Luca Troncone1, Marco Luciani1, Matthew Coggins1, Elissa H Wilker2, Cheng-Ying Ho3, Kari Elise Codispoti3, Matthew P Frosch4, Rakez Kayed5, Federica Del Monte6. 1. Cardiovascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts. 2. Cardiovascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 3. Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland. 4. Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts. 5. Department of Neurology, University of Texas Medical Branch Health, Galveston, Texas. 6. Cardiovascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Division of Cardiology Massachusetts General Hospital, Boston, Massachusetts. Electronic address: fdelmont@bidmc.harvard.edu.
Abstract
BACKGROUND: Individually, heart failure (HF) and Alzheimer's disease (AD) are severe threats to population health, and their potential coexistence is an alarming prospect. In addition to sharing analogous epidemiological and genetic profiles, biochemical characteristics, and common triggers, the authors recently recognized common molecular and pathological features between the 2 conditions. Whereas cognitive impairment has been linked to HF through perfusion defects, angiopathy, and inflammation, whether patients with AD present with myocardial dysfunction, and if the 2 conditions bear a common pathogenesis as neglected siblings are unknown. OBJECTIVES: Here, the authors investigated whether amyloid beta (Aβ) protein aggregates are present in the hearts of patients with a primary diagnosis of AD, affecting myocardial function. METHODS: The authors examined myocardial function in a retrospective cross-sectional study from a cohort of AD patients and age-matched controls. Imaging and proteomics approaches were used to identify and quantify Aβ deposits in AD heart and brain specimens compared with controls. Cell shortening and calcium transients were measured on isolated adult cardiomyocytes. RESULTS: Echocardiographic measurements of myocardial function suggest that patients with AD present with an anticipated diastolic dysfunction. As in the brain, Aβ40 and Aβ42 are present in the heart, and their expression is increased in AD. CONCLUSIONS: Here, the authors provide the first report of the presence of compromised myocardial function and intramyocardial deposits of Aβ in AD patients. The findings depict a novel biological framework in which AD may be viewed either as a systemic disease or as a metastatic disorder leading to heart, and possibly multiorgan failure. AD and HF are both debilitating and life-threatening conditions, affecting enormous patient populations. Our findings underline a previously dismissed problem of a magnitude that will require new diagnostic approaches and treatments for brain and heart disease, and their combination.
BACKGROUND: Individually, heart failure (HF) and Alzheimer's disease (AD) are severe threats to population health, and their potential coexistence is an alarming prospect. In addition to sharing analogous epidemiological and genetic profiles, biochemical characteristics, and common triggers, the authors recently recognized common molecular and pathological features between the 2 conditions. Whereas cognitive impairment has been linked to HF through perfusion defects, angiopathy, and inflammation, whether patients with AD present with myocardial dysfunction, and if the 2 conditions bear a common pathogenesis as neglected siblings are unknown. OBJECTIVES: Here, the authors investigated whether amyloid beta (Aβ) protein aggregates are present in the hearts of patients with a primary diagnosis of AD, affecting myocardial function. METHODS: The authors examined myocardial function in a retrospective cross-sectional study from a cohort of ADpatients and age-matched controls. Imaging and proteomics approaches were used to identify and quantify Aβ deposits in AD heart and brain specimens compared with controls. Cell shortening and calcium transients were measured on isolated adult cardiomyocytes. RESULTS: Echocardiographic measurements of myocardial function suggest that patients with AD present with an anticipated diastolic dysfunction. As in the brain, Aβ40 and Aβ42 are present in the heart, and their expression is increased in AD. CONCLUSIONS: Here, the authors provide the first report of the presence of compromised myocardial function and intramyocardial deposits of Aβ in ADpatients. The findings depict a novel biological framework in which AD may be viewed either as a systemic disease or as a metastatic disorder leading to heart, and possibly multiorgan failure. AD and HF are both debilitating and life-threatening conditions, affecting enormous patient populations. Our findings underline a previously dismissed problem of a magnitude that will require new diagnostic approaches and treatments for brain and heart disease, and their combination.
Authors: Renée F A G de Bruijn; Marileen L P Portegies; Maarten J G Leening; Michiel J Bos; Albert Hofman; Aad van der Lugt; Wiro J Niessen; Meike W Vernooij; Oscar H Franco; Peter J Koudstaal; M Arfan Ikram Journal: Neurology Date: 2015-01-28 Impact factor: 9.910
Authors: Duanxiang Li; Sharie B Parks; Jessica D Kushner; Deirdre Nauman; Donna Burgess; Susan Ludwigsen; Julie Partain; Randal R Nixon; Charles N Allen; Robert P Irwin; Petra M Jakobs; Michael Litt; Ray E Hershberger Journal: Am J Hum Genet Date: 2006-10-24 Impact factor: 11.025