Understanding of metals dysregulation in patients with systolic and diastolic dysfunction in ischemic heart disease

Abstract

ischemic heart disease (iHD) is the leading cause of death and chronic disability in the world. iHD affects both the systolic and diastolic function of the heart which progressively leads to heart failure; a structural and functional impairment of filling or ejection of blood from the heart. In this study, the progression of systolic and diastolic dysfunction characterized according to their echocardiographic parameters including left ventricular ejection fraction (EF), grades of diastolic dysfunction and ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/eʹ), were correlated with differential regulation of various metals in patients sera samples (n = 62) using inductive coupled plasma-mass spectrometry (ICP-MS). Chromium, nickel and selenium were found significant (p < 0.05) in patients having EF < 45% compared with EF > 45%. In patients with systolic dysfunction (EF < 45%), the level of selenium was decreased while the level of chromium and nickel was increased compared to patients with EF > 45%. Selenium level was also decreased significantly (p < 0.05) in grade 1A and 2 patients that are considered as higher grades of diastole dysfunction in comparison to grade 0-1. Overall, selenium deficiency was identified in both systolic and diastolic dysfunctions of IHD patients corresponding to the progression of disease that could be related to many metabolic and translational pathways specifically which involve selenoproteins. Cardiovascular diseases (CVDs) are the leading cause of death worldwide 1. An estimated 17.9 million people died from CVDs in 2015, representing 31% of all global deaths. Ischemic heart disease (IHD) account for the majority of the cases of health lost to CVDs. There are large number of prevalent cases of IHD making it the leading cause of chronic disability 1,2. The most common cause of IHD is atherosclerosis which is a chronic inflammatory process represented by highly specific cellular and molecular responses 3. IHD affects both the systolic and diastolic function of the heart which progressively leads to heart failure; a structural and functional impairment of filling or ejection of blood from the heart 4. Despite advances in the current treatment plans, heart failure remains one of the major health care issues of the world not only due to its increasing prevalence but also health care costs 5 .

Metallomics in pulmonary arterial hypertension patients

“… 32 In another human study of 62 patients, chromium levels were found significantly higher in patients with systolic ischemic heart disease. 33 The exact mechanisms of how chromium contribute to PAH disease progression is unknown. Possible explanations could be worse RV function from chromium exposure or hypotension effects from chromium exacerbates RV ischemia and causes further deterioration.…”

“…A recent meta‐analysis of 11 eligible randomized controlled trials with 637 participants indicated that supplementation with chromium significantly decrease blood pressures 32 . In another human study of 62 patients, chromium levels were found significantly higher in patients with systolic ischemic heart disease 33 . The exact mechanisms of how chromium contribute to PAH disease progression is unknown.…”

The role of chromium supplementation in cardiovascular risk factors: A comprehensive reviews of putative molecular mechanisms

“…A number of studies reported that the Chromium intakes at dose of 400 and 42 μg (in combination with 9 g brewer's yeast) during 12 and 4 weeks have been related to SBP reduction [ 35 , 36 ]. Moreover, in a study, individuals with systolic dysfunction have been shown with higher serum Chromium levels compared to those with normal systolic function [ 37 ]. A systematic reviews and meta-analyses also indicated that Chromium supplementation may have protective effects against myocardial infarction, reduce CVD-associated inflammatory biomarkers [ 13 ], and decrease DBP [ 34 ].…”

Blood Chromium Levels and Their Association with Cardiovascular Diseases, Diabetes, and Depression: National Health and Nutrition Examination Survey (NHANES) 2015–2016

“…Plasma chromium levels have also been reported to be negatively correlated with blood pressure and low-density lipoproteins [44]. However, another study reported that individuals with systolic dysfunction had increased serum chromium levels compared to those with normal systolic function [45]. A cross-sectional study reported that increasing circulating levels of chromium is associated with reduced lipid infiltration in the vascular wall (echogenicity of the intima-media complex) in the elderly [46].…”