Angiotensin II Type 1 Receptor–Associated Protein Is an Endogenous Inhibitor of Angiotensin II Type 1 Receptor Action in Cardiac Hypertrophy

FAM114A1 influences cardiac pathological remodeling by regulating angiotensin II signaling

Cardiac pathological remodeling, a primary contributor to heart failure (HF) and death, is an important target for HF therapy. However, the signaling pathways that govern cardiac remodeling are not fully elucidated. Here, we found that a functionally unannotated human myocardial infarction–associated (MI-associated) gene, family with sequence similarity 114 member A1 (FAM114A1), is induced in failing human and mouse hearts compared with nonfailing hearts. Homozygous KO of Fam114a1 (Fam114a1^–/–) in the mouse genome reduces cardiomyocyte hypertrophy, inflammation, and cardiac fibrosis while restoring cardiac function in angiotensin II–induced (Ang II–induced) and MI-induced HF mouse models. Cardiac fibroblasts (CFs) exhibit the highest FAM114A1 expression among different cardiac cell types. FAM114A1 is a critical autonomous factor for CF proliferation, activation, and migration. Mechanistically, FAM114A1 interacts with angiotensin receptor–associated protein (AGTRAP) and regulates the expression of angiotensin type 1 receptor (AT1R) and downstream Ang II signaling transduction, and it subsequently influences profibrotic response. Our results indicate that FAM114A1 regulates Ang II signaling, thereby activating CFs and other cardiac cells and augmenting pathological cardiac remodeling. These findings provide potentially novel insights into the regulation of cardiac remodeling and identify FAM114A1 as a therapeutic target for the treatment of heart disease.

Prognostic model of the adaptive changes from hypertensive cardiopathy: from mild diastolic dysfunction to depressed systolic function

Introduction

By definition, hypertensive cardiopathy is a series of complex and variable effects responsible for the chronic elevation of blood pressure in the heart. It stands out within a broad spectrum of cardiovascular diseases associated with hypertension.

Objective

To evaluate the capacity to predict the development of adaptive changes to hypertensive cardiopathy within ten years following diagnosis of the condition, using a model based on prognostic factors.

Methods

A prospective cohort study was conducted in hypertensive patients. The patients were followed at the specialized hypertension physicians office of the specialty policlinic attached to Carlos Manuel de Céspedes University Hospital, in the Bayamo Municipality, Granma Province, Cuba, from 1 January 2008 to 31 December 2018.

Results

Coxs proportional regression model showed a significant statistical relationship between most of the factors and the development of the adaptive changes in hypertensive cardiopathy within ten years of follow-up after the diagnosis of this condition. The lack of blood pressure control (Hazard ratio: 2.090; confidence interval 95%: 1.688 to 2.588; p: 0.000) followed by stage 2 of hypertension (hazard ratio: 1.987; confidence interval 95%: 1.584 to 2.491; p: 0.000) were the main factors. Internal validation of the model, discriminant capacity (C- statistic: 0.897) and calibration Hosmer-Lemeshow (χ2: 5.384; p: 0.716), was acceptable.

Conclusions

We develop a model to predict the progression of hypertensive cardiopathy from grade I to grade IV with adequate discriminatory capacity. The model is based on prognostic factors, among which characteristic effects of arterial hypertension, diabetes mellitus, and chronic kidney disease stood out.

Factors associated to hypertensive heart disease development: a prospective cohort study in Bayamo, Cuba

INTRODUCTION

Among the conditions resulting from target organ damage by arterial hypertension, hypertensive cardiopathy is the one that exhibits the highest morbidity and mortality rates. Its prevention should be a target of all high blood pressure medical care programs.

OBJECTIVE

To identify risk factors for the development of hypertensive cardiopathy.

METHODS

A prospective cohort study was carried out in hypertensive patients assisted at the specialized arterial hypertension physicians’ offices of the “Carlos Manuel de Céspedes” Specialty Policlinic attached to the General University Hospital, Bayamo Municipality, Granma Province, Cuba, from January 1st, 2000 to December 31st, 2009.

RESULTS

Multivariate analysis done to estimate the hazard rate (HR) of developing hypertensive cardiopathy, showed significant independent statistic association for most factors. The first place was occupied by lack of blood pressure control (HR=2.022; 95% CI: 1.659-2.465; p<0.005), followed by hypertension stage 2 (HR=2.015; 95% CI: 1.715-2.366; p<0.005). Another factors with significant HRs were microalbuminuria (HR=1.9; 95% CI: 1.6-2.2) and age over 60 years (HR=1.6; 95% CI: 1.4-1.9).

CONCLUSIONS

Several risk factors must be considered for the prevention of hypertensive heart disease in high blood pressure patients.