Impaired Relaxation and Reduced Lusitropic Reserve in Atrial Myocardium in the Obese Patients
Background: Obesity can influence the structure and function of the atrium, but most studies focused on the relationship of body mass index (BMI) and overt left atrium (LA) dysfunction as assessed by clinical imaging. We combined the assessment of right atrium (RA) function in vivo and in vitro in o...
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.739907/full |
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| author | Yan Wen Yan Wen Peter M. Deißler Peter M. Deißler Uwe Primeßnig Uwe Primeßnig Uwe Primeßnig Simon Dushe Simon Dushe Volkmar Falk Volkmar Falk Volkmar Falk Volkmar Falk Abdul Shokor Parwani Leif-Hendrik Boldt Florian Blaschke Christoph Knosalla Herko Grubitzsch Herko Grubitzsch Burkert M. Pieske Burkert M. Pieske Burkert M. Pieske Frank R. Heinzel Frank R. Heinzel |
| author_facet | Yan Wen Yan Wen Peter M. Deißler Peter M. Deißler Uwe Primeßnig Uwe Primeßnig Uwe Primeßnig Simon Dushe Simon Dushe Volkmar Falk Volkmar Falk Volkmar Falk Volkmar Falk Abdul Shokor Parwani Leif-Hendrik Boldt Florian Blaschke Christoph Knosalla Herko Grubitzsch Herko Grubitzsch Burkert M. Pieske Burkert M. Pieske Burkert M. Pieske Frank R. Heinzel Frank R. Heinzel |
| author_sort | Yan Wen |
| collection | DOAJ |
| description | Background: Obesity can influence the structure and function of the atrium, but most studies focused on the relationship of body mass index (BMI) and overt left atrium (LA) dysfunction as assessed by clinical imaging. We combined the assessment of right atrium (RA) function in vivo and in vitro in obese and non-obese patients scheduled for elective cardiac surgery.Methods: Atrial structure and function were quantified pre-operatively by echocardiography. RA tissue removed for the establishment of extracorporeal support was collected and RA trabeculae function was quantified in vitro at baseline and with adrenergic stimulation (isoproterenol). Fatty acid-binding protein 3 (FABP3) was quantified in RA tissue. Results were stratified according to the BMI of the patients.Results: About 76 patients were included pre-operatively for the echocardiographic analysis. RA trabeculae function at baseline was finally quantified from 46 patients and RA function in 28 patients was also assessed with isoproterenol. There was no significant correlation between BMI and the parameters of atrial function measured by the clinical echocardiography. However, in vitro measurements revealed a significant correlation between BMI and a prolonged relaxation of the atrial myocardium at baseline, which persisted after controlling for the atrial fibrillation and diabetes by the partial correlation analysis. Acceleration of relaxation with isoproterenol was significantly lower in the obese group (BMI ≥ 30 kg/m2). As a result, relaxation with adrenergic stimulation in the obese group remained significantly higher compared to the overweight group (25 kg/m2 ≤ BMI < 30 kg/m2, p = 0.027) and normal group (18.5 kg/m2 ≤ BMI < 25 kg/m2, p = 0.036). There were no differences on impacts of the isoproterenol on (systolic) developed force between groups. The expression of FABP3 in the obese group was significantly higher compared to the normal group (p = 0.049) and the correlation analysis showed the significant correlations between the level of FABP3 in the RA trabeculae function.Conclusion: A higher BMI is associated with the early subclinical changes of RA myocardial function with the slowed relaxation and reduced adrenergic lusitropy. |
| first_indexed | 2024-12-19T03:51:36Z |
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| language | English |
| last_indexed | 2024-12-19T03:51:36Z |
| publishDate | 2021-10-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-6c58fe6bf13046fc8a97df1ac24e0a6b2022-12-21T20:36:58ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-10-01810.3389/fcvm.2021.739907739907Impaired Relaxation and Reduced Lusitropic Reserve in Atrial Myocardium in the Obese PatientsYan Wen0Yan Wen1Peter M. Deißler2Peter M. Deißler3Uwe Primeßnig4Uwe Primeßnig5Uwe Primeßnig6Simon Dushe7Simon Dushe8Volkmar Falk9Volkmar Falk10Volkmar Falk11Volkmar Falk12Abdul Shokor Parwani13Leif-Hendrik Boldt14Florian Blaschke15Christoph Knosalla16Herko Grubitzsch17Herko Grubitzsch18Burkert M. Pieske19Burkert M. Pieske20Burkert M. Pieske21Frank R. Heinzel22Frank R. Heinzel23Department of Internal Medicine and Cardiology, Charité University Medicine, Campus Virchow-Klinikum, Berlin, GermanyDepartment of Intensive Care Unit, The First Affiliated Hospital of Fujian Medical University, Fuzhou, ChinaDepartment of Internal Medicine and Cardiology, Charité University Medicine, Campus Virchow-Klinikum, Berlin, GermanyGerman Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, GermanyDepartment of Internal Medicine and Cardiology, Charité University Medicine, Campus Virchow-Klinikum, Berlin, GermanyGerman Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, GermanyBerlin Institute of Health (BIH), Berlin, GermanyBerlin Institute of Health (BIH), Berlin, GermanyDepartment of Cardiovascular Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Intensive Care Unit, The First Affiliated Hospital of Fujian Medical University, Fuzhou, ChinaBerlin Institute of Health (BIH), Berlin, GermanyDepartment of Cardiovascular Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Berlin, GermanyDepartment of Internal Medicine and Cardiology, Charité University Medicine, Campus Virchow-Klinikum, Berlin, GermanyDepartment of Internal Medicine and Cardiology, Charité University Medicine, Campus Virchow-Klinikum, Berlin, GermanyDepartment of Internal Medicine and Cardiology, Charité University Medicine, Campus Virchow-Klinikum, Berlin, GermanyDepartment of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, GermanyBerlin Institute of Health (BIH), Berlin, GermanyDepartment of Cardiovascular Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Internal Medicine and Cardiology, Charité University Medicine, Campus Virchow-Klinikum, Berlin, GermanyGerman Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, GermanyDepartment of Internal Medicine and Cardiology, German Heart Center Berlin, Berlin, GermanyDepartment of Internal Medicine and Cardiology, Charité University Medicine, Campus Virchow-Klinikum, Berlin, GermanyGerman Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, GermanyBackground: Obesity can influence the structure and function of the atrium, but most studies focused on the relationship of body mass index (BMI) and overt left atrium (LA) dysfunction as assessed by clinical imaging. We combined the assessment of right atrium (RA) function in vivo and in vitro in obese and non-obese patients scheduled for elective cardiac surgery.Methods: Atrial structure and function were quantified pre-operatively by echocardiography. RA tissue removed for the establishment of extracorporeal support was collected and RA trabeculae function was quantified in vitro at baseline and with adrenergic stimulation (isoproterenol). Fatty acid-binding protein 3 (FABP3) was quantified in RA tissue. Results were stratified according to the BMI of the patients.Results: About 76 patients were included pre-operatively for the echocardiographic analysis. RA trabeculae function at baseline was finally quantified from 46 patients and RA function in 28 patients was also assessed with isoproterenol. There was no significant correlation between BMI and the parameters of atrial function measured by the clinical echocardiography. However, in vitro measurements revealed a significant correlation between BMI and a prolonged relaxation of the atrial myocardium at baseline, which persisted after controlling for the atrial fibrillation and diabetes by the partial correlation analysis. Acceleration of relaxation with isoproterenol was significantly lower in the obese group (BMI ≥ 30 kg/m2). As a result, relaxation with adrenergic stimulation in the obese group remained significantly higher compared to the overweight group (25 kg/m2 ≤ BMI < 30 kg/m2, p = 0.027) and normal group (18.5 kg/m2 ≤ BMI < 25 kg/m2, p = 0.036). There were no differences on impacts of the isoproterenol on (systolic) developed force between groups. The expression of FABP3 in the obese group was significantly higher compared to the normal group (p = 0.049) and the correlation analysis showed the significant correlations between the level of FABP3 in the RA trabeculae function.Conclusion: A higher BMI is associated with the early subclinical changes of RA myocardial function with the slowed relaxation and reduced adrenergic lusitropy.https://www.frontiersin.org/articles/10.3389/fcvm.2021.739907/fullright atrial complianceobesityBMIatrial trabeculaeearly subclinical changes |
| spellingShingle | Yan Wen Yan Wen Peter M. Deißler Peter M. Deißler Uwe Primeßnig Uwe Primeßnig Uwe Primeßnig Simon Dushe Simon Dushe Volkmar Falk Volkmar Falk Volkmar Falk Volkmar Falk Abdul Shokor Parwani Leif-Hendrik Boldt Florian Blaschke Christoph Knosalla Herko Grubitzsch Herko Grubitzsch Burkert M. Pieske Burkert M. Pieske Burkert M. Pieske Frank R. Heinzel Frank R. Heinzel Impaired Relaxation and Reduced Lusitropic Reserve in Atrial Myocardium in the Obese Patients Frontiers in Cardiovascular Medicine right atrial compliance obesity BMI atrial trabeculae early subclinical changes |
| title | Impaired Relaxation and Reduced Lusitropic Reserve in Atrial Myocardium in the Obese Patients |
| title_full | Impaired Relaxation and Reduced Lusitropic Reserve in Atrial Myocardium in the Obese Patients |
| title_fullStr | Impaired Relaxation and Reduced Lusitropic Reserve in Atrial Myocardium in the Obese Patients |
| title_full_unstemmed | Impaired Relaxation and Reduced Lusitropic Reserve in Atrial Myocardium in the Obese Patients |
| title_short | Impaired Relaxation and Reduced Lusitropic Reserve in Atrial Myocardium in the Obese Patients |
| title_sort | impaired relaxation and reduced lusitropic reserve in atrial myocardium in the obese patients |
| topic | right atrial compliance obesity BMI atrial trabeculae early subclinical changes |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.739907/full |
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