TY - THES A1 - Bertero, Edoardo T1 - Mechano-energetic uncoupling in Barth syndrome cardiomyopathy T1 - Mechano-energetische Entkopplung bei der Barth Syndrom Kardiomyopathie N2 - In this Doctoral Thesis we investigated the consequences of perturbed mitochondrial calcium handling in the context of a rare human disease, Barth syndrome, in which the altered phospholipid composition of the inner mitochondrial membrane affects the structural organization of several protein complexes, including the mitochondrial calcium uniporter. We discovered that loss of the mitochondrial calcium uniporter in cardiac, but not skeletal muscle mitochondria hinders the calcium-induced adaptation of mitochondrial oxidative metabolism during workload transitions. This mechano-energetic uncoupling impairs the physiological increase in contractile force during physical exercise and might predispose Barth syndrome patients to the development of arrhythmias. N2 - Diese Doktorarbeit umfasst vier Studien, deren verbindendes Thema die Rolle von Calcium (Ca2+) als Verbindung zwischen elektromechanischer Kopplung und mitochondrialem oxidativen Metabolismus im Herzen unter physiologischen und pathologischen Bedingungen ist. Dieser Prozess wird als mechano-energetische Kopplung bezeichnet. Während eine übermäßige Ca2+ Aufnahme in Mitochondrien katastrophale Folgen für die oxidative Phosphorylierung hat und zum Zelltod führt, stimuliert die physiologische Ca2+-Aufnahme über den mitochondrialen Ca2+ uniporter (MCU) die Krebs-Zyklus abhängige Erzeugung von Reduktionsäquivalenten, die sowohl die Atmungskette als auch die mitochondrialen Antioxidationssysteme antreiben, und spielt somit eine wesentliche Rolle sowohl für die ATP Produktion als auch für die Eliminierung reaktiver Sauerstoffspezies (ROS). ... KW - Barth syndrome KW - Cardiomyopathy KW - Mitochondria KW - Calcium KW - Cardiolipin Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-255176 ER - TY - JOUR A1 - Wanner, Christoph A1 - Feldt-Rasmussen, Ulla A1 - Jovanovic, Ana A1 - Linhart, Aleš A1 - Yang, Meng A1 - Ponce, Elvira A1 - Brand, Eva A1 - Germain, Dominique P. A1 - Hughes, Derralynn A. A1 - Jefferies, John L. A1 - Martins, Anna Maria A1 - Nowak, Albina A1 - Vujkovac, Bojan A1 - Weidemann, Frank A1 - West, Michael L. A1 - Ortiz, Alberto T1 - Cardiomyopathy and kidney function in agalsidase beta-treated female Fabry patients: a pre-treatment vs. post-treatment analysis JF - ESC Heart Failure N2 - Long-term treatment effect studies in large female Fabry patient groups are challenging to design because of phenotype heterogeneity and lack of appropriate comparison groups, and have not been reported. We compared long-term cardiomyopathy and kidney function outcomes after agalsidase beta treatment with preceding treatment-naive outcomes. Methods and results Self-controlled pretreatment and post-treatment comparison (piecewise mixed linear modelling) included Fabry female patients ≥18 years at treatment initiation who received agalsidase beta (0.9–1.1 mg/kg every other week) for ≥2 years, with ≥2 pretreatment and ≥2 post-treatment outcome measurements during 10-year follow-up. Left ventricular posterior wall thickness (LVPWT)/interventricular septal thickness (IVST) and estimated glomerular filtration rate (eGFR, Chronic Kidney Disease Epidemiology Collaboration creatinine equation) analyses included 42 and 86 patients, respectively, aged 50.0 and 46.3 years at treatment initiation, respectively. LVPWT and IVST increased pretreatment (follow-up 3.5 years) but stabilized during 3.6 years of treatment (LVPWT: n = 38, slope difference [95% confidence interval (CI)] = - 0.41 [ - 0.68, - 0.15] mm/year, P\(_{pre–post difference}\)<0.01; IVST: n = 38, slope difference =-0.32 [-0.67, 0.02] mm/year, P\(_{pre–post difference}\) = 0.07). These findings were not modified by renal involvement or antiproteinuric agent use. Compared with the treatment-naive period (follow-up 3.6 years), eGFR decline remained modest and stabilized within normal ranges during 4.1 years of treatment (slope difference, 95% CI: -0.13 [-1.15, 0.89] mL/min/1.73m\(^2\)/year, P\(_{pre–post difference}\) = 0.80). Conclusions Cardiac hypertrophy, progressing during pretreatment follow-up, appeared to stabilize during sustained agalsidase beta treatment. eGFR decline remained within normal ranges. This suggests that treatment may prevent further Fabry-related progression of cardiomyopathy in female patients and maintain normal kidney function. KW - Agalsidase beta KW - Enzyme replacement therapy KW - Fabry disease KW - Cardiomyopathy KW - Kidney function KW - Female patients Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-235963 VL - 7 IS - 3 ER -