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Pubblicazioni recenti - cardiac disease
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Trials and Tribulations: mHealth Clinical Trials in the COVID-19 Pandemic.
Yearb Med Inform2021 Apr;():. doi: 10.1055/s-0041-1726487.
Indraratna Praveen, Biswas Uzzal, Yu Jennifer, Schreier Guenter, Ooi Sze-Yuan, Lovell Nigel H, Redmond Stephen J,
Abstract
INTRODUCTION:
Mobile phone-based interventions in cardiovascular disease are growing in popularity. A randomised control trial (RCT) for a novel smartphone app-based model of care, named TeleClinical Care - Cardiac (TCC-Cardiac), commenced in February 2019, targeted at patients being discharged after care for an acute coronary syndrome or episode of decompensated heart failure. The app was paired to a digital sphygmomanometer, weighing scale and a wearable fitness band, all loaned to the patient, and allowed clinicians to respond to abnormal readings. The onset of the COVID-19 pandemic necessitated several modifications to the trial in order to protect participants from potential exposure to infection. The use of TCC-Cardiac during the pandemic inspired the development of a similar model of care (TCC-COVID), targeted at patients being managed at home with a diagnosis of COVID-19.
METHODS:
Recruitment for the TCC-Cardiac trial was terminated shortly after the World Health Organization announced COVID-19 as a global pandemic. Telephone follow-up was commenced, in order to protect patients from unnecessary exposure to hospital staff and patients. Equipment was returned or collected by a 'no-contact' method. The TCC-COVID app and model of care had similar functionality to the original TCC-Cardiac app. Participants were enrolled exclusively by remote methods. Oxygen saturation and pulse rate were measured by a pulse oximeter, and symptomatology measured by questionnaire. Measurement results were manually entered into the app and transmitted to an online server for medical staff to review.
RESULTS:
A total of 164 patients were involved in the TCC-Cardiac trial, with 102 patients involved after the onset of the pandemic. There were no hospitalisations due to COVID-19 in this cohort. The study was successfully completed, with only three participants lost to follow-up. During the pandemic, 5 of 49 (10%) of patients in the intervention arm were readmitted compared to 12 of 53 (23%) in the control arm. Also, in this period, 28 of 29 (97%) of all clinically significant alerts received by the monitoring team were managed successfully in the outpatient setting, avoiding hospitalisation. Patients found the user experience largely positive, with the average rating for the app being 4.56 out of 5. 26 patients have currently been enrolled for TCC-COVID. Recruitment is ongoing. All patients have been safely and effectively monitored, with no major adverse clinical events or technical malfunctions. Patient satisfaction has been high.
CONCLUSION:
The TCC-Cardiac RCT was successfully completed despite the challenges posed by COVID-19. Use of the app had an added benefit during the pandemic as participants could be monitored safely from home. The model of care inspired the development of an app with similar functionality designed for use with patients diagnosed with COVID-19.
IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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Music of the cosmos and the heart.
Eur Heart J2021 Apr;42(16):1538-1540. doi: 10.1093/eurheartj/ehaa539.
Tonia Lina, Stefanidis Alexandros, Mparmpatzas Nick, Popescu Bogdan A,
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Telemedicine for adult congenital heart disease patients during the first wave of COVID-19 era: a single center experience.
J Cardiovasc Med (Hagerstown)2021 Apr;():. doi: 10.2459/JCM.0000000000001195.
Grandinetti Maria, Di Molfetta Arianna, Graziani Francesca, Delogu Angelica Bibiana, Lillo Rosa, Perri Gianluigi, Pavone Natalia, Bruno Piergiorgio, Aspromonte Nadia, Amodeo Antonio, Crea Filippo, Massetti Massimo,
Abstract
AIM:
To summarize our experience on the implementation of a telemedicine service dedicated to adult congenital heart disease (ACHD) patients during the lockdown for the first wave of COVID-19.
METHODS:
This is a prospective study enrolling all ACHD patients who answered a questionnaire dedicated telematic cardiovascular examination.
RESULTS:
A total of 289 patients were enrolled, 133 (47%) were male, 25 (9%) were affected by a genetic syndrome. The median age was 38 (29-51) years, whereas the median time interval between the last visit and the telematic follow-up was 9.5 (7.5-11.5) months. Overall, 35 patients (12%) reported a worsening of fatigue in daily life activity, 17 (6%) experienced chest pain, 42 (15%) had presyncope and 2 (1%) syncope; in addition, 28 patients (10%) presented peripheral edema and 14 (5%) were orthopneic. A total of 116 (40%) patients reported palpitations and 12 had at least one episode of atrial fibrillation and underwent successful electrical (8) or pharmacological (4) cardioversion. One patient was admitted to the emergency department for uncontrolled arterial hypertension, five for chest pain, and one for heart failure. Two patients presented fever but both had negative COVID-19 nasal swab.
CONCLUSION:
During the COVID-19 pandemic, the use of telemedicine dramatically increased and here we report a positive experience in ACHD patients. The postpandemic role of telemedicine will depend on permanent regulatory solutions and this early study might encourage a more systematic telematic approach for ACHD patients.
Copyright © 2021 Italian Federation of Cardiology. All rights reserved.
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Italian Cardiological Guidelines (COCIS) for Competitive Sport Eligibility in athletes with heart disease: update 2020.
J Cardiovasc Med (Hagerstown)2021 Apr;():. doi: 10.2459/JCM.0000000000001186.
Delise Pietro, Mos Lucio, Sciarra Luigi, Basso Cristina, Biffi Alessandro, Cecchi Franco, Colivicchi Furio, Corrado Domenico, D'Andrea Antonello, Di Cesare Ernesto, Di Lenarda Andrea, Gervasi Salvatore, Giada Franco, Guiducci Vincenzo, Inama Giuseppe, Leoni Loira, Palamà Zefferino, Patrizi Giampiero, Pelliccia Antonio, Penco Maria, Robles Antonio Gianluca, Romano Silvio, Romeo Francesco, Sarto Patrizio, Sarubbi Berardo, Sinagra Gianfranco, Zeppilli Paolo,
Abstract
Since 1989, SIC Sport and a FMSI, in partnership with leading Italian Cardiological Scientific Associations (ANCE, ANMCO and SIC) have produced Cardiological Guidelines for Completive Sports Eligibility for athletes with heart disease (COCIS -- 1989, 1995, 2003, 2009 and 2017). The English version of the Italian Cardiological Guidelines for Competitive Sports Eligibility for athletes with heart disease was published in 2013 in this Journal. This publication is an update with respect to the document previously published in English in 2013. It includes the principal innovations that have emerged over recent years, and is divided into five main chapters: arrhythmias, ion channel disorders, congenital heart diseases, acquired valve diseases, cardiomyopathies, myocarditis and pericarditis and ischemic heart disease. Wherever no new data have been introduced with respect to the 2013 publication, please refer to the previous version. This document is intended to complement recent European and American guidelines but an important difference should be noted. The European and American guidelines indicate good practice for people engaging in physical activity at various levels, not only at the competitive level. In contrast, the COCIS guidelines refer specifically to competitive athletes in various sports including those with high cardiovascular stress. This explains why Italian guidelines are more restrictive than European and USA ones. COCIS guidelines address 'sports doctors' who, in Italy, must certify fitness to participate in competitive sports. In Italy, this certificate is essential for participating in any competition.
Copyright © 2021 Italian Federation of Cardiology. All rights reserved.
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The Impact of Expedited Discharge on 30-Day Readmission Following Lung Resection: A National Study.
Ann Thorac Surg2021 Apr;():. doi: S0003-4975(21)00701-3.
Tran Zachary, Chervu Nikhil, Williamson Catherine, Verma Arjun, Hadaya Joseph, Gandjian Matthew, Revels Sha'Shonda, Benharash Peyman,
Abstract
BACKGROUND:
Expedited discharge (within 24 hours) following lung resection has received scrutiny due to concerns for higher readmissions and paradoxically increased costs. The present study examined the impact of expedited discharge on hospitalization costs and unplanned readmissions using a nationally-representative sample. In addition, we sought to determine inter-hospital practice variation.
METHODS:
Adults undergoing elective lobar or sublobar resection were identified using the 2016-2018 Nationwide Readmissions Database, while those with postoperative duration of hospitalization >5 days or experienced any perioperative complication, were excluded. Patients were classified as Expedited if postoperative hospitalization was 0 or 1 day and otherwise as Routine. Inverse probability of treatment weighing was utilized to adjust for intergroup differences. Hospitals were ranked according to risk-adjusted early discharge rates. Multivariable regression models were developed to assess the association of expedited discharge on nonelective 30-day readmissions as well as associated mortality and costs.
RESULTS:
Of an estimated 84,152 patients, 13,834 (16.4%) comprised the Expedited group. Compared to Routine, Expedited were younger, less likely to have chronic obstructive pulmonary disease and undergo open procedures. Following adjustment, early discharge was associated with lower incremental costs (? coefficient: -$3.6K, 95%CI: -4.4 - -2.8) as well as similar readmissions (odds ratio: 0.89, 95%CI: 0.70 - 1.13) and related-mortality. Nearly half (48.1%) of all hospitals performed zero early discharges.
CONCLUSIONS:
Expedited discharge following lung resection is a feasible management strategy and is associated with decreased costs and similar readmission risk compared to the norm. Select individuals should be strongly considered for expedited discharge following lung resection.
Copyright © 2021. Published by Elsevier Inc.
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Surgical and percutaneous management of aboriginal Australians with rheumatic heart disease: Timeliness and concordance between practice and guidelines.
Int J Cardiol2021 Apr;():. doi: S0167-5273(21)00666-5.
Roberts-Thomson Ross L, Baumann Angus, Reade Julie, Culgan Libby, Kaethner Alex, Ilton Marcus, Kangaharan Nadarajah, Tayeb Hussam, Sinhal Ajay, Chew Derek, Bennetts Jayme, Nicholls Stephen J, Psaltis Peter J, Brown Alex,
Abstract
BACKGROUND:
Rheumatic heart disease (RHD) affects over 40 million people globally who are predominantly young and from impoverished communities. The barriers to valvular intervention are complex and contribute to the high morbidity and mortality associated with RHD. The rates of guideline indicated intervention in patients with significant RHD have not yet been reported.
METHODS:
From 2007 to 2017, we used the Australian Northern Territory Cardiac Database to identify patients with RHD who fulfilled at least one ESC/EACTS guideline indication for mitral valve intervention. Baseline clinical status, comorbidities, echocardiographic parameters, indication for intervention, referral and any interventions were recorded.
RESULTS:
154 patients (mean age 38.5 ± 14.6, 66.1% female) were identified as having a class I or IIa indication for invasive management. Symptoms, atrial fibrillation and pulmonary hypertension were the most common indications for surgery (74.5%, 48.1%, 40.9%). From the onset of a guideline indication the actuarial rates of accepted referral and intervention within two-years were 66.0%?±?4.0% and 53.1%?±?4.4% respectively. Of those who were referred and accepted for intervention, 86% received it within 2?years. The rates of accepted referral for patients with class I indications were 72.5% ± 4.2% while class IIa indications were 42.5% ± 9.0% (p?
CONCLUSIONS:
Approximately half of Aboriginal patients with significant rheumatic mitral valve disease who met ESC/EACTS guideline indications for intervention received surgery or valvuloplasty within two-years. A significant difference in referral rates was found between Class I and Class IIa indications for valvular intervention.
Copyright © 2021. Published by Elsevier B.V.
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Multivalent Aptamer-Functionalized Single-Strand RNA Origami as Effective, Target-Specific Anticoagulants with Corresponding Reversal Agents.
Adv Healthc Mater2021 Apr;():e2001826. doi: 10.1002/adhm.202001826.
Krissanaprasit Abhichart, Key Carson M, Froehlich Kristen, Pontula Sahil, Mihalko Emily, Dupont Daniel M, Andersen Ebbe S, Kjems Jørgen, Brown Ashley C, LaBean Thomas H,
Abstract
Anticoagulants are commonly utilized during surgeries and to treat thrombotic diseases like stroke and deep vein thrombosis. However, conventional anticoagulants have serious side-effects, narrow therapeutic windows, and lack safe reversal agents (antidotes). Here, an alternative RNA origami displaying RNA aptamers as target-specific anticoagulant is described. Improved design and construction techniques for self-folding, single-molecule RNA origami as a platform for displaying pre-selected RNA aptamers with precise orientational and spatial control are reported. Nuclease resistance is added using 2'-fluoro-modified pyrimidines during in vitro transcription. When four aptamers are displayed on the RNA origami platform, the measured thrombin inhibition and anticoagulation activity is higher than observed for free aptamers, ssRNA-linked RNA aptamers, and RNA origami displaying fewer aptamers. Importantly, thrombin inhibition is immediately switched off by addition of specific reversal agents. Results for single-stranded DNA (ssDNA) and single-stranded peptide nucleic acid (PNA) antidotes show restoration of 63% and 95% coagulation activity, respectively. To demonstrate potential for practical, long-term storage for clinical use, RNA origami is freeze-dried, and stored at room temperature. Freshly produced and freeze-dried RNA show identical levels of activity in coagulation assays. Compared to current commercial intravenous anticoagulants, RNA origami-based molecules show promise as safer alternatives with rapid activity switching for future therapeutic applications.
© 2021 Wiley-VCH GmbH.
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Editorial overview: Microtubules in nervous system development.
Dev Neurobiol2021 Apr;81(3):229-230. doi: 10.1002/dneu.22817.
Bradke Frank, Roll-Mecak Antonina,
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Six-month Risk of Pneumocystis Pneumonia following Acute Cellular Rejection: A case-control Study in Solid Organ Transplant Recipients.
Clin Transplant2021 Apr;():e14322. doi: 10.1111/ctr.14322.
Hosseini-Moghaddam Seyed M, Shokoohi Mostafa, Singh Gagandeep, Nagpal Atul D, Jevnikar Anthony M,
Abstract
BACKGROUND:
Solid organ transplant (SOT) recipients are at risk of Pneumocystis pneumonia (PCP). PCP is associated with significant morbidity and mortality. The effect of acute T cell-mediated rejection (TCMR) on post-transplant PCP has not been determined yet.
METHODS:
In this case-control study, we estimated the risk of PCP following acute TCMR during a lookback period of 180 days. We also determined the effects of contributing factors such as CMV infection.
RESULTS:
We compared 15 SOT (8 kidney, 4 heart, 2 liver and 1 kidney-pancreas) recipients with PCP with 60 matched recipients who did not develop PCP (control group) during the study period (December 2013 to February 2016). PCP occurred after a complete course of prophylaxis (i.e., late-onset PCP) in 60% of patients. Patients with PCP frequently required intensive care unit (ICU) admission (73.3%). Post-transplant PCP was associated with considerable allograft loss (53.4%) and mortality (26.7%). In the 6-month lookback period, acute TCMR (OR: 13.1, 95% CI: 3.2, 53.2) and CMV infection (OR:15.1,95% CI:4.0, 53.2.1) were significantly associated with post-transplant PCP.
CONCLUSIONS:
Post-transplant PCP is associated with substantial risk of ICU admission, allograft failure and mortality. Anti-Pneumocystis prophylaxis for at least 6 months following acute TCMR may reduce the risk.
This article is protected by copyright. All rights reserved.
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Cause of death during prostate cancer survivorship: A contemporary, US population-based analysis.
Cancer2021 Apr;():. doi: 10.1002/cncr.33584.
Weiner Adam B, Li Eric V, Desai Anuj S, Press David J, Schaeffer Edward M,
Abstract
BACKGROUND:
More than 3.6 million men in the United States harbor a diagnosis of prostate cancer (PCa). The authors sought to provide in-depth analyses of the causes of death for contemporary survivors.
METHODS:
The authors performed a population-based cohort study in the United States (2000-2016) to assess causes of death for men diagnosed with PCa stratified by demographics and tumor stage. Using general population data, they calculated standardized mortality ratios (SMRs) as observed-to-expected death ratios.
RESULTS:
In total, 752,092 men with PCa, including 200,302 who died (27%), were assessed. A total of 29,048 men with local/regional disease (17%) died of PCa, whereas more than 4-fold men died of other causes (n = 143,719 [83%]). SMRs for death from noncancer causes (0.77; 95% confidence interval [CI], 0.77-0.78) suggested that these men were less likely than the general population to die of most other causes. The most common noncancer cause of death was cardiac-related (23%; SMR, 0.76; 95% CI, 0.75-0.77). Among men with distant PCa, 90% of deaths occurred within 5 years of diagnosis. Although deaths due to PCa composed the majority of deaths (74%), SMRs suggested that men with distant PCa were at heightened risk for death from most other noncancer causes (1.50; 95% CI, 1.46-1.54) and, in particular, for cardiac-related death (SMR, 1.48; 95% CI, 1.41-1.54) and suicide (SMR, 2.32; 95% CI, 1.78-2.96). Further analyses demonstrated that causes of death varied by patient demographics.
CONCLUSIONS:
Causes of death during PCa survivorship vary by patient and tumor characteristics. These data provide valuable information regarding health care prioritization during PCa survivorship.
LAY SUMMARY:
Men with early-stage prostate cancer are 4-fold more likely to die of other causes, whereas those with advanced prostate cancer are at increased risk for several causes not related to prostate cancer in comparison with the general population. These findings can help guide physicians taking care of men with a diagnosis of prostate cancer.
© 2021 American Cancer Society.
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Effectiveness and cardiac safety of bedaquiline-based therapy for drug-resistant tuberculosis: a prospective cohort study.
Clin Infect Dis2021 Apr;():. doi: ciab335.
Brust James C M, Gandhi Neel R, Wasserman Sean, Maartens Gary, Omar Shaheed V, Ismail Nazir A, Campbell Angela, Joseph Lindsay, Hahn Alexandria, Allana Salim, Hernandez-Romieu Alfonso C, Zhang Chenshu, Mlisana Koleka, Viljoen Charle A, Zalta Benjamin, Ebrahim Ismaeel, Franczek Meghan, Master Iqbal, Ramangoaela Limpho, Te Riele Julian, Meintjes Graeme, ,
Abstract
BACKGROUND:
Bedaquiline improves treatment outcomes in patients with rifampin-resistant TB (RR-TB) but prolongs the QT-interval and carries a black-box warning by the U.S. Food and Drug Administration. The World Health Organization recommends that all patients with RR-TB receive a regimen containing bedaquiline, yet a phase 3 clinical trial demonstrating its cardiac safety has not been published.
METHODS:
We conducted an observational cohort study of RR-TB patients from 3 provinces in South Africa who received regimens containing bedaquiline. We performed rigorous cardiac monitoring, including electrocardiograms (ECGs) performed in triplicate at four time points during bedaquiline therapy. Participants were followed until the end of therapy or 24 months. Outcomes included final tuberculosis treatment outcome and QT-prolongation, defined as any QTcF>500 ms or an absolute change from baseline (? QTcF) >60 ms.
RESULTS:
We enrolled 195 eligible participants, of whom 40% had extensively drug-resistant (XDR) TB. Most participants (97%) received concurrent clofazimine. 74% of participants were cured or successfully completed treatment, and outcomes did not differ by HIV status. QTcF continued to increase throughout bedaquiline therapy, with a mean increase of 23.7 (SD 22.7) ms from baseline to month 6. Four participants experienced a QTcF>500 ms and 19 experienced a ?QTcF>60 ms. Older age was independently associated with QT-prolongation. QT-prolongation was neither more common nor severe in participants receiving concurrent lopinavir-ritonavir.
CONCLUSIONS:
Severe QT-prolongation was uncommon and did not require permanent discontinuation of either bedaquiline or clofazimine. Close QT-monitoring may be advisable in older patients.
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.
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Emerging role of non-coding RNA in health and disease.
Metab Brain Dis2021 Apr;():. doi: 10.1007/s11011-021-00739-y.
Bhatti Gurjit Kaur, Khullar Naina, Sidhu Inderpal Singh, Navik Uma Shanker, Reddy Arubala P, Reddy P Hemachandra, Bhatti Jasvinder Singh,
Abstract
Human diseases have always been a significant turf of concern since the origin of mankind. It is cardinal to know the cause, treatment, and cure for every disease condition. With the advent and advancement in technology, the molecular arena at the microscopic level to study the mechanism, progression, and therapy is more rational and authentic pave than a macroscopic approach. Non-coding RNAs (ncRNAs) have now emerged as indispensable players in the diagnosis, development, and therapeutics of every abnormality concerning physiology, pathology, genetics, epigenetics, oncology, and developmental diseases. This is a comprehensive attempt to collate all the existing and proven strategies, techniques, mechanisms of genetic disorders including Silver Russell Syndrome, Fascio- scapula humeral muscular dystrophy, cardiovascular diseases (atherosclerosis, cardiac fibrosis, hypertension, etc.), neurodegenerative diseases (Spino-cerebral ataxia type 7, Spino-cerebral ataxia type 8, Spinal muscular atrophy, Opitz-Kaveggia syndrome, etc.) cancers (cervix, breast, lung cancer, etc.), and infectious diseases (viral) studied so far. This article encompasses discovery, biogenesis, classification, and evolutionary prospects of the existence of this junk RNA along with the integrated networks involving chromatin remodelling, dosage compensation, genome imprinting, splicing regulation, post-translational regulation and proteomics. In conclusion, all the major human diseases are discussed with a facilitated technology transfer, advancements, loopholes, and tentative future research prospects have also been proposed.
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Comparison of annual eGFR decline among primary kidney diseases in patients with CKD G3b-5: results from a REACH-J CKD cohort study.
Clin Exp Nephrol2021 Apr;():. doi: 10.1007/s10157-021-02059-y.
Hoshino Junichi, Tsunoda Ryoya, Nagai Kei, Kai Hirayasu, Saito Chie, Ito Yukiko, Asahi Koichi, Kondo Masahide, Iseki Kunitoshi, Iseki Chiho, Okada Hirokazu, Kashihara Naoki, Narita Ichiei, Wada Takashi, Combe Christian, Pisoni Ronald L, Robinson Bruce M, Yamagata Kunihiro,
Abstract
BACKGROUND:
Disease-specific trajectories of renal function in advanced chronic kidney disease (CKD) are not well defined. Here, we compared these trajectories in the estimated glomerular filtration rate (eGFR) by CKD stages.
METHODS:
Patients with multiple eGFR measurements during the 5-year preregistration period of the REACH-J study were enrolled. Mean annual eGFR declines were calculated from linear mixed effect models with the adjustment variables of baseline CKD stage, age, sex and the current CKD stage and the level of proteinuria (CKDA1-3).
RESULTS:
Among 1,969 eligible patients with CKDG3b-5, the adjusted eGFR decline (ml/min/1.73 m/year) was significantly faster in diabetic kidney disease (DKD) patients and polycystic kidney disease (PKD) patients than in patients with other kidney diseases (DKD, - 2.96?±?0.13; PKD, - 2.82?±?0.17; and others, - 1.95?±?0.05, p?
CONCLUSION:
Our study revealed the disease-specific annual eGFR declines by CKD stages and the level of proteinuria. Comparing to the other kidney diseases, the declines in PKD patients were getting faster from early stages of CKD. These results suggest the importance of CKD managements in PKD patients from the early stages.
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Integrating Measures of Myocardial Fibrosis in the Transition from Hypertensive Heart Disease to Heart Failure.
Curr Hypertens Rep2021 Apr;23(4):22. doi: 10.1007/s11906-021-01135-8.
Stacey R Brandon, Hundley W Gregory,
Abstract
PURPOSE OF REVIEW:
This review aims to summarize recent developments in identifying and quantifying both the presence and amount of myocardial fibrosis by imaging and biomarkers. Further, this review seeks to describe in general ways how this information may be used to identify hypertension and the transition to heart failure with preserved ejection fraction.
RECENT FINDINGS:
Recent studies using cardiac magnetic resonance imaging highlight the progressive nature of fibrosis from normal individuals to those with hypertension to those with clinical heart failure. However, separating hypertensive patients from those with heart failure remains challenging. Recent studies involving echocardiography show the subclinical myocardial strain changes between hypertensive heart disease and heart failure. Lastly, recent studies highlight the potential use of biomarkers to identify those with hypertension at the greatest risk of developing heart failure. In light of the heterogeneous nature between hypertension and heart failure with preserved ejection fraction, an integrated approach with cardiac imaging and biomarker analysis may enable clinicians and investigators to more accurately characterize, prevent, and treat heart failure in those with hypertension.
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Retraction: Development of functional hydrogels for heart failure.
J Mater Chem B2021 Apr;9(15):3412. doi: 10.1039/d1tb90051j.
Han Yanxin, Yang Wengbo,
Abstract
Retraction for 'Development of functional hydrogels for heart failure' by Yanxin Han et al., J. Mater. Chem. B, 2019, 7, 1563-1580, DOI: .
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Liver circadian clock disruption alters perivascular adipose tissue gene expression and aortic function in mice.
Am J Physiol Regul Integr Comp Physiol2021 Apr;():. doi: 10.1152/ajpregu.00128.2020.
Pati Paramita, Valcin Jennifer A, Zhang Dingguo, Neder Thomas H, Millender-Swain Telisha, Allan John Miller, Sedaka Randee S, Jin Chunhua, Becker Bryan K, Pollock David M, Bailey Shannon M, Pollock Jennifer S,
Abstract
The liver plays a central role that influences cardiovascular disease outcomes through regulation of glucose and lipid metabolism. It is recognized that the local liver molecular clock regulates some liver-derived metabolites. However, it is unknown whether the liver clock may impact cardiovascular function. Perivascular adipose tissue (PVAT) is a specialized type of adipose tissue surrounding blood vessels. Importantly, crosstalk between the endothelium and PVAT via vasoactive factors is critical for vascular function. Therefore, we designed studies to test the hypothesis that cardiovascular function, including PVAT function, is impaired in mice with liver-specific circadian clock disruption. Bmal1 is a core circadian clock gene, thus studies were undertaken in male hepatocyte-specific Bmal1 knockout (HBK) mice and littermate controls (i.e., flox mice). HBK mice showed significantly elevated plasma levels of ?-hydroxybutyrate, non-esterified fatty acids/free fatty acids, triglycerides and insulin-like growth factor 1 compared to flox mice. Thoracic aorta PVAT in HBK mice had increased mRNA expression of several key regulatory and metabolic genes, Ppargc1a, Pparg, Adipoq, Lpl and Ucp1, suggesting altered PVAT energy metabolism and thermogenesis. Sensitivity to acetylcholine-induced vasorelaxation was significantly decreased in aortae of HBK mice with PVAT attached compared to aortae of HBK mice with PVAT removed, however, aortic vasorelaxation in flox mice showed no differences with or without attached PVAT. HBK mice had a significantly lower systolic blood pressure during the inactive period of the day. These new findings establish a novel role of the liver circadian clock in regulating PVAT metabolic gene expression and PVAT-mediated aortic vascular function.
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Cardioprotective effects of transplanted adipose-derived stem cells under Ang II stress with Danggui administration augments cardiac function through upregulation of insulin-like growth factor 1 receptor in late-stage hypertension rats.
Environ Toxicol2021 Apr;():. doi: 10.1002/tox.23145.
Barik Parthasarathi, Shibu Marthandam Asokan, Hsieh Dennis Jine-Yuan, Day Cecilia Hsuan, Chen Ray-Jade, Kuo Wei-Wen, Chang Yung-Ming, Padma V Vijaya, Ho Tsung-Jung, Huang Chih-Yang,
Abstract
In aging hypertensive conditions, deterioration of insulin-like growth factor 1 receptor (IGF1R) cause a pathological impact on hypertensive hearts with an increased Ang II level. Recovering these adverse conditions through transplanted adipose-derived stem cells is a challenging approach. Moreover, Danggui, a Traditional Chinese medicine (TCM), is used for the treatment of cardioprotective effects. In this study, to evaluate whether the combined effect of MSCs and TCM can recover the cardiac function in late-stage hypertension rats. We observed that lower dose of Danggui crude extract treatment showed an increased level of cell viability with maintained stemness properties and growth rate in rat adipose-derived stem cells (rADSCs). Further, we cocultured the H9c2 cells with rADSCs and the results revealed that Danggui-treated MSCs enhanced the IGF1R expression and attenuated the hypertrophy in H9c2 cells against Ang II challenge by immunoblot and rhodamine-phalloidin staining. In addition, Danggui crude extract was also quantified and characterized by HPLC and LC-MS analysis. Furthermore, the in vivo study was performed by considering 11?months old rats (n = 7). Importantly, the oral administration of Danggui crude extract with stem cells intravenous injection in SHR-D-ADSCs group showed a combination effect to augment the cardiac function through enhancement of ejection fraction, fractional shortening, contractility function in the late-stage hypertension conditions. We have also observed a decreased apoptosis rate in the heart tissue of SHR-D-ADSCs group. Taken together, these results indicate that the combinatorial effects of Danggui crude extract and stem cell therapy enhanced cardiac function in late-stage SHR rats.
© 2021 Wiley Periodicals LLC.
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Urinary peptides in heart failure: a link to molecular pathophysiology.
Eur J Heart Fail2021 Apr;():. doi: 10.1002/ejhf.2195.
He Tianlin, Mischak Michaela, Clark Andrew L, Campbell Ross T, Delles Christian, Díez Javier, Filipatos Gerasimos, Mebazaa Alexandre, McMurray John J V, González Arantxa, Raad Julia, Stroggilos Rafael, Bosselmann Helle S, Campbell Archie, Kerr Shona, Jackson Colette E, Cannon Jane A, Schou Morten, Girerd Nicolas, Rossignol Patrick, McConnachie Alex, Rossing Kasper, Schanstra Joost P, Zannad Faiez, Vlahou Antonia, Mullen William, Jankowski Vera, Mischak Harald, Zhang Zhenyu, Staessen Jan A, Latosinska Agnieszka,
Abstract
AIMS:
Heart failure (HF) is a major public health concern worldwide. The diversity of HF makes it challenging to decipher the underlying complex pathological processes using single biomarkers. We examined the association between urinary peptides and HF with reduced (HFrEF), mid-range (HFmrEF) and preserved (HFpEF) ejection fraction, defined based on European Society of Cardiology guidelines, and the links between these peptide biomarkers and molecular pathophysiology.
METHODS AND RESULTS:
Analysable data from 5,608 participants were available in the Human Urinary Proteome database. The urinary peptide profiles from participants diagnosed with HFrEF, HFmrEF, HFpEF and controls matched for sex, age, estimated glomerular filtration rate, systolic and diastolic blood pressure, diabetes and hypertension were compared applying the Mann Whitney test, followed by correction for multiple testing. Unsupervised learning algorithms were applied to investigate groups of similar urinary profiles. 577 urinary peptides significantly associated with HF were sequenced, 447 of which (77%) were collagen fragments. In silico analysis suggested that urinary biomarker abnormalities in HF principally reflect changes in collagen turnover and immune response, both associated with fibrosis. Unsupervised clustering separated study participants into two clusters, with 83% of non-HF controls allocated to cluster 1, while 65% of patients with HF were allocated to cluster 2 (p<0.0001). No separation based on HF subtype was detectable.
CONCLUSIONS:
HF, irrespective of ejection fraction subtype, was associated with differences in abundance of urinary peptides reflecting collagen turnover and inflammation. These peptides should be studied as tools in early detection, prognostication, and prediction of therapeutic response.
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MOVAS Cells: A Versatile Cell Line for Studying Vascular Smooth Muscle Cell Cholesterol Metabolism.
Lipids2021 Apr;():. doi: 10.1002/lipd.12303.
Esobi Ikechukwu Collins, Barksdale Christian, Heard-Tate Caterra, Reigers Powell Rhonda, Bruce Terri F, Stamatikos Alexis,
Abstract
Cholesterol metabolism is paramount to cells. Aberrations to cholesterol metabolism affects cholesterol homeostasis, which may impact the risk of several diseases. Recent evidence has suggested that vascular smooth muscle cell (VSMC) cholesterol metabolism may play a role in atherosclerosis. However, there is scant in vitro mechanistic data involving primary VSMC that directly tests how VSMC cholesterol metabolism may impact atherosclerosis. One reason for this lack of data is due to the impracticality of gene manipulation studies in primary VSMC, as cultured primary VSMC become senescent and lose their morphology rapidly. However, there are no immortalized VSMC lines known to be suitable for studying VSMC cholesterol metabolism. The purpose of this study was to determine whether MOVAS cells, a commercially available VSMC line, are suitable to use for studying VSMC cholesterol metabolism. Using immunoblotting and immunofluorescence, we showed that MOVAS cells express ABCA1, ABCG1, and SREBP-2. We also determined that MOVAS cells efflux cholesterol to apoAI and HDL, which indicates functionality of ABCA1/ABCG1. In serum-starved MOVAS cells, SREBP-2 target gene expression was increased, confirming SREBP-2 functionality. We detected miR-33a expression in MOVAS cells and determined this microRNA can silence ABCA1 and ABCG1 via identifying conserved miR-33a binding sites within ABCA1/ABCG1 3'UTR in MOVAS cells. We showed that cholesterol-loading MOVAS cells results in this cell line to transdifferentiate into a macrophage-like cell, which also occurs when VSMC accumulate cholesterol. Our characterization of MOVAS cells sufficiently demonstrates that they are suitable to use for studying VSMC cholesterol metabolism in the context of atherosclerosis.
© 2021 AOCS.
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Major cardiovascular events at 5 years in surgical versus percutaneous revascularization for left main stem disease: an updated meta-analysis.
Interact Cardiovasc Thorac Surg2021 Apr;32(4):530-536. doi: 10.1093/icvts/ivaa301.
Urso Stefano, Sadaba Rafel, Nogales Eliú, González Jesús María, Tena María Ángeles, Paredes Federico, González-Barbeito Miguel, Portela Francisco,
Abstract
The aim of the present study was to analyse the incidence of major adverse cardiovascular events in patients undergoing either coronary artery bypass grafting (CABG) or percutaneous coronary intervention with drug-eluting stents for left main stem disease. Five manuscripts publishing 5-year results of 4 trials (SYNTAX, PRECOMBAT, NOBLE and EXCEL) were included. Overall meta-analysis with inclusion of the 5-year results from the EXCEL trial using the protocol definition for myocardial infarction showed that CABG is associated with a significant reduction in the risk of major adverse cardiovascular events (MACE) (risk ratio = 0.74; 95% confidence interval?=?0.68-0.80). When the universal definition was used to define myocardial infarction in the EXCEL trial, the analysis demonstrated a larger benefit of coronary surgery in terms of reduction in the risk of MACE (risk ratio?=?0.70; 95% confidence interval?=?0.63-0.76). Non-significant differences were detected in terms of risk of overall mortality, cardiac mortality or stroke. In conclusion, this meta-analysis shows that CABG significantly reduces the risk of MACE in patients with left main stem disease. The inclusion of the 5-year results of the EXCEL trial using third universal definition amplifies the benefit of CABG over percutaneous coronary intervention.
© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
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