Abstract:Objectives-Left ventricular (LV) septal hypertrophy in aortic stenosis raises diagnostic and therapeutic questions. However, the etiology and clinical consequences of this finding have not been well studied. The aim of this study was to perform a morphologic evaluation of the LV in aortic stenosis and to investigate the contributing factors and consequences of septal hypertrophy.Methods-Patients with moderate or severe aortic stenosis were prospectively enrolled. Patients with previous myocardial infarction, w… Show more
“…This phenotype, which shows a pattern more characteristic of cardiac dysfunction than of non-asymmetrical hypertrophy, resembles that in patients with hypertrophic cardiomyopathy ( Marian and Braunwald, 2017 ; Yousefzai et al, 2017 ), one of the leading causes of sudden death among young people ( Maron and Maron, 2013 ). Although it has been shown that hypertrophic cardiomyopathy may be inherited ( Katayama et al, 2018 ), it seems unlikely that the effects observed in our global KO model are early development related, since basal signs of cardiac hypertrophy do not develop spontaneously in young Metrnβ-null mice. However, we cannot completely rule out this possibility, because Metrnβ has been reported to have effects on neuronal growth and brain development during embryogenesis ( Jørgensen et al, 2012 ).…”
Meteorin-like/Meteorin-β (Metrnl/Metrnβ) is a secreted protein produced by skeletal muscle and adipose tissue that exerts metabolic actions that improve glucose metabolism. The role of Metrnβ in cardiac disease is completely unknown. Here, we show that Metrnβ-null mice exhibit asymmetrical cardiac hypertrophy, fibrosis, and enhanced signs of cardiac dysfunction in response to isoproterenol-induced cardiac hypertrophy and aging. Conversely, adeno-associated virus–mediated specific overexpression of Metrnβ in the heart prevents the development of cardiac remodeling. Furthermore, Metrnβ inhibits cardiac hypertrophy development in cardiomyocytes in vitro, indicating a direct effect on cardiac cells. Antibody-mediated blockage of Metrnβ in cardiomyocyte cell cultures indicated an autocrine action of Metrnβ on the heart, in addition to an endocrine action. Moreover, Metrnβ is highly produced in the heart, and analysis of circulating Metrnβ concentrations in a large cohort of patients reveals that it is a new biomarker of heart failure with an independent prognostic value.
“…This phenotype, which shows a pattern more characteristic of cardiac dysfunction than of non-asymmetrical hypertrophy, resembles that in patients with hypertrophic cardiomyopathy ( Marian and Braunwald, 2017 ; Yousefzai et al, 2017 ), one of the leading causes of sudden death among young people ( Maron and Maron, 2013 ). Although it has been shown that hypertrophic cardiomyopathy may be inherited ( Katayama et al, 2018 ), it seems unlikely that the effects observed in our global KO model are early development related, since basal signs of cardiac hypertrophy do not develop spontaneously in young Metrnβ-null mice. However, we cannot completely rule out this possibility, because Metrnβ has been reported to have effects on neuronal growth and brain development during embryogenesis ( Jørgensen et al, 2012 ).…”
Meteorin-like/Meteorin-β (Metrnl/Metrnβ) is a secreted protein produced by skeletal muscle and adipose tissue that exerts metabolic actions that improve glucose metabolism. The role of Metrnβ in cardiac disease is completely unknown. Here, we show that Metrnβ-null mice exhibit asymmetrical cardiac hypertrophy, fibrosis, and enhanced signs of cardiac dysfunction in response to isoproterenol-induced cardiac hypertrophy and aging. Conversely, adeno-associated virus–mediated specific overexpression of Metrnβ in the heart prevents the development of cardiac remodeling. Furthermore, Metrnβ inhibits cardiac hypertrophy development in cardiomyocytes in vitro, indicating a direct effect on cardiac cells. Antibody-mediated blockage of Metrnβ in cardiomyocyte cell cultures indicated an autocrine action of Metrnβ on the heart, in addition to an endocrine action. Moreover, Metrnβ is highly produced in the heart, and analysis of circulating Metrnβ concentrations in a large cohort of patients reveals that it is a new biomarker of heart failure with an independent prognostic value.
“…We retrieved a total of 7 247 902 drug-event pairs between January cardiomyopathy. 26,27 Myocardial fibrosis is a significant risk factor for hypertrophic cardiomyopathy, and is associated with a myriad of severe adverse cardiovascular outcomes including sudden cardiac death, ventricular tachyarrhythmias, left ventricular dysfunction, and heart failure. 28…”
Section: Resultsmentioning
confidence: 99%
“…However, our novel findings include the identification of cardiac septal hypertrophy and myocardial fibrosis associated with hydroxychloroquine therapy, and these signals require further confirmation. Cardiac septal hypertrophy in older adults is associated with disturbance in intraventricular conduction and is an independent predictor of progression to atrial fibrillation in patients with hypertrophic cardiomyopathy 26,27 . Myocardial fibrosis is a significant risk factor for hypertrophic cardiomyopathy, and is associated with a myriad of severe adverse cardiovascular outcomes including sudden cardiac death, ventricular tachyarrhythmias, left ventricular dysfunction, and heart failure 28 …”
Purpose: The purpose of this study is to analyze the US FDA Adverse Event Reporting System (FAERS) to identify adverse cardiac events of hydroxychloroquine in older adults. Method: A case/non-case method was used to determine adverse events associated with hydroxychloroquine as the primary suspect drug between January 1, 2004, and December 31, 2019, for older adults (≥65 years). Adverse events are preferred terms (PTs) defined in MedDRA. We used frequentist approaches, including the reporting odds ratio (ROR) and the proportional reporting ratio (PRR) to measure disproportionality. We used Bayesian approaches to derive information component (IC) value and Empirical Bayesian Geometric Mean (EBGM) score. Signals were defined as the number of reports > 3 and the lower limit of 95% confidence intervals (CI) of ROR ≥ 2, PRR ≥ 2, IC > 0, EBGM > 1. Results: We identified 334 adverse cardiac events comprising 71 different MedDRA PTs from 2004 to 2019 for hydroxychloroquine in older adults. Strong disproportionality signals were noted for "Restrictive cardiomyopathy" (ROR = 272.43
“…Несмотря на значимые достижения активного полувекового изучения этой загадочной патологии сердца, многочисленные современные научные исследования продолжают предпринимать попытки эволюционировать представление о ГКМП с целью определения парадигм диагностики и лечения. Подобная актуальность связана с тем, что на фоне постепенно нарастающей одышки, основным проявлением ГКМП является внезапная сердечная смерть (ВСС) [1]. Гипертрофическая кардиомиопатия, как причина ВСС у молодых людей, является наиболее часто встречающейся, а у действующих спортсменов занимает первое место среди прочих сердечно-сосудистых патологий, достигая 36% [2, 3,4].…”
Section: гипертрофическая кардиомиопатия -современное состояние много...unclassified
Сложнейшая проблема современной кардиохирургии – гипертрофическая кардиомиопатия. На основании анализа крупных, преимущественно англоязычных, исследований по изучению гипертрофической кардиомиопатии, представлены данные по эпидемиологии, рассмотрены достижения генетики и морфологии, освещены современные возможности диагностики и лечения этого заболевания. Разобраны спорные механизмы развития обструкции выходного тракта левого желудочка. Подчеркнуты недостатки диагностических критериев и лечебных подходов, влияющих на прогноз естественного течения заболевания, исходы медикаментозного и инвазивных методов лечения. Озвучены значимые проблемы и вопросы, решение которых позволит пересмотреть существующие абстрактные парадигмы диагностики и лечения для достижения наилучших клинических результатов.
Бұл шолу мақала заманауи кардиохирургияның ең күрделі мәселесі – гипертрофиялық кардиомиопатияға арналған. Бұл мақалада жан-жақты ауқымды, негізінен ағылшын тілінде жүргізілген кешенді талдау негізінде гипертрофиялық кардиомиопатияны зерттеу бойынша талдаулар, эпидемиологиялық деректер, генетика және морфологияның жетістіктері, сондай-ақ осы ауруды диагностикалау мен емдеудің заманауи мүмкіндіктері көрсетілген. Сол қарынша шығу жолы тарылуының дамуындағы даулы механизмдер талданады. Аурудың табиғи ағымының болжамына әсер ететін диагностикалық критерийлер мен терапиялық тәсілдердің кемшіліктері, емдеудің медикаментозды және инвазивті әдістерінің нәтижелері атап өтіледі. Ең жақсы клиникалық нәтижелерге қол жеткізу үшін қолданыстағы диагностика мен емдеудің абстрактілі парадигмаларын қайта қарауға мүмкіндік беретін өзекті мәселелер мен сұрақтар айтылады
Hypertrophic cardiomyopathy isa sophisticated problem of modern cardiac surgery.. This review based on a comprehensive analysis of large, predominantly English-language, studies ofhypertrophic cardiomyopathy. The review also presents epidemiologic data , considers the achievements of genetics and morphology, and highlights modern possibilities for diagnosing and treating the disease. Controversial mechanisms of left ventricular outflow tract obstruction are considered. The shortcomings of diagnostic criteria and therapeutic approaches influencing the prognosis of the natural course of the disease, outcomes of medical and invasive treatment methods are highlighted. Mentioned significant problems and questions solution of which will make it possible to revise the existing abstract paradigms of diagnosis and treatment in order to achieve the best clinical results.
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