Myocardial Aldosterone Receptor and Aquaporin 1 Up-Regulation Is Associated with Cardiomyocyte Remodeling in Human Heart Failure

Background: Abnormal aldosterone signaling is a recognized source of cardiovascular damage. Its influence on cardiomyocyte structure, function, and hormonal receptors when associated with heart failure is still unreported. Methods: Twenty-six consecutive patients with heart failure (LVEF < 40%) and normal coronaries and valves underwent left ventricular endomyocardial biopsy (EMB) for evaluation of myocardial substrate. Biopsy samples were processed for histology, electron microscopy, immunohistochemistry, and Western blot analysis of myocardial aldosterone receptor and aquaporin-1 correlated with plasma aldosterone (AD) and renin activity (PRA). Eight patients with virus-negative inflammatory cardiomyopathy (ICM) had a control EMB after 6 months of immunosuppressive therapy and recovery of cardiac function with re-evaluation of cardiomyocyte structure and receptor expression. Results: EMB in addition to the diagnosis of myocarditis (15 cases), dilated cardiomyopathy CM (6), alcohol CM (2), and diabetic CM (3) showed vacuolar degeneration and cloudy swelling of cardiomyocytes corresponding at electron microscopy to ions and water accumulation into cytosol, membrane-bound vesicles, nucleus, and other organelles, and was associated with an increased AD, PRA, and myocardial expression of aldosterone receptor (2.6 fold) and aquaporin 1 (2.7 fold). In the 8 patients recovered from ICM, cardiomyocyte diameter reduced with disappearance of intracellular vacuoles and normalization of cytosol, nucleus, and cell organelles’ electron-density, along with down-regulation of aldosterone receptor and aquaporin-1. Conclusion: Human heart failure is associated with overexpression of myocardial aldosterone receptor and aquaporin-1. These molecular changes are paralleled by intracellular water overloading and cardiomyocyte swelling and dysfunction. Cardiac recovery is accompanied by down-regulation of hormonal receptors and normalization of cell structure and composition.

Frequency of triple negative breast cancer in referrals patients to an oncology radiotherapy section

Introduction: Breast cancer is the most common cancer in women and the first cause of cancer death in women. This tumor often has hormonal receptors. The absence of these hormonal receptors leads to inability to treat the normal hormonal methods correctly. Objectives: In the present study, frequency of triple negative breast cancer in referrals patients to all patients with breast cancer involvement was investigated. Patients and Methods: This cross-sectional study was performed on patients with breast cancer. Accordingly, all patients with breast cancer involvement who referred to Firoozgar hospital from 2016 Until 2019 were evaluated sensually. The extracted parameters included the age, the status of the hormonal receptors in terms of positive or negative, and the degree of tumor based on the pathology in the case. Results: In this study, 1840 patients were diagnosed with malignancies, of which 266 (14.5%) were infected with a variety of breast malignancies negative triple breast was 48 patients (20.6%). Mean and standard deviation of patients with triple negative malignancy were 47.63 ± 13.34 years. We also observed the stage of breast cancer, the second most common stage (23 patients and 47.9%), and the first stage with the lowest incidence (4 patients and 8.3%) among patients. Conclusion: Considering the increased use of chemotherapy in treating this type of malignancy and the high cost of treatment in these patients, this malignancy should be considered in order to identify the disease early in order to plan for proper health and reduce the cost of the treatment.