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Machado RS, Tavares FN, Sousa IP. Global landscape of coxsackieviruses in human health. Virus Res 2024; 344:199367. [PMID: 38561065 PMCID: PMC11002681 DOI: 10.1016/j.virusres.2024.199367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/04/2024]
Abstract
Coxsackieviruses-induced infections, particularly in infants and young children, are one of the most important public health issues in low- and middle-income countries, where the surveillance system varies substantially, and these manifestations have been disregarded. They are widespread throughout the world and are responsible for a broad spectrum of human diseases, from mildly symptomatic conditions to severe acute and chronic disorders. Coxsackieviruses (CV) have been found to have 27 identified genotypes, with overlaps in clinical phenotypes between genotypes. In this review, we present a concise overview of the most recent studies and findings of coxsackieviruses-associated disorders, along with epidemiological data that provides comprehensive details on the distribution, variability, and clinical manifestations of different CV types. We also highlight the significant roles that CV infections play in the emergence of neurodegenerative illnesses and their effects on neurocognition. The current role of CVs in oncolytic virotherapy is also mentioned. This review provides readers with a better understanding of coxsackieviruses-associated disorders and pointing the impact that CV infections can have on different organs with variable pathogenicity. A deeper knowledge of these infections could have implications in designing current surveillance and prevention strategies related to severe CVs-caused infections, as well as encourage studies to identify the emergence of more pathogenic types and the etiology of the most common and most severe disorders associated with coxsackievirus infection.
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Affiliation(s)
- Raiana S Machado
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Virologia e Parasitologia Molecular, Rio de Janeiro, 21040-900, Brasil; Programa de Pós-Graduação em Medicina Tropical, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brasil; Laboratório de Referência Regional em Enteroviroses, Seção de Virologia, Instituto Evandro Chagas, Rodovia BR 316‑ KM 07, S/N Bairro Levilândia, Ananindeua, PA 67030000, Brasil
| | - Fernando N Tavares
- Laboratório de Referência Regional em Enteroviroses, Seção de Virologia, Instituto Evandro Chagas, Rodovia BR 316‑ KM 07, S/N Bairro Levilândia, Ananindeua, PA 67030000, Brasil
| | - Ivanildo P Sousa
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Virologia e Parasitologia Molecular, Rio de Janeiro, 21040-900, Brasil.
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Chin CG, Chen YC, Lin FJ, Lin YK, Lu YY, Cheng TY, Chen SA, Chen YJ. Targeting NLRP3 signaling reduces myocarditis-induced arrhythmogenesis and cardiac remodeling. J Biomed Sci 2024; 31:42. [PMID: 38650023 PMCID: PMC11034044 DOI: 10.1186/s12929-024-01032-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 04/14/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Myocarditis substantially increases the risk of ventricular arrhythmia. Approximately 30% of all ventricular arrhythmia cases in patients with myocarditis originate from the right ventricular outflow tract (RVOT). However, the role of NLRP3 signaling in RVOT arrhythmogenesis remains unclear. METHODS Rats with myosin peptide-induced myocarditis (experimental group) were treated with an NLRP3 inhibitor (MCC950; 10 mg/kg, daily for 14 days) or left untreated. Then, they were subjected to electrocardiography and echocardiography. Ventricular tissue samples were collected from each rat's RVOT, right ventricular apex (RVA), and left ventricle (LV) and examined through conventional microelectrode and histopathologic analyses. In addition, whole-cell patch-clamp recording, confocal fluorescence microscopy, and Western blotting were performed to evaluate ionic currents, intracellular Ca2+ transients, and Ca2+-modulated protein expression in individual myocytes isolated from the RVOTs. RESULTS The LV ejection fraction was lower and premature ventricular contraction frequency was higher in the experimental group than in the control group (rats not exposed to myosin peptide). Myocarditis increased the infiltration of inflammatory cells into cardiac tissue and upregulated the expression of NLRP3; these observations were more prominent in the RVOT and RVA than in the LV. Furthermore, experimental rats treated with MCC950 (treatment group) improved their LV ejection fraction and reduced the frequency of premature ventricular contraction. Histopathological analysis revealed higher incidence of abnormal automaticity and pacing-induced ventricular tachycardia in the RVOTs of the experimental group than in those of the control and treatment groups. However, the incidences of these conditions in the RVA and LV were similar across the groups. The RVOT myocytes of the experimental group exhibited lower Ca2+ levels in the sarcoplasmic reticulum, smaller intracellular Ca2+ transients, lower L-type Ca2+ currents, larger late Na+ currents, larger Na+-Ca2+ exchanger currents, higher reactive oxygen species levels, and higher Ca2+/calmodulin-dependent protein kinase II levels than did those of the control and treatment groups. CONCLUSION Myocarditis may increase the rate of RVOT arrhythmogenesis, possibly through electrical and structural remodeling. These changes may be mitigated by inhibiting NLRP3 signaling.
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Affiliation(s)
- Chye-Gen Chin
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yao-Chang Chen
- Department of Biomedical Engineering, National Defense Medical Center, Taipei, Taiwan
| | - Fong-Jhih Lin
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
- Department of Biomedical Engineering, National Defense Medical Center, Taipei, Taiwan
| | - Yung-Kuo Lin
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yen-Yu Lu
- Division of Cardiology, Department of Internal Medicine, Sijhih Cathay General Hospital, New Taipei City, Taiwan
| | - Tzu-Yu Cheng
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Cardiovascular Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shih-Ann Chen
- Heart Rhythm Center and Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Cardiology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yi-Jen Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Cardiovascular Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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Chen Y, Li X, Wang M, Li Y, Fan J, Yan J, Zhang S, Lu L, Zou P. A cysteine protease inhibitor GC376 displays potent antiviral activity against coxsackievirus infection. CURRENT RESEARCH IN MICROBIAL SCIENCES 2023; 5:100203. [PMID: 37767059 PMCID: PMC10520345 DOI: 10.1016/j.crmicr.2023.100203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Abstract
Infection with coxsackievirus A10 (CV-A10) can cause hand-foot-mouth disease and is also associated with severe complications, including viral pneumonia, aseptic and viral meningitis. Coxsackievirus infection may also play a role in the pathogenesis of acute myocardial infarction and in the increased risk of type 1 diabetes mellitus in adults. However, there are no approved vaccines or direct antiviral agents available to prevention or treatment of coxsackievirus infection. Here, we reported that GC376 potently inhibited CV-A10 infection in different cell lines without cytotoxicity, significantly suppressed production of viral proteins, and strongly reduced the yields of infectious progeny virions. Further study indicated that GC376, as viral 3C protease inhibitor, had the potential to restrain the cleavage of the viral polyprotein into individually functional proteins, thus suppressed the replication of CV-A10. Furthermore, the drug exhibited antiviral activity against coxsackieviruses of various serotypes including CV-A6, CV-A7 and CV-A16, suggesting that GC376 is a broad-spectrum anti-coxsackievirus inhibitor and the 3C protease is a promising target for developing anti-coxsackievirus agents.
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Affiliation(s)
- Yongkang Chen
- Shanghai Institute of Infectious Disease and Biosecurity, Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Xiaohong Li
- Shanghai Institute of Infectious Disease and Biosecurity, Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Min Wang
- Shanghai Institute of Infectious Disease and Biosecurity, Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yuan Li
- Shanghai Institute of Infectious Disease and Biosecurity, Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jun Fan
- Shanghai Institute of Infectious Disease and Biosecurity, Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jingjing Yan
- Shanghai Institute of Infectious Disease and Biosecurity, Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Shuye Zhang
- Clinical Center for BioTherapy and Institutes of Biomedical Sciences, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lu Lu
- Shanghai Institute of Infectious Disease and Biosecurity, Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Peng Zou
- Shanghai Institute of Infectious Disease and Biosecurity, Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Sciences, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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Baumeier C, Harms D, Aleshcheva G, Gross U, Escher F, Schultheiss HP. Advancing Precision Medicine in Myocarditis: Current Status and Future Perspectives in Endomyocardial Biopsy-Based Diagnostics and Therapeutic Approaches. J Clin Med 2023; 12:5050. [PMID: 37568452 PMCID: PMC10419903 DOI: 10.3390/jcm12155050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
The diagnosis and specific and causal treatment of myocarditis and inflammatory cardiomyopathy remain a major clinical challenge. Despite the rapid development of new imaging techniques, endomyocardial biopsies remain the gold standard for accurate diagnosis of inflammatory myocardial disease. With the introduction and continued development of immunohistochemical inflammation diagnostics in combination with viral nucleic acid testing, myocarditis diagnostics have improved significantly since their introduction. Together with new technologies such as miRNA and gene expression profiling, quantification of specific immune cell markers, and determination of viral activity, diagnostic accuracy and patient prognosis will continue to improve in the future. In this review, we summarize the current knowledge on the pathogenesis and diagnosis of myocarditis and inflammatory cardiomyopathies and highlight future perspectives for more in-depth and specialized biopsy diagnostics and precision, personalized medicine approaches.
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Affiliation(s)
- Christian Baumeier
- Institute of Cardiac Diagnostics and Therapy, IKDT GmbH, 12203 Berlin, Germany; (D.H.); (G.A.); (U.G.); (H.-P.S.)
| | - Dominik Harms
- Institute of Cardiac Diagnostics and Therapy, IKDT GmbH, 12203 Berlin, Germany; (D.H.); (G.A.); (U.G.); (H.-P.S.)
- Department of Infectious Diseases, Robert Koch Institute, 13353 Berlin, Germany
| | - Ganna Aleshcheva
- Institute of Cardiac Diagnostics and Therapy, IKDT GmbH, 12203 Berlin, Germany; (D.H.); (G.A.); (U.G.); (H.-P.S.)
| | - Ulrich Gross
- Institute of Cardiac Diagnostics and Therapy, IKDT GmbH, 12203 Berlin, Germany; (D.H.); (G.A.); (U.G.); (H.-P.S.)
| | - Felicitas Escher
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Virchow Klinikum, 13353 Berlin, Germany;
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, 10785 Berlin, Germany
| | - Heinz-Peter Schultheiss
- Institute of Cardiac Diagnostics and Therapy, IKDT GmbH, 12203 Berlin, Germany; (D.H.); (G.A.); (U.G.); (H.-P.S.)
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Johnson D, Jiang W. Infectious diseases, autoantibodies, and autoimmunity. J Autoimmun 2023; 137:102962. [PMID: 36470769 PMCID: PMC10235211 DOI: 10.1016/j.jaut.2022.102962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 11/27/2022] [Indexed: 12/04/2022]
Abstract
Infections are known to trigger flares of autoimmune diseases in humans and serve as an inciting cause of autoimmunity in animals. Evidence suggests a causative role of infections in triggering antigen-specific autoimmunity, previous thought mainly through antigen mimicry. However, an infection can induce bystander autoreactive T and B cell polyclonal activation, believed to result in non-pathogenic and pathogenic autoimmune responses. Lastly, epitope spreading in autoimmunity is a mechanism of epitope changes of autoreactive cells induced by infection, promoting the targeting of additional self-epitopes. This review highlights recent research findings, emphasizes infection-mediated autoimmune responses, and discusses the possible mechanisms involved.
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Affiliation(s)
- Douglas Johnson
- Department of Microbiology and Immunology, Medical University of South Carolina, 173 Ashley Ave., Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Wei Jiang
- Department of Microbiology and Immunology, Medical University of South Carolina, 173 Ashley Ave., Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA; Divison of Infectious Disease, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
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Luo Y, Zhang H, Yu J, Wei L, Li M, Xu W. Stem cell factor/mast cell/CCL2/monocyte/macrophage axis promotes Coxsackievirus B3 myocarditis and cardiac fibrosis by increasing Ly6C high monocyte influx and fibrogenic mediators production. Immunology 2022; 167:590-605. [PMID: 36054617 DOI: 10.1111/imm.13556] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 02/10/2022] [Indexed: 06/15/2023] Open
Abstract
Mast cells (MCs), central players in allergy and parasitic infections, play key roles in inflammation and fibrosis. Here, the impact of MCs on the progression of Coxsackievirus B3 (CVB3)-induced viral myocarditis (VMC) and fibrosis was investigated using MC-deficient KitW-sh mice. Viral titres, cellular infiltrates and heart pathologies were evaluated and compared with wild-type (WT) mice during acute CVB3 infection of C57BL/6 mice. CVB3 infection induced an increased accumulation and degranulation of MCs in the hearts of mice during acute infection. MC-deficient KitW-sh mice had slightly higher viral titres, decreased VMC and cardiac fibrosis and improved cardiac dysfunction compared to WT mice via decreasing cardiac influx of Ly6Chigh monocytes/macrophages (Mo/Mφ). While bone marrow-derived MC reconstitution decreased viral titre and worsened improved survival and VMC severity in Wsh mice. MC-fibroblasts co-culture revealed a cardiac MC-fibroblasts crosstalk during early infection: fibroblasts trigger MC degranulation and secretion of CCL2 and tumour necrosis factor alpha (TNF-α) via producing early stem cell factor (SCF); while MCs-fibrogenic mediators (TNF-α) stimulate fibroblasts to increase CCL2, α-smooth muscle actin (SMA), collagen and transforming growth factor beta(TGFβ) expression, thus aggravating cardiac fibrosis. MCs and fibroblast-derived CCL2s are both essential for cardiac Ly6Chigh Mo/Mφ influx. Administration of recombinant mouse SCF to CVB3-infected mice aggravates VMC via accelerating MCs accumulation and cardiac influx of Ly6Chi Mo/Mφ. Collectively, our data highlight an early MC-fibroblast crosstalk and SCF/MC/CCL2/Mo/Mφ axis as important mechanisms required for triggering VMC and myocardial fibrosis. This finding indicates critical roles of MCs in initiating and modulating cardiac innate response to CVB3 and has an implication in developing new and more effective treatments for VMC.
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Affiliation(s)
- Yuan Luo
- Jiangsu Provincial Key Laboratory of Infection and Immunity, Institutes of Biology and Medical Sciences, Soochow University, Suzhou, China
| | - Hongkai Zhang
- Jiangsu Provincial Key Laboratory of Infection and Immunity, Institutes of Biology and Medical Sciences, Soochow University, Suzhou, China
| | - Jie Yu
- Jiangsu Provincial Key Laboratory of Infection and Immunity, Institutes of Biology and Medical Sciences, Soochow University, Suzhou, China
| | - Lin Wei
- Jiangsu Provincial Key Laboratory of Infection and Immunity, Institutes of Biology and Medical Sciences, Soochow University, Suzhou, China
| | - Min Li
- Jiangsu Provincial Key Laboratory of Infection and Immunity, Institutes of Biology and Medical Sciences, Soochow University, Suzhou, China
| | - Wei Xu
- Jiangsu Provincial Key Laboratory of Infection and Immunity, Institutes of Biology and Medical Sciences, Soochow University, Suzhou, China
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Oliveras T, Revuelta-López E, García-García C, Cserkóová A, Rueda F, Labata C, Ferrer M, Montero S, El-Ouaddi N, Martínez MJ, Roura S, Gálvez-Montón C, Bayes-Genis A. Circulating virome and inflammatory proteome in patients with ST-elevation myocardial infarction and primary ventricular fibrillation. Sci Rep 2022; 12:7910. [PMID: 35552514 PMCID: PMC9098642 DOI: 10.1038/s41598-022-12075-x] [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: 09/02/2021] [Accepted: 05/05/2022] [Indexed: 11/09/2022] Open
Abstract
Primary ventricular fibrillation (PVF) is a life-threatening complication of ST-segment elevation myocardial infarction (STEMI). It is unclear what roles viral infection and/or systemic inflammation may play as underlying triggers of PVF, as a second hit in the context of acute ischaemia. Here we aimed to evaluate whether the circulating virome and inflammatory proteome were associated with PVF development in patients with STEMI. Blood samples were obtained from non-PVF and PVF STEMI patients at the time of primary PCI, and from non-STEMI healthy controls. The virome profile was analysed using VirCapSeq-VERT (Virome Capture Sequencing Platform for Vertebrate Viruses), a sequencing platform targeting viral taxa of 342,438 representative sequences, spanning all virus sequence records. The inflammatory proteome was explored with the Olink inflammation panel, using the Proximity Extension Assay technology. After analysing all viral taxa known to infect vertebrates, including humans, we found that non-PVF and PVF patients only significantly differed in the frequencies of viruses in the Gamma-herpesvirinae and Anelloviridae families. In particular, most showed a significantly higher relative frequency in non-PVF STEMI controls. Analysis of systemic inflammation revealed no significant differences between the inflammatory profiles of non-PVF and PVF STEMI patients. Inflammatory proteins associated with cell adhesion, chemotaxis, cellular response to cytokine stimulus, and cell activation proteins involved in immune response (IL6, IL8 CXCL-11, CCL-11, MCP3, MCP4, and ENRAGE) were significantly higher in STEMI patients than non-STEMI controls. CDCP1 and IL18-R1 were significantly higher in PVF patients compared to healthy subjects, but not compared to non-PVF patients. The circulating virome and systemic inflammation were not associated with increased risk of PVF development in acute STEMI. Accordingly, novel strategies are needed to elucidate putative triggers of PVF in the setting of acute ischaemia, in order to reduce STEMI-driven sudden death burden.
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Affiliation(s)
- Teresa Oliveras
- Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, Badalona, 08916, Barcelona, Spain. .,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Elena Revuelta-López
- Heart Failure and Cardiac Regeneration (ICREC) Research Program, Health Sciences Research Institute Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Cosme García-García
- Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, Badalona, 08916, Barcelona, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,Faculty of Medicine, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Barcelona, Spain
| | - Adriana Cserkóová
- Heart Failure and Cardiac Regeneration (ICREC) Research Program, Health Sciences Research Institute Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Ferran Rueda
- Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, Badalona, 08916, Barcelona, Spain
| | - Carlos Labata
- Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, Badalona, 08916, Barcelona, Spain
| | - Marc Ferrer
- Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, Badalona, 08916, Barcelona, Spain
| | - Santiago Montero
- Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, Badalona, 08916, Barcelona, Spain
| | - Nabil El-Ouaddi
- Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, Badalona, 08916, Barcelona, Spain
| | - Maria José Martínez
- Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, Badalona, 08916, Barcelona, Spain
| | - Santiago Roura
- Heart Failure and Cardiac Regeneration (ICREC) Research Program, Health Sciences Research Institute Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,Faculty of Medicine, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Barcelona, Spain
| | - Carolina Gálvez-Montón
- Heart Failure and Cardiac Regeneration (ICREC) Research Program, Health Sciences Research Institute Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Antoni Bayes-Genis
- Heart Failure Unit and Cardiology Department, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, Badalona, 08916, Barcelona, Spain. .,Heart Failure and Cardiac Regeneration (ICREC) Research Program, Health Sciences Research Institute Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain. .,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain. .,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. .,Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, Badalona, 08916, Barcelona, Spain.
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Yang Q, Yan D, Song Y, Zhu S, He Y, Han Z, Wang D, Ji T, Zhang Y, Xu W. Whole-genome analysis of coxsackievirus B3 reflects its genetic diversity in China and worldwide. Virol J 2022; 19:69. [PMID: 35436962 PMCID: PMC9014606 DOI: 10.1186/s12985-022-01796-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 04/03/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Coxsackievirus B3 (CVB3) has emerged as an active pathogen in myocarditis, aseptic meningitis, hand, foot, and mouth disease (HFMD), and pancreatitis, and is a heavy burden on public health. However, CVB3 has not been systematically analyzed with regard to whole-genome diversity and recombination. Therefore, this study was undertaken to systematically examine the genetic characteristics of CVB3 based on its whole genome.
Methods
We combined CVB3 isolates from our national HFMD surveillance and global sequences retrieved from GenBank. Phylogenetic analysis was performed to examine the whole genome variety and recombination forms of CVB3 in China and worldwide.
Results
Phylogenetic analysis showed that CVB3 strains isolated worldwide could be classified into clusters A–E based on the sequence of the entire VP1 region. The predominant CVB3 strains in China belonged to cluster D, whereas cluster E CVB3 might be circulated globally compared to other clusters. The average nucleotide substitution rate in the P1 region of CVB3 was 4.82 × 10–3 substitutions/site/year. Myocarditis was more common with cluster A. Clusters C and D presented more cases of acute flaccid paralysis, and cluster D may be more likely to cause HFMD. Multiple recombination events were detected among CVB3 variants, and there were twenty-three recombinant lineages of CVB3 circulating worldwide.
Conclusions
Overall, this study provides full-length genomic sequences of CVB3 isolates with a wide geographic distribution over a long-term time scale in China, which will be helpful for understanding the evolution of this pathogen. Simultaneously, continuous surveillance of CVB3 is indispensable to determine its genetic diversity in China as well as worldwide.
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Valera IC, Wacker AL, Hwang HS, Holmes C, Laitano O, Landstrom AP, Parvatiyar MS. Essential roles of the dystrophin-glycoprotein complex in different cardiac pathologies. Adv Med Sci 2021; 66:52-71. [PMID: 33387942 DOI: 10.1016/j.advms.2020.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/12/2020] [Accepted: 12/17/2020] [Indexed: 12/20/2022]
Abstract
The dystrophin-glycoprotein complex (DGC), situated at the sarcolemma dynamically remodels during cardiac disease. This review examines DGC remodeling as a common denominator in diseases affecting heart function and health. Dystrophin and the DGC serve as broad cytoskeletal integrators that are critical for maintaining stability of muscle membranes. The presence of pathogenic variants in genes encoding proteins of the DGC can cause absence of the protein and/or alterations in other complex members leading to muscular dystrophies. Targeted studies have allowed the individual functions of affected proteins to be defined. The DGC has demonstrated its dynamic function, remodeling under a number of conditions that stress the heart. Beyond genetic causes, pathogenic processes also impinge on the DGC, causing alterations in the abundance of dystrophin and associated proteins during cardiac insult such as ischemia-reperfusion injury, mechanical unloading, and myocarditis. When considering new therapeutic strategies, it is important to assess DGC remodeling as a common factor in various heart diseases. The DGC connects the internal F-actin-based cytoskeleton to laminin-211 of the extracellular space, playing an important role in the transmission of mechanical force to the extracellular matrix. The essential functions of dystrophin and the DGC have been long recognized. DGC based therapeutic approaches have been primarily focused on muscular dystrophies, however it may be a beneficial target in a number of disorders that affect the heart. This review provides an account of what we now know, and discusses how this knowledge can benefit persistent health conditions in the clinic.
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Affiliation(s)
- Isela C Valera
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA
| | - Amanda L Wacker
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA
| | - Hyun Seok Hwang
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA
| | - Christina Holmes
- Department of Chemical and Biomedical Engineering, Florida A&M University-Florida State University College of Engineering, Tallahassee, FL, USA
| | - Orlando Laitano
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA
| | - Andrew P Landstrom
- Department of Pediatrics, Division of Cardiology, Duke University School of Medicine, Durham, NC, USA; Department of Cell Biology, Duke University School of Medicine, Durham, NC, USA
| | - Michelle S Parvatiyar
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA.
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10
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Glinge C, Engstrøm T, Midgley SE, Tanck MWT, Madsen JEH, Pedersen F, Ravn Jacobsen M, Lodder EM, Al-Hussainy NR, Kjær Stampe N, Trebbien R, Køber L, Gerds T, Torp-Pedersen C, Kølsen Fischer T, Bezzina CR, Tfelt-Hansen J, Jabbari R. Seasonality of ventricular fibrillation at first myocardial infarction and association with viral exposure. PLoS One 2020; 15:e0226936. [PMID: 32101559 PMCID: PMC7043782 DOI: 10.1371/journal.pone.0226936] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 11/25/2019] [Indexed: 11/19/2022] Open
Abstract
AIMS To investigate seasonality and association of increased enterovirus and influenza activity in the community with ventricular fibrillation (VF) risk during first ST-elevation myocardial infarction (STEMI). METHODS This study comprised all consecutive patients with first STEMI (n = 4,659; aged 18-80 years) admitted to the invasive catheterization laboratory between 2010-2016, at Copenhagen University Hospital, Rigshospitalet, covering eastern Denmark (2.6 million inhabitants, 45% of the Danish population). Hospital admission, prescription, and vital status data were assessed using Danish nationwide registries. We utilized monthly/weekly surveillance data for enterovirus and influenza from the Danish National Microbiology Database (2010-2016) that receives copies of laboratory tests from all Danish departments of clinical microbiology. RESULTS Of the 4,659 consecutively enrolled STEMI patients, 581 (12%) had VF before primary percutaneous coronary intervention. In a subset (n = 807), we found that VF patients experienced more generalized fatigue and flu-like symptoms within 7 days before STEMI compared with the patients without VF (OR 3.39, 95% CI 1.76-6.54). During the study period, 2,704 individuals were diagnosed with enterovirus and 19,742 with influenza. No significant association between enterovirus and VF (OR 1.00, 95% CI 0.99-1.02), influenza and VF (OR 1.00, 95% CI 1.00-1.00), or week number and VF (p-value 0.94 for enterovirus and 0.89 for influenza) was found. CONCLUSION We found no clear seasonality of VF during first STEMI. Even though VF patients had experienced more generalized fatigue and flu-like symptoms within 7 days before STEMI compared with patients without VF, no relationship was found between enterovirus or influenza exposure and occurrence of VF.
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Affiliation(s)
- Charlotte Glinge
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Thomas Engstrøm
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Cardiology, University of Lund, Lund, Sweden
| | - Sofie E. Midgley
- Department of Virus and Microbiological Special Diagnostics, Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Michael W. T. Tanck
- Amsterdam UMC, University of Amsterdam, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health (APH), Amsterdam, The Netherlands
| | - Jeppe Ekstrand Halkjær Madsen
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Section of Biostatistics, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Frants Pedersen
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mia Ravn Jacobsen
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Elisabeth M. Lodder
- Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Nour R. Al-Hussainy
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Niels Kjær Stampe
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ramona Trebbien
- Department of Virus and Microbiological Special Diagnostics, Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Lars Køber
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thomas Gerds
- Section of Biostatistics, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Clinical Investigation and Cardiology, Nordsjaellands Hospital, Hillerød, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Thea Kølsen Fischer
- Department of Virus and Microbiological Special Diagnostics, Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
- Department of Infectious Diseases and Department of Global Health, Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Connie R. Bezzina
- Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Jacob Tfelt-Hansen
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Reza Jabbari
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- International External Collaborator Sponsored Staff at Division of Preventive Medicine, Brigham & Women's Hospital, Boston, MA, United States of America
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11
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Alekseeva YV, Rebenkova MS, Gombozhapova AE, Rogovskaya YV, Ryabov VV. [Detection of Antigens of Cardiotropic Viruses in Atherosclerotic Plaques in Patients with Fatal Myocardial Infarction]. ACTA ACUST UNITED AC 2019; 59:38-43. [PMID: 31322088 DOI: 10.18087/cardio.2019.7.2577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 07/19/2019] [Indexed: 11/18/2022]
Abstract
AIM To assess the frequency of detection of cardiotropic virus antigens in coronary artery atherosclerotic plaques in patients with fatal myocardial infarction (MI). MATERIALS AND METHODS We examined fragments of coronary plaques of 12 patients with fatal type 1 MI. Immunohistochemistry (IHC) of plaques was performed with the paraffin blocks using antibodies to Herpes simplex virus (HSV)-1, HSV-2, HSV-6, cytomegalovirus (CMV), parvovirus B19, adenovirus, Epstein-Barr virus and enteroviruses. RESULTS According to the IHC all patients had virus antigens. The most common virus agents in fragments of coronary plaques were HSV-6 (10 patients) and enteroviruses (5 patients). Antigens of CMV, parvovirus B19, adenovirus, Epstein-Barr virus were not detected in any case. CONCLUSIONS In this study viral antigens in coronary artery atherosclerotic plaques were found in all victims of fatal MI. There was no difference in the frequency of detection and type of viral agents between plaques in culprit arteries and uncomplicated atherosclerotic plaques.
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12
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Cartoski MJ, Nikolov PP, Prakosa A, Boyle PM, Spevak PJ, Trayanova NA. Computational Identification of Ventricular Arrhythmia Risk in Pediatric Myocarditis. Pediatr Cardiol 2019; 40:857-864. [PMID: 30840104 PMCID: PMC6451890 DOI: 10.1007/s00246-019-02082-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 02/27/2019] [Indexed: 12/11/2022]
Abstract
Children with myocarditis have increased risk of ventricular tachycardia (VT) due to myocardial inflammation and remodeling. There is currently no accepted method for VT risk stratification in this population. We hypothesized that personalized models developed from cardiac late gadolinium enhancement magnetic resonance imaging (LGE-MRI) could determine VT risk in patients with myocarditis using a previously-validated protocol. Personalized three-dimensional computational cardiac models were reconstructed from LGE-MRI scans of 12 patients diagnosed with myocarditis. Four patients with clinical VT and eight patients without VT were included in this retrospective analysis. In each model, we incorporated a personalized spatial distribution of fibrosis and myocardial fiber orientations. Then, VT inducibility was assessed in each model by pacing rapidly from 26 sites distributed throughout both ventricles. Sustained reentrant VT was induced from multiple pacing sites in all patients with clinical VT. In the eight patients without clinical VT, we were unable to induce sustained reentry in our simulations using rapid ventricular pacing. Application of our non-invasive approach in children with myocarditis has the potential to correctly identify those at risk for developing VT.
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Affiliation(s)
- Mark J. Cartoski
- Divison of Pediatric Cardiology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Plamen P. Nikolov
- Institute for Computational Medicine and Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Adityo Prakosa
- Institute for Computational Medicine and Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Patrick M. Boyle
- Institute for Computational Medicine and Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Philip J. Spevak
- Divison of Pediatric Cardiology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Natalia A. Trayanova
- Institute for Computational Medicine and Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA,Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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13
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Abstract
Infectious myocarditis is the result of an immune response to a microbial infection of the heart. The blood vessels of the heart, both the intramyocardial microvasculature and the large epicardial coronary arteries, play an important role in the pathogenesis of infectious myocarditis. First of all, in addition to cardiomyocytes, endothelial cells of the cardiac (micro)vasculature are direct targets for infection. Moreover, through the expression of adhesion molecules and antigen presenting Major Histocompatibility Complex molecules, the blood vessels assist in shaping the cellular immune response in infectious myocarditis. In addition, damage and dysfunction of the cardiac (micro)vasculature are associated with thrombus formation as well as aberrant regulation of vascular tone including coronary vasospasm. These in turn can cause cardiac perfusion abnormalities and even myocardial infarction. In this review, we will discuss the role of the cardiac (micro)vasculature in the pathogenesis of infectious myocarditis.
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14
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Peterson JM, Wang DJ, Shettigar V, Roof SR, Canan BD, Bakkar N, Shintaku J, Gu JM, Little SC, Ratnam NM, Londhe P, Lu L, Gaw CE, Petrosino JM, Liyanarachchi S, Wang H, Janssen PML, Davis JP, Ziolo MT, Sharma SM, Guttridge DC. NF-κB inhibition rescues cardiac function by remodeling calcium genes in a Duchenne muscular dystrophy model. Nat Commun 2018; 9:3431. [PMID: 30143619 PMCID: PMC6109146 DOI: 10.1038/s41467-018-05910-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 07/25/2018] [Indexed: 12/20/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is a neuromuscular disorder causing progressive muscle degeneration. Although cardiomyopathy is a leading mortality cause in DMD patients, the mechanisms underlying heart failure are not well understood. Previously, we showed that NF-κB exacerbates DMD skeletal muscle pathology by promoting inflammation and impairing new muscle growth. Here, we show that NF-κB is activated in murine dystrophic (mdx) hearts, and that cardiomyocyte ablation of NF-κB rescues cardiac function. This physiological improvement is associated with a signature of upregulated calcium genes, coinciding with global enrichment of permissive H3K27 acetylation chromatin marks and depletion of the transcriptional repressors CCCTC-binding factor, SIN3 transcription regulator family member A, and histone deacetylase 1. In this respect, in DMD hearts, NF-κB acts differently from its established role as a transcriptional activator, instead promoting global changes in the chromatin landscape to regulate calcium genes and cardiac function.
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Affiliation(s)
- Jennifer M Peterson
- Department of Cancer Biology and Genetics, Columbus, OH, 43210, USA.,Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Department of Pharmacy and Pharmaceutical Sciences, SUNY Binghamton University, Binghamton, NY, 13902, USA
| | - David J Wang
- Department of Cancer Biology and Genetics, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, 29425, USA
| | - Vikram Shettigar
- Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Department of Physiology and Cell Biology, The Ohio State University Medical Center, Columbus, 43210, Ohio, USA
| | - Steve R Roof
- Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Department of Physiology and Cell Biology, The Ohio State University Medical Center, Columbus, 43210, Ohio, USA.,Q Test Labs, Columbus, OH, 43235, USA
| | - Benjamin D Canan
- Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Department of Physiology and Cell Biology, The Ohio State University Medical Center, Columbus, 43210, Ohio, USA
| | - Nadine Bakkar
- Department of Cancer Biology and Genetics, Columbus, OH, 43210, USA.,Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Department of Neurobiology, St Joseph's Hospital and Medical Center-Barrow Neurological Institute, Phoenix, AZ, 85013, USA
| | - Jonathan Shintaku
- Department of Cancer Biology and Genetics, Columbus, OH, 43210, USA.,Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Department of Neurology, Columbia University Medical Center, New York, NY, 10032, USA
| | - Jin-Mo Gu
- Department of Cancer Biology and Genetics, Columbus, OH, 43210, USA.,Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Department of Biomedical Engineering and Pediatrics, Emory University, Decatur, GA, 30322, USA
| | - Sean C Little
- Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Department of Physiology and Cell Biology, The Ohio State University Medical Center, Columbus, 43210, Ohio, USA.,Bristol-Myers Squibb, Wallingford, CT, 06492, USA
| | - Nivedita M Ratnam
- Department of Cancer Biology and Genetics, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA
| | - Priya Londhe
- Department of Cancer Biology and Genetics, Columbus, OH, 43210, USA.,Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Molecular Oncology Research Institute, Tufts Medical Center, Boston, MA, 02111, USA
| | - Leina Lu
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Christopher E Gaw
- The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Jennifer M Petrosino
- Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA
| | - Sandya Liyanarachchi
- Department of Cancer Biology and Genetics, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA
| | - Huating Wang
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Paul M L Janssen
- Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Department of Physiology and Cell Biology, The Ohio State University Medical Center, Columbus, 43210, Ohio, USA
| | - Jonathan P Davis
- Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Department of Physiology and Cell Biology, The Ohio State University Medical Center, Columbus, 43210, Ohio, USA
| | - Mark T Ziolo
- Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA.,The Ohio State University Medical Center, Columbus, OH, 43210, USA.,Department of Physiology and Cell Biology, The Ohio State University Medical Center, Columbus, 43210, Ohio, USA
| | - Sudarshana M Sharma
- Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Denis C Guttridge
- Department of Cancer Biology and Genetics, Columbus, OH, 43210, USA. .,Center for Muscle Health and Neuromuscular Disorders, Columbus, OH, 43210, USA. .,The Ohio State University Medical Center, Columbus, OH, 43210, USA. .,Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, 29425, USA.
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15
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García-García C, Oliveras T, Rueda F, Pérez-Fernández S, Ferrer M, Serra J, Labata C, Vila J, Carrillo X, Rodríguez-Leor O, Fernández-Nofrerias E, Faixedas MT, Jiménez J, Mauri J, Lupón J, Bayes-Genis A. Primary Ventricular Fibrillation in the Primary Percutaneous Coronary Intervention ST-Segment Elevation Myocardial Infarction Era (from the "Codi IAM" Multicenter Registry). Am J Cardiol 2018; 122:529-536. [PMID: 29960663 DOI: 10.1016/j.amjcard.2018.04.054] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/20/2018] [Accepted: 04/24/2018] [Indexed: 12/31/2022]
Abstract
Primary ventricular fibrillation (PVF) is a dreadful complication of ST segment elevation myocardial infarction (STEMI). Scarce data are available regarding PVF prognosis since primary percutaneous coronary intervention (PPCI) became routine practice in STEMI. Our aim was to compare 30-day and 1-year mortality for patients with and without PVF (including out-of-hospital and in-hospital PVF) within a regional registry of PPCI-treated STEMI patients. This prospective multicenter registry included all consecutive STEMI patients treated with PPCI from January 2010 to December 2014. Patients were classified as non-PVF or PVF, with further subdivision into out-of-hospital and in-hospital PVF. We analyzed 30-day and 1-year all-cause mortality in groups. The registry included 10,965 patients. PVF occurred in 949 patients (8.65%), including 74.2% out-of-hospital and 25.8% in-hospital PVF. Compared with the non-PVF group, PVF patients were younger; less commonly diabetic; more frequently had anterior wall STEMI, higher Killip-Kimball class, and left main disease; and showed significantly higher 24-hour (5.1% vs 1.1%), 30-day (18.5% vs 4.7%), and 1-year mortality (23.2% vs 7.9%) (all p <0.001). Mortality did not differ in out-of-hospital versus in-hospital PVF. After multivariable adjustment, PVF remained associated with all-cause 30-day (2.32, 95% CI: 1.91 to 2.82, p <0.001) and 1-year (HR: 1.59, 95% CI: 1.13 to 2.24, p = 0.008) mortality. In conclusion, we present the largest registry of PVF patients in the era of routine PPCI in STEMI. Although overall STEMI mortality has declined, PVF emerged as a predictor of both 30-day and 1-year mortality. These data warrant prospective validation and proper identification and protection of high-risk patients.
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Affiliation(s)
- Cosme García-García
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain.
| | - Teresa Oliveras
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Ferran Rueda
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | - Marc Ferrer
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Jordi Serra
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Carlos Labata
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Joan Vila
- IMIM (Institut Hospital del Mar d'Investigacions Mèdiques. Grup d'Epidemiologia i Genètica Cardiovasculars (EGEC). REGICOR Study Group, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Xavier Carrillo
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Oriol Rodríguez-Leor
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain
| | | | - Maria Teresa Faixedas
- Catalan Health Service. Generalitat de Catalunya, Codi IAM Registry, Barcelona, Spain
| | - Javier Jiménez
- Catalan Health Service. Generalitat de Catalunya, Codi IAM Registry, Barcelona, Spain
| | - Josepa Mauri
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Catalan Health Service. Generalitat de Catalunya, Codi IAM Registry, Barcelona, Spain
| | - Josep Lupón
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Antoni Bayes-Genis
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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16
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Glinge C, Jabbari R, Tfelt-Hansen J. Virus infection as a trigger for sudden cardiac arrest. Int J Cardiol 2018; 263:163-164. [PMID: 29754915 DOI: 10.1016/j.ijcard.2018.03.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 03/21/2018] [Indexed: 10/16/2022]
Affiliation(s)
- Charlotte Glinge
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Reza Jabbari
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jacob Tfelt-Hansen
- The Heart Centre, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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17
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Kruger MM, Martin LJ, Maistry S, Heathfield LJ. A systematic review exploring the relationship between infection and sudden unexpected death between 2000 and 2016: A forensic perspective. Forensic Sci Int 2018; 289:108-119. [PMID: 29860163 DOI: 10.1016/j.forsciint.2018.05.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/07/2018] [Accepted: 05/14/2018] [Indexed: 11/30/2022]
Abstract
Death due to infectious diseases is a major health concern worldwide. This is of particular concern in developing countries where poor-socio economic status and a lack of healthcare resources contribute to the high burden of disease. In some cases death due to infection can be acute and aggressive, and death may occur without a diagnosis whilst the person is still alive. These deaths may ultimately lead to a medico-legal autopsy being performed. There are various mechanisms by which sudden death due to infection may occur. In addition, there are many risk factors associated with sudden death due to infection, which differ between infants and older individuals. However, it is unclear which pathogens and risk factors are most frequently associated with sudden death due to infection. Therefore a systematic review of articles and case reports published between 1 January 2000 and 30 June 2016 was undertaken in order to (1) explore the relationship between pathogens and their causative role and (2) identify the relationship between predisposing and/or risk factors associated with sudden death due to infection. Major databases were searched and after critical appraisal 143 articles were identified. It was found that respiratory infections and deaths involving bacterial pathogens were most commonly associated with these deaths. In addition the most common risk factors in infants were exposure to tobacco smoke and co-sleeping. In adults the most common risk factors were co-morbid conditions and illnesses. This information aids in a better understanding of these deaths and highlights the need for more research in this field, particularly in developing countries.
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Affiliation(s)
- Mia M Kruger
- Division of Forensic Medicine and Toxicology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925, South Africa.
| | - Lorna J Martin
- Division of Forensic Medicine and Toxicology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925, South Africa.
| | - Sairita Maistry
- Division of Forensic Medicine and Toxicology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925, South Africa.
| | - Laura J Heathfield
- Division of Forensic Medicine and Toxicology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925, South Africa.
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18
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Functional Consequences of RNA 5'-Terminal Deletions on Coxsackievirus B3 RNA Replication and Ribonucleoprotein Complex Formation. J Virol 2017; 91:JVI.00423-17. [PMID: 28539455 DOI: 10.1128/jvi.00423-17] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/17/2017] [Indexed: 12/11/2022] Open
Abstract
Group B coxsackieviruses are responsible for chronic cardiac infections. However, the molecular mechanisms by which the virus can persist in the human heart long after the signs of acute myocarditis have abated are still not completely understood. Recently, coxsackievirus B3 strains with 5'-terminal deletions in genomic RNAs were isolated from a patient suffering from idiopathic dilated cardiomyopathy, suggesting that such mutant viruses may be the forms responsible for persistent infection. These deletions lacked portions of 5' stem-loop I, which is an RNA secondary structure required for viral RNA replication. In this study, we assessed the consequences of the genomic deletions observed in vivo for coxsackievirus B3 biology. Using cell extracts from HeLa cells, as well as transfection of luciferase replicons in two types of cardiomyocytes, we demonstrated that coxsackievirus RNAs harboring 5' deletions ranging from 7 to 49 nucleotides in length can be translated nearly as efficiently as those of wild-type virus. However, these 5' deletions greatly reduced the synthesis of viral RNA in vitro, which was detected only for the 7- and 21-nucleotide deletions. Since 5' stem-loop I RNA forms a ribonucleoprotein complex with cellular and viral proteins involved in viral RNA replication, we investigated the binding of the host cell protein PCBP2, as well as viral protein 3CDpro, to deleted positive-strand RNAs corresponding to the 5' end. We found that binding of these proteins was conserved but that ribonucleoprotein complex formation required higher PCBP2 and 3CDpro concentrations, depending on the size of the deletion. Overall, this study confirmed the characteristics of persistent CVB3 infection observed in heart tissues and provided a possible explanation for the low level of RNA replication observed for the 5'-deleted viral genomes-a less stable ribonucleoprotein complex formed with proteins involved in viral RNA replication.IMPORTANCE Dilated cardiomyopathy is the most common indication for heart transplantation worldwide, and coxsackie B viruses are detected in about one-third of idiopathic dilated cardiomyopathies. Terminal deletions at the 5' end of the viral genome involving an RNA secondary structure required for RNA replication have been recently reported as a possible mechanism of virus persistence in the human heart. These mutations are likely to disrupt the correct folding of an RNA secondary structure required for viral RNA replication. In this report, we demonstrate that transfected RNAs harboring 5'-terminal sequence deletions are able to direct the synthesis of viral proteins, but not genomic RNAs, in human and murine cardiomyocytes. Moreover, we show that the binding of cellular and viral replication factors to viral RNA is conserved despite genomic deletions but that the impaired RNA synthesis associated with terminally deleted viruses could be due to destabilization of the ribonucleoprotein complexes formed.
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19
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Cocco G, Jerie P, Amiet P, Pandolfi S. Inflammation in Heart Failure: known knowns and unknown unknowns. Expert Opin Pharmacother 2017; 18:1225-1233. [DOI: 10.1080/14656566.2017.1351948] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | - Paul Jerie
- Cardiology Office, Rheinfelden, Switzerland
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20
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Woudstra L, Biesbroek PS, Emmens RW, Heymans S, Juffermans LJ, van Rossum AC, Niessen HWM, Krijnen PAJ. Lymphocytic myocarditis occurs with myocardial infarction and coincides with increased inflammation, hemorrhage and instability in coronary artery atherosclerotic plaques. Int J Cardiol 2017; 232:53-62. [PMID: 28087177 DOI: 10.1016/j.ijcard.2017.01.052] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 12/28/2016] [Accepted: 01/04/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Although lymphocytic myocarditis (LM) clinically can mimic myocardial infarction (MI), they are regarded as distinct clinical entities. However, we observed a high prevalence (32%) of recent MI in patients diagnosed post-mortem with LM. To investigate if LM changes coronary atherosclerotic plaque, we analyzed in autopsied hearts the inflammatory infiltrate and stability in coronary atherosclerotic lesions in patients with LM and/or MI. METHODS The three main coronary arteries were isolated at autopsy of patients with LM, with MI of 3-6h old, with LM and MI of 3-6h old (LM+MI) and controls. In tissue sections of atherosclerotic plaque-containing coronary segments inflammatory infiltration, plaque stability, intraplaque hemorrhage and thrombi were determined via (immuno)histological criteria. RESULTS In tissue sections of those coronary segments the inflammatory infiltrate was found to be significantly increased in patients with LM, LM+MI and MI compared with controls. This inflammatory infiltrate consisted predominantly of macrophages and neutrophils in patients with only LM or MI, of lymphocytes in LM+MI and MI patients and of mast cells in LM+MI patients. Moreover, in LM+MI and MI patients this coincided with an increase of unstable plaques and thrombi. Finally, LM and especially MI and LM+MI patients showed significantly increased intraplaque hemorrhage. CONCLUSIONS This study demonstrates prevalent co-occurrence of LM with a very recent MI at autopsy. Moreover, LM was associated with remodeling and inflammation of atherosclerotic plaques indicative of plaque destabilization pointing to coronary spasm, suggesting that preexistent LM, or its causes, may facilitate the development of MI.
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Affiliation(s)
- Linde Woudstra
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands; ICaR-VU, Institute for Cardiovascular Research, VU University Medical Center, The Netherlands.
| | - P Stefan Biesbroek
- ICaR-VU, Institute for Cardiovascular Research, VU University Medical Center, The Netherlands; Department of Cardiology, VU University Medical Center, The Netherlands; ICIN, Inter-university Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Reindert W Emmens
- ICaR-VU, Institute for Cardiovascular Research, VU University Medical Center, The Netherlands
| | - Stephane Heymans
- Center for Heart Failure Research, Cardiovascular Research Institute Maastricht (CARIM), University Hospital Maastricht, Maastricht, The Netherlands
| | - Lynda J Juffermans
- ICaR-VU, Institute for Cardiovascular Research, VU University Medical Center, The Netherlands; Department of Cardiology, VU University Medical Center, The Netherlands
| | - Albert C van Rossum
- ICaR-VU, Institute for Cardiovascular Research, VU University Medical Center, The Netherlands; Department of Cardiology, VU University Medical Center, The Netherlands
| | - Hans W M Niessen
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands; ICaR-VU, Institute for Cardiovascular Research, VU University Medical Center, The Netherlands; Department of Cardiothoracic Surgery, VU University Medical Center, The Netherlands
| | - Paul A J Krijnen
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands; ICaR-VU, Institute for Cardiovascular Research, VU University Medical Center, The Netherlands
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21
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Karam N, Bataille S, Marijon E, Giovannetti O, Tafflet M, Savary D, Benamer H, Caussin C, Garot P, Juliard JM, Pires V, Boche T, Dupas F, Le Bail G, Lamhaut L, Laborne F, Lefort H, Mapouata M, Lapostolle F, Spaulding C, Empana JP, Jouven X, Lambert Y. Identifying Patients at Risk for Prehospital Sudden Cardiac Arrest at the Early Phase of Myocardial Infarction. Circulation 2016; 134:2074-2083. [DOI: 10.1161/circulationaha.116.022954] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 09/28/2016] [Indexed: 11/16/2022]
Abstract
Background:
In-hospital mortality of ST-segment–elevation myocardial infarction (STEMI) has decreased drastically. In contrast, prehospital mortality from sudden cardiac arrest (SCA) remains high and difficult to reduce. Identification of the patients with STEMI at higher risk for prehospital SCA could facilitate rapid triage and intervention in the field.
Methods:
Using a prospective, population-based study evaluating all patients with STEMI managed by emergency medical services in the greater Paris area (11.7 million inhabitants) between 2006 and 2010, we identified characteristics associated with an increased risk of prehospital SCA and used these variables to build an SCA prediction score, which we validated internally and externally.
Results:
In the overall STEMI population (n=8112; median age, 60 years; 78% male), SCA occurred in 452 patients (5.6%). In multivariate analysis, younger age, absence of obesity, absence of diabetes mellitus, shortness of breath, and a short delay between pain onset and call to emergency medical services were the main predictors of SCA. A score built from these variables predicted SCA, with the risk increasing 2-fold in patients with a score between 10 and 19, 4-fold in those with a score between 20 and 29, and >18-fold in patients with a score ≥30 compared with those with scores <10. The SCA rate was 28.9% in patients with a score ≥30 compared with 1.6% in patients with a score ≤9 (
P
for trend <0.001). The area under the curve values were 0.7033 in the internal validation sample and 0.6031 in the external validation sample. Sensitivity and specificity varied between 96.9% and 10.5% for scores ≥10 and between 18.0% and 97.6% for scores ≥30, with scores between 20 and 29 achieving the best sensitivity and specificity (65.4% and 62.6%, respectively).
Conclusions:
At the early phase of STEMI, the risk of prehospital SCA can be determined through a simple score of 5 routinely assessed predictors. This score might help optimize the dispatching and management of patients with STEMI by emergency medical services.
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Affiliation(s)
- Nicole Karam
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Sophie Bataille
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Eloi Marijon
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Olivier Giovannetti
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Muriel Tafflet
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Dominique Savary
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Hakim Benamer
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Christophe Caussin
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Philippe Garot
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Jean-Michel Juliard
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Virginie Pires
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Thévy Boche
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - François Dupas
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Gaelle Le Bail
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Lionel Lamhaut
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - François Laborne
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Hugues Lefort
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Mireille Mapouata
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Frederic Lapostolle
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Christian Spaulding
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Jean-Philippe Empana
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Xavier Jouven
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
| | - Yves Lambert
- From Sudden Death Expertise Center, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Université Paris Descartes, Sorbonne Paris Cité, Paris, France (N.K., E.M., M.T., C.S., J.-P.E., X.J.); Cardiology Department, European Georges Pompidou Hospital–APHP, Paris, France (N.K., E.M., C.S., X.J.); Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France (N.K., E.M., O.G., M.T., M.M., C.S., J.-P.E., X.J.); Regional Health Agency of Ile-de-France, Paris, France (S.B.); Emergency Department
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22
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Wang Q, Wehrens XHT. Connecting enterovirus infection to dystrophin dysfunction in dilated cardiomyopathy. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:S23. [PMID: 27867991 DOI: 10.21037/atm.2016.10.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Qiongling Wang
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Molecular Physiology & Biophysics, Baylor College of Medicine, Houston, TX, USA
| | - Xander H T Wehrens
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, USA; Department of Molecular Physiology & Biophysics, Baylor College of Medicine, Houston, TX, USA; Department of Medicine (Cardiology), Baylor College of Medicine, Houston, TX, USA; Department of Pediatrics (Cardiology), Baylor College of Medicine, Houston, TX, USA
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23
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Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. Epidemiology of coronary heart disease and acute coronary syndrome. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:256. [PMID: 27500157 DOI: 10.21037/atm.2016.06.33] [Citation(s) in RCA: 621] [Impact Index Per Article: 77.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The aim of this review is to summarize the incidence, prevalence, trend in mortality, and general prognosis of coronary heart disease (CHD) and a related condition, acute coronary syndrome (ACS). Although CHD mortality has gradually declined over the last decades in western countries, this condition still causes about one-third of all deaths in people older than 35 years. This evidence, along with the fact that mortality from CHD is expected to continue increasing in developing countries, illustrates the need for implementing effective primary prevention approaches worldwide and identifying risk groups and areas for possible improvement.
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Affiliation(s)
| | - Carme Perez-Quilis
- Research Institute of the Hospital 12 de Octubre ('i+12'), Madrid, Spain
| | - Roman Leischik
- Faculty of Health, School of Medicine, University Witten/Herdecke, Hagen, Germany
| | - Alejandro Lucia
- Research Institute of the Hospital 12 de Octubre ('i+12'), Madrid, Spain;; European University of Madrid, Madrid, Spain
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24
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Abstract
Viral myocarditis remains a prominent infectious-inflammatory disease for patients throughout the lifespan. The condition presents several challenges including varied modes of clinical presentation, a range of timepoints when patients come to attention, a diversity of approaches to diagnosis, a spectrum of clinical courses, and unsettled perspectives on therapeutics in different patient settings and in the face of different viral pathogens. In this review, we examine current knowledge about viral heart disease and especially provide information on evolving understanding of mechanisms of disease and efforts by investigators to identify and evaluate potential therapeutic avenues for intervention.
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Affiliation(s)
- Gabriel Fung
- From the Department of Pathology and Laboratory Medicine (G.F., H.L., Y.Q., D.Y., B.M.), Centre for Heart Lung Innovation (G.F., H.L., Y.Q., D.Y., B.M.), Centre of Excellence for Prevention of Organ Failure (PROOF Centre), and Institute for Heart + Lung Health, St. Paul's Hospital (B.M.), University of British Columbia, Vancouver, British Columbia, Canada
| | - Honglin Luo
- From the Department of Pathology and Laboratory Medicine (G.F., H.L., Y.Q., D.Y., B.M.), Centre for Heart Lung Innovation (G.F., H.L., Y.Q., D.Y., B.M.), Centre of Excellence for Prevention of Organ Failure (PROOF Centre), and Institute for Heart + Lung Health, St. Paul's Hospital (B.M.), University of British Columbia, Vancouver, British Columbia, Canada
| | - Ye Qiu
- From the Department of Pathology and Laboratory Medicine (G.F., H.L., Y.Q., D.Y., B.M.), Centre for Heart Lung Innovation (G.F., H.L., Y.Q., D.Y., B.M.), Centre of Excellence for Prevention of Organ Failure (PROOF Centre), and Institute for Heart + Lung Health, St. Paul's Hospital (B.M.), University of British Columbia, Vancouver, British Columbia, Canada
| | - Decheng Yang
- From the Department of Pathology and Laboratory Medicine (G.F., H.L., Y.Q., D.Y., B.M.), Centre for Heart Lung Innovation (G.F., H.L., Y.Q., D.Y., B.M.), Centre of Excellence for Prevention of Organ Failure (PROOF Centre), and Institute for Heart + Lung Health, St. Paul's Hospital (B.M.), University of British Columbia, Vancouver, British Columbia, Canada
| | - Bruce McManus
- From the Department of Pathology and Laboratory Medicine (G.F., H.L., Y.Q., D.Y., B.M.), Centre for Heart Lung Innovation (G.F., H.L., Y.Q., D.Y., B.M.), Centre of Excellence for Prevention of Organ Failure (PROOF Centre), and Institute for Heart + Lung Health, St. Paul's Hospital (B.M.), University of British Columbia, Vancouver, British Columbia, Canada.
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25
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Barnabei MS, Sjaastad FV, Townsend D, Bedada FB, Metzger JM. Severe dystrophic cardiomyopathy caused by the enteroviral protease 2A-mediated C-terminal dystrophin cleavage fragment. Sci Transl Med 2016; 7:294ra106. [PMID: 26136477 DOI: 10.1126/scitranslmed.aaa4804] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Enterovirus infection can cause severe cardiomyopathy in humans. The virus-encoded 2A protease is known to cleave the cytoskeletal protein dystrophin. It is unclear, however, whether cardiomyopathy results from the loss of dystrophin or is due to the emergence of a dominant-negative dystrophin cleavage product. We show for the first time that the 2A protease-mediated carboxyl-terminal dystrophin cleavage fragment (CtermDys) is sufficient to cause marked dystrophic cardiomyopathy. The sarcolemma-localized CtermDys fragment caused myocardial fibrosis, heightened susceptibility to myocardial ischemic injury, and increased mortality during cardiac stress testing in vivo. CtermDys cardiomyopathy was more severe than in hearts completely lacking dystrophin. In vivo titration of CtermDys peptide content revealed an inverse relationship between the decay of membrane-bound CtermDys and the restoration of full-length dystrophin at the sarcolemma, in support of a physiologically relevant loss of dystrophin function in this model. CtermDys gene titration and dystrophin replacement studies further established a target threshold of 50% membrane-bound intact dystrophin necessary to prevent mice from CtermDys cardiomyopathy. Conversely, the NtermDys fragment did not compete with dystrophin and had no pathological effect. Thus, CtermDys must be localized to the sarcolemma, with intact dystrophin <50% of normal levels, to exert dominant-negative peptide-dependent cardiomyopathy. These data support a two-hit dominant-negative disease mechanism where membrane-associated CtermDys severs the link to cortical actin and inhibits both full-length dystrophin and compensatory utrophin from binding at the membrane. Therefore, membrane-bound CtermDys is a new potential translational target for virus-mediated cardiomyopathy.
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Affiliation(s)
- Matthew S Barnabei
- Department of Integrative Biology and Physiology, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Frances V Sjaastad
- Department of Integrative Biology and Physiology, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - DeWayne Townsend
- Department of Integrative Biology and Physiology, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Fikru B Bedada
- Department of Integrative Biology and Physiology, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Joseph M Metzger
- Department of Integrative Biology and Physiology, University of Minnesota Medical School, Minneapolis, MN 55455, USA.
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26
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Liu S, Liu N, Ruan Y, Li X, Wen D, Chen L, Guo X, Guo L, Jiang C, Long D, Yu R, Tang R, Sang C, Bai Y, Zhang T, Bai R, Du X, Dong J, Ma X, Ma C. Plasma IgG antibody against cytomegalovirus but not herpes simplex virus is associated with recurrence of atrial fibrillation after catheter ablation. Eur Heart J Suppl 2016. [DOI: 10.1093/eurheartj/suw007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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27
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Malvestio LM, Celes MR, Milanezi C, Silva JS, Jelicks LA, Tanowitz HB, Rossi MA, Prado CM. Role of dystrophin in acute Trypanosoma cruzi infection. Microbes Infect 2014; 16:768-77. [DOI: 10.1016/j.micinf.2014.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 07/15/2014] [Accepted: 07/25/2014] [Indexed: 10/24/2022]
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28
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Gutierrez FRS, Sesti-Costa R, Silva GK, Trujillo ML, Guedes PMM, Silva JS. Regulation of the immune response during infectious myocarditis. Expert Rev Cardiovasc Ther 2014; 12:187-200. [DOI: 10.1586/14779072.2014.879824] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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29
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Simkó J, Szabó Z, Barta K, Ujvárosi D, Nánási P, Lőrincz I. [Molecular and genetic background of sudden cardiac death]. Orv Hetil 2012; 153:1967-83. [PMID: 23220363 DOI: 10.1556/oh.2012.29498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Despite recent findings on the functional, structural and genetic background of sudden cardiac death, the incidence is still relatively high in the entire population. A thorough knowledge on susceptibility, as well as pathophysiology behind the development of malignant arrhythmias will help us to identify individuals at risk and prevent sudden cardiac death. This article presents a review of the current literature on the role of altered intracellular Ca2+ handling, acute myocardial ischaemia, cardiac autonomic innervation, renin-angiotensin-aldosterone system, monogenic and complex heritability in the pathogenesis of sudden cardiac death.
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Affiliation(s)
- József Simkó
- Miskolci Semmelweis Ignác Egészségügyi Központ és Egyetemi Oktatókórház Nonprofit Kft. Belgyógyászati Intézet, Kardiológiai Osztály Miskolc.
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30
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Fairweather D, Petri MA, Coronado MJ, Cooper LT. Autoimmune heart disease: role of sex hormones and autoantibodies in disease pathogenesis. Expert Rev Clin Immunol 2012; 8:269-84. [PMID: 22390491 DOI: 10.1586/eci.12.10] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cardiovascular disease (CVD) and autoimmune diseases (ADs) are the first and third highest causes of death in the USA, respectively. Men have an increased incidence of the majority of CVDs, including atherosclerosis, myocarditis, dilated cardiomyopathy and heart failure. By contrast, nearly 80% of all ADs occur in women. However, in one category of ADs, rheumatic diseases, CVD is the main cause of death. Factors that link rheumatic ADs to CVD are inflammation and the presence of autoantibodies. In this review we will examine recent findings regarding sex differences in the immunopathogenesis of CVD and ADs, explore possible reasons for the increased occurrence of CVD within rheumatic ADs and discuss whether autoantibodies, including rheumatoid factor, could be involved in disease pathogenesis.
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Affiliation(s)
- DeLisa Fairweather
- Johns Hopkins University Bloomberg School of Public Health, Department of Environmental Health Sciences, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
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31
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Quantitative genomic and antigenomic enterovirus RNA detection in explanted heart tissue samples from patients with end-stage idiopathic dilated cardiomyopathy. J Clin Microbiol 2012; 50:3378-80. [PMID: 22837323 DOI: 10.1128/jcm.01612-12] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Standardized one-step real-time RT-PCR assay detected enterovirus RNA in cardiac biopsy samples from 4 of 20 patients suffering from idiopathic dilated cardiomyopathy (IDCM). The median viral load was 287 copies per microgram of total extracted nucleic acids, with positive- to negative-strand RNA ratios ranging from 2 to 20. These results demonstrate enterovirus persistence in the heart of IDCM patients, characterized by low viral loads and low positive- to negative-RNA ratios.
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32
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Russo AD, Casella M, Pieroni M, Pelargonio G, Bartoletti S, Santangeli P, Zucchetti M, Innocenti E, Di Biase L, Carbucicchio C, Bellocci F, Fiorentini C, Natale A, Tondo C. Drug-Refractory Ventricular Tachycardias After Myocarditis. Circ Arrhythm Electrophysiol 2012; 5:492-8. [DOI: 10.1161/circep.111.965012] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background—
Ventricular tachycardia (VT) is a significant therapeutic challenge in patients with myocarditis. This study aimed to assess the efficacy and safety of radiofrequency catheter ablation (RFCA) of VT in patients with myocarditis.
Methods and Results—
We enrolled 20 patients (15 men; age, 42 [28–52] years) with a history of biopsy-proven viral myocarditis and drug-refractory VT; 5 patients presented with electrical storm. The median left ventricular ejection fraction was 55% (45–60%). All patients underwent endocardial RFCA with an irrigated catheter, using contact electroanatomic mapping. Recurrence of sustained VT after endocardial RFCA was treated with additional epicardial RFCA. Endocardial RFCA was acutely successful in 14 patients (70%) while in the remaining 6 (30%) clinical VT was successfully ablated by epicardial RFCA. In 1 patient, hemodynamic instability required an intra-aortic balloon pump to complete RFCA. No major complication occurred during or after RFCA. Over a median follow-up time of 28 (11–48) months, 18 patients (90%) remained free of sustained VT; 2 patients (10%, both with baseline left ventricular ejection fraction ≤35%) died of acute heart failure unrelated to ventricular arrhythmias.
Conclusions—
In patients with myocarditis, RFCA of drug-refractory VT is feasible, safe, and effective. Epicardial RFCA should be considered as an important therapeutic option to increase success rate.
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Affiliation(s)
- Antonio Dello Russo
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
| | - Michela Casella
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
| | - Maurizio Pieroni
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
| | - Gemma Pelargonio
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
| | - Stefano Bartoletti
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
| | - Pasquale Santangeli
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
| | - Martina Zucchetti
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
| | - Ester Innocenti
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
| | - Luigi Di Biase
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
| | - Corrado Carbucicchio
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
| | - Fulvio Bellocci
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
| | - Cesare Fiorentini
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
| | - Andrea Natale
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
| | - Claudio Tondo
- From the Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy (A.D.R., M.C., S.B., M.Z., E.I., C.C., C.F., C.T.); the Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy (M.P., G.P., F.B.); Texas Cardiac Arrhythmia Institute at St David’s Medical Center, Austin, TX (P.S., L.D.B., A.N.); University of Foggia, Foggia, Italy (L.D.B.); the Department of Biomedical Engineering, University of Texas, Austin, TX (L.D.B., A.N.); and the
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Marsman RFJ, Wilde AAM, Bezzina CR. Genetic predisposition for sudden cardiac death in myocardial ischaemia: the Arrhythmia Genetics in the NEtherlandS study. Neth Heart J 2011; 19:96-100. [PMID: 21461030 PMCID: PMC3040308 DOI: 10.1007/s12471-010-0070-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Sudden cardiac death from ventricular fibrillation during myocardial infarction is a leading cause of total and cardiovascular mortality. This multifactorial, complex condition clusters in families, suggesting a substantial genetic cause. We carried out a genomewide association study (GWAS) for sudden cardiac death, in the AGNES (Arrhythmia Genetics in the Netherlands) population, consisting of patients with (cases) and without (controls) ventricular fibrillation during a first ST-elevation myocardial infarction. The most significant association was found at chromosome 21q21 (rs2824292; odds ratio = 1.78, 95% CI 1.47–2.13, P = 3.3 × 10−10), 98 kb proximal of the CXADR gene, encoding the Coxsackie and adenovirus receptor. This locus has not previously been implicated in arrhythmia susceptibility. Further research on the mechanism of this locus will ultimately provide novel insight into arrhythmia mechanisms in this condition.
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Affiliation(s)
- R. F. J. Marsman
- Heart Failure Research Center, Department of Experimental Cardiology, Academic Medical Center, Meibergdreef 15, 1105 AZ Amsterdam, the Netherlands
| | - A. A. M. Wilde
- Heart Failure Research Center, Department of Experimental Cardiology, Academic Medical Center, Meibergdreef 15, 1105 AZ Amsterdam, the Netherlands
- Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands
| | - C. R. Bezzina
- Heart Failure Research Center, Department of Experimental Cardiology, Academic Medical Center, Meibergdreef 15, 1105 AZ Amsterdam, the Netherlands
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34
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Abstract
Sudden cardiac death (SCD) is a leading cause of total and cardiovascular mortality, and ventricular fibrillation is the underlying arrhythmia in the majority of cases. In the young, where the incidence of SCD is low, a great proportion of SCDs occur in the context of inherited disorders such as cardiomyopathy or primary electrical disease, where a monogenic hereditary component is a strong determinant of risk. Marked advancement has been made over the past 15 years in the understanding of the genetic basis of the primary electrical disorders, and this has had an enormous impact on the management of these patients. At older ages, the great majority of SCDs occur in the context of acute myocardial ischemia and infarction. Although epidemiologic studies have shown that heritable factors also determine risk in these cases, inheritance is likely complex and multifactorial, and progress in understanding the genetic and molecular mechanisms that determine susceptibility to these arrhythmias, affecting a greater proportion of the population, has been very limited. We review the most recent insights gained into the genetic basis of both the monogenic and the more complex ventricular arrhythmias.
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Affiliation(s)
- Raha Pazoki
- Department of Clinical and Experimental Cardiology, Heart Failure Research Center, Amsterdam, The Netherlands
- Department of Clinical Epidemiology Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands
| | - Arthur A. M. Wilde
- Department of Clinical and Experimental Cardiology, Heart Failure Research Center, Amsterdam, The Netherlands
| | - Connie R. Bezzina
- Department of Clinical and Experimental Cardiology, Heart Failure Research Center, Amsterdam, The Netherlands
- Department of Experimental Cardiology, Academic Medical Center, Room L2-108-1 Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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35
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Vandenberghe N, Leveque N, Corcia P, Brunaud-Danel V, Salort-Campana E, Besson G, Tranchant C, Clavelou P, Beaulieux F, Ecochard R, Vial C, Broussolle E, Lina B. Cerebrospinal fluid detection of enterovirus genome in ALS: a study of 242 patients and 354 controls. ACTA ACUST UNITED AC 2010; 11:277-82. [PMID: 19900148 DOI: 10.3109/17482960903262083] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Detection of enterovirus (EV) in the spinal cord of patients with amyotrophic lateral sclerosis (ALS) has been reported on post mortem central nervous system tissues. In cases of persistent infection, it is very likely that the EV genome might be detected in the cerebrospinal fluid (CSF). A study was conducted in seven French amyotrophic lateral sclerosis (ALS) centres between 1997 and 2002. A total of 242 ALS patients and 354 age- and sex-matched controls (non-ALS patients) were enrolled. A sensitive RT-PCR method was performed on the CSF to assess the presence of EV RNA; 14.5% of ALS patients were positive compared to 7.6% of controls (chi(2) value, 5.31; p = 0.02). Although EV infection has a seasonal pattern, we observed no seasonality in positive detection of the EV genome among ALS patients. There was no significant relationship among ALS patients between the initial clinical form or survival and the result of the RT-PCR. These findings suggest a relationship between the presence of EV sequences in CSF and ALS. Our study is consistent with the hypothesis that persistent EV infection can be one of the multiple factors involved in the development of ALS.
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Affiliation(s)
- Nadia Vandenberghe
- Hospices Civils de Lyon, Centre SLA de Lyon (Service d'Electroneuromyographie et Service de Neurologie C), Hôpital Neurologique Pierre Wertheimer, Lyon, France.
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36
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Bezzina CR, Pazoki R, Bardai A, Marsman RF, de Jong JSSG, Blom MT, Scicluna BP, Jukema JW, Bindraban NR, Lichtner P, Pfeufer A, Bishopric NH, Roden DM, Meitinger T, Chugh SS, Myerburg RJ, Jouven X, Kääb S, Dekker LRC, Tan HL, Tanck MWT, Wilde AAM. Genome-wide association study identifies a susceptibility locus at 21q21 for ventricular fibrillation in acute myocardial infarction. Nat Genet 2010; 42:688-691. [PMID: 20622880 DOI: 10.1038/ng.623] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 06/15/2010] [Indexed: 11/09/2022]
Abstract
Sudden cardiac death from ventricular fibrillation during acute myocardial infarction is a leading cause of total and cardiovascular mortality. To our knowledge, we here report the first genome-wide association study for this trait, conducted in a set of 972 individuals with a first acute myocardial infarction, 515 of whom had ventricular fibrillation and 457 of whom did not, from the Arrhythmia Genetics in The Netherlands (AGNES) study. The most significant association to ventricular fibrillation was found at 21q21 (rs2824292, odds ratio = 1.78, 95% CI 1.47-2.13, P = 3.3 x 10(-10)). The association of rs2824292 with ventricular fibrillation was replicated in an independent case-control set consisting of 146 out-of-hospital cardiac arrest individuals with myocardial infarction complicated by ventricular fibrillation and 391 individuals who survived a myocardial infarction (controls) (odds ratio = 1.49, 95% CI 1.14-1.95, P = 0.004). The closest gene to this SNP is CXADR, which encodes a viral receptor previously implicated in myocarditis and dilated cardiomyopathy and which has recently been identified as a modulator of cardiac conduction. This locus has not previously been implicated in arrhythmia susceptibility.
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Affiliation(s)
- Connie R Bezzina
- Heart Failure Research Center, Department of Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Raha Pazoki
- Heart Failure Research Center, Department of Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Abdennasser Bardai
- Heart Failure Research Center, Department of Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Roos F Marsman
- Heart Failure Research Center, Department of Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jonas S S G de Jong
- Heart Failure Research Center, Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Marieke T Blom
- Heart Failure Research Center, Department of Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Brendon P Scicluna
- Heart Failure Research Center, Department of Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.,Durrer Center for Cardiogenetic Research, Amsterdam, The Netherlands
| | - Navin R Bindraban
- Heart Failure Research Center, Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Social Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter Lichtner
- Institute of Human Genetics, Klinikum Rechts der Isar Technische Universität München, Munich, Germany
| | - Arne Pfeufer
- Institute of Human Genetics, Klinikum Rechts der Isar Technische Universität München, Munich, Germany.,Institute of Human Genetics, Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany
| | - Nanette H Bishopric
- Division of Cardiology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.,Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Dan M Roden
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Thomas Meitinger
- Institute of Human Genetics, Klinikum Rechts der Isar Technische Universität München, Munich, Germany.,Institute of Human Genetics, Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany
| | - Sumeet S Chugh
- The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Robert J Myerburg
- Division of Cardiology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Xavier Jouven
- Université Paris Descartes, Assistance Publique-Hopitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Stefan Kääb
- Department of Medicine I, University Hospital Grosshadern, Ludwig-Maximilians-Universität, Munich, Germany
| | - Lukas R C Dekker
- Heart Failure Research Center, Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | - Hanno L Tan
- Heart Failure Research Center, Department of Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Heart Failure Research Center, Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael W T Tanck
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Arthur A M Wilde
- Heart Failure Research Center, Department of Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Heart Failure Research Center, Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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A single coxsackievirus B2 capsid residue controls cytolysis and apoptosis in rhabdomyosarcoma cells. J Virol 2010; 84:5868-79. [PMID: 20375176 DOI: 10.1128/jvi.02383-09] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Coxsackievirus B2 (CVB2), one of six human pathogens of the group B coxsackieviruses within the enterovirus genus of Picornaviridae, causes a wide spectrum of human diseases ranging from mild upper respiratory illnesses to myocarditis and meningitis. The CVB2 prototype strain Ohio-1 (CVB2O) was originally isolated from a patient with summer grippe in the 1950s. Later on, CVB2O was adapted to cytolytic replication in rhabdomyosarcoma (RD) cells. Here, we present analyses of the correlation between the adaptive mutations of this RD variant and the cytolytic infection in RD cells. Using reverse genetics, we identified a single amino acid change within the exposed region of the VP1 protein (glutamine to lysine at position 164) as the determinant for the acquired cytolytic trait. Moreover, this cytolytic virus induced apoptosis, including caspase activation and DNA degradation, in RD cells. These findings contribute to our understanding of the host cell adaptation process of CVB2O and provide a valuable tool for further studies of virus-host interactions.
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Ventéo L, Bourlet T, Renois F, Douche-Aourik F, Mosnier JF, Maison GLDLG, Pluot M, Pozzetto B, Andreoletti L. Enterovirus-related activation of the cardiomyocyte mitochondrial apoptotic pathway in patients with acute myocarditis. Eur Heart J 2009; 31:728-36. [PMID: 19933281 DOI: 10.1093/eurheartj/ehp489] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS We examined the impact of enterovirus (EV) cardiac replication activity on the endomyocardial mitochondrial pathway in patients with acute myocarditis. METHODS AND RESULTS Levels of apoptotic cardiomyocytes were determined by TUNEL and ligation-mediated polymerase chain reaction (PCR) assays and EV replication activity was assessed by immunostaining of EV VP1 capsid protein in ventricular myocytes of patients with acute myocarditis (n = 25), and healthy heart controls (n = 15). Ratio of cytosolic/mitochondrial cytochrome c concentrations was determined by ELISA assay, levels of active caspase-9 were determined by western blot analysis and Bax/Bcl2 mRNA ratio was assessed by real-time reverse transcription-polymerase chain reaction (RT-PCR) in the same cardiac tissues. Patients with EV-associated acute myocarditis (n = 15) exhibited a significantly higher number of apoptotic cardiomyocytes than those with non-EV-associated acute myocarditis (n = 10) and controls (n = 15) (P < 0.001). Endomyocardial ratio of cytosolic/mitochondrial cytochrome c concentrations and levels of active caspase-9 protein were significantly increased in EV than in non-EV-related myocarditis patients (P < 0.001). Moreover, Bax/Bcl2 mRNA ratio was significantly increased in EV than in non-EV-related myocarditis patients (P < 0.001). CONCLUSION Our findings evidence an EV-related activation of the cardiomyocyte mitochondrial apoptotic pathway in patients with acute myocarditis. Moreover, our results indicate that this EV-induced pro-apoptotic mechanism could be partly related to an up-regulation of Bax expression, and suggest that inhibition of this cell death process may constitute the basis for novel therapies.
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Affiliation(s)
- Lydie Ventéo
- Laboratoire de Virologie médicale et moléculaire Hôpital Robert Debré, IFR 53/EA4303, CHU et Faculté de Médecine de Reims, Avenue du Général Koenig, 51092 REIMS Cedex, France
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39
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Viral causes of human myocarditis. Arch Cardiovasc Dis 2009; 102:559-68. [PMID: 19664576 DOI: 10.1016/j.acvd.2009.04.010] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Revised: 04/20/2009] [Accepted: 04/21/2009] [Indexed: 12/17/2022]
Abstract
The diagnosis of acute myocarditis is complex and challenging. The use of the Dallas criteria in the diagnosis of myocarditis is associated with poor sensitivity and specificity because of the sampling error related to the often focal distribution of the specific histological lesions in cardiac tissue and the variability in pathological interpretation. To improve histological diagnosis, additional virological evaluation of cardiac tissues is required, with immunohistochemical and polymerase chain reaction (PCR) techniques allowing identification and quantification of viral infection markers. The diagnostic gold standard is endomyocardial biopsy (EMB) with the histological Dallas criteria, in association with new immunohistochemical and PCR analyses of cardiac tissues. Using real-time PCR and reverse transcription PCR assays, parvovirus B19, Coxsackie B virus, human herpesvirus 6 (HHV-6) type B and adenovirus have been detected in 37, 33, 11 and 8% of EMB, respectively, from young adults (aged<35 years) with histologically proven acute myocarditis. Viral co-infections have also been found in 12% of acute myocarditis cases, generally parvovirus B19 plus HHV-6. Moreover, herpesviruses such as the Epstein-Barr virus or cytomegalovirus can also be associated with myocarditis after heart transplantation. During the clinical course of myocarditis, the immunohistochemical detection of enterovirus, adenovirus or parvovirus B19 capsid proteins or herpesvirus late proteins is necessary to differentiate a viral cardiac infection with replication activities from a persistent or latent cardiac infection. These new viral diagnostic approaches can lead to better identification of the aetiology of myocarditis and may therefore enable the development and evaluation of specific aetiology-directed treatment strategies.
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40
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Heymans S, Hirsch E, Anker SD, Aukrust P, Balligand JL, Cohen-Tervaert JW, Drexler H, Filippatos G, Felix SB, Gullestad L, Hilfiker-Kleiner D, Janssens S, Latini R, Neubauer G, Paulus WJ, Pieske B, Ponikowski P, Schroen B, Schultheiss HP, Tschöpe C, Van Bilsen M, Zannad F, McMurray J, Shah AM. Inflammation as a therapeutic target in heart failure? A scientific statement from the Translational Research Committee of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2009; 11:119-29. [PMID: 19168509 DOI: 10.1093/eurjhf/hfn043] [Citation(s) in RCA: 244] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The increasing prevalence of heart failure poses enormous challenges for health care systems worldwide. Despite effective medical interventions that target neurohumoral activation, mortality and morbidity remain substantial. Evidence for inflammatory activation as an important pathway in disease progression in chronic heart failure has emerged in the last two decades. However, clinical trials of 'anti-inflammatory' therapies (such as anti-tumor necrosis factor-alpha approaches) have to date failed to show benefit in heart failure patients. The Heart Failure Association of the European Society of Cardiology recently organized an expert workshop to address the issue of inflammation in heart failure from a basic science, translational and clinical perspective, and to assess whether specific inflammatory pathways may yet serve as novel therapeutic targets for this condition. This consensus document represents the outcome of the workshop and defines key research questions that still need to be addressed as well as considering the requirements for future clinical trials in this area.
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Affiliation(s)
- Stephane Heymans
- Experimental & Molecular Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands.
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Abstract
Myocarditis may present with a wide range of symptoms, ranging from mild dyspnea or chest pain that resolves without specific therapy to cardiogenic shock and death. Dilated cardiomyopathy with chronic heart failure is the major long-term sequela of myocarditis. Most often, myocarditis results from common viral infections; less commonly, specific forms of myocarditis may result from other pathogens, toxic or hypersensitivity drug reactions, giant-cell myocarditis, or sarcoidosis. The prognosis and treatment of myocarditis vary according to the cause, and clinical and hemodynamic data usually provide guidance to decide when to refer a patient to a specialist for endomyocardial biopsy. The aim of this review is to provide a practical and current approach to the evaluation and treatment of suspected myocarditis.
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Affiliation(s)
- Leslie T Cooper
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
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42
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Burgner D, Davila S, Breunis WB, Ng SB, Li Y, Bonnard C, Ling L, Wright VJ, Thalamuthu A, Odam M, Shimizu C, Burns JC, Levin M, Kuijpers TW, Hibberd ML. A genome-wide association study identifies novel and functionally related susceptibility Loci for Kawasaki disease. PLoS Genet 2009; 5:e1000319. [PMID: 19132087 PMCID: PMC2607021 DOI: 10.1371/journal.pgen.1000319] [Citation(s) in RCA: 208] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2008] [Accepted: 11/26/2008] [Indexed: 02/01/2023] Open
Abstract
Kawasaki disease (KD) is a pediatric vasculitis that damages the coronary arteries in 25% of untreated and approximately 5% of treated children. Epidemiologic data suggest that KD is triggered by unidentified infection(s) in genetically susceptible children. To investigate genetic determinants of KD susceptibility, we performed a genome-wide association study (GWAS) in 119 Caucasian KD cases and 135 matched controls with stringent correction for possible admixture, followed by replication in an independent cohort and subsequent fine-mapping, for a total of 893 KD cases plus population and family controls. Significant associations of 40 SNPs and six haplotypes, identifying 31 genes, were replicated in an independent cohort of 583 predominantly Caucasian KD families, with NAALADL2 (rs17531088, p(combined) = 1.13 x 10(-6)) and ZFHX3 (rs7199343, p(combined) = 2.37 x 10(-6)) most significantly associated. Sixteen associated variants with a minor allele frequency of >0.05 that lay within or close to known genes were fine-mapped with HapMap tagging SNPs in 781 KD cases, including 590 from the discovery and replication stages. Original or tagging SNPs in eight of these genes replicated the original findings, with seven genes having further significant markers in adjacent regions. In four genes (ZFHX3, NAALADL2, PPP1R14C, and TCP1), the neighboring markers were more significantly associated than the originally associated variants. Investigation of functional relationships between the eight fine-mapped genes using Ingenuity Pathway Analysis identified a single functional network (p = 10(-13)) containing five fine-mapped genes-LNX1, CAMK2D, ZFHX3, CSMD1, and TCP1-with functional relationships potentially related to inflammation, apoptosis, and cardiovascular pathology. Pair-wise blood transcript levels were measured during acute and convalescent KD for all fine-mapped genes, revealing a consistent trend of significantly reduced transcript levels prior to treatment. This is one of the first GWAS in an infectious disease. We have identified novel, plausible, and functionally related variants associated with KD susceptibility that may also be relevant to other cardiovascular diseases.
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Affiliation(s)
- David Burgner
- School of Pediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Sonia Davila
- Infectious Diseases, Genome Institute of Singapore, Singapore, Singapore
| | - Willemijn B. Breunis
- Division of Pediatric Hematology, Immunology, and Infectious Diseases, Emma Children's Hospital Academic Medical Center, Amsterdam, The Netherlands
| | - Sarah B. Ng
- Infectious Diseases, Genome Institute of Singapore, Singapore, Singapore
| | - Yi Li
- Human Genetics Programme, Genome Institute of Singapore, Singapore, Singapore
| | - Carine Bonnard
- Human Genetics Programme, Genome Institute of Singapore, Singapore, Singapore
| | - Ling Ling
- Infectious Diseases, Genome Institute of Singapore, Singapore, Singapore
| | - Victoria J. Wright
- Department of Pediatrics, Division of Medicine, Imperial College London, London, United Kingdom
| | | | - Miranda Odam
- School of Pediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Chisato Shimizu
- Department of Pediatrics, University of California San Diego School of Medicine, Rady Children's Hospital, San Diego, California, United States of America
| | - Jane C. Burns
- Department of Pediatrics, University of California San Diego School of Medicine, Rady Children's Hospital, San Diego, California, United States of America
| | - Michael Levin
- Department of Pediatrics, Division of Medicine, Imperial College London, London, United Kingdom
| | - Taco W. Kuijpers
- Division of Pediatric Hematology, Immunology, and Infectious Diseases, Emma Children's Hospital Academic Medical Center, Amsterdam, The Netherlands
| | - Martin L. Hibberd
- Infectious Diseases, Genome Institute of Singapore, Singapore, Singapore
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Toll-like receptor 8 polymorphism and coronary artery disease. Mol Biol Rep 2008; 36:1897-901. [PMID: 18985439 DOI: 10.1007/s11033-008-9396-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2008] [Accepted: 10/20/2008] [Indexed: 10/21/2022]
Abstract
Toll-like receptors (TLRs) play roles in innate and adaptive immune responses. Some TLRs are involved in the pathogenesis of cardiovascular diseases. Coronary artery disease (CAD) has an inflammatory and immunological basis. We investigated whether TLR8 Met1Val and TLR8-129G>C single nucleotide polymorphisms (SNPs rs3764879 and rs3764880) are associated with CAD in the Chinese population. We enrolled 412 consecutive patients (185 with coronary stenosis >/=50% or previous myocardial infarction and 227 controls). Ligase detection reaction was performed to detect SNPs rs3764879 and rs3764880 of TLR8. The SNP at rs3764879 is in complete linkage disequilibrium with rs3764880. No significant difference was found in genotypic or allelic frequencies of these two common SNPs between CAD cases and controls (P > 0.05, respectively). No associations existed between these two SNPs and the severity of coronary artery stenosis (All P > 0.05). These results do not support an involvement of SNPs rs3764879 and rs3764880 of TLR8 in predisposition to CAD.
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Reply. J Am Coll Cardiol 2008. [DOI: 10.1016/j.jacc.2008.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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45
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Yilmaz A, Klingel K, Kandolf R, Sechtem U. A Geographical Mystery: Do Cardiotropic Viruses Respect National Borders? J Am Coll Cardiol 2008; 52:82; author reply 82-3. [DOI: 10.1016/j.jacc.2008.01.072] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Accepted: 01/16/2008] [Indexed: 11/30/2022]
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46
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Mirza A, Menhart N. Stability of dystrophin STR fragments in relation to junction helicity. BIOCHIMICA ET BIOPHYSICA ACTA-PROTEINS AND PROTEOMICS 2008; 1784:1301-9. [PMID: 18589007 DOI: 10.1016/j.bbapap.2008.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 04/22/2008] [Accepted: 05/19/2008] [Indexed: 11/16/2022]
Abstract
Dystrophin is a rod shaped protein consisting of amino- and carboxy-terminal binding domains linked by a large central rod composed of 24 homologous copies of the STR motif and 4 non-homologous regions termed hinges. These hinges are proposed to confer local flexibility; conversely, the tacit implication is that the STR regions away from the hinges are comparatively rigid. This, and the repeating nature of this rod, has contributed to the view that the STR region of the rod is uniform and monolithic. However, we have produced various 2 STR fragments, chosen to have high and low alpha-helix content at their junctions with each other, and show that they exhibit markedly different stabilities. In contrast to a related protein, spectrin, these differences are not correlated with the calculated helicity, but appear to be an intrinsic property of the motifs themselves. A full understanding of how these properties vary along the length of the rod has implications for the engineering of these rods regions in exon skipping and minidystrophin therapies.
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Affiliation(s)
- Ahmed Mirza
- Department of Biological, Chemical and Physical Sciences, Illinois Institute of Technology, 3101 South Dearborn, Chicago, IL 60616, USA
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47
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Myocardial infarction, viral infection, and the cytoskeleton final common pathways of a common disease? J Am Coll Cardiol 2007; 50:2215-7. [PMID: 18061068 DOI: 10.1016/j.jacc.2007.08.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2007] [Accepted: 08/02/2007] [Indexed: 11/22/2022]
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