scholarly journals Circulating Omentin-1 Levels Are Decreased in Dilated Cardiomyopathy Patients with Overt Heart Failure

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ying Huang ◽  
Yingzhong Lin ◽  
Shumin Zhang ◽  
Zhijian Wang ◽  
Jianwei Zhang ◽  
...  

Background. Recent evidence demonstrated that the circulating levels of omentin-1 are related to the presence of ischemic heart disease and heart failure. However, omentin-1 plasma levels in patients with nonischemic dilated cardiomyopathy (DCM), which is the most common etiology of heart failure, have yet to be investigated.Methods. Plasma levels of omentin-1 and adiponectin were measured in 100 patients with DCM and 45 healthy controls.Results. Plasma omentin-1 levels significantly decreased in DCM patients compared with the control group, whereas adiponectin levels significantly increased in DCM patients compared with the control group. Plasma omentin-1 levels were negatively correlated with adiponectin (R=-0.376,P=0.005), C-reactive protein (CRP) (R=-0.320,P=0.001), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (R=-0.365,P=0.000) levels as well as left ventricular end-diastolic diameter (LVEDD) (R=-0.200,P=0.046) but were positively correlated with left ventricular ejection fraction (LVEF) (R=0.496,P=0.000). Plasma adiponectin levels were positively correlated with CRP (R=0.273,P=0.006) and NT-proBNP (R=0.329,P=0.001) levels but were negatively correlated with fasting glucose (R=-0.218,P=0.029) and LVEF (R=-0.615,P=0.000) levels. Furthermore, omentin-1 (OR 0.983, 95% CI 0.970 to 0.996;P=0.008) levels were independently associated with the presence of DCM before NT-proBNP was added.Conclusions. Omentin-1 is a novel biomarker of DCM.

2009 ◽  
Vol 17 (4) ◽  
pp. 382-388 ◽  
Author(s):  
Kitipan V Arom ◽  
Permyos Ruengsakulrach ◽  
Michael Belkin ◽  
Montip Tiensuwan

To determine the efficacy of intramyocardial injection of angiogenic cell precursors in nonischemic dilated cardiomyopathy, 35 patients with nonischemic dilated cardiomyopathy underwent injections of angiogenic cell precursors into the left ventricle (cell group). Seventeen patients with nonischemic dilated cardiomyopathy were matched from the heart failure database to form a control group that was treated medically. Angiogenic cell precursors were obtained from autologous blood, cultured in vitro, and injected into all free-wall areas of the left ventricle in the cell group. After these injections, New York Heart Association functional class improved significantly by 1.1 ± 0.7 classes at 284.7 ± 136.2 days, and left ventricular ejection fraction improved in 71.4% of patients (25/35); the mean increase in left ventricular ejection fraction was 4.4% ± 10.6% at 192.7 ± 135.1 days. Improved quality of life was demonstrated by better physical function, role-physical, general health, and vitality domains in a short-form health survey at the 3-month follow-up. In the control group, there were no significant improvements in left ventricular ejection fraction or New York Heart Association class which increased by 0.6 ± 0.8 classes. It was concluded that intramyocardial angiogenic cell precursor injection is probably effective in the treatment of nonischemic dilated cardiomyopathy. Disclosures and Freedom of Investigation Professor Michael Belkin is an advisory board member, a minor shareholder, and receives a consulting fee from TheraVitae Co. Ltd. However, the authors had full control of the study, methods used, outcome measurements, data analysis, and production of the written report.


2018 ◽  
Vol 45 (1) ◽  
pp. 27-30 ◽  
Author(s):  
Samuel G. Wittekind ◽  
Yvette Gerdes ◽  
Wayne Mays ◽  
Clifford Chin ◽  
John L. Jefferies

Nonischemic dilated cardiomyopathy is deadly and costly, and treatment options are limited. Cardiac rehabilitation has proved safe and beneficial for adults with various types of heart failure. Therefore, we retrospectively evaluated the hypothesis that rehabilitation is safe and improves cardiometabolic health in young patients with nonischemic dilated cardiomypathy. From 2011 through 2015, 8 patients (4 males) (mean age, 20.6 ± 6.6 yr; range, 10–31 yr) underwent rehabilitation at our institution. They were in American Heart Association class C or D heart failure and were on maximal medical therapy. Their mean left ventricular ejection fraction at baseline was 0.26 ± 0.15. Two patients had a left ventricular assist device, and 2 were inpatients. To evaluate safety, we documented adverse events during rehabilitation sessions. Clinical endpoints were measured at baseline, immediately after completing rehabilitation, and after one year. Patients attended 120 of 141 possible sessions (85%), with no adverse events. There were no marked changes in mean left ventricular ejection fraction or body mass index. The patients' mean waist circumference decreased by 1.37 ± 0.6 in (n=5; 95% CI, −2.1 to −0.63). Their 6-minute walk distance increased by a mean of 111 ± 75 m (n=5; 95% CI, 18–205). In our small sample of young patients with nonischemic dilated cardiomyopathy, cardiac rehabilitation was feasible and was associated with minimal risk. Our findings suggest that prospective studies in this population are warranted.


Author(s):  
Eftihia Sbarouni ◽  
Panagiota Georgiadou ◽  
Maria Koutelou ◽  
Ioannis Sklavainas ◽  
Demosthenes Panagiotakos ◽  
...  

Background Biomarkers of myocardial necrosis may be increased in patients with chronic heart failure. We investigated whether ischaemia-modified albumin (IMA), a marker of ischaemia, is also elevated in patients with compensated heart failure, due to dilated cardiomyopathy (DCM). Methods We studied 42 patients with DCM and an equal number of age-matched normal volunteers. We assessed IMA serum levels with the albumin cobalt binding test. Results IMA was 89.9 ± 13.1 (71–117) KU/L in the patient group and 93.9 ± 9.9 (76–122) KU/L in the control group, with no significant difference between the two ( P = 0.11). However, IMA differed significantly according to the New York Heart Association classification ( P = 0.003) and was negatively correlated with the left ventricular ejection fraction ( r = −0.40, P = 0.014). Conclusions We conclude that IMA, a marker of ischaemia, does not differ in patients with clinically stable DCM compared with normal subjects, but varies significantly in relation to the severity of the disease.


Author(s):  
Klaudia Rakusiewicz ◽  
Krystyna Kanigowska ◽  
Wojciech Hautz ◽  
Lidia Ziółkowska

Abstract Purpose To evaluate choroidal thickness (CTh) in children with chronic heart failure (CHF) secondary to dilated cardiomyopathy (DCM) using spectral domain optical coherence tomography (SD-OCT) and to compare their values to those of healthy children. Methods Sixty eyes of thirty children (mean age 9.9 ± 3.57 years) with chronic heart failure (left ventricular ejection fraction, LVEF ≤ 55%) due to DCM lasting for over 6 months were prospectively enrolled. The control group consisted of 30 age- (mean age 10.16 ± 3.42 years) and sex-matched healthy children. All participants underwent transthoracic echocardiography with LVEF measured using the Simpson method and had the blood serum level of N-terminal-pro-brain natriuretic peptide marker (NT-proBNP) determined. All children underwent SD-OCT and had subfoveal choroidal thickness (SFCTh) and CTh measured at 1500 µm (μm) nasally, temporally, superiorly and inferiorly from the fovea in both eyes by two investigators. Results CTh at all locations was statistically significantly lower in children with DCM compared to the control group. Mean CTh in the group with CHF compared to the control group were (304.03 vs. 369.72 μm, p < 0.05) at the subfoveal location, (245.87 vs. 284 μm, p < 0.05) 1500 μm nasally from the fovea, (291.5 vs. 355.95 μm, p < 0.05) 1500 μm temporally from the fovea, (303.98 vs. 357.58 μm, p < 0.05) 1500 μm superiorly from the fovea and (290.92 vs. 344.96 μm, p < 0.05) 1500 μm inferiorly from the fovea. The average difference CTh between the study groups ranged from 38.13 to 65.69 μm at individual locations. In both groups, CTh was the thickest at subfoveal location (304.03 vs. 369.72 μm, p < 0.05) and the thinnest was 1500 μm nasally from the fovea (262.37 vs. 336.87 μm, p < 0.05). There was no correlation between CTh and age, gender, biometry and refractive error. No correlation was found between CTh and LVEF and NT-proBNP. Conclusion Patients with CHF due to DCM had a thinner CTh at all measured locations. The results of our research indicate that CHF affects CTh and this parameter may be very helpful in monitoring the clinical course of the disease in children with DCM.


2018 ◽  
Vol 46 (5) ◽  
pp. 1939-1950 ◽  
Author(s):  
Tao Wu ◽  
Yichen Chen ◽  
Yantao Du ◽  
Jin Tao ◽  
Zhong Zhou ◽  
...  

Background/Aims: MicroRNAs (miRNAs) can be used as biomarkers for cardiovascular diseases, especially for heart failure. However, there are few reports on serum exosomal miRNA biomarkers in patients with acute heart failure (AHF) due to Dilated cardiomyopathy (DCM). Methods: We analyzed 3 different serum exosomal miRNAs (exo-miR-92b-5p, exo-miR-192-5p, and exo-miR-320a) in 43 patients with DCM-AHF and 34 healthy volunteers as a control group (CG) by using exosome separation followed by a quantitative reverse-transcript PCR assay. Exosomes were identified by electron microscopy, NaNOZS-90, and western blot analyses (CD63 and Hsp70). Results: Serum exo-miR-92b-5p expression was increased in DCM-AHF patients compared to the CG (Mann–Whitney U-test: P < 0.001). Exo-miR-92b-5p was positively related to age and some ultrasound data (Spearman’s correlation: exo-miR-92b-5p vs. age, r = 0.297, P = 0.014; exo-miR-92b-5p vs. left atrial diameter, r = 0.431, P < 0.001; exo-miR-92b-5p vs. left ventricular diastolic diameter, r = 0.419, P < 0.001; exo-miR-92b-5p vs. left ventricular systolic diameter, r = 0.446, P < 0.001). Exo-miR-92b-5p was also negatively related to other ultrasound data (Spearman’s correlation: exo-miR-92b-5p vs. left ventricular fraction shortening, r = -0.497, P < 0.001; exo-miR-92b-5p vs. left ventricular ejection fraction, r = -0.482, P < 0.001). The discrimination of DCM-AHF patients from the CG by exo-miR-92b-5p was demonstrated by a receiver operating characteristic curve (exo-miR-92b-5p: cutoff value = 0.0023, area under the curve = 0.808, P < 0.001, sensitivity = 62.8%, specificity = 85.3%). Conclusion: Serum exo-miR-92b-5p is a potential biomarker for the diagnosis of DCM-AHF.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Helen Sjöland ◽  
Jonas Silverdal ◽  
Entela Bollano ◽  
Aldina Pivodic ◽  
Ulf Dahlström ◽  
...  

Abstract Background Temporal trends in clinical composition and outcome in dilated cardiomyopathy (DCM) are largely unknown, despite considerable advances in heart failure management. We set out to study clinical characteristics and prognosis over time in DCM in Sweden during 2003–2015. Methods DCM patients (n = 7873) from the Swedish Heart Failure Registry were divided into three calendar periods of inclusion, 2003–2007 (Period 1, n = 2029), 2008–2011 (Period 2, n = 3363), 2012–2015 (Period 3, n = 2481). The primary outcome was the composite of all-cause death, transplantation and hospitalization during 1 year after inclusion into the registry. Results Over the three calendar periods patients were older (p = 0.022), the proportion of females increased (mean 22.5%, 26.4%, 27.6%, p = 0.0001), left ventricular ejection fraction was higher (p = 0.0014), and symptoms by New York Heart Association less severe (p < 0.0001). Device (implantable cardioverter defibrillator and/or cardiac resynchronization) therapy increased by 30% over time (mean 11.6%, 12.3%, 15.1%, p < 0.0001). The event rates for mortality, and hospitalization were consistently decreasing over calendar periods (p < 0.0001 for all), whereas transplantation rate was stable. More advanced physical symptoms correlated with an increased risk of a composite outcome over time (p = 0.0043). Conclusions From 2003 until 2015, we observed declining mortality and hospitalizations in DCM, paralleled by a continuous change in both demographic profile and therapy in the DCM population in Sweden, towards a less affected phenotype.


2014 ◽  
Vol 9 ◽  
pp. IMI.S13939 ◽  
Author(s):  
Bandi Hari Krishna ◽  
Pravati Pal ◽  
G. K. Pal ◽  
J. Balachander ◽  
E. Jayasettiaseelon ◽  
...  

Aims The purpose of this study was to evaluate whether yoga training in addition to standard medical therapy can improve cardiac function and reduce N terminal pro B-type natriuretic peptide (NT pro BNP) in heart failure (HF). Methods 130 patients were recruited and randomized into two groups: Control Group (CG) ( n = 65), Yoga Group (YG). In YG, 44 patients and in CG, 48 patients completed the study. Cardiac function using left ventricular ejection fraction (LVEF), myocardial performance index (Tei index), and NT pro BNP, a biomarker of HF, was assessed at baseline and after 12 weeks. Result Improvement in LVEF, Tei index, and NT pro BNP were statistically significant in both the groups. Furthermore, when the changes in before and after 12 weeks were in percentage, LVEF increased 36.88% in the YG and 16.9% in the CG, Tei index was reduced 27.87% in the YG and 2.79% in the CG, NT pro BNP was reduced 63.75% in the YG and 10.77% in the CG. The between group comparisons from pre to post 12 weeks were significant for YG improvements (LVEF, P < 0.01, Tei index, P < 0.01, NT pro BNP, P < 0.01). Conclusion These results indicate that the addition of yoga therapy to standard medical therapy for HF patients has a markedly better effect on cardiac function and reduced myocardial stress measured using NT pro BNP in patients with stable HF.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Marcus Sandri ◽  
Stephan Gielen ◽  
Norman Mangner ◽  
Volker Adams ◽  
Sandra Erbs ◽  
...  

Background: The concept of ventricular-arterial coupling implies that LV-function is determined by the three factors left ventricular diastolic, left ventricular systolic and arterial elastance. We have previously documented an improvement in endothelial function and systolic LV-function in patients with chronic heart failure (CHF) after 6 months of exercise training (ET). It remains, however, unclear, how shorter ET periods may affect endothelial, systolic and diastolic ventricular function as echocardiographic parameters related to ventricular arterial coupling in patients with CHF. METHODS: In this ongoing study we randomised 43 patients with stable CHF (age 60.3 ± 2.9 years, EF 27.4 ± 1.7%, VO 2 max 14.7 ± 4.3ml/kg*min) to a training or a control group (C). Patients in the training group exercised 4 times daily at 70% of the individual heart rate reserve for 4 weeks under supervision. At baseline and after 4 weeks the E/A ratio and septal/lateral E’/A’ velocities were determined by echocardiography with tissue Doppler. Exercise capacity was measured by ergospirometry and flow-mediated dilatation (FMD) was assessed by high-resolution radial ultrasound. RESULTS: After only 4 weeks of ET oxygen uptake at peak exercise increased from 14.9 ± 3.3 to 18.1 ± 4.7 ml/min/kg, (p<0.01 vs. C) in training subjects. Left ventricular ejection fraction improved from 26.8 ± 4.6 to 33.1 ± 5.5% (p<0.05 vs. C) in patients of the training group while it remained unchanged in the control group. E/A-ratio mended from 0.63 ± 0.12 to 0.81 ± 0.22 (p<0.01 vs. C) in training patients. Septal E’ velocities increased from 5.5 ± 0.5 to 7.8 ± 1.4 cm/s in training patients (p<0.05 vs. C). FMD of the radial artery improved from 8.2 ± 2.1 to 15.2 ± 3.8% (p<0.01 vs. C) as a result of ET. CONCLUSIONS: Only 4 weeks of endurance training are highly effective with significantly improved FMD accompanied by an emended systolic and diastolic LV-function. We hypothesise that the improvement in LV-EF in training patients may be caused by a corrected ventricular-arterial coupling: ventricular diastolic relaxation and effective endothelial function are ameliorated resulting in an augmentation of stroke volume.


2021 ◽  
Vol 102 (4) ◽  
pp. 510-517
Author(s):  
E V Khazova ◽  
O V Bulashova

The discussion continues about the role of systemic inflammation in the pathogenesis of cardiovascular diseases of ischemic etiology. This article reviews the information on the role of C-reactive protein in patients with atherosclerosis and heart failure in risk stratification for adverse cardiovascular events, including assessment of factors affecting the basal level of highly sensitive C-reactive protein. Research data (MRFIT, MONICA) have demonstrated a relationship between an increased level of C-reactive protein and the development of coronary heart disease. An increase in the serum level of highly sensitive C-reactive protein is observed in arterial hypertension, dyslipidemia, type 2 diabetes mellitus and insulin resistance, which indicates the involvement of systemic inflammation in these disorders. Currently, the assessment of highly sensitive C-reactive protein is used to determine the risk of developing myocardial infarction and stroke. It has been proven that heart failure patients have a high level of highly sensitive C-reactive protein compared with patients without heart failure. The level of C-reactive protein is referred to as modifiable risk factors for cardiovascular diseases of ischemic origin, since lifestyle changes or taking drugs such as statins, non-steroidal anti-inflammatory drugs, glucocorticoids, etc. reduce the level of highly sensitive C-reactive protein. In patients with heart failure with different left ventricular ejection fraction values, it was found that the regression of the inflammatory response is accompanied by an improvement in prognosis, which confirms the hypothesis of inflammation as a response to stress, which has negative consequences for the cardiovascular system.


2019 ◽  
Vol 18 (3) ◽  
pp. 41-47
Author(s):  
E. A. Polunina ◽  
L. P. Voronina ◽  
E. A. Popov ◽  
I. S. Belyakova ◽  
O. S. Polunina ◽  
...  

Aim. To develop a mathematical equation (algorithm) to predict the development of chronic heart failure (CHF) for three years, depending on the clinical phenotype.Material and methods. Three hundred forty five patients with CHF with a different left ventricular ejection fraction (preserved, mean, low) were examined. The control group included somatically healthy individuals (n=60). In all patients, 48 parameters that most widely characterize the pathogenesis of CHF (gender-anamnestic, clinical, instrumental, biochemical) were analyzed. To isolate phenotypes, dispersive and cluster analysis was used: the hierarchical classification method and the k-means method. In the development of algorithms we used binary logistic regression method. We used ROC curve to assess the quality of the obtained algorithms.Results. We identified four phenotypes in patients with CHF: fibro-rigid, fibro-inflammatory, inflammatory-destructive, dilated-maladaptive. For the first three phenotypes, a mathematical logistic regression method was used to develop mathematical models for predicting the progression of CHF for three years, with the release of predictors for each phenotype. Belonging to the dilatedmaladaptive phenotype according to the results of the analysis is already an indicator of an unfavorable prognosis in patients with CHF.Conclusion. The developed algorithms based on the selected phenotypes have high diagnostic sensitivity and specificity and can be recommended for use in clinical practice.


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