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Aidara ML, Walsh-Wilkinson É, Thibodeau SÈ, Labbé EA, Morin-Grandmont A, Gagnon G, Boudreau DK, Arsenault M, Bossé Y, Couët J. Cardiac reverse remodeling in a mouse model with many phenotypical features of heart failure with preserved ejection fraction: effects of modifying lifestyle. Am J Physiol Heart Circ Physiol 2024; 326:H1017-H1036. [PMID: 38363584 DOI: 10.1152/ajpheart.00462.2023] [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: 07/26/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/17/2024]
Abstract
Multiple factors cause heart failure with preserved ejection fraction (HFpEF) and involve various systems. HFpEF prevalence is rapidly rising, and its prognosis remains poor after the first hospitalization. Adopting a more active lifestyle has been shown to provide beneficial clinical outcomes for patients with HFpEF. Using a two-hit HfpEF murine model, we studied cardiac reverse remodeling (RR) after stopping the causing stress and introducing voluntary exercise (VE). We checked in 2-mo-old male and female C57Bl6/J mice the heart's response to angiotensin II (ANG II; 1.5 mg/kg/day for 28 days) fed or not with a high-fat diet (HFD). Then, ANG II and/or the HFD were stopped, and VE was started for an additional 4 wk. ANG II and ANG II + HFD (metabolic-hypertensive stress, MHS) caused cardiac hypertrophy (CH) and myocardial fibrosis, left ventricular (LV) concentric remodeling, atrial enlargement, and reduced exercise capacity. HFD alone induced CH and LV concentric remodeling in female mice only. CH and LV concentric remodeling were reversed 4 wk after stopping ANG II, starting VE, and a low-fat diet. Left atrial enlargement and exercise capacity were improved but differed from controls. We performed bulk LV RNA sequencing and observed that MHS upregulated 58% of the differentially expressed genes (DEGs) compared with controls. In the RR group, compared with MHS animals, 60% of the DEGs were downregulated. In an HfpEF mouse model, we show that correcting hypertension, diet, and introducing exercise can lead to extensive cardiac reverse remodeling.NEW & NOTEWORTHY Using a two-hit murine model of heart failure with preserved ejection fraction (HfpEF), combining elevated blood pressure, obesity, and exercise intolerance in male and female animals, we showed that correction of hypertension, normalization of the diet, and introduction of voluntary exercise could help reverse the remodeling of the left ventricle and double exercise capacity. We also identify genes that escape normalization after myocardial recovery and differences between males' and females' responses to stress and recovery.
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Affiliation(s)
- Mohamed Lamine Aidara
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec City, Québec, Canada
| | - Élisabeth Walsh-Wilkinson
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec City, Québec, Canada
| | - Sara-Ève Thibodeau
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec City, Québec, Canada
| | - Emylie-Ann Labbé
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec City, Québec, Canada
| | - Audrey Morin-Grandmont
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec City, Québec, Canada
| | - Geneviève Gagnon
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec City, Québec, Canada
| | - Dominique K Boudreau
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec City, Québec, Canada
| | - Marie Arsenault
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec City, Québec, Canada
| | - Yohan Bossé
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec City, Québec, Canada
| | - Jacques Couët
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec City, Québec, Canada
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Walsh-Wilkinson É, Aidara ML, Morin-Grandmont A, Thibodeau SÈ, Gagnon J, Genest M, Arsenault M, Couet J. Age and sex hormones modulate left ventricle regional response to Angiotensin II in male and female mice. Am J Physiol Heart Circ Physiol 2022; 323:H643-H658. [PMID: 35984762 DOI: 10.1152/ajpheart.00044.2022] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Age, hypertension, and the female sex are among risk factors in the development of heart failure with preserved ejection fraction. We studied by standard and speckle-tracking echocardiography (STE), the response of the left ventricle (LV) to aging and angiotensin II (AngII; 1.5 mg/kg/day for 28 days) in 2-month-old and 12-month-old male and female C57Bl6/J mice. We also investigated the effects of the loss of sex steroids by gonadectomy (GDX). We used STE data from 48 points or regions of interest (ROIs) around the LV endocardium from B-mode images and generated profiles of maximal strain, strain rate (SR) and reverse SR for each experimental group of mice. In young mice, LV strain, strain rate (SR) and reverse SR profile levels were higher in females than in males. Aging was characterized by concentric LV remodeling and a decrease of strain, SR and reverse SR. GDX at 6 weeks of age slowed normal cardiac growth in male mice. In females, GDX reduced LV strain, SR and reverse SR but did not influence cardiac growth. AngII caused similar levels of hypertrophy in young and older mice. In young mice, AngII had little effects on STE parameters, whereas in older animals, strain, SR and reverse SR were reduced, mainly for the LV posterior wall. In older GDX mice, hypertrophic response to AngII was decreased compared to intact animals. Generating detailed STE profile for the LV wall can help detect differences linked to sex, age or to a stressor better than global strain measurements.
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Affiliation(s)
- Élisabeth Walsh-Wilkinson
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Mohamed Lamine Aidara
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Audrey Morin-Grandmont
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Sara-Ève Thibodeau
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Juliette Gagnon
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Mathieu Genest
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Marie Arsenault
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Jacques Couet
- Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
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Shen M, Tastet L, Capoulade R, Bédard É, Arsenault M, Clavel MA, Pibarot P. Determinants of Aortic Stenosis Progression in Bicuspid and Tricuspid Aortic Valves. CJC Pediatr Congenit Heart Dis 2022; 1:184-192. [PMID: 37969929 PMCID: PMC10642113 DOI: 10.1016/j.cjcpc.2022.06.004] [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] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/19/2022] [Indexed: 11/17/2023]
Abstract
Background Bicuspid aortic valve (BAV) is associated with a faster progression of aortic stenosis (AS). Whether the determinants of AS progression are the same or different in patients with BAV vs tricuspid aortic valve (TAV) is unknown. The aim of this study was to identify the factors associated with the progression of AS in patients with BAV vs patients with TAV. Methods Patients with AS were prospectively recruited in the Metabolic Determinants of the Progression of Aortic Stenosis (PROGRESSA) study (ClinicalTrials.gov Identifier: NCT01679431). The haemodynamic progression rate of AS was assessed by the annualized progression rate of peak aortic jet velocity (Vpeak). Univariable and multivariable linear regression analyses were used to identify the factors associated with a faster progression of AS in patients with BAV vs patients with TAV. Results There were 79 patients with BAV and 208 patients with TAV. The baseline severity of AS was similar between the 2 groups of patients as well as the annualized progression rate of AS. In patients with BAV, obesity (β = 0.25, P = 0.04), diabetes (β = 0.26, P = 0.02), and BAV with right-noncoronary cusp fusion (β = 0.29, P = 0.01) were found to be independently associated with a faster progression of AS, whereas in patients with TAV, AS baseline severity (baseline Vpeak, β = 0.14, P = 0.04) and chronic kidney disease (β = 0.16, P = 0.02) were significantly associated with AS progression. Conclusion Factors associated with progression rate of AS are different in BAV and TAV. The main factors associated with a faster progression of AS appear to be obesity, diabetes, right-noncoronary cusp fusion in patients with BAV vs chronic kidney disease in patients with TAV.
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Affiliation(s)
- Mylène Shen
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Université Laval, Québec City, Québec, Canada
| | - Lionel Tastet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Université Laval, Québec City, Québec, Canada
| | - Romain Capoulade
- CHU Nantes, CNRS, INSERM, l’institut du thorax, Université de Nantes, Nantes, France
| | - Élisabeth Bédard
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Université Laval, Québec City, Québec, Canada
| | - Marie Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Université Laval, Québec City, Québec, Canada
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Université Laval, Québec City, Québec, Canada
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Université Laval, Québec City, Québec, Canada
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Tastet L, Shen M, Capoulade R, Arsenault M, Bédard E, Côté N, Clavel M, Pibarot P. TIMING AND DETERMINANTS OF THE DETERIORATION OF FUNCTIONAL STATUS IN PATIENTS WITH AORTIC STENOSIS. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.170] [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: 11/29/2022] Open
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Shen M, Tastet L, Capoulade R, Arsenault M, Bédard É, Clavel MA, Pibarot P. Effect of bicuspid aortic valve phenotype on progression of aortic stenosis. Eur Heart J Cardiovasc Imaging 2021; 21:727-734. [PMID: 32386199 DOI: 10.1093/ehjci/jeaa068] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 01/06/2020] [Revised: 02/12/2020] [Accepted: 03/25/2020] [Indexed: 11/14/2022] Open
Abstract
AIMS To compare the progression of aortic stenosis (AS) in patients with bicuspid aortic valve (BAV) or tricuspid aortic valve (TAV). METHODS AND RESULTS One hundred and forty-one patients with mild-to-moderate AS, recruited prospectively in the PROGRESSA study, were included in this sub-analysis. Baseline clinical, Doppler echocardiography and multidetector computed tomography characteristics were compared between BAV (n = 32) and TAV (n = 109) patients. The 2-year haemodynamic [i.e. peak aortic jet velocity (Vpeak) and mean transvalvular gradient (MG)] and anatomic [i.e. aortic valve calcification density (AVCd) and aortic valve calcification density ratio (AVCd ratio)] progression of AS were compared between the two valve phenotypes. The 2-year progression rate of Vpeak was: 16 (-0 to 40) vs. 17 (3-35) cm/s, P = 0.95; of MG was: 1.8 (-0.7 to 5.8) vs. 2.6 (0.4-4.8) mmHg, P = 0.56; of AVCd was 32 (2-109) vs. 52 (25-85) AU/cm2, P = 0.15; and of AVCd ratio was: 0.08 (0.01-0.23) vs. 0.12 (0.06-0.18), P = 0.16 in patients with BAV vs. TAV. In univariable analyses, BAV was not associated with AS progression (all, P ≥ 0.26). However, with further adjustment for age, AS baseline severity, and several risk factors (i.e. sex, history of hypertension, creatinine level, diabetes, metabolic syndrome), BAV was independently associated with faster haemodynamic (Vpeak: β = 0.31, P = 0.02) and anatomic (AVCd: β = 0.26, P = 0.03 and AVCd ratio: β = 0.26, P = 0.03) progression of AS. CONCLUSION In patients with mild-to-moderate AS, patients with BAV have faster haemodynamic and anatomic progression of AS when compared to TAV patients with similar age and risk profile. This study highlights the importance and necessity to closely monitor patients with BAV and to adequately control and treat their risk factors. CLINICAL TRIAL REGISTRATION https://clinicaltrials.gov Unique identifier: NCT01679431.
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Affiliation(s)
- Mylène Shen
- Department of Medicine, Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval/Quebec Heart & Lung Institute-Laval University, 2725 Chemin Sainte-Foy, Quebec City, Quebec G1V 4G5, Canada
| | - Lionel Tastet
- Department of Medicine, Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval/Quebec Heart & Lung Institute-Laval University, 2725 Chemin Sainte-Foy, Quebec City, Quebec G1V 4G5, Canada
| | - Romain Capoulade
- Inserm UMR 1087/CNRS UMR 6291, IRS-UN, L'institut du thorax, CHU Nantes, UNIV Nantes, 8 quai Moncousu, BP 70721, 44007 Nantes Cedex 1, France
| | - Marie Arsenault
- Department of Medicine, Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval/Quebec Heart & Lung Institute-Laval University, 2725 Chemin Sainte-Foy, Quebec City, Quebec G1V 4G5, Canada
| | - Élisabeth Bédard
- Department of Medicine, Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval/Quebec Heart & Lung Institute-Laval University, 2725 Chemin Sainte-Foy, Quebec City, Quebec G1V 4G5, Canada
| | - Marie-Annick Clavel
- Department of Medicine, Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval/Quebec Heart & Lung Institute-Laval University, 2725 Chemin Sainte-Foy, Quebec City, Quebec G1V 4G5, Canada
| | - Philippe Pibarot
- Department of Medicine, Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval/Quebec Heart & Lung Institute-Laval University, 2725 Chemin Sainte-Foy, Quebec City, Quebec G1V 4G5, Canada
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Walsh-Wilkinson E, Arsenault M, Couet J. Segmental analysis by speckle-tracking echocardiography of the left ventricle response to isoproterenol in male and female mice. PeerJ 2021; 9:e11085. [PMID: 33763310 PMCID: PMC7958899 DOI: 10.7717/peerj.11085] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/18/2021] [Indexed: 01/03/2023] Open
Abstract
We studied by conventional and speckle-tracking echocardiography, the response of the left ventricle (LV) to a three-week continuous infusion of isoproterenol (Iso), a non-specific beta-adrenergic receptor agonist in male and female C57Bl6/J mice. Before and after Iso (30 mg/kg/day), we characterized LV morphology and function as well as global and segmental strain. We observed that Iso reduced LV ejection in both male (−8.7%) and female (−14.7%) mice. Several diastolic function parameters were negatively regulated in males and females such as E/A, E/E′, isovolumetric relaxation time. Global longitudinal (GLS) and circumferential (GCS) strains were reduced by Iso in both sexes, GLS by 31% and GCS by about 20%. For the segmental LV analysis, we measured strain, strain rate, reverse strain rate, peak speckle displacement and peak speckle velocity in the parasternal long axis. We observed that radial strain of the LV posterior segments were more severely modulated by Iso than those of the anterior wall in males. In females, on the other hand, both posterior and anterior wall segments were negatively impacted by Iso. Longitudinal strain showed similar results to the radial strain for both sexes. Strain rate, on the other hand, was only moderately changed by Iso. Reverse strain rate measurements (an index of diastolic function) showed that posterior LV segments were negatively regulated by Iso. We then studied the animals 5 and 17 weeks after Iso treatment. Compared to control mice, LV dilation was still present in males. Ejection fraction was decreased in mice of both sex compared to control animals. Diastolic function parameters, on the other hand, were back to normal. Taken together, our study indicates that segmental strain analysis can identify LV regions that are more negatively affected by a cardiotoxic agent such as Iso. In addition, cessation of Iso was not accompanied with a complete restoration of cardiac function after four months.
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Affiliation(s)
- Elisabeth Walsh-Wilkinson
- Universite Laval, Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Quebec, Quebec, Canada
| | - Marie Arsenault
- Universite Laval, Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Quebec, Quebec, Canada
| | - Jacques Couet
- Universite Laval, Groupe de recherche sur les valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Quebec, Quebec, Canada
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Bernard J, Tastet L, Capoulade R, Shen M, Clisson M, Guzzetti E, Larose É, Arsenault M, Bédard É, Côté N, Clavel MA, Pibarot P. Left ventricular asymmetric remodeling and subclinical left ventricular dysfunction in patients with calcific aortic valve stenosis - Results from a subanalysis of the PROGRESSA study. Int J Cardiol 2021; 332:148-156. [PMID: 33727121 DOI: 10.1016/j.ijcard.2021.03.017] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 01/09/2021] [Accepted: 03/08/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND LV asymmetric remodeling (LVAR) is a feature commonly found in AS patients and it is presumed to be mainly related to the severity of valve stenosis. The aim of this study was to determine the associated factors and impact on left ventricular (LV) systolic function of LVAR in patients with mild and moderate aortic valve stenosis (AS). METHODS Clinical, Doppler-echocardiographic and computed-tomographic data of 155 AS patients with preserved LV ejection fraction (≥50%) prospectively recruited in the PROGRESSA study (NCT01679431) were analyzed. LVAR was defined as a septal wall thickness ≥ 13 mm and a ratio of septal/posterior wall thickness > 1.5. LV global longitudinal strain (LV-GLS) was available in 129 patients. Plasma levels of N-terminal natriuretic B-type peptides (Nt-proBNP) were also measured. RESULTS Mean age was 63 ± 15 years (70% men). LVAR was present in 21% (n = 33) of patients. A series of nested multivariate analysis revealed that age was the only factor associated with LVAR (all p ≤ 0.03). Additionally, these patients had higher baseline Nt-proBNP ratio (median [25-75 percentiles]: 1.04 [0.66-2.41] vs. 0.65 [0.33-1.19], p = 0.02), and significantly reduced LV-GLS (17.9[16.6-19.5] vs. 19.3[17.4-20.7] |%|, p = 0.04). A 1:1 matched analysis showed a significant association of LVAR with reduced LV-GLS (17.9[16.6-19.5] vs. 19.8[18.1-20.7] |%|, p = 0.02) and elevated Nt-proBNP (134[86-348] vs. 83[50-179]pg/ml, p = 0.03). Multivariable analysis also revealed that LVAR remains significantly associated with reduced LV-GLS (p = 0.03) and elevated Nt-proBNP (p = 0.001). LVAR was significantly associated with increased risk of major adverse cardiac events and death (Hazard ratio [95% confidence interval]: 2.32[1.28-4.22], p = 0.006). CONCLUSIONS LVAR was found in ~20% of patients with mild or moderate AS and was not related to the degree of AS severity or concomitant comorbidities, but rather to older age. LVAR was significantly associated with reduced LV longitudinal systolic function, increased Nt-proBNP levels, and higher risk of major adverse events and death. These findings provide support for closer clinical and echocardiographic surveillance of patients harboring this adverse LV remodeling feature.
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Affiliation(s)
- Jérémy Bernard
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Lionel Tastet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Romain Capoulade
- l'institut du thorax, INSERM, CNRS UNIV Nantes, CHU Nantes, Nantes, France
| | - Mylène Shen
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Marine Clisson
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Ezequiel Guzzetti
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Éric Larose
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Marie Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Élisabeth Bédard
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Nancy Côté
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
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Guzzetti E, Tastet L, Annabi MS, Capoulade R, Shen M, Bernard J, García J, Le Ven F, Arsenault M, Bédard E, Larose E, Clavel MA, Pibarot P. Effect of Regional Upper Septal Hypertrophy on Echocardiographic Assessment of Left Ventricular Mass and Remodeling in Aortic Stenosis. J Am Soc Echocardiogr 2021; 34:62-71. [DOI: 10.1016/j.echo.2020.08.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 01/09/2023]
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Tastet L, Shen M, Capoulade R, Arsenault M, Bédard É, Côté N, Clavel MA, Pibarot P. Bone Mineral Density and Progression Rate of Calcific Aortic Valve Stenosis. J Am Coll Cardiol 2020; 75:1725-1726. [PMID: 32273038 DOI: 10.1016/j.jacc.2020.01.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 01/17/2020] [Accepted: 01/27/2020] [Indexed: 11/27/2022]
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Steinberg C, Nadeau-Routhier C, André P, Philippon F, Sarrazin JF, Nault I, O'Hara G, Blier L, Molin F, Plourde B, Roy K, Larose E, Arsenault M, Champagne J. Ventricular Arrhythmia in Septal and Apical Hypertrophic Cardiomyopathy: The French-Canadian Experience. Front Cardiovasc Med 2020; 7:548564. [PMID: 33195448 PMCID: PMC7642600 DOI: 10.3389/fcvm.2020.548564] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 08/25/2020] [Indexed: 11/26/2022] Open
Abstract
Background: Apical hypertrophic cardiomyopathy (aHCM) is thought to have a more benign clinical course compared to septal HCM (sHCM), but most data have been derived from Asian cohorts. Comparative data on clinical outcome in Caucasian aHCM cohorts are scarce, and the results are conflicting. The aim of this study was to estimate the prevalence and outcome of aHCM in French-Canadians of Caucasian descent. Methods and results: We conducted a retrospective, single-center cohort study. The primary endpoint was a composite of documented sustained ventricular arrhythmia (VA), appropriate ICD therapy, arrhythmogenic syncope, cardiac arrest, or all-cause mortality. A total of 301 HCM patients (65% males) were enrolled including 80/301 (27%) with aHCM and 221/301 (73%) with sHCM. Maximal wall thickness was similar in both groups. Left ventricular apical aneurysm was significantly more common in aHCM (10 vs. 0.5%; p < 0.001). The proportion of patients with myocardial fibrosis ≥ 15% of the left ventricular mass was similar between aHCM and sHCM (21 vs. 24%; p = 0.68). Secondary prevention ICDs were more often implanted in aHCM patients (16 vs. 7%; p = 0.02). The primary endpoint occurred in 26% of aHCM and 10.4% of sHCM patients (p = 0.001) and was driven by an increased incidence of sustained VA (10 vs. 2.3%; p = 0.01). Multivariate analysis identified apical aneurysm and a phenotype of aHCM as independent predictors of the primary endpoint and the occurrence of sustained ventricular tachycardia. Unexplained syncope and a family history of sudden cardiac death were additional predictors for sustained VA. Apical HCM was associated with an increased risk of ventricular arrhythmia even when excluding patients with apical aneurysm. Conclusions: The phenotype of apical HCM is much more common in French-Canadians (27%) of Caucasian descent compared to other Caucasian HCM populations. Apical HCM in French-Canadians is associated with an increased risk for ventricular arrhythmia.
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Marsit O, Clavel MA, Côté-Laroche C, Hadjadj S, Bouchard MA, Handschumacher MD, Clisson M, Drolet MC, Boulanger MC, Kim DH, Guerrero JL, Bartko PE, Couet J, Arsenault M, Mathieu P, Pibarot P, Aïkawa E, Bischoff J, Levine RA, Beaudoin J. Attenuated Mitral Leaflet Enlargement Contributes to Functional Mitral Regurgitation After Myocardial Infarction. J Am Coll Cardiol 2020; 75:395-405. [PMID: 32000951 DOI: 10.1016/j.jacc.2019.11.039] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 10/15/2019] [Revised: 11/08/2019] [Accepted: 11/13/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Mitral leaflet enlargement has been identified as an adaptive mechanism to prevent mitral regurgitation in dilated left ventricles (LVs) caused by chronic aortic regurgitation (AR). This enlargement is deficient in patients with functional mitral regurgitation, which remains frequent in the population with ischemic cardiomyopathy. Maladaptive fibrotic changes have been identified in post-myocardial infarction (MI) mitral valves. It is unknown if these changes can interfere with valve growth and whether they are present in other valves. OBJECTIVES This study sought to test the hypothesis that MI impairs leaflet growth, seen in AR, and induces fibrotic changes in mitral and tricuspid valves. METHODS Sheep models of AR, AR + MI, and controls were followed for 90 days. Cardiac magnetic resonance, echocardiography, and computed tomography were performed at baseline and 90 days to assess LV volume, LV function, mitral regurgitation and mitral leaflet size. Histopathology and molecular analyses were performed in excised valves. RESULTS Both experimental groups developed similar LV dilatation and dysfunction. At 90 days, mitral valve leaflet size was smaller in the AR + MI group (12.8 ± 1.3 cm2 vs. 15.1 ± 1.6 cm2, p = 0.03). Mitral regurgitant fraction was 4% ± 7% in the AR group versus 19% ± 10% in the AR + MI group (p = 0.02). AR + MI leaflets were thicker compared with AR and control valves. Increased expression of extracellular matrix remodeling genes was found in both the mitral and tricuspid leaflets in the AR + MI group. CONCLUSIONS In these animal models of AR, the presence of MI was associated with impaired adaptive valve growth and more functional mitral regurgitation, despite similar LV size and function. More pronounced extracellular remodeling was observed in mitral and tricuspid leaflets, suggesting systemic valvular remodeling after MI.
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Affiliation(s)
- Ons Marsit
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada
| | - Claudia Côté-Laroche
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada
| | - Sandra Hadjadj
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada
| | - Marc-André Bouchard
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada
| | - Mark D Handschumacher
- Center for Excellence in Vascular Biology, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Marine Clisson
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada
| | - Marie-Claude Drolet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada
| | - Marie-Chloé Boulanger
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada
| | - Dae-Hee Kim
- Division of Cardiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - J Luis Guerrero
- Cardiac Ultrasound Lab, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Philipp Emanuel Bartko
- Cardiac Ultrasound Lab, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jacques Couet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada
| | - Marie Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada
| | - Patrick Mathieu
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada
| | - Elena Aïkawa
- Cardiac Ultrasound Lab, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joyce Bischoff
- Vascular Biology Program and Department of Surgery, Boston Children's Hospital and Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Robert A Levine
- Cardiac Ultrasound Lab, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jonathan Beaudoin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec City, Quebec, Canada.
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12
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Guzzetti E, Capoulade R, Tastet L, Garcia J, Le Ven F, Arsenault M, Bédard E, Larose E, Clavel MA, Pibarot P. Estimation of Stroke Volume and Aortic Valve Area in Patients with Aortic Stenosis: A Comparison of Echocardiography versus Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr 2020; 33:953-963.e5. [PMID: 32580897 DOI: 10.1016/j.echo.2020.03.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 12/02/2019] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND In aortic stenosis, accurate measurement of left ventricular stroke volume (SV) is essential for the calculation of aortic valve area (AVA) and the assessment of flow status. Current American Society of Echocardiography and European Association of Cardiovascular Imaging guidelines suggest that measurements of left ventricular outflow tract diameter (LVOTd) at different levels (at the annulus vs 5 or 10 mm below) yield similar measures of SV and AVA. The aim of this study was to assess the effect of the location of LVOTd measurement on the accuracy of SV and AVA measured on transthoracic echocardiography (TTE) compared with cardiovascular magnetic resonance (CMR). METHODS One hundred six patients with aortic stenosis underwent both TTE and CMR. SV was estimated on TTE using the continuity equation with LVOTd measurements at four locations: at the annulus and 2, 5, and 10 mm below annulus. SV was also determined on CMR using phase contrast acquired in the aorta (SVCMR-PC), and a hybrid AVACMR-PC was calculated by dividing SVCMR-PC by the transthoracic echocardiographic Doppler aortic velocity-time integral. Comparison between methods was made using Bland-Altman analysis. RESULTS Compared with the referent method of phase-contrast CMR for the estimation of SVCMR-PC and AVACMR-PC (SVCMR-PC 83 ± 16 mL, AVACMR-PC 1.27 ± 0.35 cm2), the best agreement was obtained by measuring LVOTd at the annulus or 2 mm below (P = NS), whereas measuring 5 and 10 mm below the annulus resulted in significant underestimation of SV and AVA by up to 15.9 ± 17.3 mL and 0.24 ± 0.28 cm2, respectively (P < .01 for all). Accuracy for classification of low flow was best at the annulus (86%) and 2 mm below (82%), whereas measuring 5 and 10 mm below the annulus significantly underperformed (69% and 61%, respectively, P < .001). CONCLUSIONS Measuring LVOTd at the annulus or very close to it provides the most accurate measures of SV and AVA, whereas measuring LVOTd 5 or 10 mm below significantly underestimates these parameters and leads to significant overestimation of the severity of aortic stenosis and prevalence of low-flow status.
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Affiliation(s)
- Ezequiel Guzzetti
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Romain Capoulade
- Institut du Thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
| | - Lionel Tastet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Julio Garcia
- Department of Cardiac Sciences and Radiology, Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, Alberta, Canada; Libin Cardiovascular Institute of Alberta, Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | | | - Marie Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Elisabeth Bédard
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Eric Larose
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada.
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Beaumont C, Walsh-Wilkinson É, Drolet MC, Roussel É, Melançon N, Fortier É, Harpin G, Beaudoin J, Arsenault M, Couet J. Testosterone deficiency reduces cardiac hypertrophy in a rat model of severe volume overload. Physiol Rep 2020; 7:e14088. [PMID: 31054220 PMCID: PMC6499867 DOI: 10.14814/phy2.14088] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/25/2019] [Accepted: 04/13/2019] [Indexed: 12/16/2022] Open
Abstract
The aim of the study was to characterize if the development of cardiac hypertrophy (CH) caused by severe left ventricle (LV) volume overload (VO) from chronic aortic valve regurgitation (AR) in male rats was influenced by androgens. We studied Wistar rats with/without orchiectomy (Ocx) either sham-operated (S) or with severe AR for 26 weeks. Loss of testosterone induced by Ocx decreased general body growth. Cardiac hypertrophy resulting from AR was relatively more important in intact (non-Ocx) animals than in Ocx ones compared to their respective S group (60% vs. 40%; P = 0.019). The intact AR group had more LV dilation, end-diastolic LV diameter being increased by 37% over S group and by 17% in AROcx rats (P < 0.0001). Fractional shortening (an index of systolic function) decreased only by 15% in AROcx compared to 26% for intact AR animals (P = 0.029). Changes in LV gene expression resulting from CH were more marked in intact rats than in AROcx animals, especially for genes linked to extracellular matrix remodeling and energy metabolism. The ratio of hydroxyacyl-Coenzyme A dehydrogenase activity over hexokinase activity, an index of the shift of myocardial substrate use toward glucose from the preferred fatty acids, was significantly decreased in the AR group but not in AROcx. Finally, pJnk2 LV protein content was more abundant in AR than in AROcx rats, indicating decreased activation of this stress pathway in the absence of androgens. In summary, testosterone deficiency in rats with severe LV VO resulted in less CH and a normalization of the LV gene expression profile.
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Affiliation(s)
- Catherine Beaumont
- Groupe de recherche sur les valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Canada
| | - Élisabeth Walsh-Wilkinson
- Groupe de recherche sur les valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Canada
| | - Marie-Claude Drolet
- Groupe de recherche sur les valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Canada
| | - Élise Roussel
- Groupe de recherche sur les valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Canada
| | - Nicolas Melançon
- Groupe de recherche sur les valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Canada
| | - Émile Fortier
- Groupe de recherche sur les valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Canada
| | - Geneviève Harpin
- Groupe de recherche sur les valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Canada
| | - Jonathan Beaudoin
- Groupe de recherche sur les valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Canada
| | - Marie Arsenault
- Groupe de recherche sur les valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Canada
| | - Jacques Couet
- Groupe de recherche sur les valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Canada
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14
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Tastet L, Kwiecinski J, Pibarot P, Capoulade R, Everett RJ, Newby DE, Shen M, Guzzetti E, Arsenault M, Bédard É, Larose É, Beaudoin J, Dweck M, Clavel MA. Sex-Related Differences in the Extent of Myocardial Fibrosis in Patients With Aortic Valve Stenosis. JACC Cardiovasc Imaging 2020; 13:699-711. [PMID: 31422128 DOI: 10.1016/j.jcmg.2019.06.014] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [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: 02/13/2019] [Revised: 06/13/2019] [Accepted: 06/14/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of this study was to assess the effect of sex on myocardial fibrosis as assessed by using cardiac magnetic resonance (CMR) imaging in aortic stenosis (AS). BACKGROUND Previous studies reported sex-related differences in the left ventricular (LV) remodeling response to pressure overload in AS. However, there are very few data regarding the effect of sex on myocardial fibrosis, a key marker of LV decompensation and adverse cardiac events in AS. METHODS A total of 249 patients (mean age 66 ± 13 years; 30% women) with at least mild AS were recruited from 2 prospective observational cohort studies and underwent comprehensive Doppler echocardiography and CMR examinations. On CMR, T1 mapping was used to quantify extracellular volume (ECV) fraction as a marker of diffuse fibrosis, and late gadolinium enhancement (LGE) was used to assess focal fibrosis. RESULTS There was no difference in age between women and men (age 66 ± 15 years vs 66 ± 12 years; p = 0.78). However, women presented with a better cardiovascular risk profile than men with less hypertension, dyslipidemia, diabetes, and coronary artery disease (all, p ≤ 0.10). As expected, LV mass index measured by CMR imaging was smaller in women than in men (p < 0.0001). Despite fewer comorbidities, women presented with larger ECV fraction (median: 29.0% [25th to 75th percentiles: 27.4% to 30.6%] vs. 26.8% [25th to 75th percentiles: 25.1% to 28.7%]; p < 0.0001) and similar LGE (median: 4.5% [25th-75th percentiles: 2.3% to 7.0%] vs. 2.8% [25th-75th percentiles: 0.6% to 6.8%]; p = 0.20) than men. In multivariable analysis, female sex remained an independent determinant of higher ECV fraction and LGE (all, p ≤ 0.05). CONCLUSIONS Women have greater diffuse and focal myocardial fibrosis independent of the degree of AS severity. These findings further emphasize the sex-related differences in LV remodeling response to pressure overload.
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Affiliation(s)
- Lionel Tastet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Jacek Kwiecinski
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Romain Capoulade
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Russell J Everett
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - David E Newby
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Mylène Shen
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Ezequiel Guzzetti
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Marie Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Élisabeth Bédard
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Éric Larose
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Jonathan Beaudoin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada
| | - Marc Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, Québec, Canada.
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15
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Walsh-Wilkinson E, Drolet MC, Arsenault M, Couet J. Sex differences in the evolution of left ventricle remodeling in rats with severe volume overload. BMC Cardiovasc Disord 2020; 20:51. [PMID: 32013884 PMCID: PMC6998357 DOI: 10.1186/s12872-020-01360-0] [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] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background Aortic valve regurgitation (AR) results in left ventricle (LV) volume overload (VO) leading to its dilation and hypertrophy (H). We study a rat model of severe AR induced by puncturing one or two leaflets using a catheter. Most of our studies were conducted in male animals. Recently, we started investigating if sex dimorphism existed in the AR rat model. We observed that AR females developed as much LVH as males but morphological remodeling differences were present. A head-to-head comparison of LV morphological and functional changes had never been performed in AR males (M) and females (F) using the latest modalities in cardiac imaging by echocardiography. Methods We performed a longitudinal study to evaluate the development of LV hypertrophy caused by chronic AR in male and female rats over 6 months. Sham-operated (sham) animals were used as controls. Results LV diastolic volumes (EDV) increased more over 6 months in sham males than in females (38% vs. 23% for EDV, both p < 0.01). AR resulted in significant LV dilation for both sexes (54% vs. 51% increase in EDV) vs. baseline values. Since normal cardiac growth was less in females, dilation from AR was relatively more important for them (88% (M) vs. 157% (F) increase in EDV over sham). AR caused LV wall thickening in both males and females. It happened sooner for AR females and was more important than in males (25% (M) vs. 56% (F) increase in septum thickness at 2 months and 10% (M) vs. 30% (F) at 6 months). We then evaluated if AR was associated with changes in LV strain using speckle-tracking 2D echocardiography. Global longitudinal strain remained similar between AR and sham animals. Circumferential strain was negatively modulated by AR but only in females and early after VO induction (13% (M) vs. 26% (F)). Conclusion AR resulted in more LV dilation and quicker wall thickening in female AR rats compared to males. Global circumferential strain was negatively modulated in AR females but not in males. AR also seemed to lead to a more spherical LV shape in females whereas; it kept mostly an ellipsoid shape in males. This can influence validity of mass estimation of the dilated LV in females by echocardiography.
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Affiliation(s)
- Elisabeth Walsh-Wilkinson
- Groupe de recherche en valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725, Chemin Sainte-Foy, Québec City, G1V 4G5, Canada
| | - Marie-Claude Drolet
- Groupe de recherche en valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725, Chemin Sainte-Foy, Québec City, G1V 4G5, Canada
| | - Marie Arsenault
- Groupe de recherche en valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725, Chemin Sainte-Foy, Québec City, G1V 4G5, Canada
| | - Jacques Couet
- Groupe de recherche en valvulopathies, Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725, Chemin Sainte-Foy, Québec City, G1V 4G5, Canada.
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16
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Walsh-Wilkinson E, Beaumont C, Drolet MC, Roy ÈM, Le Houillier C, Beaudoin J, Arsenault M, Couet J. Effects of the loss of estrogen on the heart's hypertrophic response to chronic left ventricle volume overload in rats. PeerJ 2019; 7:e7924. [PMID: 31656705 PMCID: PMC6812667 DOI: 10.7717/peerj.7924] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 07/09/2019] [Accepted: 09/20/2019] [Indexed: 02/05/2023] Open
Abstract
Aortic valve regurgitation (AR) can result in heart failure from chronic overloading of the left ventricle (LV). Little is known of the role of estrogens in the LV responses to this condition. The aim of the study was to compare LV remodeling in female rats with severe AR in absence of estrogens by ovariectomy (Ovx). In a first study, we investigated over 6 months the development of hypertrophy in four groups of female Wistar rats: AR or sham-operated (sham) and Ovx or not. Ovx reduced normal heart growth. As expected, volume overload (VO) from AR resulted in significant LV dilation (42% and 32% increase LV end-diastolic diameter in intact and Ovx groups vs. their respective sham group; p < 0.0001). LV weight was also significantly and similarly increased in both AR groups (non-Ovx and Ovx). Increase in stroke volume or cardiac output and loss of systolic function were similar between AR intact and AR Ovx groups compared to sham. We then investigated what were the effects of 17beta-estradiol (E2; 0.03 mg/kg/day) treatment on the parameters studied in Ovx rats. Ovx reduced uterus weight by 85% and E2 treatment restored up to 65% of the normal weight. E2 also helped normalize heart size to normal values. On the other hand, it did not influence the extent of the hypertrophic response to AR. In fact, E2 treatment further reduced LV hypertrophy in AR Ovx rats (41% over Sham Ovx + E2). Systolic and diastolic functions parameters in AR Ovx + E2 were similar to intact AR animals. Ovx in sham rats had a significant effect on the LV gene expression of several hypertrophy markers. Atrial natriuretic peptide (Nppa) gene expression was reduced by Ovx in sham-operated females whereas brain natriuretic peptide (Nppb) expression was increased. Alpha (Myh6) and beta (Myh7) myosin heavy chain genes were also significantly modulated by Ovx in sham females. In AR rats, LV expression of both Nppa and Nppb genes were increased as expected. Ovx further increased it of AR rats for Nppa and did the opposite for Nppb. Interestingly, AR in Ovx rats had only minimal effects on Myh6 and Myh7 genes whereas they were modulated as expected for intact AR animals. In summary, loss of estrogens by Ovx in AR rats was not accompanied by a worsening of hypertrophy or cardiac function. Normal cardiac growth was reduced by Ovx in sham females but not the hypertrophic response to AR. On the other hand, Ovx had important effects on LV gene expression both in sham and AR female rats.
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Affiliation(s)
- Elisabeth Walsh-Wilkinson
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Catherine Beaumont
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Marie-Claude Drolet
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Ève-Marie Roy
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Charlie Le Houillier
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Jonathan Beaudoin
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Marie Arsenault
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Jacques Couet
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
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Tastet L, Shen M, Capoulade R, Arsenault M, Bédard É, Clavel M, Pibarot P. BONE MINERAL DENSITY AND PROGRESSION RATE OF CALCIFIC AORTIC VALVE STENOSIS - RESULTS FROM THE PROGRESSA STUDY. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.521] [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: 10/25/2022] Open
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Shen M, Tastet L, Capoulade R, Arsenault M, É Bédard, Clavel M, Pibarot P. HEMODYNAMIC AND ANATOMIC PROGRESSION OF AORTIC STENOSIS IN PATIENTS WITH BICUSPID AND TRICUSPID AORTIC VALVES. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.192] [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: 11/24/2022] Open
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Walsh-Wilkinson É, Drolet MC, Le Houillier C, Roy ÈM, Arsenault M, Couet J. Sex differences in the response to angiotensin II receptor blockade in a rat model of eccentric cardiac hypertrophy. PeerJ 2019; 7:e7461. [PMID: 31404429 PMCID: PMC6686841 DOI: 10.7717/peerj.7461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 04/12/2019] [Accepted: 07/11/2019] [Indexed: 12/11/2022] Open
Abstract
Background. Men and women differ in their susceptibility to cardiovascular disease, though the underlying mechanism has remained elusive. Heart disease symptoms, evolution and response to treatment are often sex-specific. This has been studied in animal models of hypertension or myocardial infarction in the past but has received less attention in the context of heart valve regurgitation. The aim of the study was to evaluate the development of cardiac hypertrophy (CH) in response to left ventricle (LV) volume overload (VO) caused by chronic aortic valve regurgitation (AR) in male and female rats treated or not with angiotensin II receptor blocker (ARB), valsartan. We studied eight groups of Wistar rats: male or female, AR or sham-operated (sham) and treated or not with valsartan (30 mg/kg/day) for 9 weeks starting one week before AR surgical induction. Results. As expected, VO from AR resulted for both male and female rats in significant LV dilation (39% vs. 40% end-diastolic LV diameter increase, respectively; p < 0.0001) and CH (53% vs. 64% heart weight increase, respectively; p < 0.0001) compared to sham. Sex differences were observed in LV wall thickening in response to VO. In untreated AR males, relative LV wall thickness (a ratio of wall thickness to end-diastolic diameter) was reduced compared to sham, whereas this ratio in females remained unchanged. ARB treatment did not prevent LV dilation in both male and female animals but reversed LV wall thickening in females. Systolic and diastolic functions in AR animals were altered similarly for both sexes. ARB treatment did not improve systolic function but helped normalizing diastolic parameters such as left atrial mass and E wave slope in female AR rats. Increased LV gene expression of Anp and Bnp was normalized by ARB treatment in AR females but not in males. Other hypertrophy gene markers (Fos, Trpc6, Klf15, Myh6 and Myh7) were not modulated by ARB treatment. The same was true for genes related to LV extracellular matrix remodeling (Col1a1, Col3a1, Fn1, Mmp2, Timp1 and Lox). In summary, ARB treatment of rats with severe AR blocked the female-specific hypertrophic response characterized by LV chamber wall thickening. LV dilation, on the other hand, was not significantly decreased by ARB treatment. This also indicates that activation of the angiotensin II receptor is probably more involved in the early steps of LV remodeling caused by AR in females than in males.
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Affiliation(s)
- Élisabeth Walsh-Wilkinson
- Université Laval, Groupe de recherche sur les valvulopathies, Centre de recherche, Institut universitaire de cardiologie et de pneumologie de Quebec, Québec, Québec, Canada
| | - Marie-Claude Drolet
- Université Laval, Groupe de recherche sur les valvulopathies, Centre de recherche, Institut universitaire de cardiologie et de pneumologie de Quebec, Québec, Québec, Canada
| | - Charlie Le Houillier
- Université Laval, Groupe de recherche sur les valvulopathies, Centre de recherche, Institut universitaire de cardiologie et de pneumologie de Quebec, Québec, Québec, Canada
| | - Ève-Marie Roy
- Université Laval, Groupe de recherche sur les valvulopathies, Centre de recherche, Institut universitaire de cardiologie et de pneumologie de Quebec, Québec, Québec, Canada
| | - Marie Arsenault
- Université Laval, Groupe de recherche sur les valvulopathies, Centre de recherche, Institut universitaire de cardiologie et de pneumologie de Quebec, Québec, Québec, Canada
| | - Jacques Couet
- Université Laval, Groupe de recherche sur les valvulopathies, Centre de recherche, Institut universitaire de cardiologie et de pneumologie de Quebec, Québec, Québec, Canada
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Tastet L, Tribouilloy C, Maréchaux S, Vollema EM, Delgado V, Salaun E, Shen M, Capoulade R, Clavel MA, Arsenault M, Bédard É, Bernier M, Beaudoin J, Narula J, Lancellotti P, Bax JJ, Généreux P, Pibarot P. Staging Cardiac Damage in Patients With Asymptomatic Aortic Valve Stenosis. J Am Coll Cardiol 2019; 74:550-563. [DOI: 10.1016/j.jacc.2019.04.065] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/11/2019] [Accepted: 04/12/2019] [Indexed: 12/12/2022]
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Pibarot P, Hahn RT, Weissman NJ, Arsenault M, Beaudoin J, Bernier M, Dahou A, Khalique OK, Asch FM, Toubal O, Leipsic J, Blanke P, Zhang F, Parvataneni R, Alu M, Herrmann H, Makkar R, Mack M, Smalling R, Leon M, Thourani VH, Kodali S. Association of Paravalvular Regurgitation With 1-Year Outcomes After Transcatheter Aortic Valve Replacement With the SAPIEN 3 Valve. JAMA Cardiol 2019; 2:1208-1216. [PMID: 28973091 DOI: 10.1001/jamacardio.2017.3425] [Citation(s) in RCA: 142] [Impact Index Per Article: 28.4] [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] [Indexed: 11/14/2022]
Abstract
Importance Moderate/severe and even mild paravalvular regurgitation (PVR) are associated with increased mortality following transcatheter aortic valve replacement (TAVR) with first and second generations of transcatheter valves. Objective To examine the incidence, evolution, and effect on 1-year outcomes of PVR following TAVR with a third-generation balloon-expandable transcatheter heart valve. Design, Setting, and Participants Prespecified analysis of PVR in the Placement of Aortic Transcatheter Valves (PARTNER) II SAPIEN 3 trial, conducted between October 1, 2013, and September 3, 2014. Multicenter, nonrandomized registry of 1661 patients at intermediate or high surgical risk undergoing TAVR with the SAPIEN 3. Patients with severe, symptomatic aortic stenosis and high/intermediate surgical risk were enrolled in the registry at 51 sites in the United States and Canada. Interventions Transcatheter aortic valve replacement with the SAPIEN 3 valve. Main Outcomes and Measures Paravalvular regurgitation was assessed in a core laboratory at 30 days and 1 year according to a 5-class scheme: 0, none or trace; 1, mild; 2, mild to moderate; 3, moderate; 4, moderate to severe; and 5, severe. We assessed the effect of PVR on 1-year mortality and heart failure rehospitalization. Results Among the 1661 included in the registry, 1592 received a SAPIEN 3 valve and had assessment of PVR. Of these patients, 55.7% had none-trace PVR, 32.6% had mild, 8.2% had mild to moderate, and 3.5% had at least moderate PVR at 30 days. At 1 year, 9.3% of patients had died and 14.2% had been rehospitalized. Only patients with at least moderate PVR had higher 1-year mortality (hazard ratio [HR], 2.40; 95% CI, 1.30-4.43; P = .005) and composite of mortality/rehospitalization (HR, 2.35; 95% CI, 1.52-3.62; P < .001). In a paired comparison including 1213 patients, 73% of the patients with at least moderate PVR at 30 days showed a reduction in PVR severity of at least 1 PVR class at 1 year. Conclusions and Relevance In this series of patients undergoing TAVR with the SAPIEN 3 valve, at least moderate PVR was rare but associated with increased risk of death and heart failure rehospitalization at 1 year. Even the upper range of the mild class in the 3-class grading scheme (ie, mild to moderate in the 5-class scheme) had no significant effect on short-term mortality or rehospitalization. Most patients with at least moderate PVR at 30 days showed a decrease of PVR severity grade at 1 year. Trial Registration clinicaltrials.gov Identifier: NCT01314313.
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Affiliation(s)
- Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Department of Medicine, Laval University, Québec, Canada
| | - Rebecca T Hahn
- Columbia University Medical Center/New York Presbyterian Hospital, New York, New York
| | - Neil J Weissman
- MedStar Health Research Institute and Georgetown University, Washington, DC
| | - Marie Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Department of Medicine, Laval University, Québec, Canada
| | - Jonathan Beaudoin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Department of Medicine, Laval University, Québec, Canada
| | - Mathieu Bernier
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Department of Medicine, Laval University, Québec, Canada
| | - Abdellaziz Dahou
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Department of Medicine, Laval University, Québec, Canada
| | - Omar K Khalique
- Columbia University Medical Center/New York Presbyterian Hospital, New York, New York
| | - Federico M Asch
- MedStar Health Research Institute and Georgetown University, Washington, DC
| | - Oumhani Toubal
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Department of Medicine, Laval University, Québec, Canada
| | | | - Philipp Blanke
- St Paul Hospital, Vancouver, British Columbia, Vancouver
| | - Feifan Zhang
- Cardiovascular Research Foundation, New York, New York
| | | | - Maria Alu
- Cardiovascular Research Foundation, New York, New York
| | | | - Raj Makkar
- Raj Makkar, Cedars-Sinai Medical center, Los Angeles, California
| | - Michael Mack
- Department of Cardiovascular Surgery, Baylor Scott and White Health, Plano, Texas
| | | | - Martin Leon
- Columbia University Medical Center/New York Presbyterian Hospital, New York, New York
| | | | - Susheel Kodali
- Columbia University Medical Center/New York Presbyterian Hospital, New York, New York
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Shen M, Capoulade R, Tastet L, Guzzetti E, Clavel MA, Salaun E, Bédard É, Arsenault M, Chetaille P, Tizón-Marcos H, Le Ven F, Pibarot P, Larose É. Prevalence of left ventricle non-compaction criteria in adult patients with bicuspid aortic valve versus healthy control subjects. Open Heart 2018; 5:e000869. [PMID: 30364562 PMCID: PMC6196966 DOI: 10.1136/openhrt-2018-000869] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/08/2018] [Accepted: 08/14/2018] [Indexed: 01/17/2023] Open
Abstract
Objective The aim of this study was to compare the prevalence of left ventricle non-compaction (LVNC) criteria (or hypertrabeculation) in a cohort of patients with bicuspid aortic valve (BAV) and healthy control subjects (CTL) without cardiovascular disease using cardiovascular MR (CMR). Methods 79 patients with BAV and 85 CTL with tricuspid aortic valve and free of known cardiovascular disease underwent CMR to evaluate the presence of LVNC criteria. The left ventricle was assessed at end-systole and end-diastole, in the short-axis, two-chamber and four-chamber views and divided into the 16 standardised myocardial segments. LVNC was assessed using the non-compacted/compacted (NC/C) myocardium ratio and was considered to be present if at least one of the myocardial segments had a NC/C ratio superior to the cut-off values defined in previous studies: Jenni et al (>2.0 end-systole); Petersen et al (>2.3 end-diastole); or Fazio et al (>2.5 end-diastole). Results 15 CTL (17.6%) vs 8 BAV (10.1%) fulfilled Jenni et al’s criterion; 69 CTL (81.2%) vs 49 BAV (62.0%) fulfilled Petersen et al’s criterion; and 66 CTL (77.6%) vs 43 BAV (54.4%) fulfilled Fazio et al’s criterion. Petersen et al and Fazio et al’s LVNC criteria were met more often by CTL (p=0.006 and p=0.002, respectively) than patients with BAV, whereas this difference was not statistically significant according to Jenni et al’s criterion (p=0.17). In multivariable analyses, after adjusting for age, sex, the presence of significant valve dysfunction (>mild stenosis or >mild regurgitation), indexed LV mass, indexed LV end-diastolic volume and LV ejection fraction, BAV was not associated with any of the three LVNC criteria. Conclusion Patients with BAV do not harbour more LVNC than the general population and there is no evidence that they are at higher risk for the development of LVNC cardiomyopathy.
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Affiliation(s)
- Mylène Shen
- Institut Universitaire de Cardiologie et de Pneumologie de Québec / Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Romain Capoulade
- Institut Universitaire de Cardiologie et de Pneumologie de Québec / Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Lionel Tastet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec / Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Ezequiel Guzzetti
- Institut Universitaire de Cardiologie et de Pneumologie de Québec / Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec / Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Erwan Salaun
- Institut Universitaire de Cardiologie et de Pneumologie de Québec / Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Élisabeth Bédard
- Institut Universitaire de Cardiologie et de Pneumologie de Québec / Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Marie Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec / Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Philippe Chetaille
- Department of Pediatrics, Centre Mère Enfants Soleil, Centre Hospitalier Universitaire de Québec, Laval University, Quebec City, Quebec, Canada
| | - Helena Tizón-Marcos
- Institut Universitaire de Cardiologie et de Pneumologie de Québec / Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Florent Le Ven
- Institut Universitaire de Cardiologie et de Pneumologie de Québec / Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec / Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Éric Larose
- Institut Universitaire de Cardiologie et de Pneumologie de Québec / Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
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Walsh-Wilkinson É, Beaumont C, Drolet M, Roussel É, Melançon N, Beaudoin J, Arsenault M, Couet J. SEXUAL DIMORPHISM IN THE HEART HYPERTROPHIC RESPONSE TO CHRONIC LEFT VENTRICLE VOLUME OVERLOAD: IMPORTANCE OF ANDROGENS. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.266] [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: 11/28/2022] Open
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24
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Shen M, Tastet L, Capoulade R, Arsenault M, Bédard É, Pibarot P, Clavel M. IMPACT OF THE RENIN-ANGIOTENSIN SYSTEM ACTIVATION ON THE PROGRESSION RATE OF AORTIC STENOSIS. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.164] [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: 10/28/2022] Open
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Bernard J, Tastet L, Capoulade R, Shen M, Bédard R, Guzzetti E, Clisson M, Côté N, Arsenault M, Bédard É, Pibarot P, Clavel M. DETERMINANTS AND IMPACT OF LEFT VENTRICULAR ASYMMETRIC REMODELING ON LEFT VENTRICULAR FUNCTION IN PATIENTS WITH AORTIC STENOSIS - RESULTS FROM THE PROGRESSA STUDY. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.191] [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: 11/25/2022] Open
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26
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Tastet L, Kwiecinski J, Pibarot P, Capoulade R, Everett R, Newby D, Shen M, Guzzetti E, Arsenault M, Bédard É, Larose É, Beaudoin J, Dweck M, Clavel M. SEX-RELATED DIFFERENCES IN THE EXTENT OF MYOCARDIAL FIBROSIS IN PATIENTS WITH AORTIC VALVE STENOSIS. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.315] [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: 11/29/2022] Open
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Roussel E, Drolet MC, Lavigne AM, Arsenault M, Couet J. Multiple short-chain dehydrogenases/reductases are regulated in pathological cardiac hypertrophy. FEBS Open Bio 2018; 8:1624-1635. [PMID: 30338214 PMCID: PMC6168690 DOI: 10.1002/2211-5463.12506] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 03/13/2018] [Revised: 07/04/2018] [Accepted: 07/23/2018] [Indexed: 12/18/2022] Open
Abstract
Cardiac hypertrophy (CH) is an important and independent predictor of morbidity and mortality. Through expression profiling, we recently identified a subset of genes (Dhrs7c, Decr, Dhrs11, Dhrs4, Hsd11b1, Hsd17b10, Hsd17b8, Blvrb, Pecr), all of which are members of the short‐chain dehydrogenase/reductase (SDR) superfamily and are highly expressed in the heart, that were significantly dysregulated in a rat model of CH caused by severe aortic valve regurgitation (AR). Here, we studied their expression in various models of CH, as well as factors influencing their regulation. Among the nine SDR genes studied, all but Hsd11b1 were down‐regulated in CH models (AR rats or mice infused with either isoproterenol or angiotensin II). This regulation showed a clear sex dimorphism, being more evident in males than in females irrespective of CH levels. In neonatal rat cardiomyocytes, we observed that treatment with the α1‐adrenergic receptor agonist phenylephrine mostly reproduced the observations made in CH animals models. Retinoic acid, on the other hand, stimulated the expression of most of the SDR genes studied, suggesting that their expression may be related to cardiomyocyte differentiation. Indeed, levels of expression were found to be higher in the hearts of adult animals than in neonatal cardiomyocytes. In conclusion, we identified a group of genes modulated in animal models of CH and mostly in males. This could be related to the activation of the fetal gene expression program in pathological CH situations, in which these highly expressed genes are down‐regulated in the adult heart.
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Affiliation(s)
- Elise Roussel
- Groupe de recherche sur les valvulopathies Centre de Recherche Institut universitaire de cardiologie et de pneumologie de Québec Université Laval Quebec City Canada
| | - Marie-Claude Drolet
- Groupe de recherche sur les valvulopathies Centre de Recherche Institut universitaire de cardiologie et de pneumologie de Québec Université Laval Quebec City Canada
| | - Anne-Marie Lavigne
- Groupe de recherche sur les valvulopathies Centre de Recherche Institut universitaire de cardiologie et de pneumologie de Québec Université Laval Quebec City Canada
| | - Marie Arsenault
- Groupe de recherche sur les valvulopathies Centre de Recherche Institut universitaire de cardiologie et de pneumologie de Québec Université Laval Quebec City Canada
| | - Jacques Couet
- Groupe de recherche sur les valvulopathies Centre de Recherche Institut universitaire de cardiologie et de pneumologie de Québec Université Laval Quebec City Canada
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Capoulade R, Clavel MA, Le Ven F, Dahou A, Thébault C, Tastet L, Shen M, Arsenault M, Bédard É, Beaudoin J, O'Connor K, Bernier M, Dumesnil JG, Pibarot P. Impact of left ventricular remodelling patterns on outcomes in patients with aortic stenosis. Eur Heart J Cardiovasc Imaging 2018; 18:1378-1387. [PMID: 28064154 DOI: 10.1093/ehjci/jew288] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [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: 06/22/2016] [Accepted: 11/04/2016] [Indexed: 11/12/2022] Open
Abstract
Aims The objective of this study was to examine the association between the different patterns of left ventricular (LV) remodelling/hypertrophy on all-cause and cardiovascular mortality in patients with aortic stenosis (AS). Methods and results In total, 747 consecutive patients (69 ± 14 years, 57% men) with AS and preserved LV ejection fraction were included in this study. According to LV mass index and relative wall thickness, patients were classified into four LV patterns: normal, concentric remodelling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). One hundred and sixteen patients (15%) had normal pattern, 66 (9%) had EH, 169 (23%) had CR, and 396 (53%) had CH. During a median follow-up of 6.4 years, 339 patients died (242 from cardiovascular causes). CH was associated with higher risk of all-cause mortality compared with the three other LV patterns (all P < 0.05). After multivariable adjustment, CH remained associated with higher risk of mortality (HR = 1.27, 95% CI 1.01-1.61, P = 0.046). There was a significant interaction (P < 0.05) between sex and CH with regards to the impact on mortality: CH was associated with worse outcome in women (P = 0.0001) but not in men (P = 0.22). In multivariable analysis, CH remained associated with higher risk of worse outcome in women (HR = 1.56, 95% CI 1.08-2.24, P = 0.018). Conclusions This study shows that CH was independently associated with increased risk of mortality in AS patients with preserved ejection fraction. This association was observed in women but not in men. The pattern of LV remodelling/hypertrophy should be integrated in the risk stratification process in patients with AS.
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Affiliation(s)
- Romain Capoulade
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Florent Le Ven
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Abdellaziz Dahou
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Christophe Thébault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Lionel Tastet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Mylène Shen
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Marie Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Élisabeth Bédard
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Jonathan Beaudoin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Kim O'Connor
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Mathieu Bernier
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Jean G Dumesnil
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec City, QC, Canada G1V-4G5
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Tastet L, Capoulade R, Shen M, Clavel MA, Côté N, Mathieu P, Arsenault M, Bédard É, Tremblay A, Samson M, Bossé Y, Dumesnil JG, Arsenault BJ, Beaudoin J, Bernier M, Després JP, Pibarot P. ApoB/ApoA-I Ratio is Associated With Faster Hemodynamic Progression of Aortic Stenosis: Results From the PROGRESSA (Metabolic Determinants of the Progression of Aortic Stenosis) Study. J Am Heart Assoc 2018; 7:JAHA.117.007980. [PMID: 29440006 PMCID: PMC5850203 DOI: 10.1161/jaha.117.007980] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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] [Indexed: 01/25/2023]
Abstract
BACKGROUND Previous studies reported that middle-aged patients with atherogenic lipoprotein-lipid profile exhibit faster progression of aortic valve stenosis (AS). The ratio of apolipoprotein B/apolipoprotein A-I (apoB/apoA-I) reflects the balance between atherogenic and anti-atherogenic lipoproteins. The aim of this study was to examine the association between apoB/apoA-I ratio and AS hemodynamic progression and to determine whether this association varies according to age. METHODS AND RESULTS A total of 159 patients (66±13 years, 73% men) with AS were prospectively recruited in the PROGRESSA (Metabolic Determinants of the Progression of Aortic Stenosis) study. Hemodynamic progression of AS was determined by the change in peak aortic jet velocity (Vpeak) measured by Doppler-echocardiography between baseline and 2-year follow-up. Patients in the top tertile of apoB/apoA-I ratio (≥0.62) had a faster progression rate of AS compared with those in the bottom/mid tertiles (Vpeak progression: 0.30 [0.09-0.49] versus 0.16 [0.01-0.36] m/s, P=0.02). There was a significant interaction (P=0.007) between apoB/apoA-I ratio and age. Among younger patients (ie, aged <70 years; median value of the cohort), those in the top tertile of apoB/apoA-I ratio had a 3.4-fold faster AS progression compared with those in the bottom/mid tertiles (Vpeak progression: 0.34 [0.13-0.69] versus 0.10 [-0.03-0.31] m/s, P=0.002), whereas there was no significant difference between tertiles in the subgroup of older patients (P=0.83). After comprehensive adjustment, higher apoB/apoA-I ratio was significantly associated with faster AS progression in the subset of younger patients (all, standardized β≥0.36; P≤0.01). CONCLUSIONS Higher apoB/apoA-I ratio is significantly associated with faster hemodynamic progression of AS in the younger patients. These findings suggest that atherogenic lipid factors may play a crucial role in the pathogenesis of AS in younger patients, but may be are less important in older patients. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01679431.
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Affiliation(s)
- Lionel Tastet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Romain Capoulade
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Mylène Shen
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Nancy Côté
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Patrick Mathieu
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Marie Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Élisabeth Bédard
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Alexe Tremblay
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Marilie Samson
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Yohan Bossé
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Jean G Dumesnil
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Benoit J Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Jonathan Beaudoin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Mathieu Bernier
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Jean-Pierre Després
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Laval University, Québec City, QC, Canada
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Dupuis M, Mahjoub H, Clavel MA, Côté N, Toubal O, Tastet L, Dumesnil JG, O'Connor K, Dahou A, Thébault C, Bélanger C, Beaudoin J, Arsenault M, Bernier M, Pibarot P. Forward Left Ventricular Ejection Fraction: A Simple Risk Marker in Patients With Primary Mitral Regurgitation. J Am Heart Assoc 2017; 6:JAHA.117.006309. [PMID: 29079561 PMCID: PMC5721745 DOI: 10.1161/jaha.117.006309] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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] [Indexed: 01/08/2023]
Abstract
Background The timing of mitral valve surgery in asymptomatic patients with primary mitral regurgitation (MR) is controversial. We hypothesized that the forward left ventricular (LV) ejection fraction (LVEF; ie, LV outflow tract stroke volume divided by LV end‐diastolic volume) is superior to the total LVEF to predict outcomes in MR. The objective of this study was to examine the association between echocardiographic parameters of MR severity and LV function and outcomes in patients with MR. Methods and Results The clinical and Doppler‐echocardiographic data of 278 patients with ≥mild MR and no class I indication of mitral valve surgery at baseline were retrospectively analyzed. The primary study end point was the composite of mitral valve surgery or death. During a mean follow‐up of 5.4±3.2 years, there were 147 (53%) events: 96 (35%) MV surgeries and 66 (24%) deaths. Total LVEF and global longitudinal strain were not associated with the occurrence of events, whereas forward LVEF (P<0.0001) and LV end‐systolic diameter (P=0.0003) were. After adjustment for age, sex, MR severity, Charlson probability, coronary artery disease, and atrial fibrillation, forward LVEF remained independently associated with the occurrence of events (adjusted hazard ratio: 1.09, [95% confidence interval]: 1.02–1.17 per 5% decrease; P=0.01), whereas LV end‐systolic diameter was not (P=0.48). Conclusions The results of this study suggest that the forward LVEF may be superior to the total LVEF and LV end‐systolic diameter to predict outcomes in patients with primary MR. This simple and easily measurable parameter may be useful to improve risk stratification and select the best timing for intervention in patients with primary MR.
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Affiliation(s)
- Marlène Dupuis
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Haïfa Mahjoub
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Nancy Côté
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Oumhani Toubal
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Lionel Tastet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Jean G Dumesnil
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Kim O'Connor
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Abdellaziz Dahou
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Christophe Thébault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Catherine Bélanger
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Jonathan Beaudoin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Marie Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Mathieu Bernier
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute Laval University, Québec City, Québec, Canada
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Tastet L, Capoulade R, Shen M, Clisson M, Arsenault M, Bédard E, Larose E, Pibarot P, Clavel M. RELATIONSHIP BETWEEN PROGRESSION OF AORTIC VALVE CALCIFICATION AND HEMODYNAMIC SEVERITY OF AORTIC STENOSIS: RESULTS FROM THE PROGRESSA STUDY. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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André P, Nadeau-Routhier C, Champagne J, Philippon F, Sarrazin J, Nault I, O’Hara G, Blier L, Molin F, Plourde B, Roy K, Larose E, Arsenault M, Steinberg C. VENTRICULAR ARRHYTHMIA IN APICAL AND SEPTAL HYPERTROPHIC CARDIOMYOPATHY: THE FRENCH-CANADIAN EXPERIENCE. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Bouchard M, Marsit O, Clavel M, Clisson M, Drolet M, Arsenault M, Couet J, Boulanger M, Mathieu P, Pibarot P, Beaudoin J. USE OF CARDIAC MAGNETIC RESONANCE TO IDENTIFY MITRAL VALVE FIBROTIC CHANGES AFTER MYOCARDIAL INFARCTION: VALIDATION IN A LARGE ANIMAL MODEL. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.378] [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: 11/16/2022] Open
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Marsit O, Royer O, Drolet MC, Arsenault M, Couet J, Morin S, Levine RA, Pibarot P, Beaudoin J. Early Activation of Growth Pathways in Mitral Leaflets Exposed to Aortic Regurgitation: New Insights from an Animal Model. J Heart Valve Dis 2017; 26:281-289. [PMID: 29092112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND AIM OF THE STUDY Mitral leaflet enlargement in patients with chronic aortic regurgitation (AR) has been identified as an adaptive mechanism potentially able to prevent functional mitral regurgitation (FMR) in response to left ventricular (LV) dilatation. The timing of valve enlargement is not known, and the related mechanisms are largely unexplored. METHODS AR was induced in 58 rats, and another 54 were used as sham controls. Animals were euthanized at different time points after AR creation (48 h, one week, and three months), and AR severity, FMR and LV dilatation were assessed using echocardiography. Mitral valves were harvested to document the reactivation of embryonic growth pathways. RESULTS AR animals had increased LV dimensions and mitral annulus size. No animal developed FMR. No change in leaflet length or thickness was seen at 48 h; however, anterior mitral leaflets were longer and thicker in AR animals at one week and three months. Molecular changes were present early (at 48 h and at one week), with positive staining for transforming growth factor-b1 (TGF-b1), Alpha-smooth muscle actin (α-SMA) and matrix metalloproteinase-2 (MMP-2), which suggested active matrix remodeling. Increased gene expression for collagen 1, TGF-β1, α-SMA and MMP-2 was found in the mitral valve at 48 h and at one week, but after three months their expression had returned to normal. CONCLUSIONS This model of AR induces active expansion and thickening of the mitral leaflets. Growth signals are expressed acutely, but not at three months, which suggests that most of this enlargement occurs at an early stage. The stimulation of valvular growth could represent a new strategy for the prevention of FMR.
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Affiliation(s)
- Ons Marsit
- Groupe de Recherche en Valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Olivier Royer
- Groupe de Recherche en Valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Marie-Claude Drolet
- Groupe de Recherche en Valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Marie Arsenault
- Groupe de Recherche en Valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Jacques Couet
- Groupe de Recherche en Valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Stéphane Morin
- Groupe de Recherche en Valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Robert A Levine
- Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Philippe Pibarot
- Groupe de Recherche en Valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Jonathan Beaudoin
- Groupe de Recherche en Valvulopathies, Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada. Electronic correspondence:
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Tastet L, Enriquez-Sarano M, Capoulade R, Malouf J, Araoz PA, Shen M, Michelena HI, Larose É, Arsenault M, Bédard É, Pibarot P, Clavel MA. Impact of Aortic Valve Calcification and Sex on Hemodynamic Progression and Clinical Outcomes in AS. J Am Coll Cardiol 2017; 69:2096-2098. [DOI: 10.1016/j.jacc.2017.02.037] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 02/06/2017] [Accepted: 02/08/2017] [Indexed: 01/08/2023]
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Tastet LL, Enriquez-Sarano M, Capoulade R, Maalouf Y, Araoz P, Simard L, Shen M, Michelena H, Larose E, Arsenault M, Bédard É, Miller J, Pibarot P, Clavel MA. IMPACT OF AORTIC VALVE CALCIFICATION AND SEX ON HEMODYNAMIC PROGRESSION AND CLINICAL OUTCOMES IN AORTIC STENOSIS. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)35318-4] [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: 10/20/2022]
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Leclerc J, Arsenault M, Després JP, Brassard P, Gaudreault V, Bergeron J, Alméras N, Tremblay A, Auclair A, Ross MK, Denault-Bissonnette S, Poirier P. Determinants of Improvement In Left Ventricular Diastolic Function Following a 1-Year Lifestyle Modification Program in Abdominally Obese Men with Features of the Metabolic Syndrome. Metab Syndr Relat Disord 2016; 14:483-491. [PMID: 27754772 DOI: 10.1089/met.2016.0021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 12/13/2022] Open
Abstract
BACKGROUND Abdominal obesity and presence of the metabolic syndrome (MetS) are associated with cardiac abnormalities. Among those, left ventricular diastolic dysfunction (LVDD) is the most frequently encountered in clinical practice. Few studies evaluated the reversibility of LVDD by an approach promoting lifestyle modifications in abdominally obese subjects with MetS. METHODS We assessed the impact of a 1-year lifestyle modification program combining nutritional and physical activity counseling on LVDD and metabolic profile of abdominally obese men with MetS. Echocardiograms, oral glucose tolerance test, lipids profile, dual energy X-ray absorptiometry, computed tomography scans (visceral obesity assessment), heart rate variability (HRV), as well as maximal and submaximal exercise tests were performed in participants before and after a 1-year program combining healthy eating and a physical activity/exercise program. RESULTS Fifty-one abdominally obese men participated in this study. At baseline, 86% of the participants had LVDD (n = 44). After the 1-year program, LVDD improved in 57% of participants (n = 29, P < 0.0001). All metabolic, adiposity, and exercise tolerance measures improved from baseline (P < 0.0001), but were not associated with improvement in LVDD. Participants who improved LVDD had better exercise performance at baseline. Exercise tolerance during the submaximal exercise test, parasympathetic cardiac autonomic activity, and fasting insulin predicted 50% of LVDD improvements. CONCLUSIONS There was a significant improvement in LVDD after a 1-year lifestyle intervention program in abdominally obese men with MetS, such an improvement being associated with increased exercise tolerance, enhanced HRV, and reduced insulin levels.
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Affiliation(s)
- Jacinthe Leclerc
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,2 Faculté de Pharmacie, Université Laval , Québec, Canada
| | - Marie Arsenault
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,3 Faculté de médecine, Université Laval , Québec, Canada
| | - Jean-Pierre Després
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,4 Département de kinésiologie, Faculté de médecine, Université Laval , Québec, Canada
| | - Patrice Brassard
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,4 Département de kinésiologie, Faculté de médecine, Université Laval , Québec, Canada
| | - Valérie Gaudreault
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,2 Faculté de Pharmacie, Université Laval , Québec, Canada
| | - Jean Bergeron
- 3 Faculté de médecine, Université Laval , Québec, Canada .,5 Centre Hospitalier Universitaire de Québec-Université Laval , Québec, Canada
| | - Natalie Alméras
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,3 Faculté de médecine, Université Laval , Québec, Canada
| | - Angelo Tremblay
- 4 Département de kinésiologie, Faculté de médecine, Université Laval , Québec, Canada
| | - Audrey Auclair
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,2 Faculté de Pharmacie, Université Laval , Québec, Canada
| | - Marie-Kristelle Ross
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,3 Faculté de médecine, Université Laval , Québec, Canada .,6 Centre Hospitalier de Lévis , Québec, Québec, Canada
| | - Stéphanie Denault-Bissonnette
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,3 Faculté de médecine, Université Laval , Québec, Canada .,5 Centre Hospitalier Universitaire de Québec-Université Laval , Québec, Canada
| | - Paul Poirier
- 1 Centre de recherche , Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada .,2 Faculté de Pharmacie, Université Laval , Québec, Canada
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Shen M, Capoulade R, Tastet L, Clavel M, Bédard É, Arsenault M, Chetaille P, Tizon-Marcos H, Le Ven F, Pibarot P, Larose E. LEFT VENTRICLE NON-COMPACTION IN PATIENTS WITH A BICUSPID AORTIC VALVE. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.228] [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: 10/20/2022] Open
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Tastet L, Capoulade R, Shen M, Clavel M, Côté N, Mathieu P, Arsenault M, Bédard É, Beaudoin J, Bernier M, Dumesnil J, Després J, Pibarot P. HIGHER APOLIPOPROTEIN B / APOLIPOPROTEIN A-I RATIO IS ASSOCIATED WITH FASTER HEMODYNAMIC PROGRESSION OF AORTIC STENOSIS IN YOUNGER PATIENTS - RESULTS FROM THE PROGRESSA STUDY-. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.402] [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: 11/28/2022] Open
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Marlene D, Pibarot P, Clavel M, Mahjoub H, Toubal O, Tastet L, Dahou A, Dumesnil J, O'Connor K, Bernier M, Thebault C, Beaudoin J, Côté N, Arsenault M. FORWARD EJECTION FRACTION TO IMPROVE RISK STRATIFICATION IN PATIENTS WITH PRIMARY MITRAL REGURGITATION. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.432] [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: 10/20/2022] Open
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Tastet L, Pibarot P, Capoulade R, Maalouf J, Araoz P, Simard L, Shen M, Michelena H, Larose É, Arsenault M, Bédard É, Sarano M, Clavel M. RELATIONSHIP BETWEEN AORTIC VALVE CALCIFICATION AND HEMODYNAMIC PROGRESSION OF AORTIC STENOSIS: RESULTS FROM AN INTERNATIONAL REGISTRY STUDY. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.404] [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: 10/20/2022] Open
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Shen M, Tastet L, Capoulade R, Larose É, Bédard É, Arsenault M, Chetaille P, Dumesnil JG, Mathieu P, Clavel MA, Pibarot P. Effect of age and aortic valve anatomy on calcification and haemodynamic severity of aortic stenosis. Heart 2016; 103:32-39. [DOI: 10.1136/heartjnl-2016-309665] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/21/2016] [Accepted: 07/13/2016] [Indexed: 11/03/2022] Open
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Capoulade R, Le Ven F, Clavel MA, Dumesnil JG, Dahou A, Thébault C, Arsenault M, O'Connor K, Bédard É, Beaudoin J, Sénéchal M, Bernier M, Pibarot P. Echocardiographic predictors of outcomes in adults with aortic stenosis. Heart 2016; 102:934-42. [DOI: 10.1136/heartjnl-2015-308742] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 02/25/2016] [Indexed: 11/04/2022] Open
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Marsit O, Royer O, Drolet MC, Arsenault M, Couet J, Beaudoin J. EARLY ACTIVATION OF GROWTH PATHWAYS IN MITRAL LEAFLETS EXPOSED TO AORTIC REGURGITATION: ACTIVE MECHANISM TO PREVENT FUNCTIONAL MITRAL REGURGITATION IN THE DILATED VENTRICLE. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)32188-x] [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: 10/22/2022]
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Tastet L, Capoulade R, Clavel MA, Larose É, Shen M, Dahou A, Arsenault M, Mathieu P, Bédard É, Dumesnil JG, Tremblay A, Bossé Y, Després JP, Pibarot P. Systolic hypertension and progression of aortic valve calcification in patients with aortic stenosis: results from the PROGRESSA study. Eur Heart J Cardiovasc Imaging 2016; 18:70-78. [PMID: 26896413 DOI: 10.1093/ehjci/jew013] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [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: 12/29/2015] [Accepted: 01/14/2016] [Indexed: 01/12/2023] Open
Abstract
AIMS Hypertension is highly prevalent in patients with aortic stenosis (AS) and is associated with worse outcomes. The current prospective study assessed the impact of systolic hypertension (SHPT) on the progression of aortic valve calcification (AVC) measured by multidetector computed tomography (MDCT) in patients with AS. METHODS AND RESULTS The present analysis includes the first series of 101 patients with AS prospectively recruited in the PROGRESSA study. Patients underwent comprehensive Doppler echocardiography and MDCT exams at baseline and after 2-year follow-up. AVC and coronary artery calcification (CAC) were measured using the Agatston method. Patients with SHPT at baseline (i.e. systolic blood pressure ≥140 mmHg; n = 37, 37%) had faster 2-year AVC progression compared with those without SHPT (i.e. systolic blood pressure <140 mmHg) (AVC median [25th percentile-75th percentile]: +370 [126-824] vs. +157 [58-303] AU; P = 0.007, respectively). Similar results were obtained with the analysis of AVC progression divided by the cross-sectional area of the aortic annulus (AVCdensity: +96 [34-218] vs. +45 [14-82] AU/cm2, P = 0.01, respectively). In multivariable analysis, SHPT remained significantly associated with faster progression of AVC or AVCdensity (all P = 0.001). There was no significant difference between groups with respect to progression of CAC (+39 [3-199] vs. +41 [0-156] AU, P = 0.88). CONCLUSION This prospective study shows for the first time that SHPT is associated with faster AVC progression but not with CAC progression in AS patients. These findings provide further support for the elaboration of randomized clinical trials to assess the efficacy of antihypertensive medication to slow the stenosis progression in patients with AS.
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Affiliation(s)
- Lionel Tastet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
| | - Romain Capoulade
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
| | - Éric Larose
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
| | - Mylène Shen
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
| | - Abdellaziz Dahou
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
| | - Marie Arsenault
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
| | - Patrick Mathieu
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
| | - Élisabeth Bédard
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
| | - Jean G Dumesnil
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
| | - Alexe Tremblay
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
| | - Yohan Bossé
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
| | - Jean-Pierre Després
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart and Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Québec city, Québec, Canada G1V-4G5
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Tastet L, Capoulade R, Larose E, Dumesnil J, Shen M, Dahou A, Arsenault M, Bédard E, Després J, Mathieu P, Clavel M, Pibarot P. SYSTOLIC HYPERTENSION AND PROGRESSION OF AORTIC VALVE CALCIFICATION IN PATIENTS WITH AORTIC STENOSIS - RESULTS FROM THE PROGRESSA STUDY. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.154] [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: 11/28/2022] Open
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Drolet MC, Desbiens-Brassard V, Roussel E, Tu V, Couet J, Arsenault M. Blockade of the acute activation of mTOR complex 1 decreases hypertrophy development in rats with severe aortic valve regurgitation. Springerplus 2015; 4:435. [PMID: 26306297 PMCID: PMC4542859 DOI: 10.1186/s40064-015-1230-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/10/2015] [Indexed: 01/19/2023]
Abstract
Background Hypertrophy (H) is an adaptive response of the heart to a hemodynamic overload. Severe left ventricular (LV) volume overload (VO) from valve regurgitations (aortic (AR) or mitral regurgitation) leads to eccentric LVH. Increased protein turnover is a major event during development of LVH and the mechanistic target of rapamycin (mTOR) is a key molecule for its control. The role of mTOR inhibition in the development of LVH using rapamycin for relatively short periods of time (days to a few weeks) has been studied in the past in pressure overload models but not in VO models. We investigated if mTOR pathway was activated during LVH development in a model of severe VO (AR) in rats and if a rapamycin treatment can slow heart remodeling in this situation. Methods and Results Male rats with severe AR were studied acutely at 2 days, at 8 weeks (compensated phase) and 6 months (late phase) after VO induction. mTOR complex (mTORC) 1 (ribosomal S6 protein phosphorylation) was activated early after AR induction but not later in the disease whereas mTORC2 activity levels (Akt phosphorylation at Ser473) remained stable. We observed that a moderate dose of rapamycin (2 mg/kg/day; orally) for 8 weeks prevented severe LVH caused by AR (−46 %: p < 0.001). Rapamycin treatment specifically inhibited LV mTORC1 without altering mTORC2 activity at 8 weeks. Rapamycin also prevented cardiac myocyte hypertrophy caused by AR. Conclusion Rapamycin slows hypertrophy in LV VO by inhibiting early activation of mTORC1 without modulating mTORC2.
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Affiliation(s)
- Marie-Claude Drolet
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche de l'Institut universitaire de Cardiologie et pneumologie de Québec, Université Laval, 2725, Chemin Sainte-Foy, Quebec, QC G1V 4G5 Canada
| | - Vincent Desbiens-Brassard
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche de l'Institut universitaire de Cardiologie et pneumologie de Québec, Université Laval, 2725, Chemin Sainte-Foy, Quebec, QC G1V 4G5 Canada
| | - Elise Roussel
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche de l'Institut universitaire de Cardiologie et pneumologie de Québec, Université Laval, 2725, Chemin Sainte-Foy, Quebec, QC G1V 4G5 Canada
| | - Veronique Tu
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche de l'Institut universitaire de Cardiologie et pneumologie de Québec, Université Laval, 2725, Chemin Sainte-Foy, Quebec, QC G1V 4G5 Canada
| | - Jacques Couet
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche de l'Institut universitaire de Cardiologie et pneumologie de Québec, Université Laval, 2725, Chemin Sainte-Foy, Quebec, QC G1V 4G5 Canada
| | - Marie Arsenault
- Groupe de Recherche sur les Valvulopathies, Centre de Recherche de l'Institut universitaire de Cardiologie et pneumologie de Québec, Université Laval, 2725, Chemin Sainte-Foy, Quebec, QC G1V 4G5 Canada
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Tremblay JP, Gérard C, Xiao X, Filali M, Coulombe Z, Arsenault M, Couet J, Li J, Drolet MC, Chapdelaine P, Chikh A. 384. AAV9 -Frataxin Reduces the Symptoms and Prolongs the Life of Friedreich Ataxia Mouse Models. Mol Ther 2015. [DOI: 10.1016/s1525-0016(16)33993-4] [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: 10/20/2022] Open
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Capoulade R, Mahmut A, Tastet L, Arsenault M, Bédard É, Dumesnil JG, Després JP, Larose É, Arsenault BJ, Bossé Y, Mathieu P, Pibarot P. Impact of Plasma Lp-PLA2 Activity on the Progression of Aortic Stenosis. JACC Cardiovasc Imaging 2015; 8:26-33. [DOI: 10.1016/j.jcmg.2014.09.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 09/12/2014] [Accepted: 09/22/2014] [Indexed: 02/05/2023]
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Lachance D, Dhahri W, Drolet MC, Roussel É, Gascon S, Sarrhini O, Rousseau JA, Lecomte R, Arsenault M, Couet J. Endurance training or beta-blockade can partially block the energy metabolism remodeling taking place in experimental chronic left ventricle volume overload. BMC Cardiovasc Disord 2014; 14:190. [PMID: 25518920 PMCID: PMC4279960 DOI: 10.1186/1471-2261-14-190] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [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: 09/25/2014] [Accepted: 12/11/2014] [Indexed: 01/24/2023] Open
Abstract
Background Patients with chronic aortic valve regurgitation (AR) causing left ventricular (LV) volume overload can remain asymptomatic for many years despite having a severely dilated heart. The sudden development of heart failure is not well understood but alterations of myocardial energy metabolism may be contributive. We studied the evolution of LV energy metabolism in experimental AR. Methods LV glucose utilization was evaluated in vivo by positron emission tomography (microPET) scanning of 6-month AR rats. Sham-operated or AR rats (n = 10-30 animals/group) were evaluated 3, 6 or 9 months post-surgery. We also tested treatment intervention in order to evaluate their impact on metabolism. AR rats (20 animals) were trained on a treadmill 5 times a week for 9 months and another group of rats received a beta-blockade treatment (carvedilol) for 6 months. Results MicroPET revealed an abnormal increase in glucose consumption in the LV free wall of AR rats at 6 months. On the other hand, fatty acid beta-oxidation was significantly reduced compared to sham control rats 6 months post AR induction. A significant decrease in citrate synthase and complex 1 activity suggested that mitochondrial oxidative phosphorylation was also affected maybe as soon as 3 months post-AR. Moderate intensity endurance training starting 2 weeks post-AR was able to partially normalize the activity of various myocardial enzymes implicated in energy metabolism. The same was true for the AR rats treated with carvedilol (30 mg/kg/d). Responses to these interventions were different at the level of gene expression. We measured mRNA levels of a number of genes implicated in the transport of energy substrates and we observed that training did not reverse the general down-regulation of these genes in AR rats whereas carvedilol normalized the expression of most of them. Conclusion This study shows that myocardial energy metabolism remodeling taking place in the dilated left ventricle submitted to severe volume overload from AR can be partially avoided by exercise or beta-blockade in rats. Electronic supplementary material The online version of this article (doi:10.1186/1471-2261-14-190) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Jacques Couet
- Groupe de recherche sur les valvulopathies, Centre de Recherche, Institut Universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725, Chemin Sainte-Foy, Québec City, Québec G1V 4G5, Canada.
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