The role of cytomegalovirus infection in ischemic heart failure progression

Abstract Objective To study an association between cytomegalovirus infection (CMV) and molecular biomarkers (NT-proBNP, tumor necrosis factor (TNF-α), Interleukin-1β) and evaluate prognostic role of CMV infection in ischemic heart failure (HF) progression during the 12-month follow-up period. Methods A total of 104 patients (61.5% men, median age of 59 [53; 62.5] years) with stable coronary artery disease and baseline left ventricular ejection fraction (LVEF) of 43% [36; 57]% were enrolled in the study. At baseline evaluation HF patients were of New York Heart Association (NYHA) class I (7.7%), class II (61.0%), and class III (31.3%). Sixty five percent of patients had prior myocardial infarction and 70.2% received prior myocardial revascularization (coronary artery bypass graft/stent). Cytomegalovirus DNA concentrations in EDTA whole-blood samples were measured using a polymerase chain reaction baseline and at 12 months of follow-up period. Serum levels of NT-proBNP, Interleukin-1β, TNF-α were measured baseline using an enzyme immunoassay. Two-dimensional transthoracic echocardiography was performed at baseline and at the 12 months. Results At baseline, all patients were divided into 2 groups: group A comprised CMV seropositive patients (n=52); group B comprised CMV seronegative patients (n=52). Plasma concentration of cytomegalovirus DNA was 1709.4 [615; 3176] copies/mL. The values of cytomegalovirus DNA significantly correlated with NT-proBNP (r=0.781), TNF-α (r=0.799) and Interleukin-1β (r=0.756). Levels of NT-proBNP were higher (p=0.0001) in group A by 36.6% than in group 2 (559 [364; 756] vs. 354.5 [279; 545.5] pg/mL, respectively). Levels of TNF-α were also higher (p<0,001) by 35.3% (8.5 [6.5; 10.9] vs. 5.5 [4.1; 7.3] ng/mL, respectively) and levels of Interleukin-1β (p<0,001) by 17.6% (19.3 [15.8; 23.75] vs. 15.9 [13.15; 18.7] ng/mL, respectively) in group A than in group B. During the 12-month follow-up period in group A the rate of HF progression was 51.6% cases, and in group B 26.9% (p=0.009). Based on ROC-analysis, baseline plasma concentration of cytomegalovirus DNA ≥2020 copies/mL (AUC=0.798; specificity 67%, sensitivity 82%; p<0.001) were identified as a cut-off values predicting development of HF progression during the 12-month follow-up period. 12-month levels of cytomegalovirus DNA did not differ (p=0,678) in comparison to baseline ones and were 1737.9 [321; 3384] copies /mL. In group A LVEF significantly increased by 18.8% from 50.5 [36.5; 56.0] to 41.0 [35.0; 50.0]%, end-systolic dimension significantly increased by 7.3%, end-diastolic dimension by 9.6% (p<0,0001), while in group B these parameters did not change. Conclusion Our data suggest that values of cytomegalovirus DNA are associated with NT-proBNP, TNF-α, Interleukin-1β levels, and may be considered as non-invasive biomarker for prediction of ischemic heart failure progression during the 12-month follow-up period. FUNDunding Acknowledgement Type of funding sources: None.

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Clinical significance of late diastolic tissue doppler parameters after onset of STEMI: from the view point of the timing of the echocardipography

European Heart Journal ◽

10.1093/ehjci/ehaa946.0074 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

N Iwahashi ◽

J Kirigaya ◽

M Horii ◽

T Abe ◽

E Akiyama ◽

...

Keyword(s):

Tissue Doppler ◽

Atrial Function ◽

Diastolic Velocity ◽

Long Time ◽

Group A ◽

St Elevation ◽

Group B ◽

First Time

Abstract Background The early transmitral flow velocity (E) divided by the early diastolic velocity of the mitral valve annulus (e') is referred to as the “E/e' ratio,” is useful even for ST elevation acute myocardial infarction (STEMI). However, the role of late diastolic velocity (a') which reveals the atrial function for STEMI is still unclear. Objectives We evaluated the clinical usefulness of tissue Doppler including atrial function for a first-time STEMI by long time follow up. Furthermore, we evaluated the meaning of each parameters by performing immediately after PCI or 2 weeks later. Methods We treated consecutive 571 first-time STEMI patients by immediate PCI within 12 hours after onset, and we examined 270 patients at immediately after PCI (GroupA, 65 years, 250 male) and 301 patients at 2 weeks after onset (GroupB, 64 years, 243 male). We examined trans mitral flow and TDI, then defined E/e' as LV filling pressure and A/a' as left atrial function. We followed them for a long time (>5 years). The primary end point (PE) was cardiac death or re-admission for heart failure (HF). Results We followed the patients in Group A for 10 years, Group B for 5 years. PE occurred in 64 patients in GroupA during 10 years, and 45 patients in GroupB during 5 years. We analyzed the univariate and multivariate Cox hazard analyses and we compared e' and a', E/e' and A/a' (Table). In GroupA, a' and A/a' were the independent predictors, on the other hand neither a' nor A/a' were the predictors in GroupB. E/e' was an independent predictor both in GroupA and B. Conclusion TDI parameters have different meanings by the timing of echocardiography after onset of a first-time STEMI. These results demonstrated that atrial dysfunction immediately after onset of STEMI suggests the poor prognosis after STEMI. Cox Hazard Proportional Analysis Funding Acknowledgement Type of funding source: None

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Sex-specific differences in ischemic heart failure: Role of estrogen

Gender Medicine ◽

10.1016/j.genm.2008.08.003 ◽

2008 ◽

Vol 5 (3) ◽

pp. 239-243 ◽

Cited By ~ 3

Author(s):

Michael Bauer ◽

Bruno K. Podesser

Keyword(s):

Heart Failure ◽

Ischemic Heart ◽

Ischemic Heart Failure

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NADPH Oxidase 4 Regulates Inflammation in Ischemic Heart Failure: Role of Soluble Epoxide Hydrolase

Antioxidants and Redox Signaling ◽

10.1089/ars.2018.7548 ◽

2019 ◽

Vol 31 (1) ◽

pp. 39-58 ◽

Cited By ~ 4

Author(s):

Mark D. Stevenson ◽

Chandrika Canugovi ◽

Aleksandr E. Vendrov ◽

Takayuki Hayami ◽

Dawn E. Bowles ◽

...

Keyword(s):

Heart Failure ◽

Nadph Oxidase ◽

Epoxide Hydrolase ◽

Soluble Epoxide Hydrolase ◽

Ischemic Heart ◽

Ischemic Heart Failure ◽

Nadph Oxidase 4

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The role of mitochondrial membrane potential in ischemic heart failure

Mitochondrion ◽

10.1016/j.mito.2011.06.001 ◽

2011 ◽

Vol 11 (5) ◽

pp. 700-706 ◽

Cited By ~ 53

Author(s):

Bernhard Kadenbach ◽

Rabia Ramzan ◽

Rainer Moosdorf ◽

Sebastian Vogt

Keyword(s):

Heart Failure ◽

Membrane Potential ◽

Mitochondrial Membrane Potential ◽

Mitochondrial Membrane ◽

Ischemic Heart ◽

Ischemic Heart Failure

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P4590Intra-myocardial injection of mesenchymal stromal cells in severe ischemic heart failure: final follow-up of the randomized placebo-controlled MSC-HF trial

European Heart Journal ◽

10.1093/eurheartj/ehy563.p4590 ◽

2018 ◽

Vol 39 (suppl_1) ◽

Author(s):

A B Mathiasen ◽

A A Qayyum ◽

E Jorgensen ◽

S Helqvist ◽

K Kofoed ◽

...

Keyword(s):

Heart Failure ◽

Mesenchymal Stromal Cells ◽

Stromal Cells ◽

Ischemic Heart ◽

Ischemic Heart Failure

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Role of Panchamooladya Choorna in Grahani Roga (irritable bowel syndrome)-pilot study

Ayurline: International Journal of Research in Indian Medicine ◽

10.52482/ayurline.v4i06.463 ◽

2020 ◽

Vol 4 (06) ◽

Author(s):

Akshaya Patil

Keyword(s):

Irritable Bowel Syndrome ◽

Dietary Habits ◽

Modern Medicine ◽

Disturbed Sleep ◽

Principal Factors ◽

Group A ◽

Irritable Bowel ◽

Group B

Lifestyle disorders like unhealthy dietary habits, physical habits, disturbed sleep and rest patterns are the principal factors that cause many digestion related disease. Irritable bowel syndrome (IBS) is also one such disease which occurs due to the ingestion of unwholesome diet causing disturbances in Agni. According to Ayurvedic science, this disease can be considered as a Grahani roga. So we may consider IBS as Grahani roga. Various herbal medications and panchakarma (biopurification) procedures are described in the treatment of Grahani roga though there is no reliable medical treatment for IBS in modern medicine; various efforts have been made to overcome this problem by the virtue of Ayurvedic therapy. The present study was done to assess the efficacy of Panchmooladya choorna with Takra(buttermilk) as anupan in Group A(10Patients) and Group B(10Patients)with luke warm water as anupan in management of Grahani roga in total of 20patients.The results of therapy were assessed by various parameters after 1month with follow up of 15days.The result concluded that Panchmooladya choorna with Takra as anupan reduced the symptoms of Grahani rog as compared to Group B.

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Abstract 17296: Arrhythmia Recurrence and Subsequent Heart Failure Hospitalization in Atrial Fibrillation Patients Undergoing Catheter Ablation: A Landmark Analysis From the Kansai Plus Atrial Fibrillation (KPAF) Registry

Circulation ◽

10.1161/circ.142.suppl_3.17296 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Nobuaki Tanaka ◽

KOICHI INOUE ◽

Atsushi Kobori ◽

Kazuaki Kaitani ◽

Takeshi Morimoto ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Catheter Ablation ◽

Large Scale ◽

Multicenter Observational Study ◽

History Of ◽

Group A ◽

Group B ◽

Af Recurrence

Background: Heart failure (HF) is the leading cause of death in patients with atrial fibrillation (AF). Radiofrequency catheter ablation (RFCA) of AF is effective for maintaining sinus rhythm though its impact on heart failure still remains controversial. Purpose: We sought to elucidate whether AF recurrence following RFCA was associated with subsequent HF hospitalizations. Methods: We conducted a large-scale, prospective, multicenter, observational study. A total of 4931 consecutive patients who underwent an initial RFCA for AF with longer than 1-year of follow-up in 26 centers were enrolled (average age, 64±10 years; non-paroxysmal AF, 35.7%). The median follow-up duration was 2.9 years. The primary endpoint was an HF hospitalization more than 1-year after the index RFCA. We compared the patients without AF recurrences (group A) to those with AF recurrences within 1-year post RFCA (group B). Results: The 1-year cumulative incidence of AF recurrences after a single procedure was 30.7% (group A=3418, group B=1513 patients). Group B had a lower body mass index (group A vs. group B,24.1±3.6 vs. 23.8±3.4 kg/m 2 , p=0.014), longer history of AF (1.9 vs. 3.1 years, p<0.0001), higher prevalence of non-paroxysmal AF (32.1% vs. 33.9%, p<0.0001), and valvular heart disease (5.9% vs. 7.8%, p=0.013). They also had a lower ejection fraction (63.7±9.4% vs. 62.8±9.6%, p=0.0043) and larger left atrial dimeter (39.7±6.6 vs. 40.6±7.0 mm, p<0.0001) on echocardiography. Hospitalizations for HF were observed in 57 patients (1.14%) more than 1-year after the RFCA and were significantly higher in group B than group A (group A vs. group B, 0.91% vs 1.72%, log-rank p=0.019). Conclusions: Among AF patients receiving RFCA, those with AF recurrences were at a greater risk of subsequent heart failure hospitalizations than those without AF recurrences. Recognition that AF recurrence following RFCA is a risk factor for a subsequent HF-related hospitalization is appropriate in clinical practice.

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Role of KATP Channels in Beneficial Effects of Exercise in Ischemic Heart Failure

Medicine & Science in Sports & Exercise ◽

10.1249/mss.0000000000000714 ◽

2015 ◽

Vol 47 (12) ◽

pp. 2504-2512 ◽

Cited By ~ 9

Author(s):

JASENKA KRALJEVIC ◽

MORTEN ANDRE HØYDAL ◽

MARKO LJUBKOVIC ◽

JOSE BIANCO NASCIMENTO MOREIRA ◽

KARI JØRGENSEN ◽

...

Keyword(s):

Heart Failure ◽

Katp Channels ◽

Ischemic Heart ◽

Ischemic Heart Failure ◽

Beneficial Effects

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P1239His-bundle pacing in CHF-patients with narrow QRS and chronic AF using dual-chamber ICD

European Heart Journal ◽

10.1093/eurheartj/ehz748.0197 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A Slawuta ◽

K Boczar ◽

A Zabek ◽

A Ciesielski ◽

J Hiczkiewicz ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Congestive Heart Failure ◽

Dual Chamber ◽

His Bundle ◽

His Bundle Pacing ◽

Narrow Qrs ◽

Group A ◽

Group B

Abstract The heart rate regularization is crucial for proper treatment of patients with atrial fibrillation and congestive heart failure. The standard resynchronization can be applied, but in patients with narrow QRS this procedure is of no use. The aim of our study is to assess the efficacy of direct His-bundle pacing in patients with congestive heart failure and chronic atrial fibrillation using dual chamber ICD implanted for prevention of sudden cardiac death. Methods The study population included 78 patients with CHF and chronic AF: group A - 56 pts treated with direct His-bundle pacing using atrial port of dual chamber ICD and group B - 22 patients implanted with single chamber ICD as recommended by the guidelines. The patients in group B constituting clinical controls were derived from the Heart Failure Outpatients Clinic with established clinical status and pharmacotherapy. Results The demographic data, clinical characteristics and echocardiography measurements at baseline and during follow-up were presented in the table: Table 1 Group A Group B P value Age (years) 69.7±6.9 66.7±11.3 n.s. Sex (% of male sex) 84.0 86.4 n.s. Ventricular pacing (%) – 46.3±31.2 – His-bundle pacing (%) 81.7±9.2 – – pre post pre post pre vs. post LVEDD (mm) 66.9±4.9 59.9±4.7 64.8±8.0 64.7±8.1 <0.01 n.s. EF (%) 29.6±3.8 43.6±5.9 28.1±6.1 28.8±7.3 <0.01 n.s. NYHA class 2.7±0.6 1.4±0.6 2.5±0.6 2.0±0.2 <0.05 n.s. B-blocker dose (metoprolol equivalent dose) 104.6±41.6 214.3±82.6 78.3±56.6 103.1±49.2 <0.001 <0.05 During 12-months of follow-up the mean values of NYHA functional class, EF and LV dimensions did not change in group B but significantly improved in group A. The physiological His-bundle based pacing enabled optimal beta-blocker dosing. The studied groups had no tachyarrhythmia at baseline so the presumable atrial fibrillation-related harm depends on the rhythm irregularity. Conclusions His-bundle-based pacing in CHF-chronic AF patients contributes to significant echocardiographic and clinical improvement. Standard single-chamber ICD implantation in CHF-chronic AF patients yields only SCD prevention without influence on remodeling process. The CHF-patients with narrow QRS and chronic AF benefit from substantially higher beta-blockade which can be instituted in His-bundle pacing group.

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