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Machado FJDM, Marta-Enguita J, Gómez SU, Rodriguez JA, Páramo-Fernández JA, Herrera M, Zandio B, Aymerich N, Muñoz R, Bermejo R, Marta-Moreno J, López B, González A, Roncal C, Orbe J. Transcriptomic Analysis of Extracellular Vesicles in the Search for Novel Plasma and Thrombus Biomarkers of Ischemic Stroke Etiologies. Int J Mol Sci 2024; 25:4379. [PMID: 38673963 PMCID: PMC11050408 DOI: 10.3390/ijms25084379] [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] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Accurate etiologic diagnosis provides an appropriate secondary prevention and better prognosis in ischemic stroke (IS) patients; still, 45% of IS are cryptogenic, urging us to enhance diagnostic precision. We have studied the transcriptomic content of plasma extracellular vesicles (EVs) (n = 21) to identify potential biomarkers of IS etiologies. The proteins encoded by the selected genes were measured in the sera of IS patients (n = 114) and in hypertensive patients with (n = 78) and without atrial fibrillation (AF) (n = 20). IGFBP-2, the most promising candidate, was studied using immunohistochemistry in the IS thrombi (n = 23) and atrium of AF patients (n = 13). In vitro, the IGFBP-2 blockade was analyzed using thromboelastometry and endothelial cell cultures. We identified 745 differentially expressed genes among EVs of cardioembolic, atherothrombotic, and ESUS groups. From these, IGFBP-2 (cutoff > 247.6 ng/mL) emerged as a potential circulating biomarker of embolic IS [OR = 8.70 (1.84-41.13) p = 0.003], which was increased in patients with AF vs. controls (p < 0.001) and was augmented in cardioembolic vs. atherothrombotic thrombi (p < 0.01). Ex vivo, the blockage of IGFBP-2 reduced clot firmness (p < 0.01) and lysis time (p < 0.001) and in vitro, diminished endothelial permeability (p < 0.05) and transmigration (p = 0.06). IGFBP-2 could be a biomarker of embolic IS and a new therapeutic target involved in clot formation and endothelial dysfunction.
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Affiliation(s)
- Florencio J. D. M. Machado
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
| | - Juan Marta-Enguita
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
| | - Susan U. Gómez
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
| | - Jose A. Rodriguez
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - José Antonio Páramo-Fernández
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Hematology Department, Clinica Universidad de Navarra, 31008 Pamplona, Spain
| | - María Herrera
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Beatriz Zandio
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Nuria Aymerich
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Roberto Muñoz
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Rebeca Bermejo
- Neurointervencionist Radiology, Hospital Universitario de Navarra, 31008 Pamplona, Spain;
| | - Javier Marta-Moreno
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
- Neurology Department, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS-Aragon), 50009 Zaragoza, Spain
| | - Begoña López
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Cardiovascular Diseases Program, Cima Universidad de Navarra, 31008 Pamplona, Spain
| | - Arantxa González
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Cardiovascular Diseases Program, Cima Universidad de Navarra, 31008 Pamplona, Spain
- Department of Pathology, Anatomy and Physiology, Universidad de Navarra, 31008 Pamplona, Spain
| | - Carmen Roncal
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Josune Orbe
- Laboratory of Atherothrombosis, Cima Universidad de Navarra, 31008 Pamplona, Spain; (F.J.D.M.M.); (J.M.-E.); (S.U.G.); (J.A.R.); (J.A.P.-F.); (C.R.)
- Instituto de Investigación Sanitaria de Navarra IdiSNA, 31008 Pamplona, Spain; (M.H.); (B.L.)
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS)-Ictus, Instituto Salud Carlos III, 28029 Madrid, Spain; (B.Z.); (N.A.); (R.M.); (J.M.-M.)
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González A, López B, Ravassa S, San José G, Latasa I, Butler J, Díez J. Myocardial Interstitial Fibrosis in Hypertensive Heart Disease: From Mechanisms to Clinical Management. Hypertension 2024; 81:218-228. [PMID: 38084597 DOI: 10.1161/hypertensionaha.123.21708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Hypertensive heart disease (HHD) can no longer be considered as the beneficial adaptive result of the hypertrophy of cardiomyocytes in response to pressure overload leading to the development of left ventricular hypertrophy. The current evidence indicates that in patients with HHD, pathological lesions in the myocardium lead to maladaptive structural remodeling and subsequent alterations in cardiac function, electrical activity, and perfusion, all contributing to poor outcomes. Diffuse myocardial interstitial fibrosis is probably the most critically involved lesion in these disorders. Therefore, in this review, we will focus on the histological characteristics, the mechanisms, and the clinical consequences of myocardial interstitial fibrosis in patients with HHD. In addition, we will consider the most useful tools for the noninvasive diagnosis of myocardial interstitial fibrosis in patients with HHD, as well as the most effective available therapeutic strategies to prevent its development or facilitate its regression in this patient population. Finally, we will issue a call to action for the need for more fundamental and clinical research on myocardial interstitial fibrosis in HHD.
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Affiliation(s)
- Arantxa González
- Program of Cardiovascular Disease, Centro de Investigación Médica Aplicada Universidad de Navarra (CIMA), Pamplona, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
- Insitituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
- Center for Biomedical Research in Cardiovascular Diseases Network (CIBERCV), Carlos III Institute of Health, Madrid, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
- Department of Pathology, Anatomy and Physiology, Universidad de Navarra, Pamplona, Spain (A.G.)
| | - Begoña López
- Program of Cardiovascular Disease, Centro de Investigación Médica Aplicada Universidad de Navarra (CIMA), Pamplona, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
- Insitituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
- Center for Biomedical Research in Cardiovascular Diseases Network (CIBERCV), Carlos III Institute of Health, Madrid, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
| | - Susana Ravassa
- Program of Cardiovascular Disease, Centro de Investigación Médica Aplicada Universidad de Navarra (CIMA), Pamplona, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
- Insitituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
- Center for Biomedical Research in Cardiovascular Diseases Network (CIBERCV), Carlos III Institute of Health, Madrid, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
| | - Gorka San José
- Program of Cardiovascular Disease, Centro de Investigación Médica Aplicada Universidad de Navarra (CIMA), Pamplona, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
- Insitituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
- Center for Biomedical Research in Cardiovascular Diseases Network (CIBERCV), Carlos III Institute of Health, Madrid, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
| | - Iñigo Latasa
- Program of Cardiovascular Disease, Centro de Investigación Médica Aplicada Universidad de Navarra (CIMA), Pamplona, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
- Insitituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
- Center for Biomedical Research in Cardiovascular Diseases Network (CIBERCV), Carlos III Institute of Health, Madrid, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
| | - Javed Butler
- Baylor Scott and White Research Institute, Dallas, TX (J.B.)
- Department of Medicine, University of Mississippi, Jackson (J.B.)
| | - Javier Díez
- Program of Cardiovascular Disease, Centro de Investigación Médica Aplicada Universidad de Navarra (CIMA), Pamplona, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
- Insitituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
- Center for Biomedical Research in Cardiovascular Diseases Network (CIBERCV), Carlos III Institute of Health, Madrid, Spain (A.G., B.L., S.R., G.S.J., I.L., J.D.)
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Garrido D, López B, Carballo G. Bilingualism and language in children with autistic spectrum disorder: a systematic review. Neurologia 2024; 39:84-96. [PMID: 38065434 DOI: 10.1016/j.nrleng.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/06/2021] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Communication and language skills are among the most severely affected domains in individuals with autistic spectrum disorder (ASD). When a child diagnosed with ASD lives in a bilingual environment, the parents often express concerns about whether their child should learn both languages simultaneously, turning to specialists for advice. Despite the lack of evidence of any negative effect, some professionals disagree on this subject. In this systematic review we study whether bilingualism affects language development in children with ASD. METHODS We reviewed the literature published in 4 different databases. After applying a series of selection criteria, we selected 12 scientific articles, including a total of 328 children diagnosed with ASD (169 bilingual and 159 monolingual), with ages ranging from 3 to 12 years. These patients were evaluated with different receptive and expressive language assessment instruments covering several areas. The assessments were performed directly on the children, although indirect assessment of parents was also performed in some studies. CONCLUSIONS There seems to be consensus regarding the assertion that bilingualism does not entail any additional difficulty for language development in children with ASD from the age of 3.
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Affiliation(s)
- D Garrido
- Departamento de Psicología, Facultad de Ciencias de la Salud, Universidad de Castilla La Mancha, Castilla La Mancha, Spain; Facultad de Psicología, Universidad de Granada, Granada, Spain.
| | - B López
- Facultad de Psicología, Universidad de Granada, Granada, Spain
| | - G Carballo
- Facultad de Psicología, Universidad de Granada, Granada, Spain
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Ravassa S, López B, Treibel TA, San José G, Losada-Fuentenebro B, Tapia L, Bayés-Genís A, Díez J, González A. Cardiac Fibrosis in heart failure: Focus on non-invasive diagnosis and emerging therapeutic strategies. Mol Aspects Med 2023; 93:101194. [PMID: 37384998 DOI: 10.1016/j.mam.2023.101194] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/09/2023] [Accepted: 06/14/2023] [Indexed: 07/01/2023]
Abstract
Heart failure is a leading cause of mortality and hospitalization worldwide. Cardiac fibrosis, resulting from the excessive deposition of collagen fibers, is a common feature across the spectrum of conditions converging in heart failure. Eventually, either reparative or reactive in nature, in the long-term cardiac fibrosis contributes to heart failure development and progression and is associated with poor clinical outcomes. Despite this, specific cardiac antifibrotic therapies are lacking, making cardiac fibrosis an urgent unmet medical need. In this context, a better patient phenotyping is needed to characterize the heterogenous features of cardiac fibrosis to advance toward its personalized management. In this review, we will describe the different phenotypes associated with cardiac fibrosis in heart failure and we will focus on the potential usefulness of imaging techniques and circulating biomarkers for the non-invasive characterization and phenotyping of this condition and for tracking its clinical impact. We will also recapitulate the cardiac antifibrotic effects of existing heart failure and non-heart failure drugs and we will discuss potential strategies under preclinical development targeting the activation of cardiac fibroblasts at different levels, as well as targeting additional extracardiac processes.
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Affiliation(s)
- Susana Ravassa
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Begoña López
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Thomas A Treibel
- Institute of Cardiovascular Science, University College London, UK; Barts Heart Centre, St Bartholomew's Hospital, London, UK
| | - Gorka San José
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Blanca Losada-Fuentenebro
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Leire Tapia
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Antoni Bayés-Genís
- CIBERCV, Carlos III Institute of Health, Madrid, Spain; Servei de Cardiologia i Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; ICREC Research Program, Germans Trias i Pujol Health Science Research Institute, Badalona, Spain
| | - Javier Díez
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain.
| | - Arantxa González
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain.
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Rypdal KB, Olav Melleby A, Robinson EL, Li J, Palmero S, Seifert DE, Martin D, Clark C, López B, Andreassen K, Dahl CP, Sjaastad I, Tønnessen T, Stokke MK, Louch WE, González A, Heymans S, Christensen G, Apte SS, Lunde IG. ADAMTSL3 knock-out mice develop cardiac dysfunction and dilatation with increased TGFβ signalling after pressure overload. Commun Biol 2022; 5:1392. [PMID: 36539599 PMCID: PMC9767913 DOI: 10.1038/s42003-022-04361-1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
Heart failure is a major cause of morbidity and mortality worldwide, and can result from pressure overload, where cardiac remodelling is characterized by cardiomyocyte hypertrophy and death, fibrosis, and inflammation. In failing hearts, transforming growth factor (TGF)β drives cardiac fibroblast (CFB) to myofibroblast differentiation causing excessive extracellular matrix production and cardiac remodelling. New strategies to target pathological TGFβ signalling in heart failure are needed. Here we show that the secreted glycoprotein ADAMTSL3 regulates TGFβ in the heart. We found that Adamtsl3 knock-out mice develop exacerbated cardiac dysfunction and dilatation with increased mortality, and hearts show increased TGFβ activity and CFB activation after pressure overload by aortic banding. Further, ADAMTSL3 overexpression in cultured CFBs inhibits TGFβ signalling, myofibroblast differentiation and collagen synthesis, suggesting a cardioprotective role for ADAMTSL3 by regulating TGFβ activity and CFB phenotype. These results warrant future investigation of the potential beneficial effects of ADAMTSL3 in heart failure.
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Affiliation(s)
- Karoline B Rypdal
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway. .,Division of Diagnostics and Technology, Akershus University Hospital, Lørenskog, Norway. .,K.G. Jebsen Center for Cardiac Biomarkers, University of Oslo, Oslo, Norway.
| | - A Olav Melleby
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway.,Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Emma L Robinson
- Department of Cardiology, Maastricht University, CARIM School for Cardiovascular Diseases, Maastricht, Netherlands
| | - Jia Li
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Sheryl Palmero
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Deborah E Seifert
- Department of Biomedical Engineering, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
| | - Daniel Martin
- Department of Biomedical Engineering, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
| | - Catelyn Clark
- Department of Biomedical Engineering, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
| | - Begoña López
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Kristine Andreassen
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Christen P Dahl
- Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Ivar Sjaastad
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Theis Tønnessen
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway.,Department of Cardiothoracic Surgery, Oslo University Hospital Ullevål, Oslo, Norway
| | - Mathis K Stokke
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - William E Louch
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Arantxa González
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Stephane Heymans
- Department of Cardiology, Maastricht University, CARIM School for Cardiovascular Diseases, Maastricht, Netherlands.,Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Leuven, Belgium
| | - Geir Christensen
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Suneel S Apte
- Department of Biomedical Engineering, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
| | - Ida G Lunde
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway.,Division of Diagnostics and Technology, Akershus University Hospital, Lørenskog, Norway.,K.G. Jebsen Center for Cardiac Biomarkers, University of Oslo, Oslo, Norway
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López B, Castañón-Apilánez M, Molina-Gil J, Fernández-Gordón Sánchez S, González G, Reguera Acuña A, Jimenez JM, Larrosa Campo D, Delgado MG, Benavente-Fernández L, Rico-Santos M, García-Cabo C, Calleja Puerta S, López-Cancio E. Serum Prealbumin Levels on Admission as a Prognostic Marker in Stroke Patients Treated with Mechanical Thrombectomy. Cerebrovasc Dis Extra 2022; 12:103-108. [PMID: 36007497 PMCID: PMC9941761 DOI: 10.1159/000526354] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 07/22/2022] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Prealbumin is a marker of malnutrition and inflammation. It has been associated with poor prognosis in cardiovascular disease, but less is known in stroke patients. Our objective was to evaluate the association of prealbumin levels at admission with prognosis in patients with stroke treated with mechanical thrombectomy. METHODS Retrospective study of a prospective database of consecutive patients treated with mechanical thrombectomy. Clinical, radiological, and blood parameters including serum prealbumin, and prognostic variables such as respiratory infection, in-hospital mortality, and the modified Rankin scale at 3 months were collected. RESULTS We included 319 patients between 2018 and 2019. Prealbumin levels were significantly lower in patients older than 80 years, women, patients with a prestroke Rankin score >2, a glomerular filtrate rate <60 mL/min, and in those with atrial fibrillation. Regarding prognostic variables, prealbumin levels were not associated with respiratory infection. Low prealbumin levels were associated with poor functional prognosis (Rankin score >2), in-hospital mortality, and 3-month mortality. In multivariate analysis, prealbumin was an independent risk factor associated with mortality at 3 months, OR 0.92 [0.86-0.98], p = 0.019. CONCLUSION Lower prealbumin levels at admission behaved as an independent predictor of long-term mortality in patients treated with mechanical thrombectomy. These results should be replicated in other cohorts.
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Affiliation(s)
- Begoña López
- Department of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain,
| | - Maria Castañón-Apilánez
- aDepartment of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain,bInstituto de Investigación Sanitaria Principado de Asturias, ISPA, Oviedo, Spain
| | - Javier Molina-Gil
- aDepartment of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Gemma González
- aDepartment of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Antía Reguera Acuña
- aDepartment of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Jose Maria Jimenez
- cDepartment of Radiology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Davinia Larrosa Campo
- aDepartment of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain,bInstituto de Investigación Sanitaria Principado de Asturias, ISPA, Oviedo, Spain,dUniversity of Oviedo, Oviedo, Spain
| | - Montserrat González Delgado
- aDepartment of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain,bInstituto de Investigación Sanitaria Principado de Asturias, ISPA, Oviedo, Spain,dUniversity of Oviedo, Oviedo, Spain
| | - Lorena Benavente-Fernández
- aDepartment of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain,bInstituto de Investigación Sanitaria Principado de Asturias, ISPA, Oviedo, Spain,dUniversity of Oviedo, Oviedo, Spain
| | - Maria Rico-Santos
- aDepartment of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain,bInstituto de Investigación Sanitaria Principado de Asturias, ISPA, Oviedo, Spain
| | - Carmen García-Cabo
- aDepartment of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain,bInstituto de Investigación Sanitaria Principado de Asturias, ISPA, Oviedo, Spain
| | - Sergio Calleja Puerta
- aDepartment of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain,bInstituto de Investigación Sanitaria Principado de Asturias, ISPA, Oviedo, Spain
| | - Elena López-Cancio
- aDepartment of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain,bInstituto de Investigación Sanitaria Principado de Asturias, ISPA, Oviedo, Spain,dUniversity of Oviedo, Oviedo, Spain,*Elena López-Cancio,
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7
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Genovese F, Reese-Petersen A, Karsdal MA, López B, García Fernández N, Diez J, González A. MO747: Endotrophin Levels are Extremely Elevated in Dialysis Patients with Heart Failure with Preserved Ejection Fraction (HFPEF) and are Influenced by Background Treatment with Diuretics and ARBS/ACEI. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac079.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Endotrophin, a bioactive molecule derived from the cleavage of the collagen type VI pro-peptide, released during collagen maturation, has been associated with multiple pathogenic processes, including inflammation and fibrosis.
PRO-C6, a biomarker reflecting circulating endotrophin levels, has been associated with an adverse prognosis in multiple disease settings, including chronic kidney disease and heart failure with preserved ejection fraction (HFpEF).
Here, we assessed levels of PRO-C6 in a population of dialysis patients with and without heart failure, and we observed an association of PRO-C6 with imaging and soluble biomarkers of heart disease, presence of co-morbidities and medications.
METHOD
PRO-C6 was measured with the enzyme-linked immunosorbent assay developed by Nordic Bioscience (Denmark) in serum of 46 patients undergoing dialysis (mean age 70 years, 37% female) and with HFpEF (61%), HFmrEF (7%), HFrEF (2%) or no HF (30%) collected at the Clínica Universidad de Navarra (Spain). The samples were collected pre-dialysis. PRO-C6 was also measured in serum of 50 healthy individuals (mean age 61 years, 50% female) collected at the same site. Differences between groups were estimated with the Kruskal–Wallis test, correlations were estimated with Spearman’s rank correlation coefficient.
RESULTS
Levels of PRO-C6 were extremely elevated in the serum of dialysis patients compared with healthy individuals (81 ng/mL versus 6.3 ng/mL; P < 0.0001), and also compared with previously seen levels in HFpEF patients (patients with levels above 16 ng/mL were at increased risk of worse outcome in the TOPCAT cohort).
Among the dialysis patients, patients with HFpEF had significantly increased PRO-C6 levels compared with patients with no HF (90.2 ng/mL versus 61.8 ng/mL; P = 0.03). Due to the low number of events, the numerical increase in PRO-C6 levels in patients that died, had myocardial infarction and pulmonary hypertension did not reach statistical significance.
PRO-C6 showed modest direct correlations with age, NT-proBNP, hsTNT and collagen type I C-terminal telopeptide (CITP), and a modest inverse correlation with eGFR. When looking at echo parameters, PRO-C6 was modestly directly correlated with left ventricular posterior wall thickness and relative wall thickness and modestly inversely correlated with left ventricular end diastolic volume.
Interestingly, patients treated with ARB/ACEi and diuretics presented significantly lower levels of PRO-C6 compared with those that were not receiving these drugs (64.4 ng/mL versus 90.2 ng/mL; P = 0.01 and 59.0 ng/mL versus 87.1 ng/mL; P = 0.008, respectively). Patients treated with antiplatelets on the contrary had higher levels of PRO-C6 (88.9 ng/mL versus 67.7 ng/mL; P = 0.04).
CONCLUSION
Even in a population of kidney failure patients, presenting very high levels of circulating endotrophin, the presence of HFpEF was associated with further increased levels of endotrophin. Moreover, endotrophin levels were associated with echo parameters and biomarkers reflecting diastolic disfunction and left ventricular stress and damage. We have shown here for the first time that patients treated with ARB/ACEi and diuretics present lower levels of circulating endotrophin.
PRO-C6 measuring endotrophin confirms being a biomarker of interest in HFpEF patients, even in the presence of kidney failure.
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Affiliation(s)
| | | | | | - Begoña López
- CIMA (Center for Applied Medical Research), University of Navarre, Pamplona, Spain
| | | | - Javier Diez
- CIMA (Center for Applied Medical Research), University of Navarre, Pamplona, Spain
| | - Arantxa González
- CIMA (Center for Applied Medical Research), University of Navarre, Pamplona, Spain
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8
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Ravassa S, López B, Ferreira JP, Girerd N, Bozec E, Pellicori P, Mariottoni B, Cosmi F, Hazebroek M, Verdonschot JAJ, Cuthbert J, Petutschnigg J, Moreno MU, Heymans S, Staessen JA, Pieske B, Edelmann F, Clark AL, Cleland JGF, Zannad F, Díez J, González A. Biomarker-based assessment of collagen cross-linking identifies patients at risk of heart failure more likely to benefit from spironolactone effects on left atrial remodelling. Insights from the HOMAGE clinical trial. Eur J Heart Fail 2021; 24:321-331. [PMID: 34841615 DOI: 10.1002/ejhf.2394] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 05/27/2021] [Revised: 10/19/2021] [Accepted: 11/22/2021] [Indexed: 11/06/2022] Open
Abstract
AIMS The HOMAGE randomized trial found that spironolactone reduced left atrial volume index (LAVI), E:A ratio, and a marker of collagen type I synthesis (procollagen type I C-terminal propeptide) in patients at risk of heart failure (HF). Previous trials showed that patients with HF, preserved ejection fraction and low serum collagen type I C-terminal telopeptide to matrix metalloproteinase-1 ratio (CITP:MMP-1), associated with high collagen cross-linking, had less improvement in diastolic function with spironolactone. We evaluated the interaction between serum CITP:MMP-1 and spironolactone on cardiac function in the HOMAGE trial. METHODS AND RESULTS Patients at risk of HF were randomized to spironolactone (n = 260) or not (n = 255). Blood sampling and echocardiography were done at baseline, one and nine months. CITP:MMP-1 was used as an indirect measure of collagen cross-linking. Higher baseline CITP:MMP-1 (i.e. lower collagen cross-linking) was associated with greater reductions in LAVI with spironolactone at both one (p = 0.003) and nine (p = 0.01) months, but no interaction was observed for E:A ratio. Spironolactone reduced LAVI after one and nine months only for those patients in the third tertile of CITP:MMP-1 (estimated lowest collagen cross-linking) [mean differencesspiro/control : -1.77 (95% confidence interval, CI -2.94 to -0.59) and -2.52 (95% CI -4.46 to -0.58) mL/m2 ; interaction pacross-tertiles = 0.005; interaction pthird tertile = 0.008] with a similar trend for N-terminal pro-B-type natriuretic peptide which was consistently reduced by spironolactone only in the lowest collagen cross-linking tertile [mean differencesspiro/control : -0.47 (95% CI -0.66 to -0.28) and -0.31 (95% CI -0.59 to -0.04) ng/L; interaction pacross-tertiles = 0.09; interaction pthird tertile < 0.001]. CONCLUSIONS These findings suggest that, for patients at risk of HF, the effects of spironolactone on left atrial remodelling may be more prominent in patients with less collagen cross-linking (indirectly assessed by serum CITP:MMP-1).
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Affiliation(s)
- Susana Ravassa
- Program of Cardiovascular Diseases, CIMA, Universidad de Navarra and IdiSNA, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Begoña López
- Program of Cardiovascular Diseases, CIMA, Universidad de Navarra and IdiSNA, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - João Pedro Ferreira
- Université de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, U1116, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France
| | - Nicolas Girerd
- Université de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, U1116, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France
| | - Erwan Bozec
- Université de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, U1116, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France
| | - Pierpaolo Pellicori
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | | | - Franco Cosmi
- Department of Cardiology, Cortona Hospital, Arezzo, Italy
| | - Mark Hazebroek
- Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Job A J Verdonschot
- Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Joe Cuthbert
- Department of Cardiology, University of Hull, Castle Hill Hospital, Cottingham, UK
| | - Johannes Petutschnigg
- Department of Internal Medicine and Cardiology Campus Virchow Klinikum, Charité University Medicine Berlin and German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - María U Moreno
- Program of Cardiovascular Diseases, CIMA, Universidad de Navarra and IdiSNA, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Stephane Heymans
- Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan A Staessen
- Non-Profit Research Institute Alliance for the Promotion of Preventive Medicine, Mechelen (APPREMED), Mechelen, Belgium.,Biomedical Sciences Group, Faculty of Medicine, University of Leuven, Leuven, Belgium
| | - Burkert Pieske
- Department of Internal Medicine and Cardiology Campus Virchow Klinikum, Charité University Medicine Berlin and German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Frank Edelmann
- Department of Internal Medicine and Cardiology Campus Virchow Klinikum, Charité University Medicine Berlin and German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Andrew L Clark
- Department of Cardiology, University of Hull, Castle Hill Hospital, Cottingham, UK
| | - John G F Cleland
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - Faiez Zannad
- Université de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, U1116, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France
| | - Javier Díez
- Program of Cardiovascular Diseases, CIMA, Universidad de Navarra and IdiSNA, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain.,Departments of Nephrology and Cardiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Arantxa González
- Program of Cardiovascular Diseases, CIMA, Universidad de Navarra and IdiSNA, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain
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9
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Lloret A, Esteve D, Lloret MA, Monllor P, López B, León JL, Cervera-Ferri A. Is Oxidative Stress the Link Between Cerebral Small Vessel Disease, Sleep Disruption, and Oligodendrocyte Dysfunction in the Onset of Alzheimer's Disease? Front Physiol 2021; 12:708061. [PMID: 34512381 PMCID: PMC8424010 DOI: 10.3389/fphys.2021.708061] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/28/2021] [Indexed: 01/07/2023] Open
Abstract
Oxidative stress is an early occurrence in the development of Alzheimer’s disease (AD) and one of its proposed etiologic hypotheses. There is sufficient experimental evidence supporting the theory that impaired antioxidant enzymatic activity and increased formation of reactive oxygen species (ROS) take place in this disease. However, the antioxidant treatments fail to stop its advancement. Its multifactorial condition and the diverse toxicological cascades that can be initiated by ROS could possibly explain this failure. Recently, it has been suggested that cerebral small vessel disease (CSVD) contributes to the onset of AD. Oxidative stress is a central hallmark of CSVD and is depicted as an early causative factor. Moreover, data from various epidemiological and clinicopathological studies have indicated a relationship between CSVD and AD where endothelial cells are a source of oxidative stress. These cells are also closely related to oligodendrocytes, which are, in particular, sensitive to oxidation and lead to myelination being compromised. The sleep/wake cycle is another important control in the proliferation, migration, and differentiation of oligodendrocytes, and sleep loss reduces myelin thickness. Moreover, sleep plays a crucial role in resistance against CSVD, and poor sleep quality increases the silent markers of this vascular disease. Sleep disruption is another early occurrence in AD and is related to an increase in oxidative stress. In this study, the relationship between CSVD, oligodendrocyte dysfunction, and sleep disorders is discussed while focusing on oxidative stress as a common occurrence and its possible role in the onset of AD.
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Affiliation(s)
- Ana Lloret
- INCLIVA, CIBERFES, Department of Physiology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Daniel Esteve
- INCLIVA, CIBERFES, Department of Physiology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Maria Angeles Lloret
- Department of Clinical Neurophysiology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Paloma Monllor
- INCLIVA, CIBERFES, Department of Physiology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Begoña López
- Department of Neurology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - José Luis León
- Departament of Neuroradiology, Ascires Biomedical Group, Hospital Clinico Universitario, Valencia, Spain
| | - Ana Cervera-Ferri
- Department of Anatomy and Human Embryology, University of Valencia, Valencia, Spain
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10
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Martínez-Lirola M, Jajou R, Mathys V, Martin A, Cabibbe AM, Valera A, Sola-Campoy PJ, Abascal E, Rodríguez-Maus S, Garrido-Cárdenas JA, Bonillo M, Chiner-Oms Á, López B, Vallejo-Godoy S, Comas I, Muñoz P, Cirillo DM, van Soolingen D, Pérez-Lago L, García de Viedma D. Integrative transnational analysis to dissect tuberculosis transmission events along the migratory route from Africa to Europe. J Travel Med 2021; 28:6211020. [PMID: 33822988 DOI: 10.1093/jtm/taab054] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/26/2021] [Accepted: 03/24/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Growing international migration has increased the complexity of tuberculosis transmission patterns. Italy's decision to close its borders in 2018 made of Spain the new European porte entrée for migration from the Horn of Africa (HA). In one of the first rescues of migrants from this region at the end of 2018, tuberculosis was diagnosed in eight subjects, mainly unaccompanied minors. METHODS Mycobacterium tuberculosis isolates from these recently arrived migrants were analysed by Mycobacterial Interspersed Repetitive-Unit/Variable-Number of Tandem Repeat (MIRU-VNTR) and subsequent whole genome sequencing (WGS) analysis. Data were compared with those from collections from other European countries receiving migrants from the HA and a strain-specific PCR was applied for a fast searching of common strains. Infections in a cellular model were performed to assess strain virulence. RESULTS MIRU-VNTR analysis allowed identifying an epidemiological cluster involving three of the eight cases from Somalia (0 single-nucleotide polymorphisms between isolates, HA cluster). Following detailed interviews revealed that two of these cases had shared the same migratory route in most of the trip and had spent a long time at a detention camp in Libya. To confirm potential en route transmission for the three cases, we searched the same strain in collections from other European countries receiving migrants from the HA. MIRU-VNTR, WGS and a strain-specific PCR for the HA strain were applied. The same strain was identified in 12 cases from Eritrea diagnosed soon after their arrival in 2018 to the Netherlands, Belgium and Italy. Intracellular replication rate of the strain did not reveal abnormal virulence. CONCLUSIONS Our study suggests a potential en route transmission of a pan-susceptible strain, which caused at least 15 tuberculosis cases in Somalian and Eritrean migrants diagnosed in four different European countries.
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Affiliation(s)
| | - Rana Jajou
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Vanessa Mathys
- Unit Bacterial Diseases Service, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - Anandi Martin
- Université catholique de Louvain (UCLouvain) & Syngulon, 4102, Seraing, Belgium
| | - Andrea Maurizio Cabibbe
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ana Valera
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Pedro J Sola-Campoy
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Estefanía Abascal
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Sandra Rodríguez-Maus
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Magdalena Bonillo
- Unidad de Prevención, Promoción y Vigilancia de la Salud del Área Sanitaria Norte de Almería. Consejería de Salud. Junta de Andalucia, Almería, Spain
| | - Álvaro Chiner-Oms
- Centro Superior de Investigación en Salud Pública (FISABIO)-Universitat de València, Valencia, Spain
| | - Begoña López
- UPPV Distrito Sanitario Granada metropolitano, Granada, Spain
| | | | - Iñaki Comas
- Instituto de Biomedicina de Valencia-CSIC, Valencia, Spain.,CIBER Salud Pública (CIBERESP), Madrid, Spain
| | - Patricia Muñoz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Departamento de Medicina, Universidad Complutense, Madrid, Spain
| | - Daniela Maria Cirillo
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Dick van Soolingen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Laura Pérez-Lago
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Darío García de Viedma
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
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11
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Garrido D, López B, Carballo G. Bilingualism and language in children with autistic spectrum disorder: a systematic review. Neurologia 2021; 39:S0213-4853(21)00077-3. [PMID: 34088533 DOI: 10.1016/j.nrl.2021.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Communication and language skills are among the most severely affected domains in individuals with autistic spectrum disorder (ASD). When a child diagnosed with ASD lives in a bilingual environment, the parents often express concerns about whether their child should learn both languages simultaneously, turning to specialists for advice. Despite the lack of evidence of any negative effect, some professionals disagree on this subject. In this systematic review we study whether bilingualism affects language development in children with ASD. METHODS We reviewed the literature published in 4 different databases. After applying a series of selection criteria, we selected 12 scientific articles, including a total of 328 children diagnosed with ASD (169 bilingual and 159 monolingual), with ages ranging from 3 to 12 years. These patients were evaluated with different receptive and expressive language assessment instruments covering several areas. The assessments were performed directly on the children, although indirect assessment of parents was also performed in some studies. CONCLUSIONS There seems to be consensus regarding the assertion that bilingualism does not entail any additional difficulty for language development in children with ASD from the age of 3.
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Affiliation(s)
- D Garrido
- Departamento de Psicología, Facultad de Ciencias de la Salud, Universidad de Castilla La Mancha, Castilla La Mancha, España; Facultad de Psicología, Universidad de Granada, Granada, España.
| | - B López
- Facultad de Psicología, Universidad de Granada, Granada, España
| | - G Carballo
- Facultad de Psicología, Universidad de Granada, Granada, España
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12
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Romero-González G, Ravassa S, Diaz-Dorronsoro A, De la Fuente A, Garcia-Fernandez N, Rojas MA, Lorenzo I, García-Trigo I, Mateo-De Castro FM, López B, González A, Diez J. MO734CONTRIBUTION OF SOLUBLE ST2 TO THE EFFECT OF RIGHT VENTRICULAR DYSFUNCTION ON MORTALITY IN HEMODIALYSIS PATIENTS. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab097.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
Right ventricular dysfunction (RVD) has been shown to predict mortality in patients with kidney failure. It has been proposed that RVD in these patients is mediated by inflammatory and fibrotic mechanisms, which may be enhanced by hemodialysis (HD). The present study aimed to investigate the potential associations between RVD and circulating biomarkers of myocardial inflammation and fibrosis with all-cause mortality in HD patients.
Method
We performed a retrospective single-centre cohort study of prevalent patients admitted in a chronic HD program for more than 3 months. Clinical characteristics and echocardiographic parameters were assessed in all patients. Pre-dialysis blood samples for measurement of inflammatory (e.g., C reactive protein, interleukin-1, interleukin-18) and fibrotic (e.g., soluble suppression of tumorigenesis-2 [sST2], galectin-3, C-terminal pro-peptide of procollagen type I and N-terminal pro-peptide of procollagen type III) biomarkers were collected. Right ventricular dysfunction (RVD) was defined using tricuspid annular plane systolic excursion (TAPSE) <1.7 cm or pulsed Doppler peak annular velocity (S´) <9.5 cm/s. The ability of sST2 to discriminate between mortality was assessed using AuROC curve.
Results
We enrolled 48 patients (mean age 74 [64–79] years, 62.5% males) followed over a period of 1.4 years. Mortality was higher 45.5% (log-rank, p=0.003) in patients with RVD as diagnosed by S' than in patients without RVD. No difference in mortality was observed for RVD defined by TAPSE. There were no differences in the morphology and function parameters of the left ventricle between patients with and without RVD. From all biomarkers measured only sST2 was associated with RVD. Indeed, an age- and sex-adjusted analyses showed that doubling of sST2 was inversely associated with a decreased in S´ (estimate=-2.03, 95% CI [-3.04 to -1.00] cm/s; P=0.002). Mortality was increased in patients with sST2 ≥40.45 ng/mL compared to patients with sST2 <40.45 ng/mL (66.7% vs. 18.9%, log-rank; p=0.004). Crude analysis showed that patients presenting with S’ <9.5 cm/s and sST2 ≥40.45 ng/mL exhibited higher mortality (log-rank; p=0.001) than patients with S’ >9.5 cm/s and sST2 <40.45pg/mL.
Conclusion
Albeit preliminary these findings suggest that an excess of sST2 may be involved in RVD and on its effect on mortality in HD patients. The myocardial pro-remodeling effect of sST2 among HD patients with RVD warrants further investigation.
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Affiliation(s)
- Gregorio Romero-González
- Complejo Hospitalario de Navarra, Nephrology, Pamplona, Spain
- Centre for Applied Medical Research - University of Navarra, Program of Cardiovascular Disease, Pamplona, Spain
| | - Susanna Ravassa
- Centre for Applied Medical Research - University of Navarra, Program of Cardiovascular Disease, Pamplona, Spain
| | | | | | | | - Miguel A Rojas
- Clinica Universidad de Navarra, Nephrology, Pamplona, Spain
| | | | | | | | - Begoña López
- Centre for Applied Medical Research - University of Navarra, Program of Cardiovascular Disease, Pamplona, Spain
| | - Arantxa González
- Centre for Applied Medical Research - University of Navarra, Program of Cardiovascular Disease, Pamplona, Spain
| | - Javier Diez
- Centre for Applied Medical Research - University of Navarra, Program of Cardiovascular Disease, Pamplona, Spain
- Clinica Universidad de Navarra, Cardiology, Pamplona, Spain
- Clinica Universidad de Navarra, Nephrology, Pamplona, Spain
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13
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Etxeberria A, Iribar J, Vrotsou K, Rotaeche R, Barral I, Barral I, Belzunegui J, Bustinduy A, Caso J, Del Bosque C, Etxeberria A, Frias O, Iribar J, Lekuona A, Lombera L, López B, Núñez J, Olasagasti B, Rotaeche R, Royo I, Vrotsou K, Zapata E, Zubeldia X. [Evaluation of the collaboration between Primary and Hospital Care in order to improve inappropriate prescription]. J Healthc Qual Res 2021; 36:91-97. [PMID: 33495114 DOI: 10.1016/j.jhqr.2020.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/12/2020] [Accepted: 09/20/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND OBJECTIVES To evaluate the implementation of a collaborative experience between Primary (PC) and Hospital Care (HC) aimed at reducing potentially inappropriate prescribing (PIP) in patients with polypharmacy. MATERIALS AND METHODS Collaborative experience including a controlled before-after intervention study, carried out in the Donostialdea Integrated Health Organization (IHO), with Bilbao Basurto IHO as control group, Osakidetza, Basque Health Service. Participant were 227 PC physicians and physicians from 7 hospital services, and patients with 5 or more drugs meeting at least one PIP criteria. The intervention consisted of communication and knowledge between professionals, PC-HC consensus, training, identification of patients at risk, medication review, evaluation and feed-back. The collaboration process (agreements, consensus documents, training activities) and the change in the prevalence of PIP in polymedicated patients (using computerised health records) were evaluated. RESULTS A total of 21 PIP criteria and 6 recommendation documents were agreed. An analysis was performed on 15,570 PIP from OSI Donostialdea and 24,866 from the control group. The prevalence of PIP in polymedicated patients was reduced by -4.53% (95% CI: -4.71 to -4.36, P< .0001) in comparison with the control group. The before-after differences were statistically significant across the 7 services. CONCLUSIONS PC-HC collaboration is feasible and, along with other intervention components, reduces inappropriate polypharmacy in the context of a recently integrated healthcare organisation. The collaboration process is complex and requires continuous monitoring, policy involvement, leadership that encourages health professional participation, and intensive use of information systems.
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Affiliation(s)
- A Etxeberria
- Osakidetza, OSI Donostialdea, Farmacia Atención Primaria, Hernani, España; Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, Donostia-San Sebastián, España
| | - J Iribar
- Osakidetza, OSI Donostialdea, Farmacia Atención Primaria, Hernani, España.
| | - K Vrotsou
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, Donostia-San Sebastián, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Instituto de Investigación en Servicios de Salud Kronikgune, Torre del BEC, Barakaldo, España
| | - R Rotaeche
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, Donostia-San Sebastián, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Osakidetza, OSI Donostialdea, Centro de Salud de Alza, Donostia-San Sebastián, España
| | - I Barral
- Osakidetza, Hospital Universitario Donostia, Donostia-San Sebastián, España
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14
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He T, Melgarejo JD, Clark AL, Yu YL, Thijs L, Díez J, López B, González A, Cleland JG, Schanstra JP, Vlahou A, Latosinska A, Mischak H, Staessen JA, Zhang ZY, Jankowski V. Serum and urinary biomarkers of collagen type-I turnover predict prognosis in patients with heart failure. Clin Transl Med 2021; 11:e267. [PMID: 33463057 PMCID: PMC7803349 DOI: 10.1002/ctm2.267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/07/2020] [Accepted: 12/12/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Tianlin He
- Mosaiques Diagnostics GmbH, Hannover, Germany.,Institute for Molecular Cardiovascular Research (IMCAR), RWTH Aachen University, Aachen, Germany
| | - Jesus D Melgarejo
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Andrew L Clark
- Department of Academic Cardiology, Castle Hill Hospital, University of Hull, Cottingham, UK
| | - Yu-Ling Yu
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Javier Díez
- Program of Cardiovascular Diseases, Centre for Applied Medical, University of Navarra and IdisNA, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain.,Departments of Cardiology and Cardiac Surgery and of Nephrology, University of Navarra Clinic, Pamplona, Spain
| | - Begoña López
- Program of Cardiovascular Diseases, Centre for Applied Medical, University of Navarra and IdisNA, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain.,Departments of Cardiology and Cardiac Surgery and of Nephrology, University of Navarra Clinic, Pamplona, Spain
| | - Arantxa González
- Program of Cardiovascular Diseases, Centre for Applied Medical, University of Navarra and IdisNA, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain.,Departments of Cardiology and Cardiac Surgery and of Nephrology, University of Navarra Clinic, Pamplona, Spain
| | - John G Cleland
- Robertson Centre for Biostatistics and Clinical Trials, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Joost P Schanstra
- Institute of Cardiovascular and Metabolic Disease, INSERM, Toulouse, France.,Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Antonia Vlahou
- Biotechnology Laboratory, Centre of Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | | | - Harald Mischak
- Mosaiques Diagnostics GmbH, Hannover, Germany.,BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.,NPA Alliance for the Promotion of Preventive Medicine (APPREMED), Mechelen, Belgium
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Vera Jankowski
- Institute for Molecular Cardiovascular Research (IMCAR), RWTH Aachen University, Aachen, Germany
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15
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Lau ES, Liu E, Paniagua SM, Sarma AA, Zampierollo G, López B, Díez J, Wang TJ, Ho JE. Galectin-3 Inhibition With Modified Citrus Pectin in Hypertension. JACC Basic Transl Sci 2021; 6:12-21. [PMID: 33532663 PMCID: PMC7838053 DOI: 10.1016/j.jacbts.2020.10.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 01/10/2023]
Abstract
We investigated the effect of galectin-3 (Gal-3) inhibition with modified citrus pectin on markers of collagen metabolism in a proof-of-concept randomized placebo-controlled trial of participants with elevated Gal-3 levels and hypertension. Although higher Gal-3 levels were associated with female sex, diabetes, and reduced glomerular filtration rate in cross-sectional analyses, treatment with modified citrus pectin did not change collagen markers. The effect of Gal-3 inhibition among individuals with heart failure warrants further investigation.
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Key Words
- AIx, augmentation index
- AP, augmentation pressure
- CITP, N-terminal telopeptide of type I collagen
- Gal-3, galectin-3
- HF, heart failure
- LV, left ventricular
- MCP, modified citrus pectin
- MMP, matrix metalloproteinase
- PICP, C-terminal propeptide of type I procollagen
- PIIINP, N-terminal propeptide of type III procollagen
- PWV, pulsed wave velocity
- cardiac fibrosis
- eGFR, estimated glomerular filtration rate
- galectin-3
- heart failure
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Affiliation(s)
- Emily S. Lau
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Elizabeth Liu
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Samantha M. Paniagua
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Amy A. Sarma
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Begoña López
- Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain
| | - Javier Díez
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Thomas J. Wang
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jennifer E. Ho
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
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16
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Romero-González G, González A, López B, Ravassa S, Díez J. Heart failure in chronic kidney disease: the emerging role of myocardial fibrosis. Nephrol Dial Transplant 2020; 37:817-824. [PMID: 33313766 DOI: 10.1093/ndt/gfaa284] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Indexed: 12/27/2022] Open
Abstract
Heart failure (HF) is one of the main causes of morbidity and mortality in patients with chronic kidney disease (CKD). Decreased glomerular filtration rate is associated with diffuse deposition of fibrotic tissue in the myocardial interstitium [i.e. myocardial interstitial fibrosis (MIF)] and loss of cardiac function. MIF results from cardiac fibroblast-mediated alterations in the turnover of fibrillary collagen that lead to the excessive synthesis and deposition of collagen fibres. The accumulation of stiff fibrotic tissue alters the mechanical properties of the myocardium, thus contributing to the development of HF. Accumulating evidence suggests that several mechanisms are operative along the different stages of CKD that may converge to alter fibroblasts and collagen turnover in the heart. Therefore, focusing on MIF might enable the identification of fibrosis-related biomarkers and targets that could potentially lead to a new strategy for the prevention and treatment of HF in patients with CKD. This article summarizes current knowledge on the mechanisms and detrimental consequences of MIF in CKD and discusses the validity and usefulness of available biomarkers to recognize the clinical-pathological variability of MIF and track its clinical evolution in CKD patients. Finally, the currently available and potential future therapeutic strategies aimed at personalizing prevention and reversal of MIF in CKD patients, especially those with HF, will be also discussed.
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Affiliation(s)
| | - Arantxa González
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra, Pamplona, Spain.,Institute of Medical Research of Navarra, IDISNA, Pamplona, Spain.,Center of Network Biomedical Research in Cardiovascular Diseases (CIBERCV), Carlos III Institute of Health, Madrid, Spain
| | - Begoña López
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra, Pamplona, Spain.,Institute of Medical Research of Navarra, IDISNA, Pamplona, Spain.,Center of Network Biomedical Research in Cardiovascular Diseases (CIBERCV), Carlos III Institute of Health, Madrid, Spain
| | - Susana Ravassa
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra, Pamplona, Spain.,Institute of Medical Research of Navarra, IDISNA, Pamplona, Spain.,Center of Network Biomedical Research in Cardiovascular Diseases (CIBERCV), Carlos III Institute of Health, Madrid, Spain
| | - Javier Díez
- Department of Nephrology, University of Navarra Clinic, Pamplona, Spain.,Program of Cardiovascular Diseases, CIMA Universidad de Navarra, Pamplona, Spain.,Institute of Medical Research of Navarra, IDISNA, Pamplona, Spain.,Center of Network Biomedical Research in Cardiovascular Diseases (CIBERCV), Carlos III Institute of Health, Madrid, Spain.,Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain
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17
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Garrido-Hoyos S, Garcia K, Miranda E, López B, Briseño J. Kinetics and drainage index in function of pH, in the dewatering of arsenic iron sludge. Sci Total Environ 2020; 742:140251. [PMID: 32623155 DOI: 10.1016/j.scitotenv.2020.140251] [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] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 06/13/2020] [Accepted: 06/14/2020] [Indexed: 06/11/2023]
Abstract
Water for human consumption containing arsenic from natural and anthropogenic sources is a public health problem worldwide. Therefore, different technologies must be used to remove it from the water (coagulation-filtration assisted with ferric chloride, adsorption, membranes, etc.). While these technologies produce water that is free from arsenic, they also produce toxic residuals with high arsenic concentrations, which must be treated in order to decrease their volume and thereby facilitate transport and final disposal. Thus, the main purpose of this investigation was to study the physical and chemical properties of arsenic iron sludge in thickening, chemical conditioning, and dewatering processes, as well as to propose new kinetic criteria for obtaining the drainage index (Eg) based on polymer dose, mesh permeability, specific resistance to filtration, and pH. We found a significant improvement in the physical and chemical properties when thickening the sludge, in particular, floc size increased and specific resistance to filtration and Z-potential decreased due to weakened repulsive forces, resulting in more sedimentation. The polymer AN913VHM (PF2) had the best behavior in the chemical conditioning and dewatering tests, with an optimal dose of 8 mg/L and a mesh permeability of 80-100 ft3/min ft2, which made it possible to retain more flocs (60% in 3.74 min). The pH affected the amount of total solids in the cake, with more solids obtained at a pH of 6 (25.93 g/L) and 6.5 (21.81 g/L), and with rapid drainage of surface water (69.28%). Furthermore, new kinetic criteria were obtained for a drainage time of 120 s in order to eliminate 60% of the total volume of the filtrate mass, with Eg of 3.05 at a pH of 6. This value is considered medium drainage for this type of sludge, which is difficult to treat.
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Affiliation(s)
- S Garrido-Hoyos
- Instituto Mexicano de Tecnología del Agua (IMTA), Paseo Cuahnauhuac 8532, Jiutepec, Mor. 62550, Mexico.
| | - K Garcia
- Instituto Mexicano de Tecnología del Agua (IMTA), Paseo Cuahnauhuac 8532, Jiutepec, Mor. 62550, Mexico
| | - E Miranda
- Postgraduate Program in Master and Doctorate in Environmental Engineering, UNAM-IMTA, Morelos, Mexico
| | - B López
- Universidad Politécnica del Estado de Morelos (UPEMOR), Blvd. Paseo Cuauhnáhuac 566, Lomas del Texcal, Jiutepec, Mor. 62574, Mexico
| | - J Briseño
- Universidad Politécnica del Estado de Morelos (UPEMOR), Blvd. Paseo Cuauhnáhuac 566, Lomas del Texcal, Jiutepec, Mor. 62574, Mexico
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18
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Ravassa S, Beaumont J, Cediel G, Lupón J, López B, Querejeta R, Díez J, Bayés-Genís A, González A. Interacción cardiorrenal y evolución de la insuficiencia cardiaca. ¿Tiene un papel la proteína de unión del factor de crecimiento de tipo insulina 2? Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2019.10.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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19
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Pei J, Harakalova M, Treibel TA, Lumbers RT, Boukens BJ, Efimov IR, van Dinter JT, González A, López B, El Azzouzi H, van den Dungen N, van Dijk CGM, Krebber MM, den Ruijter HM, Pasterkamp G, Duncker DJ, Nieuwenhuis EES, de Weger R, Huibers MM, Vink A, Moore JH, Moon JC, Verhaar MC, Kararigas G, Mokry M, Asselbergs FW, Cheng C. H3K27ac acetylome signatures reveal the epigenomic reorganization in remodeled non-failing human hearts. Clin Epigenetics 2020; 12:106. [PMID: 32664951 PMCID: PMC7362435 DOI: 10.1186/s13148-020-00895-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/30/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND H3K27ac histone acetylome changes contribute to the phenotypic response in heart diseases, particularly in end-stage heart failure. However, such epigenetic alterations have not been systematically investigated in remodeled non-failing human hearts. Therefore, valuable insight into cardiac dysfunction in early remodeling is lacking. This study aimed to reveal the acetylation changes of chromatin regions in response to myocardial remodeling and their correlations to transcriptional changes of neighboring genes. RESULTS We detected chromatin regions with differential acetylation activity (DARs; Padj. < 0.05) between remodeled non-failing patient hearts and healthy donor hearts. The acetylation level of the chromatin region correlated with its RNA polymerase II occupancy level and the mRNA expression level of its adjacent gene per sample. Annotated genes from DARs were enriched in disease-related pathways, including fibrosis and cell metabolism regulation. DARs that change in the same direction have a tendency to cluster together, suggesting the well-reorganized chromatin architecture that facilitates the interactions of regulatory domains in response to myocardial remodeling. We further show the differences between the acetylation level and the mRNA expression level of cell-type-specific markers for cardiomyocytes and 11 non-myocyte cell types. Notably, we identified transcriptome factor (TF) binding motifs that were enriched in DARs and defined TFs that were predicted to bind to these motifs. We further showed 64 genes coding for these TFs that were differentially expressed in remodeled myocardium when compared with controls. CONCLUSIONS Our study reveals extensive novel insight on myocardial remodeling at the DNA regulatory level. Differences between the acetylation level and the transcriptional level of cell-type-specific markers suggest additional mechanism(s) between acetylome and transcriptome. By integrating these two layers of epigenetic profiles, we further provide promising TF-encoding genes that could serve as master regulators of myocardial remodeling. Combined, our findings highlight the important role of chromatin regulatory signatures in understanding disease etiology.
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Affiliation(s)
- Jiayi Pei
- Department of Nephrology and Hypertension, DIGD, UMC Utrecht, University of Utrecht, Utrecht, Netherlands
- Department of Cardiology, Division Heart & Lungs, UMC Utrecht, University of Utrecht, Utrecht, Netherlands
- Regenerative Medicine Utrecht (RMU), UMC Utrecht, University of Utrecht, Utrecht, Netherlands
| | - Magdalena Harakalova
- Department of Cardiology, Division Heart & Lungs, UMC Utrecht, University of Utrecht, Utrecht, Netherlands
- Regenerative Medicine Utrecht (RMU), UMC Utrecht, University of Utrecht, Utrecht, Netherlands
- Department of Pathology, UMC Utrecht, University of Utrecht, Utrecht, Netherlands
| | - Thomas A Treibel
- Institute of Cardiovascular Science, University College London, London, UK
| | - R Thomas Lumbers
- Institute of Cardiovascular Science, University College London, London, UK
| | | | - Igor R Efimov
- Department of Biomedical Engineering, GWU, Washington, D.C, USA
| | - Jip T van Dinter
- Department of Cardiology, Division Heart & Lungs, UMC Utrecht, University of Utrecht, Utrecht, Netherlands
| | - Arantxa González
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain
- CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Begoña López
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain
- CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Hamid El Azzouzi
- Department of Cardiology, Division Heart & Lungs, UMC Utrecht, University of Utrecht, Utrecht, Netherlands
| | | | - Christian G M van Dijk
- Department of Nephrology and Hypertension, DIGD, UMC Utrecht, University of Utrecht, Utrecht, Netherlands
| | - Merle M Krebber
- Department of Nephrology and Hypertension, DIGD, UMC Utrecht, University of Utrecht, Utrecht, Netherlands
| | - Hester M den Ruijter
- Department of Experimental Cardiology, UMC Utrecht, University of Utrecht, Utrecht, Netherlands
| | - Gerard Pasterkamp
- Laboratory of Clinical Chemistry and Hematology, UMC Utrecht, Utrecht, Netherlands
| | - Dirk J Duncker
- Division of Experimental Cardiology, Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Roel de Weger
- Department of Pathology, UMC Utrecht, University of Utrecht, Utrecht, Netherlands
| | - Manon M Huibers
- Department of Pathology, UMC Utrecht, University of Utrecht, Utrecht, Netherlands
| | - Aryan Vink
- Department of Pathology, UMC Utrecht, University of Utrecht, Utrecht, Netherlands
| | - Jason H Moore
- Institute for Biomedical Informatics, UPENN, Philadelphia, USA
| | - James C Moon
- Institute of Cardiovascular Science, University College London, London, UK
| | - Marianne C Verhaar
- Department of Nephrology and Hypertension, DIGD, UMC Utrecht, University of Utrecht, Utrecht, Netherlands
| | - Georgios Kararigas
- Charité - Universitätsmedizin Berlin, and DZHK (German Centre for Cardiovascular Research), partner site, Berlin, Germany
| | - Michal Mokry
- Regenerative Medicine Utrecht (RMU), UMC Utrecht, University of Utrecht, Utrecht, Netherlands.
- Laboratory of Clinical Chemistry and Hematology, UMC Utrecht, Utrecht, Netherlands.
- Division of Paediatrics, UMC Utrecht, University of Utrecht, Utrecht, Netherlands.
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart & Lungs, UMC Utrecht, University of Utrecht, Utrecht, Netherlands.
- Institute of Cardiovascular Science, Faculty of Population Health Science, University College London, London, UK.
- Health Data Research UK and Institute of Health Informatics, University College London, London, UK.
| | - Caroline Cheng
- Department of Nephrology and Hypertension, DIGD, UMC Utrecht, University of Utrecht, Utrecht, Netherlands.
- Regenerative Medicine Utrecht (RMU), UMC Utrecht, University of Utrecht, Utrecht, Netherlands.
- Division of Experimental Cardiology, Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands.
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20
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Romero-González G, Diaz-Dorronsoro A, De la Fuente A, Ravassa S, Garcia-Fernandez N, Martin-Moreno PL, Lavilla J, González O, Rojas MA, Lorenzo I, García-Trigo I, Ania N, Osácar E, Sabalza A, Amézqueta P, López B, González A, Diez J. P1309RIGHT VENTRICULAR-PULMONARY ARTERIAL UNCOUPLING IN PATIENTS ON CHRONIC HEMODIALYSIS WITH SEVERE RIGHT VENTRICULAR REMODELING. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Patients on chronic hemodialysis (HD) may present right ventricular (RV) dysfunction and increased pulmonary artery pressure (PA). The aim of the current study is to describe the RV-PA coupling in chronic patients on HD.
Method
This study explored the adequacy of RV-PA coupling in 41 patients on HD. They underwent a comprehensive transthoracic Doppler echocardiography, and were stratified in accordance with the severity of RV remodeling defined by the presence of RV dilation (tricuspid annulus ≥40 mm) and RV systolic dysfunction (tricuspid annulus systolic excursion plane [TAPSE] <17 mm). RV-PA coupling was estimated by the TAPSE to PA systolic pressure (TAPSE:PASP) ratio.
Results
Three groups of patients were identified: No RV remodeling (Group 1, n=26), mild-to-moderate RV remodeling (Group 2, n=11) and severe RV remodeling (Group 3, n=4). Compared to patients from Groups 1 and 2, patients from Group 3 exhibited significant lower TAPSE values (p<0.001), a tendency to higher PASP values (p=0.054) and significant lower TAPSE:PASP ratio values (p=0.012). C-reactive protein levels and were directly correlated with PASP (r=0.405, p=0.017) and inversely with TAPSE (r=-0.311, p=0.041) and the TAPSE:PASP ratio (r= -0.392, p=0.015) in all patients. These echocardiographic parameters were not correlated with other biochemical, hemodynamic or anthropometric parameters.
Conclusion
These findings suggest that RV-PA coupling is markedly decreased in HD patients with severe RV remodeling. The role of systemic inflammation in RV remodeling and RV-PA uncoupling in HD patients warrants further studies.
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Affiliation(s)
- Gregorio Romero-González
- University of Navarra Clinic, Nephrology Department, Pamplona, Spain
- CIMA (Center for Applied Medical Research) University of Navarre, Cardiovascular Disease, Pamplona, Spain
| | - Agnes Diaz-Dorronsoro
- CIMA (Center for Applied Medical Research) University of Navarre, Cardiovascular Disease, Pamplona, Spain
- University of Navarra Clinic, Cardiology Department, Pamplona, Spain
| | - Ana De la Fuente
- University of Navarra Clinic, Cardiology Department, Pamplona, Spain
| | - Susanna Ravassa
- CIMA (Center for Applied Medical Research) University of Navarre, Cardiovascular Disease, Pamplona, Spain
| | | | | | - Javier Lavilla
- University of Navarra Clinic, Nephrology Department, Pamplona, Spain
| | - Omar González
- University of Navarra Clinic, Nephrology Department, Pamplona, Spain
| | - Miguel A Rojas
- University of Navarra Clinic, Nephrology Department, Pamplona, Spain
| | - Ignacio Lorenzo
- University of Navarra Clinic, Nephrology Department, Pamplona, Spain
| | | | - Noelia Ania
- University of Navarra Clinic, Nephrology Department, Pamplona, Spain
| | - Elena Osácar
- University of Navarra Clinic, Nephrology Department, Pamplona, Spain
| | - Ana Sabalza
- University of Navarra Clinic, Nephrology Department, Pamplona, Spain
| | - Pilar Amézqueta
- University of Navarra Clinic, Nephrology Department, Pamplona, Spain
| | - Begoña López
- CIMA (Center for Applied Medical Research) University of Navarre, Cardiovascular Disease, Pamplona, Spain
| | - Arantxa González
- CIMA (Center for Applied Medical Research) University of Navarre, Cardiovascular Disease, Pamplona, Spain
| | - Javier Diez
- University of Navarra Clinic, Nephrology Department, Pamplona, Spain
- CIMA (Center for Applied Medical Research) University of Navarre, Cardiovascular Disease, Pamplona, Spain
- University of Navarra Clinic, Cardiology Department, Pamplona, Spain
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Purtí E, Inglés J, De la Peña L, Rodríguez MC, Puiggené M, Bernad MC, Calvet S, Orriols RM, López B, Martínez E, Torres MC, Alonso S, Ramada JM. [The Catalan Society of Occupational Health(@SCSL) facing the big challenge of COVID-19]. Arch Prev Riesgos Labor 2020. [PMID: 32320539 DOI: 10.12961/aprl.2020.23.02.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Con la llegada a España del SARS-CoV-2, el incremento exponencial de enfermos de COVID-19 y sus lamentables consecuencias para un número importante de personas, la @SCSL ha tenido que adaptarse a esta nueva situación. El virus se ha propagado en muchos hogares, en numerosas empresas y en todos los centros sanitarios, sociosanitarios y residenciales del país, llegando incluso a situarnos al borde del colapso asistencial. Esta nueva variable, en forma de riesgo biológico, llegó provocando en la población trabajadora un desequilibrio de la siempre compleja relación bidireccional entre el trabajo y la salud…
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Purtí E, Inglés J, De la Peña L, Rodríguez MC, Puiggené M, Bernad MC, Calvet S, Orriols RM, López B, Martínez E, Torres MC, Alonso S, Ramada JM. [The Catalan Society of Occupational Health(@SCSL) facing the big challenge of COVID-19]. Arch Prev Riesgos Labor 2020; 23:146-153. [PMID: 32320539 DOI: 10.12961/aprl.2020.23.02.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 09/29/2022]
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Smyrnias I, Gray SP, Okonko DO, Sawyer G, Zoccarato A, Catibog N, López B, González A, Ravassa S, Díez J, Shah AM. Cardioprotective Effect of the Mitochondrial Unfolded Protein Response During Chronic Pressure Overload. J Am Coll Cardiol 2020; 73:1795-1806. [PMID: 30975297 PMCID: PMC6456800 DOI: 10.1016/j.jacc.2018.12.087] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 12/04/2018] [Accepted: 12/10/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND The mitochondrial unfolded protein response (UPRmt) is activated when misfolded proteins accumulate within mitochondria and leads to increased expression of mitochondrial chaperones and proteases to maintain protein quality and mitochondrial function. Cardiac mitochondria are essential for contractile function and regulation of cell viability, while mitochondrial dysfunction characterizes heart failure. The role of the UPRmt in the heart is unclear. OBJECTIVES The purpose of this study was to: 1) identify conditions that activate the UPRmt in the heart; and 2) study the relationship among the UPRmt, mitochondrial function, and cardiac contractile function. METHODS Cultured cardiac myocytes were subjected to different stresses in vitro. Mice were subjected to chronic pressure overload. Tissues and blood biomarkers were studied in patients with aortic stenosis. RESULTS Diverse neurohumoral or mitochondrial stresses transiently induced the UPRmt in cultured cardiomyocytes. The UPRmt was also induced in the hearts of mice subjected to chronic hemodynamic overload. Boosting the UPRmt with nicotinamide riboside (which augments NAD+ pools) in cardiomyocytes in vitro or hearts in vivo significantly mitigated the reductions in mitochondrial oxygen consumption induced by these stresses. In mice subjected to pressure overload, nicotinamide riboside reduced cardiomyocyte death and contractile dysfunction. Myocardial tissue from patients with aortic stenosis also showed evidence of UPRmt activation, which correlated with reduced tissue cardiomyocyte death and fibrosis and lower plasma levels of biomarkers of cardiac damage (high-sensitivity troponin T) and dysfunction (N-terminal pro-B-type natriuretic peptide). CONCLUSIONS These results identify the induction of the UPRmt in the mammalian (including human) heart exposed to pathological stresses. Enhancement of the UPRmt ameliorates mitochondrial and contractile dysfunction, suggesting that it may serve an important protective role in the stressed heart.
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Affiliation(s)
- Ioannis Smyrnias
- School of Cardiovascular Medicine & Sciences, King's College London British Heart Foundation Centre, London, United Kingdom.
| | - Stephen P Gray
- School of Cardiovascular Medicine & Sciences, King's College London British Heart Foundation Centre, London, United Kingdom
| | - Darlington O Okonko
- School of Cardiovascular Medicine & Sciences, King's College London British Heart Foundation Centre, London, United Kingdom
| | - Greta Sawyer
- School of Cardiovascular Medicine & Sciences, King's College London British Heart Foundation Centre, London, United Kingdom
| | - Anna Zoccarato
- School of Cardiovascular Medicine & Sciences, King's College London British Heart Foundation Centre, London, United Kingdom
| | - Norman Catibog
- School of Cardiovascular Medicine & Sciences, King's College London British Heart Foundation Centre, London, United Kingdom
| | - Begoña López
- Program of Cardiovascular Diseases, CIMA, University of Navarra, IdiSNA, Pamplona, Spain, and CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Arantxa González
- Program of Cardiovascular Diseases, CIMA, University of Navarra, IdiSNA, Pamplona, Spain, and CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Susana Ravassa
- Program of Cardiovascular Diseases, CIMA, University of Navarra, IdiSNA, Pamplona, Spain, and CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Javier Díez
- Program of Cardiovascular Diseases, CIMA, University of Navarra, IdiSNA, Pamplona, Spain, and CIBERCV, Carlos III Institute of Health, Madrid, Spain; Department of Cardiology and Cardiac Surgery and Department of Nephrology, University of Navarra Clinic, Pamplona, Spain
| | - Ajay M Shah
- School of Cardiovascular Medicine & Sciences, King's College London British Heart Foundation Centre, London, United Kingdom.
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Eiros R, Romero-González G, Gavira JJ, Beloqui O, Colina I, Fortún Landecho M, López B, González A, Díez J, Ravassa S. Does Chronic Kidney Disease Facilitate Malignant Myocardial Fibrosis in Heart Failure with Preserved Ejection Fraction of Hypertensive Origin? J Clin Med 2020; 9:jcm9020404. [PMID: 32028612 PMCID: PMC7073733 DOI: 10.3390/jcm9020404] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/28/2020] [Accepted: 01/31/2020] [Indexed: 12/28/2022] Open
Abstract
In hypertensive patients with heart failure (HF) a serum biomarker combination of high carboxy-terminal propeptide of procollagen type-I (PICP) and low carboxy-terminal telopeptide of collagen type-I to matrix metalloproteinase-1 (CITP:MMP-1) ratio identifies a histomolecular phenotype of malignant myocardial fibrosis (mMF) associated with severe diastolic dysfunction (DD) and poor outcomes. As chronic kidney disease (CKD) facilitates MF and DD, we investigated the influence of CKD on the mMF biomarker combination in HF patients with preserved ejection fraction (HFpEF). Hypertensives (n = 365), 232 non-HF and 133 HFpEF, were studied, and 35% non-HF and 46% HFpEF patients had CKD (estimated glomerular filtration rate < 60 mL/min/1.73 m2 or urine albumin-to-creatinine ratio ≥ 30 mg/g). Specific immunoassays were performed to determine biomarkers. Medians were used to establish the high PICP and low CITP:MMP-1 combination. A comparison with non-HF showed that the biomarker combination presence was increased in HFpEF patients, being associated with CKD in all patients. CKD influenced the association of the biomarker combination and HFpEF (p for interaction ≤ 0.019). The E:e’ ratio was associated with the biomarker combination in CKD patients. Among CKD patients with HFpEF, those with the biomarker combination exhibited higher (p = 0.016) E:e’ ratio than those without the pattern. These findings suggest that CKD facilitates the development of biomarker-assessed mMF and DD in hypertensive HFpEF patients.
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Affiliation(s)
- Rocio Eiros
- Department of Cardiology and Cardiac Surgery, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (J.J.G.); (J.D.)
- Correspondence: ; Tel.: +34-948194700
| | | | - Juan Jose Gavira
- Department of Cardiology and Cardiac Surgery, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (J.J.G.); (J.D.)
- Program of Cardiovascular and Renal Diseases, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (O.B.); (I.C.); (M.F.L.); (B.L.); (A.G.); (S.R.)
| | - Oscar Beloqui
- Program of Cardiovascular and Renal Diseases, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (O.B.); (I.C.); (M.F.L.); (B.L.); (A.G.); (S.R.)
- Department of Internal Medicine, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Inmaculada Colina
- Program of Cardiovascular and Renal Diseases, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (O.B.); (I.C.); (M.F.L.); (B.L.); (A.G.); (S.R.)
- Department of Internal Medicine, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Manuel Fortún Landecho
- Program of Cardiovascular and Renal Diseases, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (O.B.); (I.C.); (M.F.L.); (B.L.); (A.G.); (S.R.)
- Department of Internal Medicine, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Begoña López
- Program of Cardiovascular and Renal Diseases, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (O.B.); (I.C.); (M.F.L.); (B.L.); (A.G.); (S.R.)
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra, 31008 Pamplona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Arantxa González
- Program of Cardiovascular and Renal Diseases, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (O.B.); (I.C.); (M.F.L.); (B.L.); (A.G.); (S.R.)
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra, 31008 Pamplona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Javier Díez
- Department of Cardiology and Cardiac Surgery, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (J.J.G.); (J.D.)
- Department of Nephrology, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
- Program of Cardiovascular and Renal Diseases, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (O.B.); (I.C.); (M.F.L.); (B.L.); (A.G.); (S.R.)
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra, 31008 Pamplona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
| | - Susana Ravassa
- Program of Cardiovascular and Renal Diseases, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain; (O.B.); (I.C.); (M.F.L.); (B.L.); (A.G.); (S.R.)
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra, 31008 Pamplona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
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Ravassa S, Beaumont J, Cediel G, Lupón J, López B, Querejeta R, Díez J, Bayés-Genís A, González A. Cardiorenal interaction and heart failure outcomes. A role for insulin-like growth factor binding protein 2? Rev Esp Cardiol (Engl Ed) 2020; 73:835-843. [PMID: 31948893 DOI: 10.1016/j.rec.2019.10.012] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/24/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION AND OBJECTIVES Preliminary results suggest that high circulating insulin-like growth factor binding protein 2 (IGFBP2) levels are associated with mortality risk in heart failure (HF) patients. As IGFBP2 levels are increased in patients with chronic kidney disease (CKD), which is associated with a higher mortality risk in HF patients, we examined whether IGFBP2 is associated with CKD in HF patients, and whether CKD modifies the prognostic value of this protein in HF patients. METHODS HF patients (n=686, mean age 66.6 years, 32.7% women) were enrolled and followed up for a median of 3.5 (min-max range: 0.1-6) years. Patients were classified as having CKD with decreased estimated glomerular filtration rate (eGFR <60mL/min/1.73 m2) or as having CKD with nondecreased eGFR (≥ 60mL/min/1.73 m2). Serum IGFBP2 was detected by ELISA. RESULTS IGFBP2 was increased (P <.001) in CKD patients with decreased eGFR (n=290, 42.3%) compared with patients with nondecreased eGFR. IGFBP2 was directly associated with NT-proBNP (P <.001) and inversely associated with eGFR (P <.001), with both associations being independent of confounding factors. IGFBP2 was directly and independently associated with cardiovascular and all-cause death (P <.001) in the whole group of patients, but showed a stronger association with cardiovascular death in CKD patients with decreased eGFR (P for interaction <.05), improving risk prediction in these patients over clinically relevant risk factors. CONCLUSIONS Serum IGFBP2 is associated with impaired renal function and prognosticates cardiovascular death in patients with HF and CKD with decreased eGFR. Thus, there is an effect modification of CKD on circulating IGFBP2 and on its association with cardiovascular mortality in HF patients.
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Affiliation(s)
- Susana Ravassa
- Programa de Enfermedades Cardiovasculares, CIMA Universidad de Navarra, Pamplona, Navarra, Spain; Área de Enfermedades Cardiovasculares, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Instituto de Salud Carlos III, CIBERCV, Madrid, Spain.
| | - Javier Beaumont
- Programa de Enfermedades Cardiovasculares, CIMA Universidad de Navarra, Pamplona, Navarra, Spain; Área de Enfermedades Cardiovasculares, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Instituto de Salud Carlos III, CIBERCV, Madrid, Spain
| | - Germán Cediel
- Servei de Cardiologia i Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Josep Lupón
- Instituto de Salud Carlos III, CIBERCV, Madrid, Spain; Servei de Cardiologia i Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Begoña López
- Programa de Enfermedades Cardiovasculares, CIMA Universidad de Navarra, Pamplona, Navarra, Spain; Área de Enfermedades Cardiovasculares, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Instituto de Salud Carlos III, CIBERCV, Madrid, Spain
| | - Ramón Querejeta
- Servicio de Cardiología, Hospital Universitario Donostia, San Sebastián, Gipuzkoa, Spain
| | - Javier Díez
- Programa de Enfermedades Cardiovasculares, CIMA Universidad de Navarra, Pamplona, Navarra, Spain; Área de Enfermedades Cardiovasculares, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Instituto de Salud Carlos III, CIBERCV, Madrid, Spain; Departamento de Cardiología y Cirugía Cardiaca, Clínica Universidad de Navarra, Pamplona, Navarra, Spain; Departamento de Nefrología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Antoni Bayés-Genís
- Instituto de Salud Carlos III, CIBERCV, Madrid, Spain; Servei de Cardiologia i Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; Grupo ICREC (Insuficiència Cardíaca i Regeneració Cardíaca), Instituto de Investigación en Ciencias de la Salud Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Arantxa González
- Programa de Enfermedades Cardiovasculares, CIMA Universidad de Navarra, Pamplona, Navarra, Spain; Área de Enfermedades Cardiovasculares, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; Instituto de Salud Carlos III, CIBERCV, Madrid, Spain
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Schimmel K, Jung M, Foinquinos A, José GS, Beaumont J, Bock K, Grote-Levi L, Xiao K, Bär C, Pfanne A, Just A, Zimmer K, Ngoy S, López B, Ravassa S, Samolovac S, Janssen-Peters H, Remke J, Scherf K, Dangwal S, Piccoli MT, Kleemiss F, Kreutzer FP, Kenneweg F, Leonardy J, Hobuß L, Santer L, Do QT, Geffers R, Braesen JH, Schmitz J, Brandenberger C, Müller DN, Wilck N, Kaever V, Bähre H, Batkai S, Fiedler J, Alexander KM, Wertheim BM, Fisch S, Liao R, Diez J, González A, Thum T. Natural Compound Library Screening Identifies New Molecules for the Treatment of Cardiac Fibrosis and Diastolic Dysfunction. Circulation 2020; 141:751-767. [PMID: 31948273 PMCID: PMC7050799 DOI: 10.1161/circulationaha.119.042559] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Myocardial fibrosis is a hallmark of cardiac remodeling and functionally involved in heart failure development, a leading cause of deaths worldwide. Clinically, no therapeutic strategy is available that specifically attenuates maladaptive responses of cardiac fibroblasts, the effector cells of fibrosis in the heart. Therefore, our aim was to develop novel antifibrotic therapeutics based on naturally derived substance library screens for the treatment of cardiac fibrosis. METHODS Antifibrotic drug candidates were identified by functional screening of 480 chemically diverse natural compounds in primary human cardiac fibroblasts, subsequent validation, and mechanistic in vitro and in vivo studies. Hits were analyzed for dose-dependent inhibition of proliferation of human cardiac fibroblasts, modulation of apoptosis, and extracellular matrix expression. In vitro findings were confirmed in vivo with an angiotensin II-mediated murine model of cardiac fibrosis in both preventive and therapeutic settings, as well as in the Dahl salt-sensitive rat model. To investigate the mechanism underlying the antifibrotic potential of the lead compounds, treatment-dependent changes in the noncoding RNAome in primary human cardiac fibroblasts were analyzed by RNA deep sequencing. RESULTS High-throughput natural compound library screening identified 15 substances with antiproliferative effects in human cardiac fibroblasts. Using multiple in vitro fibrosis assays and stringent selection algorithms, we identified the steroid bufalin (from Chinese toad venom) and the alkaloid lycorine (from Amaryllidaceae species) to be effective antifibrotic molecules both in vitro and in vivo, leading to improvement in diastolic function in 2 hypertension-dependent rodent models of cardiac fibrosis. Administration at effective doses did not change plasma damage markers or the morphology of kidney and liver, providing the first toxicological safety data. Using next-generation sequencing, we identified the conserved microRNA 671-5p and downstream the antifibrotic selenoprotein P1 as common effectors of the antifibrotic compounds. CONCLUSIONS We identified the molecules bufalin and lycorine as drug candidates for therapeutic applications in cardiac fibrosis and diastolic dysfunction.
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Affiliation(s)
- Katharina Schimmel
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Mira Jung
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Ariana Foinquinos
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Gorka San José
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,CIBERCV, Institute of Health Carlos III, Madrid, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.)
| | - Javier Beaumont
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,CIBERCV, Institute of Health Carlos III, Madrid, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.)
| | - Katharina Bock
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Lea Grote-Levi
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Ke Xiao
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Christian Bär
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Angelika Pfanne
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Annette Just
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Karina Zimmer
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Soeun Ngoy
- Department of Medicine, Divisions of Genetics and Cardiology (S.N., S.F., R.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Begoña López
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,CIBERCV, Institute of Health Carlos III, Madrid, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.)
| | - Susana Ravassa
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,CIBERCV, Institute of Health Carlos III, Madrid, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.)
| | - Sabine Samolovac
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Heike Janssen-Peters
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Janet Remke
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Kristian Scherf
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany.,Cardiovascular Institute, Stanford University School of Medicine, CA (K.S., S.D., K.M.A., R.L.)
| | - Seema Dangwal
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany.,Cardiovascular Institute, Stanford University School of Medicine, CA (K.S., S.D., K.M.A., R.L.)
| | - Maria-Teresa Piccoli
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Felix Kleemiss
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Fabian Philipp Kreutzer
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Franziska Kenneweg
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Julia Leonardy
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Lisa Hobuß
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Laura Santer
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Quoc-Tuan Do
- Greenpharma SAS, Department of Chemoinformatics, Orléans, France (Q.-T.D.)
| | - Robert Geffers
- Helmholtz Centre for Infection Research, Research Group Genome Analytics, Braunschweig, Germany (R.G.)
| | - Jan Hinrich Braesen
- Institute for Pathology, Nephropathology Unit (J.H.B., J.S.), Hannover Medical School, Germany
| | - Jessica Schmitz
- Institute for Pathology, Nephropathology Unit (J.H.B., J.S.), Hannover Medical School, Germany
| | - Christina Brandenberger
- Institute of Functional and Applied Anatomy (C. Brandenberger), Hannover Medical School, Germany
| | - Dominik N Müller
- Experimental and Clinical Research Center, a cooperation of Charité-Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Germany (D.N.M., N.W.)
| | - Nicola Wilck
- Experimental and Clinical Research Center, a cooperation of Charité-Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Germany (D.N.M., N.W.).,Division of Nephrology and Internal Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Germany (N.W.)
| | - Volkhard Kaever
- Research Core Unit Metabolomics, Institute of Pharmacology (V.K., H.B.), Hannover Medical School, Germany
| | - Heike Bähre
- Research Core Unit Metabolomics, Institute of Pharmacology (V.K., H.B.), Hannover Medical School, Germany
| | - Sandor Batkai
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Jan Fiedler
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany
| | - Kevin M Alexander
- Cardiovascular Institute, Stanford University School of Medicine, CA (K.S., S.D., K.M.A., R.L.)
| | - Bradley M Wertheim
- Department of Medicine, Division of Pulmonary and Critical Care Medicine (B.M.W.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Sudeshna Fisch
- Department of Medicine, Divisions of Genetics and Cardiology (S.N., S.F., R.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Ronglih Liao
- Cardiovascular Institute, Stanford University School of Medicine, CA (K.S., S.D., K.M.A., R.L.).,Department of Medicine, Divisions of Genetics and Cardiology (S.N., S.F., R.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Javier Diez
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,CIBERCV, Institute of Health Carlos III, Madrid, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,Department of Cardiology and Cardiac Surgery and Department of Nephrology, Clínica Universidad de Navarra, Pamplona, Spain (J.D.)
| | - Arantxa González
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.).,CIBERCV, Institute of Health Carlos III, Madrid, Spain (G.S.J., J.B., B.L., S.R., J.D., A.G.)
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies (K.S., M.J., A.F., K.B., L.G.-L., K.X., C. Bär, A.P., A.J., K.Z., S.S., H.J.-P., J.R., K.S., S.D., M.-T.P., F.K., F.P.K., F.K., J.L., L.H., L.S., S.B., J.F., T.T.), Hannover Medical School, Germany.,REBIRTH Center of Translational Regenerative Medicine (T.T.), Hannover Medical School, Germany
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Cauwenberghs N, Ravassa S, Thijs L, Haddad F, Yang WY, Wei FF, López B, González A, Díez J, Staessen JA, Kuznetsova T. Circulating Biomarkers Predicting Longitudinal Changes in Left Ventricular Structure and Function in a General Population. J Am Heart Assoc 2020; 8:e010430. [PMID: 30638123 PMCID: PMC6497333 DOI: 10.1161/jaha.118.010430] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Serial imaging studies in the general population remain important to evaluate the usefulness of pathophysiologically relevant biomarkers in predicting progression of left ventricular (LV) remodeling and dysfunction. Here, we assessed in a general population whether these circulating biomarkers at baseline predict longitudinal changes in LV structure and function. Methods and Results In 592 participants (mean age, 50.8 years; 51.4% women; 40.5% hypertensive), we derived echocardiographic indexes reflecting LV structure and function at baseline and after 4.7 years. At baseline, we measured alkaline phosphatase, markers of collagen turnover (procollagen type I, C-terminal telopeptide, matrix metalloproteinase-1) and high-sensitivity cardiac troponin T. We regressed longitudinal changes in LV indexes on baseline biomarker levels and reported standardized effect sizes as a fraction of the standard deviation of LV change. After full adjustment, a decline in LV longitudinal strain (-14.2%) and increase in E/e' ratio over time (+18.9%; P≤0.019) was associated with higher alkaline phosphatase activity at baseline. Furthermore, longitudinal strain decreased with higher levels of collagen I production and degradation at baseline (procollagen type I, -14.2%; C-terminal telopeptide, -16.4%; P≤0.029). An increase in E/e' ratio over time was borderline associated with lower matrix metalloproteinase-1 (+9.8%) and lower matrix metalloproteinase-1/tissue inhibitor of metalloproteinase-1 ratio (+11.9%; P≤0.041). Higher high-sensitivity cardiac troponin T levels at baseline correlated significantly with an increase in relative wall thickness (+23.1%) and LV mass index (+18.3%) during follow-up ( P≤0.035). Conclusions We identified a set of biomarkers predicting adverse changes in LV structure and function over time. Circulating biomarkers reflecting LV stiffness, injury, and collagen composition might improve the identification of subjects at risk for subclinical cardiac maladaptation.
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Affiliation(s)
- Nicholas Cauwenberghs
- 1 Research Unit Hypertension and Cardiovascular Epidemiology KU Leuven Department of Cardiovascular Sciences University of Leuven Belgium
| | - Susana Ravassa
- 2 Program of Cardiovascular Diseases Centre for Applied Medical Research University of Navarra Pamplona Spain.,3 IdiSNA Navarra Institute for Health Research Pamplona Spain.,4 CIBERCV Carlos III Institute of Health Madrid Spain
| | - Lutgarde Thijs
- 1 Research Unit Hypertension and Cardiovascular Epidemiology KU Leuven Department of Cardiovascular Sciences University of Leuven Belgium
| | - Francois Haddad
- 5 Division of Cardiovascular Medicine Stanford University School of Medicine and Stanford Cardiovascular Institute Stanford CA
| | - Wen-Yi Yang
- 1 Research Unit Hypertension and Cardiovascular Epidemiology KU Leuven Department of Cardiovascular Sciences University of Leuven Belgium
| | - Fang-Fei Wei
- 1 Research Unit Hypertension and Cardiovascular Epidemiology KU Leuven Department of Cardiovascular Sciences University of Leuven Belgium
| | - Begoña López
- 2 Program of Cardiovascular Diseases Centre for Applied Medical Research University of Navarra Pamplona Spain.,3 IdiSNA Navarra Institute for Health Research Pamplona Spain.,4 CIBERCV Carlos III Institute of Health Madrid Spain
| | - Arantxa González
- 2 Program of Cardiovascular Diseases Centre for Applied Medical Research University of Navarra Pamplona Spain.,3 IdiSNA Navarra Institute for Health Research Pamplona Spain.,4 CIBERCV Carlos III Institute of Health Madrid Spain
| | - Javier Díez
- 2 Program of Cardiovascular Diseases Centre for Applied Medical Research University of Navarra Pamplona Spain.,3 IdiSNA Navarra Institute for Health Research Pamplona Spain.,4 CIBERCV Carlos III Institute of Health Madrid Spain.,6 Department of Cardiology and Cardiac Surgery University of Navarra Pamplona Spain.,7 Department of Nephrology University of Navarra Pamplona Spain
| | - Jan A Staessen
- 1 Research Unit Hypertension and Cardiovascular Epidemiology KU Leuven Department of Cardiovascular Sciences University of Leuven Belgium
| | - Tatiana Kuznetsova
- 1 Research Unit Hypertension and Cardiovascular Epidemiology KU Leuven Department of Cardiovascular Sciences University of Leuven Belgium
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28
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Treibel TA, López B, González A, Menacho K, Schofield RS, Ravassa S, Fontana M, White SK, DiSalvo C, Roberts N, Ashworth MT, Díez J, Moon JC. Reappraising myocardial fibrosis in severe aortic stenosis: an invasive and non-invasive study in 133 patients. Eur Heart J 2019; 39:699-709. [PMID: 29020257 PMCID: PMC5888951 DOI: 10.1093/eurheartj/ehx353] [Citation(s) in RCA: 157] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 06/23/2017] [Indexed: 12/16/2022] Open
Abstract
Aims To investigate myocardial fibrosis (MF) in a large series of severe aortic stenosis (AS) patients using invasive biopsy and non-invasive imaging. Methods and results One hundred thirty-three patients with severe, symptomatic AS accepted for surgical aortic valve replacement underwent cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE) and extracellular volume fraction (ECV) quantification. Intra-operative left ventricular (LV) biopsies were performed by needle or scalpel, yielding tissue with (n = 53) and without endocardium (n = 80), and compared with 10 controls. Myocardial fibrosis occurred in three patterns: (i) thickened endocardium with a fibrotic layer; (ii) microscopic scars, with a subendomyocardial predominance; and (iii) diffuse interstitial fibrosis. Collagen volume fraction (CVF) was elevated (P < 0.001) compared with controls, and higher (P < 0.001) in endocardium-containing samples with a decreasing CVF gradient from the subendocardium (P = 0.001). Late gadolinium enhancement correlated with CVF (P < 0.001) but not ECV. Both LGE and ECV correlated independently (P < 0.001) with N-terminal pro-brain natriuretic peptide and high-sensitivity-troponin T. High ECV was also associated with worse LV remodelling, left ventricular ejection fraction and functional capacity. Combining high ECV and LGE better identified patients with more adverse LV remodelling, blood biomarkers and histological parameters, and worse functional capacity than each parameter alone. Conclusion Myocardial fibrosis in severe AS is complex, but three main patterns exist: endocardial fibrosis, microscars (mainly in the subendomyocardium), and diffuse interstitial fibrosis. Neither histological CVF nor the CMR parameters ECV and LGE capture fibrosis in its totality. A combined, multi-parametric approach with ECV and LGE allows best stratification of AS patients according to the response of the myocardial collagen matrix. ![]()
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Affiliation(s)
- Thomas A Treibel
- Cardiac Imaging, Barts Heart Centre, St. Bartholomew's Hospital, 2nd Floor, King George V Block, Barts Heart Centre, St. Bartholomew's Hospital, London EC1A 7BE, UK.,Institute for Cardiovascular Sciences, University College London, Gower Street, London WC1E 6BT, UK
| | - Begoña López
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Avda/ Pío XII 55, 31008, Pamplona, Spain.,CIBERCV, National Institute of Health Carlos III, C/ Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Arantxa González
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Avda/ Pío XII 55, 31008, Pamplona, Spain.,CIBERCV, National Institute of Health Carlos III, C/ Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Katia Menacho
- Cardiac Imaging, Barts Heart Centre, St. Bartholomew's Hospital, 2nd Floor, King George V Block, Barts Heart Centre, St. Bartholomew's Hospital, London EC1A 7BE, UK
| | - Rebecca S Schofield
- Cardiac Imaging, Barts Heart Centre, St. Bartholomew's Hospital, 2nd Floor, King George V Block, Barts Heart Centre, St. Bartholomew's Hospital, London EC1A 7BE, UK
| | - Susana Ravassa
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Avda/ Pío XII 55, 31008, Pamplona, Spain.,CIBERCV, National Institute of Health Carlos III, C/ Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Marianna Fontana
- Institute for Cardiovascular Sciences, University College London, Gower Street, London WC1E 6BT, UK
| | - Steven K White
- Institute for Cardiovascular Sciences, University College London, Gower Street, London WC1E 6BT, UK
| | - Carmelo DiSalvo
- Cardiac Imaging, Barts Heart Centre, St. Bartholomew's Hospital, 2nd Floor, King George V Block, Barts Heart Centre, St. Bartholomew's Hospital, London EC1A 7BE, UK
| | - Neil Roberts
- Cardiac Imaging, Barts Heart Centre, St. Bartholomew's Hospital, 2nd Floor, King George V Block, Barts Heart Centre, St. Bartholomew's Hospital, London EC1A 7BE, UK
| | - Michael T Ashworth
- Institute for Cardiovascular Sciences, University College London, Gower Street, London WC1E 6BT, UK.,Department of Histopathology, Great Ormond Street Hospital for Children National Health Service Trust, Great Ormond Street, London WC1N 3JH, UK
| | - Javier Díez
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Avda/ Pío XII 55, 31008, Pamplona, Spain.,CIBERCV, National Institute of Health Carlos III, C/ Monforte de Lemos 3-5, 28029, Madrid, Spain.,Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Avda/ Pío XII 36, 31008, Pamplona, Spain
| | - James C Moon
- Cardiac Imaging, Barts Heart Centre, St. Bartholomew's Hospital, 2nd Floor, King George V Block, Barts Heart Centre, St. Bartholomew's Hospital, London EC1A 7BE, UK.,Institute for Cardiovascular Sciences, University College London, Gower Street, London WC1E 6BT, UK
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Santer L, López B, Ravassa S, Baer C, Riedel I, Chatterjee S, Moreno MU, González A, Querejeta R, Pinet F, Thum T, Díez J. Circulating Long Noncoding RNA LIPCAR Predicts Heart Failure Outcomes in Patients Without Chronic Kidney Disease. Hypertension 2019; 73:820-828. [PMID: 30686085 DOI: 10.1161/hypertensionaha.118.12261] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [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: 12/12/2022]
Abstract
The plasma levels of long noncoding RNA LIPCAR are elevated in heart failure (HF) patients with reduced ejection fraction and associated with left ventricular remodeling and poor outcomes. We studied whether the presence of chronic kidney disease (CKD), as defined by an estimated glomerular filtration rate value <60mL/(min·1.73m2) modified the associations of plasma LIPCAR with left ventricular remodeling and outcomes in HF patients. Two hundred and thirty-four patients (mean age 74 [9.14] years, 50% male) were enrolled and followed for 4.73 (0.24-7.25) years. Plasma LIPCAR was detected by real-time quantitative polymerase chain reaction. LIPCAR was increased ( P=0.005) in patients compared with 17 age- and sex-matched controls, directly correlated with age ( P=0.001) and with the maximal early transmitral flow velocity to the mean peak early diastolic velocity of the mitral annulus displacement ratio ( P=0.001) and inversely correlated with estimated glomerular filtration rate ( P<0.001). LIPCAR was associated with hospitalization for HF, cardiovascular death, and a composite of hospitalization for HF or cardiovascular death ( P≤0.010), these associations being dependent of estimated glomerular filtration rate. The interactions between estimated glomerular filtration rate and LIPCAR with respect to these outcomes were statistically significant or of borderline significance ( P≤0.060). LIPCAR was increased in CKD patients compared with non-CKD patients ( P=0.021). LIPCAR was independently associated with hospitalization for HF ( P≤0.039) only in non-CKD patients, but its addition to traditional risk factors did not improve risk prediction in these patients. In conclusion, plasma LIPCAR prognosticates outcomes in elderly HF patients without CKD. Thus, there is an effect modification of CKD on the association of circulating LIPCAR with outcomes in HF patients.
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Affiliation(s)
- Laura Santer
- From the Institute of Molecular and Translational Therapeutic Strategies (IMTTS) and REBIRTH Excellence Cluster, Hannover Medical School, Germany (L.S., C.B., I.R., S.C., T.T.)
| | - Begoña López
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (B.L., S.R., M.U.M., A.G., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (B.L., S.R., M.U.M., A.G., J.D.).,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain (B.L., S.R., M.U.M., A.G., J.D.)
| | - Susana Ravassa
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (B.L., S.R., M.U.M., A.G., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (B.L., S.R., M.U.M., A.G., J.D.).,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain (B.L., S.R., M.U.M., A.G., J.D.)
| | - Christian Baer
- From the Institute of Molecular and Translational Therapeutic Strategies (IMTTS) and REBIRTH Excellence Cluster, Hannover Medical School, Germany (L.S., C.B., I.R., S.C., T.T.)
| | - Isabelle Riedel
- From the Institute of Molecular and Translational Therapeutic Strategies (IMTTS) and REBIRTH Excellence Cluster, Hannover Medical School, Germany (L.S., C.B., I.R., S.C., T.T.)
| | - Shambhabi Chatterjee
- From the Institute of Molecular and Translational Therapeutic Strategies (IMTTS) and REBIRTH Excellence Cluster, Hannover Medical School, Germany (L.S., C.B., I.R., S.C., T.T.)
| | - María U Moreno
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (B.L., S.R., M.U.M., A.G., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (B.L., S.R., M.U.M., A.G., J.D.).,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain (B.L., S.R., M.U.M., A.G., J.D.)
| | - Arantxa González
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (B.L., S.R., M.U.M., A.G., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (B.L., S.R., M.U.M., A.G., J.D.).,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain (B.L., S.R., M.U.M., A.G., J.D.)
| | - Ramón Querejeta
- Division of Cardiology, Donostia University Hospital, San Sebastián, Spain (R.Q.)
| | - Florence Pinet
- Inserm U1167-Univ Lille, Institut Pasteur de Lille, FHU-REMOD-VHF, France (F.P.)
| | - Thomas Thum
- From the Institute of Molecular and Translational Therapeutic Strategies (IMTTS) and REBIRTH Excellence Cluster, Hannover Medical School, Germany (L.S., C.B., I.R., S.C., T.T.).,National Heart and Lung Institute, Imperial College London, United Kingdom (T.T.)
| | - Javier Díez
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (B.L., S.R., M.U.M., A.G., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (B.L., S.R., M.U.M., A.G., J.D.).,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain (B.L., S.R., M.U.M., A.G., J.D.).,Departments of Cardiology and Cardiac Surgery, and Nephrology, University of Navarra Clinic, Pamplona, Spain (J.D.)
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30
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Martínez-Martínez E, Brugnolaro C, Ibarrola J, Ravassa S, Buonafine M, López B, Fernández-Celis A, Querejeta R, Santamaria E, Fernández-Irigoyen J, Rábago G, Moreno MU, Jaisser F, Díez J, González A, López-Andrés N. CT-1 (Cardiotrophin-1)-Gal-3 (Galectin-3) Axis in Cardiac Fibrosis and Inflammation. Hypertension 2019; 73:602-611. [PMID: 30612490 DOI: 10.1161/hypertensionaha.118.11874] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [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: 11/16/2022]
Abstract
Myocardial fibrosis is a main contributor to the development of heart failure (HF). CT-1 (cardiotrophin-1) and Gal-3 (galectin-3) are increased in HF and associated with myocardial fibrosis. The aim of this study is to analyze whether CT-1 regulates Gal-3. Proteomic analysis revealed that Gal-3 was upregulated by CT-1 in human cardiac fibroblasts in parallel with other profibrotic and proinflammatory markers. CT-1 upregulation of Gal-3 was mediated by ERK (extracellular signal-regulated kinase) 1/2 and Stat-3 (signal transducer and activator of transcription 3) pathways. Male Wistar rats and B6CBAF1 mice treated with CT-1 (20 µg/kg per day) presented higher cardiac Gal-3 levels and myocardial fibrosis. In CT-1-treated rats, direct correlations were found between cardiac CT-1 and Gal-3 levels, as well as between Gal-3 and perivascular fibrosis. Gal-3 genetic disruption in human cardiac fibroblasts and pharmacological Gal-3 inhibition in mice prevented the profibrotic and proinflammatory effects of CT-1. Dahl salt-sensitive hypertensive rats with diastolic dysfunction showed increased cardiac CT-1 and Gal-3 expression together with cardiac fibrosis and inflammation. CT-1 and Gal-3 directly correlated with myocardial fibrosis. In HF patients, myocardial and plasma CT-1 and Gal-3 were increased and directly correlated. In addition, HF patients with high CT-1 and Gal-3 plasma levels presented an increased risk of cardiovascular death. Our data suggest that CT-1 upregulates Gal-3 which, in turn, mediates the proinflammatory and profibrotic myocardial effects of CT-1. The elevation of both molecules in HF patients identifies a subgroup of patients with a higher risk of cardiovascular mortality. The CT-1/Gal-3 axis emerges as a candidate therapeutic target and a potential prognostic biomarker in HF.
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Affiliation(s)
- Ernesto Martínez-Martínez
- From the Cardiovascular Translational Research, Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona. Spain (E.M.-M., J.I., A.F.-C., N.L.-A.).,INSERM UMRS 1138 Team 1, Centre de Recherche des Cordeliers, University Pierre and Marie Curie, Paris, France (E.M.M., M.B., F.J.)
| | - Cristina Brugnolaro
- Program of Cardiovascular Diseases, CIMA University of Navarra and IdiSNA, Pamplona. Spain (C.B., S.R., B.L., M.U.M., J.D., A.G.)
| | - Jaime Ibarrola
- From the Cardiovascular Translational Research, Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona. Spain (E.M.-M., J.I., A.F.-C., N.L.-A.)
| | - Susana Ravassa
- Program of Cardiovascular Diseases, CIMA University of Navarra and IdiSNA, Pamplona. Spain (C.B., S.R., B.L., M.U.M., J.D., A.G.).,CIBERCV, Carlos III Institute of Health, Madrid. Spain (S.R., B.L., M.U.M., J.D., A.G.)
| | - Mathieu Buonafine
- INSERM UMRS 1138 Team 1, Centre de Recherche des Cordeliers, University Pierre and Marie Curie, Paris, France (E.M.M., M.B., F.J.)
| | - Begoña López
- Program of Cardiovascular Diseases, CIMA University of Navarra and IdiSNA, Pamplona. Spain (C.B., S.R., B.L., M.U.M., J.D., A.G.).,CIBERCV, Carlos III Institute of Health, Madrid. Spain (S.R., B.L., M.U.M., J.D., A.G.)
| | - Amaya Fernández-Celis
- From the Cardiovascular Translational Research, Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona. Spain (E.M.-M., J.I., A.F.-C., N.L.-A.)
| | - Ramón Querejeta
- Department of Cardiology, Donostia University Hospital, Biodonostia, Basque Country University, San Sebastián, Spain (R.Q.)
| | - Enrique Santamaria
- Proteored-ISCIII, Proteomics Unit, Navarrabiomed, Departamento de Salud, UPNA, IdiSNA, Pamplona, Spain (E.S., J.F.-I.)
| | - Joaquín Fernández-Irigoyen
- Proteored-ISCIII, Proteomics Unit, Navarrabiomed, Departamento de Salud, UPNA, IdiSNA, Pamplona, Spain (E.S., J.F.-I.)
| | - Gregorio Rábago
- Department of Cardiology and Cardiac Surgery (G.R., J.D.), Clinic Universtity of Navarra, Pamplona. Spain
| | - María U Moreno
- Program of Cardiovascular Diseases, CIMA University of Navarra and IdiSNA, Pamplona. Spain (C.B., S.R., B.L., M.U.M., J.D., A.G.).,CIBERCV, Carlos III Institute of Health, Madrid. Spain (S.R., B.L., M.U.M., J.D., A.G.)
| | - Frédéric Jaisser
- INSERM UMRS 1138 Team 1, Centre de Recherche des Cordeliers, University Pierre and Marie Curie, Paris, France (E.M.M., M.B., F.J.).,INSERM, Centre d'Investigations Cliniques-Plurithématique 1433, UMR 1116 Université de Lorraine, CHRU de Nancy, France (F.J., N.L.-A.)
| | - Javier Díez
- Program of Cardiovascular Diseases, CIMA University of Navarra and IdiSNA, Pamplona. Spain (C.B., S.R., B.L., M.U.M., J.D., A.G.).,CIBERCV, Carlos III Institute of Health, Madrid. Spain (S.R., B.L., M.U.M., J.D., A.G.).,Department of Cardiology and Cardiac Surgery (G.R., J.D.), Clinic Universtity of Navarra, Pamplona. Spain.,Department of Nephrology (J.D.), Clinic Universtity of Navarra, Pamplona. Spain
| | - Arantxa González
- Program of Cardiovascular Diseases, CIMA University of Navarra and IdiSNA, Pamplona. Spain (C.B., S.R., B.L., M.U.M., J.D., A.G.).,CIBERCV, Carlos III Institute of Health, Madrid. Spain (S.R., B.L., M.U.M., J.D., A.G.)
| | - Natalia López-Andrés
- From the Cardiovascular Translational Research, Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona. Spain (E.M.-M., J.I., A.F.-C., N.L.-A.).,INSERM, Centre d'Investigations Cliniques-Plurithématique 1433, UMR 1116 Université de Lorraine, CHRU de Nancy, France (F.J., N.L.-A.)
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González A, López B, Ravassa S, San José G, Díez J. Reprint of "The complex dynamics of myocardial interstitial fibrosis in heart failure. Focus on collagen cross-linking". Biochim Biophys Acta Mol Cell Res 2019; 1867:118521. [PMID: 31394074 DOI: 10.1016/j.bbamcr.2019.07.016] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 05/21/2019] [Accepted: 06/03/2019] [Indexed: 12/12/2022]
Abstract
Myocardial interstitial fibrosis (MIF) is a common finding in heart failure (HF) patients, both with preserved and reduced ejection fraction, as well as in HF animal models. MIF is associated with impaired cardiac function and worse clinical outcome. The impact of MIF is influenced not only by the quantity but also by changes in the quality of collagen fibers and in the extracellular matrix components, such as a shift in collagen types proportion, increased fibronectin polymerization and increased degree of collagen cross-linking (CCL). In particular, CCL, a process that renders collagen fibers stiffer and more resistant to degradation, is increased both in patients and animal models of HF. Importantly, in HF patients increased cardiac CCL is directly associated with increased left ventricular stiffness and a higher risk of hospitalization for HF. The aim of this review is to address the complexity of MIF in HF, focusing on CCL.
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Affiliation(s)
- Arantxa González
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain.
| | - Begoña López
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Susana Ravassa
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Gorka San José
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Javier Díez
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain; Departments of Cardiology and Cardiac Surgery and of Nephrology, Clínica Universidad de Navarra, Pamplona, Spain
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32
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González A, López B, Ravassa S, San José G, Díez J. The complex dynamics of myocardial interstitial fibrosis in heart failure. Focus on collagen cross-linking. Biochim Biophys Acta Mol Cell Res 2019; 1866:1421-1432. [PMID: 31181222 DOI: 10.1016/j.bbamcr.2019.06.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 05/21/2019] [Accepted: 06/03/2019] [Indexed: 12/11/2022]
Abstract
Myocardial interstitial fibrosis (MIF) is a common finding in heart failure (HF) patients, both with preserved and reduced ejection fraction, as well as in HF animal models. MIF is associated with impaired cardiac function and worse clinical outcome. The impact of MIF is influenced not only by the quantity but also by changes in the quality of collagen fibers and in the extracellular matrix components, such as a shift in collagen types proportion, increased fibronectin polymerization and increased degree of collagen cross-linking (CCL). In particular, CCL, a process that renders collagen fibers stiffer and more resistant to degradation, is increased both in patients and animal models of HF. Importantly, in HF patients increased cardiac CCL is directly associated with increased left ventricular stiffness and a higher risk of hospitalization for HF. The aim of this review is to address the complexity of MIF in HF, focusing on CCL.
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Affiliation(s)
- Arantxa González
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain.
| | - Begoña López
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Susana Ravassa
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Gorka San José
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Javier Díez
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA, Pamplona, Spain; CIBERCV, Carlos III Institute of Health, Madrid, Spain; Departments of Cardiology and Cardiac Surgery and of Nephrology, Clínica Universidad de Navarra, Pamplona, Spain
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Ballesteros G, Ravassa S, Bragard J, Ramos P, López B, Vives E, Neglia R, Wise B, González A, Moreno MU, Díez J, García‐Bolao I. Association of left atrium voltage amplitude and distribution with the risk of atrial fibrillation recurrence and evolution after pulmonary vein isolation: An ultrahigh‐density mapping study. J Cardiovasc Electrophysiol 2019; 30:1231-1240. [DOI: 10.1111/jce.13972] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 02/11/2019] [Revised: 05/01/2019] [Accepted: 05/03/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Gabriel Ballesteros
- Department of Cardiology and Cardiac SurgeryClínica Universidad de Navarra Pamplona Spain
| | - Susana Ravassa
- Program of Cardiovascular Diseases, Center for Applied Medical Research (CIMA)Universidad de Navarra Pamplona Spain
- IdiSNANavarra Institute for Health Research Pamplona Spain
- CIBERCVCarlos III Institute of Health Madrid Spain
| | - Jean Bragard
- Department of Physics and Applied MathUniversidad de Navarra Pamplona Spain
| | - Pablo Ramos
- Department of Cardiology and Cardiac SurgeryClínica Universidad de Navarra Pamplona Spain
| | - Begoña López
- Program of Cardiovascular Diseases, Center for Applied Medical Research (CIMA)Universidad de Navarra Pamplona Spain
- IdiSNANavarra Institute for Health Research Pamplona Spain
- CIBERCVCarlos III Institute of Health Madrid Spain
| | - Enrique Vives
- Department of Cardiology and Cardiac SurgeryClínica Universidad de Navarra Pamplona Spain
| | - Renzo Neglia
- Department of Cardiology and Cardiac SurgeryClínica Universidad de Navarra Pamplona Spain
| | - Bernardo Wise
- Department of Cardiology and Cardiac SurgeryClínica Universidad de Navarra Pamplona Spain
| | - Arantxa González
- Program of Cardiovascular Diseases, Center for Applied Medical Research (CIMA)Universidad de Navarra Pamplona Spain
- IdiSNANavarra Institute for Health Research Pamplona Spain
- CIBERCVCarlos III Institute of Health Madrid Spain
| | - María U. Moreno
- Program of Cardiovascular Diseases, Center for Applied Medical Research (CIMA)Universidad de Navarra Pamplona Spain
- IdiSNANavarra Institute for Health Research Pamplona Spain
- CIBERCVCarlos III Institute of Health Madrid Spain
| | - Javier Díez
- Department of Cardiology and Cardiac SurgeryClínica Universidad de Navarra Pamplona Spain
- Program of Cardiovascular Diseases, Center for Applied Medical Research (CIMA)Universidad de Navarra Pamplona Spain
- IdiSNANavarra Institute for Health Research Pamplona Spain
- CIBERCVCarlos III Institute of Health Madrid Spain
- Department of NephrologyClínica Universidad de Navarra Pamplona Spain
| | - Ignacio García‐Bolao
- Department of Cardiology and Cardiac SurgeryClínica Universidad de Navarra Pamplona Spain
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Affiliation(s)
- Arantxa González
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.)
| | - Susana Ravassa
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.)
| | - Begoña López
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.)
| | - María U Moreno
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.)
| | - Javier Beaumont
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.)
| | - Gorka San José
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.)
| | - Ramón Querejeta
- Division of Cardiology, Donostia University Hospital, University of the Basque Country, San Sebastián, Spain (R.Q.)
| | - Antoni Bayés-Genís
- CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.).,Heart Failure Unit and Cardiology Service, Hospital Universitari Germans Trias i Pujol, Badalona, Spain (A.B.-G.).,Department of Medicine, Universitat Autònoma de Barcelona, Spain (A.B.-G.)
| | - Javier Díez
- From the Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., J.D.).,CIBERCV, Carlos III Institute of Health, Madrid, Spain (A.G., S.R., B.L., M.U.M., J.B., G.S.J., A.B.-G., J.D.).,Department of Cardiology and Cardiac Surgery (J.D.).,Department of Nephrology (J.D.), University of Navarra Clinic, University of Navarra, Pamplona, Spain
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Garcia-Fernandez N, Lavilla J, Martín PL, Romero-González G, González A, López B, Ravassa S, Díez J. Increased Fibroblast Growth Factor 23 in Heart Failure: Biomarker, Mechanism, or Both? Am J Hypertens 2019; 32:15-17. [PMID: 30325410 DOI: 10.1093/ajh/hpy153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 10/11/2018] [Indexed: 12/23/2022] Open
Affiliation(s)
- Nuria Garcia-Fernandez
- Department of Nephrology, University of Navarra Clinic, University of Navarra, Pamplon, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Javier Lavilla
- Department of Nephrology, University of Navarra Clinic, University of Navarra, Pamplon, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Paloma L Martín
- Department of Nephrology, University of Navarra Clinic, University of Navarra, Pamplon, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Gregorio Romero-González
- Department of Nephrology, University of Navarra Clinic, University of Navarra, Pamplon, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Arantxa González
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Program of Cardiovascular Diseases, Centre of Applied Medical Research, University of Navarra, Pamplona, Spain
- CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Begoña López
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Program of Cardiovascular Diseases, Centre of Applied Medical Research, University of Navarra, Pamplona, Spain
- CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Susana Ravassa
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Program of Cardiovascular Diseases, Centre of Applied Medical Research, University of Navarra, Pamplona, Spain
- CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Javier Díez
- Department of Nephrology, University of Navarra Clinic, University of Navarra, Pamplon, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Program of Cardiovascular Diseases, Centre of Applied Medical Research, University of Navarra, Pamplona, Spain
- CIBERCV, Carlos III Institute of Health, Madrid, Spain
- Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, University of Navarra, Pamplon, Spain
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Ferreira JP, Rossignol P, Pizard A, Machu JL, Collier T, Girerd N, Huby AC, Gonzalez A, Diez J, López B, Sattar N, Cleland JG, Sever PS, Zannad F. Potential spironolactone effects on collagen metabolism biomarkers in patients with uncontrolled blood pressure. Heart 2018; 105:307-314. [PMID: 30121630 DOI: 10.1136/heartjnl-2018-313182] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 02/21/2018] [Revised: 07/21/2018] [Accepted: 07/26/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND An increase in myocardial collagen content may contribute to the development of heart failure; this might be inhibited or reversed by mineralocorticoid receptor antagonists (MRAs). We investigated changes in serum concentrations of the collagen synthesis biomarkers N-terminal propeptide of procollagen type III (PIIINP) (primary outcome) and C-terminal propeptide of procollagen type I (PICP) (secondary outcome) after non-randomised initiation of spironolactone as add-on therapy among patients with resistant hypertension enrolled in the 'Anglo-Scandinavian Cardiac Outcomes' trial (ASCOT). METHODS An age/sex matching plus propensity-scored logistic regression model incorporating variables related to the outcome and spironolactone treatment was created to compare patients treated with spironolactone for a 9-month period versus matched controls. A within-person analysis comparing changes in serum biomarker concentrations in the 9 months before versus after spironolactone treatment was also performed. RESULTS Patients included in the between-person analysis (n=146) were well matched: the mean age was 63±7 years and 11% were woman. Serum concentrations of PIIINP and PICP rose in 'controls' and fell during spironolactone treatment (adjusted means +0.52 (-0.05 to 1.09) vs -0.41 (-0.97 to 0.16) ng/mL, p=0.031 for PIIINP and +4.54(-1.77 to 10.9) vs -6.36 (-12.5 to -0.21) ng/mL, p=0.023 for PICP). For the within-person analysis (n=173), spironolactone treatment was also associated with a reduction in PICP (beta estimate=-11.82(-17.53 to -6.10) ng/mL, p<0.001) but not in PIIINP levels. CONCLUSIONS Treatment with spironolactone was associated with a reduction in serum biomarkers of collagen synthesis independently of blood pressure in patients with hypertension, suggesting that spironolactone might exert favourable effects on myocardial collagen synthesis and fibrosis. Whether this effect might contribute to slowing the progression to heart failure is worth investigating.
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Affiliation(s)
- João Pedro Ferreira
- Centre d'Investigations Cliniques Plurithématique Inserm 1433, Université de Lorraine, Nancy, France.,CHRU de Nancy, Inserm U1116, Université de Lorraine, Nancy, France.,FCRIN INI-CRCT, Université de Lorraine, Nancy, France.,Department of Physiology, University of Porto, Porto, Portugal.,Department of Cardiothoracic Surgery, University of Porto, Porto, Portugal
| | - Patrick Rossignol
- Centre d'Investigations Cliniques Plurithématique Inserm 1433, Université de Lorraine, Nancy, France.,CHRU de Nancy, Inserm U1116, Université de Lorraine, Nancy, France.,FCRIN INI-CRCT, Université de Lorraine, Nancy, France
| | - Anne Pizard
- Centre d'Investigations Cliniques Plurithématique Inserm 1433, Université de Lorraine, Nancy, France.,CHRU de Nancy, Inserm U1116, Université de Lorraine, Nancy, France.,FCRIN INI-CRCT, Université de Lorraine, Nancy, France
| | - Jean-Loup Machu
- Centre d'Investigations Cliniques Plurithématique Inserm 1433, Université de Lorraine, Nancy, France.,CHRU de Nancy, Inserm U1116, Université de Lorraine, Nancy, France.,FCRIN INI-CRCT, Université de Lorraine, Nancy, France
| | - Timothy Collier
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Nicolas Girerd
- Centre d'Investigations Cliniques Plurithématique Inserm 1433, Université de Lorraine, Nancy, France.,CHRU de Nancy, Inserm U1116, Université de Lorraine, Nancy, France.,FCRIN INI-CRCT, Université de Lorraine, Nancy, France
| | - Anne-Cécile Huby
- Centre d'Investigations Cliniques Plurithématique Inserm 1433, Université de Lorraine, Nancy, France.,CHRU de Nancy, Inserm U1116, Université de Lorraine, Nancy, France.,FCRIN INI-CRCT, Université de Lorraine, Nancy, France
| | - Arantxa Gonzalez
- Program of Cardiovascular Diseases, CIMA, University of Navarra and Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Javier Diez
- Program of Cardiovascular Diseases, CIMA, University of Navarra and Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain.,Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain
| | - Begoña López
- CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - John G Cleland
- Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow, Glasgow, UK.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Peter S Sever
- International Centre for Circulatory Health, Imperial College London, London, UK
| | - Faiez Zannad
- Centre d'Investigations Cliniques Plurithématique Inserm 1433, Université de Lorraine, Nancy, France.,CHRU de Nancy, Inserm U1116, Université de Lorraine, Nancy, France.,FCRIN INI-CRCT, Université de Lorraine, Nancy, France
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Zamora cervantes A, López B, Torrent-Fontbona F, Pozo-Alonso A, Paluzie G, García-Vilches J, García Flores A, Massa R, Martín-Urda A, Capellá D. “Clinical decision support system” with “smart data analysis” can improve detection and treatment of familial hypercholesterolemia and high vascular risk patients. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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López B, Lupi T, León J, López F, Agudo B, Delgado J. Characterization of the commercial growth curves of Spanish Merino, Fleischschaf, and crossbred lambs in an associative economy context. Small Rumin Res 2018. [DOI: 10.1016/j.smallrumres.2018.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ravassa S, Trippel T, Bach D, Bachran D, González A, López B, Wachter R, Hasenfuss G, Delles C, Dominiczak AF, Pieske B, Díez J, Edelmann F. Biomarker-based phenotyping of myocardial fibrosis identifies patients with heart failure with preserved ejection fraction resistant to the beneficial effects of spironolactone: results from the Aldo-DHF trial. Eur J Heart Fail 2018; 20:1290-1299. [PMID: 29709099 DOI: 10.1002/ejhf.1194] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [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: 12/18/2017] [Revised: 02/19/2018] [Accepted: 03/12/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Myocardial fibrosis is characterized by excessive cross-linking and deposition of collagen type I and is involved in left ventricular stiffening and left ventricular diastolic dysfunction (LVDD). We investigated whether the effect of spironolactone on LVDD in patients with heart failure with preserved ejection fraction (HFpEF) depends on its effects on collagen cross-linking and/or deposition. METHODS AND RESULTS We investigated 381 HFpEF patients from the multicentre, randomized, placebo-controlled Aldo-DHF trial with measures of the E:e' ratio. The ratio of serum carboxy-terminal telopeptide of collagen type I to serum matrix metalloproteinase-1 (CITP:MMP-1, an inverse index of myocardial collagen cross-linking) and serum carboxy-terminal propeptide of procollagen type I (PICP, a direct index of myocardial collagen deposition) were determined at baseline and after 1-year treatment with spironolactone 25 mg once daily or placebo. Patients were classified by CITP:MMP-1 and PICP tertiles at baseline. While CITP:MMP-1 tertiles at baseline interacted (P < 0.05) with spironolactone effect on E:e', PICP tertiles did not. In fact, while spironolactone treatment did not modify E:e' in patients with lower CITP:MMP-1 levels, this ratio was significantly reduced in the remaining spironolactone-treated patients. In addition, PICP was unchanged in patients with lower CITP:MMP-1 levels but was reduced in the remaining spironolactone-treated patients. CONCLUSIONS A biochemical phenotype of high collagen cross-linking identifies HFpEF patients resistant to the beneficial effects of spironolactone on LVDD. It is suggested that excessive collagen cross-linking, which stabilizes collagen type I fibres, diminishes the ability of spironolactone to reduce collagen deposition in these patients.
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Affiliation(s)
- Susana Ravassa
- University of Navarra, CIMA, Program of Cardiovascular Diseases, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain, CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Tobias Trippel
- Institute for Internal Medicine and Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Doris Bach
- Institute for Internal Medicine and Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Diana Bachran
- Institute for Internal Medicine and Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Arantxa González
- University of Navarra, CIMA, Program of Cardiovascular Diseases, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain, CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Begoña López
- University of Navarra, CIMA, Program of Cardiovascular Diseases, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain, CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Rolf Wachter
- Department of Cardiology and Pneumology, University of Göttingen Medical Centre Göttingen, Göttingen, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Göttingen, Göttingen, Germany
| | - Gerd Hasenfuss
- Department of Cardiology and Pneumology, University of Göttingen Medical Centre Göttingen, Göttingen, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Göttingen, Göttingen, Germany
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Anna F Dominiczak
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Burkert Pieske
- Institute for Internal Medicine and Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,Deutsches Herzzentrum Berlin (DHZB), Department of Cardiology, Berlin, Germany
| | - Javier Díez
- University of Navarra, CIMA, Program of Cardiovascular Diseases, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain, CIBERCV, Carlos III Institute of Health, Madrid, Spain.,University of Navarra Clinic, Departments of Cardiology and Cardiac Surgery, and Nephrology, Pamplona, Spain
| | - Frank Edelmann
- Institute for Internal Medicine and Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.,Department of Cardiology and Pneumology, University of Göttingen Medical Centre Göttingen, Göttingen, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Göttingen, Göttingen, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
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Treibel TA, Kozor R, Schofield R, Benedetti G, Fontana M, Bhuva AN, Sheikh A, López B, González A, Manisty C, Lloyd G, Kellman P, Díez J, Moon JC. Reverse Myocardial Remodeling Following Valve Replacement in Patients With Aortic Stenosis. J Am Coll Cardiol 2018; 71:860-871. [PMID: 29471937 PMCID: PMC5821681 DOI: 10.1016/j.jacc.2017.12.035] [Citation(s) in RCA: 235] [Impact Index Per Article: 39.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/12/2017] [Accepted: 12/12/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Left ventricular (LV) hypertrophy, a key process in human cardiac disease, results from cellular (hypertrophy) and extracellular matrix expansion (interstitial fibrosis). OBJECTIVES This study sought to investigate whether human myocardial interstitial fibrosis in aortic stenosis (AS) is plastic and can regress. METHODS Patients with symptomatic, severe AS (n = 181; aortic valve area index 0.4 ± 0.1 cm2/m2) were assessed pre-aortic valve replacement (AVR) by echocardiography (AS severity, diastology), cardiovascular magnetic resonance (CMR) (for volumes, function, and focal or diffuse fibrosis), biomarkers (N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin T), and the 6-min walk test. CMR was used to measure the extracellular volume fraction (ECV), thereby deriving matrix volume (LV mass × ECV) and cell volume (LV mass × [1 - ECV]). Biopsy excluded occult bystander disease. Assessment was repeated at 1 year post-AVR. RESULTS At 1 year post-AVR in 116 pacemaker-free survivors (age 70 ± 10 years; 54% male), mean valve gradient had improved (48 ± 16 mm Hg to 12 ± 6 mm Hg; p < 0.001), and indexed LV mass had regressed by 19% (88 ± 26 g/m2 to 71 ± 19 g/m2; p < 0.001). Focal fibrosis by CMR late gadolinium enhancement did not change, but ECV increased (28.2 ± 2.9% to 29.9 ± 4.0%; p < 0.001): this was the result of a 16% reduction in matrix volume (25 ± 9 ml/m2 to 21 ± 7 ml/m2; p < 0.001) but a proportionally greater 22% reduction in cell volume (64 ± 18 ml/m2 to 50 ± 13 ml/m2; p < 0.001). These changes were accompanied by improvement in diastolic function, N-terminal pro-B-type natriuretic peptide, 6-min walk test results, and New York Heart Association functional class. CONCLUSIONS Post-AVR, focal fibrosis does not resolve, but diffuse fibrosis and myocardial cellular hypertrophy regress. Regression is accompanied by structural and functional improvements suggesting that human diffuse fibrosis is plastic, measurable by CMR and a potential therapeutic target. (Regression of Myocardial Fibrosis After Aortic Valve Replacement; NCT02174471).
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Affiliation(s)
- Thomas A Treibel
- Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom; Institute for Cardiovascular Sciences, University College London, London, United Kingdom
| | - Rebecca Kozor
- Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
| | - Rebecca Schofield
- Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
| | - Giulia Benedetti
- Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
| | - Marianna Fontana
- Institute for Cardiovascular Sciences, University College London, London, United Kingdom
| | - Anish N Bhuva
- Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom; Institute for Cardiovascular Sciences, University College London, London, United Kingdom
| | - Amir Sheikh
- Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
| | - Begoña López
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Cardiovascular Biomedical Research Center Network (CIBERCV), Carlos III National Institute of Health, Madrid, Spain
| | - Arantxa González
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Cardiovascular Biomedical Research Center Network (CIBERCV), Carlos III National Institute of Health, Madrid, Spain
| | - Charlotte Manisty
- Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom; Institute for Cardiovascular Sciences, University College London, London, United Kingdom
| | - Guy Lloyd
- Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom; Institute for Cardiovascular Sciences, University College London, London, United Kingdom
| | - Peter Kellman
- National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Javier Díez
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Cardiovascular Biomedical Research Center Network (CIBERCV), Carlos III National Institute of Health, Madrid, Spain; Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain
| | - James C Moon
- Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom; Institute for Cardiovascular Sciences, University College London, London, United Kingdom.
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Nieto C, López B, Gandía H. Relationships between atypical sensory processing patterns, maladaptive behaviour and maternal stress in Spanish children with autism spectrum disorder. J Intellect Disabil Res 2017; 61:1140-1150. [PMID: 29154486 DOI: 10.1111/jir.12435] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 09/14/2017] [Accepted: 10/06/2017] [Indexed: 05/26/2023]
Abstract
BACKGROUND This study investigated sensory processing in a sample of Spanish children with autism spectrum disorder (ASD). Specifically, the study aimed to explore (1) the prevalence and distribution of atypical sensory processing patterns, (2) the relationship between adaptive and maladaptive behaviour with atypical sensory processing and (3) the possible relationship between sensory subtype and maternal stress. METHODS The short sensory profile 2 (Dunn 2014) and the vineland adaptive behavior scale (Sparrow et al. 1984) were administered to examine the sensory processing difficulties and maladaptive behaviours of 45 children with ASD aged 3 to 14; their mothers also completed the parenting stress index-short form (Abidin 1995). RESULTS Atypical sensory features were found in 86.7% of the children; avoider and sensor being the two most common patterns. No significant relationship was found between atypical sensory processing and adaptive behaviour. However, the analysis showed a strong relationship between sensory processing and maladaptive behaviour. Both maladaptive behaviour and sensory processing difficulties correlated significantly with maternal stress although maternal stress was predicted only by the sensory variable, and in particular by the avoider pattern. CONCLUSIONS The findings suggest that sensory features in ASD may be driving the high prevalence of parental stress in carers. They also suggest that the effect on parental stress that has been attributed traditionally to maladaptive behaviours may be driven by sensory difficulties. The implications of these findings are discussed in relation to the development of interventions and the need to explore contextual and cultural variables as possible sources of variability.
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Affiliation(s)
- C Nieto
- Department of Basic Psychology, Universidad Autónoma de Madrid, Spain
| | - B López
- Department of Psychology, University of Portsmouth, UK
| | - H Gandía
- Department of Basic Psychology, Universidad Autónoma de Madrid, Spain
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Echegaray K, Andreu I, Lazkano A, Villanueva I, Sáenz A, Elizalde MR, Echeverría T, López B, Garro A, González A, Zubillaga E, Solla I, Sanz I, González J, Elósegui-Artola A, Roca-Cusachs P, Díez J, Ravassa S, Querejeta R. Papel del colágeno miocárdico en la estenosis aórtica grave con fracción de eyección conservada y síntomas de insuficiencia cardiaca. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.12.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Trippel TD, Van Linthout S, Westermann D, Lindhorst R, Sandek A, Ernst S, Bobenko A, Kasner M, Spillmann F, González A, López B, Ravassa S, Pieske B, Paulus WJ, Díez J, Edelmann F, Tschöpe C. Investigating a biomarker-driven approach to target collagen turnover in diabetic heart failure with preserved ejection fraction patients. Effect of torasemide versus furosemide on serum C-terminal propeptide of procollagen type I (DROP-PIP trial). Eur J Heart Fail 2017; 20:460-470. [PMID: 28891228 DOI: 10.1002/ejhf.960] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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: 04/12/2017] [Revised: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 12/28/2022] Open
Abstract
AIM Heart failure with preserved ejection fraction (HFpEF) is associated with myocardial remodelling including severe pro-fibrotic changes contributing to an increase in left ventricular stiffness and diastolic dysfunction. Serum C-terminal propeptide of procollagen type I (PIP) strongly correlates with the turnover of extracellular cardiac matrix proteins and fibrosis. Torasemide, but not furosemide, was described to reduce collagen type I synthesis in clinically unstable patients with heart failure with reduced ejection fraction. We evaluated whether its effect translated to HFpEF patients with type 2 diabetes mellitus (T2DM) and abnormal basal PIP levels. METHODS AND RESULTS We performed a relatively small, single-centre, randomised, double-blind, two-arm parallel-group, active controlled clinical trial in 35 HFpEF patients with T2DM to determine the effects of a 9-month treatment with torasemide vs. furosemide on changes of serum PIP levels. Patients with increased PIP levels (≥110 ng/mL), or evidence of structural changes with a left atrial volume index (LAVI) >29 mL/m2 and abnormal PIP levels (≥70 ng/mL), were eligible to participate. Fifteen patients were female (42%), mean age was 69 years, body mass index was 34.7 kg/m2 , 83% were in New York Heart Association class II/III. Echocardiographic characteristics showed a mean left ventricular ejection fraction of >60%, a left ventricular mass index >120 g/m2 , an E/e' ratio of 14, and a LAVI of 40 mL/m2 with a NT-proBNP of 174 ng/L and a 6-minute walk distance of 421 m. Mean per cent change in PIP was 2.63 ± 5.68% (±SEM) in torasemide vs. 2.74 ± 6.49% in furosemide (P = 0.9898) treated patients. Torasemide was not superior to furosemide in improving functional capacity, diastolic function, quality of life, or neuroendocrine activation. CONCLUSION In this hypothesis-generating, mechanistic trial in stable HFpEF patients with T2DM, neither long-term administration of torasemide nor furosemide was associated with a significant effect on myocardial fibrosis, as assessed by serum PIP. Further studies are urgently needed in this field. More specific diuretic and anti-fibrotic treatment strategies in T2DM and/or HFpEF are warranted.
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Affiliation(s)
- Tobias Daniel Trippel
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Sophie Van Linthout
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Berlin-Brandenburg Centre for Regenerative Therapies, Berlin, Germany
| | - Dirk Westermann
- Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Ruhdja Lindhorst
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Anja Sandek
- Department of Cardiology and Pneumology, University Medical Centre Göttingen, Göttingen, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | | | - Anna Bobenko
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Mario Kasner
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Cardiology, Department of Medicine (CBF), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Frank Spillmann
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Arantxa González
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, IdiSNA, Navarra Institute for Health Research, CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Begoña López
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, IdiSNA, Navarra Institute for Health Research, CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Susana Ravassa
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, IdiSNA, Navarra Institute for Health Research, CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Burkert Pieske
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Walter J Paulus
- Department of Physiology, Institute of Cardiovascular Research VU, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Javier Díez
- Program of Cardiovascular Diseases, Center for Applied Medical Research, University of Navarra, IdiSNA, Navarra Institute for Health Research, CIBERCV, Carlos III Institute of Health, Madrid, Spain.,Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, University of Navarra, Pamplona, Spain
| | - Frank Edelmann
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Carsten Tschöpe
- Department of Medicine and Cardiology (CVK), Charité - Universitätsmedizin Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Berlin-Brandenburg Centre for Regenerative Therapies, Berlin, Germany
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Zhang ZY, Ravassa S, Pejchinovski M, Yang WY, Zürbig P, López B, Wei FF, Thijs L, Jacobs L, González A, Voigt JU, Verhamme P, Kuznetsova T, Díez J, Mischak H, Staessen JA. A Urinary Fragment of Mucin-1 Subunit α Is a Novel Biomarker Associated With Renal Dysfunction in the General Population. Kidney Int Rep 2017; 2:811-820. [PMID: 28920100 PMCID: PMC5589115 DOI: 10.1016/j.ekir.2017.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 12/17/2016] [Revised: 03/04/2017] [Accepted: 03/31/2017] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Sequencing peptides included in the urinary proteome identifies the parent proteins and may reveal mechanisms underlying the pathophysiology of chronic kidney disease. METHODS In 805 randomly recruited Flemish individuals (50.8% women; mean age, 51.1 years), we determined the estimated glomerular filtration rate (eGFR) from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. We categorized eGFR according to the National Kidney Foundation Kidney Disease Outcomes Quality Initiative guideline. We analyzed 74 sequenced urinary peptides with a detectable signal in more than 95% of participants. Follow-up measurements of eGFR were available in 597 participants. RESULTS In multivariable analyses, baseline eGFR decreased (P ≤ 0.022) with urinary fragments of mucin-1 (standardized association size expressed in ml/min/1.73 m2, -4.48), collagen III (-2.84), and fibrinogen (-1.70) and was bi-directionally associated (P ≤ 0.0006) with 2 urinary collagen I fragments (+2.28 and -3.20). The eGFR changes over 5 years (follow-up minus baseline) resulted in consistent estimates (P ≤ 0.025) for mucin-1 (-1.85), collagen (-1.37 to 1.43) and fibrinogen (-1.45) fragments. Relative risk of having or progressing to eGFR <60 ml/min/1.73 m2 was associated with mucin-1. Partial least-squares analysis confirmed mucin-1 as the strongest urinary marker associated with decreased eGFR, with a score of 2.47 compared with 1.80 for a collagen I fragment as the next contender. Mucin-1 predicted eGFR decline to <60 ml/min/1.73 m2 over and above microalbuminuria (P = 0.011) and retained borderline significance (P = 0.05) when baseline eGFR was accounted for. DISCUSSION In the general population, mucin-1 subunit α, an extracellular protein that is shed from renal tubular epithelium, is a novel biomarker associated with renal dysfunction.
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Affiliation(s)
- Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Susana Ravassa
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Navarra Institute for Health Research, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | | | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Petra Zürbig
- Mosaiques Diagnostic and Therapeutics AG, Hannover, Germany
| | - Begoña López
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Navarra Institute for Health Research, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Arantxa González
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Navarra Institute for Health Research, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain
| | - Jens-Uwe Voigt
- Research Unit Cardiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Peter Verhamme
- Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Tatiana Kuznetsova
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Javier Díez
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Navarra Institute for Health Research, Pamplona, Spain.,CIBERCV, Carlos III Institute of Health, Madrid, Spain.,Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain
| | - Harald Mischak
- Mosaiques Diagnostic and Therapeutics AG, Hannover, Germany.,BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium.,R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
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Pérez del Villar C, Savvatis K, López B, Kasner M, Martinez-Legazpi P, Yotti R, González A, Díez J, Fernández-Avilés F, Tschöpe C, Bermejo J. Impact of acute hypertension transients on diastolic function in patients with heart failure with preserved ejection fraction. Cardiovasc Res 2017; 113:906-914. [DOI: 10.1093/cvr/cvx047] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 03/08/2017] [Indexed: 12/12/2022] Open
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Beaumont J, López B, Ravassa S, Hermida N, San José G, Gallego I, Valencia F, Gómez-Doblas JJ, de Teresa E, Díez J, González A. MicroRNA-19b is a potential biomarker of increased myocardial collagen cross-linking in patients with aortic stenosis and heart failure. Sci Rep 2017; 7:40696. [PMID: 28091585 PMCID: PMC5238428 DOI: 10.1038/srep40696] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/08/2016] [Indexed: 01/07/2023] Open
Abstract
This study analyzed the potential associations of 7 myocardial fibrosis-related microRNAs with the quality of the collagen network (e.g., the degree of collagen fibril cross-linking or CCL) and the enzyme lysyl oxidase (LOX) responsible for CCL in 28 patients with severe aortic stenosis (AS) of whom 46% had a diagnosis of chronic heart failure (HF). MicroRNA expression was analyzed in myocardial and blood samples. From the studied microRNAs only miR-19b presented a direct correlation (p < 0.05) between serum and myocardium. Compared to controls both myocardial and serum miR-19b were reduced (p < 0.01) in AS patients. In addition, miR-19b was reduced in the myocardium (p < 0.01) and serum (p < 0.05) of patients with HF compared to patients without HF. Myocardial and serum miR-19b were inversely correlated (p < 0.05) with LOX, CCL and LV stiffness in AS patients. In in vitro studies miR-19b inhibition increased (p < 0.05) connective tissue growth factor protein and LOX protein expression in human fibroblasts. In conclusion, decreased miR-19b may be involved in myocardial LOX up-regulation and excessive CCL, and consequently increased LV stiffness in AS patients, namely in those with HF. Serum miR-19b can be a biomarker of these alterations of the myocardial collagen network in AS patients, particularly in patients with HF.
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Affiliation(s)
- Javier Beaumont
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Begoña López
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Susana Ravassa
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Nerea Hermida
- Institute of Experimental and Clinical Research, University of Louvain (UCL) Medical School, B-1200 Brussels, Belgium
| | - Gorka San José
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Idoia Gallego
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Félix Valencia
- Division of Cardiology, Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | | | - Eduardo de Teresa
- Division of Cardiology, Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | - Javier Díez
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain.,Department of Cardiology and Cardiovascular Surgery, University of Navarra Clinic, 31008 Pamplona, Spain
| | - Arantxa González
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, 31008 Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
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Moreno MU, Eiros R, Gavira JJ, Gallego C, González A, Ravassa S, López B, Beaumont J, San José G, Díez J. The Hypertensive Myocardium: From Microscopic Lesions to Clinical Complications and Outcomes. Med Clin North Am 2017; 101:43-52. [PMID: 27884234 DOI: 10.1016/j.mcna.2016.08.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The chronic hemodynamic load imposed by hypertension on the left ventricle leads to lesions in the myocardium that result in structural remodeling, which provides support for alterations in cardiac function, perfusion, and electrical activity that adversely influence the clinical evolution of hypertensive heart disease. Management must include detecting, reducing, and reversing left ventricular hypertrophy, as well as the detection and repair of microscopic lesions responsible for myocardial remodeling. Reducing the burden associated with hypertensive heart disease can be targeted using personalized treatment. The noninvasive, biomarker-mediated identification of subsets of patients with hypertensive heart disease is essential to provide personalized treatment.
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Affiliation(s)
- María U Moreno
- Program of Cardiovascular Diseases, Center of Applied Medical Research, University of Navarra, Edificio CIMA, Av. Pío XII, 55, Pamplona 31008, Spain; IdiSNA, Navarra Institute for Health Resarch, Pamplona, Spain
| | - Rocío Eiros
- Department of Cardiology and Cardiac Surgery, University Clinic, University of Navarra, Av. Pío XII, 36, Pamplona 31008, Spain
| | - Juan J Gavira
- Department of Cardiology and Cardiac Surgery, University Clinic, University of Navarra, Av. Pío XII, 36, Pamplona 31008, Spain; IdiSNA, Navarra Institute for Health Resarch, Pamplona, Spain
| | - Catalina Gallego
- Program of Cardiovascular Diseases, Center of Applied Medical Research, University of Navarra, Edificio CIMA, Av. Pío XII, 55, Pamplona 31008, Spain; Programa de Cardiología Clínica, Clínica CardioVID, Universidad Pontificia Bolivariana, Calle 78B 75-21, Medellín, Colombia
| | - Arantxa González
- Program of Cardiovascular Diseases, Center of Applied Medical Research, University of Navarra, Edificio CIMA, Av. Pío XII, 55, Pamplona 31008, Spain; IdiSNA, Navarra Institute for Health Resarch, Pamplona, Spain
| | - Susana Ravassa
- Program of Cardiovascular Diseases, Center of Applied Medical Research, University of Navarra, Edificio CIMA, Av. Pío XII, 55, Pamplona 31008, Spain; IdiSNA, Navarra Institute for Health Resarch, Pamplona, Spain
| | - Begoña López
- Program of Cardiovascular Diseases, Center of Applied Medical Research, University of Navarra, Edificio CIMA, Av. Pío XII, 55, Pamplona 31008, Spain; IdiSNA, Navarra Institute for Health Resarch, Pamplona, Spain
| | - Javier Beaumont
- Program of Cardiovascular Diseases, Center of Applied Medical Research, University of Navarra, Edificio CIMA, Av. Pío XII, 55, Pamplona 31008, Spain; IdiSNA, Navarra Institute for Health Resarch, Pamplona, Spain
| | - Gorka San José
- Program of Cardiovascular Diseases, Center of Applied Medical Research, University of Navarra, Edificio CIMA, Av. Pío XII, 55, Pamplona 31008, Spain; IdiSNA, Navarra Institute for Health Resarch, Pamplona, Spain
| | - Javier Díez
- Program of Cardiovascular Diseases, Center of Applied Medical Research, University of Navarra, Edificio CIMA, Av. Pío XII, 55, Pamplona 31008, Spain; Department of Cardiology and Cardiac Surgery, University Clinic, University of Navarra, Av. Pío XII, 36, Pamplona 31008, Spain; IdiSNA, Navarra Institute for Health Resarch, Pamplona, Spain.
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48
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Llorente C, López B, Hernández V, Guijarro A, Pérez-Fernández E. Variability in complications and operative mortality after radical cystectomy in Spain. Actas Urol Esp 2017; 41:32-38. [PMID: 27543258 DOI: 10.1016/j.acuro.2016.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/04/2016] [Accepted: 06/06/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the literature, mortality for radical cystectomy (RC) varies between 2.3% and 7.5%. In Spain, there are no published general data on morbidity and mortality. OBJECTIVE To identify the complications and mortality of RC in Spain through an analysis of all procedures performed over a 3-year period and to study the geographic variability of these results. MATERIAL AND METHODS We identified patients who underwent RC in the Spanish National Health System between 2011 and 2013 based on the minimum basic data set. We analysed the complications and mortality during hospitalisation and at 30, 60 and 90 days. We compared these results in the various autonomous communities, adjusted them by age, Charlson score and sex and subsequently added the hospital size. RESULTS We studied 7999 patients who underwent RC in 197 hospitals of the Spanish National Health System. The mean age of the series was 67.2±9.8 years. The median stay was 15 days (IQR, 11-24). Some 47.2% of the patients had complications. The mean mortality in-hospital and at 30, 60 and 90 days was 4.7, 2.9, 5 and 6.2%, respectively. There was considerable variability in the mortality at 90 days among the communities (3.8-9.1%). When adjusting by the patient and hospital characteristics, there were still significant geographic variations (3.8-11.5%). CONCLUSIONS RC mortality in Spain at 90 days is similar to the rate in the literature. There are significant geographic variations unexplained by the characteristics of the patients or by those of the hospitals in which these operations were performed.
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Affiliation(s)
- C Llorente
- Servicio de Urología y Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), España.
| | - B López
- Servicio de Urología y Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), España
| | - V Hernández
- Servicio de Urología y Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), España
| | - A Guijarro
- Servicio de Urología y Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), España
| | - E Pérez-Fernández
- Servicio de Urología y Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón (Madrid), España
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49
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Yang J, Savvatis K, Kang JS, Fan P, Zhong H, Schwartz K, Barry V, Mikels-Vigdal A, Karpinski S, Kornyeyev D, Adamkewicz J, Feng X, Zhou Q, Shang C, Kumar P, Phan D, Kasner M, López B, Diez J, Wright KC, Kovacs RL, Chen PS, Quertermous T, Smith V, Yao L, Tschöpe C, Chang CP. Targeting LOXL2 for cardiac interstitial fibrosis and heart failure treatment. Nat Commun 2016; 7:13710. [PMID: 27966531 PMCID: PMC5171850 DOI: 10.1038/ncomms13710] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 10/26/2016] [Indexed: 01/14/2023] Open
Abstract
Interstitial fibrosis plays a key role in the development and progression of heart failure. Here, we show that an enzyme that crosslinks collagen—Lysyl oxidase-like 2 (Loxl2)—is essential for interstitial fibrosis and mechanical dysfunction of pathologically stressed hearts. In mice, cardiac stress activates fibroblasts to express and secrete Loxl2 into the interstitium, triggering fibrosis, systolic and diastolic dysfunction of stressed hearts. Antibody-mediated inhibition or genetic disruption of Loxl2 greatly reduces stress-induced cardiac fibrosis and chamber dilatation, improving systolic and diastolic functions. Loxl2 stimulates cardiac fibroblasts through PI3K/AKT to produce TGF-β2, promoting fibroblast-to-myofibroblast transformation; Loxl2 also acts downstream of TGF-β2 to stimulate myofibroblast migration. In diseased human hearts, LOXL2 is upregulated in cardiac interstitium; its levels correlate with collagen crosslinking and cardiac dysfunction. LOXL2 is also elevated in the serum of heart failure (HF) patients, correlating with other HF biomarkers, suggesting a conserved LOXL2-mediated mechanism of human HF.
Lysyl oxidase-like 2 (LOXL2) is an enzyme that promotes scaffolding of extracellular matrix proteins. Here the authors show that LOXL2 is crucial for pressure-overload induced cardiac fibrosis, and that antibody-mediated inhibition or genetic disruption of Loxl2 in mice shows therapeutic potential for treatment of cardiac fibrosis.
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Affiliation(s)
- Jin Yang
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.,Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.,Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
| | - Konstantinos Savvatis
- Department of Cardiology, Campus Virchow-Klinikum, Charité University Medicine Berlin, 13353 Berlin, Germany.,Berlin-Brandenburg Centre for Regenerative Therapies, Charité University Medicine Berlin, 10117 Berlin, Germany
| | - Jong Seok Kang
- Gilead Sciences Inc., Foster City, California 94404, USA
| | - Peidong Fan
- Gilead Sciences Inc., Foster City, California 94404, USA
| | - Hongyan Zhong
- Gilead Sciences Inc., Foster City, California 94404, USA
| | - Karen Schwartz
- Gilead Sciences Inc., Foster City, California 94404, USA
| | - Vivian Barry
- Gilead Sciences Inc., Foster City, California 94404, USA
| | | | | | | | | | - Xuhui Feng
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.,Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.,Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
| | - Qiong Zhou
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.,Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.,Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
| | - Ching Shang
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.,Division of Cardiovascular Medicine, Stanford University, Stanford, California 94305, USA
| | - Praveen Kumar
- Gilead Sciences Inc., Foster City, California 94404, USA
| | - Dillon Phan
- Gilead Sciences Inc., Foster City, California 94404, USA
| | - Mario Kasner
- Department of Cardiology, Campus Virchow-Klinikum, Charité University Medicine Berlin, 13353 Berlin, Germany
| | - Begoña López
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, Department of Cardiology and Cardiac Surgery, University Clinic, University of Navarra, 31008 Pamplona, Spain
| | - Javier Diez
- Program of Cardiovascular Diseases, Centre for Applied Medical Research, Department of Cardiology and Cardiac Surgery, University Clinic, University of Navarra, 31008 Pamplona, Spain
| | - Keith C Wright
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
| | - Roxanne L Kovacs
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
| | - Thomas Quertermous
- Division of Cardiovascular Medicine, Stanford University, Stanford, California 94305, USA
| | - Victoria Smith
- Gilead Sciences Inc., Foster City, California 94404, USA
| | - Lina Yao
- Gilead Sciences Inc., Foster City, California 94404, USA
| | - Carsten Tschöpe
- Department of Cardiology, Campus Virchow-Klinikum, Charité University Medicine Berlin, 13353 Berlin, Germany.,Berlin-Brandenburg Centre for Regenerative Therapies, Charité University Medicine Berlin, 10117 Berlin, Germany.,DZHK, German Centre for Cardiovascular Research, Partner Site Berlin - Charité, 13347 Berlin, Germany
| | - Ching-Pin Chang
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.,Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.,Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.,Gilead Sciences Inc., Foster City, California 94404, USA
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50
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Zhang ZY, Ravassa S, Yang WY, Petit T, Pejchinovski M, Zürbig P, López B, Wei FF, Pontillo C, Thijs L, Jacobs L, González A, Koeck T, Delles C, Voigt JU, Verhamme P, Kuznetsova T, Díez J, Mischak H, Staessen JA. Diastolic Left Ventricular Function in Relation to Urinary and Serum Collagen Biomarkers in a General Population. PLoS One 2016; 11:e0167582. [PMID: 27959898 PMCID: PMC5154519 DOI: 10.1371/journal.pone.0167582] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 11/16/2016] [Indexed: 01/15/2023] Open
Abstract
Current knowledge on the pathogenesis of diastolic heart failure predominantly rests on case-control studies involving symptomatic patients with preserved ejection fraction and relying on invasive diagnostic procedures including endomyocardial biopsy. Our objective was to gain insight in serum and urinary biomarkers reflecting collagen turnover and associated with asymptomatic diastolic LV dysfunction. We randomly recruited 782 Flemish (51.3% women; 50.5 years). We assessed diastolic LV function from the early and late diastolic peak velocities of the transmitral blood flow and of the mitral annulus. By sequencing urinary peptides, we identified 70 urinary collagen fragments. In serum, we measured carboxyterminal propeptide of procollagen type 1 (PICP) as marker of collagen I synthesis and tissue inhibitor of matrix metalloproteinase type 1 (TIMP-1), an inhibitor of collagen-degrading enzymes. In multivariable-adjusted analyses with Bonferroni correction, we expressed effect sizes per 1-SD in urinary collagen I (uCI) or collagen III (uCIII) fragments. In relation to uCI fragments, e’ decreased by 0.183 cm/s (95% confidence interval, 0.017 to 0.350; p = 0.025), whereas E/e’ increased by 0.210 (0.067 to 0.353; p = 0.0012). E/e’ decreased with uCIII by 0.168 (0.021 to 0.316; p = 0.018). Based on age-specific echocardiographic criteria, 182 participants (23.3%) had subclinical diastolic LV dysfunction. Partial least squares discriminant analysis contrasting normal vs. diastolic LV dysfunction confirmed the aforementioned associations with the uCI and uCIII fragments. PICP and TIMP-1 increased in relation to uCI (p<0.0001), whereas these serum markers decreased with uCIII (p≤0.0006). Diastolic LV dysfunction was associated with higher levels of TIMP-1 (653 vs. 696 ng/mL; p = 0.013). In a general population, the non-invasively assessed diastolic LV function correlated inversely with uCI and serum markers of collagen I deposition, but positively with uCIII. These observations generalise previous studies in patients to randomly recruited people, in whom diastolic LV function ranged from normal to subclinical impairment, but did not encompass overt diastolic heart failure.
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Affiliation(s)
- Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Susana Ravassa
- Program of Cardiovascular Diseases, Centre for Applied Medical, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Thibault Petit
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | | | - Petra Zürbig
- Mosaiques Diagnostic and Therapeutics AG, Hannover, Germany
| | - Begoña López
- Program of Cardiovascular Diseases, Centre for Applied Medical, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | | | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Lotte Jacobs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Arantxa González
- Program of Cardiovascular Diseases, Centre for Applied Medical, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Thomas Koeck
- Mosaiques Diagnostic and Therapeutics AG, Hannover, Germany
| | - Christian Delles
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Jens-Uwe Voigt
- Research Unit Cardiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Peter Verhamme
- Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Tatiana Kuznetsova
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Javier Díez
- Program of Cardiovascular Diseases, Centre for Applied Medical, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
- Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, University of Navarra, Pamplona, Spain
| | - Harald Mischak
- Mosaiques Diagnostic and Therapeutics AG, Hannover, Germany
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Jan A. Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
- R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
- * E-mail: ,
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