scholarly journals A Pilot Study on the 1H-NMR Serum Metabolic Profile of Takotsubo Patients Reveals Systemic Response to Oxidative Stress

Antioxidants ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1982
Author(s):  
Domitilla Vanni ◽  
Nicola Viceconte ◽  
Greta Petrella ◽  
Flavio Giuseppe Biccirè ◽  
Francesco Pelliccia ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Pilot Study ◽  
1H Nmr ◽  
Metabolic Profile ◽  
Ketone Bodies ◽  
Obstructive Coronary Artery Disease ◽  
Left Ventricular ◽  
Systemic Response ◽  
Coronary Syndrome ◽  
Metabolic Fingerprint

Takotsubo syndrome (TTS) presents as an acute coronary syndrome characterized by severe left ventricular (LV) dysfunction and non-obstructive coronary artery disease that typically shows spontaneous recovery within days or weeks. The mechanisms behind TTS are mainly related to beta-adrenergic overstimulation and acute endogenous catecholamine surge, both of which could increase oxidative status that may induce further deterioration of cardiac function. Although several studies reported evidence of inflammation and oxidative stress overload in myocardial tissue of TTS models, systemic biochemical evidence of augmented oxidant activity in patients with TTS is lacking. In this study, serum samples of ten TTS patients and ten controls have been analyzed using 1H-NMR spectroscopy. The results of this pilot study show a marked alteration in the systemic metabolic profile of TTS patients, mainly characterized by significant elevation of ketone bodies, 2-hydroxybutyrate, acetyl-L-carnitine, and glutamate levels, in contrast with a decrease of several amino acid levels. The overall metabolic fingerprint reflects a systemic response to oxidative stress caused by the stressor that triggered the syndrome’s onset.

Atypical Takotsubo Cardiomyopathy with Hypokinetic Left Mid-ventricle and Apical Wall Sparing: A Case Report and Literature Review

2020 ◽  
Vol 16 (3) ◽  
pp. 241-246
Author(s):  
Dipesh Ludhwani ◽  
Belaal Sheikh ◽  
Vasu K Patel ◽  
Khushali Jhaveri ◽  
Mohammad Kizilbash ◽  
...  
Keyword(s):  
Case Report ◽  
Takotsubo Cardiomyopathy ◽  
Systolic Dysfunction ◽  
Obstructive Coronary Artery Disease ◽  
Left Ventricular ◽  
Reduced Ejection Fraction ◽  
Coronary Syndrome ◽  
Normal Left Ventricular ◽  
Artery Disease

Background: Takotsubo Cardiomyopathy (TTC) is an uncommon cause of acute reversible ventricular systolic dysfunction in the absence of obstructive Coronary Artery Disease (CAD). Typically manifesting as apical wall ballooning, TTC can rarely present atypically with apical wall sparing. Case report: A 62-year-old female presented with complaints of chest pain and features mimicking acute coronary syndrome. Coronary angiogram revealed no obstructive CAD and left ventriculogram showed reduced ejection fraction, normal left ventricular apex and hypokinetic mid-ventricles consistent with atypical TTC. The patient was discharged home on heart failure medications and a follow-up transthoracic echocardiogram demonstrated improved left ventricular function with no wall motion abnormality. Conclusion: This case report provides an insight into the diagnosis and management of TTC in the absence of pathognomic features.

The aging-induced hyperexcretion of glucose-dependent insulinotropic peptide is essential for the healthy cardiac remodeling by prevention of cardiac ceramide accumulation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Kureishi Bando ◽  
Y.R Remina ◽  
T.K Kamihara ◽  
K.N Nishimura ◽  
T.M Murohara
Keyword(s):  
Oxidative Stress ◽  
Ketone Bodies ◽  
Left Ventricular ◽  
Heart Weight ◽  
Lv Function ◽  
Cardiac Aging ◽  
Normal Left Ventricular ◽  
Insulinotropic Peptide ◽  
Ceramide Accumulation ◽  
And Oxidative Stress

Abstract Background Glucose-dependent insulinotropic peptide (GIP) is incretin hormone that is emerged as an important regulator of lipid metabolism. Fat intake induces hypersecretion of GIP that is involved in obesity and ectopic fat accumulation. Aging is another stimulant of GIP hypersecretion, which is suggested as a cause of “sarcopenic obesity in elderly”. In heart, aging is the known risk factor of HFpEF, of which typical characteristics is pathological cardiac hypertrophy induced by unknown cause(s). It remained uncertain whether any ectopic fat accumulation, such as cardiac steatosis may cause the aging-induced cardiac hypertrophy. Ceramide is one of the lipid metabolites that involves in apoptosis, inflammation, and stress responses, which are among the pathogenic components of heart failure. However, it remained unclear whether the ceramide may play any pathophysiological role in cardiac aging. Purpose We thus hypothesized whether cardiac aging may alter cardiac lipid metabolism and the GIP may play a regulatory role in the cardiac aging via modulating cardiac steatosis, particularly ceramide. Methods Mouse model of GIPR deficiency (GIPR-KO) was employed and cardiac evaluation of GIPR-KO and the age-matched wild type mice were performed. Results Aging (50w/o) induced GIP hypersecretion in control mice and their body and heart weight were 50% increased as compared to younger counterpart (10w/o). In contrast, the aging-induced increase rate in body and heart weight of GIPR-KO was significantly lower (22%). Aging also increased the circulating ketone bodies with increase in FGF21 expression in heart and, notably, there was no pathological increase in cardiac ceremide and oxidative stress with normal left-ventricular (LV) function (LVEF=82.2±1.8). In contrast, GIPR-KO exhibited pathological increase in cardiac ceramide without the elevation of the circulating ketone bodies. The younger GIPR-KO (10 w/o) exhibited normal left-ventricular (LV) function, however, the older mice (50 w/o) exhibited systolic LV dysfunction (LVEF=55.8±8.5) with increase in cardiac apoptosis and oxidative stress. Cardiac ceramide accumulation was increased in the aged normal mice, which was significantly higher in the aged GIPR-KO. Furthermore, GIPR-KO exhibited increase in cardiac fibrosis and oxidative stress, which were absent in the aged normal counterpart. Conclusion Aging increased circulating GIP level the leads to compensatory rise in the circulating ketone bodies without pathological increase in cardiac ceremide and related oxidative stress in heart. Loss of GIP signaling caused pathological increase in cardiac ceramide, leading to the aging-induced progression of systolic left-ventricular dysfunction. Collectively, we conclude that the aging-induced GIP hyperexcretion is essential for the aging-induced healthy cardiac remodeling by augmenting compensatory ketone body elevation. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): KAKEN-HI

scholarly journals Acute coronary syndrome with non-obstructive coronary arteries (ACS-NOCA) in patients with hypertrophic cardiomyopathy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarinya Puwanant ◽  
Angkawipa Trongtorsak ◽  
Chaisiri Wanlapakorn ◽  
Nattakorn Songsirisuk ◽  
Aekarach Ariyachaipanich ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Hypertrophic Cardiomyopathy ◽  
Obstructive Coronary Artery Disease ◽  
Significant Coronary Artery Disease ◽  
Left Ventricular ◽  
Lower Probability ◽  
Coronary Syndrome ◽  
Artery Disease

Abstract Objectives Our study aimed to determine the prevalence and prognosis of acute coronary syndrome with non-obstructive coronary artery (ACS-NOCA) in patients with hypertrophic cardiomyopathy (HCM). Methods and results We enrolled a total of 200 consecutive patients with HCM over a 139-month period from 2002 to 2013. The study found that 28 patients (14% of overall patients, 51% of patients with ACS) had ACS-NOCA, and 18 patients (9% of overall patients, 86% of patients with acute MI) had MINOCA as initial clinical presentations. The highest prevalence of non-obstructive coronary artery disease (NOCA) in patients with HCM was found in acute ST-elevation myocardial infarction (STEMI) (100%), followed by non-STEMI (82%), and unstable angina (29%). Patients with ACS-NOCA had more frequent ventricular tachycardia and lower resting left ventricular (LV) outflow tract gradients than those with no ACS-NOCA (p < 0.05 for all). The ACS-NOCA group had a lower probability of HCM-related death compared with the no ACS-NOCA group and the significant coronary artery disease (CAD) group (p-log-rank = 0.0018). Conclusions MINOCA or ACS-NOCA is not an uncommon initial presentation (prevalence rate 9–14%) in patients with HCM. NOCA was highly prevalent (51–86%) in patients with HCM presenting with ACS and had a favorable prognosis. Our findings highlight as a reminder that in an era of rapid reperfusion therapy, ACS in patients with HCM is not only a result of obstructive epicardial CAD, but also stems from the complex cellular mechanisms of myocardial necrosis.

scholarly journals Effects of 3-Month Astaxanthin Supplementation on Cardiac Function in Heart Failure Patients with Left Ventricular Systolic Dysfunction-A Pilot Study

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1896 ◽  
Author(s):  
Takao Kato ◽  
Takatoshi Kasai ◽  
Akihiro Sato ◽  
Sayaki Ishiwata ◽  
Shoichiro Yatsu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Heart Failure ◽  
Pilot Study ◽  
Cardiac Function ◽  
Exercise Tolerance ◽  
Systolic Dysfunction ◽  
Cardiac Contractility ◽  
Antioxidant Properties ◽  
Left Ventricular ◽  
Reactive Oxygen Metabolite

Astaxanthin has strong antioxidant properties. We conducted a prospective pilot study on heart failure (HF) patients with left ventricular (LV) systolic dysfunction to investigate improvements in cardiac function and exercise tolerance in relation to suppression of oxidative stress by 3-month astaxanthin supplementation. Oxidative stress markers—serum Diacron reactive oxygen metabolite (dROM), biological antioxidant potential (BAP), and urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) concentrations, LV ejection fraction (LVEF), and 6-min walk distance (6MWD) were assessed before and after 3-month astaxanthin supplementation. Finally, the data of 16 HF patients were analyzed. Following 3-month astaxanthin supplementation, dROM level decreased from 385.6 ± 82.6 U.CARR to 346.5 ± 56.9 U.CARR (p = 0.041) despite no changes in BAP and urinary 8-OHdG levels. LVEF increased from 34.1 ± 8.6% to 38.0 ± 10.0% (p = 0.031) and 6MWD increased from 393.4 ± 95.9 m to 432.8 ± 93.3 m (p = 0.023). Significant relationships were observed between percent changes in dROM level and those in LVEF. In this study, following 3-month astaxanthin supplementation, suppressed oxidative stress and improved cardiac contractility and exercise tolerance were observed in HF patients with LV systolic dysfunction. Correlation between suppression of oxidative stress and improvement of cardiac contractility suggests that suppression of oxidative stress by astaxanthin supplementation had therapeutic potential to improve cardiac functioning.

scholarly journals COMPARATIVE ANALYSIS OF DEMOGRAPHIC, ANAMNESTIC, CLINICAL-LABORATORY AND INSTRUMENTAL DATA IN PATIENTS WITH MYOCARDIAL INFARCTION WITH AND WITHOUT OBSTRUCTIVE LESION OF CORONARY ARTERIES

2019 ◽  
Vol 33 (4) ◽  
pp. 69-75
Author(s):  
S. V. Kruchinova ◽  
E. D. Kosmacheva ◽  
V. A. Porkhanov
Keyword(s):  
Myocardial Infarction ◽  
Comparative Analysis ◽  
Coronary Disease ◽  
Coronary Arteries ◽  
Obstructive Coronary Artery Disease ◽  
Laboratory Data ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
Coronary Syndrome ◽  
Obstructive Lesion

Objective: to give a comparative characterization of myocardial infarction with and without obstructive lesion of coronary arteries.Material and Methods. The study involved 4639 patients included in the first total register of acute coronary syndrome in the Krasnodar Territory for the first 12 months of register operation. A comparative analysis of patients with myocardial infarction with obstructive lesion and without obstructive lesion of coronary arteries was performed.Results. Between November 2016 and November 2017, 4453 patients with myocardial infarction with obstructive coronary disease, including 2261 men (50.8%) and 2192 women (49.2%) were enrolled in the register. The mean age of patients was 68.3±12.03 years (69.3±3.42 years in men; 63.4±7.35 years in women). The criteria for myocardial infarction without obstructive coronary artery disease were present in 186 people (4.1%), including 72 men (38.7%) and 114 women (72.3%). The average age of the patients was 54.2±4.53 years; age of men with myocardial infarction without obstructive coronary disease was 56.3±3.52 years; age of women was 52.1±3.12 years. The article presents a detailed comparative analysis of demographic, medical history, clinical-instrumental, and laboratory data of these patient groups. Conclusion. Compared with patients who had obstructive coronary changes, the cohort of patients with myocardial infarction without obstructive lesions of the coronary arteries was younger and included more female patients; among the risk factors in this group, smoking and arterial hypertension were significant; the rates of newly diagnosed diabetes mellitus and Q-positive myocardial infarction were higher. According to the analysis of echocardiographic data, significant decrease in global contractility of the left ventricular myocardium was less common; analysis of laboratory data showed that patients more often had low platelet count.

scholarly journals 711 A rare case of takotsubo syndrome induced by pacemaker implantation

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Antonio Strangio ◽  
Isabella Leo ◽  
Jolanda Sabatino ◽  
Letizia Rosa Romano ◽  
Sabrina La Bella ◽  
...  
Keyword(s):  
Rare Case ◽  
Troponin T ◽  
Obstructive Coronary Artery Disease ◽  
Pacemaker Implantation ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Takotsubo Syndrome ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome

Abstract Aims Takotsubo syndrome (TTS) is an acute cardiac condition characterized by a temporary wall motion abnormality of the left ventricle that mimics an acute coronary syndrome (ACS). TTS usually occurs following emotionally or physically triggering event. We report a rare case of Takotsubo syndrome following a pacemaker implantation. Methods and results A 77-year-old woman was admitted to our hospital with a third-degree atrioventricular block. She was asymptomatic with a history of hypertension, diabetes, hyperlipidaemia and extrapyramidal syndrome. Laboratory tests reported High-Sensitive cardiac Troponin T (HS-cTnT) 32.9 ng/L (ULN &lt;14), creatine kinase muscle and brain (CK-MB) 4.1 ng/mL (ULN &lt; 4.94) and NT-proB-type Natriuretic Peptide (NT-proBNP) 1465 pg/ml (ULN &lt; 125). Echocardiography showed a normal left ventricular ejection fraction (EF = 58%) (Figure 2A). The patient underwent dual chamber pacemaker implantation without immediate complications. Three days later, a routine ECG showed new T wave inversions (Figure 1), in absence of symptoms. Echocardiography revealed apical akinesia, with ‘apical ballooning’ (EF 30%) (Figure 2B). Serum cardiac markers were increased (CK-MB 8.2 ng/ml, HS-cTnT 189.7 pg/ml, NT-proBNP 15 005 pg/ml. A coronary angiography excluded obstructive coronary artery disease (Figure 3). Given the impossibility of carrying out a cardiac RMI for the recent pacemaker implantation and after exclusion of other diagnoses, pacemaker implantation induced Takotsubo syndrome was suspected. Conclusions The trigger of this case of TTS was the pacemaker implantation, a relatively brief and painless procedure that, in her case could have constitute a considerable emotional and physical stress. To the best of our knowledge 13 cases of TTS after pacemaker implantation have been described to date. Of those cases, four had an asymptomatic course. Therefore, the real incidence of TTS following pacemaker implantation may be underestimated and ECG and echocardiography should always be performed after pacemaker implantation.

An Atypical Presentation of Acute Coronary Syndrome

2012 ◽  
Vol 8 (1) ◽  
pp. 67
Author(s):  
Syed Khurram Mushtaq Gardezi ◽  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Systolic Function ◽  
Artery Bypass ◽  
Left Ventricular Systolic Function ◽  
Regional Wall Motion ◽  
Dobutamine Stress ◽  
Left Ventricular ◽  
Ventricular Systolic Function ◽  
Coronary Syndrome

A 61-year-old man was admitted to hospital with severe occipital headache and weakness and numbness of the left arm. His electrocardiograms showed changes hinting at acute coronary syndrome (ACS). However, in view of his clinical presentation, he underwent tests for likely subarachnoid haemorrhage, but this was ruled out. The next day, he was referred to cardiology. A transthoracic echocardiogram showed reduced left ventricular systolic function along with regional wall motion abnormalities involving inferoposterior walls. The patient was treated as per the protocol for ACS. A dobutamine stress echocardiogram confirmed inferior myocardial infarction with evidence of myocardial viability in the affected left ventricular segments. Subsequent investigations confirmed three-vessel coronary artery disease and reduced left ventricular systolic function. The patient underwent successful coronary artery bypass grafting.

Sign in / Sign up

Export Citation Format

Share Document