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metabolism and heart failure

Pedro Moliner, Cristina Enjuanes, Marta Tajes, Miguel Cainzos-Achirica, Josep Lupón, Alberto Garay, Santiago Jimenez-Marrero, Sergi Yun, Núria Farré, Mercé Cladellas, Carles Díez, Jose Gonzalez-Costello, Josep Comin-Colet
Background Mechanisms underlying iron homeostasis dysregulation in patients with chronic heart failure remain unsettled. In cardiomyocyte models, norepinephrine may lead to intracellular iron depletion, but the potential association between catecholamines (sympathetic activation markers) and iron metabolism biomarkers in chronic heart failure is unknown. Methods and Results In this cross-sectional analysis, we studied the association between plasma norepinephrine levels and serum iron status biomarkers indicating iron storage (ferritin), iron transport (transferrin saturation), and iron demand (soluble transferrin receptor) in a prospective cohort of 742 chronic heart failure patients (mean age, 72±11 years; 56% male)...
February 19, 2019: Journal of the American Heart Association
Theodosios D Filippatos, Angelos Liontos, Ioanna Papakitsou, Moses S Elisaf
Sodium-glucose co-transporter 2 (SGLT2) inhibitors inhibit glucose re-absorption in the proximal renal tubules. Two trials have shown significant reductions of cardiovascular (CV) events with empagliflozin and canagliflozin, which could not be attributed solely to their antidiabetic effects. Aim of the review is the critical presentation of suggested mechanisms/hypotheses for the SGLT2 inhibitors-cardioprotection. The search of the literature revealed many possible cardioprotective mechanisms, because SGLT2 inhibitors i) increase natriuresis and act as diuretics with unique properties leading to a reduction in preload and myocardial stretch (the diuretic hypothesis); ii) decrease blood pressure and afterload (the blood pressure lowering hypothesis), iii) favor the production of ketones, which can act as a "superfuel" in the cardiac and renal tissue (the "thrifty substrate" hypothesis), iv) improve many metabolic variables (the metabolic effects hypothesis), v) exert many anti-inflammatory effects (the anti-inflammatory effects hypothesis), vi) can act through the angiotensin II type II receptors in the context of simultaneous renin-angiotensin-aldosterone-system (RAAS) blockade leading to vasodilation and positive inotropic effects (the RAAS hypothesis), vii) directly decrease the activity of the upregulated in heart failure Na+ -H+ exchanger in myocardial cells leading to restoration of mitochondrial calcium handling in cardiomyocytes (the sodium hypothesis)...
February 13, 2019: Postgraduate Medicine
Gillian Grafton, Thomas Cascino, Daniel Perry, Carmel Ashur, Todd M Koelling
BACKGROUND: Resting oxygen consumption (VO2 ) is often estimated and frequently used to guide therapeutic decisions in symptomatic heart failure (HF) patients. The relationship between resting VO2 and symptomatic HF and the accuracy of estimations of VO2 in this population are unknown. METHODS AND RESULTS: We performed a cross-sectional study of HF patients (n=691) and healthy controls (n=77). VO2 was measured using a metabolic cart and estimated VO2 was calculated using the Dehmer, LaFarge, and Bergstra formulas and the thermodilution method...
February 9, 2019: Journal of Cardiac Failure
Nicola Riccardo Pugliese, Iacopo Fabiani, Claudia Santini, Ilaria Rovai, Roberto Pedrinelli, Andrea Natali, Frank L Dini
Aims: To characterize heart failure (HF) with mid-range ejection fraction (HFmrEF), combining cardiopulmonary exercise test, and exercise stress echocardiography. Methods and results: We studied 169 consecutive subjects (age 62.3 ± 11 years; 74% male): 30 healthy controls, 45 patients with HF and preserved EF (HFpEF), 40 HFmrEF, and 54 with HF and reduced EF (HFrEF). Left ventricular (LV) stroke volume (SV), EF, elastance, global longitudinal strain, E/E', oxygen consumption (VO2), and arterial-venous oxygen content difference (AVO2diff) were measured in all exercise stages...
February 11, 2019: European Heart Journal Cardiovascular Imaging
Müge Çakırca, İsa Sözen, Gülsüm Tozlu Bindal, Mustafa Baydar, Ahmet Çınar Yastı
BACKGROUND: Due to a massive increase in capillary permeability during the state of shock caused by burns, albumin and intravascular fluid rapidly move to the extravascular areas. Therefore, hypoalbuminemia is seen as an early and prolonged finding in major burns. Hypoalbuminemia leads to various problems. The aim of this study was to investigate the effect of the preoperative albumin level on perioperative morbidity and mortality in patients with major burns. METHODS: Demographic data, preoperative albumin levels, surgical records, and clinical follow-up records of a total of 61 patients who underwent surgery for major burns in our hospital for the last 2 years were examined...
January 2019: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Jan Biegus, Robert Zymliński, Mateusz Sokolski, Ewa A Jankowska, Waldemar Banasiak, Piotr Ponikowski
BACKGROUND: We believe that there is a physiological link between intracellular iron status (assessed by sTfR (soluble transferrin receptor)) and efficiency of energy production/consumption (assessed by lactate, a product of anaerobic cell metabolism), which may further impact the outcome of patients with acute heart failure (AHF). AIM: To examine if elevated lactates (>2 mmol/L) accompanied with unmet cellular iron requirements (defined by sTfR of >1.59 mg/L) identify AHF patients with an unfavourable outcome...
February 11, 2019: Kardiologia Polska
Roxana Aldea, Roy O Weller, Donna M Wilcock, Roxana O Carare, Giles Richardson
The human brain is the organ with the highest metabolic activity but it lacks a traditional lymphatic system responsible for clearing waste products. We have demonstrated that the basement membranes of cerebral capillaries and arteries represent the lymphatic pathways of the brain along which intramural periarterial drainage (IPAD) of soluble metabolites occurs. Failure of IPAD could explain the vascular deposition of the amyloid-beta protein as cerebral amyloid angiopathy (CAA), which is a key pathological feature of Alzheimer's disease...
2019: Frontiers in Aging Neuroscience
Mariann Bombicz, Daniel Priksz, Rudolf Gesztelyi, Rita Kiss, Nora Hollos, Balazs Varga, Jozsef Nemeth, Attila Toth, Zoltan Papp, Zoltan Szilvassy, Bela Juhasz
Background and Aims : Diabetic cardiomyopathy (DCM) is an emerging problem worldwide due to an increase in the incidence of type 2 diabetes. Animal studies have indicated that metformin and pioglitazone can prevent DCM partly by normalizing insulin resistance, and partly by other, pleiotropic mechanisms. One clinical study has evidenced the insulin-senzitizing effect of the drug candidate BGP-15, along with additional animal studies that have confirmed its beneficial effects in models of diabetes, muscular dystrophy and heart failure, with the drug affecting chaperones, contractile proteins and mitochondria...
February 7, 2019: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
YanLiang Yuan, Bing Huang, Haoran Miao, Xiucheng Liu, Hao Zhang, Fan Qiu, Zhiwei Liu, Yiqian Zhang, Hongyan Dong, Zhongming Zhang
Background The failure to maintain the viability of ischemic myocardium is one of the mechanisms causing ischemic heart dysfunction after revascularization. Hibernating Myocardium is considered to be able to maintain a long-term viability during chronic hypoperfusion. Pigment epithelium-derived factor (PEDF) decreases the contractility of hypoxic cardiomyocytes and protects cardiomyocytes against ischemic injury, which is strikingly similar to the pathophysiologic characteristics of Hibernating Myocardium. We therefore postulate that PEDF may induce the acute ischemic myocardium into a "Hibernating-like" state to maintain its viability...
February 8, 2019: Human Gene Therapy
Kelly McHugh, Adam D DeVore, Jingjing Wu, Roland A Matsouaka, Gregg C Fonarow, Paul A Heidenreich, Clyde W Yancy, Jennifer B Green, Natasha Altman, Adrian F Hernandez
Heart failure with preserved ejection fraction (HFpEF) is now the most common form of HF, affecting over 3 million adults in the United States alone. HFpEF is a heterogenous syndrome. One important phenotype may be related to comorbid conditions, including diabetes mellitus (DM). DM has a prevalence of approximately 45% in HFpEF, but characteristics and outcomes of this population are poorly understood. In this review, the authors summarize data from several clinical trials of HFpEF therapeutics and provide original data from a large cohort using the Get With The Guidelines-HF registry, which together suggest that DM is associated with increased morbidity and long-term mortality in HFpEF...
February 12, 2019: Journal of the American College of Cardiology
Damilola D Adingupu, Sven O Göpel, Julia Grönros, Margareta Behrendt, Matus Sotak, Tasso Miliotis, Ulrika Dahlqvist, Li-Ming Gan, Ann-Cathrine Jönsson-Rylander
BACKGROUND: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) is the first class of anti-diabetes treatment that reduces mortality and risk for hospitalization due to heart failure. In clinical studies it has been shown that SGLT2i's promote a general shift to fasting state metabolism characterized by reduced body weight and blood glucose, increase in glucagon/insulin ratio and modest increase in blood ketone levels. Therefore, we investigated the connection between metabolic changes and cardiovascular function in the ob/ob-/- mice; a rodent model of early diabetes with specific focus on coronary microvascular function...
February 7, 2019: Cardiovascular Diabetology
Caroline J Coats, Menelaos Pavlou, Oliver T Watkinson, Alexandros Protonotarios, Linda Moss, Rebecca Hyland, Khadija Rantell, Antonis A Pantazis, Maite Tome, William J McKenna, Michael P Frenneaux, Rumana Omar, Perry M Elliott
Importance: Hypertrophic cardiomyopathy causes limiting symptoms in patients, mediated partly through inefficient myocardial energy use. There is conflicting evidence for therapy with inhibitors of myocardial fatty acid metabolism in patients with nonobstructive hypertrophic cardiomyopathy. Objective: To determine the effect of oral therapy with trimetazidine, a direct inhibitor of fatty acid β-oxidation, on exercise capacity in patients with symptomatic nonobstructive hypertrophic cardiomyopathy...
February 6, 2019: JAMA Cardiology
Anne E Atkins, Beth A Tarini, Emily K Phillips, Amy R U L Calhoun
The Iowa Newborn Screening (NBS) Program began screening for very long-chain acyl-CoA dehydrogenase deficiency (VLCAD) in 2003. Untreated VLCAD can lead to liver failure, heart failure, and death. Current confirmatory testing recommendations by the American College of Medical Genetics (ACMG) for VLCAD list molecular and functional analysis (i.e., fibroblast fatty acid oxidation probe) as optional. This can lead to misclassification of VLCAD carriers as false positives. Iowa implemented a comprehensive VLCAD confirmatory testing algorithm at the beginning of 2016 that included both molecular and fibroblast analysis...
February 5, 2019: Journal of Community Genetics
R I Dmitrieva, T A Lelyavina, M Y Komarova, V L Galenko, O A Ivanova, P A Tikanova, N V Khromova, A S Golovkin, M A Bortsova, A Sergushichev, M Yu Sitnikova, A A Kostareva
Background and Purpose: In heart failure (HF), metabolic alterations induce skeletal muscle wasting and decrease of exercise capacity and quality of life. The activation of skeletal muscle regeneration potential is a prospective strategy to reduce muscle wasting; therefore, the aim of this project was to determine if functional properties of skeletal muscle mesenchymal progenitor cells (SM-MPC) were affected by HF-induced functional and metabolic dysregulations. Methods: Gastrocnemius muscle biopsy samples were obtained from 3 healthy donors (HD) and 12 HF patients to purify mRNA for further analysis and to isolate SM-MPC...
2019: Stem Cells International
Mengchao Jin, Zhiyuan Qian, Jiayu Yin, Weiting Xu, Xiang Zhou
Accumulating evidence has indicated that intestinal microbiota is involved in the development of various human diseases, including cardiovascular diseases (CVDs). In the recent years, both human and animal experiments have revealed that alterations in the composition and function of intestinal flora, recognized as gut microflora dysbiosis, can accelerate the progression of CVDs. Moreover, intestinal flora metabolizes the diet ingested by the host into a series of metabolites, including trimethylamine N-oxide, short chain fatty acids, secondary bile acid and indoxyl sulfate, which affects the host physiological processes by activation of numerous signalling pathways...
February 3, 2019: Journal of Cellular and Molecular Medicine
Yong Sub Na, Sang-Gon Park
BACKGROUND Tumor lysis syndrome (TLS) is an oncologic emergency resulting from the massive destruction of tumor cells after cytotoxic chemotherapy for chemosensitive malignancies with a high tumor burden. Its clinical manifestations include severe electrolyte disturbances, metabolic acidosis, acute renal failure secondary to urate deposition in the kidney, heart, and skeletal muscle, and nervous system dysfunction. We report an extremely rare case of spontaneous TLS (STLS) in idiopathic primary myelofibrosis (PMF)...
February 3, 2019: American Journal of Case Reports
Jacob Joseph
No abstract text is available yet for this article.
January 11, 2019: American Journal of the Medical Sciences
Qingguo Lu, Xuan Li, Jia Liu, Xiaodong Sun, Thomas Rousselle, Di Ren, Nanwei Tong, Ji Li
Diabetics have higher morbidity and mortality in cardiovascular disease (CVD). A variety of anti-diabetic agents are available for clinical choice. Cardiovascular (CV) safety assessment of these agents is crucial in addition to hypoglycemic effect before clinical prescription. Adenosine 5'-monophosphate-activated protein kinase (AMPK) is an important cell energy sensor, which plays an important role in regulating myocardial energy metabolism, reducing ischemia and ischemia/reperfusion (I/R) injury, improving heart failure (HF) and ventricular remodeling, ameliorating vascular endothelial dysfunction, anti-chronic inflammation, anti-apoptosis and regulating autophagy...
February 1, 2019: Bioscience Reports
Jack F Price
Congestive heart failure is a final common clinical pathway for several diseases in childhood, such as familial cardiomyopathy, viral myocarditis, inborn errors of metabolism, and autoimmune disorders. Early identification and treatment can reduce symptom severity and may affect outcomes. In this review, the clinical characteristics of pediatric heart failure are described, and the initial diagnostic evaluation is outlined. Evidence-based heart failure treatment strategies at various clinical stages are discussed in detail, including the management of acute decompensated heart failure...
February 2019: Pediatrics in Review
Emily Hanson, Mark Sheldon, Brenda Pacheco, Mohammed Alkubeysi, Veena Raizada
Friedreich's ataxia (FRDA), which occurs in 1/50000 live births, is the most prevalent inherited neuromuscular disorder. Nearly all FRDA patients develop cardiomyopathy at some point in their lives. The clinical manifestations of FRDA include ataxia of the limbs and trunk, dysarthria, diabetes mellitus, and cardiac diseases. However, the broad clinical spectrum makes FRDA difficult to identify. The diagnosis of FRDA is based on the presence of suspicious clinical factors, the use of the Harding criteria and, more recently, the use of genetic testing for identifying the expansion of a triplet nucleotide sequence...
January 26, 2019: World Journal of Cardiology
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