Heart failure with preserved ejection fraction in patients with type 2 diabetes mellitus: pathophysiology and treatment options

Борисов, А. А.; Gvozdeva, Anna; Агеев, Ф Т

doi:10.21886/2219-8075-2021-12-2-6-15

Cited by 2 publications

(1 citation statement)

References 51 publications

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“…К факторам развития структурного ремоделирования миокарда и, как следствие, СНсФВ традиционно относят женский пол, пожилой возраст, наличие артериальной гипертензии, СД, ожирения или избыточной массы тела, ФП, ишемическую болезнь сердца [19]. Небольшой объем выборки, полиэтиологический характер развития СНсФВ и многообразие фенотипов данной патологии могут объяснять отсутствие корреляций с рядом исследованных ЭхоКГпараметров, считающихся маркерами ремоделирования миокарда.…”

Section: Conclusionalthoughtheserumconcentrationsofcilp-1andhif-1αdon...unclassified

Associations of cartilage intermediate layer protein 1 and hypoxia-inducible factor-1-alpha with transthoracic echocardiography results in patients with heart failure with preserved ejection fraction

Timofeev,

Fokina,

Metelskaya

et al. 2024

Russ J Cardiol

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Aim. To evaluate the relationship of serum concentrations of myocardial remodeling and cellular hypoxia biomarkers cartilage intermediate layer protein 1 (CILP-1) and hypoxia-inducible factor-1-alpha (HIF-1α) with paraclinical parameters in patients with heart failure with preserved ejection fraction (HFpEF) and in the control group.Material and methods. The study included 47 patients diagnosed with HFpEF, aged from 47 to 79 years, who were treated from May 2018 to December 2019 in the hospital of the National Medical Research Center for Therapy and Preventive Medicine. The control group consisted of 32 people without a diagnosis of HFpEF, matched by sex and age. All participants underwent transthoracic echocardiography with assessment of diastolic function. Serum concentrations of CILP-1 and HIF-1α were determined by enzyme immunoassay using standardized test systems (RayBio and Clone-Cloud, USA).Results. In patients with HFpEF, the median serum concentrations of CILP-1 (3,24 ng/ml) and HIF-1α (14,3 pg/ml) were not significantly different from the values obtained in the control group (3,6 ng/ml and 7,5 pg/ml, respectively). Significant correlations of CILP-1 with echocardiographic indicators of the left ventricular interstitial fibrosis severity were revealed, while echocardiographic markers of HFpEF positively correlated with the HIF-1α level.Conclusion. Although the serum concentrations of CILP-1 and HIF-1α do not differ depending on HFpEF presence, it demonstrates an association with a number of echocardiographic parameters both in subgroups of patients with HFpEF and in subgroups of controls with different body mass index.

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Section: Conclusionalthoughtheserumconcentrationsofcilp-1andhif-1αdon...unclassified

Associations of cartilage intermediate layer protein 1 and hypoxia-inducible factor-1-alpha with transthoracic echocardiography results in patients with heart failure with preserved ejection fraction

Timofeev,

Fokina,

Metelskaya

et al. 2024

Russ J Cardiol

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The role of endosarcomeric cytoskeleton proteins in the mechanisms of left ventricular diastolic dysfunction: focus on titin

Kalyuzhin,

Teplyakov,

Bespalova

et al. 2023

Bûll. sib. med.

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Recognizing the fact that isolated left ventricular (LV) diastolic dysfunction (DD) underlies approximately 50% of all heart failure cases requires a deep understanding of its principal mechanisms so that effective diagnostic and treatment strategies can be developed. Despite abundance of knowledge about the mechanisms underlying DD, many important questions regarding the pathophysiology of diastole remain unresolved. In particular, the role of endosarcomeric cytoskeleton pathology in the deterioration of the so-called active (relaxation of the LV myocardium and the atrioventricular pressure gradient at the beginning of diastole, closely related to it in a healthy heart) and passive (myocardial stiffness) characteristics of diastole needs to be clarified.The lecture briefly discusses the complex hierarchy of DD mechanisms (from the sarcomere to the whole heart) and covers the role of the giant protein titin in the latter, which is the main determinant of intracellular stiffness. Impairment of myocardial relaxation and deterioration of its wall compliance under a wide range of pathological conditions (pressure overload, ischemia, inflammation, cardiotoxic effects, oxidative stress, etc.) underlying DD can be explained by a shift in titin expression toward its more rigid N2B isoform, hypophosphorylation by protein kinases A and G or dephosphorylation by serine / threonine phosphatase 5 of its molecule in the extensible protein segment containing a unique N2B sequence, hyperphosphorylation of PEVK regions of titin by protein kinase C, as well as inhibition of the Ca2+-dependent titin – actin interaction.The results of deciphering these mechanisms can become a tool for developing new approaches to targeted therapy for diastolic heart failure that currently does not have effective treatment, on the one hand, and the key to understanding the therapeutic effects of drugs already used to treat chronic heart failure with preserved LV ejection fraction, on the other hand.

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Heart failure with preserved ejection fraction in patients with type 2 diabetes mellitus: pathophysiology and treatment options

Cited by 2 publications

References 51 publications

Associations of cartilage intermediate layer protein 1 and hypoxia-inducible factor-1-alpha with transthoracic echocardiography results in patients with heart failure with preserved ejection fraction

Associations of cartilage intermediate layer protein 1 and hypoxia-inducible factor-1-alpha with transthoracic echocardiography results in patients with heart failure with preserved ejection fraction

The role of endosarcomeric cytoskeleton proteins in the mechanisms of left ventricular diastolic dysfunction: focus on titin

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