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Pubblicazioni recenti - cardiac hypertrophy
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Effects of chronic intermittent hypoxia on left cardiac function in young and aged mice.
Am J Physiol Regul Integr Comp Physiol2022 Jan;():. doi: 10.1152/ajpregu.00256.2021.
Wei Qin, Xu Xuan, Chen Long, Wang Tao, Xie Liang, Yu Fu-Chao, Song Si-Fan, Sheng Zhi-Qiang, Tong Jia-Yi,
Abstract
Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular disease that is characterized by chronic intermittent hypoxia (CIH), and its impact is related to age. This study aims to assess the age-related impact of CIH on cardiac function and to further explore the mechanism. After 8 weeks of severe CIH exposure, the hearts of young mice showed slight physiological hypertrophy, decreased diastolic function, and collagen I accumulation but no obvious change in contractile function. However, the contractile function of the hearts of aged mice was severely decreased. CIH exposure promoted the fragmentation of mitochondria in the hearts of aged mice and decreased the mitochondrial membrane potential of cardiomyocytes, but these effects were not observed in young mice exposed to the same conditions. CIH induced significant decreases in basal respiration, maximum respiration and ATP production in cardiac mitochondria of aged mice compared to those of young mice. The assessment of mitochondrial-related proteins showed that young mouse hearts had upregulated adaptive nuclear respiratory factors (Nrf)1/2 sirtuin (SIRT)1/3 and transcription factor A (TFAM) expression that stabilized mitochondrial function in response to CIH exposure. Aged mouse hearts exhibited maladaptation to CIH exposure, and downregulation of SIRT1 and TFAM expression resulted in mitochondrial dysfunction.
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Imaging assessment of the right atrium: anatomy and function.
Eur Heart J Cardiovasc Imaging2022 Jan;():. doi: jeac011.
Lang Roberto M, Cameli Matteo, Sade Leila E, Faletra Francesco F, Fortuni Federico, Rossi Alexia, Soulat-Dufour Laurie,
Abstract
The right atrium (RA) is the cardiac chamber that has been least well studied. Due to recent advances in interventional cardiology, the need for greater understanding of the RA anatomy and physiology has garnered significant attention. In this article, we review how a comprehensive assessment of RA dimensions and function using either echocardiography, cardiac computed tomography, and magnetic resonance imaging may be used as a first step towards a better understanding of RA pathophysiology. The recently published normative data on RA size and function will likely shed light on RA atrial remodelling in atrial fibrillation (AF), which is a complex phenomenon that occurs in both atria but has only been studied in depth in the left atrium. Changes in RA structure and function have prognostic implications in pulmonary hypertension (PH), where the increased right ventricular (RV) afterload first induces RV remodelling, predominantly characterized by hypertrophy. As PH progresses, RV dysfunction and dilatation may begin and eventually lead to RV failure. Thereafter, RV overload and increased RV stiffness may lead to a proportional increase in RA pressure. This manuscript provides an in-depth review of RA anatomy, function, and haemodynamics with particular emphasis on the changes in structure and function that occur in AF, tricuspid regurgitation, and PH.
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2022. For permissions, please email: journals.permissions@oup.com.
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[Left ventricular hypertrophy in hemodialysis patient: Prevalence, electrocardiographic, echocardiographic study and associated risk factors].
Nephrol Ther2022 Jan;():. doi: S1769-7255(21)00543-5.
Chargui Soumaya, Allouche Emna, Dkhil Wiem, Agrebi Sahar, Ben Ahmed Habib, Ezzaouia Khaled, Hajji Mariem, Ezzamouri Asma, Basdah Leila, Ben Hamida Fethi, Harzallah Amel, Abderrahim Ezzeddine,
Abstract
BACKGROUND:
Left ventricular hypertrophy is the most prevalent cardiac abnormality in hemodialysis patients. The diagnosis of this abnormality is possible by electrocardiogram and/or echocardiography. Our study aimed to assess the prevalence of left ventricular hypertrophy in hemodialysis patients and the accuracy of different electrocardiographic criteria.
METHODS:
This was a cross-sectional retrospective study including 60 hemodialysis patients between 2017 and 2018. A left ventricular mass index higher than 115g/m and 95g/m respectively in men and women defines echocardiographic left ventricular hypertrophy. We assessed left ventricular hypertrophy prevalence, sensitivity, specificity, and area under the receiver-operating characteristics (ROC) curve of fourteen different electrocardiographic criteria for identification of left ventricular hypertrophy.
RESULTS:
This was a cohort of 60 patients composed of 27 men and 33 women with a mean age 52.6±15,8years. Hypertension was the most common cardiovascular risk factor (82 %). The prevalence of left ventricular hypertrophy at echography was 65 %. Prevalence of left ventricular hypertrophy at electrocardiographic varied across the different criteria ranging from 5 % (R wave in DI) to 32 % (Perugia score). The highest left ventricular hypertrophy prevalence at electrocardiographic was found with the five following criteria: Perugia score (32 %), Peguero-Lo Presti index (28 %), Sokolow-Lyon index, Cornell index, Framingham-adjusted Cornell voltage (17 %). Sensitivity was ranged from 5 % (R in DI, Gubner-Ungerleider index, and product) to 41 % (Perugia score). The specificity of most criteria was ?90 % except for the Perugia score (85 %). The sensitivity, specificity, postitive and negative productive values and left ventricular hypertrophy prevalence using the five most accurate criteria combined were respectively 48, 90, 70.28, 77.85 and 33 %. Hypertension, duration of HD, arteriovenous fistula, interdialytic weight gain, systolic blood pressure, hemoglobin
CONCLUSION:
The prevalence of left ventricular hypertrophy detected by echocardiography was high. All electrocardiographic criteria had a low sensibility and a high specificity in the diagnostic of echocardiographic left ventricular hypertrophy. To improve the accuracy of electrocardiographic criteria, it is necessary to combine several electrocardiographic criteria and not often focused on a single classic electrocardiographic index.
Copyright © 2021. Published by Elsevier Masson SAS.
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Interplay between mineral bone disorder and cardiac damage in acute kidney injury: from Ca mishandling and preventive role of Klotho in mice to its potential mortality prediction in human.
Transl Res2022 Jan;():. doi: S1931-5244(22)00002-0.
González-Lafuente Laura, Navarro-García José Alberto, Rodríguez-Sánchez Elena, Aceves-Ripoll Jennifer, Poveda Jonay, Vázquez-Sánchez Sara, Mercado-García Elisa, Fernández-Velasco María, Kuro-O Makoto, Liaño Fernando, Ruilope Luis M, Ruiz-Hurtado Gema,
Abstract
Biomarkers of mineral bone disorders (MBD) including phosphorus, fibroblast growth factor (FGF)-23 and Klotho are strongly altered in patients with acute kidney injury (AKI) who have high cardiac outcomes and mortality rates. However, the crosslink between MBD and cardiac damage after an AKI episode still remains unclear. We tested MBD and cardiac biomarkers in an experimental AKI model after 24 or 72 hours of folic acid injection and we analyzed structural cardiac remodeling, intracellular calcium (Ca) dynamics in cardiomyocytes and cardiac rhythm. AKI mice presented high levels of FGF-23, phosphorus and cardiac troponin T (cTnT) and exhibited a cardiac hypertrophy phenotype accompanied by an increase in systolic Ca release 24 hours after AKI. Ca transients and contractile dysfunction were reduced 72 hours after AKI while diastolic sarcoplasmic reticulum Ca leak, pro-arrhythmogenic Ca events and ventricular arrhythmias were increased. These cardiac events were linked to the activation of the calcium/calmodulin-dependent kinase II pathway through the increased phosphorylation of ryanodine receptors and phospholamban specific sites after AKI. Cardiac hypertrophy and the altered intracellular Ca dynamics were prevented in transgenic mice overexpressing Klotho after AKI induction. In a translational retrospective longitudinal clinical study, we determined that combining FGF-23 and phosphorus with cTnT levels achieved a better prediction of mortality in AKI patients at hospital admission. Thus, monitoring MBD and cardiac damage biomarkers could be crucial to prevent mortality in AKI patients. In this setting, Klotho might be considered as a new cardioprotective therapeutic tool to prevent deleterious cardiac events in AKI conditions.
Copyright © 2022. Published by Elsevier Inc.
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Beta-arrestins in the context of cardiovascular diseases: Focusing on type 1 angiotensin II receptor (AT1R).
Cell Signal2022 Jan;():110253. doi: S0898-6568(22)00013-4.
Lino Caroline Antunes, Barreto-Chaves Maria Luiza,
Abstract
Cardiovascular diseases are the leading cause of death worldwide. The renin-angiotensin-aldosterone system is one of the major regulators of cardiovascular homeostasis and the type 1-angiotensin II receptor (AT1R) mediates the main deleterious effects resulting from the hyperactivation of this hormonal system. Beta-arrestins are multifunctional proteins that regulate the desensitization and internalization of G protein-coupled receptors. After the discovery of beta-arrestins, many efforts have been made towards characterizing and distinguishing this new signaling pathway for drug discovery. Here, we summarize recent advances that address the beta-arrestin signaling in the cardiovascular system, focusing on the activation of the AT1R.
Copyright © 2021. Published by Elsevier Inc.
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Left ventricular mass index-to-QRS-voltage ratio predicts outcomes in heart failure with preserved ejection fraction.
ESC Heart Fail2022 Jan;():. doi: 10.1002/ehf2.13778.
Kinugasa Yoshiharu, Nakamura Kensuke, Kamitani Hiroko, Hirai Masayuki, Yanagihara Kiyotaka, Kato Masahiko, Nagai Toshiyuki, Yoshikawa Tsutomu, Saito Yoshihiko, Takeishi Yasuchika, Yamamoto Kazuhiro, Anzai Toshihisa,
Abstract
AIMS:
Increased left ventricular mass index (LVMI) disproportionate to electrocardiographic QRS voltage has been reported to be associated with cardiac fibrosis and amyloid infiltration to myocardium. This study aimed to assess whether the LVMI-to-QRS-voltage ratio predicts clinical outcomes in heart failure with preserved ejection fraction (HFpEF).
METHODS AND RESULTS:
The Japanese Heart Failure Syndrome with Preserved Ejection Fraction (JASPER) registry is a nationwide, observational, and prospective registration of Japanese patients hospitalized with HFpEF (EF ? 50%). LVMI was assessed by echocardiography using the cube formula. QRS voltage was assessed by Sokolow-Lyon voltage criteria. We divided 290 patients in the registry who met inclusion criteria into five groups according to the quintile values of their LVMI-to-QRS-voltage ratio. In the highest quintile group (?71.8 g/m /mV), approximately 50% of the patients had concentric hypertrophy and 30% had eccentric hypertrophy. These patients had the highest proportion of atrial fibrillation (61.4%) and history of pacemaker implantation (12.1%) among the five groups (P
CONCLUSIONS:
A high LVMI-to-QRS-voltage ratio is independently associated with poor outcomes in patients with HFpEF.
© 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
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Emerging therapeutic targets for cardiac hypertrophy.
Expert Opin Ther Targets2022 Jan;():. doi: 10.1080/14728222.2022.2031974.
Winkle Alex J, Nassal Drew M, Shaheen Rebecca, Thomas Evelyn, Mohta Shivangi, Gratz Daniel, Weinberg Seth H, Hund Thomas J,
Abstract
INTRODUCTION:
Cardiac hypertrophy is associated with adverse outcomes across cardiovascular disease states. Despite strides over the last three decades in identifying molecular and cellular mechanisms driving hypertrophy, the link between pathophysiological stress stimuli and specific myocyte/heart growth profiles remains unclear. Moreover, the optimal strategy for preventing pathology in the setting of hypertrophy remains controversial.
AREAS COVERED:
This review discusses molecular mechanisms underlying cardiac hypertrophy with a focus on factors driving the orientation of myocyte growth and the impact on heart function. We highlight recent work showing a novel role for the spectrin-based cytoskeleton, emphasizing regulation of myocyte dimensions but not hypertrophy per se. Finally, we consider opportunities for directing the orientation of myocyte growth in response to hypertrophic stimuli as an alternative therapeutic approach. Relevant publications on the topic were identified through Pubmed with open ended search dates.
EXPERT OPINION:
To define new therapeutic avenues, more precision is required when describing changes in myocyte and heart structure/function in response to hypertrophic stimuli. Recent developments in computational modeling of hypertrophic networks, in concert with more refined experimental approaches will catalyze translational discovery to advance the field and further our understanding of cardiac hypertrophy and its relationship with heart disease.
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Relationship between overweight and obesity and cardiac dimensions and function in a paediatric population.
Eur J Pediatr2022 Jan;():. doi: 10.1007/s00431-022-04384-0.
Cabeza Juan Fernández, Aristizábal-Duque Cristhian H, Sánchez Isabel María Blancas, Ortiz Martín Ruíz, Almodóvar Ana Rodríguez, Ortega Mónica Delgado, Martínez Fátima Esteban, Saldaña Manuel Romero, Del Pozo Francisco Javier Fonseca, Álvarez-Ossorio Manuel Pan, Rubio María Dolores Mesa,
Abstract
Obesity in adults is associated with left ventricular hypertrophy, dilatation, and myocardial fibrosis, as well as heart failure and coronary heart disease. These associations have been studied to a lesser extent in the paediatric population. This study aims to investigate the relationship between obesity and cardiac structure and function in the paediatric population. In a southern Spanish village, we selected all inhabitants aged 6-17 years stratifying by age, gender, and educational centres. We performed a complete transthoracic echocardiogram evaluating all the cardiac morphological and functional parameters commonly measured in an echocardiographic study. There were 212 children and adolescents included. Of them, 48.1% were males. The mean age was 10.9?±?3.0 years. A total of 106 (50%) were normal weight, 57 (26.9%) overweight, and 49 (23.1%) obese. Sex and age were similar in all three groups. Overweight and obesity were associated with larger left ventricular end-diastolic and end-systolic volumes (p?0.0005), greater left ventricular mass (p?0.0005), and smaller ejection fraction (p?0.0005). They were also associated with larger atrial, aortic, and right ventricular size. Lateral and mean E/e' ratios were higher (p?=?0.007 and p?=?0.01 respectively). Body mass index was independently associated with all cavity size variables as well as left ventricular ejection fraction.Conclusion: Childhood obesity is independently associated with larger heart chambers, greater left ventricle mass, and smaller left ventricle ejection fraction. What is Known: ? Childhood obesity is related to the development of cardiovascular risk factors and is considered an epidemic of the twenty-first century; its prevalence is rising. What is New: ? Childhood overweight and obesity lead to changes in cardiac structure and function which, although not considered clinically pathological, are significant and a result of obesity, and which behave as unfavourable incipient alterations at an early age.
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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Zyxin protects from hypertension-induced cardiac dysfunction.
Cell Mol Life Sci2022 Jan;79(2):93. doi: 10.1007/s00018-022-04133-4.
Al-Hasani Jaafar, Sens-Albert Carla, Ghosh Subhajit, Trogisch Felix A, Nahar Taslima, Friede Prisca A P, Reil Jan-Christian, Hecker Markus,
Abstract
Arterial hypertension causes left ventricular hypertrophy leading to dilated cardiomyopathy. Following compensatory cardiomyocyte hypertrophy, cardiac dysfunction develops due to loss of cardiomyocytes preceded or paralleled by cardiac fibrosis. Zyxin acts as a mechanotransducer in vascular cells that may promote cardiomyocyte survival. Here, we analyzed cardiac function during experimental hypertension in zyxin knockout (KO) mice. In zyxin KO mice, made hypertensive by way of deoxycorticosterone acetate (DOCA)-salt treatment telemetry recording showed an attenuated rise in systolic blood pressure. Echocardiography indicated a systolic dysfunction, and isolated working heart measurements showed a decrease in systolic elastance. Hearts from hypertensive zyxin KO mice revealed increased apoptosis, fibrosis and an upregulation of active focal adhesion kinase as well as of integrins ?5 and ?1. Both interstitial and perivascular fibrosis were even more pronounced in zyxin KO mice exposed to angiotensin II instead of DOCA-salt. Stretched microvascular endothelial cells may release collagen 1?2 and TGF-?, which is characteristic for the transition to an intermediate mesenchymal phenotype, and thus spur the transformation of cardiac fibroblasts to myofibroblasts resulting in excessive scar tissue formation in the heart of hypertensive zyxin KO mice. While zyxin KO mice per se do not reveal a cardiac phenotype, this is unmasked upon induction of hypertension and owing to enhanced cardiomyocyte apoptosis and excessive fibrosis causes cardiac dysfunction. Zyxin may thus be important for the maintenance of cardiac function in spite of hypertension.
© 2022. The Author(s).
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Morphological study of the spectrum of lesions encountered in the heart and coronaries on autopsy.
Indian J Pathol Microbiol;65(1):18-22. doi: 10.4103/IJPM.IJPM_1203_20.
Siddiqui Md Ibrahim, Mahanta Anita A, Umesh S R, Neeha Saara, Andola Sainath K,
Abstract
Background and Objectives:
This research study has been carried out to study the various morphological changes in the heart in medicolegal autopsies and to compile data for the frequency of heart diseases found in autopsy cases.
Methods:
The present study comprised 430 medicolegal autopsy cases. Details of the cases were entered in a proforma prepared for the study. The heart was fixed in 10% formalin, and then, opened along the flow of blood. The findings were based on gross and microscopic examinations.
Results:
Out of 430 adult hearts, 211 (49.0%) cases showed 253 cardiac lesions; 35 (8.1%) cases of coronary atherosclerosis and 196 (45.5%) aortic atherosclerosis were noted; 7 cases of ischemic lesions (1.6%) were identified; 12 (2.7%) cases of hypertrophy; 2 cases of valve calcification; and 1 of cardiomyopathy were noted.
Conclusion:
In the present study, among medicolegal autopsies, atherosclerotic disease was the most frequently encountered lesion followed by hypertrophy. The incidence of atherosclerosis was found to be 47.6%. This study shows the high prevalence of atherosclerosis in the population.
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Electrocardiographic features and need for pacemaker in cardiac amyloidosis: Analysis of 58 cases.
Med Clin (Barc)2022 Jan;():. doi: S0025-7753(21)00631-X.
Pericet-Rodriguez Cristina, López-Aguilera José, Durán-Torralba Carmen, Castillo-Dominguez Juan Carlos, Ruiz-Ortiz Martín, Perea-Armijo Jorge, Delgado-Ortega Mónica, Mesa-Rubio Dolores, González-Manzanares Rafael, Ruiz de Castroviejo Joaquín, Martín-Dorado Ernesto, Gallo-Fernández Ignacio, López-Baizán Josúe, Pastor-Wulf Daniel, Rodriguez-Almodovar Ana, Pan Álvarez-Osorio Manuel, Anguita-Sánchez Manuel,
Abstract
AIM:
Amyloidosis is a disease in which amyloid fibrils can be deposited in different cardiac structures, and several electrocardiographic abnormalities can be produced by this phenomenon. The objective of this study was to describe the most common basal electrocardiographic alterations in patients diagnosed with cardiac amyloidosis (CA) and to determine if these abnormalities have an impact on the need of pacemaker.
METHODS:
This retrospective study included patients who had an established diagnosis of CA [light-chain cardiac amyloidosis (LA-CA) or transthyretin cardiac amyloidosis (TTR-CA)] between January 2013 and March 2021. The baseline heart rate, the percentage of patients with a pseudo-infarct pattern, low-voltage pattern or cardiac conductions disturbances, and the impact of these factors on the need of pacemaker were analysed.
RESULTS:
Fifty-eight patients with CA (20 with LA-CA and 38 with TTR-CA) were included, and the majority were male (69.0%). Twenty-one patients had atrial fibrillation (AF) at diagnosis. Thirty-five patients had a pseudo-infarct pattern, 35% had a low-voltage pattern, and 22% had criteria for ventricular hypertrophy. Two hirds had a conduction disorder: 18 patients with first degree atrioventricular block, 12 right bundle branch block, 3 left bundle branch block and 25 with a branch hemiblock. There were no differences between LA-CA and TTR-CA. Patients with TTR-CA had a greater need for pacemakers in the folow-up (39±40 meses). Bundle branch block was a predictor of the need for a permanent pacemaker (HR: 23.43; CI 95%: 4.09.134.09; P=.01).
CONCLUSIONS:
Electrocardiographic abnormalities in patients diagnosed wich CA are heterogeneus. Most frecuent is the presence of conduction disorders, the pseudoinfarction pattern, followed by the low voltage pattern. Patients with any bundle branch block at the baseline electrocardiogram need more frecuent to require a pacemaker during follow-up, especially in TTR-CA.
Copyright © 2021 Elsevier España, S.L.U. All rights reserved.
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Diastolic function: modeling left ventricular untwisting as a damped harmonic oscillator.
Physiol Meas2022 Jan;():. doi: 10.1088/1361-6579/ac4e6e.
Gamble Forrest Nolan, Aufan M Rifqi, Sharifov Oleg F, Williams Lamario J, Reighard Shane, Calhoun David A, Gupta Himanshu, Dell'Italia Louis J, Denney Thomas S, Lloyd Steven G,
Abstract
OBJECTIVE:
We developed a method using cardiovascular magnetic resonance imaging (CMR) to model the untwisting of the left ventricle (LV) as a damped torsional harmonic oscillator to estimate shear modulus (intrinsic myocardial stiffness) and frictional damping, then applied this method to evaluate the torsional stiffness of patients with Resistant Hypertension (RH) compared to a Control group.
APPROACH:
The angular displacement of the LV during diastole was measured. Myocardial shear modulus and damping constant were determined by solving a system of equations modeling the diastolic untwisting as a damped, unforced harmonic oscillator, in 100 subjects with RH and 36 control subjects.
MAIN RESULTS:
Though overall torsional stiffness was increased in RH (41.7 (27.1 - 60.7) vs. 29.6 (17.3 - 35.7) kdyn*cm; p = 0.001), myocardial shear modulus was not different between RH and control subjects (0.34 (0.23 - 0.50) vs. 0.33 (0.22 - 0.46) kPa; p=0.758). RH demonstrated an increase in overall diastolic frictional damping (6.13 ± 3.77 vs. 3.35 ± 1.70 kdyn*cm*s; p
SIGNIFICANCE:
We have developed a phenomenological method, estimating the intrinsic stiffness and relaxation properties of the LV based on restorative diastolic untwisting. This model finds increased overall stiffness in RH and points to hypertrophy, rather than tissue- level changes, as the major factor leading to increased stiffness.
© 2022 Institute of Physics and Engineering in Medicine.
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Common Arterial Trunk with Interrupted Aortic Arch.
Braz J Cardiovasc Surg2022 Jan;():. doi: 10.21470/1678-9741-2021-0008.
Estephan Lys Molina Hernandes, Aranda Aline Simões, Marchi Carlos Henrique De, Croti Ulisses Alexandre,
Abstract
Clinical data: Patient diagnosed with common arterial trunk, submitted to pulmonary artery banding in another center and lost to clinical follow-up. Referred to our center at four years old, extremely cyanotic. Chest radiography: Cardiomegaly; attenuated peripheral vascular markings. Electrocardiography: Right ventricular hypertrophy. Echocardiography: Common arterial trunk, but it was not possible to analyze all the structures. Computed tomography angiography: Van Praagh type A4 common arterial trunk. Extremely hypoplastic right and left pulmonary arteries. Diagnosis: Association of aortic arch interruption type A is uncommon and should be considered. Operation: Debanding of pulmonary arteries allowing for possible future complete repair.
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Effect of Combined Endurance Training and MitoQ on Cardiac Function and Serum Level of Antioxidants, NO, miR-126, and miR-27a in Hypertensive Individuals.
Biomed Res Int2022 ;2022():8720661. doi: 10.1155/2022/8720661.
Masoumi-Ardakani Yaser, Najafipour Hamid, Nasri Hamid Reza, Aminizadeh Soheil, Jafari Shirin, Moflehi Daruosh,
Abstract
Objectives:
Hypertension (HTN) is one of the most important risk factors for cardiovascular diseases. Despite advances in treatment and control of HTN, the prevalence of HTN is still increasing. MitoQ is a supplement that acts on mitochondria and attenuates reactive oxygen species (ROS), which plays an important role in cardiovascular health. miRNAs play an important role in the pathophysiology of HTN. We evaluated the effects of MitoQ supplementation and endurance training (ET), alone and in combination, on functional indices of the heart and serum levels of miR-126, miR-27a, antioxidants, and NO, in patients with HTN.
Methods:
In a double-blind randomized clinical trial, 52 male participants (age 40-55 years) were randomly divided into four groups ( = 13) of placebo, MitoQ (20?mg/day, oral), ET (cycle ergometer, moderate intensity, 40-60% VO peak, heart rate 120-140?b/min, 45?min a day, three days/week for six weeks), and MitoQ+ET. Cardiac function indices were assessed by echocardiography before and after interventions.
Results:
Systolic blood pressure (SBP) significantly decreased in all intervention groups (
Conclusions:
Compared to MitoQ and ET alone, their combination has more prominent improving effects on cardiac health and amelioration of BP in the patients with HTN. These effects are through miR-126 and miR-27a modulation and ameliorating mitochondrial ROS production.
Copyright © 2022 Yaser Masoumi-Ardakani et al.
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Layer-By-Layer Fabrication of Thicker and Larger Human Cardiac Muscle Patches for Cardiac Repair in Mice.
Front Cardiovasc Med2021 ;8():800667. doi: 10.3389/fcvm.2021.800667.
Wang Lu, Zhang Jianyi,
Abstract
The engineered myocardial tissues produced most manufacturing techniques are typically just a few dozen micrometers thick, which is too thin for therapeutic applications in patients. Here, we used a modified layer-by-layer (LBL) fabrication protocol to generate thick human cardiac muscle patches (hCMPs) with thicknesses of ~3.75 mm. The LBL-hCMPs were composed of a layer of endothelial cells (ECs) sandwiched between two layers of cardiomyocytes (CMs): both cell populations were differentiated from the same human induced pluripotent stem cell line (hiPSCs) and suspended in a fibrin matrix, and the individual layers were sutured together, leaving channels that allowed the culture medium to access the internal cell layer. The LBL-hCMPs were cultured on a dynamic culture platform with electrical stimulation, and when compared to Control-hCMPs consisting of the same total number of hiPSC-ECs and -CMs suspended in a single layer of fibrin, hiPSC-CMs in the LBL-hCMPs were qualitatively more mature with significantly longer sarcomeres and expressed significantly higher levels of mRNA transcripts for proteins that participate in cardiomyocyte contractile activity and calcium handing. Apoptotic cells were also less common in LBL- than in Control-hCMPs. The thickness of fabricated LBL-hCMP gradually decreased to 0.8 mm by day 28 in dynamic culture. When the hCMP constructs were compared in a mouse model of myocardial infarction, the LBL-hCMPs were associated with significantly better measurements of engraftment, cardiac function, infarct size, hypertrophy, and vascularity. Collectively these observations indicate that our modified LBL fabrication protocol produced thicker hCMPs with no decline in cell viability, and that LBL-hCMPs were more potent than Control-hCMPs for promoting myocardial repair in mice.
Copyright © 2022 Wang and Zhang.
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Congenital portosystemic shunt concurrent with an atrial septal defect in a Maltese dog.
Open Vet J;11(4):724-727. doi: 10.5455/OVJ.2021.v11.i4.24.
Kim Dongwook, Chang Dongwoo, Kim Gonhyung,
Abstract
Background:
Portosystemic shunt and atrial septal defect (ASD) are generally congenital diseases in dogs. Rarely, dogs with congenital vascular anomalies could be related to other vascular anomalies.
Case Description:
A 1-year-old male Maltese dog, neutered and weighing 1.7 kg, was brought in for an additional assessment of a congenital portosystemic shunt (CPSS). CPSS was diagnosed as portocaval shunt by computed tomography. Surgical attenuation was performed. Although prognosis after CPSS attenuation was good, the dog was presented with exercise intolerance 1 year after the operation. Thoracic radiographs observed generalized cardiomegaly. Echocardiography revealed pulmonary hypertension and right-to-left shunting ASD.
Conclusion:
The present study reports a rare case of CPSS concurrent with ASD in a dog. As dogs with CPSS might have been associated with other vascular anomalies; therefore, echocardiography is recommended for early diagnosis of other cardiovascular anomalies.
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Abnormal torsion and helical flow patterns of the neo-aorta in hypoplastic left heart syndrome assessed with 4D-flow MRI.
Cardiovasc Diagn Ther2021 Dec;11(6):1379-1388. doi: 10.21037/cdt-20-770.
Gabbert Dominik Daniel, Trotz Patrick, Kheradvar Arash, Jerosch-Herold Michael, Scheewe Jens, Kramer Hans-Heiner, Voges Inga, Rickers Carsten,
Abstract
Background:
The Norwood procedure is the first stage of correction for patients with hypoplastic left heart syndrome (HLHS) and may lead to an abnormal neoaortic anatomy. We prospectively studied the neoaorta's fluid dynamics and the abnormal twist of the neoaorta by MRI examinations of HLHS patients in Fontan circulation. This study for the first time investigates the hypothesis that the neoaorta twist is associated with increased helical flow patterns, which may lead to an increased workload for the systemic right ventricle (RV) and ultimately to RV hypertrophy.
Methods:
A group of forty-two HLHS patients with a median age of 4.9 (2.9-17.0) years, at NYHA I was studied along with a control group of eleven subjects with healthy hearts and a median age of 12.1 (4.0-41.6). All subjects underwent MRI of the thoracic aorta including ECG-gated 2D balanced SSFP cine for an axial slice stack and 4D-flow MRI for a sagittal volume slab covering the thoracic aorta. The twist of the neoaortic arch was quantified by the effective geometric torsion, defined as the product of curvature and geometric torsion. Fluid dynamics and geometry in the neoaorta, including the flow helicity index, were evaluated using an in-house analysis software (MeVisLab-based). Myocardial mass of the systemic ventricle at end-diastole was estimated by planimetry of the short-axis stack.
Results:
Compared to the control group, the neoaorta in the HLHS patients shows an increased twist (P=0.04) and higher peak helicity density (P=0.03). The maximum helicity density was correlated with maximum effective torsion of the ascending neoaorta (P
Conclusions:
This study shows that the abnormal twist of the neoaortic arch in HLHS patients is associated with abnormal helical flow patterns, which may contribute to increased RV afterload and may adversely affect the systemic RV by stimulation of myocardial hypertrophy. These findings suggest that further improvements of surgical aortic reconstruction, guided by insights from 4D-flow MRI, could lead to better neoaortic fluid dynamics in patients with HLHS.
2021 Cardiovascular Diagnosis and Therapy. All rights reserved.
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Molecular signaling pathways in right ventricular impairment of adult patients after tetralogy of Fallot repair.
Cardiovasc Diagn Ther2021 Dec;11(6):1295-1309. doi: 10.21037/cdt-20-894.
Pollmann Kathrin, Raj Murthi Sarala, Kra?un Damir, Schwarzmayr Thomas, Petry Andreas, Cleuziou Julie, Hörer Jürgen, Klop Mathieu, Ewert Peter, Görlach Agnes, Wolf Cordula Maria,
Abstract
Background:
Right ventricular impairment (RVI) secondary to altered hemodynamics contributes to morbidity and mortality in adult patients after tetralogy of Fallot (TOF) repair. The goal of this study was to describe signaling pathways contributing to right ventricular (RV) remodeling by analyzing over lifetime alterations of RV gene expression in affected patients.
Methods:
RV tissue was collected at the time of cardiac surgery in 13 patients with a diagnosis of TOF. RNA was isolated and whole transcriptome sequencing was performed. Gene profiles were compared between a group of 6 adults with signs of RVI undergoing right ventricle to pulmonary artery conduit surgery and a group of 7 infants, undergoing TOF correction. Definition of RVI in adult patients was based on clinical symptoms, evidence of RV hypertrophy, dilation, dysfunction or elevated pressure on echocardiographic, cardiovascular magnetic resonance, or catheterization evaluation.
Results:
Median age was 34 years in RVI patients and 5 months in infants. Based on P adjusted value
Conclusions:
RV transcriptome profiling in adult patients with RVI after TOF repair allows identification of signaling pathways, contributing to pathologic RV remodeling and helps in the discovery of biomarkers for disease progression and of new therapeutic targets.
2021 Cardiovascular Diagnosis and Therapy. All rights reserved.
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Morphofunctional and immunological cardiac evaluation of protein restriction on rat offspring.
Ann Anat2022 Jan;():151889. doi: S0940-9602(22)00004-8.
Masiero Beatriz Calloni, Calsa Bruno, Oliveira Camila Andreia, Moretti de Andrade Thiago Antônio, Esquisatto Marcelo Augusto Marretto, Catisti Rosana,
Abstract
Cardiovascular diseases affect a large part of the population during adulthood. Several epidemiological and experimental studies have demonstrated an association between maternal protein restriction and a marked risk of developing heart disease during early intrauterine and postnatal life. Maternal nutritional conditions act by modulating the microenvironment, thus favoring adaptive processes of the fetal organism for development to occur. However, the physiological profile is established in this period and its effects can be observed in the long term. In the present study, the cardiac muscles of 15-day-old offspring of Wistar rats subjected to maternal protein restriction during pregnancy and/or lactation were evaluated to identify possible cardiac changes relevant for heart disease in adulthood. The offspring of restricted female rats during pregnancy had a lower birth weight. Male offspring subjected to restriction during pregnancy and lactation showed an increase in the concentration of HO, a reduction in the expression of the Mn-SOD enzyme, and a greater expression of ?-MHC and Connexin 43. There was also an increase in the MPO enzyme activity in the tissue. It was observed that the effects of protein restriction are sex-specific, since the cardiac muscle of male animals showed alterations suggestive of oxidative stress, hypertrophy, signs of tissue inflammation, and increased expression of important proteins in intercellular communication. These changes characterize the ongoing cardiac remodeling process. Finally, the data revealed that the lactation phase accentuated harmful effects on the cardiac tissue of the offspring.
Copyright © 2022. Published by Elsevier GmbH.
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Icariin inhibits isoproterenol-induced cardiomyocyte hypertropic injury through activating autophagy via the AMPK/mTOR signaling pathway.
Biochem Biophys Res Commun2022 Jan;593():65-72. doi: S0006-291X(22)00044-4.
Hu Lin, Wang Ziyuan, Li Huan, Wei Jiarui, Tang Fengyue, Wang Qing, Wang Jing, Zhang Xiaoqiao, Zhang Qiufang,
Abstract
Icariin (ICA), a bioactive flavonoid compound derived from Epimedium, have been demonstrated possessing anti-oxidative stress, anti-inflammation in the cardiovascular disease. But its effects on cardiomyocyte hypertrophy and the underlying mechanisms remains unclear. Here we found that ICA alleviated ISO-induced H9c2 or NRCM myocytes hypertrophy, assessed by surface area and the expression of ANP, BNP and ?-MHC. Furthemore, ICA reversed cardiomcytes enlargment by suppresing apoptotic injury and increasing autophagic flux. By contrast, 3-MA, an autophagy inhibitor, could abolished the antihypertrophic and pro-autophagic flux effects of ICA. Mechanistically, ICA increased the phosphorylation levels of AMPK and autophagy-related markers beclin-1, Atg5 and the LC3II/I ratio, and decreased phosphorylated mTOR. But the effects of ICA on ISO-induced cardiomyocytes hypertrophy were attenuated by selective AMPK inhibitor Compound C. In conclusion, these findings indicated that ICA attenuated cardiomyocyte hypertrophy induced by ISO and prevented cell injury, and the specific mechanism was mediated by AMPK/mTOR pathway to enhance autophagy and reduce autophagy-related cardiomyocyte apoptosis.
Copyright © 2022. Published by Elsevier Inc.
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