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Jones RE, Gruszczyk AV, Schmidt C, Hammersley DJ, Mach L, Lee M, Wong J, Yang M, Hatipoglu S, Lota AS, Barnett SN, Toscano-Rivalta R, Owen R, Raja S, De Robertis F, Smail H, De-Souza A, Stock U, Kellman P, Griffin J, Dumas ME, Martin JL, Saeb-Parsy K, Vazir A, Cleland JGF, Pennell DJ, Bhudia SK, Halliday BP, Noseda M, Frezza C, Murphy MP, Prasad SK. Assessment of left ventricular tissue mitochondrial bioenergetics in patients with stable coronary artery disease. NATURE CARDIOVASCULAR RESEARCH 2023; 2:733-745. [PMID: 38666037 PMCID: PMC11041759 DOI: 10.1038/s44161-023-00312-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 06/29/2023] [Indexed: 04/28/2024]
Abstract
Recurrent myocardial ischemia can lead to left ventricular (LV) dysfunction in patients with coronary artery disease (CAD). In this observational cohort study, we assessed for chronic metabolomic and transcriptomic adaptations within LV myocardium of patients undergoing coronary artery bypass grafting. During surgery, paired transmural LV biopsies were acquired on the beating heart from regions with and without evidence of inducible ischemia on preoperative stress perfusion cardiovascular magnetic resonance. From 33 patients, 63 biopsies were acquired, compared to analysis of LV samples from 11 donor hearts. The global myocardial adenosine triphosphate (ATP):adenosine diphosphate (ADP) ratio was reduced in patients with CAD as compared to donor LV tissue, with increased expression of oxidative phosphorylation (OXPHOS) genes encoding the electron transport chain complexes across multiple cell types. Paired analyses of biopsies obtained from LV segments with or without inducible ischemia revealed no significant difference in the ATP:ADP ratio, broader metabolic profile or expression of ventricular cardiomyocyte genes implicated in OXPHOS. Differential metabolite analysis suggested dysregulation of several intermediates in patients with reduced LV ejection fraction, including succinate. Overall, our results suggest that viable myocardium in patients with stable CAD has global alterations in bioenergetic and transcriptional profile without large regional differences between areas with or without inducible ischemia.
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Affiliation(s)
- Richard E. Jones
- National Heart and Lung Institute, Imperial College London, London, UK
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
- Anglia Ruskin University, Chelmsford, UK
- Essex Cardiothoracic Centre, Basildon, UK
| | - Anja V. Gruszczyk
- MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK
| | | | - Daniel J. Hammersley
- National Heart and Lung Institute, Imperial College London, London, UK
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Lukas Mach
- National Heart and Lung Institute, Imperial College London, London, UK
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Michael Lee
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Joyce Wong
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Ming Yang
- MRC Cancer Unit, University of Cambridge, Cambridge, UK
- University of Cologne, CECAD, Cologne, Germany
| | - Suzan Hatipoglu
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Amrit S. Lota
- National Heart and Lung Institute, Imperial College London, London, UK
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Sam N. Barnett
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Ruth Owen
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Shahzad Raja
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Fabio De Robertis
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Hassiba Smail
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Anthony De-Souza
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Ulrich Stock
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Peter Kellman
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD USA
| | - Julian Griffin
- The Rowett Institute, University of Aberdeen, Aberdeen, UK
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Marc-Emmanuel Dumas
- National Heart and Lung Institute, Imperial College London, London, UK
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- European Genomic Institute of Diabetes, INSERM U1283, CNRS 8199, Institut Pasteur de Lille, Lille University Hospital, University of Lille, Lille, France
- McGill Genome Centre, McGill University, Montréal, QC Canada
| | - Jack L. Martin
- Department of Surgery and Cambridge NIHR Biomedical Research Centre, Biomedical Campus, University of Cambridge, Cambridge, UK
| | - Kourosh Saeb-Parsy
- Department of Surgery and Cambridge NIHR Biomedical Research Centre, Biomedical Campus, University of Cambridge, Cambridge, UK
| | - Ali Vazir
- National Heart and Lung Institute, Imperial College London, London, UK
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | | | - Dudley J. Pennell
- National Heart and Lung Institute, Imperial College London, London, UK
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Sunil K. Bhudia
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Brian P. Halliday
- National Heart and Lung Institute, Imperial College London, London, UK
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
| | - Michela Noseda
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Michael P. Murphy
- MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK
| | - Sanjay K. Prasad
- National Heart and Lung Institute, Imperial College London, London, UK
- Royal Brompton and Harefield Hospitals, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
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Gerontas A, Avgerinos D, Charitakis K, Maragou H, Drosatos K. 1821-2021: Contributions of physicians and researchers of Greek descent in the advancement of clinical and experimental cardiology and cardiac surgery. Front Cardiovasc Med 2023; 10:1231762. [PMID: 37600045 PMCID: PMC10436502 DOI: 10.3389/fcvm.2023.1231762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/24/2023] [Indexed: 08/22/2023] Open
Abstract
While the role of Greeks in the development of early western medicine is well-known and appreciated, the contributions of modern Greek medical practitioners are less known and often overlooked. On the occasion of the 200-year anniversary of the Greek War of Independence, this review article sheds light onto the achievements of modern scientists of Greek descent in the development of cardiology, cardiac surgery, and cardiovascular research, through a short history of the development of these fields and of the related institutions in Greece. In the last decades, the Greek cardiology and Cardiac Surgery communities have been active inside and outside Greece and have a remarkable presence internationally, particularly in the United States. This article highlights the ways in which Greek cardiology and cardiovascular research has been enriched by absorbing knowledge produced in international medical centers, academic institutes and pharmaceutical industries in which generations of Greek doctors and researchers trained prior to their return to the homeland; it also highlights the achievements of medical practitioners and researchers of Greek descent who excelled abroad, producing ground-breaking work that has left a permanent imprint on global medicine.
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Affiliation(s)
- Apostolos Gerontas
- School of Applied Natural Sciences, Coburg University, Coburg, Germany
- School of Liberal Arts and Sciences, The American College of Greece, Athens, Greece
| | - Dimitrios Avgerinos
- Department of Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece
- ARISTEiA-Institute for the Advancement of Research and Education in Arts, Sciences and Technology, McLean, VA, United States
| | - Konstantinos Charitakis
- Department of Internal Medicine, Division of Cardiology, University of Texas Health Science Center, Houston, TX, United States
| | - Helena Maragou
- School of Liberal Arts and Sciences, The American College of Greece, Athens, Greece
| | - Konstantinos Drosatos
- ARISTEiA-Institute for the Advancement of Research and Education in Arts, Sciences and Technology, McLean, VA, United States
- Metabolic Biology Laboratory, Cardiovascular Center, Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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Moparthi KP, Al Rushaidi MT, Muddam MR, Obajeun OA, Abaza A, Jaramillo AP, Sid Idris F, Anis Shaikh H, Vahora I, Nath TS. Efficacy and Safety of Sodium-Glucose Cotransporter 2 Inhibitors to Decrease the Risk of Cardiovascular Diseases: A Systematic Review. Cureus 2023; 15:e44054. [PMID: 37638274 PMCID: PMC10457136 DOI: 10.7759/cureus.44054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/24/2023] [Indexed: 08/29/2023] Open
Abstract
Cardiovascular disorders are one of the most frequent causes of death in people throughout the world. These disorders can account for the deaths of 31% of people worldwide. This systematic review examines the effectiveness of sodium-glucose cotransporter 2 (SGLT2) inhibitors in lowering the likelihood of cardiovascular diseases. The study aimed to evaluate various types of research, including randomized controlled trials and observational studies, to analyze how SGLT2 inhibitors impact cardiovascular disorders and establish evidence-based recommendations for clinical practice. The data in this research study were collected from 19 relevant published research articles. The key findings emphasized the potential advantages of SGLT2 inhibitors in reducing major cardiovascular disorders, such as myocardial infarction and stroke. Nonetheless, the study had certain limitations, including reliance on existing literature, exclusion of articles published prior to 2018, and restriction to English-language studies. Despite these limitations, this study contributed significantly to understanding the role of SGLT2 inhibitors in decreasing cardiovascular risk.
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Affiliation(s)
- Kiran Prasad Moparthi
- General Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Majdah T Al Rushaidi
- Psychology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Meghana Reddy Muddam
- General Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Omobolanle A Obajeun
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Abdelrahman Abaza
- Pathology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Arturo P Jaramillo
- General Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Faten Sid Idris
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Humna Anis Shaikh
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ilma Vahora
- General Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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García P, Bustamante A, Echeverría F, Encina C, Palma M, Sanhueza L, Sambra V, Pando ME, Jiménez P. A Feasible Approach to Developing Fiber-Enriched Bread Using Pomegranate Peel Powder: Assessing Its Nutritional Composition and Glycemic Index. Foods 2023; 12:2798. [PMID: 37509890 PMCID: PMC10379044 DOI: 10.3390/foods12142798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/14/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
The consumption of dietary fiber (DF) has been associated with a reduced incidence of non-communicable diseases. Despite various strategies implemented worldwide to increase DF intake, it remains low. Therefore, the development of new fiber-rich food products that are widely consumed could be a strategy to improve DF intake. In this study, an agro-industrial by-product, pomegranate peel powder (PPP), was used as an innovative source of DF and antioxidant. The objective was to develop a bread enriched with DF, antioxidants, and sensory characteristics by partially replacing wheat flour (WF) with PPP at levels of 0%, 2.5%, 5%, 7.5%, and 10%. Bread with 2.5% and 5% PPP was chosen for a clinical trial to evaluate glycemic response (GR) in healthy subjects and determine the bread's glycemic index (GI). As the percentage of PPP increased, both the DF and total polyphenol content increased significantly. The highest overall acceptability was achieved with bread containing up to 5% PPP. Consumption of bread with 2.5% and 5.0% PPP significantly reduced the GI compared to the control bread, while the decrease in GR was not significant. PPP could be a potential food and low-cost ingredient to improve the bread's nutritional quality through its contribution to DF and antioxidants.
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Affiliation(s)
- Paula García
- Departamento de Nutrición, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Andrés Bustamante
- Departamento de Nutrición, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Francisca Echeverría
- Carrera de Nutrición y Dietética, Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile
| | - Cristian Encina
- Nutrición y Dietética, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago 7500912, Chile
| | - Manuel Palma
- P&M Foods, Los Olmos 3465, Santiago 7810668, Chile
| | - Leyla Sanhueza
- Departamento Ciencia de los Alimentos y Tecnología Química, Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago 8380492, Chile
| | - Verónica Sambra
- Departamento de Nutrición, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Maria Elsa Pando
- Departamento de Nutrición, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Paula Jiménez
- Departamento de Nutrición, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
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Petkovic A, Erceg S, Munjas J, Ninic A, Vladimirov S, Davidovic A, Vukmirovic L, Milanov M, Cvijanovic D, Mitic T, Sopic M. LncRNAs as Regulators of Atherosclerotic Plaque Stability. Cells 2023; 12:1832. [PMID: 37508497 PMCID: PMC10378138 DOI: 10.3390/cells12141832] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Current clinical data show that, despite constant efforts to develop novel therapies and clinical approaches, atherosclerotic cardiovascular diseases (ASCVD) are still one of the leading causes of death worldwide. Advanced and unstable atherosclerotic plaques most often trigger acute coronary events that can lead to fatal outcomes. However, despite the fact that different plaque phenotypes may require different treatments, current approaches to prognosis, diagnosis, and classification of acute coronary syndrome do not consider the diversity of plaque phenotypes. Long non-coding RNAs (lncRNAs) represent an important class of molecules that are implicated in epigenetic control of numerous cellular processes. Here we review the latest knowledge about lncRNAs' influence on plaque development and stability through regulation of immune response, lipid metabolism, extracellular matrix remodelling, endothelial cell function, and vascular smooth muscle function, with special emphasis on pro-atherogenic and anti-atherogenic lncRNA functions. In addition, we present current challenges in the research of lncRNAs' role in atherosclerosis and translation of the findings from animal models to humans. Finally, we present the directions for future lncRNA-oriented research, which may ultimately result in patient-oriented therapeutic strategies for ASCVD.
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Affiliation(s)
- Aleksa Petkovic
- Clinical-Hospital Centre "Dr Dragiša Mišović-Dedinje", 11000 Belgrade, Serbia
| | - Sanja Erceg
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
| | - Jelena Munjas
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
| | - Ana Ninic
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
| | - Sandra Vladimirov
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
| | - Aleksandar Davidovic
- Intern Clinic, Clinical Ward for Cardiovascular Diseases, Clinical-Hospital Centre Zvezdara, 11000 Belgrade, Serbia
- Department for Internal Medicine, Faculty of Dentistry, University of Belgrade, 11000 Belgrade, Serbia
| | - Luka Vukmirovic
- Intern Clinic, Clinical Ward for Cardiovascular Diseases, Clinical-Hospital Centre Zvezdara, 11000 Belgrade, Serbia
| | - Marko Milanov
- Intern Clinic, Clinical Ward for Cardiovascular Diseases, Clinical-Hospital Centre Zvezdara, 11000 Belgrade, Serbia
| | - Dane Cvijanovic
- Intern Clinic, Clinical Ward for Cardiovascular Diseases, Clinical-Hospital Centre Zvezdara, 11000 Belgrade, Serbia
| | - Tijana Mitic
- Centre for Cardiovascular Science, The Queen's Medical Research Institute, Edinburgh EH16 4TJ, UK
| | - Miron Sopic
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
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Gora AH, Rehman S, Dias J, Fernandes JMO, Olsvik PA, Sørensen M, Kiron V. Protective mechanisms of a microbial oil against hypercholesterolemia: evidence from a zebrafish model. Front Nutr 2023; 10:1161119. [PMID: 37435570 PMCID: PMC10332275 DOI: 10.3389/fnut.2023.1161119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/20/2023] [Indexed: 07/13/2023] Open
Abstract
A Western diet elevates the circulating lipoprotein and triglyceride levels which are the major risk factors in cardiovascular disease (CVD) development. Consumption of long-chain omega-3 fatty acids can stall the disease progression. Although these fatty acids can significantly impact the intestine under a hypercholesterolemic condition, the associated changes have not been studied in detail. Therefore, we investigated the alterations in the intestinal transcriptome along with the deviations in the plasma lipids and liver histomorphology of zebrafish offered DHA- and EPA-rich oil. Fish were allocated to 4 dietary treatments: a control group, a high cholesterol group and microbial oil groups with low (3.3%) and high (6.6%) inclusion levels. We quantified the total cholesterol, lipoprotein and triglyceride levels in the plasma. In addition, we assessed the liver histology, intestinal transcriptome and plasma lipidomic profiles of the study groups. The results suggested that higher levels of dietary microbial oil could control the CVD risk factor indices in zebrafish plasma. Furthermore, microbial oil-fed fish had fewer liver vacuoles and higher mRNA levels of genes involved in β-oxidation and HDL maturation. Analyses of the intestine transcriptome revealed that microbial oil supplementation could influence the expression of genes altered by a hypercholesterolemic diet. The plasma lipidomic profiles revealed that the higher level of microbial oil tested could elevate the long-chain poly-unsaturated fatty acid content of triglyceride species and lower the concentration of several lysophosphatidylcholine and diacylglycerol molecules. Our study provides insights into the effectiveness of microbial oil against dyslipidemia in zebrafish.
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Affiliation(s)
- Adnan H. Gora
- Faculty of Biosciences and Aquaculture, Nord University, Bodø, Norway
| | - Saima Rehman
- Faculty of Biosciences and Aquaculture, Nord University, Bodø, Norway
| | | | | | - Pål A. Olsvik
- Faculty of Biosciences and Aquaculture, Nord University, Bodø, Norway
| | - Mette Sørensen
- Faculty of Biosciences and Aquaculture, Nord University, Bodø, Norway
| | - Viswanath Kiron
- Faculty of Biosciences and Aquaculture, Nord University, Bodø, Norway
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Mao W, Lu P, Wan R, Mao K, Lv Y, Hu J, Fu Z, Wang J. Efficacy and safety of Danlou tablets in traditional Chinese medicine for coronary heart disease: a systematic review and meta-analysis. Front Cardiovasc Med 2023; 10:1100006. [PMID: 37351285 PMCID: PMC10282777 DOI: 10.3389/fcvm.2023.1100006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/09/2023] [Indexed: 06/24/2023] Open
Abstract
Background Danlou tablets exert auxiliary advantages in treating coronary heart disease (CHD), but a summary of evidence-based proof is lacking. This study aims to systematically evaluate Danlou tablets in treating CHD from two aspects, including efficacy and safety. Methods By a thorough retrieval of the four English databases, namely, PubMed, The Cochrane Library, Embase, and Web of Science, and the four Chinese databases, namely, CNKI, Wanfang, VIP database, and China Biomedical Literature Service System, we found all randomized controlled trials (RCTs) related to Danlou tablets in treating CHD. The retrieval time was from the construction of the database to April 2022. We engaged two researchers to screen the studies, extract the required data, and assess the risk of bias. We then used RevMan5.3 and STATA.14 software to conduct a meta-analysis. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of outcome indicators. Results Seventeen RCTs involving 1,588 patients were included. The meta-analysis results are displayed as follows: clinical treatment effect [risk ratio (RR) = 1.22, 95% confidence interval (CI): 1.16, 1.28, P < 0.00001], angina pectoris duration [MD = -0.2.15, 95% CI: -2.91, -1.04, P < 0.00001], angina pectoris frequency [standard mean difference (SMD) = -2.48, 95% CI: -3.42, -1.54, P < 0.00001], angina pectoris degree [SMD = -0.96, 95% CI: -1.39, -0.53, P < 0.0001], TC [MD = -0.71, 95% CI: -0.92, -0.51, P < 0.00001], TG [MD = -0.38, 95% CI: -0.53, -0.22, P < 0.00001], low-density lipoprotein cholesterol [MD = -0.64, 95% CI: -0.76, -0.51, P < 0.00001], high-density lipoprotein cholesterol [MD = 0.16, 95% CI: 0.11, 0.21, P < 0.00001], and adverse events [RR = 0.46, 95% CI: 0.24, 0.88, P = 0.02]. Conclusion The current evidence suggests that the combination of Danlou tablets and Western medicine can enhance the efficacy of CHD and does not increase adverse events. However, because of the limited number and quality of the included studies, the results of our study should be treated with caution. Further large-scale RCTs are necessary to verify the benefits of this approach.
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Affiliation(s)
- WeiLi Mao
- Department of Pharmacy, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
| | - Peng Lu
- Department of Pharmacy, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Renhong Wan
- School of Acupuncture and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Kaili Mao
- Department of Pharmacy, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
| | - Yanzhu Lv
- School of Acupuncture and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jie Hu
- Department of Pharmacy, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
| | - Zhenling Fu
- Department of Pharmacy, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
| | - Jun Wang
- Department of Pharmacy, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, China
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Kang G, Zhang H, Zhou J, Wan D. The WeChat platform-based health education improves health outcomes among patients with stable coronary artery disease. PATIENT EDUCATION AND COUNSELING 2023; 111:107704. [PMID: 36906932 DOI: 10.1016/j.pec.2023.107704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/03/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of the WeChat platform-based health education on patients with stable coronary artery disease (CAD) compared with usual care. METHODS We conducted a randomized controlled trial that included patients with stable CAD who were admitted to the Bin Hai Wan Central Hospital of Dongguan between January 2020 and December 2020. Participants in the control group received a standard regimen of care. In the WeChat group, the patients were provided with the WeChat platform-based health education by multidisciplinary team members in addition to usual care. The coprimary outcome of the study was the blood pressure, lipid profile, fasting blood glucose, Hamilton Anxiety Scale (HAMA) scores, Hamilton Depression Scale (HAMD) scores and Seattle Angina Questionnaire (SAQ) scores at 12 months, relative to baseline levels. RESULTS Between January 2020 and December 2020, 200 eligible CAD patients were randomly assigned to WeChat group (n = 100) or usual care group (n = 100). After 12 months, the number of participants who knew the risk factors, symptoms, diagnostic criteria, management methods and treating target of CAD was significantly larger in the WeChat group than at baseline (P < 0.05) and also larger than the post-intervention level of the control group (P < 0.05). The systolic blood pressure after intervention of the WeChat group significantly decreased compared to those of the control group (132.06 ± 8.87 mmHg vs 140.32 ± 9.42 mmHg; P < 0.05). After intervention, the triglycerides, total cholesterol, and low-density lipoprotein cholesterol of the WeChat group significantly decreased compared to those at baseline and significantly decreased than those in the control group (all P < 0.05). After the intervention, scores of HAMA and HAMD both significantly decreased in the two groups. Moreover, the decreases were more significant in the WeChat group than in the control group (5.78 ± 0.98 vs 8.54 ± 1.24; 6.27 ± 1.03 vs 8.63 ± 1.66; P < 0.05). The SAQ scores of WeChat group were significantly higher than those of the control group in all 5 dimensions at the 1-year follow-up (72.71 ± 10.83 vs 59.32 ± 9.86; 80.01 ± 11.56 vs 61.98 ± 11.02; 76.76 ± 12.64 vs 65.22 ± 10.72; 83.17 ± 13.06 vs 67.01 ± 12.86; 71.82 ± 12.78 vs 55.79 ± 11.90; all P < 0.05). CONCLUSION This study showed the high efficacy of the WeChat platform-based health education in improving health outcomes in patients with CAD. PRACTICE IMPLICATIONS This study highlighted the potential of social media as a helpful tool for health education among patients with CAD.
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Affiliation(s)
- GuanYang Kang
- Department of Cardiology, Bin Hai Wan Central Hospital of Dongguan, The Dongguan Affiliated Hospital of Jinan University (also called The Fifth People's Hospital of Dongguan, Taiping People's Hospital of Dongguan), Dongguan, Guangdong, China.
| | - HuiQing Zhang
- Department of Clinical Pharmacy, Bin Hai Wan Central Hospital of Dongguan, The Dongguan Affiliated Hospital of Jinan University (also called The Fifth People's Hospital of Dongguan, Taiping People's Hospital of Dongguan), Dongguan, Guangdong, China
| | - Jian Zhou
- Department of Cardiovascular Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200123, China
| | - DeLi Wan
- Department of Cardiology, Bin Hai Wan Central Hospital of Dongguan, The Dongguan Affiliated Hospital of Jinan University (also called The Fifth People's Hospital of Dongguan, Taiping People's Hospital of Dongguan), Dongguan, Guangdong, China
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Fiori G, Fuiano F, Conforto S, Sciuto SA, Scorza A. A Novel Equivalent Time Sampling-Based Method for Pulse Transit Time Estimation with Applications into the Cardiovascular Disease Diagnosis. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23115005. [PMID: 37299732 DOI: 10.3390/s23115005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023]
Abstract
The increasing incidence of cardiovascular diseases (CVDs) is reflected in additional costs for healthcare systems all over the world. To date, pulse transit time (PTT) is considered a key index of cardiovascular health status and for diagnosis of CVDs. In this context, the present study focuses on a novel image analysis-based method for PTT estimation through the application of equivalent time sampling. The method, which post-processes color Doppler videos, was tested on two different setups: a Doppler flow phantom set in pulsatile mode and an in-house arterial simulator. In the former, the Doppler shift was due to the echogenic properties of the blood mimicking fluid only, since the phantom vessels are non-compliant. In the latter, the Doppler signal relied on the wall movement of compliant vessels in which a fluid with low echogenic properties was pumped. Therefore, the two setups allowed the measurement of the flow average velocity (FAV) and the pulse wave velocity (PWV), respectively. Data were collected through an ultrasound diagnostic system equipped with a phased array probe. Experimental outcomes confirm that the proposed method can represent an alternative tool for the local measurement of both FAV in non-compliant vessels and PWV in compliant vessels filled with low echogenic fluids.
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Affiliation(s)
- Giorgia Fiori
- Department of Industrial, Electronic and Mechanical Engineering, University of Roma Tre, 00146 Rome, Italy
| | - Fabio Fuiano
- Department of Industrial, Electronic and Mechanical Engineering, University of Roma Tre, 00146 Rome, Italy
| | - Silvia Conforto
- Department of Industrial, Electronic and Mechanical Engineering, University of Roma Tre, 00146 Rome, Italy
| | - Salvatore Andrea Sciuto
- Department of Industrial, Electronic and Mechanical Engineering, University of Roma Tre, 00146 Rome, Italy
| | - Andrea Scorza
- Department of Industrial, Electronic and Mechanical Engineering, University of Roma Tre, 00146 Rome, Italy
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60
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Liberale L, Puspitasari YM, Ministrini S, Akhmedov A, Kraler S, Bonetti NR, Beer G, Vukolic A, Bongiovanni D, Han J, Kirmes K, Bernlochner I, Pelisek J, Beer JH, Jin ZG, Pedicino D, Liuzzo G, Stellos K, Montecucco F, Crea F, Lüscher TF, Camici GG. JCAD promotes arterial thrombosis through PI3K/Akt modulation: a translational study. Eur Heart J 2023; 44:1818-1833. [PMID: 36469488 PMCID: PMC10200023 DOI: 10.1093/eurheartj/ehac641] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 09/14/2022] [Accepted: 10/26/2022] [Indexed: 12/11/2022] Open
Abstract
AIMS Variants of the junctional cadherin 5 associated (JCAD) locus associate with acute coronary syndromes. JCAD promotes experimental atherosclerosis through the large tumor suppressor kinase 2 (LATS2)/Hippo pathway. This study investigates the role of JCAD in arterial thrombosis. METHODS AND RESULTS JCAD knockout (Jcad-/-) mice underwent photochemically induced endothelial injury to trigger arterial thrombosis. Primary human aortic endothelial cells (HAECs) treated with JCAD small interfering RNA (siJCAD), LATS2 small interfering RNA (siLATS2) or control siRNA (siSCR) were employed for in vitro assays. Plasma JCAD was measured in patients with chronic coronary syndrome or ST-elevation myocardial infarction (STEMI). Jcad-/- mice displayed reduced thrombogenicity as reflected by delayed time to carotid occlusion. Mechanisms include reduced activation of the coagulation cascade [reduced tissue factor (TF) expression and activity] and increased fibrinolysis [higher thrombus embolization episodes and D-dimer levels, reduced vascular plasminogen activator inhibitor (PAI)-1 expression]. In vitro, JCAD silencing inhibited TF and PAI-1 expression in HAECs. JCAD-silenced HAECs (siJCAD) displayed increased levels of LATS2 kinase. Yet, double JCAD and LATS2 silencing did not restore the control phenotype. si-JCAD HAECs showed increased levels of phosphoinositide 3-kinases (PI3K)/ proteinkinase B (Akt) activation, known to downregulate procoagulant expression. The PI3K/Akt pathway inhibitor-wortmannin-prevented the effect of JCAD silencing on TF and PAI-1, indicating a causative role. Also, co-immunoprecipitation unveiled a direct interaction between JCAD and Akt. Confirming in vitro findings, PI3K/Akt and P-yes-associated protein levels were higher in Jcad-/- animals. Lastly, as compared with chronic coronary syndrome, STEMI patients showed higher plasma JCAD, which notably correlated positively with both TF and PAI-1 levels. CONCLUSIONS JCAD promotes arterial thrombosis by modulating coagulation and fibrinolysis. Herein, reported translational data suggest JCAD as a potential therapeutic target for atherothrombosis.
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Affiliation(s)
- Luca Liberale
- Center for Molecular Cardiology, Schlieren Campus, University of
Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland
- First Clinic of Internal Medicine, Department of Internal Medicine,
University of Genoa, 6 viale Benedetto XV, 16132
Genoa, Italy
| | - Yustina M Puspitasari
- Center for Molecular Cardiology, Schlieren Campus, University of
Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland
| | - Stefano Ministrini
- Center for Molecular Cardiology, Schlieren Campus, University of
Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland
- Internal Medicine, Angiology and Atherosclerosis, Department of Medicine
and Surgery, University of Perugia, piazzale Gambuli 1, 06124
Perugia, Italy
| | - Alexander Akhmedov
- Center for Molecular Cardiology, Schlieren Campus, University of
Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland
| | - Simon Kraler
- Center for Molecular Cardiology, Schlieren Campus, University of
Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland
| | - Nicole R Bonetti
- Center for Molecular Cardiology, Schlieren Campus, University of
Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland
- Department of Cardiology, University Heart Center, University Hospital
Zurich, Rämistrasse 100, 8092 Zurich, Switzerland
| | - Georgia Beer
- Center for Molecular Cardiology, Schlieren Campus, University of
Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland
| | - Ana Vukolic
- Center for Molecular Cardiology, Schlieren Campus, University of
Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland
| | - Dario Bongiovanni
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero
Cantonale (EOC), Lugano, Switzerland
- Department of Biomedical Sciences, Humanitas University, Pieve
Emanuele, Milan, Italy
- Department of Cardiovascular Medicine, IRCCS Humanitas Research
Hospital, Rozzano, Milan, Italy
- Department of Internal Medicine I, School of Medicine, University Hospital
rechts der Isar, Technical University of Munich,
Munich, Germany
| | - Jiaying Han
- Department of Internal Medicine I, School of Medicine, University Hospital
rechts der Isar, Technical University of Munich,
Munich, Germany
| | - Kilian Kirmes
- Department of Internal Medicine I, School of Medicine, University Hospital
rechts der Isar, Technical University of Munich,
Munich, Germany
| | - Isabell Bernlochner
- Department of Internal Medicine I, School of Medicine, University Hospital
rechts der Isar, Technical University of Munich,
Munich, Germany
| | - Jaroslav Pelisek
- Department of Vascular Surgery, University Hospital Zurich,
Zurich, Switzerland
| | - Jürg H Beer
- Center for Molecular Cardiology, Schlieren Campus, University of
Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland
- Department of Internal Medicine, Cantonal Hospital of Baden,
Im Ergel 1, 5404 Baden, Switzerland
| | - Zheng-Gen Jin
- Department of Medicine, Aab Cardiovascular Research Institute, University
of Rochester School of Medicine and Dentistry, Rochester,
NY, USA
| | - Daniela Pedicino
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario
A. Gemelli-IRCCS, Largo A. Gemelli 8, Rome 00168,
Italy
- Cardiovascular and Pulmonary Sciences, Catholic University,
Largo G. Vito, 1 - 00168 Rome, Italy
| | - Giovanna Liuzzo
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario
A. Gemelli-IRCCS, Largo A. Gemelli 8, Rome 00168,
Italy
- Cardiovascular and Pulmonary Sciences, Catholic University,
Largo G. Vito, 1 - 00168 Rome, Italy
| | - Konstantinos Stellos
- Biosciences Institute, Vascular Biology and Medicine Theme, Faculty of
Medical Sciences, Newcastle University, Newcastle Upon
Tyne, UK
- Department of Cardiology, Freeman Hospital, Newcastle upon Tyne Hospitals
NHS Foundation Trust, Newcastle Upon Tyne,
UK
- Department of Cardiovascular Research, European Center for Angioscience
(ECAS), Medical Faculty Mannheim, Heidelberg University,
Mannheim, Germany
- German Centre for Cardiovascular Research (Deutsches Zentrum für
Herz-Kreislauf-Forschung, DZHK), Heidelberg/Mannheim Partner Site,
Mannheim, Germany
- Department of Cardiology, University Hospital Mannheim,
Mannheim, Germany
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine,
University of Genoa, 6 viale Benedetto XV, 16132
Genoa, Italy
- IRCCS Ospedale Policlinico San Martino Genoa—Italian Cardiovascular
Network, L.go R. Benzi 10, 16132 Genoa, Italy
| | - Filippo Crea
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario
A. Gemelli-IRCCS, Largo A. Gemelli 8, Rome 00168,
Italy
- Cardiovascular and Pulmonary Sciences, Catholic University,
Largo G. Vito, 1 - 00168 Rome, Italy
| | - Thomas F Lüscher
- Center for Molecular Cardiology, Schlieren Campus, University of
Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland
- Heart Division, Royal Brompton and Harefield Hospitals and Nationl Heart
and Lung Institute, Imperial College, London,
United Kingdom
| | - Giovanni G Camici
- Center for Molecular Cardiology, Schlieren Campus, University of
Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland
- Department of Research and Education, University Hospital
Zurich, Rämistrasse 100, 8092 Zurich, Switzerland
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van der Velden J. Individual, societal and clinical burden of cardiovascular disease: health technology assessment to guide new diagnostics and treatment strategies. Neth Heart J 2023; 31:217-218. [PMID: 37160559 DOI: 10.1007/s12471-023-01787-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 05/11/2023] Open
Affiliation(s)
- Jolanda van der Velden
- Department of Physiology, Amsterdam University Medical Centres, location Free University Amsterdam, Amsterdam, The Netherlands.
- Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, location Free University Medical Centre, Amsterdam, The Netherlands.
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Miao F, Wu D, Liu Z, Zhang R, Tang M, Li Y. Wearable sensing, big data technology for cardiovascular healthcare: current status and future prospective. Chin Med J (Engl) 2023; 136:1015-1025. [PMID: 36103984 PMCID: PMC10228482 DOI: 10.1097/cm9.0000000000002117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Wearable technology, which can continuously and remotely monitor physiological and behavioral parameters by incorporated into clothing or worn as an accessory, introduces a new era for ubiquitous health care. With big data technology, wearable data can be analyzed to help long-term cardiovascular care. This review summarizes the recent developments of wearable technology related to cardiovascular care, highlighting the most common wearable devices and their accuracy. We also examined the application of these devices in cardiovascular healthcare, such as the early detection of arrhythmias, measuring blood pressure, and detecting prevalent diabetes. We provide an overview of the challenges that hinder the widespread application of wearable devices, such as inadequate device accuracy, data redundancy, concerns associated with data security, and lack of meaningful criteria, and offer potential solutions. Finally, the future research direction for cardiovascular care using wearable devices is discussed.
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Affiliation(s)
- Fen Miao
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China
- Key Laboratory for Health Informatics, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China
| | - Dan Wu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China
- Key Laboratory for Health Informatics, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China
| | - Zengding Liu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China
- Key Laboratory for Health Informatics, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China
| | - Ruojun Zhang
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China
- Key Laboratory for Health Informatics, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China
| | - Min Tang
- Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Ye Li
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China
- Key Laboratory for Health Informatics, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China
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Nasr N, Soltész B, Sándor J, Ádány R, Fiatal S. Comparison of Genetic Susceptibility to Coronary Heart Disease in the Hungarian Populations: Risk Prediction Models for Coronary Heart Disease. Genes (Basel) 2023; 14:1033. [PMID: 37239393 PMCID: PMC10218435 DOI: 10.3390/genes14051033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/17/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
Background and Aim: It was evaluated whether the integration of genetic risk scores (GRS-unweighted, wGRS-weighted) into conventional risk factor (CRF) models for coronary heart disease or acute myocardial infarction (CHD/AMI) could improve the predictive ability of the models. Methods: Subjects and data collected in a previous survey were used to perform regression and ROC curve analyses as well as to examine the role of genetic components. Thirty SNPs were selected, and genotype and phenotype data were available for 558 participants (general: N = 279 and Roma: N = 279). Results: The mean GRS (27.27 ± 3.43 vs. 26.68 ± 3.51, p = 0.046) and wGRS (3.52 ± 0.68 vs. 3.33 ± 0.62, p = 0.001) were significantly higher in the general population. The addition of the wGRS to the CRF model yielded the strongest improvement in discrimination among Roma (from 0.8616 to 0.8674), while the addition of GRS to the CRF model yielded the strongest improvement in discrimination in the general population (from 0.8149 to 0.8160). In addition to that, the Roma individuals were likely to develop CHD/AMI at a younger age than subjects in the general population. Conclusions: The combination of the CRFs and genetic components improved the model's performance and predicted AMI/CHD better than CRFs alone.
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Affiliation(s)
- Nayla Nasr
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - Beáta Soltész
- Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary
| | - János Sándor
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Róza Ádány
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- ELKH-DE Public Health Research Group, Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Szilvia Fiatal
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
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Ballantyne BA, Chew DS, Vandenberk B. Paradigm Shifts in Cardiac Pacing: Where Have We Been and What Lies Ahead? J Clin Med 2023; 12:jcm12082938. [PMID: 37109274 PMCID: PMC10146747 DOI: 10.3390/jcm12082938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/07/2023] [Accepted: 04/09/2023] [Indexed: 04/29/2023] Open
Abstract
The history of cardiac pacing dates back to the 1930s with externalized pacing and has evolved to incorporate transvenous, multi-lead, or even leadless devices. Annual implantation rates of cardiac implantable electronic devices have increased since the introduction of the implantable system, likely related to expanding indications, and increasing global life expectancy and aging demographics. Here, we summarize the relevant literature on cardiac pacing to demonstrate the enormous impact it has had within the field of cardiology. Further, we look forward to the future of cardiac pacing, including conduction system pacing and leadless pacing strategies.
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Affiliation(s)
- Brennan A Ballantyne
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Derek S Chew
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Bert Vandenberk
- Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
- Department of Cardiology, University Hospitals Leuven, 3000 Leuven, Belgium
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65
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Vandewalle L, Duchi F, Verhelle K, Vanacker P. Suboptimal lipid management in patients with acute ischemic stroke. Clin Neurol Neurosurg 2023; 229:107717. [PMID: 37079961 DOI: 10.1016/j.clineuro.2023.107717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/17/2023] [Accepted: 04/16/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE Lipid-lowering drugs are among the most widely used drugs in cardiovascular prevention. Statins are often abandoned due to side effects, or under dosed, leading to unreached LDL-cholesterol goals and increased occurrence of cardiovascular events. METHODS We included hospitalized patients with an ischemic stroke or transient ischemic attack. Of 92 patients, low density lipoprotein cholesterol (LDL-C) levels and lipid lowering therapy at admission and discharge were assessed. Based on their cardiovascular risk before the current event according to the most recent European guidelines, LDL-C targets were determined. Low, moderate, high and very high risk corresponded with LDL-C targets below 116, 100, 70 and 55 mg/dL respectively. RESULTS Before current event, 59 (64%) were very high, 21 (23%) high, 11 (12%) moderate and 1 low risk patients and eight patients were treated with low, 23 moderate, and 21 high intensity lipid-lowering therapy. Upon admission, 75 patients had insufficiently managed LDL-cholesterol levels, yet 39 of them were taking lipid lowering therapy. Only eight of the 21 patients on high intensity lipid lowering therapy reached their LDL-C target. During hospitalization 40 patients were switched to a high-intensity statin. Thirty-three patients switched from no treatment or a lower-intensity to a moderate-intensity lipid lowering therapy. Three were dismissed with low-intensity lipid lowering therapy, and five in association with Ezetimibe. Three patients had documented statin-intolerance. CONCLUSION In this study, LDL-cholesterol was insufficiently managed according to international guidelines for prevention of ischemic stroke. Further optimization of lipid management in primary and secondary prevention and the use of higher intensity lipid lowering therapy in clinical practice is mandatory.
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Affiliation(s)
- L Vandewalle
- Department of Neurology, AZ Groeninge, Pres. Kennedylaan 4, 8500 Kortrijk, Belgium; Department of Neurology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Neurosciences, Experimental neurology, KU Leuven - University of Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - F Duchi
- Department of Clinical Pharmacy, AZ Groeninge, Pres. Kennedylaan 4, 8500 Kortrijk, Belgium.
| | - K Verhelle
- Department of Clinical Pharmacy, AZ Groeninge, Pres. Kennedylaan 4, 8500 Kortrijk, Belgium.
| | - P Vanacker
- Department of Neurology, AZ Groeninge, Pres. Kennedylaan 4, 8500 Kortrijk, Belgium; Research Group on Translational Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium; Antwerp University Hospital, Neurovascular Reference Center, Department of Neurology, Drie Eikenstraat 655, 2650 Edegem, Belgium.
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66
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Huang C, Zhang W, Chen X, Xu X, Qiu J, Pan Z. Fibrinogen is an independent preoperative predictor of hospital length of stay among patients undergoing coronary artery bypass grafting. J Cardiothorac Surg 2023; 18:112. [PMID: 37029421 PMCID: PMC10082530 DOI: 10.1186/s13019-023-02238-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/02/2023] [Indexed: 04/09/2023] Open
Abstract
OBJECTIVE This study aims to examine the impact of preoperative fibrinogen concentration on the short-term outcomes and hospital length of stay (LOS) of patients undergoing Coronary Artery Bypass Grafting (CABG). METHODS Between January 2010 and June 2022, a retrospective analysis comprised 633 patients who sequentially received isolated, primary CABG. These patients were categorized into normal fibrinogen group (fibrinogen < 3.5 g/L) and high fibrinogen group (fibrinogen ≥ 3.5 g/L) according to preoperative fibrinogen concentration. The primary outcome was LOS. To correct for confounding and investigate the effect of preoperative fibrinogen concentration on the short-term outcomes and LOS, we employed propensity score matching (PSM). The correlation between fibriongen concentration and LOS in subgroups was examined using subgroup analysis. RESULTS We categorized 344 and 289 patients in the "normal fibrinogen group" and "high fibrinogen group", respectively. After PSM, compared to the normal fibrinogen group, the high fibrinogen group had a longer LOS [12.00 (9.00-15.00) vs. 13.00 (10.00-16.00), P = 0.028] and higher incidence of postoperative renal impairment [49 (22.1%) vs. 72 (32.4%), P = 0.014]. Cardiopulmonary bypass (CPB) or non-CPB CABG patients showed similar correlations between various fibrinogen concentrations and LOS, according to subgroup analyses. CONCLUSIONS Fibrinogen is an independent preoperative predictor of both the LOS and the postoperative renal impairment that occurs after CABG. Patients with high preoperative fibrinogen concentration had a higher incidence of postoperative renal impairment and a longer LOS, emphasizing the significance of preoperative fibrinogen management.
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Affiliation(s)
- Chunsheng Huang
- Department of Anesthesiology, Ningbo Medical Center Lihuili Hospital, Medical School of Ningbo University, Zhejiang, 315040, China
| | - Wenyuan Zhang
- Department of Anesthesiology and Intensive Care, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Xiaofei Chen
- Department of Anesthesiology, Ningbo Medical Center Lihuili Hospital, Medical School of Ningbo University, Zhejiang, 315040, China
| | - Xia Xu
- Department of Anesthesiology, Ningbo Medical Center Lihuili Hospital, Medical School of Ningbo University, Zhejiang, 315040, China
| | - Jun Qiu
- Department of Anesthesiology, Ningbo Medical Center Lihuili Hospital, Medical School of Ningbo University, Zhejiang, 315040, China
| | - Zhihao Pan
- Department of Anesthesiology, Ningbo Medical Center Lihuili Hospital, Medical School of Ningbo University, Zhejiang, 315040, China.
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Galli M, Vescovo GM, Andreotti F, D'Amario D, Leone AM, Benenati S, Vergallo R, Niccoli G, Trani C, Porto I. Impact of coronary stenting on top of medical therapy and of inclusion of periprocedural infarctions on hard composite endpoints in patients with chronic coronary syndromes: a meta-analysis of randomized controlled trials. Minerva Cardiol Angiol 2023; 71:221-229. [PMID: 33944534 DOI: 10.23736/s2724-5683.21.05645-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Composite endpoints are pivotal when assessing rare outcomes over relatively short follow-ups. Most randomized controlled trials (RCTs) comparing percutaneous coronary intervention (PCI) with stent implantation to optimal medical therapy (OMT) in chronic coronary syndromes (CCS) patients included both hard and soft outcomes in their primary endpoint, with periprocedural myocardial infarctions (MIs) systematically allocated to the PCI arm. We meta-analyzed the above RCTs for composite hard endpoints, with and without periprocedural MIs. EVIDENCE ACQUISITION This study is registered in PROSPERO CRD42020166754 and follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane Collaboration reporting. Patients had inducible ischemia, no left main disease nor severe left ventricular dysfunction. EVIDENCE SYNTHESIS Six RCTs involving 10,751 patients followed for a mean of 4.4 years were included. PCI+OMT versus OMT alone was associated with no difference in the two co-primary composite endpoints of all-cause death/MI/stroke and cardiovascular death/MI including all-MIs (IRR 0.99; 95% CI 0.90-1.08 and IRR 0.95; 95% CI 0.83-1.08 respectively). After inclusion of spontaneous rather than all-MIs (i.e., excluding periprocedural MIs), the odds showed benefit of PCI+OMT for both co-primary endpoints (IRR 0.88; 95% CI 0.80-0.97, P<0.01 and IRR 0.81; 95% CI 0.69-0.95, P=0.01 respectively) with numbers needed to treat of 42 in both cases. CONCLUSIONS Among CCS patients with inducible myocardial ischemia without severely reduced ejection fraction or left main disease, adding PCI to OMT reduces hard composite outcomes only after exclusion of periprocedural MIs. Continued efforts to define periprocedural MIs reproducibly, to assess their prognostic relevance and to prevent them are warranted.
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Affiliation(s)
- Mattia Galli
- Department of Cardiovascular and Thoracic Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Sacred Heart Catholic University, Rome, Italy
| | - Giovanni M Vescovo
- Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Felicita Andreotti
- Department of Cardiovascular and Thoracic Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Sacred Heart Catholic University, Rome, Italy
| | - Domenico D'Amario
- Department of Cardiovascular and Thoracic Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | | | - Stefano Benenati
- IRCCS San Martino University Hospital, Italian Cardiovascular Network, University of Genoa, Genoa, Italy
| | - Rocco Vergallo
- Department of Cardiovascular and Thoracic Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Giampaolo Niccoli
- Department of Cardiovascular and Thoracic Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Sacred Heart Catholic University, Rome, Italy
| | - Carlo Trani
- Department of Cardiovascular and Thoracic Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Sacred Heart Catholic University, Rome, Italy
| | - Italo Porto
- IRCCS San Martino University Hospital, Italian Cardiovascular Network, University of Genoa, Genoa, Italy -
- Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy
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Kranen SH, Oliveira RS, Bond B, Williams CA, Barker AR. The effect of 4 weeks of high-intensity interval training and 2 weeks of detraining on cardiovascular disease risk factors in male adolescents. Exp Physiol 2023; 108:595-606. [PMID: 36855259 PMCID: PMC10103894 DOI: 10.1113/ep090340] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 01/31/2023] [Indexed: 03/02/2023]
Abstract
NEW FINDINGS What is the central question of this study? What is the effect of 4 weeks of high-intensity interval training (HIIT) and 2 weeks of detraining on vascular function and traditional cardiovascular disease (CVD) risk factors in male adolescents? What is the main finding and its importance? Four weeks of HIIT improved macrovascular function in adolescents. However, this training period did not measurably change microvascular function, body composition or blood biomarkers. Following 2 weeks of detraining, the improvement in flow-mediated dilatation (FMD) was lost. This highlights the importance of the continuation of regular exercise for the primary prevention of CVD. ABSTRACT High-intensity interval training (HIIT) represents an effective method to improve cardiometabolic health in adolescents. This study aimed to investigate the effect of 4 weeks of HIIT followed by 2 weeks of detraining on vascular function and traditional cardiovascular disease (CVD) risk factors in adolescent boys. Nineteen male adolescents (13.3 ± 0.5 years) were randomly allocated to either a training (TRAIN, n = 10) or control (CON, n = 9) group. Participants in TRAIN completed 4 weeks of HIIT running with three sessions per week. Macro- (flow-mediated dilatation, FMD) and microvascular (peak reactive hyperaemia, PRH) function, body composition (fat mass, fat free mass, body fat percentage) and blood biomarkers (glucose, insulin, total cholesterol, high- and low-density lipoprotein, triacylglycerol) were assessed pre-, 48 h post- and 2 weeks post-training for TRAIN and at equivalent time points for CON. Following training, FMD was significantly greater in TRAIN compared to CON (9.88 ± 2.40% and 8.64 ± 2.70%, respectively; P = 0.036) but this difference was lost 2 weeks after training cessation (8.22 ± 2.47% and 8.61 ± 1.99%, respectively; P = 0.062). No differences were detected between groups for PRH (P = 0.821), body composition (all P > 0.14) or blood biomarkers (all P > 0.18). In conclusion, 4 weeks of HIIT improved macrovascular function; however, this training period did not measurably change microvascular function, body composition or blood biomarkers. The reversal of the FMD improvement 2 weeks post-training highlights the importance of the continuation of regular exercise for the primary prevention of CVD.
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Affiliation(s)
- Sascha H. Kranen
- Children's Health and Exercise Research Centre, Public Health and Sports SciencesUniversity of Exeter Medical School, Faculty of Health and Life Sciences, University of ExeterExeterUK
| | - Ricardo S. Oliveira
- Children's Health and Exercise Research Centre, Public Health and Sports SciencesUniversity of Exeter Medical School, Faculty of Health and Life Sciences, University of ExeterExeterUK
- Department of Physical EducationFederal University of Rio Grande do NorteNatalBrazil
| | - Bert Bond
- Children's Health and Exercise Research Centre, Public Health and Sports SciencesUniversity of Exeter Medical School, Faculty of Health and Life Sciences, University of ExeterExeterUK
| | - Craig A. Williams
- Children's Health and Exercise Research Centre, Public Health and Sports SciencesUniversity of Exeter Medical School, Faculty of Health and Life Sciences, University of ExeterExeterUK
| | - Alan R. Barker
- Children's Health and Exercise Research Centre, Public Health and Sports SciencesUniversity of Exeter Medical School, Faculty of Health and Life Sciences, University of ExeterExeterUK
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Kernbach JM, Hartwigsen G, Lim JS, Bae HJ, Yu KH, Schlaug G, Bonkhoff A, Rost NS, Bzdok D. Bayesian stroke modeling details sex biases in the white matter substrates of aphasia. Commun Biol 2023; 6:354. [PMID: 37002267 PMCID: PMC10066402 DOI: 10.1038/s42003-023-04733-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
Ischemic cerebrovascular events often lead to aphasia. Previous work provided hints that such strokes may affect women and men in distinct ways. Women tend to suffer strokes with more disabling language impairment, even if the lesion size is comparable to men. In 1401 patients, we isolate data-led representations of anatomical lesion patterns and hand-tailor a Bayesian analytical solution to carefully model the degree of sex divergence in predicting language outcomes ~3 months after stroke. We locate lesion-outcome effects in the left-dominant language network that highlight the ventral pathway as a core lesion focus across different tests of language performance. We provide detailed evidence for sex-specific brain-behavior associations in the domain-general networks associated with cortico-subcortical pathways, with unique contributions of the fornix in women and cingular fiber bundles in men. Our collective findings suggest diverging white matter substrates in how stroke causes language deficits in women and men. Clinically acknowledging such sex disparities has the potential to improve personalized treatment for stroke patients worldwide.
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Affiliation(s)
- Julius M Kernbach
- Neurosurgical Artificial Intelligence Laboratory Aachen (NAILA), RWTH Aachen University Hospital, Aachen, Germany
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Music, Neuroimaging, and Stroke Recovery Laboratory, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - Gesa Hartwigsen
- Max Planck Institute for Human Cognitive and Brain Sciences, Lise Meitner Research Group Cognition and Plasticity, Leipzig, Germany
| | - Jae-Sung Lim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hee-Joon Bae
- Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Gottfried Schlaug
- Music, Neuroimaging, and Stroke Recovery Laboratory, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - Anna Bonkhoff
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Natalia S Rost
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Danilo Bzdok
- Department of Biomedical Engineering, McConnell Brain Imaging Centre, Montreal Neurological Institute, Faculty of Medicine, School of Computer Science, McGill University, Montreal, QC, Canada.
- Mila - Quebec Artificial Intelligence Institute, Montreal, QC, Canada.
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70
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Olsen DB, Pedersen PU, Noergaard MW. Prehabilitation before elective coronary artery bypass grafting surgery: a scoping review. JBI Evid Synth 2023:02174543-990000000-00142. [PMID: 36929938 DOI: 10.11124/jbies-22-00265] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE The objective of this scoping review was to identify and map existing preoperative interventions, referred to as prehabilitation, in adult patients at home awaiting elective coronary artery bypass grafting surgery. This review also sought to report feasibility and patient experiences to shape clinical practice and underpin a future systematic review. INTRODUCTION As patients age, comorbidities become more common. Strategies to improve postoperative outcomes and to accelerate recovery are required in patients undergoing coronary artery bypass grafting. Prehabilitation refers to a proactive process of increasing functional capacity before surgery to improve the patient's ability to withstand upcoming physiologic stress and, thus, avoid postoperative complications. INCLUSION CRITERIA Studies that included adult patients awaiting coronary artery bypass grafting surgery at home and that described interventions optimizing preoperative physical and psychological health in any setting were included. METHODS The JBI methodology for conducting scoping reviews was used to identify relevant studies in MEDLINE, CINAHL, Cochrane Library, Embase, Scopus, SweMed+, PsycINFO, and PEDro. Gray literature was identified searching Google Scholar, ProQuest Dissertations and Theses, MedNar, OpenGrey, NICE Evidence search, and SIGN. Studies in Danish, English, German, Norwegian, and Swedish were considered for inclusion, with no geographical or cultural limitations, or date restrictions. Two independent reviewers screened titles and abstracts, and studies meeting the inclusion criteria were imported into Covidence. Sixty-seven studies from November 1987 to September 2022 were included. The data extraction tool used for the included papers was developed in accordance with the review questions and tested for adequacy and comprehensiveness with the first 5 studies by the same 2 independent reviewers. The tool was then edited to best reflect the review questions. Extracted findings are described and supported by figures and tables. RESULTS Sixty-seven studies were eligible for inclusion, representing 28,553 participants. Analyses of extracted data identified various preoperative interventions for optimizing postoperative and psychological outcomes for adult patients awaiting elective coronary artery bypass grafting surgery. Based on similarities, interventions were grouped into 5 categories. Eighteen studies reported on multimodal interventions, 17 reported on psychological interventions, 14 on physical training interventions, 13 on education interventions, and 5 on oral health interventions. CONCLUSION This scoping review provides a comprehensive summary of strategies that can be applied when developing a prehabilitation program for patients awaiting elective coronary artery bypass surgery. Although prehabilitation has been tested extensively and appears to be feasible, available evidence is mostly based on small studies. For patients undergoing elective coronary artery bypass grafting to derive benefit from prehabilitation, methodologically robust clinical trials and knowledge synthesis are required to identify optimal strategies for patient selection, intervention design, adherence, and intervention duration. Future research should also consider the cost-effectiveness of prehabilitation interventions before surgery. Finally, there is a need for more qualitative studies examining whether individual interventions are meaningful and appropriate to patients, which is an important factor if interventions are to be effective.
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Affiliation(s)
- Dorte Baek Olsen
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Preben U Pedersen
- Danish Centre of Systematic Reviews: A JBI Centre of Exellence, Centre of Clinical Guidelines - Danish National Clearinghouse, Faculty of Medicine, Aalborg University, Denmark
| | - Marianne Wetendorff Noergaard
- Danish Centre of Systematic Reviews: A JBI Centre of Exellence, Centre of Clinical Guidelines - Danish National Clearinghouse, Faculty of Medicine, Aalborg University, Denmark.,Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Liao L, Tang Y, Li B, Tang J, Xu H, Zhao K, Zhang X. Stachydrine, a potential drug for the treatment of cardiovascular system and central nervous system diseases. Biomed Pharmacother 2023; 161:114489. [PMID: 36940619 DOI: 10.1016/j.biopha.2023.114489] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/21/2023] [Accepted: 03/07/2023] [Indexed: 03/23/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death globally and poses at significant challenge in terms of effective medical treatment. Leonurus japonicus Houtt, a traditional Chinese herb, is widely used in China for the treatment of obstetrical and gynecological disorders, including menstrual disorders, dysmenorrhea, amenorrhea, blood stasis, postpartum bleeding, and blood-related diseases such as CVD. Stachydrine, the main alkaloid component of Leonurus, has been shown to exhibit a wide range of biological activities including anti-inflammatory, antioxidant, anti-coagulant, anti-apoptotic, vasodilator, angiogenic promoter. Additionally, it has been demonstrated to have unique advantages in the prevention and treatment of CVD through regulation of various disease-related signaling pathways and molecular targets. In this comprehensive review, we examine the latest pharmacological effects and molecular mechanisms of Stachydrine in treating cardiovascular and cerebrovascular diseases. Our aim is to solid scientific basis for the development of new CVD drug formulations.
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Affiliation(s)
- Li Liao
- Yibin Second People's Hospital - Yibin Hospital of West China Hospital of Sichuan University, Yibin 644000, China.
| | - Yan Tang
- Yibin Second People's Hospital - Yibin Hospital of West China Hospital of Sichuan University, Yibin 644000, China
| | - Bo Li
- Third Affiliated Hospital of Chengdu Medical College, Chengdu Pidu District People's Hospital, Chengdu 611700, China
| | - Jing Tang
- Yibin Second People's Hospital - Yibin Hospital of West China Hospital of Sichuan University, Yibin 644000, China
| | - Hone Xu
- Yibin Second People's Hospital - Yibin Hospital of West China Hospital of Sichuan University, Yibin 644000, China
| | - Ke Zhao
- Yibin Second People's Hospital - Yibin Hospital of West China Hospital of Sichuan University, Yibin 644000, China
| | - Xiaochun Zhang
- Yibin Second People's Hospital - Yibin Hospital of West China Hospital of Sichuan University, Yibin 644000, China.
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Wu M, Pelacho B, Claus P, De Buck S, Veltman D, Gillijns H, Holemans P, Pokreisz P, Caluwé E, Iglesias Colino E, Cohen S, Prosper F, Janssens S. Alginate sulfate-nanoparticles loaded with hepatocyte growth factor and insulin-like growth factor-1 improve left ventricular repair in a porcine model of myocardial ischemia reperfusion injury. Eur J Pharm Biopharm 2023; 184:83-91. [PMID: 36693545 DOI: 10.1016/j.ejpb.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/09/2023] [Accepted: 01/19/2023] [Indexed: 01/22/2023]
Abstract
Nanomedicine offers great potential for the treatment of cardiovascular disease and particulate systems have the capacity to markedly improve bioavailability of therapeutics. The delivery of pro-angiogenic hepatocyte growth factor (HGF) and pro-survival and pro-myogenic insulin-like growth factor (IGF-1) encapsulated in Alginate-Sulfate nanoparticles (AlgS-NP) might improve left ventricular (LV) functional recovery after myocardial infarction (MI). In a porcine ischemia-reperfusion model, MI is induced by 75 min balloon occlusion of the mid-left anterior descending coronary artery followed by reperfusion. After 1 week, pigs (n = 12) with marked LV-dysfunction (LV ejection fraction, LVEF < 45%) are randomized to fusion imaging-guided intramyocardial injections of 8 mg AlgS-NP prepared with 200 µg HGF and IGF-1 (HGF/IGF1-NP) or PBS (Control). Intramyocardial injection is safe and pharmacokinetic studies of Cy5-labeled NP confirm superior cardiac retention compared to intracoronary infusion. Seven weeks after intramyocardial-injection of HGF/IGF1-NP, infarct size, measured using magnetic resonance imaging, is significantly smaller than in controls and is associated with increased coronary flow reserve. Importantly, HGF/IGF1-NP-treated pigs show significantly increased LVEF accompanied by improved myocardial remodeling. These findings demonstrate the feasibility and efficacy of using AlgS-NP as a delivery system for growth factors and offer the prospect of innovative treatment for refractory ischemic cardiomyopathy.
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Affiliation(s)
- Ming Wu
- Department of Cardiovascular Sciences, University of Leuven, KU Leuven, B-3000 Leuven, Belgium
| | - Beatriz Pelacho
- Hematology-Oncology and Regenerative Medicine, Clínica Universidad de Navarra and Center for Applied Medical Research, University of Navarra, Pamplona, PC 31008, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, PC 31008, Spain
| | - Piet Claus
- Department of Cardiovascular Sciences, University of Leuven, KU Leuven, B-3000 Leuven, Belgium
| | - Stijn De Buck
- Department of Cardiology, University Hospital Leuven, B-3000 Leuven, Belgium
| | - Denise Veltman
- Department of Cardiovascular Sciences, University of Leuven, KU Leuven, B-3000 Leuven, Belgium
| | - Hilde Gillijns
- Department of Cardiovascular Sciences, University of Leuven, KU Leuven, B-3000 Leuven, Belgium
| | - Patricia Holemans
- Department of Cardiovascular Sciences, University of Leuven, KU Leuven, B-3000 Leuven, Belgium
| | - Peter Pokreisz
- Department of Cardiovascular Sciences, University of Leuven, KU Leuven, B-3000 Leuven, Belgium; Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Ellen Caluwé
- Department of Cardiovascular Sciences, University of Leuven, KU Leuven, B-3000 Leuven, Belgium
| | - Estefania Iglesias Colino
- Hematology-Oncology and Regenerative Medicine, Clínica Universidad de Navarra and Center for Applied Medical Research, University of Navarra, Pamplona, PC 31008, Spain
| | - Smadar Cohen
- Avram and Stella Goldstein-Goren Department of Biotechnology Engineering and Regenerative Medicine and Stem Cell Research Center, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
| | - Felipe Prosper
- Hematology-Oncology and Regenerative Medicine, Clínica Universidad de Navarra and Center for Applied Medical Research, University of Navarra, Pamplona, PC 31008, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, PC 31008, Spain; Centro de Investigación Biomédica en Red de Cáncer, CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Stefan Janssens
- Department of Cardiovascular Sciences, University of Leuven, KU Leuven, B-3000 Leuven, Belgium; Department of Cardiology, University Hospital Leuven, B-3000 Leuven, Belgium.
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Lăcraru AE, Busnatu ȘS, Pană MA, Olteanu G, Șerbănoiu L, Gand K, Schlieter H, Kyriazakos S, Ceban O, Andrei CL, Sinescu CJ. Assessing the Efficacy of a Virtual Assistant in the Remote Cardiac Rehabilitation of Heart Failure and Ischemic Heart Disease Patients: Case-Control Study of Romanian Adult Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3937. [PMID: 36900948 PMCID: PMC10002163 DOI: 10.3390/ijerph20053937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Cardiovascular diseases (CVDs) are the leading cause of mortality in Europe, with potentially more than 60 million deaths per year, with an age-standardized rate of morbidity-mortality higher in men than women, exceeding deaths from cancer. Heart attacks and strokes account for more than four out of every five CVD fatalities globally. After a patient overcomes an acute cardiovascular event, they are referred for rehabilitation to help them to restore most of their normal cardiac functions. One effective way to provide this activity regimen is via virtual models or telerehabilitation, where the patient can avail themselves of the rehabilitation services from the comfort of their homes at designated timings. Under the funding of the European Union's Horizon 2020 Research and Innovation program, grant no 769807, a virtual rehabilitation assistant has been designed for elderly patients (vCare), with the overall objective of supporting recovery and an active life at home, enhancing patients' quality of life, lowering disease-specific risk factors, and ensuring better adherence to a home rehabilitation program. In the vCare project, the Carol Davila University of Bucharest (UMFCD) was in charge of the heart failure (HF) and ischemic heart disease (IHD) groups of patients. By creating a digital environment at patients' homes, the vCare system's effectiveness, use, and feasibility was evaluated. A total of 30 heart failure patients and 20 ischemic heart disease patients were included in the study. Despite the COVID-19 restrictions and a few technical difficulties, HF and IHD patients who performed cardiac rehabilitation using the vCare system had similar results compared to the ambulatory group, and better results compared to the control group.
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Affiliation(s)
- Andreea-Elena Lăcraru
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Ștefan-Sebastian Busnatu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Maria-Alexandra Pană
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Gabriel Olteanu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Liviu Șerbănoiu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Kai Gand
- Research Group Digital Health, Faculty of Business and Economics, Technische Universitat Dresden, 01062 Dresden, Germany
| | - Hannes Schlieter
- Research Group Digital Health, Faculty of Business and Economics, Technische Universitat Dresden, 01062 Dresden, Germany
| | - Sofoklis Kyriazakos
- Department of Business Development and Technology, Aarhus University, 7400 Aarhus, Denmark
| | - Octavian Ceban
- Economic Cybernetics and Informatics Department, University of Economic Studies, 010374 Bucharest, Romania
| | - Cătălina Liliana Andrei
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
| | - Crina-Julieta Sinescu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania
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Gawinski L, Burzynska M, Marczak M, Kozlowski R. Assessment of In-Hospital Mortality and Its Risk Factors in Patients with Myocardial Infarction Considering the Logistical Aspects of the Treatment Process-A Single-Center, Retrospective, Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3603. [PMID: 36834296 PMCID: PMC9963836 DOI: 10.3390/ijerph20043603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Technological progress, such as the launching of a new generation of drug-coated stents as well as new antiplatelet drugs, has resulted in the treatment of myocardial infarction (MI) becoming much more effective. The aim of this study was to assess in-hospital mortality and to conduct an assessment of risk factors relevant to the in-hospital death of patients with MI. This study was based on an observational hospital registry of patients with MI (ACS GRU registry). For the purpose of the statistical analysis of the risk factors of death, a univariate logistic regression model was applied. In-hospital general mortality amounted to 7.27%. A higher death risk was confirmed in the following cases: (1) serious adverse events (SAEs) that occurred during the procedure; (2) patients transferred from another department of a hospital (OR = 2.647, p = 0.0056); (3) primary percutaneous coronary angioplasty performed on weekdays between 10 p.m. and 8 a.m. (OR = 2.540, p = 0.0146). The influence of workload and operator experience on the risk of death in a patient with MI has not been confirmed. The results of this study indicate the increasing importance of new risk factors for in-hospital death in patients with MI, such as selected logistical aspects of the MI treatment process and individual SAEs.
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Affiliation(s)
- Lukasz Gawinski
- Department of Management and Logistics in Health Care, Medical University of Lodz, 90-237 Lodz, Poland
| | - Monika Burzynska
- Department of Epidemiology and Biostatistics, Medical University of Lodz, 90-237 Lodz, Poland
| | - Michal Marczak
- Collegium of Management, WSB University in Warsaw, 03-204 Warsaw, Poland
| | - Remigiusz Kozlowski
- Center of Security Technologies in Logistics, Faculty of Management, University of Lodz, 90-237 Lodz, Poland
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Tao X, Chen Y, Zhen K, Ren S, Lv Y, Yu L. Effect of continuous aerobic exercise on endothelial function: A systematic review and meta-analysis of randomized controlled trials. Front Physiol 2023; 14:1043108. [PMID: 36846339 PMCID: PMC9950521 DOI: 10.3389/fphys.2023.1043108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/01/2023] [Indexed: 02/12/2023] Open
Abstract
Background: Current research suggests that continuous aerobic exercise can be effective in improving vascular endothelial function, while the effect between different intensities and durations of exercise is unclear. The aim of this study was to explore the effect of different durations and intensities of aerobic exercise on vascular endothelial function in different populations. Methods: Searches were performed in PubMed, Web of Science, and EBSCO databases. We included studies that satisfied the following criteria: 1) randomized controlled trials (RCTs); 2) including both an intervention and control group; 3) using flow-mediated dilation (FMD) as the outcome measure; and 4) testing FMD on the brachial artery. Results: From 3,368 search records initially identified, 41 studies were eligible for meta-analysis. There was a significant effect of continuous aerobic exercise on improving flow-mediated dilation (FMD) [weighted mean difference (WMD), 2.55, (95% CI, 1.93-3.16), p < 0.001]. Specifically, moderate-intensity [2.92 (2.02-3.825), p < 0.001] and vigorous-intensity exercise [2.58 (1.64-3.53), p < 0.001] significantly increased FMD. In addition, a longer duration [<12 weeks, 2.25 (1.54-2.95), p < 0.001; ≥12 weeks, 2.74 (1.95-3.54), p < 0.001], an older age [age <45, 2.09 (0.78-3.40), p = 0.002; 45 ≤ age <60, 2.25 (1.49-3.01), p < 0.001; age ≥60, 2.62 (1.31-3.94), p < 0.001], a larger basal body mass index (BMI) [20 < BMI < 25, 1.43 (0.98-1.88), p < 0.001; 25 ≤ BMI < 30, 2.49 (1.07-3.90), p < 0.001; BMI ≥ 30, 3.05 (1.69-4.42), p < 0.001], and a worse basal FMD [FMD < 4, 2.71 (0.92-4.49), p = 0.003; 4 ≤ FMD < 7, 2.63 (2.03-3.23), p < 0.001] were associated with larger improvements in FMD. Conclusion: Continuous aerobic exercise, especially moderate-intensity and vigorous-intensity aerobic exercise, contributed to improving FMD. The effect of continuous aerobic exercise on improving FMD was associated with duration and participant's characteristics. Specifically, a longer duration, an older age, a larger basal BMI, and a worse basal FMD contributed to more significant improvements in FMD. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=341442], identifier [CRD42022341442].
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Affiliation(s)
- Xifeng Tao
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China,Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Yiyan Chen
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Kai Zhen
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Shiqi Ren
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China,China Institute of Sport and Health Science, Beijing Sport University, Beijing, China,*Correspondence: Yuanyuan Lv, ; Laikang Yu,
| | - Laikang Yu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China,Department of Sports Performance, Beijing Sport University, Beijing, China,*Correspondence: Yuanyuan Lv, ; Laikang Yu,
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Shi H, Xiong L, Zhu C, Wang J, Li Y, Luo Y, Wang T, Zhang C. Design, synthesis, and biological evaluation of novel NO-releasing 4-chromanone derivatives as potential vasodilator agents. Chem Biol Drug Des 2023; 101:408-421. [PMID: 36054155 DOI: 10.1111/cbdd.14140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 08/02/2022] [Accepted: 08/21/2022] [Indexed: 01/14/2023]
Abstract
The nitric oxide/cyclic guanosine monophosphate (NO/cGMP) signaling pathway is an effective mechanism involved in the treatment of hypertension. In our search for potential antihypertensive agents, a series of novel NO-donor derivatives of the 4-chromanone skeleton were designed and synthesized by coupling furoxans or nitrooxy NO-donor moieties. All derivatives showed enhanced nitric oxide releasing capacity and vasodilator activity with EC50 values ranging from 0.0215 μM to 1.46 μM, obviously superior to those of precursor 3. These biological evaluations indicated that all compounds displayed an important vasorelaxant effect, and several compounds (9c, 14b, 14c, 14d) presented good vasodilator activity, with 14c being the best. Furthermore, molecular modeling studies revealed that compound 14c occupied the pocket well with the phosphodiesterase 5 domain in a favorable conformation. In conclusion, we observed that these novel compounds can act as structural templates for the design and subsequent development of new vasodilators and antihypertensive drugs.
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Affiliation(s)
- Hao Shi
- Department of Chemistry, College of Science, Shanghai University, Shanghai, China.,School of Medicine, Shanghai University, Shanghai, China
| | - Liyan Xiong
- School of Medicine, Shanghai University, Shanghai, China
| | - Chenchen Zhu
- School of Medicine, Shanghai University, Shanghai, China
| | - Jing Wang
- Department of Pharmacy, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Yi Li
- School of Medicine, Shanghai University, Shanghai, China
| | - Yunchun Luo
- School of Medicine, Shanghai University, Shanghai, China
| | - Tingfang Wang
- School of Medicine, Shanghai University, Shanghai, China
| | - Chuan Zhang
- Department of Chemistry, College of Science, Shanghai University, Shanghai, China.,School of Medicine, Shanghai University, Shanghai, China
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77
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Nyulas KI, Germán-Salló M, Fazakas Z, Preg Z, Pál T, Pál S, Tripon RG, Cseh MJ, Simon-Szabó Z, Arbănași EM, Nemes-Nagy E. Relationship between Nutrition, Lifestyle Habits and Laboratory Parameters in Hypertensive Patients with/without Cognitive Dysfunction. Life (Basel) 2023; 13:311. [PMID: 36836668 PMCID: PMC9960921 DOI: 10.3390/life13020311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
(1) Background: Cognitive dysfunction is a major concern in hypertensive patients. Lifestyle habits and nutrition influence laboratory parameters, with an impact on clinical course. The objective of the study was to evaluate nutrition and lifestyle habits in hypertensive patients with/without cognitive dysfunction and establish correlations to laboratory parameters. MATERIAL AND METHODS 50 patients admitted to the Cardiovascular Rehabilitation Clinic in Târgu Mureș were enrolled in this study between March-June 2021. We evaluated their cognitive function, and they filled in a questionnaire about lifestyle and nutrition. Biochemical blood tests were performed using a Konelab Prime 60i analyzer. IBM-SPSS22 and GraphPad InStat3 were used for statistics. RESULTS Mean age of hypertensive patients (n = 50) was 70.42 ± 4.82 (SD) years, half of them had cognitive dysfunction. Zinc deficiency was present in 74% of the subjects. The subgroup with cognitive dysfunction had significantly higher BMI (p = 0.009) and microalbuminuria (p = 0.0479), as well as significantly lower magnesium intake (p = 0.032) and cholesterol intake (p = 0.022), compared to those with normal cognitive status. CONCLUSIONS Nutrition is in a close relationship with laboratory parameters; significant differences (microalbuminuria, cholesterol intake, BMI, etc.) are present between hypertensive patients with/without cognitive dysfunction. A healthy diet is important for the maintenance of metabolic balance, the achievement of optimal body weight, and the prevention of complications.
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Affiliation(s)
- Kinga-Ilona Nyulas
- Doctoral School of GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Márta Germán-Salló
- Department of Internal Medicine II, Faculty of Medicine, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Zita Fazakas
- Department of Biochemistry and Chemistry of Environmental Factors, Faculty of Pharmacy, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Zoltán Preg
- Department of General Medicine, Faculty of Medicine, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Tünde Pál
- Emergency Institute for Cardiovascular Diseases and Transplantation, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Sándor Pál
- Department of Laboratory Medicine, Department of Transfusion Medicine, Medical School, University of Pécs, H-7622 Pécs, Hungary
| | - Robert Gabriel Tripon
- Department of Ophthalmology, Faculty of Medicine, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Margit Judit Cseh
- Nutrition and Dietetics Deparment, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Zsuzsánna Simon-Szabó
- Department of Pathophysiology, Faculty of Medicine, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Emil Marian Arbănași
- Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Târgu Mureș, Romania
| | - Enikő Nemes-Nagy
- Department of Chemistry and Medical Biochemistry, Faculty of Medicine in English, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
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78
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Domenico T, Rita A, Giacomo S, Diego A, Thelma P, Mariana G, Giampaolo N, Francesco N, Maria G, Francesco F, Bruno B, Marco M, Diana C. Salivary biomarkers for diagnosis of acute myocardial infarction: A systematic review. Int J Cardiol 2023; 371:54-64. [PMID: 36167219 DOI: 10.1016/j.ijcard.2022.09.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/11/2022] [Accepted: 09/20/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Acute myocardial infarction (AMI) accounts for about 7 million deaths per year worldwide. The early identification of signs and symptoms and the detection of specific serological markers of this disease are mandatory to reach a prompt diagnosis and begin potentially life-saving treatment. Point-of-care technologies applied to salivary diagnostics can provide rapid, simple, low-cost, and accurate measurements of specific markers and can also be used in emergency settings. The present systematic review was developed to answer the following question: "Are salivary biomarkers useful in identifying patients with acute myocardial infarction?" METHODS Following the "Preferred Reporting Item for Systematic Reviews and Meta-analysis" (PRISMA) guidelines, we selected 17 papers. The critical appraisal and quality assessment were performed following the National Institute of Health and the classification of the Oxford Center for Evidence-Based Medicine. RESULTS Twenty-six salivary biomarkers were explored in association with AMI. Troponins, C-reactive protein, and adiponectin were the most frequently investigated molecules. We found that the evaluated biomarkers had different levels of diagnostic accuracy in discriminating patients with AMI from healthy controls. We also observed a lack of good-quality studies on the association between the occurrence of AMI and the presence of related salivary biomarkers. CONCLUSIONS There is evidence that salivary isoforms of cardiac troponin, C-reactive protein, and creatine phosphokinase (CPK) could be useful markers for the prompt diagnosis of AMI. However, the effective use of these markers as possible substitutes for serological markers should be confirmed by further studies that avoid the bias highlighted in the present review.
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Affiliation(s)
- Tuttolomondo Domenico
- Department of Cardiology, Parma University Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | - Antonelli Rita
- Centro Universitario di Odontoiatria, University of Parma, Via Gramsci 14, Parma 43126, Italy.
| | - Setti Giacomo
- Centro Universitario di Odontoiatria, University of Parma, Via Gramsci 14, Parma 43126, Italy; Dentistry and Oral and Maxillofacial Surgery-Department of Surgical, Medical, Dental and Morphological Science with interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Largo del Pozzo 71, 41125 Modena, Italy.
| | - Ardissino Diego
- Department of Cardiology, Parma University Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | - Pertinhez Thelma
- Department of Medicine and Surgery, University of Parma, Via Volturno 39, 43126 Parma, Italy.
| | - Gallo Mariana
- Department of Medicine and Surgery, University of Parma, Via Volturno 39, 43126 Parma, Italy.
| | - Niccoli Giampaolo
- Department of Cardiology, Parma University Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | - Nicolini Francesco
- Department of Cardiac Surgery, Parma University Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | - Georgaki Maria
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str., 11527, Goudi, Athens, Greece
| | - Formica Francesco
- Department of Cardiac Surgery, Parma University Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | - Borrello Bruno
- Department of Cardiac Surgery, Parma University Hospital, Via Gramsci 14, 43126 Parma, Italy.
| | - Meleti Marco
- Centro Universitario di Odontoiatria, University of Parma, Via Gramsci 14, Parma 43126, Italy.
| | - Cassi Diana
- Dentistry and Oral and Maxillofacial Surgery-Department of Surgical, Medical, Dental and Morphological Science with interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Largo del Pozzo 71, 41125 Modena, Italy.
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79
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Mols RE, Borregaard B, Løgstrup BB, Rasmussen TB, Thrysoee L, Thorup CB, Christensen AV, Ekholm O, Rasmussen AA, Eiskjær H, Risør BW, Berg SK. Patient-reported outcome is associated with health care costs in patients with ischaemic heart disease and arrhythmia. Eur J Cardiovasc Nurs 2023; 22:23-32. [PMID: 35543021 DOI: 10.1093/eurjcn/zvac030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/18/2022] [Accepted: 03/18/2022] [Indexed: 01/14/2023]
Abstract
AIMS Systematic use of patient-reported outcomes (PROs) have the potential to improve quality of care and reduce costs of health care services. We aimed to describe whether PROs in patients diagnosed with heart disease are directly associated with health care costs. METHODS AND RESULTS A national cross-sectional survey including PROs at discharge from a heart centre with 1-year follow-up using data from national registers. We included patients with either ischaemic heart disease (IHD), arrhythmia, heart failure (HF), or valvular heart disease (VHD). The Hospital Anxiety and Depression Scale, the heart-specific quality of life, the EuroQol five-dimensional questionnaire, and the Edmonton Symptom Assessment Scale were used. The economic analysis was based on direct costs including primary, secondary health care, and medical treatment. Patient-reported outcomes were available from 13 463 eligible patients out of 25.241 [IHD (n = 7179), arrhythmia (n = 4322), HF (n = 987), or VHD (n = 975)]. Mean annual total direct costs in all patients were €23 228 (patients with IHD: €19 479, patients with arrhythmia: €21 076, patients with HF: €34 747, patients with VDH: €48 677). Hospitalizations contributed overall to the highest part of direct costs. For patients discharged with IHD or arrhythmia, symptoms of anxiety or depression, worst heart-specific quality of life or health status, and the highest symptom burden were associated with increased economic expenditure. We found no associations in patients with HF or VHD. CONCLUSION Patient-reported outcomes at discharge from a heart centre were associated with direct health care costs in patients with IHD and arrhythmia. REGISTRATION ClinicalTrials.gov: NCT01926145.
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Affiliation(s)
- Rikke E Mols
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Britt Borregaard
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, J.B. Winsløwsvej 4, 5000 Odense C, Denmark.,Department of Cardiology, Odense University Hospital, J.B. Winsløwsvej 4, 5000 Odense C, Denmark.,University of Southern, Odense University Hospital, J.B. Winsløwsvej 4, 5000 Odense C, Denmark
| | - Brian B Løgstrup
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Trine B Rasmussen
- Department of Cardiology, Herlev and Gentofte University Hospital, Gentofte, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Nørregade 10, 1017 Copenhagen K, Denmark
| | - Lars Thrysoee
- Department of Cardiology, Odense University Hospital, J.B. Winsløwsvej 4, 5000 Odense C, Denmark.,University of Southern, Odense University Hospital, J.B. Winsløwsvej 4, 5000 Odense C, Denmark
| | - Charlotte B Thorup
- Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark.,Department of Cardiothoracic Surgery and Clinical Nursing Research Unit, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark
| | - Anne V Christensen
- Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | - Anne A Rasmussen
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Hans Eiskjær
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Bettina W Risør
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.,Department of Social and Health Services, DEFACTUM, Central Denmark Region, Olof Palmes Allé 15, 8200 Aarhus N, Denmark
| | - Selina K Berg
- Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.,National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
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80
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Xiao K, Liu M, Sun X, Zhang Y, Si J, Shi N, Sun L, Miao Z, Zhang H, Zhao T, Liu Z, Fan Z, Gao J, Li J. Association of vascular endothelial function and quality of life in patients with ischemia and non-obstructive coronary artery disease. Heart Vessels 2023; 38:617-625. [PMID: 36598570 DOI: 10.1007/s00380-022-02213-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 12/01/2022] [Indexed: 01/05/2023]
Abstract
Improvements are required in the quality of life (QoL) of patients with ischemia and non-obstructive coronary artery disease (INOCA). Several patients with INOCA experience vascular endothelial dysfunction. However, the relationship between endothelial function and QoL remains unelucidated. This study aimed to initially investigate the relationship between endothelial function and QoL in patients with INOCA. This prospective observational study included 121 patients with INOCA (aged 31-85 years). Vascular endothelial function was assessed by flow-mediated dilatation (FMD) of the peripheral brachial artery. QoL was evaluated using the 36-Item Short-Form Health Survey (SF-36). Patients with INOCA were divided into two groups according to the median FMD change during the 1-year follow-up (group A, ≥ median FMD change cut-off; group B, < median FMD change cut-off). The median change in FMD was 0.92%. The mean baseline SF-36 scores were comparable between the two groups (53.95 ± 6.46 vs. 53.92 ± 4.29, p = 0.98). The QoL at follow-up was better in group A than in group B (56.61 ± 5.50 vs. 53.32 ± 5.58, p = 0.002). The change in FMD (r = 0.34, p < 0.01), rather than FMD at baseline (r = - 0.01, p = 0.89) or follow-up (r = 0.13, p = 0.15), was related to the follow-up SF-36 scores. FMD improvement was an independent predictor of increased QoL (odds ratio, 3.90; 95% confidence interval: 1.59-9.53, p = 0.003). Endothelial function change is associated with QoL, and patients with improved endothelial function have a better QoL than those without.
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Affiliation(s)
- Keling Xiao
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, #45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Machao Liu
- Division of Cardiology, Xuanwu Hospital Capital Medical University, #45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Xipeng Sun
- Division of Cardiology, Xuanwu Hospital Capital Medical University, #45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Yinghua Zhang
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, #45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Jin Si
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, #45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Ning Shi
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, #45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Lijie Sun
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, #45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Zupei Miao
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, #45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Haoyu Zhang
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, #45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Ting Zhao
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, #45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Zhi Liu
- Division of Cardiology, Xuanwu Hospital Capital Medical University, #45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Zhenxing Fan
- Division of Cardiology, Xuanwu Hospital Capital Medical University, #45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Jing Gao
- Division of Cardiology, Xuanwu Hospital Capital Medical University, #45 Changchun Street, Xicheng District, Beijing, 100053, China.
| | - Jing Li
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, #45 Changchun Street, Xicheng District, Beijing, 100053, China.
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81
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Home Blood Pressure Self-monitoring plus Self-titration of Antihypertensive Medication for Poorly Controlled Hypertension in Primary Care: the ADAMPA Randomized Clinical Trial. J Gen Intern Med 2023; 38:81-89. [PMID: 36219303 PMCID: PMC9849508 DOI: 10.1007/s11606-022-07791-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 09/06/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Patient empowerment through pharmacological self-management is a common strategy in some chronic diseases such as diabetes, but it is rarely used for controlling blood pressure. OBJECTIVE This study aimed to assess self-monitoring plus self-titration of antihypertensive medication versus usual care for reducing systolic blood pressure (SBP) at 12 months in poorly controlled hypertensive patients. DESIGN The ADAMPA study was a pragmatic, controlled, randomized, non-masked clinical trial with two parallel arms in Valencia, Spain. PARTICIPANTS Hypertensive patients older than 40 years, with SBP over 145 mmHg and/or diastolic blood pressure (DBP) over 90 mmHg, were recruited from July 2017 to June 2018. INTERVENTION Participants were randomized 1:1 to usual care versus an individualized, pre-arranged plan based on self-monitoring plus self-titration. MAIN MEASURE The primary outcome was the adjusted mean difference (AMD) in SBP between groups at 12 months. KEY RESULTS Primary outcome data were available for 312 patients (intervention n=156, control n=156) of the 366 who were initially recruited. The AMD in SBP at 12 months (main analysis) was -2.9 mmHg (95% CI, -5.9 to 0.1, p=0.061), while the AMD in DBP was -1.9 mmHg (95% CI, -3.7 to 0.0, p=0.052). The results of the subgroup analysis were consistent with these for the main outcome measures. More patients in the intervention group achieved good blood pressure control (<140/90 mmHg) at 12 months than in the control group (55.8% vs 42.3%, difference 13.5%, 95% CI, 2.5 to 24.5%, p=0.017). At 12 months, no differences were observed in behavior, quality of life, use of health services, or adverse events. CONCLUSION Self-monitoring plus self-titration of antihypertensive medication based on an individualized pre-arranged plan used in primary care may be a promising strategy for reducing blood pressure at 12 months compared to usual care, without increasing healthcare utilization or adverse events. TRIAL REGISTRATION EudraCT, number 2016-003986-25 (registered 17 March 2017) and clinicaltrials.gov , NCT03242785.
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82
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Tang Y, Yin L, Gao S, Long X, Du Z, Zhou Y, Zhao S, Cao Y, Pan S. A small-diameter vascular graft immobilized peptides for capturing endothelial colony-forming cells. Front Bioeng Biotechnol 2023; 11:1154986. [PMID: 37101749 PMCID: PMC10123284 DOI: 10.3389/fbioe.2023.1154986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/23/2023] [Indexed: 04/28/2023] Open
Abstract
Combining synthetic polymers and biomacromolecules prevents the occurrence of thrombogenicity and intimal hyperplasia in small-diameter vascular grafts (SDVGs). In the present study, an electrospinning poly (L)-lactic acid (PLLA) bilayered scaffold is developed to prevent thrombosis after implantation by promoting the capture and differentiation of endothelial colony-forming cells (ECFCs). The scaffold consists of an outer PLLA scaffold and an inner porous PLLA biomimetic membrane combined with heparin (Hep), peptide Gly-Gly-Gly-Arg-Glu-Asp-Val (GGG-REDV), and vascular endothelial growth factor (VEGF). Attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy, X-ray photoelectron spectroscopy (XPS), and contact angle goniometry were performed to determine successful synthesis. The tensile strength of the outer layer was obtained using the recorded stress/strain curves, and hemocompatibility was evaluated using the blood clotting test. The proliferation, function, and differentiation properties of ECFCs were measured on various surfaces. Scanning electronic microscopy (SEM) was used to observe the morphology of ECFCs on the surface. The outer layer of scaffolds exhibited a similar strain and stress performance as the human saphenous vein via the tensile experiment. The contact angle decreased continuously until it reached 56° after REDV/VEGF modification, and SEM images of platelet adhesion showed a better hemocompatibility surface after modification. The ECFCs were captured using the REDV + VEGF + surface successfully under flow conditions. The expression of mature ECs was constantly increased with the culture of ECFCs on REDV + VEGF + surfaces. SEM images showed that the ECFCs captured by the REDV + VEGF + surface formed capillary-like structures after 4 weeks of culture. The SDVGs modified by REDV combined with VEGF promoted ECFC capture and rapid differentiation into ECs, forming capillary-like structures in vitro. The bilayered SDVGs could be used as vascular devices that achieved a high patency rate and rapid re-endothelialization.
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Affiliation(s)
- Yaqi Tang
- Heart Center, Qingdao Women and Children’s Hospital, Qingdao University, Qingdao, China
| | - Lu Yin
- College of Material, Chemistry and Chemical Engineering, Hangzhou Normal University, Hangzhou, China
| | - Shuai Gao
- Heart Center, Qingdao Women and Children’s Hospital, Qingdao University, Qingdao, China
| | - Xiaojing Long
- State Key Laboratory of Bio-fibers and Eco-textiles, Qingdao University, Qingdao, China
| | - Zhanhui Du
- Heart Center, Qingdao Women and Children’s Hospital, Qingdao University, Qingdao, China
| | - Yingchao Zhou
- Heart Center, Qingdao Women and Children’s Hospital, Qingdao University, Qingdao, China
| | - Shuiyan Zhao
- Heart Center, Qingdao Women and Children’s Hospital, Qingdao University, Qingdao, China
| | - Yue Cao
- Heart Center, Qingdao Women and Children’s Hospital, Qingdao University, Qingdao, China
| | - Silin Pan
- Heart Center, Qingdao Women and Children’s Hospital, Qingdao University, Qingdao, China
- *Correspondence: Silin Pan,
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83
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Spinal Cord Stimulation Attenuates Neural Remodeling, Inflammation, and Fibrosis After Myocardial Infarction. Neuromodulation 2023; 26:57-67. [PMID: 35088742 DOI: 10.1016/j.neurom.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/22/2020] [Accepted: 09/28/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Spinal cord stimulation (SCS) is an established neuromodulation method that regulates the cardiac autonomic system. However, the biological mechanisms of the therapeutic effects of SCS after myocardial infarction (MI) remain unclear. MATERIALS AND METHODS Twenty-five rabbits were divided into five groups: SCS-MI (voltage: 0.5 v; pulse width: 0.2 ms; 50 Hz; ten minutes on and 30 minutes off; two weeks; n = 5), MI (n = 5), sham SCS-MI (voltage: 0 v; two weeks; n = 5), sham MI (n = 5), and blank control (n = 5) groups. MI was induced by permanent left anterior descending artery ligation. SCS-MI and sham SCS-MI rabbits received the corresponding interventions 24 hours after MI. Autonomic remodeling was evaluated using enzyme-linked immunosorbent assay and immunohistochemistry. Inflammation and myocardial fibrosis were assessed using immunohistochemistry, quantitative polymerase chain reaction, hematoxylin and eosin staining, Masson staining, and Western blot. RESULTS SCS improved the abnormal systemic autonomic activity. Cardiac norepinephrine decreased after MI (p < 0.01) and did not improve with SCS. Cardiac acetylcholine increased with SCS compared with the MI group (p < 0.05). However, no difference was observed between the MI and blank control groups. Growth-associated protein 43 (p < 0.001) and tyrosine hydroxylase (p < 0.001) increased whereas choline acetyltransferase (p < 0.05) decreased in the MI group compared with the blank control group. These changes were attenuated with SCS. SCS inhibited inflammation, decreased the ratio of phosphorylated-Erk to Erk (p < 0.001), and increased the ratio of phosphorylated-STAT3 to STAT3 (p < 0.001) compared with the MI group. Myocardial fibrosis was also attenuated by SCS. CONCLUSIONS SCS improved abnormal autonomic activity after MI, leading to reduced inflammation, reactivation of STAT3, and inhibition of Erk. Additionally, SCS attenuated myocardial fibrosis. Our results warrant future studies of biological mechanisms of the therapeutic effects of SCS after MI.
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84
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Vatseba MO, Haliuk NM, Merhel TV, Nesterak RV, Yusypchuk UV. THE ROLE OF NEUROHORMONAL FACTORS IN THE FORMATION OF A PATIENT'S CLINICAL PROFILE AND THE IMPACT ON STRUCTURAL CARDIAC AND VASCULAR REMODELING IN PATIENTS WITH MYOCARDIAL INFARCTION AFTER REPERFUSION THERAPY. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:2308-2312. [PMID: 37948731 DOI: 10.36740/wlek202310127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
OBJECTIVE The aim: To determine the dynamics of galectin-3 in the formation of the patient's clinical profile and the impact on structural cardiac and vascular remodeling in patients with myocardial infarction after reperfusion therapy. PATIENTS AND METHODS Materials and methods: 140 patients with class II A CHF syndrome according to Vasilenko-Strazhesko FC II-III (NYHA), which occurred in patients with MI, and 22 patients with MI without signs of CHF were examined. RESULTS Results: The average serum galectin-3 level of the studied patients was analyzed. The average concentration of galectin-3 in patients with stenting without signs of CHF was (10.87±1.65) ng/ml comparing to (6.57±0.21) ng/ml in healthy subjects (p<0.05). An increase in the concentration of this indicator was observed in the group of patients with CHF after MI with reperfusion - (35.2±1.76) ng/ml, which is significantly higher in comparison with practically healthy subjects, and in patients without revascularization it was (38.94±1.97) ng/ml (p<0.001). Positive correlations of medium strength were found between left ventricular end-systolic volume (ESV), left ventricular end-diastolic volume (LVEDV) and serum galectin-3 concentration in the examined patients. The correlation coefficient between the abovementioned indicators was 0.60 (p<0.01) and 0.53 (p<0.05), respectively. CONCLUSION Conclusions: It has been determined that in patients with CHF with postinfarction cardiosclerosis there is a direct correlation of medium strength between the values of indicators of LV myocardial remodeling with plasma galectin-3 concentration, including ESV, EDV, in examined patients. The role of galectin-3 as a marker of postinfarction remodeling in patients with CHF for early diagnosis, prognosis, and risk stratification has been presented.
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Affiliation(s)
- Mariana O Vatseba
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | - Nadiia M Haliuk
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
| | - Tetiana V Merhel
- IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE
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We are what we eat: The role of lipids in metabolic diseases. ADVANCES IN FOOD AND NUTRITION RESEARCH 2023. [PMID: 37516463 DOI: 10.1016/bs.afnr.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Lipids play a fundamental role, both structurally and functionally, for the correct functioning of the organism. In the last two decades, they have evolved from molecules involved only in energy storage to compounds that play an important role as components of cell membranes and signaling molecules that regulate cell homeostasis. For this reason, their interest as compounds involved in human health has been gaining weight. Indeed, lipids derived from dietary sources and endogenous biosynthesis are relevant for the pathophysiology of numerous diseases. There exist pathological conditions that are characterized by alterations in lipid metabolism. This is particularly true for metabolic diseases, such as liver steatosis, type 2 diabetes, cancer and cardiovascular diseases. The main issue to be considered is lipid homeostasis. A precise control of fat homeostasis is required for a correct regulation of metabolic pathways and safe and efficient energy storage in adipocytes. When this fails, a deregulation occurs in the maintenance of systemic metabolism. This happens because an increased concentrations of lipids impair cellular homeostasis and disrupt tissue function, giving rise to lipotoxicity. Fat accumulation results in many alterations in the physiology of the affected organs, mainly in metabolic tissues. These alterations include the activation of oxidative and endoplasmic reticulum stress, mitochondrial dysfunction, increased inflammation, accumulation of bioactive molecules and modification of gene expression. In this chapter, we review the main metabolic diseases in which alterations in lipid homeostasis are involved and discuss their pathogenic mechanisms.
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86
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He C, Chen Q, Shen Z, Zhang Y, Hou H, Pei Y, Wang W, Zhang X. Prevalence and the age of onset patterns of stroke in Jiangsu Province, China. Neurol Sci 2023; 44:215-227. [PMID: 36190684 DOI: 10.1007/s10072-022-06428-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 09/23/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Little was known regarding the current age of onset patterns of stroke. This study aimed to examine the prevalence of stroke and explore the age of onset patterns of stroke in Jiangsu Province, China. MATERIALS AND METHODS Participants were recruited from April 2012 to April 2013 in Jiangsu Province, China. Survival analysis models were used to evaluate the hazards of stroke by a single year of age. Kaplan-Meier analysis and the log-rank test were used to explore the disparities of the age of onset patterns of stroke. RESULTS This population-based study was conducted among 39,887 participants aged ≥ 18 years in Jiangsu Province, China. Of the 740 (1.9%) events of stroke, 13.2% suffered from hemorrhagic stroke (HS) and 86.8% suffered from ischemic stroke (IS). The prevalence of HS and IS were 0.3% and 1.7%, respectively. The estimated mean age of onset of stroke was 71.98 (95% CI: 71.97-71.99) years by the survival model. Up to age of 45 years, the estimated hazards of stroke onset were at a relatively low level. From the age of 45 years, the increases in hazards accelerated and peaked at age 75 years. Urban, smoking, and drinking males had a higher risk of stroke than their counterparts (P < 0.05). However, no such difference was found among females. CONCLUSIONS The findings emphasize the importance of implementing stroke prevention interventions in Jiangsu Province, China, especially for urban, smoking, and drinking males. It is of great significance to strengthen comprehensive management of health-related behaviors, including smoking cessation and moderate consumption of alcohol to have sustained beneficial effects on stroke risk. Chenlu He and Qian Chen contributed equally to this work.
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Affiliation(s)
- Chenlu He
- School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, 221004, Jiangsu, China
| | - Qian Chen
- School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, 221004, Jiangsu, China
| | - Ziyuan Shen
- School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, 221004, Jiangsu, China
| | - Ying Zhang
- School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, 221004, Jiangsu, China
| | - Hao Hou
- School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, 221004, Jiangsu, China
| | - Yifei Pei
- School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, 221004, Jiangsu, China
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, 221004, Jiangsu, China.
| | - Xunbao Zhang
- School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, 221004, Jiangsu, China.
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Semenov VV, Bosdriesz JR, Kuryata O. The Predictive Value of Serum Aldosterone Level for Coronary Artery Calcium Score in Patients with Chronic Kidney Disease: A Single-center Study. Prague Med Rep 2023; 124:242-254. [PMID: 37736948 DOI: 10.14712/23362936.2023.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Abstract
Patients with chronic kidney disease (CKD) have high cardiovascular risk (CVR), which is often underestimated by conventional tools. The coronary artery calcium score (CACS) significantly improves CVR stratification by conventional tools, but it is often not available in low-resources settings. Aldosterone may be a cheaper alternative to CACS for CVR assessment in CKD patients. The aim was to assess the ability of serum aldosterone level to predict CACS in patients with CKD in comparison to standard predictors. This single-center study included 57 patients aged 40 to 67 years with CKD (estimated glomerular filtration rate [eGFR] ≥45 ml/min) and arterial hypertension. Serum aldosterone, sex, age, body mass index, blood pressure, total cholesterol, eGFR, and proteinuria were used for prediction of CACS>0 Agatston units (AU) and CACS>100 AU. The area under the curve (AUC) with 95% confidence intervals (CI) and the mean Brier scores were examined for predictors of CACS. Aldosterone predicted a CACS>100 AU (AUC = 0.72, 95% CI: 0.56-0.88), but not a CACS>0 AU. Age predicted a CACS>100 AU (AUC = 0.80, 95% CI: 0.67-0.93) and a CACS>0 AU (AUC = 0.75, 95% CI: 0.62-0.89). The addition of aldosterone to age for prediction of a CACS>100 AU improved the mean Brier score, compared to the model with age alone, from 0.16 to 0.14, but not the AUC (0.83, 95% CI: 0.70-0.95). Aldosterone was a significant predictor of a CACS>100 AU in patients with CKD, but aldosterone was not a better predictor than age alone.
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Affiliation(s)
- Viktor V Semenov
- Department of Internal Medicine 2 and Phthisiology, Dnipro State Medical University, Dnipro, Ukraine.
| | - Jizzo R Bosdriesz
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Olexandr Kuryata
- Department of Internal Medicine 2 and Phthisiology, Dnipro State Medical University, Dnipro, Ukraine
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Magni V, Capra D, Cozzi A, Monti CB, Mobini N, Colarieti A, Sardanelli F. Mammography biomarkers of cardiovascular and musculoskeletal health: A review. Maturitas 2023; 167:75-81. [PMID: 36308974 DOI: 10.1016/j.maturitas.2022.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022]
Abstract
Breast density (BD) and breast arterial calcifications (BAC) can expand the role of mammography. In premenopause, BD is related to body fat composition: breast adipose tissue and total volume are potential indicators of fat storage in visceral depots, associated with higher risk of cardiovascular disease (CVD). Women with fatty breast have an increased likelihood of hypercholesterolemia. Women without cardiometabolic diseases with higher BD have a lower risk of diabetes mellitus, hypertension, chest pain, and peripheral vascular disease, while those with lower BD are at increased risk of cardiometabolic diseases. BAC, the expression of Monckeberg sclerosis, are associated with CVD risk. Their prevalence, 13 % overall, rises after menopause and is reduced in women aged over 65 receiving hormonal replacement therapy. Due to their distinct pathogenesis, BAC are associated with hypertension but not with other cardiovascular risk factors. Women with BAC have an increased risk of acute myocardial infarction, ischemic stroke, and CVD death; furthermore, moderate to severe BAC load is associated with coronary artery disease. The clinical use of BAC assessment is limited by their time-consuming manual/visual quantification, an issue possibly solved by artificial intelligence-based approaches addressing BAC complex topology as well as their large spectrum of extent and x-ray attenuations. A link between BD, BAC, and osteoporosis has been reported, but data are still inconclusive. Systematic, standardised reporting of BD and BAC should be encouraged.
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Affiliation(s)
- Veronica Magni
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy.
| | - Davide Capra
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy.
| | - Andrea Cozzi
- Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Italy.
| | - Caterina B Monti
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy.
| | - Nazanin Mobini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy.
| | - Anna Colarieti
- Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Italy
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milano, Italy; Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Italy.
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G Protein-Coupled Receptor 15 Expression Is Associated with Myocardial Infarction. Int J Mol Sci 2022; 24:ijms24010180. [PMID: 36613626 PMCID: PMC9820726 DOI: 10.3390/ijms24010180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022] Open
Abstract
Beyond the influence of lifestyle-related risk factors for myocardial infarction (MI), the mechanisms of genetic predispositions for MI remain unclear. We sought to identify and characterize differentially expressed genes in early-onset MI in a translational approach. In an observational case−control study, transcriptomes from 112 early-onset MI individuals showed upregulated G protein-coupled receptor 15 (GPR15) expression in peripheral blood mononuclear cells compared to controls (fold change = 1.4, p = 1.87 × 10−7). GPR15 expression correlated with intima-media thickness (β = 0.8498, p = 0.111), C-reactive protein (β = 0.2238, p = 0.0052), ejection fraction (β = −0.9991, p = 0.0281) and smoking (β = 0.7259, p = 2.79 × 10−10). The relation between smoking and MI was diminished after the inclusion of GPR15 expression as mediator in mediation analysis (from 1.27 (p = 1.9 × 10−5) to 0.46 (p = 0.21)). The DNA methylation of two GPR15 sites was 1%/5% lower in early-onset MI individuals versus controls (p = 2.37 × 10−6/p = 0.0123), with site CpG3.98251219 significantly predicting risk for incident MI (hazard ratio = 0.992, p = 0.0177). The nucleotide polymorphism rs2230344 (C/T) within GPR15 was associated with early-onset MI (odds ratio = 3.61, p = 0.044). Experimental validation showed 6.3-fold increased Gpr15 expression in an ischemic mouse model (p < 0.05) and 4-fold increased Gpr15 expression in cardiomyocytes under ischemic stress (p < 0.001). After the induction of MI, Gpr15gfp/gfp mice showed lower survival (p = 0.042) and deregulated gene expression for response to hypoxia and signaling pathways. Using a translational approach, our data provide evidence that GPR15 is linked to cardiovascular diseases, mediating the adverse effects of smoking.
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Li S, Dong X, Li D, Zhang H, Zhou S, Maimaitiming M, Ma J, Li N, Zhou Q, Jin Y, Zheng ZJ. Inequities in ambulance allocation associated with transfer delay and mortality in acute coronary syndrome patients: evidence from 89 emergency medical stations in China. Int J Equity Health 2022; 21:178. [PMID: 36527098 PMCID: PMC9756777 DOI: 10.1186/s12939-022-01777-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/16/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Allocation of healthcare resources has a great influence on treatment and outcome of patients. This study aimed to access the inequality of ambulance allocation across regions, and estimate the associations between ambulance density and pre-hospital transfer time and mortality of acute coronary syndromes (ACS) patients. METHODS This cross-sectional study was based on an integrated database of electronic medical system for 3588 ACS patients from 31 hospitals, ambulance information of 89 emergency medical stations, and public geographical information of 8 districts in Shenzhen, China. The primary outcomes were the associations between ambulance allocation and transfer delay and in-hospital mortality of ACS patients. The Theil index and Gini coefficient were used to assess the fairness and inequality degree of ambulance allocation. Logistic regression was used to model the associations. RESULTS There was a significant inequality in ambulance allocation in Shenzhen (Theil index: 0.59), and the inequality of inter-districts (Theil index: 0.38) was greater than that of intra-districts (Theil index: 0.21). The gap degree of transfer delay, ambulance allocation, and mortality across districts resulted in a Gini coefficient of 0.35, 0.53, 0.65, respectively. Ambulance density was negatively associated with pre-hospital transfer time (OR = 0.79, 95%CI: 0.64,0.97, P = 0.026), with in-hospital mortality (OR = 0.31, 95%CI:0.14,0.70, P = 0.005). The ORs of Theil index in transfer time and in-hospital mortality were 1.09 (95%CI:1.01,1.10, P < 0.001) and 1.80 (95%CI:1.15,3.15, P = 0.009), respectively. CONCLUSIONS Regional inequities existed in ambulance allocation and has a significant impact on pre-hospital transfer delay and in-hospital mortality of ACS patients. It was suggested to increase the ambulance accessibility and conduct health education for public.
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Affiliation(s)
- Siwen Li
- Shenzhen Center for Prehospital Care, 3 Meigang South Street, West Nigang Road, Futian District, Shenzhen, 518025 China ,grid.11135.370000 0001 2256 9319Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191 China ,grid.11135.370000 0001 2256 9319Institute for Global Health and Development, Peking University, Beijing, China
| | - Xuejie Dong
- grid.11135.370000 0001 2256 9319Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191 China ,grid.11135.370000 0001 2256 9319Institute for Global Health and Development, Peking University, Beijing, China
| | - Dongmei Li
- Shenzhen Center for Prehospital Care, 3 Meigang South Street, West Nigang Road, Futian District, Shenzhen, 518025 China
| | - Hongjuan Zhang
- Shenzhen Center for Prehospital Care, 3 Meigang South Street, West Nigang Road, Futian District, Shenzhen, 518025 China
| | - Shuduo Zhou
- grid.11135.370000 0001 2256 9319Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191 China ,grid.11135.370000 0001 2256 9319Institute for Global Health and Development, Peking University, Beijing, China
| | - Mailikezhati Maimaitiming
- grid.11135.370000 0001 2256 9319Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191 China ,grid.11135.370000 0001 2256 9319Institute for Global Health and Development, Peking University, Beijing, China
| | - Junxiong Ma
- grid.11135.370000 0001 2256 9319Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191 China ,grid.11135.370000 0001 2256 9319Institute for Global Health and Development, Peking University, Beijing, China
| | - Na Li
- grid.11135.370000 0001 2256 9319Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191 China ,grid.11135.370000 0001 2256 9319Institute for Global Health and Development, Peking University, Beijing, China
| | - Qiang Zhou
- Shenzhen Center for Prehospital Care, 3 Meigang South Street, West Nigang Road, Futian District, Shenzhen, 518025 China
| | - Yinzi Jin
- grid.11135.370000 0001 2256 9319Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191 China ,grid.11135.370000 0001 2256 9319Institute for Global Health and Development, Peking University, Beijing, China
| | - Zhi-Jie Zheng
- grid.11135.370000 0001 2256 9319Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191 China ,grid.11135.370000 0001 2256 9319Institute for Global Health and Development, Peking University, Beijing, China
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Introduction of specialized heart failure nurses in primary care and its impact on readmissions. Prim Health Care Res Dev 2022; 23:e78. [PMID: 36484241 PMCID: PMC9817084 DOI: 10.1017/s1463423622000676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Heart failure (HF) has a 2% prevalence in the population and is a major cause of morbidity and mortality. Multiple efforts have been made worldwide to improve quality of care and decrease unplanned readmissions for HF patients, one of which has been the introduction of specialist HF nurses (HFN) in primary health care. The present evidence on the benefits of HFN is contradicting. This study aims to evaluate the impact of a quality improvement intervention, availability of a HFN in Swedish primary care, on hospital readmissions. METHODS All patients over the age of 65 with a HF diagnosis and with complete information on availability of a HFN were included in this retrospective register-based study. Using propensity score matching (PSM) techniques, two comparable groups of 128 patients each were created according to the exposure status, availability or no availability of a HFN. The rate of readmission was compared between the groups. RESULTS Using PSM, 256 patients were matched, 128 in the HFN group and 128 in the no-HFN group. A total of 50% and 46.09% of patients in the HFN and no-HFN groups were readmitted, respectively. Mean number of readmissions per patient was 1.19 (SD 0.61) in the HFN group and 1.10 (SD 0.44) in the no-HFN group. Patients in the HFN had 17.6% higher odds of being readmitted during the study period, OR: 1.176 (CI: 0.716-1.932), and 3.8% lower odds of being readmitted within 30 days, OR: 0.962 (CI: 0.528-1.750). CONCLUSIONS Availability of a HFN in primary care was not significantly associated with reduced readmissions for the patients included in this study. Further investigations are warranted looking at the impacts of availability and access to a HFN in primary care on readmissions and other patient outcomes.
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Cholesterol crystals and atherosclerotic plaque instability: Therapeutic potential of Eicosapentaenoic acid. Pharmacol Ther 2022; 240:108237. [PMID: 35772589 DOI: 10.1016/j.pharmthera.2022.108237] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 12/15/2022]
Abstract
Atherosclerotic plaques associated with acute coronary syndromes (ACS), i.e. culprit lesions, frequently feature a ruptured fibrous cap with thrombotic complications. On imaging, these plaques exhibit a low attenuation, lipid-rich, necrotic core containing cholesterol crystals and are inherently unstable. Indeed, cholesterol crystals are causally associated with plaque vulnerability in vivo; their formation results from spontaneous self-assembly of cholesterol molecules. Cholesterol homeostasis is a central determinant of the physicochemical conditions leading to crystal formation, which are favored by elevated membrane free cholesterol content in plaque endothelial cells, smooth muscle cells, monocyte-derived macrophages, and foam cells, and equally by lipid oxidation. Emerging evidence from imaging trials in patients with coronary heart disease has highlighted the impact of intervention involving the omega-3 fatty acid, eicosapentaenoic acid (EPA), on vulnerable, low attenuation atherosclerotic plaques. Thus, EPA decreased features associated with unstable plaque by increasing fibrous cap thickness in statin-treated patients, by reducing lipid volume and equally attenuating intraplaque inflammation. Importantly, atherosclerotic plaques rapidly incorporate EPA; indeed, a high content of EPA in plaque tissue is associated with decreased plaque inflammation and increased stability. These findings are entirely consistent with the major reduction seen in cardiovascular events in the REDUCE-IT trial, in which high dose EPA was administered as its esterified precursor, icosapent ethyl (IPE); moreover, clinical benefit was proportional to circulating EPA levels. Eicosapentaenoic acid is efficiently incorporated into phospholipids, where it modulates cholesterol-enriched domains in cell membranes through physicochemical lipid interactions and changes in rates of lipid oxidation. Indeed, biophysical analyses indicate that EPA exists in an extended conformation in membranes, thereby enhancing normal cholesterol distribution while reducing propagation of free radicals. Such effects mitigate cholesterol aggregation and crystal formation. In addition to its favorable effect on cholesterol domain structure, EPA/IPE exerts pleiotropic actions, including antithrombotic, antiplatelet, anti-inflammatory, and proresolving effects, whose plaque-stabilizing potential cannot be excluded. Docosahexaenoic acid is distinguished from EPA by a higher degree of unsaturation and longer carbon chain length; DHA is thus predisposed to changes in its conformation with ensuing increase in membrane lipid fluidity and promotion of cholesterol aggregation into discrete domains. Such distinct molecular effects between EPA and DHA are pronounced under conditions of high cellular cholesterol content and oxidative stress. This review will focus on the formation and role of cholesterol monohydrate crystals in destabilizing atherosclerotic plaques, and on the potential of EPA as a therapeutic agent to attenuate the formation of deleterious cholesterol membrane domains and of cholesterol crystals. Such a therapeutic approach may translate to enhanced plaque stability and ultimately to reduction in cardiovascular risk.
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van der Linde-van den Bor M, Frans-Rensen SA, Slond F, Liesdek OC, de Heer LM, Suyker WJ, Jaarsma T, Weldam SW. Patients' voices in the development of pre-surgical patient education using virtual reality: A qualitative study. PEC INNOVATION 2022; 1:100015. [PMID: 37213731 PMCID: PMC10194275 DOI: 10.1016/j.pecinn.2021.100015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/17/2021] [Accepted: 12/29/2021] [Indexed: 05/23/2023]
Abstract
Objective To identify the information needs and perceptions of patients regarding the application of virtual reality in pre-surgical patient education. Methods A qualitative study was conducted between March and July 2020. The study population consisted of a purposive sample of patients scheduled for cardiac surgery from a single institution. Semi-structured individual interviews (n=19) were conducted and analysed using thematic analysis. Results Patient perceptions regarding virtual reality and information needs related to hospitalisation and surgery could be categorised into three themes: Creating familiarity, contents to explore and challenges and preconditions. Conclusions Virtual reality technology is a promising tool that can enhance conventional patient education to improve understanding and to potentially reduce concerns and anxieties. The virtual reality environment creates an opportunity for patients to be in control of the timing, quantity, depth and frequency of patient education. A virtual reality education tool should not be a substitute for personal contact with the physician. Innovation Patient information needs were identified profoundly to the further development of a virtual reality intervention. This intervention aims to educate patients prior to elective cardiac surgery.
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Affiliation(s)
| | - Sarah A. Frans-Rensen
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
| | - Fiona Slond
- Utrecht University Medical Centre, Centre for Education, Department of Technology Enhanced Learning, Utrecht, The Netherlands
| | - Omayra C.D. Liesdek
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
| | - Linda M. de Heer
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
| | - Willem J.L. Suyker
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
| | - Tiny Jaarsma
- Utrecht University Medical Centre, Julius Centre for Health Sciences and Primary Care, Utrecht, The Netherlands
- Linkoping University, Department of Health, Medicine and Caring Services, Linkoping, Sweden
| | - Saskia W.M. Weldam
- Utrecht University Medical Centre, Department of Cardiothoracic Surgery, Utrecht, The Netherlands
- Corresponding author at: Heart and Lung Department, Utrecht University Medical Centre (UMC Utrecht), Internal PO E03.511, PO Box 85500, 3508 GA Utrecht, The Netherlands.
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Abstract
PURPOSE OF REVIEW Aging is an important risk factor for cardiovascular disease and is associated with increased vessel wall stiffness. Pathophysiological stiffening, notably in arteries, disturbs the integrity of the vascular endothelium and promotes permeability and transmigration of immune cells, thereby driving the development of atherosclerosis and related vascular diseases. Effective therapeutic strategies for arterial stiffening are still lacking. RECENT FINDINGS Here, we overview the literature on age-related arterial stiffening, from patient-derived data to preclinical in-vivo and in-vitro findings. First, we overview the common techniques that are used to measure stiffness and discuss the observed stiffness values in atherosclerosis and aging. Next, the endothelial response to stiffening and possibilities to attenuate this response are discussed. SUMMARY Future research that will define the endothelial contribution to stiffness-related cardiovascular disease may provide new targets for intervention to restore endothelial function in atherosclerosis and complement the use of currently applied lipid-lowering, antihypertensive, and anti-inflammatory drugs.
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Affiliation(s)
- Aukie Hooglugt
- Amsterdam UMC, University of Amsterdam, Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences
- Amsterdam UMC, VU University Medical Center, Department of Physiology, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Olivia Klatt
- Amsterdam UMC, University of Amsterdam, Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences
| | - Stephan Huveneers
- Amsterdam UMC, University of Amsterdam, Department of Medical Biochemistry, Amsterdam Cardiovascular Sciences
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Zhao M, Zheng Z, Li C, Wan J, Wang M. Developmental endothelial locus-1 in cardiovascular and metabolic diseases: A promising biomarker and therapeutic target. Front Immunol 2022; 13:1053175. [PMID: 36518760 PMCID: PMC9742254 DOI: 10.3389/fimmu.2022.1053175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
Cardiovascular and metabolic diseases (CVMDs) are a leading cause of death worldwide and impose a major socioeconomic burden on individuals and healthcare systems, underscoring the urgent need to develop new drug therapies. Developmental endothelial locus-1 (DEL-1) is a secreted multifunctional domain protein that can bind to integrins and play an important role in the occurrence and development of various diseases. Recently, DEL-1 has attracted increased interest for its pharmacological role in the treatment and/or management of CVMDs. In this review, we present the current knowledge on the predictive and therapeutic role of DEL-1 in a variety of CVMDs, such as atherosclerosis, hypertension, cardiac remodeling, ischemic heart disease, obesity, and insulin resistance. Collectively, DEL-1 is a promising biomarker and therapeutic target for CVMDs.
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Affiliation(s)
- Mengmeng Zhao
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China,Cardiovascular Research Institute, Wuhan University, Wuhan, China,Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Zihui Zheng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China,Cardiovascular Research Institute, Wuhan University, Wuhan, China,Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Chenfei Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China,Cardiovascular Research Institute, Wuhan University, Wuhan, China
| | - Jun Wan
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China,Cardiovascular Research Institute, Wuhan University, Wuhan, China,Hubei Key Laboratory of Cardiology, Wuhan, China,*Correspondence: Menglong Wang, ; Jun Wan,
| | - Menglong Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China,Cardiovascular Research Institute, Wuhan University, Wuhan, China,Hubei Key Laboratory of Cardiology, Wuhan, China,*Correspondence: Menglong Wang, ; Jun Wan,
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Kommata V, Deharo JC, Drossart I, Foldager D, Svennberg E, Vernooy K, Verstrael A, Duncker D. The 'myrhythmdevice.org' educational website for patients with implanted cardiac devices from the European Heart Rhythm Association. Europace 2022; 24:1713-1715. [PMID: 36002946 DOI: 10.1093/europace/euac137] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Varvara Kommata
- Department of Cardiology, Uppsala University Hospital, 75317 Uppsala, Sweden.,Department of Cardiology and Medical Sciences, Uppsala University, 75317 Uppsala, Sweden
| | - Jean-Claude Deharo
- Assistance Publique - Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, 13385 Marseille Cedex 05, France.,Aix Marseille Université, C2VN, 13385 Marseille Cedex 05, France
| | - Inga Drossart
- ESC Patient Forum, CS 80179 Biot 06903 Sophia Antipolis Cedex, France.,European Society of Cardiology, CS 80179 Biot 06903 Sophia Antipolis Cedex, France
| | - Dan Foldager
- ESC Patient Forum, CS 80179 Biot 06903 Sophia Antipolis Cedex, France
| | - Emma Svennberg
- Karolinska Institutet, Department of Medicine, Karolinska University Hospital, 141 86 Stockholm, Sweden
| | - Kevin Vernooy
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands
| | - Axel Verstrael
- ESC Patient Forum, CS 80179 Biot 06903 Sophia Antipolis Cedex, France
| | - David Duncker
- Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, 30539 Hannover, Germany
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97
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Comparing cardiovascular disease incidence and prevalence between depressed and non-depressed older persons over time: Cohort differences in the Longitudinal Aging Study Amsterdam. J Psychosom Res 2022; 162:111015. [PMID: 36162162 DOI: 10.1016/j.jpsychores.2022.111015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 08/01/2022] [Accepted: 08/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Previous studies suggest that prevention of cardiovascular disease (CVD) is more difficult in depressed persons. Although the prevalence and incidence of CVD decreased over the past decades, it is uncertain whether this is also true for depressed persons. This study examined whether changes in the prevalence and incidence of CVD differ between depressed and non-depressed older persons. METHODS Longitudinal data from three community-based representative birth cohorts aged 55-65 years of the Longitudinal Aging Study Amsterdam were used; N = 1070 born in 1926-1937, N = 995 born in 1938-1947, N = 1019 born in 1948-1957. The outcome included fatal and non-fatal CVD. Depression was defined as ≥16 points on the Center for Epidemiological Studies Depression Scale or a general practitioner's diagnosis of depression. Data were analysed with for age and sex adjusted logistic regression and cox regression models. RESULTS Comparing cohort 2 and 3 with cohort 1 in the complete sample, the prevalence of CVD decreased by 2% (OR = 0.98, 95%CI = 0.76-1.26) and 32% (OR = 0.68, 95%CI = 0.52-0.89), respectively, and the three-year incidence of CVD decreased by 6% (OR = 0.94, 95%CI = 0.63-1.41) and 26% (OR = 0.74, 95%CI = 0.48-1.15), respectively. The 13-year incidence of CVD decreased by 19% (HR = 0.81, 95%CI = 0.67-0.99) in cohort 2 compared to cohort 1. These decreases did not differ statistically significantly between depressed and non-depressed respondents (p-values of interaction terms: 0.35-0.98). CONCLUSION Substantial decreases in the prevalence and incidence of CVD were observed in depressed and non-depressed older persons. Although this is encouraging, cardiovascular risk remained higher in depressed persons over time, warranting tailored prevention programs for depressed older persons.
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98
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Liu D, Zeng Y, Liang P, Jiang Y, An S, Ren P. Efficacy and safety of Xuefu Zhuyu Granules combined with western medicine in the treatment of angina pectoris of coronary heart disease: A study protocol of a randomized, double-blind, placebo-controlled clinical trial. Medicine (Baltimore) 2022; 101:e31235. [PMID: 36316861 PMCID: PMC9622600 DOI: 10.1097/md.0000000000031235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Despite advances in treatment strategies for coronary heart disease, angina pectoris remains a major cardiovascular disease causing death worldwide. For patients with angina pectoris of coronary heart disease, new or adjuvant treatment regimens are needed. The available evidence suggests that Xuefu Zhuyu Granules combined with Western medicine has advantages in the treatment of angina pectoris of coronary heart disease, but whether its efficacy has a placebo effect and whether it can be used as an adjuvant regimen for the treatment of angina pectoris of coronary heart disease remains controversial. METHODS This is a prospective, randomized, double-blind, placebo-controlled trial to study the efficacy and safety of Xuefu Zhuyu Granules combined with Western medicine in the treatment of angina pectoris of coronary heart disease. Participants will be randomly divided into a treatment group or a control group, and all patients will receive Western medicine treatment based on guideline recommendations. On this basis, the treatment group orally takes Xuefu Zhuyu Granules and the control group orally takes Xuefu Zhuyu Granules mimic, and are followed up for 24 weeks after 12 weeks of continuous treatment. The observation indexes include: cardiac function parameters (left ventricular end-diastolic diameter; left ventricular end-systolic diameter; left ventricular ejection fraction, blood lipid levels (total cholesterol; triacylglycerol; low-density lipoprotein cholesterol; high-density lipoprotein cholesterol), the number of angina attacks per week, total amount of nitroglycerin tablets taken, and adverse reactions. Finally, SPSS22.0 (IBM Company, New York, NY) software will be used for statistical analysis of the data. DISCUSSION This study will evaluate the efficacy and safety of Xuefu Zhuyu Granules combined with Western medicine in the treatment of angina pectoris of coronary heart disease. The results of this study will verify whether the efficacy of Xuefu Zhuyu Granules in the treatment of angina pectoris of coronary heart disease belongs to the placebo effect, which will also provide a reference for the clinical use of Xuefu Zhuyu Granules as a supplementary scheme for the treatment of angina pectoris of coronary heart disease.
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Affiliation(s)
- Dong Liu
- The People’s Hospital of DaZu, Chongqing, China
| | - Yunjie Zeng
- The People’s Hospital of DaZu, Chongqing, China
| | - Peng Liang
- The People’s Hospital of DaZu, Chongqing, China
| | - Yunlu Jiang
- The People’s Hospital of DaZu, Chongqing, China
| | - Su An
- The People’s Hospital of DaZu, Chongqing, China
| | - Pengcheng Ren
- The People’s Hospital of DaZu, Chongqing, China
- * Correspondence: Pengcheng Ren, The People’s Hospital of DaZu, No. 1073 Erhuan South Road, Tangxiang Street, Dazu District, Chongqing, DaZu District, Chongqing 402360, China (e-mail: )
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99
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Liu YZ, Li ZX, Zhang LL, Wang D, Liu YP. Phenotypic plasticity of vascular smooth muscle cells in vascular calcification: Role of mitochondria. Front Cardiovasc Med 2022; 9:972836. [PMID: 36312244 PMCID: PMC9597684 DOI: 10.3389/fcvm.2022.972836] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 09/20/2022] [Indexed: 12/02/2022] Open
Abstract
Vascular calcification (VC) is an important hallmark of cardiovascular disease, the osteo-/chondrocyte phenotype differentiation of vascular smooth muscle cells (VSMCs) is the main cause of vascular calcification. Accumulating evidence shows that mitochondrial dysfunction may ultimately be more detrimental in the VSMCs calcification. Mitochondrial participate in essential cellular functions, including energy production, metabolism, redox homeostasis regulation, intracellular calcium homeostasis, apoptosis, and signal transduction. Mitochondrial dysfunction under pathological conditions results in mitochondrial reactive oxygen species (ROS) generation and metabolic disorders, which further lead to abnormal phenotypic differentiation of VSMCs. In this review, we summarize existing studies targeting mitochondria as a treatment for VC, and focus on VSMCs, highlighting recent progress in determining the roles of mitochondrial processes in regulating the phenotype transition of VSMCs, including mitochondrial biogenesis, mitochondrial dynamics, mitophagy, mitochondrial energy metabolism, and mitochondria/ER interactions. Along these lines, the impact of mitochondrial homeostasis on VC is discussed.
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100
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Duval V, Alayrac P, Mallat Z, Silvestre JS. [Deleterious role of spleen marginal zone B lymphocytes in ventricular remodeling after myocardial infarction]. Med Sci (Paris) 2022; 38:766-768. [PMID: 36219074 DOI: 10.1051/medsci/2022119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
| | - Paul Alayrac
- Université Paris Cité, Inserm, PARCC, Paris, France
| | - Ziad Mallat
- Université Paris Cité, Inserm, PARCC, Paris, France - Division of cardiovascular medicine, Cambridge University, Cambridge, Royaume-Uni
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