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Sandstedt M, Vukusic K, Johansson M, Jonsson M, Magnusson R, Mattsson Hultén L, Dellgren G, Jeppsson A, Lindahl A, Synnergren J, Sandstedt J. Regional transcriptomic profiling reveals immune system enrichment in nonfailing atria and all chambers of the failing human heart. Am J Physiol Heart Circ Physiol 2023; 325:H1430-H1445. [PMID: 37830984 DOI: 10.1152/ajpheart.00438.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/18/2023] [Accepted: 10/06/2023] [Indexed: 10/14/2023]
Abstract
The different chambers of the human heart demonstrate regional physiological traits and may be differentially affected during pathological remodeling, resulting in heart failure. Few previous studies, however, have characterized the different chambers at a transcriptomic level. We, therefore, conducted whole tissue RNA sequencing and gene set enrichment analysis of biopsies collected from the four chambers of adult failing (n = 8) and nonfailing (n = 11) human hearts. Atria and ventricles demonstrated distinct transcriptional patterns. When compared with nonfailing ventricles, the transcriptional pattern of nonfailing atria was enriched for many gene sets associated with cardiogenesis, the immune system and bone morphogenetic protein (BMP), transforming growth factor-β (TGF-β), MAPK/JNK, and Wnt signaling. Differences between failing and nonfailing hearts were also determined. The transcriptional pattern of failing atria was distinct compared with that of nonfailing atria and enriched for gene sets associated with the innate and adaptive immune system, TGF-β/SMAD signaling, and changes in endothelial, smooth muscle cell, and cardiomyocyte physiology. Failing ventricles were also enriched for gene sets associated with the immune system. Based on the transcriptomic patterns, upstream regulators associated with heart failure were identified. These included many immune response factors predicted to be similarly activated for all chambers of failing hearts. In summary, the heart chambers demonstrate distinct transcriptional patterns that differ between failing and nonfailing hearts. Immune system signaling may be a hallmark of all four heart chambers in failing hearts and could constitute a novel therapeutic target.NEW & NOTEWORTHY The transcriptomic patterns of the four heart chambers were characterized in failing and nonfailing human hearts. Both nonfailing atria had distinct transcriptomic patterns characterized by cardiogenesis, the immune system and BMP/TGF-β, MAPK/JNK, and Wnt signaling. Failing atria and ventricles were enriched for gene sets associated with the innate and adaptive immune system. Key upstream regulators associated with heart failure were identified, including activated immune response elements, which may constitute novel therapeutic targets.
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Affiliation(s)
- Mikael Sandstedt
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kristina Vukusic
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Markus Johansson
- Department of Biology and Bioinformatics, School of Bioscience, University of Skövde, Skövde, Sweden
| | - Marianne Jonsson
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Rasmus Magnusson
- Department of Biology and Bioinformatics, School of Bioscience, University of Skövde, Skövde, Sweden
| | - Lillemor Mattsson Hultén
- Region Västra Götaland, Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Göran Dellgren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Jeppsson
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Lindahl
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jane Synnergren
- Department of Biology and Bioinformatics, School of Bioscience, University of Skövde, Skövde, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Joakim Sandstedt
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
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Lin S, Yang Z, Liu Y, Bi Y, Liu Y, Zhang Z, Zhang X, Jia Z, Wang X, Mao J. Risk Prediction Models and Novel Prognostic Factors for Heart Failure with Preserved Ejection Fraction: A Systematic and Comprehensive Review. Curr Pharm Des 2023; 29:1992-2008. [PMID: 37644795 PMCID: PMC10614113 DOI: 10.2174/1381612829666230830105740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/24/2023] [Accepted: 07/21/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Patients with heart failure with preserved ejection fraction (HFpEF) have large individual differences, unclear risk stratification, and imperfect treatment plans. Risk prediction models are helpful for the dynamic assessment of patients' prognostic risk and early intensive therapy of high-risk patients. The purpose of this study is to systematically summarize the existing risk prediction models and novel prognostic factors for HFpEF, to provide a reference for the construction of convenient and efficient HFpEF risk prediction models. METHODS Studies on risk prediction models and prognostic factors for HFpEF were systematically searched in relevant databases including PubMed and Embase. The retrieval time was from inception to February 1, 2023. The Quality in Prognosis Studies (QUIPS) tool was used to assess the risk of bias in included studies. The predictive value of risk prediction models for end outcomes was evaluated by sensitivity, specificity, the area under the curve, C-statistic, C-index, etc. In the literature screening process, potential novel prognostic factors with high value were explored. RESULTS A total of 21 eligible HFpEF risk prediction models and 22 relevant studies were included. Except for 2 studies with a high risk of bias and 2 studies with a moderate risk of bias, other studies that proposed risk prediction models had a low risk of bias overall. Potential novel prognostic factors for HFpEF were classified and described in terms of demographic characteristics (age, sex, and race), lifestyle (physical activity, body mass index, weight change, and smoking history), laboratory tests (biomarkers), physical inspection (blood pressure, electrocardiogram, imaging examination), and comorbidities. CONCLUSION It is of great significance to explore the potential novel prognostic factors of HFpEF and build a more convenient and efficient risk prediction model for improving the overall prognosis of patients. This review can provide a substantial reference for further research.
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Affiliation(s)
- Shanshan Lin
- Department of Cardiovascular, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, Changling Road, Xiqing District, Tianjin 300381, China
- Tianjin University of Traditional Chinese Medicine, No. 10, Poyang Lake Road, West Tuanpo New Town, Jinghai District, Tianjin 301617, China
| | - Zhihua Yang
- Tianjin University of Traditional Chinese Medicine, No. 10, Poyang Lake Road, West Tuanpo New Town, Jinghai District, Tianjin 301617, China
| | - Yangxi Liu
- Department of Cardiovascular, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, Changling Road, Xiqing District, Tianjin 300381, China
- Tianjin University of Traditional Chinese Medicine, No. 10, Poyang Lake Road, West Tuanpo New Town, Jinghai District, Tianjin 301617, China
| | - Yingfei Bi
- Department of Cardiovascular, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, Changling Road, Xiqing District, Tianjin 300381, China
| | - Yu Liu
- Department of Cardiovascular, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, Changling Road, Xiqing District, Tianjin 300381, China
| | - Zeyu Zhang
- Department of Cardiovascular, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, Changling Road, Xiqing District, Tianjin 300381, China
- Tianjin University of Traditional Chinese Medicine, No. 10, Poyang Lake Road, West Tuanpo New Town, Jinghai District, Tianjin 301617, China
| | - Xuan Zhang
- Department of Cardiovascular, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, Changling Road, Xiqing District, Tianjin 300381, China
- Tianjin University of Traditional Chinese Medicine, No. 10, Poyang Lake Road, West Tuanpo New Town, Jinghai District, Tianjin 301617, China
| | - Zhuangzhuang Jia
- Department of Cardiovascular, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, Changling Road, Xiqing District, Tianjin 300381, China
| | - Xianliang Wang
- Department of Cardiovascular, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, Changling Road, Xiqing District, Tianjin 300381, China
| | - Jingyuan Mao
- Department of Cardiovascular, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, Changling Road, Xiqing District, Tianjin 300381, China
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Edvardsen T, Donal E, Muraru D, Gimelli A, Fontes-Carvalho R, Maurer G, Petersen SE, Cosyns B. The year 2021 in the European Heart Journal—Cardiovascular Imaging: Part I. Eur Heart J Cardiovasc Imaging 2022; 23:1576-1583. [DOI: 10.1093/ehjci/jeac210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
The European Heart Journal—Cardiovascular Imaging was introduced in 2012 and has during these 10 years become one of the leading multimodality cardiovascular imaging journals. The journal is currently ranked as Number 19 among all cardiovascular journals. It has an impressive impact factor of 9.130 and our journal is well established as one of the top cardiovascular journals. The most important studies published in our Journal in 2021 will be highlighted in two reports. Part I of the review will focus on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging, while Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease.
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Affiliation(s)
- Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet , Sognsvannsveien 20, Postbox 4950 Nydalen, NO-0424 Oslo , Norway
- Institute for Clinical Medicine, University of Oslo , Sognsvannsveien 20, NO-0424 Oslo , Norway
| | - Erwan Donal
- Department of Cardiology and CIC-IT1414, CHU Rennes, Inserm, LTSI-UMR 1099, University Rennes-1, Rennes F-35000 , France
| | - Denisa Muraru
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS , Piazzale Brescia 20, 20149 Milan , Italy
- Department of Medicine and Surgery, University of Milano-Bicocca , Via Cadore 48, 20900 Monza , Italy
| | - Alessia Gimelli
- Imaging Department, Fondazione Toscana G. Monasterio , Via Giuseppe Moruzzi, 1, 56124 Pisa PI , Italy
| | - Ricardo Fontes-Carvalho
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Dr. Francisco Sá Carneiro 4400-129 , 4430-999 Vila Nova de Gaia , Portugal
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto , Alameda Prof. Hernâni Monteiro 4200-319 Porto , Portugal
| | - Gerald Maurer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna , Wahringer Gurtel 18-20, 1090 Vienna , Austria
| | - Steffen E Petersen
- Barts Heart Centre, Barts Health NHS Trust , West Smithfield, London EC1A 7BE , UK
- William Harvey Research Institute, Queen Mary University of London , Charterhouse Square, London EC1M 6BQ , UK
| | - Bernard Cosyns
- Department of Cardiology, CHVZ (Centrum voor Hart en Vaatziekten), ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Universitair ziekenhuis Brussel , 1090 Jette, Brussels , Belgium
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Nikhanj A, Kashyap N, Wang K, Phan CL, Siddiqi ZA, Becher H, Oudit GY. Trajectory of left ventricular ejection fraction in response to therapies in patients with muscular dystrophy. Echocardiography 2022; 39:1328-1337. [PMID: 36198087 DOI: 10.1111/echo.15460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/21/2022] [Accepted: 09/09/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Patients with muscular dystrophy (MD) are at elevated risk of serious cardiac complications and clinical assessment is limited due to inherent physical limitations. We assessed the utility of left ventricular ejection fraction (LVEF) derived from transthoracic echocardiogram (TTE) as a prognostic marker for major adverse cardiac events (MACE) in a mixed adult MD cohort. METHODS One hundred and sixty-five MD patients (median age: 36 (interquartile range [IQR]: 23.0-49.0) years; 65 [39.4%] females) were enrolled in our prospective cohort study. Diagnoses included dystrophinopathies (n = 42), limb-girdle MD (n = 31), type 1 myotonic dystrophy (n = 71), and facioscapulohumeral MD (n = 21). Left ventricular ejection fraction, ventricular dimensions at end-diastole and end-systole, and serial measures (n = 124; follow-up period: 2.19 [IQR: 1.05-3.32] years) stratified patients for MACE risk. RESULTS Cardiomyopathy was diagnosed in 60 (36.4%) patients of the broader cohort (median LVEF: 45.0 [IQR: 35.0-50.0] %). Ninety-eight MACE occurred over the 7-year study period. At baseline, patients with a LVEF < 55.0% had a high risk of MACE (adjusted odds ratio: 8.30; 95% confidence interval [CI]: 3.18-21.7), concordant with the analysis of LV dimensions. Forty-one percent of these patients showed an improvement in LVEF with the optimization of medical and device therapies. Relative to patients with preserved LVEF, patients with reduced LVEF were at an elevated risk of MACE (adjusted hazard ratio [aHR]: 7.21; 95% CI: 1.99-26.1), and improved LVEF resulted in comparable outcomes (aHR: 1.84; 95% CI: .49-6.91) associated with optimization of medical and device therapies. Reduction in QRS duration by CRT therapy was associated with an improvement in LVEF (average improvement: 12.8 [± 2.30] %; p = .04). CONCLUSIONS Reduction in LVEF indicates an increased risk of cardiovascular events in patients with MD. Baseline and serial LVEF obtained by TTE can prognosticate patients for MACE and guide clinical management.
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Affiliation(s)
- Anish Nikhanj
- Division of Cardiology, University of Alberta, Edmonton, Canada.,Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| | - Niharika Kashyap
- Division of Cardiology, University of Alberta, Edmonton, Canada.,Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| | - Kaiming Wang
- Division of Cardiology, University of Alberta, Edmonton, Canada.,Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| | - Cecile L Phan
- Division of Neurology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Zaeem A Siddiqi
- Division of Neurology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Harald Becher
- Division of Cardiology, University of Alberta, Edmonton, Canada.,Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| | - Gavin Y Oudit
- Division of Cardiology, University of Alberta, Edmonton, Canada.,Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
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Morfino P, Aimo A, Castiglione V, Vergaro G, Emdin M, Clerico A. Biomarkers of HFpEF: Natriuretic Peptides, High-Sensitivity Troponins and Beyond. J Cardiovasc Dev Dis 2022; 9:jcdd9080256. [PMID: 36005420 PMCID: PMC9409788 DOI: 10.3390/jcdd9080256] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 11/28/2022] Open
Abstract
Heart failure (HF) is a significant cause of morbidity and mortality worldwide. HF with preserved ejection fraction (HFpEF) is a complex syndrome, often participated by several cardiac and extracardiac conditions, including chronic kidney disease, pulmonary disease, anaemia and advanced age. Circulating biomarkers reflecting pathophysiological pathways involved in HFpEF development and progression may assist clinicians in early diagnosis and management of this condition. Natriuretic peptides (NPs) are cardioprotective hormones released by cardiomyocytes in response to pressure or volume overload and in response to activation of neuro-endocrine-immune system. The relevance of B-type NP (BNP) and N-terminal pro-B-type NP (NT-proBNP) for diagnosis and risk stratification has been extensively demonstrated, and these biomarkers are emerging tools for population screening and as guides to the start of treatment in subclinical HF. On the contrary, conflicting evidence exists on the value of NPs to guide HF therapy. Among the other biomarkers, high-sensitivity troponins and soluble suppression of tumorigenesis-2 are the most promising biomarkers for risk stratification, predicting outcome independently from NPs. In this review, some novel biomarkers are being tested in such clinical scenario, more tightly linked to specific pathophysiological processes of cardiac damage.
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Affiliation(s)
- Paolo Morfino
- Interdisciplinary Center of Health Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Alberto Aimo
- Interdisciplinary Center of Health Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, 56127 Pisa, Italy
| | - Vincenzo Castiglione
- Interdisciplinary Center of Health Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, 56127 Pisa, Italy
| | - Giuseppe Vergaro
- Interdisciplinary Center of Health Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, 56127 Pisa, Italy
| | - Michele Emdin
- Interdisciplinary Center of Health Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, 56127 Pisa, Italy
| | - Aldo Clerico
- Interdisciplinary Center of Health Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, 56127 Pisa, Italy
- Correspondence:
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Pavon AG, Masci PG, Pucci L, Landi A, Bermano A, Vaxman A, Gotsman C, Rutz T, Monney P, Godihno R, Saraiva Rodrigues D, Muller O, Valgimigli M, Schwitter J. Left atrial adaptation in ischemic heart disease: insights from a cardiovascular magnetic resonance study. Int J Cardiovasc Imaging 2022; 38:10.1007/s10554-022-02536-9. [PMID: 35174427 DOI: 10.1007/s10554-022-02536-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/21/2022] [Indexed: 11/30/2022]
Abstract
Left atrium (LA) plays a key role in the overall cardiac performance. However, it remains unclear how LA adapts, in terms of function and volumes, to left ventricular dysfunction in the acute and post-acute phases of myocardial infarction. LA volumes and function were evaluated in patients in the acute phase of ST-segment elevation myocardial infarction (acute-STEMI group) and in the post-acute phase after STEMI (post-acute STEMI group). Ten age and sex-matched healthy controls served as control group. In all subjects LA was assessed by a compressed-sensing cine pulse sequence and by a 3D non-model-based reconstruction. LV infarct size and microvascular obstruction were determined on late-gadolinium-enhancement data and LV myocardial oedema and myocardial haemorrhage were measured on T2-mapping data. Indexed LA maximum and minimum volumes did not differ between the acute (n = 50) and post-acute (n = 47) STEMI groups. LA active emptying fraction (LAAEF) was higher in the acute-STEMI as compared with the post-acute STEMI groups (0.63 ± 0.23 vs 0.37 ± 0.24, p < 0.0001). Conversely, LA passive emptying fraction (LAPEF) was lower in the acute-STEMI compared with post-acute-STEMI (0.34 ± 0.15 vs 0.65 ± 0.15, p < 0.0001) patients. In the acute-STEMI group, LAAEF was positively and LAPEF negatively correlated with LV myocardial tissue damage (r = 0.523 p = 0.0001; r = - 0.451 p = 0.0013). Negative and positive correlations were also found between LAAEF and LAPEF and time after STEMI (r = - 0.559 p = 0.0013 and r = 0.589 p = 0.0006, respectively). LA increases its active contractile function in the acute phase of STEMI to support LV filling. The extent (but not the type) of LV damage determines LA adaptions which normalizes over time.
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Affiliation(s)
- Anna Giulia Pavon
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland.
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland.
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete 48, 6900, Lugano, Switzerland.
| | - Pier Giorgio Masci
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
- School of Bioengineer and Medical Sciences, Life Sciences, King's College London, London, UK
| | - Lorenzo Pucci
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Antonio Landi
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete 48, 6900, Lugano, Switzerland
| | - Amit Bermano
- The Blavatnik School of Computer Science, Tel-Aviv University, Tel Aviv, Israel
| | - Amir Vaxman
- Department of Information and Computing Sciences, Utrecht University, Utrecht, Netherlands
| | - Craig Gotsman
- Ying Wu College of Computing, New-Jersey Institute of Technology, Newark, USA
| | - Tobias Rutz
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Pierre Monney
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Rita Godihno
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
| | - David Saraiva Rodrigues
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Olivier Muller
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Marco Valgimigli
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Via Tesserete 48, 6900, Lugano, Switzerland
| | - Juerg Schwitter
- Center of Cardiac Magnetic Resonance - Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Division, Cardiovascular Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
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Bandera F, Mollo A, Frigelli M, Guglielmi G, Ventrella N, Pastore MC, Cameli M, Guazzi M. Cardiac Imaging for the Assessment of Left Atrial Mechanics Across Heart Failure Stages. Front Cardiovasc Med 2022; 8:750139. [PMID: 35096989 PMCID: PMC8792604 DOI: 10.3389/fcvm.2021.750139] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/14/2021] [Indexed: 12/26/2022] Open
Abstract
The left atrium (LA) is emerging as a key element in the pathophysiology of several cardiac diseases due to having an active role in contrasting heart failure (HF) progression. Its morphological and functional remodeling occurs progressively according to pressure or volume overload generated by the underlying disease, and its ability of adaptation contributes to avoid pulmonary circulation congestion and to postpone HF symptoms. Moreover, early signs of LA dysfunction can anticipate and predict the clinical course of HF diseases before the symptom onset which, particularly, also applies to patients with increased risk of HF with still normal cardiac structure (stage A HF). The study of LA mechanics (chamber morphology and function) is moving from a research interest to a clinical application thanks to a great clinical, prognostic, and pathophysiological significance. This process is promoted by the technological progress of cardiac imaging which increases the availability of easy-to-use tools for clinicians and HF specialists. Two-dimensional (2D) speckle tracking echocardiography and feature tracking cardiac magnetic resonance are becoming essential for daily practice. In this context, a deep understanding of LA mechanics, its prognostic significance, and the available approaches are essential to improve clinical practice. The present review will focus on LA mechanics, discussing atrial physiology and pathophysiology of main cardiac diseases across the HF stages with specific attention to the prognostic significance. Imaging techniques for LA mechanics assessment will be discussed with an overlook on the dynamic (under stress) evaluation of the chamber.
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Affiliation(s)
- Francesco Bandera
- Department of Biomedical Sciences for Health, University of Milano, Milan, Italy
- Cardiology University Department, IRCCS Policlinico San Donato, Milan, Italy
| | - Anita Mollo
- Cardiology University Department, IRCCS Policlinico San Donato, Milan, Italy
| | - Matteo Frigelli
- Cardiology University Department, IRCCS Policlinico San Donato, Milan, Italy
| | - Giulia Guglielmi
- Cardiology University Department, IRCCS Policlinico San Donato, Milan, Italy
| | - Nicoletta Ventrella
- Cardiology University Department, IRCCS Policlinico San Donato, Milan, Italy
| | | | - Matteo Cameli
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - Marco Guazzi
- Department of Biological Sciences, University of Milano, Milan, Italy
- Cardiology Division, San Paolo Hospital, Milan, Italy
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Lin S, Shi Q, Ge Z, Liu Y, Cao Y, Yang Y, Zhao Z, Bi Y, Hou Y, Wang S, Wang X, Mao J. Efficacy and Safety of Traditional Chinese Medicine Injections for Heart Failure With Reduced Ejection Fraction: A Bayesian Network Meta-Analysis of Randomized Controlled Trials. Front Pharmacol 2021; 12:659707. [PMID: 34916929 PMCID: PMC8669995 DOI: 10.3389/fphar.2021.659707] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 10/29/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Heart failure as an important issue in global public health, has brought a heavy economic burden. Traditional Chinese medicine injections (TCMIs) have significant effects on heart failure with reduced ejection fraction (HFrEF). However, it is difficult for clinicians to identify the differences in clinical efficacy and safety of various TCMIs. The purpose of this study is to compare the efficacy and safety of various TCMIs for treating HFrEF by conducting a Bayesian network meta-analysis (NMA) and to further provide references for clinical decision-making. Methods: The clinical randomized controlled trials of TCMIs for treating HFrEF were searched in seven database from inception to August 3rd, 2021. The Cochrane collaboration's tool was used to assess the risk of bias. NMA was performed in a Bayesian hierarchical framework. The surface under the cumulative ranking curve (SUCRA), the multi-dimensional efficacy analysis, the comparison-adjusted funnel plot, and the node-splitting analysis were conducted using R software. Results: A total of 107 eligible RCTs involving 9,073 HFrEF patients and 6 TCMIs were included. TCMIs include Huangqi injection (HQ) also called Astragalus injection, Shenfu injection (SF), Shengmai injection (SGM), Shenmai injection (SM), Xinmailong injection (XML), and Yiqifumai lyophilized injection (YQFM). The results of NMA and SUCRA showed that with conventional treatment (CT) as a common control, in terms of clinical efficacy, CT + XML was most effective in New York Heart Association cardiac functional classification efficiency, brain natriuretic peptide, and N-terminal pro-brain natriuretic peptide; the CT + SM was most effective in 6-min walking test, left ventricular end-diastolic diameter, left ventricular end-systolic diameter and cardiac output; the CT + YQFM was most effective in left ventricular ejection fraction; the CT + HQ was most effective in stroke volume; the CT + SF was most effective in Minnesota Living with Heart Failure Questionnaire. In terms of safety, there was no significant difference between CT + TCMIs and CT. Conclusion: This Bayesian network meta-analysis results show that the combination of qualified TCMIs and CT is more effective for HFrEF patients than CT alone, and CT + XML and CT + SM may be one of the potential optimal treatments. Also, the safety of these TCMIs needs to be further observed. However, due to some limitations, the conclusions need to be verified by more large-sample, double-blind, multi-center RCTs.
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Affiliation(s)
- Shanshan Lin
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qingyang Shi
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhao Ge
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yangxi Liu
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yawen Cao
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ying Yang
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhiqiang Zhao
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yingfei Bi
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yazhu Hou
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shuai Wang
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xianliang Wang
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jingyuan Mao
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Cosyns B, Sade LE, Gerber BL, Gimelli A, Muraru D, Maurer G, Edvardsen T. The year 2020 in the European Heart Journal-Cardiovascular Imaging: part II. Eur Heart J Cardiovasc Imaging 2021:jeab225. [PMID: 34718480 DOI: 10.1093/ehjci/jeab225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Indexed: 12/18/2022] Open
Abstract
The European Heart Journal-Cardiovascular Imaging was launched in 2012 and has during these years become one of the leading multimodality cardiovascular imaging journal. The journal is now established as one of the top cardiovascular journals and is the most important cardiovascular imaging journal in Europe. The most important studies published in our Journal from 2020 will be highlighted in two reports. Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease. While Part I of the review has focused on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging.
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Affiliation(s)
- Bernard Cosyns
- Department of Cardiology, CHVZ (Centrum voor Hart en Vaatziekten), ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Universitair Ziekenhuis Brussel, 101 Laarbeeklaan, 1090 Brussels, Belgium
| | - Leyla Elif Sade
- University of Pittsburgh Medical Center, Heart and Vascular Institute, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, USA
- Department of Cardiology, University of Baskent, Bağlıca Kampüsü, Dumlupınar Blv. 20. Km, 06810 Etimesgut/Ankara, Turkey
| | - Bernhard L Gerber
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Av Hippocrate 10/2806, Brussels, Belgium
| | - Alessia Gimelli
- Fondazione Toscana G. Monasterio, Via Giuseppe Moruzzi, 1, 56124 Pisa PI, Italy
| | - Denisa Muraru
- Department of Cardiac, Neurological and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, Piazzale Brescia 20, 20149 Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Gerald Maurer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Spitalgasse 23, 1090 Wien, Austria
| | - Thor Edvardsen
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo Norway and Institute for clinical medicine, University of Oslo, Sognsvannsveien 9, 0372 Oslo, Norway
- KG Jebsen Cardiac Research Centre, Institute for clinical medicine, University of Oslo, Sognsvannsveien 20, NO-0424 Oslo, Norway
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10
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Jensen J, Schou M, Kistorp C, Faber J, Hansen TW, Jensen MT, Andersen HU, Rossing P, Vilsbøll T, Jørgensen PG. MR-proANP and incident cardiovascular disease in patients with type 2 diabetes with and without heart failure with preserved ejection fraction. Cardiovasc Diabetol 2020; 19:180. [PMID: 33066783 PMCID: PMC7568388 DOI: 10.1186/s12933-020-01155-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/10/2020] [Indexed: 11/10/2022] Open
Abstract
Background Mid-regional pro-atrial natriuretic peptide (MR-proANP) is a useful biomarker in outpatients with type 2 diabetes (T2D) to diagnose heart failure (HF). Elevated B-type natriuretic peptides are included in the definition of HF with preserved ejection fraction (HFpEF) but little is known about the prognostic value of including A-type natriuretic peptides (MR-proANP) in the evaluation of patients with T2D. Methods We prospectively evaluated the risk of incident cardiovascular (CV) events in outpatients with T2D (n = 806, mean ± standard deviation age 64 ± 10 years, 65% male, median [interquartile range] duration of diabetes 12 [6–17] years, 17.5% with symptomatic HFpEF) according to MR-proANP levels and stratified according to HF-status including further stratification according to a prespecified cut-off level of MR-proANP. Results A total of 126 CV events occurred (median follow-up 4.8 [4.1–5.3] years). An elevated MR-proANP, with a cut-off of 60 pmol/l or as a continuous variable, was associated with incident CV events (p < 0.001). Compared to patients without HF, patients with HFpEF and high MR-proANP (≥ 60 pmol/l; median 124 [89–202] pmol/l) and patients with HF and reduced ejection fraction (HFrEF) had a higher risk of CV events (multivariable model; hazard ratio (HR) 2.56 [95% CI 1.64–4.00] and 3.32 [1.64–6.74], respectively). Conversely, patients with HFpEF and low MR-proANP (< 60 pmol/l; median 46 [32–56] pmol/l) did not have an increased risk (HR 2.18 [0.78–6.14]). Conclusions Patients with T2D and HFpEF with high MR-proANP levels had an increased risk for CV events compared to patients with HFpEF without elevated MR-proANP and compared to patients without HF, supporting the use of MR-proANP in the definition of HFpEF from a prognostic point-of-view.
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Affiliation(s)
- Jesper Jensen
- Department of Cardiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark. .,Faculty of Health and Medical Sciences, Copenhagen University, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
| | - Morten Schou
- Department of Cardiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.,Faculty of Health and Medical Sciences, Copenhagen University, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Caroline Kistorp
- Department of Endocrinology, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Copenhagen University, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Jens Faber
- Department of Endocrinology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.,Faculty of Health and Medical Sciences, Copenhagen University, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Tine W Hansen
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820, Gentofte, Denmark
| | - Magnus T Jensen
- Department of Cardiology, Copenhagen University Hospital Amager-Hvidovre Hospital, Kettegård Alle 30, 2650, Hvidovre, Denmark
| | - Henrik U Andersen
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820, Gentofte, Denmark
| | - Peter Rossing
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820, Gentofte, Denmark.,Faculty of Health and Medical Sciences, Copenhagen University, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Tina Vilsbøll
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820, Gentofte, Denmark.,Faculty of Health and Medical Sciences, Copenhagen University, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Peter G Jørgensen
- Department of Cardiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark
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