Persoon, Sven and Paulus, Michael and Hirt, Stephan and Jungbauer, Carsten and Dietl, Alexander and Luchner, Andreas and Schmid, Christof and Maier, Lars S. and Birner, Christoph (2018) Cardiac unloading by LVAD support differentially influences components of the cGMP-PKG signaling pathway in ischemic and dilated cardiomyopathy. HEART AND VESSELS, 33 (8). pp. 948-957. ISSN 0910-8327, 1615-2573
Full text not available from this repository. (Request a copy)Abstract
Implantation of left ventricular assist devices (LVADs) as bridge to transplant in end-stage heart failure allows for analyzing reverse remodeling processes of the supported heart. Whether this therapy influences the cGMP-PKG signaling pathway, which is currently under thorough investigation for developing new heart failure therapeutics, is unknown. In fourteen end-stage heart failure patients (8 with dilated cardiomyopathy, DCM; 6 with ischemic cardiomyopathy, ICM) tissue specimens of left ventricles were collected at LVAD implantation and afterwards at receiver heart explantation, respectively. Then the expressions of key components of the cGMP-PKG signaling pathway were determined by polymerase chain reaction (ANP; BNP; natriuretic peptide receptor A, NPR-A; natriuretic peptide receptor C, NPR-C; neprilysin; NOS3; soluble guanylyl cyclase, sGC; PDE5; cGMP-dependent protein kinase G, PKG) and enzyme-linked immunosorbent assay (cGMP), respectively. Patients were predominantly male, 52 +/- 10 years old, were receiving recommended heart failure therapy, and had their donor organ implanted after 351 +/- 317 days of LVAD support. Except for more DCM patients with ICD therapy, no significant differences were detected between ICM and DCM, which also applies to the expression of cGMP-PKG pathway components at baseline. After LVAD support, ANP, NPR-C, and cGMP were significantly down-regulated and neprilysin, PDE5, and PKG I expressions were reduced with borderline significance in DCM, but not in ICM patients. Multiple significant correlations were found for expression differences (i.e., expression at LVAD implantation minus expression at heart transplantation) both in DCM and ICM, even though there was a closer connection between the NO and NP side of the cGMP-PKG pathway in DCM patients. Furthermore, duration of LVAD support negatively correlated with expression differences of PKG I, PDE5, and sGC in ICM, but not in DCM. Originating from the same activation level at LVAD implantation, cardiac unloading significantly alters key components of the cGMP-PKG pathway in DCM, but not in ICM patients. This etiology-specific regulation should be considered when analyzing therapeutic interventions with effects on this signaling pathway.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | VENTRICULAR ASSIST DEVICE; PRESERVED EJECTION FRACTION; CHRONIC HEART-FAILURE; GUANYLATE-CYCLASE STIMULATOR; FAILING HUMAN HEART; EXERCISE CAPACITY; GENE-EXPRESSION; CLINICAL STATUS; INHIBITION; VERICIGUAT; Heart failure; Cardiac unloading; LVAD; cGMP-PKG pathway |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Mar 2020 06:30 |
| Last Modified: | 06 Mar 2020 06:30 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14183 |
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