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Current Problems in Cardiology Dec 2023Myocardial regeneration has been a topic of interest in literature and research in recent years. An evolving approach reported is glucocorticoid (GC) receptor antagonism... (Review)
Review
Myocardial regeneration has been a topic of interest in literature and research in recent years. An evolving approach reported is glucocorticoid (GC) receptor antagonism and its role in the regeneration of cardiomyocytes. The authors of this study aim to explore the reported literature on GC receptor antagonism and its effects on cardiomyocyte remodeling, hypertrophy, scar formation, and ongoing cardiomyocyte death following cardiac injury. This article overviews cellular biology, mechanisms of action, clinical implications, challenges, and future considerations. The authors of this study conducted a systematic review utilizing the Cochrane methodology and PRISMA guidelines. This study includes data collected and interpreted from 30 peer-reviewed articles from 3 databases with the topic of interest. The mammalian heart has regenerative potential during its embryonic and fetal phases which is lost during its developmental processes. The microenvironment, intrinsic molecular mechanisms, and systemic and external factors impact cardiac regeneration. GCs influence these aspects in some cases. Consequently, GC receptor antagonism is emerging as a promising potential target for stimulating endogenous cardiomyocyte proliferation, aiding in cardiomyocyte regeneration following a cardiac injury such as a myocardial infarction (MI). Experimental studies on neonatal mice and zebrafish have shown promising results with GC receptor ablation (or brief pharmacological antagonism) promoting the survival of myocardial cells, re-entry into the cell cycle, and cellular division, resulting in cardiac muscle regeneration and diminished scar formation. Transient GC receptor antagonism has the potential to stimulate cardiomyocyte regeneration and help prevent the dreaded complications of MI. More trials based on human populations are encouraged to justify their applications and weigh the risk-benefit ratio.
Topics: Animals; Mice; Humans; Myocytes, Cardiac; Receptors, Glucocorticoid; Zebrafish; Cicatrix; Regeneration; Myocardial Infarction; Mammals
PubMed: 37481215
DOI: 10.1016/j.cpcardiol.2023.101986 -
British Journal of Sports Medicine Oct 2014Non-compaction cardiomyopathy (NCCM) is typified by deep invaginations of the myocardium and is caused by an arrest of normal myocardial morphogenesis. NCCM was once... (Review)
Review
Non-compaction cardiomyopathy (NCCM) is typified by deep invaginations of the myocardium and is caused by an arrest of normal myocardial morphogenesis. NCCM was once considered rare, but is now widely recognised owing to frequent use of advanced imaging techniques. NCCM can also be detected when competitive athletes undergo preparticipation screening for cardiac disease or when being evaluated for cardiac symptoms. It is not clear how athletes with NCCM should be managed. We searched PubMed and Google for articles addressing the issue of NCCM and athletic participation. We were able to identify only 18 cases of NCCM described in the context of sports, athletics or exercise. We conclude that there are insufficient data to develop firm recommendations on how to manage vigorous activity in patients with NCCM and future registries of sudden death in athletes should include a careful search for cases of NCCM among the victims so that clinicians can develop more definitive recommendations for athletes with this condition.
Topics: Arrhythmias, Cardiac; Death, Sudden, Cardiac; Echocardiography; Humans; Isolated Noncompaction of the Ventricular Myocardium; Magnetic Resonance Angiography; Sports; Syncope; Thromboembolism
PubMed: 23511696
DOI: 10.1136/bjsports-2012-091855 -
Cardiovascular Pathology : the Official... 2016The most significant cardiovascular anatomoclinical observations from Morgagni's masterpiece De sedibus et causis morborum per anatomen indagatis (1761) are herein... (Review)
Review
The most significant cardiovascular anatomoclinical observations from Morgagni's masterpiece De sedibus et causis morborum per anatomen indagatis (1761) are herein reported, divided into the current taxonomy according to cardiac structure: (a) aorta and pulmonary artery, (b) pericardium, (c) coronary arteries, (d) myocardium, (e) endocardium, (f) congenital heart defects, and (g) heart rhythm disorders. Morgagni's interpretations in cardiovascular pathology were strictly related with the most advanced theories of his time, such as those of blood circulation and iatromechanics; nevertheless, he remained close to the empirical description of clinical and pathological anatomy phenomena with their individual specificity. Through a systematic review of the literature, he compared the data from his own observations and experiments with those from physicians he considered reliable by applying the method of literature review which is still valid nowadays.
Topics: Cardiology; Cardiovascular System; History, 15th Century; History, 16th Century; History, 17th Century; History, 18th Century; History, Medieval; Humans; Medical Illustration; Pathology
PubMed: 27611360
DOI: 10.1016/j.carpath.2016.07.004 -
Critical Reviews in Oncology/hematology Jul 2015Erdheim-Chester disease (ECD) is a rare form of non-Langerhans-cell histiocytosis, associated in more than 50% of cases to BRAF(V600E) mutations in early multipotent... (Review)
Review
Erdheim-Chester disease (ECD) is a rare form of non-Langerhans-cell histiocytosis, associated in more than 50% of cases to BRAF(V600E) mutations in early multipotent myelomonocytic precursors or in tissue-resident histiocytes. It encompasses a spectrum of disorders ranging from asymptomatic bone lesions to multisystemic, life-threatening variants. We reviewed all published reports of histologically-confirmed ECD and explored clinical, radiological, prognostic and therapeutic characteristics in a population of 448 patients, including a unique patient from our Department. To find a clinically relevant signature defining differentiated prognostic profiles, the patients' disease features were compared in relation to their CNS involvement that occurred in 56% of the entire population. Diabetes insipidus, visual disturbances, pyramidal and extra-pyramidal syndromes were the most recurrent neurological signs, whereas concomitant pituitary involvement, retro-orbital masses and axial lesions in the presence of symmetric bilateral osteosclerosis of long bones depicted the typical ECD clinical picture. Patients with CNS infiltration showed a lower occurrence of heart involvement and a higher incidence of bone, skin, retro-peritoneal, lung, aortic and renal infiltration. No difference in the therapeutic algorithm was found after stratification for CNS involvement. A better understanding of the disease pathogenesis, including BRAF deregulation, in keeping with improved prognostic criteria, will provide novel suggestions for the management of ECD.
Topics: Adrenal Cortex Hormones; Adult; Bone and Bones; Central Nervous System; Erdheim-Chester Disease; Humans; Kidney; Male; Myocardium; Point Mutation; Prognosis; Proto-Oncogene Proteins B-raf
PubMed: 25744785
DOI: 10.1016/j.critrevonc.2015.02.004 -
BMC Pharmacology & Toxicology Sep 2014Cardiotoxicity is a serious side effect to treatment with 5-fluorouracil (5-FU), but the underlying mechanisms are not fully understood. The objective of this systematic... (Review)
Review
BACKGROUND
Cardiotoxicity is a serious side effect to treatment with 5-fluorouracil (5-FU), but the underlying mechanisms are not fully understood. The objective of this systematic review was to evaluate the pathophysiology of 5-FU- induced cardiotoxicity.
METHODS
We systematically searched PubMed for articles in English using the search terms: 5-FU OR 5-fluorouracil OR capecitabine AND cardiotoxicity. Papers evaluating the pathophysiology of this cardiotoxicity were included.
RESULTS
We identified 27 articles of 26 studies concerning the pathophysiology of 5-FU-induced cardiotoxicity. The studies demonstrated 5-FU-induced: hemorrhagic infarction, interstitial fibrosis and inflammatory reaction in the myocardium; damage of the arterial endothelium followed by platelet aggregation; increased myocardial energy metabolism and depletion of high energy phosphate compounds; increased superoxide anion levels and a reduced antioxidant capacity; vasoconstriction of arteries; changes in red blood cell (RBC) structure, function and metabolism; alterations in plasma levels of substances involved in coagulation and fibrinolysis and increased endothelin-1 levels and N-terminal-pro brain natriuretic peptide levels. Based on these findings the proposed mechanisms are: endothelial injury followed by thrombosis, increased metabolism leading to energy depletion and ischemia, oxidative stress causing cellular damage, coronary artery spasm leading to myocardial ischemia and diminished ability of RBCs to transfer oxygen resulting in myocardial ischemia.
CONCLUSIONS
There is no evidence for a single mechanism responsible for 5-FU-induced cardiotoxicity, and the underlying mechanisms might be multifactorial. Further research is needed to elucidate the pathogenesis of this side effect.
Topics: Animals; Antimetabolites, Antineoplastic; Fluorouracil; Heart; Humans
PubMed: 25186061
DOI: 10.1186/2050-6511-15-47 -
Frontiers in Pharmacology 2023Myocardial ischemia-reperfusion (I/R) injury is a complex clinical problem that often leads to further myocardial injury. Curcumin is the main component of turmeric,...
Myocardial ischemia-reperfusion (I/R) injury is a complex clinical problem that often leads to further myocardial injury. Curcumin is the main component of turmeric, which has been proved to have many cardioprotective effects. However, the cardioprotective potential of curcumin remains unclear. The present systematic review and meta-analysis aimed to evaluate the clinical and preclinical (animal model) evidence regarding the effect of curcumin on myocardial I/R injury. Eight databases and three register systems were searched from inception to 1 November 2022. Data extraction, study quality assessment, data analyses were carried out strictly. Then a fixed or random-effects model was applied to analyze the outcomes. SYRCLE's-RoB tool and RoB-2 tool was used to assess the methodological quality of the included studies. RevMan 5.4 software and stata 15.1 software were used for statistical analysis. 24 animal studies, with a total of 503 animals, and four human studies, with a total of 435 patients, were included in this study. The meta-analysis of animal studies demonstrated that compared with the control group, curcumin significantly reduced myocardial infarction size ( < 0.00001), and improved the cardiac function indexes (LVEF, LVFS, LVEDd, and LVESd) ( < 0.01). In addition, the indexes of myocardial injury markers, myocardial oxidation, myocardial apoptosis, inflammation, and other mechanism indicators also showed the beneficial effect of curcumin ( < 0.05). In terms of clinical studies, curcumin reduced the incidence of cardiac dysfunction, myocardial infarction in the hospital and MACE in the short term, which might be related to its anti-inflammatory and anti-oxidative property. Dose-response meta-analysis predicted, 200 mg/kg/d bodyweight was the optimal dose of curcumin in the range of 10-200 mg/kg/d, which was safe and non-toxic according to the existing publications. Our study is the first meta-analysis that includes both preclinical and clinical researches. We suggested that curcumin might play a cardioprotective role in acute myocardial infarction in animal studies, mainly through anti-oxidative, anti-inflammatory, anti-apoptosis, and anti-fibrosis effects. In addition, from the clinical studies, we found that curcumin might need a longer course of treatment and a larger dose to protect the myocardium, and its efficacy is mainly reflected on reducing the incidence of myocardial infarction and MACE. Our finding provides some meaningful advice for the further research.
PubMed: 36969839
DOI: 10.3389/fphar.2023.1111459 -
Magnetic Resonance Imaging Jun 2021Elevated myocardial T-mapping and extracellular volume (ECV) measured on cardiac MR (CMR) imaging is associated with myocardial abnormalities such as oedema or fibrosis.... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Elevated myocardial T-mapping and extracellular volume (ECV) measured on cardiac MR (CMR) imaging is associated with myocardial abnormalities such as oedema or fibrosis. This meta-analysis aims to provide a summary of T-mapping and ECV values in pulmonary arterial hypertension (PAH) and compare their values with controls.
METHODS
We searched CENTRAL, MEDLINE, Embase, and Web of Science in August 2020. We included CMR studies reporting T-mapping or ECV values in adults with any type of PAH. We calculated the mean difference of T-values and ECV between PAH and controls.
RESULTS
We included 12 studies with 674 participants. T-values were significantly higher in PAH with the highest mean difference (MD) recorded at the RV insertion points (RVIP) (108 milliseconds (ms), 95% confidence intervals (CI) 89 to 128), followed by the RV free wall (MD 91 ms, 95% CI 56 to 126). The pooled mean T-value in PAH at the RVIP was 1084, 95% CI (1071 to 1097) measured using 1.5 Tesla Siemens systems. ECV was also higher in PAH with an MD of 7.5%, 95% CI (5.9 to 9.1) at the RV free wall.
CONCLUSION
T mapping values in PAH patients are on average 9% higher than healthy controls when assessed under the same conditions including the same MRI system, magnetic field strength or sequence used for acquisition. The highest T and ECV values are at the RVIP. T mapping and ECV values in PH are higher than the values reported in cardiomyopathies and were associated with poor RV function and RV dilatation.
Topics: Adult; Cardiomyopathies; Contrast Media; Fibrosis; Humans; Magnetic Resonance Imaging; Magnetic Resonance Imaging, Cine; Myocardium; Predictive Value of Tests; Pulmonary Arterial Hypertension
PubMed: 33745961
DOI: 10.1016/j.mri.2021.03.011 -
The Journal of Dermatological Treatment May 2017Atopic eczema (AE), or atopic dermatitis, is a common inflammatory skin disease. As conventional medicines for moderate and severe AE patients have been reported to be... (Review)
Review
Atopic eczema (AE), or atopic dermatitis, is a common inflammatory skin disease. As conventional medicines for moderate and severe AE patients have been reported to be associated with unwanted side effects, many patients with AE have sought other therapies. Chinese herbal medicine (CHM) is one of the most commonly used complementary therapies with a long history of being applied for the treatment of AE. Clinical evidence for CHM for AE in systematic reviews and randomised controlled trials (RCTs) published from 2013 to 2016 was reviewed. Findings from the Cochrane systematic review suggested that oral use of a CHM formulation may improve health-related quality of life (HRQoL) of children with moderate or severe AE. The benefit on improvement of AE requires further high-quality clinical studies.
Topics: Child; Clinical Trials as Topic; Dermatitis, Atopic; Drugs, Chinese Herbal; Humans; Myocardium; Quality of Life; Severity of Illness Index; Spleen
PubMed: 27538116
DOI: 10.1080/09546634.2016.1214673 -
Frontiers in Cardiovascular Medicine 2020Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated cardiac injury has been postulated secondary to several mechanisms. While tissue diagnosis is...
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated cardiac injury has been postulated secondary to several mechanisms. While tissue diagnosis is limited during the acute illness, postmortem studies can help boost our understanding and guide management. To report the cardiac tissue autopsy findings in coronavirus disease 2019 (COVID-19) decedents. Articles published in PubMed and Embase reporting postmortem cardiac pathology of COVID-19 decedents till September 2020. We included adult studies excluding preprints. The Joanna Briggs Institute Critical Appraisal Checklist for Case Reports was used to assess quality. We extracted gross and histology data as well as the incidence of myocarditis, cardiac ischemia, thrombosis, and dilatation. We also looked at the reported cause of death (PROSPERO registration CRD42020190898). Forty-one relevant studies identified including 316 cases. The deceased were mostly male (62%) and elderly (median age, 75; range, 22-97 years). The most common comorbidities were hypertension (48%) and coronary artery disease (33%). Cardiac pathologies contributed to the death of 15 cases. Besides chronic cardiac pathologies, postmortem examination demonstrated cardiac dilatation (20%), acute ischemia (8%), intracardiac thrombi (2.5%), pericardial effusion (2.5%), and myocarditis (1.5%). SARS-CoV-2 was detected within the myocardium of 47% of studied hearts. SARS-CoV-2 can invade the heart, but a minority of cases were found to have myocarditis. Cardiac dilatation, ischemia, mural, and microthrombi were the most frequent findings. The systematic review was limited by the small number of cases and the quality of the studies, and there is a need to standardize the cardiac postmortem protocols.
PubMed: 33585586
DOI: 10.3389/fcvm.2020.626975 -
Arquivos Brasileiros de Cardiologia Jul 2015Acute myocardial infarction is the leading cause of morbidity and mortality worldwide. Furthermore, research has shown that exercise, in addition to reducing... (Review)
Review
BACKGROUND
Acute myocardial infarction is the leading cause of morbidity and mortality worldwide. Furthermore, research has shown that exercise, in addition to reducing cardiovascular risk factors, can also protect the heart against injury due to ischemia and reperfusion through a direct effect on the myocardium. However, the specific mechanism involved in exerciseinduced cardiac preconditioning is still under debate.
OBJECTIVE
To perform a systematic review of the studies that have addressed the mechanisms by which aerobic exercise promotes direct cardioprotection against ischemia and reperfusion injury.
METHODS
A search was conducted using MEDLINE, Literatura Latino-Americana e do Caribe de Informação em Ciências da Saúde, and Scientific Electronic Library Online databases. Data were extracted in a standardized manner by two independent researchers, who were responsible for assessing the methodological quality of the studies.
RESULTS
The search retrieved 78 studies; after evaluating the abstracts, 30 studies were excluded. The manuscripts of the remaining 48 studies were completely read and, of these, 20 were excluded. Finally, 28 studies were included in this systematic review.
CONCLUSION
On the basis of the selected studies, the following are potentially involved in the cardioprotective response to exercise: increased heat shock protein production, nitric oxide pathway involvement, increased cardiac antioxidant capacity, improvement in ATP-dependent potassium channel function, and opioid system activation. Despite all the previous investigations, further research is still necessary to obtain more consistent conclusions.
Topics: Antioxidants; Exercise; Exercise Therapy; Heat-Shock Proteins; Humans; KATP Channels; Myocardial Infarction; Myocardial Reperfusion Injury; Time Factors
PubMed: 25830711
DOI: 10.5935/abc.20150024