Oral batyl alcohol supplementation rescues decreased cardiac conduction in ether phospholipid-deficient mice.

Plasmalogens (Pls) are a class of membrane phospholipids which serve a number of essential biological functions. Deficiency of Pls is associated with common disorders such as Alzheimer's disease or ischemic heart disease. A complete lack of Pls due to genetically determined defective biosynthesis gives rise to rhizomelic chondrodysplasia punctata (RCDP), characterized by a number of severe disabling pathologic features and death in early childhood. Frequent cardiac manifestations of RCDP include septal defects, mitral valve prolapse, and patent ductus arteriosus. In a mouse model of RCDP, reduced nerve conduction velocity was partially rescued by dietary oral supplementation of the Pls precursor batyl alcohol (BA). Here, we examine the impact of Pls deficiency on cardiac impulse conduction in a similar mouse model (Gnpat KO). In-vivo electrocardiographic recordings showed that the duration of the QRS complex was significantly longer in Gnpat KO mice than in age- and sex-matched wild-type animals, indicative of reduced cardiac conduction velocity. Oral supplementation of BA for 2 months resulted in normalization of cardiac Pls levels and of the QRS duration in Gnpat KO mice but not in untreated animals. BA treatment had no effect on the QRS duration in age-matched wild-type mice. These data suggest that Pls deficiency is associated with increased ventricular conduction time which can be rescued by oral BA supplementation.

High betatrophin in coronary patients protects from cardiovascular events.

BACKGROUND AND AIMS: Betatrophin, also known as angiopoietin-like protein 8 (ANGPTL8) or lipasin, is a nutritionally-regulated mammalian-specific protein secreted by the liver and adipose tissue. Many conflicting data exist with respect to its association with type 2 diabetes mellitus (T2DM), insulin resistance, and lipid markers, but no data are available on its association with cardiovascular risk. METHODS: We measured betatrophin in 553 coronary patients undergoing coronary angiography for the evaluation of established or suspected stable coronary artery disease (CAD) and prospectively recorded cardiovascular events during a follow-up of up to 8 years. RESULTS: During follow-up, 201 patients suffered a cardiovascular event and 64 died from cardiovascular causes. High betatrophin (upper tertile) was significantly and inversely associated with cardiovascular events both univariately (HR = 0.64 [95%CI 0.47-0.87], p = 0.004) and after full adjustment including the status of CAD and T2DM (adj. HR = 0.55 [95%CI 0.40-0.76], p < 0.001). The inclusion of betatrophin into a basic prediction model for the cardiovascular event risk significantly improved the model performance (NRI = 0.728, p < 0.001). CONCLUSIONS: This study is the first to show that betatrophin predicts cardiovascular events independently of conventional risk factors including the presence of CAD and T2DM.

The novel adipokine CTRP1 is significantly associated with the incidence of major adverse cardiovascular events.

BACKGROUND AND AIMS: The recently identified adiponectin paralogue C1q and tumor necrosis factor-related protein 1 (CTRP1) has been associated with obesity-linked disorders and coronary atherosclerosis. So far, the impact of circulating CTRP1 on the incidence of future cardiovascular events is unclear. Therefore, we aimed at investigating the association between CTRP1 and future cardiovascular risk. METHODS: We measured CTRP1 serum levels in 539 patients undergoing coronary angiography for the evaluation of established or suspected stable coronary artery disease (CAD). Prospectively, we recorded major adverse cardiovascular events (MACE), defined as the incidence of cardiovascular death, non-fatal myocardial infarction and non-fatal stroke over a follow-up period of 8 years. RESULTS: At baseline, obesity, the metabolic syndrome, type 2 diabetes, and non-alcoholic fatty liver disease were significantly associated with increased CTRP1 (all p-values ≤0.001). Prospectively, MACE rates were lowest in the first quartile (15.3%) and increased over the second (23.7%) to the third and fourth quartile (each 29.0%; ptrend = 0.008). Moreover, after multivariable adjustment, CTRP1 was significantly associated with future MACE, with adjusted HRs of 1.83 [1.04-3.23]; p=0.037, 2.16 [1.25-3.75]; p=0.006, and 1.80 [1.03-3.15]; p=0.038, for CTRP1 quartiles two, three and four, respectively, when compared to quartile one. CONCLUSIONS: We conclude that high serum levels of CTRP1 are significantly associated with future MACE.

Serum uromodulin is a predictive biomarker for cardiovascular events and overall mortality in coronary patients.

BACKGROUND: Uromodulin is a protein produced exclusively by the kidneys and present in urine and blood. In contrast to weak and in part contradictory study data on uromodulin in urine samples, the analysis of serum samples recently proved uromodulin's value as superior biomarker for ongoing kidney disease. Whether serum uromodulin is associated with cardiovascular event risk and whether it has predictive power for overall mortality is still unknown and has been evaluated in the present study. METHODS: We measured uromodulin in a series of 529 patients without acute coronary syndrome undergoing coronary angiography for the evaluation of established or suspected stable coronary artery disease (CAD) and prospectively recorded mortality as well as cardiovascular events in our patients during a follow-up of up to 8years. RESULTS: We recorded 95 deaths and 145 cardiovascular events over 8years. Serum uromodulin proved protective for overall mortality (HR=0.56 [95%CI 0.43-0.72]; p<0.001), even after full adjustment including eGFR, current smoking, diabetes, and CAD status (adj. HR=0.57 [95%CI 0.37-0.89]; p=0.014). Patients in the lowest tertile of serum uromodulin had a significantly higher cardiovascular event risk compared to patients in the medium and highest tertile (HR=of 1.45 (95%CI 1.04-2.02, p=0.027). The ratio between creatinine and uromodulin was significantly associated with kidney function (r=-0.322; p<0.001) and significantly predicted the incidence of cardiovascular events (HR of 1.26 [95%CI 1.12-1.41], p<0.001) and major cardiovascular events (HR of 1.37 [95%CI 1.21-1.56], p<0.001). CONCLUSION: We conclude that serum uromodulin is a valuable biomarker to predict overall mortality and cardiovascular events.