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Li F, Li H, Luo R, Pei JB, Yu XY. Lyophilized recombinant human brain natriuretic peptide for chronic heart failure: Effects on cardiac function and inflammation. World J Clin Cases 2023; 11:6066-6072. [PMID: 37731575 PMCID: PMC10507552 DOI: 10.12998/wjcc.v11.i26.6066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/20/2023] [Accepted: 08/03/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Chronic heart failure (CHF) is a serious and prevalent condition characterized by impaired cardiac function and inflammation. Standard therapy for CHF has limitations, prompting the exploration of alternative treatments. Recombinant human brain natriuretic peptide (BNP) has emerged as a potential therapy, with evidence suggesting that it can improve cardiac function and reduce inflammation in patients with CHF. However, further research is required to determine the efficacy and safety of lyophilized recombinant human BNP in CHF patients and its impact on microinflammatory status. This study aimed to investigate the effects of lyophilized recombinant human BNP therapy on CHF patients' cardiac function and microinflammatory status. AIM To investigate the effects of freeze-dried recombinant human BNP therapy on cardiac function and microinflammatory status in patients with CHF. METHODS In total, 102 CHF patients admitted to our hospital from January 2021 to January 2022 were randomly assigned to control and observation groups (n = 51 patients/group). The control patients were treated with standard HF therapy for 3 d, whereas the observational patients were injected with the recombinant human BNP for 3 d. Clinical efficacy, inflammatory factor levels, myocardial damage, cardiac function before and after the treatment, and adverse reactions during treatment were compared between the two groups. RESULTS The overall clinical efficacy was higher in the observation group than in the control group. Compared with baseline, serum hypersensitive C-reactive protein, N-terminal proBNP, and troponin I level, and physical, emotional, social, and economic scores were lower in both groups after treatment, with greater reductions in levels and scores noted in the observation group than in the control group. The overall incidence of adverse reactions in the observation group was not significantly different compared with that in the control group (P > 0.05). CONCLUSION Freeze-dried recombinant human BNP therapy can improve heart function and enhance microinflammatory status, thereby improving overall quality of life without any obvious side effects. This therapy is safe and reliable.
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Affiliation(s)
- Feng Li
- Department of Cardiovascular Internal Medicine, People's Hospital of Jieshou, Jieshou 236500, Anhui Province, China
| | - Hao Li
- Department of Cardiovascular Internal Medicine, People's Hospital of Jieshou, Jieshou 236500, Anhui Province, China
| | - Rong Luo
- Department of Cardiovascular Internal Medicine, People's Hospital of Jieshou, Jieshou 236500, Anhui Province, China
| | - Jia-Bao Pei
- Department of Cardiovascular Internal Medicine, People's Hospital of Jieshou, Jieshou 236500, Anhui Province, China
| | - Xue-Ying Yu
- Department of Cardiovascular Internal Medicine, People's Hospital of Jieshou, Jieshou 236500, Anhui Province, China
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Poty A, Krim F, Lopes P, Garaud Y, Leprêtre PM. Benefits of a Supervised Ambulatory Outpatient Program in a Cardiovascular Rehabilitation Unit Prior to a Heart Transplant: A Case Study. Front Cardiovasc Med 2022; 9:811458. [PMID: 35665250 PMCID: PMC9160327 DOI: 10.3389/fcvm.2022.811458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
Preoperative peak oxygen uptake (V.O2peak) and ventilatory efficiency (V.E/V.CO2slope) are related to the vital prognosis after cardiac transplantation (HTx). The objective of our study was to evaluate the effects of exercise-based cardiac rehabilitation (ECR) program on the preoperative exercise capacity of a HTx candidate. A male patient, aged 50–55 years, with chronic heart failure was placed on the HTx list and performed 12 weeks of intensive ECR (5 sessions-a-week). Our results showed that the cardiac index continuously increased between the onset and the end of ECR (1.40 vs. 2.53 L.min–1.m2). The first 20 sessions of ECR induced a V.O2peak increase (15.0 vs. 19.3 ml.min–1.kg–1, corresponding to 42.0 and 53.0% of its maximal predicted values, respectively). The peak V.O2 plateaued between the 20th and the 40th ECR session (19.3 vs. 19.4 ml.min–1.kg–1) then progressively increased until the 60th ECR session to reach 25.7 ml.min–1.kg–1, i.e., 71.0% of the maximal predicted values. The slope of V.E/V.CO2 showed a biphasic response during the ECR program, with an increase between the onset and the 20th ECR session (58.02 vs. 70.48) and a decrease between the 20th and the 40th ECR session (70.48 vs. 40.94) to reach its minimal value at the 60th ECR session (31.97). After the first 40 sessions of the ECR program, the Seattle Heart Failure Model score predicted median survival time was estimated at 7.2 years. In conclusion, the improvement in exercise capacity and cardiorespiratory function following the ECR helped delay the heart transplant surgery in our patient awaiting heart transplantation.
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Affiliation(s)
- Antoine Poty
- Exercise Physiology and Rehabilitation Laboratory, Picardie Jules Verne University, Amiens, France
- Fundation Léopold Bellan, Chateau d’Ollencourt, Unit of Cardiac Rehabilitation, Tracy-le-Mont, France
| | - Florent Krim
- Service de Réadaptation Cardiovasculaire, Centre Hospitalier de Corbie, Corbie, France
- Association Picardie de Recherche en Réadaptation Cardiaque, Association Picardie de Recherche en Réadaptation Cardiaque, Corbie, France
| | - Philippe Lopes
- Laboratoire de Biologie de l’Exercice Pour la Performance et la Santé, Université d’Évry Val d’Essonne, Évry, France
| | - Yves Garaud
- Fundation Léopold Bellan, Chateau d’Ollencourt, Unit of Cardiac Rehabilitation, Tracy-le-Mont, France
| | - Pierre-Marie Leprêtre
- Exercise Physiology and Rehabilitation Laboratory, Picardie Jules Verne University, Amiens, France
- Service de Réadaptation Cardiovasculaire, Centre Hospitalier de Corbie, Corbie, France
- Association Picardie de Recherche en Réadaptation Cardiaque, Association Picardie de Recherche en Réadaptation Cardiaque, Corbie, France
- *Correspondence: Pierre-Marie Leprêtre,
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Puetz A, Artati A, Adamski J, Schuett K, Romeo F, Stoehr R, Marx N, Federici M, Lehrke M, Kappel BA. Non-targeted metabolomics identify polyamine metabolite acisoga as novel biomarker for reduced left ventricular function. ESC Heart Fail 2022; 9:564-573. [PMID: 34811951 PMCID: PMC8788009 DOI: 10.1002/ehf2.13713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/12/2021] [Accepted: 10/31/2021] [Indexed: 11/25/2022] Open
Abstract
AIMS Chronic heart failure with reduced ejection fraction remains a major health issue. To date, no reliable biomarker is available to predict reduced left ventricular ejection fraction (LV-EF). We aimed to identify novel circulating biomarkers for reduced left ventricular function using untargeted serum metabolomics in two independent patient cohorts. METHODS AND RESULTS Echocardiography and non-targeted serum metabolomics were conducted in two patient cohorts with varying left ventricular function: (1) 25 patients with type 2 diabetes with established cardiovascular disease or high cardiovascular risk (LV-EF range 20-66%) (discovery cohort) and (2) 37 patients hospitalized for myocardial infarction (LV-EF range 25-60%) (validation cohort). In the discovery cohort, untargeted metabolomics revealed seven metabolites performing better than N-terminal pro-B-type natriuretic peptide in the prediction of impaired left ventricular function shown by LV-EF. For only one of the metabolites, acisoga, the predictive value for LV-EF could be confirmed in the validation cohort (r = -0.37, P = 0.02). In the discovery cohort, acisoga did not only correlate with LV-EF (r = -60, P = 0.0016), but also with global circumferential strain (r = 0.67, P = 0.0003) and global longitudinal strain (r = 0.68, P = 0.0002). Similar results could be detected in the discovery cohort in a 6 month follow-up proofing stability of these results over time. With an area under the curve of 0.86 in the receiver operating characteristic analysis, acisoga discriminated between patients with normal EF and LV-EF < 40%. Multivariate analysis exposed acisoga as independent marker for impairment of LV-EF (Beta = -0.71, P = 0.004). CONCLUSIONS We found the polyamine metabolite acisoga to be elevated in patients with impaired LV-EF in two independent cohorts. Our analyses suggest that acisoga may be a valuable biomarker to detect patients with heart failure with reduced ejection fraction.
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Affiliation(s)
- Andreas Puetz
- Department of Internal Medicine 1, University Hospital AachenRWTH Aachen UniversityAachenGermany
| | - Anna Artati
- Metabolomics and Proteomics CoreHelmholtz Zentrum München, German Research Center for Environmental Health (GmbH)NeuherbergGermany
| | - Jerzy Adamski
- Institute of Experimental GeneticsHelmholtz Zentrum München, German Research Center for Environmental HealthNeuherbergGermany
- Institute of Biochemistry, Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
- Department of Biochemistry, Yong Loo Lin School of MedicineNational University of SingaporeSingapore
| | - Katharina Schuett
- Department of Internal Medicine 1, University Hospital AachenRWTH Aachen UniversityAachenGermany
| | - Francesco Romeo
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Robert Stoehr
- Department of Internal Medicine 1, University Hospital AachenRWTH Aachen UniversityAachenGermany
| | - Nikolaus Marx
- Department of Internal Medicine 1, University Hospital AachenRWTH Aachen UniversityAachenGermany
| | - Massimo Federici
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
- Center for AtherosclerosisPoliclinico Tor VergataRomeItaly
| | - Michael Lehrke
- Department of Internal Medicine 1, University Hospital AachenRWTH Aachen UniversityAachenGermany
| | - Ben A. Kappel
- Department of Internal Medicine 1, University Hospital AachenRWTH Aachen UniversityAachenGermany
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Dong G, Chen H, Zhang H, Gu Y. Long-Term and Short-Term Prognostic Value of Circulating Soluble Suppression of Tumorigenicity-2 Concentration in Chronic Heart Failure: A Systematic Review and Meta-Analysis. Cardiology 2021; 146:433-440. [PMID: 33902050 DOI: 10.1159/000509660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/23/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Soluble suppression of tumorigenicity-2 (sST2) has been considered as a prognostic factor of cardiovascular disease. However, the prognostic value of sST2 concentration in chronic heart failure remains to be summarized. METHODS We searched PubMed, Embase, and Web of Science for eligible studies up to January 1, 2020. Data extracted from articles and provided by authors were used in agreement with the PRISMA statement. The endpoints were all-cause mortality (ACM), cardiovascular mortality (CVM)/heart failure-related hospitalization (HFH), and all-cause mortality (ACM)/heart failure-related readmission (HFR). RESULTS A total of 11 studies with 5,121 participants were included in this analysis. Higher concentration of sST2 predicted the incidence of long-term ACM (hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 1.02-1.04), long-term ACM/HFR (HR: 1.42, CI: 1.27-1.59), and long-term CVM/HFH (HR: 2.25, CI: 1.82-2.79), regardless of short-term ACM/HFR (HR: 2.31, CI: 0.71-7.49). CONCLUSION Higher sST2 concentration at baseline is associated with increasing risk of long-term ACM, ACM/HFR, and CVM/HFH and can be a tool for the prognosis of chronic heart failure.
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Affiliation(s)
- Guoqi Dong
- School of Acupuncture and Tuina, Nanjing University of CM, Nanjing, China
| | - Hao Chen
- School of Acupuncture and Tuina, Nanjing University of CM, Nanjing, China
| | - Hongru Zhang
- School of Acupuncture and Tuina, Nanjing University of CM, Nanjing, China
| | - Yihuang Gu
- School of Acupuncture and Tuina, Nanjing University of CM, Nanjing, China
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Galectin-3 Is a Potential Mediator for Atherosclerosis. J Immunol Res 2020; 2020:5284728. [PMID: 32149158 PMCID: PMC7042544 DOI: 10.1155/2020/5284728] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/13/2020] [Accepted: 02/04/2020] [Indexed: 12/22/2022] Open
Abstract
Atherosclerosis is a multifactorial chronic inflammatory arterial disease forming the pathological basis of many cardiovascular diseases such as coronary heart disease, heart failure, and stroke. Numerous studies have implicated inflammation as a key player in the initiation and progression of atherosclerosis. Galectin-3 (Gal-3) is a 30 kDa β-galactose, highly conserved and widely distributed intracellularly and extracellularly. Gal-3 has been demonstrated in recent years to be a novel inflammatory factor participating in the process of intravascular inflammation, lipid endocytosis, macrophage activation, cellular proliferation, monocyte chemotaxis, and cell adhesion. This review focuses on the role of Gal-3 in atherosclerosis and the mechanism involved and several classical Gal-3 agonists and antagonists in the current studies.
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Parovic M, Okwose NC, Bailey K, Velicki L, Fras Z, Seferovic PM, MacGowan GA, Jakovljevic DG. NT-proBNP is a weak indicator of cardiac function and haemodynamic response to exercise in chronic heart failure. ESC Heart Fail 2019; 6:449-454. [PMID: 30788904 PMCID: PMC6437429 DOI: 10.1002/ehf2.12424] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/13/2019] [Accepted: 02/03/2019] [Indexed: 11/11/2022] Open
Abstract
AIMS N-terminal prohormone of brain natriuretic peptide (NT-proBNP) plays an important role in diagnosis and management of heart failure. The aim of the present study was to assess haemodynamic response to exercise and to evaluate the relationship between NT-proBNP, cardiac function, and exercise tolerance in chronic heart failure. METHODS AND RESULTS A single-centre, cross-sectional pilot study recruited 17 patients with chronic heart failure with reduced left ventricular ejection fraction (age 67 ± 7 years) and 20 healthy volunteers (age 65 ± 12 years). The NT-proBNP was measured in the heart failure group. All participants completed maximal graded cardiopulmonary exercise stress testing coupled with gas exchange (using metabolic analyser for determination of exercise tolerance, i.e. peak O2 consumption) and continuous haemodynamic measurements (i.e. cardiac output and cardiac power output) using non-invasive bioreactance technology. Heart failure patients demonstrated significantly lower peak exercise cardiac function and exercise tolerance than healthy controls, i.e. cardiac power output (5.0 ± 2.0 vs. 3.2 ± 1.2 W, P < 0.01), cardiac output (18.2 ± 6.3 vs. 13.5 ± 4.0 L/min, P < 0.01), heart rate (148 ± 23.7 vs. 111 ± 20.9 beats/min, P < 0.01), and oxygen consumption (24.3 ± 9.5 vs. 16.8 ± 3.8 mL/kg/min, P < 0.01). There was no significant relationship between NT-proBNP and cardiac function at rest, i.e. cardiac power output (r = -0.28, P = 0.28), cardiac output (r = -0.18, P = 0.50), and oxygen consumption (r = -0.18, P = 0.50), or peak exercise, i.e. cardiac power output (r = 0.18, P = 0.49), cardiac output (r = 0.13, P = 0.63), and oxygen consumption (r = -0.05, P = 0.84). CONCLUSIONS Lack of a significant and strong relationship between the NT-proBNP and measures of cardiac function and exercise tolerance may suggest that natriuretic peptides should be considered with caution in interpretation of the severity of cardiac dysfunction and functional capacity in chronic heart failure.
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Affiliation(s)
- Milos Parovic
- Cardiovascular Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,Institute of Genetic Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Nduka C Okwose
- Cardiovascular Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,Institute of Genetic Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Kristian Bailey
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Lazar Velicki
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.,Department of Cardiovascular Surgery, Institute of Cardiovascular Diseases Vojvodina, Sremska Kamenica, Serbia
| | - Zlatko Fras
- Department of Vascular Diseases, Division of Internal Medicine, University Medical Center Ljubljana, Ljubljana, Slovenia.,Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Petar M Seferovic
- Cardiology Department, Medical School, University of Belgrade, Belgrade, Serbia.,Clinical Centre Serbia, Belgrade, Serbia.,Serbian Academy of Science and Arts, Belgrade, Serbia
| | - Guy A MacGowan
- Cardiovascular Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,Institute of Genetic Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Djordje G Jakovljevic
- Cardiovascular Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,Institute of Genetic Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,RCUK Centre for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
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