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Svagusa T, Sikiric S, Milavic M, Sepac A, Seiwerth S, Milicic D, Gasparovic H, Biocina B, Rudez I, Sutlic Z, Manola S, Varvodic J, Udovicic M, Urlic M, Ivankovic S, Plestina S, Paic F, Kulic A, Bakovic P, Sedlic F. Heart failure in patients is associated with downregulation of mitochondrial quality control genes. Eur J Clin Invest 2023; 53:e14054. [PMID: 37403271 DOI: 10.1111/eci.14054] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/27/2023] [Accepted: 06/15/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Mitochondrial dysfunction is one of key factors causing heart failure. We performed a comprehensive analysis of expression of mitochondrial quality control (MQC) genes in heart failure. METHODS Myocardial samples were obtained from patients with ischemic and dilated cardiomyopathy in a terminal stage of heart failure and donors without heart disease. Using quantitative real-time PCR, we analysed a total of 45 MQC genes belonging to mitochondrial biogenesis, fusion-fission balance, mitochondrial unfolded protein response (UPRmt), translocase of the inner membrane (TIM) and mitophagy. Protein expression was analysed by ELISA and immunohistochemistry. RESULTS The following genes were downregulated in ischemic and dilated cardiomyopathy: COX1, NRF1, TFAM, SIRT1, MTOR, MFF, DNM1L, DDIT3, UBL5, HSPA9, HSPE1, YME1L, LONP1, SPG7, HTRA2, OMA1, TIMM23, TIMM17A, TIMM17B, TIMM44, PAM16, TIMM22, TIMM9, TIMM10, PINK1, PARK2, ROTH1, PARL, FUNDC1, BNIP3, BNIP3L, TPCN2, LAMP2, MAP1LC3A and BECN1. Moreover, MT-ATP8, MFN2, EIF2AK4 and ULK1 were downregulated in heart failure from dilated, but not ischemic cardiomyopathy. VDAC1 and JUN were only genes that exhibited significantly different expression between ischemic and dilated cardiomyopathy. Expression of PPARGC1, OPA1, JUN, CEBPB, EIF2A, HSPD1, TIMM50 and TPCN1 was not significantly different between control and any form of heart failure. TOMM20 and COX proteins were downregulated in ICM and DCM. CONCLUSIONS Heart failure in patients with ischemic and dilated cardiomyopathy is associated with downregulation of large number of UPRmt, mitophagy, TIM and fusion-fission balance genes. This indicates multiple defects in MQC and represents one of potential mechanisms underlying mitochondrial dysfunction in patients with heart failure.
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Affiliation(s)
- T Svagusa
- Department of Cardiovascular Diseases, Dubrava Clinical Hospital, Zagreb, Croatia
| | - S Sikiric
- Department of Pathology, University of Zagreb School of Medicine, Zagreb, Croatia
| | - M Milavic
- Department of Pathology, University of Zagreb School of Medicine, Zagreb, Croatia
| | - A Sepac
- Department of Pathology, University of Zagreb School of Medicine, Zagreb, Croatia
- Department of Pathology and Cytology, University Hospital Center Zagreb, Zagreb, Croatia
| | - S Seiwerth
- Department of Pathology, University of Zagreb School of Medicine, Zagreb, Croatia
- Department of Pathology and Cytology, University Hospital Center Zagreb, Zagreb, Croatia
| | - D Milicic
- Department of Internal Medicine, University of Zagreb School of Medicine, Zagreb, Croatia
- Department of Cardiovascular Diseases, University Hospital Center Zagreb, Zagreb, Croatia
| | - H Gasparovic
- Department of Surgery, University of Zagreb School of Medicine, Zagreb, Croatia
- Department of Cardiac Surgery, University Hospital Center Zagreb, Zagreb, Croatia
| | - B Biocina
- Department of Surgery, University of Zagreb School of Medicine, Zagreb, Croatia
- Department of Cardiac Surgery, University Hospital Center Zagreb, Zagreb, Croatia
| | - I Rudez
- Department of Surgery, University of Zagreb School of Medicine, Zagreb, Croatia
- Department of Cardiac and Transplant Surgery, Dubrava Clinical Hospital, Zagreb, Croatia
| | - Z Sutlic
- Department of Surgery, University of Zagreb School of Medicine, Zagreb, Croatia
- Department of Cardiac and Transplant Surgery, Dubrava Clinical Hospital, Zagreb, Croatia
| | - S Manola
- Department of Cardiovascular Diseases, Dubrava Clinical Hospital, Zagreb, Croatia
| | - J Varvodic
- Department of Cardiac and Transplant Surgery, Dubrava Clinical Hospital, Zagreb, Croatia
| | - M Udovicic
- Department of Cardiovascular Diseases, Dubrava Clinical Hospital, Zagreb, Croatia
- Department of Internal Medicine, University of Zagreb School of Medicine, Zagreb, Croatia
| | - M Urlic
- Department of Cardiac Surgery, University Hospital Center Zagreb, Zagreb, Croatia
| | - S Ivankovic
- Department of Cardiac Surgery, University Hospital Center Split, Split, Croatia
| | - S Plestina
- Department of Pathophysiology, University of Zagreb School of Medicine, Zagreb, Croatia
- Department of Oncology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - F Paic
- Department of Medical Biology, University of Zagreb School of Medicine, Zagreb, Croatia
| | - A Kulic
- Department of Oncology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - P Bakovic
- Department of Pathophysiology, University of Zagreb School of Medicine, Zagreb, Croatia
| | - F Sedlic
- Department of Pathophysiology, University of Zagreb School of Medicine, Zagreb, Croatia
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Tzeis S, Kojic D, Manola S, Brusich S, Pernat A, Asvestas D, Xenos T, Tomovic M, Cubranic Z, Rauber M, Pavlovic N. Ablation of residual potentials along the circumferential line reduces acute reconnection in patients undergoing pulmonary vein isolation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.599] [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
Introduction
Acute pulmonary vein (PV) reconnection is frequently encountered in patients with atrial fibrillation (AF) subjected to PV isolation (PVI).
Purpose
In this prospective, multicenter, randomized study, we investigated whether the identification and ablation of sites along the circumferential line with specific electrogram criteria indicative of nontrasmurality, after initial achievement of PVI, reduces acute PV reconnection rate.
Methods
Patients referred for AF ablation at five European centers were enrolled. PVI with antral circumferential isolation of ipsilateral PVs was performed using a contact force sensing ablation catheter delivering 35–40W at the anterior/superior and 30W at the posterior wall with target ablation index of 550 at the anterior wall/roof and 400 at the posterior/inferior segments. Following PVI, mapping with the ablation catheter was performed to identify residual potentials (RP) along the ablation line, defined as bipolar amplitude ≥0.2 mV or 0.1–0.19 mV combined with negative component of the unipolar electrogram as recorded by the 3D mapping system. Ipsilateral PV sets with RPs were randomized to either no further ablation (Group B) or to additional ablation of RPs (Group C). The primary study endpoint was defined as spontaneous or adenosine-mediated recovery of conduction after 30-minute waiting period which was also evaluated in ipsilateral PV sets without residual potentials (Group A).
Results
In total, 109 patients (59.3±10.6 years, 47% hypertension, 9.3% diabetes, left atrial diameter 39.1±4.6mm) were enrolled in the study. After initial isolation of 194 PV pairs, 98 PV pairs had no RPs (Group A) while the remaining 96 with RPs were randomized to either Group B or C (48 PV pairs each). The number of sites with RPs did not differ between groups B and C (4.1±2.5 vs 4.7±3.2, p=0.27). The occurrence of the primary endpoint in Group A was 7.1%. Ablation of residual potentials resulted in significant reduction of spontaneous or adenosine mediated reconnection (14.6% vs 47.9%, p<0.001).
Conclusion
Following initial PVI achievement, ablation of RPs along the antral circumferential line reduces spontaneous or adenosine-mediated acute PV reconnection rate in patients undergoing first-time AF ablation. Therefore, scanning of the PVI line in search of weak links with specific electrogram criteria indicative of nontrasmurality, and subsequent deployment of bonus lesions, could represent a convenient and practical way to reduce acute PV reconnection. Further studies are required to assess long term effects on AF recurrence rates.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Tzeis
- Mitera Hospital , Athens , Greece
| | - D Kojic
- Cardiovascular Institute Dedinje , Belgrade , Serbia
| | - S Manola
- University Hospital Dubrava , Zagreb , Croatia
| | - S Brusich
- University of Rijeka, Department of Cardiovascular Medicine , Rijeka , Croatia
| | - A Pernat
- University Medical Centre of Ljubljana, Cardiology Department , Ljubljana , Slovenia
| | | | - T Xenos
- Mitera Hospital , Athens , Greece
| | - M Tomovic
- Cardiovascular Institute Dedinje , Belgrade , Serbia
| | - Z Cubranic
- University of Rijeka, Department of Cardiovascular Medicine , Rijeka , Croatia
| | - M Rauber
- University Medical Centre of Ljubljana, Cardiology Department , Ljubljana , Slovenia
| | - N Pavlovic
- University Hospital Dubrava , Zagreb , Croatia
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Potpara T, Grujic M, Ostojic M, Vujisic B, Polovina M, Mujovic N, Hatzinikolaou-Kotsakou E, Reppas E, Beleveslis TH, Moschos G, Kotsakou M, Tsakiridis K, Simeonidou E, Papandreou A, Tsigas G, Michalakeas C, Tsitlakidis C, Alexopoulos D, Lekakis J, Kremastinos DT, Poci D, Backmn L, Karlsson TH, Edvardsson N, Golzio PG, Vinci M, Amellone C, Jorfida M, Veglio V, Gaido E, Trevi GP, Bongiorni MG, Ding L, Hua WEI, Zhang SHU, Chen KEPING, Wang FZ, Chen XIN, Dokumaci B, Dokumaci AS, Ozyildirim S, Yolcu M, Uyan C, Nicolas-Franco S, Rodriguez Gonzalez J, Albacete-Moreno C, Ruiz-Villa G, Sanchez-Martos A, Bixquert-Genoves D, Skoczynski P, Gajek J, Zysko D, Porebska M, Josiak K, Mazurek W, Providencia RA, Silva J, Seca L, Gomes PL, Barra S, Mota P, Nascimento J, Leitao-Marques AM, Kikuchi Y, Brady PA, Erne P, Val-Mejias J, Schwab J, Schimpf R, Orlov M, Mattioni T, Amlie J, Sacher F, Lahitton B, Laborderie J, Wright M, Haissaguerre M, Berger T, Zwick R, Dichtl W, Stuehlinger M, Pachinger O, Hintringer F, Toli K, Koutras K, Stauropoulos J, Vichos S, Mantas J, Rodriguez Artuza CR, Hidalgo L JA, Garcia A, Fumero P, Perez A, Rangel I, Providencia RA, Silva J, Seca L, Gomes PL, Nascimento J, Leitao-Marques AM, Perl S, Stiegler P, Kollmann A, Rotman B, Lercher P, Anelli-Monti M, Tscheliessnigg KH, Pieske BM, Nakamura K, Naito S, Kumagai K, Goto K, Iwamoto J, Funabashi N, Oshima S, Komuro I, Toli K, Stavropoulos J, Koutras D, Vichos S, Mantas J, Di Biase L, Beheiry S, Hongo R, Horton R, Morganti K, Hao S, Javier Sanchez J, Natale A, Digby G, Parfrey B, Morriello F, Lim L, Hopman WM, Simpson CS, Redfearn DP, Baranchuk A, Madsen T, Schmidt EB, Toft E, Christensen JH, Patel D, Shaheen M, Sonne K, Mohanty P, Dibiase L, Horton RP, Sanchez JE, Natale A, Krynski T, Stec SM, Stanke A, Baszko A, Kulakowski P, Rondano E, Bortnik M, Occhetta E, Teodori G, Caimmi PP, Marino PN, Osmancik P, Peroutka Z, Herman D, Stros P, Budera P, Straka Z, Petrac D, Radeljic V, Delic-Brkljacic D, Manola S, Pavlovic N, Inama G, Pedrinazzi C, Adragao P, Arribas F, Landolina M, Merino JL, De Sousa J, Gulizia M, Neuzil P, Holy F, Skoda J, Petru J, Sediva L, Kralovec S, Brada J, Taborsky M, Takami M, Yoshida A, Fukuzawa K, Takami K, Kumagai H, Tanaka S, Itoh M, Hirata K, Jacques F, Champagne J, Doyle D, Charbonneau E, Dagenais F, Voisine P, Dumont E, Aboelhoda A, Nawar M, Khadragui I, Loutfi M, Ramadan B, Makboul G, Gianfranchi L, Pacchioni F, Bettiol K, Alboni P, Gallardo Lobo R, Pap R, Bencsik G, Makai A, Marton G, Saghy L, Forster T, Stockburger M, Trautmann F, Nitardy A, Just-Teetzmann M, Schade S, Celebi O, Krebs A, Dietz R, Pastore CA, Douglas RA, Samesima N, Martinelli Filho M, Nishioka SAD, Pastor Fuentes A, Perea J, Tur N, Berzal B, Boldt LH, Polotzki M, Posch MG, Perrot A, Lohse M, Rolf S, Ozcelik C, Haverkamp W, Tunyan LG, Grigoryan SV, Barsheshet A, Abu Sham'a R, Kuperstein R, Feinberg MS, Sandach A, Luria D, Eldar M, Glikson M, Vatasescu RG, Berruezo A, Iorgulescu C, Fruntelata A, Dorobantu M, Chaumeil A, Philippon F, O'hara G, Blier L, Molin F, Gilbert M, Champagne J, Paslawska U, Gajek J, Zysko D, Noszczyk-Nowak A, Skrzypczak P, Nicpon J, Mazurek W, Chevallier S, Van Oosterom A, Pruvot E, Iga A, Igarashi M, Itou H, Fujino T, Tsubota T, Yamazaki J, Yoshihara K, Arsenos P, Gatzoulis K, Dilaveris P, Gialernios T, Papaioannou T, Masoura K, Archontakis S, Stefanadis C, Nasr GM, Khashaba A, Osman H, El-Barbary M, Heinke M, Heinke T, Ismer B, Kuehnert H, Surber R, Figulla HR. Poster session 3: Miscellaneous. Europace 2009. [DOI: 10.1093/europace/euq230] [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: 11/13/2022] Open
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