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Xie Z, Zeinstra N, Kirby MA, Le NM, Murry CE, Zheng Y, Wang RK. Quantifying Microvascular Structure in Healthy and Infarcted Rat Hearts Using Optical Coherence Tomography Angiography. IEEE TRANSACTIONS ON MEDICAL IMAGING 2024; 43:2878-2887. [PMID: 38568757 PMCID: PMC11341234 DOI: 10.1109/tmi.2024.3381934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Myocardial infarction (MI) is a life-threatening medical emergency resulting in coronary microvascular dysregulation and heart muscle damage. One of the primary characteristics of MI is capillary loss, which plays a significant role in the progression of this cardiovascular condition. In this study, we utilized optical coherence tomography angiography (OCTA) to image coronary microcirculation in fixed rat hearts, aiming to analyze coronary microvascular impairment post-infarction. Various angiographic metrics are presented to quantify vascular features, including the vessel area density, vessel complexity index, vessel tortuosity index, and flow impairment. Pathological differences identified from OCTA analysis are corroborated with histological analysis. The quantitative assessments reveal a significant decrease in microvascular density in the capillary-sized vessels and an enlargement for the arteriole/venule-sized vessels. Further, microvascular tortuosity and complexity exhibit an increase after myocardial infarction. The results underscore the feasibility of using OCTA to offer qualitative microvascular details and quantitative metrics, providing insights into coronary vascular network remodeling during disease progression and response to therapy.
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Khoja A, Andraweera PH, Tavella R, Gill TK, Dekker GA, Roberts CT, Edwards S, Arstall MA. Influence of Socioeconomic Status on the Association Between Pregnancy Complications and Premature Coronary Artery Disease: Linking Three Cohorts. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:120-131. [PMID: 38404672 PMCID: PMC10890942 DOI: 10.1089/whr.2023.0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 02/27/2024]
Abstract
Background We hypothesized that there is an influence of socioeconomic status (SES) on association between pregnancy complications and premature coronary artery disease (PCAD) risk. Materials and Methods This project involved a data linkage approach merging three databases of South Australian cohorts using retrospective, age-matched case-control study design. Cases (n = 721), that is, women aged <60 years from Coronary Angiogram Database of South Australia (CADOSA) were linked to South Australian Perinatal Statistics Collection (SAPSC) to ascertain prior pregnancy outcomes and SES. Controls (n = 194) were selected from North West Adelaide Health Study (NWAHS), comprising women who were healthy or had health conditions unrelated to CAD, age matched to CADOSA (±5 years), and linked to SAPSC to determine prior pregnancy outcomes and SES. This project performed comparative analysis of SES using socioeconomic indexes for areas-index of relative socioeconomic advantage and disadvantage (SEIFA-IRSAD) scores across three databases. Results Findings revealed that SEIFA-IRSAD scores at the time of pregnancy (p-value = 0.005) and increase in SEIFA-IRSAD scores over time (p-value = 0.040) were significantly associated with PCAD. In addition, when models were adjusted for SEIFA-IRSAD scores at the time of pregnancy and age, risk factors including placenta-mediated pregnancy complications such as preterm birth (odds ratio [OR] = 4.77, 95% confidence interval [CI]: 1.74-13.03) and history of a miscarriage (OR = 2.14, 95% CI: 1.02-4.49), and cardiovascular disease (CVD) risk factors including smoking (OR = 8.60, 95% CI: 3.25-22.75) were significantly associated with PCAD. When the model was adjusted for change in SEIFA-IRSAD scores (from CADOSA/NWAHS to SAPSC) and age, pregnancy-mediated pregnancy complications including preterm birth (OR = 4.40, 95% CI: 1.61-12.05) and history of a miscarriage (OR = 2.09, 95% CI: 1.00-4.35), and CVD risk factor smoking (OR = 8.75, 95% CI: 3.32-23.07) were significantly associated with PCAD. Conclusion SES at the time of pregnancy and change in SES were not associated with PCAD risk.
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Affiliation(s)
- Adeel Khoja
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, Australia
| | - Prabha H. Andraweera
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, Australia
| | - Rosanna Tavella
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South, Australia
| | - Tiffany K. Gill
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Gustaaf A. Dekker
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Obstetrics and Gynaecology, Lyell McEwin Hospital, University of Adelaide, Adelaide, Australia
| | - Claire T. Roberts
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Medicine, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, Australia
| | - Suzanne Edwards
- Department of Medicine, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, Australia
| | - Margaret A. Arstall
- Department of Cardiology, Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, Australia
- Department of Medicine, Medical Specialties, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia
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Khoja A, Andraweera PH, Tavella R, Gill TK, Dekker GA, Roberts CT, Edwards S, Arstall MA. Pregnancy Complications Are Associated with Premature Coronary Artery Disease: Linking Three Cohorts. J Womens Health (Larchmt) 2023; 32:1208-1218. [PMID: 37815882 DOI: 10.1089/jwh.2023.0239] [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: 10/12/2023] Open
Abstract
Background: There is increasing evidence that women who experience placenta-mediated pregnancy complications and gestational diabetes mellitus (GDM) are at higher risk for the development of coronary artery disease (CAD) later in life. We hypothesized that there is an association between placenta-mediated pregnancy complications, GDM, and risk of premature CAD (PCAD). Methods: This research project involved a data linkage approach merging three databases of South Australian cohorts by using a retrospective, age-matched case-control study design. Cases (n = 721) were ascertained from the Coronary Angiogram Database of South Australia (CADOSA). Women <60 years from CADOSA were linked to South Australian Perinatal Statistics Collection (SAPSC) to ascertain their prior pregnancy outcomes. Controls (n = 194) were selected from North West Adelaide Health Study (NWAHS) and comprised women who were healthy or had other health conditions unrelated to CAD, age-matched to CADOSA (±5 years), and linked to SAPSC to determine their pregnancy outcomes. PCAD was defined as >50% stenosis in one or more coronary arteries at coronary angiography. Results: Compared with women without a history of PCAD, women who were diagnosed with PCAD were more likely to have experienced the placenta-mediated pregnancy complications of preterm birth (adjusted odds ratio [OR] = 2.46, 95% confidence interval [CI]: 1.21-5.00) or low-birth weight (adjusted OR = 2.44, 95% CI: 1.22-4.88), or have been diagnosed with active asthma during pregnancy (adjusted OR = 3.52, 95% CI: 1.05-11.76). Conclusion: Placenta-mediated pregnancy complications should be recognized as clear risk markers for future PCAD.
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Affiliation(s)
- Adeel Khoja
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, Australia
| | - Prabha H Andraweera
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, Australia
| | - Rosanna Tavella
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South, Australia
| | - Tiffany K Gill
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Gustaaf A Dekker
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Obstetrics and Gynaecology, Lyell McEwin Hospital, The University of Adelaide, Adelaide, Australia
| | - Claire T Roberts
- Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Department of Medicine, The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Medicine, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, Australia
| | - Suzanne Edwards
- Department of Medicine, Adelaide Health Technology Assessment, School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Margaret A Arstall
- Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, Australia
- Department of Medicine, Medical Specialties, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia
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Wang Y, Muthurangu V, Wurdemann HA. Toward Autonomous Pulmonary Artery Catheterization: A Learning-based Robotic Navigation System. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-5. [PMID: 38082621 DOI: 10.1109/embc40787.2023.10340140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Providing imaging during interventional treatments of cardiovascular diseases is challenging. Magnetic Resonance Imaging (MRI) has gained popularity as it is radiation-free and returns high resolution of soft tissue. However, the clinician has limited access to the patient, e.g., to their femoral artery, within the MRI scanner to accurately guide and manipulate an MR-compatible catheter. At the same time, communication will need to be maintained with a clinician, located in a separate control room, to provide the most appropriate image to the screen inside the MRI room. Hence, there is scope to explore the feasibility of how autonomous catheterization robots could support the steering of catheters along trajectories inside complex vessel anatomies.In this paper, we present a Learning from Demonstration based Gaussian Mixture Model for a robot trajectory optimisation during pulmonary artery catheterization. The optimisation algorithm is integrated into a 2 Degree-of-Freedom MR-compatible interventional robot allowing for continuous and simultaneous translation and rotation. Our methodology achieves autonomous navigation of the catheter tip from the inferior vena cava, through the right atrium and the right ventricle into the pulmonary artery where an interventions is performed. Our results show that our MR-compatible robot can follow an advancement trajectory generated by our Learning from Demonstration algorithm. Looking at the overall duration of the intervention, it can be concluded that procedures performed by the robot (teleoperated or autonomously) required significantly less time compared to manual hand-held procedures.
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Blatch Armon D, Buhayer A, Dobretz K, Meinlschmidt G, Battegay E. Clinical practice guidelines for cardiovascular disease: how is depression addressed? Protocol for a systematic review. BMJ Open 2023; 13:e071940. [PMID: 37130663 PMCID: PMC10163515 DOI: 10.1136/bmjopen-2023-071940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
INTRODUCTION Depression frequently affects patients with cardiovascular disease (CVD). When these conditions co-occur, outcomes such as quality of life and life expectancy worsen. In everyday practice, this specific and prevalent disease-disease interaction complicates patient management. Clinical practice guidelines (CPGs) aim to provide the best available advice for clinical decision-making to improve patient care. This study will aim to evaluate how CPGs specifically address depression in patients with CVD, and whether they provide any operational guidance for screening and management of depression in the primary care and outpatient setting. METHODS AND ANALYSIS We will conduct a systematic review of CPGs on CVD management published from 2012 to 2023. A broad literature search for guidelines will be performed through electronic medical databases, grey literature search tools, and websites of national and professional medical organisations.Based on the inclusion criteria, two independent reviewers will evaluate eligible guidelines for screening and management recommendations on depression in patients with CVD. Additional points to be evaluated will be any mention of drug-drug or drug-disease interactions, other aspects of specific relevance to treating physicians, as well as general information on mental health. We will assess the quality of CPGs with a recommendation regarding depression in CVD patients using the Appraisal of Guidelines for Research and Evaluation II. ETHICS AND DISSEMINATION As this systematic review is based on available published data, ethics approval and consent are not applicable. Our intent is that our results will be published in a peer-reviewed journal, presented at international scientific meetings, and distributed to healthcare providers. PROSPERO REGISTRATION NUMBER CRD42022384152.
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Affiliation(s)
- Dana Blatch Armon
- Department of Psychosomatic Medicine, International Center for Multimorbidity and Complexity in Medicine, University of Zurich, University Hospital Basel, Merian Iselin Klinik, Basel, Switzerland
| | - Aliki Buhayer
- Department of Psychosomatic Medicine, International Center for Multimorbidity and Complexity in Medicine, University of Zurich, University Hospital Basel, Merian Iselin Klinik, Basel, Switzerland
| | - Kevin Dobretz
- Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Gunther Meinlschmidt
- Department of Digital and Blended Psychosomatics and Psychotherapy, Psychosomatic Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
- Division of Clinical Psychology and Cognitive Behavioural Therapy, International Psychoanalytic University Berlin, Berlin, Germany
| | - Edouard Battegay
- Department of Psychosomatic Medicine, International Center for Multimorbidity and Complexity in Medicine, University of Zurich, University Hospital Basel, Merian Iselin Klinik, Basel, Switzerland
- Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
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Chen H, Gao J, Xu Q, Wan D, Zhai W, Deng L, Qie R. MiR-145-5p modulates lipid metabolism and M2 macrophage polarization by targeting PAK7 and regulating β-catenin signaling in hyperlipidemia. Can J Physiol Pharmacol 2021; 99:857-863. [PMID: 34143694 DOI: 10.1139/cjpp-2020-0539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The present study aims to explore the role of microRNA 145-5p (miR-145-5p) in hyperlipidemia. Using bioinformatics tools and a wide range of function and mechanism assays, we attempted to understand the specific function and potential mechanism of miR-145-5p in hyperlipidemia. A cholesterol-enriched diet induced an increase of serum cholesterol and triacylglycerol but a decrease of serum high-density lipoprotein. MiR-145-5p level was decreased in hyperlipidemia rat models. MiR-145-5p regulated lipid metabolism by antagonizing the alteration of high-density lipoprotein, cholesterol, and triacylglycerol in serum mediated by a cholesterol-enriched diet. In mechanism, miR-145-5p directly bound with p21 protein (RAC1)-activated kinase 7 (PAK7) and negatively regulated mRNA and protein levels of PAK7 in THP-1 cells. Furthermore, miR-145-5p level was negatively associated with PAK7 level in rat cardiac tissues. Finally, overexpression of PAK7 reversed the effects of miR-145-5p on β-catenin activation and M2 macrophages polarization in THP-1 cells. In conclusion, MiR-145-5p modulated lipid metabolism and M2 macrophage polarization by targeting PAK7 and regulating β-catenin signaling in hyperlipidemia, which may provide a potential biomarker for the treatment of hyperlipidemia-induced cardiovascular diseases.
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Affiliation(s)
- Huijun Chen
- Department of Cardiology, Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150001, Heilongjiang, China
| | - Jing Gao
- Department of Cardiology, Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150001, Heilongjiang, China
| | - Qian Xu
- Department of Cardiology, Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150001, Heilongjiang, China
| | - Dongmei Wan
- Department of Cardiology, Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150001, Heilongjiang, China
| | - Wenji Zhai
- Department of Cardiology, Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150001, Heilongjiang, China
| | - Limei Deng
- Department of Cardiology, Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150001, Heilongjiang, China
| | - Rui Qie
- Department of Emergency, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, Heilongjiang, China
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Al‐Hamed FS, Kouniaris S, Tamimi I, Lordkipanidzé M, Madathil SA, Kezouh A, Karp I, Nicolau B, Tamimi F. Acetylcholinesterase inhibitors and risk of bleeding and acute ischemic events in non-hypertensive Alzheimer's patients. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12184. [PMID: 34458554 PMCID: PMC8377777 DOI: 10.1002/trc2.12184] [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: 08/06/2020] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Acetylcholinesterase inhibitors (AChEIs) are commonly used to treat mild to moderate cases of Alzheimer disease (AD). To the best of our knowledge, there has been no study estimating the risk of bleeding and cardiovascular events in patients with non-hypertensive AD. Therefore, this study aimed to estimate the association between AChEIs and the risk of bleeding and cardiovascular ischemic events in patients with non-hypertensive AD. METHODS A nested case-control study was conducted to estimate the risk of bleeding and ischemic events (angina, myocardial infarction [MI], and stroke) in patients with AD. This study was conducted using the UK Clinical Practice Research Datalink and Hospital Episode Statistics (HES) databases. The study cohort consisted of AD patients ≥65 years of age. The case groups included all AD subjects in the database who had a bleeding or ischemic event during the cohort follow-up. Four controls were selected for each case. Patients were classified as current users or past users based on a 60-day threshold of consuming the drug. Simple and multivariable conditional logistic regression analyses were used to calculate the adjusted odds ratio for bleeding events and cardiovascular events. RESULTS We identified 507 cases and selected 2028 controls for the bleeding event cohort and 555 cases and 2220 controls for the ischemic event cohort. The adjusted odds ratio (OR) (95% confidence interval [CI]) for the association of AChEI use was 0.93 (0.75 to 1.16) for bleeding events, 2.58 (1.01 to 6.59) for angina, and 1.89 (1.07 to 3.33) for MI. Past users of AChEIs were also at increased risk of stroke (1.51 [1.00 to 2.27]). DISCUSSION This is the first study assessing the risk of bleeding and cardiovascular events in patients with non-hypertensive AD. Our findings could be of great interest for clinicians and researchers working on AD.
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Affiliation(s)
- Faez Saleh Al‐Hamed
- Faculty of DentistryMcGill University2001 McGill College AvenueMontrealQuebecH3A 1G1Canada
| | - Stamatis Kouniaris
- Faculty of DentistryMcGill University2001 McGill College AvenueMontrealQuebecH3A 1G1Canada
| | - Iskandar Tamimi
- Orthopedic Surgery DepartmentHospital Regional Universitario de MalagaMalagaSpain
| | - Marie Lordkipanidzé
- Faculté de pharmacieUniversité de MontréalMontréalQuebecCanada
- Research CenterMontreal Heart InstituteMontrealQuebecCanada
| | | | - Abbas Kezouh
- Department of Epidemiology and BiostatisticsDavis InstituteMontrealQuebecCanada
| | - Igor Karp
- Department of Epidemiology and BiostatisticsSchulich School of Medicine and DentistryWestern UniversityLondonOntarioCanada
- Département de Médecine Sociale et PréventiveUniversité de MontréalMontréalQuébecCanada
| | - Belinda Nicolau
- Faculty of DentistryMcGill University2001 McGill College AvenueMontrealQuebecH3A 1G1Canada
| | - Faleh Tamimi
- Faculty of DentistryMcGill University2001 McGill College AvenueMontrealQuebecH3A 1G1Canada
- College of Dental MedicineQatar UniversityDohaQatar
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Aerts N, Le Goff D, Odorico M, Le Reste JY, Van Bogaert P, Peremans L, Musinguzi G, Van Royen P, Bastiaens H. Systematic review of international clinical guidelines for the promotion of physical activity for the primary prevention of cardiovascular diseases. BMC FAMILY PRACTICE 2021; 22:97. [PMID: 34011279 PMCID: PMC8136198 DOI: 10.1186/s12875-021-01409-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/09/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Cardiovascular diseases are the world's leading cause of morbidity and mortality. An active lifestyle is one of the cornerstones in the primary prevention of cardiovascular disease. An initial step in guiding primary prevention programs is to refer to clinical guidelines. We aimed to systematically review clinical practice guidelines on primary prevention of cardiovascular disease and their recommendations regarding physical activity. METHODS We systematically searched Trip Medical Database, PubMed and Guidelines International Network from January 2012 up to December 2020 using the following search strings: 'cardiovascular disease', 'prevention', combined with specific cardiovascular disease risk factors. The identified records were screened for relevance and content. We methodologically assessed the selected guidelines using the AGREE II tool. Recommendations were summarized using a consensus-developed extraction form. RESULTS After screening, 27 clinical practice guidelines were included, all of which were developed in Western countries and showed consistent rigor of development. Guidelines were consistent about the benefit of regular, moderate-intensity, aerobic physical activity. However, recommendations on strategies to achieve and sustain behavior change varied. Multicomponent interventions, comprising education, counseling and self-management support, are recommended to be delivered by various providers in primary health care or community settings. Guidelines advise to embed patient-centered care and behavioral change techniques in prevention programs. CONCLUSIONS Current clinical practice guidelines recommend similar PA lifestyle advice and propose various delivery models to be considered in the design of such interventions. Guidelines identify a gap in evidence on the implementation of these recommendations into practice.
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Affiliation(s)
- N. Aerts
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - D. Le Goff
- Department of General Medicine, SPURBO, Université de Bretagne Occidentale, University of West Brittany, 7479 Brest, EA France
| | - M. Odorico
- Department of General Medicine, SPURBO, Université de Bretagne Occidentale, University of West Brittany, 7479 Brest, EA France
| | - J. Y. Le Reste
- Department of General Medicine, SPURBO, Université de Bretagne Occidentale, University of West Brittany, 7479 Brest, EA France
| | - P. Van Bogaert
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
| | - L. Peremans
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
| | - G. Musinguzi
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - P. Van Royen
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - H. Bastiaens
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Song F, Zhou Y, Zhang K, Liang YF, He X, Li L. The role of the plasma glycosylated hemoglobin A1c/Apolipoprotein A-l ratio in predicting cardiovascular outcomes in acute coronary syndrome. Nutr Metab Cardiovasc Dis 2021; 31:570-578. [PMID: 33358616 DOI: 10.1016/j.numecd.2020.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/30/2020] [Accepted: 10/12/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND AIMS Glucose and lipid metabolism are major prognostic indicators of coronary heart disease. The ratio of plasma glycosylated hemoglobin A1c (HbA1c) to apolipoprotein A-l (ApoA-l) is an indirect measure of insulin resistance. The study aimed to evaluate whether the HbA1c/ApoA-1 ratio can predict the prognosis in patients with the acute coronary syndrome (ACS). METHODS AND RESULTS A total of 476 ACS patients diagnosed by coronary angiography were enrolled in this longitudinal, observational, retrospective study. Plasma HbA1c, fasting blood glucose and lipid profile were measured. Patients were stratified according to the tertiles of HbA1c/ApoA-l levels. Cox proportional hazard model was used to examine the predictive value of HbA1c/ApoA-l for study endpoints. The association between the Log HbA1c/ApoA-l ratio and major adverse cardiovascular events (MACEs) was estimated using multiple logistic regression. Baseline characteristics showed a mean age of 66 ± 8 years, and 52.5% were hypertensive, 26.8% diabetic, and 54.5% current or prior smokers. During a mean follow-up period of 22.3 ± 1.7 months, 59 deaths occurred. After adjusting for age, gender, smoking, hypertension, diabetes, and coronary artery disease severity, patients in the highest HbA1c/ApoA-l ratio tertile had a 4.36-fold increased risk of mortality compared with those in the lowest tertile. The multivariate logistic regression showed that the Log HbA1c/ApoA-l ratio was associated with MACEs (Odds ratio 2.95, p = 0.013). CONCLUSION After adjusting for traditional cardiovascular risk factors and ACS severity scores, the HbA1c/ApoA-1 ratio remained an independent predictor of all-cause mortality and MACEs in the ACS patients undergoing angiography.
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Affiliation(s)
- Feier Song
- Department of Emergency and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
| | - Yu Zhou
- Division of Vascular Surgery, National-Local Joint Engineering Laboratory of Vascular Disease Treatment, Engineering and Technology Center for Diagnosis and Treatment of Vascular Diseases, Guangdong Engineering Laboratory of Diagnosis and Treatment of Vascular Disease, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Kunyi Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, 510060, China; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University, Guangzhou, 510060, China.
| | - Yuan-Feng Liang
- General Division, Guangdong Geriatric Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
| | - Xuyu He
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
| | - Liwen Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
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Jabbari A, Jafari A, Hadian M, Ghasemi M. Model-based Cost-effectiveness Analysis of Atorvastatin Drugs for Prevention of Cardiovascular Diseases in Iran. Int J Prev Med 2020; 11:57. [PMID: 32577187 PMCID: PMC7297424 DOI: 10.4103/ijpvm.ijpvm_578_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 02/20/2020] [Indexed: 01/16/2023] Open
Abstract
Background: Today, cardiovascular disease is one of the main causes of mortality and disability in most developed and developing countries. The prediction of the major causes of deaths all over the world at all ages shows that 61% of deaths are due to chronic diseases, of which 30% is due to cardiovascular disease. The aim of this study was to assess the cost-utility analysis of atorvastatin for the prevention of cardiovascular diseases using the Markov model. Methods: Markov model with a lifetime horizon was developed to evaluate economic and health outcomes for atorvastatin drugs for the prevention of cardiovascular diseases for a cohort of 1,000 patients. The effectiveness indicator in this study was quality-adjusted life-years (QALYs); robustness of results was examined by one-way and probabilistic sensitivity analysis. Results: The results showed that the use of atorvastatin compared to no drug intervention was highly cost-effective with USD173 per additional QALY. The results of one-way and probabilistic sensitivity analysis confirmed the results of this study. The findings of this study also showed that the highest cost items were hospitalization costs in the cardiac care unit (CCU). Also, the highest cost items in para-clinical services were related to echocardiography costs, and troponin constituted the largest cost of laboratory tests. Conclusions: Based on the results of this study, it is recommended that cardiologists use atorvastatin in the prevention of cardiovascular disease.
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Affiliation(s)
- Alireza Jabbari
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdosaleh Jafari
- Health Human Resources Research Center, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marziye Hadian
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ghasemi
- Member of Social Determinant of Health Center, Birjand University of Medical Sciences, Birjand, Iran
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11
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The Prevalence and 5-Year Incidence Rate of Low Physical Activity in an Urban Population of 10,000 in Southeastern Iran: Relationship With Other Cardiovascular Risk Factors. J Phys Act Health 2020; 17:435-442. [PMID: 32109881 DOI: 10.1123/jpah.2019-0426] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 11/11/2019] [Accepted: 01/11/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Because of high prevalence of coronary artery diseases (CADs) in Iran and their relationship with low physical activity (LPA), this study aimed to measure the epidemic size of LPA, its incidence rate, and its relationship with other CAD risk factors in Kerman, Iran. METHODS About 10,000 adults were randomly recruited through single-stage cluster sampling. Demographic characteristics, biochemical variables, smoking, opium use, mental status, and physical activities were assessed. The relationship between LPA and 7 other CAD risk factors was measured. Five-year incidence rate of LPA was calculated according to the data from the physically active participants in the first phase of the study (n = 3416) who attended the second phase after 5 years. RESULTS The prevalence of low, moderate, and intense physical activity was 47.2%, 34.8%, and 18.0%, respectively. LPA rose from 45.1% to 62.2% after the age of 25 years. Women had higher LPA than men. Participants with LPA had significantly higher chance of cigarette smoking, diabetes, overweight/obesity, hypertension, and opium addiction. Five-year incidence rate of LPA was 5.1 persons/100 person-years among physically active population. CONCLUSION Almost half of the studied population suffering from LPA was at risk of CAD. Such risky lifestyle pattern while worsened in the last 5 years makes the emerging of CAD epidemic unavoidable, if appropriate timely interventions not being in place accordingly.
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12
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Koirala B, Amgai C, Davidson P. Conducting nursing research in low- and middle-income countries: experiences, challenges and solutions. Nurse Res 2020; 28:e1661. [PMID: 31894926 DOI: 10.7748/nr.2020.e1661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Conducting nursing research in low- and middle-income countries (LMICs) balances challenges and opportunities. Understanding the shared experiences of researchers who have completed studies in diverse cultural contexts using various methodologies is important, to advance global nursing research and to build health research capacity and sustainability strategies. AIM To provide a reflexive account using a case-study methodology of transactions and processes conducted during a study in a LMIC. DISCUSSION Lessons learned from the study include the importance of preplanning, being flexible and creative, engaging local collaborators early in planning, establishing good rapport and respectful relationships with gatekeepers and collaborators, having a backup plan, appreciating cultural differences, and sharing findings. CONCLUSION Conducting research in LMICs is complex, especially negotiating access and obtaining ethical approval. Understanding the issues will benefit future research and prepare nurse researchers who take on the challenges and rewards of conducting international research in LMICs. IMPLICATIONS FOR PRACTICE This paper provides a roadmap to help novice researchers conduct research in LMICs.
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Affiliation(s)
- Binu Koirala
- Johns Hopkins University School of Nursing, Baltimore, Maryland, US
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13
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Lo Re O, Maugeri A, Hruskova J, Jakubik J, Kucera J, Bienertova-Vasku J, Oben JA, Kubala L, Dvorakova A, Ciz M, Vinciguerra M. Obesity-induced nucleosome release predicts poor cardio-metabolic health. Clin Epigenetics 2019; 12:2. [PMID: 31892362 PMCID: PMC6938639 DOI: 10.1186/s13148-019-0797-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 12/16/2019] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE While circulating nucleosome levels are high in obese mouse models, it is unknown where these nucleosomes originate from and whether they are a marker of cardio-metabolic health in humans. Here, we aimed to determine whether an association exists between circulating nucleosomes and the risk of developing obesity, metabolic syndrome (MetS) and/or a dysfunctional cardiovascular performance. METHODS We randomly selected 120 participants of the Kardiovize Brno 2030 study across three BMI strata: BMI 18-25, 25-30, and > 30. We assessed the association between circulating nucleosome levels and the risk of obesity, MetS, and poor cardiovascular health. We then cultured human neutrophils, adipocytes, and hepatoma cells to study nucleosome origins in a fat-rich environment. RESULTS Circulating nucleosome levels positively correlated with BMI (R = 0.602, p < 0.05), fatty liver index (R = 0.622, p < 0.05), left ventricular mass (R = 0.457, p < 0.05), and associated with MetS (p < 0.001) and poor cardiovascular health (p < 0.001). Incubating neutrophils with 1-10 μM free fatty acids triggered nucleosome production without concomitant cell death. Nucleosomes were not produced during pre-adipocyte differentiation or upon incubation of hepatic cells with palmitic acid. CONCLUSIONS Neutrophils are a bona fide source of circulating nucleosomes in an obesogenic environment and in overweight/obese patients. High nucleosome levels are associated with MetS and cardiovascular performance, and might represent novel candidate biomarkers for cardio-metabolic health.
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Affiliation(s)
- Oriana Lo Re
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic.,Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Andrea Maugeri
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic.,Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Jana Hruskova
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
| | - Juraj Jakubik
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
| | - Jan Kucera
- Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Julie Bienertova-Vasku
- Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of Science, Masaryk University, Brno, Czech Republic.,Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jude A Oben
- Institute for Liver and Digestive Health, Division of Medicine, University College London (UCL), London, UK
| | - Lukas Kubala
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic.,Institute of Biophysics, Academy of Sciences of the Czech Republic, 61265, Brno, Czech Republic
| | - Adela Dvorakova
- Institute of Biophysics, Academy of Sciences of the Czech Republic, 61265, Brno, Czech Republic.,Department of Animal Physiology and Immunology, Institute of Experimental Biology, Masaryk University, Brno, Czech Republic
| | - Milan Ciz
- Institute of Biophysics, Academy of Sciences of the Czech Republic, 61265, Brno, Czech Republic.,Department of Animal Physiology and Immunology, Institute of Experimental Biology, Masaryk University, Brno, Czech Republic
| | - Manlio Vinciguerra
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic. .,Institute for Liver and Digestive Health, Division of Medicine, University College London (UCL), London, UK.
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14
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Bayés de Luna A, Baranchuk A. A Project to Improve Global Cardiovascular Care: JACC Spanish. J Am Coll Cardiol 2018; 72:2932-2933. [PMID: 30522655 DOI: 10.1016/j.jacc.2018.10.037] [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: 10/27/2022]
Affiliation(s)
- Antoni Bayés de Luna
- Universitat Autònoma de Barcelona, Institut Català Ciències Cardiovasculars-Hospital de la Santa Creu i Sant Pau and Hospital Quirón Barcelona, Barcelona, Spain.
| | - Adrian Baranchuk
- Queen's University, Arrhythmia service, Kingston, Ontario, Canada
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15
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Maugeri A, Kunzova S, Medina-Inojosa JR, Agodi A, Barchitta M, Homolka M, Kiacova N, Bauerova H, Sochor O, Lopez-Jimenez F, Vinciguerra M. Association between eating time interval and frequency with ideal cardiovascular health: Results from a random sample Czech urban population. Nutr Metab Cardiovasc Dis 2018; 28:847-855. [PMID: 29753587 DOI: 10.1016/j.numecd.2018.04.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS The frequency and timing of meals may affect cardiovascular health (CVH) outcomes, but large-scale epidemiological studies are lacking. The aim of this study was to understand the relationship between eating time interval and frequency, and measures of ideal CVH in the Kardiovize Brno cohort study, a random urban sample population in Central Europe. METHODS AND RESULTS 1659 members of the Kardiovize Brno 2030 cohort were included in a cross-sectional study (mean age = 46.86 years; 44.6% male). Exposure variables were eating time interval and frequency, and skipping meals. Primary outcomes were indices of CVH, including body mass index, diet, physical activity, smoking, blood pressure, glucose and cholesterol, and the composite CVH score. Cluster analysis and binary logistic regression analysis were used to evaluate eating habits and the association between variables. After adjustment for well-known risk factors, subjects who skipped breakfast or the afternoon snack had a higher risk of poor CVH (OR = 1.613; 95%CI = 1.121-2.320; p = 0.010; OR = 1.409; 95%CI = 1.110-1.788; p = 0.005, respectively). Moreover, we identified three clusters of individuals based on eating habits; from cluster 1 to cluster 3, eating time interval and frequency increased and this was associated with increases in CVH score from 8.70 (SEM = 0.10) in cluster 1, and 9.06 (SEM = 0.08) in cluster 2 to 9.42 (SEM = 0.09) in cluster 3 (p-trend = 0.019). CONCLUSIONS Our findings suggest that skipping breakfast or the afternoon snack are risk factors for poor CVH, while higher eating time interval and frequency may promote ideal CVH.
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Affiliation(s)
- A Maugeri
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic; Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - S Kunzova
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
| | - J R Medina-Inojosa
- Department of Cardiovascular Medicine, Division of Preventive Cardiology, Mayo Clinic, Rochester MN, USA
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - M Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - M Homolka
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
| | - N Kiacova
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
| | - H Bauerova
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
| | - O Sochor
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
| | - F Lopez-Jimenez
- Department of Cardiovascular Medicine, Division of Preventive Cardiology, Mayo Clinic, Rochester MN, USA
| | - M Vinciguerra
- International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic; Division of Medicine, University College London (UCL), London, UK.
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16
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Hruskova J, Maugeri A, Podroužková H, Štípalová T, Jakubík J, Barchitta M, Medina-Inojosa JR, Homolka M, Agodi A, Kunzova S, Sochor O, Lopez-Jimenez F, Vinciguerra M. Association of Cardiovascular Health with Epicardial Adipose Tissue and Intima Media Thickness: The Kardiovize Study. J Clin Med 2018; 7:jcm7050113. [PMID: 29757253 PMCID: PMC5977152 DOI: 10.3390/jcm7050113] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 12/31/2022] Open
Abstract
Background: Intima-media thickness (IMT) has been proposed as a measurement of subclinical atherosclerosis and has been associated with cardiovascular disease (CVD). Epicardial adipose tissue (EAT) is a fat depot between the pericardium and myocardium and has been associated with coronary atherosclerosis. The relationship between IMT and EAT thickness has not been reported before. We investigated the relationship between EAT thickness, IMT, CVD risk factors, and ideal cardiovascular health (CVH) metrics using subjects from the Kardiovize Brno 2030 cohort study, a random urban sample population in Central Europe. Methods: We studied 102 individuals (65 males) aged 25–64 years (median = 37 years) with no current or past CVD history. We measured IMT using a vascular ultrasound and EAT thickness using transthoracic echocardiography, and collected data on anthropometric factors, CVD risk factors, and CVH score. Correlation tests and multiple linear regression models were applied. Results: In the age- and gender-adjusted model, we demonstrated that, among CVD risk factors, only BMI was significantly and positively associated with EAT thickness (β = 0.182, SE = 0.082, p = 0.030), while no significant associations with IMT were evident. Although both EAT thickness and IMT were negatively correlated with CVH score (r = −0.45, p < 0.001, and r = −0.38, p < 0.001, respectively), we demonstrated that overall CVH score (β = −0.262; SE = 0.077; p = 0.001), as well as BMI (β = −1.305; SE = 0.194; p < 0.001) and blood pressure CVH metrics (β = −0.607; SE = 0.206; p = 0.004) were significantly associated with EAT thickness but not with IMT. Conclusions: Our study is important as it demonstrated for the first time that CVH is associated with EAT thickness. Interestingly, this relationship seems to be dependent on BMI and blood pressure rather than on the other CVH metrics. However, outcome-driven studies are required to confirm these findings.
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Affiliation(s)
- Jana Hruskova
- International Clinical Research Center, St'Anne University Hospital, Brno 60200, Czech Republic.
| | - Andrea Maugeri
- International Clinical Research Center, St'Anne University Hospital, Brno 60200, Czech Republic.
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Helena Podroužková
- Department of Internal Medicine ⁻ Cardioangiology, Faculty of Medicine, Masaryk University, Brno 65691, Czech Republic.
| | - Tatiana Štípalová
- Department of Internal Medicine ⁻ Cardioangiology, Faculty of Medicine, Masaryk University, Brno 65691, Czech Republic.
| | - Juraj Jakubík
- International Clinical Research Center, St'Anne University Hospital, Brno 60200, Czech Republic.
| | - Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Jose R Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA.
| | - Martin Homolka
- International Clinical Research Center, St'Anne University Hospital, Brno 60200, Czech Republic.
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Sarka Kunzova
- International Clinical Research Center, St'Anne University Hospital, Brno 60200, Czech Republic.
| | - Ondrej Sochor
- International Clinical Research Center, St'Anne University Hospital, Brno 60200, Czech Republic.
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA.
| | - Manlio Vinciguerra
- International Clinical Research Center, St'Anne University Hospital, Brno 60200, Czech Republic.
- Division of Medicine, University College London (UCL), London, NW3 2PF, UK.
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17
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Reyes LM, Davenport MH. Exercise as a therapeutic intervention to optimize fetal weight. Pharmacol Res 2018; 132:160-167. [PMID: 29684673 DOI: 10.1016/j.phrs.2018.04.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/16/2018] [Accepted: 04/18/2018] [Indexed: 12/29/2022]
Abstract
The Developmental Origins of Health and Disease suggest the in utero environment programs offspring obesity and cardiovascular disease. Therefore, there is a need to implement safe therapeutic interventions that do not involve the intake of medications or biological products during pregnancy that can improve maternal and fetal health. Prenatal exercise is established to promote maternal and fetal health. It is generally recommended that women accumulate at least 150 min per week of moderate-intensity exercise. It has been demonstrated that prenatal exercise maintains healthy weight gain and improves maternal glucose control, maternal cardiac autonomic control, placental efficiency (increases angiogenesis, downregulates genes involved in fatty acid transport and insulin transport across the placenta, and upregulates genes involved in amino acid transport across the placenta), and oxidative stress. These adaptations following exercise improve maternal metabolism and provide adequate uteroplacental perfusion. In this review, we will focus on exercise as a therapeutic intervention to optimize fetal weight. It has been established that prenatal exercise does not increase the risk of having a small for gestational age baby. To the contrary, prenatal exercise has been associated with the prevention of excessive fat accumulation in the newborn and the maintenance of fetal muscle mass.
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Affiliation(s)
- Laura M Reyes
- Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport and Recreation, 1-052 Li Ka Shing Centre for Health Research Innovation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, T6G 2E1, Alberta, Canada.
| | - Margie H Davenport
- Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport and Recreation, 1-052 Li Ka Shing Centre for Health Research Innovation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, T6G 2E1, Alberta, Canada.
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18
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Wang F, Xiong R, Feng S, Lu X, Li H, Wang S. Association of Circulating Levels of ADMA with Carotid Intima-Media Thickness in Patients with CKD: a Systematic Review and Meta-Analysis. Kidney Blood Press Res 2018; 43:25-33. [DOI: 10.1159/000486743] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/11/2018] [Indexed: 11/19/2022] Open
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19
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Strazhesko ID, Tkacheva ON, Akasheva DU, Dudinskaya EN, Plokhova EV, Pykhtina VS, Kruglikova AS, Brailova NV, Sharashkina NV, Kashtanova DA, Isaykina OY, Pokrovskaya MS, Vygodin VA, Ozerova IN, Skvortsov DA, Boytsov SA. Growth Hormone, Insulin-Like Growth Factor-1, Insulin Resistance, and Leukocyte Telomere Length as Determinants of Arterial Aging in Subjects Free of Cardiovascular Diseases. Front Genet 2017; 8:198. [PMID: 29375617 PMCID: PMC5770739 DOI: 10.3389/fgene.2017.00198] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/20/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Increased arterial stiffness (AS), intima-media thickness (IMT), and the presence of atherosclerotic plaques (PP) have been considered as important aspects of vascular aging. It is well documented that the cardiovascular system is an important target organ for growth hormone (GH) and insulin-like growth factor (IGF)-1 in humans, and GH /IGF-1 deficiency significantly increases the risk for cardiovascular diseases (CVD). The telomere length of peripheral blood leukocytes (LTL) is a biomarker of cellular senescence and that has been proposed as an independent predictor of (CVD). The aim of this study is to determine the role of GH/IGF-1, LTL and their interaction cardiovascular risk factors (CVRF) in the vascular aging. Methods: The study group included 303 ambulatory participants free of known CVD (104 males and 199 females) with a mean age of 51.8 ± 13.3 years. All subjects had one or more CVRF [age, smoking, arterial hypertension, obesity, dyslipidemia, fasting hyperglycemia, insulin resistance-HOMA (homeostatic model assessment) >2.5, or high glycated hemoglobin]. The study sample was divided into the two groups according to age as "younger" (m ≤ 45 years, f ≤ 55 years) and "older" (m > 45 years, f > 55 years). IMT and PP were determined by ultrasonography, AS was determined by measuring the carotid-femoral pulse wave velocity (c-f PWV) using the SphygmoCor system (AtCor Medical). LTL was determined by PCR. Serum IGF-1 and GH concentrations we measured by immunochemiluminescence analysis. Results: Multiple linear regression analysis with adjustment for CVRF indicated that HOMA, GH, IGF-1, and LTL had an independent relationship with all the arterial wall parameters investigated in the younger group. In the model with c-f PWV as a dependent variable, p < 0.001 for HOMA, p = 0.03 for GH, and p = 0.004 for LTL. In the model with IMT as a dependent variable, p = 0.0001 for HOMA, p = 0.044 for GH, and p = 0.004 for IGF-1. In the model with the number of plaques as a dependent variable, p = 0.0001 for HOMA, and p = 0.045 for IGF-1. In the older group, there were no independent significant associations between GH/IGF-1, LTL, HOMA, and arterial wall characteristics. Conclusions: GH/IGF-1, IR, HOMA, and LTL were the important parameters of arterial aging in younger healthy participants.
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Affiliation(s)
- Irina D Strazhesko
- Department of Clinical Cardiology and Molecular Genetics, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia.,Department of Age-associated Diseases, Medical Scientific and Educational Center, Lomonosov Moscow State University, Moscow, Russia
| | - Olga N Tkacheva
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Dariga U Akasheva
- Department of Fundamental and Applied Aspects of Obesity, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Ekaterina N Dudinskaya
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Ekaterina V Plokhova
- Department of Cardiology, Federal Scientific and Clinical Center of the Federal Medico-Biological Agency, Moscow, Russia
| | - Valentina S Pykhtina
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Anna S Kruglikova
- Department of Aging and Age-associated Diseases Prevention, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Natalia V Brailova
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Natalia V Sharashkina
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Daria A Kashtanova
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Olesya Y Isaykina
- Department of Primary Prevention of Chronic Non-Communicable Diseases in the Healthcare System, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Mariya S Pokrovskaya
- Biobank, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Vladimir A Vygodin
- Department of Epidemiology of Chronic Non-Communicable Diseases Laboratory of Biostatistics, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Irina N Ozerova
- Department of Biochemical Markers of Chronic Non-Communicable Diseases Research, Federal State Institution National Medical Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Dmitry A Skvortsov
- Department of Chemistry, Lomonosov Moscow State University, Moscow, Russia
| | - Sergey A Boytsov
- National Medical Research Center for Cardiology of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
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20
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Liu K, Cui R, Eshak ES, Cui M, Dong JY, Kiyama M, Okada T, Kitamura A, Umesawa M, Yamagishi K, Imano H, Ohira T, Iso H. Associations of central aortic pressure and brachial blood pressure with flow mediated dilatation in apparently healthy Japanese men: The Circulatory Risk in Communities Study (CIRCS). Atherosclerosis 2017; 259:46-50. [PMID: 28285093 DOI: 10.1016/j.atherosclerosis.2017.02.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 02/23/2017] [Accepted: 02/24/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIMS Endothelial dysfunction is considered the first stage in the development of atherosclerosis and cardiovascular disease, and brachial flow-mediated dilation (FMD) is a measure of endothelial function. It is uncertain which of central systolic aortic pressure (CAP) or brachial systolic blood pressure (SBP) is more strongly associated with FMD. Therefore, we examined the correlations of CAP and SBP with FMD in Japanese men. METHODS The study subjects comprised 507 male volunteers aged 30-79 years that were residents in two communities under the Circulatory Risk in Communities Study (CIRCS) between 2013 and 2015. The low percent change of FMD (%FMD) ≤5.0%, after 5 min of reactive hyperemia evaluated by the brachial artery diameter, was used to assess endothelial dysfunction. Values of CAP and SBP were divided into tertiles, with the lowest tertile used as a reference. RESULTS After adjustment for cardiovascular risk factors, the multivariable odds ratio (95% CI) of low FMD for the highest versus lowest tertile of CAP was 1.5 (0.9-2.6) for total subjects and 1.4 (0.5-3.8) for those with, and 2.4 (1.2-4.8) for those without antihypertensive medication use. The corresponding odd ratios for the highest versus lowest tertile of SBP were 0.9 (0.5-1.5), 0.8 (0.3-2.2), and 1.3 (0.7-2.5), respectively. CONCLUSIONS Higher CAP levels were associated with low FMD for men without antihypertensive medication, but such an association was not found for SBP levels.
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Affiliation(s)
- Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Japan
| | - Renzhe Cui
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Japan
| | - Ehab S Eshak
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Japan; Department of Public Health and Preventive Medicine, Minia University, Egypt
| | - Meishan Cui
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Japan
| | - Jia-Yi Dong
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer, Cardiovascular Disease Prevention, Japan
| | - Takeo Okada
- Osaka Center for Cancer, Cardiovascular Disease Prevention, Japan
| | - Akihiko Kitamura
- Osaka Center for Cancer, Cardiovascular Disease Prevention, Japan; Tokyo Metropolitan Institute of Gerontology, Japan
| | - Mitsumasa Umesawa
- Department of Public Health, Dokkyo Medical University, School of Medicine, Japan
| | - Kazumasa Yamagishi
- Departments of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Japan.
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Bridging the silos in HIV and Hepatitis C prevention: a cross-provincial qualitative study. Int J Public Health 2016; 62:739-746. [PMID: 27783101 PMCID: PMC5585297 DOI: 10.1007/s00038-016-0914-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/29/2016] [Accepted: 10/18/2016] [Indexed: 11/27/2022] Open
Abstract
Objectives The Our Youth Our Response (OYOR) study explored the scope and accessibility of existing youth-oriented human immunodeficiency virus (HIV) and Hepatitis C (HCV) prevention in Atlantic Canada. Methods A cross-provincial, qualitative population health and gender-based analytic approach was used in this study. Four hundred and twenty-five documents were part of the initial scoping review, while 47 in-depth interviews across youth-relevant sectors were undertaken to explore the perceptions related to current approaches to youth-oriented HIV/HCV prevention policies and programs. The study also conducted focus group discussions with 21 key informants aimed at identifying strategies to address the challenges identified from the interview data. Results Five overarching themes emerged from our triangulated data in relation to the present state of youth-related HIV/HCV prevention. These included: inter-organizational and intersectoral collaboration; youth engagement; access to testing; harm reduction; and education. Conclusions Our findings will assist in informing the next generation for HIV/HCV prevention aimed at youth. Specifically, the results indicate that future prevention initiatives should support the use of intersectoral collaboration, gender-based approaches, and HIV/HCV testing innovation to help de-stigmatize prevention efforts.
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22
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Gholami M, Fallahi Khoshknab M, Khankeh HR, Ahmadi F, Maddah SSB, Mousavi Arfaa N. The Motivations of Iranian Patients With Cardiovascular Disease to Seek Health Information: A Qualitative Study. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e26039. [PMID: 27437128 PMCID: PMC4939227 DOI: 10.5812/ircmj.26039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 01/02/2015] [Accepted: 01/07/2015] [Indexed: 02/03/2023]
Abstract
Background Cardiovascular patients need information to preserve and promote their health, but not all of them have the necessary motivation to seek relevant health knowledge. Objectives The present study analyzed experiences of patients, family caregivers, and healthcare providers to explore the motivating factors that cause cardiovascular patients to seek important health information. Patients and Methods This study was conducted using a qualitative approach and conventional qualitative content analysis method. Thirty-six people, including 18 cardiovascular patients, 7 family caregivers, and 11 healthcare providers (from multidisciplinary backgrounds) participated in the study. The data were collected through semi-structured interviews and purposeful sampling and continued until data saturation. Data collection and analysis proceeded simultaneously and with constant comparison; this study was carried out from May 2012 to May 2013. Results During the analysis process, three main themes were extracted that characterized participants’ experiences, perceptions, and motivations to seek health information. The themes were “Optimizing quality of life, “Desire for personal rights to be respected,” and “Gaining confidence through consultation.” Conclusions Our findings showed that, through seeking information, patients try to achieve well-being and realize their personal rights as well as their right to security. They should also be encouraged to enhance their quality of life by using the Knowles’ learning theory to formulate their needs and learning priorities.
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Affiliation(s)
- Mohammad Gholami
- Assistant Professor of Nursing Education, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, IR Iran
| | - Masoud Fallahi Khoshknab
- University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, IR Iran
- Corresponding Author: Masoud Fallahi Khoshknab, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, IR Iran. Tel/Fax: +98-2122180036, E-mail:
| | - Hamid Reza Khankeh
- Nursing Department, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, IR Iran
| | - Fazlollah Ahmadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
| | - Sadat Seyed Bagher Maddah
- Nursing Department, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, IR Iran
| | - Nazila Mousavi Arfaa
- Medical Library and Information Sciences, Central Library, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, IR Iran
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Muñoz-Gutierrez C, Adasme-Carreño F, Fuentes E, Palomo I, Caballero J. Computational study of the binding orientation and affinity of PPARγ agonists: inclusion of ligand-induced fit by cross-docking. RSC Adv 2016. [DOI: 10.1039/c6ra12084a] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A cross-docking study for describing differential binding energies of PPARγ and agonists was successful after the inclusion of protein flexibility through the use of several crystal receptor conformations.
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Affiliation(s)
| | | | - Eduardo Fuentes
- Department of Clinical Biochemistry and Immunohematology
- Faculty of Health Sciences
- Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES)
- Talca University
- Talca
| | - Iván Palomo
- Department of Clinical Biochemistry and Immunohematology
- Faculty of Health Sciences
- Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES)
- Talca University
- Talca
| | - Julio Caballero
- Centro de Bioinformatica y Simulacion Molecular (CBSM)
- Universidad de Talca
- Talca
- Chile
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Lin HY, Lee DC, Wang HD, Chi YH, Chiu IM. Activation of FGF1B Promoter and FGF1 Are Involved in Cardiogenesis Through the Signaling of PKC, but Not MAPK. Stem Cells Dev 2015; 24:2853-63. [DOI: 10.1089/scd.2015.0157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hung-Yu Lin
- Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli, Taiwan
- Graduate Program of Biotechnology in Medicine, Department of Life Science, Institute of Biotechnology, National Tsing Hua University, Hsinchu, Taiwan
- Institute of Biotechnology, National Tsing Hua University, Hsinchu, Taiwan
| | - Don-Ching Lee
- Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli, Taiwan
| | - Horng-Dar Wang
- Graduate Program of Biotechnology in Medicine, Department of Life Science, Institute of Biotechnology, National Tsing Hua University, Hsinchu, Taiwan
- Institute of Biotechnology, National Tsing Hua University, Hsinchu, Taiwan
| | - Ya-Hui Chi
- Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli, Taiwan
- Graduate Program of Biotechnology in Medicine, Department of Life Science, Institute of Biotechnology, National Tsing Hua University, Hsinchu, Taiwan
| | - Ing-Ming Chiu
- Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli, Taiwan
- Graduate Program of Biotechnology in Medicine, Department of Life Science, Institute of Biotechnology, National Tsing Hua University, Hsinchu, Taiwan
- Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan
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25
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Garg VP, Vedanthan R, Islami F, Pourshams A, Poutschi H, Khademi H, Naeimi M, Malekshah AFT, Jafari E, Salahi R, Kamangar F, Etemadi A, Pharoah PD, Abnet CC, Brennan P, Dawsey SM, Fuster V, Boffetta P, Malekzadeh R. Heart Disease Is Associated With Anthropometric Indices and Change in Body Size Perception Over the Life Course: The Golestan Cohort Study. Glob Heart 2015; 10:245-254.e1. [PMID: 26014653 PMCID: PMC4561595 DOI: 10.1016/j.gheart.2014.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 09/21/2014] [Accepted: 10/20/2014] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cardiovascular disease and obesity are now becoming leading causes of morbidity and mortality in low- and middle-income countries. OBJECTIVES We investigated the relationship between prevalent heart disease (HD) and current anthropometric indices and body size perception over time from adolescence to adulthood in Iran. METHODS We present a cross-sectional analysis of baseline data from a prospective study of adults in Golestan Province, Iran. Demographics, cardiac history, and current anthropometric indices-body mass index, waist circumference, and waist to hip ratio-were recorded. Body size perception for ages 15 years, 30 years, and at the time of interview was assessed via pictograms. Associations of these factors and temporal change in perceived body size with HD were evaluated using multivariable logistic regression models. RESULTS Complete data were available for 50,044 participants; 6.1% of which reported having HD. Higher body mass index, waist circumference, and waist to hip ratio were associated with HD (p < 0.001). Men had a U-shaped relationship between HD and body size perception at younger ages. For change in body size perception, men and women demonstrated a U-shaped relationship with prevalent HD from adolescence to early adulthood, but a J-shaped pattern from early to late adulthood. CONCLUSIONS HD was associated with anthropometric indices and change in body size perception over time for men and women in Iran. Due to the increasing prevalence of overweight and obesity in low- and middle-income countries, interventions focused on decreasing the cumulative burden of risk factors throughout the life course may be an important component of cardiovascular risk reduction.
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Affiliation(s)
- Vaani P. Garg
- Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY 10029
| | - Rajesh Vedanthan
- Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY 10029
| | - Farhad Islami
- Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY 10029
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Jamshidiyeh, Tehran 14117-13135, Iran
| | - Akram Pourshams
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Jamshidiyeh, Tehran 14117-13135, Iran
| | - Hossein Poutschi
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Jamshidiyeh, Tehran 14117-13135, Iran
| | - Hooman Khademi
- International Agency for Research on Cancer, 150 Cours Albert Thomas 69008 Lyon, France
| | - Mohammad Naeimi
- Department of Internal Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Akbar Fazel-Tabar Malekshah
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Jamshidiyeh, Tehran 14117-13135, Iran
| | - Elham Jafari
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Jamshidiyeh, Tehran 14117-13135, Iran
| | - Rasool Salahi
- Department of Internal Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Farin Kamangar
- Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, 1700 E Cold Spring Lane, Baltimore, MD 21251
| | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892
| | - Paul D. Pharoah
- Departments of Oncology and Public Health and Primary Care, University of Cambridge, The Old Schools, Trinity Lane, Cambridge CB2 1TN, United Kingdom
| | - Christian C. Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892
| | - Paul Brennan
- International Agency for Research on Cancer, 150 Cours Albert Thomas 69008 Lyon, France
| | - Sanford M. Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892
| | - Valentin Fuster
- Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY 10029
- Centro Nacional de Investigaciones Cardiovasculares, Calle de Melchor Fernandez Almagro, 3, 28029 Madrid, Spain
| | - Paolo Boffetta
- Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, New York, NY 10029
- International Prevention Research Institute, Lyon, France
| | - Reza Malekzadeh
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Jamshidiyeh, Tehran 14117-13135, Iran
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Reyes LM, Kirschenman R, Quon A, Morton JS, Shah A, Davidge ST. Aerobic exercise training reduces cardiac function in adult male offspring exposed to prenatal hypoxia. Am J Physiol Regul Integr Comp Physiol 2015; 309:R489-98. [DOI: 10.1152/ajpregu.00201.2015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 07/03/2015] [Indexed: 12/19/2022]
Abstract
Intrauterine growth restriction (IUGR) has been associated with increased susceptibility to myocardial ischemia-reperfusion (I/R) injury. Exercise is an effective preventive intervention for cardiovascular diseases; however, it may be detrimental in conditions of compromised health. The aim of this study was to determine whether exercise training can improve cardiac performance after I/R injury in IUGR offspring. We used a hypoxia-induced IUGR model by exposing pregnant Sprague-Dawley rats to 21% oxygen (control) or hypoxic (11% oxygen; IUGR) conditions from gestational day 15 to 21. At 10 wk of age, offspring were randomized to a sedentary group or to a 6-wk exercise protocol. Transthoracic echocardiography assessments were performed after 6 wk. Twenty-four hours after the last bout of exercise, ex vivo cardiac function was determined using a working heart preparation. With exercise training, there was improved baseline cardiac performance in male control offspring but a reduced baseline cardiac performance in male IUGR exercised offspring ( P < 0.05). In male offspring, exercise decreased superoxide generation in control offspring, while in IUGR offspring, it had the polar opposite effect (interaction P ≤ 0.05). There was no effect of IUGR or exercise on cardiac function in female offspring. In conclusion, in male IUGR offspring, exercise may be a secondary stressor on cardiac function. A reduction in cardiac performance along with an increase in superoxide production in response to exercise was observed in this susceptible group.
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Affiliation(s)
- Laura M. Reyes
- Department of Physiology, University of Alberta, Edmonton, Alberta, Canada
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada; and
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Raven Kirschenman
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada; and
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Anita Quon
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada; and
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Jude S. Morton
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada; and
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Amin Shah
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada; and
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Sandra T. Davidge
- Department of Physiology, University of Alberta, Edmonton, Alberta, Canada
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada; and
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
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Plasma homocysteine levels are independently associated with alterations of large artery stiffness in men but not in women. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2015; 12:251-6. [PMID: 26089849 PMCID: PMC4460168 DOI: 10.11909/j.issn.1671-5411.2015.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 04/02/2015] [Accepted: 04/07/2015] [Indexed: 11/23/2022]
Abstract
Objectives To investigate the associations of the plasma homocysteine levels with the alterations in arterial stiffness in a community-based cohort. The gender differences in these associations were examined. Methods We evaluated the relationship between plasma homocysteine levels to three measures of vascular function [carotid-femoral pulse wave velocity (CF-PWV), carotid-ankle PWV (CA-PWV) and heart rate corrected augmentation index (AI)] in 1680 participants (mean age: 61.5 years; 709 men, 971 women) from communities of Beijing, China. Results In univariate analysis, plasma homocysteine levels was positively related to the CF-PWV (r = 0.211, P < 0.0001) and CA-PWV (r = 0.148, P < 0.0001), whereas inversely associated with AI (r = −0.052, P = 0.016). In multiple linear regression models adjusting for covariants, plasma homocysteine remained positively related to the CF-PWV (standardized β = 0.065, P = 0.007) in total cases. When the groups of men and women were examined separately, plasma homocysteine remained positively associated with the CF-PWV (standardized β = 0.082, P = 0.023) in men, whereas the relations between homocysteine and any of the arterial stiffness indices were not further present in women. Conclusions In Chinese population, plasma homocysteine levels are independently associated with alterations of large artery stiffness in men but not in women.
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Kachamakova-Trojanowska N, Bukowska-Strakova K, Zukowska M, Dulak J, Jozkowicz A. The real face of endothelial progenitor cells - Circulating angiogenic cells as endothelial prognostic marker? Pharmacol Rep 2015; 67:793-802. [PMID: 26321283 DOI: 10.1016/j.pharep.2015.05.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/18/2015] [Accepted: 05/19/2015] [Indexed: 02/08/2023]
Abstract
Endothelial progenitor cells (EPCs) have been extensively studied for almost 19 years now and were considered as a potential marker for endothelial regeneration ability. On the other hand, circulating endothelial cells (CEC) were studied as biomarker for endothelial injury. Yet, in the literature, there is also huge incoherency in regards to terminology and protocols used. This results in misleading conclusions on the role of so called "EPCs", especially in the clinical field. The discrepancies are mainly due to strong phenotypic overlap between EPCs and circulating angiogenic cells (CAC), therefore changes in "EPC" terminology have been suggested. Other factors leading to inconsistent results are varied definitions of the studied populations and the lack of universal data reporting, which could strongly affect data interpretation. The current review is focused on controversies concerning the use of "EPCs"/CAC and CEC as putative endothelial diagnostic markers.
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Affiliation(s)
- Neli Kachamakova-Trojanowska
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Karolina Bukowska-Strakova
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Monika Zukowska
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Jozef Dulak
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Alicja Jozkowicz
- Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland.
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Kritikou E, Kuiper J, Kovanen PT, Bot I. The impact of mast cells on cardiovascular diseases. Eur J Pharmacol 2015; 778:103-15. [PMID: 25959384 DOI: 10.1016/j.ejphar.2015.04.050] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 04/10/2015] [Accepted: 04/21/2015] [Indexed: 12/30/2022]
Abstract
Mast cells comprise an innate immune cell population, which accumulates in tissues proximal to the outside environment and, upon activation, augments the progression of immunological reactions through the release and diffusion of either pre-formed or newly generated mediators. The released products of mast cells include histamine, proteases, as well as a variety of cytokines, chemokines and growth factors, which act on the surrounding microenvironment thereby shaping the immune responses triggered in various diseased states. Mast cells have also been detected in the arterial wall and are implicated in the onset and progression of numerous cardiovascular diseases. Notably, modulation of distinct mast cell actions using genetic and pharmacological approaches highlights the crucial role of this cell type in cardiovascular syndromes. The acquired evidence renders mast cells and their mediators as potential prognostic markers and therapeutic targets in a broad spectrum of pathophysiological conditions related to cardiovascular diseases.
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Affiliation(s)
- Eva Kritikou
- Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Johan Kuiper
- Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | | | - Ilze Bot
- Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands.
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The association between triglyceride/high-density lipoprotein cholesterol ratio and all-cause mortality in acute coronary syndrome after coronary revascularization. PLoS One 2015; 10:e0123521. [PMID: 25880982 PMCID: PMC4399840 DOI: 10.1371/journal.pone.0123521] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 02/20/2015] [Indexed: 02/05/2023] Open
Abstract
Aims High triglycerides (TG) and low high-density lipoprotein cholesterol (HDL-C) are cardiovascular risk factors. A positive correlation between elevated TG/HDL-C ratio and all-cause mortality and cardiovascular events exists in women. However, utility of TG to HDL-C ratio for prediction is unknown among acute coronary syndrome (ACS). Methods Fasting lipid profiles, detailed demographic data, and clinical data were obtained at baseline from 416 patients with ACS after coronary revascularization. Subjects were stratified into three levels of TG/HDL-C. We constructed multivariate Cox-proportional hazard models for all-cause mortality over a median follow-up of 3 years using log TG to HDL-C ratio as a predictor variable and analyzing traditional cardiovascular risk factors. We constructed a logistic regression model for major adverse cardiovascular events (MACEs) to prove that the TG/HDL-C ratio is a risk factor. Results The subject’s mean age was 64 ± 11 years; 54.5% were hypertensive, 21.8% diabetic, and 61.0% current or prior smokers. TG/HDL-C ratio ranged from 0.27 to 14.33. During the follow-up period, there were 43 deaths. In multivariate Cox models after adjusting for age, smoking, hypertension, diabetes, and severity of angiographic coronary disease, patients in the highest tertile of ACS had a 5.32-fold increased risk of mortality compared with the lowest tertile. After adjusting for conventional coronary heart disease risk factors by the logistic regression model, the TG/HDL-C ratio was associated with MACEs. Conclusion The TG to HDL-C ratio is a powerful independent predictor of all-cause mortality and is a risk factor of cardiovascular events.
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Bloomfield GS, Baldridge A, Agarwal A, Huffman MD, Colantonio LD, Bahiru E, Ajay VS, Prabhakaran P, Lewison G, Prabhakaran D. Disparities in cardiovascular research output and citations from 52 African countries: a time-trend, bibliometric analysis (1999-2008). J Am Heart Assoc 2015; 4:jah3925. [PMID: 25836056 PMCID: PMC4579930 DOI: 10.1161/jaha.114.001606] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Cardiovascular research output and citations of publications from Africa have historically been low yet may be increasing. However, data from the continent are limited. METHODS AND RESULTS To evaluate the cardiovascular research output and citations from 52 African countries between 1999 and 2008, we created a bibliometric filter to capture cardiovascular research articles published in the Web of Knowledge based on specialist journals and title words. Two coauthors with expertise in cardiovascular medicine tested and refined this filter to achieve >90% precision and recall. We matched retrieved records with their associated citation reports and calculated the running 5-year citation count postpublication, including the year of publication. Publications from Africa were identified by author addresses. South Africa published 872 cardiovascular research papers, Egypt 393, Tunisia 264, and Nigeria 192 between 1999 and 2008. The number of publications increased over the time period for a small number of countries (range 0.1 to 4.8 more publications per year by fractional count). Most countries' citations were low (<50), but citations were greatest for South Africa (7063), Egypt (2557), Tunisia (903), and Nigeria (540). The same countries had the greatest annual increase in 5-year citation index values: 65 (95% CI: 30, 99) for South Africa, 46 (34, 58) for Egypt, 22 (15, 28) for Tunisia, and 8 (2, 14) for Nigeria. The burden of cardiovascular disease had a weak and inconsistent relationship to cardiovascular publications (r(2)=0.07, P=0.05). Greater gross domestic product was associated with more cardiovascular publications in 2008 (r(2)=0.53, P<0.0001). CONCLUSIONS The increases in cardiovascular research outputs from Africa are concentrated in a few countries. The reasons for regional differences in research outputs require further investigation, particularly relative to competing disease burdens. Higher prioritization of cardiovascular research funding from African countries is warranted.
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Affiliation(s)
- Gerald S Bloomfield
- Department of Medicine, Duke University, Durham, NC (G.S.B., A.A.) Duke Clinical Research Institute, Duke University, Durham, NC (G.S.B.) Duke Global Health Institute, Duke University, Durham, NC (G.S.B.)
| | - Abigail Baldridge
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (A.B., M.D.H., E.B.)
| | - Anubha Agarwal
- Department of Medicine, Duke University, Durham, NC (G.S.B., A.A.)
| | - Mark D Huffman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (A.B., M.D.H., E.B.)
| | | | - Ehete Bahiru
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (A.B., M.D.H., E.B.)
| | - Vamadevan S Ajay
- Centre for Chronic Disease Control, New Delhi, India (V.S.A., P.P., D.P.) Public Health Foundation of India, New Delhi, India (V.S.A., D.P.)
| | | | | | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi, India (V.S.A., P.P., D.P.) Public Health Foundation of India, New Delhi, India (V.S.A., D.P.)
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Banerjee A, Pogge T. The Health Impact Fund: how might it work for novel anticoagulants in atrial fibrillation? Glob Heart 2015; 9:255-261.e2. [PMID: 25667097 DOI: 10.1016/j.gheart.2014.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 01/14/2014] [Accepted: 01/23/2014] [Indexed: 11/16/2022] Open
Abstract
Cardiovascular diseases represent the greatest burden of global disease. Spending on cardiovascular diseases is higher than for other diseases, with the majority being spent on drugs. Therefore, these drugs and these diseases are hugely important to health systems, society, and pharmaceutical companies. The Health Impact Fund represents a new mechanism by which pharmaceutical innovators would be rewarded on the basis of the health impact of their new drugs. This review illustrates the concept of the Health Impact Fund using the example of novel anticoagulants for prevention of stroke and thromboembolism in atrial fibrillation. By considering existing data and the current situation for novel anticoagulants, we suggest that epidemiologic data and modeling techniques can be used to predict future trends in disease and the health impact of new drugs. The Health Impact Fund may offer potential benefits to pharmaceutical companies, patients, and governments and warrants proper investigation.
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Affiliation(s)
- Amitava Banerjee
- Centre for Cardiovascular Sciences, College of Medical and Dental Sciences, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK.
| | - Thomas Pogge
- Department of Philosophy, Yale University, New Haven, CT, USA
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Abderrazak A, Syrovets T, Couchie D, El Hadri K, Friguet B, Simmet T, Rouis M. NLRP3 inflammasome: from a danger signal sensor to a regulatory node of oxidative stress and inflammatory diseases. Redox Biol 2015; 4:296-307. [PMID: 25625584 PMCID: PMC4315937 DOI: 10.1016/j.redox.2015.01.008] [Citation(s) in RCA: 524] [Impact Index Per Article: 58.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 01/11/2015] [Accepted: 01/12/2015] [Indexed: 02/07/2023] Open
Abstract
IL-1β production is critically regulated by cytosolic molecular complexes, termed inflammasomes. Different inflammasome complexes have been described to date. While all inflammasomes recognize certain pathogens, it is the distinctive feature of NLRP3 inflammasome to be activated by many and diverse stimuli making NLRP3 the most versatile, and importantly also the most clinically implicated inflammasome. However, NLRP3 activation has remained the most enigmatic. It is not plausible that the intracellular NLRP3 receptor is able to detect all of its many and diverse triggers through direct interactions; instead, it is discussed that NLRP3 is responding to certain generic cellular stress-signals induced by the multitude of molecules that trigger its activation. An ever increasing number of studies link the sensing of cellular stress signals to a direct pathophysiological role of NLRP3 activation in a wide range of autoinflammatory and autoimmune disorders, and thus provide a novel mechanistic rational, on how molecules trigger and support sterile inflammatory diseases. A vast interest has created to unravel how NLRP3 becomes activated, since mechanistic insight is the prerequisite for a knowledge-based development of therapeutic intervention strategies that specifically target the NLRP3 triggered IL-1β production. In this review, we have updated knowledge on NLRP3 inflammasome assembly and activation and on the pyrin domain in NLRP3 that could represent a drug target to treat sterile inflammatory diseases. We have reported mutations in NLRP3 that were found to be associated with certain diseases. In addition, we have reviewed the functional link between NLRP3 inflammasome, the regulator of cellular redox status Trx/TXNIP complex, endoplasmic reticulum stress and the pathogenesis of diseases such as type 2 diabetes. Finally, we have provided data on NLRP3 inflammasome, as a critical regulator involved in the pathogenesis of obesity and cardiovascular diseases.
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Affiliation(s)
- Amna Abderrazak
- Sorbonne Universités, UPMC Univ Paris 06, UMR 8256, Biological Adaptation and Ageing - IBPS, F-75005 Paris, France; CNRS-UMR 8256, F-75005 Paris, France; Inserm U1164, F-75005 Paris, France
| | - Tatiana Syrovets
- Institute of Pharmacology of Natural Products & Clinical Pharmacology, Ulm University, D-89081 Ulm, Germany
| | - Dominique Couchie
- Sorbonne Universités, UPMC Univ Paris 06, UMR 8256, Biological Adaptation and Ageing - IBPS, F-75005 Paris, France; CNRS-UMR 8256, F-75005 Paris, France; Inserm U1164, F-75005 Paris, France
| | - Khadija El Hadri
- Sorbonne Universités, UPMC Univ Paris 06, UMR 8256, Biological Adaptation and Ageing - IBPS, F-75005 Paris, France; CNRS-UMR 8256, F-75005 Paris, France; Inserm U1164, F-75005 Paris, France
| | - Bertrand Friguet
- Sorbonne Universités, UPMC Univ Paris 06, UMR 8256, Biological Adaptation and Ageing - IBPS, F-75005 Paris, France; CNRS-UMR 8256, F-75005 Paris, France; Inserm U1164, F-75005 Paris, France
| | - Thomas Simmet
- Institute of Pharmacology of Natural Products & Clinical Pharmacology, Ulm University, D-89081 Ulm, Germany
| | - Mustapha Rouis
- Sorbonne Universités, UPMC Univ Paris 06, UMR 8256, Biological Adaptation and Ageing - IBPS, F-75005 Paris, France; CNRS-UMR 8256, F-75005 Paris, France; Inserm U1164, F-75005 Paris, France.
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Huang LL, Pan C, Yu TT, Guo K, Wang XH, Zhang JY, Wang HZ, Gao S. Benefical therapeutic effect of Chinese Herbal Xinji'erkang formula on hypertension-induced renal injury in the 2-kidney-1-clip hypertensive rats. AFRICAN JOURNAL OF TRADITIONAL, COMPLEMENTARY, AND ALTERNATIVE MEDICINES : AJTCAM 2014; 11:16-27. [PMID: 25395699 PMCID: PMC4202512 DOI: 10.4314/ajtcam.v11i5.3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Increase in evidence shows that the role of kidney injury in hypertension is important. Xinji'erkang (XJEK), a Chinese herbal formula, has been identified as an effective preparation in the treatment of coronary heart disease and myocarditis. We have previously demonstrated that XJEK attenuate oxidative stress and hypertension target organ damage. The aim of this study was to assess the renal protective function of XJEK. MATERIALS AND METHODS Two Kidney One Clip (2K1C) model was adopted to induce hypertension in rats. We submitted male Sprague Dawley (150-180) g rats to either renal artery clipping or sham operation. Renal hypertension was established after four weeks of surgery. Rats were randomized divided into the four groups: sham-operated group (Sh-Op) (n=10), two-kidney, one-clip hypertension group (2K1C) (n=10), Xinji'erkang treatment group (XJEK) (n=10) and Fosinopril (n=10) treatment group. Drugs were administered orally daily for four weeks. Systolic pressures were measured every week using the tail-cuff apparatus. 24h before death, urine samples were collected for detect of urinary proteins. The kidney weight (KW) index was expressed as kidney weight/body weight (KW/BW). The histological changes were investigated by hematoxylin and eosin and Van Gieson staining. Immunohistochemical assay was employed to observe the intra-renal transforming growth factor-β1 (TGF-β1) protein expression. Serum creatinine (SCR) and blood urea nitrogen (BUN) were assayed by automatic biochemical analyzer. ELISA kit was used to assay Angiotensin II (Ang II) and TGF-β1 content in serum. RESULTS Administration of XJEK markedly alleviated the rise in blood pressure and declined LKW/BW ratio. Histo-pathological injuries including hypertrophic glomerular, glomerular sclerosis, glomerular and interstitial fibrosis were attenuated. XJEK also decreased SCR, BUN, urinary proteins in 24h urine, serum Ang II and TGF-β1 concentrations and the intra-renal TGF-β1 protein expression. CONCLUSION XJEK therapy in the 2K1C hypertensive rats affects the rise in blood pressure and ameliorates the severity of kidney injury. The protective effect is most likely due to the ability of XJEK to affect the Renin-Angiotensin-Aldosterone System (RAAS) and the TGF-β systems.
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Affiliation(s)
- Ling-Ling Huang
- Department of Pharmacology, Basic Medical College, Anhui Medical University, Hefei 230032, China
- Cancer Hospital, Hefei Institutes of Physical Science, Chinese Academy of Science, Hefei 230031, China
| | - Chen Pan
- Department of Clinical of Pharmacy, Lishui People's Hospital, Zhe Jiang 323000, China
| | - Ting-ting Yu
- Department of Pharmacology, Basic Medical College, Anhui Medical University, Hefei 230032, China
| | - Kun Guo
- Department of Pharmacology, Basic Medical College, Anhui Medical University, Hefei 230032, China
| | - Xing-hui Wang
- Department of Pharmacy, the Second People's Hospital of Hefei, Hefei 230011, China
| | - Jun-Yan Zhang
- Department of Pharmacology, Basic Medical College, Anhui Medical University, Hefei 230032, China
| | - Hong-zhi Wang
- Cancer Hospital, Hefei Institutes of Physical Science, Chinese Academy of Science, Hefei 230031, China
| | - Shan Gao
- Department of Pharmacology, Basic Medical College, Anhui Medical University, Hefei 230032, China
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Abstract
Ischemic heart disease (IHD) is the greatest single cause of mortality and loss of disability-adjusted life years worldwide, and a substantial portion of this burden falls on low- and middle-income countries (LMICs). Deaths from IHD and acute coronary syndrome (ACS) occur, on average, at younger ages in LMICs than in high-income countries, often at economically productive ages, and likewise frequently affect the poor within LMICs. Although data about ACS in LMICs are limited, there is a growing literature in this area and the research gaps are being steadily filled. In high-income countries, decades of investigation into the risk factors for ACS and development of behavioral programs, medications, interventional procedures, and guidelines have provided us with the tools to prevent and treat events. Although similar tools can be, and in fact have been, implemented in many LMICs, challenges remain in the development and implementation of cardiovascular health promotion activities across the entire life course, as well as in access to treatment for ACS and IHD. Intersectoral policy initiatives and global coordination are critical elements of ACS and IHD control strategies. Addressing the hurdles and scaling successful health promotion, clinical and policy efforts in LMICs are necessary to adequately address the global burden of ACS and IHD.
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Affiliation(s)
- Rajesh Vedanthan
- From the Department of Medicine, Division of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, NY (R.V., V.F.); Department of Biology and School of Medicine, Stanford University, Palo Alto, CA (B.S.); and Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (V.F.)
| | - Benjamin Seligman
- From the Department of Medicine, Division of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, NY (R.V., V.F.); Department of Biology and School of Medicine, Stanford University, Palo Alto, CA (B.S.); and Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (V.F.)
| | - Valentin Fuster
- From the Department of Medicine, Division of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, NY (R.V., V.F.); Department of Biology and School of Medicine, Stanford University, Palo Alto, CA (B.S.); and Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (V.F.).
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Kones R, Rumana U. Prevention of cardiovascular disease: updating the immensity of the challenge and the role of risk factors. Hosp Pract (1995) 2014; 42:92-100. [PMID: 24566601 DOI: 10.3810/hp.2014.02.1096] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Despite remarkable decreases in the mortality of coronary heart disease, there is concern that continued high levels of cardiovascular risk in the population may reverse these gains. By 2015, the prevalence of cardiovascular disease in the United States will be 37.8%. Obesity, hypertension, dyslipidemia, diabetes mellitus (DM), metabolic syndrome, and inflammation are the primary components driving cardiovascular risk. Approximately 70% of adults are overweight or obese, yet diet quality continues to deteriorate and authoritative information is insufficiently promoted. More than half of US adults have lipid abnormalities; 27% of US adults have high values of low-density lipoprotein cholesterol, 23% have low values of high-density lipoprotein cholesterol concentrations, and 30% have high triglyceride levels. Approximately 34% of adults have hypertension; 40% of these adults are unaware of the diagnosis. In patients with hypertension who are treated, 54% remain uncontrolled. The prevalence of hypertension in elderly patients has increased from 35% to 41%. In addition, 30% of adults have prehypertension. The burden of hypertension alone accounts for approximately 1000 deaths per day. Trends in the prevalence of glucose intolerance are similar. The prevalence of DM is approximately 12%, with 27% of cases remaining undiagnosed. Thirty-five percent of US adults aged > 20 years have prediabetes and 7.3% of adults are unaware of the diagnosis. If the present trends continue, 1 in 3 of US adults will have DM by 2050. Participation in exercise has been low and a "straight line" for > 2 decades. Accelerometer data indicate that individuals who attain minimal exercise goals are only a fraction of the often quoted levels of > 35%. Control of risk factors in primary prevention, although improved, remains decidedly incomplete. Lowering the burden of cardiovascular risk factors at the population level has been exceptionally difficult. For reasons outlined, the solution to this problem is multifaceted and extends well beyond the delivery of medical care into the structure of society and the environment.
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Affiliation(s)
- Richard Kones
- The Cardiometabolic Research Institute, Houston, TX.
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Zaher W, Harkness L, Jafari A, Kassem M. An update of human mesenchymal stem cell biology and their clinical uses. Arch Toxicol 2014; 88:1069-82. [PMID: 24691703 DOI: 10.1007/s00204-014-1232-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 03/18/2014] [Indexed: 12/13/2022]
Abstract
In the past decade, an increasing urge to develop new and novel methods for the treatment of degenerative diseases where there is currently no effective therapy has lead to the emerging of the cell therapy or cellular therapeutics approach for the management of those conditions where organ functions are restored through transplantation of healthy and functional cells. Stem cells, because of their nature, are currently considered among the most suitable cell types for cell therapy. There are an increasing number of studies that have tested the stromal stem cell functionality both in vitro and in vivo. Consequently, stromal (mesenchymal) stem cells (MSCs) are being introduced into many clinical trials due to their ease of isolation and efficacy in treating a number of disease conditions in animal preclinical disease models. The aim of this review is to revise MSC biology, their potential translation in therapy, and the challenges facing their adaptation in clinical practice.
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Affiliation(s)
- Walid Zaher
- Endocrine Research (KMEB), Department of Endocrinology, Odense University Hospital, University of Southern Denmark, 5000, Odense C, Denmark
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Fuentes E, Fuentes F, Palomo I. Mechanism of the anti-platelet effect of natural bioactive compounds: Role of peroxisome proliferator-activated receptors activation. Platelets 2013; 25:471-9. [DOI: 10.3109/09537104.2013.849334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Mahmood DFD, Abderrazak A, El Hadri K, Simmet T, Rouis M. The thioredoxin system as a therapeutic target in human health and disease. Antioxid Redox Signal 2013; 19:1266-303. [PMID: 23244617 DOI: 10.1089/ars.2012.4757] [Citation(s) in RCA: 227] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The thioredoxin (Trx) system comprises Trx, truncated Trx (Trx-80), Trx reductase, and NADPH, besides a natural Trx inhibitor, the thioredoxin-interacting protein (TXNIP). This system is essential for maintaining the balance of the cellular redox status, and it is involved in the regulation of redox signaling. It is also pivotal for growth promotion, neuroprotection, inflammatory modulation, antiapoptosis, immune function, and atherosclerosis. As an ubiquitous and multifunctional protein, Trx is expressed in all forms of life, executing its function through its antioxidative, protein-reducing, and signal-transducing activities. In this review, the biological properties of the Trx system are highlighted, and its implications in several human diseases are discussed, including cardiovascular diseases, heart failure, stroke, inflammation, metabolic syndrome, neurodegenerative diseases, arthritis, and cancer. The last chapter addresses the emerging therapeutic approaches targeting the Trx system in human diseases.
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Peñalvo JL, Santos-Beneit G, Sotos-Prieto M, Martínez R, Rodríguez C, Franco M, López-Romero P, Pocock S, Redondo J, Fuster V. A cluster randomized trial to evaluate the efficacy of a school-based behavioral intervention for health promotion among children aged 3 to 5. BMC Public Health 2013; 13:656. [PMID: 23855415 PMCID: PMC3716774 DOI: 10.1186/1471-2458-13-656] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 07/11/2013] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The onset of inadequate behaviors leading to the development of risk factors for chronic diseases is known to occur early in life. An effective program for health promotion should therefore focus on children and their environment, as the starting point for behavior development. The overarching objective of the Program SI! (Salud Integral - Comprehensive Health) is to intervene at the school level, to establish and develop life-lasting habits that will help preserving health during adulthood. The Program SI! comprises five consecutive subprograms according to the five stages of education in Spain, the first being in preschoolers. This study aims to evaluate the efficacy of Program SI! to establish and improve lifestyle behaviors in children (preschoolers aged 3-5 years), their parents, and teachers, and also improving the school environment. A secondary objective is to evaluate improvements in cardiovascular health-related markers (anthropometric parameters, blood pressure, and dietary and physical activity patterns) in these same children. METHODS/DESIGN 24 public schools from the city of Madrid (Spain) were allocated through stratified randomization to intervention or control. The intervention schools follow the Program SI!, which provides didactic units, emotions cards, healthy tips, and online resources. The intervention schools integrate the Program SI! into their scholar curriculum organized in four complete weeks during each academic year during the 3 years of preschool education. Control schools follow their normal curriculum. Primary outcomes are 1-year, and 3-year changes from baseline of scores for knowledge, attitudes, and habits (KAH) of children, their parents and teachers in regards to a healthy lifestyle. Secondary outcomes are 1-year, and 3-year changes from baseline in clinical and anthropometric parameters of children. DISCUSSION The Program SI! is a long-term health promotion program starting in 3 years old. It incorporates the traditional areas of intervention (diet and physical activity), introducing additional components such as knowledge of the human body and management of emotions to achieve a comprehensive intervention. The Program SI! is designed to be an effective, sustainable health promotion program for the adoption of healthy behaviors from early in life. TRIAL REGISTRATION TRIAL REGISTRATION NUMBER NCT01579708.
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Affiliation(s)
- José L Peñalvo
- Department of Epidemiology, Atherothrombosis and Imaging, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, 28029, Spain
| | - Gloria Santos-Beneit
- Department of Epidemiology, Atherothrombosis and Imaging, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, 28029, Spain
- International SHE Foundation, Barcelona, Spain
| | - Mercedes Sotos-Prieto
- Department of Epidemiology, Atherothrombosis and Imaging, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, 28029, Spain
- International SHE Foundation, Barcelona, Spain
| | | | | | - Manuel Franco
- Department of Epidemiology, Atherothrombosis and Imaging, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, 28029, Spain
- Division of Epidemiology and Public Health, Universidad de Alcalá, Madrid, Spain
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Pedro López-Romero
- Department of Epidemiology, Atherothrombosis and Imaging, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, 28029, Spain
| | - Stuart Pocock
- Department of Epidemiology, Atherothrombosis and Imaging, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, 28029, Spain
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Juliana Redondo
- Department of Epidemiology, Atherothrombosis and Imaging, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, 28029, Spain
| | - Valentín Fuster
- Department of Epidemiology, Atherothrombosis and Imaging, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, 28029, Spain
- Department of Cardiology, Mount Sinai School of Medicine, New York, NY, USA
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Bloomfield GS, Barasa FA, Doll JA, Velazquez EJ. Heart failure in sub-Saharan Africa. Curr Cardiol Rev 2013; 9:157-73. [PMID: 23597299 PMCID: PMC3682399 DOI: 10.2174/1573403x11309020008] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 11/15/2012] [Accepted: 11/18/2012] [Indexed: 02/06/2023] Open
Abstract
The heart failure syndrome has been recognized as a significant contributor to cardiovascular disease burden in sub-Saharan African for many decades. Seminal knowledge regarding heart failure in the region came from case reports and case series of the early 20th century which identified infectious, nutritional and idiopathic causes as the most common. With increasing urbanization, changes in lifestyle habits, and ageing of the population, the spectrum of causes of HF has also expanded resulting in a significant burden of both communicable and non-communicable etiologies. Heart failure in sub-Saharan Africa is notable for the range of etiologies that concurrently exist as well as the healthcare environment marked by limited resources, weak national healthcare systems and a paucity of national level data on disease trends. With the recent publication of the first and largest multinational prospective registry of acute heart failure in sub-Saharan Africa, it is timely to review the state of knowledge to date and describe the myriad forms of heart failure in the region. This review discusses several forms of heart failure that are common in sub-Saharan Africa (e.g., rheumatic heart disease, hypertensive heart disease, pericardial disease, various dilated cardiomyopathies, HIV cardiomyopathy, hypertrophic cardiomyopathy, endomyocardial fibrosis, ischemic heart disease, cor pulmonale) and presents each form with regard to epidemiology, natural history, clinical characteristics, diagnostic considerations and therapies. Areas and approaches to fill the remaining gaps in knowledge are also offered herein highlighting the need for research that is driven by regional disease burden and needs.
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Karwalajtys T, Kaczorowski J, Chambers LW, Hall H, McDonough B, Dolovich L, Sebaldt R, Lohfeld L, Hutchison B. Community Mobilization, Participation, and Blood Pressure Status in a Cardiovascular Health Awareness Program in Ontario. Am J Health Promot 2013; 27:252-61. [DOI: 10.4278/ajhp.101221-qual-408] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To determine the feasibility of a community-wide approach integrated with primary care (Cardiovascular Health Awareness Program [CHAP]) to promote monitoring of blood pressure (BP) and awareness of cardiovascular disease risk. Design. Demonstration project. Setting. Two midsized Ontario communities. Participants. Community-dwelling seniors. Intervention. CHAP sessions were offered in pharmacies and promoted to seniors using advertising and personalized letters from physicians. Trained volunteers measured BP, completed risk profiles, and provided risk-specific education materials. Method. We examined the distribution of risk factors among participants and predictors of multiple visits and elevated BP. Results. Opinion leaders aided recruitment of family physicians (n = 56/63) and pharmacists (n = 18/19). Over 90 volunteers were recruited. Invitations were mailed to 4394 seniors. Over 10 weeks, there were 4165 assessments of 2350 unique participants (approximately 30% of senior residents). 37.5% of attendees had untreated (16%; 360/2247) or uncontrolled (21.5%; 482/2247) high BP. Participants who received a letter (odds ratio [OR] 2.5, 95% confidence interval [CI] 2.1–3.0), had an initial elevated BP (OR 1.2, 95% CI 1.0–1.5), or reported current antihypertensive medication (OR 1.4, 95% CI 1.1–1.6) were more likely to attend multiple sessions (p ≤ .05 for all). Older age (≥ 70 years; OR 1.5, 95% CI 1.3–1.8), BMI ≥ 30 (OR 1.7, 95% CI 1.4–2.2), current antihypertensive medication (OR 1.6, 95% CI 1.3–1.9), and diabetes (OR 2.4, 95% CI 1.9–3.2) predicted elevated BP (p < .001 for all). Conclusion. The program yielded learning about community mobilization and identified a substantial number of seniors with undiagnosed/uncontrolled high BP.
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Bai Y, Sun L, Du L, Zhang T, Xin W, Lan X, Du G. Association of circulating levels of asymmetric dimethylarginine (ADMA) with carotid intima-media thickness: evidence from 6168 participants. Ageing Res Rev 2013; 12:699-707. [PMID: 22353385 DOI: 10.1016/j.arr.2012.02.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Revised: 01/23/2012] [Accepted: 02/06/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Epidemiologic investigations have linked the circulating levels of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase (NOS), to carotid intima-media thickness (IMT). However, these studies result in various extent of relation between ADMA and IMT, the conclusions were inconsistent, and the precise relationship is therefore under debate. The objective of this systematic review and meta-analysis is to provide an overview of the relevant studies evaluating the association of levels of ADMA with carotid IMT and to gain more robust estimate of the relationship. METHODS Studies were identified through PubMed, Cochrane Library, Embase, reviews, and reference lists of relevant papers. Weighted means of the correlation coefficient (R) and partial correlation coefficient (PR) were calculated for relations by using random-effect models. RESULTS 22 studies with a total of 6168 subjects were included in our meta-analysis. In an overall pooled estimate of correlation coefficient (R), levels of ADMA were significantly related to carotid IMT (pooled R: 0.29; 95% confidence interval [CI]: 0.20-0.38, P<0.001). Pooled estimate of partial correlation coefficient (PR) also resulted in a significant association of ADMA with carotid IMT (pooled PR: 0.21; 95% CI: 0.14-0.29; P<0.001). Furthermore, subgroup analysis found that the relation between ADMA and IMT was stronger in patients with chronic kidney diseases (CKDs) than that in subject with normal renal function. CONCLUSIONS Circulating levels of ADMA were positively related to carotid IMT, especially in patients with CKDs. The findings need confirmation in longitudinal and interventional studies.
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Kones R. Reducing residual risk: modern pharmacochemistry meets old-fashioned lifestyle and adherence improvement. Ther Adv Cardiovasc Dis 2013; 7:169-82. [DOI: 10.1177/1753944712467828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Despite remarkable advances in identifying and managing coronary heart disease, the global burden of cardiovascular (CV) risk and levels of undetected, subclinical heart disease remain enormous. Substantial numbers of patients do not reach their therapeutic goals, others are unable to tolerate the treatments, half may fail to adhere to their programs, and in those who do attain their targets, major cardiovascular events may continue. Well-known risk factors, such as obesity and diabetes, have now gained the upper hand, with no evidence-based remedy capable of reversing this trend. All told, less than 1% of American adults and adolescents qualify for ideal CV health; world-wide, the growing prevalence of CV risk factors in children is imposing. A number of novel emerging drug therapies are in development, some recently approved for use in patients with familial hypercholesterolemia. Hopefully, they will contribute significantly to the current therapeutic armamentarium. However, for meaningful improvement in total and residual CV risk, an optimal mix of all available modalities will likely be necessary, including earlier and more effective prevention, aggressive medical care, revascularization and device implantation, judicious use of novel agents, and reengineering of the environment.
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Affiliation(s)
- Richard Kones
- Cardiometabolic Research Institute Inc., 8181 Fannin Street, U314 Houston, TX 77055, USA
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Everton KL, Mazal J, Mollura DJ. White paper report of the 2011 RAD-AID Conference on International Radiology for Developing Countries: integrating multidisciplinary strategies for imaging services in the developing world. J Am Coll Radiol 2012; 9:488-94. [PMID: 22748790 DOI: 10.1016/j.jacr.2012.01.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 01/06/2012] [Indexed: 11/28/2022]
Abstract
The 2011 RAD-AID Conference on International Radiology for Developing Countries discussed data, experiences, and models pertaining to radiology in the developing world, where widespread shortages of imaging services significantly reduce health care quality and increase health care disparities. This white paper from the 2011 RAD-AID conference represents consensus advocacy of multidisciplinary strategies to improve the planning, accessibility, and quality of imaging services in the developing world. Conference presenters and participants discussed numerous solutions to imaging and health care disparities, including (1) economic development for radiologic service planning, (2) public health mechanisms to address disease and prevention at the population and community levels, (3) comparative clinical models to implement various clinical and workflow strategies adapted to unique developing world community contexts, (4) education to improve training and optimize service quality, and (5) technology innovation to bring new technical capabilities to limited-resource regions.
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Affiliation(s)
- Kathryn L Everton
- Department of Radiology, Duke University, Durham, North Carolina, USA.
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Alqahtani M, Alanazi T, Binsalih S, Aljohani N, Alshammari M, Ashagag A, Abdullah M, Buabbas S, Abdulbaqi M. Characteristics of Saudi patients with congestive heart failure and adherence to management guidelines in a tertiary hospital in Riyadh. Ann Saudi Med 2012; 32:583-7. [PMID: 23396020 PMCID: PMC6081124 DOI: 10.5144/0256-4947.2012.583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There is limited data available on the characteristics of local Saudi patients diagnosed with congestive heart failure (CHF) and on their adherence to guidelines for managing the disease. This study aimed to fill this gap. DESIGN AND SETTING Retrospective study of patients treated at King Abdulaziz Medical City from 20022008. SUBJECTS AND METHODS The records were reviewed of subjects admitted secondary to heart failure (defined as systolic heart failure [ejection fraction < 55%] and/or heart failure with preserved ejection fraction diagnosed either clinically and/or by echocardiogram and/or cardiac catheterization) or who visited the outpatient department for the same complaint. RESULTS Of 392 CHF cases, the mean age was 67.8 (12.8) years and the majority were males (53.1%). Hypertension was the predominant comorbid illness, accounting for 84.9% of cases, followed by diabetes mellitus type 2 and hyperlipidemia. Almost three-fourths (73.7%) of the subjects had mild to severe left ventricular dysfunction, with 68.5% of the cases having right ischemic cardiomyopathy. Spironolactone, exercise and vaccination were the the least least adhered to recommendations (30.0%, 20.5% and 15.2%, respectively). CONCLUSIONS The study highlights the need for proper education of patients and caregivers to increase compliance to medications. Physicians are also encouraged to undergo continuing medical education and training courses to properly implement current recommendations in the management of heart failure. Further studies are needed on a larger scale in order to formulate an effective management scheme that will address the current challenges faced by both clinicians and CHF patients.
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Lunder M, Drevenšek G, Černe D, Marc J, Janić M, Šabovič M. Treatment With Low-dose Atorvastatin, Losartan, and Their Combination Increases Expression of Vasoactive-Related Genes in Rat Aortas. J Cardiovasc Pharmacol Ther 2012; 18:177-83. [DOI: 10.1177/1074248412463966] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Recently it has been shown that statins and angiotensin receptor blockers (ARBs) at low doses express beneficial pleiotropic vascular effects. We aimed to explore whether these drugs at low doses induce the expression of vasoactive-related genes. Sixty adult Wistar rats were treated with low-dose atorvastatin (2 mg/kg), low-dose losartan (5 mg/kg), their combination or saline daily for 4, 6, or 8 weeks. Expression of the vasoactive-related genes endothelin receptor type A ( EDNRA), endothelial nitric oxide synthase 3 ( NOS3), inducible nitric oxide synthase 2 ( NOS2), and angiotensin II receptor type 1 ( AGTRL1a) was measured in isolated thoracic aortas. Expression of EDNRA gradually decreased, the lowest values being obtained after 8 weeks (low-dose atorvastatin, losartan [1.6- and 1-7-fold vs controls, respectively; both P < .05], and the combination [2.3-fold vs control, P < .001]). The highest values of NOS3 were obtained after 6 weeks (low-dose atorvastatin, losartan, and their combination, 3.1-fold, P < .01; 3.4-fold, P < .001; and 3.6-fold, P < .001 vs controls, respectively) and then declined after 8 weeks. The combination was more effective in inducing total NOS3 expression when compared to the separate drugs (1.4-fold; P < .05). Importantly, expression of NOS3 was associated with increased plasma NO levels and positively correlated with thoracic aorta relaxation. No changes in expression of NOS2 and AGTRL1a were observed. We showed that low-dose atorvastatin or losartan and especially their combination increases the expression of NOS3 and decreases the expression of EDNRA. These findings are valuable in explaining the effectiveness of the “low-dose pharmacological approach” for improvement in arterial function.
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Affiliation(s)
- Mojca Lunder
- Institute of Pharmacology and Experimental Toxicology, University of Ljubljana, Ljubljana, Slovenia
- Department of Vascular Diseases, University of Ljubljana Medical Centre, Ljubljana, Slovenia
| | - Gorazd Drevenšek
- Institute of Pharmacology and Experimental Toxicology, University of Ljubljana, Ljubljana, Slovenia
| | - Darko Černe
- Department of Clinical Biochemistry, University of Ljubljana, Ljubljana, Slovenia
| | - Janja Marc
- Department of Clinical Biochemistry, University of Ljubljana, Ljubljana, Slovenia
| | - Miodrag Janić
- Department of Vascular Diseases, University of Ljubljana Medical Centre, Ljubljana, Slovenia
| | - Mišo Šabovič
- Department of Vascular Diseases, University of Ljubljana Medical Centre, Ljubljana, Slovenia
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Inhibition of cholesterol absorption: targeting the intestine. Pharm Res 2012; 29:3235-50. [PMID: 22923351 DOI: 10.1007/s11095-012-0858-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 08/06/2012] [Indexed: 01/06/2023]
Abstract
Atherosclerosis, the gradual formation of a lipid-rich plaque in the arterial wall is the primary cause of Coronary Artery Disease (CAD), the leading cause of mortality worldwide. Hypercholesterolemia, elevated circulating cholesterol, was identified as a key risk factor for CAD in epidemiological studies. Since the approval of Mevacor in 1987, the primary therapeutic intervention for hypercholesterolemia has been statins, drugs that inhibit the biosynthesis of cholesterol. With improved understanding of the risks associated with elevated cholesterol levels, health agencies are recommending reductions in cholesterol that are not achievable in every patient with statins alone, underlying the need for improved combination therapies. The whole body cholesterol pool is derived from two sources, biosynthesis and diet. Although statins are effective at reducing the biosynthesis of cholesterol, they do not inhibit the absorption of cholesterol, making this an attractive target for adjunct therapies. This report summarizes the efforts to target the gastrointestinal absorption of cholesterol, with emphasis on specifically targeting the gastrointestinal tract to avoid the off-target effects sometimes associated with systemic exposure.
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Low-dose atorvastatin, losartan, and particularly their combination, provide cardiovascular protection in isolated rat heart and aorta. Heart Vessels 2012; 28:246-54. [PMID: 22610592 DOI: 10.1007/s00380-012-0259-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 04/20/2012] [Indexed: 01/06/2023]
Abstract
Statins and angiotensin receptor blockers at therapeutic doses have beneficial cardiovascular effects, which can be applied for cardiovascular protection. We explored whether low doses of atorvastatin, losartan, and particularly their combination, possess important pleiotropic vasodilatory effects. Wistar rats were treated daily with low-dose atorvastatin (2 mg/kg, n = 15), low-dose losartan (5 mg/kg, n = 15), their combination (n = 15), or saline (n = 15). After 4, 6, or 8 weeks the animals were anesthetized, blood samples taken, and their hearts and thoracic aortas isolated. Two kinds of experiments were performed: the measurement of coronary flow rate after ischemia/reperfusion myocardial injury and endothelium-dependent relaxation of thoracic aorta. In both models, maximal vasodilation activity was obtained in rats treated for 6 weeks. In the ischemia/reperfusion myocardial injury model, coronary flow increased (atorvastatin or losartan 1.9-fold, P < 0.01; combination 2.4-fold, P < 0.001) compared with controls. In the thoracic aorta model, endothelium-dependent relaxation significantly increased only in the combination group compared with the control group (up to 1.4-fold; P < 0.01). Simultaneously, we detected increased anti-inflammatory activity and increased nitric oxide concentration, but no changes in lipids and blood pressure. In a rat model we showed important vasodilatory activity of low-dose atorvastatin, losartan, and particularly their combination. The effects of the low-dose combination were accompanied by, and probably at least partly achieved by, anti-inflammatory and nitric oxide pathways. Overall, these results could be valuable for the development of new vascular protective strategies focusing on a low-dose regimen of statins and sartans, and particularly their combination.
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