The influence of metabolic syndrome coexistence on the prognosis of patients with heart failure without atrial fibrillation. Analysis of Polish  data from the pilot survey for the  ESC Heart Failure Registry

Wełnicki, Marcin; Śliż, Daniel; Szeligowska, Jowita; Duda-Król, Wiesława B.; Chomiuk, Tomasz; Dąbrowska, Dominika; Dróżdż, Jarosław; Mamcarz, Artur

doi:10.5603/kp.2018.0077

Cited by 4 publications

(1 citation statement)

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“…MetS affect about one third of the population in the United States and increases as the population ages [7]. The presence of MetS is associated with poor prognosis after myocardial infarction, more severe post-infarction left ventricular (LV) dysfunction, and progression to heart failure [49,52]. MetS has also been related to atherosclerotic renal artery stenosis (RAS) and chronic kidney disease (CKD) [25,48], and their coexistence, in turn, further disrupts cardiac structure and function, ultimately leading to an increase of cardiovascular morbidity and mortality [26].…”

Section: Introductionmentioning

confidence: 99%

Selective intrarenal delivery of mesenchymal stem cell-derived extracellular vesicles attenuates myocardial injury in experimental metabolic renovascular disease

et al. 2020

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Background: Extracellular vesicles (EVs) deliver genes and proteins to recipient cells, and mediate paracrine actions of their parent cells. Intrarenal delivery of mesenchymal stem cell (MSC)-derived EVs preserves stenotic-kidney function and reduces release of pro-inflammatory cytokines in a swine model of coexisting metabolic syndrome (MetS) and renal artery stenosis (RAS). We hypothesized that this approach is also capable of blunting cardiac injury and dysfunction.Methods: Five groups of pigs were studied after 16 weeks of diet-induced MetS and RAS (MetS +RAS), MetS and MetS+RAS treated 4 weeks earlier with a single intra-renal delivery of EVsrich fraction harvested from autologous adipose tissue-derived MSCs, and Lean and MetS Shams. Cardiac structure, function, and myocardial oxygenation were assessed in-vivo using imaging, and cardiac inflammation, senescence, and fibrosis ex-vivo. Inflammatory cytokine levels were measured in circulating and renal vein blood. Results:Intrarenal EV delivery improved stenotic-kidney glomerular filtration rate and renal blood flow, and decreased renal release of monocyte-chemoattractant protein-1 and interleukin-6. Furthermore, despite unchanged systemic hemodynamics, intrarenal EV delivery in MetS+RAS normalized cardiac diastolic function, attenuated left ventricular remodeling, cellular senescence and inflammation, and improved myocardial oxygenation and capillary density in MetS+RAS. Conclusions:Intrarenal delivery of MSC-derived EVs blunts myocardial injury in experimental MetS+RAS, possibly related to improvement in renal function and systemic inflammatory profile. These observations underscore the central role of inflammation in the crosstalk between the kidney and heart, and the important contribution of renal function to cardiac structural and functional integrity in coexisting MetS and RAS.

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