Heart Failure/metabolism* ; Humans ; Myocardium/metabolism*

Dilated cardiomyopathy (DCM) is a significant contributor to heart failure and can lead to life-threatening cardiovascular events at any stage. RNA-binding motif protein 20 (RBM20) gene mutation is known to be one of the causes of DCM. This mutation exhibits familial aggregation and is associated with arrhythmias, increasing the risk of sudden and early death. This article delves into the characteristics of the RBM20 gene, highlighting its role in regulating alternative splicing of the TTN gene and calcium/calmodulin-dependent protein kinase type II gene. Furthermore, the article provides a summary of treatment options available for DCM caused by RBM20 gene mutations, aiming to enhance clinicians' understanding of the RBM20 gene and provide new ideas for precision medicine treatment.
Humans ; Alternative Splicing ; Cardiomyopathy, Dilated/metabolism* ; Heart Failure/metabolism* ; Mutation

Heart failure (HF) has become a major challenge in the treatment of global cardiovascular diseases. Great progress has been made in the drug treatment of HF, however, rehospitalization rate and mortality of patients with HF are still high. Hence, there is an urgent need to explore new treatment strategy and new underlying pathogenic mechanisms. In recent years, some researchers have suggested that regulation of ketone body metabolism may become a potentially promising therapeutic approach for HF. Some studies showed that the oxidative utilization of fatty acids and glucose was decreased in the failing heart, accompanied by the increase of ketone body oxidative metabolism. The enhancement of ketone body metabolism in HF is a compensatory change during HF. The failing heart preferentially uses ketone body oxidation to provide energy, which helps to improve the body's cardiac function. This review will discuss the potential significance of ketone body metabolism in the treatment of HF from three aspects: normal myocardial ketone body metabolism, the change of ketone body metabolism in HF, the effect of ketogenic therapy on HF and its treatment.
Humans ; Heart Failure/metabolism* ; Myocardium/metabolism* ; Ketone Bodies/metabolism* ; Cardiovascular Diseases ; Fatty Acids/metabolism* ; Energy Metabolism

Objective To study the effect of overwork stress response on the expression of connexin 43（Cx43） and connexin 45（Cx45） in cardiomyocytes and on cardiac function. Methods The experimental animals were divided into control group, overworked 1-month group and overworked 2-month group. A overworked rat model was established by forcing swimming of overworked group. The expressions of Cx43 and Cx45 in myocardial tissues of experimental animals were detected by Western blotting, while the corresponding myocardial tissues were stained with hematoxylin-eosin （HE） staining and Masson's staining, then histologically observed. Results Western blotting results showed that, compared with the control group, Cx43 expression in myocardial tissues of overworked rats decreased while Cx45 expression increased. HE staining and Masson's staining results showed that hypertrophy, rupture and interstitial fiber tissue hyperplasia were observed in myocardial fibers of overworked rats. Conclusion Overwork stress response may affect cardiac function as an independent factor and may even cause heart failure or arrhythmias and lead to death.
Animals ; Arrhythmias, Cardiac/metabolism* ; Connexin 43/metabolism* ; Connexins/metabolism* ; Heart Failure ; Myocardium ; Myocytes, Cardiac/metabolism* ; Rats

The aim of the present study is to investigate the differences in cardiac function, and the expression and activity of calcium regulatory proteins between rabbit systolic heart failure (SHF) and diastolic heart failure (DHF) models. New Zealand white rabbits were randomly divided into three groups: sham operation (SO) group, DHF group (receiving abdominal aortic constriction) and SHF group (receiving aortic valve destruction and abdominal aortic constriction). The cardiac function was detected by echocardiographic and hemodynamic assays. The mRNA expression levels of sarcoplasmic reticulum Ca(2+) ATPase 2a (SERCA2a) and phospholamban (PLB) were evaluated by RT-PCR. The protein expression levels of SERCA2a, PLB, phosphoserine 16-PLB (pSer-16-PLB) and protein kinase A (PKA) were evaluated by Western blot, and the phosphorylation status of PLB was determined by the ratio of pSer-16-PLB protein level to that of PLB. The activity of SERCA2a was measured through inorganic phosphate. The activity of PKA was measured by gamma-(32)P ATP-binding assays. Compared with SO group, there were significantly increased ventricular wall thickness, raised left ventricular end diastolic pressure (LVEDP), reduced diastolic function in DHF group (P<0.05 or P<0.01), and significantly increased ventricular cavity size and LVEDP, reduced systolic function in SHF group (P<0.05 or P<0.01). The expression levels of SERCA2a in DHF and SHF groups were lower than that in SO group (P<0.05), while the expression and activity of PKA in DHF and SHF groups were higher than that in SO group (P<0.05 or P<0.01), and there was no significant difference between DHF and SHF groups. The expression levels of PLB and pSer-16-PLB as well as the phosphorylation status of PLB and activity of SERCA2a in SHF group were lower than those in DHF and SO groups respectively. Posing a contrast, the phosphorylation status of PLB and activity of SERCA2a in DHF group were higher than that in SO group (P<0.05). These results indicate that the SHF and DHF models were successfully established, and there are some differences in the expression and activity of calcium regulatory proteins between two models.
Animals ; Calcium-Binding Proteins ; metabolism ; Disease Models, Animal ; Heart Failure, Diastolic ; metabolism ; Heart Failure, Systolic ; metabolism ; Rabbits ; Sarcoplasmic Reticulum ; metabolism ; Sarcoplasmic Reticulum Calcium-Transporting ATPases ; metabolism

OBJECTIVETo explore the expression and distribution of calcineurin (CaN) in normal and failing human myocardium.

METHODSLeft and right ventricles were obtained from end-staged heart failure patients (n = 12) undergoing heart transplantation and donor hearts (n = 5) taken from victims of vehicle accidents. Immunohistochemistry and SDS-PAGE technique were used to demonstrate expression and distribution of CaN.

RESULTSPositive immunoreactive staining for CaN was detected in human cardiomyocytes, cardiac fibroblasts and epicardial mesothelial cells, but not detected in cardiac vascular endothelial cells and smooth muscle cells. There was no difference in CaN protein levels between failing hearts and donor hearts (Band intensity of right ventricle in failing hearts and donor hearts was 130.20 +/- 8.66 and 139.87 +/- 6.21, P = 0.33. Band intensity of left ventricle in failing hearts and donor hearts was 106.45 and 126.34 +/- 12.09) and between left ventricular and right ventricular myocardium (Band intensity of left and right ventricles in failing hearts was 96.99 +/- 10.67 and 104.58 +/- 13.18, P = 0.63. Band intensity of left and right ventricles in failing hearts was 132.12 and 120.74).

CONCLUSIONSCaN is expressed in human cardiomyocytes, fibroblasts and epicardial mesothelial cells and the protein level and distribution of CaN are similar in failing and donor hearts.

Adult ; Calcineurin ; metabolism ; Female ; Heart Failure ; metabolism ; Humans ; Male ; Middle Aged ; Myocardium ; metabolism

To discuss the potential role of medicinal herbs, especially those with effect of strengthening Qi, in the treatment of chronic heart failure (CHF) via modulating myocardial substrate metabolism. The relationships among heart failure, myocardial energetic metabolism and herbal medicine were analyzed in detail through reviewing and summarizing the accumulating knowledge and recent findings on myocardial metabolism, heart failure and herbal medicine. Either energy lack or abnormal energetic metabolism is one of the main causes to the initiation and development of heart failure. Recent studies suggest that the cardiac function in the patients with CHF could be improved by inhibiting the energy production from metabolism of fatty acid and enhancing the energy production from glucose metabolism. The concept of Qi in Chinese medicine is very close to the energy in western medicine. The decoction of Chinese medicine containing herbal medicine with effect of strengthening Qi and the herbal medicine themselves and their components were evidenced to be effective in improvement of heart failure and regulation of both lipid and glucose metabolism; more importantly, all these herbal medicine contain the multi-sugar which can be metabolized into single unit of sugar which may be metabolized as a substrate by myocardium and potentially produce the cardioprotective effect. Therefore, we may find out a novel way to explain why the herbal medicine with effect of strengthening Qi can improve cardiac function in patients with CHF. In other words, regulating myocardial metabolism is one of the mechanisms underlying the cardioprotection produced by herbal medicine with effect of strengthening Qi in the treatment of heart failure.
Energy Metabolism ; drug effects ; Heart Failure ; drug therapy ; metabolism ; Humans ; Medicine, Chinese Traditional ; Myocardium ; metabolism

Natriuretic peptides (NPs) have been found to be useful markers in differentiating acute dyspneic patients presenting to the emergency department (ED) and emerged as potent prognostic markers for patients with congestive heart failure (CHF). The best-established and widely used clinical application of BNP and NT-proBNP testing is for the emergent diagnosis of CHF in patients presenting with acute dyspnea. Nevertheless, elevated NPs levels can be found in many circumstances involving left ventricular (LV) dysfunction or hypertrophy; right ventricular (RV) dysfunction secondary to pulmonary diseases; cardiac inflammatory or infectious diseases; endocrinology diseases and high output status without decreased LV ejection fraction. Even in the absence of significant clinical evidence of volume overload or LV dysfunction, markedly elevated NP levels can be found in patients with multiple comorbidities with a certain degree of prognostic value. Potential clinical applications of NPs are expanded accompanied by emerging reports regarding screening the presence of secondary cardiac dysfunction; monitoring the therapeutic responses, risk stratifications and providing prognostic values in many settings. Clinicians need to have expanded knowledge regarding the interpretation of elevated NPs levels and potential clinical applications of NPs. Clinicians should recognize that currently the only reasonable application for routine practice is limited to differentiation of acute dyspnea, rule-out-diagnostic-tests, monitoring of therapeutic responses and prognosis of acute or decompensated CHF. The rationales as well the potential applications of NPs in these settings are discussed in this review article.
Acute Coronary Syndrome/metabolism ; Arrhythmias, Cardiac/metabolism ; Heart Failure/*metabolism ; Humans ; Hypertension, Pulmonary/metabolism ; Natriuretic Peptides/*metabolism ; Sepsis/metabolism

Apoptosis ; Child ; Heart Failure ; metabolism ; physiopathology ; Humans ; Signal Transduction ; Sympathetic Nervous System ; metabolism ; physiopathology ; Ventricular Remodeling

Chronic Disease ; Heart Failure ; metabolism ; Humans ; Phosphorylation ; Ryanodine Receptor Calcium Release Channel ; metabolism