Abstract:Background:Pressure overload-induced myocardial hypertrophy is a key step leading to heart failure. Previous cellular and animal studies demonstrated that deteriorated excitation–contraction coupling occurs as early as the compensated stage of hypertrophy before the global decrease in left ventricular ejection fraction (LVEF). This study was to evaluate the cardiac electromechanical coupling time in evaluating cardiac systolic function in the early stage of heart failure.Methods:Twenty-six patients with Stage … Show more
“…HR is related to the electrical and mechanical activities of the heart ( 18 ). We determined all the data of electromechanical coupling time courses with HR correction, referenced as the formula in a previous study: electromechanical coupling time courses with HR correction = electromechanical coupling time courses without HR correction/HR × 60 ( 12 , 18 ).…”
Section: Methodsmentioning
confidence: 99%
“…Cardiac excitation-contraction coupling is a process that links cardiomyocyte action potential to cardiomyocyte contractile ( 11 ). The process is difficult to test experimentally; nevertheless, cardiac electromechanical coupling efficiency, presented as electromechanical coupling time, previously evaluated by combining tissue Doppler imaging (TDI) echo and electrocardiogram (ECG) measurement has been proven ( 12 ). In a preliminary study, electromechanical coupling time was proposed as a potential index for evaluating cardiac systolic function in patients with stage B HF, which is a precursor of HF ( 12 , 13 ).…”
Section: Introductionmentioning
confidence: 99%
“…The process is difficult to test experimentally; nevertheless, cardiac electromechanical coupling efficiency, presented as electromechanical coupling time, previously evaluated by combining tissue Doppler imaging (TDI) echo and electrocardiogram (ECG) measurement has been proven ( 12 ). In a preliminary study, electromechanical coupling time was proposed as a potential index for evaluating cardiac systolic function in patients with stage B HF, which is a precursor of HF ( 12 , 13 ). Few studies have explored electromechanical coupling time and outcomes in HCM, and we hypothesised that electromechanical coupling time was delayed in HCM with HF and would predict HF in patients with HCM.…”
ObjectiveThis study aimed to establish a model embraced electromechanical coupling time (EMC-T) and assess the value of the model for the prediction of heart failure (HF) in patients with hypertrophic cardiomyopathy (HCM).Materials and MethodsData on 82 patients with HCM at Shaanxi Provincial People’s Hospital between February 2019 and November 2021 were collected and then formed the training dataset (n = 82). Data were used to screen predictors of HF using univariate and multivariate analyses. Predictors were implemented to discover the optimal cut-off value, were incorporated into a model, and shown as a nomogram. The cumulative HF curve was calculated using the Kaplan–Meier method. Additionally, patients with HCM at other hospitals collected from March 2019 to March 2021 formed the validation dataset. The model’s performance was confirmed both in training and validation sets.ResultsDuring a median of 22.91 months, 19 (13.38%) patients experienced HF. Cox analysis showed that EMC-T courses in the lateral wall, myoglobin, PR interval, and left atrial volume index were independent predictors of HF in patients with HCM. Five factors were incorporated into the model and shown as a nomogram. Stratification of patients into two risk subgroups by applying risk score (<230.65, ≥230.65) allowed significant distinction between Kaplan–Meier curves for cumulative incidence of HF events. In training dataset, the model had an AUC of 0.948 (95% CI: 0.885–1.000, p < 0.001) and achieved a good C-index of 0.918 (95% CI: 0.867–0.969). In validation dataset, the model had an AUC of 0.991 (95% CI: 0.848–1.000, p < 0.001) and achieved a strong C-index of 0.941 (95% CI: 0.923–1.000). Calibration plots showed high agreement between predicted and observed outcomes in both two datasets.ConclusionWe established and validated a novel model incorporating electromechanical coupling time courses for predicting HF in patients with HCM.
“…HR is related to the electrical and mechanical activities of the heart ( 18 ). We determined all the data of electromechanical coupling time courses with HR correction, referenced as the formula in a previous study: electromechanical coupling time courses with HR correction = electromechanical coupling time courses without HR correction/HR × 60 ( 12 , 18 ).…”
Section: Methodsmentioning
confidence: 99%
“…Cardiac excitation-contraction coupling is a process that links cardiomyocyte action potential to cardiomyocyte contractile ( 11 ). The process is difficult to test experimentally; nevertheless, cardiac electromechanical coupling efficiency, presented as electromechanical coupling time, previously evaluated by combining tissue Doppler imaging (TDI) echo and electrocardiogram (ECG) measurement has been proven ( 12 ). In a preliminary study, electromechanical coupling time was proposed as a potential index for evaluating cardiac systolic function in patients with stage B HF, which is a precursor of HF ( 12 , 13 ).…”
Section: Introductionmentioning
confidence: 99%
“…The process is difficult to test experimentally; nevertheless, cardiac electromechanical coupling efficiency, presented as electromechanical coupling time, previously evaluated by combining tissue Doppler imaging (TDI) echo and electrocardiogram (ECG) measurement has been proven ( 12 ). In a preliminary study, electromechanical coupling time was proposed as a potential index for evaluating cardiac systolic function in patients with stage B HF, which is a precursor of HF ( 12 , 13 ). Few studies have explored electromechanical coupling time and outcomes in HCM, and we hypothesised that electromechanical coupling time was delayed in HCM with HF and would predict HF in patients with HCM.…”
ObjectiveThis study aimed to establish a model embraced electromechanical coupling time (EMC-T) and assess the value of the model for the prediction of heart failure (HF) in patients with hypertrophic cardiomyopathy (HCM).Materials and MethodsData on 82 patients with HCM at Shaanxi Provincial People’s Hospital between February 2019 and November 2021 were collected and then formed the training dataset (n = 82). Data were used to screen predictors of HF using univariate and multivariate analyses. Predictors were implemented to discover the optimal cut-off value, were incorporated into a model, and shown as a nomogram. The cumulative HF curve was calculated using the Kaplan–Meier method. Additionally, patients with HCM at other hospitals collected from March 2019 to March 2021 formed the validation dataset. The model’s performance was confirmed both in training and validation sets.ResultsDuring a median of 22.91 months, 19 (13.38%) patients experienced HF. Cox analysis showed that EMC-T courses in the lateral wall, myoglobin, PR interval, and left atrial volume index were independent predictors of HF in patients with HCM. Five factors were incorporated into the model and shown as a nomogram. Stratification of patients into two risk subgroups by applying risk score (<230.65, ≥230.65) allowed significant distinction between Kaplan–Meier curves for cumulative incidence of HF events. In training dataset, the model had an AUC of 0.948 (95% CI: 0.885–1.000, p < 0.001) and achieved a good C-index of 0.918 (95% CI: 0.867–0.969). In validation dataset, the model had an AUC of 0.991 (95% CI: 0.848–1.000, p < 0.001) and achieved a strong C-index of 0.941 (95% CI: 0.923–1.000). Calibration plots showed high agreement between predicted and observed outcomes in both two datasets.ConclusionWe established and validated a novel model incorporating electromechanical coupling time courses for predicting HF in patients with HCM.
“…ECG was performed using a Vevo 2,100 system (FUJIFILM VisualSonics, Canada), and the cardiac dimensions and functional parameters were measured. The tissue Doppler imaging (TDI) echo combined with ECG was used to measure the electromechanical coupling time at the lateral wall of the left ventricle as described previously (19).…”
Section: Ecg and Electromechanical Coupling Time Measurementmentioning
Cyclophosphamide (CYP)-induced cardiotoxicity is a common side effect of cancer treatment. Although it has received significant attention, the related mechanisms of CYP-induced cardiotoxicity remain largely unknown. In this study, we used cell and animal models to investigate the effect of CYP on cardiomyocytes. Our data demonstrated that CYP-induced a prolonged cardiac QT interval and electromechanical coupling time courses accompanied by JPH2 downregulation. Moreover, N6-methyladenosine (m6A) methylation sequencing and RNA sequencing suggested that CYP induced cardiotoxicity by dysregulating calcium signaling. Importantly, our results demonstrated that CYP induced an increase in the m6A level of JPH2 mRNA by upregulating methyltransferases METTL3, leading to the reduction of JPH2 expression levels, as well as increased field potential duration and action potential duration in cardiomyocytes. Our results revealed a novel mechanism for m6A methylation-dependent regulation of JPH2, which provides new strategies for the treatment and prevention of CYP-induced cardiotoxicity.
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