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Preoperative hyperamylasemia relates to renal dysfunction and hyperamylasemia in cardiac surgery: an observational study. 术前高淀粉酶血症与心脏手术中肾功能障碍和高淀粉酶血症的关系:一项观察性研究。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-21 DOI: 10.1007/s00380-024-02463-w
Hiroki Iwata, Shingo Kawashima, Yoshiki Nakajima, Hiroyuki Kinoshita

The role of preoperative hyperamylasemia in the perioperative enzyme levels in patients undergoing cardiac surgery is unclear. The primary outcome of this observational clinical study was to determine whether patients with preoperative hyperamylasemia undergoing on-pump cardiac surgery document an increase in serum amylase levels perioperatively compared with patients with normal serum amylase levels preoperatively. This prospective study evaluated serum total, pancreatic, and salivary amylase levels, estimated glomerular filtration rate (eGFR), and serum creatinine before the operation at postoperative days (POD) 1, 2, 3, and 7. We also followed up on any perioperative symptoms, including abdominal pain and lower ear or jaw swelling. We preoperatively had 157 patients with normal amylase levels (Normal group) and 45 with hyperamylasemia (Hyperamylasemia group). The Hyperamylasemia group demonstrated continuously lower eGFR and higher creatinine values at the preoperative time, postoperative days 1, 2, 3, and 7, compared with the Normal group. The Hyperamylasemia group showed higher serum total, pancreatic, and salivary amylase levels at preoperative (total 70 [55-90] [Normal] vs. 142 [107 to 162] [Hyperamylasemia] IU/L, median [25-75th percentile], P < 0.001) and postoperative periods compared with the Normal group. The relationship between renal dysfunction and serum amylase levels in all patients was significant in the preoperative, but not postoperative, periods. We noted no patients demonstrating clinical symptoms. Preoperative hyperamylasemia in patients undergoing on-pump cardiac surgery was associated with renal dysfunction without needing hemodialysis. However, whether the relation affects postoperative serum amylase levels is inconclusive.

术前高淀粉酶血症对心脏手术患者围手术期酶水平的影响尚不明确。这项观察性临床研究的主要目的是确定,与术前血清淀粉酶水平正常的患者相比,术前患有高淀粉酶血症、接受泵上心脏手术的患者围手术期血清淀粉酶水平是否升高。这项前瞻性研究评估了术前在术后第 1、2、3 和 7 天 (POD) 的血清总淀粉酶、胰腺淀粉酶和唾液淀粉酶水平、估计肾小球滤过率 (eGFR) 和血清肌酐。我们还随访了围手术期的任何症状,包括腹痛、下耳或下颌肿胀。术前,我们发现 157 名患者淀粉酶水平正常(正常组),45 名患者患有高淀粉酶血症(高淀粉酶血症组)。与正常组相比,高淀粉酶血症组在术前、术后第 1、2、3 和 7 天的 eGFR 值和肌酐值持续降低。与正常组相比,高淀粉酶血症组在术前和术后的血清总淀粉酶、胰腺淀粉酶和唾液淀粉酶水平更高(总淀粉酶 70 [55-90] [正常] vs. 142 [107-162] [高淀粉酶血症] IU/L,中位数 [第 25-75 百分位数],P <0.001)。所有患者的肾功能障碍与血清淀粉酶水平之间的关系在术前(而非术后)均显著。我们注意到没有患者出现临床症状。接受体外循环心脏手术的患者术前高淀粉酶血症与肾功能不全有关,但无需进行血液透析。但是,这种关系是否会影响术后血清淀粉酶水平尚无定论。
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引用次数: 0
Metabolic syndrome is linked to most cancers incidence. 代谢综合征与大多数癌症的发病率有关。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-09 DOI: 10.1007/s00380-024-02474-7
Naoki Kimoto, Yohei Miyashita, Yutaka Yata, Takeshi Aketa, Masami Yabumoto, Yasushi Sakata, Takashi Washio, Seiji Takashima, Masafumi Kitakaze

Since many people die of either cancers or cardiovascular diseases worldwide, it is important to find the clinical pitfall that provokes cardiovascular diseases and cancer overall. Since metabolic syndrome (MetS) is largely linked to cardiovascular diseases, we have come to consider that MetS, even in its early state, may prime the occurrence of cancers overall. Indeed, the importance of MetS in causing pancreatic cancer has been proved using our large medical database. We analyzed Japanese healthcare and clinical data in 2005, who were followed up until 2020 and we examined the incidence of major cancers. At the enrollment, we examined the presence or absence of MetS judged by either Japanese criteria or NCEP/ATPIII. Of 2.7 million subjects without missing data, 102,930; 200,231; 237,420; 63,435; 76,172; and 2,422 subjects suffered lung, stomach, colon, liver and prostate cancer, respectively, and myelogenous leukemia during follow-up. MetS, defined by Japanese criteria, increased (p < 0.005 each) the incidence of cancer with a hazard ratio (HR) of 1.03-1.47 for lung, stomach, colon, liver, prostate cancers, and myelogenous leukemia. According to Japanese criteria, cancer incidence in the pre-stage MetS group was comparable to the MetS group. The results were almost identical when we defined MetS using NCEP ATP III. Taken together, we conclude that MetS is linked to majority of cancers.

由于全球有许多人死于癌症或心血管疾病,因此找到引发心血管疾病和癌症的临床隐患非常重要。由于代谢综合征(MetS)在很大程度上与心血管疾病有关,我们开始考虑代谢综合征,即使是在其早期状态,也可能会导致癌症的发生。事实上,我们的大型医疗数据库已经证明了代谢综合征在导致胰腺癌方面的重要性。我们分析了 2005 年的日本医疗保健和临床数据,对这些人进行了跟踪调查,直至 2020 年,并研究了主要癌症的发病率。在登记时,我们根据日本标准或 NCEP/ATPIII 判断是否存在 MetS。在 270 万名无数据缺失的受试者中,分别有 102,930 人、200,231 人、237,420 人、63,435 人、76,172 人和 2,422 人在随访期间罹患肺癌、胃癌、结肠癌、肝癌和前列腺癌以及骨髓性白血病。根据日本标准定义的 MetS 增加(p
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引用次数: 0
The role of E-wave velocity in predicting early left ventricular dysfunction and significant decline in left ventricular ejection fraction after mitral valve repair for severe chronic primary mitral regurgitation. 二尖瓣修复术治疗严重慢性原发性二尖瓣反流后,E 波速度在预测早期左心室功能障碍和左心室射血分数显著下降方面的作用。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-08 DOI: 10.1007/s00380-024-02468-5
Chanjuan Gong, Takeshi Kinoshita, Masakazu Hayashida, Atsuko Hara, Maho Kakemizu-Watanabe, Sakiko Miyazaki, Minoru Tabata

Preoperative left ventricular (LV) ejection fraction (LVEF) and LV end-systolic dimension (LVESD) are established predictors of LV dysfunction (LVD) after mitral valve repair (MVr) for mitral regurgitation (MR). Although elevated estimated right ventricular systolic pressure (eRVSP) indicating pulmonary hypertension is the best proposed additional predictor, we hypothesized that transthoracic echocardiography (TTE) parameters more directly reflecting left atrial pressure (LAP) would more accurately predict LVD than eRVSP. Furthermore, predictors of a significant decline in LVEF remain unknown. We retrospectively studied 622 patients, aged 20-87 years, who underwent MVr for severe chronic primary MR. As previously reported predictors of postoperative LVD, we collected seven preoperative TTE parameters, including LVESD, LVEF, eRVSP, LV end-diastolic dimension, left atrial volume index (LAVI), early transmitral annular (e') velocity, and atrial fibrillation. Furthermore, as LAP-related TTE parameters, we collected left atrial dimension, E-wave velocity, and E/e' ratio, in addition to eRVSP and LAVI. Using multivariate logistic regression and receiver operating characteristic curve analyses, we explored predictors of early postoperative LVD, defined as LVEF < 50% measured on postoperative day 7. We further explored predictors of a significant decline in LVEF, defined as an absolute decline in LVEF of > 12 percentage points, the third quintile of the data. Incidences of postoperative LVD and a significant LVEF decline were 12.9% and 23.2%, respectively. In addition to LVESD and LVEF, E-wave velocity, but not eRVSP, remained a significant predictor of postoperative LVD. E-wave velocity, LVESD, and LVEF had additive effects in risk prediction. Furthermore, E-wave velocity was the strongest predictor of a significant LVEF decline. E-wave velocities > 121.5 cm/s and > 101.5 cm/s were associated with increased risks of postoperative LVD (odds ratio [OR], 2.896; 95% confidence interval [95%CI], 1.792-4.681; p < 0.001) and a significant LVEF decline (OR, 6.345; 95%CI, 3.707-10.86; p < 0.001), respectively. After adjustment for multiple TTE parameters, E-wave velocity, but not eRVSP, remained significant predictors of postoperative LVD and a significant LVEF decline after MVr. These results were reproducible in 461 patients who underwent follow-up TTE at 1 year, suggesting an important role of E-wave velocity in risk prediction.

术前左心室射血分数(LVEF)和左心室收缩末期尺寸(LVESD)是二尖瓣反流(MR)二尖瓣修复术(MVr)后左心室功能障碍(LVD)的既定预测指标。尽管显示肺动脉高压的右心室收缩压(eRVSP)估测值升高是最好的额外预测指标,但我们假设,与 eRVSP 相比,更能直接反映左心房压力(LAP)的经胸超声心动图(TTE)参数能更准确地预测 LVD。此外,预测 LVEF 显著下降的因素仍然未知。我们回顾性研究了 622 名因严重慢性原发性 MR 而接受 MVr 的患者,他们的年龄在 20-87 岁之间。与之前报道的术后 LVD 预测因素一样,我们收集了术前七项 TTE 参数,包括 LVESD、LVEF、eRVSP、LV 舒张末期尺寸、左心房容积指数(LAVI)、早期透射瓣环(e')速度和心房颤动。此外,作为与 LAP 相关的 TTE 参数,除 eRVSP 和 LAVI 外,我们还收集了左心房尺寸、E 波速度和 E/e' 比值。通过多变量逻辑回归和接收器操作特征曲线分析,我们探索了术后早期 LVD 的预测因素,LVD 的定义是 LVEF 12 个百分点,即数据的第三个五分位数。术后 LVD 和 LVEF 显著下降的发生率分别为 12.9% 和 23.2%。除 LVESD 和 LVEF 外,E 波速度(而非 eRVSP)仍是术后 LVD 的重要预测因素。E波速度、LVESD和LVEF在风险预测中具有叠加效应。此外,E 波速度是 LVEF 显著下降的最强预测因子。E波速度>121.5 cm/s和>101.5 cm/s与术后LVD风险增加有关(几率比[OR],2.896;95%置信区间[95%CI],1.792-4.681;P<0.05)。
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引用次数: 0
Usefulness of tissue tracking to differentiate tachycardia-induced cardiomyopathy from dilated cardiomyopathy in patients admitted for heart failure. 组织追踪技术在区分因心力衰竭入院的患者中心动过速诱发的心肌病和扩张型心肌病方面的实用性。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-08 DOI: 10.1007/s00380-024-02471-w
Alberto Vera, Alberto Cecconi, Pablo Martínez-Vives, Beatriz López-Melgar, María José Olivera, Susana Hernández, Antonio Rojas-González, Pablo Díez-Villanueva, Jorge Salamanca, Paloma Caballero, Luis Jesús Jiménez-Borreguero, Fernando Alfonso

Introduction: Differentiation of tachycardia-induced cardiomyopathy (TIC) from dilated cardiomyopathy (DCM) in patients admitted for heart failure (HF) with left ventricular dysfunction and supraventricular tachyarrhythmia (SVT) remains challenging. The role of tissue tracking (TT) in this setting remains unknown.

Methods: Forty-three consecutive patients admitted for HF due to SVT with left ventricular ejection fraction (LVEF) < 50% undergoing CMR were retrospectively included. Those eventually evolving to LVEF > 50% at follow-up were classified as TIC and those maintaining a LVEF < 50% were classified as DCM. Clinical, echocardiography, and CMR findings, including TT, were analyzed to predict LVEF recovery.

Results: Twenty-five (58%) patients were classified as TIC. Late gadolinium enhancement (LGE) was more frequent in DCM group (61% vs 16%, p = 0.004). Left ventricle (LV) peak systolic radial velocity and peak diastolic radial strain rate were lower in DCM group (7.24 ± 4.44 mm/s vs 10.8 ± 4.5 mm/s; p = 0.015 and -0.12 ± 0.33 1/s vs -0.48 ± 0.51 1/s; p = 0.016, respectively). Right ventricle (RV) peak circumferential displacement was lower in patients with TIC (0.2 ± 1.3 vs 1.3 ± 0.9°; p = 0.009). In the multivariate analysis, diabetes (p = 0.046), presence of LGE (p = 0.028), LV peak systolic radial velocity < 7.5 mm/s (p = 0.034), and RV peak circumferential displacement > 0.5° (p = 0.028) were independent predictors of lack of LVEF recovery.

Conclusion: In the setting of acute HF with LV dysfunction related to SVT, diabetes, LGE, LV peak systolic velocity, and RV peak circumferential displacement are independent predictors of lack of LVEF recovery and, therefore, represent clinically useful parameters to differentiate TIC from DCM.

导言:在因左心室功能障碍和室上性心动过速(SVT)而入院的心力衰竭(HF)患者中,心动过速诱发的心肌病(TIC)与扩张型心肌病(DCM)的鉴别仍具有挑战性。组织追踪(TT)在这种情况下的作用仍然未知:方法:连续收治 43 例因 SVT 导致心房颤动且随访时左室射血分数(LVEF)为 50%的患者,将其分为 TIC 和保持 LVEF 的患者:25例(58%)患者被归类为TIC。晚期钆增强(LGE)在 DCM 组中更为常见(61% 对 16%,P = 0.004)。左心室(LV)收缩期径向峰值速度和舒张期径向峰值应变率在 DCM 组较低(分别为 7.24 ± 4.44 mm/s vs 10.8 ± 4.5 mm/s; p = 0.015 和 -0.12 ± 0.33 1/s vs -0.48 ± 0.51 1/s; p = 0.016)。TIC患者的右心室(RV)周向位移峰值较低(0.2 ± 1.3 vs 1.3 ± 0.9°;p = 0.009)。在多变量分析中,糖尿病(p = 0.046)、LGE(p = 0.028)、左心室收缩峰值径向速度 0.5°(p = 0.028)是 LVEF 缺乏恢复的独立预测因素:结论:在急性心力衰竭伴有与 SVT、糖尿病相关的左心室功能障碍的情况下,LGE、左心室收缩期峰值速度和 RV 峰值周向位移是 LVEF 缺乏恢复的独立预测因子,因此是区分 TIC 和 DCM 的临床有用参数。
{"title":"Usefulness of tissue tracking to differentiate tachycardia-induced cardiomyopathy from dilated cardiomyopathy in patients admitted for heart failure.","authors":"Alberto Vera, Alberto Cecconi, Pablo Martínez-Vives, Beatriz López-Melgar, María José Olivera, Susana Hernández, Antonio Rojas-González, Pablo Díez-Villanueva, Jorge Salamanca, Paloma Caballero, Luis Jesús Jiménez-Borreguero, Fernando Alfonso","doi":"10.1007/s00380-024-02471-w","DOIUrl":"https://doi.org/10.1007/s00380-024-02471-w","url":null,"abstract":"<p><strong>Introduction: </strong>Differentiation of tachycardia-induced cardiomyopathy (TIC) from dilated cardiomyopathy (DCM) in patients admitted for heart failure (HF) with left ventricular dysfunction and supraventricular tachyarrhythmia (SVT) remains challenging. The role of tissue tracking (TT) in this setting remains unknown.</p><p><strong>Methods: </strong>Forty-three consecutive patients admitted for HF due to SVT with left ventricular ejection fraction (LVEF) < 50% undergoing CMR were retrospectively included. Those eventually evolving to LVEF > 50% at follow-up were classified as TIC and those maintaining a LVEF < 50% were classified as DCM. Clinical, echocardiography, and CMR findings, including TT, were analyzed to predict LVEF recovery.</p><p><strong>Results: </strong>Twenty-five (58%) patients were classified as TIC. Late gadolinium enhancement (LGE) was more frequent in DCM group (61% vs 16%, p = 0.004). Left ventricle (LV) peak systolic radial velocity and peak diastolic radial strain rate were lower in DCM group (7.24 ± 4.44 mm/s vs 10.8 ± 4.5 mm/s; p = 0.015 and -0.12 ± 0.33 1/s vs -0.48 ± 0.51 1/s; p = 0.016, respectively). Right ventricle (RV) peak circumferential displacement was lower in patients with TIC (0.2 ± 1.3 vs 1.3 ± 0.9°; p = 0.009). In the multivariate analysis, diabetes (p = 0.046), presence of LGE (p = 0.028), LV peak systolic radial velocity < 7.5 mm/s (p = 0.034), and RV peak circumferential displacement > 0.5° (p = 0.028) were independent predictors of lack of LVEF recovery.</p><p><strong>Conclusion: </strong>In the setting of acute HF with LV dysfunction related to SVT, diabetes, LGE, LV peak systolic velocity, and RV peak circumferential displacement are independent predictors of lack of LVEF recovery and, therefore, represent clinically useful parameters to differentiate TIC from DCM.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Differences in vascular tissue response after stent implantation between biolimus-eluting and everolimus-eluting stents: a sub-study of the NEXT study. 比奥利姆斯洗脱支架和依维莫司洗脱支架植入后血管组织反应的差异:NEXT 研究的一项子研究。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-08 DOI: 10.1007/s00380-024-02467-6
Hajime Imai, Masanori Kawasaki, Akihiro Yoshida, Hiromitsu Kanamori, Hiroyuki Okura

NEXT [NOBORI biolimus-eluting stent (BES) versus XIENCE/PROMUS everolimus-eluting stent (EES) trial] was a multicenter, randomized, prospective trial that included 3235 patients with 8-12 months of follow-up imaging at 18 centers. IB-IVUS images were analyzed at an interval of 0.5 mm using a motorized pull-back system in each plaque that required stent implantation. We analyzed seven cross-sections at the site of minimal lumen area and ten cross-sections in proximal and distal peripheral sites prior to the procedure, after stent implantation and after 8 months. We averaged the relative blue volume, relative green volume, relative yellow volume, and relative red volume across seven cross-sections using the manufacturer's default setting. Fifty-four lesions in 50 patients were analyzed. There were 28 lesions in 25 patients in the EES group and 26 lesions in 25 patients in the BES group. The patient characteristics did not differ significantly between the two groups except high-density lipoprotein cholesterol. There were no significant differences before and after stent implantation after 8 months in relative red volume, relative yellow volume, relative green volume or relative blue volume. Although the present study was likely underpowered for statistical analyses and larger populations are needed to confirm the conclusions, the vascular response regarding tissue characterization was similar between EES and BES, even though the thickness and releasing materials differed between the stents.

NEXT[NOBORI生物利莫司洗脱支架(BES)与 XIENCE/PROMUS 依维莫司洗脱支架(EES)试验]是一项多中心、随机、前瞻性试验,共纳入 3235 例患者,在 18 个中心进行了 8-12 个月的随访成像。在每个需要植入支架的斑块中,使用电动回拉系统以 0.5 毫米的间隔对 IB-IVUS 图像进行分析。在手术前、支架植入后和 8 个月后,我们分析了最小管腔面积部位的 7 个横截面以及近端和远端外周部位的 10 个横截面。我们使用制造商的默认设置对七个横截面的相对蓝色体积、相对绿色体积、相对黄色体积和相对红色体积进行平均。我们对 50 名患者的 54 个病灶进行了分析。EES 组 25 名患者中有 28 个病灶,BES 组 25 名患者中有 26 个病灶。除高密度脂蛋白胆固醇外,两组患者的特征无明显差异。8 个月后,在相对红色体积、相对黄色体积、相对绿色体积或相对蓝色体积方面,支架植入前后无明显差异。尽管本研究的统计分析能力可能不足,而且需要更多的人群来证实结论,但尽管 EES 和 BES 支架的厚度和释放材料不同,但它们在组织特征方面的血管反应相似。
{"title":"Differences in vascular tissue response after stent implantation between biolimus-eluting and everolimus-eluting stents: a sub-study of the NEXT study.","authors":"Hajime Imai, Masanori Kawasaki, Akihiro Yoshida, Hiromitsu Kanamori, Hiroyuki Okura","doi":"10.1007/s00380-024-02467-6","DOIUrl":"https://doi.org/10.1007/s00380-024-02467-6","url":null,"abstract":"<p><p>NEXT [NOBORI biolimus-eluting stent (BES) versus XIENCE/PROMUS everolimus-eluting stent (EES) trial] was a multicenter, randomized, prospective trial that included 3235 patients with 8-12 months of follow-up imaging at 18 centers. IB-IVUS images were analyzed at an interval of 0.5 mm using a motorized pull-back system in each plaque that required stent implantation. We analyzed seven cross-sections at the site of minimal lumen area and ten cross-sections in proximal and distal peripheral sites prior to the procedure, after stent implantation and after 8 months. We averaged the relative blue volume, relative green volume, relative yellow volume, and relative red volume across seven cross-sections using the manufacturer's default setting. Fifty-four lesions in 50 patients were analyzed. There were 28 lesions in 25 patients in the EES group and 26 lesions in 25 patients in the BES group. The patient characteristics did not differ significantly between the two groups except high-density lipoprotein cholesterol. There were no significant differences before and after stent implantation after 8 months in relative red volume, relative yellow volume, relative green volume or relative blue volume. Although the present study was likely underpowered for statistical analyses and larger populations are needed to confirm the conclusions, the vascular response regarding tissue characterization was similar between EES and BES, even though the thickness and releasing materials differed between the stents.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anti-inflammatory effects of proprotein convertase subtilisin/kexin 9 inhibitor therapy in the early phase of acute myocardial infarction. 急性心肌梗死早期阶段丙蛋白转化酶枯草酶/kexin 9抑制剂的抗炎作用。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-05 DOI: 10.1007/s00380-024-02473-8
Tomohiro Shimizu, Tetsuji Morishita, Hiroyasu Uzui, Yusuke Sato, Tatsuhiro Kataoka, Machiko Miyoshi, Junya Yamaguchi, Yuichiro Shiomi, Hiroyuki Ikeda, Naoto Tama, Kanae Hasegawa, Kentaro Ishida, Hiroshi Tada

This study examined the anti-inflammatory and endothelial function-enhancing effects of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitor therapy in the early phase after acute myocardial infarction (AMI) by assessing changes in tumor necrosis factor-α (TNF-α) levels and the L-arginine/asymmetric-dimethylarginine (ADMA) ratio. This retrospective, single-center cohort study included patients who underwent successful timely primary percutaneous coronary intervention (PCI) for first-onset AMI between September 2017 and March 2018. The PCSK9 inhibitor group comprised patients who received 75 mg alirocumab up to 7 days after AMI, while the standard therapy group comprised patients who did not. We evaluated the change in TNF-α levels and the L-arginine/ADMA ratio at the time of hospital admission and prior to discharge. PCSK9 inhibitor therapy in the early phase after AMI suppressed TNF-α levels (standard therapy group, 1.64 ± 2.14 pg/mL vs. PCSK9 inhibitor group, 0.26 ± 0.33 pg/mL; p = 0.033) and increased the L-arginine/ADMA ratio (standard therapy group, - 13.0 ± 39.7 vs. PCSK9 inhibitor group, 23.2 ± 39.7; p = 0.042). Upon multiple regression analysis adjusted for sex, age, and peak creatine kinase levels, PCSK9 inhibitor therapy was associated with TNF-α suppression (p = 0.025; β = - 0.235, 95% confidence interval [CI], - 0.436 to - 0.033). The L-arginine/ADMA ratio was also analyzed using multiple regression, adjusted for sex, age, peak creatine kinase levels, and smoking, showing a significant improvement in the ratio (p = 0.018; β = 41.913, 95% CI, 10.337-73.491). Moreover, a weak negative correlation was suggested between the change in TNF-α levels and the change in L-arginine/ADMA ratio (r = - 0.393, p = 0.058). PCSK9 inhibitor therapy in the early phase after AMI suppresses TNF-α levels and improves the L-arginine/ADMA ratio, potentially indicating anti-inflammatory and endothelial function-enhancing effects.

本研究通过评估肿瘤坏死因子-α(TNF-α)水平和L-精氨酸/不对称二甲基精氨酸(ADMA)比值的变化,考察了丙蛋白转化酶亚基酶/kexin 9(PCSK9)抑制剂疗法在急性心肌梗死(AMI)后早期阶段的抗炎和增强内皮功能作用。这项回顾性、单中心队列研究纳入了2017年9月至2018年3月间因首次发病AMI而及时成功接受初次经皮冠状动脉介入治疗(PCI)的患者。PCSK9抑制剂组包括在AMI后7天内接受75毫克阿利库单抗治疗的患者,而标准治疗组包括未接受阿利库单抗治疗的患者。我们评估了入院时和出院前 TNF-α 水平和 L-精氨酸/ADMA比率的变化。急性心肌梗死后早期的 PCSK9 抑制剂治疗抑制了 TNF-α 水平(标准治疗组,1.64 ± 2.14 pg/mL vs. PCSK9 抑制剂组,0.26 ± 0.33 pg/mL;p = 0.033),提高了 L-精氨酸/ADMA比率(标准治疗组,- 13.0 ± 39.7 vs. PCSK9 抑制剂组,23.2 ± 39.7;p = 0.042)。经调整性别、年龄和肌酸激酶峰值水平后进行多元回归分析,PCSK9 抑制剂治疗与 TNF-α 抑制相关(p = 0.025;β = - 0.235,95% 置信区间 [CI],- 0.436 至 - 0.033)。在对性别、年龄、肌酸激酶峰值水平和吸烟进行调整后,还使用多元回归法分析了 L-精氨酸/ADMA比率,结果显示该比率有了显著改善(p = 0.018;β = 41.913,95% 置信区间 [CI],10.337-73.491)。此外,TNF-α水平的变化与L-精氨酸/ADMA比率的变化之间呈弱负相关(r = - 0.393,p = 0.058)。在急性心肌梗死后的早期阶段使用 PCSK9 抑制剂治疗可抑制 TNF-α 水平并改善 L-精氨酸/ADMA比率,这可能表明了抗炎和增强内皮功能的作用。
{"title":"Anti-inflammatory effects of proprotein convertase subtilisin/kexin 9 inhibitor therapy in the early phase of acute myocardial infarction.","authors":"Tomohiro Shimizu, Tetsuji Morishita, Hiroyasu Uzui, Yusuke Sato, Tatsuhiro Kataoka, Machiko Miyoshi, Junya Yamaguchi, Yuichiro Shiomi, Hiroyuki Ikeda, Naoto Tama, Kanae Hasegawa, Kentaro Ishida, Hiroshi Tada","doi":"10.1007/s00380-024-02473-8","DOIUrl":"https://doi.org/10.1007/s00380-024-02473-8","url":null,"abstract":"<p><p>This study examined the anti-inflammatory and endothelial function-enhancing effects of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitor therapy in the early phase after acute myocardial infarction (AMI) by assessing changes in tumor necrosis factor-α (TNF-α) levels and the L-arginine/asymmetric-dimethylarginine (ADMA) ratio. This retrospective, single-center cohort study included patients who underwent successful timely primary percutaneous coronary intervention (PCI) for first-onset AMI between September 2017 and March 2018. The PCSK9 inhibitor group comprised patients who received 75 mg alirocumab up to 7 days after AMI, while the standard therapy group comprised patients who did not. We evaluated the change in TNF-α levels and the L-arginine/ADMA ratio at the time of hospital admission and prior to discharge. PCSK9 inhibitor therapy in the early phase after AMI suppressed TNF-α levels (standard therapy group, 1.64 ± 2.14 pg/mL vs. PCSK9 inhibitor group, 0.26 ± 0.33 pg/mL; p = 0.033) and increased the L-arginine/ADMA ratio (standard therapy group, - 13.0 ± 39.7 vs. PCSK9 inhibitor group, 23.2 ± 39.7; p = 0.042). Upon multiple regression analysis adjusted for sex, age, and peak creatine kinase levels, PCSK9 inhibitor therapy was associated with TNF-α suppression (p = 0.025; β = - 0.235, 95% confidence interval [CI], - 0.436 to - 0.033). The L-arginine/ADMA ratio was also analyzed using multiple regression, adjusted for sex, age, peak creatine kinase levels, and smoking, showing a significant improvement in the ratio (p = 0.018; β = 41.913, 95% CI, 10.337-73.491). Moreover, a weak negative correlation was suggested between the change in TNF-α levels and the change in L-arginine/ADMA ratio (r = - 0.393, p = 0.058). PCSK9 inhibitor therapy in the early phase after AMI suppresses TNF-α levels and improves the L-arginine/ADMA ratio, potentially indicating anti-inflammatory and endothelial function-enhancing effects.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between serum level of uric acid in Japanese young patients with coronary spastic angina receiving coronary angiography. 接受冠状动脉造影术的日本年轻冠状动脉痉挛性心绞痛患者血清尿酸水平之间的关系。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-05 DOI: 10.1007/s00380-024-02469-4
Kota Tanazawa, Hidefumi Akioka, Kunio Yufu, Taiki Makita, Hiroki Sato, Yuki Iwabuchi, Yuma Ono, Hirochika Yamasaki, Masaki Takahashi, Naoko Ogawa, Taisuke Harada, Kazuki Mitarai, Nozomi Kodama, Shuichiro Yamauchi, Masayuki Takano, Kei Hirota, Miho Miyoshi, Keisuke Yonezu, Katsunori Tawara, Ichitaro Abe, Hidekazu Kondo, Shotaro Saito, Akira Fukui, Tomoko Fukuda, Tetsuji Shinohara, Kumiko Akiyoshi, Yasushi Teshima, Naohiko Takahashi

Endothelial dysfunction may trigger coronary spastic angina (CSA). However, the risk factors for CSA in young patients remain unclear. This study aimed to investigate the age-dependent role of serum uric acid levels in patients with CSA. We enrolled 423 patients who underwent an ergonovine tolerance test during coronary angiography for the CSA evaluation. We categorized the patients as (1) young (age ≤ 65 years) CSA-positive (n = 33), (2) young CSA-negative (n = 138), (3) elderly (age > 66 years) CSA-positive (n = 42), and (4) elderly CSA-negative (n = 210) groups. In the young groups, the smoker proportion (57.6 vs. 38.4%, p = 0.04) and serum uric acid levels (6.3 ± 1.4 vs. 5.4 ± 1.5 mg/dl, p = 0.006) were significantly higher in the CSA-positive compared with the CSA-negative group. Conversely, in the elderly group, the male proportion (66.6 vs. 47.1%, p = 0.02) and alcohol consumption level (40.5 vs. 21.0%, p = 0.01) were significantly higher in the CSA-positive compared with the CSA-negative group. The multivariate analysis in young groups revealed the independent association between the serum uric acid level (p = 0.02) and the presence of CSA. Our results indicate that elevated serum uric acid levels may affect CSA development in young patients.

内皮功能障碍可能引发冠状动脉痉挛性心绞痛(CSA)。然而,年轻患者发生 CSA 的风险因素仍不清楚。本研究旨在探讨血清尿酸水平在 CSA 患者中的年龄依赖性作用。我们招募了 423 名在冠状动脉造影术中接受麦角新碱耐受试验以评估 CSA 的患者。我们将患者分为:(1) 年轻组(年龄小于 65 岁)CSA 阳性(33 人);(2) 年轻组 CSA 阴性(138 人);(3) 老年组(年龄大于 66 岁)CSA 阳性(42 人);(4) 老年组 CSA 阴性(210 人)。在年轻组中,CSA 阳性组的吸烟者比例(57.6% 对 38.4%,P = 0.04)和血清尿酸水平(6.3 ± 1.4 对 5.4 ± 1.5 mg/dl,P = 0.006)明显高于 CSA 阴性组。相反,在老年组中,与 CSA 阴性组相比,CSA 阳性组的男性比例(66.6% 对 47.1%,p = 0.02)和饮酒水平(40.5% 对 21.0%,p = 0.01)明显更高。年轻组的多变量分析显示,血清尿酸水平(p = 0.02)与 CSA 的存在之间存在独立关联。我们的研究结果表明,血清尿酸水平升高可能会影响年轻患者 CSA 的发生。
{"title":"Association between serum level of uric acid in Japanese young patients with coronary spastic angina receiving coronary angiography.","authors":"Kota Tanazawa, Hidefumi Akioka, Kunio Yufu, Taiki Makita, Hiroki Sato, Yuki Iwabuchi, Yuma Ono, Hirochika Yamasaki, Masaki Takahashi, Naoko Ogawa, Taisuke Harada, Kazuki Mitarai, Nozomi Kodama, Shuichiro Yamauchi, Masayuki Takano, Kei Hirota, Miho Miyoshi, Keisuke Yonezu, Katsunori Tawara, Ichitaro Abe, Hidekazu Kondo, Shotaro Saito, Akira Fukui, Tomoko Fukuda, Tetsuji Shinohara, Kumiko Akiyoshi, Yasushi Teshima, Naohiko Takahashi","doi":"10.1007/s00380-024-02469-4","DOIUrl":"https://doi.org/10.1007/s00380-024-02469-4","url":null,"abstract":"<p><p>Endothelial dysfunction may trigger coronary spastic angina (CSA). However, the risk factors for CSA in young patients remain unclear. This study aimed to investigate the age-dependent role of serum uric acid levels in patients with CSA. We enrolled 423 patients who underwent an ergonovine tolerance test during coronary angiography for the CSA evaluation. We categorized the patients as (1) young (age ≤ 65 years) CSA-positive (n = 33), (2) young CSA-negative (n = 138), (3) elderly (age > 66 years) CSA-positive (n = 42), and (4) elderly CSA-negative (n = 210) groups. In the young groups, the smoker proportion (57.6 vs. 38.4%, p = 0.04) and serum uric acid levels (6.3 ± 1.4 vs. 5.4 ± 1.5 mg/dl, p = 0.006) were significantly higher in the CSA-positive compared with the CSA-negative group. Conversely, in the elderly group, the male proportion (66.6 vs. 47.1%, p = 0.02) and alcohol consumption level (40.5 vs. 21.0%, p = 0.01) were significantly higher in the CSA-positive compared with the CSA-negative group. The multivariate analysis in young groups revealed the independent association between the serum uric acid level (p = 0.02) and the presence of CSA. Our results indicate that elevated serum uric acid levels may affect CSA development in young patients.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Global use of angiotensin receptor neprilysin inhibitor in heart failure and reduced, below normal and supranormal ejection fraction. 血管紧张素受体肾素抑制剂在心力衰竭和射血分数降低、低于正常和超常情况下的全球应用。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-05 DOI: 10.1007/s00380-024-02459-6
Yu Horiuchi, Masahiko Asami, Kazuyuki Yahagi, Asahi Oshima, Yuki Gonda, Daiki Yoshiura, Kota Komiyama, Hitomi Yuzawa, Jun Tanaka, Jiro Aoki, Kengo Tanabe

Background: The global use of angiotensin receptor neprilysin inhibitor (ARNI) in clinical practice, especially in patients with heart failure and below-normal ejection fraction (HFbnEF), has not been thoroughly evaluated. We aimed to investigate the characteristics, outcomes, and adverse events in patients treated with ARNI for HF with reduced (HFrEF), below-normal (HFbnEF), and supranormal left ventricular EF (HFsnEF).

Methods: This observational study analyzed data from the electronic healthcare records (EHR) of patients with HF treated with ARNI between 2015 and 2022 in North and South America, Europe, the Middle East, Africa, and Asia-Pacific. Based on the left ventricular EF, patients were categorized as HFrEF (< 40%), HFbnEF (40-60%), and HFsnEF (> 60%). Mortality and the incidence of adverse events were investigated.

Results: Of the 11,141 patients analyzed, HFrEF, HFbnEF and HFsnEF accounted for 74%, 22%, and 4%, respectively. Patients with a higher EF were more likely to be older, female, and obese. Hypertension and atrial fibrillation were the most common in HFsnEF. Systolic blood pressure was lower and natriuretic peptide levels were higher in the lower EF groups. Mortality was lowest in HFbnEF (7.7 per 100 patient-years follow-up in HFrEF, 5.8 in HFmrEF, and 6.0 in HFsnEF). Similarly, hypotension and acute kidney injury were the least frequent in HFbnEF. Incidence of elevated serum potassium levels was similar between the groups.

Conclusions: In this analysis of large-scale EHR, ARNI was mainly used in HFrEF and HFbnEF, consistent with previous randomized trials and pooled analyses. Adverse events were less common in HFbnEF.

背景:血管紧张素受体肾利酶抑制剂(ARNI)在全球临床实践中的应用,尤其是在射血分数低于正常(HFbnEF)的心力衰竭患者中的应用,尚未得到全面评估。我们旨在调查接受 ARNI 治疗的左心室射血分数降低(HFrEF)、低于正常(HFbnEF)和高于正常(HFsnEF)的心力衰竭患者的特征、预后和不良事件:这项观察性研究分析了2015年至2022年间北美、南美、欧洲、中东、非洲和亚太地区接受ARNI治疗的高血压患者的电子医疗记录(EHR)数据。根据左心室EF,患者被归类为HFrEF(60%)。对死亡率和不良事件发生率进行了调查:在分析的 11141 名患者中,HFrEF、HFbnEF 和 HFsnEF 分别占 74%、22% 和 4%。EF值较高的患者更可能是老年人、女性和肥胖者。高血压和心房颤动在HFsnEF中最为常见。在 EF 值较低的组别中,收缩压较低,钠尿肽水平较高。HFbnEF 的死亡率最低(每随访 100 名患者,HFrEF 为 7.7 人/年,HFmrEF 为 5.8 人/年,HFsnEF 为 6.0 人/年)。同样,低血压和急性肾损伤在 HFbnEF 中发生率最低。各组血清钾水平升高的发生率相似:在这项大规模 EHR 分析中,ARNI 主要用于 HFrEF 和 HFbnEF,这与之前的随机试验和汇总分析一致。不良事件在 HFbnEF 中较少见。
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引用次数: 0
Long-term clinical outcomes of drug-coated balloon angioplasty for de novo coronary lesions in patients with diabetes mellitus. 药物涂层球囊血管成形术治疗糖尿病患者新发冠状动脉病变的长期临床疗效。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-04 DOI: 10.1007/s00380-024-02470-x
Mitsuyo Ito, Raisuke Iijima, Manabu Sato, Hidehiko Hara, Masao Moroi

Background: We investigated whether drug-coated balloon (DCB) treatment is effective for all de novo cases of coronary artery disease (CAD) in patients with diabetes mellitus. Furthermore, we also investigated the relationship between the degree of diabetes mellitus and clinical outcomes after DCB treatment.

Methods: In this study, we included 516 consecutive patients with de novo CAD who were treated with DCB. The patients were divided into the diabetic and non-diabetic groups. Patients with diabetes mellitus were further classified into non-insulin-treated diabetes mellitus (NITDM) and insulin-treated diabetes mellitus (ITDM). The primary endpoints were major adverse cardiovascular ischemic events (MACE) and clinically driven target lesion revascularization (CD-TLR).

Results: Within a mean clinical follow-up period of 2.5 years, the incidence of MACE among patients with diabetes mellitus (22.1%) was almost twice that of non-diabetic patients (11.9%) with a relative risk of 1.86 (95% CI 1.24-2.79, p = 0.002). The 3-year CD-TLR occurred in 28 patients with diabetes mellitus (10.6%) and 13 non-diabetic patients (5.1%, p = 0.02). ITDM patients had a significantly higher rate of MACE compared with non-diabetic patients with a relative risk of 2.86 (95% CI 1.76-4.63, p = 0.0002). ITDM remained an independent predictor of 3-year MACE with an odd ratio of 1.96 (95% CI 1.00-3.83, p = 0.05).

Conclusion: In patients undergoing DCB, the presence of DM was associated with a higher risk of MACE and CD-TLR. Particularly in DCB, treatment was still inadequately effective for ITDM patients.

背景:我们研究了药物涂层球囊(DCB)治疗是否对糖尿病患者的所有新发冠状动脉疾病(CAD)有效。此外,我们还研究了糖尿病程度与 DCB 治疗后临床结果之间的关系:在这项研究中,我们连续纳入了 516 例接受 DCB 治疗的新发 CAD 患者。这些患者被分为糖尿病组和非糖尿病组。糖尿病患者又分为非胰岛素治疗糖尿病(NITDM)和胰岛素治疗糖尿病(ITDM)。主要终点是主要不良心血管缺血事件(MACE)和临床驱动的靶病变血管再通(CD-TLR):在平均 2.5 年的临床随访期内,糖尿病患者的 MACE 发生率(22.1%)几乎是非糖尿病患者(11.9%)的两倍,相对风险为 1.86(95% CI 1.24-2.79,P = 0.002)。28名糖尿病患者(10.6%)和13名非糖尿病患者(5.1%,P = 0.02)发生了3年CD-TLR。与非糖尿病患者相比,ITDM 患者的 MACE 发生率明显更高,相对风险为 2.86(95% CI 1.76-4.63,p = 0.0002)。ITDM仍然是3年MACE的独立预测因素,奇异比为1.96(95% CI 1.00-3.83,P = 0.05):结论:在接受DCB手术的患者中,DM的存在与较高的MACE和CD-TLR风险相关。特别是在DCB中,对ITDM患者的治疗仍然不够有效。
{"title":"Long-term clinical outcomes of drug-coated balloon angioplasty for de novo coronary lesions in patients with diabetes mellitus.","authors":"Mitsuyo Ito, Raisuke Iijima, Manabu Sato, Hidehiko Hara, Masao Moroi","doi":"10.1007/s00380-024-02470-x","DOIUrl":"https://doi.org/10.1007/s00380-024-02470-x","url":null,"abstract":"<p><strong>Background: </strong>We investigated whether drug-coated balloon (DCB) treatment is effective for all de novo cases of coronary artery disease (CAD) in patients with diabetes mellitus. Furthermore, we also investigated the relationship between the degree of diabetes mellitus and clinical outcomes after DCB treatment.</p><p><strong>Methods: </strong>In this study, we included 516 consecutive patients with de novo CAD who were treated with DCB. The patients were divided into the diabetic and non-diabetic groups. Patients with diabetes mellitus were further classified into non-insulin-treated diabetes mellitus (NITDM) and insulin-treated diabetes mellitus (ITDM). The primary endpoints were major adverse cardiovascular ischemic events (MACE) and clinically driven target lesion revascularization (CD-TLR).</p><p><strong>Results: </strong>Within a mean clinical follow-up period of 2.5 years, the incidence of MACE among patients with diabetes mellitus (22.1%) was almost twice that of non-diabetic patients (11.9%) with a relative risk of 1.86 (95% CI 1.24-2.79, p = 0.002). The 3-year CD-TLR occurred in 28 patients with diabetes mellitus (10.6%) and 13 non-diabetic patients (5.1%, p = 0.02). ITDM patients had a significantly higher rate of MACE compared with non-diabetic patients with a relative risk of 2.86 (95% CI 1.76-4.63, p = 0.0002). ITDM remained an independent predictor of 3-year MACE with an odd ratio of 1.96 (95% CI 1.00-3.83, p = 0.05).</p><p><strong>Conclusion: </strong>In patients undergoing DCB, the presence of DM was associated with a higher risk of MACE and CD-TLR. Particularly in DCB, treatment was still inadequately effective for ITDM patients.</p>","PeriodicalId":12940,"journal":{"name":"Heart and Vessels","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Azelnidipine protects HL-1 cardiomyocytes from hypoxia/reoxygenation injury by enhancement of NO production independently of effects on gene expression. 阿折地平通过增强 NO 的产生保护 HL-1 心肌细胞免受缺氧/复氧损伤,而不依赖于对基因表达的影响。
IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-01 Epub Date: 2024-05-26 DOI: 10.1007/s00380-024-02415-4
Hiroyuki Minato, Ryo Endo, Yasutaka Kurata, Tomomi Notsu, Yoshiharu Kinugasa, Takayuki Wakimizu, Motokazu Tsuneto, Yasuaki Shirayoshi, Haruaki Ninomiya, Kazuhiro Yamamoto, Ichiro Hisatome, Akihiro Otsuki

It remains to be elucidated whether Ca2+ antagonists induce pharmacological preconditioning to protect the heart against ischemia/reperfusion injury. The aim of this study was to determine whether and how pretreatment with a Ca2+ antagonist, azelnidipine, could protect cardiomyocytes against hypoxia/reoxygenation (H/R) injury in vitro. Using HL-1 cardiomyocytes, we studied effects of azelnidipine on NO synthase (NOS) expression, NO production, cell death and apoptosis during H/R. Action potential durations (APDs) were determined by the whole-cell patch-clamp technique. Azelnidipine enhanced endothelial NOS phosphorylation and NO production in HL-1 cells under normoxia, which was abolished by a heat shock protein 90 inhibitor, geldanamycin, and an antioxidant, N-acetylcysteine. Pretreatment with azelnidipine reduced cell death and shortened APDs during H/R. These effects of azelnidipine were diminished by a NOS inhibitor, L-NAME, but were influenced by neither a T-type Ca2+ channel inhibitor, NiCl2, nor a N-type Ca2+ channel inhibitor, ω-conotoxin. The azelnidipine-induced reduction in cell death was not significantly enhanced by either additional azelnidipine treatment during H/R or increasing extracellular Ca2+ concentrations. RNA sequence (RNA-seq) data indicated that azelnidipine-induced attenuation of cell death, which depended on enhanced NO production, did not involve any significant modifications of gene expression responsible for the NO/cGMP/PKG pathway. We conclude that pretreatment with azelnidipine protects HL-1 cardiomyocytes against H/R injury via NO-dependent APD shortening and L-type Ca2+ channel blockade independently of effects on gene expression.

Ca2+拮抗剂是否能诱导药理预处理以保护心脏免受缺血/再灌注损伤仍有待阐明。本研究旨在确定用 Ca2+ 拮抗剂阿折地平进行预处理是否以及如何在体外保护心肌细胞免受缺氧/再氧合(H/R)损伤。我们使用 HL-1 心肌细胞研究了阿折地平对 H/R 期间 NO 合酶(NOS)表达、NO 生成、细胞死亡和凋亡的影响。通过全细胞贴片钳技术测定了动作电位持续时间(APD)。在常氧状态下,阿折地平增强了HL-1细胞内皮NOS磷酸化和NO的产生,而热休克蛋白90抑制剂格尔德霉素和抗氧化剂N-乙酰半胱氨酸则抑制了这种作用。用阿折地平预处理可减少细胞死亡,缩短H/R过程中的APD。NOS抑制剂L-NAME会减弱阿折地平的这些作用,但T型Ca2+通道抑制剂NiCl2和N型Ca2+通道抑制剂ω-conotoxin都不会影响阿折地平的作用。在 H/R 期间额外使用阿折地平或增加细胞外 Ca2+ 浓度都不会显著增强阿折地平诱导的细胞死亡减少。RNA 序列(RNA-seq)数据表明,唑尼地平诱导的细胞死亡衰减依赖于 NO 生成的增强,并不涉及 NO/cGMP/PKG 通路基因表达的任何重大改变。我们的结论是,阿折地平通过NO依赖性APD缩短和L型Ca2+通道阻滞保护HL-1心肌细胞免受H/R损伤,而不依赖于对基因表达的影响。
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引用次数: 0
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Heart and Vessels
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