Search Results for: Come stress e attacchi di cuore sono collegati

Circulation, Volume 150, Issue Suppl_1, Page A4138348-A4138348, November 12, 2024. Methods and Results:We describe a comprehensive characterization of the AVICs nucleus landscape as determined by transmission electron microscopy (TEM) of samples obtained from CAVD patients. Turbulence led to nuclear envelope integrity lose in AVICs cultured in shear stress experiments, with three different fluid conditions [static (ST), laminar stress (LS), and oscillatory stress (OS)], indicated by Western blot and immunofluorescence (IF). Silencing lamin A/C (LMNA) through small interfering RNA (siRNA), accelerated nuclear envelope damage , as indicated by Western blot, qPCR, and immunofluorescence (IF). The formation of Z-DNA and its co-localization with Z-DNA binding protein (ZBP1) was observed due to the nuclear envelope damage by IF. Western blot, qPCR, IHC and IF confirmed Z-DNA-induced inflammation in AVICs through the ZBP1-RIPK3-NF-κB signaling pathway. ZBP1 and RIPK3 knockdown with siRNA markedly reduced the protein level of osteogenic markers alkaline phosphatase (ALP), runt-related transcription factor 2 (RUNX2), and bone morphogenetic protein 2 (BMP2) in VICs. In vivo, aortic valve disease was constructed by direct wire injury (DWI), and we showed that overexpression of LMNA by adeno-associated virus significantly decelerated the progression of aortic valve lesion induced by DWI in mice.Conclusion:Excessive mechanical stress can induce damage to the nuclear envelope of AVICs by causing cytoskeletal remodeling, initiating the formation of Z-DNA, and hastening the calcification process in AVICs and CAVD.

Circulation, Volume 150, Issue Suppl_1, Page A4139708-A4139708, November 12, 2024. Background:Racial and ethnic disparities exist in cardiovascular health (CVH) in pregnancy. While social determinants of health (SDOH) affect CVH, the extent to which SDOH assessed in early pregnancy explain racial and ethnic differences in CVH postpartum remains to be defined.Objective:This study examines the relative contribution of SDOH in early pregnancy to racial and ethnic differences in maternal CVH 2-7 years after delivery.Methods:This is a secondary analysis of the prospective nulliparous pregnancy outcomes study: Monitoring Mothers-to-be Heart Health Study (nuMoM2b-HHS) cohort. The outcome was maternal CVH defined using the American Heart Association’s Life’s Essential 8 (LE8) framework, which included body mass index, blood pressure, lipids, fasting glucose, diet, physical activity, sleep health, and smoking status, and calculated as a score of 0-100. We used the Blinder-Oaxaca decomposition to quantify the statistical contributions of differences in demographic (age and nativity), socioeconomic status ([SES], education, income, insurance, and health literacy), and psychosocial (resilience, social support, anxiety, depression, and stress) factors in early pregnancy to differences in mean postpartum CVH between the two largest self-identified minoritized racial and ethnic groups (non-Hispanic [NH] Black and Hispanic) and NH White individuals.Results:Of 4,161 assessed pregnant individuals, 17.7% identified as Hispanic, 15% as Black, and 67.3% as White. After adjusting for demographic, SES, and psychosocial factors, the average CVH score in White individuals was 12.2 (SE 1.2) points higher (better) than in Black individuals and 3.3 (SE 0.8) points higher than in Hispanic individuals (Figure, all p

Circulation, Volume 150, Issue Suppl_1, Page A4141959-A4141959, November 12, 2024. Blood pressure (BP) control among older adults may differ by neighborhood due to differences in access to healthy foods, safe places to exercise, and stress. Neighborhood disadvantage may also influence clinician behaviors for hypertension management.This retrospective observational study utilized electronic health data from 52,750 primary care visits among 8,434 adults age ≥ 65 years with hypertension between January 1, 2017, and March 10, 2020 to examine the association of Area Deprivation Index (ADI) with odds of uncontrolled BP during a clinic visit and with therapeutic inertia (TI). Higher ADI values indicate higher deprivation. TI was defined as the absence of a prescription for or escalation of a new BP lowering medication during clinic visits with systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg. Binary generalized linear mixed models were used to determine the association of ADI quartiles with uncontrolled BP and with TI during a clinic visit while adjusting for demographics, comorbidities, insurance status, and the intra-patient correlation. Among the 8,434 patients, the mean age at the first visit was 74.3 years (standard deviation 7.8), 57.7% were female, and race/ethnicity was self-reported as non-Hispanic (NH) White in 69.1%, NH Black in 15.9%, NH Other in 5.0%, and Hispanic in 8.2%. The median ADI was 41 (interquartile range: 26-53). The percentage of clinic visits with uncontrolled BP ranged from 39.1% in the first to 44.1% in the fourth ADI quartile.Figure 1 shows the unadjusted and adjusted odds of uncontrolled BP and TI by ADI quartiles. Adjusted odds of uncontrolled BP during a clinic visit was 1.17 (95% confidence interval (CI) 1.06, 1.28) in the fourth vs. first ADI quartile. Among the 21,928 clinic visits with uncontrolled BP, TI occurred in 79.5%, 82.2%, 83.0%, and 81.6% of visits in ADI quartiles one, two, three, and four, respectively. Adjusted odds of TI during a clinic visit was 1.16 (95% CI 1.01, 1.33) in the fourth vs. first ADI quartile.Our findings of higher odds of uncontrolled BP and TI during clinic visits with patients residing in neighborhoods with higher vs. lower ADI suggest that neighborhood disadvantage is associated with both uncontrolled BP and TI in older adults.

Circulation, Volume 150, Issue Suppl_1, Page A4122024-A4122024, November 12, 2024. Background:Hypertrophic cardiomyopathy (HCM) is a relatively rare but debilitating diagnosis in pediatric patients. This represents a vulnerable population who often require heart transplantation. Here, we examine the transcriptome in ventricular tissue to identify underlying cellular processes unique to pediatric HCM (pHCM).Methods:We performed single-nucleus RNA sequencing on explanted hearts at transplant in female patients with end-stage pHCM (n=3) and compared findings to pediatric control (n=2) and adult HCM (n=5; Figure 1A-1B).Results:We generated 91,682 single-cell transcriptomes from 8 tissue samples. Principal component analysis exhibited the largest source of transcriptional variation separated pHCM and controls (Figure 1C). We identified distinct underlying cellular processes in cardiomyocytes, fibroblasts, endothelial cells, and myeloid cells in pHCM. pHCM was enriched in cardiomyocytes with stressed signatures and pathways associated with hypertrophy (Figure 1D); we noted depletion of tissue-resident macrophages (Figure 1D) and increased vascular remodeling in endothelial cells in pHCM. Fibroblasts exhibited activation signatures and compared to adult HCM, showed heightened fibrotic processes and a unique pro-fibrotic cluster with increased metabolic stress, mitochondrial turnover, and anti-apoptotic properties (Figure 2). In cell-to-cell communication, the differential number and weight of interactions were higher in pHCM compared to controls and fibroblasts had the highest strength of outgoing interactions.Conclusions:Our analysis provides the first single-nuclei analysis focused on pHCM. Fibroblast-mediated cellular processes contributed most to the disrupted micro-tissue environment; they had more downstream processes associated with fibrosis and may respond to metabolic stress differently compared to adult HCM. This advances our understanding of the early presentation of pHCM, providing a crucial steppingstone toward improved patient outcomes.

Circulation, Volume 150, Issue Suppl_1, Page A4143744-A4143744, November 12, 2024. Introduction/Background:Hypertension and hypercholesterolemia are important risk factors of endothelial dysfunction and atherosclerosis. Previous studies suggested a crosstalk between an activated renin-angiotensin-aldosterone system (RAAS), reactive oxygen species (ROS) and oxidized low-density lipoproteins (oxLDL) in atherosclerosis, but the underlying molecular mechanisms are not well understood.Research Question/Hypothesis:Can we identify novel signaling pathways controlling the molecular crosstalk of the RAAS with ROS and oxLDL in endothelial dysfunction and atherosclerosis?Methods/Approach:The impact of AT1R blockade on oxLDL-induced superoxide anion formation and endothelial dysfunction was studied in human umbilical artery endothelial cells and aortic rings of wild-type mice by chemiluminescence and Mulvany myograph. We cloned 5’-terminal deletions of the AT1R promoter and assessed the luciferase activity in human endothelial cells. Oct-1 binding to the human AT1R promoter region was studied by EMSA. Further assays included real-time PCR, confocal microscopy, Western blotting, G protein reporter assays, phospho-ERK1/2 antibodies and specific siRNAs. The data were validated in heart of obese C57BL/6 mice and cardiac and aortic tissue of AT1a/AT1bdouble knockout micein vivo.Results/Data:AT1R promoter activation studies upon Ang II- and oxLDL-stimulation in endothelial cells revealed that Ang II and oxLDL activate AT1R signaling through G protein Gα12/13, followed by activation of ERK1/2 MAP kinases, and transcription and translation of Oct-1, resulting in up-regulation of AT1R, LOX-1 and NOX2 expression, which could be antagonized by specific inhibitors at each step of the identified signaling cascade. AT1R blockade improved oxLDL-induced endothelial dysfunction in aortic rings of wild-type mice. Male C57BL/6 mice fed a high-fat diet exhibited upregulation of Oct-1 levels in cardiac tissues, compared to normal controls, while AT1a/AT1bdouble knockout mice demonstrated downregulation of Oct-1, AT1R, LOX-1, and NOX2 on mRNA and protein level in cardiac and aorta tissue, thus confirming the identified signaling cascadein vivo.Conclusions:Oct-1 is an essential transcription factor for Ang II- and oxLDL-induced upregulation of AT1R and LOX-1 expression in endothelium, thus identifying a novel molecular cross-talk of oxLDL with ROS signaling and the RAAS contributing to development of endothelial dysfunction and atherosclerosis.

Circulation, Volume 150, Issue Suppl_1, Page A4147293-A4147293, November 12, 2024. Introduction:GLP1 receptor agonists (GLP1RA) improves outcomes by reducing event rates of myocardial infarction (MI). Whether GLP1RA also reduce MI size by ameliorating myocardial ischemia-reperfusion (I/R) injury remains incompletely understood. The main cardioprotective pathways to induce myocardial salvage are RISK (activation of Akt) and SAFE (activation of STAT3). We hypothesized that semaglutide increases myocardial salvage, reduces myocardial infarction (MI) size, improves left ventricular (LV) systolic function, and decreases apoptosis and oxidative stress in a porcine model of I/R mediated via activation of both RISK and SAFE pathwaysMethods:Myocardial I/R injury was induced in Yorkshire pigs by balloon occlusion of the proximal LAD for 60 min, followed by reperfusion. Animals randomly received semaglutide 0.5mg the day before I/R (to mimick patients on chronic GLP1RA), or saline for controls (n=6/group). Animals were evaluated at 1-day post-MI with cardiac MRI, 3D-echo, histology (apoptosis and oxidative stress) and molecular biology (activation of RISK and SAFE). To mechanistically study the effect of each molecular pathway, two additional groups were treated with GLP1RA+wortmannin (inhibitor of RISK) and GLP1RA+AG490 (inhibitor of SAFE)Results:Despite similar of myocardium at risk in both groups (42.8±2.2% vs 42.2±2.7%, p=NS), semaglutide significantly reduced LGE-determined MI size (33.1±2.3% vs 41.1±2.8% of LV, p

Circulation, Volume 150, Issue Suppl_1, Page A4146878-A4146878, November 12, 2024. Background:Increasing evidence support a vasoprotective role of the major endothelial NADPH oxidase isoform 4 (NOX4). NOX4 is notably induced by hypoxia.Research Question:What is the functional role of NOX4 under hypoxic conditions in the vessel wall?Aim:We aimed to elucidate NOX4’s significance in endothelial and vascular function under hypoxia.Methods:Primary cultures of human endothelial cells were exposed to hypoxia of 1% O2. Internal mammary arteries were obtained from patients undergoing coronary artery bypass grafting surgery. Surgical specimens of the artery wall proximal to occlusion were obtained from patients with peripheral arterial disease. Human NOX4 was downregulated by lentiviral shNOX4. Primary microvascular lung endothelial cells were isolated from wild-type and Nox4-/-mice. Vascular function was assessed under hypoxia in murine mesenteric arteries and aortas in a Mulvany myograph. Laminar flow was applied by cone-and-plate viscometer or ibidi pump system. NO was measured by Griess reaction, H2O2by Amplex Red Assay and gene expression by real-time PCR and Western blot.Results:Hypoxia significantly elevated NOX4 expression and activity in endothelial cells. Inhibition of prolyl hydroxylase domain (PHD) enzymes, which stabilize hypoxia-inducible factors (HIFs), increasedNOX4expression even under normoxic conditions. In human hypoxia-prone vessels,NOX4expression strongly correlated with genes relevant for vascular function, such as prostaglandin I2 synthase (PTGIS). Endothelial function assessments under hypoxia revealed elevated contraction and endothelial dysfunction in both wild-type and Nox4-/-mice with Nox4-/-mice exhibiting the most severe alterations in endothelium-dependent vasodilation. Laminar shear stress attenuated the hypoxic response in endothelial cells, reducing HIF1a andNOX4expression while enhancing eNOS expression. NO synthase inhibition under combined hypoxia and laminar flow conditions upregulatedNOX4. Furthermore,NOX4deletion affected PECAM1 expression and endothelial cell adhesion. Inhibition of NOX4 under combined hypoxia and laminar flow increased the number of endothelial cells not aligned in the direction of flow.Conclusions:Hypoxia-induced NOX4 ensures vasodilation in both conductive and resistant arteries. Laminar blood flow restores eNOS expression and mitigates the hypoxic response on NOX4. NOX4 deletion affects PECAM1 expression, reduces endothelial cell adhesion and alignment.

Circulation, Volume 150, Issue Suppl_1, Page A4143847-A4143847, November 12, 2024. Introduction:Our previous studies have shown that sustained activation of the DNA damage response (DDR) in cardiomyocytes leads to p53/p21 activation and cardiac dysfunction. Although the DDR generally involves molecules in DNA replication and repair pathways, the non-proliferative nature of cardiomyocytes suggests a cardio-specific DDR mechanism. However, our understanding of DDR in cardiomyocytes remains limited. Here, we aim to use CRISPR interference (CRISPRi) knockdown screens to identify genes critically involved in DDR regulation in human cardiomyocytes. We hypothesize that identifying these gene clusters may allow us to develop methods to prevent cardiac dysfunction by suppressing DDR in cardiomyocytes.Methods and Results:We established a human iPS cell line stably expressing dCas9-KRAB, which allows CRISPRi-mediated gene knockdown, and differentiated the cells into cardiomyocytes. The resulting human iPS cell-derived cardiomyocytes (hiPSCMs) showed the achievement of approximately 80% knockdown efficiency after gRNA transfection. We stimulated the hiPSCMs with H2O2and quantitatively evaluated the expression levels of the DDR markers γH2AX and p21 by immunostaining using the Operetta®high content imaging system. The DDR markers showed a significant concentration-dependent increase in response to H2O2administration. For arrayed CRISPRi screening, we constructed a gRNA library targeting 437 DDR-related genes. Using this library, we knocked down each DDR-related gene in hiPSCMs followed by H2O2stimulation. We quantified the expression levels of DDR markers by calculating the fluorescence intensity ratios relative to control after gene knockdown, and standardized them to calculate Z scores for all 437 genes. The screening successfully revealed the differential impact of each gene knockdown on γH2AX and p21 expression. We identified 71 genes that significantly affected their expression (Z-score < -1 or > 1). Mapping these genes to DDR pathways highlighted the differential impact of gene knockdown within the same pathway, and stratified their importance in cardiomyocytes.Conclusions:Arrayed CRISPR screening using hiPSCMs revealed differential functional significance of DDR-related genes in cardiomyocytes, identifying 71 genes of particularly significant importance. These findings provide a critical understanding of the cardio-specific DDR pathway and important clues for establishing an appropriate method to suppress DDR in the failing heart.

Circulation, Volume 150, Issue Suppl_1, Page A4144880-A4144880, November 12, 2024. Introduction:Atherosclerosis is the leading cause of death globally. Growing evidence suggests that mitochondrial dysfunction plays a significant role in atherosclerosis. However, the progression of mitochondrial energy generation disorders during atherosclerosis development remains unclear. In 2021, our lab indicated that activation of G-Protein Coupled Receptor 55 (GPR55) in human aortic endothelial cells (HAECs) could lead to EC activation, potentially increasing inflammation by altering mitochondrial transcription. EC activation is the central pathological event in atherosclerosis. However, whether and how mitochondrial dysfunction leads to EC activationin vivoand promotes atherosclerosis through the GPR55 pathway is still unknown.Methods:Lysophosphatidylinositol (lysoPI), an endogenous ligand for GPR55 activation, was used as a stimulus (20uM for 24hrs) to treat HAECs for Seahorse mitochondrial stressin vitroanalysis. Wild-type mice, apolipoprotein E (ApoE-/-) deficiency mice, and GPR55/ApoE double knockout (DKO) mice were used for bulk RNA sequencing andEn faceanalysis.Results:DKO mice showed a significant decrease in atherogenic lesions compared to ApoE-/- mice.In vitroMito-stress indicated that GPR55 activation significantly increased basal respiration, spare capacity, maximal respiration, proton leak, and ATP production in HAECs, while inhibition of GPR55 reduced these parameters to basal levels. This suggests that GPR55 activation enhances mitochondrial function without affecting non-mitochondrial oxygen consumption, coupling efficiency, or mitochondrial membrane potential. We also generated a list of 289 genes associated with mitochondrial energy generation genetic disorders. Transcriptomic profiling of these genes in atherogenic mice fed with an HF diet for 3, 6, 12, 32, and 72 weeks showed a downward trend in significantly downregulated OXPHOS genes. This significant downregulation suggests increased OXPHOS biogenesis reprogramming as the disease progresses. Additionally, by comparing upregulated genes in ApoE-/- mice with those downregulated in DKO mice, we identified seven potential genes downstream of GPR55 signaling, including M2, MP, A1, F4, P8, H10, and S2, which are involved in the TCA cycle and metabolism, protein import, and lipid modification.Conclusion:Our study provides the first comprehensive examination of how impairments in mitochondrial OXPHOS biogenesis influence atherosclerosis progression via GPR55 signaling.

Circulation, Volume 150, Issue Suppl_1, Page A4140462-A4140462, November 12, 2024. Background:Right ventricular pacing (RVP) can have adverse cardiac effects and cause pacing induced cardiomyopathy (PiCM). His bundle pacing (HBP)&Left Bundle Branch area pacing (LBBAP) mimic physiologic conduction (PhysioP) and maintain biventricular synchrony.Hypothesis and Aims:Reduced left ventricular (LV) systolic function reserve in the presence of normal baseline LV ejection fraction (EF) could precede development of RV PiCM. Our aim was to compare the effects of RVP vs. PhysioP on bicycle exercise cardiopulmonary performance in patients with normal LVEF who required pacing for bradyarrhythmias.Methods:Patients with sinus rhythm and RVP or PhysioP&ventricular pacing burden of >70% who completed cardiopulmonary exercise test and simultaneous stress echocardiography (SE) were included. Pulmonary gas exchange was calculated using Ventilation/CO2 production at rest and during exercise. Changes in LV size, EF, longitudinal strain and diastolic function and gas exchange parameters were compared post and pre exercise in the 2 groups.Results:25 of 29 patients completed the study [68 ± 23 yrs, 48% M; LVEF 56±5%, 11 RVP, 14 PhysioP]. There was no difference in baseline demographic&clinical variables, exercise duration, rest and peak heart rate and blood pressure between 2 groups. Pacing duration was 2.61±1.48 yrs in RVP vs. 0.84±0.67 yrs (p=0.003) in the Physio group. Resting echocardiographic parameters (Table 1A)were comparable. Compared to RVP, reduction in LV end-diastolic volume (EDV) 3.4±14.1 ml vs. -23.1±18.1ml, p=0.006)&LV end-systolic volume (ESV -5.7±11.6 ml vs. -18.0±9.5ml, p=0.01) was more pronounced in the PhysioP group. Changes in LVEF, LV strain&diastolic function were not different between the 2 groups (Table 1B). There were no significant differences in changes in pulmonary gas exchange parameters in the 2 groups.Conclusions:In patients with normal LVEF and pacemaker dependent, RVP is associated with impaired but PhysioP with preserved LV systolic function reserve, which can be detected by exercise SE. SE may help identify patients at risk for RV PiCM. Benefit of PhysioP needs to be determined by larger studies with longer follow-up.

Circulation, Volume 150, Issue Suppl_1, Page A4129523-A4129523, November 12, 2024. Introduction:Patients with diabetes are at higher risk of chronic limb-threatening ischemia (CLTI), a severe form of peripheral artery disease (PAD) causing restricted blood flow to the lower limbs due, in part, to impaired angiogenesis. However, the role of microRNAs (miRNAs) in diabetic CLTI remains poorly understood. By integrating plasma miRNA sequencing data from PAD patients with diabetes with a diabetic CLTI mouse model, we have recently identified the conserved miRNA miR-1282 that is in cis-antisense orientation to SERF2, a gene associated with amyloid aggregation. Therefore, we hypothesize that miR-1282 orchestrates endothelial angiogenesis and proteostasis during diabetic CLTI.Methods:Using miR-1282 overexpression or SERF2 knockdown studies, we characterized mouse orthologs of human miR-1282 and SERF2 for angiogenesis, apoptosis, protein aggregation, and oxidative stress in diabetic mouse skeletal muscle endothelial cells (ECs). In vivo, miR-1282 mimics were delivered intramuscularly to assess their impact on blood flow recovery, angiogenesis, and protein aggregation. Mechanistic insights in ECs were gained via RNA-seq, predictive algorithms, and proteomic analyses.Results:miR-1282 inhibited the expression of its cis-antisense target SERF2 by 98%. miR-1282 is a hypoxia-induced endothelial-enriched miRNA, and its expression was inversely correlated with SERF2 expression. miR-1282 levels were markedly reduced after femoral artery ligation (FAL) in diabetic db/db mice. Overexpression of miR-1282 or SERF2 knockdown enhanced angiogenesis and reduced protein aggregation, apoptosis, and oxidative stress in both normal and hypoxic conditions in vitro. Delivery of miR-1282 mimics in db/db mice improved blood flow recovery by 108% and angiogenesis by 98%, and reduced protein aggregation by 48% and tissue necrosis. Coupling RNA-seq profiling and prediction algorithms of ECs upon miR-1282 overexpression or SERF2 knockdown revealed EREG, BAG5, CASP3, ARG1, and HSP90AA1 as potential downstream regulators. Pathway enrichment analysis implicated inhibition of endothelial apoptosis, ER stress, and protein stability among the most dysregulated processes.Conclusion:A novel mouse ortholog of human miR-1282 augments endothelial functions and diminishes protein aggregation in diabetic CLTI via suppression of its cis-antisense target SERF2. These findings uncover new potential therapeutic targets in treating diabetic CLTI.

Circulation, Volume 150, Issue Suppl_1, Page A4135229-A4135229, November 12, 2024. Background:Endothelial glycocalyx (eGC) is a layer of glycosaminoglycans adhered to proteoglycans that cover the inner surface of the vessels. The integrity of this structure sustains some vascular properties such as shear stress-induced nitric oxide release and the prevention of platelets and neutrophils adhesion on the vessel surface. eGC shedding could contribute to atherosclerotic plaque vulnerability and acute myocardial infarction (AMI) installation. This research investigated whether acute eGC damage and microvascular dysfunction occurred during AMI.Methods:Sublingual microcirculation was assessed through Capiscope HCVS Handheld Video Capillaroscopy System (KK Technology, Honiton, UK) during the first 72h of hospital admission because of ST-elevation AMI (before) and repeated around six months later (after). All images were automatically analyzed using the GlycoCheck (Alpine, UT, USA), which estimated the perfused vascular density (PVD), the red blood cell (RBC) filling of the vessels, the perfused boundary region (PBR) in µm, an inverse parameter of the eGC thickness; and the microvascular health score (MVHS). This score ranges from 0-10; the lower its numerical value, the greater the microvascular impairment.Results:Twenty patients were included (61±10 years old, 85% males, 55% anterior AMI, 70% hypertension, 25% diabetes, 45% current smoker, all underwent primary PCI). The time between the two sublingual assessments was 188±31 days. The PBR [1.96±0.22µm vs. 1.84±0.19µm]; p=0.047 and flow-adjusted PBR [1.40±0.25µm vs. 1.24±0.16µm]; p=0.045 decreased statistically significant over time. The RBC filling [71.56±4.33% vs. 74.02±3.88%]; p=0.016 and the MVHS [4.28 (interquartile range (IRQ) 3.38-4.90) vs. 5.04 (IQR 4.37-6.00)]; p=0.044 increased statistically significant over time. The PVD [500±86 x10-2µm/mm vs. 522±84×10-2µm/mm]; p=0.255 did not modify over time.Conclusion:This finding was compatible with eGC shedding and microvascular dysfunction during AMI and later reconstitution of this structure after six months.

Circulation, Volume 150, Issue Suppl_1, Page A4142206-A4142206, November 12, 2024. Background:To apply human pluripotent stem cell-derived endothelial cells (hPSC-ECs) in regenerative medicine, exploring methods for highly purified ECs is desirable. Cell sorting is a versatile technique for isolating and purifying specific cell types, yet mechanical cell loss persists. Previously, we established a differentiation method for human induced pluripotent stem cell-derived ECs (hiPSC-ECs) based on lineage control using vascular endothelial growth factor (VEGF) and 8-Bromo cyclic adenosine monophosphate (cAMP). However, achieving high hiPSC-ECs purity without cell sorting has not yet been possible.Hypothesis:We speculated that applying digital rocker-generated shear stress during a specific period of hiPSC-EC induction would yield highly purified hiPSC-ECs without cell sorting.Methods:We applied cyclic share stress to the cultured cells using a digital rocker. To optimize the frequency and duration of digital rocker application, ECs purity on day 13 of differentiation (d13) was analyzed by flow cytometry for vascular endothelial cadherin (VE-Cadherin). Shear stress was measured using a simulation model. The functionality of ECs was evaluated through reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) for endothelial nitric oxide synthase (eNOS) and angiogenesis assay.Results:The optimized protocol consisted of a rocking period from day 5 (representing the EC progenitor stage) to d13, at 30 cycles/min with 13° tilt (equivalent to 1.09 dyn/cm2), which significantly increased the purity of ECs (Control vs Rocking: VE-Cadherin; 69.25±17.43 vs 86.68±6.023 %, P = 0.0090). Examining the number of cells on d13 revealed rocking stimulation reduced both ECs and non-ECs. Non-ECs were nearly absent, suggesting EC purification occurs by removing non-ECs, indicating ECs are more resistant to being eliminated by the rocking stimulation. The rocking culture also led to increased eNOS mRNA expression on d13 (Control vs Rocking: 0.5574±0.4985 vs 1.056±0.1652, P = 0.0393). The angiogenesis assay showed a longer vascular structure length trend in the rocking group, indicating enhanced angiogenic capacity. (Control vs Rocking: 15407±2929 vs 18335±3568 Pixel, P= 0.4309).Conclusion:In this study, we developed a method where digital rocker-generated shear stress during a specific period of hiPSC-EC induction not only selectively purifies ECs without cell sorting, but also enhances endothelial function, demonstrating their therapeutic potential.

Circulation, Volume 150, Issue Suppl_1, Page A4147117-A4147117, November 12, 2024. Background:Cardiovascular disease (CVD) is the primary cause of mortality worldwide, and heavy metal exposure, including lead (Pb), cadmium (Cd), and mercury (Hg), significantly impacts this global burden of disease. Heavy metal-related cardiovascular toxicity results from their ability to induce oxidative stress, inflammation, endothelial dysfunction, and dysregulation of lipid metabolism. We aim to investigate the cardiovascular disease mortality associated with high blood levels of Pb, Cd, and Hg.Method:Using the 1999–2018 National Health and Nutrition Examination Survey (NHANES) data, we examined the association of blood Pb, Cd, and Hg levels with CVD mortality. Pb, Cd, and Hg levels were transformed into quartiles. Mortality hazard ratios were calculated using Cox proportional multivariate regression models adjusting for confounders identified by way of univariate analysis and from literature. Survival across quartiles of Pb, Cd, and Hg levels are depicted using K-M curves. Survival probabilities were compared using KM curves. All analyses were conducted using STATA version 17.0Results:The study population comprised 55,081 participants spanning over 20-years period, among whom 2401 (4.36%) experienced CVD related to Pd, Cd, and Hg exposure. Of the participants, 48% were male, with the majority being White participants, followed by Hispanic and Black participants. Most participants (82.4%) had a college education or higher, 53.2% were from high-income families, and 91.3% did not report a history of CVD. Mean levels of Pb, Cd, and Hg were 0.51 µg/L, 1.62 µg/L, and 1.56 µg/L, respectively. Significant differences in CVD mortality were observed between the toxic metal exposure group and those without exposure. The mortality group was associated with a higher prevalence of diabetes, higher BMI, CVD history, and higher levels of Cd and Pb but lower Hg levels.Conclusions:In conclusion, our study revealed a higher prevalence of cardiovascular mortality in individuals with elevated blood Pb and Cd levels. In contrast, those with higher blood Hg levels exhibited reduced cardiovascular mortality

Circulation, Volume 150, Issue Suppl_1, Page A4114198-A4114198, November 12, 2024. Background:Mitochondrial dysfunction contributes to heart failure (HF) progression via diminished energy supply, release of reactive oxygen species, and increased cell death. However, there has yet to be clinically relevant biomarkers that address mitochondrial-mediated cardiac injury in patients. Humanin (HN) is a mitochondria-derived peptide that protects cells through the interference of apoptosis and reduction of oxidative stress. The objectives of our study were to measure circulating plasma HN levels in patients with HF with reduced ejection fraction and describe the relationship of HN to validated, clinically relevant measures of HF.Methods:We conducted a prospective cohort study. To be included in the study, patients must have: 1) left ventricular ejection fraction

Circulation, Volume 150, Issue Suppl_1, Page A4146183-A4146183, November 12, 2024. Background:Patients with rheumatoid arthritis (RA) display around 20% increased risk of heart failure, even after adjusting for traditional atherosclerotic risk factors. The reasons behind this are not fully understood. Analogous states of chronic inflammation such as type two diabetes have been shown to be associated with deleterious effects on myocardial metabolism and energetic depletion which predispose to systolic dysfunction. The impact of RA on myocardial energetics and cardiac phenotype in individuals at risk of RA has yet to be established.Aims:Using31Phosphorous magnetic resonance spectroscopy (31P MRS) and cardiovascular magnetic resonance (CMR), we aimed to establish if myocardial energetics, measured as phosphocreatine (PCr) /ATP ratio and quantitative myocardial perfusion were reduced in individuals at risk with isolated anti-CCP positivity (CCP+ve) and those with refractory RA (RRA) compared to healthy volunteers (HV).Methods:A total of 30 age and sex matched participants were recruited (11 CCP+ve, 9 RRA and 10 HV). All subjects underwent31P MRS and comprehensive CMR protocol including volumetric analysis, quantitative myocardial perfusion and T1 mapping.Results:Table-1 shows clinical and CMR /31P MRS data.Groups were matched for age, sex, body mass index (BMI) and systolic blood pressure.Left ventricular volumes, bi-ventricular systolic function, maximal LV wall thickness and left atrial function were similar between groups. Native T1 values and LV mass were increased in both CCP+ve and RRA versus controls.PCr/ATP was significantly reduced in both CCP+ve and RRA groups compared to healthy controls.No significant difference was observed in either stress myocardial blood flow (MBF) or myocardial perfusion reserve (MPR).Conclusions:This is the first-time energetic impairment has been reported in both patients with anti-CCP positivity and refractory RA. Our findings also demonstrate increased LV mass and diffuse fibrosis in these groups compared to age, sex and BMI matched controls. These findings may provide a mechanistic insight to the increased incidence of heart failure in individuals with rheumatoid arthritis.