Changes in heart morphometric parameters over the course of a monocrotaline-induced pulmonary arterial hypertension rat model.

BACKGROUND: Aim of this study was to assess changes in cardiac morphometric parameters at different stages of pulmonary arterial hypertension (PAH) using a monocrotaline-induced rat model. METHODS: Four groups were distinguished: I-control, non-PAH (n = 18); II-early PAH (n = 12); III-end-stage PAH (n = 23); and IV-end-stage PAH with myocarditis (n = 7). RESULTS: Performed over the course of PAH in vivo echocardiography showed significant thickening of the right ventricle free wall (end-diastolic dimension), tricuspid annular plane systolic excursion reduction and decrease in pulmonary artery acceleration time normalized to cycle length. No differences in end-diastolic left ventricle free wall thickness measured in echocardiography was observed between groups. Significant increase of right ventricle and decrease of left ventricle systolic pressure was observed over the development of PAH. Thickening and weight increase (241.2% increase) of the right ventricle free wall and significant dilatation of the right ventricle was observed over the course of PAH (p < 0.001). Reduction in the left ventricle free wall thickness was also observed in end-stage PAH (p < 0.001). Significant trend in the left ventricle free wall weight decrease was observed over the course of PAH (p < 0.001, 24.3% reduction). Calculated right/left ventricle free wall weight ratio gradually increased over PAH stages (p < 0.001). The reduction of left ventricle diameter was observed in rats with end-stage PAH both with and without myocarditis (p < 0.001). CONCLUSIONS: PAH leads to multidimensional changes in morphometric cardiac parameters. Right ventricle morphological and functional failure develop gradually from early stage of PAH, while left ventricle changes develop at the end stages of PAH.

[Prevalence and knowledge of modifiable cardiovascular risk factors among patients of primary health care. Malopolska CArdiovascular Preventive Intervention Study (M-CAPRI)].

Introduction: Cardiovascular diseases (CVD) are the main cause of death in Poland. The prevalence of CVD risk factors is regionally differentiated. Awareness of their presence in the population is crucial for identification of high-risk patients and implementation of appropriate preventive intervention. Therefore, the aim of our study was to assess the prevalence and knowledge of modifiable CVD risk factors among patients of primary health care in Malopolska. Material and Methods: The study was conducted among participants of Malopolska CArdiovascular Preventive Intervention Study (M-CAPRI). Standardized questionnaire and clinical evaluation was conducted in a total of 978 consecutive patients (aged 45.7±13.0) without known CVD in randomly selected primary care units in Malopolska. Results: The most common major modifiable CVD risk factor was hypercholesterolemia (648; 66.3%) while predisposing was incorrect nutrition (890; 91.0%). The prevalence of hypertension, hypercholesterolemia, diabetes and obesity was increased with age but cigarette smoking, low physical activity and poor nutrition remain unchanged. CVD risk assessed using Pol-SCORE charts was high or very high in 104 (16.9%) and moderate in 369 (59.5%) patients. Each of the modifiable CVD risk factors was often identified by people with higher education and educated beforehand by a doctor or nurse. The presence of a particular CVD risk factor was not associated with better knowledge of it except for diabetes (OR 3.44, 95% CI 0.996-11.863). Conclusions: Educated patients have better knowledge on CVD risk factors. Identification of CVD risk factors and education about them should be implemented during visits in primary health care.

Myocardial proteomic profile in pulmonary arterial hypertension.

Pulmonary arterial hypertension (PAH) is a rare, fatal, and incurable disorder. Although advances in the understanding of the PAH pathobiology have been seen in recent years, molecular processes underlying heart remodelling over the course of PAH are still insufficiently understood. Therefore, the aim of this study was to investigate myocardial proteomic profile of rats at different stages of monocrotaline-induced PAH. Samples of left and right ventricle (LV and RV) free wall collected from 32 Wistar rats were subjected to proteomic analysis using an isobaric tag for relative quantitation method. Hemodynamic parameters indicated development of mild elevation of pulmonary artery pressure in the early PAH group (27.00 ± 4.93 mmHg) and severe elevation in the end-stage PAH group (50.50 ± 11.56 mmHg). In early PAH LV myocardium proteins that may be linked to an increase in inflammatory response, apoptosis, glycolytic process and decrease in myocardial structural proteins were differentially expressed compared to controls. During end-stage PAH an increase in proteins associated with apoptosis, fibrosis and cardiomyocyte Ca2+ currents as well as decrease in myocardial structural proteins were observed in LV. In RV during early PAH, especially proteins associated with myocardial structural components and fatty acid beta-oxidation pathway were upregulated. During end-stage PAH significant changes in RV proteins abundance related to the increased myocardial structural components, intensified fibrosis and glycolytic processes as well as decreased proteins related to cardiomyocyte Ca2+ currents were observed. At both PAH stages changes in RV proteins linked to apoptosis inhibition were observed. In conclusion, we identified changes of the levels of several proteins and thus of the metabolic pathways linked to the early and late remodelling of the left and right ventricle over the course of monocrotaline-induced PAH to delineate potential therapeutic targets for the treatment of this severe disease.