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Llagostera-Martín M, Cainzos M, Salvatella N, Cubero-Gallego H, Mas-Stachurska A, Sánchez-Carpintero A, Tizón-Marcos H, Calvo-Fernández A, Molina L, Vaquerizo B. Single antiplatelet therapy after left atrial appendage closure in patients with AF: safety and effectiveness. Rev Esp Cardiol (Engl Ed) 2024; 77:150-157. [PMID: 37879431 DOI: 10.1016/j.rec.2023.06.020] [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: 02/22/2023] [Accepted: 06/16/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION AND OBJECTIVES The optimal antithrombotic strategy following left atrial appendage closure (LAAC) is poorly defined in patients with nonvalvular atrial fibrillation. We assessed the safety and effectiveness of a single antiplatelet treatment (SAPT) strategy after LAAC in a population at high risk of ischemic and bleeding events. METHODS This single-center, observational, prospective study included a consecutive cohort of patients who underwent LAAC using the LAmbre device (Lifetech Scientific, China) and who were discharged with SAPT. The primary outcome was a composite of stroke, systemic embolism, and device-related thrombosis during follow-up. Secondary endpoints were cardiovascular mortality and major bleeding events (BARC ≥3a). Clinical follow-up was performed at 1, 6, and 12 months and subsequently on an annual basis. Transesophageal echocardiography was performed at 1 and 12 months of follow-up. RESULTS The study comprised 74 patients. The median age was 77 [72-83] years and 43% were women. The cohort exhibited a high prevalence of comorbidities and cardiovascular risk factors. The median CHA2DS2-VASc and HAS-BLED scores were 4 [3-6] and 4 [4-5], respectively. The median length of follow-up was 2.5 years (188 patients-year). During follow-up, device-related thrombosis occurred in 3 patients (4%). Ischemic stroke occurred in 1 patient (1.3%, rate 0.5%/y), representing a 90.9% relative risk reduction compared with the risk predicted by CHA2DS2-VASc. Major bleeding events occurred in 12 patients (16%, 6.4%/y), with a relative risk reduction of 26.4% of that predicted by HAS-BLED. Cardiovascular-related mortality was observed in 2 patients (2.7%). CONCLUSIONS SAPT appears to be a safe and effective treatment following LAAC in patients at high ischemic and hemorrhagic risk. Further studies are needed to confirm our findings.
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Affiliation(s)
| | - Miguel Cainzos
- Servicio de Cardiología, Hospital del Mar, Barcelona, Spain; Grupo de Investigación en Enfermedades del Corazón (GREC), Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain
| | | | - Héctor Cubero-Gallego
- Servicio de Cardiología, Hospital del Mar, Barcelona, Spain; Grupo de Investigación en Enfermedades del Corazón (GREC), Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain
| | - Aleksandra Mas-Stachurska
- Servicio de Cardiología, Hospital del Mar, Barcelona, Spain; Servicio de Cardiología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Helena Tizón-Marcos
- Servicio de Cardiología, Hospital del Mar, Barcelona, Spain; Grupo de Investigación en Enfermedades del Corazón (GREC), Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Alicia Calvo-Fernández
- Servicio de Cardiología, Hospital del Mar, Barcelona, Spain; Departamento de Medicina, Universidad Pompeu Fabra, Barcelona, Spain
| | - Luis Molina
- Servicio de Cardiología, Hospital del Mar, Barcelona, Spain; Grupo de Investigación en Enfermedades del Corazón (GREC), Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain; Departamento de Medicina, Universidad Pompeu Fabra, Barcelona, Spain
| | - Beatriz Vaquerizo
- Servicio de Cardiología, Hospital del Mar, Barcelona, Spain; Grupo de Investigación en Enfermedades del Corazón (GREC), Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain; Departamento de Medicina, Universidad Pompeu Fabra, Barcelona, Spain; Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
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Yáñez-Bisbe L, Moya M, Rodríguez-Sinovas A, Ruiz-Meana M, Inserte J, Tajes M, Batlle M, Guasch E, Mas-Stachurska A, Miró E, Rivas N, Ferreira González I, Garcia-Elias A, Benito B. TRPV4 Channels Promote Pathological, but Not Physiological, Cardiac Remodeling through the Activation of Calcineurin/NFAT and TRPC6. Int J Mol Sci 2024; 25:1541. [PMID: 38338818 PMCID: PMC10855372 DOI: 10.3390/ijms25031541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/10/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
TRPV4 channels, which respond to mechanical activation by permeating Ca2+ into the cell, may play a pivotal role in cardiac remodeling during cardiac overload. Our study aimed to investigate TRPV4 involvement in pathological and physiological remodeling through Ca2+-dependent signaling. TRPV4 expression was assessed in heart failure (HF) models, induced by isoproterenol infusion or transverse aortic constriction, and in exercise-induced adaptive remodeling models. The impact of genetic TRPV4 inhibition on HF was studied by echocardiography, histology, gene and protein analysis, arrhythmia inducibility, Ca2+ dynamics, calcineurin (CN) activity, and NFAT nuclear translocation. TRPV4 expression exclusively increased in HF models, strongly correlating with fibrosis. Isoproterenol-administered transgenic TRPV4-/- mice did not exhibit HF features. Cardiac fibroblasts (CFb) from TRPV4+/+ animals, compared to TRPV4-/-, displayed significant TRPV4 overexpression, elevated Ca2+ influx, and enhanced CN/NFATc3 pathway activation. TRPC6 expression paralleled that of TRPV4 in all models, with no increase in TRPV4-/- mice. In cultured CFb, the activation of TRPV4 by GSK1016790A increased TRPC6 expression, which led to enhanced CN/NFATc3 activation through synergistic action of both channels. In conclusion, TRPV4 channels contribute to pathological remodeling by promoting fibrosis and inducing TRPC6 upregulation through the activation of Ca2+-dependent CN/NFATc3 signaling. These results pose TRPV4 as a primary mediator of the pathological response.
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Affiliation(s)
- Laia Yáñez-Bisbe
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.Y.-B.); (A.R.-S.); (M.R.-M.); (J.I.); (E.M.); (I.F.G.)
| | - Mar Moya
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.Y.-B.); (A.R.-S.); (M.R.-M.); (J.I.); (E.M.); (I.F.G.)
| | - Antonio Rodríguez-Sinovas
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.Y.-B.); (A.R.-S.); (M.R.-M.); (J.I.); (E.M.); (I.F.G.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marisol Ruiz-Meana
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.Y.-B.); (A.R.-S.); (M.R.-M.); (J.I.); (E.M.); (I.F.G.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Javier Inserte
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.Y.-B.); (A.R.-S.); (M.R.-M.); (J.I.); (E.M.); (I.F.G.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marta Tajes
- Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
| | - Montserrat Batlle
- Institute for Biomedical Research August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (M.B.); (E.G.); (A.M.-S.)
| | - Eduard Guasch
- Institute for Biomedical Research August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (M.B.); (E.G.); (A.M.-S.)
- Cardiology Department, Hospital Clínic, 08036 Barcelona, Spain
| | - Aleksandra Mas-Stachurska
- Institute for Biomedical Research August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (M.B.); (E.G.); (A.M.-S.)
- Cardiology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - Elisabet Miró
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.Y.-B.); (A.R.-S.); (M.R.-M.); (J.I.); (E.M.); (I.F.G.)
| | - Nuria Rivas
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.Y.-B.); (A.R.-S.); (M.R.-M.); (J.I.); (E.M.); (I.F.G.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
| | - Ignacio Ferreira González
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.Y.-B.); (A.R.-S.); (M.R.-M.); (J.I.); (E.M.); (I.F.G.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Anna Garcia-Elias
- Department of Clinical Research, ASCIRES-CETIR Biomedic Group, 08029 Barcelona, Spain;
| | - Begoña Benito
- Cardiovascular Diseases Research Group, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.Y.-B.); (A.R.-S.); (M.R.-M.); (J.I.); (E.M.); (I.F.G.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Cardiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
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Mas-Stachurska A, Bouma BJ, de Bruin Bon R, Mulder B, Bijnens B, Sitges M. Cardiac remodeling in patients with Marfan syndrome: impact of gender and vasodilator therapy. Rev Esp Cardiol (Engl Ed) 2023; 76:69-71. [PMID: 35753612 DOI: 10.1016/j.rec.2022.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/11/2022] [Indexed: 12/29/2022]
Affiliation(s)
- Aleksandra Mas-Stachurska
- Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, Barcelona, Spain; Departamento de Medicina, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
| | - Berto J Bouma
- Cardiology Department, Amsterdam University Medical Centers, Location Academisch Medisch Centrum, Ámsterdam, Países Bajos
| | - Rianne de Bruin Bon
- Cardiology Department, Amsterdam University Medical Centers, Location Academisch Medisch Centrum, Ámsterdam, Países Bajos
| | - Barbara Mulder
- Cardiology Department, Amsterdam University Medical Centers, Location Academisch Medisch Centrum, Ámsterdam, Países Bajos
| | - Bart Bijnens
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institución Catalana de Investigación y Estudios Avanzados (ICREA), Barcelona, Spain
| | - Marta Sitges
- Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, Barcelona, Spain; Departamento de Medicina, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovaculares (CIBERCV), Spain; Centres de Recerca de Catalunya (CERCA), Generalitat de Catalunya, Barcelona, Spain
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Navarro-Romero A, Galera-López L, Ortiz-Romero P, Llorente-Ovejero A, de Los Reyes-Ramírez L, Bengoetxea de Tena I, Garcia-Elias A, Mas-Stachurska A, Reixachs-Solé M, Pastor A, de la Torre R, Maldonado R, Benito B, Eyras E, Rodríguez-Puertas R, Campuzano V, Ozaita A. Cannabinoid signaling modulation through JZL184 restores key phenotypes of a mouse model for Williams-Beuren syndrome. eLife 2022; 11:72560. [PMID: 36217821 PMCID: PMC9553213 DOI: 10.7554/elife.72560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/26/2022] [Indexed: 11/17/2022] Open
Abstract
Williams–Beuren syndrome (WBS) is a rare genetic multisystemic disorder characterized by mild-to-moderate intellectual disability and hypersocial phenotype, while the most life-threatening features are cardiovascular abnormalities. Nowadays, there are no pharmacological treatments to directly ameliorate the main traits of WBS. The endocannabinoid system (ECS), given its relevance for both cognitive and cardiovascular function, could be a potential druggable target in this syndrome. We analyzed the components of the ECS in the complete deletion (CD) mouse model of WBS and assessed the impact of its pharmacological modulation in key phenotypes relevant for WBS. CD mice showed the characteristic hypersociable phenotype with no preference for social novelty and poor short-term object-recognition performance. Brain cannabinoid type-1 receptor (CB1R) in CD male mice showed alterations in density and coupling with no detectable change in main endocannabinoids. Endocannabinoid signaling modulation with subchronic (10 days) JZL184, a selective inhibitor of monoacylglycerol lipase, specifically normalized the social and cognitive phenotype of CD mice. Notably, JZL184 treatment improved cardiovascular function and restored gene expression patterns in cardiac tissue. These results reveal the modulation of the ECS as a promising novel therapeutic approach to improve key phenotypic alterations in WBS. Williams-Beuren syndrome (WBS) is a rare disorder that causes hyper-social behavior, intellectual disability, memory problems, and life-threatening overgrowth of the heart. Behavioral therapies can help improve the cognitive and social aspects of the syndrome and surgery is sometimes used to treat the effects on the heart, although often with limited success. However, there are currently no medications available to treat WBS. The endocannabinoid system – which consists of cannabis-like chemical messengers that bind to specific cannabinoid receptor proteins – has been shown to influence cognitive and social behaviors, as well as certain functions of the heart. This has led scientists to suspect that the endocannabinoid system may play a role in WBS, and drugs modifying this network of chemical messengers could help treat the rare condition. To investigate, Navarro-Romero, Galera-López et al. studied mice which had the same genetic deletion found in patients with WBS. Similar to humans, the male mice displayed hyper-social behaviors, had memory deficits and enlarged hearts. Navarro-Romero, Galera-López et al. found that these mutant mice also had differences in the function of the receptor protein cannabinoid type-1 (CB1). The genetically modified mice were then treated with an experimental drug called JZL184 that blocks the breakdown of endocannabinoids which bind to the CB1 receptor. This normalized the number and function of receptors in the brains of the WBS mice, and reduced their social and memory symptoms. The treatment also restored the animals’ heart cells to a more normal size, improved the function of their heart tissue, and led to lower blood pressure. Further experiments revealed that the drug caused the mutant mice to activate many genes in their heart muscle cells to the same level as normal, healthy mice. These findings suggest that JZL184 or other drugs targeting the endocannabinoid system may help ease the symptoms associated with WBS. More studies are needed to test the drug’s effectiveness in humans with this syndrome. Furthermore, the dramatic effect JZL184 has on the heart suggests that it might also help treat high blood pressure or conditions that cause the overgrowth of heart cells.
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Affiliation(s)
- Alba Navarro-Romero
- Laboratory of Neuropharmacology, Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Lorena Galera-López
- Laboratory of Neuropharmacology, Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Paula Ortiz-Romero
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of Barcelona, and centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Alberto Llorente-Ovejero
- Department of Pharmacology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Spain
| | - Lucía de Los Reyes-Ramírez
- Laboratory of Neuropharmacology, Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Iker Bengoetxea de Tena
- Department of Pharmacology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Spain
| | - Anna Garcia-Elias
- Laboratory of Neuropharmacology, Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Aleksandra Mas-Stachurska
- Hospital del Mar Medical Research Institute (IMIM), Autonomous University of Barcelona, Barcelona, Spain
| | - Marina Reixachs-Solé
- EMBL Australia Partner Laboratory Network at the Australian National University, Canberra, Australia.,The John Curtin School of Medical Research, Australian National University, Canberra, Australia
| | - Antoni Pastor
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | | | - Rafael Maldonado
- Laboratory of Neuropharmacology, Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Begoña Benito
- Group of Cardiovascular Experimental and Translational Research (GET-CV), Vascular Biology and Metabolism, Vall d'Hebron Research Institute (VHIR),, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBER-CV), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduardo Eyras
- EMBL Australia Partner Laboratory Network at the Australian National University, Canberra, Australia.,The John Curtin School of Medical Research, Australian National University, Canberra, Australia.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Rafael Rodríguez-Puertas
- Department of Pharmacology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Spain.,Neurodegenerative Diseases, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Victoria Campuzano
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of Barcelona, and centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Andres Ozaita
- Laboratory of Neuropharmacology, Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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Mas-Stachurska A, Bouma BJ, de Bruin Bon R, Mulder B, Bijnens B, Sitges M. Remodelado cardiaco asociado con el síndrome de Marfan: impacto del sexo y el tratamiento vasodilatador. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Galian-Gay L, Escalona Silva RA, Teixidó-Turà G, Casas G, Ferrer-Sistach E, Mitroi C, Mingo S, Monivas V, Saura D, Vidal B, Trasca L, Moral S, Calvo F, Castiñeira Busto M, Sánchez V, Gonzalez A, Guzman G, Mora MN, Arnau Vives M, Peteiro J, Bouzas A, Mas-Stachurska A, González-Alujas T, Gutiérrez L, Fernandez-Galera R, Valente F, Guala A, Ruiz-Muñoz A, Avilés CAS, Palomares JFR, Ferreira I, Evangelista A. Prognosis of Paradoxical Low-Flow Low-Gradient Aortic Stenosis: A Severe, Non-critical Form, With Surgical Treatment Benefits. Front Cardiovasc Med 2022; 9:852954. [PMID: 35433871 PMCID: PMC9011160 DOI: 10.3389/fcvm.2022.852954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/07/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives To determine the risk of mortality and need for aortic valve replacement (AVR) in patients with low-flow low-gradient (LFLG) aortic stenosis (AS). Methods A longitudinal multicentre study including consecutive patients with severe AS (aortic valve area [AVA] < 1.0 cm2) and normal left ventricular ejection fraction (LVEF). Patients were classified as: high-gradient (HG, mean gradient ≥ 40 mmHg), normal-flow low-gradient (NFLG, mean gradient < 40 mmHg, indexed systolic volume (SVi) > 35 ml/m2) and LFLG (mean gradient < 40 mmHg, SVi ≤ 35 ml/m2). Results Of 1,391 patients, 147 (10.5%) had LFLG, 752 (54.1%) HG, and 492 (35.4%) NFLG. Echocardiographic parameters of the LFLG group showed similar AVA to the HG group but with less severity in the dimensionless index, calcification, and hypertrophy. The HG group required AVR earlier than NFLG (p < 0.001) and LFLG (p < 0.001), with no differences between LFLG and NFLG groups (p = 0.358). Overall mortality was 27.7% (CI 95% 25.3–30.1) with no differences among groups (p = 0.319). The impact of AVR in terms of overall mortality reduction was observed the most in patients with HG (hazard ratio [HR]: 0.17; 95% CI: 0.12–0.23; p < 0.001), followed by patients with LFLG (HR: 0.25; 95% CI: 0.13–0.49; p < 0.001), and finally patients with NFLG (HR: 0.29; 95% CI: 0.20–0.44; p < 0.001), with a risk reduction of 84, 75, and 71%, respectively. Conclusions Paradoxical LFLG AS affects 10.5% of severe AS, and has a lower need for AVR than the HG group and similar to the NFLG group, with no differences in mortality. AVR had a lower impact on LFLG AS compared with HG AS. Therefore, the findings of the present study showed LFLG AS to have an intermediate clinical risk profile between the HG and NFHG groups.
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Affiliation(s)
- Laura Galian-Gay
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Roxana Andreina Escalona Silva
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gisela Teixidó-Turà
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Guillem Casas
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Ferrer-Sistach
- Department of Cardiology, Hospital Universitari Germans Tries i Pujol, Badalona, Spain
| | - Cristina Mitroi
- Department of Cardiology, Hospital Puerta de Hierro - Majadahonda, Madrid, Spain
| | - Susana Mingo
- Department of Cardiology, Hospital Puerta de Hierro - Majadahonda, Madrid, Spain
| | - Vanessa Monivas
- Department of Cardiology, Hospital Puerta de Hierro - Majadahonda, Madrid, Spain
| | - Daniel Saura
- Department of Cardiology, CIBER-CV, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Bàrbara Vidal
- Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Livia Trasca
- Department of Cardiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sergio Moral
- Department of Cardiology, Hospital Josep Trueta, Girona, Spain
| | - Francisco Calvo
- Department of Cardiology, Hospital Alvaro Cunqueiro, Vigo, Spain
| | | | - Violeta Sánchez
- Department of Cardiology, CIBER-CV, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ariana Gonzalez
- Department of Cardiology, Hospital Ramón y Cajal, Madrid, Spain
| | - Gabriela Guzman
- Department of Cardiology, Hospital Universitario La Paz, Madrid, Spain
| | - Marta Noris Mora
- Department of Cardiology, Hospital Universitario Son Espases, IdISBa, Mallorca, Spain
| | | | - Jesús Peteiro
- Department of Cardiology, CIBER-CV, Complexo Hospitalario Universitario A Coruña, Coruña, Spain
| | - Alberto Bouzas
- Department of Cardiology, CIBER-CV, Complexo Hospitalario Universitario A Coruña, Coruña, Spain
| | | | - Teresa González-Alujas
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Gutiérrez
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rubén Fernandez-Galera
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Filipa Valente
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrea Guala
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Aroa Ruiz-Muñoz
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cesar Augusto Sao Avilés
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José F. Rodríguez Palomares
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ignacio Ferreira
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
- Ignacio Ferreira
| | - Artur Evangelista
- Department of Cardiology, Hospital Universitari Vall d'Hebron, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
- *Correspondence: Artur Evangelista
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Garcia-Ribas C, Ble M, Gómez M, Mas-Stachurska A, Farré-López N, Cladellas M. Importance of Tricuspid Regurgitation Velocity Threshold in Risk Assessment of Pulmonary Hypertension-Long-Term Outcome of Patients Submitted to Aortic Valve Replacement. Front Cardiovasc Med 2021; 8:720643. [PMID: 34859063 PMCID: PMC8631497 DOI: 10.3389/fcvm.2021.720643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The upper physiological threshold for tricuspid regurgitation velocity (TRV) of 2.8 m/s proposed by the Pulmonary Hypertension (PH) guidelines had been questioned. The aim of this study was to evaluate the prognostic significance of preoperative PH in patients with aortic stenosis, long-term after valve replacement, using two different TRV thresholds (2.55 and 2.8 m/s). Methods: Four hundred and forty four patients were included (mean age 73 ± 9 years; 55% male), with a median follow-up of 5.8 years (98% completed). Patients were divided into three PH probability groups according to guidelines (low, intermediate and high) for both thresholds (TRV ≤ 2.8 m/s and TRV ≤ 2.55 m/s), using right atrial area>18 cm2 and right ventricle/left ventricle ratio>1 as additional echocardiographic variables. Results: In patients with measurable TRV (n = 304), the low group mortality rate was 25% and 30%, respectively for 2.55 and 2.8 m/s TRV thresholds. The intermediate group with TRV > 2.55 m/s was an independent mortality risk factor (HR 2.04; 95% CI: 1.91 to 3.48, p = 0.01), in contrast to the intermediate group with TRV>2.8 m/s (HR 1.44; 95% CI: 0.89 to 2.32, p = 0.14). Both high probability groups were associated with an increased mortality risk, as compared to their respective low groups. When including all patients (with measurable and non-measurable TRV), both intermediate groups remained independently associated with an increased mortality risk: HR 1.62 (95% CI 1.11 to 2.35 p = 0.01) for the new cut-off point; and HR 1.43 (95% CI: 0.96 to 2.13, p = 0.07) for guidelines threshold. Conclusion: A TRV threshold of 2.55 m/s, together with right cavities measures, allowed a better risk assessment of patients with PH secondary to severe aortic stenosis, with or without tricuspid regurgitation.
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Affiliation(s)
- Cora Garcia-Ribas
- Department of Cardiology, Hospital del Mar, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mirea Ble
- Department of Cardiology, Hospital del Mar, Barcelona, Spain
| | - Miquel Gómez
- Department of Cardiology, Hospital del Mar, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
| | | | - Núria Farré-López
- Department of Cardiology, Hospital del Mar, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Mercè Cladellas
- Department of Cardiology, Hospital del Mar, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
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8
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Ble M, Benito B, Cuadrado-Godia E, Pérez-Fernández S, Gómez M, Mas-Stachurska A, Tizón-Marcos H, Molina L, Martí-Almor J, Cladellas M. Left Atrium Assessment by Speckle Tracking Echocardiography in Cryptogenic Stroke: Seeking Silent Atrial Fibrillation. J Clin Med 2021; 10:jcm10163501. [PMID: 34441797 PMCID: PMC8397042 DOI: 10.3390/jcm10163501] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/31/2021] [Accepted: 08/04/2021] [Indexed: 01/01/2023] Open
Abstract
Silent atrial fibrillation (AF) may be the cause of some cryptogenic strokes (CrS). The aim of the study was to analyse atrial size and function by speckle tracking echocardiography in CrS patients to detect atrial disease. Patients admitted to the hospital due to CrS were included prospectively. Echocardiogram analysis included left atrial ejection fraction (LAEF) and atrial strain. Insertable cardiac monitor was implanted, and AF was defined as an episode of ≥1 min in the first year after stroke. Left atrial enlargement was defined as indexed volume > 34 mL/m2. Seventy-five consecutive patients were included, aged 76 ± 9 years (arterial hypertension 75%). AF was diagnosed in 49% of cases. The AF group had higher atrial volume and worse atrial function: peak atrial longitudinal strain (PALs) 19.6 ± 5.7% vs. 29.5 ± 7.2%, peak atrial contraction strain (PACs) 8.9 ± 3.9% vs. 16.5 ± 6%, LAEF 46.8 ± 11.5% vs. 60.6 ± 5.2%; p < 0.001. AF was diagnosed in 20 of 53 patients with non-enlarged atrium, and in 18 of them, atrial dysfunction was present. The multivariate logistic regression analysis demonstrated an independent association between detection of AF and atrial volume, LAEF, and strain. Cut-off values were obtained: LAEF < 55%, PALs < 21.4%, and PACs < 12.9%. In conclusion, speckle tracking echocardiography in CrS patients improves silent atrial disease diagnosis, with or without atrial enlargement.
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Affiliation(s)
- Mireia Ble
- Medicine Department, Universidad Autónoma de Barcelona, 08035 Barcelona, Spain;
- Cardiology Department, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain; (A.M.-S.); (H.T.-M.); (L.M.); (J.M.-A.)
- Correspondence: ; Tel.: +34-932-483-018
| | - Begoña Benito
- Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (B.B.); (E.C.-G.); (S.P.-F.)
- Cardiology Department, Hospital Vall d’Hebron, 08035 Barcelona, Spain
| | - Elisa Cuadrado-Godia
- Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (B.B.); (E.C.-G.); (S.P.-F.)
- Neurology Department, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain
| | - Sílvia Pérez-Fernández
- Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (B.B.); (E.C.-G.); (S.P.-F.)
- CIBER of Cardiovascular Diseases (CIBERCV), 08003 Barcelona, Spain
| | - Miquel Gómez
- Cardiology Department, Hospital de Barcelona, 08034 Barcelona, Spain;
| | - Aleksandra Mas-Stachurska
- Cardiology Department, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain; (A.M.-S.); (H.T.-M.); (L.M.); (J.M.-A.)
- Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (B.B.); (E.C.-G.); (S.P.-F.)
| | - Helena Tizón-Marcos
- Cardiology Department, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain; (A.M.-S.); (H.T.-M.); (L.M.); (J.M.-A.)
- Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (B.B.); (E.C.-G.); (S.P.-F.)
| | - Lluis Molina
- Cardiology Department, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain; (A.M.-S.); (H.T.-M.); (L.M.); (J.M.-A.)
- Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (B.B.); (E.C.-G.); (S.P.-F.)
- Cardiology Department, Hospital de Barcelona, 08034 Barcelona, Spain;
| | - Julio Martí-Almor
- Cardiology Department, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain; (A.M.-S.); (H.T.-M.); (L.M.); (J.M.-A.)
- Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (B.B.); (E.C.-G.); (S.P.-F.)
| | - Mercè Cladellas
- Medicine Department, Universidad Autónoma de Barcelona, 08035 Barcelona, Spain;
- Cardiology Department, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain; (A.M.-S.); (H.T.-M.); (L.M.); (J.M.-A.)
- Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain; (B.B.); (E.C.-G.); (S.P.-F.)
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9
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Mas-Stachurska A, Egea G, de Bruin-Bon R, Rudenick P, Sanchis L, Bouma BJ, Mulder BJ, Bijnens B, Sitges M. Postsystolic thickening is a potential new clinical sign of injured myocardium in marfan syndrome. Sci Rep 2021; 11:15790. [PMID: 34349174 PMCID: PMC8338999 DOI: 10.1038/s41598-021-95263-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 07/22/2021] [Indexed: 11/09/2022] Open
Abstract
The mechanisms leading to cardiac remodeling in Marfan syndrome (MFS) are a matter of debate since it could be either due to structural dysfunction of the myocardial extracellular matrix or to increased afterload caused by the dilated aorta. We aim to characterize the presence of abnormal myocardial function in MFS and to investigate its potential association with increased afterload. Aorta, left ventricle (LV) and the postsystolic thickening (PST) were analyzed in echocardiography in Fbn1C1039G/+ mice and in patients with MFS in comparison with wild type (WT) mice and healthy humans. PST was more frequent in MFS than in WT mice (p < 0.05). MFS mice with PST showed larger aorta than those without PST. Patients with MFS showed larger aorta, poorer LV function and a higher prevalence of PST (56%) than did the healthy controls (23%); p = 0.003. Blood pressure was similar. The higher prevalence of PST in an experimental murine model and in MFS patients, regardless of systemic arterial pressure, suggests an increased afterload on the LV myocardium. This finding supports the use of PST as an indicator of myocardial damage and encourage searching for novel early preventive therapy.
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Affiliation(s)
- Aleksandra Mas-Stachurska
- Cardiovascular Institute, Hospital Clinic, University of Barcelona and Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CERCA Programme/Generalitat de Catalunya, Barcelona, Spain.
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
| | - Gustavo Egea
- Department of Biomedical Sciences, University of Barcelona School of Medicine and Health Sciences and Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Rianne de Bruin-Bon
- Cardiology Department, Amsterdam University Medical Centers, Location Academic Medic Centrum, Amsterdam, The Netherlands
| | | | - Laura Sanchis
- Cardiovascular Institute, Hospital Clinic, University of Barcelona and Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CERCA Programme/Generalitat de Catalunya, Barcelona, Spain
| | - Berto J Bouma
- Cardiology Department, Amsterdam University Medical Centers, Location Academic Medic Centrum, Amsterdam, The Netherlands
| | - Barbara J Mulder
- Cardiology Department, Amsterdam University Medical Centers, Location Academic Medic Centrum, Amsterdam, The Netherlands
| | - Bart Bijnens
- Cardiovascular Institute, Hospital Clinic, University of Barcelona and Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CERCA Programme/Generalitat de Catalunya, Barcelona, Spain
- ICREA, Barcelona, Spain
| | - Marta Sitges
- Cardiovascular Institute, Hospital Clinic, University of Barcelona School of Medicine and Health Sciences and Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERCV, Instituto de Salud Carlos III (CB16/11/00354); CERCA Programme/Generalitat de Catalunya, Barcelona, Spain
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10
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Marsico S, Orellana-Fernandez R, Tizon-Marcos H, Mas-Stachurska A, Solano A, Zuccarino F. Multimodality imaging evaluation of a primary cardiac epithelioid hemangioendothelioma. Acta Cardiol 2021; 77:557-559. [PMID: 33827376 DOI: 10.1080/00015385.2021.1908704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- S. Marsico
- Department of Radiology, Hospital del Mar, Barcelona, Spain
| | | | - H. Tizon-Marcos
- Departamento de Cardiología, Hospital del Mar, Barcelona, Spain
| | | | - A. Solano
- Department of Radiology, Hospital del Mar, Barcelona, Spain
| | - F. Zuccarino
- Department of Radiology, Hospital del Mar, Barcelona, Spain
- Imaging Department of the Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
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11
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García-Guimaraes M, Mojón D, Calvo A, Izquierdo A, Belarte-Tornero L, Salvatella N, Llagostera M, Negrete A, Mas-Stachurska A, Ruiz S, Valdivielso S, Ribas N, Marrugat J, Farré N, Vaquerizo B. Influence of cardiovascular disease and cardiovascular risk factors in COVID-19 patients. Data from a large prospective Spanish cohort. REC: CardioClinics 2021. [PMCID: PMC7670893 DOI: 10.1016/j.rccl.2020.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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12
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Llagostera-Martín M, Cubero-Gallego H, Mas-Stachurska A, Salvatella N, Sánchez-Carpintero A, Tizon-Marcos H, Garcia-Guimaraes M, Calvo-Fernandez A, Molina L, Vaquerizo B. Left Atrial Appendage Closure with a New Occluder Device: Efficacy, Safety and Mid-Term Performance. J Clin Med 2021; 10:1421. [PMID: 33915971 PMCID: PMC8036586 DOI: 10.3390/jcm10071421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/17/2021] [Accepted: 03/26/2021] [Indexed: 11/17/2022] Open
Abstract
The LAmbreTM device is a novel system designed for left atrial appendage closure (LAAC). First registries showed a high rate of device implantation success. However, few mid-term results are available. We present our 1- and 12-month follow-up results for this device. This prospective, single-center registry included consecutive patients with nonvalvular atrial fibrillation who underwent LAAC with the LAmbreTM device. Transesophageal echocardiography (TEE) was performed at 1-month follow-up. In total, 55 patients were included. The population was elderly (75 ± 9.4 years), with a high proportion of comorbidities. The mean CHA2DS2-VASc and HAS-BLED scores were 4.6 ± 1.6 and 3.9 ± 1.0, respectively. Previous history of a major bleeding event was present in 37 patients (67.3%). Procedural success was achieved in 54 patients (98.2%). Device success was achieved in 100% of patients in whom device implantation was attempted (54 patients). Major in-hospital device-related complications included mortality of one patient (1.8%) and pericardial tamponade in two patients (3.6%); the incidence of stroke was 0%. No thrombus or significant leaks (≥5 mm) were observed on 1-month TEE. At 12 months, adverse events were overall death (1.8%), transient ischemic attack/ischemic stroke (1.8%), and major bleeding events (Bleeding Academic Research Consortium (BARC) 3a and 3c; 11%). In this high-risk population, the LAmbreTM device seems to be a safe and effective option for LAAC with a remarkable mid-term performance.
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Affiliation(s)
- Marc Llagostera-Martín
- Interventional Cardiology Unit, Cardiology Department, Hospital del Mar, 08003 Barcelona, Spain; (M.L.-M.); (H.C.-G.); (A.M.-S.); (N.S.); (A.S.-C.); (H.T.-M.); (M.G.-G.); (A.C.-F.); (L.M.)
| | - Hector Cubero-Gallego
- Interventional Cardiology Unit, Cardiology Department, Hospital del Mar, 08003 Barcelona, Spain; (M.L.-M.); (H.C.-G.); (A.M.-S.); (N.S.); (A.S.-C.); (H.T.-M.); (M.G.-G.); (A.C.-F.); (L.M.)
| | - Aleksandra Mas-Stachurska
- Interventional Cardiology Unit, Cardiology Department, Hospital del Mar, 08003 Barcelona, Spain; (M.L.-M.); (H.C.-G.); (A.M.-S.); (N.S.); (A.S.-C.); (H.T.-M.); (M.G.-G.); (A.C.-F.); (L.M.)
- Heart Diseases Biomedical Research Group (GREC), Hospital del Mar Medical Investigation Institute-IMIM, 08003 Barcelona, Spain
| | - Neus Salvatella
- Interventional Cardiology Unit, Cardiology Department, Hospital del Mar, 08003 Barcelona, Spain; (M.L.-M.); (H.C.-G.); (A.M.-S.); (N.S.); (A.S.-C.); (H.T.-M.); (M.G.-G.); (A.C.-F.); (L.M.)
| | - Andrea Sánchez-Carpintero
- Interventional Cardiology Unit, Cardiology Department, Hospital del Mar, 08003 Barcelona, Spain; (M.L.-M.); (H.C.-G.); (A.M.-S.); (N.S.); (A.S.-C.); (H.T.-M.); (M.G.-G.); (A.C.-F.); (L.M.)
| | - Helena Tizon-Marcos
- Interventional Cardiology Unit, Cardiology Department, Hospital del Mar, 08003 Barcelona, Spain; (M.L.-M.); (H.C.-G.); (A.M.-S.); (N.S.); (A.S.-C.); (H.T.-M.); (M.G.-G.); (A.C.-F.); (L.M.)
- Heart Diseases Biomedical Research Group (GREC), Hospital del Mar Medical Investigation Institute-IMIM, 08003 Barcelona, Spain
| | - Marcos Garcia-Guimaraes
- Interventional Cardiology Unit, Cardiology Department, Hospital del Mar, 08003 Barcelona, Spain; (M.L.-M.); (H.C.-G.); (A.M.-S.); (N.S.); (A.S.-C.); (H.T.-M.); (M.G.-G.); (A.C.-F.); (L.M.)
| | - Alicia Calvo-Fernandez
- Interventional Cardiology Unit, Cardiology Department, Hospital del Mar, 08003 Barcelona, Spain; (M.L.-M.); (H.C.-G.); (A.M.-S.); (N.S.); (A.S.-C.); (H.T.-M.); (M.G.-G.); (A.C.-F.); (L.M.)
| | - Luis Molina
- Interventional Cardiology Unit, Cardiology Department, Hospital del Mar, 08003 Barcelona, Spain; (M.L.-M.); (H.C.-G.); (A.M.-S.); (N.S.); (A.S.-C.); (H.T.-M.); (M.G.-G.); (A.C.-F.); (L.M.)
- Heart Diseases Biomedical Research Group (GREC), Hospital del Mar Medical Investigation Institute-IMIM, 08003 Barcelona, Spain
- Medicine Department, Autonomous University of Barcelona-UAB, 08193 Barcelona, Spain
| | - Beatriz Vaquerizo
- Interventional Cardiology Unit, Cardiology Department, Hospital del Mar, 08003 Barcelona, Spain; (M.L.-M.); (H.C.-G.); (A.M.-S.); (N.S.); (A.S.-C.); (H.T.-M.); (M.G.-G.); (A.C.-F.); (L.M.)
- Heart Diseases Biomedical Research Group (GREC), Hospital del Mar Medical Investigation Institute-IMIM, 08003 Barcelona, Spain
- Medicine Department, Autonomous University of Barcelona-UAB, 08193 Barcelona, Spain
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13
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Cladellas M, Garcia-Ribas C, Ble M, Gómez M, Farré N, Mas-Stachurska A, Ivern C, Vila J, Martí-Almor J. Impact of Preoperative Measurement of Right Heart Chambers in the Evaluation of Pulmonary Hypertension Following Aortic Valve Replacement. Chest 2020; 157:1597-1605. [PMID: 31958443 DOI: 10.1016/j.chest.2019.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 11/15/2019] [Accepted: 12/04/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Severe pulmonary hypertension (PH) in patients with aortic stenosis is related to poor prognosis following aortic valve replacement (AVR). Current European PH guidelines recommend adding two different echocardiographic signs to tricuspid regurgitation velocity (TRV) in PH estimation, classifying its probability as low (TRV ≤ 2.8 m/s), intermediate (TRV 2.9-3.4 m/s), and high (TRV > 3.4 m/s). The right ventricle is an important determinant of prognosis in PH. The goal of this study was to analyze the value of right atrial area > 18 cm2 and right ventricular/left ventricular ratio > 1 in the long-term prognosis following AVR, mainly in the intermediate probability group. METHODS This study included 429 consecutive patients (mean age, 73 ± 8 years; 55% male) with a median follow-up of 4.25 years (completed in 98%). Patients were divided into low (n = 247), intermediate (n = 117), and high probability groups (n = 65). The intermediate probability group was divided into two subgroups: subgroup 2a (n = 27; TRV nonmeasurable or ≤ 2.8 m/s and two signs present) and subgroup 2b (n = 90; TRV 2.9-3.4 m/s, and none or only one sign present). RESULTS Overall mortality rates during follow-up of the low, intermediate, and high probability groups were 24%, 32%, and 42%, respectively. High PH probability was an independent predictor of all-cause mortality (hazard ratio [HR], 1.82; 95% CI, 1.11-3.00), but the intermediate probability group did not reach significance following multivariate analysis (HR, 1.40; 95% CI, 0.91-2.16). When the intermediate probability group was divided into subgroups, the subgroup 2a mortality rate (56%) was higher than that of both subgroup 2b (24%; P = .002) and the low probability group (24%; P < .001). Following multivariate analysis, subgroup 2a showed a significantly higher mortality (HR, 2.13; 95% CI, 1.11-4.10) in contrast to subgroup 2b (HR, 1.24; 95% CI, 0.75-2.05), both compared with the low probability group. CONCLUSIONS Incorporating measurement of the right cavities into the PH probability model in the assessment of long-term prognosis following AVR allowed better risk discrimination, especially in the intermediate probability group.
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Affiliation(s)
- Mercè Cladellas
- Department of Cardiology, Hospital del Mar. Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Medicine, Universitat Autónoma de Barcelona.
| | - Cora Garcia-Ribas
- Department of Cardiology, Hospital del Mar. Barcelona, Spain; Department of Medicine, Universitat Autónoma de Barcelona
| | - Mirea Ble
- Department of Cardiology, Hospital del Mar. Barcelona, Spain
| | - Miquel Gómez
- Department of Cardiology, Hospital del Mar. Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Medicine, Universitat Autónoma de Barcelona
| | - Núria Farré
- Department of Cardiology, Hospital del Mar. Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Medicine, Universitat Autónoma de Barcelona
| | | | - Consol Ivern
- Department of Cardiology, Hospital del Mar. Barcelona, Spain
| | - Joan Vila
- IMIM Hospital del Mar Medical Research Institute, Inflammatory and Cardiovascular Disorders, Barcelona; CIBER Epidemiology and Public Health
| | - Julio Martí-Almor
- Department of Cardiology, Hospital del Mar. Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Medicine, Universitat Autónoma de Barcelona
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14
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Mas-Stachurska A, Cladellas M, Vaquerizo B, Higueras L, Calvo A, Farre N, Ble M, Millan R, Molina L, Gomez M, Marti-Almor J. P2652Impact of transfemoral aortic valve implantation and surgical aortic valve replacement on right ventricular function up to six months of post-procedural phase. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - M Cladellas
- Hospital del Mar, Cardiology, Barcelona, Spain
| | - B Vaquerizo
- Hospital del Mar, Cardiology, Barcelona, Spain
| | - L Higueras
- Hospital del Mar, Cardiology, Barcelona, Spain
| | - A Calvo
- Hospital del Mar, Cardiology, Barcelona, Spain
| | - N Farre
- Hospital del Mar, Cardiology, Barcelona, Spain
| | - M Ble
- Hospital del Mar, Cardiology, Barcelona, Spain
| | - R Millan
- Hospital del Mar, Cardiology, Barcelona, Spain
| | - L Molina
- Hospital del Mar, Cardiology, Barcelona, Spain
| | - M Gomez
- Hospital del Mar, Cardiology, Barcelona, Spain
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15
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Redondo-Angulo I, Mas-Stachurska A, Sitges M, Tinahones FJ, Giralt M, Villarroya F, Planavila A. Fgf21 is required for cardiac remodeling in pregnancy. Cardiovasc Res 2018; 113:1574-1584. [PMID: 28472473 DOI: 10.1093/cvr/cvx088] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 05/03/2017] [Indexed: 11/13/2022] Open
Abstract
Aims Fibroblast growth factor-21 (Fgf21) is an endocrine factor that contributes to many physiological and pathological processes, mainly via its action as a metabolic regulator. Recent studies have shown that Fgf21 plays an important role in cardiac tissue. Pregnancy offers a physiological model of adaptive and reversible heart enlargement, but the molecular mechanisms underlying this cardiac hypertrophy are poorly understood. Therefore, the aim was to analyze the role of Fgf21 during late pregnancy, and assess the physiological relevance of Fgf21 for cardiac tissue during this process. Methods and results Female mice and rats at day 18 of gestation and pregnant women in their third trimester were used as models of late pregnancy, and our results revealed that their plasma levels of Fgf21 were significantly increased relative to non-pregnant controls. Pregnant wild-type (wt) mice exhibited a PPARα (peroxisome proliferator-activated receptor-α)-dependent enhancement of Fgf21 expression in the liver and heart. Moreover, pregnancy altered the levels of Fgf21 receptor-1 (FGFR1) and β-klotho, and activated intracellular Fgf21 signaling in the heart. Fgf21-/- mice did not develop the pregnancy-induced cardiac remodeling seen in wt mice. Furthermore, the hearts of Fgf21-/- mice exhibited reductions in their fatty acid oxidation levels, which may compromise cardiac function during pregnancy. Conclusions During pregnancy, both systemic and cardiac-produced Fgf21 act on the heart, leading to the normal physiological cardiac changes that are associated with pregnancy. Thus, Fgf21 acts as an endocrine/autocrine factor required for cardiac remodeling response to gestation.
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Affiliation(s)
- Ibon Redondo-Angulo
- Departament de Bioquímica i Biologia Molecular, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, 08028 Barcelona, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Barcelona, Spain
| | - Aleksandra Mas-Stachurska
- Cardiology Department, Thorax Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
| | - Marta Sitges
- Cardiology Department, Thorax Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
| | - Francisco José Tinahones
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Barcelona, Spain.,Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Teatinos Campus, 29010 Malaga, Spain.,Investigation Unit (IBIMA), Virgen de la Victoria Hospital, 29010 Malaga, Spain
| | - Marta Giralt
- Departament de Bioquímica i Biologia Molecular, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, 08028 Barcelona, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Barcelona, Spain
| | - Francesc Villarroya
- Departament de Bioquímica i Biologia Molecular, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, 08028 Barcelona, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Barcelona, Spain
| | - Anna Planavila
- Departament de Bioquímica i Biologia Molecular, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, 08028 Barcelona, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Barcelona, Spain
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Rupérez C, Lerin C, Ferrer-Curriu G, Cairo M, Mas-Stachurska A, Sitges M, Villarroya J, Giralt M, Villarroya F, Planavila A. Autophagic control of cardiac steatosis through FGF21 in obesity-associated cardiomyopathy. Int J Cardiol 2018. [DOI: 10.1016/j.ijcard.2018.02.109] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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17
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Jiménez-Altayó F, Meirelles T, Crosas-Molist E, Sorolla MA, Del Blanco DG, López-Luque J, Mas-Stachurska A, Siegert AM, Bonorino F, Barberà L, García C, Condom E, Sitges M, Rodríguez-Pascual F, Laurindo F, Schröder K, Ros J, Fabregat I, Egea G. Redox stress in Marfan syndrome: Dissecting the role of the NADPH oxidase NOX4 in aortic aneurysm. Free Radic Biol Med 2018; 118:44-58. [PMID: 29471108 DOI: 10.1016/j.freeradbiomed.2018.02.023] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [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: 11/30/2017] [Revised: 02/12/2018] [Accepted: 02/15/2018] [Indexed: 11/16/2022]
Abstract
Marfan syndrome (MFS) is characterized by the formation of ascending aortic aneurysms resulting from altered assembly of extracellular matrix fibrillin-containing microfibrils and dysfunction of TGF-β signaling. Here we identify the molecular targets of redox stress in aortic aneurysms from MFS patients, and investigate the role of NOX4, whose expression is strongly induced by TGF-β, in aneurysm formation and progression in a murine model of MFS. Working models included aortae and cultured vascular smooth muscle cells (VSMC) from MFS patients, and a NOX4-deficient Marfan mouse model (Fbn1C1039G/+-Nox4-/-). Increased tyrosine nitration and reactive oxygen species levels were found in the tunica media of human aortic aneurysms and in cultured VSMC. Proteomic analysis identified nitrated and carbonylated proteins, which included smooth muscle α-actin (αSMA) and annexin A2. NOX4 immunostaining increased in the tunica media of human Marfan aorta and was transcriptionally overexpressed in VSMC. Fbn1C1039G/+-Nox4-/- mice aortas showed a reduction of fragmented elastic fibers, which was accompanied by an amelioration in the Marfan-associated enlargement of the aortic root. Increase in the contractile phenotype marker calponin in the tunica media of MFS mice aortas was abrogated in Fbn1C1039G/+-Nox4-/- mice. Endothelial dysfunction evaluated by myography in the Marfan ascending aorta was prevented by the absence of Nox4 or catalase-induced H2O2 decomposition. We conclude that redox stress occurs in MFS, whose targets are actin-based cytoskeleton members and regulators of extracellular matrix homeostasis. Likewise, NOX4 have an impact in the progression of the aortic dilation in MFS and in the structural organization of the aortic tunica media, the VSMC phenotypic modulation, and endothelial function.
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Affiliation(s)
- Francesc Jiménez-Altayó
- Departament de Farmacologia, Terapèutica i Toxicologia, Institut de Neurociències, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Thayna Meirelles
- Department de Biomedicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, and IDIBAPS, Barcelona, Spain
| | - Eva Crosas-Molist
- TGF-β and Cancer Group, Oncobell Program, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Alba Sorolla
- Institut de Recerca Biomèdica de Lleida (IRB Lleida), Lleida, Spain; Departament de Ciències Mèdiques Bàsiques, Universitat de Lleida, Lleida, Spain
| | - Darya Gorbenko Del Blanco
- Department de Biomedicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, and IDIBAPS, Barcelona, Spain
| | - Judit López-Luque
- TGF-β and Cancer Group, Oncobell Program, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Ana-Maria Siegert
- Department de Biomedicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, and IDIBAPS, Barcelona, Spain
| | - Fabio Bonorino
- Department de Biomedicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, and IDIBAPS, Barcelona, Spain
| | - Laura Barberà
- Department de Biomedicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, and IDIBAPS, Barcelona, Spain
| | - Carolina García
- Department of Pathology, Hospital de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, and Department of Pathology and Experimental Therapeutics, University of Barcelona, Barcelona, Spain
| | - Enric Condom
- Department of Pathology, Hospital de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, and Department of Pathology and Experimental Therapeutics, University of Barcelona, Barcelona, Spain
| | - Marta Sitges
- Cardiovascular Institute, Hospital Clinic, IDIBAPS-University of Barcelona, Barcelona, Spain
| | | | - Francisco Laurindo
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, Brazil
| | - Katrin Schröder
- German Center of Cardiovascular Research (DZHK), Partner site Rhein Main, Frankfurt am Main, Germany
| | - Joaquim Ros
- Institut de Recerca Biomèdica de Lleida (IRB Lleida), Lleida, Spain; Departament de Ciències Mèdiques Bàsiques, Universitat de Lleida, Lleida, Spain
| | - Isabel Fabregat
- TGF-β and Cancer Group, Oncobell Program, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department de Ciències Fisiològiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Gustavo Egea
- Department de Biomedicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, and IDIBAPS, Barcelona, Spain.
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Mas-Stachurska A, Siegert AM, Batlle M, Gorbenko Del Blanco D, Meirelles T, Rubies C, Bonorino F, Serra-Peinado C, Bijnens B, Baudin J, Sitges M, Mont L, Guasch E, Egea G. Cardiovascular Benefits of Moderate Exercise Training in Marfan Syndrome: Insights From an Animal Model. J Am Heart Assoc 2017; 6:JAHA.117.006438. [PMID: 28947563 PMCID: PMC5634291 DOI: 10.1161/jaha.117.006438] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Marfan syndrome (MF) leads to aortic root dilatation and a predisposition to aortic dissection, mitral valve prolapse, and primary and secondary cardiomyopathy. Overall, regular physical exercise is recommended for a healthy lifestyle, but dynamic sports are strongly discouraged in MF patients. Nonetheless, evidence supporting this recommendation is lacking. Therefore, we studied the role of long-term dynamic exercise of moderate intensity on the MF cardiovascular phenotype. METHODS AND RESULTS In a transgenic mouse model of MF (Fbn1C1039G/+), 4-month-old wild-type and MF mice were subjected to training on a treadmill for 5 months; sedentary littermates served as controls for each group. Aortic and cardiac remodeling was assessed by echocardiography and histology. The 4-month-old MF mice showed aortic root dilatation, elastic lamina rupture, and tunica media fibrosis, as well as cardiac hypertrophy, left ventricular fibrosis, and intramyocardial vessel remodeling. Over the 5-month experimental period, aortic root dilation rate was significantly greater in the sedentary MF group, compared with the wild-type group (∆mm, 0.27±0.07 versus 0.13±0.02, respectively). Exercise significantly blunted the aortic root dilation rate in MF mice compared with sedentary MF littermates (∆mm, 0.10±0.04 versus 0.27±0.07, respectively). However, these 2 groups were indistinguishable by aortic root stiffness, tunica media fibrosis, and elastic lamina ruptures. In MF mice, exercise also produced cardiac hypertrophy regression without changes in left ventricular fibrosis. CONCLUSIONS Our results in a transgenic mouse model of MF indicate that moderate dynamic exercise mitigates the progression of the MF cardiovascular phenotype.
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Affiliation(s)
| | - Anna-Maria Siegert
- Departament de Biomedicina, Facultat de Medicina, Universitat de Barcelona, Spain
| | - Monsterrat Batlle
- Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBERCV, Barcelona, Spain
| | | | - Thayna Meirelles
- Departament de Biomedicina, Facultat de Medicina, Universitat de Barcelona, Spain
| | - Cira Rubies
- Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Fabio Bonorino
- Departament de Biomedicina, Facultat de Medicina, Universitat de Barcelona, Spain
| | - Carla Serra-Peinado
- Departament de Biomedicina, Facultat de Medicina, Universitat de Barcelona, Spain
| | - Bart Bijnens
- ICREA, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Julio Baudin
- Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marta Sitges
- Institut Cardiovascular, Hospital Clínic de Barcelona Universitat de Barcelona, Spain.,Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBERCV, Barcelona, Spain
| | - Lluís Mont
- Institut Cardiovascular, Hospital Clínic de Barcelona Universitat de Barcelona, Spain.,Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBERCV, Barcelona, Spain
| | - Eduard Guasch
- Institut Cardiovascular, Hospital Clínic de Barcelona Universitat de Barcelona, Spain .,Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBERCV, Barcelona, Spain
| | - Gustavo Egea
- Departament de Biomedicina, Facultat de Medicina, Universitat de Barcelona, Spain .,Institut de Nanociències i Nanotecnologia (IN2UB), Universitat de Barcelona, Spain.,Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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19
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Mas-Stachurska A, Slieker MG, Rosner A, Bonello B, Cieplucha A, Almeida Morais L, Morillas Climent H, Nogueira MA, Guasch E, Sitges M, Batlle M, Meirelles T, Castillo N, Rudenick P, Bijnens B, Egea G, Meza JM, Mccrindle BW, Karamlou T, Tchervenkov CI, Jacobs ML, Decampli WM, Burch PT, Mertens L, Khalapyan T, Dalen H, Mc Elhinney D, Chen S, Haeffele C, Fernandes S, Bijnens B, Friedberg M, Lui GK, Carr M, Iriart X, Ciliberti P, Christov G, Sullivan I, Derrick G, Kostolny M, Tsang V, Bull C, Giardini A, Marek J, Trojnarska O, Pyda M, Kociemba A, Lanocha M, Barczynski M, Kramer L, Grajek S, Abreu A, Agapito A, De Sousa L, Oliveira JA, Viveiros Monteiro A, Modas Daniel P, Antonio M, Jalles Tavares N, Cruz-Ferreira R, Osa Saez A, Cano Perez O, Domingo Valero D, Igual Munoz B, Martinez-Dolz L, Serrano Martinez F, Montero Argudo A, Plaza Lopez D, Rueda Soriano J, Branco LM, Timoteo AT, Oliveira M, Agapito A, Portugal G, Sousa L, Oliveira JA, Cruz Ferreira R. Rapid Fire Abstract: Congenital heart disease470Impact of training on aortic and cardiac remodelling in a murine model of Marfan syndrome: an echocardiographic study471Pre-intervention morphologic and functional echocardiographic characteristics of 651 neonates with critical left ventricular outflow tract obstruction472Ventricular geometry and function in adult patients with Fontan surgery473Long term functional and myocardial assessment of patients with critical aortic valve stenosis474Late gadolinium enhancement and exercise capacity in adults with Ebstein's anomaly475Exercise echocardiography value in the evaluation of operated aortic coarctation patients476Functional evolution of the right ventricle after pulmonary valve replacement due to significant regurgitation. Implications in the surgical moment decision477Independent predictors of arrhythmias in adult patients with surgically corrected tetralogy of fallot: role of two-dimensional and speckle-tracking echocardiography. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Enache R, Sawada N, Molina Ferragut L, Monney P, Jobbe Duval A, Peluso D, Beladan CC, Diego Bellavia DB, Popa E, Jurcut R, Badea R, Calin A, Beladan CC, Rosca M, Platon P, Coman IM, Popescu BA, Ginghina C, Kawata T, Daimon M, Kimura K, Nakao T, Chiang S, Mahara K, Okubo T, Yatomi Y, Komuro I, Uhl D, Gomez M, Ble M, Mas-Stachurska A, Cladellas M, Enjuanes C, Moliner P, Marti J, Comin J, Ehret G, Crisinel V, Reverdin S, Conti L, Mach F, Jeanrenaud X, Bochud M, Mueller H, Thebault O, Poilane M, Piriou N, Jaafar P, Warin-Fresse K, Serfaty JM, Cueff C, Le Tourneau T, Kovacs A, Surkova E, Muraru D, Perazzolo Marra M, Iliceto S, Badano LP, Predescu L, Platon P, Mateescu AD, Enache R, Calin A, Rosca M, Egher L, Inta O, Jurcut R, Ginghina C, Popescu BA, Attilio Iacovoni AI, Sonia Dell'oglio SD, Giuseppe Romano GR, Michele Senni MS, Chiara Mina' CM, Gabriele Di Gesaro GD, Michele Pilato MP, Fletcher Miller FAM, Cesare Scardulla CS, Francesco Clemenza FC, Joseph Maalouf JM, Michael Dandel MD. Moderated Posters: Imaging of the right heart - What is new?P814Prognostic value of parameters of pulmonary artery stiffness in patients with pulmonary hypertension receiving specific vasodilator therapyP815Reconsidering of inferior vena cava parameters for estimating right atrial pressure: a comparative simultaneous ultrasound-catheterization studyP816Pulmonary hypertension is the main factor echocardiography to predicting mortality in medium and long term in a cohort of patients with heart failureP817Normal values for 3D-right atrial volumes : results from the SKIPOGH-II population studyP818Assessment of right ventricular function by free wall longitudinal strain in organic mitral regurgitationP819Importance of radial dysfunction to determine the impairment of right ventricular ejection fraction in patients with pulmonary hypertensionP820Influence of tricuspid regurgitation severity on non-invasive assessment of right heart hemodynamics: a simultaneous echocardiography-catheterization studyP821Right ventricular failure following ventricular assist device implant: systematic review and meta-analysis of clinical and echocardiographic predictors. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Osto E, Planavila A, Huisamen B, Doytcheva P, Baechler T, Tarasco E, Pellegrini G, Matter C, Lutz T, Luescher T, Ruperez C, Lerin C, Mas-Stachurska A, Sitges M, Giralt M, Villarroya F, Van Vuuren M, Espach Y, Marais E, Lochner A. Obesity and Cardiac Microvascular Function496Roux-en-y gastric bypass surgery reverses obesity-induced vascular dysfunction by blunting jnk2-endothelial activation497Involvement of the Fgf21 system in obesity-associated cardiomyopathy498Is low ATM protein responsible for myocardial insulin resistance associated with obesity? Cardiovasc Res 2016. [DOI: 10.1093/cvr/cvw147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sanchis L, Montserrat S, Obach V, Cervera Á, Chamorro Á, Vidal B, Mas-Stachurska A, Bijnens B, Sitges M. Left Atrial Function Is Impaired in Some Patients With Stroke of Undetermined Etiology: Potential Implications for Evaluation and Therapy. ACTA ACUST UNITED AC 2016; 69:650-6. [PMID: 26949013 DOI: 10.1016/j.rec.2015.11.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 11/26/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION AND OBJECTIVES Stroke etiology remains undetermined in up to 30% of cases. Paroxysmal atrial fibrillation is found in 20% to 28% of patients with stroke initially classified as being of undetermined etiology. The aim of our study was to analyze left atrial function in ischemic stroke patients to identify patterns associated with cardioembolic etiology and to determine whether the patterns identified can be found in individuals initially classified as having a stroke of undetermined etiology. METHODS We studied a cohort of in-hospital ischemic stroke patients referred for transthoracic echocardiography. Treating neurologists determined stroke etiology based on the TOAST classification. Left atrial contractile function was assessed using 2-dimensional echocardiography to determine their ejection fraction and speckle tracking to measure left atrial strain rate: a-wave. Left atrial function was compared between stroke etiology subgroups and healthy controls. RESULTS Ninety-seven patients (aged 67±15 years) with ischemic stroke (16.5% large-artery atherosclerosis, 15.5% small-vessel occlusion, 11.3% cardioembolic, 5.1% other determined etiology, 51.1% undetermined etiology) and 10 healthy volunteers (aged 63±7 years) were included. Left atrial ejection fraction was significantly decreased only in patients with stroke of cardioembolic and undetermined etiology compared with the control group (31.5±17.2%, 40.2±17.1%, and 59.1±8.4%, respectively; P=.004). The left atrial strain rate was significantly lower in patients with stroke caused by cardioembolic or undetermined etiology, or large-artery atherosclerosis compared with controls (-0.86±0.49, -1.31±0.56, -1.5±0.47, -2.37±1.18, respectively; P<.001). CONCLUSIONS Patients with stroke of undetermined etiology with left atrial function (ejection fraction and strain) similar to that of cardioembolic stroke patients may be misclassified and could potentially benefit from prolonged electrocardiography monitoring. Left atrial function analysis (ejection fraction and strain) might help to identify potential cardioembolic sources in patients with stroke of undetermined etiology.
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Affiliation(s)
- Laura Sanchis
- Departamento de Cardiología, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Spain.
| | - Silvia Montserrat
- Departamento de Cardiología, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Spain
| | - Víctor Obach
- Departamento de Neurología, Hospital Clínic, Barcelona, Spain
| | - Álvaro Cervera
- Departamento de Neurología, Hospital Clínic, Barcelona, Spain
| | - Ángel Chamorro
- Departamento de Neurología, Hospital Clínic, Barcelona, Spain
| | - Bàrbara Vidal
- Departamento de Cardiología, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Spain
| | | | - Bart Bijnens
- ICREA-Universidad Pompeu Fabra, Barcelona, Spain
| | - Marta Sitges
- Departamento de Cardiología, Hospital Clínic, IDIBAPS, Universidad de Barcelona, Spain
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Redondo-Angulo I, Mas-Stachurska A, Sitges M, Giralt M, Villarroya F, Planavila A. C/EBPβ is required in pregnancy-induced cardiac hypertrophy. Int J Cardiol 2016; 202:819-28. [DOI: 10.1016/j.ijcard.2015.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 09/01/2015] [Accepted: 10/03/2015] [Indexed: 10/22/2022]
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Haland T, Neglia L, Mas-Stachurska A, Malanin D, Baruteau AE, Pontnau F, Capotosto L, Hristova K, Sevilla T, Wojtkowska A, Almaas VM, Hasselberg NE, Saberniak J, Leren IS, Hopp E, Edvardsen T, Haugaa KH, Piazza R, Doronzo A, Leonelli V, Morosin M, Leiballi E, Pecoraro R, Lutman C, Dragos A, Cassin M, Sitges M, Meirelles T, Hernandez V, Egea G, Bijnens B, Poggio D, Ferrazzi P, Spirito P, Specchia G, Grillo M, Amigoni P, Bersano C, Pisani M, Chioffi M, Hascoet S, Piot D, Lambert V, Petit J, Ladouceur M, Ferreira A, Iserin L, Mousseaux E, D'angeli I, Conde Y, Ashurov R, Miraldi F, Vitarelli A, Dasheva A, Marinov R, Lasarov S, Mitev I, Mitev P, Konstantinov G, Kaneva A, Katova TZ, Revilla-Orodea A, Uruena-Martinez N, Fuertes-Alija JJ, Rodriguez-Velasco M, Gomez-Salvador I, San Roman-Calvar JA, Tomaszewski A, Czekajska-Chehab E, Wysokinski A, Adamczyk P, Siek E, Zakoscielna M. Moderated Posters session: advanced echo techniques in congenital heart diseaseP526Systolic function by strain echocardiography is related to cardiac fibrosis and arrhythmias in hypertrophic cardiomyopathyP527Natural history of bicuspid aortic valve valvulo-aortopathy in affected patients followed in a single centerP528Postsystolic thickening as a likely sign of altered deformation due to pressure overload in a Marfan murine model.P529Strain rate echocardiography in patients with hypertrophic cardiomyopathy undergoing surgical myectomy.P530Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in childrenP531Aortic root dilatation and stiffness assessed by magnetic resonance imaging in adults with repaired tetralogy of FallotP532Assessment of biventricular and vascular function using three-dimensional speckle tracking echocardiography in adult patients with surgical repair of tetralogy of FallotP533A study of functional anatomy of aortic-mitral valve coupling using 3D echocardiography in patients with double orifice mitral valveP534Evaluation of bicuspid aortic valve and its repercussion in the left ventricle with cardiovascular magnetic resonanceP535Echocardiographic assessment of anomalous pulmonary venous connection. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mas-Stachurska A, Sitges M, Bosch X, Prat S, Robles R, Azqueta M, Perea RJ, De Caralt TM, Pare C, Ortiz-Perez JT. A randomized study of exercise echocardiography versus computed coronary angiography in the evaluation of acute chest pain. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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