Heart Stress

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Eugenio Picano - One of the best experts on this subject based on the ideXlab platform.

  • Right Heart Stress Echocardiography
    Stress Echocardiography, 2015
    Co-Authors: Ekkehard Grunig, Eugenio Picano
    Abstract:

    The behavior of the right side of the Heart during Stress has been underemphasized and sparsely investigated by cardiologists and pneumologists. Reasons vary, but the right ventricle has traditionally been considered a passive conduit between the venous system and the lungs largely because of early animal experiments showing no increase of central venous pressure after the free wall of the right ventricle had been destroyed [1–3]. In addition, echocardiography of the right Heart is less well standardized [4] as imaging of the left ventricle. Recent pathophysiological, clinical, and prognostic data have defined an important role for the right ventricle in many conditions, including ischemic Heart disease and Heart failure. Given that the right ventricle and the left ventricle share a common septum, have an overlapping blood supply, and are bound together by the pericardium, changes induced by myocardial ischemia and/or Heart failure are reflected in pulmonary hemodynamics and right ventricular function [5]. Modern Doppler echocardiography allows a systematic evaluation of five key aspects of cardiopulmonary pathophysiology during Stress: segmental right ventricular function; global right ventricular longitudinal function; coronary flow reserve in the posterior descending of the right coronary artery; indices of pulmonary hemodynamics, namely, pulmonary artery systolic pressure, pulmonary velocity time integrals, and pulmonary vascular resistances; and extravascular lung water in the lung, mirroring the diStress of the alveolar–capillary membrane. Technical improvements were also matched by a greater understanding of the complexity and the clinical relevance of the adaptation of the right Heart (functionally including pulmonary circulation and lung alveolar–capillary membrane) in several pathological conditions, from coronary artery disease to Heart failure [5]. In many situations, it is not possible to fully understand Heart disease if we do not look at the right Heart and pulmonary Stress hemodynamics.

Ekkehard Grunig - One of the best experts on this subject based on the ideXlab platform.

  • Right Heart Stress Echocardiography
    Stress Echocardiography, 2015
    Co-Authors: Ekkehard Grunig, Eugenio Picano
    Abstract:

    The behavior of the right side of the Heart during Stress has been underemphasized and sparsely investigated by cardiologists and pneumologists. Reasons vary, but the right ventricle has traditionally been considered a passive conduit between the venous system and the lungs largely because of early animal experiments showing no increase of central venous pressure after the free wall of the right ventricle had been destroyed [1–3]. In addition, echocardiography of the right Heart is less well standardized [4] as imaging of the left ventricle. Recent pathophysiological, clinical, and prognostic data have defined an important role for the right ventricle in many conditions, including ischemic Heart disease and Heart failure. Given that the right ventricle and the left ventricle share a common septum, have an overlapping blood supply, and are bound together by the pericardium, changes induced by myocardial ischemia and/or Heart failure are reflected in pulmonary hemodynamics and right ventricular function [5]. Modern Doppler echocardiography allows a systematic evaluation of five key aspects of cardiopulmonary pathophysiology during Stress: segmental right ventricular function; global right ventricular longitudinal function; coronary flow reserve in the posterior descending of the right coronary artery; indices of pulmonary hemodynamics, namely, pulmonary artery systolic pressure, pulmonary velocity time integrals, and pulmonary vascular resistances; and extravascular lung water in the lung, mirroring the diStress of the alveolar–capillary membrane. Technical improvements were also matched by a greater understanding of the complexity and the clinical relevance of the adaptation of the right Heart (functionally including pulmonary circulation and lung alveolar–capillary membrane) in several pathological conditions, from coronary artery disease to Heart failure [5]. In many situations, it is not possible to fully understand Heart disease if we do not look at the right Heart and pulmonary Stress hemodynamics.

Leo Sher - One of the best experts on this subject based on the ideXlab platform.

  • type d personality the Heart Stress and cortisol
    QJM: An International Journal of Medicine, 2005
    Co-Authors: Leo Sher
    Abstract:

    Many studies have demonstrated the role of psychosocial and behavioural risk factors in the aetiology and pathogenesis of cardiovascular disorders. Recently, a new personality construct, the type D or 'diStressed' personality, has been proposed. Type D behaviour is characterized by the joint tendency to experience negative emotions and to inhibit these emotions while avoiding social contacts with others. The observation that cardiac patients with type D personality are at increased risk for cardiovascular morbidity and mortality underlines the importance of examining both acute (e.g. major depression) and chronic (e.g. certain personality features) factors in patients at risk for coronary events. Both type D dimensions (negative affectivity and social inhibition) are associated with greater cortisol reactivity to Stress. Elevated cortisol may be a mediating factor in the association between type D personality and the increased risk for coronary Heart disease and, possibly, other medical disorders. Studies of the effect of age on hypothalamic-pituitary-adrenal (HPA) function in healthy humans have produced inconsistent results. This may relate to a different prevalence of type D individuals in study samples (i.e. some type D individuals may have alterations within the HPA axis that are similar to HPA axis changes in depressed patients). Further studies of the psychological and biological features of type D individuals may help develop treatment approaches to improve the psychological and physical health of individuals with type D personality.

Katsuhito Fujiu - One of the best experts on this subject based on the ideXlab platform.

  • Cardiac macrophages prevent sudden death during Heart Stress.
    Nature communications, 2021
    Co-Authors: Junichi Sugita, Katsuhito Fujiu, Yukiteru Nakayama, Takumi Matsubara, Jun Matsuda, Tsukasa Oshima, Yuxiang Liu, Yujin Maru, Eriko Hasumi, Toshiya Kojima
    Abstract:

    Cardiac arrhythmias are a primary contributor to sudden cardiac death, a major unmet medical need. Because right ventricular (RV) dysfunction increases the risk for sudden cardiac death, we examined responses to RV Stress in mice. Among immune cells accumulated in the RV after pressure overload-induced by pulmonary artery banding, interfering with macrophages caused sudden death from severe arrhythmias. We show that cardiac macrophages crucially maintain cardiac impulse conduction by facilitating myocardial intercellular communication through gap junctions. Amphiregulin (AREG) produced by cardiac macrophages is a key mediator that controls connexin 43 phosphorylation and translocation in cardiomyocytes. Deletion of Areg from macrophages led to disorganization of gap junctions and, in turn, lethal arrhythmias during acute Stresses, including RV pressure overload and β-adrenergic receptor stimulation. These results suggest that AREG from cardiac resident macrophages is a critical regulator of cardiac impulse conduction and may be a useful therapeutic target for the prevention of sudden death.

  • Contributions of cardiomyocyte–cardiac fibroblast–immune cell interactions in Heart failure development
    Basic Research in Cardiology, 2013
    Co-Authors: Katsuhito Fujiu, Ryozo Nagai
    Abstract:

    The Heart contains various types of cells, including cardiomyocytes, cardiac fibroblasts, many kinds of immune cells and vascular cells. Initial studies mainly focused on cardiomyocytes, which directly reflect the contractile function of the Heart. Recently, pivotal functions of cardiac fibroblasts have been revealed in the maintenance of cardiac function, physiological cardiac remodeling after Heart Stress and pathological remodeling using genetically engineered mouse models, like the fibroblast-specific gene knockout mouse, bone marrow transplantation and immune cell-specific gene knockout. Moreover, chronic inflammation is considered to be a basic pathological mechanism that underlies various diseases, including Heart failure. In the development of Heart failure, the contributions of immune cells like T lymphocytes and monocyte/macrophage lineage cells have been also reported. Immune cells have diverse and multiple functions in regulating both pro-inflammatory effects and the resolution of Heart failure. On the one hand, immune cells have protective effects to compensate for and overcome Heart Stresses. On the other hand, they also contribute to sustained inflammation and result in the development of Heart failure. These observations prompted a shift in the Heart-related studies to include the complex communications between cardiomyocytes and other kinds of cardiac cells, including inflammatory cells residing in or recruited to the Heart. This review will summarize the current knowledge regarding cell–cell interactions during cardiac remodeling and the development of Heart failure. We will especially focus on the interactions among cardiomyocytes, cardiac fibroblasts and immune cells.

  • Contributions of cardiomyocyte-cardiac fibroblast-immune cell interactions in Heart failure development.
    Basic research in cardiology, 2013
    Co-Authors: Katsuhito Fujiu, Ryozo Nagai
    Abstract:

    The Heart contains various types of cells, including cardiomyocytes, cardiac fibroblasts, many kinds of immune cells and vascular cells. Initial studies mainly focused on cardiomyocytes, which directly reflect the contractile function of the Heart. Recently, pivotal functions of cardiac fibroblasts have been revealed in the maintenance of cardiac function, physiological cardiac remodeling after Heart Stress and pathological remodeling using genetically engineered mouse models, like the fibroblast-specific gene knockout mouse, bone marrow transplantation and immune cell-specific gene knockout. Moreover, chronic inflammation is considered to be a basic pathological mechanism that underlies various diseases, including Heart failure. In the development of Heart failure, the contributions of immune cells like T lymphocytes and monocyte/macrophage lineage cells have been also reported. Immune cells have diverse and multiple functions in regulating both pro-inflammatory effects and the resolution of Heart failure. On the one hand, immune cells have protective effects to compensate for and overcome Heart Stresses. On the other hand, they also contribute to sustained inflammation and result in the development of Heart failure. These observations prompted a shift in the Heart-related studies to include the complex communications between cardiomyocytes and other kinds of cardiac cells, including inflammatory cells residing in or recruited to the Heart. This review will summarize the current knowledge regarding cell-cell interactions during cardiac remodeling and the development of Heart failure. We will especially focus on the interactions among cardiomyocytes, cardiac fibroblasts and immune cells.

Thomas Flohr - One of the best experts on this subject based on the ideXlab platform.

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