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Role of Neuropeptide Y and Peroxisome Proliferator-activated Receptor γ Coactivator-1α in stress cardiomyopathy

Journal of Huazhong University of Science and Technology(Medical Sciences) 2012年第6期32卷 823-828页

作者：阿兰达王云云朱少华王荣帅周小伟卓荦孙婷怡任亮刘茜董红梅刘艳刘良 Department of Forensic Medicine Tongji Medical CollegeHuazhong University of Science and Technology

Death following situations of intense emotional stress has been linked to the cardiac pathology described as stress cardiomyopathy, whose pathomechanism is still not clear. In this study, we sought to determine, via an animal model, whether the transcriptional coactivator peroxisome proliferator-activated receptor γ coactivator-1alpha (PGC-1α) and the amino peptide neuropeptide Y (NPY) play a role in the pathogenesis of this cardiac entity. Male Sprague-Dawley rats in the experimental group were subjected to immobilization in a plexy glass box for 1 h, which was followed by low voltage elec-tric foot shock for about 1h at 10s intervals in a cage fitted with metallic rods. After 25 days the rats were sacrificed and sections of their hearts were processed. Hematoxylin-eosin staining of cardiac tissues revealed the characteristic cardiac lesions of stress cardiomyopathy such as contraction band necrosis, inflammatory cell infiltration and fibrosis. The semi-quantitative RT-PCR analysis for PGC-1α mRNA expression showed significant overexpression of PGC1-α in the stress-subjected rats (Pstress-subjected rats as compared to the control rats (P=0.0027). Thus, we are led to conclude that following periods of intense stress, an increased expression of PGC1-α in the heart and an overflow of NPY may lead to stress car-diomyopathy and even death in susceptible victims. Moreover, these markers can be used to identify stress cardiomyopathy as the cause of sudden death in specific cases.

关键词： stress cardiomyopathy peroxisome proliferator-activated receptor γ coactivator-1alpha neuropeptide Y sudden death forensic pathology

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stress cardiomyopathy in critical care:A case series of 109 patients

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World Journal of Critical Care Medicine 2022年第3期11卷 149-159页

作者： Parth Pancholi Nader Emami Melissa J Fazzari Sumit Kapoor Department of Medicine Montefiore Medical CenterAlbert Einstein College of MedicineBronxNY 10467United States Division of Critical Care Medicine Department of MedicineMontefiore Medical CenterAlbert Einstein College of MedicineBronxNY 10467United States Department of Epidemiology and Population Health Albert Einstein College of MedicineBronxNY 10461United States

BACKGROUND Critically ill patients are at risk of developing stress cardiomyopathy(SC)but can be *** To describe a case series of patients with SC admitted to critical care *** We conducted a retrospective observational study at a tertiary care teaching *** adult(≥18 years old)patients admitted to the critical care units with stress cardiomyopathy over 5 years were *** Of 24279 admissions to the critical care units[19139 to medical-surgical intensive care units(MSICUs)and 5140 in coronary care units(CCUs)],109 patients with SC were ***(55%)were admitted to the coronary care units(CCUs)and forty-nine(45%)to the medical-surgical units(MSICUs).The overall incidence of SC was 0.44%,incidence in CCU and MSICU was 1.16%and 0.25%***-two(57%)had confirmed SC and underwent cardiac catheterization whereas 47(43%)had clinical SC,and did not undergo cardiac ***-three(72%)patients in the CCUs were diagnosed with primary SC,whereas all(100%)patients in MSICUs developed secondary *** respiratory failure that required invasive mechanical ventilation and shock developed in twenty-nine(59%)MSICU *** were no statistically significant differences in intensive care unit(ICU)mortality,in-hospital mortality,use of inotropic or mechanical circulatory support based on type of unit or anatomical *** stress cardiomyopathy can be under-recognized in the critical care *** should have a high index of suspicion for SC in patients who develop sudden or worsening unexplained hemodynamic instability,arrhythmias or respiratory failure in ICU.

关键词： stress cardiomyopathy Critical care Shock Respiratory failure

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Acute myocardial injury in patients with COVID-19:Possible mechanisms and clinical implications

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World Journal of Clinical Cases 2022年第3期10卷 762-776页

作者： Iulia Rusu Malina Turlacu Miruna Mihaela Micheu Department of Cardiology Clinical Emergency Hospital of BucharestBucharest 014461Romania

Severe acute respiratory syndrome coronavirus 2 infection affects not only the lungs,but also the cardiovascular system,having a major impact on patients’*** injury(MI)occurs in the context of coronavirus infectious disease 2019(COVID-19)and is associated with a higher risk of severe clinical outcome and ***-19-related MI can have various clinical manifestations,of which the main ones are myocarditis,stress cardiomyopathy,acute coronary syndrome,and pulmonary *** exact mechanisms of how MI occurs in these patients are not yet fully *** injury,through direct viral myocardial invasion,and indirect injury,through interaction with angiotensin I converting enzyme 2,increased inflammation,and thrombocyte and endothelial dysfunction,could be involved in acute MI in patients with COVID-19.A better understanding of these multiple potential mechanisms may help to develop new targeted therapeutic *** purpose of this review is to provide the current understanding of the potential mechanisms involved in MI induced by COVID-19 and to discuss the current progress in the therapeutic strategies.

关键词： Myocardial injury Myocarditis stress cardiomyopathy Acute coronary syndrome Pulmonary embolism Coronavirus infectious disease SARS-CoV-2

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Cardiovascular complications following medical termination of pregnancy: An updated review

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World Journal of Cardiology 2023年第10期15卷 518-530页

作者： Tejveer Singh Ajay K Mishra Nikhil Vojjala Kevin John John Anu A George Anil Jha Michelle Hadley Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States Department of Internal Medicine Post-Graduation Institute of Medical Education and ResearchChandigarh 00000India Department of Internal Medicine Tufts Medical CenterBostonMA 01212United States

BACKGROUND Around 1 million cases of medical termination of pregnancy(MTP)take place yearly in the United States of America with around 2 percent of this population developing *** cardiovascular(CVD)complications occurring post MTP or after stillbirth is not very well *** To help the reader better understand,prepare,and manage these complications by reviewing various cardiac comorbidities seen after *** We performed a literature search in PubMed,Medline,RCA,and google scholar,using the search terms“abortions”or“medical/legal termination of pregnancy”and“cardiac complications”or“cardiovascular complications”.RESULTS The most common complications described in the literature following MTP were infective endocarditis(IE)(n=16),takotsubo cardiomyopathy(TTC)(n=7),arrhythmias(n=5),and sudden coronary artery dissection(SCAD)(n=4).The most common valve involved in IE was the tricuspid valve in 69%(n=10).The most observed causative organism was group B Streptococcus in 81%(n=12).The most common type of TTC was apical type in 57%(n=4).Out of five patients de veloping arrhythmia,bradycardia was the most common and was seen in 60%(3/5)of the *** four cases of SCAD-P type presented as acute coronary syndrome 10-14 d post termination of pregnancy with predominant involvement of the right coronary *** was only reported following IE in 6.25%.Clinical recovery was reported consistently after optimal medical management following all these *** In conclusion,the occurrence of CVD complications following pregnancy termination is infrequently documented in the existing *** this review,the most common CVD complication following MTP was noted to be IE and TTC.

关键词： Cardiovascular complications Termination of pregnancy Infective Endocarditis stress cardiomyopathy Outcome

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Diagnostic and therapeutic challenge of heart failure after liver transplant:Case series

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World Journal of Hepatology 2017年第33期9卷 1253-1260页

作者： Manish Tandon Sunaina Tejpal Karna Chandra Kant Pandey Ravindra Chaturvedi Institute of Liver and Biliary Sciences New Delhi 110070India

Heart failure(HF) following liver transplant(LT) surgery is a distinct clinical entity with high mortality. It is known to occur in absence of obvious risk factors. No preoperative workup including electrocardiogram, echocardiography at rest and on stress, reasonably prognosticates the risk. In patients of chronic liver disease, cirrhotic cardiomyopathy, alcoholic cardiomyopathy, and stress induced cardiomyopathy have each been implicated as a cause for HF after LT. However distinguishing one etiology from another not only is difficult, several etiologies may possibly coexist in a given patient. Diagnostic dilemma is further compounded by the fact that presentation and management of HF irrespective of the possible underlying cause, remains the same. In this case series, 6 cases are presented and in the light of existing literature modification in the preoperative workup are suggested.

关键词： Liver transplant Heart failure Cirrhotic cardiomyopathy stress cardiomyopathy Alcohol cardiomyopathy

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