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Query: UMLS:C0018801 (
heart failure
)
72,216
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The majority of patients with chronic
heart failure
(CHF) have a decreased exercise tolerance. It has not been well established if muscle fatigue is related to a peripheral myopathy with specific metabolic, histologic and biochemical abnormalities. CHF patients demonstrate depressed oxidative capacity and activation of anaerobic glycolysis, leading to a reduction in the energy substrates. In addition, the skeletal muscles of the lower limbs demonstrate a shift toward type IIb fibers. Many factors, such as prolonged immobilization, reduced blood flow and neuroendocrine activation, can be cited in order to explain the origin of this myopathy. Recent studies show that immobilization is not the only reason for modifications in skeletal muscle composition, since patients with disuse atrophy show an increased percentage in
myosin heavy chain
I, while IIb is decreased. The opposite pattern is observed in CHF. It would appear that several factors such as deconditioning, prolonged immobilization and reduced blood flow, may produce muscular atrophy. The reasons behind specific changes in fibre composition may be found in metabolic factors such as insulin resistance, TNF levels and dysfunction of the ergo-metabolo muscle receptors.
...
PMID:[Skeletal musculature modifications and mechanisms of fatigue in chronic heart failure]. 928 Jul 30
Cardiomyopathies, and more specifically hypertrophic cardiomyopathy, have opened the route to what is now called genetic cardiology. Hypertrophic cardiomyopathy (HCM) is characterized by unexplained left and/or right ventricular hypertrophy, and disorganisation of tissular architecture. Approximately 60% of HCM are transmitted as an autosomal dominant trait. The clinical aspects of HCM vary markedly, and several morphological variants were described, depending on the localization of hypertrophy. This pathology is often complicated by
cardiac failure
, but the major risk is sudden death, and the predictive factors are presently very unrefined. Several pathogenic hypotheses were forwarded in the past, and one surprising result of genetic analyses is that none of these hypotheses was confirmed. Four disease genes were identified, and they encode sarcomeric proteins, cardiac
myosin heavy chain
, troponin T, tropomyosin and cardiac myosin binding protein C. To this high intergenic heterogeneity is associated a high intragenic heterogeneity. A major fall out of these genetic findings is the recent discovery of adult healthy carriers, around 30% in our experience. Genetype/phenotype relationships are being performed, and this is the first approach to a prognostic evaluation based on genetic localisation. The work on hypertrophic cardiomyopathy is currently being used as a model to analyse dilated cardiomyopathies, characterized by dilatation and impaired contraction of the left or both ventricles. The mode of inheritance of these forms of cardiomyopathies is complex. Five families with an autosomal inheritance were analyzed since two years, the loci were found, but the disease genes are not identified yet. Identification of patients at high risk and early treatment or prevention are the current goals.
...
PMID:[Cardiomyopathies]. 929 66
We asked whether thyroid hormone (T4) would improve heart function in left ventricular hypertrophy (LVH) induced by pressure overload (aortic banding). After banding for 10-22 wk, rats were treated with T4 or saline for 10-14 d. Isovolumic LV pressure and cytosolic [Ca2+] (indo-1) were assessed in perfused hearts. Sarcoplasmic reticulum Ca2+-ATPase (SERCA), phospholamban, and alpha- and beta-myosin heavy chain (
MHC
) proteins were assayed in homogenates of myocytes isolated from the same hearts. Of 14 banded hearts treated with saline, 8 had compensated LVH with normal function (LVHcomp), whereas 6 had abnormal contraction, relaxation, and calcium handling (LVHdecomp). In contrast, banded animals treated with T4 had no myocardial dysfunction; these hearts had increased contractility, and faster relaxation and cytosolic [Ca2+] decline compared with LVHcomp and LVHdecomp. Myocytes from banded hearts treated with T4 were hypertrophied but had increased concentrations of alpha-MHC and SERCA proteins, similar to physiological hypertrophy induced by exercise. Thus thyroid hormone improves LV function and calcium handling in pressure overload hypertrophy, and these beneficial effects are related to changes in myocyte gene expression. Induction of physiological hypertrophy by thyroid hormone-like signaling might be a therapeutic strategy for treating cardiac dysfunction in pathological hypertrophy and
heart failure
.
...
PMID:Thyroid hormone improves function and Ca2+ handling in pressure overload hypertrophy. Association with increased sarcoplasmic reticulum Ca2+-ATPase and alpha-myosin heavy chain in rat hearts. 931 72
The present study investigated whether functional, molecular, and biochemical alterations occurring in chronic
heart failure
can already be detected in compensated hypertensive cardiac hypertrophy. Force of contraction (isolated papillary muscle strip preparations), sarcoplasmic reticulum (SR) protein and
myosin heavy chain
isoform expression (Northern and Western blot analysis), myocardial fibrosis (collagen stains, hydroxyproline quantification), myocardial renin mRNA (RT-PCR), and angiotensin II levels and plasma aldosterone concentrations (radioimmunoassay) were studied in hypertrophied myocardium from transgenic rats harboring the mouse Ren-2d gene. Contraction and relaxation velocities of isolated papillary muscle strips were significantly reduced in cardiac hypertrophy. The beta-/alpha-myosin heavy chain ratio was significantly increased in the hypertrophied left ventricles, whereas SR Ca2+-ATPase (SERCA 2a) and phospholamban mRNA and protein levels were significantly decreased. The decrease in SERCA 2a was more pronounced than the decrease in phospholamban levels. There was no increased myocardial fibrosis. Left ventricular myocardial renin mRNA and angiotensin II concentrations, as well as plasma aldosterone levels, were higher in transgenic than in control rats. In hypertensive cardiac hypertrophy,
myosin heavy chain
isoform shift and reduction of SR protein levels are related to systolic and diastolic dysfunction, respectively. These alterations precede the development of myocardial fibrosis. Increased myocardial renin mRNA and angiotensin II concentrations suggest that an activated tissue renin-angiotensin system might contribute to these alterations. Since the alterations in compensated cardiac hypertrophy apparently precede those in chronic
heart failure
, they might accelerate the transition from hypertrophy to failure and could therefore be targets for pharmacological interventions.
...
PMID:Contractile systolic and diastolic dysfunction in renin-induced hypertensive cardiomyopathy. 931 21
We recently demonstrated dynamic alterations in protein turnover 3 days and 1 month after surgical induction of aortic regurgitation (AR). To characterize protein synthesis and degradation during the long-term plateau phase, we performed [3H]-leucine infusion 2.5 years after induction of AR in 10 New Zealand White rabbits and 12 sham-operated controls. Protein fractional synthesis rates were obtained by analyses of plasma and protein hydrolysates, growth rates from protein concentration and heart weight measurements, and degradation rates by subtraction of growth from synthesis rates. AR (regurgitant fraction 25 +/- 11%) caused a 57% increase in left ventricular (LV) weight in comparison with controls (7.4 +/- 1.7 vs. 4.7 +/- 0.6 g, p < 0.001) and no evidence of
heart failure
. Although concentrations of total cardiac protein,
myosin heavy chain
and actin were similar, the enlarged AR hearts had increased amounts of total cardiac protein (1,009 +/- 312 vs. 682 +/- 120 mg/LV, p < 0.05),
myosin heavy chain
(148 +/- 91 vs. 81 +/- 29 mg/LV, p < 0.05), and actin (73 +/- 42 vs. 44 +/- 16 mg/LV, p < 0.06). Individual protein fractional synthesis and degradation rates were closely balanced. However, myosin fractional synthesis rates were 152% (p < 0.01) greater than those of total cardiac protein in AR animals, while only 52% (p < 0.05) greater in controls (AR vs. controls, p = 0.05). Variations in actin turnover between AR and control animals did not attain statistical significance. Myosin and actin fractional synthesis rates correlated closely in AR rabbits (R = 0.81, p < 0.02), but not among controls (R = 0.41, NS). Thus, selective alterations in myofibrillar protein turnover contribute to the maintenance of increased myofibrillar protein content in the 'compensatory' LV hypertrophy of chronic AR.
...
PMID:Protein turnover in compensated chronic aortic regurgitation. 939 5
Chronic heart failure (CHF) is accompanied by a reduced exercise capacity, and the symptoms can be at least in part explained by qualitative and quantitative changes in the skeletal muscle composition and metabolism. We have correlated the
myosin heavy chain
(
MHC
) composition of the gastrocnemius in 20 patients with different degrees of CHF to expiratory gases measured during maximal cardiopulmonary exercise testing, NYHA functional class and echocardiographic parameters.
MHC
composition was determined electrophoretically in skeletal muscle needle microbiopsies and the percent distribution calculated by laser densitometry. There was no correlation between ejection fraction, left ventricular end-diastolic and end-systolic diameters and
MHC
composition. The percentage of
MHC
1 (slow aerobic isoform) was positively correlated with peak VO2 (r2 = 0.5, p = 0.0004), ventilatory threshold (VT, r2 = 0.33, p = 0.008), and O2 pulse (peak VO2/HR, r2 = 0.40, p = 0.003). There was a negative correlation between
MHC
2a and 2b (fast isoforms) and peak VO2 (r2 = 0.38 and 0.37, p = 0.004, respectively), VT (r2 = 0.2, p = 0.05; r2 = 0.34, p = 0.007, respectively) and O2 pulse (r2 = 0.39, p = 0.003; r2 = 0.23, p = 0.03, respectively). NYHA functional class was also negatively correlated with the same parameters (r2 = 0.2, p = 0.01; r2 = 0.4, p = 0.001; r2 = 0.34, p = 0.006, respectively) as well as with
MHC
1 (r2 = 0.62, p = 0.0001). A positive correlation was found between NYHA functional class and
MHC
2a and 2b (r2 = 0.46, p = 0.001; r2 = 0.41, p = 0.002, respectively). The severity of
heart failure
is paralleled by a shift of the
MHC
pattern toward the fast
MHC
2b. The correlation between the magnitude of the MHCs shift, from the slow aerobic to the fast type, with both clinical parameters (NYHA functional class) and functional measurements (peak VO2, VT, O2 pulse) of exercise capacity seem to suggest that changes in skeletal muscle composition may play a key role in exercise tolerance in patients with CHF.
...
PMID:[Myosin isoforms in skeletal muscle in patients with chronic heart decompensation: distribution and correlation with with exercise tolerance]. 941 May 67
Two isoforms of
myosin heavy chain
(MyHC), alpha and beta, exist in the mammalian ventricular myocardium, and their relative expression is correlated with the contractile velocity of cardiac muscle. Several pathologic stimuli can cause a shift in the MyHC composition of the rodent ventricle from alpha- to beta-MyHC. Given the potential physiological consequences of cardiac MyHC isoform shifts, we determined MyHC gene expression in human
heart failure
where cardiac contractility is impaired significantly. In this study, we quantitated the relative amounts of alpha- and beta-MyHC mRNA in the left ventricular free walls (LVs) of 14 heart donor candidates with no history of cardiovascular disease or structural cardiovascular abnormalities. This group consisted of seven patients with nonfailing (NF) hearts and seven patients with hearts that exhibited donor heart dysfunction (DHD). These were compared with 19 patients undergoing cardiac transplantation for chronic end-stage
heart failure
(F). The relative amounts of alpha-MyHC mRNA to total (i.e., alpha + beta) MyHC mRNA in the NF- and DHD-LVs were surprisingly high compared with previous reports (33.3+/-18.9 and 35.4+/-16.5%, respectively), and were significantly higher than those in the F-LVs, regardless of the cause of
heart failure
(2.2+/-3.5%, P < 0.0001). There was no significant difference in the ratios in NF- and DHD-LVs. Our results demonstrate that a considerable amount of alpha-MyHC mRNA is expressed in the normal heart, and is decreased significantly in chronic end-stage
heart failure
. If protein and enzymatic activity correlate with mRNA expression, this molecular alteration may be sufficient to explain systolic dysfunction in F-LVs, and therapeutics oriented towards increasing alpha-MyHC gene expression may be feasible.
...
PMID:Myosin heavy chain gene expression in human heart failure. 941 Sep 16
Chronic tachycardia causes LV dilatation and dysfunction, with no hypertrophy. However, the contributing mechanisms responsible for the left ventricular (LV) remodeling in the absence of myocardial growth in this model of
heart failure
remain unclear. Therefore, the goal of the present study was to serially examine changes in LV function, steady state
myosin heavy chain
(
MHC
) mRNA levels, in vivo synthesis rates, and abundance with the progression of chronic tachycardia induced
heart failure
. Adult rabbits (3.5-4.5 kg) were studied after one, two, or three weeks of pacing ventricular tachycardia (VT; 400 bpm) and in controls (n = 6 for all groups). LV fractional shortening was reduced by 30% at week one and by over 50% at week three of chronic VT. End-diastolic dimension (EDD) increased at week two compared to controls (1.66 +/- 0.10 vs 1.35 +/- 0.11 cm, p < 0.05) and increased further at week three of VT (1.70 +/- 0.06 cm, p < 0.05). The progressive changes in LV geometry and function with chronic VT were not associated with concomitant time dependent changes in LV mass or
MHC
mRNA levels. In contrast,
MHC
fractional synthesis rates increased and reached statistical significance at week three of VT compared to controls (8.3 +/- 0.8 vs 5.5 +/- 0.5%/day, p < 0.05). Despite the stable or increased
MHC
protein synthesis rates, there was no change in
MHC
protein abundance at any point during the progression of VT induced
heart failure
, implicating enhanced
MHC
protein degradation. Thus, this study demonstrated that a contributory mechanism for the LV remodeling and lack of myocardial growth, which occurs with VT induced
heart failure
, is enhanced contractile protein degradative processes.
...
PMID:Myosin heavy chain synthesis during the progression of chronic tachycardia induced heart failure in rabbits. 953 37
We have reported that the production of endothelin (ET)-1 is markedly increased in the failing heart of rats with chronic
heart failure
(CHF) and that the long-term (3-month) treatment with the ETA receptor antagonist BQ-123 markedly ameliorated the long-term survival and hemodynamic parameters in rats with CHF. In this study we investigated whether this therapy affects the alteration of the mRNA expression of cardiac
myosin heavy chain
(
MHC
) isoforms in the hearts of rats with CHF. The change from alpha-MHC to beta-
MHC
is regarded as a molecular marker for
heart failure
. The expression of beta-
MHC
mRNA was dominant in the left ventricle (LV) of CHF rats treated with saline, whereas that of alpha-MHC was dominant in the LV of sham-operated rats treated with saline. Therefore, in the failing rat heart, a change from alpha-MHC to beta-
MHC
occurred. In the LV of CHF rats treated with BQ-123, this treatment effectively prevents the switching of
MHC
isoforms. These findings suggest that long-term BQ-123 treatment inhibits the change in
MHC
isoforms and suggest that this treatment ameliorates
heart failure
in CHF rats at the molecular level.
...
PMID:Altered expression of isoforms of myosin heavy chain mRNA in the failing rat heart is ameliorated by chronic treatment with an endothelin receptor antagonist. 959 65
The clinical course and prognosis of familial hypertrophic cardiomyopathy (HCM) are different according to the type of mutation in the genes for sarcomere proteins. It has been disputed that a mutation, which occurs at a functionally important region in the sarcomere proteins, may increase the penetrance and expressivity of the disease. We searched for a causative mutation in an HCM family, which is characterized by early expression of clinical phenotype, high incidence of sudden death at young ages, and progressive
heart failure
in adults. Among the 32 family members in 4 generations, 13 were affected; 4 died suddenly before age 16, 2 children have already had full expression of the cardiac hypertrophy, and other adults have either progressive
heart failure
or poor left ventricular systolic functions. PCR-SSCP (polymerase chain reaction-single strand confirmation polymorphism) analysis of genomic DNAs isolated from peripheral blood leukocytes of the family members identified a Gly716Arg mutation in the cardiac beta-myosin heavy chain gene, which was cosegregated with the clinical phenotype. The mutation is localized near a functionally important site of the
myosin heavy chain
, the 2 active thiols, which contribute to the adenosine triphosphatase activity of myosin S1. This family provides further evidence that the mutation, which occurs at a functionally important site of the
myosin heavy chain
, is associated with the high penetrance and early expression of HCM.
...
PMID:Early expression of a malignant phenotype of familial hypertrophic cardiomyopathy associated with a Gly716Arg myosin heavy chain mutation in a Korean family. 987 56
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