Emerging role of angiogenesis in adaptive and maladaptive right ventricular remodeling in pulmonary hypertension

Right ventricular (RV) function is the primary prognostic factor for both morbidity and mortality in pulmonary hypertension (PH). RV hypertrophy is initially an adaptive physiological response to increased overload; however, with persistent and/or progressive afterload increase, this response frequently transitions to more pathological maladaptive remodeling. The mechanisms and disease processes underlying this transition are mostly unknown. Angiogenesis has recently emerged as a major modifier of RV adaptation in the setting of pressure overload. A novel paradigm has emerged that suggests that angiogenesis and angiogenic signaling are required for RV adaptation to afterload increases and that impaired and/or insufficient angiogenesis is a major driver of RV decompensation. Here, we summarize our current understanding of the concepts of maladaptive and adaptive RV remodeling, discuss the current literature on angiogenesis in the adapted and failing RV, and identify potential therapeutic approaches targeting angiogenesis in RV failure

Exercise for endurance and strength:Always separate?

Physical training can be classified into three main types: endurance, resistance, and patterned movements. The first two of them have a significant impact on muscle phenotype and metabolism while patterned movement exercises concern changes in a motor program in the central nervous system and result in only slight changes in muscle tissue. Adaptation to endurance versus resistance training in most aspects is extremely different. Due to the mutually opposite nature, in classical training systems, endurance and resistance exercises are very often separated. Nowadays, in sport as well as recreation and rehabilitation it is postulated to combine both types of exercises. Because of this, the very important question arises as to how combined workouts including strength and endurance exercises will affect the body. An even more important question concerns the proportions of both types of exercises, their intensity and duration. Therefore, defining safe and effective training systems can be beneficial not only for athletes but also for the prevention of civilization-related diseases and aging effect.</p

Fault-Tolerant Real-Time Streaming with FEC thanks to Capillary Multi-Path Routing

Erasure resilient FEC codes in off-line packetized streaming rely on time diversity. This requires unrestricted buffering time at the receiver. In real-time streaming the playback buffering time must be very short. Path diversity is an orthogonal strategy. However, the large number of long paths increases the number of underlying links and consecutively the overall link failure rate. This may increase the overall requirement in redundant FEC packets for combating the link failures. We introduce the Redundancy Overall Requirement (ROR) metric, a routing coefficient specifying the total number of FEC packets required for compensation of all underlying link failures. We present a capillary routing algorithm for constructing layer by layer steadily diversifying multi-path routing patterns. By measuring the ROR coefficients of a dozen of routing layers on hundreds of network samples, we show that the number of required FEC packets decreases substantially when the path diversity is increased by the capillary routing construction algorithm

Metabolic reprogramming promotes myogenesis during aging

Sarcopenia is the age-related progressive loss of skeletal muscle mass and strength finally leading to poor physical performance. Impaired myogenesis contributes to the pathogenesis of sarcopenia, while mitochondrial dysfunctions are thought to play a primary role in skeletal muscle loss during aging. Here we studied the link between myogenesis and metabolism. In particular, we analyzed the effect of the metabolic modulator trimetazidine (TMZ) on myogenesis in aging. We show that reprogramming the metabolism by TMZ treatment for 12 consecutive days stimulates myogenic gene expression in skeletal muscle of 22-month-old mice. Our data also reveal that TMZ increases the levels of mitochondrial proteins and stimulates the oxidative metabolism in aged muscles, this finding being in line with our previous observations in cachectic mice. Moreover, we show that, besides TMZ also other types of metabolic modulators (i.e., 5-Aminoimidazole-4-Carboxamide Ribofuranoside-AICAR) can stimulate differentiation of skeletal muscle progenitors in vitro. Overall, our results reveal that reprogramming the metabolism stimulates myogenesis while triggering mitochondrial proteins synthesis in vivo during aging. Together with the previously reported ability of TMZ to increase muscle strength in aged mice, these new data suggest an interesting non-invasive therapeutic strategy which could contribute to improving muscle quality and neuromuscular communication in the elderly, and counteracting sarcopenia

The Physiological Consequences of Bed Rest

Bed rest often is used to treat a wide variety of medical conditions. However, bed rest results in profound deconditioning of the body. Bed rest reduces the hydrostatic pressure gradient within the cardiovascular system, reduces muscle force production, virtually eliminates compression on the bones, and lowers total energy expenditure. This review focuses on the deconditioning that occurs in the cardiovascular, muscular, and skeletal systems following bed rest. Reduction in plasma volume reduces cardiac preload, stroke volume, cardiac output, and ultimately, maximal oxygen consumption. Skeletal muscle volume, muscle cross sectional area, and fiber cross sectional area decrease, which results in diminished muscular strength. These changes are most pronounced in the antigravity muscles. Increased bone resorption leads to a negative calcium balance and eventually decreased bone mass, particularly in the lower limbs. Diminished bone mass coupled with decreased muscular strength increases the risk of bone fractures, even with minor falls. It is important for clinicians to recognize these negative consequences of bed rest, which can be explained independent of disease or disorder. With this in mind, bed rest can be minimized as much as possible and early ambulation and physical activity may be prescribed to limit the deconditioning effects of bed rest

AMPK regulates basal skeletal muscle capillarization and VEGF expression, but is not necessary for the angiogenic response to exercise

5 -AMP-activated protein kinase(AMPK)is a metabolic fuel sensor that monitors cellular energy charge, while the vasculature is important for maintaining cellular energy homeostasis. Mice with muscle-specific inactive AMPK (AMPK DN) were used to investigate if AMPK regulates skeletal muscle capillarization and the angiogenic responses to exercise. Two hours of the AMP analogueAICAR(1.0 g kg - 1)or systemichypoxia (6%O2) increased vascular endothelial growth factor (VEGF) mRNA in wild-type (WT), but not in AMPK DN mice. In contrast, the increase in VEGF mRNA with acute exercise (1 h at 20m min - 1, 10% gradient) was greater in AMPK DN compared to WT mice. Nuclear run-on assay demonstrated that exercise increased VEGF transcription, while hypoxia decreased VEGF transcription. There was no difference in VEGF transcription between WT and AMPK DN. There was a strong correlation between VEGF transcription and VEGF mRNA at rest and with exercise. Resting capillarization was lower in AMPK DN compared to WT. Wheel running (28 days) increased capillarization and this response was AMPK independent. Significant correlations between VEGF protein and muscle capillarization are consistent with VEGF being an important determinant of skeletal muscle capillarization. These data are to our knowledge the first to demonstrate in skeletal muscle in vivo that: (1) AMPK is necessary for hypoxia-induced VEGF mRNA stabilization, (2) acute exercise increases VEGF transcription, (3) inhibition of AMPK augments the VEGF mRNA response to acute exercise, and (4) AMPK regulates basal VEGF expression and capillarization, but is not necessary for exercise-induced angiogenesis. Originally published Journal of Physiology, Vol. 586, No. 24, Dec 200

Periodic assessment of plasma sFlt-1 and PlGF concentrations and its association with placental morphometry in gestational hypertension (GH) - a prospective follow-up study.

BACKGROUND: Hypertensive disorders in pregnancy contributes to about 12% of maternal deaths in Malaysia and similarly worldwide. Early detection and adequate management are preventable strategies. Biochemical markers of abnormal angiogenesis would be more specific in early detection than routine blood pressure and proteinuria measurements. The aim of this study was to estimate maternal plasma PlGF and sFlt-1 levels in pregnant women with gestational hypertension at three intervals of pregnancy and correlate these biomarker levels with placental morphometry. METHODS: Venous blood samples (antepartum, intrapartum and post partum periods) were drawn to estimate for sFlt-1 and PlGF levels while placental tissue samples were examined for placental morphometry. RESULTS: PlGF levels were lower in gestational hypertension (GH) compared to normotensive during antepartum and intrapartum period, whereas sFlt-1 levels were elevated in GH at antepartum, intrapartum and postpartum intervals during pregnancy. An inverse relationship between these two biomarkers was observed through correlation analysis. PlGF levels were inversely correlated with total villous surface area of the placental periphery (TCsa-C) and villous capillarization (VC-C) of the placental periphery. CONCLUSION: We established periodic values of for sFlt-1 and PlGF levels for the first time in an ethnically diverse Malaysian setting. We suggest the development of GH in women is related to defective capillarization. In demonstrating periodic changes, this study suggest the possibility of developing GH and other long term health complications as a result of prolonged exposure to sFlt-1. The correlation between PlGF levels and morphometric findings also support possible capillarization defect

Serum Bile Acid Concentrations, Histopathological Features, and Short-, and Long-term Survival in Horses with Hepatic Disease

BACKGROUND: Serum bile acid concentrations (SBA) and a histopathological biopsy score [Equine Vet J 35 (2003) 534] are used prognostically in equine hepatic disease. HYPOTHESIS: Histopathologic features and scores, but not SBA, differ between survivors and nonsurvivors and correlate with histopathologic evidence of hepatic inflammation and fibrosis. ANIMALS: Retrospective study. Records (1999–2011) of horses with hepatic disease diagnosed by biopsy and with concurrent measurements of SBA. METHODS: Retrospective cohort study. Biopsies were examined for inflammatory cell infiltration including type and distribution, fibrosis, irreversible cytopathology affecting hepatocytes, hemosiderin, or other pigment deposition and bile duct proliferation. SBA, histopathological findings and a histological score [Equine Vet J 35 (2003) 534] were compared between short‐ (survival to discharge) and long‐term (>6 months) survivors and correlations between SBA and histopathological findings investigated. RESULTS: Of 81 cases 90% survived short‐term and 83% long‐term. Short‐term and long‐term nonsurvival were associated with SBA (P = .009; P = .006), overall (P = .001; P = .002) and parenchymal (short‐term only; P = .01) inflammation, portal and bridging fibrosis (all P < .001), apoptosis or single cell necrosis (P < .001; P = .008), hemosiderin deposition in hepatocytes (P = .011; P = .028), biliary (both P < .001), vascular (P = .003; P = .045) and endothelial (P < .001; P = .02) hyperplasia, nucleic changes (P = .004; P < .001) and the histopathological score (both P < .001). SBA were significantly and positively correlated with overall (P = .001), parenchymal (P < .001) and portal (P = .004) inflammation and portal (P = .036) and bridging (P = .002) fibrosis. CONCLUSIONS AND CLINICAL IMPORTANCE: SBA, histopathological findings and scores differ between survivors and nonsurvivors. SBA concentrations are associated with inflammation and fibrosis suggesting interference with hepatic function. A histopathological score >2 and, less so, SBA >20 μmol/L are specific but not sensitive indicators of nonsurvival