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Chung B, Wang Y, Thiel M, Rostami F, Rogoll A, Hirsch VG, Malik Z, Bührke A, Bär C, Klintschar M, Schmitto JD, Vogt C, Werlein C, Jonigk D, Bauersachs J, Wollert KC, Kempf T. Pre-emptive iron supplementation prevents myocardial iron deficiency and attenuates adverse remodelling after myocardial infarction. Cardiovasc Res 2023; 119:1969-1980. [PMID: 37315201 DOI: 10.1093/cvr/cvad092] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/20/2023] [Accepted: 04/08/2023] [Indexed: 06/16/2023] Open
Abstract
AIMS Heart failure (HF) after myocardial infarction (MI) is a major cause of morbidity and mortality. We sought to investigate the functional importance of cardiac iron status after MI and the potential of pre-emptive iron supplementation in preventing cardiac iron deficiency (ID) and attenuating left ventricular (LV) remodelling. METHODS AND RESULTS MI was induced in C57BL/6J male mice by left anterior descending coronary artery ligation. Cardiac iron status in the non-infarcted LV myocardium was dynamically regulated after MI: non-haem iron and ferritin increased at 4 weeks but decreased at 24 weeks after MI. Cardiac ID at 24 weeks was associated with reduced expression of iron-dependent electron transport chain (ETC) Complex I compared with sham-operated mice. Hepcidin expression in the non-infarcted LV myocardium was elevated at 4 weeks and suppressed at 24 weeks. Hepcidin suppression at 24 weeks was accompanied by more abundant expression of membrane-localized ferroportin, the iron exporter, in the non-infarcted LV myocardium. Notably, similarly dysregulated iron homeostasis was observed in LV myocardium from failing human hearts, which displayed lower iron content, reduced hepcidin expression, and increased membrane-bound ferroportin. Injecting ferric carboxymaltose (15 µg/g body weight) intravenously at 12, 16, and 20 weeks after MI preserved cardiac iron content and attenuated LV remodelling and dysfunction at 24 weeks compared with saline-injected mice. CONCLUSION We demonstrate, for the first time, that dynamic changes in cardiac iron status after MI are associated with local hepcidin suppression, leading to cardiac ID long term after MI. Pre-emptive iron supplementation maintained cardiac iron content and attenuated adverse remodelling after MI. Our results identify the spontaneous development of cardiac ID as a novel disease mechanism and therapeutic target in post-infarction LV remodelling and HF.
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Affiliation(s)
- Bomee Chung
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Yong Wang
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Marleen Thiel
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Fatemeh Rostami
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Anika Rogoll
- Institute for Analytical Chemistry, TU Bergakademie, Leipziger Straße 29, 09599 Freiberg, Germany
| | - Valentin G Hirsch
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Zulaikha Malik
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Anne Bührke
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Michael Klintschar
- Institute of Forensic Medicine, Hannover Medical School, Carl-Neuberger-Straße 1, 30625 Hannover, Germany
| | - Jan D Schmitto
- Department of Cardiac-, Thoracic-, Transplantation, and Vascular Surgery, Hannover Medical School, Carl-Neuberger-Straße 1, 30625 Hannover, Germany
| | - Carla Vogt
- Institute for Analytical Chemistry, TU Bergakademie, Leipziger Straße 29, 09599 Freiberg, Germany
| | - Christopher Werlein
- Institute of Pathology and German Centre for Lung Research, Biomedical Research in End-stage and Obstructive Lung Disease Hannover, Hannover Medical School, Carl-Neuberger-Straße 1, 30625 Hannover, Germany
| | - Danny Jonigk
- Institute of Pathology and German Centre for Lung Research, Biomedical Research in End-stage and Obstructive Lung Disease Hannover, Hannover Medical School, Carl-Neuberger-Straße 1, 30625 Hannover, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Kai C Wollert
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Tibor Kempf
- Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
- Division of Molecular and Translational Cardiology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
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Hirsch VG, Schallhorn S, Zwadlo C, Diekmann J, Länger F, Jonigk DD, Kempf T, Schultheiss HP, Bauersachs J. Giant Cell Myocarditis after First Dose of BNT162b2 - a Case Report. Eur J Heart Fail 2022; 24:1319-1322. [PMID: 35733299 PMCID: PMC9350328 DOI: 10.1002/ejhf.2590] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/27/2022] [Accepted: 06/19/2022] [Indexed: 11/10/2022] Open
Abstract
Herein we report the case of a young man, admitted to the Department of Cardiology and Angiology at Hannover Medical School with shortness of breath and elevated troponin. Few weeks earlier the patient received the first dose of BioNTech's mRNA vaccine (Comirnaty, BNT162b2). After diagnostic work‐up revealed giant cell myocarditis, the patient received immunosuppressive therapy. In the present context of myocarditis after mRNA vaccination we discuss this rare aetiology and the patient's treatment strategy in the light of current recommendations.
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Affiliation(s)
- V G Hirsch
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - S Schallhorn
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - C Zwadlo
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - J Diekmann
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - F Länger
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - D D Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - T Kempf
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - H P Schultheiss
- Institute of Cardiac Diagnostics and Therapy, IKDT GmbH, Berlin, Germany
| | - J Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
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Hirsch VG, Tongers J, Bode J, Berliner D, Widder JD, Escher F, Mutsenko V, Chung B, Rostami F, Guba‐Quint A, Giannitsis E, Schultheiss H, Vogt C, Bauersachs J, Wollert KC, Kempf T. Cardiac iron concentration in relation to systemic iron status and disease severity in non‐ischaemic heart failure with reduced ejection fraction. Eur J Heart Fail 2020; 22:2038-2046. [DOI: 10.1002/ejhf.1781] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 12/12/2022] Open
Affiliation(s)
- Valentin G. Hirsch
- Division of Molecular and Translational Cardiology Hannover Medical School Hannover Germany
- Department of Cardiology and Angiology Hannover Medical School Hannover Germany
| | - Jörn Tongers
- Department of Cardiology and Angiology Hannover Medical School Hannover Germany
| | - Julia Bode
- Institute for Analytical Chemistry University of Mining and Technology Freiberg Germany
| | - Dominik Berliner
- Department of Cardiology and Angiology Hannover Medical School Hannover Germany
| | - Julian D. Widder
- Department of Cardiology and Angiology Hannover Medical School Hannover Germany
| | | | - Vitalii Mutsenko
- Institute for Multiphase Processes Leibniz University Hannover Germany
| | - Bomee Chung
- Division of Molecular and Translational Cardiology Hannover Medical School Hannover Germany
- Department of Cardiology and Angiology Hannover Medical School Hannover Germany
| | - Fatemeh Rostami
- Division of Molecular and Translational Cardiology Hannover Medical School Hannover Germany
- Department of Cardiology and Angiology Hannover Medical School Hannover Germany
| | - Anja Guba‐Quint
- Division of Molecular and Translational Cardiology Hannover Medical School Hannover Germany
- Department of Cardiology and Angiology Hannover Medical School Hannover Germany
| | - Evangelos Giannitsis
- Cardiology, Department of Internal Medicine III University Hospital Heidelberg Heidelberg Germany
| | | | - Carla Vogt
- Institute for Analytical Chemistry University of Mining and Technology Freiberg Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology Hannover Medical School Hannover Germany
| | - Kai C. Wollert
- Division of Molecular and Translational Cardiology Hannover Medical School Hannover Germany
- Department of Cardiology and Angiology Hannover Medical School Hannover Germany
| | - Tibor Kempf
- Division of Molecular and Translational Cardiology Hannover Medical School Hannover Germany
- Department of Cardiology and Angiology Hannover Medical School Hannover Germany
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