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Havlenova T, Skaroupkova P, Miklovic M, Behounek M, Chmel M, Jarkovska D, Sviglerova J, Stengl M, Kolar M, Novotny J, Benes J, Cervenka L, Petrak J, Melenovsky V. Right versus left ventricular remodeling in heart failure due to chronic volume overload. Sci Rep 2021; 11:17136. [PMID: 34429479 PMCID: PMC8384875 DOI: 10.1038/s41598-021-96618-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/06/2021] [Accepted: 08/10/2021] [Indexed: 02/07/2023] Open
Abstract
Mechanisms of right ventricular (RV) dysfunction in heart failure (HF) are poorly understood. RV response to volume overload (VO), a common contributing factor to HF, is rarely studied. The goal was to identify interventricular differences in response to chronic VO. Rats underwent aorto-caval fistula (ACF)/sham operation to induce VO. After 24 weeks, RV and left ventricular (LV) functions, gene expression and proteomics were studied. ACF led to biventricular dilatation, systolic dysfunction and hypertrophy affecting relatively more RV. Increased RV afterload contributed to larger RV stroke work increment compared to LV. Both ACF ventricles displayed upregulation of genes of myocardial stress and metabolism. Most proteins reacted to VO in a similar direction in both ventricles, yet the expression changes were more pronounced in RV (pslope: < 0.001). The most upregulated were extracellular matrix (POSTN, NRAP, TGM2, CKAP4), cell adhesion (NCAM, NRAP, XIRP2) and cytoskeletal proteins (FHL1, CSRP3) and enzymes of carbohydrate (PKM) or norepinephrine (MAOA) metabolism. Downregulated were MYH6 and FAO enzymes. Therefore, when exposed to identical VO, both ventricles display similar upregulation of stress and metabolic markers. Relatively larger response of ACF RV compared to the LV may be caused by concomitant pulmonary hypertension. No evidence supports RV chamber-specific regulation of protein expression in response to VO.
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Affiliation(s)
- Tereza Havlenova
- grid.418930.70000 0001 2299 1368Department of Cardiology, Institute for Clinical and Experimental Medicine - IKEM, Videnska 1958/9, 140 21 Prague 4, Czech Republic ,grid.4491.80000 0004 1937 116XDepartment of Pathophysiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petra Skaroupkova
- grid.418930.70000 0001 2299 1368Department of Cardiology, Institute for Clinical and Experimental Medicine - IKEM, Videnska 1958/9, 140 21 Prague 4, Czech Republic
| | - Matus Miklovic
- grid.418930.70000 0001 2299 1368Department of Cardiology, Institute for Clinical and Experimental Medicine - IKEM, Videnska 1958/9, 140 21 Prague 4, Czech Republic ,grid.4491.80000 0004 1937 116XDepartment of Pathophysiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Matej Behounek
- grid.4491.80000 0004 1937 116XBIOCEV, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Martin Chmel
- grid.4491.80000 0004 1937 116XBIOCEV, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Dagmar Jarkovska
- grid.4491.80000 0004 1937 116XFaculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Jitka Sviglerova
- grid.4491.80000 0004 1937 116XFaculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Milan Stengl
- grid.4491.80000 0004 1937 116XFaculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Michal Kolar
- grid.418827.00000 0004 0620 870XInstitute of Molecular Genetics of the Czech Academy of Sciences, Prague, Czech Republic
| | - Jiri Novotny
- grid.418827.00000 0004 0620 870XInstitute of Molecular Genetics of the Czech Academy of Sciences, Prague, Czech Republic
| | - Jan Benes
- grid.418930.70000 0001 2299 1368Department of Cardiology, Institute for Clinical and Experimental Medicine - IKEM, Videnska 1958/9, 140 21 Prague 4, Czech Republic
| | - Ludek Cervenka
- grid.418930.70000 0001 2299 1368Department of Cardiology, Institute for Clinical and Experimental Medicine - IKEM, Videnska 1958/9, 140 21 Prague 4, Czech Republic ,grid.4491.80000 0004 1937 116XDepartment of Pathophysiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiri Petrak
- grid.4491.80000 0004 1937 116XBIOCEV, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vojtech Melenovsky
- grid.418930.70000 0001 2299 1368Department of Cardiology, Institute for Clinical and Experimental Medicine - IKEM, Videnska 1958/9, 140 21 Prague 4, Czech Republic
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2
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Dawidowski M, Król M, Szulczyk B, Chodkowski A, Podsadni P, Konopelski P, Ufnal M, Szuberski P, Wróbel MZ, Zhang Y, El Harchi A, Hancox JC, Jarkovska D, Mistrova E, Sviglerova J, Štengl M, Popowicz GM, Turło J. Structure-activity relationship and cardiac safety of 2-aryl-2-(pyridin-2-yl)acetamides as a new class of broad-spectrum anticonvulsants derived from Disopyramide. Bioorg Chem 2020; 98:103717. [PMID: 32171994 DOI: 10.1016/j.bioorg.2020.103717] [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: 10/02/2019] [Revised: 12/23/2019] [Accepted: 02/28/2020] [Indexed: 10/24/2022]
Abstract
A series of 2-aryl-2-(pyridin-2-yl)acetamides were synthesized and screened for their anticonvulsant activity in animal models of epilepsy. The compounds were broadly active in the 'classical' maximal electroshock seizure (MES) and subcutaneous Metrazol (scMET) tests as well as in the 6 Hz and kindling models of pharmacoresistant seizures. Furthermore, the compounds showed good therapeutic indices between anticonvulsant activity and motor impairment. Structure-activity relationship (SAR) trends clearly showed the highest activity resides in unsubstituted phenyl derivatives or compounds having ortho- and meta- substituents on the phenyl ring. The 2-aryl-2-(pyridin-2-yl)acetamides were derived by redesign of the cardiotoxic sodium channel blocker Disopyramide (DISO). Our results show that the compounds preserve the capability of the parent compound to inhibit voltage gated sodium currents in patch-clamp experiments; however, in contrast to DISO, a representative compound from the series 1 displays high levels of cardiac safety in a panel of in vitro and in vivo experiments.
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Affiliation(s)
- Maciej Dawidowski
- Department of Drug Technology and Pharmaceutical Biotechnology, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland.
| | - Marek Król
- Department of Drug Technology and Pharmaceutical Biotechnology, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland
| | - Bartłomiej Szulczyk
- Department of Drug Technology and Pharmaceutical Biotechnology, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland; Laboratory of Physiology and Pathophysiology, Centre for Preclinical Research, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland
| | - Andrzej Chodkowski
- Department of Drug Technology and Pharmaceutical Biotechnology, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland
| | - Piotr Podsadni
- Department of Drug Technology and Pharmaceutical Biotechnology, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland
| | - Piotr Konopelski
- Department of Experimental Physiology and Pathophysiology, Centre for Preclinical Research, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland
| | - Marcin Ufnal
- Department of Experimental Physiology and Pathophysiology, Centre for Preclinical Research, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland
| | - Piotr Szuberski
- Department of Drug Technology and Pharmaceutical Biotechnology, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland
| | - Martyna Zofia Wróbel
- Department of Drug Technology and Pharmaceutical Biotechnology, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland
| | - Yihong Zhang
- School of Physiology, Pharmacology and Neuroscience, Faculty of Medical Sciences, University of Bristol, Bristol BS8 1TD, United Kingdom
| | - Aziza El Harchi
- School of Physiology, Pharmacology and Neuroscience, Faculty of Medical Sciences, University of Bristol, Bristol BS8 1TD, United Kingdom
| | - Jules C Hancox
- School of Physiology, Pharmacology and Neuroscience, Faculty of Medical Sciences, University of Bristol, Bristol BS8 1TD, United Kingdom
| | - Dagmar Jarkovska
- Department of Physiology, Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Alej Svobody 1655/76, 323 00 Pilsen, Czech Republic
| | - Eliska Mistrova
- Department of Physiology, Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Alej Svobody 1655/76, 323 00 Pilsen, Czech Republic
| | - Jitka Sviglerova
- Department of Physiology, Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Alej Svobody 1655/76, 323 00 Pilsen, Czech Republic
| | - Milan Štengl
- Department of Physiology, Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Alej Svobody 1655/76, 323 00 Pilsen, Czech Republic
| | - Grzegorz M Popowicz
- Institute of Structural Biology, Helmholtz Zentrum München, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - Jadwiga Turło
- Department of Drug Technology and Pharmaceutical Biotechnology, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland
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3
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Horak J, Nalos L, Martinkova V, Tegl V, Vistejnova L, Kuncova J, Kohoutova M, Jarkovska D, Dolejsova M, Benes J, Stengl M, Matejovic M. Evaluation of Mesenchymal Stem Cell Therapy for Sepsis: A Randomized Controlled Porcine Study. Front Immunol 2020; 11:126. [PMID: 32117276 PMCID: PMC7019005 DOI: 10.3389/fimmu.2020.00126] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 06/24/2019] [Accepted: 01/17/2020] [Indexed: 01/22/2023] Open
Abstract
Background: Treatment with mesenchymal stem cells (MSCs) has elicited considerable interest as an adjunctive therapy in sepsis. However, the encouraging effects of experiments with MSC in rodents have not been adequately studied in large-animal models with better relevance to human sepsis. Objectives: Here, we aimed to assess safety and efficacy of bone marrow-derived MSCs in a clinically relevant porcine model of progressive peritonitis-induced sepsis. Methods: Thirty-two anesthetized, mechanically ventilated, and instrumented pigs were randomly assigned into four groups (n = 8 per group): (1) sham-operated group (CONTROL); (2) sham-operated group treated with MSCs (MSC-CONTROL); (3) sepsis group with standard supportive care (SEPSIS); and (4) sepsis group treated with MSCs (MSC-SEPSIS). Peritoneal sepsis was induced by inoculating cultivated autologous feces. MSCs (1 × 106/kg) were administered intravenously at 6 h after sepsis induction. Results: Before, 12, 18, and 24 h after the induction of peritonitis, we measured systemic, regional, and microvascular hemodynamics, multiple-organ functions, mitochondrial energy metabolism, systemic immune-inflammatory response, and oxidative stress. Administration of MSCs in the MSC-CONTROL group did not elicit any measurable acute effects. Treatment of septic animals with MSCs failed to mitigate sepsis-induced hemodynamic alterations or the gradual rise in Sepsis-related organ failure assessment scores. MSCs did not confer any protection against sepsis-mediated cellular myocardial depression and mitochondrial dysfunction. MSCs also failed to modulate the deregulated immune-inflammatory response. Conclusion: Intravenous administration of bone marrow-derived MSCs to healthy animals was well-tolerated. However, in this large-animal, clinically relevant peritonitis-induced sepsis model, MSCs were not capable of reversing any of the sepsis-induced disturbances in multiple biological, organ, and cellular systems.
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Affiliation(s)
- Jan Horak
- First Medical Department, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia.,Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czechia
| | - Lukas Nalos
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czechia.,Department of Physiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Vendula Martinkova
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czechia.,Third Department of Surgery, University Hospital Motol and First Medical School, Charles University, Prague, Czechia
| | - Vaclav Tegl
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czechia.,Department of Anesthesia and Intensive Care Medicine, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Lucie Vistejnova
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czechia.,Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Jitka Kuncova
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czechia.,Department of Physiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Michaela Kohoutova
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czechia.,Department of Physiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Dagmar Jarkovska
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czechia.,Department of Physiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Martina Dolejsova
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czechia
| | - Jan Benes
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czechia.,Department of Anesthesia and Intensive Care Medicine, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Milan Stengl
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czechia.,Department of Physiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Martin Matejovic
- First Medical Department, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia.,Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czechia
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4
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Jarkovska D, Markova M, Horak J, Nalos L, Benes J, Al-Obeidallah M, Tuma Z, Sviglerova J, Kuncova J, Matejovic M, Stengl M. Cellular Mechanisms of Myocardial Depression in Porcine Septic Shock. Front Physiol 2018; 9:726. [PMID: 29946267 PMCID: PMC6005898 DOI: 10.3389/fphys.2018.00726] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 11/07/2017] [Accepted: 05/25/2018] [Indexed: 12/29/2022] Open
Abstract
The complex pathogenesis of sepsis and septic shock involves myocardial depression, the pathophysiology of which, however, remains unclear. In this study, cellular mechanisms of myocardial depression were addressed in a clinically relevant, large animal (porcine) model of sepsis and septic shock. Sepsis was induced by fecal peritonitis in eight anesthetized, mechanically ventilated, and instrumented pigs of both sexes and continued for 24 h. In eight control pigs, an identical experiment but without sepsis induction was performed. In vitro analysis of cardiac function included measurements of action potentials and contractions in the right ventricle trabeculae, measurements of sarcomeric contractions, calcium transients and calcium current in isolated cardiac myocytes, and analysis of mitochondrial respiration by ultrasensitive oxygraphy. Increased values of modified sequential organ failure assessment score and serum lactate levels documented the development of sepsis/septic shock, accompanied by hyperdynamic circulation with high heart rate, increased cardiac output, peripheral vasodilation, and decreased stroke volume. In septic trabeculae, action potential duration was shortened and contraction force reduced. In septic cardiac myocytes, sarcomeric contractions, calcium transients, and L-type calcium current were all suppressed. Similar relaxation trajectory of the intracellular calcium-cell length phase-plane diagram indicated unchanged calcium responsiveness of myofilaments. Mitochondrial respiration was diminished through inhibition of Complex II and Complex IV. Defective calcium handling with reduced calcium current and transients, together with inhibition of mitochondrial respiration, appears to represent the dominant cellular mechanisms of myocardial depression in porcine septic shock.
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Affiliation(s)
- Dagmar Jarkovska
- Department of Physiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia.,Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Michaela Markova
- Department of Physiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia.,Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Jan Horak
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia.,Department of Internal Medicine I, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Lukas Nalos
- Department of Physiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia.,Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Jan Benes
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia.,Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Mahmoud Al-Obeidallah
- Department of Physiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Zdenek Tuma
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Jitka Sviglerova
- Department of Physiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia.,Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Jitka Kuncova
- Department of Physiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia.,Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Martin Matejovic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia.,Department of Internal Medicine I, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Milan Stengl
- Department of Physiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia.,Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
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5
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Jarkovska D, Bludovska M, Mistrova E, Krizkova V, Kotyzova D, Kubikova T, Slavikova J, Erek SN, Djordjevic A, Chottova Dvorakova M. Expression of classical mediators in hearts of rats with hepatic dysfunction. Can J Physiol Pharmacol 2017; 95:1351-1359. [PMID: 28746816 DOI: 10.1139/cjpp-2017-0060] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Liver cirrhosis is associated with impairment of cardiovascular function including alterations of the heart innervation, humoral and nervous dysregulation, changes in systemic circulation and electrophysiological abnormalities. Choline acetyltransferase (ChAT), enzyme forming acetylcholine, tyrosine hydroxylase (TH), and dopamine-β-hydroxylase (DBH), enzymes participating in noradrenaline synthesis, are responsible for the production of classical neurotransmitters, and atrial natriuretic peptide (ANP) is produced by cardiomyocytes. The aim of this study was to evaluate the influence of experimentally induced hepatic dysfunction on the expression of proANP, ChAT, TH, and DBH in the heart. Hepatic dysfunction was induced by application of thioacetamide (TAA) or by ligation of bile duct. Biochemical parameters of hepatic injury and levels of peroxidation in the liver and heart were measured. Liver enzymes measured in the plasma were significantly elevated. Cardiac level of peroxidation was increased in operated but not TAA group animals. In the left atrium of operated rats, the expression of TH and DBH was lower, while expression of ChAT remained unchanged. In TAA group, no significant differences in the expression of the genes compared to controls were observed. Liver injury induced by ligation leads to an imbalance in the intracardiac innervation, which might impair nervous control of the heart.
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Affiliation(s)
- Dagmar Jarkovska
- a Biomedical Center, Faculty of Medicine in Pilsen, Charles University, alej Svobody 1655/76, Pilsen 323 00, Czech Republic.,b Department of Physiology, Faculty of Medicine in Pilsen, Charles University, alej Svobody 1655/76, Pilsen 323 00, Czech Republic
| | - Monika Bludovska
- a Biomedical Center, Faculty of Medicine in Pilsen, Charles University, alej Svobody 1655/76, Pilsen 323 00, Czech Republic.,c Department of Pharmacology and Toxicology, Faculty of Medicine in Pilsen, Charles University, alej Svobody 1655/76, Pilsen 323 00, Czech Republic
| | - Eliska Mistrova
- a Biomedical Center, Faculty of Medicine in Pilsen, Charles University, alej Svobody 1655/76, Pilsen 323 00, Czech Republic.,b Department of Physiology, Faculty of Medicine in Pilsen, Charles University, alej Svobody 1655/76, Pilsen 323 00, Czech Republic
| | - Vera Krizkova
- d Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Lidicka 1, Pilsen 323 00, Czech Republic
| | - Dana Kotyzova
- c Department of Pharmacology and Toxicology, Faculty of Medicine in Pilsen, Charles University, alej Svobody 1655/76, Pilsen 323 00, Czech Republic
| | - Tereza Kubikova
- a Biomedical Center, Faculty of Medicine in Pilsen, Charles University, alej Svobody 1655/76, Pilsen 323 00, Czech Republic.,d Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Lidicka 1, Pilsen 323 00, Czech Republic
| | - Jana Slavikova
- a Biomedical Center, Faculty of Medicine in Pilsen, Charles University, alej Svobody 1655/76, Pilsen 323 00, Czech Republic
| | - Sumeyye Nur Erek
- b Department of Physiology, Faculty of Medicine in Pilsen, Charles University, alej Svobody 1655/76, Pilsen 323 00, Czech Republic
| | - Aleksandar Djordjevic
- b Department of Physiology, Faculty of Medicine in Pilsen, Charles University, alej Svobody 1655/76, Pilsen 323 00, Czech Republic
| | - Magdalena Chottova Dvorakova
- a Biomedical Center, Faculty of Medicine in Pilsen, Charles University, alej Svobody 1655/76, Pilsen 323 00, Czech Republic.,b Department of Physiology, Faculty of Medicine in Pilsen, Charles University, alej Svobody 1655/76, Pilsen 323 00, Czech Republic
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6
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Jarkovska D, Valesova L, Chvojka J, Benes J, Danihel V, Sviglerova J, Nalos L, Matejovic M, Stengl M. Heart-rate variability depression in porcine peritonitis-induced sepsis without organ failure. Exp Biol Med (Maywood) 2017; 242:1005-1012. [PMID: 28440737 DOI: 10.1177/1535370217700521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Depression of heart-rate variability (HRV) in conditions of systemic inflammation has been shown in both patients and experimental animal models and HRV has been suggested as an early indicator of sepsis. The sensitivity of HRV-derived parameters to the severity of sepsis, however, remains unclear. In this study we modified the clinically relevant porcine model of peritonitis-induced sepsis in order to avoid the development of organ failure and to test the sensitivity of HRV to such non-severe conditions. In 11 anesthetized, mechanically ventilated and instrumented domestic pigs of both sexes, sepsis was induced by fecal peritonitis. The dose of feces was adjusted and antibiotic therapy was administered to avoid multiorgan failure. Experimental subjects were screened for 40 h from the induction of sepsis. In all septic animals, sepsis with hyperdynamic circulation and increased plasma levels of inflammatory mediators developed within 12 h from the induction of peritonitis. The sepsis did not progress to multiorgan failure and there was no spontaneous death during the experiment despite a modest requirement for vasopressor therapy in most animals (9/11). A pronounced reduction of HRV and elevation of heart rate developed quickly (within 5 h, time constant of 1.97 ± 0.80 h for HRV parameter TINN) upon the induction of sepsis and were maintained throughout the experiment. The frequency domain analysis revealed a decrease in the high-frequency component. The reduction of HRV parameters and elevation of heart rate preceded sepsis-associated hemodynamic changes by several hours (time constant of 11.28 ± 2.07 h for systemic vascular resistance decline). A pronounced and fast reduction of HRV occurred in the setting of a moderate experimental porcine sepsis without organ failure. Inhibition of parasympathetic cardiac signaling probably represents the main mechanism of HRV reduction in sepsis. The sensitivity of HRV to systemic inflammation may allow early detection of a moderate sepsis without organ failure. Impact statement A pronounced and fast reduction of heart-rate variability occurred in the setting of a moderate experimental porcine sepsis without organ failure. Dominant reduction of heart-rate variability was found in the high-frequency band indicating inhibition of parasympathetic cardiac signaling as the main mechanism of heart-rate variability reduction. The sensitivity of heart-rate variability to systemic inflammation may contribute to an early detection of moderate sepsis without organ failure.
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Affiliation(s)
- Dagmar Jarkovska
- 1 Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 32300 Pilsen, Czech Republic.,2 Department of Physiology, Faculty of Medicine in Pilsen, Charles University, 32300 Pilsen, Czech Republic
| | - Lenka Valesova
- 1 Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 32300 Pilsen, Czech Republic.,3 First Medical Department, Faculty of Medicine in Pilsen, Charles University, 30460 Pilsen, Czech Republic
| | - Jiri Chvojka
- 1 Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 32300 Pilsen, Czech Republic.,3 First Medical Department, Faculty of Medicine in Pilsen, Charles University, 30460 Pilsen, Czech Republic
| | - Jan Benes
- 1 Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 32300 Pilsen, Czech Republic.,4 Department of Anesthesia and Intensive Care Medicine, Faculty of Medicine in Pilsen, Charles University, 30460 Pilsen, Czech Republic
| | - Vojtech Danihel
- 1 Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 32300 Pilsen, Czech Republic.,3 First Medical Department, Faculty of Medicine in Pilsen, Charles University, 30460 Pilsen, Czech Republic
| | - Jitka Sviglerova
- 1 Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 32300 Pilsen, Czech Republic.,2 Department of Physiology, Faculty of Medicine in Pilsen, Charles University, 32300 Pilsen, Czech Republic
| | - Lukas Nalos
- 1 Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 32300 Pilsen, Czech Republic.,2 Department of Physiology, Faculty of Medicine in Pilsen, Charles University, 32300 Pilsen, Czech Republic
| | - Martin Matejovic
- 1 Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 32300 Pilsen, Czech Republic.,3 First Medical Department, Faculty of Medicine in Pilsen, Charles University, 30460 Pilsen, Czech Republic
| | - Milan Stengl
- 1 Biomedical Center, Faculty of Medicine in Pilsen, Charles University, 32300 Pilsen, Czech Republic.,2 Department of Physiology, Faculty of Medicine in Pilsen, Charles University, 32300 Pilsen, Czech Republic
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7
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Jarkovska D, Valesova L, Chvojka J, Benes J, Sviglerova J, Florova B, Nalos L, Matejovic M, Stengl M. Heart Rate Variability in Porcine Progressive Peritonitis-Induced Sepsis. Front Physiol 2016; 6:412. [PMID: 26779039 PMCID: PMC4701909 DOI: 10.3389/fphys.2015.00412] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 11/06/2015] [Accepted: 12/14/2015] [Indexed: 12/21/2022] Open
Abstract
Accumulating evidence suggests that heart rate variability (HRV) alterations could serve as an indicator of sepsis progression and outcome, however, the relationships of HRV and major pathophysiological processes of sepsis remain unclear. Therefore, in this experimental study HRV was investigated in a clinically relevant long-term porcine model of severe sepsis/septic shock. HRV was analyzed by several methods and the parameters were correlated with pathophysiological processes of sepsis. In 16 anesthetized, mechanically ventilated, and instrumented domestic pigs of either gender, sepsis was induced by fecal peritonitis. Experimental subjects were screened up to the refractory shock development or death. ECG was continuously recorded throughout the experiment, afterwards RR intervals were detected and HRV parameters computed automatically using custom made measurement and analysis MATLAB routines. In all septic animals, progressive hyperdynamic septic shock developed. The statistical measures of HRV, geometrical measures of HRV and Poincaré plot analysis revealed a pronounced reduction of HRV that developed quickly upon the onset of sepsis and was maintained throughout the experiment. The frequency domain analysis demonstrated a decrease in the high frequency component and increase in the low frequency component together with an increase of the low/high frequency component ratio. The reduction of HRV parameters preceded sepsis-associated hemodynamic changes including heart rate increase or shock progression. In a clinically relevant porcine model of peritonitis-induced progressive septic shock, reduction of HRV parameters heralded sepsis development. HRV reduction was associated with a pronounced parasympathetic inhibition and a shift of sympathovagal balance. Early reduction of HRV may serve as a non-invasive and sensitive marker of systemic inflammatory syndrome, thereby widening the therapeutic window for early interventions.
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Affiliation(s)
- Dagmar Jarkovska
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University in PraguePilsen, Czech Republic; Department of Physiology, Faculty of Medicine in Pilsen, Charles University in PraguePilsen, Czech Republic
| | - Lenka Valesova
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University in PraguePilsen, Czech Republic; First Medical Department, Faculty of Medicine in Pilsen, Charles University in PraguePilsen, Czech Republic
| | - Jiri Chvojka
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University in PraguePilsen, Czech Republic; First Medical Department, Faculty of Medicine in Pilsen, Charles University in PraguePilsen, Czech Republic
| | - Jan Benes
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University in PraguePilsen, Czech Republic; Department of Anesthesia and Intensive Care Medicine, Faculty of Medicine in Pilsen, Charles University in PraguePilsen, Czech Republic
| | - Jitka Sviglerova
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University in PraguePilsen, Czech Republic; Department of Physiology, Faculty of Medicine in Pilsen, Charles University in PraguePilsen, Czech Republic
| | - Blanka Florova
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University in Prague Pilsen, Czech Republic
| | - Lukas Nalos
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University in PraguePilsen, Czech Republic; Department of Physiology, Faculty of Medicine in Pilsen, Charles University in PraguePilsen, Czech Republic
| | - Martin Matejovic
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University in PraguePilsen, Czech Republic; First Medical Department, Faculty of Medicine in Pilsen, Charles University in PraguePilsen, Czech Republic
| | - Milan Stengl
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University in PraguePilsen, Czech Republic; Department of Physiology, Faculty of Medicine in Pilsen, Charles University in PraguePilsen, Czech Republic
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Mistrova E, Bludovska M, Jarkovska D, Kotyzova, Slavikova J, Dvorakova MC. Effect of induced hepatic dysfunction on the innervation of the rat heart. Auton Neurosci 2015. [DOI: 10.1016/j.autneu.2015.07.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Stengl M, Ledvinova L, Chvojka J, Benes J, Jarkovska D, Holas J, Soukup P, Sviglerová J, Matejovic M. Effects of clinically relevant acute hypercapnic and metabolic acidosis on the cardiovascular system: an experimental porcine study. Crit Care 2013; 17:R303. [PMID: 24377654 PMCID: PMC4056780 DOI: 10.1186/cc13173] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 12/11/2013] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Hypercapnic acidosis (HCA) that accompanies lung-protective ventilation may be considered permissive (a tolerable side effect), or it may be therapeutic by itself. Cardiovascular effects may contribute to, or limit, the potential therapeutic impact of HCA; therefore, a complex physiological study was performed in healthy pigs to evaluate the systemic and organ-specific circulatory effects of HCA, and to compare them with those of metabolic (eucapnic) acidosis (MAC). METHODS In anesthetized, mechanically ventilated and instrumented pigs, HCA was induced by increasing the inspired fraction of CO2 (n = 8) and MAC (n = 8) by the infusion of HCl, to reach an arterial plasma pH of 7.1. In the control group (n = 8), the normal plasma pH was maintained throughout the experiment. Hemodynamic parameters, including regional organ hemodynamics, blood gases, and electrocardiograms, were measured in vivo. Subsequently, isometric contractions and membrane potentials were recorded in vitro in the right ventricular trabeculae. RESULTS HCA affected both the pulmonary (increase in mean pulmonary arterial pressure (MPAP) and pulmonary vascular resistance (PVR)) and systemic (increase in mean arterial pressure (MAP), decrease in systemic vascular resistance (SVR)) circulations. Although the renal perfusion remained unaffected by any type of acidosis, HCA increased carotid, portal, and, hence, total liver blood flow. MAC influenced the pulmonary circulation only (increase in MPAP and PVR). Both MAC and HCA reduced the stroke volume, which was compensated for by an increase in heart rate to maintain (MAC), or even increase (HCA), the cardiac output. The right ventricular stroke work per minute was increased by both MAC and HCA; however, the left ventricular stroke work was increased by HCA only. In vitro, the trabeculae from the control pigs and pigs with acidosis showed similar contraction force and action-potential duration (APD). Perfusion with an acidic solution decreased the contraction force, whereas APD was not influenced. CONCLUSIONS MAC preferentially affects the pulmonary circulation, whereas HCA affects the pulmonary, systemic, and regional circulations. The cardiac contractile function was reduced, but the cardiac output was maintained (MAC), or even increased (HCA). The increased ventricular stroke work per minute revealed an increased work demand placed by acidosis on the heart.
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Skarka L, Baumruk F, Kopecky J, Jarkovska D, Ostadal B. Ontogenetic development of mitochondrial membrane potential in rat heart. J Mol Cell Cardiol 2001. [DOI: 10.1016/s0022-2828(01)90445-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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