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Bazrafshan M, Nematollahi S, Kamali M, Farrokhian A, Moeinvaziri N, Bazrafshan H, Noormohammadi N, Keshtvarz Hesam Abadi M, Bazrafshan Drissi H. Bariatric surgery mitigated electrocardiographic abnormalities in patients with morbid obesity. Sci Rep 2024; 14:6710. [PMID: 38509211 PMCID: PMC10954646 DOI: 10.1038/s41598-024-57155-2] [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: 04/09/2023] [Accepted: 03/14/2024] [Indexed: 03/22/2024] Open
Abstract
Obesity can lead to cardiovascular dysfunctions and cause electrocardiographic disruptions. Bariatric surgery plays a significant role in weight loss. To assess its benefits, this study investigated electrocardiographic changes before and after bariatric surgery. The present article describes a retrospective cohort study with a 6-month follow-up period. Electrocardiograms were interpreted and compared before and six months after surgery. The relationships between weight loss, type of surgery, and electrocardiographic alterations were analyzed. A total of 200 patients participated in the study, with 34 (17%) men and 166 (83%) women. The mean age of the participants was 44.6 ± 8.6, and their mean body mass index was 43.8 ± 5.5 kg/m2. The mean of QTc decreased after the surgery, while the Sokolow-Lyon scores increased. The statistical analysis showed that QTc dispersion (> 40) (P < 0.001), right ventricular hypertrophy (P < 0.001), abnormal R wave progression (P < 0.001), QTc (P < 0.001) and Sokolow-Lyon criteria (P < 0.001) significantly changed postoperatively. In conclusion, bariatric surgery can reduce QTc, correct poor R wave progression, and resolve right ventricular hypertrophy (RVH) in patients with morbid obesity.
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Affiliation(s)
| | - Soroush Nematollahi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ariya Farrokhian
- Department of Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Moeinvaziri
- Laparoscopy Research Center, Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hanieh Bazrafshan
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Gasimov E, Yılmaz B, Benbir Şenel G, Karadeniz D, Öztunç EF. Analysis of QRS complex morphology in children and adolescents with obstructive sleep apnea syndrome. Eur J Pediatr 2024; 183:1199-1207. [PMID: 38085282 DOI: 10.1007/s00431-023-05365-7] [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: 08/20/2023] [Revised: 11/21/2023] [Accepted: 12/03/2023] [Indexed: 03/20/2024]
Abstract
Obstructive sleep apnea syndrome (OSAS) leads to many cardiovascular, neurologic, metabolic, and neurocognitive consequences. Conduction deficits, deviations in electrical axis, and changes in QRS morphology reflect the impairments in cardiac muscle activity and underlie the cardiovascular complications of OSAS. Here we aimed to determine the relationship between OSAS and changes in the cardiac conduction system in children and adolescents. During the 6-month duration of the study, all children having the diagnosis of OSAS in Sleep and Disorders Unit following a full-night polysomnography (PSG) were consecutively evaluated. ECGs were performed and analyzed in the Division of Pediatric Cardiology, Department of Pediatrics. The maximum spatial vector size (QRSmax), QRS electrical axis (EA), left and right ventricular hypertrophy, and the presence of fragmented QRS (fQRS) or prolonged R or S wave were examined in detail. A total of 17 boys with OSAS and 13 healthy boys participated in the study. The mean QRSmax and the QRSmax on V5 derivative were significantly lower in the patient group compared to those in the control group (p = 0.011 and p = 0.017, respectively). EA was similar between the two groups. While none of the patients with OSAS nor the control group had left ventricular hypertrophy, only one boy with OSAS had right ventricular hypertrophy according to ECG-derived analysis. The percentage of fQRS or notched R or S waves was significantly higher in patients with OSAS compared to healthy controls (p = 0.035), especially in children below the age of 5 years (p = 0.036). Conclusion: This study demonstrated that male children and adolescents with OSAS have a combination of QRS complex changes characterized by low QRS voltages, and increased frequency of fragmented QRS. These findings reflect that the electrical remodeling and structural remodeling of the myocardium are considerably affected by OSAS in children and adolescents, leading to ventricular changes and intraventricular conduction problems. What is Known: • Pediatric obstructive sleep apnea syndrome (OSAS) characterized by recurrent intermittent hypoxemia, hypercapnia, and sleep fragmentation results in sympathetic nervous system activation, increased inflammation, and hypoxic endothelial dysfunction. When left untreated, OSAS leads to many cardiovascular, neurologic, metabolic and neurocognitive consequences, and also to sudden infant death syndrome in young children, probably due to the involvement of the cardiac conduction system. What is New: • This study demonstrated that mean QRSmax was significantly lower in male children and adolescents with OSAS, reflecting the structural and electrical remodeling of the myocardium, and one boy with OSAS had RVH according to ECG-derived analysis. The percentage of fQRS or notched R or S waves was much higher in boys with OSAS, especially in children below the age of five years. These finding showed that myocardium was considerably affected to impair the intraventricular conduction in younger children with OSAS.
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Affiliation(s)
- Elnur Gasimov
- Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Başak Yılmaz
- Sleep and Disorders Unit, Division of Clinical Neurophysiology, Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, 34303, Turkey
| | - Gülçin Benbir Şenel
- Sleep and Disorders Unit, Division of Clinical Neurophysiology, Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, 34303, Turkey.
| | - Derya Karadeniz
- Sleep and Disorders Unit, Division of Clinical Neurophysiology, Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, 34303, Turkey
| | - Emine Funda Öztunç
- Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Oknińska M, Zajda K, Zambrowska Z, Grzanka M, Paterek A, Mackiewicz U, Szczylik C, Kurzyna M, Piekiełko-Witkowska A, Torbicki A, Kieda C, Mączewski M. Role of Oxygen Starvation in Right Ventricular Decompensation and Failure in Pulmonary Arterial Hypertension. JACC Heart Fail 2024; 12:235-247. [PMID: 37140511 DOI: 10.1016/j.jchf.2023.03.010] [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] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 02/22/2023] [Accepted: 03/16/2023] [Indexed: 05/05/2023]
Abstract
Right ventricular (RV) function and eventually failure determine outcome in patients with pulmonary arterial hypertension (PAH). Initially, RV responds to an increased load caused by PAH with adaptive hypertrophy; however, eventually RV failure ensues. Unfortunately, it is unclear what causes the transition from compensated RV hypertrophy to decompensated RV failure. Moreover, at present, there are no therapies for RV failure; those for left ventricular (LV) failure are ineffective, and no therapies specifically targeting RV are available. Thus there is a clear need for understanding the biology of RV failure and differences in physiology and pathophysiology between RV and LV that can ultimately lead to development of such therapies. In this paper, we discuss RV adaptation and maladaptation in PAH, with a particular focus of oxygen delivery and hypoxia as the principal drivers of RV hypertrophy and failure, and attempt to pinpoint potential sites for therapy.
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Affiliation(s)
- Marta Oknińska
- Department of Clinical Physiology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Karolina Zajda
- Laboratory of Molecular Oncology and Innovative Therapies, Military Medical Institute, Warsaw, Poland
| | - Zuzanna Zambrowska
- Department of Clinical Physiology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Małgorzata Grzanka
- Department of Biochemistry and Molecular Biology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Aleksandra Paterek
- Department of Clinical Physiology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Urszula Mackiewicz
- Department of Clinical Physiology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Cezary Szczylik
- Department of Oncology at ECZ-Otwock, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Marcin Kurzyna
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology at ECZ-Otwock, ERN-LUNG Member, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Adam Torbicki
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology at ECZ-Otwock, ERN-LUNG Member, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Claudine Kieda
- Laboratory of Molecular Oncology and Innovative Therapies, Military Medical Institute, Warsaw, Poland; Centre for Molecular Biophysics, UPR, CNRS 4301, Orléans CEDEX 2, France; Department of Molecular and Translational Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Michał Mączewski
- Department of Clinical Physiology, Centre of Postgraduate Medical Education, Warsaw, Poland.
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Zimmer A, Teixeira RB, Constantin RL, Fernandes-Piedras TRG, Campos-Carraro C, Türck P, Visioli F, Baldo G, Schenkel PC, Araujo AS, Belló-Klein A. Thioredoxin system activation is associated with the progression of experimental pulmonary arterial hypertension. Life Sci 2021; 284:119917. [PMID: 34478759 DOI: 10.1016/j.lfs.2021.119917] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 08/19/2021] [Accepted: 08/22/2021] [Indexed: 11/21/2022]
Abstract
In addition to being an antioxidant, thioredoxin (Trx) is known to stimulate signaling pathways involved in cell proliferation and to inhibit apoptosis. The aim of this study was to explore the role of Trx in some of these pathways along the progression of monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH). Male rats were first divided into two groups: monocrotaline (MCT - 60 mg/kg i.p.) and control (received saline), that were further divided into three groups: 1, 2, and 3 weeks. Animals were submitted to echocardiographic analysis. Right and left ventricles were used for the measurement of hypertrophy, through morphometric and histological analysis. The lung was prepared for biochemical and molecular analysis. One week after MCT injection, there was an increase in thioredoxin reductase (TrxR) activity, a reduction in glutathione reductase (GR) activity, and an increase in Trx-1 and vitamin D3 up-regulated protein-1 (VDUP-1) expression. Two weeks after MCT injection, there was an increase in VDUP-1, Akt and cleaved caspase-3 activation, and a decrease in Trx-1 and Nrf2 expression. PAH-induced by MCT promoted a reduction in Nrf2 and Trx-1 expression as well as an increase in Akt and VDUP-1 expression after three weeks. The increase in pulmonary vascular resistance was accompanied by increased TrxR activity, suggesting an association between the Trx system and functional changes in the progression of PAH. It seems that Trx-1 activation was an adaptive response to MCT administration to cope with pulmonary remodeling and disease progression, suggesting a potential new target for PAH therapeutics.
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Affiliation(s)
- Alexsandra Zimmer
- Laboratory of Cardiovascular Physiology and Reactive Oxygen Species, Physiology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rayane Brinck Teixeira
- Laboratory of Cardiovascular Physiology and Reactive Oxygen Species, Physiology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rosalia Lempk Constantin
- Laboratory of Cardiovascular Physiology and Reactive Oxygen Species, Physiology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Tânia Regina Gatelli Fernandes-Piedras
- Laboratory of Cardiovascular Physiology and Reactive Oxygen Species, Physiology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Cristina Campos-Carraro
- Laboratory of Cardiovascular Physiology and Reactive Oxygen Species, Physiology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Patrick Türck
- Laboratory of Cardiovascular Physiology and Reactive Oxygen Species, Physiology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernanda Visioli
- Laboratory of Oral Pathology, Post-Graduation Program in Dentistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Guilherme Baldo
- Laboratory of Cardiovascular Physiology and Reactive Oxygen Species, Physiology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Paulo Cavalheiro Schenkel
- Laboratory of Cardiovascular Physiology, Department of Physiology and Pharmacology, Biology Institute, Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil.
| | - Alex Sander Araujo
- Laboratory of Cardiovascular Physiology and Reactive Oxygen Species, Physiology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Adriane Belló-Klein
- Laboratory of Cardiovascular Physiology and Reactive Oxygen Species, Physiology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.
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Karoor V, Strassheim D, Sullivan T, Verin A, Umapathy NS, Dempsey EC, Frank DN, Stenmark KR, Gerasimovskaya E. The Short-Chain Fatty Acid Butyrate Attenuates Pulmonary Vascular Remodeling and Inflammation in Hypoxia-Induced Pulmonary Hypertension. Int J Mol Sci 2021; 22:9916. [PMID: 34576081 PMCID: PMC8467617 DOI: 10.3390/ijms22189916] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 07/30/2021] [Revised: 09/01/2021] [Accepted: 09/10/2021] [Indexed: 12/30/2022] Open
Abstract
Pulmonary hypertension (PH) is a progressive cardiovascular disorder in which local vascular inflammation leads to increased pulmonary vascular remodeling and ultimately to right heart failure. The HDAC inhibitor butyrate, a product of microbial fermentation, is protective in inflammatory intestinal diseases, but little is known regarding its effect on extraintestinal diseases, such as PH. In this study, we tested the hypothesis that butyrate is protective in a Sprague-Dawley (SD) rat model of hypoxic PH. Treatment with butyrate (220 mg/kg intake) prevented hypoxia-induced right ventricular hypertrophy (RVH), hypoxia-induced increases in right ventricular systolic pressure (RVSP), pulmonary vascular remodeling, and permeability. A reversal effect of butyrate (2200 mg/kg intake) was observed on elevated RVH. Butyrate treatment also increased the acetylation of histone H3, 25-34 kDa, and 34-50 kDa proteins in the total lung lysates of butyrate-treated animals. In addition, butyrate decreased hypoxia-induced accumulation of alveolar (mostly CD68+) and interstitial (CD68+ and CD163+) lung macrophages. Analysis of cytokine profiles in lung tissue lysates showed a hypoxia-induced upregulation of TIMP-1, CINC-1, and Fractalkine and downregulation of soluble ICAM (sICAM). The expression of Fractalkine and VEGFα, but not CINC-1, TIMP-1, and sICAM was downregulated by butyrate. In rat microvascular endothelial cells (RMVEC), butyrate (1 mM, 2 and 24 h) exhibited a protective effect against TNFα- and LPS-induced barrier disruption. Butyrate (1 mM, 24 h) also upregulated tight junctional proteins (occludin, cingulin, claudin-1) and increased the acetylation of histone H3 but not α-tubulin. These findings provide evidence of the protective effect of butyrate on hypoxic PH and suggest its potential use as a complementary treatment for PH and other cardiovascular diseases.
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Affiliation(s)
- Vijaya Karoor
- Department of Medicine Cardiovascular and Pulmonary Research Laboratory, University of Colorado Denver, Denver, CO 80204, USA; (V.K.); (D.S.); (T.S.); (E.C.D.); (K.R.S.)
| | - Derek Strassheim
- Department of Medicine Cardiovascular and Pulmonary Research Laboratory, University of Colorado Denver, Denver, CO 80204, USA; (V.K.); (D.S.); (T.S.); (E.C.D.); (K.R.S.)
| | - Timothy Sullivan
- Department of Medicine Cardiovascular and Pulmonary Research Laboratory, University of Colorado Denver, Denver, CO 80204, USA; (V.K.); (D.S.); (T.S.); (E.C.D.); (K.R.S.)
| | - Alexander Verin
- Vascular Biology Center, Augusta University, Augusta, GA 30912, USA; (A.V.); (N.S.U.)
| | - Nagavedi S. Umapathy
- Vascular Biology Center, Augusta University, Augusta, GA 30912, USA; (A.V.); (N.S.U.)
- Center for Blood Disorders, Augusta University, Augusta, GA 30912, USA
| | - Edward C. Dempsey
- Department of Medicine Cardiovascular and Pulmonary Research Laboratory, University of Colorado Denver, Denver, CO 80204, USA; (V.K.); (D.S.); (T.S.); (E.C.D.); (K.R.S.)
- Rocky Mountain Regional VA Center, Aurora, CO 80045, USA
| | - Daniel N. Frank
- Division of Infectious Diseases, Department of Medicine, University of Colorado Denver, Denver, CO 80204, USA;
| | - Kurt R. Stenmark
- Department of Medicine Cardiovascular and Pulmonary Research Laboratory, University of Colorado Denver, Denver, CO 80204, USA; (V.K.); (D.S.); (T.S.); (E.C.D.); (K.R.S.)
- Division of Critical Care Medicine, Department of Pediatrics, University of Colorado Denver, Denver, CO 80204, USA
| | - Evgenia Gerasimovskaya
- Department of Medicine Cardiovascular and Pulmonary Research Laboratory, University of Colorado Denver, Denver, CO 80204, USA; (V.K.); (D.S.); (T.S.); (E.C.D.); (K.R.S.)
- Division of Critical Care Medicine, Department of Pediatrics, University of Colorado Denver, Denver, CO 80204, USA
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Beik A, Najafipour H, Joukar S, Rajabi S, Iranpour M, Kordestani Z. Perillyl alcohol suppresses monocrotaline-induced pulmonary arterial hypertension in rats via anti-remodeling, anti-oxidant, and anti-inflammatory effects. Clin Exp Hypertens 2021; 43:270-280. [PMID: 33322932 DOI: 10.1080/10641963.2020.1860080] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Abstract
Background: Pulmonary arterial hypertension (PAH) is a disastrous disease that current treatments cannot prevent its progression. The present study investigated the effects of perillyl alcohol (PA), a natural monoterpene, on the experimental PAH in male Wistar rats. Methods: Rats divided into eight groups of control, Monocrotaline (MCT), MCT+vehicle, and MCT+PA with doses of 20, 30, 40, 50, and 60 mg/kg. PAH was induced by a single injection of monocrotaline (60 mg/kg) on day 0. The animals in the groups of MCT+vehicle and MCT+PA received the vehicle or PA from day 22 to 42 once a day. On day 43, under general anesthesia, right ventricular systolic pressure (RVSP), as an index of pulmonary artery systolic pressure, and the ratio of the right ventricle to the left ventricle plus septum weight, as the right ventricular hypertrophy index (RVHI), were measured. Also, some histological and biochemical indices were assessed in the lung tissue. Results: MCT significantly (p < .001) enhanced the RVSP and RVHI compared to the control group (89.4 ± 8.2 vs 23 ± 3.3 mmHg & 0.63 ± 0.08 vs 0.26 ± 0.04 respectively). It also increased oxidative stress and inflammatory cytokines and reduced Bax/Bcl2 ratio. Treatment with PA significantly recovered RVSP and hypertrophy index and suppressed vascular cell proliferation, oxidant production, and inflammatory processes. Conclusion: PA exerted noticeable protective and curative effects against MCT-induced PAH and pulmonary vascular remodeling through inhibiting cellular proliferation, oxidative stress, and inflammation. Therefore, PA can be considered as a new therapeutic goal for the treatment of PAH.
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Affiliation(s)
- Ahmad Beik
- Department of Physiology and Pharmacology, Afzalipour Medical Faculty, and Physiology Research Center, Kerman University of Medical Sciences , Kerman, Iran
| | - Hamid Najafipour
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Science , Kerman, Iran
| | - Siyavash Joukar
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Science , Kerman, Iran
| | - Soodeh Rajabi
- Department of Physiology and Pharmacology, Afzalipour Medical Faculty, and Physiology Research Center, Kerman University of Medical Sciences , Kerman, Iran
| | - Maryam Iranpour
- Pathology and Stem Cell Research Center, Kerman University of Medical Sciences , Kerman, Iran
| | - Zeinab Kordestani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences , Kerman, Iran
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Wang M, Luo P, Shi W, Guo J, Huo S, Yan D, Peng L, Zhang C, Lv J, Lin L, Li S. S-Nitroso-L-Cysteine Ameliorated Pulmonary Hypertension in the MCT-Induced Rats through Anti-ROS and Anti-Inflammatory Pathways. Oxid Med Cell Longev 2021; 2021:6621232. [PMID: 33574976 PMCID: PMC7861928 DOI: 10.1155/2021/6621232] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/21/2020] [Accepted: 01/07/2021] [Indexed: 12/05/2022]
Abstract
Pulmonary hypertension (PH) is a progressive and life-threatening chronic disease in which increased pulmonary artery pressure (PAP) and pulmonary vasculature remodeling are prevalent. Inhaled nitric oxide (NO) has been used in newborns to decrease PAP in the clinic; however, the effects of NO endogenous derivatives, S-nitrosothiols (SNO), on PH are still unknown. We have reported that S-nitroso-L-cysteine (CSNO), one of the endogenous derivatives of NO, inhibited RhoA activity through oxidative nitrosation of its C16/20 residues, which may be beneficial for both vasodilation and remodeling. In this study, we presented data to show that inhaled CSNO attenuated PAP in the monocrotaline- (MCT-) induced PH rats and, moreover, improved right ventricular (RV) hypertrophy and fibrosis induced by RV overloaded pressure. In addition, aerosolized CSNO significantly inhibited the hyperactivation of signal transducers and activators of transduction 3 (STAT3) and extracellular regulated protein kinases (ERK) pathways in the lung of MCT-induced rats. CSNO also regulated the expression of smooth muscle contractile protein and improved aberrant endoplasmic reticulum (ER) stress and mitophagy in lung tissues following MCT induction. On the other hand, CSNO inhibited reactive oxygen species (ROS) production in vitro, which is induced by angiotensin II (AngII) as well as interleukin 6 (IL-6). In addition, CSNO inhibited excessive ER stress and mitophagy induced by AngII and IL-6 in vitro; finally, STAT3 and ERK phosphorylation was inhibited by CSNO in a concentration-dependent manner. Taken together, CSNO led to pulmonary artery relaxation and regulated pulmonary circulation remodeling through anti-ROS and anti-inflammatory pathways and may be used as a therapeutic option for PH treatment.
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Affiliation(s)
- Moran Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pengcheng Luo
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Shi
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junyi Guo
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shengqi Huo
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Yan
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lulu Peng
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cuntai Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiagao Lv
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Lin
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Li
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Muthuramu I, Amin R, Postnov A, Mishra M, Jacobs F, Gheysens O, Van Veldhoven PP, De Geest B. Coconut Oil Aggravates Pressure Overload-Induced Cardiomyopathy without Inducing Obesity, Systemic Insulin Resistance, or Cardiac Steatosis. Int J Mol Sci 2017; 18:ijms18071565. [PMID: 28718833 PMCID: PMC5536053 DOI: 10.3390/ijms18071565] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/05/2017] [Accepted: 07/15/2017] [Indexed: 12/16/2022] Open
Abstract
Studies evaluating the effects of high-saturated fat diets on cardiac function are most often confounded by diet-induced obesity and by systemic insulin resistance. We evaluated whether coconut oil, containing C12:0 and C14:0 as main fatty acids, aggravates pressure overload-induced cardiomyopathy induced by transverse aortic constriction (TAC) in C57BL/6 mice. Mortality rate after TAC was higher (p < 0.05) in 0.2% cholesterol 10% coconut oil diet-fed mice than in standard chow-fed mice (hazard ratio 2.32, 95% confidence interval 1.16 to 4.64) during eight weeks of follow-up. The effects of coconut oil on cardiac remodeling occurred in the absence of weight gain and of systemic insulin resistance. Wet lung weight was 1.76-fold (p < 0.01) higher in coconut oil mice than in standard chow mice. Myocardial capillary density (p < 0.001) was decreased, interstitial fibrosis was 1.88-fold (p < 0.001) higher, and systolic and diastolic function was worse in coconut oil mice than in standard chow mice. Myocardial glucose uptake was 1.86-fold (p < 0.001) higher in coconut oil mice and was accompanied by higher myocardial pyruvate dehydrogenase levels and higher acetyl-CoA carboxylase levels. The coconut oil diet increased oxidative stress. Myocardial triglycerides and free fatty acids were lower (p < 0.05) in coconut oil mice. In conclusion, coconut oil aggravates pressure overload-induced cardiomyopathy.
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Affiliation(s)
- Ilayaraja Muthuramu
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven 3000, Belgium.
| | - Ruhul Amin
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven 3000, Belgium.
| | - Andrey Postnov
- Nuclear Medicine & Molecular Imaging, Department of Imaging & Pathology, Catholic University of Leuven, Leuven 3000, Belgium.
| | - Mudit Mishra
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven 3000, Belgium.
| | - Frank Jacobs
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven 3000, Belgium.
| | - Olivier Gheysens
- Nuclear Medicine & Molecular Imaging, Department of Imaging & Pathology, Catholic University of Leuven, Leuven 3000, Belgium.
| | - Paul P Van Veldhoven
- Laboratory of Lipid Biochemistry and Protein Interactions, Department of Cellular and Molecular Medicine, Catholic University of Leuven, Leuven 3000, Belgium.
| | - Bart De Geest
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven 3000, Belgium.
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9
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Pankova NV, Artem'eva MM, Medvedeva NA. [INFLUENCE OF THE FEMALE SEX HORMONE 17-BETA-ESTRADIOL ON THE DEGREE OF HYPOXIC PULMONARY HYPERTENSION IN MALE AND FEMALE WISTAR RATS.]. Eksp Klin Farmakol 2017; 80:9-13. [PMID: 29873996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The influence of endogenous and exogenous 17-beta-estradiol on the degree of hypoxic pulmonary hypertension (HPH) in male and female Wistar rats has been studied. Endogenous estradiol reduced the right ventricular systolic pressure (RVSP) in normal female rats, but not in male rats. Exogenous estradiol (15 pg/kg for 4 weeks) caused the same effect. The HPH was induced by exposure to intermittent hypobaric hypoxia (10 h a day, 02 = 10%). Two weeks after hypoxia exposure, increased RVSP was more developed in females as compared to males. Comparison of RVSP between hypertensive and normotensive fet'a- le groups showed that the pathology in hypertensive females with retained ovaries is developed more than in ovariectomized ones. Exogenous estradiol exhibi- ted no protective effect in hypoxic ovariectomized female rats. In males, the ovariectomy did not influence the RVSP level, but caused hypertrophy of the right ventricle. In this case, exogenous estradiol led to an increase in RVSP. Thus, endogenous 17-beta-estradiol has a protective effect on the pulmonary blood flow in normal females. In the case of hypoxic pulmonary hypertension, endogenous estradiol enhances the development of this pathology in females and ovariecto- mized males.
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10
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Chen G. [Study on tissue Doppler imaging in diagnosis of right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2014; 32:931-933. [PMID: 25608902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the value of tissue Doppler imaging (TDI) in the diagnosis of right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease. METHODS A total of 50 cases of silicosis complicated by chronic pulmonary heart disease in our hospital underwent conventional electrocardiography (ECG) and TDI. The detection rates for right ventricular hypertrophy by two methods were compared. RESULTS Of 50 cases of silicosis complicated by chronic pulmonary heart disease, 19 were diagnosed with right ventricular hypertrophy by ECG, with a detection rate of 38.0%; 29 were diagnosed with right ventricular hypertrophy by TDI, with a detection rate off 58.0%. Statistical analysis suggested that TDI leads to a significantly higher detection rate for right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease (χ² = 4.006, P = 0.036). CONCLUSION Both TDI and ECG can be used for detecting right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease, but the detection rate is higher when TDI is employed. In addition, ECG cannot directly reflect the increase in pulmonary artery pressure. Therefore, TDI is more suitable for the diagnosis of right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease and provides a strong diagnostic basis for the clinical treatment of silicosis complicated by pulmonary heart disease.
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Affiliation(s)
- Gongquan Chen
- Minda Hospital of Hubei Nationalities Intitute, Enshi 445000, China
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11
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Wandall-Frostholm C, Skaarup LM, Sadda V, Nielsen G, Hedegaard ER, Mogensen S, Köhler R, Simonsen U. Pulmonary hypertension in wild type mice and animals with genetic deficit in KCa2.3 and KCa3.1 channels. PLoS One 2014; 9:e97687. [PMID: 24858807 PMCID: PMC4032241 DOI: 10.1371/journal.pone.0097687] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 04/22/2014] [Indexed: 11/18/2022] Open
Abstract
Objective In vascular biology, endothelial KCa2.3 and KCa3.1 channels contribute to arterial blood pressure regulation by producing membrane hyperpolarization and smooth muscle relaxation. The role of KCa2.3 and KCa3.1 channels in the pulmonary circulation is not fully established. Using mice with genetically encoded deficit of KCa2.3 and KCa3.1 channels, this study investigated the effect of loss of the channels in hypoxia-induced pulmonary hypertension. Approach and Result Male wild type and KCa3.1−/−/KCa2.3T/T(+DOX) mice were exposed to chronic hypoxia for four weeks to induce pulmonary hypertension. The degree of pulmonary hypertension was evaluated by right ventricular pressure and assessment of right ventricular hypertrophy. Segments of pulmonary arteries were mounted in a wire myograph for functional studies and morphometric studies were performed on lung sections. Chronic hypoxia induced pulmonary hypertension, right ventricular hypertrophy, increased lung weight, and increased hematocrit levels in either genotype. The KCa3.1−/−/KCa2.3T/T(+DOX) mice developed structural alterations in the heart with increased right ventricular wall thickness as well as in pulmonary vessels with increased lumen size in partially- and fully-muscularized vessels and decreased wall area, not seen in wild type mice. Exposure to chronic hypoxia up-regulated the gene expression of the KCa2.3 channel by twofold in wild type mice and increased by 2.5-fold the relaxation evoked by the KCa2.3 and KCa3.1 channel activator NS309, whereas the acetylcholine-induced relaxation - sensitive to the combination of KCa2.3 and KCa3.1 channel blockers, apamin and charybdotoxin - was reduced by 2.5-fold in chronic hypoxic mice of either genotype. Conclusion Despite the deficits of the KCa2.3 and KCa3.1 channels failed to change hypoxia-induced pulmonary hypertension, the up-regulation of KCa2.3-gene expression and increased NS309-induced relaxation in wild-type mice point to a novel mechanism to counteract pulmonary hypertension and to a potential therapeutic utility of KCa2.3/KCa3.1 activators for the treatment of pulmonary hypertension.
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Affiliation(s)
| | | | - Veeranjaneyulu Sadda
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Institute for Molecular Medicine, Cardiovascular and Renal Research, University of Southern Denmark, Odense, Denmark
| | - Gorm Nielsen
- Institute for Molecular Medicine, Cardiovascular and Renal Research, University of Southern Denmark, Odense, Denmark
| | | | - Susie Mogensen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Ralf Köhler
- Institute for Molecular Medicine, Cardiovascular and Renal Research, University of Southern Denmark, Odense, Denmark
- Aragon Institute of Health Sciences I+CS and ARAID, Zaragoza, Spain
| | - Ulf Simonsen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
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12
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Campen MJ, Paffett ML, Colombo ES, Lucas SN, Anderson T, Nysus M, Norenberg JP, Gershman B, Hesterman J, Hoppin J, Willis M. Muscle RING finger-1 promotes a maladaptive phenotype in chronic hypoxia-induced right ventricular remodeling. PLoS One 2014; 9:e97084. [PMID: 24811453 PMCID: PMC4014601 DOI: 10.1371/journal.pone.0097084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 12/17/2013] [Accepted: 04/14/2014] [Indexed: 11/18/2022] Open
Abstract
Exposure to chronic hypoxia (CH) induces elevated pulmonary artery pressure/resistance, leading to an eventual maladaptive right ventricular hypertrophy (RVH). Muscle RING finger-1 (MuRF1) is a muscle-specific ubiquitin ligase that mediates myocyte atrophy and has been shown to play a role in left ventricular hypertrophy and altered cardiac bioenergetics in pressure overloaded hearts. However, little is known about the contribution of MuRF1 impacting RVH in the setting of CH. Therefore, we hypothesized that MuRF1 deletion would enhance RVH compared to their wild-type littermates, while cardiac-specific overexpression would reduce hypertrophy following CH-induced pulmonary hypertension. We assessed right ventricular systolic pressure (RVSP), right ventricle to left ventricle plus septal weight ratio (RV/LV+S) and hematocrit (Hct) following a 3-wk isobaric CH exposure. Additionally, we conducted dual-isotope SPECT/CT imaging with cardiac function agent 201Tl-chloride and cell death agent 99mTc-annexin V. Predictably, CH induced pulmonary hypertension, measured by increased RVSP, RV/LV+S and Hct in WT mice compared to normoxic WT mice. Normoxic WT and MuRF1-null mice exhibited no significant differences in RVSP, RV/LV+S or Hct. CH-induced increases in RVSP were also similar between WT and MuRF1-null mice; however, RV/LV+S and Hct were significantly elevated in CH-exposed MuRF1-null mice compared to WT. In cardiac-specific MuRF1 overexpressing mice, RV/LV+S increased significantly due to CH exposure, even greater than in WT mice. This remodeling appeared eccentric, maladaptive and led to reduced systemic perfusion. In conclusion, these results are consistent with an atrophic role for MuRF1 regulating the magnitude of right ventricular hypertrophy following CH-induction of pulmonary hypertension.
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Affiliation(s)
- Matthew J. Campen
- Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
- * E-mail:
| | - Michael L. Paffett
- Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
| | - E. Sage Colombo
- Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
| | - Selita N. Lucas
- Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
| | - Tamara Anderson
- Radiopharmaceutical Sciences Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
| | - Monique Nysus
- Radiopharmaceutical Sciences Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
| | - Jeffrey P. Norenberg
- Radiopharmaceutical Sciences Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
| | - Ben Gershman
- inviCRO, LLC., Boston, Massachusetts, United States of America
| | - Jacob Hesterman
- inviCRO, LLC., Boston, Massachusetts, United States of America
| | - Jack Hoppin
- inviCRO, LLC., Boston, Massachusetts, United States of America
| | - Monte Willis
- McAllister Heart Institute and Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
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13
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Spas'ka HO. [Changes of the hemodynamics, heart structure and functional state in patients with reactive arthritis]. Lik Sprava 2014:73-78. [PMID: 25906650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Our investigation showed for the patients with reactive arthritis typical is hyperkinetic type of haemodynamic, and also structural changes of the heart which manifestate by interventricular partition's thickness as a result of inflammatory edema and it's valve consolidation frequently whithout expressed blood regurgitation, and diastolic dysfunction's development of the left and right heart ventricles in hypertrophic type with disorders of their active relaxation and growth their chamber's rigidity. These changes, probably, evidence about development of the inflammatory cardiopathy in these patients and can be preconditions of the heart failure.
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MESH Headings
- Adolescent
- Adult
- Arthritis, Reactive/complications
- Arthritis, Reactive/pathology
- Arthritis, Reactive/physiopathology
- Blood Pressure
- Edema, Cardiac/complications
- Edema, Cardiac/pathology
- Edema, Cardiac/physiopathology
- Female
- Heart Ventricles/pathology
- Heart Ventricles/physiopathology
- Humans
- Hypertrophy, Left Ventricular/complications
- Hypertrophy, Left Ventricular/pathology
- Hypertrophy, Left Ventricular/physiopathology
- Hypertrophy, Right Ventricular/complications
- Hypertrophy, Right Ventricular/pathology
- Hypertrophy, Right Ventricular/physiopathology
- Male
- Middle Aged
- Mitral Valve/pathology
- Mitral Valve/physiopathology
- Stroke Volume
- Tricuspid Valve/pathology
- Tricuspid Valve/physiopathology
- Ventricular Remodeling
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14
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Glancy DL, Atluri P. ECG of the month. ECG in a dyspneic 54-year-old man. Sinus tachycardia; right atrial enlargement; right axis deviation; right ventricular hypertrophy with repolarization change. J La State Med Soc 2013; 165:342-343. [PMID: 25073262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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15
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Nelson SE, Shroff GR, Johannsen RA, Karim RM. Right ventricular pacing for right ventricular outflow tract obstruction in a man with biventricular hypertrophic cardiomyopathy. Tex Heart Inst J 2013; 40:367-369. [PMID: 23914044 PMCID: PMC3709235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
WEBSITE FEATURE
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MESH Headings
- Adult
- Cardiac Pacing, Artificial/methods
- Cardiomyopathy, Hypertrophic/complications
- Cardiomyopathy, Hypertrophic/diagnosis
- Cardiomyopathy, Hypertrophic/physiopathology
- Echocardiography, Doppler, Color
- Electrocardiography
- Hemodynamics
- Humans
- Hypertrophy, Left Ventricular/complications
- Hypertrophy, Left Ventricular/diagnosis
- Hypertrophy, Left Ventricular/physiopathology
- Hypertrophy, Right Ventricular/complications
- Hypertrophy, Right Ventricular/diagnosis
- Hypertrophy, Right Ventricular/physiopathology
- Magnetic Resonance Imaging
- Male
- Treatment Outcome
- Ventricular Function, Right
- Ventricular Outflow Obstruction/diagnosis
- Ventricular Outflow Obstruction/etiology
- Ventricular Outflow Obstruction/physiopathology
- Ventricular Outflow Obstruction/therapy
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Affiliation(s)
- Sarah E Nelson
- Department of Internal Medicine, Hennepin County Medical Center, Minneapolis, Minnesota 55415, USA.
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16
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Yoshikawa N, Shimizu N, Maruyama T, Sano M, Matsuhashi T, Fukuda K, Kataoka M, Satoh T, Ojima H, Sawai T, Morimoto C, Kuribara A, Hosono O, Tanaka H. Cardiomyocyte-specific overexpression of HEXIM1 prevents right ventricular hypertrophy in hypoxia-induced pulmonary hypertension in mice. PLoS One 2012; 7:e52522. [PMID: 23300697 PMCID: PMC3534105 DOI: 10.1371/journal.pone.0052522] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 11/14/2012] [Indexed: 01/19/2023] Open
Abstract
Right ventricular hypertrophy (RVH) and right ventricular (RV) contractile dysfunction are major determinants of prognosis in pulmonary arterial hypertension (PAH) and PAH remains a severe disease. Recently, direct interruption of left ventricular hypertrophy has been suggested to decrease the risk of left-sided heart failure. Hexamethylene bis-acetamide inducible protein 1 (HEXIM1) is a negative regulator of positive transcription elongation factor b (P-TEFb), which activates RNA polymerase II (RNAPII)-dependent transcription and whose activation is strongly associated with left ventricular hypertrophy. We hypothesized that during the progression of PAH, increased P-TEFb activity might also play a role in RVH, and that HEXIM1 might have a preventive role against such process. We revealed that, in the mouse heart, HEXIM1 is highly expressed in the early postnatal period and its expression is gradually decreased, and that prostaglandin I(2), a therapeutic drug for PAH, increases HEXIM1 levels in cardiomyocytes. These results suggest that HEXIM1 might possess negative effect on cardiomyocyte growth and take part in cardiomyocyte regulation in RV. Using adenovirus-mediated gene delivery to cultured rat cardiomyocytes, we revealed that overexpression of HEXIM1 prevents endothelin-1-induced phosphorylation of RNAPII, cardiomyocyte hypertrophy, and mRNA expression of hypertrophic genes, whereas a HEXIM1 mutant lacking central basic region, which diminishes P-TEFb-suppressing activity, could not. Moreover, we created cardiomyocyte-specific HEXIM1 transgenic mice and revealed that HEXIM1 ameliorates RVH and prevents RV dilatation in hypoxia-induced PAH model. Taken together, these findings indicate that cardiomyocyte-specific overexpression of HEXIM1 inhibits progression to RVH under chronic hypoxia, most possibly via inhibition of P-TEFb-mediated enlargement of cardiomyocytes. We conclude that P-TEFb/HEXIM1-dependent transcriptional regulation may play a pathophysiological role in RVH and be a novel therapeutic target for mitigating RVH in PAH.
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Affiliation(s)
- Noritada Yoshikawa
- Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Noriaki Shimizu
- Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Takako Maruyama
- Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Motoaki Sano
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | | | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Masaharu Kataoka
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
- Department of Cardiology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Toru Satoh
- Department of Cardiology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Hidenori Ojima
- Pathology Division, National Cancer Center Research Institute, Tokyo, Japan
| | - Takashi Sawai
- Department of Pathology, Iwate Medical University School of Medicine, Shiwa-gun, Iwate, Japan
| | - Chikao Morimoto
- Department of Therapy Development and Innovation for Immune Disorders, Juntendo University, Tokyo, Japan, Cancers, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Akiko Kuribara
- Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Osamu Hosono
- Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Hirotoshi Tanaka
- Department of Rheumatology and Allergy, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- * E-mail:
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17
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Öztürk C, Deniz A. A patient with severe congenital pulmonary stenosis and severe right ventricular hypertrophy. Anadolu Kardiyol Derg 2012; 12:E31-E32. [PMID: 22728745 DOI: 10.5152/akd.2012.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Cengiz Öztürk
- Clinic of Cardiology, Eskişehir Military Hospital, Eskişehir-Turkey.
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18
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Bartelds B, Borgdorff MA, Smit-van Oosten A, Takens J, Boersma B, Nederhoff MG, Elzenga NJ, van Gilst WH, De Windt LJ, Berger RMF. Differential responses of the right ventricle to abnormal loading conditions in mice: pressure vs. volume load. Eur J Heart Fail 2011; 13:1275-82. [PMID: 22024026 DOI: 10.1093/eurjhf/hfr134] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS Right ventricular (RV) dysfunction is a major determinant of long-term morbidity and mortality in congenital heart disease. The right ventricle (RV) is genetically different from the left ventricle (LV), but it is unknown as to whether this has consequences for the cellular responses to abnormal loading conditions. In the LV, calcineurin-activation is a major determinant of pathological hypertrophy and an important target for therapeutic strategies. We studied the functional and molecular adaptation of the RV in mouse models of pressure and volume load, focusing on calcineurin-activation. METHODS AND RESULTS Mice were subjected to pulmonary artery banding (PAB), aorto-caval shunt (Shunt), or sham surgery (Control). Four weeks later, mice were functionally evaluated with cardiac magnetic resonance imaging, pressure measurements, and voluntary cage wheel exercise. Right ventricular hypertrophy and calcineurin-activation were assessed after sacrifice. Mice with increased pressure load (PAB) or volume load (Shunt) of the RV developed similar degrees of hypertrophy, yet revealed different functional and molecular adaptation. Pulmonary artery banding increased expression of Modulatory-Calcineurin-Interacting-Protein 1 (MCIP1), indicating calcineurin-activation, and the ratio of beta/alpha-Myosin Heavy Chain (MHC). In addition, PAB reduced exercise capacity and induced moderate RV dilatation with normal RV output at rest. In contrast, Shunt did not increase MCIP1 expression, and only moderately increased beta/alpha-MHC ratio. Shunt did not affect exercise capacity, but increased RV volumes and output at rest. CONCLUSIONS Pressure and volume load induced different functional and molecular adaptations in the RV. These results may have important consequences for therapeutic strategies to prevent RV failure in the growing population of adults with congenital heart disease.
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Affiliation(s)
- Beatrijs Bartelds
- Department of Pediatric Cardiology, Center for Congenital Heart Disease, Beatrix Children's Hospital, University Medical Center Groningen, Hanzeplein 1, Groningen, The Netherlands.
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19
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Zhang F, Gu W, Dong R, Dong Q, Yu B. Anesthetic management of pheochromocytoma resection in a patient with F4 and a complete endocardial cushion defect. Acta Anaesthesiol Scand 2010; 54:785-6. [PMID: 20618165 DOI: 10.1111/j.1399-6576.2009.02188.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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20
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Mittal SR. Isolated right ventricular hypertrophic obstructive cardiomyopathy. J Assoc Physicians India 2010; 58:249-250. [PMID: 21046883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A case of isolated right ventricular hypertrophic obstructive cardiomyopathy without left ventricular involvement is reported. This is a rare cause of isolated right ventricular strain and needs to be differentiated form ventricular septal defect and pulmonary valve stenosis.
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Affiliation(s)
- S R Mittal
- Department of Cardiology, St. Francis Hospital, Ajmer, Rajasthan, India
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21
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Graham JK, Mosunjac M, Hanzlick RL, Mosunjac M. Sickle cell lung disease and sudden death: a retrospective/prospective study of 21 autopsy cases and literature review. Am J Forensic Med Pathol 2007; 28:168-72. [PMID: 17525572 DOI: 10.1097/01.paf.0000257397.92466.50] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Sudden death in the setting of sickle cell lung disease (SCLD), is periodically seen in the practice of medical examiners. The goal of the present study was to identify the most common pathologic findings of SCLD associated with sudden or unexpected death. A retrospective/prospective review of 21 autopsy cases from sickle cell patients between 1990 and 2004 was performed. Review of medical records, autopsy reports, and H&E-stained slides of lung tissue was performed. Oil-Red-O and elastic staining of lung tissue were evaluated. All cases were screened for both acute and chronic forms of SCLD. Patients admitted for sickle cell pain crisis ranged in age from 8 months to 65 years. Fifteen out of 21 cases (71.4%) showed significant pulmonary pathology. The most frequent lung findings included pulmonary edema (47.6%), pulmonary thromboembolism (38.1%), fat emboli (33.3%), pulmonary hypertension, grades I-IV (33.3%), and microvascular occlusive thrombi (28.5%). Our study demonstrates higher-than-expected percentages of acute and chronic sickle cell-related lung injury such as fat embolism (33.3%) and pulmonary hypertension (33.3%), with right ventricular hypertrophy (33.3%). Therefore, we propose a simple and high-yield autopsy algorithm of ancillary procedures that should be applied on all known and suspected autopsy cases of sickle cell disease.
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Affiliation(s)
- Jason K Graham
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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Abstract
BACKGROUND Pulmonary arterial capacitance (PAC) has been associated with right ventricular (RV) workload and mortality in pulmonary hypertension, but is not routinely evaluated in children. We investigated whether PAC can be estimated noninvasively by echocardiography. METHODS We retrospectively determined PAC in 31 children with pulmonary hypertension, using echocardiography, and compared the results with those obtained at cardiac catheterization. RESULTS PAC derived from echocardiography was similar to that derived from catheterization (mean +/- SD 1.16 +/- 1.0 vs 1.10 +/- 0.95 mL(3) x mm Hg(-1), P = not significant) and the two correlated well (r = 0.74, P < .0001). There was a highly significant polynomial relationship between PAC and RV anterior wall thickness indexed to body surface area (R(2) = 0.54, P < .0001), but not between pulmonary vascular resistance and RV wall thickness. Pulmonary vascular resistance and PAC did not correlate. CONCLUSIONS Echocardiography can reliably estimate PAC, which strongly correlates with RV hypertrophy, a surrogate for RV work.
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Affiliation(s)
- Mark K Friedberg
- Division of Pediatric Cardiology, Stanford University, Stanford, California, USA
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23
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Murcia Sánchez E, Germán MJ, Ibáñez V, Pérez-Cerdá F. [Anesthetic management for mediastinoscopy in a patient with severe pulmonary hypertension]. Rev Esp Anestesiol Reanim 2007; 54:55-6. [PMID: 17319437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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24
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Glancy DL, Jones MB, Helmcke FR. ECG of the month. Exertional dyspnea with mild cyanosis and clubbing in a HIV-positive woman. Diagnosis: sinus rhythm, right axis deviation, right ventricular hypertrophy. J La State Med Soc 2006; 158:268-9. [PMID: 17283971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Affiliation(s)
- D Luke Glancy
- Louisiana State University Health Sciences Center, USA
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Abstract
We present a case of intracardiac thrombus with pulmonary embolism and pulmonary infarction in a patient with protein S deficiency. Secondary infection of the pulmonary infarction resulted in pneumomediastinum. Thrombus in an unusual location in a young patient without known predisposing conditions is a characteristic feature of a hereditary thrombophilic disorder. Cavitation within a lesion adjacent to the mediastinal pleura can result in pneumomediastinum.
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Affiliation(s)
- Pierre D Maldjian
- Department of Radiology, University Hospital, UMDNJ-NJ Medical School, Newark, NJ 07103-2406, USA.
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Arrington CB, Nightengale D, Lowichik A, Rosenthal ET, Christian-Ritter K, Viskochil DH. Pathologic and molecular analysis in a family with rare mixed supravalvar aortic and pulmonic stenosis. Pediatr Dev Pathol 2006; 9:297-306. [PMID: 16944981 DOI: 10.2350/06-01-0014.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2006] [Accepted: 03/02/2006] [Indexed: 11/20/2022]
Abstract
Nonsyndromic supravalvar aortic stenosis (SVAS) is an obstructive vascular disorder often inherited in an autosomal dominant manner. With pulmonary artery involvement, stenotic lesions are nearly always peripheral or downstream of the pulmonic valve. In rare cases when the supravalvar pulmonic region is affected, the stenoses usually improve over time and rarely affect prognosis. We evaluated a unique family in which 10 of 14 individuals have nonsyndromic SVAS and 7 of the 10 affected family members with SVAS have the rare finding of supravalvar pulmonic stenosis (SVPS). In at least 2 of these individuals, the severity of SVPS was so significant that it led to death in early infancy. Pathologic examination of stenotic lesions in this kindred group revealed concentrically organized smooth muscle cells separated by dense elastic fibers. In contrast, the arterial pathology reported for other individuals with nonsyndromic SVAS demonstrates increased numbers of hypertrophied smooth muscle cells separated by thin, fragmented elastin fibers. Molecular analysis identified a novel ELN mutation within the donor splice site of exon 16, which may be responsible for the unique phenotype and distinct elastin histopathology found in this kindred.
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MESH Headings
- Adolescent
- Adult
- Aortic Valve Stenosis/complications
- Aortic Valve Stenosis/genetics
- Aortic Valve Stenosis/pathology
- Cardiovascular Abnormalities/genetics
- Cardiovascular Abnormalities/pathology
- Cells, Cultured
- Child
- Child, Preschool
- DNA Mutational Analysis
- Elastin/genetics
- Elastin/metabolism
- Family Health
- Fatal Outcome
- Female
- Fibroblasts/chemistry
- Fibroblasts/pathology
- Genes, Dominant/genetics
- Genetic Predisposition to Disease
- Genotype
- Heart Ventricles/pathology
- Humans
- Hypertrophy, Right Ventricular/complications
- Hypertrophy, Right Ventricular/genetics
- Hypertrophy, Right Ventricular/pathology
- Infant
- Infant, Newborn
- Male
- Middle Aged
- Muscle, Smooth, Vascular/pathology
- Mutation
- Pedigree
- Point Mutation
- Polymorphism, Single-Stranded Conformational
- Pulmonary Valve Stenosis/complications
- Pulmonary Valve Stenosis/genetics
- Pulmonary Valve Stenosis/pathology
- RNA, Messenger/metabolism
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Affiliation(s)
- Cammon B Arrington
- Departments of Pediatrics, University of Utah, Salt Lake City, UT 84132, USA. Cammon.
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27
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Zeltser I, Gaynor JW, Petko M, Myung RJ, Birbach M, Waibel R, Ittenbach RF, Tanel RE, Vetter VL, Rhodes LA. The roles of chronic pressure and volume overload states in induction of arrhythmias: An animal model of physiologic sequelae after repair of tetralogy of Fallot. J Thorac Cardiovasc Surg 2005; 130:1542-8. [PMID: 16307996 DOI: 10.1016/j.jtcvs.2005.08.034] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2005] [Revised: 07/20/2005] [Accepted: 08/16/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Sudden death occurs in as many as 8% of patients after repair of tetralogy of Fallot and has been attributed to arrhythmias. The purpose of this study was to establish an animal model to evaluate the individual contribution of different physiologic sequelae after tetralogy of Fallot repair in the development of late-onset arrhythmias. METHODS Forty-nine piglets were divided into 5 groups: (1) pulmonary artery band; (2) pulmonary valvotomy; (3) pulmonary artery band plus pulmonary valvotomy; (4) infundibular scar; and (5) age-matched control animals. Baseline and follow-up electrocardiograms were obtained and recorded, as well as changes in QRS duration. A total of 45 animals underwent hemodynamic evaluation and programmed electrical stimulation at 5.6 months postoperatively. RESULTS Sustained ventricular tachyarrhythmias (ventricular tachycardia/ventricular fibrillation) were induced in 31.1%, and atrial arrhythmias were induced in 33.3%. The pulmonary valvotomy group was 30 times more likely to evidence arrhythmias than control animals for sustained ventricular tachycardia/ventricular fibrillation, as well as atrial arrhythmias (P = .01). The pulmonary artery band group was 15 times more likely to evidence atrial arrhythmias than control animals (P = .02). Prolonged QRS duration was predictive of inducibility of both atrial arrhythmias (P < .01) and sustained ventricular tachycardia/ventricular fibrillation (P = .01). Mean right atrial (P = .01) and capillary wedge (P = .01) pressures predicted atrial arrhythmia inducibility. Right ventricular end-diastolic pressure predicted atrial arrhythmia (P= .01) and sustained ventricular tachycardia/ventricular fibrillation inducibility (P = .05). Right ventricular systolic pressure did not predict inducibility of either atrial arrhythmias (P = .10) or sustained ventricular tachycardia/ventricular fibrillation (P = .94). CONCLUSIONS Chronic right ventricular volume overload resulted in an increased incidence of inducible ventricular and atrial arrhythmias.
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Affiliation(s)
- Ilana Zeltser
- Division of Cardiology at Children's Medical Center at Dallas and the University of Texas Southwestern Medical Center, Dallas, Tex 75235, USA.
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28
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Aldashev AA, Kojonazarov BK, Amatov TA, Sooronbaev TM, Mirrakhimov MM, Morrell NW, Wharton J, Wilkins MR. Phosphodiesterase type 5 and high altitude pulmonary hypertension. Thorax 2005; 60:683-7. [PMID: 16061711 PMCID: PMC1747498 DOI: 10.1136/thx.2005.041954] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND This study explored phosphodiesterase type 5 (PDE5) inhibition as a strategy for treating high altitude pulmonary arterial hypertension (HAPH). METHODS 689 subjects (313 men) of mean (SD) age 44 (0.6) years living above 2500 m were screened for HAPH by medical examination and electrocardiography, and 188 (27%) met the criteria for right ventricular hypertrophy. 44 underwent cardiac catheterisation and 29 (66%) had a resting mean pulmonary artery pressure (PAP) above 25 mmHg. 22 patients with a raised mean PAP were randomised to receive sildenafil (25 or 100 mg) or matching placebo taken 8 hourly for 12 weeks. RESULTS At 3 months, patients on sildenafil 25 mg 8 hourly (n = 9) had a significantly (p = 0.018) lower mean PAP (-6.9 mmHg) at the end of the dosing interval than those on placebo (n = 8) (95% CI -12.4 to -1.3). The treatment effect for sildenafil 100 mg 8 hourly (n = 5) compared with placebo was -6.4 mm Hg (95% CI -12.9 to 0.1). Both doses improved 6 minute walk distance, the lower dose by 45.4 m (95% CI 11.5 to 79.4; p = 0.011) and the higher dose by 40.0 m (95% CI 0.2 to 79.8; p = 0.049). Sildenafil was well tolerated. Necroscopic lung specimens from three subjects with HAPH showed abundant PDE5 in the muscular coat of remodelled pulmonary arterioles. CONCLUSIONS PDE5 is an attractive drug target for the treatment of HAPH and a larger study of the long term effects of PDE5 inhibition in HAPH is warranted.
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Affiliation(s)
- A A Aldashev
- Institute of Molecular Biology and Medicine, Bishkek, Kyrgyzstan
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29
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Gambí Pisonero N, Torres Isidro MV, Castilla Miguel S, Balsa Bretón MA, Penin FJ, Pey C. Isquemia de ventrículo derecho y cor pulmonale. ACTA ACUST UNITED AC 2005; 24:250-2. [PMID: 16122409 DOI: 10.1157/13076643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
48 year old man with chronic obstructive pulmonary disease (COPD) secondary to pulmonary hypertension with domiciliary non-invasive ventilation was seen. He came to the emergency department with acute exacerbation of COPD. The patient was admitted to the Cardiology Service with the diagnosis of congestive heart failure. Diagnostic imaging (chest X-ray, transthoracic Doppler-echocardiography, multidetector row spiral CT and myocardial perfusion imaging) revealed an enlarged right ventricle. ECG was consistent with right ventricular failure. The heart perfusion imaging (pharmacologic stress testing with dobutamine) showed cor pulmonale and right ventricle ischemia induced by drug stress with dobutamine. Although right ventricle myocardial chronic dysfunction rarely causes right ventricular failure, it can occur when cor pulmonale and ischemia heart disease are present.
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30
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Vonk-Noordegraaf A, Marcus JT, Holverda S, Roseboom B, Postmus PE. Early changes of cardiac structure and function in COPD patients with mild hypoxemia. Chest 2005; 127:1898-903. [PMID: 15947300 DOI: 10.1378/chest.127.6.1898] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND COPD is often associated with changes of the structure and the function of the heart. Although functional abnormalities of the right ventricle (RV) have been well described in COPD patients with severe hypoxemia, little is known about these changes in patients with normoxia and mild hypoxemia. STUDY OBJECTIVES To assess the structural and functional cardiac changes in COPD patients with normal Pa(O2) and without signs of RV failure. METHODS In 25 clinically stable COPD patients (FEV1, 1.23 +/- 0.51 L/s; Pa(O2), 82 +/- 10 mm Hg [mean +/- SD]) and 26 age-matched control subjects, the RV and left ventricular (LV) structure and function were measured by MRI. Pulmonary artery pressure (PAP) was estimated from right pulmonary artery distensibility. RESULTS RV mass divided by RV end-diastolic volume as a measure of RV adaptation was 0.72 +/- 0.18 g/mL in the COPD group and 0.41 +/- 0.09 g/mL in the control group (p < 0.01). LV and RV ejection fractions were 62 +/- 14% and 53 +/- 12% in the COPD patients, and 68 +/- 11% and 53 +/- 7% in the control subjects, respectively. PAP estimated from right pulmonary artery distensibility was not elevated in the COPD group. CONCLUSION From these results, we conclude that concentric RV hypertrophy is the earliest sign of RV pressure overload in patients with COPD. This structural adaptation of the heart does not alter RV and LV systolic function.
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Affiliation(s)
- Anton Vonk-Noordegraaf
- Department of Pulmonary Medicine, Institute for Cardiovascular Research, Vrije Universiteit Medical Center, PO Box 7057, 1007 MB Amsterdam, Netherlands.
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31
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Abstract
AIM Left ventricular (LV) hypertrophy is a common feature in Fabry disease-related progressive infiltrative hypertrophic cardiomyopathy and affects both men and women, but at different ages. To date, however, little is known about the role of right ventricular (RV) function in Fabry disease. Therefore, this study aimed to investigate the extent of RV involvement in patients with Fabry disease. METHODS Echocardiographic examination of the right and left ventricle was carried out in 129 patients (80 women and 49 men) with Fabry disease. RESULTS RV hypertrophy was present in 46 patients (35.7%). Of these patients, 13 showed signs of severely depressed right systolic function (tricuspid annulus movement < 10 mm and a prolonged RV pre-ejection period/pulmonary ejection time ratio) and six patients showed additional severe depression of parameters of diastolic function (pseudo-normal or restrictive RV filling pattems). Those patients with RV hypertrophy and severely compromised systolic and diastolic function had the highest LV masses (92 +/- 11.7 g/m(2.7)). CONCLUSION RV involvement is common in Fabry disease and ultimately progresses to severe systolic and diastolic RV dysfunction. These findings might explain why patients with preserved LV function can develop clinical features such as reduced exercise capacity, organomegaly and lymphoedema.
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MESH Headings
- Adult
- Blood Pressure/physiology
- Body Mass Index
- Cardiomyopathies/complications
- Cardiomyopathies/diagnosis
- Cardiomyopathies/physiopathology
- Diagnosis, Differential
- Electrocardiography
- Fabry Disease/complications
- Fabry Disease/physiopathology
- Female
- Heart Failure/complications
- Heart Failure/diagnosis
- Heart Failure/physiopathology
- Humans
- Hypertrophy, Left Ventricular/complications
- Hypertrophy, Left Ventricular/pathology
- Hypertrophy, Left Ventricular/physiopathology
- Hypertrophy, Right Ventricular/complications
- Hypertrophy, Right Ventricular/pathology
- Hypertrophy, Right Ventricular/physiopathology
- Male
- Ventricular Dysfunction, Right/complications
- Ventricular Dysfunction, Right/diagnosis
- Ventricular Dysfunction, Right/physiopathology
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Affiliation(s)
- C Kampmann
- Department of Cardiology, University Children's Hospital, Mainz, Germany.
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32
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Deuchar GA, Hicks MN, MacLean MR. The role of 5-hydroxytryptamine in the control of pulmonary vascular tone in a rabbit model of pulmonary hypertension secondary to left ventricular dysfunction. Pulm Pharmacol Ther 2005; 18:23-31. [PMID: 15607124 DOI: 10.1016/j.pupt.2004.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2003] [Revised: 04/05/2004] [Accepted: 07/27/2004] [Indexed: 11/18/2022]
Abstract
The role of 5-hydroxytryptamine (5-HT) in a rabbit model of pulmonary hypertension (PHT) secondary to left ventricular dysfunction was investigated. Following pulmonary artery catheterisation under anaesthesia, 5-HT (1-400 microg kg(-1) i.v.) was administered before and after either 5-HT(2A) receptor antagonism with ketanserin (0.5 mg kg(-1)) or infusion of the nitric oxide synthase inhibitor, l-NAME (30 micromol min(-1)). Eight week coronary artery ligated rabbits demonstrate increased mean pulmonary arterial pressure (PAP) compared to controls (17.0+/-0.5 versus 12.0+/-0.5 mmHg, P<0.001) accompanied by right ventricular hypertrophy. 5-HT alone produced a greater pulmonary pressor response in rabbits with PHT (increase of 7.5+/-1.2, n=12 c.f. 3.5+/-0.4 mmHg in shams, n=12, P<0.01). Ketanserin had no effect on basal PAP in either PHT or control rabbits but inhibited the response to 5-HT in both groups. The response to 5-HT following l-NAME was increased in both groups and was greater in rabbits with PHT (an increase of 20.1+/-2.9, n=6 c.f. 11.4+/-1.8 mmHg, n=6, P<0.05). These results suggest that the difference shown in the in vivo pulmonary response to exogenous 5-HT is mediated largely through 5-HT(2A) receptors in this model. However, activity of endogenous 5-HT at the 5-HT(2A) receptors is not responsible for maintaining the raised basal PAP through vasoconstriction in PHT rabbits once PHT has developed.
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MESH Headings
- Animals
- Aorta
- Blood Pressure/drug effects
- Blood Pressure/physiology
- Cardiac Output/drug effects
- Disease Models, Animal
- Heart Rate/drug effects
- Heart Rate/physiology
- Hypertension, Pulmonary/chemically induced
- Hypertension, Pulmonary/complications
- Hypertension, Pulmonary/physiopathology
- Hypertrophy, Left Ventricular/complications
- Hypertrophy, Left Ventricular/physiopathology
- Hypertrophy, Right Ventricular/complications
- Hypertrophy, Right Ventricular/physiopathology
- Ketanserin/pharmacology
- Male
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/physiopathology
- NG-Nitroarginine Methyl Ester/pharmacology
- Organ Size/drug effects
- Pulmonary Artery/drug effects
- Pulmonary Artery/physiopathology
- Rabbits
- Receptor, Serotonin, 5-HT2A/drug effects
- Receptor, Serotonin, 5-HT2A/physiology
- Serotonin/pharmacology
- Serotonin/physiology
- Serotonin Antagonists/pharmacology
- Stroke Volume/drug effects
- Stroke Volume/physiology
- Ventricular Dysfunction, Left/complications
- Ventricular Dysfunction, Left/physiopathology
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Affiliation(s)
- Graeme A Deuchar
- Department of Medical Cardiology, Division of Cardiovascular and Medical Sciences, University of Glasgow, Royal Infirmary, Glasgow G31 2ER, UK.
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33
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Abstract
Neurohormonal activation has been shown to be a major factor in congestive heart failure progression and mortality. The beneficial effects obtained in clinical trials with angiotensin converting enzyme (ACE) inhibitors, beta-blockers and aldosterone antagonists have confirmed this hypothesis. 5,6-Diisobutirroyloxy-2-methyl-aminotetraline hydrochloride (nolomirole) is a selective agonist of prejunctional D(2)-dopaminergic and alpha(2)-adrenergic receptors. The stimulation of these receptors inhibits catecholamine release from sympathetic nerve endings. To confirm that this mechanism can be useful in congestive heart failure, we studied the effects of nolomirole on monocrotaline-induced congestive heart failure. The ACE inhibitor trandolapril was used as reference compound. Rats were given single intraperitoneal injection of either saline (control group; n=20) or monocrotaline (50 mg kg(-1)). Three days later, the monocrotaline-treated animals were randomly allocated (n=50 per group) to oral treatment with distilled water (vehicle group), nolomirole (0.25 mg kg(-1)) twice a day, or trandolapril (0.3 mg kg(-1)) once a day up to sacrifice. On the fourth week after monocrotaline injection, animals with signs of congestive heart failure were sacrificed for evaluation of heart hypertrophy and neuroendocrine alterations. Atrial natriuretic peptide (ANP) and alderosterone were determined by radioimmunoassay in plasma. Tissue norepinephrine concentration was quantified by high-pressure liquid chromatography. Nolomirole and trandolapril significantly reduced (a) hypertrophy of right atria and ventricles, (b) plasma levels of ANP and presence of pleural/peritoneal effusions and (c) norepinephrine depletion of right ventricle. These findings confirmed that nolomirole, like trandolapril, is able to attenuate the heart failure signs in the monocrotaline-induced congestive heart failure model.
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Affiliation(s)
- Evasio Pasini
- Laboratory of Cardiovascular Physiopathology, Fondazione S. Maugeri, Via Pindololo 23, 25064 Brescia, Gussago, Italy.
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34
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Baĭdurin SA, Berkimbaev SF, Al'mukhamedova AK, Iskakova BK, Imankulov SB, Aĭnakulova GA, Khasenova BD, Shveĭkina NG. [A case of diagnostics of dilatational cardiomyopathy with isolated right atrium involvement]. Klin Med (Mosk) 2005; 83:67-70. [PMID: 15941149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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35
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Abstract
Case 1, a 28-year-old woman (third daughter of Case 2) delivered her first child in September 2000, but leg edema and dyspnea on exertion appeared the following January. At the time of our first examination of the patient in May 2001, a chest X-ray showed cardiomegaly and pulmonary artery enlargement. Echocardiography demonstrated enlargement of the right ventricle and small left ventricular dimensions, and an electrocardiogram revealed right ventricle hypertrophy. After perfusion-ventilation lung scintigraphy and cardiac catheterization, she was diagnosed as having primary pulmonary hypertension (PPH). Although she was discharged with prescriptions for a diuretic, warfarin and beraprost sodium, she died of a pulmonary hypertensive crisis twenty days after readmission. Case 2, a 60-year-old woman(mother of Case 1) developed the same symptoms as those in Case 1, in May 2001, but recovered after medication. PPH is a rare disease and only a few familial cases are reported. In this family, the eldest daughter of Case 2 had also died of pulmonary hypertension ten years ago, several months after her first delivery. In contrast to the daughters, the mother's symptoms developed gradually.
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Affiliation(s)
- Kazuhito Yamashita
- The Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
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36
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Abstract
Background—
In patients with acute pulmonary embolism (PE), rapid and accurate risk assessment is paramount in selecting the appropriate treatment strategy. Right ventricular (RV) enlargement on chest CT has previously been shown to correlate with an unstable hospital course, but its role as a predictor of death is unknown.
Methods and Results—
We evaluated 431 consecutive patients (mean age, 59±16 years; 55% women) with acute PE confirmed by multidetector-row chest CT. With the use of multiplanar reformats of axial CT data, CT 4-chamber (4-CH) views were reconstructed and right and left ventricular dimensions (RV
D
, LV
D
) were measured. RV enlargement, defined as RV
D
/LV
D
>0.9, was present in 276 (64.0%; 95% CI, 59.5% to 68.6%) patients. Thirty-day mortality rate was 15.6% (95% CI, 11.3% to 19.9%) in patients with and 7.7% (95% CI, 3.5% to 12.0%) without RV enlargement (log rank,
P
=0.018). The hazard ratio of RV
D
/LV
D
>0.9 for predicting 30-day death was 3.36 (95% CI, 1.13 to 9.97;
P
=0.029). On multivariable analysis, RV enlargement predicted 30-day death (hazard ratio, 5.17; 95% CI, 1.63 to 16.35;
P
=0.005) after adjusting for pneumonia (hazard ratio, 2.95; 95% CI, 1.19 to 3.83;
P
=0.002), cancer (hazard ratio, 2.13; 95% CI, 1.19 to 3.83;
P
=0.011), chronic lung disease (hazard ratio, 2.00; 95% CI, 1.04 to 3.86;
P
=0.039), and age (hazard ratio, 1.03; 95% CI, 1.01 to 1.05;
P
=0.005).
Conclusions—
In patients with acute PE, RV enlargement on reconstructed CT 4-CH view helps predict early death.
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Affiliation(s)
- U Joseph Schoepf
- Department of Radiology, Medical University of South Carolina, Charleston, SC, USA
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37
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Otto C, Hein L, Brede M, Jahns R, Engelhardt S, Gröne HJ, Schütz G. Pulmonary Hypertension and Right Heart Failure in Pituitary Adenylate Cyclase–Activating Polypeptide Type I Receptor–Deficient Mice. Circulation 2004; 110:3245-51. [PMID: 15520307 DOI: 10.1161/01.cir.0000147235.53360.59] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Pituitary adenylate cyclase–activating polypeptide (PACAP), acting via 3 different G protein–coupled receptors, has been implicated in the regulation of several homeostatic systems in the body, including cardiopulmonary control. To define the physiologic role of the PACAP-preferring type I receptor, PAC1, in cardiopulmonary function, we developed a mutant mouse strain lacking functional PAC1 receptors.
Methods and Results—
When PAC1-deficient mice were crossed onto a C57BL/6 background, almost all mutants died during the second postnatal week. Whereas mutant mice were indistinguishable from their wild-type littermates at birth, they showed progressive weakness and died from rapidly developing heart failure. Right ventricles of PAC1 mutants were massively dilated and showed cardiac myocyte hypertrophy, whereas left ventricular structure was unaltered. On direct cardiac catheterization, right ventricular pressure was elevated by 45% in PAC1-deficient mice, indicating increased pulmonary artery pressure, as no malformations were detected in the valves or outflow tract of the right ventricle. Consistent with elevated pulmonary pressure, lung capillary density was decreased by 30% and small pulmonary arteries of mutant mice had significant vascular smooth muscle cell hypertrophy compared with wild-type mice.
Conclusions—
Whereas PACAP induces vasodilation in isolated pulmonary vessels in wild-type mice, the absence of its specific receptor PAC1 causes pulmonary hypertension and right heart failure after birth. These in vivo findings demonstrate the crucial importance of PAC1-mediated signaling for the maintenance of normal pulmonary vascular tone during early postnatal life.
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MESH Headings
- Animals
- Capillaries/pathology
- Cell Size
- Corticosterone/blood
- Crosses, Genetic
- Heart Failure/etiology
- Heart Failure/genetics
- Heart Failure/metabolism
- Hypertension, Pulmonary/genetics
- Hypertension, Pulmonary/metabolism
- Hypertrophy
- Hypertrophy, Right Ventricular/complications
- Hypertrophy, Right Ventricular/diagnostic imaging
- Hypertrophy, Right Ventricular/genetics
- Hypertrophy, Right Ventricular/metabolism
- Lung/blood supply
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Muscle, Smooth, Vascular/pathology
- Myocytes, Cardiac/pathology
- Nerve Growth Factors/physiology
- Neuropeptides/physiology
- Neurotransmitter Agents/physiology
- Pituitary Adenylate Cyclase-Activating Polypeptide
- Pressure
- Pulmonary Artery/growth & development
- Pulmonary Artery/pathology
- Receptors, Cell Surface/deficiency
- Receptors, Cell Surface/genetics
- Receptors, Cell Surface/physiology
- Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide
- Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide, Type I
- Signal Transduction
- Ultrasonography
- Vascular Resistance/physiology
- Vasodilation/genetics
- Vasodilation/physiology
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Affiliation(s)
- Christiane Otto
- Division of Molecular Biology of the Cell, German Cancer Research Center, Heidelberg, Germany
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38
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Miao CY, Cai GJ, Tao X, Xie HH, Su DF. GREATER HYPERTROPHY IN RIGHT THAN LEFT VENTRICLES IS ASSOCIATED WITH PULMONARY VASCULOPATHY IN SINOAORTIC-DENERVATED WISTAR-KYOTO RATS. Clin Exp Pharmacol Physiol 2004; 31:450-5. [PMID: 15236633 DOI: 10.1111/j.1440-1681.2004.04023.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
1. Biventricular hypertrophy has been described in a high blood pressure variability (BPV) model of sinoaortic-denervated (SAD) rats without systemic hypertension. To explore the possible involvement of the lung in SAD-induced right ventricular hypertrophy (RVH), we examined lung morphology, in addition to systemic haemodynamics and ventricle morphology, in Wistar-Kyoto rats 32 weeks after SAD. 2. In Wistar-Kyoto rats 32 weeks after SAD, there existed a substantial elevation in BPV, with no change in the average level of arterial pressure. Biventricular hypertrophy following SAD was characterized by a greater hypertrophy in right than left ventricles; both absolute and normalized right ventricular weights were significantly increased by 22 and 27%, respectively, and only normalized left ventricular weight was significantly increased by 12%. No infarcts were found in any ventricles examined. 3. In the lung, the most prominent change following SAD was pulmonary vasculopathy, including wall thickening, perivascular fibrosis and cell infiltration. In pulmonary arteries with an internal diameter of 70-130 microm, the external diameter, wall thickness and wall thickness to internal diameter ratio were increased in SAD compared with control rats. 4. There was no correlation between right and left ventricular weights. In contrast with BPV-correlated left ventricular weight, right ventricular weight was correlated with the wall thickness of the pulmonary artery, but not with BPV. 5. These findings suggest that greater RVH following SAD is associated with pulmonary vasculopathy, but is not secondary to the left ventricular problems or high BPV.
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Affiliation(s)
- Chao-Yu Miao
- Department of Pharmacology, Second Military Medical University, Shanghai, China.
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39
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Roeleveld RJ, Vonk-Noordegraaf A, Marcus JT, Bronzwaer JGF, Marques KMJ, Postmus PE, Boonstra A. Effects of epoprostenol on right ventricular hypertrophy and dilatation in pulmonary hypertension. Chest 2004; 125:572-9. [PMID: 14769740 DOI: 10.1378/chest.125.2.572] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVES To gain more knowledge of changes in main pulmonary artery flow and right ventricular mass and volumes in patients with pulmonary hypertension during epoprostenol therapy. METHODS Eleven patients (9 women) were evaluated before the start of therapy and every 4 months thereafter. Right and left ventricular volumes and masses were measured by cine MRI. Flow was measured with MRI velocity quantification. At the same times, 6-min walking tests were performed. Right-heart catheterizations were performed at baseline and after 1 year. RESULTS Right ventricular mass in the patient group was significantly higher from that in a control group of healthy volunteers (95 +/- 26 g vs 42 +/- 10 g, p < 0.05 [mean +/- SD]), whereas the stroke volume was lower (34 +/- 11 mL vs 81 +/- 11 mL, p < 0.05). The greatest improvement in right ventricular stroke volume (to 41 +/- 11 mL, p < 0.05) took place in the first 4 months. During the 1-year follow-up, right ventricular end-diastolic volume and mass did not change, and mean pulmonary artery pressure remained nearly stable at 55 mm Hg at baseline and 53 mm Hg after 1 year. Pulmonary vascular resistance decreased by 12.5% (p = 0.06). CONCLUSIONS From these data we conclude that epoprostenol lowers pulmonary vascular resistance, leading to an increase in pulmonary artery flow. This increase in pulmonary artery flow corresponds well with the increase in 6-min walking distance and can be noninvasively monitored by MRI (flow quantification). Right ventricular dilatation and hypertrophy are not reversed by epoprostenol therapy, but do not progress either.
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Affiliation(s)
- Roald J Roeleveld
- Department of Pulmonology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
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40
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Comella A, Magnacca M, Gistri R, Lombardi M, Neglia D, Poddighe R, Pesola A. [Right ventricular involvement in hypertrophic cardiomyopathy. A case report and brief review of the literature]. Ital Heart J Suppl 2004; 5:154-9. [PMID: 15080536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
A clinical case of non-obstructive hypertrophic cardiomyopathy with involvement of the right ventricle is reported. The patient was a 42-year-old male with symptoms suggesting an effort angina of recent onset. The diagnosis was established by echocardiography, which showed asymmetric hypertrophy of the interventricular septum (20 mm), hypertrophy of the right ventricular free wall, and severe hypertrophy of the septal papillary muscle of the tricuspid valve. The patient underwent a complete diagnostic evaluation, including exercise stress test, Holter monitoring, magnetic resonance, myocardial tomoscintigraphy and complete hemodynamic assessment. Medical treatment with atenolol 50 mg day was started; at 1-year follow-up the patient's clinical conditions are good, with decrease of anginal episodes. The literature review elicits the paucity of information about this condition, despite a frequent involvement of both ventricles in hypertrophic obstructive cardiomyopathy. The case reported shows two atypical aspects: a) the involvement of the right ventricle in non-obstructive hypertrophic cardiomyopathy is anecdotal; b) this pattern of hypertrophy (right ventricular free wall/septal papillary muscle) has never been previously reported. Right ventricular involvement in patients with hypertrophic cardiomyopathy must be carefully investigated, because it may be more frequent than conventionally deemed.
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MESH Headings
- Adrenergic beta-Antagonists/therapeutic use
- Adult
- Angina Pectoris/etiology
- Atenolol/therapeutic use
- Cardiomyopathy, Hypertrophic/complications
- Cardiomyopathy, Hypertrophic/diagnostic imaging
- Cardiomyopathy, Hypertrophic/drug therapy
- Cardiomyopathy, Hypertrophic/epidemiology
- Cardiomyopathy, Hypertrophic/pathology
- Echocardiography
- Electrocardiography, Ambulatory
- Exercise Test
- Heart Septum/diagnostic imaging
- Heart Septum/pathology
- Hemodynamics
- Humans
- Hypertrophy, Right Ventricular/complications
- Hypertrophy, Right Ventricular/diagnostic imaging
- Hypertrophy, Right Ventricular/drug therapy
- Hypertrophy, Right Ventricular/pathology
- Male
- Physical Exertion
- Prevalence
- Tricuspid Valve/diagnostic imaging
- Tricuspid Valve/pathology
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Affiliation(s)
- Alessandro Comella
- UOC di Cardiologia, Ospedale della Versilia, ASL 12, Lido di Camaiore, LU.
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41
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Karoli NA, Rebrov AP. [Pulmonary hypertension right and left cardiac cavities in patients with systemic scleroderma]. Klin Med (Mosk) 2004; 82:47-50. [PMID: 15230042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Lung lesion is a most common organ changes in systemic scleroderma (SSD) detectable in approximately 70% of the patients at autopsy. Echocardiography is now one of the main non-invasive diagnostic methods for pulmonary hypertension (PH), in patients with scleroderma in particular. The study was undertaken to examine the incidence of PH and the specific features of its development in patients with SSD. Thirty-one patients with SSD (30 females and 1 males) treated at the rheumatological unit of the regional clinical hospital in 2000 to 2002 were examined. The patients' age ranged from 33 to 75 years (mean 47.7 +/- 1.7 years). Pulmonary systolic blood pressure (PSBP) (higher than 30 mm Hg) was recorded in 51.6% of the patients. Hypertrophy of the right ventricle (RV) (more than 0.5-cm increases in the thickness of its anterior wall) was found in 20 (64.5%) patients with SSD, 4 cases had hypertrophy of the RV anterior wall without resting elevated PSBP. More than 2.5-cm RV dilation was observed in 6 (19.4%) patients. This study has provided evidence for that echocardiography is of high informative value in detecting PH and right cardiac changes in patients with systemic scleroderma, which shows this technique to be a screening in these cases.
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42
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Elmedal B, de Dam MY, Mulvany MJ, Simonsen U. The superoxide dismutase mimetic, tempol, blunts right ventricular hypertrophy in chronic hypoxic rats. Br J Pharmacol 2003; 141:105-13. [PMID: 14656807 PMCID: PMC1574166 DOI: 10.1038/sj.bjp.0705580] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
1. The purpose of this study was to investigate whether a membrane-permeable superoxide dismutase mimetic, tempol, added either alone or in combination with the nitric oxide (NO) donor molsidomine, prevents the development of pulmonary hypertension (PH) in chronic hypoxic rats. 2. Chronic hypobaric hypoxia (10% oxygen) for 2 weeks increased the right ventricular systolic pressure (RVSP), right ventricle and lung wet weight. Relaxations evoked by acetylcholine (ACh) and the molsidomine metabolite SIN-1 were impaired in isolated proximal, but not distal pulmonary arteries, from chronic hypoxic rats. 3. Treatment with tempol (86 mg x kg(-1) day(-1) in drinking water) normalized RVSP and reduced right ventricular hypertrophy, while systemic blood pressure, lung and liver weights, and blunted ACh relaxation of pulmonary arteries were unchanged. 4. Treatment with molsidomine (15 mg x kg(-1) day(-1) in drinking water) had the same effects as tempol, except that liver weight was reduced, and potassium and U46619-evoked vasoconstrictions in pulmonary arteries were increased. Combining tempol and molsidomine did not have additional effects compared to tempol alone. ACh relaxation in pulmonary arteries was not normalized by these treatments. 5. The media to lumen diameter ratio of the pulmonary arteries was greater for the hypoxic rats compared to the normoxic rats, and was not reversed by treatment with tempol, molsidomine, or the combination of tempol and molsidomine. 6. We conclude that tempol, like molsidomine, is able to correct RVSP and reduce right ventricular weight in the rat hypoxic model. Functional and structural properties of pulmonary small arteries were little affected. The results support the possibility that superoxide dismutase mimetics may be a useful means for the treatment of PH.
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MESH Headings
- 15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid/administration & dosage
- Acetylcholine/pharmacology
- Administration, Oral
- Animals
- Body Weight/drug effects
- Body Weight/physiology
- Chronic Disease
- Cyclic N-Oxides/administration & dosage
- Cyclic N-Oxides/pharmacokinetics
- Cyclic N-Oxides/therapeutic use
- Disease Models, Animal
- Dose-Response Relationship, Drug
- Drug Synergism
- Drug Therapy, Combination
- Endothelin-1/pharmacology
- Free Radical Scavengers/administration & dosage
- Free Radical Scavengers/pharmacokinetics
- Free Radical Scavengers/therapeutic use
- Heart Rate/drug effects
- Hypertrophy, Right Ventricular/complications
- Hypertrophy, Right Ventricular/physiopathology
- Hypertrophy, Right Ventricular/prevention & control
- Hypoxia/complications
- Hypoxia/drug therapy
- Hypoxia/physiopathology
- Male
- Molsidomine/analogs & derivatives
- Molsidomine/metabolism
- Molsidomine/pharmacology
- Molsidomine/therapeutic use
- Muscle, Smooth, Vascular
- Organ Size/drug effects
- Pulmonary Artery/anatomy & histology
- Pulmonary Artery/drug effects
- Rats
- Rats, Wistar
- Spin Labels
- Superoxide Dismutase/administration & dosage
- Superoxide Dismutase/therapeutic use
- Vasoconstriction/drug effects
- Vasodilation/drug effects
- Ventricular Pressure/drug effects
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Affiliation(s)
- Britt Elmedal
- Department of Pharmacology, University of Aarhus, 8000 Aarhus C, Denmark
| | - Mette Y de Dam
- Department of Pharmacology, University of Aarhus, 8000 Aarhus C, Denmark
| | | | - Ulf Simonsen
- Department of Pharmacology, University of Aarhus, 8000 Aarhus C, Denmark
- Author for correspondence:
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43
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Ambat'ello LG, Blinova EV, Sakhnova TA, Chazova IE. [Electrocardiographic picture in patients with congenital defect of atrial septum operated upon in adult age]. Kardiologiia 2003; 43:60-4. [PMID: 12891275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Electrocardiograms from 30 patients with congenital atrial septal defect operated upon in adult age were analyzed. One of frequent variants of QRS configuration in standard leads was SIqIII type. It was observed in 50% of patients. Most frequent (in 67% of patients) variants of QRS configuration in lead V1 were rSr' and rSR'. Signs of right ventricular hypertrophy were most often found in a group of patients with high pulmonary hypertension. Changes of terminal portion of ventricular complex such as negative or biphasic T waves were found in 29 of 30 patients (in 63% of cases these changes were localized in leads V1-V3).
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44
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Tulevski II, Bresser P, Hirsch A, Groenink M, Channick RN, Jamieson SW, Mulder BJM. Decreased plasma neurohormones and improved cardiac performance after surgical treatment of chronic pulmonary embolism. Ann Thorac Surg 2003; 76:287-90. [PMID: 12842565 DOI: 10.1016/s0003-4975(03)00160-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The findings of this case report suggest that quantitative assessment of plasma neurohormones and magnetic resonance imaging functional parameters in patients with right ventricular pressure overload due to chronic pulmonary embolism might be used as indicators for right ventricular function before and after intervention. Monitoring of changes in these parameters may provide quantitative follow-up of right ventricular function in these patients.
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Affiliation(s)
- Igor I Tulevski
- Department of Cardiology, University of Amsterdam, The Netherlands.
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45
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Affiliation(s)
- Dominic J R Abrams
- Department of Paediatric Cardiology, The Royal Brompton & Harefield NHS Trust, London, UK
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46
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Kilner PJ, Sievers B, Meyer GP, Ho SY. Double-chambered right ventricle or sub-infundibular stenosis assessed by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2003; 4:373-9. [PMID: 12234109 DOI: 10.1081/jcmr-120013300] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
This paper presents magnetic resonance findings in four adults with double-chambered right ventricle or sub-infundibular stenosis, a condition that is treatable by surgery, but which can be difficult to assess echocardiographically. Four patients referred for cardiovascular magnetic resonance in the last 2 years were identified from CMR findings, although not necessarily from previous echocardiography, as having sub-infundibular stenosis. We used multislice spin echo imaging, cine imaging in oblique sagittal planes, and phase velocity mapping. We performed spin echo imaging of a post-mortem heart without known structural abnormality to illustrate right ventricular myocardial morphology. Results in patients showed evidence of sub-infundibular muscular obstruction separating the hypertrophied inlet and apical portions of the right ventricle from a thin-walled, unobstructed infundibular region in each case, with a systolic jet originating at least 15 mm beneath the unstenosed pulmonary valve. In addition to previously described structural components contributing to stenosis--enlargement and/or displacement of the septomarginal trabeculation, septoparietal trabeculations or the moderator band--CMR suggested additional components: a right ventricular papillary muscle in one, an anteriorly bulging aortic sinus in one, and hypertrophied muscular ridges of the parietal wall of the right ventricle. Even in this small group of patients, the causes of sub-infundibular stenosis appeared to be varied and multi-factorial. The abilities of magnetic resonance to give unrestricted, multi-planar views of right ventricular anatomy, movement and flow make it well suited for diagnosis and characterization of sub-infundibular stenosis, especially in adults.
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Affiliation(s)
- Philip J Kilner
- Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital Site of Imperial College, London, UK.
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47
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Leineweber K, Brandt K, Wludyka B, Beilfuss A, Pönicke K, Heinroth-Hoffmann I, Brodde OE. Ventricular hypertrophy plus neurohumoral activation is necessary to alter the cardiac beta-adrenoceptor system in experimental heart failure. Circ Res 2002; 91:1056-62. [PMID: 12456492 DOI: 10.1161/01.res.0000045088.59360.b7] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Treatment of rats with monocrotaline (MCT) leads to pulmonary hypertension, right ventricular (RV) hypertrophy, and finally to RV heart failure. This is associated with characteristic changes in right ventricular beta-adrenoceptors (beta-AR), neuronal noradrenaline transporter (NAT) density and activity (uptake1), and G protein-coupled receptor kinase (GRK) activity. This study aimed to find out factors that determine beta-AR, uptake1, and GRK changes. Thus, 6-week-old rats were treated with 50 mg/kg MCT subcutaneous or 0.9% saline. Within 13 to 19 days after MCT application (group A), RV weight (222+/-6 versus 147+/-5 mg) and RV/left ventricular (LV) weight ratio (0.42+/-0.01 versus 0.29+/-0.01) were significantly increased, whereas plasma noradrenaline, RV beta-AR density, RV NAT density and activity, and RV GRK activity were not significantly altered. Twenty-one to twenty-eight days after MCT (group B), however, not only RV weight (316+/-4 versus 148+/-2 mg) and RV/LV weight ratio (0.61+/-0.01 versus 0.3+/-0.01) were markedly increased but also plasma noradrenaline (645+/-63 versus 278+/-18 pg/mL); now, RV beta-AR density (13.4+/-1.3 versus 26.5+/-1.1 fmol/mg protein), RV NAT density (50.9+/-11.3 versus 79.6+/-2.9 fmol/mg protein), and RV NAT activity (65.4+/-7.4 versus 111.8+/-15.9 pmol [3H]-NA/mg tissue slices/15 min) were significantly decreased and RV-membrane GRK activity (100+/-15 versus 67+/-6 [32P]-rhodopsin in cpm) significantly increased. LV parameters of MCT-treated rats were only marginally different from control LV. We conclude that in MCT-treated rats ventricular hypertrophy per se is not sufficient to cause characteristic alterations in the myocardial beta-AR system often seen in heart failure; only if ventricular hypertrophy is associated with neurohumoral activation beta-ARs are downregulated and GRK activity is increased.
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MESH Headings
- Animals
- Binding, Competitive/drug effects
- Binding, Competitive/physiology
- Cell Membrane/chemistry
- Cell Membrane/metabolism
- Disease Models, Animal
- Eye Proteins
- Fluoxetine/analogs & derivatives
- Fluoxetine/pharmacokinetics
- G-Protein-Coupled Receptor Kinase 1
- Heart Failure/chemically induced
- Heart Failure/complications
- Heart Failure/physiopathology
- Hypertension, Pulmonary/chemically induced
- Hypertension, Pulmonary/complications
- Hypertrophy, Right Ventricular/chemically induced
- Hypertrophy, Right Ventricular/complications
- Hypertrophy, Right Ventricular/physiopathology
- Male
- Monocrotaline
- Myocardium/metabolism
- Norepinephrine/blood
- Norepinephrine/pharmacokinetics
- Norepinephrine Plasma Membrane Transport Proteins
- Organ Size/drug effects
- Protein Kinases/metabolism
- Rats
- Rats, Wistar
- Receptors, Adrenergic, beta/metabolism
- Receptors, Neurotransmitter/metabolism
- Rhodopsin/pharmacokinetics
- Symporters/analysis
- Symporters/metabolism
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Affiliation(s)
- Kirsten Leineweber
- Institute of Pharmacology, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
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Nishimura T, Faul JL, Berry GJ, Vaszar LT, Qiu D, Pearl RG, Kao PN. Simvastatin attenuates smooth muscle neointimal proliferation and pulmonary hypertension in rats. Am J Respir Crit Care Med 2002; 166:1403-8. [PMID: 12406854 DOI: 10.1164/rccm.200203-268oc] [Citation(s) in RCA: 149] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Hypertensive pulmonary vascular disease is characterized by abnormal proliferation of vascular endothelial and smooth muscle cells, leading to occlusion of pulmonary arterioles, pulmonary hypertension, right ventricular failure, and death. Compounds with antiproliferative effects on vascular endothelial and smooth muscle cells, such as 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, may prevent the development of experimental hypertensive pulmonary vascular disease. Pneumonectomized rats injected with monocrotaline at 7 days develop severe hypertensive pulmonary vascular disease with neointimal formation. Rats were randomized to receive either vehicle or treatment with the HMG-CoA reductase inhibitor simvastatin (2 mg/kg per day). By Day 35, rats that received vehicle had higher mean pulmonary arterial pressures (53 +/- 2 mm Hg) and right ventricular hypertrophy (right ventricle/[left ventricle plus septum] [RV/LV+S] = 0.78 +/- 0.09) than rats in Group PMS5-35 that received simvastatin from Day 5 to 35 (mean pulmonary arterial pressure = 27 +/- 3 mm Hg, RV/LV+S = 0.34 +/- 0.08; p < or = 0.001). Pulmonary vascular remodeling with neointimal formation consisting of vascular smooth muscle cells was more severe in vehicle-treated rats (vascular occlusion score, 1.98 +/- 0.02) than in Group PMS5-35 (vascular occlusion score, 0.59 +/- 0.46; p < 0.001). In addition, lung endothelial nitric oxide synthase gene expression was decreased in vehicle-treated animals but was restored toward normal levels in simvastatin-treated animals. Simvastatin attenuates monocrotaline-induced pulmonary vascular remodeling with neointimal formation, pulmonary arterial hypertension, and right ventricular hypertrophy in rats.
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MESH Headings
- Animals
- Anticholesteremic Agents/therapeutic use
- Body Weight/drug effects
- Body Weight/physiology
- Cholesterol/blood
- Disease Models, Animal
- Gene Expression Regulation/drug effects
- Heart Ventricles/pathology
- Hemodynamics/drug effects
- Hemodynamics/physiology
- Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
- Hypertension, Pulmonary/blood
- Hypertension, Pulmonary/complications
- Hypertension, Pulmonary/prevention & control
- Hypertrophy, Right Ventricular/blood
- Hypertrophy, Right Ventricular/complications
- Hypertrophy, Right Ventricular/prevention & control
- Lung/blood supply
- Lung/metabolism
- Lung/pathology
- Male
- Monocrotaline/administration & dosage
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/pathology
- Nitric Oxide Synthase/biosynthesis
- Nitric Oxide Synthase/drug effects
- Organ Size/drug effects
- Organ Size/physiology
- Pneumonectomy
- Pulmonary Artery/pathology
- RNA, Messenger/drug effects
- RNA, Messenger/metabolism
- Rats
- Rats, Sprague-Dawley
- Simvastatin/therapeutic use
- Treatment Outcome
- Tunica Intima/drug effects
- Tunica Intima/pathology
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Affiliation(s)
- Toshihiko Nishimura
- Division of Pulmonary and Critical Care Medicine, and Department of Pathology, Stanford University Medical Center, Stanford, California 94305, USA
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Lewczuk J, Ajlan AW, Piszko P, Mikulewicz M, Jagas J, Sobkowicz B, Wrabec K. [Electrocardiographic signs of right ventricular overload useful in improving diagnosis of chronic thromboembolic pulmonary hypertension (CTE-PH) in patients with chronic exertional dyspnea]. Pol Arch Med Wewn 2002; 108:1049-54. [PMID: 12685245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The early recognition of chronic thromboembolic pulmonary hypertension (CTE-PH) is troublesome because of "honey moon" period with chronic dyspnea on exertion as the only one symptom. To find if routine electrocardiography may be useful in improving the diagnosis, value of right ventricular overload (RVO) signs in recognition echocardiographically determined chronic pulmonary hypertension (CPH) and angiographically confirmed CTE-PH in 90 consecutive patients hospitalized due to chronic exertional dyspnea was studied. CPE was found in 76.5% and CTE-PH in 33% of those patients, at least one of twelve founded electrocardiographic signs of RVO was present in 50% patients. The most frequently occurred signs: negative T wave in lead V1-V6, right axis deviation and pulmonale P wave as well as 9 other occurred at frequency below 20% signs of RVO had low to medium sensitivity and negative predictive value and 80-90% positive predictive value for diagnosing CPE and 90-100% positive predictive value for diagnosing CTE-PH. It was concluded that in patients with chronic exertional dyspnea electrocardiographic signs of RVO may be useful in initial diagnosing of CPH and CTE-PH in particular.
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Affiliation(s)
- Jerzy Lewczuk
- Oddział Kardiologiczny Wojewódzkiego Szpitala Specjalistycznego, Wrocławiu
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50
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MESH Headings
- Adult
- Bundle-Branch Block/complications
- Bundle-Branch Block/diagnosis
- Cardiac Catheterization
- Dyspnea/etiology
- Echocardiography, Doppler
- Electrocardiography
- Female
- Heart Defects, Congenital/complications
- Heart Defects, Congenital/diagnosis
- Heart Defects, Congenital/surgery
- Heart Murmurs/etiology
- Heart Septal Defects, Ventricular/complications
- Heart Septal Defects, Ventricular/diagnosis
- Heart Ventricles/abnormalities
- Heart Ventricles/surgery
- Humans
- Hypertrophy, Right Ventricular/complications
- Hypertrophy, Right Ventricular/diagnosis
- Hypertrophy, Right Ventricular/surgery
- Magnetic Resonance Imaging, Cine
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Affiliation(s)
- Tareq Ibrahim
- Deutsches Herzzentrum München & I. Medizinische Klinik, Technische Universität München, Munich, Germany. T.Ibrahim@ Lrz.tu-muenchen.de
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