Risk Factor For Cardiomyopathy Research Articles

Nicotinamide Mononucleotide Alleviates Cardiomyopathy Phenotypes Caused by Short-Chain Enoyl-Coa Hydratase 1 Deficiency

Short-chain enoyl-CoA hydratase 1 (ECHS1) deficiency plays a role in cardiomyopathy. Whether ECHS1 deficiency causes or is only associated with cardiomyopathy remains unclear. By using Echs1 heterogeneous knockout (Echs1 +/-) mice, we found that ECHS1 deficiency caused cardiac dysfunction, as evidenced by diffuse myocardial fibrosis and upregulated fibrosis-related genes. Mechanistically, ECHS1 interacts with the p300 nuclear localization sequence, preventing its nuclear translocation in fibroblasts. ECHS1 deficiency promotes p300 nuclear translocation, leading to increased H3K9 acetylation, a known risk factor for cardiomyopathy. Nicotinamide mononucleotide-mediated acetylation targeting suppressed ECHS1 deficiency-induced cardiomyopathy phenotypes in Echs1 +/- mice. Thus, enhancing p300-mediated H3K9ac is a potential interventional approach for preventing ECHS1 deficiency-induced cardiomyopathy.

Risk factors for clozapine-induced myocarditis and cardiomyopathy: A systematic review and meta-analysis.

Clozapine is the most effective medication for treatment-refractory schizophrenia, but it is associated with severe cardiac adverse events including myocarditis and cardiomyopathy. To aid treatment decision-making for clinicians, patients and their carers, we conducted a systematic review and meta-analysis to identify potential risk factors for clozapine-induced myocarditis and cardiomyopathy. A systematic search was conducted of PubMed, Embase, CINAHL, Web of Science, Cochrane and PsycInfo for studies reporting myocarditis and cardiomyopathy among people on clozapine and potential risk factors. We calculated pooled effect sizes on risk factors using a random-effects meta-analytic model. Risk of publication bias was assessed using the Newcastle-Ottawa scale. Seven studies met the inclusion criteria, of which six studies had quantitative data included in the meta-analysis. The odds of clozapine-induced myocarditis increased with concurrent sodium valproate use (k=6, n=903, pooled OR 3.58, 95% CI 1.81-7.06), but were not significantly greater with the use of quetiapine, lithium or selective serotonin reuptake inhibitors. Our qualitative review identified conflicting results reported for increasing age and higher clozapine dose as risk factors for myocarditis. No other factors, including genetic risk, sex, ethnicity, smoking, alcohol, substance abuse or cardiometabolic disease, were associated with greater odds of myocarditis. No risk factors for cardiomyopathy were identified in the literature. Concurrent use of sodium valproate increases the odds of clozapine-induced myocarditis. Thus, clinicians should consider the temporary cessation of sodium valproate during the initial titration phase of clozapine.

Comparing left ventricular mechanical dyssynchrony between diabetic and non-diabetic patients with normal gated SPECT MPI

The aim of this study was to employ phase analysis to diagnose left ventricular mechanical dyssynchrony (LVMD) in asymptomatic patients with diabetes mellitus type 2 and normal perfusion study which may help prevent diabetic cardiomyopathy. Ninety-three consecutive patients with known type 2 diabetes and 81 age- and gender- matched patients without diabetes who were candidates for SPECT-MPI were considered as the control group. The presence of LVMD as an possible risk factor for cardiomyopathy- was determined using phase analysis for each scan with quantitative gated SPECT (QGS) and corridor4DM (4DM) software. All outcomes such as phase bandwidth (PBW) and phase standard deviation (PSD) were compared between the two groups. A total of 174 patients were included in the study. There were no statistically significant difference regarding demographic factors between the two groups (P > 0.05). PBW showed statistically significant differences (increased in diabetics) between the control and diabetic patients (P < 0.05). Kruskal Wallis analysis revealed that as the duration of diabetes is prolonged, especially more than 15years, the probability of LVMD is increased as well (P = 0.021). Fraction of asymptomatic diabetic patients with normal ejection fraction and gated SPECT MPI-especially those with prolonged diabetes- might have some degrees of LVMD. Phase analysis can detect this which in turn may prevent progress into heart failure.

Right Ventricular Function Assessment in patients with chronic stable angina with Type II DM Versus Non Diabetic Patients by TAPSE and TDI Echocardiography

Abstract Background In patients with documented right coronary artery (RCA) lesions, right ventricular function could be affected. In addition, the presence of diabetes mellitus is found to be a risk factor for cardiomyopathy. Objective The aim of the study is to assess the effect of type II DM on RV function in patients with chronic stable angina who have significant RCA lesion, using TAPSE and TDI by echocardiography Patients and Methods One hundred patients who underwent elective coronary angiography for suspected coronary artery disease and were found to have significant RCA lesion were divided into two groups according to presence of Type II DM. Echocardiography was done for all patients and RV function assessment by TAPSE and TDI was done. Results In our study 100 patients were included; 73 of patients were males and 27 were females with mean age of 56.70 ± 8.51 years. almost one fourth of the candidates were smokers, 23% were ex-smokers and about half of the candidates were non-smokers (51%).About half of the patients were known hypertensive (48%) while the rest were not. As regarding LVEF it ranged between 35-73% with a Mean ± SD of 54.10 ± 8.94, TAPSE ranged between 17-30 mm with a mean ± SD of 22.81 ± 3.08 and S ‘was ranged between 9-19cm/s with a mean ± SD of 13.50 ± 2.24. Comparison between both groups showed that control group (Group I) had a mean age of (57.34 ± 8.74) and 86% were males . All Diabetic patients (Group II) had a mean age of (56.06 ± 8.30) years, (60%) were males. There was no significant difference between the two groups with respect to age and gender. As regarding smoking status in Group II (20%) were smokers and for Group I (32%) . As regarding hypertension, in Group II (72%) were hypertensive and for the Group I (32%) were hypertensive which was significantly different in both groups.The presence of associated significant LAD lesions was found in 52% of Group II and only 32% in Group I, which was significantly differenct between 2 groups. (p = 0.043).As regarding Echocardiographic data, there was no significant difference in both groups regarding TAPSE (P value .629) and S’(P value .247). Conclusions The results of this study shows that TAPSE and S’ showed normal values in patients with chronic stable angina and there was no additional effect for type II D.M.

Risk factor algorithm used to predict frequent premature ventricular contraction-induced cardiomyopathy

BackgroundPremature ventricular contraction (PVC) QRS duration (QRSd) and high PVCs burden are known as a risk factor of PVC-induced cardiomyopathy (CMP). The aim of this study is to find useful algorithm to predict PVC-induced CMP. Methods180 patients (99 males, 51±14years) with frequent PVCs (>10%/24h), who underwent successful PVC ablation, were studied. Typical PVC-related symptoms were defined as the presence of palpitations or dropped beats during PVC. Group A (n=144) was symptomatic and Group B (n=36) was asymptomatic. ResultsThe incidence of CMP was significantly higher in group B (group A=19%, group B=66%, p<0.001). In group A, there were significant differences, between the patients with normal EF and CMP, in terms of sex (p=0.005), daily PVC burden (p=0.012), distribution of PVCs with a LV site (p<0.009), and PVC QRSd (p<0.001). In group B, the PVC QRSd was significantly wider in patients with CMP. Multivariate analysis showed that PVC QRSd (p<0.001), PVC burden (p=0.022), and LV site (p=0.043) were risk factors for CMP. ConclusionsUsing our scoring algorithm for this patient sample, we are able to predict the development of PVC-induced CMP with 80% sensitivity, 81% specificity, 64% positive predictive value, and 91% negative predictive value.

The Pediatric Cardiomyopathy Registry and Heart Failure: Key Results from the First 15 Years

Cardiomyopathy is a serious disorder of the heart muscle and, although rare, is a common cause of heart failure in children and the most common cause for heart transplantation in children older than 1 year of age. Funded by the National Heart Lung and Blood Institute since 1994, the Pediatric Cardiomyopathy Registry (PCMR) has followed more than 3500 North American children with cardiomyopathy. Early analyses determined estimates for the incidence of pediatric cardiomyopathy (1.13 cases per 100,000 children per year), risk factors for cardiomyopathy (age <1 year, male sex, black race, and living in New England as opposed to the central southwestern states), the prevalence of heart failure at diagnosis (6%-84% depending on cause), and 10-year survival (29%-94% depending on cause). More recent analyses explored cause-specific functional status, survival and transplant outcomes, and risk factors in greater detail. For many topics these analyses are based on the largest and best-documented samples of children with disease such as the muscular dystrophies, mitochondrial disorders, and Noonan syndrome. Data from the PCMR continue to provide valuable information that guides clinical management and the use of life-saving therapies, such as cardiac transplantation and approaches to treating heart failure, and prepares children, their families, and their caregivers to deal with this serious condition.

Anabolics and Cardiomyopathy in a Bodybuilder: Case Report and Literature Review

Background Athletes use androgenic-anabolic steroids to increase strength and muscle mass. Several case reports suggest that it may lead to dilated cardiomyopathy. Methods and Results We report a case of a 41-year-old bodybuilder with severe systolic dysfunction and Class IV heart failure despite maximal medical therapy. He used anabolic steroids and insulin growth factor, and did not have any other risk factors for cardiomyopathy. We briefly review the literature and summarize other reported cases with similar scenarios. In most of them cardiomyopathy was at least partially reversible after discontinuation of anabolics. Conclusions Abuse of anabolic steroids may be an uncommon cause of cardiomyopathy in young and otherwise healthy individuals.

A Novel Homoplasmic Mutation in mtDNA with a Single Evolutionary Origin as a Risk Factor for Cardiomyopathy

To clarify the relationship between variation in mtDNA and the development of cardiomyopathy (CM), the complete sequences of mtDNAs of two brothers with dilated CM were compared with those of 181 patients who had CM and with those of 168 control subjects. Five patients with CM shared a novel homoplasmic point mutation (G12192A tRNA(His)), and all of them demonstrated the evolutionarily related D-loop sequence. The results suggest that this novel mutation originated from the same ancestor and that its presence strongly predisposes carriers to CM.

HLA-C∗03 is a risk factor for cardiomyopathy in chagas disease

Previous studies have shown the effect of class 1 as detected by serology or class 2 HLA genes by oligotyping upon susceptibility or resistance to the cardiomyopathy that develops in approximately one third of the Trypanosoma cruzi chronically infected patients. Low and intermediate resolution DNA typing of class 1 alleles was performed in a sample of 113 serologically positive individuals with and without cardiomyopathy. A polymerase chain reaction-sequence-specific oligonucleotide probe method using primers and probes from the British Society of Histocompatibility and Immunogenetics as modified for the VII Latin American Histocompatibility Workshop by D. Middleton, and LiPA kits from Innogenetics were used. Several alleles (A∗11, A∗31, B∗15, B∗35, B∗45, B∗49, B∗51, and C∗03) showed increased frequencies among patients with cardiac damage versus the asymptomatic group, but only the last one remained significant after correction of the p value (OR = 5.8, p c = 0.03). HLA-C∗03 showed linkage disequilibrium with B∗40 and B∗15 and although both haplotypes were increased in cardiopathic patients compared with asymptomatic individuals, the difference is not significant. These results suggest that the HLA-C∗03 allele could confer susceptibility to the development of cardiomyopathy among Venezuelan T. cruzi seropositive individuals and contrast with the protective effect conferred by the HLA B40 Cw3 haplotype among Chilean chagasic patients. Further studies will be needed to confirm the role of this allele on the cardiomyopathy of Chagas disease.

Possible enhancement of the cardiotoxicity of doxorubicin when combined with mitomycin C.

Forty-six patients with recurrent metastatic breast cancer were treated with a combination chemotherapy including doxorubicin and mitomycin C. Myocardial contractility was monitored by means of echocardiography. During therapy there was a progressive deterioration of myocardial function, and this phenomenon was found to be linearly correlated to the cumulative dose of doxorubicin. Six patients (13.8%) developed congestive heart failure during therapy; it occurred after the median cumulative dose of 322 mg/m2 (range 135-472). Possible risk factors of cardiomyopathy could be identified in only two patients. These results suggest that mitomycin C could enhance the cardiotoxicity of doxorubicin.