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Flynn S, Srikanthan P, Ravellette K, Inoue K, Watson K, Horwich T. Urinary cortisol and cardiovascular events in women vs. men: The multi-ethnic study of atherosclerosis. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2023; 36:100344. [PMID: 37982128 PMCID: PMC10655947 DOI: 10.1016/j.ahjo.2023.100344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/21/2023]
Abstract
Research suggests that women experience greater cardiovascular ischemic effects from stress than men. Visceral adiposity is an endocrine tissue that differs by sex and interacts with stress hormones. We hypothesized that urinary cortisol would be associated with increased cardiovascular events and change in coronary artery calcium score (CAC) in women, and these relationships would vary by central obesity. In the Multi-Ethnic Study of Atherosclerosis Stress Ancillary study, cortisol was quantified by 12-h overnight urine collection. Central obesity was estimated by waist-hip ratio (WHR). Multivariable Cox models estimated the relationship between cortisol and cardiovascular events and assessed for moderation by WHR. The relationship between cortisol and change in CAC Agatston score was assessed by Tobit regression models. 918 patients were analyzed with median follow up of 11 years. There was no association between urinary cortisol and cardiovascular events in the cohort. However, in individuals with below median WHR, higher urinary cortisol levels (upper tertile) were associated with higher cardiovascular event rates in the full cohort, women, and men, but not in groups with above median WHR. There was significant moderation by WHR in women, but not men, whereby the association between elevated cortisol and increased cardiovascular events diminished as WHR increased. Urinary cortisol was associated with increased change in CAC in women (P = 0.003) but not men, without moderation by WHR. Our study highlights associations between cortisol and subclinical atherosclerosis in women, and moderation of the relationship between cortisol and cardiovascular events by central obesity in both genders.
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Affiliation(s)
- Spencer Flynn
- David Geffen School of Medicine at UCLA, United States of America
| | | | | | - Kosuke Inoue
- Kyoto University Department of Social Epidemiology, Japan
| | - Karol Watson
- UCLA Division of Cardiology, United States of America
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Cincotta AH. Brain Dopamine-Clock Interactions Regulate Cardiometabolic Physiology: Mechanisms of the Observed Cardioprotective Effects of Circadian-Timed Bromocriptine-QR Therapy in Type 2 Diabetes Subjects. Int J Mol Sci 2023; 24:13255. [PMID: 37686060 PMCID: PMC10487918 DOI: 10.3390/ijms241713255] [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] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 09/10/2023] Open
Abstract
Despite enormous global efforts within clinical research and medical practice to reduce cardiovascular disease(s) (CVD), it still remains the leading cause of death worldwide. While genetic factors clearly contribute to CVD etiology, the preponderance of epidemiological data indicate that a major common denominator among diverse ethnic populations from around the world contributing to CVD is the composite of Western lifestyle cofactors, particularly Western diets (high saturated fat/simple sugar [particularly high fructose and sucrose and to a lesser extent glucose] diets), psychosocial stress, depression, and altered sleep/wake architecture. Such Western lifestyle cofactors are potent drivers for the increased risk of metabolic syndrome and its attendant downstream CVD. The central nervous system (CNS) evolved to respond to and anticipate changes in the external (and internal) environment to adapt survival mechanisms to perceived stresses (challenges to normal biological function), including the aforementioned Western lifestyle cofactors. Within the CNS of vertebrates in the wild, the biological clock circuitry surveils the environment and has evolved mechanisms for the induction of the obese, insulin-resistant state as a survival mechanism against an anticipated ensuing season of low/no food availability. The peripheral tissues utilize fat as an energy source under muscle insulin resistance, while increased hepatic insulin resistance more readily supplies glucose to the brain. This neural clock function also orchestrates the reversal of the obese, insulin-resistant condition when the low food availability season ends. The circadian neural network that produces these seasonal shifts in metabolism is also responsive to Western lifestyle stressors that drive the CNS clock into survival mode. A major component of this natural or Western lifestyle stressor-induced CNS clock neurophysiological shift potentiating the obese, insulin-resistant state is a diminution of the circadian peak of dopaminergic input activity to the pacemaker clock center, suprachiasmatic nucleus. Pharmacologically preventing this loss of circadian peak dopaminergic activity both prevents and reverses existing metabolic syndrome in a wide variety of animal models of the disorder, including high fat-fed animals. Clinically, across a variety of different study designs, circadian-timed bromocriptine-QR (quick release) (a unique formulation of micronized bromocriptine-a dopamine D2 receptor agonist) therapy of type 2 diabetes subjects improved hyperglycemia, hyperlipidemia, hypertension, immune sterile inflammation, and/or adverse cardiovascular event rate. The present review details the seminal circadian science investigations delineating important roles for CNS circadian peak dopaminergic activity in the regulation of peripheral fuel metabolism and cardiovascular biology and also summarizes the clinical study findings of bromocriptine-QR therapy on cardiometabolic outcomes in type 2 diabetes subjects.
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Mosarla RC, Wood M. Implications of Sex Differences on Behavioral and Cardiovascular Health. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20211223-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Mohamed RMSM, Elshazly SM, Mahmoud NM. Amlexanox Exhibits Cardioprotective Effects in 5/6 Nephrectomized Rats. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e20978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Wang Y, Du J, Li X, Liu P, Wang Y, Liao Y, Jin H. Impact of Comorbidities on the Prognosis of Pediatric Postural Tachycardia Syndrome. Int J Gen Med 2021; 14:8945-8954. [PMID: 34866935 PMCID: PMC8636694 DOI: 10.2147/ijgm.s339805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/29/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the influence of comorbidities on the prognosis of pediatric postural tachycardia syndrome (POTS). METHODS In this retrospective cohort study, 275 children with POTS admitted to the Department of Pediatrics at Peking University First Hospital were recruited from 2016 to 2019 and followed up. The participants were divided into simple POTS (S-POTS, n=156 cases) and POTS with comorbidities (Co-POTS, n=119 cases) groups according to whether they were complicated with comorbidities. A Cox regression analysis was used to identify the prognostic risk factors for children with POTS, while Kaplan-Meier curves were applied to compare the cumulative symptom remission rate (CSRR) between the two groups. The rehospitalization of the children between the two groups was also compared to explore the influence of comorbidities. RESULTS Twenty-one participants (7.6%) were lost during a median follow-up of 24 months. The Cox regression model showed that comorbidities and body mass index (BMI) were associated with the CSRR of the children with POTS. The CSRR of pediatric POTS alone was 1.748 times higher than that of patients with comorbidities, and the CSRR was decreased by 5.1% for each 1 kg/m2 increase in BMI. The most common comorbidity in children with POTS in this study was allergic disorders, followed by the psychological diseases. The patients in the Co-POTS group had a lower CSRR than those in the S-POTS group (log rank P=0.0001). In addition, compared with those of the S-POTS group, the total number of rehospitalizations was high (P=0.001), and the total hospital stays were long in the Co-POTS group (P<0.001). CONCLUSION Complicating with comorbidities, pediatric patients with POTS had lower CSRR and more rehospitalizations than those without comorbidities. More attention should be given to comorbidities when managing pediatric POTS.
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Affiliation(s)
- Yaru Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, 100034, People’s Republic of China
| | - Junbao Du
- Department of Pediatrics, Peking University First Hospital, Beijing, 100034, People’s Republic of China
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, 100034, People’s Republic of China
| | - Xueying Li
- Department of Medical Statistics, Peking University First Hospital, Beijing, 100034, People’s Republic of China
| | - Ping Liu
- Department of Pediatrics, Peking University First Hospital, Beijing, 100034, People’s Republic of China
| | - Yuli Wang
- Department of Pediatrics, Peking University First Hospital, Beijing, 100034, People’s Republic of China
| | - Ying Liao
- Department of Pediatrics, Peking University First Hospital, Beijing, 100034, People’s Republic of China
| | - Hongfang Jin
- Department of Pediatrics, Peking University First Hospital, Beijing, 100034, People’s Republic of China
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Yan H, Wang S, Cai H, Zhang J, Liu P, Wang Y, Zou R, Wang C. Prognostic Value of Biomarkers in Children and Adolescents With Orthostatic Intolerance. Front Pediatr 2021; 9:752123. [PMID: 34888267 PMCID: PMC8650092 DOI: 10.3389/fped.2021.752123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022] Open
Abstract
Orthostatic intolerance (OI) refers to a series of symptoms that occur during upright standing, which can be relieved when returned to the supine position. OI is a common cause of syncope in children and adolescents. In recent years, more and more studies have been carried out to assess the prognosis of OI by using biomarkers, among which, flow-mediated vasodilation, left ventricular ejection fraction and fractional shortening, hemodynamic change during head-up tilt test, detection of 24-h urinary sodium excretion, body mass index, midregional pro-adrenomedullin, and erythrocytic H2S producing rate are relatively stable, inexpensive, and easy to obtain. With the help of biomarkers, individualized treatment can be carried out to improve the long-term prognosis of children and adolescents with OI. This article reviews the prognostic value of biomarkers in children and adolescents with OI.
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Affiliation(s)
- Huijuan Yan
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shuo Wang
- Department of Neonatology, Xiangya Hospital, Central South University, Changsha, China
| | - Hong Cai
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Juan Zhang
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ping Liu
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuwen Wang
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Runmei Zou
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Cheng Wang
- Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China
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Mosarla RC, Wood M. The Impact of Depression and Anxiety on Cardiovascular Disease Risk and Outcomes in Women. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021. [DOI: 10.1007/s11936-020-00889-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Raykh OI, Sumin AN, Kokov АN, Indukaeva EV, Artamonova GV. Association of type D personality and level of coronary artery calcification. J Psychosom Res 2020; 139:110265. [PMID: 33038817 DOI: 10.1016/j.jpsychores.2020.110265] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 09/23/2020] [Accepted: 10/02/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the association of the type D personality and the level of coronary arteries calcification in population-based sample. METHODS 1595 residents aged 25 to 64 years were recruited in a observational cross-sectional study in the period from 2012 to 2013. In addition to the ESSE-RF study protocol, we assessed the presence of a Type D personality and quantified coronary artery calcium (CAC) using multispiral computed tomography. The obtained data was analyzed by the Agatston method. The patients were divided into two groups: patients with type D personality (n = 231) and without type D (n = 1379). RESULTS CAC score differed significantly between the groups: 689.3 ± 53.7 in patients with type D and 546.5 ± 47 without type D (p = 0.04). The greatest differences of calcium score were found in the left coronary artery system, namely left anterior descending artery (p = 0.01) and circumflex artery (p = 0.03). Patients with type D had higher levels of clinically significant anxiety (p = 0.04) and depression (p = 0.02). Type D personality is associated with high levels of CAC score independently from age, sex, diabetes mellitus status, smoking, alcohol consumption, body mass index, arterial hypertension status, cholesterol level, history of brain stroke, myocardial infarction, coronary artery disease, HADS-A and HADS-D scores. CONCLUSIONS Type D personality is associated with higher average values of the CAC score, and type D may represent a potentially modifiable risk factor CAD. But it is unclear whether type D can affect the progression of CAC score.
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Affiliation(s)
- Olga Igorevna Raykh
- Federal State Budgetary Scientific Institution "Research Institute for Complex Issues of Cardiovascular Diseases", 6, Sosnoviy blvd, Kemerovo 650002, Russian Federation
| | - Alexei Nikolayevich Sumin
- Federal State Budgetary Scientific Institution "Research Institute for Complex Issues of Cardiovascular Diseases", 6, Sosnoviy blvd, Kemerovo 650002, Russian Federation.
| | - Аlexander Nikolayevich Kokov
- Federal State Budgetary Scientific Institution "Research Institute for Complex Issues of Cardiovascular Diseases", 6, Sosnoviy blvd, Kemerovo 650002, Russian Federation
| | - Elena Vladimirovna Indukaeva
- Federal State Budgetary Scientific Institution "Research Institute for Complex Issues of Cardiovascular Diseases", 6, Sosnoviy blvd, Kemerovo 650002, Russian Federation
| | - Galina Vladimirovna Artamonova
- Federal State Budgetary Scientific Institution "Research Institute for Complex Issues of Cardiovascular Diseases", 6, Sosnoviy blvd, Kemerovo 650002, Russian Federation
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Huang CC, Chung CM, Leu HB, Huang PH, Wu TC, Lin LY, Lin SJ, Pan WH, Chen JW. Sex difference in sympathetic nervous system activity and blood pressure in hypertensive patients. J Clin Hypertens (Greenwich) 2020; 23:137-146. [PMID: 33190416 PMCID: PMC8029801 DOI: 10.1111/jch.14098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 12/28/2022]
Abstract
Increased sympathetic nervous system (SNS) activity leads to increased risk of cardiovascular morbidity and mortality. This study investigated whether there were sex differences in SNS activity among Chinese patients with hypertension. Ethnic Chinese non‐diabetic hypertensive patients aged 20–50 years were enrolled in Taiwan. A total of 970 hypertensive patients (41.0 ± 7.2 years) completed the study, 664 men and 306 women. They received comprehensive evaluations including office blood pressure (BP) measurement, 24‐h ambulatory BP monitoring, and 24‐h urine sampling assayed for catecholamine excretion. Compared to women, men were younger, had higher body mass index (BMI), office systolic BP (SBP), office diastolic BP (DBP), 24‐h ambulatory BP, and 24‐h urine catecholamine excretion. In men, 24‐h urine total catecholamine levels were correlated with 24‐h SBP (r = 0.103, p = .008) and 24‐h DBP (r = 0.083, p = .033). In women, however, there was no correlation between 24‐h urine total catecholamine levels and 24‐h ambulatory BP. Multivariate linear regression indicated that being male (β = 1.65, 95% confidence interval [CI] 0.01–3.29, p = .048) and 24‐h urine total catecholamine (β = 5.03, 95% CI 0.62–9.44, p = .025) were both independently associated with 24‐h SBP; being male was independently associated with 24‐h DBP (β = 3.55, 95% CI 2.26–4.85, p < .001). In conclusion, Chinese men with hypertension had higher SNS activity than women, and SNS activity was independently associated with 24‐h ambulatory BP in men rather than in women. These findings suggest that different hypertensive treatment strategies should be considered according to patient sex.
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Affiliation(s)
- Chin-Chou Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Min Chung
- Environment-Omics-Disease Research Centre, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Hsin-Bang Leu
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tao-Cheng Wu
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Liang-Yu Lin
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shing-Jong Lin
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
| | - Wen-Harn Pan
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.,Institute of Epidemiology, School of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jaw-Wen Chen
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
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Sumin AN, Raikh ОI, Kokov AN, Indukaeva EV, Artamonova GV. Coronary calcinosis and psychological distress association, by the data from ESSE-RF study in Kemerovskaya Region. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2018. [DOI: 10.15829/1728-8800-2018-5-65-71] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To evaluate the association of coronary arteries calcinosis with personality type D, by ESSE-RF (Epidemiology of cardiovascular diseases and risk factors in various regions of Russian Federation) trial data in Kemerovskaya Oblast.Material and methods. The study has been done under the framework of ESSE-RF trial. Standard protocol was updated with personality type assessment by DS-14 questionnaire. All patients underwent quantitative assessment of coronary calcinosis with multispiral computed tomography. The data package was analyzed with Agatstone method. Two groups of patients collected: group 1 (n=231) with type D personality, and group 2 with non-D (n=1379).Results. With the evaluation of calcium index (CaI) there were significant differences in groups: 689,3+53,7 in type D patients and 546,5+47 with none (p=0,048). Moderate and severe CaI was higher in type D patients — 10,3% and 12,5% vs 5,8% and 2,9%, respectively (p=0,043 and p=0,011). Highest differences in CaI in the left coronary artery, exactly in the left anterior descending, were 189,1+12,5 in type D vs 155,6+16,7 in non-type D (p=0,011), and circumflex artery — 121,7+30,6 vs 63,8+21,7 (p=0,032). With the logistic regression, the most influencing on moderate and severe CaI were age — hazard ratio (HR) 1,07-2,14 (p=0,023), diabetes — HR 1,32; 95% CI 1,09-1,62 (p=0,032), type D personality — HR 1,42; 95% CI 1,12-1,82 (p=0,023), coronary heart disease — HR 1,12; 95% CI 1,01-1,21 (p=0,034). By the multifactorial analysis, as independent predictors of moderate and severe CI remained such parameters as coronary heart disease — HR 1,24 95% CI 1,01-1,53 (р=0,04), diabetes — HR 1,28; 95% CI 1,80-3,24 (р=0,02) and type D — HR 1,49; 95% CI 2,01-2,29 (р=0,01).Conclusion. Screening for the influence of type D personality is worthy in persons with subclinical coronary arteries lesion to conduct on-time preventive events.
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Affiliation(s)
- A. N. Sumin
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - О. I. Raikh
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - A. N. Kokov
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - E. V. Indukaeva
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - G. V. Artamonova
- Research Institute for Complex Issues of Cardiovascular Diseases
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Xie Z, Lorkiewicz P, Riggs DW, Bhatnagar A, Srivastava S. Comprehensive, robust, and sensitive UPLC-MS/MS analysis of free biogenic monoamines and their metabolites in urine. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1099:83-91. [PMID: 30248561 PMCID: PMC6398444 DOI: 10.1016/j.jchromb.2018.09.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 09/05/2018] [Accepted: 09/11/2018] [Indexed: 01/03/2023]
Abstract
Biogenic monoamines, including catecholamines and serotonin are important hormones and neurotransmitters. Abnormal urinary levels of biogenic monoamines and their metabolites are associated with smoking, neuroendocrine tumors, as well as neurological and cardiovascular diseases. Measurements of free biogenic monoamines and their metabolites have been challenging because of low concentrations in complex biological matrices. Current methods require extensive enrichment and removal of interfering substances and can analyze only basic or acidic compounds in a single run. We developed a simple and robust dilute-and-shoot method capable of measuring 10 analytes, including free biogenic monoamines and their metabolites in human urine. The assay enables sensitive measurements of analytes within expected sample concentration ranges. To assess the assay's efficacy, we measured urinary levels of free biogenic monoamines and their metabolites in 255 non-smokers and 191 smokers. Our data show that while smokers had significantly higher urinary levels of free catecholamines and metanephrines, there was a decrease in levels of biogenic amine metabolites synthesized through the monoamine oxidase pathway - homovanillic acid and vanillylmandelic acid. The method could be used for high throughput measurement of the range of free biogenic amines and their metabolites in urine under a variety of different conditions.
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Affiliation(s)
- Zhengzhi Xie
- American Heart Association - Tobacco Regulation and Addiction Center, Superfund Research Center and Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville, 580 South Preston Street, Louisville, KY, 40202, United States of America
| | - Pawel Lorkiewicz
- American Heart Association - Tobacco Regulation and Addiction Center, Superfund Research Center and Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville, 580 South Preston Street, Louisville, KY, 40202, United States of America; Department of Chemistry, University of Louisville, 2320 S. Brook St., Louisville, KY, 40292, United States of America
| | - Daniel W Riggs
- American Heart Association - Tobacco Regulation and Addiction Center, Superfund Research Center and Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville, 580 South Preston Street, Louisville, KY, 40202, United States of America
| | - Aruni Bhatnagar
- American Heart Association - Tobacco Regulation and Addiction Center, Superfund Research Center and Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville, 580 South Preston Street, Louisville, KY, 40202, United States of America
| | - Sanjay Srivastava
- American Heart Association - Tobacco Regulation and Addiction Center, Superfund Research Center and Diabetes and Obesity Center, Institute of Molecular Cardiology, University of Louisville, 580 South Preston Street, Louisville, KY, 40202, United States of America.
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Lin J, Zhao H, Shen J, Jiao F. Salivary Cortisol Levels Predict Therapeutic Response to a Sleep-Promoting Method in Children with Postural Tachycardia Syndrome. J Pediatr 2017; 191:91-95.e1. [PMID: 29037796 DOI: 10.1016/j.jpeds.2017.08.039] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 07/07/2017] [Accepted: 08/16/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To determine the value of salivary cortisol concentrations in predicting the efficacy of sleep-promoting treatment in children with postural tachycardia syndrome (POTS). STUDY DESIGN This prospective study involved 40 children with POTS and 20 healthy children (controls). POTS was diagnosed using the head-up or head-up tilt test. Patients with POTS received a sleep-promoting treatment: >8 hours of sleep every night and a midday nap in an appropriate environment; no drinking water or exercising before bedtime; and urination before bedtime. The Pittsburgh Sleep Quality Index was used to evaluate sleep quality, and symptom scores were used to assess POTS severity. Salivary samples were collected upon awakening, 30 minutes after awakening, at 12:00 p.m., 4:00 p.m., and 8:00 p.m., and at bedtime before treatment. Enzyme-linked immunosorbent assay was used to measure salivary cortisol concentrations. RESULTS Cortisol concentrations were significantly higher in patients with POTS than in the controls at all time points (P < .05 for all). PSQI scores were significantly higher in patients with POTS (7.2 ± 3.0) than in the controls (1.35 ± 1.39; t = -10.370, P <.001). Salivary cortisol concentrations at awakening were significantly higher in responders than in nonresponders (4.83 ± 0.73 vs 4.05 ± 0.79 ng/mL, t = -3.197, P = .003). The area under the receiver operating characteristic curve was 75.8%, (95% CI 59.3%-92%). Cut-off at-awakening salivary cortisol concentrations of >4.1 ng/mL yielded 83.3% sensitivity and 68.7% specificity in predicting therapeutic efficacy. CONCLUSIONS At-awakening salivary cortisol concentrations may predict the efficacy of sleep-promoting treatment in patients with POTS.
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Affiliation(s)
- Jing Lin
- Department of Child and Adolescent Health Science Center, School of Public Health, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
| | - Huacai Zhao
- Department of Urology, the Third Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China
| | - Jie Shen
- Department of Cardiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fuyong Jiao
- Department of Pediatrics, The Third Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China
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