101
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Dziedzic EA, Gąsior JS, Tuzimek A, Dąbrowski M, Kochman W. Correlation between Serum 25-Hydroxyvitamin D Concentration, Monocyte-to-HDL Ratio and Acute Coronary Syndrome in Men with Chronic Coronary Syndrome-An Observational Study. Nutrients 2023; 15:4487. [PMID: 37892562 PMCID: PMC10609971 DOI: 10.3390/nu15204487] [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: 10/05/2023] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 10/29/2023] Open
Abstract
Cardiovascular disease (CVD) continues to be the leading cause of death in European men. Atherosclerosis and its clinical consequence, chronic coronary syndrome (CCS), comprise two main elements: dysfunction of lipoprotein metabolism and an important inflammatory component that contributes to the development of complications, including acute coronary syndrome (ACS). Measures of both components are combined in a composite marker called monocyte-to-HDL ratio (MHR). Vitamin D was previously described to influence inflammation processes, and its deficiency influences CVD risk factors. This research describes the differences in MHR and total serum 25-hydroxyvitamin D (25(OH)D) concentration between male patients with different diagnoses of CCS and the correlation between 25(OH)D and MHR in this group. Significant differences were observed between ACS and CCS patients in 25(OH)D and MHR-the highest HDL and serum 25(OH)D concentrations were observed in patients with CCS, whereas the highest value of MHR was observed in patients with STEMI. A significant correlation was observed between 25(OH)D, HDL, and MHR. Due to the significant but small nominal difference in MHR values between groups of patients diagnosed with ACS and CCS, and the possible influence of age and hyperlipidemia status on the differences in vitamin D levels in these groups, this subject requires further well-designed research. The suggested bidirectional relationship between MHR and 25(OH)D and the role of MHR as a predictor of vitamin D status in the body also needs to be verified.
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Affiliation(s)
- Ewelina A. Dziedzic
- Cardiovascular Clinic, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
| | - Jakub S. Gąsior
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Agnieszka Tuzimek
- Cardiovascular Clinic, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
| | - Marek Dąbrowski
- Department of Cardiology, Bielanski Hospital, 01-809 Warsaw, Poland
| | - Wacław Kochman
- Cardiovascular Clinic, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
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102
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Yang R, Zhang X, Bai J, Wang L, Wang W, Cai J. Global, regional, and national burden of hypertensive heart disease among older adults in 204 countries and territories between 1990 and 2019: a trend analysis. Chin Med J (Engl) 2023; 136:2421-2430. [PMID: 37698022 PMCID: PMC10586836 DOI: 10.1097/cm9.0000000000002863] [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: 06/13/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Hypertensive heart disease (HHD) poses a public health challenge, but data on its burden and trends among older adults are scarce. This study aimed to identify trends in the burden of HHD among older adults between 1990 and 2019 at the global, regional, and national levels. METHODS Using the Global Burden of Diseases study 2019 data, we assessed HHD prevalence, death, and disability-adjusted life-year (DALY) rates for individuals aged 60-89 years at the global, regional, and national levels and estimated their average annual percentage changes (AAPCs) between 1990 and 2019 using joinpoint regression analysis. RESULTS In 2019, there were 14.35 million HHD prevalent cases, 0.85 million deaths, and 14.56 million DALYs in older adults. Between 1990 and 2019, the prevalence of HHD increased globally {AAPC, 0.38 (95% confidence interval [CI], 0.36, 0.41)} with decreases observed in mortality (AAPC, -0.83 [95% CI, -0.99, -0.66]) and the DALY rate (AAPC, -1.03 [95% CI, -1.19, -0.87]). This overall global trend pattern was essentially maintained for sex, age group, and sociodemographic index (SDI) quintile except for non-significant changes in the prevalence of HHD in those aged 70-74 years and in the middle SDI quintile. Notably, males had a higher HHD prevalence rate. However, HHD-related mortality and the DALY rate were higher in females. The middle SDI quintile experienced the largest decreases in mortality and the DALY rate, with a non-significant decline in prevalence between 1990 and 2019. There were significant discrepancies in the HHD burden and its trends across regions and countries. CONCLUSIONS In the past three decades, there has been an overall increasing trend in the prevalence of HHD among older adults worldwide despite decreasing trends in mortality and the DALY rate. Better management of hypertension, and prevention and control of HHD are needed in older adults.
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Affiliation(s)
| | | | | | | | | | - Jun Cai
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100037, China
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103
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Afanasieva OI, Tyurina AV, Ezhov MV, Razova OA, Klesareva EA, Pokrovsky SN. Lipoprotein(a) and Low-Molecular-Weight Apo(a) Phenotype as Determinants of New Cardiovascular Events in Patients with Premature Coronary Heart Disease. Diseases 2023; 11:145. [PMID: 37873789 PMCID: PMC10594435 DOI: 10.3390/diseases11040145] [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: 07/01/2023] [Revised: 09/29/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Lipoprotein(a) (Lp(a)) is a genetic risk factor of atherosclerotic cardiovascular diseases (ASCVDs). Proprotein convertase subtilisin/kexin type 9 (PCSK9) is related to vascular inflammation and detected in atherosclerotic plaques. A temporary increase in the circulating concentration of PCSK9 and Lp(a) was shown in patients with myocardial infarction (MI). The aim of this study was to evaluate the role of the apo(a) phenotype and the Lp(a) concentration as well as its complex with PCSK9 in the development of cardiac events and MI in patients with a premature manifestation of coronary heart disease (CHD). METHODS In a prospective study with retrospective data collection, we included 116 patients with premature CHD who were followed for a median of 14 years. The medical history and information on cardiovascular events after an initial exam as well as data on the levels of lipids, Lp(a), PCSK9, PCSK9-Lp(a) complex, and apo(a) phenotype were obtained. RESULTS The patients were divided into two groups depending on the presence of a low- (LMW, n = 52) or high-molecular weight (HMW, n = 64) apo(a) phenotype. LMW apo(a) phenotype (odds ratio 2.3 (1.1 to 4.8), p = 0.03), but not elevated Lp(a) (1.9 (0.8-4.6), p = 0.13), was an independent predictor for the development of MI after adjustment for sex, age of CHD debut, initial lipids levels, and lipid-lowering treatment. The apo(a) phenotype also determined the relationship between Lp(a) and PCSK9 concentrations. The level of the PCSK9-Lp(a) complex was higher in LMW apo(a) patients. CONCLUSION The LMW apo(a) phenotype is a risk factor for non-fatal MI in a long-term prospective follow-up of patients with premature CHD, and this link could be mediated via PCSK9.
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Affiliation(s)
- Olga I. Afanasieva
- Institute of Experimental Cardiology, National Medical Research Center of Cardiology Named after Academician E.I. Chazov, Ministry of Health of the Russian Federation, Academician Chazov str., 15a, 121552 Moscow, Russia; (O.I.A.); (O.A.R.); (E.A.K.); (S.N.P.)
| | - Alexandra V. Tyurina
- A.L. Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology Named after Academician E.I. Chazov, Ministry of Health of the Russian Federation, Academician Chazov str., 15a, 121552 Moscow, Russia;
| | - Marat V. Ezhov
- A.L. Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology Named after Academician E.I. Chazov, Ministry of Health of the Russian Federation, Academician Chazov str., 15a, 121552 Moscow, Russia;
| | - Oxana A. Razova
- Institute of Experimental Cardiology, National Medical Research Center of Cardiology Named after Academician E.I. Chazov, Ministry of Health of the Russian Federation, Academician Chazov str., 15a, 121552 Moscow, Russia; (O.I.A.); (O.A.R.); (E.A.K.); (S.N.P.)
| | - Elena A. Klesareva
- Institute of Experimental Cardiology, National Medical Research Center of Cardiology Named after Academician E.I. Chazov, Ministry of Health of the Russian Federation, Academician Chazov str., 15a, 121552 Moscow, Russia; (O.I.A.); (O.A.R.); (E.A.K.); (S.N.P.)
| | - Sergei N. Pokrovsky
- Institute of Experimental Cardiology, National Medical Research Center of Cardiology Named after Academician E.I. Chazov, Ministry of Health of the Russian Federation, Academician Chazov str., 15a, 121552 Moscow, Russia; (O.I.A.); (O.A.R.); (E.A.K.); (S.N.P.)
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104
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Gyldenkerne C, Mortensen MB, Kahlert J, Thrane PG, Warnakula Olesen KK, Sørensen HT, Thomsen RW, Maeng M. 10-Year Cardiovascular Risk in Patients With Newly Diagnosed Type 2 Diabetes Mellitus. J Am Coll Cardiol 2023; 82:1583-1594. [PMID: 37821168 DOI: 10.1016/j.jacc.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/13/2023] [Accepted: 08/14/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Contemporary data on cardiovascular disease (CVD) risk in patients with newly diagnosed type 2 diabetes mellitus (T2DM) is needed to guide appropriate preventive management. OBJECTIVES The authors sought to investigate sex- and age-specific 10-year CVD risk in patients with newly diagnosed T2DM compared with the general population. METHODS A cohort study was conducted of all Danish patients with T2DM diagnosed between 2006 and 2013 (n = 142,587) and sex- and age-matched individuals from the general population (n = 388,410), all without prior atherosclerotic CVD. Ten-year CVD risk (myocardial infarction, stroke, and fatal CVD) was estimated. RESULTS A total of 52,471 CVD events were recorded. Compared with the general population, the 10-year CVD risks were higher in patients with T2DM in both sexes and across all age groups, especially among younger individuals. For example, patients aged 40 to 49 years had the largest 10-year CVD risk difference (T2DM 6.1% vs general population 3.3%; risk difference: 2.8%, subdistribution HR: 1.91; 95% CI: 1.76-2.07). The age when a given CVD risk was reached differed substantially between the cohorts. Thus, a 10-year CVD risk of 5% was reached at age 43 in men with T2DM compared with 12 years later, at age 55, in men without T2DM. A 10-year CVD risk of 5% was reached at age 51 in women with T2DM and 10 years later, at age 61, in women without T2DM. CONCLUSIONS Newly diagnosed T2DM increased 10-year CVD risk across both sexes and all age groups, especially among younger patients, with CVD occurring ≤12 years earlier than in general population individuals.
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Affiliation(s)
- Christine Gyldenkerne
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Martin Bødtker Mortensen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Cardiology, Johns Hopkins, Baltimore, Maryland, USA
| | - Johnny Kahlert
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Reimar Wernich Thomsen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Michael Maeng
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
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105
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Haapanen MJ, Törmäkangas T, von Bonsdorff ME, Strandberg AY, Strandberg TE, von Bonsdorff MB. Midlife cardiovascular health factors as predictors of retirement age, work-loss years, and years spent in retirement among older businessmen. Sci Rep 2023; 13:16526. [PMID: 37783715 PMCID: PMC10545670 DOI: 10.1038/s41598-023-43666-x] [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: 06/13/2023] [Accepted: 09/27/2023] [Indexed: 10/04/2023] Open
Abstract
Cardiovascular disease (CVD) is one of the leading causes of premature retirement. However, the relationship between CVD risk factors and workforce participation is not well known. We studied the relationship between midlife CVD risk, age at retirement, work-loss years, and survival in retirement. Middle-aged Finnish men (initial n = 3490, mean age = 47.8 years) were assessed for CVD risk factors and general health in the 1970s. They worked as business executives and provided information on their retirement status in the year 2000. Survival was followed up to the 9th decade of life with a follow-up of up to 44 years. Work-loss years were calculated as death or retirement occurring at age ≤ 65 years. Smoking, body mass index, and alcohol use were used as covariates, excluding models of CVD risk, which were adjusted for alcohol use only. Higher risk of 10-year fatal CVD was associated with 0.32 more years (relative risk < 1 vs. 1, covariate-adjusted β = 0.32, 95% CI = 0.13, 0.53) of work-loss. Higher risk of 5-year incident (covariate-adjusted time-constant HR = 1.32, 95% CI = 1.19, 1.47) and 10-year fatal (covariate-adjusted time-dependent HR = 1.55, 95% CI = 1.30, 1.85) CVD in midlife were associated with fewer years spent in retirement. Poorer self-rated health and physical fitness and higher levels of triglycerides were associated with increased hazard of earlier retirement, more work-loss years, and fewer years spent in retirement. Poorer health and greater midlife CVD risk may be associated with earlier exit from the workforce and fewer years spent in retirement. Management of CVD risk in midlife may support people to work longer.
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Affiliation(s)
- Markus J Haapanen
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Folkhälsan Research Centre, Helsinki, Finland.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Timo Törmäkangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Monika E von Bonsdorff
- Management and Leadership, Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland
| | - Arto Y Strandberg
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo E Strandberg
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Centre for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Mikaela B von Bonsdorff
- Folkhälsan Research Centre, Helsinki, Finland
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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106
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Zhang J, Weng J, Yuan M, Shen X, Weng Y, Shen X. Effects of traditional Chinese exercises on cardiac rehabilitation in patients with myocardial infarction: a meta-analysis of randomized controlled trials. Front Cardiovasc Med 2023; 10:1223677. [PMID: 37849938 PMCID: PMC10577298 DOI: 10.3389/fcvm.2023.1223677] [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: 05/16/2023] [Accepted: 09/18/2023] [Indexed: 10/19/2023] Open
Abstract
Objective Traditional Chinese exercises (TCE) are excellent cardiac rehabilitation (CR) training that can effectively improve cardiorespiratory fitness. However, there is no published meta-analysis of TCE on CR in patients with myocardial infarction (MI). Therefore, this study aimed to provide a comprehensive evaluation from multiple perspectives. Methods This meta-analysis is based on the Cochrane Handbook of Systematic Reviews. Eight databases were searched from the date of database construction to March 15, 2023. Two investigators independently screened the literature and assessed their quality. The meta-analysis was performed with RevMan5.4 software. Results A total of 21 articles involving 1,890 patients were included. N-terminal pro-brain natriuretic peptide (NT-proBNP) in the TCE group were lower than the control group (MD = -96.34, 95%CI: -140.69 ∼-51.98, P < 0.00001, I2 = 96%), the left ventricular ejection fraction (LVEF) in the TCE group was higher than the control group (MD = 4.58, 95%CI: 3.28-5.88, P < 0.00001, I2 = 79%), the left ventricular end diastolic dimension (LVDD) in TCE group was lower than the control group (MD = -3.83, 95%CI: -5.27 ∼-2.38, P < 0.00001, I2 = 94%), the left ventricular end systolic diameter (LVESD) in TCE group was lower than the control group (MD = -2.17, 95%CI: -4.10 ∼-0.24, P < 0.00001, I2 = 96%), The 6-minute walk test (6MWT) in the TCE group was higher than the control group (MD = 69.60, 95%CI: 34.59-104.60, P < 0.00001, I2 = 99%), the oxygen uptake (VO2) in the TCE group was higher than the control group (MD = 4.38, 95%CI: 2.25-6.51, P < 0.00001, I2 = 94%), the 36-item short form survey (SF-36) in the TCE group was higher than the control group (MD = 13.34, 95%CI: 9.25-17.42, P = 0.008, I2 = 75%), the Hamilton Anxiety Scale (HAMA) in the TCE group was lower than the control group (MD = -4.34, 95%CI: -5.18 ∼-3.50, P = 1.00, I2 = 0%), the Hamilton Depression Scale (HAMD) in the TCE group was lower than the control group (MD = -3.48, 95%CI: -5.35 ∼-1.61, P = 0.0002, I2 = 88%), the incidence of major adverse cardiac events (MACEs) in the TCE group was lower than the control group (RR = 0.31, 95%CI: 0.20-0.47, P = 0.52, I2 = 0%). Subgroup analysis revealed differences in TCE types could be a potential source of heterogeneity. Conclusion MI patients who used TCE have not only notable improvements in cardiopulmonary function, physical function, quality of life, and emotions but also reduced the incidence of MACEs. Tai Chi might be more efficient than Ba Duan Jin. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023408675.
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Affiliation(s)
| | | | | | | | | | - Xiaoxu Shen
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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107
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Ibrahim DM, Fomina A, Bouten CVC, Smits AIPM. Functional regeneration at the blood-biomaterial interface. Adv Drug Deliv Rev 2023; 201:115085. [PMID: 37690484 DOI: 10.1016/j.addr.2023.115085] [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: 10/31/2022] [Revised: 06/01/2023] [Accepted: 09/07/2023] [Indexed: 09/12/2023]
Abstract
The use of cardiovascular implants is commonplace in clinical practice. However, reproducing the key bioactive and adaptive properties of native cardiovascular tissues with an artificial replacement is highly challenging. Exciting new treatment strategies are under development to regenerate (parts of) cardiovascular tissues directly in situ using immunomodulatory biomaterials. Direct exposure to the bloodstream and hemodynamic loads is a particular challenge, given the risk of thrombosis and adverse remodeling that it brings. However, the blood is also a source of (immune) cells and proteins that dominantly contribute to functional tissue regeneration. This review explores the potential of the blood as a source for the complete or partial in situ regeneration of cardiovascular tissues, with a particular focus on the endothelium, being the natural blood-tissue barrier. We pinpoint the current scientific challenges to enable rational engineering and testing of blood-contacting implants to leverage the regenerative potential of the blood.
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Affiliation(s)
- Dina M Ibrahim
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands.
| | - Aleksandra Fomina
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Graduate School of Life Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Carlijn V C Bouten
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands.
| | - Anthal I P M Smits
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, the Netherlands.
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108
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Abdelhamid M, Al Ghalayini K, Al‐Humood K, Altun B, Arafah M, Bader F, Ibrahim M, Sabbour H, Shawky Elserafy A, Skouri H, Yilmaz MB. Regional expert opinion: Management of heart failure with preserved ejection fraction in the Middle East, North Africa and Turkey. ESC Heart Fail 2023; 10:2773-2787. [PMID: 37530028 PMCID: PMC10567674 DOI: 10.1002/ehf2.14456] [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: 02/16/2023] [Revised: 06/02/2023] [Accepted: 06/21/2023] [Indexed: 08/03/2023] Open
Abstract
Although epidemiological data on heart failure (HF) with preserved ejection fraction (HFpEF) are scarce in the Middle East, North Africa and Turkey (MENAT) region, Lancet Global Burden of Disease estimated the prevalence of HF in the MENAT region in 2019 to be 0.78%, versus 0.71% globally. There is also a high incidence of HFpEF risk factors and co-morbidities in the region, including coronary artery disease, diabetes, obesity, hypertension, anaemia and chronic kidney disease. For instance, 14.5-16.2% of adults in the region reportedly have diabetes, versus 7.0% in Europe. Together with increasing life expectancy, this may contribute towards a higher burden of HFpEF in the region than currently reported. This paper aims to describe the epidemiology and burden of HFpEF in the MENAT region, including unique risk factors and co-morbidities. It highlights challenges with diagnosing HFpEF, such as the prioritization of HF with reduced ejection fraction (HFrEF), the specific profile of HFpEF patients in the region and barriers to effective management associated with the healthcare system. Guidance is given on the diagnosis, prevention and management of HFpEF, including the emerging role of sodium-glucose co-transporter-2 inhibitors. Given the high burden of HFpEF coupled with the fact that its prevalence is likely to be underestimated, healthcare professionals need to be alert to its signs and symptoms and to manage patients accordingly. Historically, HFpEF treatments have focused on managing co-morbidities and symptoms, but new agents are now available with proven effects on outcomes in patients with HFpEF.
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Affiliation(s)
| | | | | | - Bülent Altun
- Faculty of MedicineHacettepe UniversityAnkaraTurkey
| | | | - Feras Bader
- Cleveland ClinicAbu DhabiUnited Arab Emirates
| | | | | | | | - Hadi Skouri
- Sheikh Shakhbout Medical CityAbu DhabiUnited Arab Emirates
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109
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Beer S, Babel J, Martin N, Blank V, Wiegand J, Karlas T. Non-invasive assessment of steatohepatitis indicates increased risk of coronary artery disease. PLoS One 2023; 18:e0286882. [PMID: 37768969 PMCID: PMC10538770 DOI: 10.1371/journal.pone.0286882] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/25/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION Fatty liver diseases (FLD), especially defined as metabolic dysfunction-associated FLD (MAFLD), is of growing importance for patients and health-care providers. Extrahepatic comorbidities, predominantly coronary artery disease (CAD), contribute to excess morbidity and mortality in FLD. Although the association of FLD and CAD is well known, underlying pathophysiological links are not fully understood. Non-invasive means of liver diagnostic enable a fast and thorough characterization of FLD. We therefore assessed the severity of FLD in a cohort of patients at risk of CAD. METHODS Patients scheduled for coronary angiography were characterized by anthropometry, serum-based indices of liver fibrosis (NFS, FIB4), abdominal ultrasound and vibration controlled transient elastography (VCTE) including controlled attenuation parameter (CAP) and the Fibroscan-AST (FAST) score. Patients were stratified according to indication of therapeutic coronary intervention. RESULTS 120 patients were recruited, MAFLD was found in 41%, while advanced fibrosis or cirrhosis were present in only 5%. Coronary vascular intervention was indicated in 42% (n = 50). Severity of steatosis assessed by CAP and risk of fibrosis defined by elevated liver stiffness (VCTE>8 kPa) and fibrosis indices were associated with the need for coronary intervention. FAST score, a marker of fibrotic steatohepatitis, was elevated in the intervention group (0.22 vs. 0.12, p<0.001). Multivariate regression analysis revealed FAST score as strongest predictor of CAD (OR 2.3 95%, CI 1.40-2.96). DISCUSSION MAFLD is a frequent comorbidity in patients at CAD risk, but advanced liver disease has a low prevalence in patients undergoing elective coronary angiography. Therefore, a routine VCTE-based screening for FLD cannot be recommended in cardiac patients. The association of indicators of steatohepatitis with advanced CAD points to inflammatory processes as a conjoint mechanism of both diseases.
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Affiliation(s)
- Sebastian Beer
- Department of Medicine II, Division of Gastroenterology, Leipzig University Medical Center, Leipzig, Germany
- Integrated Research and Treatment Center Adiposity Diseases, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Jonas Babel
- Department of Medicine II, Division of Gastroenterology, Leipzig University Medical Center, Leipzig, Germany
- Department of Operative Medicine II, Division of Visceral-, Transplant-, Thoracic- and Vascular Surgery, Leipzig University Medical Center, Leipzig, Germany
| | - Neef Martin
- Department of Cardiology, Leipzig University Medical Center, Leipzig, Germany
| | - Valentin Blank
- Department of Medicine II, Division of Gastroenterology, Leipzig University Medical Center, Leipzig, Germany
- Department of Internal Medicine I (Gastroenterology, Pneumology) and Division of Interdisciplinary Ultrasound, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Johannes Wiegand
- Department of Medicine II, Division of Hepatology, Leipzig University Medical Center, Leipzig, Germany
| | - Thomas Karlas
- Department of Medicine II, Division of Gastroenterology, Leipzig University Medical Center, Leipzig, Germany
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110
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Grundsteins K, Diedkova K, Korniienko V, Stoppel A, Balakin S, Jekabsons K, Riekstina U, Waloszczyk N, Kołkowska A, Varava Y, Opitz J, Simka W, Beshchasna N, Pogorielov M. Nanodiamond Decorated PEO Oxide Coatings on NiTi Alloy. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:2601. [PMID: 37764630 PMCID: PMC10536358 DOI: 10.3390/nano13182601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
Cardiovascular diseases (CVDs) remain a leading cause of death in the European population, primarily attributed to atherosclerosis and subsequent complications. Although statin drugs effectively prevent atherosclerosis, they fail to reduce plaque size and vascular stenosis. Bare metal stents (BMS) have shown promise in acute coronary disease treatment but are associated with restenosis in the stent. Drug-eluting stents (DES) have improved restenosis rates but present long-term complications. To overcome these limitations, nanomaterial-based modifications of the stent surfaces have been explored. This study focuses on the incorporation of detonation nanodiamonds (NDs) into a plasma electrolytic oxidation (PEO) coating on nitinol stents to enhance their performance. The functionalized ND showed a high surface-to-volume ratio and was incorporated into the oxide layer to mimic high-density lipoproteins (HDL) for reverse cholesterol transport (RCT). We provide substantial characterization of DND, including stability in two media (acetone and water), Fourier transmission infrared spectroscopy, and nanoparticle tracking analysis. The characterization of the modified ND revealed successful functionalization and adequate suspension stability. Scanning electron microscopy with EDX demonstrated successful incorporation of DND into the ceramic layer, but the formation of a porous surface is possible only in the high-voltage PEO. The biological assessment demonstrated the biocompatibility of the decorated nitinol surface with enhanced cell adhesion and proliferation. This study presents a novel approach to improving the performance of nitinol stents using ND-based surface modifications, providing a promising avenue for cardiovascular disease.
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Affiliation(s)
- Karlis Grundsteins
- Institute of Atomic Physics and Spectroscopy, University of Latvia, 3 Jelgavas St., LV-1004 Riga, Latvia; (K.G.); (K.D.); (V.K.); (K.J.); (U.R.)
| | - Kateryna Diedkova
- Institute of Atomic Physics and Spectroscopy, University of Latvia, 3 Jelgavas St., LV-1004 Riga, Latvia; (K.G.); (K.D.); (V.K.); (K.J.); (U.R.)
- Biomedical Research Centre, Sumy State University, 2 Rymskogo-Korsakova St., 40007 Sumy, Ukraine;
| | - Viktoriia Korniienko
- Institute of Atomic Physics and Spectroscopy, University of Latvia, 3 Jelgavas St., LV-1004 Riga, Latvia; (K.G.); (K.D.); (V.K.); (K.J.); (U.R.)
- Biomedical Research Centre, Sumy State University, 2 Rymskogo-Korsakova St., 40007 Sumy, Ukraine;
| | - Anita Stoppel
- Fraunhofer Institute for Ceramic Technologies and Systems IKTS, 01109 Dresden, Germany; (A.S.); (S.B.); (J.O.); (N.B.)
| | - Sascha Balakin
- Fraunhofer Institute for Ceramic Technologies and Systems IKTS, 01109 Dresden, Germany; (A.S.); (S.B.); (J.O.); (N.B.)
| | - Kaspars Jekabsons
- Institute of Atomic Physics and Spectroscopy, University of Latvia, 3 Jelgavas St., LV-1004 Riga, Latvia; (K.G.); (K.D.); (V.K.); (K.J.); (U.R.)
| | - Una Riekstina
- Institute of Atomic Physics and Spectroscopy, University of Latvia, 3 Jelgavas St., LV-1004 Riga, Latvia; (K.G.); (K.D.); (V.K.); (K.J.); (U.R.)
| | - Natalia Waloszczyk
- Faculty of Chemistry, Silesian University of Technology, 9 Strzody St., 44-100 Gliwice, Poland; (N.W.); (A.K.)
| | - Agata Kołkowska
- Faculty of Chemistry, Silesian University of Technology, 9 Strzody St., 44-100 Gliwice, Poland; (N.W.); (A.K.)
| | - Yuliia Varava
- Biomedical Research Centre, Sumy State University, 2 Rymskogo-Korsakova St., 40007 Sumy, Ukraine;
- Faculty of Chemistry, Silesian University of Technology, 9 Strzody St., 44-100 Gliwice, Poland; (N.W.); (A.K.)
| | - Jörg Opitz
- Fraunhofer Institute for Ceramic Technologies and Systems IKTS, 01109 Dresden, Germany; (A.S.); (S.B.); (J.O.); (N.B.)
| | - Wojciech Simka
- Faculty of Chemistry, Silesian University of Technology, 9 Strzody St., 44-100 Gliwice, Poland; (N.W.); (A.K.)
| | - Natalia Beshchasna
- Fraunhofer Institute for Ceramic Technologies and Systems IKTS, 01109 Dresden, Germany; (A.S.); (S.B.); (J.O.); (N.B.)
| | - Maksym Pogorielov
- Institute of Atomic Physics and Spectroscopy, University of Latvia, 3 Jelgavas St., LV-1004 Riga, Latvia; (K.G.); (K.D.); (V.K.); (K.J.); (U.R.)
- Biomedical Research Centre, Sumy State University, 2 Rymskogo-Korsakova St., 40007 Sumy, Ukraine;
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111
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Nadarajah R, Ludman P, Laroche C, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP. Presentation, care, and outcomes of patients with NSTEMI according to World Bank country income classification: the ACVC-EAPCI EORP NSTEMI Registry of the European Society of Cardiology. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2023; 9:552-563. [PMID: 36737420 PMCID: PMC10495699 DOI: 10.1093/ehjqcco/qcad008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 01/23/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND The majority of NSTEMI burden resides outside high-income countries (HICs). We describe presentation, care, and outcomes of NSTEMI by country income classification. METHODS AND RESULTS Prospective cohort study including 2947 patients with NSTEMI from 287 centres in 59 countries, stratified by World Bank country income classification. Quality of care was evaluated based on 12 guideline-recommended care interventions. The all-or-none scoring composite performance measure was used to define receipt of optimal care. Outcomes included in-hospital acute heart failure, stroke/transient ischaemic attack, and death, and 30-day mortality. Patients admitted with NSTEMI in low to lower-middle-income countries (LLMICs), compared with patients in HICs, were younger, more commonly diabetic, and current smokers, but with a lower burden of other comorbidities, and 76.7% met very high risk criteria for an immediate invasive strategy. Invasive coronary angiography use increased with ascending income classification (LLMICs, 79.2%; upper middle income countries [UMICs], 83.7%; HICs, 91.0%), but overall care quality did not (≥80% of eligible interventions achieved: LLMICS, 64.8%; UMICs 69.6%; HICs 55.1%). Rates of acute heart failure (LLMICS, 21.3%; UMICs, 12.1%; HICs, 6.8%; P < 0.001), stroke/transient ischaemic attack (LLMICS: 2.5%; UMICs: 1.5%; HICs: 0.9%; P = 0.04), in-hospital mortality (LLMICS, 3.6%; UMICs: 2.8%; HICs: 1.0%; P < 0.001) and 30-day mortality (LLMICs, 4.9%; UMICs, 3.9%; HICs, 1.5%; P < 0.001) exhibited an inverse economic gradient. CONCLUSION Patients with NSTEMI in LLMICs present with fewer comorbidities but a more advanced stage of acute disease, and have worse outcomes compared with HICs. A cardiovascular health narrative is needed to address this inequity across economic boundaries.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 3AA, Leeds, UK
- Leeds Institute of Data Analytics, University of Leeds, LS2 9NL, Leeds, UK
- Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Cécile Laroche
- EURObservational Research Programme, European Society of Cardiology, European Heart House, Route des Colles, Sophia Antipolis, 2035, France
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria
- Sigmund Freud University, Medical Faculty, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy
- Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Begrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 3AA, Leeds, UK
- Leeds Institute of Data Analytics, University of Leeds, LS2 9NL, Leeds, UK
- Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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112
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Muíño-Domínguez D, Gómez-Sánchez L, Gallego-Fernández V, Seoane-Pillado T, López-Álvarez XL. [Twenty-year experience in strict versus non-strict control of arterial hypertension in a health center in Spain]. Semergen 2023; 49:101999. [PMID: 37302207 DOI: 10.1016/j.semerg.2023.101999] [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: 01/23/2023] [Revised: 04/20/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023]
Abstract
INTRODUCTION AND AIMS During clinical trials effective reduction of blood pressure (BP) leads to a reduction in the incidence of cardiovascular (CV) morbimortality. Our main aim is to ascertain whether, under actual conditions of clinical practice, BP monitoring leads to a long-term reduction in CV events. PATIENTS AND METHODS The study was performed on 164 patients with hypertension (HT) selected among patients who came to family medicine consultations because of HT. An analysis was performed between patients who presented clinical BP lower than 140/90mmHg and those that had higher levels. When patients entered the study, they were followed up until a CV event occurred or up to a maximum of 20 years, at which time follow up ended. RESULTS Of the total of 164 patients, good control of BP was attained by 93 (56.7%), and 71 did not attain good control (42.2%). In the multivariate analysis, the only predictive variable for CV events was the lack of strict control of BP (HR: 2.93; 95% CI: 1.45-5.89; p=0.003), and the female sex was protective for CV events (HR: 0.37; 95% CI: 0.18-0.74; p=0.005). CONCLUSIONS The fundamental predictor variable of CV morbimortality in patients with HT is the lack of HT strict control; the women also had fewer CV complications.
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Affiliation(s)
- D Muíño-Domínguez
- Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | | | | | - T Seoane-Pillado
- Área de Medicina Preventiva y Salud Pública, Departamento de Ciencias de la Salud, Universidad de A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, España
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113
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Zamorano JL, Appleby C, Benamer H, Frankenstein L, Musumeci G, Nombela-Franco L. Improving access to transcatheter aortic valve implantation across Europe by restructuring cardiovascular services: An expert council consensus statement. Catheter Cardiovasc Interv 2023; 102:547-557. [PMID: 37431253 DOI: 10.1002/ccd.30760] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/01/2023] [Accepted: 06/28/2023] [Indexed: 07/12/2023]
Abstract
Transcatheter aortic valve implantation (TAVI) is recommended for a growing range of patients with severe aortic stenosis in the European Society of Cardiology and European Association for Cardio-Thoracic Surgery (ESC/EACTS) 2021 Guidelines update. However, guideline implementation programs are needed to ensure the application of clinical recommendations which will favorably influence disease outcomes. An Expert Council was convened to identify whether cardiology services across Europe are set up to address the growing needs of patients with severe aortic stenosis for increased access to TAVI by identifying the key challenges faced in growing TAVI programs and mapping associated solutions. Wide variation exists across Europe in terms of TAVI availability and capacity to deliver the increased demand for TAVI in different countries. The recommendations of this Expert Council focus on the short-to-medium-term aspects where the most immediate, actionable impact can be achieved. The focus on improving procedural efficiency and optimizing the patient pathway via clinical practice and patient management demonstrates how to mitigate the current major issues of shortfall in catheterization laboratory, workforce, and bed capacity. Procedural efficiencies may be achieved through steps including streamlined patient assessment, the benchmarking of standards for minimalist procedures, standardized approaches around patient monitoring and conduction issues, and the implementation of nurse specialists and dedicated TAVI coordinators to manage organization, logistics, and early mobilization. Increased collaboration with wider stakeholders within institutions will support successful TAVI uptake and improve patient and economic outcomes. Further, increased education, collaboration, and partnership between cardiology centers will facilitate sharing of expertise and best clinical practice.
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Affiliation(s)
- José Luis Zamorano
- Department of Cardiology, University Hospital Ramon y Cajal, Madrid, Spain
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114
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Westwood M, Almeida AG, Barbato E, Delgado V, Dellegrottaglie S, Fox KF, Gargani L, Huber K, Maurovich-Horvat P, Merino JL, Mindham R, Muraru D, Neubeck L, Nijveldt R, Papadakis M, Pontone G, Price S, Rosano GMC, Rossi A, Sade LE, Schulz-Menger J, Weidinger F, Achenbach S, Petersen SE. Competency-based cardiac imaging for patient-centred care. A statement of the European Society of Cardiology (ESC). With the contribution of the European Association of Cardiovascular Imaging (EACVI), and the support of the Association of Cardiovascular Nursing & Allied Professions (ACNAP), the Association for Acute CardioVascular Care (ACVC), the European Association of Preventive Cardiology (EAPC), the European Association of Percutaneous Cardiovascular Interventions (EAPCI), the European Heart Rhythm Association (EHRA), and the Heart Failure Association (HFA) of the ESC. EUROPEAN HEART JOURNAL. IMAGING METHODS AND PRACTICE 2023; 1:qyad023. [PMID: 39045068 PMCID: PMC11195717 DOI: 10.1093/ehjimp/qyad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/31/2023] [Accepted: 08/21/2023] [Indexed: 07/25/2024]
Abstract
Imaging plays an integral role in all aspects of managing heart disease and cardiac imaging is a core competency of cardiologists. The adequate delivery of cardiac imaging services requires expertise in both imaging methodology-with specific adaptations to imaging of the heart-as well as intricate knowledge of heart disease. The European Society of Cardiology (ESC) and the European Association of Cardiovascular Imaging have developed and implemented a successful education and certification programme for all cardiac imaging modalities. This programme equips cardiologists to provide high quality competency-based cardiac imaging services ensuring they are adequately trained and competent in the entire process of cardiac imaging, from the clinical indication via selecting the best imaging test to answer the clinical question, to image acquisition, analysis, interpretation, storage, repository, and results dissemination. This statement emphasizes the need for competency-based cardiac imaging delivery which is key to optimal, effective and efficient, patient care.
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Affiliation(s)
- Mark Westwood
- William Harvey Research Institute, Queen Mary University of London,Charterhouse Square, London EC1M 6BQ, United Kingdom
- Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, United Kingdom
| | - Ana G Almeida
- Heart and Vessels Department, University Hospital Santa Maria, Faculty of Medicine of Lisbon University, Lisbon, Portugal
| | - Emanuele Barbato
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Victoria Delgado
- Cardiovascular Imaging, Department of Cardiology, Hospital University Germans Trias i Pujol, Badalona, Spain
- Centre de Medicina Comparativa i Bioimatge (CMCIB), Badalona, Spain
| | | | - Kevin F Fox
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Luna Gargani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Kurt Huber
- 3rd Department of Internal Medicine, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria
- Medical School, Sigmund Freud University, Vienna, Austria
| | - Pál Maurovich-Horvat
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Jose L Merino
- Cardiology Department, La Paz University Hospital, Universidad Autonoma, IdiPaz, Madrid, Spain
| | | | - Denisa Muraru
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Lis Neubeck
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Robin Nijveldt
- Cardiology Department, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Michael Papadakis
- Cardiovascular Clinical Academic Group, St. George’s, University of London, London, United Kingdom
- St. George’s University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Gianluca Pontone
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Susanna Price
- National Heart and Lung Institute, Imperial College, London, United Kingdom
- Cardiology and Critical Care, Royal Brompton & Harefield Hospitals, Part of GSTT NHS Foundation Trust, London, United Kingdom
| | | | - Alexia Rossi
- Department of Nuclear Medicine, University hospital Zurich, Zurich, Switzerland
| | - Leyla Elif Sade
- Cardiology Department, University of Pittsburgh Medical Center, Heart and Vascular Institute, Pittsburgh, PA, USA
| | - Jeanette Schulz-Menger
- Cardiology, WG CMR, Outpatient Research Department, Charite, University Medicine Berlin, Berlin, Germany
- Cardiology Department, Helios Clinics berlin-Buch, Berlin, Germany
| | - Franz Weidinger
- 2nd Department of Medicine with Cardiology and Intensive Care Medicine Vienna Healthcare Group Clinic Landstraße, Vienna, Austria
| | - Stephan Achenbach
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Department of Cardiology, University Hospital Erlangen, Erlangen, Germany
| | - Steffen E Petersen
- William Harvey Research Institute, Queen Mary University of London,Charterhouse Square, London EC1M 6BQ, United Kingdom
- Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, United Kingdom
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115
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D'Ascenzi F, Ragazzoni GL, Boncompagni A, Cavigli L. Sports cardiology: A glorious past, a well-defined present, a bright future. Clin Cardiol 2023; 46:1015-1020. [PMID: 37503665 PMCID: PMC10540010 DOI: 10.1002/clc.24112] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/21/2023] [Accepted: 07/27/2023] [Indexed: 07/29/2023] Open
Abstract
The attention towards sports cardiology has dramatically grown after the introduction of preparticipation screening and the need for specific education on electrocardiogram interpretation in athletes, given the differences between athletes and the general population. The present article stresses the need for specific skills, knowledge, and clinical expertise in sports cardiology, which are essential for appropriately screening competitive athletes to prevent sudden cardiac death and avoid overdiagnosis. However, disqualification from sports competitions may lead to sports inactivity, and athletes may enter a gray zone where little or no information is provided about what they can or cannot do to stay active. However, modern sports cardiology cannot neglect the patient's needs and the importance of the safe practice of regular exercise. In this context, the personalized exercise prescription plays a crucial role in the core curriculum and the clinical activity of professionals involved in sports cardiology programs. Given its specificities, sports cardiology requires a formal education plan for medical school students and all residents. Additional education and practice are required for young colleagues who want to focus their professional lives on sports cardiology. The future directions of emerging modern sports cardiology should not neglect the importance of a scientific community that works together, designing multicenter international outcomes-based research to address the many remaining areas of uncertainty.
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Affiliation(s)
- Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of CardiologyUniversity of SienaSienaItaly
| | - Gian L. Ragazzoni
- Department of Medical Biotechnologies, Division of CardiologyUniversity of SienaSienaItaly
| | - Alex Boncompagni
- Department of Medical Biotechnologies, Division of CardiologyUniversity of SienaSienaItaly
| | - Luna Cavigli
- Department of Medical Biotechnologies, Division of CardiologyUniversity of SienaSienaItaly
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Timóteo AT, Mano TB. Efficacy of peritoneal dialysis in patients with refractory congestive heart failure: a systematic review and meta-analysis. Heart Fail Rev 2023; 28:1053-1063. [PMID: 36738391 PMCID: PMC10403434 DOI: 10.1007/s10741-023-10297-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 02/05/2023]
Abstract
Refractory congestive heart failure (RCHF) is a common complication in the natural history of advanced heart failure. Peritoneal dialysis (PD) is a possible alternative in those patients, but studies are scarce, and mostly with small samples. We conducted this meta-analysis to evaluate the effects of PD in patients with RCHF. Articles published before July 2020 in the following databases: PubMed, Web of Science, and CENTRAL. Mean differences (MD) and 95% confidence intervals (CIs) were computed to generate a pooled effect size with a random effects model. We also assessed heterogeneity, risk of bias, publication bias, and quality of evidence. Twenty observational studies (n = 769) were included, with a "before and after intervention" design. PD was associated with a significant reduction in NYHA functional class (MD -1.37, 95% CI -0.78 to -1.96) and length of hospitalisation (MD -34.8, 95% CI -20.6 to -48.9 days/patient/year), a small but significant increase in left ventricular ejection fraction (MD 4.3, 95%CI 1.9 to 6.8%) and a non-significant change in glomerular filtration rate (MD -3.0, 95% CI -6.0 to 0 mL/min/1.73m2). Heterogeneity among studies was significant and overall risk of bias was rated from moderate to critical. No significant publication bias was found, and the overall quality of evidence was very low for all outcomes. PD in patients with RCHF improved functional class, length of hospitalisation, and ventricular functional, and had no impact in renal function. Further randomised clinical trials are warranted to confirm our results that showed some limitations.
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Affiliation(s)
- Ana Teresa Timóteo
- Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Rua Santa Marta, 1169-025, Lisbon, Portugal.
- NOVA Medical School, Lisbon, Portugal.
| | - Tânia Branco Mano
- Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Rua Santa Marta, 1169-025, Lisbon, Portugal
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Yao X, Zhong S, Xu M, Zhang G, Yuan Y, Shuai T, Li Z. Deep learning-based motion correction algorithm for coronary CT angiography: Lowering the phase requirement for morphological and functional evaluation. J Appl Clin Med Phys 2023; 24:e14104. [PMID: 37485892 PMCID: PMC10476979 DOI: 10.1002/acm2.14104] [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: 03/13/2023] [Revised: 06/27/2023] [Accepted: 07/08/2023] [Indexed: 07/25/2023] Open
Abstract
PURPOSE To investigate the performance of a deep learning-based motion correction algorithm (MCA) at various cardiac phases of coronary computed tomography angiography (CCTA), and determine the extent to which it may allow for reliable morphological and functional evaluation. MATERIALS AND METHODS The acquired image data of 53 CCTA cases, where the patient heart rate (HR) was ≥75 bpm, were reconstructed at 0, ±2, ±4, ±6, and ±8% deviations from each optimal systolic phase, with and without the MCA, yielding a total of 954 images (53 cases × 9 phases × 2 reconstructions). The overall image quality and diagnostic confidence were graded by two radiologists using a 5-point scale, with scores ≥3 being deemed clinically interpretable. Signal-to-noise ratio, contrast-to-noise ratio, vessel sharpness, and circularity were measured. The CCTA-derived fractional flow reserve (CT-FFR) was calculated in 38 vessels on 24 patients to identify functionally significant stenosis, using the invasive fractional flow reserve (FFR) as reference. All metrics were compared between two reconstructions at various phases. RESULTS Inferior image quality was observed as the phase deviation was enlarged. However, MCA significantly improved the image quality at nonoptimal phases and the optimal phase. Coronary artery evaluation was feasible within 4% phase deviation using MCA, with interpretable overall image quality and high diagnostic confidence. With MCA, the performance of identifying functionally significant stenosis via CT-FFR was increased for images at various phase deviations. However, obvious decrease in accuracy, as compared to the image at the optimal phase, was found on those with deviations >4%. CONCLUSION The deep learning-based MCA allows up to 4% phase deviation in acquiring CCTA for reliable morphological and functional evaluation on patients with high HRs.
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Affiliation(s)
- Xiaoling Yao
- Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
| | | | - Maolan Xu
- Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
| | | | - Yuan Yuan
- Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Tao Shuai
- Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Zhenlin Li
- Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
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Michaeli DT, Michaeli JC, Albers S, Boch T, Michaeli T. Established and Emerging Lipid-Lowering Drugs for Primary and Secondary Cardiovascular Prevention. Am J Cardiovasc Drugs 2023; 23:477-495. [PMID: 37486464 PMCID: PMC10462544 DOI: 10.1007/s40256-023-00594-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/02/2023] [Indexed: 07/25/2023]
Abstract
Despite treatment with statins, patients with elevated low-density lipoprotein cholesterol (LDL-C) and triglycerides remain at increased risk for adverse cardiovascular events. Consequently, novel pharmaceutical drugs have been developed to control and modify the composition of blood lipids to ultimately prevent fatal cardiovascular events in patients with dyslipidaemia. This article reviews established and emerging lipid-lowering drugs regarding their mechanism of action, development stage, ongoing clinical trials, side effects, effect on blood lipids and reduction in cardiovascular morbidity and mortality. We conducted a keyword search to identify studies on established and emerging lipid modifying drugs. Results were summarized in a narrative overview. Established pharmaceutical treatment options include the Niemann-Pick-C1 like-1 protein (NPC1L1) inhibitor ezetimibe, the protein convertase subtilisin-kexin type 9 (PCSK9) inhibitors alirocumab and evolocumab, fibrates as peroxisome proliferator receptor alpha (PPAR-α) activators, and the omega-3 fatty acid icosapent ethyl. Statins are recommended as the first-line therapy for primary and secondary cardiovascular prevention in patients with hypercholesterinaemia and hypertriglyceridemia. For secondary prevention in hypercholesterinaemia, second-line options such as statin add-on or statin-intolerant treatments are ezetimibe, alirocumab and evolocumab. For secondary prevention in hypertriglyceridemia, second-line options such as statin add-on or statin-intolerant treatments are icosapent ethyl and fenofibrate. Robust data for these add-on therapeutics in primary cardiovascular prevention remains scarce. Recent biotechnological advances have led to the development of innovative small molecules (bempedoic acid, lomitapide, pemafibrate, docosapentaenoic and eicosapentaenoic acid), antibodies (evinacumab), antisense oligonucleotides (mipomersen, volanesorsen, pelcarsen, olezarsen), small interfering RNA (inclisiran, olpasiran), and gene therapies for patients with dyslipidemia. These molecules specifically target new cellular pathways, such as the adenosine triphosphate-citrate lyase (bempedoic acid), PCSK9 (inclisiran), angiopoietin-like 3 (ANGPTL3: evinacumab), microsomal triglyceride transfer protein (MTP: lomitapide), apolipoprotein B-100 (ApoB-100: mipomersen), apolipoprotein C-III (ApoC-III: volanesorsen, olezarsen), and lipoprotein (a) (Lp(a): pelcarsen, olpasiran). The authors are hopeful that the development of new treatment modalities alongside new therapeutic targets will further reduce patients' risk of adverse cardiovascular events. Apart from statins, data on new drugs' use in primary cardiovascular prevention remain scarce. For their swift adoption into clinical routine, these treatments must demonstrate safety and efficacy as well as cost-effectiveness in randomized cardiovascular outcome trials.
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Affiliation(s)
- Daniel Tobias Michaeli
- Department of Medical Oncology, National Center for Tumour Diseases, Heidelberg University Hospital, Heidelberg, Germany.
| | - Julia Caroline Michaeli
- Department of Obstetrics and Gynaecology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sebastian Albers
- Department of Orthopaedics and Sport Orthopaedics, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Tobias Boch
- Department of Medical Oncology, National Center for Tumour Diseases, Heidelberg University Hospital, Heidelberg, Germany
- DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany
- Division of Personalized Medical Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Personalized Oncology, University Hospital Mannheim, Heidelberg University, Heidelberg, Germany
| | - Thomas Michaeli
- Department of Medical Oncology, National Center for Tumour Diseases, Heidelberg University Hospital, Heidelberg, Germany
- DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany
- Division of Personalized Medical Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Personalized Oncology, University Hospital Mannheim, Heidelberg University, Heidelberg, Germany
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van der Ploeg MA, Poortvliet RKE, Bogaerts JMK, van der Klei VMGTH, Kerse N, Rolleston A, Teh R, Robinson L, Jagger C, Arai Y, Shikimoto R, Abe Y, Blom JW, Drewes YM, Gussekloo J. The Role of a Composite Fitness Score in the Association Between Low-Density Cholesterol and All-Cause Mortality in Older Adults: An Individual Patient Data Meta-Analysis. J Gerontol A Biol Sci Med Sci 2023; 78:1708-1716. [PMID: 37314150 PMCID: PMC10460558 DOI: 10.1093/gerona/glad148] [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: 12/31/2022] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND In the general population, an increase in low-density lipoprotein cholesterol (LDL-C) predicts higher cardiovascular disease risk, and lowering LDL-C can prevent cardiovascular disease and reduces mortality risk. Interestingly, in cohort studies that include very old populations, no or inverse associations between LDL-C and mortality have been observed. This study aims to investigate whether the association between LDL-C and mortality in the very old is modified by a composite fitness score. METHODS A 2-stage meta-analysis of individual participant data from the 5 observational cohort studies. The composite fitness score was operationalized by performance on a combination of 4 markers: functional ability, cognitive function, grip strength, and morbidity. We pooled hazard ratios (HR) from Cox proportional-hazards models for 5-year mortality risk for a 1 mmol/L increase in LDL-C. Models were stratified by high/low composite fitness score. RESULTS Composite fitness scores were calculated for 2 317 participants (median 85 years, 60% females participants), of which 994 (42.9%) had a high composite fitness score, and 694 (30.0%) had a low-composite fitness score. There was an inverse association between LDL-C and 5-year mortality risk (HR 0.87 [95% CI: 0.80-0.94]; p < .01), most pronounced in participants with a low-composite fitness score (HR 0.85 [95% CI: 0.75-0.96]; p = .01), compared to those with a high composite fitness score (HR = 0.98 [95% CI: 0.83-1.15]; p = .78), the test for subgroups differences was not significant. CONCLUSIONS In this very old population, there was an inverse association between LDL-C and all-cause mortality, which was most pronounced in participants with a low-composite fitness scores.
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Affiliation(s)
- Milly A van der Ploeg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Rosalinde K E Poortvliet
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Jonathan M K Bogaerts
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Veerle M G T H van der Klei
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Ngaire Kerse
- School of Population Health, University of Auckland, Auckland, New Zealand
| | | | - Ruth Teh
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Carol Jagger
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Ryo Shikimoto
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Yukiko Abe
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Jeanet W Blom
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Yvonne M Drewes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Jacobijn Gussekloo
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
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120
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Liao YM, Chiu PY, Chien YS, Chen CF. Music Box-Inspired Semi-Automatic Hematocrit Validation Device. ACS Sens 2023; 8:2952-2959. [PMID: 37418365 DOI: 10.1021/acssensors.3c00129] [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: 07/09/2023]
Abstract
A high hematocrit (HCT) level is strongly associated with the risk of cardiovascular disease. For early diagnosis of cardiovascular disease, it is vital to regularly measure the HCT, which is typically achieved by centrifuging a blood sample to measure the percentage of red blood cells. However, the centrifugal modalities are usually bulky, expensive, and require a stable electric input, which restrict the availability. This research develops a semi-automatic and portable centrifugal device for HCT measurement. This torque-actuated semi-automatic centrifuge, which we call the tFuge, is inspired by a music box, allowing different operators to generate the same rhythm. It is electricity-free and can be controlled based on a constant torque mechanism. Repeatable test results can be received from among different users regardless of their age, sex, and activity. With the assistance of the Boycott effect on the tFuge, we proved that the HCT level is in high linearity to the length of the sedimentation of the blood cells in a tube (R2 = 0.99, sample HCT range 10-60%). The tFuge takes less than 4 min and requires no more than 10 μL of blood that can be obtained by a less-invasive finger prick to complete the testing procedure. Calibrated gradient numbers are printed onto the rotation disc for instant HCT results that can be read by the naked eye. We expect this proposed point-of-care testing device possesses the potential to replace the microhematocrit centrifuge in the regions with limited resources.
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Affiliation(s)
- You-Mao Liao
- Institute of Applied Mechanics, National Taiwan University, Taipei 106, Taiwan
| | - Ping-Yeh Chiu
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 333, Taiwan
| | - Yuh-Shiuan Chien
- Institute of Applied Mechanics, National Taiwan University, Taipei 106, Taiwan
| | - Chien-Fu Chen
- Institute of Applied Mechanics, National Taiwan University, Taipei 106, Taiwan
- Graduate School of Advanced Technology, National Taiwan University, Taipei 106, Taiwan
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121
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Wang M, Gong K, Zhu X, Chen S, Zhou J, Zhang H, Han J, Ma L, Duan Y. Identification of circulating T-cell immunoglobulin and mucin domain 4 as a potential biomarker for coronary heart disease. MedComm (Beijing) 2023; 4:e320. [PMID: 37426678 PMCID: PMC10329472 DOI: 10.1002/mco2.320] [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: 12/09/2022] [Revised: 05/27/2023] [Accepted: 06/01/2023] [Indexed: 07/11/2023] Open
Abstract
Efferocytosis, the process of engulfing and removing apoptotic cells, is attenuated in vulnerable plaques of advanced atherosclerosis. T-cell immunoglobulin and mucin domain 4 (TIMD4) is a recognition receptor protein for efferocytosis that has been implicated in atherosclerosis mouse models. However, the role of serum-soluble TIMD4 (sTIMD4) in coronary heart disease (CHD) remains unknown. In this study, we analyzed serum samples collected from two groups: Group 1 (36 healthy controls and 70 CHD patients) and Group 2 (44 chronic coronary syndrome [CCS]) and 81 acute coronary syndrome [ACS] patients). We found that sTIMD4 levels in patients with CHD were significantly higher than those in healthy controls and were also higher in ACS than in CCS patients. The area under the receiver operating characteristic curve was 0.787. Furthermore, our in vitro results showed that low-density lipoprotein/lipopolysaccharide activated p38 mitogen-activated protein kinase, which in turn enhanced a disintegrin and metalloproteinase 17, resulting in increased secretion of sTIMD4. This impairment of macrophage efferocytosis promoted inflammation. Thus, this study is not only the first identification of a potential novel biomarker of CHD, sTIMD4, but also demonstrated its pathogenesis mechanism, providing a new direction for the diagnosis and treatment of CHD.
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Affiliation(s)
- Mengyao Wang
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological EngineeringHefei University of TechnologyHefeiChina
| | - Ke Gong
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological EngineeringHefei University of TechnologyHefeiChina
| | - Xinran Zhu
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological EngineeringHefei University of TechnologyHefeiChina
| | - Shasha Chen
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological EngineeringHefei University of TechnologyHefeiChina
| | - Jie Zhou
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological EngineeringHefei University of TechnologyHefeiChina
| | - Hui Zhang
- Department of CardiologyThe First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiChina
| | - Jihong Han
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological EngineeringHefei University of TechnologyHefeiChina
- Key Laboratory of Bioactive Materials of Ministry of EducationCollege of Life SciencesState Key Laboratory of Medicinal Chemical BiologyNankai UniversityTianjinChina
| | - Likun Ma
- Department of CardiologyThe First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiChina
| | - Yajun Duan
- Department of CardiologyThe First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiChina
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Katsi V, Papakonstantinou I, Tsioufis K. Atherosclerosis, Diabetes Mellitus, and Cancer: Common Epidemiology, Shared Mechanisms, and Future Management. Int J Mol Sci 2023; 24:11786. [PMID: 37511551 PMCID: PMC10381022 DOI: 10.3390/ijms241411786] [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: 06/12/2023] [Revised: 07/03/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
The involvement of cardiovascular disease in cancer onset and development represents a contemporary interest in basic science. It has been recognized, from the most recent research, that metabolic syndrome-related conditions, ranging from atherosclerosis to diabetes, elicit many pathways regulating lipid metabolism and lipid signaling that are also linked to the same framework of multiple potential mechanisms for inducing cancer. Otherwise, dyslipidemia and endothelial cell dysfunction in atherosclerosis may present common or even interdependent changes, similar to oncogenic molecules elevated in many forms of cancer. However, whether endothelial cell dysfunction in atherosclerotic disease provides signals that promote the pre-clinical onset and proliferation of malignant cells is an issue that requires further understanding, even though more questions are presented with every answer. Here, we highlight the molecular mechanisms that point to a causal link between lipid metabolism and glucose homeostasis in metabolic syndrome-related atherosclerotic disease with the development of cancer. The knowledge of these breakthrough mechanisms may pave the way for the application of new therapeutic targets and for implementing interventions in clinical practice.
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Affiliation(s)
- Vasiliki Katsi
- Department of Cardiology, Hippokration Hospital, 11527 Athens, Greece
| | | | - Konstantinos Tsioufis
- Department of Cardiology, Hippokration Hospital, 11527 Athens, Greece
- School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Molenaar MA, Bouma BJ, Coerkamp CF, Man JP, Išgum I, Verouden NJ, Selder JL, Chamuleau SAJ, Schuuring MJ. The impact of valvular heart disease in patients with chronic coronary syndrome. Front Cardiovasc Med 2023; 10:1211322. [PMID: 37547247 PMCID: PMC10401435 DOI: 10.3389/fcvm.2023.1211322] [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: 04/24/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Background The European Society of Cardiology 2019 Guidelines on chronic coronary syndrome (CCS) recommend echocardiographic measurement of the left ventricular function for risk stratification in all patients with CCS. Whereas CCS and valvular heart disease (VHD) share common pathophysiological pathways and risk factors, data on the impact of VHD in CCS patients are scarce. Methods Clinical data including treatment and mortality of patients diagnosed with CCS who underwent comprehensive transthoracic echocardiography (TTE) in two tertiary centers were collected. The outcome was all-cause mortality. Data were analyzed with Kaplan-Meier curves and Cox proportional hazard analysis adjusting for significant covariables and time-dependent treatment. Results Between 2014 and 2021 a total of 1,984 patients with CCS (59% men) with a median age of 65 years (interquartile range [IQR] 57-73) underwent comprehensive TTE. Severe VHD was present in 44 patients and moderate VHD in 325 patients. A total of 654 patients (33%) were treated with revascularization, 39 patients (2%) received valve repair or replacement and 299 patients (15%) died during the median follow-up time of 3.5 years (IQR 1.7-5.6). Moderate or severe VHD (hazard ratio = 1.33; 95% CI 1.02-1.72) was significantly associated with mortality risk, independent of LV function and other covariables, as compared to no/mild VHD. Conclusions VHD has a significant impact on mortality in patients with CCS additional to LV dysfunction, which emphasizes the need for a comprehensive echocardiographic assessment in these patients.
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Affiliation(s)
- Mitchel A. Molenaar
- Department of Cardiology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam UMC, Amsterdam, Netherlands
| | - Berto J. Bouma
- Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam UMC, Amsterdam, Netherlands
| | - Casper F. Coerkamp
- Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam UMC, Amsterdam, Netherlands
| | - Jelle P. Man
- Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam UMC, Amsterdam, Netherlands
| | - Ivana Išgum
- Amsterdam Cardiovascular Sciences, Amsterdam UMC, Amsterdam, Netherlands
- Department of Biomedical Engineering and Physics, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
| | - Niels J. Verouden
- Department of Cardiology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam UMC, Amsterdam, Netherlands
| | - Jasper L. Selder
- Department of Cardiology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam UMC, Amsterdam, Netherlands
| | - Steven A. J. Chamuleau
- Department of Cardiology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam UMC, Amsterdam, Netherlands
| | - Mark J. Schuuring
- Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Cardiovascular Sciences, Amsterdam UMC, Amsterdam, Netherlands
- Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
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Gorbachev V, Nikitin I, Velina D, Zhuchenko N, Kosenkov AN, Sokolov A, Zavalishin I, Stolyarova A, Nikulchev E. The Impact of Social Well-Being on Population Diet Nutritional Value and Antiradical Status. Foods 2023; 12:2619. [PMID: 37444358 DOI: 10.3390/foods12132619] [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: 06/05/2023] [Revised: 06/29/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
The paper presents the result of assessing the antiradical status of consumers (in the context of Russia) in connection with their well-being. This approach is based on a multistage study, in which the results of sociological surveys were applied, as well as estimates of the antiradical potential (ARP) of diets obtained using neural networks, bootstrapping the chemical composition of diets, and calculating reference values using mathematical models. The paper presents data collected from residents living in the territories of at least 21 regions and cities of Russia: Magadan, Saint Petersburg, Moscow, Krasnodar, Lipetsk, Vladivostok, Novosibirsk, Omsk, Voronezh, etc. A total of 1001 people were interviewed, which, according to our calculations, gives a margin of error in value of approximately 3.1%. To calculate the lack of vitamins in the diets of residents of the Russian Federation, data on the chemical composition of food products from the FNDDS database were used. The assessment of dietary habits showed a lack of vitamins below the recommended level in 73% of Russians for vitamin D, 59% for retinol, 38% for β-carotenes, 13% for vitamin E, and 6% for ascorbic acid. The study showed that at least 36% of the Russian population has a low antiradical status, while it was found that "poor" consumers are more likely to consume economically more expensive foods (in terms of their nutritional value). The "poor" segments of the population consume 180-305% more canned food and 38-68% more sweet carbonated drinks than other social groups, but their consumption of vegetables is 23-48% lower. On the contrary, "wealthy" consumers consume 17-25% more complex (varied) dishes, 10-68% more fresh vegetables, and 8-39% more fish. From the obtained values it follows that consumers with low levels of ARP in their diets are in a group with an increased probability of a number of "excess" diseases (diseases of the cardiovascular system, obesity, etc.). In general, the ARP values of food consumed for low-income segments of the population were 2.3 times lower (the ratio was calculated as the percentage of consumers below the level of 11,067 equivalents necessary for the disposal of free radicals generated in the human body per day) than for those who can afford expensive food (consumers with high income). A simple increase in consumption of unbalanced foods, in our opinion, will only contribute to the entry of these consumers into the "average diet trap". All this makes it imperative to develop comprehensive measures to create a new concept of public catering; otherwise, we can expect a reduction in both the health of the population and the performance of the economy of the whole country.
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Affiliation(s)
- Victor Gorbachev
- Research Laboratory of Nutritional Systems Biotechnology, The Plekhanov Russian University of Economics, 36 Stremyanny Per., 117997 Moscow, Russia
| | - Igor Nikitin
- Research Laboratory of Nutritional Systems Biotechnology, The Plekhanov Russian University of Economics, 36 Stremyanny Per., 117997 Moscow, Russia
- Department of Biotechnology of Food Products from Plant and Animal Raw Materials, K.G. Razumovsky Moscow State University of Technologies and Management (the First Cossack University), 73 Zemlyanoy Val, 109004 Moscow, Russia
| | - Daria Velina
- Research Laboratory of Nutritional Systems Biotechnology, The Plekhanov Russian University of Economics, 36 Stremyanny Per., 117997 Moscow, Russia
- Department of Biotechnology of Food Products from Plant and Animal Raw Materials, K.G. Razumovsky Moscow State University of Technologies and Management (the First Cossack University), 73 Zemlyanoy Val, 109004 Moscow, Russia
| | - Natalia Zhuchenko
- Department of Medical Genetics, I.M. Sechenov First Moscow State Medical University, 8-2 Trubetskaya Str., 119435 Moscow, Russia
| | - Alexander N Kosenkov
- Department of Hospital Surgery, I.M. Sechenov First Moscow State Medical University, 8-2 Trubetskaya Str., 119435 Moscow, Russia
| | - Andrey Sokolov
- Mental-Health Clinic No. 1 Named after N.A. Alexeev, 2 Zagorodnoe Shosse, 117152 Moscow, Russia
| | - Igor Zavalishin
- Higher School of Public Administration, Financial University under the Government of the Russian Federation, 49 Leningradsky Prospekt, 125167 Moscow, Russia
| | - Alla Stolyarova
- Department of Management and Economics, State University of Humanities and Social Studies, 30 St. Zelenaya, 140400 Kolomna, Russia
| | - Evgeny Nikulchev
- Department of Digital Data Processing Technologies, MIREA-Russian Technological University, 78 Vernadsky Avenue, 119454 Moscow, Russia
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Puche JE, Iturregui-Guevara M, Vázquez R. [Prognostic impact of cardiovascular risk factors in patients admitted for acute coronary syndrome]. HIPERTENSION Y RIESGO VASCULAR 2023; 40:110-118. [PMID: 36273980 DOI: 10.1016/j.hipert.2022.09.004] [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: 04/03/2022] [Revised: 07/27/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION AND OBJECTIVES Cardiovascular prevention measures place the emphasis on controlling cardiovascular risk factors (CVRF). However, the most recent studies provide disappointing data, the impact of which remains to be determined. The objective of this study was to analyse the impact that the different CVRFs, and their degree of control, have on the prognosis of patients after acute coronary syndrome. PATIENTS AND METHODS Epidemiological, pharmacological, and CVRF control data were collected from 1,689 consecutive patients admitted from 2018 to 2020 for acute coronary syndrome to a tertiary hospital. Finally, the rate of major adverse cardiovascular events was calculated. RESULTS The patients admitted for acute coronary syndrome were predominantly men, with body mass index>25Kg/m2, smokers (or former smokers) and with poor CVRF control (50% for hypertension and diabetes and 35% for dyslipidaemia), especially those patients with a personal history of ischaemic heart disease. An underutilisation of useful drugs for CVRF control was found. A directly proportional relationship was observed between the number of CVRFs (or their poor control) and the incidence of major adverse cardiovascular events at 2 years, hypertension being the factor with the greatest cardiovascular impact. The SARS-CoV-2 lockdown worsened the degree of CVRF control and cardiovascular prognosis. CONCLUSION There is still room for improvement in the control of CVRF, which would translate into a prognostic benefit for patients with ischaemic heart disease. The implementation of cardiovascular prevention campaigns seems essential.
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Affiliation(s)
- J E Puche
- Servicio de Cardiología, Hospital Universitario Puerta del Mar, Cádiz, España; Servicio de Cardiología, Hospital Costa del Sol, Marbella, España.
| | - M Iturregui-Guevara
- Servicio de Endocrinología, Hospital Universitario de Jerez de la Frontera, Jerez de la Frontera, España
| | - R Vázquez
- Servicio de Cardiología, Hospital Universitario Puerta del Mar, Cádiz, España
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Dahl M, Lindholt J, Søgaard R, Refsgaard J, Svenstrup D, Moeslund NJ, Bredsgaard M, Høgh A. Relevance of the Viborg Population Based Screening Programme (VISP) for Cardiovascular Conditions Among 67 Year Olds: Attendance Rate, Prevalence, and Proportion of Initiated Cardiovascular Medicines Stratified By Sex. Eur J Vasc Endovasc Surg 2023; 66:119-129. [PMID: 36931553 DOI: 10.1016/j.ejvs.2023.03.014] [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: 07/07/2022] [Revised: 02/08/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023]
Abstract
OBJECTIVE To report sex specific overall attendance rate, prevalence of screen detected cardiovascular conditions, proportion of unknown conditions before screening, and proportion initiating prophylactic medicine among 67 year olds in Denmark. DESIGN Cross sectional cohort study. METHODS Since 2014, all 67 year olds in Viborg, Denmark, have been invited to screening for abdominal aortic aneurysm (AAA), peripheral arterial disease (PAD), carotid plaque (CP), hypertension, cardiac disease, and type 2 diabetes. Individuals with AAA, PAD, and or CP are recommended cardiovascular prophylaxis. Combining data with registries has facilitated estimation of unknown screen detected conditions. Up to August 2019, 5 505 had been invited; registry data were available for the first 4 826 who were invited. RESULTS The attendance rate was 83.7%, without sex difference. Screen detected prevalence was significantly lower among women than men: AAA, 5 (0.3%) vs. 38 (1.9%) (p < .001); PAD, 90 (4.5%) vs. 134 (6.6%) (p = .011); CP, 641 (31.8%) vs. 907 (44.8%) (p < .001); arrhythmia, 26 (1.4%) vs. 77 (4.2%) (p < .001); blood pressure ≥ 160/100 mmHg, 277 (13.8%) vs. 346 (17.1%) (p = .004); and HbA1c ≥ 48 mmol/mol, 155 (7.7%) vs. 198 (9.8%) (p = .019), respectively. Pre-screening proportions of unknown conditions were particularly high for AAA (95.4%) and PAD (87.5%). AAA, PAD, and or CP were found in 1 623 (40.2%), of whom 470 (29.0%) received pre-screening antiplatelets and 743 (45.8%) lipid lowering therapy. Furthermore, 413 (25.5%) started antiplatelet therapy and 347 (21.4%) started lipid lowering therapy. Only smoking was significantly associated with all vascular conditions in multivariable analysis: odds ratios (ORs) for current smoking were AAA 8.11 (95% CI 2.27 - 28.97), PAD 5.60 (95% CI 3.61 - 8.67) and CP 3.64 (95% CI 2.95 - 4.47). CONCLUSION The attendance rate signals public acceptability for attending cardiovascular screening. Men had more screen detected conditions than women, but prophylactic medicine was started equally frequently in both sexes. Sex specific cost effectiveness follow up is warranted.
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Affiliation(s)
- Marie Dahl
- Vascular Research Unit, Department of Vascular Surgery, Viborg Regional Hospital, Viborg, Denmark; Department of Clinical Medicine, Aarhus University, Denmark; Research Unit of Cardiac, Thoracic, and Vascular Surgery, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Denmark.
| | - Jes Lindholt
- Vascular Research Unit, Department of Vascular Surgery, Viborg Regional Hospital, Viborg, Denmark; Research Unit of Cardiac, Thoracic, and Vascular Surgery, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Denmark; Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark; Elitary Research Centre CIMA, Odense University Hospital, Odense, Denmark
| | - Rikke Søgaard
- Department of Public Health, Aarhus University, Denmark; Department of Clinical Medicine, University of Southern Denmark, Denmark
| | - Jens Refsgaard
- Department of Cardiology, Viborg Regional Hospital, Viborg, Denmark
| | - Dorthe Svenstrup
- Department of Cardiology, Viborg Regional Hospital, Viborg, Denmark
| | | | | | - Annette Høgh
- Vascular Research Unit, Department of Vascular Surgery, Viborg Regional Hospital, Viborg, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
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Nahak S, Saha G. Ensembled Feature based Multi-Label ECG Arrhythmia Classification. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083668 DOI: 10.1109/embc40787.2023.10340005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Arrhythmia is one of the major contributors to sudden cardiac death. Compared to single-label arrhythmia classification, multi-label classification provides the advantage of simultaneous detection of different cardiac ailments. Existing multi-label approaches employ deep learning models, which have several limitations, e.g., data dependency, overfitting, complexity, and lack of interpretability. In this work, we propose a multi-label classification framework with ensembled hand-crafted features added with label powerset, which better preserves the correlation between classes. Experimentation with CPSC 2018 database shows that the proposed model provides accuracy and F1-score of 88.52% and 88.45% for single-label data and 88.11% and 86.32% for multi-label data, respectively. The proposed method improves individual class performance for some important diseases compared to the existing multi-label state-of-the-art methods.Clinical relevance- Early detection of life-threatening multi-label ECG patterns consisting of atrial fibrillation, atrioventricular block, and right bundle branch block with high accuracy can reduce the sudden cardiac death rate.
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128
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Maris L, Ghitea TC. Can Cardiometabolic Risk Be Reduced in the Elderly? Comprehensive Epidemiological Study. Geriatrics (Basel) 2023; 8:73. [PMID: 37489321 PMCID: PMC10366737 DOI: 10.3390/geriatrics8040073] [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: 05/27/2023] [Revised: 06/16/2023] [Accepted: 06/26/2023] [Indexed: 07/26/2023] Open
Abstract
Through these epidemiological studies, which are based on statistical and observational calculations, without visual appeal, we tracked the incidence of public health problems. In this study, our research objective was to determine and evaluate the health patterns present in a population, along with identifying the factors that contribute to the risks or provide protection against specific diseases or conditions. The progression of cardiometabolic diseases is closely linked to various chronic conditions, such as diabetes, hypertension, dyslipidemia, and chronic kidney disease. This research study involved 578 patients, who were divided into six-year cohorts ranging from 2017 to 2022. The study examined parameters related to cardiometabolic diseases, including alcoholic hepatopathies, non-alcoholic hepatopathy, chronic kidney disease, hypertension, myocardial infarction, other forms of chronic coronary syndrome, peripheral vascular disease, microvascular diseases, macrovascular diseases, and hypercholesterolemia, while considering age and physical activity levels. The study concluded that individuals in the age group of 41-50 years exhibited the highest propensity for cardiometabolic damage. Additionally, the promotion of a healthy and active lifestyle is increasingly gaining traction among elderly patients.
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Affiliation(s)
- Lavinia Maris
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania
| | - Timea Claudia Ghitea
- Faculty of Medicine and Pharmacy, Medicine Department, University of Oradea, 410068 Oradea, Romania
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129
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Arata A, Ricci F, Khanji MY, Mantini C, Angeli F, Aquilani R, Di Baldassarre A, Renda G, Mattioli AV, Nodari S, Gallina S. Sex Differences in Heart Failure: What Do We Know? J Cardiovasc Dev Dis 2023; 10:277. [PMID: 37504533 PMCID: PMC10380698 DOI: 10.3390/jcdd10070277] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/29/2023] Open
Abstract
Heart failure (HF) remains an important global health issue, substantially contributing to morbidity and mortality. According to epidemiological studies, men and women face nearly equivalent lifetime risks for HF. However, their experiences diverge significantly when it comes to HF subtypes: men tend to develop HF with reduced ejection fraction more frequently, whereas women are predominantly affected by HF with preserved ejection fraction. This divergence underlines the presence of numerous sex-based disparities across various facets of HF, encompassing aspects such as risk factors, clinical presentation, underlying pathophysiology, and response to therapy. Despite these apparent discrepancies, our understanding of them is far from complete, with key knowledge gaps still existing. Current guidelines from various professional societies acknowledge the existence of sex-based differences in HF management, yet they are lacking in providing explicit, actionable recommendations tailored to these differences. In this comprehensive review, we delve deeper into these sex-specific differences within the context of HF, critically examining associated definitions, risk factors, and therapeutic strategies. We provide a specific emphasis on aspects exclusive to women, such as the impact of pregnancy-induced hypertension and premature menopause, as these unique factors warrant greater attention in the broader HF discussion. Additionally, we aim to clarify ongoing controversies and knowledge gaps pertaining to the pharmacological treatment of HF and the sex-specific indications for cardiac implantable electronic devices. By shining a light on these issues, we hope to stimulate a more nuanced understanding and promote the development of more sex-responsive approaches in HF management.
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Affiliation(s)
- Allegra Arata
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London, Charterhouse Square, London EC1M 6BQ, UK
- Department of Clinical Sciences, Lund University, 214 28 Malmö, Sweden
| | - Mohammed Y Khanji
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London, Charterhouse Square, London EC1M 6BQ, UK
| | - Cesare Mantini
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
| | - Francesco Angeli
- Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33-40126 Bologna, Italy
| | - Roberta Aquilani
- Cardiac Surgery Intensive Care Unit, Heart Department, SS Annunziata University Hospital, Via dei Vestini 5, 66100 Chieti, Italy
| | - Angela Di Baldassarre
- Department of Medicine and Aging Sciences, and Reprogramming and Cell Differentiation Lab, Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
| | - Giulia Renda
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
| | - Anna Vittoria Mattioli
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Savina Nodari
- Department of Cardiology, University of Brescia and ASST "Spedali Civili" Hospital, 25123 Brescia, Italy
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
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Iwański M, Sokołowska A, Wańczura P, Filipowska J, Styczkiewicz K. A COVID-19 Diagnosis Like an Avalanche Triggers a Series of Adverse Events but Saves a Life in the End. Healthcare (Basel) 2023; 11:1847. [PMID: 37444681 PMCID: PMC10340565 DOI: 10.3390/healthcare11131847] [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: 05/19/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Patients diagnosed with cancer are less frequently covered by preventive measures for cardiovascular diseases. The frequent co-occurrence of these diseases makes it necessary to apply parallel diagnostics and cardiological treatment with anti-cancer therapy. Frequently. multidisciplinary team discussions are needed. Case report: We present a case of a 73-year-old former smoker with hyperlipidemia, type 2 diabetes, and arterial hypertension, after a partial right nephrectomy in 2005 due to kidney cancer, diagnosed with SARS-CoV-2 infection in April 2022. Subsequent chest imaging showed a 20 mm focal lesion in the left lung further classified as a small-cell neuroendocrine carcinoma. Unexpectedly, the patient was hospitalized due to ST-segment elevation inferior left ventricular (LV) myocardial infarction. It was treated successfully with percutaneous coronary angioplasty (PCI) of the circumflex and first marginal artery with drug-eluting stent (DES) implantation. One day later, PCI of the left anterior artery was performed with two DES implantation; however, heart failure (HF) with a reduced left ventricle ejection fraction of 30% was diagnosed. One month later, the patient required hospitalization again due to HF decompensation, and cardiological treatment was optimized with flozin in addition to standard HF therapy. Subsequently, after cardiological approval the patient qualified for chemotherapy with the cisplatin-etoposide regimen. Therapy was continued for 6 months without HF decompensation and significant deterioration in renal function. After that, the patient underwent radical radiotherapy. Follow-up chest computed tomography scans showed regression of the neoplastic lesion. Conclusions: The coincidence of newly recognized cancer and inflammatory disease might contribute to and provoke serious cardiological events. To reduce the risk of cardiovascular complications, periodic cardiological surveillance and optimal pharmacotherapy are required.
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Affiliation(s)
- Mateusz Iwański
- College for Medical Sciences, University of Rzeszow, 35-315 Rzeszow, Poland
| | - Aldona Sokołowska
- College for Medical Sciences, University of Rzeszow, 35-315 Rzeszow, Poland
| | - Piotr Wańczura
- Department of Cardiology, The Ministry of Internal Affairs and Administration Hospital, 35-111 Rzeszow, Poland
| | - Justyna Filipowska
- Subcarpathian Oncological Center, University Clinical Hospital of Frederic Chopin, 35-055 Rzeszow, Poland
| | - Katarzyna Styczkiewicz
- College for Medical Sciences, University of Rzeszow, 35-315 Rzeszow, Poland
- Subcarpathian Oncological Center, University Clinical Hospital of Frederic Chopin, 35-055 Rzeszow, Poland
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131
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González-Domínguez A, Durán A, Hidalgo-Vega Á, Barrios V. Cost-effectiveness of the CNIC-Polypill versus separate monocomponents in cardiovascular secondary prevention in Spain. Rev Clin Esp 2023:S2254-8874(23)00077-2. [PMID: 37352973 DOI: 10.1016/j.rceng.2023.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/02/2023] [Indexed: 06/25/2023]
Abstract
INTRODUCTION AND OBJECTIVES Despite advances in treatment, cardiovascular disease is the second leading cause of death in Spain. The objective of this study was to determine the cost-effectiveness of the CNIC-Polypill strategy (acetylsalicylic acid 100 mg, atorvastatin 20/40 mg, ramipril 2.5/5/10 mg) compared with the same separate monocomponents for the secondary prevention of recurrent cardiovascular events in adults in Spain. MATERIALS AND METHODS A Markov cost-utility model was adapted considering 4 health states (stable, subsequent major adverse cardiovascular event, subsequent ischemic stroke and death) and the SMART risk equation over a lifetime horizon from the perspective of the Spanish National Healthcare System. The CNIC-Polypill strategy was compared with monocomponents in a hypothetical cohort of 1,000 secondary prevention patients. The NEPTUNO study, official databases, and the literature were reviewed to identify effectiveness, epidemiological, costs and utility data. Outcomes were costs (in 2021 euros) per life-year (LY) and quality-adjusted LY (QALY) gained. A 3% discount rate was applied. Deterministic one-way and probabilistic sensitivity analyses evaluated the robustness of the model. RESULTS The CNIC-Polypill strategy in secondary prevention results in more LY (13.22) and QALY (11.64) gains at a lower cost than monocomponents. The CNIC-Polypill is dominant and saves є280.68 per patient compared with monocomponents. The probabilistic sensitivity analysis shows that 82.4% of the simulations are below the threshold of є25,000 per QALY gained. CONCLUSIONS The CNIC-Polypill strategy in secondary cardiovascular prevention is cost-effective compared with the same separate monocomponents, resulting in a cost-saving strategy to the Spanish National Healthcare System.
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Affiliation(s)
| | | | - Á Hidalgo-Vega
- Fundación Weber, Madrid, Spain; Universidad de Castilla-La Mancha, Toledo, Spain
| | - V Barrios
- Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Servicio de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
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132
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Ispoglou T, Wilson O, McCullough D, Aldrich L, Ferentinos P, Lyall G, Stavropoulos-Kalinoglou A, Duckworth L, Brown MA, Sutton L, Potts AJ, Archbold V, Hargreaves J, McKenna J. A Narrative Review of Non-Pharmacological Strategies for Managing Sarcopenia in Older Adults with Cardiovascular and Metabolic Diseases. BIOLOGY 2023; 12:892. [PMID: 37508325 PMCID: PMC10376679 DOI: 10.3390/biology12070892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 07/30/2023]
Abstract
This narrative review examines the mechanisms underlying the development of cardiovascular disease (CVD) and metabolic diseases (MDs), along with their association with sarcopenia. Furthermore, non-pharmacological interventions to address sarcopenia in patients with these conditions are suggested. The significance of combined training in managing metabolic disease and secondary sarcopenia in type II diabetes mellitus is emphasized. Additionally, the potential benefits of resistance and aerobic training are explored. This review emphasises the role of nutrition in addressing sarcopenia in patients with CVD or MDs, focusing on strategies such as optimising protein intake, promoting plant-based protein sources, incorporating antioxidant-rich foods and omega-3 fatty acids and ensuring sufficient vitamin D levels. Moreover, the potential benefits of targeting gut microbiota through probiotics and prebiotic fibres in sarcopenic individuals are considered. Multidisciplinary approaches that integrate behavioural science are explored to enhance the uptake and sustainability of behaviour-based sarcopenia interventions. Future research should prioritise high-quality randomized controlled trials to refine exercise and nutritional interventions and investigate the incorporation of behavioural science into routine practices. Ultimately, a comprehensive and multifaceted approach is essential to improve health outcomes, well-being and quality of life in older adults with sarcopenia and coexisting cardiovascular and metabolic diseases.
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Affiliation(s)
| | - Oliver Wilson
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QQ, UK
| | | | - Luke Aldrich
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QQ, UK
| | | | - Gemma Lyall
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QQ, UK
| | | | - Lauren Duckworth
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QQ, UK
| | - Meghan A Brown
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QQ, UK
| | - Louise Sutton
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QQ, UK
| | - Alexandra J Potts
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QQ, UK
| | - Victoria Archbold
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QQ, UK
| | - Jackie Hargreaves
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QQ, UK
| | - Jim McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QQ, UK
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Jie Z, Zhu Q, Zou Y, Wu Q, Qin M, He D, Lin X, Tong X, Zhang J, Jie Z, Luo W, Xiao X, Chen S, Wu Y, Guo G, Zheng S, Li Y, Lai W, Yang H, Wang J, Xiao L, Chen J, Zhang T, Kristiansen K, Jia H, Zhong S. A consortium of three-bacteria isolated from human feces inhibits formation of atherosclerotic deposits and lowers lipid levels in a mouse model. iScience 2023; 26:106960. [PMID: 37378328 PMCID: PMC10291474 DOI: 10.1016/j.isci.2023.106960] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/21/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
By a survey of metagenome-wide association studies (MWAS), we found a robust depletion of Bacteroides cellulosilyticus, Faecalibacterium prausnitzii, and Roseburia intestinalis in individuals with atherosclerotic cardiovascular disease (ACVD). From an established collection of bacteria isolated from healthy Chinese individuals, we selected B. cellulosilyticus, R. intestinalis, and Faecalibacterium longum, a bacterium related to F. prausnitzii, and tested the effects of these bacteria in an Apoe/- atherosclerosis mouse model. We show that administration of these three bacterial species to Apoe-/- mice robustly improves cardiac function, reduces plasma lipid levels, and attenuates the formation of atherosclerotic plaques. Comprehensive analysis of gut microbiota, plasma metabolome, and liver transcriptome revealed that the beneficial effects are associated with a modulation of the gut microbiota linked to a 7α-dehydroxylation-lithocholic acid (LCA)-farnesoid X receptor (FXR) pathway. Our study provides insights into transcriptional and metabolic impact whereby specific bacteria may hold promises for prevention/treatment of ACVD.
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Affiliation(s)
- Zhuye Jie
- BGI-Shenzhen, Shenzhen, China
- Shenzhen Key Laboratory of Human Commensal Microorganisms and Health Research, BGI-Shenzhen, Shenzhen, China
- Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, Universitetsparken 13, 2100 Copenhagen, Denmark
| | - Qian Zhu
- Department of Pharmacy, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Yuanqiang Zou
- BGI-Shenzhen, Shenzhen, China
- Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, Universitetsparken 13, 2100 Copenhagen, Denmark
- Qingdao-Europe Advanced Institute for Life Sciences, BGI-Shenzhen, Qingdao 266555, China
- Shenzhen Engineering Laboratory of Detection and Intervention of Human Intestinal Microbiome, BGI-Shenzhen, Shenzhen, China
| | - Qili Wu
- Department of Pharmacy, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Min Qin
- Department of Pharmacy, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | | | | | | | | | - Zhu Jie
- BGI-Shenzhen, Shenzhen, China
| | - Wenwei Luo
- Department of Pharmacy, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
| | - Xiao Xiao
- Department of Pharmacy, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
| | - Shiyu Chen
- Department of Pharmacy, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
| | - Yonglin Wu
- Department of Pharmacy, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
| | - Gongjie Guo
- Department of Pharmacy, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Shufen Zheng
- Department of Pharmacy, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
| | - Yong Li
- Department of Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
| | - Weihua Lai
- Department of Pharmacy, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
| | - Huanming Yang
- BGI-Shenzhen, Shenzhen, China
- James D. Watson Institute of Genome Sciences, Hangzhou, China
| | - Jian Wang
- BGI-Shenzhen, Shenzhen, China
- James D. Watson Institute of Genome Sciences, Hangzhou, China
| | - Liang Xiao
- BGI-Shenzhen, Shenzhen, China
- Qingdao-Europe Advanced Institute for Life Sciences, BGI-Shenzhen, Qingdao 266555, China
- Shenzhen Engineering Laboratory of Detection and Intervention of Human Intestinal Microbiome, BGI-Shenzhen, Shenzhen, China
| | - Jiyan Chen
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
| | - Tao Zhang
- BGI-Shenzhen, Shenzhen, China
- Shenzhen Key Laboratory of Human Commensal Microorganisms and Health Research, BGI-Shenzhen, Shenzhen, China
- Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, Universitetsparken 13, 2100 Copenhagen, Denmark
| | - Karsten Kristiansen
- BGI-Shenzhen, Shenzhen, China
- Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, Universitetsparken 13, 2100 Copenhagen, Denmark
- Qingdao-Europe Advanced Institute for Life Sciences, BGI-Shenzhen, Qingdao 266555, China
| | - Huijue Jia
- BGI-Shenzhen, Shenzhen, China
- Shenzhen Key Laboratory of Human Commensal Microorganisms and Health Research, BGI-Shenzhen, Shenzhen, China
| | - Shilong Zhong
- Department of Pharmacy, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510080, P.R. China
- School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
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Mikkelsen M, Wilsgaard T, Grimsgaard S, Hopstock LA, Hansson P. Associations between postprandial triglyceride concentrations and sex, age, and body mass index: cross-sectional analyses from the Tromsø study 2015-2016. Front Nutr 2023; 10:1158383. [PMID: 37396133 PMCID: PMC10308115 DOI: 10.3389/fnut.2023.1158383] [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: 02/03/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Elevated serum triglyceride concentrations increase the risk of developing atherosclerosis, the leading cause of cardiovascular disease. Postprandial triglyceride concentrations have shown to be a stronger predictor of cardiovascular disease compared to fasting triglycerides. It is therefore clinically relevant to study patterns of postprandial triglyceride concentrations in a general adult population. Aims The aim of this cross-sectional analysis was to examine postprandial triglyceride concentrations in women and men, and the association with age, body mass index and menopausal status. Methods Non-fasting blood samples from 20,963 women and men aged 40 years and older, attending the seventh survey of the Tromsø Study (2015-2016), were analyzed for postprandial triglyceride concentrations using descriptive statistics and linear regression models. Self-reported time since last meal before blood sampling was categorized into 1-h intervals with 7+ hours considered fasting. Results Men had higher triglyceride concentrations compared to women. The pattern of postprandial triglyceride concentrations differed between the sexes. In women, the highest triglyceride concentration (19% higher compared to fasting level, p < 0.001) was found 3-4 h postprandially compared to 1-3 h in men (30% higher compared to fasting level, p < 0.001). In women, all subgroups of age and BMI had higher triglyceride concentrations than the reference group (age 40-49 years and BMI < 25 kg/m2), but no linear trend for age was observed. In men, triglyceride concentrations were inversely associated with age. Body mass index was positively associated with triglyceride concentration in both women (p < 0.001) and men (p < 0.001), although this association was somewhat modified by age in women. Postmenopausal women had significantly higher triglyceride concentrations compared to premenopausal women (p < 0.05). Conclusion Postprandial triglyceride concentrations differed in groups of sex, age, body mass index, and menopausal status.
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Affiliation(s)
- Mari Mikkelsen
- Department of Clinical Medicine, Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A. Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Patrik Hansson
- Department of Clinical Medicine, Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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135
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Yoon HJ. A Big Call to Action: Improving STEMI Management in Low-and Middle-Income Countries. JACC. ASIA 2023; 3:443-445. [PMID: 37396419 PMCID: PMC10308149 DOI: 10.1016/j.jacasi.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Affiliation(s)
- Hyuck-Jun Yoon
- Address for correspondence: Dr Hyuck-Jun Yoon, Division of Cardiology, Department of Internal Medicine, Dongsan Hospital, Keimyung University College of Medicine, 42601, Dalgubeol-daero 1035, Dalseo-gu, Daegu, South Korea.
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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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137
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Zhao L, Liang C, Huang Y, Zhou G, Xiao Y, Ji N, Zhang YT, Zhao N. Emerging sensing and modeling technologies for wearable and cuffless blood pressure monitoring. NPJ Digit Med 2023; 6:93. [PMID: 37217650 DOI: 10.1038/s41746-023-00835-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 05/05/2023] [Indexed: 05/24/2023] Open
Abstract
Cardiovascular diseases (CVDs) are a leading cause of death worldwide. For early diagnosis, intervention and management of CVDs, it is highly desirable to frequently monitor blood pressure (BP), a vital sign closely related to CVDs, during people's daily life, including sleep time. Towards this end, wearable and cuffless BP extraction methods have been extensively researched in recent years as part of the mobile healthcare initiative. This review focuses on the enabling technologies for wearable and cuffless BP monitoring platforms, covering both the emerging flexible sensor designs and BP extraction algorithms. Based on the signal type, the sensing devices are classified into electrical, optical, and mechanical sensors, and the state-of-the-art material choices, fabrication methods, and performances of each type of sensor are briefly reviewed. In the model part of the review, contemporary algorithmic BP estimation methods for beat-to-beat BP measurements and continuous BP waveform extraction are introduced. Mainstream approaches, such as pulse transit time-based analytical models and machine learning methods, are compared in terms of their input modalities, features, implementation algorithms, and performances. The review sheds light on the interdisciplinary research opportunities to combine the latest innovations in the sensor and signal processing research fields to achieve a new generation of cuffless BP measurement devices with improved wearability, reliability, and accuracy.
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Affiliation(s)
- Lei Zhao
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Center for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Cunman Liang
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Center for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Yan Huang
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China
| | - Guodong Zhou
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China
| | - Yiqun Xiao
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Center for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Nan Ji
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Center for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Yuan-Ting Zhang
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
- Hong Kong Center for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China
| | - Ni Zhao
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China.
- Hong Kong Center for Cerebro-Cardiovascular Health Engineering (COCHE), Hong Kong, China.
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Lenz M, Kiss A, Haider P, Salzmann M, Brekalo M, Krychtiuk KA, Hamza O, Huber K, Hengstenberg C, Podesser BK, Wojta J, Hohensinner PJ, Speidl WS. Short-term toll-like receptor 9 inhibition leads to left ventricular wall thinning after myocardial infarction. ESC Heart Fail 2023. [PMID: 37190856 PMCID: PMC10375131 DOI: 10.1002/ehf2.14403] [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: 12/12/2022] [Revised: 04/07/2023] [Accepted: 05/02/2023] [Indexed: 05/17/2023] Open
Abstract
AIMS Ischaemia-reperfusion injury (IRI) following myocardial infarction remains a challenging topic in acute cardiac care and consecutively arising heart failure represents a severe long-term consequence. The extent of neutrophil infiltration and neutrophil-mediated cellular damage are thought to be aggravating factors enhancing primary tissue injury. Toll-like receptor 9 was found to be involved in neutrophil activation as well as chemotaxis and may represent a target in modulating IRI, aspects we aimed to illuminate by pharmacological inhibition of the receptor. METHODS AND RESULTS Forty-nine male adult Sprague-Dawley rats were used. IRI was induced by occlusion of the left coronary artery and subsequent snare removal after 30 min. Oligonucleotide (ODN) 2088, a toll-like receptor 9 (TLR9) antagonist, control-ODN, or DNase, were administered at the time of reperfusion and over 24 h via a mini-osmotic pump. The hearts were harvested 24 h or 4 weeks after left coronary artery occlusion and immunohistochemical staining was performed. Echocardiography was done after 1 and 4 weeks to determine ventricular function. Inhibition of TLR9 by ODN 2088 led to left ventricular wall thinning (P = 0.003) in association with drastically enhanced neutrophil infiltration (P = 0.005) and increased markers of tissue damage. Additionally, an up-regulation of the chemotactic receptor CXCR2 (P = 0.046) was found after TLR9 inhibition. No such effects were observed in control-ODN or DNase-treated animals. We did not observe changes in monocyte content or subset distribution, hinting towards neutrophils as the primary mediators of the exerted tissue injury. CONCLUSIONS Our data indicate a TLR9-dependent, negative regulation of neutrophil infiltration. Blockage of TLR9 appears to prevent the down-regulation of CXCR2, followed by an uncontrolled migration of neutrophils towards the area of infarction and the exertion of disproportional tissue injury resulting in potential aneurysm formation. In comparison with previous studies conducted in TLR-/- mice, we deliberately chose a transient pharmacological inhibition of TLR9 to highlight effects occurring in the first 24 h following IRI.
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Affiliation(s)
- Max Lenz
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
| | - Attila Kiss
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
- Center for Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - Patrick Haider
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
| | - Manuel Salzmann
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Mira Brekalo
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Konstantin A Krychtiuk
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
| | - Ouafa Hamza
- Center for Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - Kurt Huber
- 3rd Medical Department for Cardiology and Emergency Medicine, Faculty of Medicine, Wilhelminenhospital and Sigmund Freud University, Vienna, Austria
| | - Christian Hengstenberg
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Bruno K Podesser
- Center for Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - Johann Wojta
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
- Core Facility Imaging, Medical University of Vienna, Vienna, Austria
| | - Philipp J Hohensinner
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
- Center for Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - Walter S Speidl
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
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139
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Damigou E, Kouvari M, Chrysohoou C, Barkas F, Kravvariti E, Pitsavos C, Skoumas J, Michelis E, Liberopoulos E, Tsioufis C, Sfikakis PP, Panagiotakos DB. Lifestyle Trajectories Are Associated with Incidence of Cardiovascular Disease: Highlights from the ATTICA Epidemiological Cohort Study (2002-2022). Life (Basel) 2023; 13:life13051142. [PMID: 37240787 DOI: 10.3390/life13051142] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/02/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
The study aimed to assess the trajectories of lifestyle characteristics and their association with 20-year cardiovascular disease (CVD) incidence. In 2002, 3042 Greek adults (aged: 45 (12) years) free of CVD were enrolled. In 2022, the 20-year follow-up was performed on 2169 participants; of those, 1988 had complete data for CVD. The 20-year CVD incidence was 3600 cases/10,000 individuals; the man-to-woman ratio was 1.25, with the peak difference in the 35-45 age group (i.e., 2.1); however, a reversal of the trend was observed in the age-groups 55-65 and 65-75, with a resumption of an almost equal incidence in those >75 years. In multi-adjusted analysis, age, sex, abnormal waist circumference, hypercholesterolemia, hypertension, and diabetes were positively associated with 20-year CVD risk, explaining 56% of the excess CVD risk, whereas an additional 30% was attributed to lifestyle trajectories; being physically active throughout life-course and being close to the Mediterranean diet were protective, while continuous smoking was detrimental against CVD risk. Mediterranean diet adherence protected against CVD development even if not sustained, while quitting smoking or engaging in physical activities during the 20-year observation did not offer any significant protection. A life-course personalized approach that is cost-effective and long-term sustained is needed to prevent CVD burden.
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Affiliation(s)
- Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772 Athens, Greece
| | - Fotios Barkas
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Evrydiki Kravvariti
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772 Athens, Greece
| | - John Skoumas
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772 Athens, Greece
| | - Evangelinos Michelis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772 Athens, Greece
| | - Evangelos Liberopoulos
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Costas Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772 Athens, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece
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El Baou C, Desai R, Cooper C, Marchant NL, Pilling S, Richards M, Saunders R, Buckman JEJ, Aguirre E, John A, Stott J. Psychological therapies for depression and cardiovascular risk: evidence from national healthcare records in England. Eur Heart J 2023; 44:1650-1662. [PMID: 37072130 PMCID: PMC10163979 DOI: 10.1093/eurheartj/ehad188] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/01/2023] [Accepted: 03/13/2023] [Indexed: 04/20/2023] Open
Abstract
AIMS People with depression are up to 72% more at risk to develop cardiovascular disease (CVD) in their lifetime. Evidence-based psychotherapies are first-line interventions for the treatment of depression and are delivered nationally in England through the National Health Service via the Improving Access to Psychological Therapy (IAPT) primary care programme. It is currently unknown whether positive therapy outcomes may be associated with cardiovascular risk reduction. This study aimed to examine the association between psychotherapy outcomes for depression and incident CVD. METHODS AND RESULTS A cohort of 636 955 individuals who have completed a course of psychotherapy was built from linked electronic healthcare record databases of national coverage in England: the national IAPT database, the Hospital Episode Statistics (HES) database, and the HES-ONS (Office of National Statistics) mortality database. Multivariable Cox models adjusting for clinical and demographic covariates were run to estimate the association between reliable improvement from depression and the risk of subsequent incidence of cardiovascular events. After a median follow-up of 3.1 years, reliable improvement from depression symptoms was associated with a lower risk of new onset of any CVD [hazard ratio (HR): 0.88, 95% confidence interval (CI): 0.86, 0.89], coronary heart disease (HR: 0.89, 95% CI: 0.86, 0.92), stroke (HR: 0.88, 95% CI: 0.83, 0.94), and all-cause mortality (HR: 0.81, 95% CI: 0.78, 0.84). This association was stronger in the under 60 compared with the over 60 for all outcomes. Results were confirmed in sensitivity analyses. CONCLUSION Management of depression through psychological interventions may be associated with reduced risk of CVD. More research is needed to understand the causality of these associations.
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Affiliation(s)
- Céline El Baou
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, UCL, 1-19 Torrington Place, Camden, London WC1E 7HB, UK
| | - Roopal Desai
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, UCL, 1-19 Torrington Place, Camden, London WC1E 7HB, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Tower Hamlets Memory Service, East London NHS Foundation Trust, London, UK
| | | | - Steve Pilling
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
- Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, UCL, London, UK
| | - Rob Saunders
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, UCL, 1-19 Torrington Place, Camden, London WC1E 7HB, UK
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Joshua E J Buckman
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
- iCope—Camden & Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Elisa Aguirre
- North East London NHS Foundation Trust (NELFT), London, UK
| | - Amber John
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, UCL, 1-19 Torrington Place, Camden, London WC1E 7HB, UK
| | - Joshua Stott
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, UCL, 1-19 Torrington Place, Camden, London WC1E 7HB, UK
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Liu S, Zhong G, He J, Yang C. Multi-task cascaded assessment of signal quality for long-term single-lead ECG monitoring. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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142
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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:genes14051033. [PMID: 37239393 DOI: 10.3390/genes14051033] [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: 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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Ferrières J, Bruckert E, Farnier M, Krempf M, Mourad JJ, Roux B, Schiele F. Evaluation of hypercholesterolemia management in at-risk patients by cardiologists in France: a case vignette-based study. J Comp Eff Res 2023; 12:e220181. [PMID: 36891969 PMCID: PMC10402750 DOI: 10.57264/cer-2022-0181] [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: 10/17/2022] [Accepted: 02/06/2023] [Indexed: 03/10/2023] Open
Abstract
Aim: This online interactive survey investigated lipid-lowering approaches of French cardiologists in high- and very high-cardiovascular risk patients with hypercholesterolemia. Materials & methods: Physicians assessed three hypothetical patients at three clinic visits, and selected the patients' cardiovascular risk category, target low-density lipoprotein cholesterol (LDL-C) and treatment. Results: A total of 162 physicians completed 480 risk assessments; 58% of assessments correctly categorized the hypothetical patients. Most physicians chose the correct LDL-C target for one of the very high-risk patients, but higher-than-recommended targets were selected for the other very high-risk patient and the high-risk patient. Statins were the most commonly chosen treatment. Conclusion: French cardiologists often underestimate cardiovascular risk in patients with hypercholesterolemia, select a higher-than-recommended LDL-C target and prescribe less intensive treatment than that recommended by guidelines.
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Affiliation(s)
- Jean Ferrières
- Department of Cardiology, Toulouse Rangueil University Hospital, Toulouse University School of Medicine, Toulouse, France
- INSERM UMR 1295, Toulouse Paul Sabatier University, Toulouse, France
| | - Eric Bruckert
- Department of Endocrinology Metabolism & Cardiovascular Prevention, Pitié Salpêtrière Hospital, E3M Institute & IHU Cardiometabolic (ICAN), Paris, France
| | - Michel Farnier
- Team PEC2, EA 7460, University of Bourgogne Franche-Comté, Dijon, France
| | - Michel Krempf
- Department of Endocrinology, Bretéché Clinic, Nantes, France
| | - Jean-Jacques Mourad
- Department of Internal Medicine, Hôpital Franco-Britannique, Levallois, France
| | | | - François Schiele
- Department of Cardiology, CHU Besançon, University of Franche-Comté, Besançon, EA 3920, France
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Yu WQ, Wang XL, Ji HH, Miao M, Zhang BH, Li H, Zhang ZY, Ji CF, Guo SD. CM3-SII polysaccharide obtained from Cordyceps militaris ameliorates hyperlipidemia in heterozygous LDLR-deficient hamsters by modulating gut microbiota and NPC1L1 and PPARα levels. Int J Biol Macromol 2023; 239:124293. [PMID: 37011745 DOI: 10.1016/j.ijbiomac.2023.124293] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023]
Abstract
Accumulating evidence has demonstrated that polysaccharides derived from edible fungi have lipid-lowering effects in mice. However, the lipid metabolism mechanisms in mice and humans are different. We have previously elucidated the structural characteristics of the alkali-extracted polysaccharide CM3-SII obtained from Cordyceps militaris. This study aimed to investigate whether CM3-SII could ameliorate hyperlipidemia in a heterozygous low-density lipoprotein receptor (LDLR)-deficient hamster model of hyperlipidemia. Our data demonstrated that CM3-SII significantly decreased total plasma cholesterol, non-high-density lipoprotein cholesterol, and triglyceride levels in heterozygous LDLR-deficient hamsters. Unlike ezetimibe, CM3-SII could enhance the concentration of plasma apolipoprotein A1 and the expression of liver X receptor α/ATP-binding cassette transporter G8 mRNA pathway and suppress the expression of Niemann-Pick C1-like 1, which help to reduce cholesterol levels further. Moreover, the results of molecular docking analysis demonstrated that CM3-SII could directly bind to Niemann-Pick C1-like 1 with high affinity. The triglyceride-lowering mechanisms of CM3-SII were related to its downregulation of sterol regulatory element-binding protein 1c and upregulation of peroxisome proliferator-activated receptor α. Importantly, CM3-SII increased the abundance of Actinobacteria and Faecalibaculum and the ratio of Bacteroidetes/Firmicutes. Thus, CM3-SII attenuated hyperlipidemia by modulating the expression of multiple molecules involved in lipid metabolism and the gut microbiota.
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Schutte AE, Jafar TH, Poulter NR, Damasceno A, Khan NA, Nilsson PM, Alsaid J, Neupane D, Kario K, Beheiry H, Brouwers S, Burger D, Charchar FJ, Cho MC, Guzik TJ, Haji Al-Saedi GF, Ishaq M, Itoh H, Jones ESW, Khan T, Kokubo Y, Kotruchin P, Muxfeldt E, Odili A, Patil M, Ralapanawa U, Romero CA, Schlaich MP, Shehab A, Mooi CS, Steckelings UM, Stergiou G, Touyz RM, Unger T, Wainford RD, Wang JG, Williams B, Wynne BM, Tomaszewski M. Addressing global disparities in blood pressure control: perspectives of the International Society of Hypertension. Cardiovasc Res 2023; 119:381-409. [PMID: 36219457 PMCID: PMC9619669 DOI: 10.1093/cvr/cvac130] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/13/2022] [Accepted: 05/31/2022] [Indexed: 11/14/2022] Open
Abstract
ABSTRACT Raised blood pressure (BP) is the leading cause of preventable death in the world. Yet, its global prevalence is increasing, and it remains poorly detected, treated, and controlled in both high- and low-resource settings. From the perspective of members of the International Society of Hypertension based in all regions, we reflect on the past, present, and future of hypertension care, highlighting key challenges and opportunities, which are often region-specific. We report that most countries failed to show sufficient improvements in BP control rates over the past three decades, with greater improvements mainly seen in some high-income countries, also reflected in substantial reductions in the burden of cardiovascular disease and deaths. Globally, there are significant inequities and disparities based on resources, sociodemographic environment, and race with subsequent disproportionate hypertension-related outcomes. Additional unique challenges in specific regions include conflict, wars, migration, unemployment, rapid urbanization, extremely limited funding, pollution, COVID-19-related restrictions and inequalities, obesity, and excessive salt and alcohol intake. Immediate action is needed to address suboptimal hypertension care and related disparities on a global scale. We propose a Global Hypertension Care Taskforce including multiple stakeholders and societies to identify and implement actions in reducing inequities, addressing social, commercial, and environmental determinants, and strengthening health systems implement a well-designed customized quality-of-care improvement framework.
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Affiliation(s)
- Aletta E Schutte
- School of Population Health, University of New South Wales, Kensington Campus, High Street, Sydney 2052 NSW, Australia; The George Institute for Global Health, King Street, Newton, Sydney NSW 2052, Australia
- Hypertension in Africa Research Team, SAMRC Unit for Hypertension and Cardiovascular Disease; North-West University, Hoffman Street, Potchefstroom 2520, South Africa
- SAMRC Development Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, 1 Jan Smuts Ave, Braamfontein, Johannesburg, 2000, South Africa
| | - Tazeen H Jafar
- Program in Health Services and Systems Research, Duke-NUS Medical School, Department of Renal Medicine, 8 College Rd., Singapore 169857, Singapore
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27710, USA
| | - Neil R Poulter
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London W12 7RH, UK
| | - Albertino Damasceno
- Faculty of Medicine, Eduardo Mondlane University, 3453 Avenida Julius Nyerere, Maputo, Mozambique
| | - Nadia A Khan
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Center for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada
| | - Peter M Nilsson
- Department of Clinical Sciences, Skane University Hospital, Lund University, Malmö, Sweden
| | - Jafar Alsaid
- Ochsner Health System, New Orleans, Louisiana, USA
- Queensland University, Brisbane, Queensland, Australia
| | - Dinesh Neupane
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Hind Beheiry
- International University of Africa, Khartoum, Sudan
| | - Sofie Brouwers
- Department of Cardiology, Cardiovascular Center Aalst, OLV Clinic Aalst, Aalst, Belgium
- Department of Experimental Pharmacology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Dylan Burger
- Kidney Research Centre, Ottawa Hospital Research Institute, Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Fadi J Charchar
- Health Innovation and Transformation Centre, Federation University, Ballarat, Victoria, Australia
- Department of Physiology and Anatomy, University of Melbourne, Melbourne, Victoria, Australia
| | - Myeong-Chan Cho
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Tomasz J Guzik
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | | | | | - Hiroshi Itoh
- Department of Endocrinology, Metabolism and Nephrology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8585, Japan
| | - Erika S W Jones
- Division of Nephrology and Hypertension, Groote Schuur Hospital and Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
| | - Taskeen Khan
- Department of Public Health Medicine, University of Pretoria, Pretoria, South Africa
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Praew Kotruchin
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Elizabeth Muxfeldt
- University Hospital Clementino Fraga Filho, Hypertension Program, Universidade Federal do Rio de Janeiro, Brazil
| | - Augustine Odili
- Circulatory Health Research Laboratory, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Mansi Patil
- Department of Nutrition and Dietetics, Asha Kiran JHC Hospital, Chinchwad, India
| | - Udaya Ralapanawa
- Faculty of Medicine, University of Peradeniya, Kandy, Central Province, Sri Lanka
| | - Cesar A Romero
- Renal Division, Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Markus P Schlaich
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Perth, Australia
- Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia
- Department of Nephrology, Royal Perth Hospital, Perth, Western Australia, Perth, Western Australia, Australia
| | - Abdulla Shehab
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Ching Siew Mooi
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia
| | - U Muscha Steckelings
- Department of Cardiovascular & Renal Research, Institute of Molecular Medicine. University of Southern Denmark, Odense, Denmark
| | - George Stergiou
- Hypertension Centre STRIDE-7, School of Medicine, Third Department of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Rhian M Touyz
- Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Thomas Unger
- CARIM - Cardiovascular Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Richard D Wainford
- Department of Pharmacology & Experimental Therapeutics and the Whitaker, Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA
| | - Ji-Guang Wang
- Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bryan Williams
- Institute of Cardiovascular Science, University College London (UCL), National Institute for Health Research (NIHR), UCL Hospitals Biomedical Research Centre, London, UK
| | - Brandi M Wynne
- Department of Internal Medicine, Division of Nephrology & Hypertension, University of Utah, Salt Lake City, UT, USA
| | - Maciej Tomaszewski
- Division of Cardiovascular Sciences, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK
- Manchester Heart Centre, Manchester University NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
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146
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Ghamkhari A, Tafti HA, Rabbani S, Ghorbani M, Ghiass MA, Akbarzadeh F, Abbasi F. Ultrasound-Triggered Microbubbles: Novel Targeted Core-Shell for the Treatment of Myocardial Infarction Disease. ACS OMEGA 2023; 8:11335-11350. [PMID: 37008126 PMCID: PMC10061684 DOI: 10.1021/acsomega.3c00067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/07/2023] [Indexed: 06/19/2023]
Abstract
Myocardial infarction (MI) is known as a main cardiovascular disease that leads to extensive cell death by destroying vasculature in the affected cardiac muscle. The development of ultrasound-mediated microbubble destruction has inspired extensive interest in myocardial infarction therapeutics, targeted delivery of drugs, and biomedical imaging. In this work, we describe a novel therapeutic ultrasound system for the targeted delivery of biocompatible microstructures containing basic fibroblast growth factor (bFGF) to the MI region. The microspheres were fabricated using poly(lactic-co-glycolic acid)-heparin-polyethylene glycol- cyclic arginine-glycine-aspartate-platelet (PLGA-HP-PEG-cRGD-platelet). The micrometer-sized core-shell particles consisting of a perfluorohexane (PFH)-core and a PLGA-HP-PEG-cRGD-platelet-shell were prepared using microfluidics. These particles responded adequately to ultrasound irradiation by triggering the vaporization and phase transition of PFH from liquid to gas in order to achieve microbubbles. Ultrasound imaging, encapsulation efficiency cytotoxicity, and cellular uptake of bFGF-MSs were evaluated using human umbilical vein endothelial cells (HUVECs) in vitro. In vivo imaging demonstrated effective accumulation of platelet- microspheres injected into the ischemic myocardium region. The results revealed the potential use of bFGF-loaded microbubbles as a noninvasive and effective carrier for MI therapy.
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Affiliation(s)
- Aliyeh Ghamkhari
- Institute
of Polymeric Materials and Faculty of Polymer Engineering, Sahand University of Technology, Tabriz 5331817634, Iran
| | - Hossein Ahmadi Tafti
- Research
Center for Advanced Technologies in Cardiovascular Medicine, Tehran
Heart Center, Tehran University of Medical
Sciences, Tehran 1416753955, Iran
| | - Shahram Rabbani
- Research
Center for Advanced Technologies in Cardiovascular Medicine, Tehran
Heart Center, Tehran University of Medical
Sciences, Tehran 1416753955, Iran
| | - Marjan Ghorbani
- Nutrition
Research Center, Tabriz University of Medical Sciences, Tabriz IR 51656-65811, Iran
| | - Mohammad Adel Ghiass
- Tissue
Engineering Department, Tarbiat Modares
University, Tehran 1411713116, Iran
| | - Fariborz Akbarzadeh
- Cardiovascular
Research Center, Tabriz University of Medical
Sciences, Tabriz 5166/15731, Iran
| | - Farhang Abbasi
- Institute
of Polymeric Materials and Faculty of Polymer Engineering, Sahand University of Technology, Tabriz 5331817634, Iran
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147
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Hijová E. Benefits of Biotics for Cardiovascular Diseases. Int J Mol Sci 2023; 24:ijms24076292. [PMID: 37047262 PMCID: PMC10093891 DOI: 10.3390/ijms24076292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
Cardiovascular diseases are the main cause of death in many countries, and the better prevention and prediction of these diseases would be of great importance for individuals and society. Nutrition, the gut microbiota, and metabolism have raised much interest in the field of cardiovascular disease research in the search for the main mechanisms that promote cardiovascular diseases. Understanding the interactions between dietary nutrient intake and the gut microbiota-mediated metabolism may provide clinical insight in order to identify individuals at risk of cardiometabolic disease progression, as well as other potential therapeutic targets to mitigate the risk of cardiometabolic disease progression. The development of cardiometabolic diseases can be modulated by specific beneficial metabolites derived from bacteria. Therefore, it is very important to investigate the impact of these metabolites on human health and the possibilities of modulating their production with dietary supplements called biotics.
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Affiliation(s)
- Emília Hijová
- Center of Clinical and Preclinical Research MEDIPARK, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Trieda SNP 1, 040 11 Košice, Slovakia
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148
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Amin B, Rehman MRU, Farooq M, Elahi A, Donaghey K, Wijns W, Shahzad A, Vazquez P. Optimizing Cardiac Wireless Implant Communication: A Feasibility Study on Selecting the Frequency and Matching Medium. SENSORS (BASEL, SWITZERLAND) 2023; 23:3411. [PMID: 37050471 PMCID: PMC10098910 DOI: 10.3390/s23073411] [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: 02/08/2023] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
Cardiac wireless implantable medical devices (CWIMD) have brought a paradigm shift in monitoring and treating various cardiac conditions, including heart failure, arrhythmias, and hypertension. One of the key elements in CWIMD is the implant antenna which uses radio frequency (RF) technology to wirelessly communicate and transmit data to external devices. However, wireless communication with a deeply implanted antenna using RF can be challenging due to the significant loss of electromagnetic (EM) signal at the air-skin interface, and second, due to the propagation and reflection of EM waves from different tissue boundaries. The air-skin interface loss of the EM wave is pronounced due to the absence of a matching medium. This paper investigates the EM propagation losses in the human body and presents a choice of optimal frequency for the design of the cardiac implant antenna and the dielectric properties of the matching medium. First, the dielectric properties of all tissues present in the human thorax including skin, fat, muscle, cartilage, and heart are analyzed as a function of frequency to study the EM wave absorption at different frequencies. Second, the penetration of EM waves inside the biological tissues is analyzed as a function of frequency. Third, a transmission line (TL) formalism approach is adopted to examine the optimal frequency band for designing a cardiac implant antenna and the matching medium for the air-skin interface. Finally, experimental validation is performed at two ISM frequencies, 433 MHz and 915 MHz, selected from the optimal frequency band (0.4-1.5 GHz) suggested by our analytical investigation. For experimental validation, two off-the-shelf flexible dipole antennas operating at selected ISM frequencies were used. The numerical and experimental findings suggested that for the specific application of a cardiac implant with a penetration depth of 7-17 cm, the most effective frequency range for operation is within 0.4-1.5 GHz. The findings based on the dielectric properties of thorax tissues, the penetration depth of EM waves, and the optimal frequency band have provided valuable information on developing and optimizing CWIMDs for cardiac care applications.
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Affiliation(s)
- Bilal Amin
- Smart Sensors Laboratory, College of Medicine, Nursing Health Sciences, University of Galway, H91 TK33 Galway, Ireland
- Electrical and Electronic Engineering, University of Galway, H91 TK33 Galway, Ireland
| | - Muhammad Riaz ur Rehman
- Smart Sensors Laboratory, College of Medicine, Nursing Health Sciences, University of Galway, H91 TK33 Galway, Ireland
| | - Muhammad Farooq
- Smart Sensors Laboratory, College of Medicine, Nursing Health Sciences, University of Galway, H91 TK33 Galway, Ireland
| | - Adnan Elahi
- Electrical and Electronic Engineering, University of Galway, H91 TK33 Galway, Ireland
| | - Kevin Donaghey
- Aurigen Medical, Atlantic Technological University (ATU) Innovation Hub, H91 FD73 Galway, Ireland
| | - William Wijns
- Smart Sensors Laboratory, College of Medicine, Nursing Health Sciences, University of Galway, H91 TK33 Galway, Ireland
| | - Atif Shahzad
- Smart Sensors Laboratory, College of Medicine, Nursing Health Sciences, University of Galway, H91 TK33 Galway, Ireland
- Centre for Systems Modeling and Quantitative Biomedicine, University of Birmingham, Birmingham B15 2TT, UK
| | - Patricia Vazquez
- Smart Sensors Laboratory, College of Medicine, Nursing Health Sciences, University of Galway, H91 TK33 Galway, Ireland
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149
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Moysidis DV, Daios S, Anastasiou V, Liatsos AC, Papazoglou AS, Karagiannidis E, Kamperidis V, Makedou K, Aikaterini T, Paraskevi K, Papadakis M, Savopoulos C, Ziakas A, Giannakoulas G, Vassilikos V, Giannopoulos G. Association of clinical, laboratory and imaging biomarkers with the occurrence of acute myocardial infarction in patients without standard modifiable risk factors - rationale and design of the "Beyond-SMuRFs Study". BMC Cardiovasc Disord 2023; 23:149. [PMID: 36959584 PMCID: PMC10037837 DOI: 10.1186/s12872-023-03180-4] [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: 12/23/2022] [Accepted: 03/11/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) remains the leading cause of mortality worldwide. The majority of patients who suffer an AMI have a history of at least one of the standard modifiable risk factors (SMuRFs): smoking, hypertension, dyslipidemia, and diabetes mellitus. However, emerging scientific evidence recognizes a clinically significant and increasing proportion of patients presenting with AMI without any SMuRF (SMuRF-less patients). To date, there are no adequate data to define specific risk factors or biomarkers associated with the development of AMIs in these patients. METHODS The ''Beyond-SMuRFs Study'' is a prospective, non-interventional cohort trial designed to enroll patients with AMI and no previous coronary intervention history, who undergo coronary angiography in two academic hospitals in Thessaloniki, Greece. The rationale of the study is to investigate potential relations between SMuRF-less AMIs and the clinical, laboratory and imaging profile of patients, by comparing parameters between patients with and without SMuRFs. Complete demographic and comprehensive clinical data will be recorded, Venous blood samples will be collected before coronary angiography and the following parameters will be measured: total blood count, standard biochemistry parameters, coagulation tests, hormone levels, glycosylated hemoglobin, N- terminal pro-B-type natriuretic peptide and high-sensitivity troponin T levels- as well as serum levels of novel atherosclerosis indicators and pro-inflammatory biomarkers. Furthermore, all participants will undergo a complete and comprehensive transthoracic echocardiographic assessment according to a pre-specified protocol within 24 h from admission. Among others, 2D-speckle-tracking echocardiographic analysis of cardiac chambers and non-invasive calculation of myocardial work indices for the left ventricle will be performed. Moreover, all patients will be assessed for angiographic parameters and the complexity of coronary artery disease using the SYNTAX score. Multivariable linear and logistic regression models will be used to phenotypically characterize SMuRF-less patients and investigate independent clinical, laboratory, echocardiographic and angiographic biomarkers-predictors of SMuRF-less status in AMI.The first patient was enrolled in March 2022 and completion of enrollment is expected until December 2023. DISCUSSION The ''Beyond-SmuRFs'' study is an ongoing prospective trial aiming to investigate potential clinical, laboratory and imaging biomarkers associated with the occurrence of AMIs in SMuRF-less patients. The configuration of these patients' profiles could lead to the development of personalized risk-stratification models predicting the occurrence of cardiovascular events in SΜuRF-less individuals. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05535582 / September 10, 2022.
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Affiliation(s)
- Dimitrios V Moysidis
- Third Department of Cardiology, Hippokration General Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Konstantinoupoleos 49, Thessaloniki, 54642, Greece
| | - Stylianos Daios
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636, Thessaloniki, Greece
| | - Vasileios Anastasiou
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636, Thessaloniki, Greece
| | - Alexandros C Liatsos
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636, Thessaloniki, Greece
| | | | - Efstratios Karagiannidis
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636, Thessaloniki, Greece
| | - Vasileios Kamperidis
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636, Thessaloniki, Greece
| | - Kali Makedou
- Laboratory of Biochemistry, Faculty of Health Sciences, School of Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, Thessaloniki, 54636, Greece
| | - Thisiadou Aikaterini
- Laboratory of Biochemistry, Faculty of Health Sciences, School of Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, Thessaloniki, 54636, Greece
| | - Karalazou Paraskevi
- Laboratory of Biochemistry, Faculty of Health Sciences, School of Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, Thessaloniki, 54636, Greece
| | - Marios Papadakis
- University Hospital Witten-Herdecke, University of Witten-Herdecke, Heusnerstrasse 40, 42283, Wuppertal, Germany.
| | - Christos Savopoulos
- University Hospital Witten-Herdecke, University of Witten-Herdecke, Heusnerstrasse 40, 42283, Wuppertal, Germany
- First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Antonios Ziakas
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636, Thessaloniki, Greece
| | - George Giannakoulas
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kyriakidi 1, 54636, Thessaloniki, Greece
| | - Vassilios Vassilikos
- Third Department of Cardiology, Hippokration General Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Konstantinoupoleos 49, Thessaloniki, 54642, Greece
| | - Georgios Giannopoulos
- Third Department of Cardiology, Hippokration General Hospital, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Konstantinoupoleos 49, Thessaloniki, 54642, Greece
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150
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Kim HL, Chung J, Han S, Joh HS, Lim WH, Seo JB, Kim SH, Zo JH, Kim MA. Arterial stiffness and its associations with left ventricular diastolic function according to heart failure types. Clin Hypertens 2023; 29:8. [PMID: 36918917 PMCID: PMC10015827 DOI: 10.1186/s40885-022-00233-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/21/2022] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Little is known about the characteristics of arterial stiffness in heart failure (HF). This study was performed to compare the degree of arterial stiffness and its association with left ventricular (LV) diastolic function among three groups: control subjects, patients with HF with reduced ejection fraction (HFrEF), and patients with HF with preserved ejection fraction (HFpEF). METHODS A total of 83 patients with HFrEF, 68 patients with HFpEF, and 84 control subjects were analyzed. All HF patients had a history of hospitalization for HF treatment. Brachial-ankle pulse wave velocity (baPWV) measurement and transthoracic echocardiography were performed at the same day in a stable condition. RESULTS The baPWV was significantly higher in patients with both HFrEF and HFpEF compared to control subjects (1,661 ± 390, 1,909 ± 466, and 1,477 ± 296 cm/sec, respectively; P < 0.05 for each). After adjustment of age, baPWV values were similar between patients with HFrEF and HFpEF (P = 0.948). In the multiple linear regression analysis, baPWV was significantly associated with both septal e' velocity (β = -0.360, P = 0.001) and E/e' (β = 0.344, P = 0.001). However, baPWV was not associated with either of the diastolic indices in HFrEF group. The baPWV was associated only with septal e' velocity (β = -0.429, P = 0.002) but not with E/e' in the HFpEF group in the same multivariable analysis. CONCLUSIONS Although arterial stiffness was increased, its association with LV diastolic function was attenuated in HF patients compared to control subjects. The degree of arterial stiffening was similar between HFrEF and HFpEF.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Jaehoon Chung
- Division of Cardiology, Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea
| | - Seokmoon Han
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Hyun Sung Joh
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Woo-Hyun Lim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae-Bin Seo
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Joo-Hee Zo
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Myung-A Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
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