Restoration of myocellular copper-trafficking proteins and mitochondrial copper enzymes repairs cardiac function in rats with diabetes-evoked heart failure

Diabetes impairs systemic copper regulation, and acts as a major independent risk factor for heart failure (HF) wherein mitochondrial dysfunction is a key pathogenic process.

Download Full-text

Abstract 4331: Elevated Albumin Excretion is an Independent Risk Factor in Patients with Chronic Heart Failure. Data from the GISSI-Heart Failure Trial

Circulation ◽

10.1161/circ.118.suppl_18.s_866 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Serge Masson ◽

Luciano Moretti ◽

Ospedale Mazzoni ◽

Maria Grazia Rossi ◽

Emanuele Carbonieri ◽

...

Keyword(s):

Heart Failure ◽

Renal Function ◽

Risk Factor ◽

Independent Risk Factor ◽

Cox Model ◽

Nyha Class ◽

Large Population ◽

Creatinine Concentration ◽

Albumin Excretion ◽

All Cause Mortality

Elevated albuminuria, a marker of endothelial renal damage, is a risk factor for cardiovascular events in the general population and in patients with diabetes or hypertension. We report here on its association with mortality in a large population of patients with chronic HF. Albuminuria (albumin/creatinine concentration ratio in a morning spot sample, UACR) was determined in 2131 patients with chronic HF enrolled in 77 centers participating to the GISSI-HF trial. Patients were divided according to normal (UACR <30 mg/g) and abnormal urinary excretion of albumin (≥30 mg/g). Association between elevated albuminuria and all-cause mortality was tested by univariable and multivariable analyses. Elevated albuminuria was found in 25.3% of the population (age 67±11 y, 78.9% males, 30.1% NYHA class III-IV, 55.5% hypertension, 26.1% diabetes) and was more frequent in older patients, those with reduced renal function, diabetes or high CRP. Mortality was significantly higher in patients with elevated albuminuria (20.1% at 1000 days) compared to normals (9.0%, p<0.0001). Elevated albuminuria remained an independent risk factor for all-cause mortality (HR [95%CI] 1.47 [1.18 –1.82]) in a Cox model adjusted for clinical risk factors such as age, gender, NYHA class, renal function, diabetes, BMI and blood pressure. About a quarter of the patients enrolled in the GISSI-HF trial had abnormal urinary albumin excretion, a marker for both renal and systemic vascular disease. We show for the first time in a large representative sample that elevated albuminuria is an independent predictor of all-cause mortality in patients with chronic HF.

Download Full-text

Abstract P341: Juvenile Exposure To Doxorubicin Differentially Alters The Cardiac Response To Angiotensin II And Isoproterenol In Adult Mice

Circulation Research ◽

10.1161/res.129.suppl_1.p341 ◽

2021 ◽

Vol 129 (Suppl_1) ◽

Author(s):

Marianne K Grant ◽

Beshay N Zordoky

Keyword(s):

Heart Failure ◽

Risk Factor ◽

Angiotensin Ii ◽

Cardiac Function ◽

Cancer Survivors ◽

Childhood Cancer ◽

Significant Risk ◽

Significant Risk Factor ◽

Childhood Cancer Survivors ◽

Cardiac Response

Hypertension is the most significant risk factor for heart failure in doxorubicin (DOX)-treated childhood cancer survivors. We previously developed a two-hit mouse model of juvenile DOX-induced latent cardiotoxicity that is exacerbated by adult-onset angiotensin II (ANGII)-induced hypertension. Nevertheless, it is still not known how juvenile exposure to DOX would predispose the heart to other cardiovascular pathologic stimuli that do not cause hypertension. The objective of this work was to compare the effects of ANGII to those of isoproterenol (ISO) in adult C57BL6/N mice pre-exposed to DOX as juveniles. Five-week-old male mice were administered a low dose of DOX (4 mg/kg/week) or saline for 3 weeks and then allowed to recover for 5 weeks. Thereafter, mice were either infused with ANGII (1.4 mg/kg/day) or injected with ISO (10 mg/kg/day) for 14 days. Juvenile exposure to DOX abrogated the hypertrophic response to both ANGII and ISO, while it failed to correct ANGII- and ISO-induced upregulation in the hypertrophic markers ANP and BNP. ANGII, but not ISO, worsened cardiac function in DOX-exposed mice as measured by echocardiography. Cardiac fibrosis was also exacerbated by ANGII, but not ISO, in DOX-exposed mice as evident by Masson’s trichrome staining and upregulation of the inflammatory and fibrotic markers, Cox-2, Col1a1, Col3a1 , and galectin-3 . In conclusion, the current work demonstrates that ANGII causes more severe deterioration in cardiac function and adverse cardiac remodeling in DOX-exposed mice when compared to ISO. The comparison between DOX/ANGII and DOX/ISO models is critical to understanding why hypertension is the most significant risk factor for heart failure in DOX-treated childhood cancer survivors and thereby devising effective therapeutic strategies against this significant clinical problem.

Download Full-text

Microalbuminuria as an independent risk factor for heart failure in the elderly patients with type 2 diabetes mellitus

Acta Medica Saliniana ◽

10.5457/ams.v49i2.496 ◽

2020 ◽

Vol 49 (2) ◽

Author(s):

Enisa Karić ◽

Zumreta Kušljugić ◽

Enisa Ramić ◽

Olivera Batić- Mujanović ◽

Amila Bajraktarević ◽

...

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Type 2 Diabetes ◽

Risk Factor ◽

Diabetes Mellitus Type 2 ◽

Independent Risk Factor ◽

The Elderly ◽

Diabetes Mellitus Type ◽

Patients With Diabetes

Introduction:The study evaluated of microalbuminuria as a predictor of heart failure in patients with diabetes mellitus type 2.Materials and methods:The prospective study conducted in a period of time from 01-Feb-2007 to 01-Feb-2010.The study included 100 patients with type 2 diabetes, who had diabetes longer than 5 years. All subjects (average age 66 ± 10 years, 33% male, 67% female) were tested for the presence of microalbuminuria, and 50 patients had microalbuminuria. The second group comprised 50 patients without of microalbuminuria with diabetes mellitus type 2.Results:In the patients with microalbuminuria and diabetes mellitus were found 22% of heart failure and 6% in the second group. Average time to the occurance of heart failure in the first group was 32,5 months, in the second group was 35,3 months.Conclusions:The results show that microalbuminuria is an independent risk factor for heart failure in patients with diabetes mellitus type 2 and microalbuminuria. Patients without microalbuminuria had 3,7 less likely to development heart failure compared to patients with microalbuminuria and diabetes mellitus.

Download Full-text

Iron deficiency is an independent risk factor of increased myocardial energy expenditure in chronic heart failure patients

Annals of Palliative Medicine ◽

10.21037/apm-21-2297 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Feng Lin ◽

Yuli Huang ◽

Dongqi An ◽

Qiong Zhan ◽

Peng Wang ◽

...

Keyword(s):

Heart Failure ◽

Risk Factor ◽

Chronic Heart Failure ◽

Iron Deficiency ◽

Energy Expenditure ◽

Independent Risk Factor ◽

Heart Failure Patients

Download Full-text

Abstract 15764: Evaluation of Pulmonary Hypertension World Health Organization Group II in the Perioperative Setting

Circulation ◽

10.1161/circ.142.suppl_3.15764 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Martin Marak ◽

Danielle Tatum ◽

Denzil Moraes

Keyword(s):

Heart Failure ◽

Pulmonary Hypertension ◽

Risk Factor ◽

World Health Organization ◽

Independent Risk Factor ◽

World Health ◽

Intermediate Risk ◽

Surgical Risk ◽

Group Ii ◽

Health Organization

Introduction: The World Health Organization (WHO) categorizes pulmonary hypertension (PHTN) into 5 groups. Group II classification denotes PHTN secondary to left-heart disease and accounts for nearly 75% of all cases. However, there is limited data regarding the effect of PHTN Group II status on outcomes in the perioperative setting. Hypothesis: PHTN WHO Group II is an independent risk factor for adverse cardiopulmonary events in the perioperative setting. Methods: Retrospective review of patients who underwent intra-abdominal surgery between January 2014 - August 2019 and had previously obtained an echocardiogram. PHTN Group II was defined as estimated pulmonary artery pressure (EPAP) > 30mmHg on echocardiogram . Other forms of PHTN were excluded. Major adverse cardiovascular events (MACE) were defined as heart failure exacerbation, arrhythmia, myocardial infarction, 30 day readmission, and death. Surgical risk was categorized as low (laparoscopic) or intermediate (open). Results: By echocardiogram findings, 65 of the 178 (36.3%) patients included were Group II PHTN. Between surgical risk classes, Group II PHTN was older (mean age 73.7 years v 60.5; P< 0.01), had more comorbidities including systolic (9.70% v 21.5%, P=0.03) and diastolic (22.1% v 34.5%, P < 0.01) heart failure, and were more likely to have a MACE ( 6.2% v 43.1%, P < 0.01). PHTN Group II patients with intermediate-risk surgeries demonstrated significantly more MACE than control (11.2% v 43.7%, P <0.01) without significant difference in comorbidities. Conclusions: Group II PHTN is an independent risk factor for MACE in patients undergoing intermediate risk surgery compared to non-PHTN counterparts. Additional studies involving severity of pulmonary hypertension may provide further insight into risk stratification.

Download Full-text