Subclinical HMOD in Hypertension: Left Ventricular Diastolic Dysfunction

Bertacchini, Fabio; Rosei, Claudia Agabiti; Buso, Giacomo; Cappellini, Sara; Stassaldi, Deborah; Aggiusti, Carlo; Salvetti, Massimo; Paini, Anna; Ciuceis, Carolina De; Muiesan, María Lorenza

doi:10.1007/s40292-022-00548-z

Cited by 6 publications

(2 citation statements)

References 81 publications

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“…Диастолическая дисфункция (ДД) левого желудочка (ЛЖ) нередко обозначается как ключевое звено сердечно-сосудистого континуума, завершающегося развитием клинически выраженной хронической сердечной недостаточности (ХСН) не только при повсеместно распространенных болезнях сердца и сосудов (ишемическая болезнь сердца, артериальная гипертензия) [1][2][3][4][5][6], но и при экзотической для многих регионов мира патологии, в частности эндемических заболеваниях паразитарной природы (например, болезни Шагаса и описторхозе) [7][8][9][10][11].…”

Section: Introductionunclassified

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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Section: Introductionunclassified

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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“…безболевой, встречающейся в 16-75% случаев и являющейся отражением ишемии миокарда, обусловлены у больных ГБ с ангиографически ИКА снижением коронарного резерва вследствие вторичной МСД [1][2][3] и параллельно раз-вивающейся диастолической дисфункцией [4][5][6][7], распространенность которой при ГБ колеблется от 30 до 87% [4,8,9]. При этом прогрессирование ДДЛЖ повышает риск сердечно-сосудистой смерти на 80% [4,10].…”

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Assessment of perfusion and diastolic function in patients with early-stage microvascular dysfunction and arterial hypertension according to 99mTc-SPECT/CT imaging

Khachirova,

Samoylenko,

Shevchenko

et al. 2024

Humans and their Health

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Objective: to study the correlation between quantitative perfusion parameters and the diastolic function in patients with microvascular dysfunction and arterial hypertension, stage 1, pain in the left half of the chest and intact coronary arteries (ICA), according to the single-photon emission computed tomography with 99mTc. Material and methods. The study included 29 patients with stage I arterial hypertension confirmed by 24-hour blood pressure monitoring, without left ventricular hypertrophy, with pain in the left half of the chest and ICA, each of whom underwent diagnostic invasive coronary angiography and SPECT/CT of the myocardium with 99mTc-technetrile at rest and in combination with stress. Results. In the examined patients with stage I arterial hypertension, without left ventricular hypertrophy with pain in the left half of the chest and ICA, according to S-SPECT/CT, disturbances in diastolic function (DF) of the LV, heterogeneity of perfusion at rest and stress-induced myocardial ischemia, corresponding to the initial manifestations of coronary insufficiency, were revealed, caused by a decrease in the perfusion reserve due to secondary microvascular dysfunction (vMSD), and is, apparently, the main factor in the occurrence of pain in the left half of the chest in this category of patients. A reliable inverse relationship has been established between speed and direct time indicators of LV DF and the prevalence and severity of stress-induced myocardial ischemia. Conclusion. In patients with stage I arterial hypertension, without left ventricular hypertrophy with pain in the left half of the chest and ICA perfusion deficiency and myocardial ischemia are associated with a significant increase in diastolic duration and a decrease in the velocity parameters of LV DF, which is revealed by SPECT/CT data already in the early stages and initial stage of the HD disease. The occurrence of left-sided heart failure in patients with hypertension and ICA is associated with coronary insufficiency caused by vMSD.

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The association between higher cardiac troponin levels and the development of left ventricular diastolic dysfunction in septic patients with diabetes mellitus

Xia,

Hua,

Kang

et al. 2023

Int J Cardiovasc Imaging

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Subclinical HMOD in Hypertension: Left Ventricular Diastolic Dysfunction

Cited by 6 publications

References 81 publications

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

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

Assessment of perfusion and diastolic function in patients with early-stage microvascular dysfunction and arterial hypertension according to 99mTc-SPECT/CT imaging

The association between higher cardiac troponin levels and the development of left ventricular diastolic dysfunction in septic patients with diabetes mellitus

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