069816 PMCID: PMC8157277 DOI: 10.3390/biomedicines9050563] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/04/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022] Open
Abstract
Cardiac tissue engineering aims at creating contractile structures that can optimally reproduce the features of human cardiac tissue. These constructs are becoming valuable tools to model some of the cardiac functions, to set preclinical platforms for drug testing, or to alternatively be used as therapies for cardiac repair approaches. Most of the recent developments in cardiac tissue engineering have been made possible by important advances regarding the efficient generation of cardiac cells from pluripotent stem cells and the use of novel biomaterials and microfabrication methods. Different combinations of cells, biomaterials, scaffolds, and geometries are however possible, which results in different types of structures with gradual complexities and abilities to mimic the native cardiac tissue. Here, we intend to cover key aspects of tissue engineering applied to cardiology and the consequent development of cardiac organoids. This review presents various facets of the construction of human cardiac 3D constructs, from the choice of the components to their patterning, the final geometry of generated tissues, and the subsequent readouts and applications to model and treat cardiac diseases.
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Affiliation(s)
- Magali Seguret
- INSERM, PARCC, Université de Paris, F-75006 Paris, France; (M.S.); (E.V.); (C.J.)
| | - Eva Vermersch
- INSERM, PARCC, Université de Paris, F-75006 Paris, France; (M.S.); (E.V.); (C.J.)
| | - Charlène Jouve
- INSERM, PARCC, Université de Paris, F-75006 Paris, France; (M.S.); (E.V.); (C.J.)
| | - Jean-Sébastien Hulot
- INSERM, PARCC, Université de Paris, F-75006 Paris, France; (M.S.); (E.V.); (C.J.)
- CIC1418 and DMU CARTE, Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, F-75015 Paris, France
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Gault N, Esposito-Farèse M, Revest M, Inamo J, Cabié A, Polard É, Hulot JS, Ghosn J, Chirouze C, Deconinck L, Diehl JL, Poissy J, Epaulard O, Lefèvre B, Piroth L, De Montmollin E, Oziol E, Etienne M, Laouénan C, Rossignol P, Costagliola D, Vidal-Petiot E. Chronic use of renin-angiotensin-aldosterone system blockers and mortality in COVID-19: A multicenter prospective cohort and literature review. Fundam Clin Pharmacol 2021; 35:1141-1158. [PMID: 33876439 PMCID: PMC8250758 DOI: 10.1111/fcp.12683] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/22/2021] [Accepted: 04/14/2021] [Indexed: 01/09/2023]
Abstract
Aims The role of renin‐angiotensin‐aldosterone system (RAAS) blockers on the course of coronavirus disease 2019 (COVID‐19) is debated. We assessed the association between chronic use of RAAS blockers and mortality among inpatients with COVID‐19 and explored reasons for discrepancies in the literature. Methods and results We included adult hypertensive patients from a prospective nationwide cohort of 3512 inpatients with COVID‐19 up to June 30, 2020. Cox proportional hazard models with various adjustment or propensity weighting methods were used to estimate the hazard ratios (HR) of 30‐day mortality for chronic users versus non‐users of RAAS blockers. We analyzed data of 1160 hypertensive patients: 719 (62%) were male and 777 (67%) were older than 65 years. The main comorbidities were diabetes (n = 416, 36%), chronic cardiac disease (n = 401, 35%), and obesity (n = 340, 29%); 705 (61%) received oxygen therapy. We recorded 135 (11.6%) deaths within 30 days of diagnosis. We found no association between chronic use of RAAS blockers and mortality (unadjusted HR = 1.13, 95% CI [0.8–1.6]; propensity inverse probability treatment weighted HR = 1.09 [0.86‐1.39]; propensity standardized mortality ratio weighted HR = 1.08 [0.79–1.47]). Our comprehensive review of previous studies highlighted that significant associations were mostly found in unrestricted populations with inappropriate adjustment, or with biased in‐hospital exposure measurement. Conclusion Our results do not support previous concerns regarding these drugs, nor a potential protective effect as reported in previous poorly designed studies and meta‐analyses. RAAS blockers should not be discontinued during the pandemic, while in‐hospital management of these drugs will be clarified by randomized trials. NCT04262921.
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Affiliation(s)
- Nathalie Gault
- Centre d'Investigations cliniques-Epidémiologie Clinique 1425, INSERM, Hôpital Bichat, Paris, 75018, France.,Département Epidémiologie Biostatistiques et Recherche Clinique, AP-HP, Hôpital Bichat, Paris, 75018, France
| | - Marina Esposito-Farèse
- Centre d'Investigations cliniques-Epidémiologie Clinique 1425, INSERM, Hôpital Bichat, Paris, 75018, France.,URC Paris Nord, AP-HP DRCI, Hôpital Bichat, Paris, 75018, France
| | - Matthieu Revest
- Service des Maladies Infectieuses et Réanimation Médicale, Univ Rennes, INSERM UMR 1230, Bacterial Regulatory RNA and Medicine, CHU Rennes, Rennes, France
| | - Jocelyn Inamo
- Département de Cardiologie, EA7525, CHU Martinique, Fort-de-France, France
| | - André Cabié
- Inserm CIC 1424, Université des Antilles EA 7524, Service de maladies infectieuses et tropicales, CHU de Martinique, Fort-de-France, France
| | - Élisabeth Polard
- Department of Clinical Pharmacology, Pharmacovigilance, Pharmacoepidemiology and Drug Information Centre, Rennes University Hospital, Rennes, France
| | - Jean-Sébastien Hulot
- PARCC, INSERM, Université de Paris, Paris, 75015, France.,INSERM Centre d'Investigations cliniques-plurithématique 1418 and DMU CARTE, F-CRIN INI-CRCT network, AP-HP, Hôpital Européen Georges-Pompidou, Paris, 751015, France
| | - Jade Ghosn
- Service de Maladie Infectieuses et Tropicales, AP-HP, Hôpital Bichat, Paris, France
| | - Catherine Chirouze
- Service de Maladie Infectieuses et Tropicales, CHU Besançon, Besançon, France
| | - Laurène Deconinck
- Service de Maladie Infectieuses et Tropicales, AP-HP, Hôpital Bichat, Paris, France
| | - Jean-Luc Diehl
- Service de Médecine Intensive Réanimation, Laboratoire de Recherche Biochirurgicale (Fondation Carpentier), AP-HP, Hôpital Européen Georges-Pompidou, Paris, France.,UMR_S 1140, Innovations thérapeutiques en Hémostase, Université de Paris, INSERM, Paris, France
| | - Julien Poissy
- Inserm U1285, CHU Lille, Pôle de réanimation, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, Université de Lille, CNRS, Lille, France
| | - Olivier Epaulard
- Service de Maladies Infectieuses et Médecine Tropicale, CHU Grenoble Rhône Alpes, Grenoble, France
| | - Benjamin Lefèvre
- Service des Maladies Infectieuses et Tropicales, CHRU Nancy, Université de Lorraine, Nancy, France.,APEMAC, Université de Lorraine, Nancy, France
| | - Lionel Piroth
- Département d'infectiologie, Université de Bourgogne, CHU Dijon Bourgogne, Dijon, France
| | - Etienne De Montmollin
- Service de réanimation médicale et des maladies infectieuses, AP-HP, Hôpital Bichat, Paris, France.,IAME UMR 1137, INSERM, Université de Paris, Paris, France
| | - Eric Oziol
- Service de Médecine Hospitalière, CHU Beziers, Beziers, France
| | - Manuel Etienne
- Service des Maladies Infectieuses et Tropicales, CHU Rouen, Rouen, France
| | - Cédric Laouénan
- Centre d'Investigations cliniques-Epidémiologie Clinique 1425, INSERM, Hôpital Bichat, Paris, 75018, France.,Département Epidémiologie Biostatistiques et Recherche Clinique, AP-HP, Hôpital Bichat, Paris, 75018, France.,IAME UMR 1137, INSERM, Université de Paris, Paris, France
| | - Patrick Rossignol
- Centre d'Investigations cliniques-plurithématique 1433, INSERM U1116, CHRU Nancy, Université de Lorraine, INSERM, Nancy, France.,F-CRIN INI-CRCT network, Nancy, France
| | - Dominique Costagliola
- Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Sorbonne Université, INSERM, Paris, France
| | - Emmanuelle Vidal-Petiot
- Service de Physiologie rénale, AP-HP, Hôpital Bichat, Paris, France.,U1149, INSERM, Université de Paris, Paris, France
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Betton M, Livrozet M, Planas D, Fayol A, Monel B, Védie B, Bruel T, Tartour E, Robillard N, Manuguerra JC, Blanchard A, Ghosn J, Visseaux B, Péré H, Lebeaux D, Schwartz O, Veyer D, Hulot JS. Sera neutralizing activities against SARS-CoV-2 and multiple variants six month after hospitalization for COVID-19. Clin Infect Dis 2021; 73:e1337-e1344. [PMID: 33851216 PMCID: PMC8083257 DOI: 10.1093/cid/ciab308] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background Humoral response to SARS-CoV-2 occurs within the first weeks after COVID-19. Those antibodies exert a neutralizing activity against SARS-CoV-2, whose evolution overtime after COVID-19 as well as efficiency against novel variants are however poorly characterized. Methods In this prospective study, sera of 107 patients hospitalized with COVID-19 were collected at 3- and 6-months post-infection. We performed quantitative neutralization experiments on top of high-throughput serological assays evaluating anti-Spike (S) and anti-Nucleocapsid (NP) IgG. Findings Levels of sero-neutralization and IgG rates against the ancestral strain decreased significantly over time. After 6 months, 2.8% of the patients had a negative serological status for both anti-S and anti-NP IgG. However, all sera had a persistent and effective neutralizing effect against SARS-CoV-2. IgG levels correlated with sero-neutralization and this correlation was stronger for anti-S than for anti-NP antibodies. The level of sero-neutralization quantified at 6 months correlated with markers of initial severity, notably admission in intensive care units and the need for mechanical invasive ventilation. In addition, sera collected at 6 months were tested against multiple SARS-CoV-2 variants and showed efficient neutralizing effects against D614G, B.1.1.7 and P.1 variants but a significantly weaker activity against B.1.351 variant. Interpretation Decrease of IgG rates and serological assays becoming negative did not imply loss of neutralizing capacity. Our results indicate a sustained humoral response against the ancestral strain and the D614G, B.1.1.7 and P.1 variants for at least 6 months in patients previously hospitalized for COVID-19. A weaker protection was however observed for the B.1.351 variant.
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Affiliation(s)
- Maureen Betton
- Université de Paris, INSERM, PARCC, F-75006 Paris, France.,CIC1418 and DMU CARTE, Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, F-75015, Paris, France
| | - Marine Livrozet
- Université de Paris, INSERM, PARCC, F-75006 Paris, France.,CIC1418 and DMU CARTE, Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, F-75015, Paris, France
| | - Delphine Planas
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR3569, Paris France.,Vaccine Research Institute, Faculté de Médecine, INSERM U955, Université Paris-Est Créteil, Créteil, France
| | - Antoine Fayol
- Université de Paris, INSERM, PARCC, F-75006 Paris, France.,CIC1418 and DMU CARTE, Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, F-75015, Paris, France
| | - Blandine Monel
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR3569, Paris France
| | - Benoit Védie
- Laboratoire de Biochimie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Timothée Bruel
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR3569, Paris France
| | - Eric Tartour
- Department of Immunology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Nicolas Robillard
- Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris 75015, France
| | | | - Anne Blanchard
- CIC1418 and DMU CARTE, Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, F-75015, Paris, France
| | - Jade Ghosn
- Infectious and Tropical Diseases Department, Hôpital Bichat Claude Bernard, AP-HP, Paris, France.,Université de Paris, IAME, INSERM, F-75018 Paris, France
| | - Benoit Visseaux
- Université de Paris, IAME, INSERM, F-75018 Paris, France.,AP-HP, Bichat Claude Bernard Hospital, Virology Department, 75018 Paris, France
| | - Hélène Péré
- Functional Genomics of Solid Tumors (FunGeST), INSERM, Centre de Recherche des Cordeliers, Université de Paris and Sorbonne Université, Paris, France
| | - David Lebeaux
- Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris 75015, France
| | - Olivier Schwartz
- Virus & Immunity Unit, Department of Virology, Institut Pasteur, CNRS UMR3569, Paris France.,Vaccine Research Institute, Faculté de Médecine, INSERM U955, Université Paris-Est Créteil, Créteil, France
| | - David Veyer
- Service de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris 75015, France.,AP-HP, Bichat Claude Bernard Hospital, Virology Department, 75018 Paris, France
| | - Jean-Sébastien Hulot
- Université de Paris, INSERM, PARCC, F-75006 Paris, France.,CIC1418 and DMU CARTE, Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, F-75015, Paris, France
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Karras A, Livrozet M, Lazareth H, Benichou N, Hulot JS, Fayol A, Chauvet S, Jannot AS, Penet MA, Diehl JL, Godier A, Sanchez O, Mirault T, Thervet E, Pallet N. Proteinuria and Clinical Outcomes in Hospitalized COVID-19 Patients: A Retrospective Single-Center Study. Clin J Am Soc Nephrol 2021; 16:514-521. [PMID: 33661756 PMCID: PMC8092053 DOI: 10.2215/cjn.09130620] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/14/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Kidney involvement is frequent among patients with coronavirus disease 2019 (COVID-19), and occurrence of AKI is associated with higher mortality in this population. The objective of this study was to describe occurrence and significance of proteinuria in this setting. DESIGN , SETTING, PARTICIPANTS MEASUREMENTS We conducted a single-center retrospective study to describe the characteristic features of proteinuria measured within 48 hours following admission among patients with COVID-19 admitted in a tertiary care hospital in France, and to evaluate its association with initiation of dialysis, intensive care unit admission, and death. RESULTS Among 200 patients with available data, urine protein-creatinine ratio at admission was ≥1 g/g for 84 (42%), although kidney function was normal in most patients, with a median serum creatinine of 0.94 mg/dl (interquartile range, 0.75-1.21). Median urine albumin-creatinine ratio was 110 mg/g (interquartile range, 50-410), with a urine albumin-protein ratio <50% in 92% of patients. Urine retinol binding protein concentrations, available for 85 patients, were ≥0.03 mg/mmol in 62% of patients. Urine protein-creatinine ratio ≥1 g/g was associated with initiation of dialysis (odds ratio, 4.87; 95% confidence interval, 2.03 to 13.0; P <0.001), admission to the intensive care unit (odds ratio, 3.55; 95% confidence interval, 1.93 to 6.71; P <0.001), and death (odds ratio, 3.56; 95% confidence interval, 1.90 to 6.54; P <0.001). CONCLUSIONS Proteinuria is very frequent among patients admitted for COVID-19 and may precede AKI. Low levels of albuminuria suggest a predominant tubular origin, confirmed by the elevated levels of urine retinol binding protein. Urine protein-creatinine ratio ≥1 g/g at admission is strongly associated with poor kidney and patient outcome.
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Affiliation(s)
- Alexandre Karras
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France,Université de Paris, Paris, France
| | - Marine Livrozet
- Université de Paris, Paris, France,Centre d'Investigation Clinique1418 and Departement Medico-Universitaire, CArdiologie Rein Transplantation nEurovasculaire, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Hélène Lazareth
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France,Université de Paris, Paris, France
| | - Nicolas Benichou
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France,Université de Paris, Paris, France
| | - Jean-Sébastien Hulot
- Université de Paris, Paris, France,Centre d'Investigation Clinique1418 and Departement Medico-Universitaire, CArdiologie Rein Transplantation nEurovasculaire, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Antoine Fayol
- Université de Paris, Paris, France,Centre d'Investigation Clinique1418 and Departement Medico-Universitaire, CArdiologie Rein Transplantation nEurovasculaire, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sophie Chauvet
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France,Université de Paris, Paris, France
| | - Anne-Sophie Jannot
- Université de Paris, Paris, France,Department of Bioinformatics, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie-Aude Penet
- Université de Paris, Paris, France,Department of Internal Medicine, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Luc Diehl
- Université de Paris, Paris, France,Department of Intensive Care Medicine, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Anne Godier
- Université de Paris, Paris, France,Department of Anaesthesiology and Intensive Care, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Olivier Sanchez
- Université de Paris, Paris, France,Department of Pneumology and Intensive Care, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Tristan Mirault
- Université de Paris, Paris, France,Department of Vascular Medicine, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eric Thervet
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France,Université de Paris, Paris, France
| | - Nicolas Pallet
- Université de Paris, Paris, France,Department of Clinical Chemistry, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
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Fayol A, Livrozet M, Boutouyrie P, Khettab H, Betton M, Tea V, Blanchard A, Bruno RM, Hulot JS. Cardiac performance in patients hospitalized with COVID-19: a 6 month follow-up study. ESC Heart Fail 2021; 8:2232-2239. [PMID: 33773099 PMCID: PMC8120370 DOI: 10.1002/ehf2.13315] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 12/30/2022] Open
Abstract
Aims Myocardial injury is frequently observed in patients hospitalized with coronavirus disease 2019 (COVID‐19) pneumonia. Different cardiac abnormalities have been reported during the acute COVID‐19 phase, ranging from infra‐clinic elevations of myocardial necrosis biomarkers to acute cardiac dysfunction and myocarditis. There is limited information on late cardiac sequelae in patients who have recovered from acute COVID‐19 illness. We aimed to document the presence and quantify the extent of myocardial functional alterations in patients hospitalized 6 months earlier for COVID‐19 infection. Methods and results We conducted a prospective echocardiographic evaluation of 48 patients (mean age 58 ± 13 years, 69% male) hospitalized 6 ± 1 month earlier for a laboratory‐confirmed and symptomatic COVID‐19. Thirty‐two (66.6%) had pre‐existing cardiovascular risks factors (systemic hypertension, diabetes, or dyslipidaemia), and three patients (6.2%) had a known prior myocardial infarction. Sixteen patients (33.3%) experienced myocardial injury during the index COVID‐19 hospitalization as identified by a rise in cardiac troponin levels. Six months later, 60.4% of patients still reported clinical symptoms including exercise dyspnoea for 56%. Echocardiographic measurements under resting conditions were not different between patients with versus without myocardial injury during the acute COVID‐19 phase. In contrast, low‐level exercise (25W for 3 min) induced a significant increase in the average E/e′ ratio (10.1 ± 4.3 vs. 7.3 ± 11.5, P = 0.01) and the systolic pulmonary artery pressure (33.4 ± 7.8 vs. 25.6 ± 5.3 mmHg, P = 0.02) in patients with myocardial injury during the acute COVID‐19 phase. Sensitivity analyses showed that these alterations of left ventricular diastolic markers were observed regardless of whether of cardiovascular risk factors or established cardiac diseases indicating SARS‐CoV‐2 infection as a primary cause. Conclusions Six months after the acute COVID‐19 phase, significant cardiac diastolic abnormalities are observed in patients who experienced myocardial injury but not in patients without cardiac involvement.
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Affiliation(s)
- Antoine Fayol
- Université de Paris, INSERM, PARCC, 56 Rue Leblanc, Paris, F-75015, France.,CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Marine Livrozet
- Université de Paris, INSERM, PARCC, 56 Rue Leblanc, Paris, F-75015, France.,CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Pierre Boutouyrie
- Université de Paris, INSERM, PARCC, 56 Rue Leblanc, Paris, F-75015, France.,Department of Pharmacology and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Hakim Khettab
- Department of Pharmacology and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Maureen Betton
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Victoria Tea
- Department of Cardiology and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Anne Blanchard
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Rosa-Maria Bruno
- Université de Paris, INSERM, PARCC, 56 Rue Leblanc, Paris, F-75015, France.,Department of Pharmacology and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Jean-Sébastien Hulot
- Université de Paris, INSERM, PARCC, 56 Rue Leblanc, Paris, F-75015, France.,CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
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Bottemanne H, Gouraud C, Hulot JS, Blanchard A, Ranque B, Lahlou-Laforêt K, Limosin F, Günther S, Lebeaux D, Lemogne C. Do Anxiety and Depression Predict Persistent Physical Symptoms After a Severe COVID-19 Episode? A Prospective Study. Front Psychiatry 2021; 12:757685. [PMID: 34858230 PMCID: PMC8631493 DOI: 10.3389/fpsyt.2021.757685] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/01/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Persistent physical symptoms are common after a coronavirus disease 2019 (COVID-19) episode, but their pathophysiological mechanisms remain poorly understood. In this study, we aimed to explore the association between anxiety and depression at 1-month after acute infection and the presence of fatigue, dyspnea, and pain complaints at 3-month follow-up. Methods: We conducted a prospective study in patients previously hospitalized for COVID-19 followed up for 3 months. The Hospital Anxiety and Depression Scale (HAD-S) was administered by physicians at 1-month follow-up, and the presence of fatigue, dyspnea, and pain complaints was assessed at both 1 month and 3 months. Multivariable logistic regressions explored the association between anxiety and depression subscores and the persistence of each of the physical symptom at 3 months. Results: A total of 84 patients were included in this study (Median age: 60 years, interquartile range: 50.5-67.5 years, 23 women). We did not find any significant interaction between anxiety and the presence of fatigue, dyspnea, or pain complaints at 1 month in predicting the persistence of these symptoms at 3 months (all p ≥ 0.36). In contrast, depression significantly interacted with the presence of pain at 1 month in predicting the persistence of pain at 3 months (OR: 1.60, 95% CI: 1.02-2.51, p = 0.039), with a similar trend for dyspnea (OR: 1.51, 95% CI: 0.99-2.28, p = 0.052). Discussion and Conclusion: Contrary to anxiety, depression after an acute COVID-19 episode may be associated with and increased risk of some persistent physical symptoms, including pain and dyspnea.
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Affiliation(s)
- Hugo Bottemanne
- Paris Brain Institute - Institut du Cerveau et de la Moelle Épiniére, UMR 7225, UMR_S 1127, CNRS, INSERM, Sorbonne University, Service de Psychiatrie de l'Adulte, Hôpital de la Pitié-Salpêtriére, DMU Neurosciences, Assistance Publique-Hôpitaux De Paris, Paris, France
| | - Clément Gouraud
- Service de Psychiatrie de l'Adulte, DMU Psychiatrie et Addictologie, Hôpital Hôtel-Dieu, Université de Paris, Assistance Publique-Hopitaux de Paris, Paris, Paris, France
| | - Jean-Sébastien Hulot
- CIC 1418 and DMU CARTE, Assistance Publique Hopitaux De Paris, Hôpital Européen Georges-Pompidou, Paris, France
| | - Anne Blanchard
- Service de Néphrologie, Assistance Publique Hopitaux De Paris, Hôpital Européen-Georges Pompidou, Université de Paris, Paris, France
| | - Brigitte Ranque
- Service de Médecine Interne, Assistance Publique Hopitaux De Paris, Hôpital Européen-Georges Pompidou, Université de Paris, Paris, France
| | - Khadija Lahlou-Laforêt
- DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'Adulte, Assistance Publique Hopitaux De Paris, Hôpital Européen-Georges Pompidou, Université de Paris, Paris, France
| | - Frédéric Limosin
- DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'Adulte, Assistance Publique Hopitaux De Paris, Hôpital Corentin Celton, Université de Paris, Paris, France
| | - Sven Günther
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, Paris, France.,Service de Physiologie, Assistance Publique Hopitaux De Paris, Georges Pompidou European Hospital, Paris, France
| | - David Lebeaux
- Service de Microbiologie, Unité Mobile d'Infectiologie, Assistance Publique Hopitaux De Paris, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France
| | - Cédric Lemogne
- Service de Microbiologie, Unité Mobile d'Infectiologie, Assistance Publique Hopitaux De Paris, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France.,Service de Psychiatrie de l'Adulte, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Assistance Publique Hopitaux De Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Université de Paris, Paris, France
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Benveniste O, Hogrel JY, Belin L, Annoussamy M, Bachasson D, Rigolet A, Laforet P, Dzangué-Tchoupou G, Salem JE, Nguyen LS, Stojkovic T, Zahr N, Hervier B, Landon-Cardinal O, Behin A, Guilloux E, Reyngoudt H, Amelin D, Uruha A, Mariampillai K, Marty B, Eymard B, Hulot JS, Greenberg SA, Carlier PG, Allenbach Y. Sirolimus for treatment of patients with inclusion body myositis: a randomised, double-blind, placebo-controlled, proof-of-concept, phase 2b trial. Lancet Rheumatol 2021; 3:e40-e48. [PMID: 38273639 DOI: 10.1016/s2665-9913(20)30280-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/10/2020] [Accepted: 07/13/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Inclusion body myositis is the most frequent myositis in patients older than 50 years. Classical immunosuppressants are ineffective in treating inclusion body myositis, and to date there are no recommendations for pharmacological approaches to treatment. When used after organ transplantation, sirolimus can block the proliferation of effector T cells, while preserving T regulatory cells, and induce autophagy, all of which are processes that are impaired in inclusion body myositis. In this pilot study, we aimed to test the efficacy of sirolimus in patients with inclusion body myositis. METHODS This randomised, double-blind, placebo-controlled, proof-of-concept, phase 2b trial was done at a single hospital in Paris, France. The study included men and women (aged 45-80 years) who had a defined diagnosis of inclusion body myositis according to established criteria. Eligible participants were randomly assigned (1:1) to receive once-daily oral sirolimus 2 mg or placebo. Centralised balanced block randomisation (blocks of four) was computer generated without stratification. The study comprised a 15-day screening period (days -15 to 0) and a 52-week treatment period (day 0 to month 12). The primary endpoint was the relative percentage change from baseline to month 12 in maximal voluntary isometric knee extension strength. Secondary endpoints included the following assessments at months 6 and 12: 6-min walking distance, isometric muscle strength for hand grip (finger flexors), knee flexion and elbow flexion and extension, forced vital capacity, muscle replacement with fat measured by quantitative nuclear MRI, Inclusion Body Myositis Weakness Composite Index (IBMWCI), Inclusion Body Myositis Functional Rating Scale (IBMFRS), Health Assessment Questionnaire without Disability Index (HAQ-DI), and analyses of T-cell subpopulations by mass cytometry. The primary analysis was done on the intention-to-treat population. The trial is registered at ClinicalTrials.gov, NCT02481453. FINDINGS Between July 15, 2015, and May 13, 2016, we screened 285 patients, 44 of whom were randomly allocated to sirolimus (22 patients) or placebo (22 patients). We observed no difference in the primary outcome of relative percentage change from baseline to month 12 of the maximal voluntary isometric knee extension strength (median difference 3·78, 95% CI -10·61 to 17·31; p=0·85). For secondary outcomes, differences between the groups were not significant for changes in strength of other muscle groups (grip, elbow flexion and extension, or knee flexion), IBMWCI, IBMFRS, and lower limb muscle fat fraction. However, we observed significant differences in favour of sirolimus between the study groups for HAQ-DI, forced vital capacity, thigh fat fraction, and 6-min walking distance. Ten (45%) of 22 patients in the sirolimus group had a serious adverse event compared with six (27%) of 22 patients in the placebo group. Four (18%) patients in the sirolimus group stopped their treatment because of adverse events (severe mouth ulcers, aseptic pneumonia, renal insufficiency, and peripheral lower limb oedema), which resolved after treatment discontinuation. Canker sores were the most frequent side-effect and were mainly mild or moderate in ten patients. INTERPRETATION We found no evidence for efficacy of sirolimus for treating inclusion body myositis based on maximal voluntary isometric knee extension strength and other muscle strength measures, and the side-effects of treatment were substantial for some patients. However, we believe there was enough evidence of benefit in certain secondary outcomes to pursue a multicentre phase 3 trial to further assess the safety and efficacy of sirolimus. FUNDING Institut national de la santé et de la recherche médicale, Direction générale de l'offre de soins, and Association Française contre les Myopathies.
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Affiliation(s)
- Olivier Benveniste
- Department of Internal Medicine and Clinical Immunology, Neuromuscular Rare Diseases Reference Center of Paris, Sorbonne Université, INSERM U974, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Paris, France.
| | - Jean-Yves Hogrel
- Neuromuscular Physiology Laboratory, Neuromuscular Investigation Center, Institute of Myology, Pitié-Salpêtrière Hospital, Paris, France
| | - Lisa Belin
- Département Biostatistique Santé Publique et Information Médicale, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris, France
| | | | - Damien Bachasson
- Neuromuscular Physiology Laboratory, Neuromuscular Investigation Center, Institute of Myology, Pitié-Salpêtrière Hospital, Paris, France
| | - Aude Rigolet
- Department of Internal Medicine and Clinical Immunology, Neuromuscular Rare Diseases Reference Center of Paris, Sorbonne Université, INSERM U974, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Paris, France
| | - Pascal Laforet
- Neuromuscular Reference Center Nord/Est/Ile de France, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris, France
| | - Gaëlle Dzangué-Tchoupou
- Department of Internal Medicine and Clinical Immunology, Neuromuscular Rare Diseases Reference Center of Paris, Sorbonne Université, INSERM U974, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Paris, France
| | - Joe-Elie Salem
- Department of Pharmacology, Sorbonne Université, INSERM, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Centre d'investigation Clinique Paris-Est, CIC 1421, Paris, France
| | - Lee S Nguyen
- Department of Pharmacology, Sorbonne Université, INSERM, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Centre d'investigation Clinique Paris-Est, CIC 1421, Paris, France
| | - Tanya Stojkovic
- Neuromuscular Reference Center Nord/Est/Ile de France, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris, France
| | - Noel Zahr
- Clinical Pharmacology & Center of Clinical Investigation Paris-Est, Sorbonne Université, AP-HP, INSERM, Paris, France
| | - Baptiste Hervier
- Department of Internal Medicine and Clinical Immunology, Neuromuscular Rare Diseases Reference Center of Paris, Sorbonne Université, INSERM U974, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Paris, France
| | - Océane Landon-Cardinal
- Division of Rheumatology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada; Department of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Anthony Behin
- Neuromuscular Reference Center Nord/Est/Ile de France, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris, France
| | - Edith Guilloux
- Department of Pharmacology, Sorbonne Université, INSERM, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Centre d'investigation Clinique Paris-Est, CIC 1421, Paris, France
| | - Harmen Reyngoudt
- NMR Laboratory, CEA/DRF/IBJF/MIRCen, Neuromuscular Investigation Center, Institute of Myology, Paris, France
| | - Damien Amelin
- Department of Internal Medicine and Clinical Immunology, Neuromuscular Rare Diseases Reference Center of Paris, Sorbonne Université, INSERM U974, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Paris, France
| | - Akinori Uruha
- Department of Internal Medicine and Clinical Immunology, Neuromuscular Rare Diseases Reference Center of Paris, Sorbonne Université, INSERM U974, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Paris, France
| | - Kuberaka Mariampillai
- Department of Internal Medicine and Clinical Immunology, Neuromuscular Rare Diseases Reference Center of Paris, Sorbonne Université, INSERM U974, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Paris, France
| | - Benjamin Marty
- NMR Laboratory, CEA/DRF/IBJF/MIRCen, Neuromuscular Investigation Center, Institute of Myology, Paris, France
| | - Bruno Eymard
- Neuromuscular Reference Center Nord/Est/Ile de France, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris, France
| | - Jean-Sébastien Hulot
- Department of Pharmacology, Sorbonne Université, INSERM, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Centre d'investigation Clinique Paris-Est, CIC 1421, Paris, France
| | - Steven A Greenberg
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Pierre G Carlier
- NMR Laboratory, CEA/DRF/IBJF/MIRCen, Neuromuscular Investigation Center, Institute of Myology, Paris, France
| | - Yves Allenbach
- Department of Internal Medicine and Clinical Immunology, Neuromuscular Rare Diseases Reference Center of Paris, Sorbonne Université, INSERM U974, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Paris, France
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Gouraud C, Bottemanne H, Lahlou-Laforêt K, Blanchard A, Günther S, Batti SE, Auclin E, Limosin F, Hulot JS, Lebeaux D, Lemogne C. Association Between Psychological Distress, Cognitive Complaints, and Neuropsychological Status After a Severe COVID-19 Episode: A Cross-Sectional Study. Front Psychiatry 2021; 12:725861. [PMID: 34539470 PMCID: PMC8446522 DOI: 10.3389/fpsyt.2021.725861] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/12/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Cognitive complaints are frequent after COVID-19 but their clinical determinants are poorly understood. This study aimed to explore the associations of objective cognitive performances and psychological distress with cognitive complaints in COVID-19 survivors. Materials and Methods: Patients previously hospitalized for COVID-19 in a university hospital during the first wave of COVID-19 pandemic in France were followed-up at 1 month after their admission. Cognitive complaints were self-reported and standardized instruments were used to assess neuropsychological status (Digit Symbol Substitution Test, Semantic Verbal Fluency Test, Mini Mental Status Examination) and psychological distress (Hospital Anxiety and Depression Scale, HADS). Multivariable analyses were adjusted for age, sex, admission in intensive care unit (ICU) and need for oxygen and C-reactive protein. Results: One hundred patients (34% women, median age: 60 years [interquartile range: 49-72)] completed the neuropsychological assessment at follow-up. In multivariable analyses, cognitive complaints at 1-month were associated with greater HADS score (OR for one interquartile range: OR: 1.96, 95% CI: 1.08-3.57) and older age (OR: 1.05, 95% CI: 1.01-1.09) and, negatively, with admission in ICU (OR: 0.22, 95% CI: 0.05-0.90). In contrast, none of the objective neuropsychological test scores was significantly associated with cognitive complaints. Exploratory analysis showed that cognitive complaints were associated with both anxiety and depressive symptoms. Discussion: These preliminary results suggest that cognitive complaints at 1 month after a hospitalization for COVID-19 are associated with psychological distress, independently of objective neuropsychological status. Anxiety and depression symptoms should be systematically screened in patients presenting with cognitive complaints after a severe COVID-19 episode.
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Affiliation(s)
- Clément Gouraud
- Université de Paris, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, Paris, France
| | - Hugo Bottemanne
- Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, DMU Neurosciences, Service de Psychiatrie de l'adulte, Paris Brain Institute - Institut du Cerveau (ICM), UMR 7225 / UMR_S 1127, / CNRS / INSERM, Paris, France
| | - Khadija Lahlou-Laforêt
- Université de Paris, AP-HP, Hôpital Européen-Georges Pompidou, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, Paris, France
| | - Anne Blanchard
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France
| | - Sven Günther
- Université de Paris, Innovative Therapies in Haemostasis, INSERM, Paris, France.,Service de Physiologie, AH-HP, Georges Pompidou European Hospital, Paris, France
| | - Salma El Batti
- Université de Paris, Service de Chirurgie Vasculaire, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, Paris, France
| | - Edouard Auclin
- Université de Paris, Service d'oncologie médicale, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, Paris, France
| | - Frédéric Limosin
- Université de Paris, AP-HP, Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte et du sujet âgé, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | | | - David Lebeaux
- Université de Paris, Service de Microbiologie, Unité Mobile d'Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, Paris, France
| | - Cédric Lemogne
- Université de Paris, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
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Affiliation(s)
- Jean-Sébastien Hulot
- Université de Paris, PARCC, INSERM, Paris, France; CIC1418 and DMU CARTE, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France.
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Melhem NJ, Chajadine M, Gomez I, Howangyin KY, Bouvet M, Knosp C, Sun Y, Rouanet M, Laurans L, Cazorla O, Lemitre M, Vilar J, Mallat Z, Tedgui A, Ait-Oufella H, Hulot JS, Callebert J, Launay JM, Fauconnier J, Silvestre JS, Taleb S. Endothelial Cell Indoleamine 2, 3-Dioxygenase 1 Alters Cardiac Function After Myocardial Infarction Through Kynurenine. Circulation 2020; 143:566-580. [PMID: 33272024 DOI: 10.1161/circulationaha.120.050301] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Ischemic cardiovascular diseases, particularly acute myocardial infarction (MI), is one of the leading causes of mortality worldwide. Indoleamine 2, 3-dioxygenase 1 (IDO) catalyzes 1 rate-limiting step of L-tryptophan metabolism, and emerges as an important regulator of many pathological conditions. We hypothesized that IDO could play a key role to locally regulate cardiac homeostasis after MI. METHODS Cardiac repair was analyzed in mice harboring specific endothelial or smooth muscle cells or cardiomyocyte or myeloid cell deficiency of IDO and challenged with acute myocardial infarction. RESULTS We show that kynurenine generation through IDO is markedly induced after MI in mice. Total genetic deletion or pharmacological inhibition of IDO limits cardiac injury and cardiac dysfunction after MI. Distinct loss of function of IDO in smooth muscle cells, inflammatory cells, or cardiomyocytes does not affect cardiac function and remodeling in infarcted mice. In sharp contrast, mice harboring endothelial cell-specific deletion of IDO show an improvement of cardiac function as well as cardiomyocyte contractility and reduction in adverse ventricular remodeling. In vivo kynurenine supplementation in IDO-deficient mice abrogates the protective effects of IDO deletion. Kynurenine precipitates cardiomyocyte apoptosis through reactive oxygen species production in an aryl hydrocarbon receptor-dependent mechanism. CONCLUSIONS These data suggest that IDO could constitute a new therapeutic target during acute MI.
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Affiliation(s)
- Nada Joe Melhem
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Mouna Chajadine
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Ingrid Gomez
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Kiave-Yune Howangyin
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Marion Bouvet
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Camille Knosp
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Yanyi Sun
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Marie Rouanet
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Ludivine Laurans
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Olivier Cazorla
- PHYSIOLOGIE ET MÉDECINE EXPÉRIMENTALE DU COEUR ET DES MUSCLES (PHYMEDEXP), Institut national de la santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Université de Montpellier, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, France (O.C., J.F.)
| | - Mathilde Lemitre
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - José Vilar
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Ziad Mallat
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.).,Division of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, United Kingdom (Z.M.)
| | - Alain Tedgui
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Hafid Ait-Oufella
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Jean-Sébastien Hulot
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Jacques Callebert
- Service de Biochimie, Assistance Publique Hôpitaux de Paris, and Institut National de la Santé et de la Recherche Médicale UMR942, Hôpital Lariboisière, France (J.C., J.-M.L.)
| | - Jean-Marie Launay
- Service de Biochimie, Assistance Publique Hôpitaux de Paris, and Institut National de la Santé et de la Recherche Médicale UMR942, Hôpital Lariboisière, France (J.C., J.-M.L.)
| | - Jeremy Fauconnier
- PHYSIOLOGIE ET MÉDECINE EXPÉRIMENTALE DU COEUR ET DES MUSCLES (PHYMEDEXP), Institut national de la santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Université de Montpellier, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, France (O.C., J.F.)
| | - Jean-Sébastien Silvestre
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
| | - Soraya Taleb
- Université de Paris, Paris-Centre de Recherche Cardiovasculaire (PARCC), Institut National de la Santé et de la Recherche Médicale, France (N.-J.M., M.C., I.G., K.-Y.H., M.B., C.K., Y.S., M.R., L.L., M.L., J.V., Z.M., A.T., H.A.-O., J.-S.H., J.-S.S., S.T.)
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Hulot JS. [Classification of heart failure and etiological approach]. Rev Prat 2020; 70:965-968. [PMID: 33739751] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Classification of heart failure and etiological approach. Heart failure, once viewed as a homogeneous disease, has become a heterogeneous syndrome in which several forms of heart failure are distinguished depending on the level of left ventricular ejection fraction (LVEF). While the diagnosis and treatment strategies are well established for patients with reduced LVEF, we are still lacking such efficient strategies for patients with heart failure with preserved ejection fraction (which represent up to half of patients with heart failure). New diagnostic scores and algorithms have thus recently been proposed to help in the management of these patients. The recognition of etiologies leading to heart failure with preserved ejection fraction is an important step because it can lead to the initiation of new targeted therapies, as is the case for example for patients with cardiac amyloidosis.
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Affiliation(s)
- Jean-Sébastien Hulot
- DMU cardiovasculaire rénal et transplantation (CARTE), Hôpital européen Georges-Pompidou, AP-HP, Paris, France
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45
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Hulot JS. [Actuality in heart failure]. Rev Prat 2020; 70:963-964. [PMID: 33739750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Jean-Sébastien Hulot
- DMU cardiovasculaire rénal et transplantation (CARTE), Hôpital européen Georges-Pompidou, AP-HP, Paris, France
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46
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Hulot JS. [Actuality in heart failure: 10 key messages]. Rev Prat 2020; 70:983. [PMID: 33739755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Jean-Sébastien Hulot
- DMU cardiovasculaire, rénal et transplantation (CARTE), Hôpital européen Georges- Pompidou, AP-HP, Paris, France
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47
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Triposkiadis F, Butler J, Abboud FM, Armstrong PW, Adamopoulos S, Atherton JJ, Backs J, Bauersachs J, Burkhoff D, Bonow RO, Chopra VK, de Boer RA, de Windt L, Hamdani N, Hasenfuss G, Heymans S, Hulot JS, Konstam M, Lee RT, Linke WA, Lunde IG, Lyon AR, Maack C, Mann DL, Mebazaa A, Mentz RJ, Nihoyannopoulos P, Papp Z, Parissis J, Pedrazzini T, Rosano G, Rouleau J, Seferovic PM, Shah AM, Starling RC, Tocchetti CG, Trochu JN, Thum T, Zannad F, Brutsaert DL, Segers VF, De Keulenaer GW. The continuous heart failure spectrum: moving beyond an ejection fraction classification. Eur Heart J 2020; 40:2155-2163. [PMID: 30957868 DOI: 10.1093/eurheartj/ehz158] [Citation(s) in RCA: 169] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/05/2019] [Accepted: 03/08/2019] [Indexed: 12/17/2022] Open
Abstract
Randomized clinical trials initially used heart failure (HF) patients with low left ventricular ejection fraction (LVEF) to select study populations with high risk to enhance statistical power. However, this use of LVEF in clinical trials has led to oversimplification of the scientific view of a complex syndrome. Descriptive terms such as 'HFrEF' (HF with reduced LVEF), 'HFpEF' (HF with preserved LVEF), and more recently 'HFmrEF' (HF with mid-range LVEF), assigned on arbitrary LVEF cut-off points, have gradually arisen as separate diseases, implying distinct pathophysiologies. In this article, based on pathophysiological reasoning, we challenge the paradigm of classifying HF according to LVEF. Instead, we propose that HF is a heterogeneous syndrome in which disease progression is associated with a dynamic evolution of functional and structural changes leading to unique disease trajectories creating a spectrum of phenotypes with overlapping and distinct characteristics. Moreover, we argue that by recognizing the spectral nature of the disease a novel stratification will arise from new technologies and scientific insights that will shape the design of future trials based on deeper understanding beyond the LVEF construct alone.
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Affiliation(s)
| | - Javed Butler
- Department of Medicine-L650, University of Mississippi Medical Center, Jackson, MS, USA
| | - Francois M Abboud
- Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA, USA
| | - Paul W Armstrong
- Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Stamatis Adamopoulos
- Transplant and Mechanical Circulatory Support Unit, Onassis Cardiac Surgery Center, Athens, Greece
| | - John J Atherton
- Department of Cardiology, Royal Brisbane and Women's Hospital, University of Queensland School of Medicine, Brisbane, Australia
| | - Johannes Backs
- Department of Molecular Cardiology and Epigenetics, Heidelberg University, Heidelberg, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | | | - Robert O Bonow
- Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, IL, USA
| | - Vijay K Chopra
- Department of Cardiology, Medanta Medicity, Gurugram, Haryana, India
| | - Rudolf A de Boer
- Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Leon de Windt
- Department of Cardiology, Faculty of Health, Medicine and Life Sciences, School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Nazha Hamdani
- Department of Systems Physiology, Ruhr University Bochum, Bochum, Germany
| | - Gerd Hasenfuss
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Stephane Heymans
- Department of Cardiology, CARIM School for Cardiovascular Diseases Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Jean-Sébastien Hulot
- Université Paris-Descartes, Sorbonne Paris Cité, Paris, France.,Paris Cardiovascular Research Center, INSERM UMR 970, Paris, France.,Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Marvin Konstam
- The CardioVascular Center of Tufts Medical Center, Boston, MA, USA
| | - Richard T Lee
- Department of Stem Cell and Regenerative Biology, Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA
| | - Wolfgang A Linke
- Institute of Physiology II, University of Münster, Münster, Germany
| | - Ida G Lunde
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Alexander R Lyon
- Cardiovascular Research Centre, Royal Brompton Hospital, London, UK.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Christoph Maack
- Comprehensive Heart Failure Center, University Clinic Würzburg, Würzburg, Germany
| | - Douglas L Mann
- Department of Medicine, Center for Cardiovascular Research, Washington University School of Medicine, St. Louis Missouri, MO, USA
| | - Alexandre Mebazaa
- Department of Anaesthesiology and Critical Care Medicine, AP-HP, Saint Louis and Lariboisière University Hospitals, Inserm U 942, Paris, France
| | | | | | - Zoltan Papp
- Division of Clinical Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - John Parissis
- Heart Failure Unit, Department of Cardiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Thierry Pedrazzini
- Experimental Cardiology Unit, Department of Cardiovascular Medicine, University of Lausanne Medical School, Lausanne, Switzerland
| | - Giuseppe Rosano
- Department of Medical Sciences, IRCCS San Raffaele, Centre for Clinical and Basic Research, Pisana Rome, Italy
| | - Jean Rouleau
- Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
| | | | - Ajay M Shah
- School of Cardiovascular Medicine & Sciences, British Heart Foundation Centre, King's College London, London, UK
| | | | - Carlo G Tocchetti
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Jean-Noel Trochu
- CIC INSERM 1413, Institut du thorax, UMR INSERM 1087, University Hospital of Nantes, Nantes, France
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hanover, Germany
| | - Faiez Zannad
- Inserm CIC 1433, Université de Lorrain, CHU de Nancy, Nancy, France
| | | | - Vincent F Segers
- Laboratory of Physiopharmacology, Antwerp University, Universiteitsplein 1, Building T, Wilrijk, Antwerp, Belgium.,Division of Cardiology, Antwerp University Hospital, Edegem, Belgium
| | - Gilles W De Keulenaer
- Laboratory of Physiopharmacology, Antwerp University, Universiteitsplein 1, Building T, Wilrijk, Antwerp, Belgium.,ZNA Hartcentrum, Antwerp, Belgium
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48
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Mirabel M, Callon D, Bruneval P, Lebreil AL, Mousseaux E, Oudard S, Hulot JS, Andreoletti L. Late-Onset Giant Cell Myocarditis Due to Enterovirus During Treatment With Immune Checkpoint Inhibitors. JACC CardioOncol 2020; 2:511-514. [PMID: 34396260 PMCID: PMC8352190 DOI: 10.1016/j.jaccao.2020.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Mariana Mirabel
- Université de Paris, Paris Cardiovascular Research Center PARCC, INSERM, Paris, France.,Cardio-oncology unit, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Domitille Callon
- Université de Reims Champagne Ardenne, Cardiovir EA-4684, Reims, France.,CHU Reims, Hôpital Robert Debré, Pathology Department, Reims, France
| | - Patrick Bruneval
- Université de Paris, Paris Cardiovascular Research Center PARCC, INSERM, Paris, France.,Assistance Publique-Hôpitaux de Paris, APHP Centre, Hôpital Européen Georges Pompidou, Pathology, Paris, France
| | | | - Elie Mousseaux
- Université de Paris, Paris Cardiovascular Research Center PARCC, INSERM, Paris, France.,Cardio-vascular imaging, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Stéphane Oudard
- Université de Paris, Paris Cardiovascular Research Center PARCC, INSERM, Paris, France.,Medical Oncology, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Jean-Sébastien Hulot
- Université de Paris, Paris Cardiovascular Research Center PARCC, INSERM, Paris, France.,Cardio-oncology unit, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.,Centre d'Investigations Cliniques CIC1418, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Laurent Andreoletti
- Université de Reims Champagne Ardenne, Cardiovir EA-4684, Reims, France.,CHU Reims, Hôpital Robert Debré, Virology Department, Reims, France
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49
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Khider L, Gendron N, Goudot G, Chocron R, Hauw-Berlemont C, Cheng C, Rivet N, Pere H, Roffe A, Clerc S, Lebeaux D, Debuc B, Veyer D, Rance B, Gaussem P, Bertil S, Badoual C, Juvin P, Planquette B, Messas E, Sanchez O, Hulot JS, Diehl JL, Mirault T, Smadja DM. Curative anticoagulation prevents endothelial lesion in COVID-19 patients. J Thromb Haemost 2020; 18:2391-2399. [PMID: 32558198 PMCID: PMC7323356 DOI: 10.1111/jth.14968] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/20/2020] [Accepted: 06/08/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Coronavirus disease-2019 (COVID-19) has been associated with cardiovascular complications and coagulation disorders. OBJECTIVES To explore the coagulopathy and endothelial dysfunction in COVID-19 patients. METHODS The study analyzed clinical and biological profiles of patients with suspected COVID-19 infection at admission, including hemostasis tests and quantification of circulating endothelial cells (CECs). RESULTS Among 96 consecutive COVID-19-suspected patients fulfilling criteria for hospitalization, 66 were tested positive for SARS-CoV-2. COVID-19-positive patients were more likely to present with fever (P = .02), cough (P = .03), and pneumonia at computed tomography (CT) scan (P = .002) at admission. Prevalence of D-dimer >500 ng/mL was higher in COVID-19-positive patients (74.2% versus 43.3%; P = .007). No sign of disseminated intravascular coagulation were identified. Adding D-dimers >500 ng/mL to gender and pneumonia at CT scan in receiver operating characteristic curve analysis significantly increased area under the curve for COVID-19 diagnosis. COVID-19-positive patients had significantly more CECs at admission (P = .008) than COVID-19-negative ones. COVID-19-positive patients treated with curative anticoagulant prior to admission had fewer CECs (P = .02) than those without. Interestingly, patients treated with curative anticoagulation and angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers had even fewer CECs (P = .007). CONCLUSION Curative anticoagulation could prevent COVID-19-associated coagulopathy and endothelial lesion.
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Affiliation(s)
- Lina Khider
- Vascular Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Nicolas Gendron
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, Paris, France
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, Paris, France
| | - Guillaume Goudot
- Vascular Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Richard Chocron
- PARCC, INSERM, Université de Paris, Paris, France
- Emergency Department, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Caroline Hauw-Berlemont
- Intensive Care Unit, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Charles Cheng
- Vascular Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Nadia Rivet
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, Paris, France
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, Paris, France
| | - Helene Pere
- PARCC, INSERM, Université de Paris, Paris, France
- Virology Department, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Ariel Roffe
- Vascular Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Sébastien Clerc
- Respiratory Medicine Department, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - David Lebeaux
- Infectious Disease Department, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Benjamin Debuc
- Plastic Surgery Department, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - David Veyer
- Virology Department, AP-HP, Georges Pompidou European Hospital, Paris, France
- Centre de Recherche des Cordeliers, Functional Genomics of Solid Tumors, INSERM, Université de Paris, Paris, France
| | - Bastien Rance
- Department of Medical Informatics, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Pascale Gaussem
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, Paris, France
- Hematology Department, AH-HP, Georges Pompidou European Hospital, Paris, France
| | - Sébastien Bertil
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, Paris, France
- Hematology Department, AH-HP, Georges Pompidou European Hospital, Paris, France
| | - Cécile Badoual
- PARCC, INSERM, Université de Paris, Paris, France
- Pathology Department and PRB (Plateforme de ressources biologiques), AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Philippe Juvin
- Emergency Department, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Benjamin Planquette
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, Paris, France
- Respiratory Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, Paris, France
| | - Emmanuel Messas
- Vascular Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Olivier Sanchez
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, Paris, France
- Respiratory Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, Paris, France
| | - Jean-Sébastien Hulot
- PARCC, INSERM, Université de Paris, Paris, France
- Clinical Center of Investigation, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Jean-Luc Diehl
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, Paris, France
- Intensive Care Unit and Biosurgical Research Lab (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, Paris, France
| | - Tristan Mirault
- Vascular Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - David M Smadja
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, Paris, France
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AH-HP, Georges Pompidou European Hospital, Paris, France
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50
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Bouvet M, Claude O, Roux M, Skelly D, Masurkar N, Mougenot N, Nadaud S, Blanc C, Delacroix C, Chardonnet S, Pionneau C, Perret C, Yaniz-Galende E, Rosenthal N, Trégouët DA, Marazzi G, Silvestre JS, Sassoon D, Hulot JS. Anti-integrin α v therapy improves cardiac fibrosis after myocardial infarction by blunting cardiac PW1 + stromal cells. Sci Rep 2020; 10:11404. [PMID: 32647159 PMCID: PMC7347632 DOI: 10.1038/s41598-020-68223-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/19/2020] [Indexed: 12/17/2022] Open
Abstract
There is currently no therapy to limit the development of cardiac fibrosis and consequent heart failure. We have recently shown that cardiac fibrosis post-myocardial infarction (MI) can be regulated by resident cardiac cells with a fibrogenic signature and identified by the expression of PW1 (Peg3). Here we identify αV-integrin (CD51) as an essential regulator of cardiac PW1+ cells fibrogenic behavior. We used transcriptomic and proteomic approaches to identify specific cell-surface markers for cardiac PW1+ cells and found that αV-integrin (CD51) was expressed in almost all cardiac PW1+ cells (93% ± 1%), predominantly as the αVβ1 complex. αV-integrin is a subunit member of the integrin family of cell adhesion receptors and was found to activate complex of latent transforming growth factor beta (TGFβ at the surface of cardiac PW1+ cells. Pharmacological inhibition of αV-integrin reduced the profibrotic action of cardiac PW1+CD51+ cells and was associated with improved cardiac function and animal survival following MI coupled with a reduced infarct size and fibrotic lesion. These data identify a targetable pathway that regulates cardiac fibrosis in response to an ischemic injury and demonstrate that pharmacological inhibition of αV-integrin could reduce pathological outcomes following cardiac ischemia.
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Affiliation(s)
- Marion Bouvet
- Université de Paris, PARCC, INSERM, 56 Rue Leblanc, 75015, Paris, France
| | - Olivier Claude
- Université de Paris, PARCC, INSERM, 56 Rue Leblanc, 75015, Paris, France
| | - Maguelonne Roux
- Sorbonne Université, UPMC Univ Paris 06, INSERM, Institute of Cardio Metabolism and Nutrition (ICAN), Paris, France
| | - Dan Skelly
- The Jackson Laboratory, Bar Harbor, ME, USA
| | - Nihar Masurkar
- Université de Paris, PARCC, INSERM, 56 Rue Leblanc, 75015, Paris, France
| | - Nathalie Mougenot
- Sorbonne Université, UPMC Univ Paris 06, PECMV, UMS28, Paris, France
| | - Sophie Nadaud
- Sorbonne Université, UPMC Univ Paris 06, INSERM, Institute of Cardio Metabolism and Nutrition (ICAN), Paris, France
| | - Catherine Blanc
- Sorbonne Université, Inserm, UMS Omique, Plateforme Post-génomique de la Pitié-Salpêtrière, P3S, 75013, Paris, France
| | - Clément Delacroix
- Université de Paris, PARCC, INSERM, 56 Rue Leblanc, 75015, Paris, France
| | - Solenne Chardonnet
- Sorbonne Université, Inserm, UMS Omique, Plateforme Post-génomique de la Pitié-Salpêtrière, P3S, 75013, Paris, France
| | - Cédric Pionneau
- Sorbonne Université, Inserm, UMS Omique, Plateforme Post-génomique de la Pitié-Salpêtrière, P3S, 75013, Paris, France
| | - Claire Perret
- Sorbonne Université, UPMC Univ Paris 06, INSERM, Institute of Cardio Metabolism and Nutrition (ICAN), Paris, France
| | - Elisa Yaniz-Galende
- Sorbonne Université, UPMC Univ Paris 06, INSERM, Institute of Cardio Metabolism and Nutrition (ICAN), Paris, France
| | | | - David-Alexandre Trégouët
- Sorbonne Université, UPMC Univ Paris 06, INSERM, Institute of Cardio Metabolism and Nutrition (ICAN), Paris, France.,INSERM UMR_S 1219, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - Giovanna Marazzi
- Université de Paris, PARCC, INSERM, 56 Rue Leblanc, 75015, Paris, France
| | | | - David Sassoon
- Université de Paris, PARCC, INSERM, 56 Rue Leblanc, 75015, Paris, France
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