Effects of Cyproheptadine on Mitral Valve Remodeling and Regurgitation After Myocardial Infarction

Marsit, Ons; Clavel, Marie‐Annick; Paquin, Amélie; Deschênes, Valérie; Hadjadj, Sandra; Sénéchal-Dumais, Isabelle; Couët, Jacques; Arsenault, Marie; Handschumacher, Mark D.; Levine, Robert A.; Aïkawa, Elena; Beaudoin, Jonathan

doi:10.1016/j.jacc.2022.05.025

Cited by 10 publications

(7 citation statements)

References 29 publications

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“…This enlargement of leaflet area is thought to protect against MR and seems to be lacking or blunted in functional MR due to LV dilatation and LV dysfunction. These data were recently corroborated by a study in sheep where a serotonin inhibitor nearly abrogated the development of functional MR by intensifying mitral leaflet growth after induction of myocardial infarction [ 38 ].…”

Section: Introductionmentioning

confidence: 64%

“…In these scenarios, AR may only be a bystander. One possible way to discriminate between these two pathophysiological entities is to examine the ratio of leaflet area to annulus area, which is higher in patients with both significant AR and MR [ 37 , 38 ]. Since both AR and MR increase LV preload and AR increases LVEDP while decreasing LV compliance, exercise echocardiography might be useful in assessing combined AR and MR.…”

Section: Introductionmentioning

confidence: 99%

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Expert proposal to analyze the combination of aortic and mitral regurgitation in multiple valvular heart disease by comprehensive echocardiography

Hagendorff¹,

Helfen

Brandt

et al. 2023

Clin Res Cardiol

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The assessment of valvular pathologies in multiple valvular heart disease by echocardiography remains challenging. Data on echocardiographic assessment—especially in patients with combined aortic and mitral regurgitation—are rare in the literature. The proposed integrative approach using semi-quantitative parameters to grade the severity of regurgitation often yields inconsistent findings and results in misinterpretation. Therefore, this proposal aims to focus on a practical systematic echocardiographic analysis to understand the pathophysiology and hemodynamics in patients with combined aortic and mitral regurgitation. The quantitative approach of grading the regurgitant severity of each compound might be helpful in elucidating the scenario in combined aortic and mitral regurgitation. To this end, both the individual regurgitant fraction of each valve and the total regurgitant fraction of both valves must be determined. This work also outlines the methodological issues and limitations of the quantitative approach by echocardiography. Finally, we present a proposal that enables verifiable assessment of regurgitant fractions. The overall interpretation of echocardiographic results includes the symptomatology of patients with combined aortic and mitral regurgitation and the individual treatment options with respect to their individual risk. In summary, a reproducible, verifiable, and transparent in-depth echocardiographic investigation might ensure consistent hemodynamic plausibility of the quantitative results in patients with combined aortic and mitral regurgitation. Graphic abstract The quantitative approach to assess LV volumes in combined AR and MR patients: explanation and algorithm of how to determine the relevant target parameters. LVSVeff—effective left ventricular (LV) stroke volume, LVSVforward—forward LV stroke volume through the aortic valve (AV), LVSVtot—total LV stroke volume, RegVolAR—regurgitant volume through the AV, RegVolMR—regurgitant volume through the mitral valve (MV), LVfilling volume = LVMV-Inflow − transmitral LV inflow, LVOT—left ventricular outflow tract, RFAR—regurgitant fraction of aortic regurgitation (AR), RFMR—regurgitant fraction of mitral regurgitation (MR), RVSVeff —effective right ventricular (RV) stroke volume, RVSVforward—forward RV stroke volume through the pulmonary valve, RVSVtot—total RV stroke volume.

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Section: Introductionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Expert proposal to analyze the combination of aortic and mitral regurgitation in multiple valvular heart disease by comprehensive echocardiography

Hagendorff¹,

Helfen

Brandt

et al. 2023

Clin Res Cardiol

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“…19 The potential to inhibit valve fibrosis in ischemic mitral regurgitation via pharmacological inhibition of CD45 was also demonstrated. Circulating factors activating serotonin receptors 20 and releasing molecular brakes on proliferative Wnt/β-catenin 21 can also provide therapeutic clues.…”

Section: Gaps In Knowledge: Mitral Valve Diseasementioning

confidence: 99%

Challenges and Opportunities in Valvular Heart Disease: From Molecular Mechanisms to the Community

Aikawa,

Blaser,

Singh

et al. 2024

ATVB

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“…Additionally, triiodothyronine pretreatment improves post-MI dysfunction and inhibits fibrosis by activating the insulin-like growth factor-1/PI3K/Akt signaling pathway ( Zeng et al, 2021 ). In an MI sheep model, the upregulation of 5-hydroxytryptamine induces valve fibrosis, which could be improved by cyproheptadine ( Marsit et al, 2022 ). Oral propionate, the important components of short-chain fatty acids, modulates macrophages polarization and pro-inflammatory cytokine via reducing JNK/p38/NF-κB phosphorylation to improve post-MI chronic cardiac remodeling ( Zhou et al, 2023 ).…”

Section: Interventions For Cardiac Fibrosismentioning

confidence: 99%

Post-myocardial infarction fibrosis: Pathophysiology, examination, and intervention

Yin

Pan

et al. 2023

Front. Pharmacol.

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Cardiac fibrosis plays an indispensable role in cardiac tissue homeostasis and repair after myocardial infarction (MI). The cardiac fibroblast-to-myofibroblast differentiation and extracellular matrix collagen deposition are the hallmarks of cardiac fibrosis, which are modulated by multiple signaling pathways and various types of cells in time-dependent manners. Our understanding of the development of cardiac fibrosis after MI has evolved in basic and clinical researches, and the regulation of fibrotic remodeling may facilitate novel diagnostic and therapeutic strategies, and finally improve outcomes. Here, we aim to elaborate pathophysiology, examination and intervention of cardiac fibrosis after MI.

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Effects of Cyproheptadine on Mitral Valve Remodeling and Regurgitation After Myocardial Infarction

Cited by 10 publications

References 29 publications

Expert proposal to analyze the combination of aortic and mitral regurgitation in multiple valvular heart disease by comprehensive echocardiography

Expert proposal to analyze the combination of aortic and mitral regurgitation in multiple valvular heart disease by comprehensive echocardiography

Challenges and Opportunities in Valvular Heart Disease: From Molecular Mechanisms to the Community

Post-myocardial infarction fibrosis: Pathophysiology, examination, and intervention

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