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Ernault AC, de Winter R, Fabrizi B, Bracht JW, Hau C, van Amersfoorth SC, Meulendijks ER, Tijsen AJ, Cócera Ortega L, van der Made I, Gasecka A, Driessen AH, Nieuwland R, Boukens BJ, van der Pol E, de Groot JR, Coronel R. MicroRNAs in extracellular vesicles released from epicardial adipose tissue promote arrhythmogenic conduction slowing. Heart Rhythm O2 2023; 4:805-814. [PMID: 38204457 PMCID: PMC10774655 DOI: 10.1016/j.hroo.2023.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
Background Patients with excess epicardial adipose tissue (EAT) are at increased risk of developing cardiac arrhythmias. EAT promotes arrhythmias by depolarizing the resting membrane of cardiomyocytes, which slows down conduction and facilitates re-entrant arrhythmias. We hypothesized that EAT slows conduction by secreting extracellular vesicles (EVs) and their microRNA (miRNA) cargo. Objective We aimed to determine the role of EAT-derived EVs and their miRNA cargo in conduction slowing. Methods EAT and subcutaneous adipose tissue (SAT) were collected from patients with atrial fibrillation. Adipose tissue explants were incubated in culture medium and secretome was collected. The numbers of EVs in the EAT and SAT secretome were measured by calibrated flow cytometry. EVs in the EAT secretome were isolated by size exclusion chromatography and miRNAs were sequenced. Pathway analysis was performed to predict candidates involved in cardiac electrophysiology. The candidates were validated in the EAT and SAT by quantitative real-time polymerase chain reaction. Finally, miRNA candidates were overexpressed in neonatal rat ventricular myocytes. Results The EV concentration was higher in the EAT secretome than in the SAT and control secretomes. miRNA sequencing of EAT-derived EVs detected a total of 824 miRNAs. Pathway analysis led to the identification of 7 miRNAs potentially involved in regulation of cardiac resting membrane potential. Validation of those miRNA candidates showed that they were all expressed in EAT, and that miR-1-3p and miR-133a-3p were upregulated in EAT in comparison with SAT. Overexpression of miR-1-3p and miR-133a-3p in neonatal rat ventricular myocytes led to conduction slowing and reduced Kcnj2 and Kcnj12 expression. Conclusion miR-1-3p and miR-133a-3p are potential mediators of EAT arrhythmogenicity.
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Affiliation(s)
- Auriane C. Ernault
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Rosan de Winter
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Benedetta Fabrizi
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Jillian W.P. Bracht
- Laboratory of Experimental Clinical Chemistry, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
- Vesicle Observation Center, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
| | - Chi Hau
- Laboratory of Experimental Clinical Chemistry, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
- Vesicle Observation Center, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
| | - Shirley C.M. van Amersfoorth
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Eva R. Meulendijks
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Anke J. Tijsen
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Lucía Cócera Ortega
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Ingeborg van der Made
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Aleksandra Gasecka
- Laboratory of Experimental Clinical Chemistry, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
- Vesicle Observation Center, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
- Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Antoine H. Driessen
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Rienk Nieuwland
- Laboratory of Experimental Clinical Chemistry, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
- Vesicle Observation Center, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
| | - Bastiaan J. Boukens
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
- Department of Medical Biology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
| | - Edwin van der Pol
- Laboratory of Experimental Clinical Chemistry, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
- Vesicle Observation Center, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
- Biomedical Engineering and Physics, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
| | - Joris R. de Groot
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Ruben Coronel
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
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Liu P, Wang Y, Zhang X, Zhang Z, Zhao N, Ou W, Wang G, Yang X, Li M, Zhang Y, Yang X, Wu S. Obesity and Cardiac Conduction Block Disease in China. JAMA Netw Open 2023; 6:e2342831. [PMID: 37955899 PMCID: PMC10644217 DOI: 10.1001/jamanetworkopen.2023.42831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 09/29/2023] [Indexed: 11/14/2023] Open
Abstract
Importance Although a high body mass index (BMI) has been found to be associated with increased risk of cardiac conduction block (CCB) in older adults, no further studies have investigated the association between obesity and CCB in the general population. Objective To investigate the association between obesity and CCB, including its subtypes. Design, Setting, and Participants This cohort study used data from participants in the Kailuan Study in China (2006-2018) who had completed a physical examination in 2006 (baseline) and had not experienced CCB before baseline. Data analysis was conducted from March to September 2023. Exposures Obesity status was defined by BMI in 3 groups: normal weight (18.5 to <24), overweight (24 to <28), and obesity (≥28). Main Outcome and Measures The primary outcome was CCB, which was diagnosed from standard 12-lead electrocardiography. The primary end point included high-grade atrioventricular block (HAVB), complete right bundle branch block, complete left bundle branch block, left anterior fascicular block (LAFB), and left posterior fascicular block. First-degree atrioventricular block (FAVB), second-degree type 1 AVB, HAVB, complete and incomplete right and left bundle branch block, LAFB, and left posterior fascicular block were considered separately as secondary end points. Results Among 86 635 participants (mean [SD] age, 50.8 [11.9] years; 68 205 males [78.7%]), there were 33 259 individuals with normal weight (38.4%), 37 069 individuals with overweight (42.8%), and 16 307 individuals with obesity (18.8%). The mean (SD) follow-up was 10.6 (3.07) years. In the multivariable Cox proportional hazards regression analysis, obesity was associated with an increased risk of incident CCB (hazard ratio [HR], 1.21; 95% CI, 1.04-1.42) vs normal BMI. In secondary analysis, obesity was associated with an increased risk of FAVB (HR, 1.44; 95% CI, 1.21-1.73), HAVB (HR, 1.99; 95% CI, 1.03-3.82), and LAFB (HR, 1.29; 95% CI, 1.03-1.62) vs normal BMI. There was no association between obesity and other CCB subtypes. Obesity was associated with a greater increase in risk of CCB vs normal BMI in older (aged ≥65 years; HR, 1.44; 95% CI, 1.05-1.96) vs younger (aged <65 years; HR, 1.13; 95% CI, 0.96-1.34) participants (P for interaction < .001) and those with diabetes (HR, 2.16; 95% CI, 1.24-3.76) vs without diabetes (HR, 1.19; 95% CI, 1.02-1.39) (P for interaction = .02). Conclusions and Relevance This study found that obesity was associated with an increased risk of CCB, with greater increases in risk for FAVB, HAVB, and LAFB. Individuals who were older and those who had diabetes had larger increases in risk.
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Affiliation(s)
- Peipei Liu
- School of Public Health, North China University of Science and Technology, Caofeidian Eco-city, Tangshan, Hebei, China
| | - Yanxiu Wang
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Xiaofu Zhang
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Caofeidian Eco-city, Tangshan, Hebei, China
| | - Zihao Zhang
- School of Public Health, North China University of Science and Technology, Caofeidian Eco-city, Tangshan, Hebei, China
| | - NaiHui Zhao
- School of Public Health, North China University of Science and Technology, Caofeidian Eco-city, Tangshan, Hebei, China
| | - Wenli Ou
- School of Public Health, North China University of Science and Technology, Caofeidian Eco-city, Tangshan, Hebei, China
| | - Guodong Wang
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Xuemei Yang
- School of Clinical Medicine, North China University of Science and Technology, Caofeidian Eco-city, Tangshan, Hebei, China
| | - Man Li
- School of Clinical Medicine, North China University of Science and Technology, Caofeidian Eco-city, Tangshan, Hebei, China
| | - Yaya Zhang
- School of Public Health, North China University of Science and Technology, Caofeidian Eco-city, Tangshan, Hebei, China
| | - Xiuhong Yang
- School of Public Health, North China University of Science and Technology, Caofeidian Eco-city, Tangshan, Hebei, China
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Caofeidian Eco-city, Tangshan, Hebei, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
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Dobreva EA, Gorbacheva AM, Bibik EE, Eremkina AK, Elfimova AR, Salimkhanov RK, Kovaleva EV, Maganeva IS, Mokrysheva NG. Cardiovascular and metabolic status in patients with primary hyperparathyroidism: a single-center experience. Front Endocrinol (Lausanne) 2023; 14:1266728. [PMID: 37842310 PMCID: PMC10570793 DOI: 10.3389/fendo.2023.1266728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/08/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Cardiovascular diseases (CVD) and metabolic disorders (MD) have retained leading positions in the structure of morbidity and mortality for many years. Primary hyperparathyroidism (PHPT) is also associated with a greater incidence of CVD and MD. The aim of the present study was to describe the prevalence and structure of CVD and MD in hospitalized patients with PHPT and to search for possible associations between these pathologies. Methods 838 patients with a verified PHPT were included in the study. The studied cohort was divided into 2 groups according to their age at the time of admission: patients aged 18 to 49 years (group A, n = 150); patients aged 50 years and older (group B, n = 688). Results There were no significant differences between two groups in parameters of calcium-phosphorus metabolism. Obesity was diagnosed in 24.2% of patients in group A and in 35.9% in group B. Type 2 diabetes mellitus was more common in older patients (14.4% in group B vs. 2.6% in group A). Arterial hypertension, ischemic heart disease, chronic heart failure and brachiocephalic arteries atherosclerosis were more frequent in older patients, occurring in 79.1%, 10.8%, 8.4%, and 84% of cases respectively. The cutoff points that increased the risk of CVD detection turned out to be age above 56 years, eGFR below 92 ml/min/1.73m2, BMI above 28.3 kg/m2. Discussion The present study demonstrated a high incidence of some CVD, as well as disorders of lipid, carbohydrate and purine metabolism in patients with PHPT.
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Affiliation(s)
- Ekaterina A. Dobreva
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Anna M. Gorbacheva
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Ekaterina E. Bibik
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Anna K. Eremkina
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Alina R. Elfimova
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Rustam Kh. Salimkhanov
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Elena V. Kovaleva
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
| | - Irina S. Maganeva
- Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia
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