scholarly journals Effectiveness of myocarditis therapy depending on the diagnosis approach (with or without myocardial biopsy)

2021 ◽  
Vol 20 (3) ◽  
pp. 2637
Author(s):  
O. V. Blagova ◽  
A. V. Nedostup ◽  
V. P. Sedov ◽  
A. Yu. Zaitsev ◽  
V. M. Novosadov ◽  
...  
Keyword(s):  
Viral Genome ◽  
Parvovirus B19 ◽  
Combined Therapy ◽  
Left Ventricular ◽  
Class Iii ◽  
Myocardial Biopsy ◽  
Non Invasive ◽  
Group 2 ◽  
Diagnosis Approach ◽  
Group 1

Aim. To evaluate the effectiveness of myocarditis therapy depending on the diagnosis approach (with or without myocardial biopsy).Material and methods. The study included 83 patients ≥18 years old with severe and moderate myocarditis (25 women and 58 men; mean age, 45,7±11,7 years), established by myocardial biopsy (group 1, n=36) or by a non-invasive diagnostic algorithm (group 2, n=47), for which immunosuppressive therapy (IST) was carried out. Inclusion criteria were left ventricular (LV) end-diastolic dimension >5,5 cm and ejection fraction (EF) <50%. An endomyocardial (n=31) or intraoperative (n=5) biopsy with a study of the viral genome and level of anticardiac antibodies were performed. Coronary angiography (29%), cardiac multislice computed tomography (75%), cardiac magnetic resonance imaging (41%), and 99mTc-MIBI scintigraphy (35%) were also carried out. The mean follow-up period was 3 years (36 [12; 65] months). The study was approved by the Intercollegiate Ethics Committee.Results. The groups were completely comparable in age, baseline parameters (class III [2,25; 3] and III [2; 3] heart failure (HF); end-diastolic LV dimension, 6,7±0,7 and 6,4±0,7 cm; EF, 29,9±8,7 and 31,4±9,3%), the extent of cardiac therapy (excluding the administration rate of в-blockers — 94,4 and 78,7%, p<0,05) and 1ST (methylprednisolone in 91,7 and 89,4% of patients at a mean dose of 24 [16; 32] and 20 [15; 32] mg/day, azathioprine in 50,0 and 46,8% of patients at a mean dose of 150 mg/day or mycophenolate mofetil 2,0 g/day in 30,6% in group 1, hydroxychloroquine 0,2 g/day in 27,8 and 23,4%). Biopsy in group 1 revealed active/borderline (61/39%) myocarditis, in 8 patients — viral genome in the myocardium, including parvovirus B19 in 7 of them. Both groups showed a comparable significant increase in EF after 6 months up to 37,6±8,1 and 42,6±11,5% (p<0,001) and after 27 [12; 54] months up to 43,4±9,6 and 45,5±12,3% (p<0,001), as well as a significant decrease in HF class to 2 [1; 2] in both groups. An increase in EF by ≥10% was recorded in 70 and 72% of patients, respectively. The mortality rate was 13,9 and 12,8%. Taking into account the only transplantation in group 2, the death+transplantation endpoints reached 13,9 and 14,9% of patients (without significant differences between the groups).Conclusion. In patients with severe and moderate myocarditis diagnosed with and without myocardial biopsy, the effectiveness of combined therapy, including IST, was comparable. If it is impossible to perform a biopsy, complex non-invasive strategy makes it possible to diagnose myocarditis with different probability rate and conduct an effective IST, the refusal of which mostly is not justified.

scholarly journals Efficiency of immunosuppressive therapy in virus-negative and virus-positive patients with morphologically verified lymphocytic myocarditis

2017 ◽  
Vol 89 (8) ◽  
pp. 57-67 ◽  
Author(s):  
O V Blagova ◽  
A V Nedostup ◽  
E A Kogan ◽  
V A Sulimov
Keyword(s):  
Immunosuppressive Therapy ◽  
Viral Genome ◽  
Parvovirus B19 ◽  
Smooth Muscles ◽  
Anticardiolipin Antibody ◽  
Left Ventricular ◽  
Lymphocytic Myocarditis ◽  
Antibody Titers ◽  
Epstein Barr ◽  
Group 2

Aim. To evaluate the efficiency of immunosuppressive therapy (IST) in virus-negative (V–) and virus-positive (V+) patients with lymphocytic myocarditis (LM). Subjects and methods. 60 patients (45 males) (mean age 46.7±11.8 years) with dilated cardiomyopathy (mean left ventricular (LV) end diastolic size (EDS) 6.7±0.7 cm; ejection fraction (EF) 26.2±9.1%) were examined. The diagnosis of active/borderline LM was verified by right ventricular endomyocardial biopsy in 38 patients, by intraoperative LV biopsy in 10, in the study of explanted hearts from 3 patients and at autopsy in 9. The investigators determined the genomes of parvovirus B19, herpes viruses types 1, 2 and 6, Epstein—Barr (EBV), zoster, and cytomegalovirus in the blood and myocardium and, if antibodies were present in the blood, hepatitis B and C viruses, as well as antibodies against antigens in the endothelium, cardiomyocytes and their nuclei, smooth muscles, fibers of the conducting system. IST was used in terms of histological, immune, and viral activities. IST was performed in 22 V+ patients (Group 1) and in 24 V– patients (Group 2); this was not done in 10 V+ patients (Group 3) and V– patients (Group 4). IST comprised methylprednisolone at a mean dose of 24 mg/day (n=40), hydroxychloroquine 200 mg/day (n=20), azathioprine at a mean dose of 150 mg/day (n=21); antiviral therapy included acyclovir, ganciclovir, intravenous immunoglobulin (n=24). The follow-up period was 19 (7.3—40.3) months. Results. The viral genome was detected in the myocardium of 32 patients who made up a V+ group. The degree of histological activity did not differ in relation to the presence of viral genome in the myocardium. The degree of immune activity (anticardiolipin antibody titers) in the V+ patients was as high as that in V– ones. At baseline, the V+ patients had a significantly higher LV EDS and a lower EF than the V– patients. Overall, IST only could lead to a significant increase in EF (from 26.5±0.9 to 36.0±10.8%; p

scholarly journals Minimising radiation exposure in catheter ablation of ventricular arrhythmias

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matevž Jan ◽  
David Žižek ◽  
Tine Prolič Kalinšek ◽  
Dimitrij Kuhelj ◽  
Primož Trunk ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Radiation Exposure ◽  
Ventricular Arrhythmias ◽  
Major Complication ◽  
Structural Heart Disease ◽  
Left Ventricular ◽  
Complex Nature ◽  
Group 2 ◽  
Procedural Outcomes ◽  
Group 1

Abstract Background Conventional fluoroscopy guided catheter ablation (CA) is an established treatment option for ventricular arrhythmias (VAs). However, with the complex nature of most procedures, patients and staff bare an increased radiation exposure. Near-zero or zero-fluoroscopy CA is an alternative method which could substantially reduce or even eliminate the radiation dose. Our aim was to analyse procedural outcomes with fluoroscopy minimising approach for treatment of VAs in patients with structurally normal hearts (SNH) and structural heart disease (SHD). Methods Fifty-two (age 53.4 ± 17.8 years, 38 male, 14 female) consecutive patients who underwent CA of VAs in our institution between May 2018 and December 2019 were included. Procedures were performed primarily with the aid of the three-dimensional electro-anatomical mapping system and intra-cardiac echocardiography. Fluoroscopy was considered only in left ventricular (LV) summit mapping for coronary angiography and when epicardial approach was planned. Acute and long-term procedural outcomes were analysed. Results Sixty CA procedures were performed. Twenty-five patients had SHD-related VAs (Group 1) and 27 patients had SNH (Group 2). While Group 1 had significantly higher total procedural time (256.9 ± 71.7 vs 123.6 ± 42.2 min; p < 0.001) compared to Group 2, overall procedural success rate [77.4% (24/31) vs 89.7% (26/29); p = 0.20)] and recurrence rate after the first procedure [8/25, (32%) vs 8/27, (29.6%); p = 0.85] were similar in both groups. Fluoroscopy was used in 3 procedures in Group 1 where epicardial approach was needed and in 4 procedures in Group 2 where LV summit VAs were ablated. Overall procedure-related major complication rate was 5%. Conclusions Fluoroscopy minimising approach for CA of VAs is feasible and safe in patients with SHD and SNH. Fluoroscopy could not be completely abolished in VAs with epicardial and LV summit substrate location.

scholarly journals The outcome of patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) and impaired kidney function: a 3-year observational study

2021 ◽  
Author(s):  
Malgorzata Zalewska-Adamiec ◽  
Jolanta Malyszko ◽  
Ewelina Grodzka ◽  
Lukasz Kuzma ◽  
Slawomir Dobrzycki ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Incidence Rate ◽  
Kidney Function ◽  
Coronary Arteries ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Risk Of Death ◽  
Group 2 ◽  
Group 1

Abstract Background Myocardial infarction with nonobstructive coronary arteries (MINOCA) constitutes about 10% of the cases of acute coronary syndromes (ACS). It is a working diagnosis and requires further diagnostics to determine the cause of ACS. Methods In this study, 178 patients were initially diagnosed with MINOCA over a period of 3 years at the Department of Invasive Cardiology of the University Clinical Hospital in Białystok. The value of estimated glomerular filtration rate (eGFR) was calculated for all patients. The patients were divided into 2 groups depending on the value of eGFR: group 1—53 patients with impaired kidney function (eGFR < 60 mL/min/1.73 m2; 29.8%) and group 2—125 patients with normal kidney function (eGFR ≥ 60 mL/min/1.73 m2; 70.2%). Results In group 1, the mean age of patients was significantly higher than that of group 2 patients (77.40 vs 59.27; p < 0.0001). Group had more women than group 2 (73.58% vs 49.60%; p = 0.003). Group 1 patients had higher incidence rate of arterial hypertension (92.45% vs 60.80%; p < 0.0001) and diabetes (32.08% vs 9.60%; p = 0.0002) and smoked cigarettes (22.64% vs 40.80%; p = 0.020). Group 1 patients had higher incidence rate of pulmonary edema, cardiogenic shock, sudden cardiac arrest (13.21% vs 4.00%; p = 0.025), and pneumonia (22.64% vs 6.40%; p = 0.001). After the 37-month observation, the mortality rate of the patients with MINOCA was 16.85%. Among group two patients, more of them became deceased during hospitalization (7.55% vs 0.80%; p = 0.012), followed by after 1 year (26.42% vs 7.20%; p = 0.0004) and after 3 years (33.96% vs 9.6%; p < 0.0001). Multivariate analysis revealed that the factors increasing the risk of death in MINOCA are as follows: older age, low eGFR, higher creatinine concentration, low left ventricular ejection fraction, and ST elevation in ECG. Conclusion Impaired kidney function is diagnosed in every third patient with MINOCA. Early and late prognosis of patents with MINOCA and renal dysfunction is poor, and their 3-year mortality is comparable to patients with myocardial infarction with significant stenosis of the coronary arteries and impaired kidney function.

scholarly journals Hypertrophy of unaffected cardiomyocytes correlates with severity of cardiomyopathy in female patients with Fabry disease

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Cristina Chimenti ◽  
Romina Verardo ◽  
Andrea Frustaci
Keyword(s):  
Fabry Disease ◽  
Wall Thickness ◽  
Left Ventricular ◽  
Female Patients ◽  
Maximal Wall Thickness ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Aim To investigate the contribution of unaffected cardiomyocytes in Fabry disease cardiomyopathy. Findings Left ventricular (LV) endomyocardial biopsies from twenty-four females (mean age 53 ± 11 ys) with Fabry disease cardiomyopathy were studied. Diagnosis of FD was based on the presence of pathogenic GLA mutation, Patients were divided in four groups according with LV maximal wall thickness (MWT): group 1 MWT ≤ 10.5 mm, group 2 MWT 10.5–15 mm, group 3 MWT 16–20 mm, group 4 MWT > 20 mm. At histology mosaic of affected and unaffected cardiomyocytes was documented. Unaffected myocytes’ size ranged from normal to severe hypertrophy. Hypertrophy of unaffected cardiomyocytes correlated with severity of MWT (p < 0.0001, Sperman r 0,95). Hypertrophy of unaffected myocytes appear to concur to progression and severity of FDCM. It is likely a paracrine role from neighboring affected myocytes.

Porcine Versus Pericardial Pulmonary Valve Replacement in Adults With Prior Congenital Cardiac Surgery: Midterm Outcomes

2019 ◽  
Vol 10 (2) ◽  
pp. 197-205 ◽  
Author(s):  
Chi Sum Yuen ◽  
Kwok Fai Lucius Lee ◽  
Inderjeet Bhatia ◽  
Nicholson Yam ◽  
Barnabe Antonio Rocha ◽  
...  
Keyword(s):  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Regurgitation ◽  
Pulmonary Valve Replacement ◽  
Left Ventricular ◽  
Congenital Cardiac Surgery ◽  
Group 2 ◽  
Bioprosthetic Valves ◽  
Group 1

Background: Postcongenital heart surgery pulmonary regurgitation requires subsequent pulmonary valve replacement. We sought to compare the outcomes of pulmonary valve replacement after using bioprosthetic valves, porcine versus pericardial bioprosthesis. Method: Retrospective single-center study of consecutive pulmonary valve replacement in patients with pulmonary regurgitation following initial congenital cardiac surgery. From 2004 to 2016, 82 adult patients (53 males, 29 females) underwent pulmonary valve replacement at a mean age of 28.7 ± 8 years (range 18-52 years) with a mean time to pulmonary valve replacement of 24 ± 7 years (range 13-43 years). Porcine bioprosthetic valves (group 1, n = 32) and pericardial valves (group 2, n = 50) were used. Cardiac magnetic resonance imaging was performed (n = 54) at a mean of 18 ± 13 months before and 24 ± 21 months after pulmonary valve replacement. Results: No significant difference was seen between the groups except that the mean follow-up was longer for group 1 (5.02 ± 2.06 vs 4.08 ± 3.21 years). In-hospital mortality was 1.1%. Follow-up completeness was 100% with no late death. Mean right ventricular end-systolic and end-diastolic volumes reduced significantly in both the groups ( P < .001), whereas right ventricular ejection fraction remained unchanged (group 1, P = .129; group 2, P = .675) . Only the left ventricular end-diastolic volume increased in both the groups, but the increase was significant for group 2 only (group 1, P = .070; group 2, P = .015), whereas the left ventricular end-systolic and ejection fraction remained unchanged in both the groups. There was no reoperation for pulmonary valve replacement. Freedom from intervention was 93.8% (group 1) and 100% (group 2) at eight years after pulmonary valve replacement ( P = .407). Conclusion: Midterm outcomes of pulmonary valve replacement in our adult cohort were satisfactory. Both types of bioprosthetic valves performed comparably for eight years and were a good option in adults.

scholarly journals Intracoronary Injection of Autologous CD34+ Cells Improves One-Year Left Ventricular Systolic Function in Patients with Diffuse Coronary Artery Disease and Preserved Cardiac Performance—A Randomized, Open-Label, Controlled Phase II Clinical Trial

2020 ◽  
Vol 9 (4) ◽  
pp. 1043 ◽  
Author(s):  
Pei-Hsun Sung ◽  
Yi-Chen Li ◽  
Mel S. Lee ◽  
Hao-Yi Hsiao ◽  
Ming-Chun Ma ◽  
...  
Keyword(s):  
Systolic Function ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Diffuse Coronary Artery Disease ◽  
Cd34 Cells ◽  
Group 2 ◽  
Artery Disease ◽  
One Year ◽  
Lv Systolic Function ◽  
Group 1

This phase II randomized controlled trial tested whether intracoronary autologous CD34+ cell therapy could further improve left ventricular (LV) systolic function in patients with diffuse coronary artery disease (CAD) with relatively preserved LV ejection fraction (defined as LVEF >40%) unsuitable for coronary intervention. Between December 2013 and November 2017, 60 consecutive patients were randomly allocated into group 1 (CD34+ cells, 3.0 × 107/vessel/n = 30) and group 2 (optimal medical therapy; n = 30). All patients were followed for one year, and preclinical and clinical parameters were compared between two groups. Three-dimensional echocardiography demonstrated no significant difference in LVEF between groups 1 and 2 (54.9% vs. 51.0%, respectively, p = 0.295) at 12 months. However, compared with baseline, 12-month LVEF was significantly increased in group 1 (p < 0.001) but not in group 2 (p = 0.297). From baseline, there were gradual increases in LVEF in group 1 compared to those in group 2 at 1-month, 3-months, 6-months and 12 months (+1.6%, +2.2%, +2.9% and +4.6% in the group 1 vs. −1.6%, −1.5%, −1.4% and −0.9% in the group 2; all p < 0.05). Additionally, one-year angiogenesis (2.8 ± 0.9 vs. 1.3 ± 1.1), angina (0.4 ± 0.8 vs. 1.8 ± 0.9) and HF (0.7 ± 0.8 vs. 1.8 ± 0.6) scores were significantly improved in group 1 compared to those in group 2 (all p < 0.001). In conclusion, autologous CD34+ cell therapy gradually and effectively improved LV systolic function in patients with diffuse CAD and preserved LVEF who were non-candidates for coronary intervention (Trial registration: ISRCTN26002902 on the website of ISRCTN registry).

scholarly journals Different lead locations guided by fluoroscopy and ECG parameters and their effect on patients functional status

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Mohamed MesbahTahaHassanin ◽  
Ahmad ShafieAmmar ◽  
Radwa M. Abdullah ◽  
Mohammad Hassan Khedr
Keyword(s):  
Functional Capacity ◽  
Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Dyssynchrony ◽  
Qrs Complex ◽  
Significant Difference ◽  
Septal Pacing ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Right ventricular apical pacing with the resultant left ventricular dyssynchrony often leads to depressed systolic function and heart failure. This study aimed at investigating the relation between various septal locations guided by ECG and fluoroscopy and the intermediate term functional capacity of the patients. Results Fifty patients who received a single lead pacemaker with assumed > 90% pacemaker dependency. Patients were randomized according to RV pacing site RV into group 1 “high septum” (n = 15), group 2 “mid septum” (n = 25), and group 3 “low septum” (n = 10) using QRS vector and duration as well as fluoroscopic parameters. Their clinical status was assessed 6 months after device implementation using 6-min walk test (6MWT). The study showed that paced QRS complex duration itself has no significant difference between the different septal pacing locations (P-value 0.675), although its combination with the paced QRS complex vector can signify the optimal pacing site and 6MWT showed a significant difference among the groups in favor of group 1; group 1 (413.3 ± 148.5), group 2 (359.8 ± 124.6), and group 3 (276.0 ± 98.5) P value 0.04. Conclusion There was a significant difference found between the three septal pacing sites concerning the patient functional capacity with superiority of high septal location. By contrast, different septal sites showed no significant difference of the paced QRS complex duration. To optimize the pacing site in the septum, assessment of the paced QRS vector in leads I and III is of a great benefit especially when combined with paced QRS complex duration assessment.

Abstract 18141: Is There Systolic Myocardial Mechanical Dysfunction in Patients With Different Degrees of Diastolic Dysfunction and Normal Ejection Fraction?

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sergio Barros-Gomes ◽  
Patricia A Pellikka ◽  
Angela Dispenzieri ◽  
Hector R Villarraga
Keyword(s):  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Al Amyloidosis ◽  
Normal Ejection Fraction ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Introduction: Diastolic dysfunction has been characterized in relation to the relaxation and compliance properties of the left ventricle; limited information exists regarding its relationship to systolic function as assessed by deformation imaging. Objectives: To determine if there is left ventricular systolic dysfunction detected by global longitudinal strain (GLS) measured by two dimensional speckle tracking echocardiography in patients with immunoglobulin light chain (AL) amyloidosis with different degrees of diastolic dysfunction and normal ejection fraction (EF). Methods: Consecutive biopsy-proven AL patients with preserved EF (≥ 55%) who had a comprehensive echocardiogram performed and strain analysis were included. Cohort was divided into 5 groups according to the different grades of diastolic dysfunction: Group 0: normal filling pressures; Group 1: abnormal relaxation; Group 2: pseudo-normal pattern; Group 3: reversible restrictive; Group 4: fixed restrictive. Images were acquired and performed on a Vivid 9 from the 3 apical views, and analyzed on vendor-specific software (Echo-PAC, GE). GLS was averaged from the 16 segments, and their means compared by ANOVA and each pair with Student’s t test. Results: A total of 858 patients were included, mean age was 63.7 years ± 10.1, and 61.5% were male. From those, 205 (24%) were in group 0; 299 (35%) in group 1; 255 (30%) in group 2; 65 (7%) in group 3; and 34 in group 4 (4%). GLS means measurements were -18.95 ± 2.4, -16.86 ± 3.4, -15.60 ± 3.9, -12.31 ± 3.0, and -10.48 ± 3.3, respectively (P<0.0001). All individual GLS values were significantly different statistically when compared between each group (P<0.01 for all pairs; figure). Conclusions: Longitudinal systolic mechanical function is progressively impaired in AL amyloid patients as diastolic dysfunction progresses, despite normal EF. This systolic dysfunction provides insights into the intrinsic relationship between the components of the cardiac cycle.

Age and Left Ventricular Impairment Predict Reopening for Bleeding

2003 ◽  
Vol 11 (2) ◽  
pp. 147-152 ◽  
Author(s):  
Yongzhi Deng ◽  
Karen Byth ◽  
Hugh S Paterson
Keyword(s):  
Renal Failure ◽  
Coronary Artery ◽  
Chronic Renal Failure ◽  
Multiple Logistic Regression Analysis ◽  
Left Ventricular ◽  
Older Age ◽  
Redo Surgery ◽  
Prophylactic Measures ◽  
Group 2 ◽  
Group 1

Statistical analysis of data collected prospectively from all patients undergoing surgery under cardiopulmonary bypass from September 1994 to November 1998 (group 1) was performed to identify preoperative risk factors for reopening for bleeding. Multiple logistic regression analysis of 19 preoperative variables was carried out with reoperation for bleeding as the endpoint. The protocol for intraoperative use of aprotinin was then changed to include high-risk patients. Data collected from all subsequent patients from May 1999 to March 2002 (group 2) were analyzed. Subgroup analyses on primary isolated coronary artery surgery were also performed. Data were obtained from 1,946 patients aged 22 to 88 years (mean, 62.5 years). Older age, severe left ventricular impairment, redo surgery, and chronic renal failure were the independent predictors of reopening for bleeding in group 1. There were no independent predictors of reopening in group 2. Older age and chronic renal failure were the predictors of reexploration for bleeding in patients undergoing primary isolated coronary artery grafting. Prophylactic measures to prevent excessive bleeding should be used in elderly patients and those with severe left ventricular impairment, redo surgery, and chronic renal failure.

scholarly journals Cellular Prion Protein Is Essential for Myocardial Regeneration but Not the Recovery of Left Ventricular Function from Apical Ballooning

Biomedicines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 167
Author(s):  
Jiunn-Jye Sheu ◽  
Han-Tan Chai ◽  
John Y. Chiang ◽  
Pei-Hsun Sung ◽  
Yi-Ling Chen ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Cell Stress ◽  
Cellular Prion Protein ◽  
Myocardial Regeneration ◽  
Stress Signaling ◽  
Opposite Pattern ◽  
Protein Expressions ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

This study tested the hypothesis that cellular prion protein (PrPC) played an essential role in myocardial regeneration and recovery of left ventricular ejection fraction (LVEF) from apical takotsubo cardiomyopathy (TCM) induced by transaortic constriction (TAC). In vitro study was categorized into G1 (H9C2), G2 (H9C2-overexpression-PrPC), G3 (H9C2-overexpression-PrPC + Stelazine/1 uM), and G4 (H9C2 + siRNA-PrPC), respectively. The results showed that the protein expressions of PrPC, cell-stress signaling (p-PI3K/p-Akt/p-m-TOR) and signal transduction pathway for cell proliferation/division (RAS/c-RAF/p-MEK/p-ERK1/2) were lowest in G1, highest in G2, significantly higher in G3 than in G4 (all p < 0.001). Adult-male B6 mice (n = 30) were equally categorized in group 1 (sham-control), group 2 (TAC) for 14 days, then relieved the knot and administered BrdU (50 ug/kg/intravenously/q.6.h for two times from day-14 after TAC) and group 3 (TAC + Stelazine/20 mg/kg/day since day 7 after TAC up to day 21 + BrdU administered as group 2), and animals were euthanized at day 28. The results showed that by day 28, the LVEF was significantly higher in group 1 than in groups 2/3 and significantly higher in group 3 than in group 2, whereas the LV chamber size exhibited an opposite pattern of LVEF (all p < 0.0001). The protein expressions of PrPC/p-PI3K/p-Akt/p-m-TOR/cyclin D/cyclin E and cellular-proliferation biomarkers (Ki67/PCNA/BrdU) exhibited an opposite pattern of LVEF (all p < 0.0001) among the three groups, whereas the protein expressions of RAS/c-RAF/p-MEK/p-ERK1/2 were significantly and progressively increased from groups 1 to 3 (all p < 0.0001). In conclusion, PrPC participated in regulating the intrinsic response of cell-stress signaling and myocardial regeneration but did not offer significant benefit on recovery of the heart function in the setting of TCM.

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