Cardiovascular disease (CVD) represents the major source of morbidity and mortality. Despite maximal therapeutic intervention, significant risks remain. There is a critical need for discovery of pathways linked to CVD pathogenesis. The proposed studies combine unbiased metabolomics approaches, with more quantitative targeted analyses, and mechanistic animal models and human studies, to define novel analytes and pathways linked to CVD pathogenesis.
In aim 1, we propose new mechanistic studies in animal models of disease, and in humans, centered around a new and unpublished pathway discovered recently during performance of our initial unbiased metabolomics studies. We have accrued substantial preliminary data in both mouse models and human clinical investigations showing a dietary nutrient abundant in red meat is metabolized by gut flora and is linked to atherosclerosis. Unpublished targeted metabolomics studies, isotope tracer studies in germ free mice and humans ? antibiotic suppression, and additional mechanistic animal model studies, collectively indicate at least three distinct metabolites produced by gut flora may possess direct biological activity impacting upon atherosclerosis susceptibility and cholesterol metabolism.
In aim 2 we propose to substantially extend upon our initial unbiased metabolomics investigations using two distinct and well defined clinical cohorts. Studies in subjects undergoing elective cardiac evaluations and for whom long term follow-up is available will enable us to discover new analytes and pathways associated with development of atherosclerotic heart disease and its adverse complications heart attack, heart failure and death. While metabolomics studies in another, a clinical trial monitored by sequential coronary intravascular ultrasound [IVUS]), will allow us to define analytes and pathways associated with response to therapy for high potency statins. Successful completion of our proposed research program will provide opportunities for development of both novel diagnostic tests and therapeutic approaches for the treatment and prevention of atherosclerotic heart disease and its major complications. It will also further establish gut flora-dependent metabolism of an abundant nutrient in red meat as a new pathway for cardiovascular disease pathogenesis discovered through unbiased metabolomics.

Public Health Relevance

Despite the identification of numerous genetic and clinical risk factors for cardiovascular disease, we can still only explain in a small fraction of patients why that individual develops the disease, and many novel pathways contributing to disease still remain unexplored. The present studies will help identify novel pathways of clinical relevance with mechanistic links to cardiovascular disease pathogenesis and adverse sequelae such as myocardial infarction and heart failure, with the hope to better diagnose and treat or prevent disease progression. (End of Abstract)

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Exploratory Grants (P20)
Project #
5P20HL113452-03
Application #
8617859
Study Section
Special Emphasis Panel (ZHL1-CSR-Q (F2))
Program Officer
Srinivas, Pothur R
Project Start
2012-04-15
Project End
2017-02-28
Budget Start
2014-03-01
Budget End
2015-02-28
Support Year
3
Fiscal Year
2014
Total Cost
$2,132,369
Indirect Cost
$365,609
Name
Cleveland Clinic Lerner
Department
Other Basic Sciences
Type
Schools of Medicine
DUNS #
135781701
City
Cleveland
State
OH
Country
United States
Zip Code
44195
Tang, W H Wilson; Kitai, Takeshi; Hazen, Stanley L (2017) Gut Microbiota in Cardiovascular Health and Disease. Circ Res 120:1183-1196
Kind, Tobias; Fiehn, Oliver (2017) Strategies for dereplication of natural compounds using high-resolution tandem mass spectrometry. Phytochem Lett 21:313-319
Tang, W H Wilson; Hazen, Stanley L (2017) The Gut Microbiome and Its Role in Cardiovascular Diseases. Circulation 135:1008-1010
Senthong, Vichai; Hudec, Timothy; Neale, Sarah et al. (2017) Relation of Red Cell Distribution Width to Left Ventricular End-Diastolic Pressure and Mortality in Patients With and Without Heart Failure. Am J Cardiol 119:1421-1427
Showalter, Megan R; Cajka, Tomas; Fiehn, Oliver (2017) Epimetabolites: discovering metabolism beyond building and burning. Curr Opin Chem Biol 36:70-76
Hammadah, Muhammad; Kalogeropoulos, Andreas P; Georgiopoulou, Vasiliki V et al. (2017) High-density lipoprotein-associated paraoxonase-1 activity for prediction of adverse outcomes in outpatients with chronic heart failure. Eur J Heart Fail 19:748-755
Senthong, Vichai; Wu, Yuping; Hazen, Stanley L et al. (2017) Predicting long-term prognosis in stable peripheral artery disease with baseline functional capacity estimated by the Duke Activity Status Index. Am Heart J 184:17-25
Tang, W H Wilson; Hazen, Stanley L (2017) Atherosclerosis in 2016: Advances in new therapeutic targets for atherosclerosis. Nat Rev Cardiol 14:71-72
Senthong, Vichai; Kirsop, Jennifer L; Tang, W H Wilson (2017) Clinical Phenotyping of Heart Failure with Biomarkers: Current and Future Perspectives. Curr Heart Fail Rep 14:106-116
Li, Xinmin S; Obeid, Slayman; Klingenberg, Roland et al. (2017) Gut microbiota-dependent trimethylamine N-oxide in acute coronary syndromes: a prognostic marker for incident cardiovascular events beyond traditional risk factors. Eur Heart J 38:814-824

Showing the most recent 10 out of 123 publications