Mitochondrial Structural Abnormalities and Cardiac Reverse Remodeling in Patients With Systolic Dysfunction.

IF 3.1 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Circulation Journal Pub Date : 2024-12-25 Epub Date: 2024-10-05 DOI:10.1253/circj.CJ-24-0451
Koji Nakano, Masayoshi Yamamoto, Yu Yamada, Tomofumi Nakatsukasa, Naoto Kawamatsu, Kimi Sato, Tomoko Machino-Ohtsuka, Nobuyuki Murakoshi, Tomoko Ishizu
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引用次数: 0

Abstract

Background: Mitochondrial dysfunction in the heart is associated with the development of heart failure (HF). However, the clinical consequences of mitochondrial structural abnormalities in patients with HF remain unexplored.

Methods and results: Ninety-one patients with left ventricular (LV) systolic dysfunction who underwent endomyocardial biopsy (EMB) were enrolled in the study. Myocardial specimens were obtained from the right ventricular septum. Specimens were characterized using electron microscopy to assess mitochondrial size, outer membrane disruption, and cristae disorganization. The primary endpoint was a composite of cardiovascular death and unplanned hospitalization for HF. Patients were classified into LV reverse remodeling (LVRR)-positive (n=52; 57.1%) and LVRR-negative (n=39; 42.9%) groups. Cristae disorganization was observed in 21 (23.1%) patients: 6 (11.5%) in the LVRR-positive group and 15 (38.5%) in the LVRR-negative group (P=0.005). During the 1-year post-EMB observation period, 16 patients (17.6%) met the primary endpoint, with 2 (2.2%) cardiovascular deaths and 14 (15.4%) HF hospitalizations. Cristae disorganization (P=0.002) was significantly associated with the endpoints, independent of age (P=0.115), systolic blood pressure (P=0.004), B-type natriuretic peptide level (P=0.042), and mitral regurgitation (P=0.003).

Conclusions: We classified mitochondrial structural abnormalities and showed that cristae disorganization was associated with LVRR and worse prognosis. These findings may affect the management of patients with HF and systolic dysfunction who undergo EMB.

收缩功能障碍患者的线粒体结构异常与心脏反向重塑
背景:心脏线粒体功能障碍与心力衰竭(HF)的发生有关。然而,线粒体结构异常对心力衰竭患者的临床影响仍有待研究:91名左心室收缩功能障碍患者接受了心内膜活检(EMB)。心肌标本取自右心室隔膜。使用电子显微镜对标本进行特征描述,以评估线粒体大小、外膜破坏情况和嵴解理情况。主要终点是心血管死亡和因高血压意外住院的复合终点。患者被分为左心室反向重塑(LVRR)阳性组(n=52;57.1%)和左心室反向重塑阴性组(n=39;42.9%)。21例(23.1%)患者出现纤溶紊乱:LVRR阳性组有6例(11.5%),LVRR阴性组有15例(38.5%)(P=0.005)。在EMB术后1年的观察期间,16名患者(17.6%)达到了主要终点,其中2人(2.2%)心血管死亡,14人(15.4%)心房颤动住院。线粒体紊乱(P=0.002)与终点显著相关,不受年龄(P=0.115)、收缩压(P=0.004)、B型钠尿肽水平(P=0.042)和二尖瓣反流(P=0.003)的影响:我们对线粒体结构异常进行了分类,结果显示嵴结构紊乱与左心室返流和预后不良有关。这些发现可能会影响接受 EMB 的高房颤和收缩功能障碍患者的治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Circulation Journal
Circulation Journal 医学-心血管系统
CiteScore
5.80
自引率
12.10%
发文量
471
审稿时长
1.6 months
期刊介绍: Circulation publishes original research manuscripts, review articles, and other content related to cardiovascular health and disease, including observational studies, clinical trials, epidemiology, health services and outcomes studies, and advances in basic and translational research.
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