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N.A. Narolska,
S. Eiras,
R.B. van Loon,
N.M. Boontje,
R. Zaremba,
S.R. Spiegelen berg,
W. Stooker, M.A.J.M. Huybregts,
F.C. Visser,
J. van der Velden,
G.J.M. Stienen
[show abstract]
[hide abstract]
ABSTRACT: Changes in myosin heavy chain (MHC) isoform expression and protein composition occur during cardiac disease and it has been
suggested that even a minor shift in MHC composition may exert a considerable effect on myocardial energetics and performance.
Here an overview is provided of the cellular basis of the energy utilisation in cardiac tissue and novel data are presented
concerning the economy of myocardial contraction in diseased atrial and ventricular human myocardium. ATP utilisation and
force development were measured at various Ca2+ concentrations during isometric contraction in chemically skinned atrial trabeculae from patients in sinus rhythm (SR) or
with chronic atrial fibrillation (AF) and in ventricular muscle strips from non-failing donor or end-stage failing hearts.
Contractile protein composition was analysed by one-dimensional gel electrophoresis. Atrial fibrillation was accompanied by
a significant shift from the fast α-MHC isoform to the slow β-MHC isoform, whereas both donor and failing ventricular tissue
contained almost exclusively the β-MHC isoform. Simultaneous measurements of force and ATP utilisation indicated that economy
of contraction is preserved in atrial fibrillation and in end-stage human heart failure.
Journal of Muscle Research and Cell Motility 04/2012; 26(1):39-48. · 1.98 Impact Factor
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K Kupreishvili,
M ter Weeme,
S A Morré,
A J C van den Brule, M A J M Huybregts,
P H A Quax,
J ten Velden,
V W M Van Hinsbergh,
W Stooker,
L Eijsman,
H W M Niessen
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ABSTRACT: Several studies have suggested an association between Chlamydophila pneumoniae (Cp) infection and atherosclerosis. A recent study detected Cp DNA in the saphenous vein of 12% of all patients before bypass grafting and in 38% of failed grafts. We used a system in which human veins were perfused with autologous blood under arterial pressure.
Veins were surplus segments of saphenous veins of coronary artery bypass grafting (CABG) patients. Vein grafts were perfused with the blood of the same patient after CABG procedures. Veins were analysed for Cp-specific membrane protein using immunohistochemical and PCR analysis. Veins were analysed before and after perfusion (up to 4 h). The number of Cp positive cells was then quantified in the vein layers.
Cp protein was detected within macrophages only. In non-perfused veins, Cp was present in the adventitia in 91% of all patients, in the circular (64%) and longitudinal (23%) layer of the media. No positivity was found in the intima. Perfusion subsequently resulted in a significant increase of Cp positive cells within the circular layer of the media that, however, differed strongly between different patients. Cp DNA was not detected by PCR in those specimens.
Cp protein was present in 91% of veins, but the number of positive cells differed remarkably between patients. Perfusion of veins resulted in increased infiltration of Cp into the circular layer. These results may point to a putative discriminating role of Cp with respect to graft failure between different patients.
European Journal of Clinical Investigation 08/2008; 38(7):462-8. · 3.02 Impact Factor
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[show abstract]
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ABSTRACT: The use of mini cardiopulmonary bypass circuits is an emerging technology. The venous and cardiotomy reservoir have been excluded from the circuit. This results in a reduction of the blood contact surface area and of the priming volume. Entrainment of venous air, however, remains a drawback in the widespread acceptance of using these mini circuits. The technique described resolves this problem by automatic removal of venous air, and explains how this mini cardiopulmonary bypass circuit was utilized on a 64-year-old female presented for a mitral valve repair. In the absence of a cardiotomy reservoir, an autotransfusion cell separator was used to process shed blood and, after CPB, the residual pump blood. This mini bypass circuit, with the safety feature to remove automatically venous air, provided an additional degree of protection. In our experience, mini bypass circuits allow us safely to perform cardiopulmonary bypass during valve procedures.
Perfusion 04/2005; 20(2):121-4. · 0.92 Impact Factor
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N A Narolska,
S Eiras,
R B van Loon,
N M Boontje,
R Zaremba,
S R Spiegelen Berg,
W Stooker, M A J M Huybregts,
F C Visser,
J van der Velden,
G J M Stienen
[show abstract]
[hide abstract]
ABSTRACT: Changes in myosin heavy chain (MHC) isoform expression and protein composition occur during cardiac disease and it has been suggested that even a minor shift in MHC composition may exert a considerable effect on myocardial energetics and performance. Here an overview is provided of the cellular basis of the energy utilisation in cardiac tissue and novel data are presented concerning the economy of myocardial contraction in diseased atrial and ventricular human myocardium. ATP utilisation and force development were measured at various Ca(2+) concentrations during isometric contraction in chemically skinned atrial trabeculae from patients in sinus rhythm (SR) or with chronic atrial fibrillation (AF) and in ventricular muscle strips from non-failing donor or end-stage failing hearts. Contractile protein composition was analysed by one-dimensional gel electrophoresis. Atrial fibrillation was accompanied by a significant shift from the fast alpha-MHC isoform to the slow beta-MHC isoform, whereas both donor and failing ventricular tissue contained almost exclusively the beta-MHC isoform. Simultaneous measurements of force and ATP utilisation indicated that economy of contraction is preserved in atrial fibrillation and in end-stage human heart failure.
Journal of Muscle Research and Cell Motility 02/2005; 26(1):39-48. · 1.98 Impact Factor
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N A Narolska,
R B van Loon,
N M Boontje,
R Zaremba,
S Eiras Penas,
J Russell,
S R Spiegelenberg, M A J M Huybregts,
F C Visser,
J W de Jong,
J van der Velden,
G J M Stienen
[show abstract]
[hide abstract]
ABSTRACT: Cardiac energetics and performance depend on the expression level of the fast (alpha-) and slow (beta-) myosin heavy chain (MHC) isoform. In ventricular tissue, the beta-MHC isoform predominates, whereas in atrial tissue a variable mixture of alpha- and beta-MHC is found. In several cardiac diseases, the slow isoform is upregulated; however, the functional implications of this transition in human myocardium are largely unknown. The aim of this study was to determine the relation between contractile properties and MHC isoform composition in healthy human myocardium using the diversity in atrial tissue.
Isometric force production and ATP consumption were measured in chemically skinned atrial trabeculae and ventricular muscle strips, and rate of force redevelopment was studied using single cardiomyocytes. MHC isoform composition was determined by one-dimensional SDS-gel electrophoresis.
Force development in ventricular tissue was about 5-fold more economical, but nine times slower, than in atrial tissue. Significant linear correlations were found between MHC isoform composition, ATP consumption and rate of force redevelopment.
These results clearly indicate that even a minor shift in MHC isoform expression has considerable impact on cardiac performance in human tissue.
Cardiovascular Research 02/2005; 65(1):221-9. · 6.06 Impact Factor
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ABSTRACT: Reduction of the inflammatory reaction with the use of heparin coating has been found during and after cardiopulmonary bypass (CPB). The question remains whether this reduced reaction also decreases the magnitude of CPB-induced pulmonary dysfunction. We therefore evaluated the effects of a heparin-coated circuit versus a similar uncoated circuit on pulmonary indices as well as on inflammatory markers of complement activation (C3b/c), elastase-alpha(1)-antitrypsin complex, and secretory phospholipase A(2) (sPLA(2)) during and after CPB. Fifty-one patients were randomly assigned into two groups undergoing coronary artery bypass grafting with either a heparin-coated (Group 1) or an uncoated (Group 2) circuit. During CPB, a continuous positive airway pressure of 5 cm H(2)O and a fraction of inspired oxygen (FIO(2)) of 0.21 were maintained. Differences in favor of the coated circuit were found in pulmonary shunt fraction (P < 0.05), pulmonary vascular resistance index (P < 0.05), and PaO(2)/FIO(2) ratio (P < 0.05) after CPB and in the intensive care unit. During and after CPB, the coated group demonstrated lower levels of sPLA(2). After CPB, C3b/c and the elastase-alpha(1)-antitrypsin complex were significantly less in the coated group (P < 0.001). The coated circuit was associated with a reduced inflammatory response, decreased pulmonary vascular resistance index and pulmonary shunt fraction, and increased PaO(2)/FIO(2) ratio, suggesting that the coated circuit may have beneficial effects on pulmonary function. The correlation with sPLA(2), leukocyte activation, and postoperative leukocyte count suggests reduced activation of pulmonary capillary endothelial cells. IMPLICATIONS: Heparin coating of the extracorporeal circuit reduces the inflammatory response during cardiopulmonary bypass. Analysis of indices of pulmonary function indicates that use of heparin coating may result in less impaired gas exchange.
Anesthesia & Analgesia 07/2004; 98(6):1586-94, table of contents. · 3.29 Impact Factor
