Pub Date : 2026-01-01Epub Date: 2025-11-21DOI: 10.1152/ajpheart.00375.2025
Owen R Vaughan, Andrew Goodspeed, Carmen C Sucharov, Theresa L Powell, Thomas Jansson
Obesity in pregnant women increases offspring cardiovascular risk and causes fetal cardiac dysfunction. The underpinning mechanisms remain unclear. We hypothesized that circulating factors in serum from fetuses of women with obesity induce pathological cardiomyocyte hypertrophy. Pregnant women with obesity or healthy weight were recruited at term and provided umbilical cord serum and placentas, which were used for isolation of primary trophoblast cells. Primary cardiomyocytes were isolated from neonatal rats. Compared with cord serum from healthy weight women, cord serum from women with obesity upregulated cardiomyocyte mRNA expression of atrial natriuretic factor (Anf) and brain natriuretic peptide (Bnp) and increased the ratio of β-to α-myosin heavy chain expression (Myh7:Myh6), when it was supplemented into the culture medium. This effect was prevented by treating the cord serum with heat-freeze cycling and DNase or RNase digestion. Separately, conditioned medium from trophoblast cells from women with obesity increased cardiomyocyte Anf expression without altering Bnp or Myh7:Myh6. MicroRNAs miR-142 and miR-17, which are associated with cardiac function, were increased in abundance in extracellular vesicles isolated from cord serum from women with obesity. However, miR-142-3p, miR-142-5p, and miR-17-5p did not increase Anf, Bnp, or Myh7:Myh6 expression when they were transfected into cardiomyocytes. Neither cord serum nor the upregulated microRNAs from women with obesity altered cardiomyocyte size. The results show that human fetal circulating and placenta-derived factors induce gene expression hallmarks of pathological hypertrophy in cardiomyocytes and may mediate cardiac dysfunction in children of women with obesity.NEW & NOTEWORTHY Obesity in pregnant women increases risk for heart problems in their children. This study treated heart cells growing in a dish with blood plasma from the umbilical cords of newborn babies. Plasma from babies of women with obesity activated genes linked to heart failure. This means we could design treatments targeting plasma molecules, like microRNAs, or the way the placenta releases them. This could improve children's heart health if the mother has obesity.
{"title":"Human fetal circulating factors from pregnancies complicated by obesity upregulate genes associated with pathological hypertrophy in neonatal rat cardiomyocytes.","authors":"Owen R Vaughan, Andrew Goodspeed, Carmen C Sucharov, Theresa L Powell, Thomas Jansson","doi":"10.1152/ajpheart.00375.2025","DOIUrl":"10.1152/ajpheart.00375.2025","url":null,"abstract":"<p><p>Obesity in pregnant women increases offspring cardiovascular risk and causes fetal cardiac dysfunction. The underpinning mechanisms remain unclear. We hypothesized that circulating factors in serum from fetuses of women with obesity induce pathological cardiomyocyte hypertrophy. Pregnant women with obesity or healthy weight were recruited at term and provided umbilical cord serum and placentas, which were used for isolation of primary trophoblast cells. Primary cardiomyocytes were isolated from neonatal rats. Compared with cord serum from healthy weight women, cord serum from women with obesity upregulated cardiomyocyte mRNA expression of atrial natriuretic factor (<i>Anf</i>) and brain natriuretic peptide (<i>Bnp</i>) and increased the ratio of β-to α-myosin heavy chain expression (<i>Myh7:Myh6</i>), when it was supplemented into the culture medium. This effect was prevented by treating the cord serum with heat-freeze cycling and DNase or RNase digestion. Separately, conditioned medium from trophoblast cells from women with obesity increased cardiomyocyte <i>Anf</i> expression without altering <i>Bnp</i> or <i>Myh7:Myh6</i>. MicroRNAs miR-142 and miR-17, which are associated with cardiac function, were increased in abundance in extracellular vesicles isolated from cord serum from women with obesity. However, miR-142-3p, miR-142-5p, and miR-17-5p did not increase <i>Anf</i>, <i>Bnp,</i> or <i>Myh7:Myh6</i> expression when they were transfected into cardiomyocytes. Neither cord serum nor the upregulated microRNAs from women with obesity altered cardiomyocyte size. The results show that human fetal circulating and placenta-derived factors induce gene expression hallmarks of pathological hypertrophy in cardiomyocytes and may mediate cardiac dysfunction in children of women with obesity.<b>NEW & NOTEWORTHY</b> Obesity in pregnant women increases risk for heart problems in their children. This study treated heart cells growing in a dish with blood plasma from the umbilical cords of newborn babies. Plasma from babies of women with obesity activated genes linked to heart failure. This means we could design treatments targeting plasma molecules, like microRNAs, or the way the placenta releases them. This could improve children's heart health if the mother has obesity.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H124-H136"},"PeriodicalIF":4.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12719755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.1152/ajpheart.00980.2025
Molly K Courish, Myles W O'Brien
{"title":"Digital Thermal Monitoring to a Reactive Hyperemia: Potential Mechanisms and Clinical Relevance Among Patients with Heart Failure with Reduced Ejection Fraction.","authors":"Molly K Courish, Myles W O'Brien","doi":"10.1152/ajpheart.00980.2025","DOIUrl":"https://doi.org/10.1152/ajpheart.00980.2025","url":null,"abstract":"","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145861633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-11-03DOI: 10.1152/ajpheart.00627.2025
Anastasia Smolina, Anum Rahman, Lindsay Cahill, Christopher K Macgowan, Mike Seed, John Kingdom, John G Sled
Fetal growth restriction (FGR) secondary to placental insufficiency often leads to morbidity and mortality in the perinatal period. Fetal adaptations such as "brain sparing" blood flow redistribution offer some protection, but predicting whether a fetus in this state will survive is challenging. The goal of this research was to identify vascular responses predictive of stillbirth or hypoxia based on serial Doppler ultrasound measurement in a mouse model of FGR. We performed serial Doppler ultrasound observations of fetal blood flow redistribution in a murine model of FGR, where prolongation of pregnancy was induced pharmacologically with progesterone in 56 CD-1 mice. Observations were made at E18.5 (physiologic term), E19.5 (term +1), and E20.5 (term +2). Flow velocity waveforms were obtained from the middle cerebral artery (MCA), ductus arteriosus (DA), main pulmonary artery (MPA), ductus venosus (DV), umbilical artery (UA), and umbilical vein (UV). Following euthanasia, pimonidazole immunohistochemistry quantified tissue hypoxia. Among 56 pregnancies, the strongest predictor of stillbirth was low DA peak systolic velocity at E19.5 (<217 mm/s, P = 0.021, R2 = 0.52). Among survivors, cerebral hypoxia was predicted by elevated MCA peak systolic (>26.6 mm/s, P = 0.022, R2 = 0.59) and end-diastolic velocity (>10.1 mm/s, P = 0.043, R2 = 0.53, whereas high MPA flow (>0.73 mL/min, P = 0.029, R2 = 0.51) predicted hepatic hypoxia. Overall, fetuses with a weaker pulmonary blood flow redistribution response were found to have worse outcomes, despite cerebral vasodilation. This minimally invasive murine model offers valuable insights into this pathophysiology of FGR-related stillbirth and highlights the prognostic potential of assessing fetal brain flow and pulmonary perfusion in tandem during sonographic surveillance of high-risk pregnancies.NEW & NOTEWORTHY Fetal growth restriction, often caused by placental disease, is an important cause of fetal injury and stillbirth. Understanding how the fetus adapts under these conditions is key to predicting survival. Here we report physiological adaptations in a mouse of model of fetal growth restriction that predict the risk of stillbirth.
{"title":"Developmental trajectories predictive of stillbirth in a longitudinal mouse model of fetal growth restriction.","authors":"Anastasia Smolina, Anum Rahman, Lindsay Cahill, Christopher K Macgowan, Mike Seed, John Kingdom, John G Sled","doi":"10.1152/ajpheart.00627.2025","DOIUrl":"10.1152/ajpheart.00627.2025","url":null,"abstract":"<p><p>Fetal growth restriction (FGR) secondary to placental insufficiency often leads to morbidity and mortality in the perinatal period. Fetal adaptations such as \"brain sparing\" blood flow redistribution offer some protection, but predicting whether a fetus in this state will survive is challenging. The goal of this research was to identify vascular responses predictive of stillbirth or hypoxia based on serial Doppler ultrasound measurement in a mouse model of FGR. We performed serial Doppler ultrasound observations of fetal blood flow redistribution in a murine model of FGR, where prolongation of pregnancy was induced pharmacologically with progesterone in 56 CD-1 mice. Observations were made at E18.5 (physiologic term), E19.5 (term +1), and E20.5 (term +2). Flow velocity waveforms were obtained from the middle cerebral artery (MCA), ductus arteriosus (DA), main pulmonary artery (MPA), ductus venosus (DV), umbilical artery (UA), and umbilical vein (UV). Following euthanasia, pimonidazole immunohistochemistry quantified tissue hypoxia. Among 56 pregnancies, the strongest predictor of stillbirth was low DA peak systolic velocity at E19.5 (<217 mm/s, <i>P</i> = 0.021, <i>R</i><sup>2</sup> = 0.52). Among survivors, cerebral hypoxia was predicted by elevated MCA peak systolic (>26.6 mm/s, <i>P</i> = 0.022, <i>R</i><sup>2</sup> = 0.59) and end-diastolic velocity (>10.1 mm/s, <i>P</i> = 0.043, <i>R</i><sup>2</sup> = 0.53, whereas high MPA flow (>0.73 mL/min, <i>P</i> = 0.029, <i>R</i><sup>2</sup> = 0.51) predicted hepatic hypoxia. Overall, fetuses with a weaker pulmonary blood flow redistribution response were found to have worse outcomes, despite cerebral vasodilation. This minimally invasive murine model offers valuable insights into this pathophysiology of FGR-related stillbirth and highlights the prognostic potential of assessing fetal brain flow and pulmonary perfusion in tandem during sonographic surveillance of high-risk pregnancies.<b>NEW & NOTEWORTHY</b> Fetal growth restriction, often caused by placental disease, is an important cause of fetal injury and stillbirth. Understanding how the fetus adapts under these conditions is key to predicting survival. Here we report physiological adaptations in a mouse of model of fetal growth restriction that predict the risk of stillbirth.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H1706-H1715"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145436745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-11-04DOI: 10.1152/ajpheart.00630.2025
Candee T Barris, Taylor C Kress, Galina Antonova, Coleton R Jordan, Austin Newman, Jessica L Faulkner, Muhammad I Saeed, Simone Kennard, Eric J Belin de Chantemèle
The global rise in obesity parallels the increasing rates of hypertension and cardiovascular disease (CVD). These trends, and recent clinical and experimental data, have revealed that obesity abolishes the protection from CVD typically conferred by female sex, predisposing young, premenopausal women to vascular dysfunction and hypertension. Findings from our group demonstrated that, in females, obesity induces hypertension via activation of the leptin-aldosterone-mineralocorticoid receptor (MR) axis. However, the origin of this sex-specific mechanism remains unknown. Based on the known effects of estrogen on blood pressure (BP) and vascular function, we tested the contribution of sex hormones. Sham and ovariectomy (OVX) surgeries were conducted in obese female agouti yellow mice to preserve or deplete female sex hormones, respectively. OVX did not significantly alter blood pressure (BP) nor autonomic control of BP or adrenal aldosterone synthase (CYP11B2) expression; however, it impaired endothelial relaxation with no further alterations to vascular function. Chronic leptin receptor blockade decreased BP in both sham and OVX mice and restored endothelium-dependent relaxation, suggesting a lack of contribution of female sex hormones to the mechanism of hypertension. Stimulation of HAC15 and human primary adrenocortical cells with female and male sex steroid hormones did not alter CYP11B2 expression. Furthermore, quantification of CYP11B2 expression in discarded human adrenal glands revealed increases with obesity in women in comparison to men and no alterations with menopause in obese hypertensive women. Collectively, these findings support that female sex hormones do not regulate aldosterone production nor do they drive the sex-specific mechanism underlying obesity-associated hypertension.NEW & NOTEWORTHY Obesity induces hypertension in females through the leptin-aldosterone-mineralocorticoid axis; however, the origin of this sex-specific mechanism remains unknown. Utilizing obese female mice, ovariectomy did not significantly impair blood pressure (BP), vascular function, or aldosterone synthase, whereas leptin receptor blockade lowered BP and restored vascular reactivity. In human cells and tissues, sex hormones did not alter aldosterone synthase expression. These data indicate that sex hormones do not drive the sex difference in the mechanism of obesity-associated hypertension.
{"title":"Female sex hormones do not drive the sex-specific mechanisms of obesity-related hypertension.","authors":"Candee T Barris, Taylor C Kress, Galina Antonova, Coleton R Jordan, Austin Newman, Jessica L Faulkner, Muhammad I Saeed, Simone Kennard, Eric J Belin de Chantemèle","doi":"10.1152/ajpheart.00630.2025","DOIUrl":"10.1152/ajpheart.00630.2025","url":null,"abstract":"<p><p>The global rise in obesity parallels the increasing rates of hypertension and cardiovascular disease (CVD). These trends, and recent clinical and experimental data, have revealed that obesity abolishes the protection from CVD typically conferred by female sex, predisposing young, premenopausal women to vascular dysfunction and hypertension. Findings from our group demonstrated that, in females, obesity induces hypertension via activation of the leptin-aldosterone-mineralocorticoid receptor (MR) axis. However, the origin of this sex-specific mechanism remains unknown. Based on the known effects of estrogen on blood pressure (BP) and vascular function, we tested the contribution of sex hormones. Sham and ovariectomy (OVX) surgeries were conducted in obese female agouti yellow mice to preserve or deplete female sex hormones, respectively. OVX did not significantly alter blood pressure (BP) nor autonomic control of BP or adrenal aldosterone synthase (CYP11B2) expression; however, it impaired endothelial relaxation with no further alterations to vascular function. Chronic leptin receptor blockade decreased BP in both sham and OVX mice and restored endothelium-dependent relaxation, suggesting a lack of contribution of female sex hormones to the mechanism of hypertension. Stimulation of HAC15 and human primary adrenocortical cells with female and male sex steroid hormones did not alter CYP11B2 expression. Furthermore, quantification of CYP11B2 expression in discarded human adrenal glands revealed increases with obesity in women in comparison to men and no alterations with menopause in obese hypertensive women. Collectively, these findings support that female sex hormones do not regulate aldosterone production nor do they drive the sex-specific mechanism underlying obesity-associated hypertension.<b>NEW & NOTEWORTHY</b> Obesity induces hypertension in females through the leptin-aldosterone-mineralocorticoid axis; however, the origin of this sex-specific mechanism remains unknown. Utilizing obese female mice, ovariectomy did not significantly impair blood pressure (BP), vascular function, or aldosterone synthase, whereas leptin receptor blockade lowered BP and restored vascular reactivity. In human cells and tissues, sex hormones did not alter aldosterone synthase expression. These data indicate that sex hormones do not drive the sex difference in the mechanism of obesity-associated hypertension.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H1526-H1535"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12694611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145443687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-25DOI: 10.1152/ajpheart.00810.2025
Ishita Kathuria, Ravi Varma Aithabathula, Bhupesh Singla
{"title":"Collagen VIII: a new guardian of endothelial cell identity in atherosclerosis.","authors":"Ishita Kathuria, Ravi Varma Aithabathula, Bhupesh Singla","doi":"10.1152/ajpheart.00810.2025","DOIUrl":"10.1152/ajpheart.00810.2025","url":null,"abstract":"","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H1693-H1695"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12594533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-25DOI: 10.1152/ajpheart.00693.2025
Andy Schumann, Yubraj Gupta, Maria Geisler, Feliberto de la Cruz, Denis Gerstorf, Ilja Demuth, Maja Olecka, Christian Gaser, Karl-Jürgen Bär
Machine learning has become an important tool in precision medicine and aging research. We introduce the cardiovascular autonomic age (CAA) gap, a novel metric quantifying the deviation between machine learning-estimated biological age and chronological age based on autonomic cardiovascular function. High-resolution electrocardiograms and continuous blood pressure recordings at rest were collected from 1,060 healthy individuals. From these signals, 29 autonomic indices were derived, including time-, frequency-, and symbol-domain heart rate variability, cardiovascular coupling, pulse wave dynamics, and QT interval features. A Gaussian process regression model was trained on 879 participants to estimate biological age, yielding the CAA. The deviation between CAA and chronological age defined the CAA gap, which was evaluated in two test sets stratified by cardiovascular risk (CVR) using the Framingham risk score. At a 0.5% threshold, the high-CVR group showed a markedly increased CAA gap (+11 yr), whereas the low-CVR group demonstrated a slightly negative gap (-1 yr). In the high-risk group, the slope of predicted versus actual age suggested accelerated physiological aging. CAA correlated positively with the Framingham risk score (r = 0.42, P < 0.001), and the CAA gap correlated with deviation from normative risk (r = 0.31, P = 0.002). Across thresholds, elevated CAA in the high-CVR group was consistently observed, with moderate effect sizes ranging from 0.32 to 0.46. These findings suggest that the CAA gap may serve as a sensitive and interpretable indicator of cardiovascular risk and aging, with potential relevance for early detection and longitudinal assessment.NEW & NOTEWORTHY The cardiovascular autonomic age (CAA) gap is a new machine learning-based marker that reveals when the body ages faster than the clock. Using resting-state cardiovascular recordings from 1,000+ participants, we show that individuals with higher cardiovascular risk exhibit accelerated autonomic aging. The CAA gap could become a sensitive, interpretable tool for early detection and long-term monitoring.
机器学习已经成为精准医疗和衰老研究的重要工具。我们引入了心血管自主年龄(CAA)差距,这是一种量化机器学习估计的生物年龄与基于自主心血管功能的实足年龄之间偏差的新度量。研究人员收集了1060名健康人静息时的高分辨率心电图和连续血压记录。从这些信号中,导出了29个自主神经指标,包括时间、频率和符号域心率变异性、心血管耦合、脉搏波动力学和QT间期特征。对879名参与者进行高斯过程回归模型训练,估计生物年龄,得到CAA。CAA与实足年龄之间的偏差定义了CAA差距,使用Framingham风险评分以心血管风险(CVR)分层进行两个测试集评估。在0.5%阈值下,高CVR组的CAA差距显著增加(+11年),而低CVR组的CAA差距略有减少(-1年)。在高危人群中,预测年龄与实际年龄的斜率表明生理衰老加速。CAA与Framingham风险评分呈正相关(r = 0.42, p < 0.001), CAA差距与偏离规范风险呈正相关(r = 0.31, p = 0.002)。跨越阈值,在高CVR组中,持续观察到CAA升高,中等效应值范围为0.32至0.46。这些发现表明,CAA缺口可能是心血管风险和衰老的敏感和可解释的指标,与早期发现和纵向评估具有潜在的相关性。
{"title":"Quantifying cardiovascular autonomic aging with machine learning.","authors":"Andy Schumann, Yubraj Gupta, Maria Geisler, Feliberto de la Cruz, Denis Gerstorf, Ilja Demuth, Maja Olecka, Christian Gaser, Karl-Jürgen Bär","doi":"10.1152/ajpheart.00693.2025","DOIUrl":"10.1152/ajpheart.00693.2025","url":null,"abstract":"<p><p>Machine learning has become an important tool in precision medicine and aging research. We introduce the cardiovascular autonomic age (CAA) gap, a novel metric quantifying the deviation between machine learning-estimated biological age and chronological age based on autonomic cardiovascular function. High-resolution electrocardiograms and continuous blood pressure recordings at rest were collected from 1,060 healthy individuals. From these signals, 29 autonomic indices were derived, including time-, frequency-, and symbol-domain heart rate variability, cardiovascular coupling, pulse wave dynamics, and QT interval features. A Gaussian process regression model was trained on 879 participants to estimate biological age, yielding the CAA. The deviation between CAA and chronological age defined the CAA gap, which was evaluated in two test sets stratified by cardiovascular risk (CVR) using the Framingham risk score. At a 0.5% threshold, the high-CVR group showed a markedly increased CAA gap (+11 yr), whereas the low-CVR group demonstrated a slightly negative gap (-1 yr). In the high-risk group, the slope of predicted versus actual age suggested accelerated physiological aging. CAA correlated positively with the Framingham risk score (<i>r</i> = 0.42, <i>P</i> < 0.001), and the CAA gap correlated with deviation from normative risk (<i>r</i> = 0.31, <i>P</i> = 0.002). Across thresholds, elevated CAA in the high-CVR group was consistently observed, with moderate effect sizes ranging from 0.32 to 0.46. These findings suggest that the CAA gap may serve as a sensitive and interpretable indicator of cardiovascular risk and aging, with potential relevance for early detection and longitudinal assessment.<b>NEW & NOTEWORTHY</b> The cardiovascular autonomic age (CAA) gap is a new machine learning-based marker that reveals when the body ages faster than the clock. Using resting-state cardiovascular recordings from 1,000+ participants, we show that individuals with higher cardiovascular risk exhibit accelerated autonomic aging. The CAA gap could become a sensitive, interpretable tool for early detection and long-term monitoring.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H1471-H1479"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-16DOI: 10.1152/ajpheart.00377.2025
Marie Louise Ndzie Noah, Nabil Deb Nath, Jun Yoshioka
Cardiotoxicity is a significant adverse effect of chemotherapy, particularly in breast cancer survivors, especially those undergoing aggressive treatment regimens or with pre-existing cardiovascular conditions. This presents a major challenge for cardio-oncologists, who must balance the effective treatment of cancer with minimizing the risk of cardiovascular damage. Addressing this challenge requires a comprehensive understanding of the mechanisms by which chemotherapy agents induce cardiotoxicity, and the development of reliable methods for early detection and the identification of effective cardioprotective strategies. Preclinical animal models have served as indispensable tools for elucidating underlying mechanisms and assessing the efficacy of potential cardioprotective strategies. This review aims to explore the key signaling pathways implicated in this process, focusing on mechanisms such as oxidative stress, reactive oxygen species generation, inflammatory pathways, cellular damage, and mitochondrial dysfunction. It also discusses advancements in detection techniques and cardioprotective strategies that have shown great promise in preserving cardiac function during cancer treatment without diminishing the effectiveness of chemotherapy. Ultimately, this review emphasizes the need to integrate cardiotoxicity management into breast cancer treatment protocols to enhance patient survival and quality of life.
{"title":"Chemotherapy-induced cardiotoxicity in breast cancer: mechanisms, diagnostic advances, and emerging protective strategies.","authors":"Marie Louise Ndzie Noah, Nabil Deb Nath, Jun Yoshioka","doi":"10.1152/ajpheart.00377.2025","DOIUrl":"10.1152/ajpheart.00377.2025","url":null,"abstract":"<p><p>Cardiotoxicity is a significant adverse effect of chemotherapy, particularly in breast cancer survivors, especially those undergoing aggressive treatment regimens or with pre-existing cardiovascular conditions. This presents a major challenge for cardio-oncologists, who must balance the effective treatment of cancer with minimizing the risk of cardiovascular damage. Addressing this challenge requires a comprehensive understanding of the mechanisms by which chemotherapy agents induce cardiotoxicity, and the development of reliable methods for early detection and the identification of effective cardioprotective strategies. Preclinical animal models have served as indispensable tools for elucidating underlying mechanisms and assessing the efficacy of potential cardioprotective strategies. This review aims to explore the key signaling pathways implicated in this process, focusing on mechanisms such as oxidative stress, reactive oxygen species generation, inflammatory pathways, cellular damage, and mitochondrial dysfunction. It also discusses advancements in detection techniques and cardioprotective strategies that have shown great promise in preserving cardiac function during cancer treatment without diminishing the effectiveness of chemotherapy. Ultimately, this review emphasizes the need to integrate cardiotoxicity management into breast cancer treatment protocols to enhance patient survival and quality of life.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H1508-H1525"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12577716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-11-10DOI: 10.1152/ajpheart.00416.2025
Emily A Shiel, Waleed Farra, Steven Medarev, Gallage H D N Ariyaratne, Elisa N Cannon, Jennifer L Steiner, Stephen P Chelko
Arrhythmogenic cardiomyopathy (ACM) is an inherited heart disease characterized by myocardial inflammation and fibrosis, ventricular dysfunction, and arrhythmias, and is a leading cause of sudden cardiac death in young adults. Acute binge alcohol consumption is a common behavior of young adults and is known to cause transient cardiac stress; however, its impact on ACM remains unclear. Wild-type and homozygous desmoglein-2 mutant (Dsg2mut/mut) mice, a robust mouse model of ACM, were gavaged with 5 g/kg of alcohol or equivalent volume/kg of saline (placebo), twice weekly from 8 to 24 wk of age to determine the effects of repeat binges on ACM disease progression. Survival, cardiac function, ectopic burden, myocardial fibrosis, and inflammatory signaling were evaluated using echocardiography, electrocardiography, histology, and molecular assays, respectively. Of note, alcohol-treated Dsg2mut/mut mice exhibited increased mortality compared with placebo-treated counterparts, accompanied by increased ventricular ectopics in Dsg2mut/mut mice that died prematurely. Increased biventricular fibrosis was noted in alcohol-treated Dsg2mut/mut mice and demonstrated a strong, positive correlation with peak blood alcohol concentration. Although alcohol-treated mice displayed decreased phosphorylated NF-κB and JNK2 myocardial levels, elevated levels of cytoplasmic and extracellular localization of HMGB1 were noted. Our findings demonstrate that acute binge alcohol exacerbates disease progression in a desmosomal-linked ACM mouse, likely through enhanced fibrotic remodeling and altered inflammatory signaling. These outcomes highlight the potential danger of binge alcohol consumption in genetically susceptible subjects with ACM, further underscoring the role of environmental factors in ACM onset and progression.NEW & NOTEWORTHY We report that acute binge alcohol consumption in a robust mouse model of arrhythmogenic cardiomyopathy (ACM) significantly elevated ventricular arrhythmias, mortality, cardiomyocyte cell death via the loss of nuclear HMGB1, and extensive myocardial fibrosis. These findings demonstrate that binge drinking may serve as an environmental factor that contributes to disease progression in subjects with ACM, highlighting the need for clinical awareness regarding alcohol use in this vulnerable population.
{"title":"Acute binge alcohol increases risk of arrhythmias and myocardial fibrosis in a mouse model of arrhythmogenic cardiomyopathy.","authors":"Emily A Shiel, Waleed Farra, Steven Medarev, Gallage H D N Ariyaratne, Elisa N Cannon, Jennifer L Steiner, Stephen P Chelko","doi":"10.1152/ajpheart.00416.2025","DOIUrl":"10.1152/ajpheart.00416.2025","url":null,"abstract":"<p><p>Arrhythmogenic cardiomyopathy (ACM) is an inherited heart disease characterized by myocardial inflammation and fibrosis, ventricular dysfunction, and arrhythmias, and is a leading cause of sudden cardiac death in young adults. Acute binge alcohol consumption is a common behavior of young adults and is known to cause transient cardiac stress; however, its impact on ACM remains unclear. Wild-type and homozygous desmoglein-2 mutant (<i>Dsg2</i><sup>mut/mut</sup>) mice, a robust mouse model of ACM, were gavaged with 5 g/kg of alcohol or equivalent volume/kg of saline (placebo), twice weekly from 8 to 24 wk of age to determine the effects of repeat binges on ACM disease progression. Survival, cardiac function, ectopic burden, myocardial fibrosis, and inflammatory signaling were evaluated using echocardiography, electrocardiography, histology, and molecular assays, respectively. Of note, alcohol-treated <i>Dsg2</i><sup>mut/mut</sup> mice exhibited increased mortality compared with placebo-treated counterparts, accompanied by increased ventricular ectopics in <i>Dsg2</i><sup>mut/mut</sup> mice that died prematurely. Increased biventricular fibrosis was noted in alcohol-treated <i>Dsg2</i><sup>mut/mut</sup> mice and demonstrated a strong, positive correlation with peak blood alcohol concentration. Although alcohol-treated mice displayed decreased phosphorylated NF-κB and JNK2 myocardial levels, elevated levels of cytoplasmic and extracellular localization of HMGB1 were noted. Our findings demonstrate that acute binge alcohol exacerbates disease progression in a desmosomal-linked ACM mouse, likely through enhanced fibrotic remodeling and altered inflammatory signaling. These outcomes highlight the potential danger of binge alcohol consumption in genetically susceptible subjects with ACM, further underscoring the role of environmental factors in ACM onset and progression.<b>NEW & NOTEWORTHY</b> We report that acute binge alcohol consumption in a robust mouse model of arrhythmogenic cardiomyopathy (ACM) significantly elevated ventricular arrhythmias, mortality, cardiomyocyte cell death via the loss of nuclear HMGB1, and extensive myocardial fibrosis. These findings demonstrate that binge drinking may serve as an environmental factor that contributes to disease progression in subjects with ACM, highlighting the need for clinical awareness regarding alcohol use in this vulnerable population.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H1608-H1620"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12771544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-06DOI: 10.1152/ajpheart.00510.2025
Brooke L O'Donnell, Madison D Williams, Marie Billaud, Luke S Dunaway, Linda Columbus, Michael Koval, Brant E Isakson
Pannexins (PANX1, PANX2, PANX3) are a family of large-pore, ion and metabolite channels present throughout the blood and lymphatic vascular networks. PANX1 has near-ubiquitous expression in the cardiovascular system and is the most highly studied pannexin in both homeostatic and disease conditions. In smooth muscle, endothelium, and blood cells, PANX1 acts at the cell surface as an ATP efflux channel to drive many vascular processes such as vasoconstriction, blood pressure, endothelial barrier function, platelet aggregation, and acute hypoxic responses. Conversely, PANX2 and PANX3 are understudied and exhibit a more intracellular localization pattern, with endothelial PANX3 modulating blood pressure through channel-independent mechanisms. In this review, we discuss the cellular localization and function of pannexins throughout the cardiovascular system, including resistance arteries, veins, lymphatics, large vessels, erythrocytes, platelets, pericytes, hearts, and lungs, as well as how this cellular activity corresponds to vascular physiology at the organism level. We also discuss the contribution of pannexins to the development and progression of various cardiovascular diseases, such as hypertension, edema, sepsis, atherosclerosis, aortic aneurysms, myocardial infarction, ischemia reperfusion, and thrombosis. In most cardiovascular diseases, PANX1 exacerbates disease development and progression, as evidenced by PANX1 channel blockade or genetic deletion in murine models improving disease outcomes, whereas the beneficial action of PANX3 in healthy vessels seems to be lost in conditions such as hypertension. With the prevalence of cardiovascular diseases and the associated burden on patients and healthcare systems, pannexin-based therapeutics may represent a novel alternative or combinatorial strategy for the treatment of many vascular conditions.
{"title":"Pannexins in the vasculature.","authors":"Brooke L O'Donnell, Madison D Williams, Marie Billaud, Luke S Dunaway, Linda Columbus, Michael Koval, Brant E Isakson","doi":"10.1152/ajpheart.00510.2025","DOIUrl":"10.1152/ajpheart.00510.2025","url":null,"abstract":"<p><p>Pannexins (PANX1, PANX2, PANX3) are a family of large-pore, ion and metabolite channels present throughout the blood and lymphatic vascular networks. PANX1 has near-ubiquitous expression in the cardiovascular system and is the most highly studied pannexin in both homeostatic and disease conditions. In smooth muscle, endothelium, and blood cells, PANX1 acts at the cell surface as an ATP efflux channel to drive many vascular processes such as vasoconstriction, blood pressure, endothelial barrier function, platelet aggregation, and acute hypoxic responses. Conversely, PANX2 and PANX3 are understudied and exhibit a more intracellular localization pattern, with endothelial PANX3 modulating blood pressure through channel-independent mechanisms. In this review, we discuss the cellular localization and function of pannexins throughout the cardiovascular system, including resistance arteries, veins, lymphatics, large vessels, erythrocytes, platelets, pericytes, hearts, and lungs, as well as how this cellular activity corresponds to vascular physiology at the organism level. We also discuss the contribution of pannexins to the development and progression of various cardiovascular diseases, such as hypertension, edema, sepsis, atherosclerosis, aortic aneurysms, myocardial infarction, ischemia reperfusion, and thrombosis. In most cardiovascular diseases, PANX1 exacerbates disease development and progression, as evidenced by PANX1 channel blockade or genetic deletion in murine models improving disease outcomes, whereas the beneficial action of PANX3 in healthy vessels seems to be lost in conditions such as hypertension. With the prevalence of cardiovascular diseases and the associated burden on patients and healthcare systems, pannexin-based therapeutics may represent a novel alternative or combinatorial strategy for the treatment of many vascular conditions.</p>","PeriodicalId":7692,"journal":{"name":"American journal of physiology. Heart and circulatory physiology","volume":" ","pages":"H1449-H1470"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}