Cholesterol induced heart valve inflammation and injury: efficacy of cholesterol lowering treatment

El-khatib, Layan; Feijter-Rupp, Heather De; Janoudi, Abed; Fry, Levi; Kehdi, Michael; Abela, George S.

doi:10.1136/openhrt-2020-001274

Cited by 12 publications

(4 citation statements)

References 32 publications

(39 reference statements)

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“…Interestingly, inflammation-related biological processes were also enhanced by a cholesterol-enriched diet in the mitral valve, as well as the processes involved in lipid biosynthesis and metabolism. This is consistent with the recent observations of increased infiltration of inflammatory cells and lipids on the histological sections of the mitral valve and their association with serum cholesterol levels ( 32 ). In contrast to a cholesterol-rich diet, a lard-enriched diet did not promote inflammatory processes in the aorta, but rather the processes involved in ECM organization, osteoblast differentiation, and ossification.…”

Section: Discussionsupporting

confidence: 93%

Differential Biological Effects of Dietary Lipids and Irradiation on the Aorta, Aortic Valve, and the Mitral Valve

Donis

Jiang

D'Emal

et al. 2022

Front. Cardiovasc. Med.

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AimsDietary cholesterol and palmitic acid are risk factors for cardiovascular diseases (CVDs) affecting the arteries and the heart valves. The ionizing radiation that is frequently used as an anticancer treatment promotes CVD. The specific pathophysiology of these distinct disease manifestations is poorly understood. We, therefore, studied the biological effects of these dietary lipids and their cardiac irradiation on the arteries and the heart valves in the rabbit models of CVD.Methods and ResultsCholesterol-enriched diet led to the thickening of the aortic wall and the aortic valve leaflets, immune cell infiltration in the aorta, mitral and aortic valves, as well as aortic valve calcification. Numerous cells expressing α-smooth muscle actin were detected in both the mitral and aortic valves. Lard-enriched diet induced massive aorta and aortic valve calcification, with no detectable immune cell infiltration. The addition of cardiac irradiation to the cholesterol diet yielded more calcification and more immune cell infiltrates in the atheroma and the aortic valve than cholesterol alone. RNA sequencing (RNAseq) analyses of aorta and heart valves revealed that a cholesterol-enriched diet mainly triggered inflammation-related biological processes in the aorta, aortic and mitral valves, which was further enhanced by cardiac irradiation. Lard-enriched diet rather affected calcification- and muscle-related processes in the aorta and aortic valve, respectively. Neutrophil count and systemic levels of platelet factor 4 and ent-8-iso-15(S)-PGF2α were identified as early biomarkers of cholesterol-induced tissue alterations, while cardiac irradiation resulted in elevated levels of circulating nucleosomes.ConclusionDietary cholesterol, palmitic acid, and cardiac irradiation combined with a cholesterol-rich diet led to the development of distinct vascular and valvular lesions and changes in the circulating biomarkers. Hence, our study highlights unprecedented specificities related to common risk factors that underlie CVD.

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Section: Discussionsupporting

confidence: 93%

Differential Biological Effects of Dietary Lipids and Irradiation on the Aorta, Aortic Valve, and the Mitral Valve

Donis

Jiang

D'Emal

et al. 2022

Front. Cardiovasc. Med.

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“…CCs on bacterial adherence and growth with a strong affiliation of both Gram positive and negative bacteria to CCs. Furthermore, we have recently demonstrated the presence of extensive CCs on heart valves from both human sclerotic valves and valves from an atherosclerotic rabbit model [9,10]. Given the current study it becomes plausible that CCs can act as a nidus for bacteria to localize on the surfaces of abnormal valves.…”

Section: Plos Onementioning

confidence: 68%

“…This can cause volume expansion within the lipid core leading to perforation of the fibrous cap and destabilization of the atherosclerotic plaque [7,8]. A similar finding of CCs perforating the valve surface was observed in human sclerotic valves and in atherosclerotic rabbit valves [9,10]. In human coronary arteries during myocardial infarction scavenger cells, primarily macrophages were present engulfing, degrading, and binding to CCs [11].…”

Section: Introductionmentioning

confidence: 65%

Interaction between bacteria and cholesterol crystals: Implications for endocarditis and atherosclerosis

et al. 2022

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Background The interaction between pathogenic bacteria and cholesterol crystals (CCs) has not been investigated. However, CCs are found extensively in atherosclerotic plaques and sclerotic cardiac valves. Interactions between pathogenic bacteria and CCs could provide insights into destabilization of atherosclerotic plaques and bacterial adhesion to cardiac valves. Methods Staphylococcus aureus and Pseudomonas aeruginosa were used to assess in vitro bacterial adhesion to CCs and proliferation in the presence of CCs compared to plastic microspheres and glass shards as controls. Ex vivo studies evaluated bacterial adhesion to atherosclerotic rabbit arteries compared to normal arteries and human atherosclerotic carotid plaques compared to normal carotid arteries. Scanning electron microscopy (SEM) was used to visualize bacterial adhesion to CCs and confocal microscopy was used to detect cholesterol binding to bacteria grown in the presence or absence of CCs. Results In vitro, S. aureus and P. aeruginosa displayed significantly greater adhesion, 36% (p<0.0001) and 89% (p<0.0001), respectively, and growth upon exposure to CCs compared to microspheres or glass shards. Rabbit and human atherosclerotic arteries contained significantly greater bacterial burdens compared to controls (4× (p<0.0004); 3× (p<0.019), respectively. SEM demonstrated that bacteria adhered and appeared to degrade CCs. Consistent with this, confocal microscopy indicated increased cholesterol bound to the bacterial cells. Conclusions This study is the first to demonstrate an interaction between bacteria and CCs showing that bacteria dissolve and bind to CCs. This interaction helps to elucidate adhesion of bacteria to sclerotic valves and atherosclerotic plaques that may contribute to endocarditis and plaque destabilization.

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“…Continuous nursing can effectively improve the psychological state of patients. Continuing care took patients who had been controlled and needed reasonable rehabilitation nursing as the research object and provided out-of-hospital nursing guidance for patients [ 27 ]. It can effectively alleviate the adverse emotions of patients and effectively improve the postoperative quality of life of patients.…”

Section: Discussionmentioning

confidence: 99%

Effect of Different Nursing Interventions on Discharged Patients with Cardiac Valve Replacement Evaluated by Deep Learning Algorithm-Based MRI Information

Zhang

Zhou

2022

Contrast Media & Molecular Imaging

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This study was aimed to explore the application of cardiac magnetic resonance imaging (MRI) image segmentation model based on U-Net in the diagnosis of a valvular heart disease. The effect of continuous nursing on the survival of discharged patients with cardiac valve replacement was analyzed in this study. In this study, the filling completion operation, cross entropy loss function, and guidance unit were introduced and optimized based on the U-Net network. The heart MRI image segmentation model ML-Net was established. We compared the Dice, Hausdorff distance (HD), and percentage of area difference (PAD) values between ML-Net and other algorithms. The MRI image features of 82 patients with valvular heart disease who underwent cardiac valve replacement were analyzed. According to different nursing methods, they were randomly divided into the control group (routine nursing) and the intervention group (continuous nursing), with 41 cases in each group. The Glasgow Outcome Scale (GOS) score and the Self-rating Anxiety Scale (SAS) were compared between the two groups to assess the degree of anxiety of patients and the survival status at 6 months, 1 year, 2 years, and 3 years after discharge. The results showed that the Dice coefficient, HD, and PAD of the ML-Net algorithm were (0.896 ± 0.071), (5.66 ± 0.45) mm, and (15.34 ± 1.22) %, respectively. The Dice, HD, and PAD values of the ML-Net algorithm were all statistically different from those of the convolutional neural networks (CNN), fully convolutional networks (FCN), SegNet, and U-Net algorithms P < 0.05 . Atrial, ventricular, and aortic abnormalities can be seen in MRI images of patients with valvular heart disease. The cardiac blood flow signal will also be abnormal. The GOS score of the intervention group was significantly higher than that of the control group P < 0.01 . The SAS score was lower than that of the control group P < 0.05 . The survival rates of patients with valvular heart disease at 6 months, 1 year, 2 years, and 3 years after discharge were significantly higher than those in the control group P < 0.05 . The abovementioned results showed that an effective segmentation model for cardiac MRI images was established in this study. Continuous nursing played an important role in the postoperative recovery of discharged patients after cardiac valve replacement. This study provided a reference value for the diagnosis and prognosis of valvular heart disease.

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Cholesterol induced heart valve inflammation and injury: efficacy of cholesterol lowering treatment

Cited by 12 publications

References 32 publications

Differential Biological Effects of Dietary Lipids and Irradiation on the Aorta, Aortic Valve, and the Mitral Valve

Differential Biological Effects of Dietary Lipids and Irradiation on the Aorta, Aortic Valve, and the Mitral Valve

Interaction between bacteria and cholesterol crystals: Implications for endocarditis and atherosclerosis

Effect of Different Nursing Interventions on Discharged Patients with Cardiac Valve Replacement Evaluated by Deep Learning Algorithm-Based MRI Information

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