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Gavara J, Merenciano-Gonzalez H, Llopis-Lorente J, Molina-Garcia T, Perez-Solé N, de Dios E, Marcos-Garces V, Monmeneu JV, Lopez-Lereu MP, Canoves J, Bonanad C, Moratal D, Núñez J, Bayés-Genis A, Sanchis J, Chorro FJ, Rios-Navarro C, Bodí V. Impact of Epicardial Adipose Tissue on Infarct Size and Left Ventricular Systolic Function in Patients with Anterior ST-Segment Elevation Myocardial Infarction. Diagnostics (Basel) 2024; 14:368. [PMID: 38396407 PMCID: PMC10888463 DOI: 10.3390/diagnostics14040368] [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: 12/19/2023] [Revised: 01/31/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024] Open
Abstract
We aimed to assess the correlation of cardiovascular magnetic resonance (CMR)-derived epicardial adipose tissue (EAT) with infarct size (IS) and residual systolic function in ST-segment elevation myocardial infarction (STEMI). We enrolled patients discharged for a first anterior reperfused STEMI submitted to undergo CMR. EAT, left ventricular (LV) ejection fraction (LVEF), and IS were quantified at the 1-week (n = 221) and at 6-month CMR (n = 167). At 1-week CMR, mean EAT was 31 ± 13 mL/m2. Patients with high EAT volume (n = 72) showed larger 1-week IS. After adjustment, EAT extent was independently related to 1-week IS. In patients with large IS at 1 week (>30% of LV mass, n = 88), those with high EAT showed more preserved 6-month LVEF. This association persisted after adjustment and in a 1:1 propensity score-matched patient subset. Overall, EAT decreased at 6 months. In patients with large IS, a greater reduction of EAT was associated with more preserved 6-month LVEF. In STEMI, a higher presence of EAT was associated with a larger IS. Nevertheless, in patients with large infarctions, high EAT and greater subsequent EAT reduction were linked to more preserved LVEF in the chronic phase. This dual and paradoxical effect of EAT fuels the need for further research in this field.
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Affiliation(s)
- Jose Gavara
- Center for Biomaterials and Tissue Engineering, Universitat Politècnica de València, 46022 Valencia, Spain; (J.G.); (D.M.)
| | - Hector Merenciano-Gonzalez
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
| | - Jordi Llopis-Lorente
- Centro de Investigación e Innovación en Bioingeniería (Ci2B), Universitat Politècnica de València, 46010 Valencia, Spain;
| | - Tamara Molina-Garcia
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
| | - Nerea Perez-Solé
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
| | - Elena de Dios
- Centro de Investigación Biomédica en Red—Cardiovascular (CIBER-CV), 28022 Madrid, Spain; (E.d.D.); (A.B.-G.)
| | - Víctor Marcos-Garces
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
| | - Jose V. Monmeneu
- Cardiovascular Magnetic Resonance Unit, ASCIRES Biomedical Group, 46004 Valencia, Spain; (J.V.M.); (M.P.L.-L.)
| | - Maria P. Lopez-Lereu
- Cardiovascular Magnetic Resonance Unit, ASCIRES Biomedical Group, 46004 Valencia, Spain; (J.V.M.); (M.P.L.-L.)
| | - Joaquim Canoves
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
| | - Clara Bonanad
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
| | - David Moratal
- Center for Biomaterials and Tissue Engineering, Universitat Politècnica de València, 46022 Valencia, Spain; (J.G.); (D.M.)
| | - Julio Núñez
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Centro de Investigación Biomédica en Red—Cardiovascular (CIBER-CV), 28022 Madrid, Spain; (E.d.D.); (A.B.-G.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Antoni Bayés-Genis
- Centro de Investigación Biomédica en Red—Cardiovascular (CIBER-CV), 28022 Madrid, Spain; (E.d.D.); (A.B.-G.)
- Cardiology Department and Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, 08193 Badalona, Spain
- Department of Medicine, Universitat Autonoma de Barcelona, 08193 Barcelona, Spain
| | - Juan Sanchis
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Centro de Investigación Biomédica en Red—Cardiovascular (CIBER-CV), 28022 Madrid, Spain; (E.d.D.); (A.B.-G.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Francisco J. Chorro
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Centro de Investigación Biomédica en Red—Cardiovascular (CIBER-CV), 28022 Madrid, Spain; (E.d.D.); (A.B.-G.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Cesar Rios-Navarro
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Department of Pathology, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
| | - Vicente Bodí
- Instituto de Investigación Sanitaria INCLIVA, 46010 Valencia, Spain; (H.M.-G.); (T.M.-G.); (N.P.-S.); (V.M.-G.); (J.C.); (C.B.); (J.N.); (J.S.); (F.J.C.)
- Centro de Investigación Biomédica en Red—Cardiovascular (CIBER-CV), 28022 Madrid, Spain; (E.d.D.); (A.B.-G.)
- Department of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, 46010 Valencia, Spain
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2
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Tang S, Li R, Ma W, Lian L, Gao J, Cao Y, Gan L. Cardiac-to-adipose axis in metabolic homeostasis and diseases: special instructions from the heart. Cell Biosci 2023; 13:161. [PMID: 37667400 PMCID: PMC10476430 DOI: 10.1186/s13578-023-01097-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/30/2023] [Indexed: 09/06/2023] Open
Abstract
Adipose tissue is essential for maintaining systemic metabolic homeostasis through traditional metabolic regulation, endocrine crosstalk, and extracellular vesicle production. Adipose dysfunction is a risk factor for cardiovascular diseases. The heart is a traditional pump organ. However, it has recently been recognized to coordinate interorgan cross-talk by providing peripheral signals known as cardiokines. These molecules include specific peptides, proteins, microRNAs and novel extracellular vesicle-carried cargoes. Current studies have shown that generalized cardiokine-mediated adipose regulation affects systemic metabolism. Cardiokines regulate lipolysis, adipogenesis, energy expenditure, thermogenesis during cold exposure and adipokine production. Moreover, cardiokines participate in pathological processes such as obesity, diabetes and ischemic heart injury. The underlying mechanisms of the cardiac-to-adipose axis mediated by cardiokines will be further discussed to provide potential therapeutic targets for metabolic diseases and support a new perspective on the need to correct adipose dysfunction after ischemic heart injury.
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Affiliation(s)
- Songling Tang
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, West China School of Medicine, Sichuan University Chengdu, Chengdu, 610041, People's Republic of China
| | - Ruixin Li
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, West China School of Medicine, Sichuan University Chengdu, Chengdu, 610041, People's Republic of China
| | - Wen Ma
- Sichuan University-The Hong Kong Polytechnic University Institute for Disaster Management and Reconstruction, Chengdu, China
| | - Liu Lian
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, West China School of Medicine, Sichuan University Chengdu, Chengdu, 610041, People's Republic of China
| | - Jiuyu Gao
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, West China School of Medicine, Sichuan University Chengdu, Chengdu, 610041, People's Republic of China
| | - Yu Cao
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, West China School of Medicine, Sichuan University Chengdu, Chengdu, 610041, People's Republic of China.
- Sichuan University-The Hong Kong Polytechnic University Institute for Disaster Management and Reconstruction, Chengdu, China.
| | - Lu Gan
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, West China School of Medicine, Sichuan University Chengdu, Chengdu, 610041, People's Republic of China.
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Wang L, Zabri H, Gorressen S, Semmler D, Hundhausen C, Fischer JW, Bottermann K. Cardiac ischemia modulates white adipose tissue in a depot-specific manner. Front Physiol 2022; 13:1036945. [DOI: 10.3389/fphys.2022.1036945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/13/2022] [Indexed: 11/13/2022] Open
Abstract
The incidence of heart failure after myocardial infarction (MI) remains high and the underlying causes are incompletely understood. The crosstalk between heart and adipose tissue and stimulated lipolysis has been identified as potential driver of heart failure. Lipolysis is also activated acutely in response to MI. However, the role in the post-ischemic remodeling process and the contribution of different depots of adipose tissue is unclear. Here, we employ a mouse model of 60 min cardiac ischemia and reperfusion (I/R) to monitor morphology, cellular infiltrates and gene expression of visceral and subcutaneous white adipose tissue depots (VAT and SAT) for up to 28 days post ischemia. We found that in SAT but not VAT, adipocyte size gradually decreased over the course of reperfusion and that these changes were associated with upregulation of UCP1 protein, indicating white adipocyte conversion to the so-called ‘brown-in-white’ phenotype. While this phenomenon is generally associated with beneficial metabolic consequences, its role in the context of MI is unknown. We further measured decreased lipogenesis in SAT together with enhanced infiltration of MAC-2+ macrophages. Finally, quantitative PCR analysis revealed transient downregulation of the adipokines adiponectin, leptin and resistin in SAT. While adiponectin and leptin have been shown to be cardioprotective, the role of resistin after MI needs further investigation. Importantly, all significant changes were identified in SAT, while VAT was largely unaffected by MI. We conclude that targeted interference with lipolysis in SAT may be a promising approach to promote cardiac healing after ischemia.
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Zhou Z, Liu C, Xu S, Wang J, Guo F, Duan S, Deng Q, Sun J, Yu F, Zhou Y, Wang M, Wang Y, Zhou L, Jiang H, Yu L. Metabolism regulator adiponectin prevents cardiac remodeling and ventricular arrhythmias via sympathetic modulation in a myocardial infarction model. Basic Res Cardiol 2022; 117:34. [PMID: 35819552 DOI: 10.1007/s00395-022-00939-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 01/31/2023]
Abstract
The stellate ganglia play an important role in cardiac remodeling after myocardial infarction (MI). This study aimed to investigate whether adiponectin (APN), an adipokine mainly secreted by adipose tissue, could modulate the left stellate ganglion (LSG) and exert cardioprotective effects through the sympathetic nervous system (SNS) in a canine model of MI. APN microinjection and APN overexpression with recombinant adeno-associated virus vector in the LSG were performed in acute and chronic MI models, respectively. The results showed that acute APN microinjection decreased LSG function and neural activity, and suppressed ischemia-induced ventricular arrhythmia. Chronic MI led to a decrease in the effective refractory period and action potential duration at 90% and deterioration in echocardiography performance, all of which was blunted by APN overexpression. Moreover, APN gene transfer resulted in favorable heart rate variability alteration, and decreased cardiac SNS activity, serum noradrenaline and neuropeptide Y, which were augmented after MI. APN overexpression also decreased the expression of nerve growth factor and growth associated protein 43 in the LSG and peri-infarct myocardium, respectively. Furthermore, RNA sequencing of LSG indicated that 4-week MI up-regulated the mRNA levels of macrophage/microglia activation marker Iba1, chemokine ligands (CXCL10, CCL20), chemokine receptor CCR5 and pro-inflammatory cytokine IL6, and downregulated IL1RN and IL10 mRNA, which were reversed by APN overexpression. Our results reveal that APN inhibits cardiac sympathetic remodeling and mitigates cardiac remodeling after MI. APN-mediated gene therapy may provide a potential therapeutic strategy for the treatment of MI.
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Affiliation(s)
- Zhen Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China.,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China.,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China.,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China
| | - Chengzhe Liu
- Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China.,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China.,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China
| | - Saiting Xu
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China.,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China.,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China.,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China
| | - Jun Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China.,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China.,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China.,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China
| | - Fuding Guo
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China.,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China.,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China.,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China
| | - Shoupeng Duan
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China.,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China.,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China.,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China
| | - Qiang Deng
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China.,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China.,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China.,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China
| | - Ji Sun
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China.,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China.,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China.,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China
| | - Fu Yu
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China.,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China.,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China.,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China
| | - Yuyang Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China.,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China.,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China.,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China
| | - Meng Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China.,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China.,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China.,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China
| | - Yueyi Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China.,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China.,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China.,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China
| | - Liping Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China.,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China.,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China.,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China.,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China
| | - Hong Jiang
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China. .,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China. .,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China. .,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China. .,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China.
| | - Lilei Yu
- Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei Province, People's Republic of China. .,Cardiac Autonomic Nervous System Research Center of Wuhan University, Wuhan, 430060, People's Republic of China. .,Institute of Molecular Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China. .,Cardiovascular Research Institute, Wuhan University, Wuhan, 430060, People's Republic of China. .,Hubei Key Laboratory of Cardiology, Wuhan, 430060, People's Republic of China.
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Mitsis A, Kadoglou NPE, Lambadiari V, Alexiou S, Theodoropoulos KC, Avraamides P, Kassimis G. Prognostic role of inflammatory cytokines and novel adipokines in acute myocardial infarction: An updated and comprehensive review. Cytokine 2022; 153:155848. [PMID: 35301174 DOI: 10.1016/j.cyto.2022.155848] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/23/2022] [Accepted: 02/28/2022] [Indexed: 12/19/2022]
Abstract
Acute myocardial infarction (AMI) is one of the major causes of morbidity and mortality worldwide. The inflammation response during and after AMI is common and seems to play a key role in the peri-AMI period, related with ischaemia-reperfusion injury, adverse cardiac remodelling, infarct size and poor prognosis. In this article, we provide an updated and comprehensive overview of the most important cytokines and adipokines involved in the complex pathophysiology mechanisms in AMI, summarizing their prognostic role post-AMI. Data so far support that elevated levels of the major proinflammatory cytokines TNFα, IL-6 and IL-1 and the adipokines adiponectin, visfatin and resistin, are linked to high mortality and morbidity. In contrary, there is evidence that anti-inflammatory cytokines and adipokines as IL-10, omentin-1 and ghrelin can suppress the AMI-induced inflammatory response and are correlated with better prognosis. Mixed data make unclear the role of the novel adipokines leptin and apelin. After all, imbalance of pro-inflammatory and anti-inflammatory cytokines may result in worst AMI prognosis. The incorporation of these inflammation biomarkers in established prognostic models could further improve their prognostic power improving overall the management of AMI patients.
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Affiliation(s)
- Andreas Mitsis
- Cardiology Department, Nicosia General Hospital, Cyprus.
| | | | - Vaia Lambadiari
- Second Department of Internal Medicine, Research Institute and Diabetes Centre, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | - Sophia Alexiou
- Second Cardiology Department, "Hippokration" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - George Kassimis
- Second Cardiology Department, "Hippokration" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Serial Changes in Exercise Capacity, NT-proBNP, and Adiponectin in Patients with Acute Coronary Syndrome before and after Phase II Rehabilitation as well as at the 12-Month Follow-Up. Cardiol Res Pract 2022; 2022:6538296. [PMID: 35111341 PMCID: PMC8803453 DOI: 10.1155/2022/6538296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 01/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background. Acute coronary syndrome (ACS) causes pathophysiological changes in exercise capacity, N-terminal part of pro-brain natriuretic peptide (NT-proBNP), and adiponectin that impact the course of coronary artery disease and clinical outcomes after cardiac rehabilitation (CR). However, the serial changes and the relationship between the changes in these parameters for a prolonged term remain uninvestigated. Methods. Eighty-one patients with ACS underwent a three- or four-week CR program after acute care and were followed up for 12 months. Exercise capacity on a cycle ergometer and blood levels of NT-proBNP and adiponectin were determined before and after CR as well as at the 12-month follow-up. Results. Exercise capacity increased from 100 watts (in median) before CR to 138 watts after CR and 150 watts at 12 months. The NT-proBNP level (526 pg/ml before CR) remained almost unchanged after CR (557 pg/ml) and then decreased at 12 months (173 pg/ml). The adiponectin level (14.5 µg/ml before CR) increased after CR (16.0 µg/ml) and at 12 months (17.2 µg/ml). There was no significant correlation among the changes in these parameters at each observation time point. Conclusion. During the observation period from before CR to the 12-month follow-up, exercise capacity, NT-proBNP, and adiponectin underwent significant changes; however, these changes were independent from each other and not correlated linearly, and they provide complementary information in clinical practice. Thus, all these parameters should be included and determined at different time points for a prolonged period of time.
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T-Cadherin and the Ratio of Its Ligands as Predictors of Carotid Atherosclerosis: A Pilot Study. Biomedicines 2021; 9:biomedicines9101398. [PMID: 34680515 PMCID: PMC8533356 DOI: 10.3390/biomedicines9101398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 12/27/2022] Open
Abstract
In the cardiovascular system, atherogenic low-density lipoproteins (LDL) and the protective hormone adiponectin bind to the same receptor, T-cadherin. In this study, we tested the hypothesis that the ratio of circulating LDL to high-molecular weight (HMW) adiponectin could predict the development of atherosclerosis. Using enzyme-linked immunosorbent assay, we measured the level of circulating HMW adiponectin in the blood of donors together with ultrasound measuring of intima-media thickness (IMT) of carotid arteries. Single-nucleotide polymorphisms in the T-cadherin gene were identified using polymerase chain reaction. We found that carotid artery IMT is inversely correlated with the level of HMW in male subjects. We also found that the G allele of rs12444338 SNP in the T-cadherin gene correlates with a lower level of circulating T-cadherin and thinner IMT and therefore could be considered as an atheroprotective genotype. Despite our data, we could not provide direct evidence for the initial study hypothesis. However, we did uncover an important correlation between circulating T-cadherin and thinner carotid IMT.
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Gunturiz Albarracín ML, Forero Torres AY. Adiponectin and Leptin Adipocytokines in Metabolic Syndrome: What Is Its Importance? DUBAI DIABETES AND ENDOCRINOLOGY JOURNAL 2020. [DOI: 10.1159/000510521] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The global obesity epidemic has motivated a large number of investigations related to adipose tissue. Within the advances in this area, a variety of factors secreted by adipose tissue and with regulatory activity on caloric intake, energy expenditure, reproduction, locomotor activity, glycidic and lipid metabolism, immune response, and bone physiology have been described. Among these adipocyte hormones, collectively called “adipokines” or “adipocytokines,” leptin (LEP) and adiponectin are addressed in this review. The regulation of adipocytokines is altered in diseases such as obesity, atherosclerosis, type 2 diabetes mellitus, and metabolic syndrome (MS) due to the increase in the mass of white adipose tissue. LEP and adiponectin have a broad spectrum of functions in regulating metabolism and are an important link between obesity and MS. Because these adipocytokines have opposite effects on subclinical inflammation and insulin resistance, it has been suggested that the combined use of these 2 adipocytokines may work as a better biomarker in the diagnosis of MS than using them individually. In this review, we address the characteristics and main functions of adipocytokines derived from adipose tissue such as adiponectin and LEP, which in the Colombian context could give good guidance for the management of MS, especially in populations of children and adolescents.
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Remote Ischaemic Preconditioning Reduces Kidney Injury Biomarkers in Patients Undergoing Open Surgical Lower Limb Revascularisation: A Randomised Trial. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:7098505. [PMID: 32047578 PMCID: PMC7003258 DOI: 10.1155/2020/7098505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 12/30/2019] [Accepted: 01/07/2020] [Indexed: 12/02/2022]
Abstract
Background and Aims Perioperative kidney injury affects 12.7% of patients undergoing lower limb revascularisation surgery. Remote ischaemic preconditioning (RIPC) is a potentially protective procedure against organ damage and consists of short nonlethal episodes of ischaemia. The main objective of this substudy was to evaluate the effect of RIPC on kidney function, inflammation, and oxidative stress in patients undergoing open surgical lower limb revascularisation. Materials and Methods. This is a subgroup analysis of a randomised, sham-controlled, double-blinded, single-centre study. A RIPC or a sham procedure was performed noninvasively along with preparation for anaesthesia in patients undergoing open surgical lower limb revascularisation. The RIPC protocol consisted of 4 cycles of 5 minutes of ischaemia, with 5 minutes of reperfusion between every episode. Blood was collected for analysis preoperatively, 2, 8, and 24 hours after surgery, and urine was collected preoperatively and 24 hours after surgery. Results Data of 56 patients were included in the analysis. Serum creatinine, cystatin C, and beta-2 microglobulin increased, and eGFR decreased across all time points significantly more in the sham group than in the RIPC group (p = 0.021, p = 0.021, p = 0.021, p = 0.021, p = 0.021, Conclusions Our finding of reduced release of kidney injury biomarkers may indicate the renoprotective effect of RIPC in patients undergoing open surgical lower limb revascularisation. The trial is registered with ClinicalTrials.gov NCT02689414.
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Maeda N, Funahashi T, Matsuzawa Y, Shimomura I. Adiponectin, a unique adipocyte-derived factor beyond hormones. Atherosclerosis 2019; 292:1-9. [PMID: 31731079 DOI: 10.1016/j.atherosclerosis.2019.10.021] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 10/01/2019] [Accepted: 10/31/2019] [Indexed: 12/11/2022]
Abstract
Visceral fat accumulation has a marked impact on atherosclerotic cardiovascular diseases and metabolic syndrome clustering diabetes, dyslipidemia, and hypertension. Adiponectin, an adipocyte-derived circulating protein, is a representative adipocytokine and uniquely possesses two major properties: 1) its circulating concentration is approximately 3-6 orders of magnitude greater than ordinary hormones and cytokines; 2) its concentration inversely correlates with body fat mass despite its adipocyte-specific production. Low serum levels of adiponectin correlate with cardiometabolic diseases. Extensive experimental evidence has demonstrated that adiponectin possesses multiple properties, such as anti-atherosclerotic, anti-diabetic, and anti-inflammatory activities. It has been shown to play a central role against the development of metabolic syndrome and its complications. However, even approximately 25 years after its discovery, the properties of adiponectin, including how and why it exerts multiple beneficial effects on various tissues and/or organs, remain unclear. Furthermore, the mechanisms responsible for the very high circulating concentrations of adiponectin in the bloodstream have not been elucidated. Several adiponectin-binding partners, such as AdipoR1/2, have been identified, but do not fully explain the multi-functional and beneficial properties of adiponectin. Recent advances in adiponectin research may resolve these issues. Adiponectin binds to and covers cell surfaces with T-cadherin, a unique glycosylphosphatidylinositol (GPI)-anchored cadherin. The adiponectin/T-cadherin complex enhances exosomal production and release, excreting cell-toxic products from cells, particularly in the vasculature. In this review, we discuss adiponectin and the role of the adiponectin/T-cadherin system in the maintenance of whole body homeostasis and cardiovascular protection.
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Affiliation(s)
- Norikazu Maeda
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan; Department of Metabolism and Atherosclerosis, Graduate School of Medicine, Osaka University, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan.
| | - Tohru Funahashi
- Division of Osaka Health Support Center, Sumitomo Mitsui Banking Corporation, 6-5, Kitahama 4-chome, Chuo-ku, Osaka, Osaka, 541-0041, Japan
| | - Yuji Matsuzawa
- Department of Endocrinology and Metabolism, Sumitomo Hospital, 5-3-20, Nakanoshima, Kita-ku, Osaka, Osaka, 530-0005, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
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Xia Y, Zhang F, Zhao S, Li Y, Chen X, Gao E, Xu X, Xiong Z, Zhang X, Zhang J, Zhao H, Wang W, Wang H, Guo Y, Liu Y, Li C, Wang S, Zhang L, Yan W, Tao L. Adiponectin determines farnesoid X receptor agonism-mediated cardioprotection against post-infarction remodelling and dysfunction. Cardiovasc Res 2019; 114:1335-1349. [PMID: 29668847 DOI: 10.1093/cvr/cvy093] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 04/12/2018] [Indexed: 12/16/2022] Open
Abstract
Aims The farnesoid X receptor (FXR) is a member of the metabolic nuclear receptor superfamily that plays a critical regulatory role in cardiovascular physiology/pathology. However, the role of systemic FXR activation in the chronic phase in myocardial infarction (MI)-induced cardiac remodelling and dysfunction remains unclear. In this study, we aimed to elucidate the role of long-term FXR activation on post-MI cardiac remodelling and dysfunction. Methods and results Mice underwent either MI surgery or sham operation. At 1 week after MI, both sham and MI mice were gavaged with 25 mg/kg/d of a synthetic FXR agonist (GW4064) or a vehicle control for 7 weeks, and cardiac performance was assessed by consecutive echocardiography studies. Administration of GW4064 significantly increased left ventricular ejection fraction at 4 weeks and 8 weeks after MI (both P < 0.01). Moreover, GW4064 treatment increased angiogenesis and mitochondrial biogenesis, reduced cardiomyocyte loss and inflammation, and ameliorated cardiac remodelling as evidenced by heart weight, lung weight, atrial natriuretic peptide/brain natriuretic peptide levels, and myocardial fibrosis at 8 weeks post-MI. At the molecular level, GW4064 significantly increased FXR mRNA expression and transcriptional activity in heart tissue. Moreover, over-expression of myocardial FXR failed to exert significant cardioprotection in vivo, indicating that GW4064 improved post-MI heart remodelling and function independent of myocardial FXR expression/activity. Among the four down-stream soluble molecules of FXR, plasma adiponectin was most significantly increased by GW4064. In cultured adipocytes, GW4064 increased mRNA levels and protein expression of adiponectin. Conditioned medium of GW4064-treated adipocytes activated AMPK-PGC-1α signalling and reduced hypoxia-induced cardiomyocyte apoptosis, all of which were attenuated by an adiponectin neutralizing anti-body. More importantly, when knocking-out adiponectin in mice, the cardioprotective effects of GW4064 were attenuated. Conclusions We are the first to show that FXR agonism ameliorated post-MI cardiac dysfunction and remodelling by stimulating adiponectin secretion. Thus, we demonstrated that FXR agonism is a potential therapeutic strategy in post-MI heart failure.
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Affiliation(s)
- Yunlong Xia
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Fuyang Zhang
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Shihao Zhao
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China.,Department of Cardiology, Hainan Branch of PLA General Hospital, Sanya 572013, China
| | - Yueyang Li
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Xiyao Chen
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Erhe Gao
- Center for Translational Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Xinyue Xu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
| | - Zhenyu Xiong
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Xiaomeng Zhang
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Jinglong Zhang
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Huishou Zhao
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Wei Wang
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Helin Wang
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Yanjie Guo
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Yi Liu
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Congye Li
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Shan Wang
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Ling Zhang
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Wenjun Yan
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Ling Tao
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
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Abstract
Studies have linked obesity, metabolic syndrome, type 2 diabetes, cardiovascular disease (CVD), nonalcoholic fatty liver disease (NAFLD) and dementia. Their relationship to the incidence and progression of these disease states suggests an interconnected pathogenesis involving chronic low-grade inflammation and oxidative stress. Metabolic syndrome represents comorbidities of central obesity, insulin resistance, dyslipidemia, hypertension and hyperglycemia associated with increased risk of type 2 diabetes, NAFLD, atherosclerotic CVD and neurodegenerative disease. As the socioeconomic burden for these diseases has grown signficantly with an increasing elderly population, new and alternative pharmacologic solutions for these cardiometabolic diseases are required. Adipose tissue, skeletal muscle and liver are central endocrine organs that regulate inflammation, energy and metabolic homeostasis, and the neuroendocrine axis through synthesis and secretion of adipokines, myokines, and hepatokines, respectively. These organokines affect each other and communicate through various endocrine, paracrine and autocrine pathways. The ultimate goal of this review is to provide a comprehensive understanding of organ crosstalk. This will include the roles of novel organokines in normal physiologic regulation and their pathophysiological effect in obesity, metabolic syndrome, type 2 diabetes, CVD, NAFLD and neurodegenerative disorders.
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Affiliation(s)
- Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Hallym University, Seoul, South Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, South Korea.
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Potenza MA, Sgarra L, Nacci C, Leo V, De Salvia MA, Montagnani M. Activation of AMPK/SIRT1 axis is required for adiponectin-mediated preconditioning on myocardial ischemia-reperfusion (I/R) injury in rats. PLoS One 2019; 14:e0210654. [PMID: 30653603 PMCID: PMC6336234 DOI: 10.1371/journal.pone.0210654] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/28/2018] [Indexed: 12/17/2022] Open
Abstract
Background Adiponectin (AD) cardioprotective activities are mediated by AMPK, a fuel-sensing molecule sharing common targets and cellular activities with SIRT-1. Whether AD preconditioning may involve SIRT-1 activity is not known; however, the protective role of SIRT-1 during ischemia and the potential interplay between AMPK and SIRT-1 suggest this possibility. Methods Isolated hearts from male Sprague-Dawley rats (n = 85) underwent ischemia/reperfusion (I/R, 30/180 min). Preconditioning with resveratrol (RSV, SIRT-1 activator) was compared to preconditioning with AD alone, or in combination with compound C (CC, AMPK inhibitor) or sirtinol (STN, SIRT-1 inhibitor). For each heart, left ventricular end-diastolic pressure (LVEDP), left ventricular developed pressure (dLVP), coronary flow (CF) and left ventricular infarct mass (IM) were measured, together with the phosphorylation/activation status of AMPK, LKB1, eNOS and SIRT-1, at the beginning (15 min) and at the end (180 min) of reperfusion. Results and conclusions When compared to I/R, both RSV and AD improved cardiac function and reduced IM (p < 0.01, p < 0.05, respectively). Cardioprotective effects of AD were completely reversed in the AD+CC group, and significantly attenuated in the AD+STN group. Both RSV and AD increased eNOS, AMPK and LKB1 phosphorylation (for each parameter: p < 0.05 vs. I/R, in both RSV and AD treatment groups) at 15 min of reperfusion, and SIRT-1 activity at the end of reperfusion (p < 0.01, p < 0.05 vs. I/R, respectively). Interestingly, AD-mediated phosphorylation of AMPK and LKB1, and SIRT-1 deacetylation activity was markedly reduced in both the AD+CC and AD+STN groups (p < 0.05 vs. AD). Thus, AD-mediated cardioprotection requires both AMPK and SIRT-1 signaling pathways, that act as a component of a cycle and regulate each other’s activities.
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Affiliation(s)
- Maria Assunta Potenza
- Department of Biomedical Sciences and Human Oncology-Pharmacology Section, Medical School-University of Bari "Aldo Moro", Bari, Italy
| | - Luca Sgarra
- Department of Emergency and Organ Transplantation-Section of Cardiovascular Diseases, Medical School-University of Bari "Aldo Moro", Bari, Italy
| | - Carmela Nacci
- Department of Biomedical Sciences and Human Oncology-Pharmacology Section, Medical School-University of Bari "Aldo Moro", Bari, Italy
| | - Valentina Leo
- Department of Biomedical Sciences and Human Oncology-Pharmacology Section, Medical School-University of Bari "Aldo Moro", Bari, Italy
| | - Maria Antonietta De Salvia
- Department of Biomedical Sciences and Human Oncology-Pharmacology Section, Medical School-University of Bari "Aldo Moro", Bari, Italy
| | - Monica Montagnani
- Department of Biomedical Sciences and Human Oncology-Pharmacology Section, Medical School-University of Bari "Aldo Moro", Bari, Italy
- * E-mail:
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Papargyri P, Zapanti E, Salakos N, Papargyris L, Bargiota A, Mastorakos G. Links between HPA axis and adipokines: clinical implications in paradigms of stress-related disorders. Expert Rev Endocrinol Metab 2018; 13:317-332. [PMID: 30422016 DOI: 10.1080/17446651.2018.1543585] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION In the human organism, a constant interplay exists between the stress system [which includes the activity of the hypothalamic-pituitary-adrenal (HPA) axis] and the adipose tissue. This interplay is mediated by hormones of the HPA axis such as corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH) and glucocorticoids (GCs) and adipokines secreted by the adipose tissue. AREAS COVERED In this critical review, the bi-directional interactions between HPA axis and the most studied adipokines such as leptin and adiponectin, as well as the pro-inflammatory adipocytokines tumor necrosis factor (TNF) and interleukin (IL) 6 are presented. Furthermore, these interactions are described in normalcy as well as in specific clinical paradigms of stress-related disorders such as eating disorders, hypothalamic amenorrhea, and stress-related endogenous hypercortisolism states. Wherever new therapeutic strategies emerge, they are presented accordingly. EXPERT COMMENTARY Additional research is needed to clarify the mechanisms involved in the interplay between the HPA axis and the adipose tissue. Research should be focused, in particular, on the development of new therapeutic means targeting dysfunctional adipose tissue in stress-related situations.
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Affiliation(s)
- Panagiota Papargyri
- a Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion Hospital, School of Medicine , National and Kapodistrian University of Athens , Athens , Greece
| | - Evangelia Zapanti
- b Department of Endocrinology , Alexandra Hospital , Athens , Greece
| | - Nicolaos Salakos
- c Second Department of Obstetrics and Gynecology, Aretaieion Hospital, School of Medicine , National and Kapodistrian University of Athens , Athens , Greece
| | - Loukas Papargyris
- d CRCINA, INSERM, Université de Nantes, Université d'Angers , Angers , France
- e LabEx IGO "Immunotherapy, Graft, Oncology," , Angers , France
| | - Alexandra Bargiota
- f Department of Endocrinology and Metabolic Diseases, Larissa University Hospital, School of Medicine , University of Thessaly , Larissa , Greece
| | - George Mastorakos
- a Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion Hospital, School of Medicine , National and Kapodistrian University of Athens , Athens , Greece
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Souza RA, Alves CMR, de Oliveira CSV, Reis AF, Carvalho AC. Circulating levels of adiponectin and extent of coronary artery disease in patients undergoing elective coronary angiography. ACTA ACUST UNITED AC 2017; 51:e6738. [PMID: 29211251 PMCID: PMC5711007 DOI: 10.1590/1414-431x20176738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 09/19/2017] [Indexed: 11/22/2022]
Abstract
Adiponectin (APN), an adipose tissue-released adipokine with demonstrated anti-inflammatory and anti-atherogenic properties, is encoded by a gene whose polymorphisms are associated with presence of coronary artery disease (CAD). Serum APN levels are inversely related with presence and complexity of CAD. Within this context, we sought to compare levels of total APN and its high molecular weight form (HMW APN) according to clinical presentation and extent of CAD in patients undergoing elective cardiac catheterization. From March 2008 to June 2010, clinical data and blood samples for APN and HMW APN measurements were collected from 415 subjects undergoing cardiac catheterization at two tertiary centers. CAD extent was estimated by the number of coronary arteries with significant stenosis (≥70% obstruction in a major coronary artery) and by Duke Jeopardy Score (DJS). Serum APN levels were similar between groups with stable or unstable CAD (APN 9.20±5.88 vs 9.47±6.23 μg/mL, P=0.738, and HMW APN 5.31±3.72 vs 5.91±4.16 μg/mL, P=0.255), even after stratification by the number of arteries involved (single-vessel vs multivessel disease: APN 9.39±5.76 vs 9.26±6.27 μg/mL, P=0.871; HMW APN 5.29±3.79 vs 5.83±4.04 μg/mL, P=0.306) and DJS score (APN, P=0.718; HMW APN, P=0.276). We conclude that APN and HMW APN serum levels are similar across clinical presentations and different extents of CAD, despite being significantly lower in the presence of obstructive CAD.
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Affiliation(s)
- R A Souza
- Cardiologia Intervencionista, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - C M R Alves
- Cardiologia Intervencionista, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - C S V de Oliveira
- Disciplina de Endocrinologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - A F Reis
- Disciplina de Endocrinologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - A C Carvalho
- Disciplina de Cardiologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Shibata R, Ouchi N, Ohashi K, Murohara T. The role of adipokines in cardiovascular disease. J Cardiol 2017; 70:329-334. [DOI: 10.1016/j.jjcc.2017.02.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 02/06/2017] [Indexed: 12/16/2022]
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17
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Serum markers of inflammation and oxidative stress in sarcopenia. Aging Clin Exp Res 2017; 29:745-752. [PMID: 27571781 DOI: 10.1007/s40520-016-0626-2] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 08/18/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Sarcopenia is a geriatric syndrome characterized by the presence of low muscle mass and function. Possible mechanisms underlying sarcopenia include oxidative stress and elevation of inflammatory cytokines. AIMS The aim of the study was to evaluate the relationship between sarcopenia and biomarkers that may be involved in its pathogenesis and hence early detection. METHODS A total of 72 patients (36 sarcopenic and 36 non-sarcopenic) were included in the study. An experienced geriatric team applied comprehensive geriatric assessment to all patients. Anthropometric measures, gait speed and handgrip strength were recorded. Bioelectrical impedance analysis was used to assess skeletal muscle mass. In addition to routine clinical laboratory tests, serum adiponectin, thioredoxin-1 and pentraxin-3 levels were measured. Sarcopenia was defined according to the European Working Group on Sarcopenia in older Adults as the presence of low muscle mass and low muscle function or muscle performance. RESULTS Sarcopenic patients were more likely to be functionally dependent and had lower scores on comprehensive geriatric assessment tools. Erythrocyte sedimentation rate (ESR) and C-reactive protein levels were significantly higher in the sarcopenic group. There was no significant difference in serum levels of thioredoxin-1 and pentraxin-3. Sarcopenic patients had lower levels of hemoglobin, albumin, total protein, calcium, triglycerides, uric acid and adiponectin (p < 0.05). Hypertension and body mass index were inversely correlated with sarcopenia whereas ESR was positively correlated. DISCUSSION AND CONCLUSION The present study demonstrated an association of sarcopenia with inflammatory markers CRP, ESR and adiponectin. Long-term prospective studies are warranted to confirm the relationship between markers oxidative stress and age related muscle decline.
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Wang Y, Ma XL, Lau WB. Cardiovascular Adiponectin Resistance: The Critical Role of Adiponectin Receptor Modification. Trends Endocrinol Metab 2017; 28:519-530. [PMID: 28473178 PMCID: PMC6391995 DOI: 10.1016/j.tem.2017.03.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 03/01/2017] [Accepted: 03/28/2017] [Indexed: 12/23/2022]
Abstract
For the past two decades, a great deal of research has been published concerning adiponectin (APN), an abundant protein responsible for regulating numerous biologic functions including antioxidative, antinitrative, anti-inflammatory, and cardioprotective effects. A review of APN and its two major receptors is timely because of new findings concerning the mechanisms by which APN signaling may be altered in pathologic processes such as diabetes and heart failure. In this review we elaborate on currently known information regarding the physiologic role of APN and the known mechanisms underlying pathologic APN resistance - namely, APN receptor downregulation and phosphorylation - and provide insight regarding the future directions of APN research including an assessment of the clinical applicability of preventing pathologic post-translational modification of the APN receptor.
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Affiliation(s)
- Yajing Wang
- Department of Emergency Medicine, Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA 19107, USA
| | - Xin L Ma
- Department of Emergency Medicine, Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA 19107, USA
| | - Wayne Bond Lau
- Department of Emergency Medicine, Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA 19107, USA.
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Bergmark BA, Cannon CP, White WB, Jarolim P, Liu Y, Bonaca MP, Zannad F, Morrow DA. Baseline adiponectin concentration and clinical outcomes among patients with diabetes and recent acute coronary syndrome in the EXAMINE trial. Diabetes Obes Metab 2017; 19:962-969. [PMID: 28195387 PMCID: PMC5765757 DOI: 10.1111/dom.12905] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 01/30/2017] [Accepted: 02/09/2017] [Indexed: 01/28/2023]
Abstract
AIM To investigate adiponectin levels and cardiovascular (CV) outcomes in patients with diabetes and recent acute coronary syndrome (ACS). MATERIALS AND METHODS We analysed baseline adiponectin concentration and CV outcomes in 5213 patients with type 2 diabetes enrolled in the EXAMINE trial of alogliptin vs placebo 15 to 90 days (median 45 days) after ACS. Event rates at 18 months are reported. RESULTS The median (interquartile range) baseline adiponectin concentration was 5.2 (3.5-7.9) μg/mL. Patients with the highest baseline adiponectin concentration (quartile [Q]4) were at significantly higher risk of death from a CV event (8.4% vs 1.7%; P < .0001), hospitalization for heart failure (HF; 7.5% vs 1.7%; P < .0001), and all-cause mortality (10.8% vs 2.4%; P < .0001) compared with those in Q1. After adjusting for age, sex, index event, HF, estimated glomerular filtration rate and hypertension, adiponectin concentration in Q4 remained associated with an increased risk of death from CV causes (hazard ratio [HR] 2.43, 95% confidence interval [CI] 1.52, 3.88), all-cause mortality (HR 2.45, 95% CI 1.65, 3.64), and HF (HR 2.44, 95% CI 1.47, 4.05), without change after stratification by body mass index. There was no significant difference in the rate of myocardial infarction or stroke. CONCLUSIONS In this contemporary population of patients with diabetes and ACS, adiponectin concentration was independently associated with increased risk of death from CV causes, all-cause mortality, and hospitalization for HF. The relationship between adiponectin and CV outcomes is complex and deserves further study.
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Affiliation(s)
- Brian A. Bergmark
- TIMI Study Group, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Christopher P. Cannon
- Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Baim Institute, Harvard Medical School, Boston, Massachusetts
| | - William B. White
- Pat and Jim Calhoun Cardiology Center, University of Connecticut, Farmington, Connecticut
| | - Petr Jarolim
- Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Yuyin Liu
- Baim Institute, Harvard Medical School, Boston, Massachusetts
| | - Marc P. Bonaca
- TIMI Study Group, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Faiez Zannad
- Centre d’Investigation Clinique Inserm 1433 and U 1116, Universite de Lorraine and CHRU, Nancy, France
| | - David A. Morrow
- TIMI Study Group, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
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20
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Wu PJ, Wang HT, Sung PH, Tong MS, Yang CH, Chen CJ, Lin CJ, Hsueh SK, Chung SY, Chung WJ, Hang CL, Wu CJ, Yip HK. No correlation between body mass index and 30-day prognostic outcome in Asians with acute ST-elevation myocardial infarction undergoing primary coronary intervention. Biomed J 2017; 40:169-177. [PMID: 28651739 PMCID: PMC6136285 DOI: 10.1016/j.bj.2016.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 12/18/2016] [Accepted: 12/27/2016] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND This study investigated whether body mass index (BMI) was a risk factor predictive of 30-day prognostic outcome in Asians with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). MATERIAL AND METHODS Data regarding the impact of BMI on the prognostic outcome in Asian populations after acute STEMI is scarce. A number of 925 STEMI patients were divided into three groups according to the BMI: normal weight (<25 kg/m2), overweight (≥25.0 to <30.0 kg/m2) and obese (≥30.0 kg/m2). RESULTS The obese group was significantly younger with significantly higher incidences of smoking and diabetes mellitus. The incidences of multi-vessel disease, final thrombolysis in myocardial infarction (TIMI)-3 flow, advanced Killip score, advance congestive heart failure, 30-day mortality and combined 30-day major adverse clinical outcome (MACO) did not differ among the three groups. Multiple regression analysis showed the age, unsuccessful reperfusion and lower left ventricular ejection fraction were most significant and independent predictor of 30-day mortality. CONCLUSION BMI is not a predictor of 30-day prognostic outcome in Asians with STEMI undergoing primary PCI.
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Affiliation(s)
- Po-Jui Wu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hui-Ting Wang
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pei-Hsun Sung
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Meng-Shen Tong
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Hsu Yang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chien-Jen Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Jei Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shu-Kai Hsueh
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sheng-Ying Chung
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Jung Chung
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chi-Ling Hang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chiung-Jen Wu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| | - Hon-Kan Yip
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Center for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Institute of Shock Wave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan; Department of Nursing, Asia University, Taichung, Taiwan.
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21
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Fuster JJ, Ouchi N, Gokce N, Walsh K. Obesity-Induced Changes in Adipose Tissue Microenvironment and Their Impact on Cardiovascular Disease. Circ Res 2017; 118:1786-807. [PMID: 27230642 DOI: 10.1161/circresaha.115.306885] [Citation(s) in RCA: 393] [Impact Index Per Article: 56.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/16/2016] [Indexed: 02/07/2023]
Abstract
Obesity is causally linked with the development of cardiovascular disorders. Accumulating evidence indicates that cardiovascular disease is the collateral damage of obesity-driven adipose tissue dysfunction that promotes a chronic inflammatory state within the organism. Adipose tissues secrete bioactive substances, referred to as adipokines, which largely function as modulators of inflammation. The microenvironment of adipose tissue will affect the adipokine secretome, having actions on remote tissues. Obesity typically leads to the upregulation of proinflammatory adipokines and the downregulation of anti-inflammatory adipokines, thereby contributing to the pathogenesis of cardiovascular diseases. In this review, we focus on the microenvironment of adipose tissue and how it influences cardiovascular disorders, including atherosclerosis and ischemic heart diseases, through the systemic actions of adipokines.
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Affiliation(s)
- José J Fuster
- From the Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA (J.J.F., N.G., K.W.); and Department of Molecular Cardiology, Nagoya University School of Medicine, Nagoya, Japan (N.O.).
| | - Noriyuki Ouchi
- From the Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA (J.J.F., N.G., K.W.); and Department of Molecular Cardiology, Nagoya University School of Medicine, Nagoya, Japan (N.O.)
| | - Noyan Gokce
- From the Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA (J.J.F., N.G., K.W.); and Department of Molecular Cardiology, Nagoya University School of Medicine, Nagoya, Japan (N.O.)
| | - Kenneth Walsh
- From the Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA (J.J.F., N.G., K.W.); and Department of Molecular Cardiology, Nagoya University School of Medicine, Nagoya, Japan (N.O.).
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22
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Natsukawa T, Maeda N, Fukuda S, Yamaoka M, Fujishima Y, Nagao H, Sato F, Nishizawa H, Sawano H, Hayashi Y, Funahashi T, Kai T, Shimomura I. Significant Association of Serum Adiponectin and Creatine Kinase-MB Levels in ST-Segment Elevation Myocardial Infarction. J Atheroscler Thromb 2017; 24:793-803. [PMID: 28100880 PMCID: PMC5556187 DOI: 10.5551/jat.38232] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Aims: Adiponectin, an adipocyte-specific secretory protein, abundantly exists in the blood stream while its concentration paradoxically decreases in obesity. Hypoadiponectinemia is one of risks of cardiovascular diseases. However, impact of serum adiponectin concentration on acute ischemic myocardial damages has not been fully clarified. The present study investigated the association of serum adiponectin and creatine kinase (CK)-MB levels in subjects with ST-segment elevation myocardial infarction (STEMI). Methods: This study is a physician-initiated observational study and is also registered with the University Hospital Medical Information Network (Number: UMIN 000014418). Patients were admitted to Senri Critical Care Medical Center, given a diagnosis of STEMI, and treated by primary percutaneous coronary intervention (PCI). Finally, 49 patients were enrolled and the association of serum adiponectin, CK-MB, and clinical features were mainly analyzed. Results: Serum adiponectin levels decreased rapidly and reached the bottom at 24 hours after recanalization. Such reduction of serum adiponectin was inversely correlated with the area under the curve (AUC) of serum CK-MB (p = 0.013). Serum adiponectin concentrations were inversely correlated with AUC of serum CK-MB. In multivariate analysis, serum adiponectin concentration on admission (p = 0.002) and collateral (p = 0.037) were significantly and independently correlated with serum AUC of CK-MB. Conclusion: Serum AUC of CK-MB in STEMI subjects was significantly associated with serum adiponectin concentration on admission and reduction of serum adiponectin levels from baseline to bottom. The present study may provide a possibility that serum adiponectin levels at acute phase are useful in the prediction for prognosis after PCI-treated STEMI subjects.
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Affiliation(s)
- Tomoaki Natsukawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University.,Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital
| | - Norikazu Maeda
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University.,Department of Metabolism and Atherosclerosis, Graduate School of Medicine, Osaka University
| | - Shiro Fukuda
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
| | - Masaya Yamaoka
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
| | - Yuya Fujishima
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
| | - Hirofumi Nagao
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
| | - Fumi Sato
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
| | - Hitoshi Nishizawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
| | - Hirotaka Sawano
- Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital
| | - Yasuyuki Hayashi
- Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital
| | - Tohru Funahashi
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University.,Department of Metabolism and Atherosclerosis, Graduate School of Medicine, Osaka University
| | - Tatsuro Kai
- Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
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Elective percutaneous coronary intervention leads to significant changes in serum resistin, leptin, and adiponectin levels regardless of periprocedural myocardial injury: an observational study. Anatol J Cardiol 2016; 16:940-946. [PMID: 27443475 PMCID: PMC5324914 DOI: 10.14744/anatoljcardiol.2016.6876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Objective: Bioactive roles of adipokines in coronary atherosclerosis and acute coronary syndromes have been demonstrated previously. However, there is a lack of data regarding the relationship between serum adipokines and periprocedural myocardial injury (PMI) following elective percutaneous coronary intervention (PCI). Therefore, we aimed to investigate the association between serum adipokines and PMI related to elective PCI. Methods: In total, 153 consecutive patients (aged 60.6±8.2 years, 98 men) with stable angina pectoris undergoing elective PCI were enrolled in this observational cross-sectional study. Serum resistin, leptin, adiponectin, and high-sensitive Troponin T (hscTnT) levels were measured immediately before PCI and after 12-h PCI. The no-injury, PMI, and type 4a myocardial infarction (type 4a MI) groups were defined as groups consisting patients with post-procedural hscTnT concentrations <14 ng/L, between 14–70 ng/L, and >70 ng/L, respectively. Results: Serum hscTnT, resistin, and leptin concentrations significantly (p<0.001) increased while serum adiponectin levels decreased (p<0.001) after 12-h elective PCI. However, no correlation was found between post-procedural hscTnT concentrations and resistin, leptin, and adiponectin levels. The no-injury group consisted of 65 patients (42.4%), whereas PMI and type 4a MI were observed in 70 (45.8%) and 18 (11.8%) patients, respectively. The average pre-procedural and post-procedural resistin, leptin, and adiponectin levels did not show any significant difference in the no-injury, PMI, and type 4a MI groups. Conclusion: There is no correlation between serum adipokine levels and post-procedural troponin elevations reflecting PMI or type 4a MI. However, serum resistin and leptin levels increase, whereas adiponectin levels decrease significantly after elective PCI.
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24
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Gohbara M, Iwahashi N, Akiyama E, Maejima N, Tsukahara K, Hibi K, Kosuge M, Ebina T, Umemura S, Kimura K. Association between epicardial adipose tissue volume and myocardial salvage in patients with a first ST-segment elevation myocardial infarction: An epicardial adipose tissue paradox. J Cardiol 2016; 68:399-405. [PMID: 27004962 DOI: 10.1016/j.jjcc.2015.10.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 10/05/2015] [Accepted: 10/20/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Epicardial adipose tissue (EAT), defined as the adipose tissue between the visceral pericardium and the outer margin of the myocardium, is associated with coronary artery disease in the general population. However, the clinical implications of EAT in patients with ST-segment elevation myocardial infarction (STEMI) remain unclear. METHODS A total of 142 patients with a first STEMI, who received reperfusion therapy within 12h from symptom onset, were enrolled. All patients underwent cardiac magnetic resonance imaging to evaluate infarct core (Core), area at risk (AAR), and EAT volume. Myocardial salvage index (MSI) was defined as AAR minus Core divided by AAR. Patients in the lower tertile of EAT volume were classified as the low EAT group (group L) and the other two-thirds as the high EAT group (group H). RESULTS The mean MSI was lower in group L than in group H (0.43±0.13 vs 0.49±0.13, p=0.01), and the mean extent of Core was higher in group L than in group H (25±10% vs 19±10%, p<0.01). Multivariate linear regression analysis including coronary risk factors and previously reported predictors of infarct size demonstrated that EAT volume was an independent predictor of MSI (β coefficient=0.002 per 1mL, p=0.002). CONCLUSIONS A lower EAT volume is associated with less myocardial salvage and larger infarct size in patients with a first STEMI.
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Affiliation(s)
- Masaomi Gohbara
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Noriaki Iwahashi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
| | - Eiichi Akiyama
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Nobuhiko Maejima
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kengo Tsukahara
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kiyoshi Hibi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Toshiaki Ebina
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Satoshi Umemura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
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25
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Ehsan M, Singh KK, Lovren F, Pan Y, Quan A, Mantella LE, Sandhu P, Teoh H, Al-Omran M, Verma S. Adiponectin limits monocytic microparticle-induced endothelial activation by modulation of the AMPK, Akt and NFκB signaling pathways. Atherosclerosis 2016; 245:1-11. [DOI: 10.1016/j.atherosclerosis.2015.11.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 11/20/2015] [Accepted: 11/20/2015] [Indexed: 12/25/2022]
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26
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Alkofide H, Huggins GS, Ruthazer R, Beshansky JR, Selker HP. Serum adiponectin levels in patients with acute coronary syndromes: Serial changes and relation to infarct size. Diab Vasc Dis Res 2015; 12:411-9. [PMID: 26193887 PMCID: PMC5586528 DOI: 10.1177/1479164115592638] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The role of adiponectin in patients with acute coronary syndromes is incompletely defined. This study investigated adiponectin levels in patients with acute coronary syndromes and the association between adiponectin and 30-day infarct size and 1-year clinical outcomes. METHODS Retrospective analysis of 120 participants with acute coronary syndromes enrolled in the Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency care Trial. Blood levels were tested three times within 24 h of onset of ischaemic symptoms. Infarct size was measured at 30 days. The 1-year clinical outcome was the composite of all-cause mortality or hospitalization for heart failure. RESULTS Using linear mixed models, log adiponectin levels decreased by -0.005 µg/mL per hour (p = 0.035). After stratifying the analysis by gender, there was no decrease in log adiponectin in men; however, levels decreased by -0.01 µg/mL per hour in women (p = 0.02). Results of multivariable regression models showed no association between log adiponectin and infarct size (β = -1.1, p = 0.64). Log adiponectin levels did not predict 1-year outcomes using Cox-proportional hazard models. CONCLUSION There was a small decrease in plasma adiponectin shortly after symptoms of ischaemia, more noticeable in women. No relationship was found between adiponectin and infarct size or clinical outcomes. This adds to evidence showing no clear association between adiponectin and adverse outcomes in patients with acute coronary syndromes.
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Affiliation(s)
- Hadeel Alkofide
- Clinical and Translational Science Graduate Program, Sackler School of Graduate Biomedical Sciences, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
| | - Gordon S Huggins
- MCRI Center for Translational Genomics, Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, USA
| | - Robin Ruthazer
- Center for Cardiovascular Health Services Research, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
| | - Joni R Beshansky
- Center for Cardiovascular Health Services Research, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA Regulatory and Clinical Research Management Graduate Program, Regis College, Weston, MA, USA
| | - Harry P Selker
- Center for Cardiovascular Health Services Research, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
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Grzywocz P, Mizia-Stec K, Wybraniec M, Chudek J. Adipokines and endothelial dysfunction in acute myocardial infarction and the risk of recurrent cardiovascular events. J Cardiovasc Med (Hagerstown) 2015; 16:37-44. [PMID: 24933198 DOI: 10.2459/jcm.0000000000000042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS The aim of the study was to evaluate the prognostic role of adipokines (adiponectin, apelin, resistin, and visfatin) in patients with acute myocardial infarction (AMI) in relation to the extent of glucose metabolism impairment and intensity of systemic low-grade inflammation. METHODS This case-control study covered 131 patients with coronary artery disease: 104 consecutive patients with AMI (74% men, mean age of 62 ± 11 years) treated with primary percutaneous coronary intervention with stent implantation, and 27 patients with stable angina (70% men, mean age of 63 ± 11 years), who were initially assessed in terms of adipokine levels, C-reactive protein and various echocardiographic and vascular parameters. Major adverse cardiovascular events were recorded in the AMI group during 3-year follow-up. RESULTS Resistin and visfatin serum levels were significantly higher (P < 0.001), and adiponectin and apelin were lower (P < 0.001) in AMI patients as compared to patients with stable angina. In AMI patients, adipokine levels were not related to glucose metabolism disturbances, yet adiponectin (P = 0.03) and resistin (P = 0.001) concentrations were related to the number of affected coronary vessels. Serum adiponectin level correlated negatively (r = -0.608, P < 0.05), whereas resistin and visfatin correlated positively (r = 0.526, P < 0.05 and r = 0.352, P < 0.05, respectively) with C-reactive protein levels. All of the analyzed adipokines significantly accounted for the flow-mediated dilation variability (Radjusted 32%) in the AMI group. The Cox survival analysis indicated that resistin and visfatin were independent risk factors of recurrent AMI/unstable angina, with the diagnostic threshold above 12.2 ng/ml for resistin and above 11.8 ng/ml for visfatin concentrations. CONCLUSION An abnormal profile in serum adipokines observed in AMI is related to systemic inflammation and the degree of atherosclerosis independently of glucose metabolism disturbances and heralds major adverse cardiovascular event occurrence in long-term observation.
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Affiliation(s)
- Patryk Grzywocz
- a2nd Department of Cardiology b1st Department of Cardiology, Medical University of Silesia in Katowice, Public Hospital No. 7 in Katowice, Upper Silesian Medical Center cDepartment of Pathophysiology, Medical University of Silesia in Katowice, Katowice, Poland
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28
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The prevention and treatment of hypoadiponectinemia-associated human diseases by up-regulation of plasma adiponectin. Life Sci 2015; 135:55-67. [DOI: 10.1016/j.lfs.2015.03.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 03/13/2015] [Accepted: 03/17/2015] [Indexed: 12/30/2022]
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29
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Yaşar Bilge NŞ, Kaşifoğlu N, Kaşifoğlu T, Şahin F, Gönüllü E, Korkmaz C. The role of methotrexate and low-dose prednisolone on adiponectine levels and insulin resistance in patients with rheumatoid arthritis naïve to disease-modifying antirheumatic drugs. Int J Rheum Dis 2015. [PMID: 26222244 DOI: 10.1111/1756-185x.12575] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIM Insulin resistance (IR) plays an important role in the development of cardiovascular events in rheumatoid arthritis (RA) patients. Adiponectin influences insulin sensitivity but its impact on IR in RA patients remains unclear. The present study aims to investigate the role of methotrexate (MTX) and low doses of prednisolone (LDP) on IR and adiponectin levels in RA patients who are naïve to disease-modifying antirheumatic drugs (DMARDs), as well as determining the relationship between disease activity, acute phase response, IR and adiponectin levels in patients with RA. METHODS Sixty-five RA patients naïve to DMARDs and prednisolone were involved in this study. The medication for RA patients was standardized for MTX and prednisolone. Body mass index, acute phase response reactants, 28-joint-count disease activity score, fasting blood glucose, serum cholesterol levels, insulin levels and adiponectin levels were measured in all RA patients both at the baseline and 3 months after the onset of the study. RESULTS Adiponectin levels in the third month of the therapy with MTX and LDP were significantly increased in patients with RA (P = 0.03). Insulin resistance tended to decrease in the third month of the treatment, which achieved no statistical significance. CONCLUSION Increased levels of adiponectin due to MTX and LDP could be related to the decrease in homeostasis model assessment insulin resistance (HOMA-IR) in RA patients. This, in turn, could prove advantageous for cardiovascular conditions in RA.
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Affiliation(s)
- Nazife Şule Yaşar Bilge
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Nilgün Kaşifoğlu
- Department of Microbiology, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Timuçin Kaşifoğlu
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Fezan Şahin
- Department of Biostatistics, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Emel Gönüllü
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Cengiz Korkmaz
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
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Ekström M, Söderberg S, Tornvall P. Acute Systemic Inflammation is Unlikely to Affect Adiponectin and Leptin Synthesis in Humans. Front Cardiovasc Med 2015; 2:7. [PMID: 26664879 PMCID: PMC4671352 DOI: 10.3389/fcvm.2015.00007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 02/12/2015] [Indexed: 11/15/2022] Open
Abstract
Adipose tissue (AT), classically thought to be merely an energy store, has been shown to produce inflammatory and metabolically active cytokines. Recently, adiponectin and leptin, adipokines primarily synthesized by adipocytes, have attracted considerable attention because inflammation has been suggested to modulate adipokine levels. However, the regulation of adiponectin and leptin is complex and the knowledge about their synthesis within the early onset of inflammation is poorly understood. The aim of this study was to investigate if the synthesis of adiponectin and leptin is affected during the early phase of an acute systemic inflammation. Eighteen healthy subjects were allocated to vaccination against Salmonella typhi or to a control group, and adiponectin and leptin concentrations measured in plasma during 24 h. Nine patients, without markers of inflammation, undergoing open heart surgery were investigated before and after the operation by analysis of plasma levels and AT gene expression of adiponectin and leptin. Plasma interleukin (IL)-6 concentrations were measured in both cohorts. Plasma levels of IL-6 were doubled after vaccination and increased 30-fold after open heart surgery. Plasma levels of adiponectin and leptin were unchanged after vaccination whereas adiponectin and leptin tended to decrease after surgery. The gene expression of adiponectin and leptin was unaltered in omental and subcutaneous AT after surgery. Despite the use of two models of stimulated in vivo systemic inflammation, we found no evidence of an early regulation of adiponectin and leptin synthesis, indicating that these two adipokines are not key elements in an acute systemic inflammation in humans.
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Affiliation(s)
- Mattias Ekström
- Cardiology Unit, Department of Medicine, Karolinska University Hospital , Solna , Sweden
| | - Stefan Söderberg
- Cardiology, Department of Public Health and Clinical Medicine, Umeå University Hospital , Umeå , Sweden
| | - Per Tornvall
- Department of Clinical Science and Education, Karolinska Institutet , Södersjukhuset, Stockholm , Sweden
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Memon AG, Rahman MA, Alghasham A, Hamid S, Hamid Q. Correlation between adipocytokines and AGE products in diabetic and non-diabetic patients with myocardial infarction. RESEARCH ON CHEMICAL INTERMEDIATES 2015. [DOI: 10.1007/s11164-013-1298-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Seropian IM, Sonnino C, Van Tassell BW, Biasucci LM, Abbate A. Inflammatory markers in ST-elevation acute myocardial infarction. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2015; 5:382-95. [PMID: 25681486 DOI: 10.1177/2048872615568965] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 01/02/2015] [Indexed: 01/05/2023]
Abstract
After acute myocardial infarction, ventricular remodeling is characterized by changes at the molecular, structural, geometrical and functional level that determine progression to heart failure. Inflammation plays a key role in wound healing and scar formation, affecting ventricular remodeling. Several, rather different, components of the inflammatory response were studied as biomarkers in ST-elevation acute myocardial infarction. Widely available and inexpensive tests, such as leukocyte count at admission, as well as more sophisticated immunoassays provide powerful predictors of adverse outcome in patients with ST-elevation acute myocardial infarction. We review the value of inflammatory markers in ST-elevation acute myocardial infarction and their association with ventricular remodeling, heart failure and sudden death. In conclusion, the use of these biomarkers may identify subjects at greater risk of adverse events and perhaps provide an insight into the mechanisms of disease progression.
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Affiliation(s)
- Ignacio M Seropian
- Interventional Cardiology Department, Hospital Italiano de Buenos Aires, Argentina
| | - Chiara Sonnino
- VCU Pauley Heart Center, Virginia Commonwealth University, USA Victoria Johnson Research Laboratory, Virginia Commonwealth University, USA Department of Cardiovascular Medicine, Catholic University, Italy
| | - Benjamin W Van Tassell
- VCU Pauley Heart Center, Virginia Commonwealth University, USA Victoria Johnson Research Laboratory, Virginia Commonwealth University, USA School of Pharmacy, Virginia Commonwealth University, USA
| | - Luigi M Biasucci
- Department of Cardiovascular Medicine, Catholic University, Italy
| | - Antonio Abbate
- VCU Pauley Heart Center, Virginia Commonwealth University, USA Victoria Johnson Research Laboratory, Virginia Commonwealth University, USA
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Maresca F, Palma VD, Bevilacqua M, Uccello G, Taglialatela V, Giaquinto A, Esposito G, Trimarco B, Cirillo P. Adipokines, Vascular Wall, and Cardiovascular Disease. Angiology 2015; 66:8-24. [DOI: 10.1177/0003319713520463] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Epidemiological evidence has shown that abdominal obesity is closely associated with the development of cardiovascular (CV) disease, suggesting that it might be considered as an independent CV risk factor. However, the pathophysiological mechanisms responsible for the association between these 2 clinical entities remain largely unknown. Adipocytes are considered able to produce and secrete chemical mediators known as “adipokines” that may exert several biological actions, including those on heart and vessels. Of interest, a different adipokine profile can be observed in the plasma of patients with obesity or metabolic syndrome compared with healthy controls. We consider the main adipokines, focusing on their effects on the vascular wall and analyzing their role in CV pathophysiology.
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Affiliation(s)
- Fabio Maresca
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples, Naples, Italy
| | - Vito Di Palma
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples, Naples, Italy
| | - Michele Bevilacqua
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples, Naples, Italy
| | - Giuseppe Uccello
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples, Naples, Italy
| | - Vittorio Taglialatela
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples, Naples, Italy
| | - Alessandro Giaquinto
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples, Naples, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples, Naples, Italy
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples, Naples, Italy
| | - Plinio Cirillo
- Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples, Naples, Italy
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Trifunovic D, Stankovic S, Marinkovic J, Beleslin B, Banovic M, Djukanovic N, Orlic D, Tesic M, Vujisic-Tesic B, Petrovic M, Nedeljkovic I, Stepanovic J, Djordjevic-Dikic A, Giga V, Ostojic M. Time-dependent changes of plasma adiponectin concentration in relation to coronary microcirculatory function in patients with acute myocardial infarction treated by primary percutaneous coronary intervention. J Cardiol 2014; 65:208-15. [PMID: 25012060 DOI: 10.1016/j.jjcc.2014.05.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 05/08/2014] [Accepted: 05/26/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND PURPOSE To analyze plasma adiponectin kinetics in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (pPCI) and its association with coronary flow reserve (CFR), an index of coronary microcirculatory function. METHODS A total of 96 consecutive patients with the first anterior STEMI treated by pPCI without heart failure were included. CFR was assessed on the 7th day after pPCI. Plasma adiponectin was measured on admission before pPCI, and on the 2nd and 7th day after pPCI. RESULTS Adiponectin concentration was the highest on admission, declined to the lowest level on the 2nd day, and rose on the 7th day remaining below admission values. Impaired coronary microcirculatory function (CFR<2) was observed in 41% of the patients. Adiponectin concentrations significantly positively correlated with CFR, and the strongest correlation was with the 2nd day adiponectin (r=0.489, p<0.001). In multivariate models, adiponectin concentrations were independent predictors of impaired CFR [on admission: odds ratio (OR) 0.175, confidence interval (CI): 0.047-0.654, p=0.010; 2nd day: OR 0.146, 95% CI: 0.044-0.485, p=0.002; 7th day: OR 0.198, CI: 0.064-0.611, p=0.005]. The best power to predict impaired CFR was the 2nd day adiponectin. Delta values of adiponectin (differences between adiponectin concentrations) did not correlate with CFR. CONCLUSIONS In patients with the first anterior STEMI treated by pPCI plasma adiponectin concentrations before and after pPCI are strongly associated with CFR. Our results support the hypothesis that low adiponectin, especially during the early post-pPCI period, carries the risk for impaired coronary microcirculatory function in STEMI patients.
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Affiliation(s)
- Danijela Trifunovic
- Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Sanja Stankovic
- Center for Medical Biochemistry, Clinical Centre of Serbia, School of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Jelena Marinkovic
- Institute of Medical Statistics and Informatics, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Branko Beleslin
- Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marko Banovic
- Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Nina Djukanovic
- Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Dejan Orlic
- Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milorad Tesic
- Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Bosiljka Vujisic-Tesic
- Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Petrovic
- Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivana Nedeljkovic
- Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Stepanovic
- Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ana Djordjevic-Dikic
- Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vojislav Giga
- Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Miodrag Ostojic
- School of Medicine, University of Belgrade, Belgrade, Serbia; Serbian Academy of Sciences and Arts, University of Belgrade, Belgrade, Serbia
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Laurikka A, Vuolteenaho K, Toikkanen V, Rinne T, Leppanen T, Tarkka M, Laurikka J, Moilanen E. Adipocytokine resistin correlates with oxidative stress and myocardial injury in patients undergoing cardiac surgery. Eur J Cardiothorac Surg 2014; 46:729-36. [DOI: 10.1093/ejcts/ezt634] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kishida K, Nakagawa Y, Kobayashi H, Mazaki T, Yokoi H, Yanagi K, Funahashi T, Shimomura I. High serum C1q-binding adiponectin levels in male patients with acute coronary syndrome. Cardiovasc Diabetol 2014; 13:9. [PMID: 24400991 PMCID: PMC3893390 DOI: 10.1186/1475-2840-13-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 01/02/2014] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The complement system is part of the immune system in acute coronary syndrome (ACS). Adiponectin has anti-atherogenic and anti-inflammatory properties. Adiponectin and C1q form a protein complex in blood, and serum C1q binding adiponectin (C1q-APN) can be measured. We investigated the comparative evaluation of serum C1q-APN levels in males with ACS, stable angina pectoris (SAP) versus controls. METHODS The study subjects were 138 Japanese patients who underwent diagnostic coronary angiography. Blood total adiponectin (Total-APN), C1q-APN and C1q were measured by enzyme-linked immunosorbent assays. Patients were divided into three groups according to the clinical condition: ACS (n = 78), SAP (n = 41) or normal coronary (NC, n = 19) groups. RESULTS Serum C1q levels were significantly higher in the ACS group (54.9±1.2 μg/mL) than in the NC group (48.0±2.5 μg/mL). Although serum Total-APN levels were significantly lower in the SAP and ACS groups, compared with the NC group (7.0±0.5, 7.2±0.3, 10.6±2.0 μg/mL, respectively), serum C1q-APN levels were significantly higher in the ACS group than in the NC and SAP groups (112.1±4.1, 66.3±4.4, 65.7±2.9 units/mL, respectively). CONCLUSIONS Patients with ACS had higher serum C1q-APN levels. TRIAL REGISTRATION UMIN000002997.
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Affiliation(s)
- Ken Kishida
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
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Funahashi T, Matsuzawa Y. Adiponectin and the cardiometabolic syndrome: an epidemiological perspective. Best Pract Res Clin Endocrinol Metab 2014; 28:93-106. [PMID: 24417949 DOI: 10.1016/j.beem.2013.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Adiponectin is an adipocyte-derived plasma protein with cardio-vasculo-protective and anti-diabetic properties. Plasma adiponectin levels are low in patients with the cardiometabolic syndrome (a cluster of multiple risk factors based on visceral fat accumulation). Routine measurement of plasma adiponectin may be useful to encourage life-style changes.
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Affiliation(s)
- Tohru Funahashi
- Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine, 2-2 B5 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Yuji Matsuzawa
- Sumitomo Hospital, 5-3-20 Nakanoshima, Kita-Ku, Osaka 530-0005, Japan.
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Abstract
Over the past two decades, adiponectin has been studied in more than eleven thousand publications. A classical adipokine, adiponectin was among the first factors secreted from adipose tissue that were found to promote metabolic function. Circulating levels of adiponectin consistently decline with increasing body mass index. Clinical and basic science studies have identified adiponectin's cardiovascular-protective actions, providing a mechanistic link to the increased incidence of cardiovascular disease in obese individuals. While progress has been made in identifying receptors essential for the metabolic actions of adiponectin (AdipoR1 and AdipoR2), few studies have examined the receptor-mediated signaling pathways in cardiovascular tissues. T-cadherin, a GPI-anchored adiponectin-binding protein, was recently identified as critical for the cardiac-protective and revascularization actions of adiponectin. Adiponectin is abundantly present on the surfaces of vascular and muscle tissues through a direct interaction with T-cadherin. Consistent with this observation, adiponectin is absent from T-cadherin-deficient tissues. Since T-cadherin lacks an intracellular domain, additional studies would further our understanding of this signaling pathway. Here, we review the diverse cardiometabolic actions of adiponectin.
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Affiliation(s)
- Jennifer L Parker-Duffen
- Whitaker Cardiovascular Institute, Boston University School of Medicine, 715 Albany Street, W611, Boston, MA 02118, USA.
| | - Kenneth Walsh
- Whitaker Cardiovascular Institute, Boston University School of Medicine, 715 Albany Street, W611, Boston, MA 02118, USA.
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Kawagoe J, Ishikawa T, Iwakiri H, Date H, Imamura T, Kitamura K. Association Between Adiponectin Production in Coronary Circulation and Future Cardiovascular Events in Patients With Coronary Artery Disease. Int Heart J 2014; 55:239-43. [DOI: 10.1536/ihj.13-287] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Junji Kawagoe
- Department of Internal Medicine, Division of Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki
| | - Tetsunori Ishikawa
- Department of Internal Medicine, Division of Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki
| | - Hironao Iwakiri
- Department of Cardiovascular Medicine, Miyakonojo Regional Medical Center
| | - Haruhiko Date
- Department of Cardiovascular Medicine, Jounan Hospital
| | - Takuroh Imamura
- Department of Cardiovascular Medicine, Koga General Hospital
| | - Kazuo Kitamura
- Department of Internal Medicine, Division of Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki
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Hasić S, Hadžović-Džuvo A, Jadrić R, Kiseljaković E. B-type natriuretic peptide and adiponectin releases in rat model of myocardial damage induced by isoproterenol administration. Bosn J Basic Med Sci 2013; 13:225-9. [PMID: 24289757 DOI: 10.17305/bjbms.2013.2329] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
B-type natriuretic peptide (BNP) and adiponectin play important role in the cardiovascular homeostasis regulation. We investigated BNP and adiponectin serum levels followed by isoproterenol (ISO) administration to rats and explored the relationship between them. Cardiac troponin I (cTnI) blood level was used as biochemical evidence of myocardial damage development. Adult male Wistar rats (average body weight 273.33 ± 21.63 g) were distributed into groups: control group received saline (n=6) and ISO groups (n=12) treated with ISO (subcutaneous single dose 100 mg/kg of rat body weight). ISO group was divided into two groups according to the time of BNP, adiponectin and cTnI determination: ISO I (n=6; 2 hours after ISO administration); ISO II (n=6; 4 hours after ISO administration). Blood for determination of parameters was taken from rat abdominal aorta. BNP, adiponectin and cTnI were determined by ELISA method. Data were statistically analysed by using SPSS version 13 computer program. P value less 0.05 was considered statistically significant. Blood BNP and adiponectin were lower at 2 hours after ISO administration in comparison with control group (p=0.004 for BNP and p=0.174 for adiponectin). Four hours after ISO administration, we have noted significant elevation of both parameters compared to ISO I group (p=0.004 for BNP; p=0.02 for adiponectin). Test of correlation have showed significant relation between their blood levels during experimental period (rho=0.577; p=0.01). BNP and adiponectin are not simple indicators of myocardial damage development. They have possible associated and additive effects in cardiovascular homeostasis regulation.
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Affiliation(s)
- Sabaheta Hasić
- Department of Medical Biochemistry, Faculty of Medicine, University of Sarajevo, Čekaluša 90, 71 000 Sarajevo, Bosnia and Herzegovina
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Pera J, Dziedzic T, Szczudlik A, Slowik A. Temporal changes of adiponectin plasma levels in patients with acute ischemic stroke. Neurol Res 2013; 35:988-91. [DOI: 10.1179/1743132813y.0000000241] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Joanna Pera
- Department of NeurologyJagiellonian University Medical College, ul. Botaniczna 3, Krakow, Poland
| | - Tomasz Dziedzic
- Department of NeurologyJagiellonian University Medical College, ul. Botaniczna 3, Krakow, Poland
| | - Andrzej Szczudlik
- Department of NeurologyJagiellonian University Medical College, ul. Botaniczna 3, Krakow, Poland
| | - Agnieszka Slowik
- Department of NeurologyJagiellonian University Medical College, ul. Botaniczna 3, Krakow, Poland
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Karmazyn M, Gan XT, Rajapurohitam V. The potential contribution of circulating and locally produced leptin to cardiac hypertrophy and failure. Can J Physiol Pharmacol 2013; 91:883-8. [DOI: 10.1139/cjpp-2013-0057] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Leptin is a 16 kDa peptide that was first identified in 1994 through positional cloning of the mouse obesity gene. Although the primary function of leptin is to act a satiety factor through its actions on the hypothalamus, it is now widely recognized that leptin can exert effects on many other organs through activation of its receptors, which are ubiquitously expressed. Leptin is secreted primarily by white adipocytes, but it is also produced by other tissues including the heart where it can exert effects in an autocrine or paracrine manner. One of these effects involves the induction of cardiomyocyte hypertrophy, which appears to occur via multiple cell signalling mechanisms. As adipocytes are the primary site of leptin production, plasma leptin concentrations are generally positively related with body mass index and the degree of adiposity. However, hyperleptinemia is also associated with cardiovascular disease, including heart failure, in the absence of obesity. Here we review the potential role of leptin in heart disease, particularly pertaining to its potential contribution to myocardial remodelling and heart failure, as well as the underlying mechanisms. We further discuss potential interactions between leptin and another adipokine, adiponectin, and the potential implications of this interaction in terms of fully understanding leptin’s effects.
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Affiliation(s)
- Morris Karmazyn
- Department of Physiology and Pharmacology, University of Western Ontario, Schulich School of Medicine and Dentistry, London, ON N6A 5C1, Canada
| | - Xiaohong Tracey Gan
- Department of Physiology and Pharmacology, University of Western Ontario, Schulich School of Medicine and Dentistry, London, ON N6A 5C1, Canada
| | - Venkatesh Rajapurohitam
- Department of Physiology and Pharmacology, University of Western Ontario, Schulich School of Medicine and Dentistry, London, ON N6A 5C1, Canada
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Comparative cardiometabolic effects of fibrates and omega-3 fatty acids. Int J Cardiol 2013; 167:2404-11. [DOI: 10.1016/j.ijcard.2013.01.223] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 01/18/2013] [Indexed: 12/20/2022]
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Morita Y, Maeda K, Kondo T, Ishii H, Matsudaira K, Okumura N, Mitsuhashi H, Shibata R, Murohara T. Impact of adiponectin and leptin on long-term adverse events in Japanese patients with acute myocardial infarction. Results from the Nagoya Acute Myocardial Infarction Study (NAMIS). Circ J 2013; 77:2778-85. [PMID: 23924849 DOI: 10.1253/circj.cj-13-0251] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Low adiponectin levels and high leptin levels are associated with a high incidence of developing cardiovascular disease. However, the relationship between the levels of these adipokines and the development of adverse events after acute myocardial infarction (AMI) remains unclear. METHODS AND RESULTS This study enrolled 724 Japanese subjects with AMI who underwent successful emergency percutaneous coronary intervention (PCI). Their serum adiponectin and leptin levels were measured 7 days after AMI onset. There were 63 adverse events during the 3-year follow-up. The levels of adiponectin and leptin and the leptin to adiponectin ratio, were significantly associated with adverse events [hazard ratio 2.08 (95% confidence interval (CI) 1.33-3.24), P=0.001; hazard ratio 0.62 (95% CI 0.43-0.90), P=0.012; hazard ratio 0.59 (95% CI 0.45-0.76), P<0.001, respectively]. The leptin to adiponectin ratio remained a significant independent predictor of adverse events during long-term follow-up in a multivariable analysis [adjusted hazard ratio 0.60 (95% CI 0.43-0.83), P=0.002]. CONCLUSIONS Higher adiponectin and lower leptin levels are associated with a high incidence of adverse events in Japanese patients after AMI, and the leptin to adiponectin ratio independently predicts prognosis after AMI.
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Affiliation(s)
- Yasuhiro Morita
- Department of Cardiology, Nagoya University Graduate School of Medicine
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45
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Abstract
The discovery of leptin in 1994 sparked dramatic new interest in the study of white adipose tissue. It is now recognised to be a metabolically active endocrine organ, producing important chemical messengers - adipokines and cytokines (adipocytokines). The search for new adipocytokines or adipokines gained added fervour with the prospect of the reconciliation between cardiovascular diseases (CVDs), obesity and metabolic syndrome. The role these new chemical messengers play in inflammation, satiety, metabolism and cardiac function has paved the way for new research and theories examining the effects they have on (in this case) CVD. Adipokines are involved in a 'good-bad', yin-yang homoeostatic balance whereby there are substantial benefits: cardioprotection, promoting endothelial function, angiogenesis and reducing hypertension, atherosclerosis and inflammation. The flip side may show contrasting, detrimental effects in aggravating these cardiac parameters.
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Affiliation(s)
- Harman S Mattu
- Division of Metabolic and Vascular Health, University of Warwick Medical School, Gibbet Hill Road, Coventry CV4 7AL, UK
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46
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Caselli C, Cantinotti M, Del Ry S, Cabiati M, Prescimone T, Storti S, Murzi B, Clerico A, Giannessi D. Adiponectin plasma levels decrease after surgery in pediatric patients with congenital heart disease. Clin Biochem 2012; 45:1510-2. [PMID: 22827963 DOI: 10.1016/j.clinbiochem.2012.07.096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 07/02/2012] [Accepted: 07/12/2012] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Adiponectin is a protein secreted by adipose tissue and involved in inflammatory process as well as in metabolic regulation. The aim of this study was to examine the response of plasma adiponectin to cardiac surgery in children with congenital defects to determine whether its measurement is associated to the response to injury. DESIGN AND METHODS Twenty-five pediatric patients undergoing heart surgery for correction of congenital defects were studied. Adiponectin plasma levels, obtained pre- and three times postoperatively, were determined by dedicated ELISA. Brain natriuretic peptide (BNP) plasma levels were also determined. RESULTS Adiponectin levels are highest in the first month of life (p=0.004 newborns vs. children) with a progressive fall in the next few years. After surgery, adiponectin increased slowly over a 1-month period, following an initial decrease in the first 3 days. CONCLUSIONS Adiponectin could be involved in the acute response to injury although further investigation into the relationship between adiponectin, glucose regulation and inflammatory process is necessary to examine the issue of the adiponectin decrease after surgery from a more integrated prospective.
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Affiliation(s)
- Chiara Caselli
- Consiglio Nazionale delle Ricerche, Institute of Clinical Physiology, Laboratory of Cardiovascular Biochemistry, Pisa, Italy
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47
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Harwood HJ. The adipocyte as an endocrine organ in the regulation of metabolic homeostasis. Neuropharmacology 2012; 63:57-75. [DOI: 10.1016/j.neuropharm.2011.12.010] [Citation(s) in RCA: 157] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 11/28/2011] [Accepted: 12/09/2011] [Indexed: 02/06/2023]
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Abstract
PURPOSE OF REVIEW Niacin has been used for more than 50 years in the management of atherosclerosis and is associated with improved patient outcomes. The routine use of niacin has been superseded in recent years with the advent of newer lipid-modulating interventions. Recently, however, there has been a renewed interest in its use due to the appreciation of its many beneficial effects on atherosclerosis and endothelial function, both 'lipid-targeted' and 'pleiotropic'. This review will consider the effects of niacin in the setting of clinical trials and will critically evaluate proposed mechanisms of action. RECENT FINDINGS The identification of the GPR109A receptor has promoted a greater insight into niacin's mechanism of action, with demonstrated beneficial effects on endothelial function and inflammation, in addition to its lipid modulation role. SUMMARY Whether niacin itself is used routinely in the future will depend on the outcomes of two large outcome trials (AIM-HIGH and HPS2-THRIVE). In the future, however, with even better understanding of niacin pharmacology, new drugs may be able to be engineered to capture aspects of niacin that capitalize on the benefits more specifically and also more selectively, to avoid troublesome side-effects.
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Abstract
Adiponectin is an adipocyte-derived hormone that has been shown to play an important role in the regulation of metabolic, inflammatory, and apoptotic pathways. Adiponectin improves insulin sensitivity, promotes vascular health, and increases cell survival. These observations suggest a potential therapeutic role for adiponectin in the treatment of diabetes mellitus, cardiovascular diseases, and cancer. However, biologically active recombinant adiponectin proteins are inherently unstable and difficult to produce, thus making it a challenge for both research and clinical development. One main challenge relates to the existence of adiponectin as homo-/hetero-trimers, and complexes containing multiple adiponectin trimer units, in plasma. The underlying mechanism for adiponectin function is also not completely understood. Two receptors for adiponectin (ADIPOR1 and ADIPOR2) have been cloned, and activation of adenosine monophosphate-activated kinase (AMPK) has been reported to be downstream of the receptors. Recent findings suggest that adiponectin potently stimulates ceramidase activity via activation of its two known receptors, therefore connecting sphingolipid metabolism to adiponectin functions and providing a potential mechanism explaining the different actions of adiponectin. Interestingly, a new report also identified a pathway involving adiponectin and insulin receptor substrate 2, which is independent of the ADIPOR1/ADIPOR2 pathway. In this manuscript, we will review previous approaches and challenges in exploring adiponectin-based therapeutics. In particular, we will review some of the recent developments in engineering adiponectin proteins as well as potential therapeutic opportunities offered by recently elucidated adiponectin-mediated signaling pathways.
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Affiliation(s)
- Wei Gu
- Amgen Inc., Thousand Oaks, CA, USA
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Aldous SJ. Cardiac biomarkers in acute myocardial infarction. Int J Cardiol 2012; 164:282-94. [PMID: 22341694 DOI: 10.1016/j.ijcard.2012.01.081] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 12/16/2011] [Accepted: 01/26/2012] [Indexed: 01/11/2023]
Abstract
Each year, a large number of patients are seen in the Emergency Department with presentations necessitating investigation for possible acute myocardial infarction. Patients can be stratified by symptoms, risk factors and electrocardiogram results but cardiac biomarkers also have a prime role both diagnostically and prognostically. This review summarizes both the history of cardiac biomarkers as well as currently available (established and novel) assays. Cardiac troponin, our current "gold standard" biomarker criterion for the diagnosis of myocardial infarction has high sensitivity and specificity for this diagnosis and therapies instituted in patients with elevated troponin have been shown to influence outcomes. Other markers of myocardial necrosis, inflammation and neurohormonal activity have also been shown to have either diagnostic or prognostic utility, but none have been shown to be superior to troponin. The measurement of multiple biomarkers and the use of point of care markers may accelerate current diagnostic protocols for the assessment of such patients.
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