METABOLIC SIGNATURE OF HUMAN RIGHT VENTRICULAR MYOCARDIUM IN END STAGE HEART FAILURE

2020 ◽  
Vol 75 (11) ◽  
pp. 1043
Author(s):  
Giovanni Davogustto ◽  
Jean Wassenaar ◽  
Fan Run ◽  
Haocan Song ◽  
Fei Ye ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Ventricular Myocardium ◽  
Human Right ◽  
Metabolic Signature ◽  
End Stage Heart Failure ◽  
End Stage

Deloading of the Left Ventricle by Ventricular Assist Device Normalizes Increased Expression of Endothelin ET A Receptors But Not Endothelin-Converting Enzyme-1 in Patients With End-Stage Heart Failure

Circulation ◽  
2000 ◽  
Vol 102 (suppl_3) ◽  
Author(s):  
Henning Morawietz ◽  
Marten Szibor ◽  
Winfried Goettsch ◽  
Babett Bartling ◽  
Matthias Barton ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Ace Inhibitor ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
Converting Enzyme ◽  
Ventricular Assist ◽  
End Stage Heart Failure ◽  
End Stage

Background —Ventricular assist devices (VAD) are implanted in patients with end-stage heart failure for bridging the time until heart transplantation, resulting in hemodynamic unloading of the failing heart, improved cardiac contractile and mitochondrial function, and reversal of cardiac hypertrophy. It is unknown whether VAD unloading may affect the cardiac endothelin (ET) system, which has been proposed as one of the putative pathomechanisms of heart failure. Methods and Results —With the use of standard-calibrated, competitive reverse-transcription–polymerase chain reaction mRNA expression of components of the ET system was analyzed in left ventricular myocardium from nonfailing donor hearts, from failing hearts without and with ACE inhibitor therapy, and from patients with end-stage heart failure at the time of VAD implantation and 103±15 days after VAD implantation during removal with subsequent heart transplantation. ET receptor A (ET A ) was markedly upregulated in failing human myocardium. This increased ET A expression was not affected by ACE inhibitor treatment but was normalized by VAD unloading. ET A expression before or after VAD implantation did not correlate with duration of VAD implantation or suppression of Pro-ANP mRNA. ET B mRNA expression was unaffected by heart failure or VAD. In contrast, increased ET-converting enzyme-1 mRNA and ET-1 peptide levels in failing myocardium were partially normalized by ACE inhibition but not by VAD unloading. Conclusions —We conclude that VAD implantation normalizes ET A expression in failing human left ventricular myocardium, probably as the result of the beneficial effects of VAD unloading.

Right Ventricular Proteome in End-Stage Heart Failure

2012 ◽  
Vol 18 (8) ◽  
pp. S33
Author(s):  
Yan Ru Su ◽  
David Friedman ◽  
Chee Lim ◽  
Thomas G. Di Salvo
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
End Stage Heart Failure ◽  
End Stage

scholarly journals Right Ventricular Protein Expression Profile in End-Stage Heart Failure

2015 ◽  
Vol 5 (3) ◽  
pp. 481-497 ◽  
Author(s):  
Yan Ru Su ◽  
Manuel Chiusa ◽  
Evan Brittain ◽  
Anna R. Hemnes ◽  
Tarek S. Absi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Protein Expression ◽  
Right Ventricular ◽  
Expression Profile ◽  
Protein Expression Profile ◽  
End Stage Heart Failure ◽  
End Stage

Abstract 13099: Evaluation of Right Ventricular Myocardial Mechanics by 2D-and 3D-STE in Patients With End-stage Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yuman Li ◽  
Fangyan Tian ◽  
Mingxing XIE
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Systolic Function ◽  
Normal Subjects ◽  
Myocardial Mechanics ◽  
Systolic Volume ◽  
Significant Difference ◽  
End Stage Heart Failure ◽  
End Stage ◽  
2D And 3D

Background: Speckle-tracking echocardiography (STE) has emerged as a more accurate tool for assessing the right ventricular (RV) function.We aimed to assess RV myocardial mechanics by 2D- and 3D-STE in patients with end-stage heart failure (HF). Methods: We enrolled 105 patients with end-stage HF and 50 normal subjects. The results of coronary artery angiography divided these patients into two subgroups : ischaemic cardiomyopathies (ICM, n=23) and non-ischaemic cardiomyopathies subgroups (NICM, n=82). RV end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF) were measured by 3D-STE. RV free wall longitudinal strain (RVLS-fre),and RV septal wall LS (RVLS-sep) were also determined by 3D-and 2D-STE. The conventional RV function parameters (fractional area change [FAC], tricuspid annular plane systolic excursion [TAPSE]) were obtained. We compared these parameters between patients and normal subjects. RVLS-fre and RVLS-sep obtained by 3D- and 2D-STE were compared between ICM and NICM. Results: Compared with controls, patients had higher RVEDV, RVESV(P<0.001),and lower RVLS-fre, RVLS-spe, RVEF, RVSV, FAC, TAPSE(P<0.001).In 105 patients, 3D-RVLS-fre was lower than 2D-RVLS-fre (-11.43±3.83% VS -12.30±3.95%;P=0.003); whereas 3D-RVLS-sep was not different from 2D-RVLS-sep. Patients with NICM had significant lower 3D-RVLS-fre(-10.68±3.55% VS -14.06±3.70%;P<0.001)and 3D-RVLS-sep (-6.68±2.76% VS -8.26±2.64%;P=0.006)than patients with ICM. There was no difference in 2D-STE between the two subgroups. Conclusions: End-stage HF patients present significant difference in RVLS values between 3D- and 2D-STE. 3D-STE is superior to 2D-STE for RV systolic function assessment in end-stage HF patients with different pathologies.

scholarly journals The effect of prolonged Intraaortic ballon pump (IABP) support on right ventricular function in end-stage heart failure

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M.J Bonios ◽  
I Armenis ◽  
N Kogerakis ◽  
A Thodou ◽  
S Fragkoulis ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Total Bilirubin ◽  
Left Ventricular ◽  
Function Optimization ◽  
Circulatory Support ◽  
Iabp Support ◽  
End Stage Heart Failure ◽  
End Stage ◽  
Rv Function

Abstract Introduction Right Ventricular (RV) function has prognostic implications in end-stage heart failure (ESHF) patients. RV failure following Left Ventricular Assist Device (LVAD) implantation increases morbidity and mortality. Achieving optimal RV function before LVAD implantation is of paramount importance. Purpose Purpose was to investigate the effect of Intra-aortic Balloon Pump (IABP) on RV function optimization in patients with bi-ventricular ESHF. Methods ESHF patients with poor RV function, presenting with acutely decompensated heart failure resistant to inotropes/vasopressors, thus requiring IABP for stabilization, were prospectively enrolled. Serum biochemistry, echocardiography and invasive hemodynamics were applied and eligibility for LVAD according to RV function was determined on the basis of pre-specified criteria (Right atrium Pressure (RAP) &lt;12mmHg, Pulmonary Artery Pulsatility index (PAPi) &gt;1.85, RAP/Pulmonary Capillary Wedge Pressure (PCWP) &lt;0.67, RV strain &lt;−14%). LV and RV tissue was harvested during LVAD or bi-ventricular mechanical circulatory implantation or at the time of heart transplantation. Fibrosis of the myocardial tissue was quantified. Results Sixteen patients aged 38±14 years were enrolled. Duration of IABP support was 62±50 (3–180) days. Three patients deteriorated requiring additional mechanical circulatory support. Two patients were stabilized without RV function improvement. In the remaining 11 patients, RV improved and fulfilled LVAD eligibility criteria (IABP responders); RA and RA/PCWP decreased from 18±6 to 10±4mmHg (p=0.0001) and from 0.60±0.19 to 0.42±0.11 (p=0.011) respectively. PAPi and RV strain improved from 1.46±0.65 to 3.20±0.58 (p=0.0001) and from −12.9±3.4% to −18.7±1.7% (p=0.0001) respectively. Significantly lower baseline NTproBNP and total bilirubin values were observed in the responders group. Six patients finally received LVAD and none suffered RV failure post-operatively (the remaining 5 were successfully transplanted). RV fibrosis correlated with post-IABP NTproBNP (r=0.91, p=0.001), total bilirubin (r=0.79, p=0.011), RAP (r=0.78, p=0.014), PAPi (r=−0.69, p=0.040), RAP/PCWP (r=0.74, p=0.022) and LV fibrosis (r=0.77, p=0.016), but not with baseline (pre-IABP) parameters. Conclusions Prolonged IABP support contributes to partial RV function recovery in patients with ESHF and bi-ventricular failure, thus leading to eligibility for LVAD implantation. RV fibrosis may predict RV response to IABP and post-IABP eligibility for LVAD. FUNDunding Acknowledgement Type of funding sources: None.

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