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Hung WC, Yu TH, Wang CP, Hsu CC, Lu YC, Wei CT, Chung FM, Lee YJ, Wu CC, Tang WH. Fibroblast growth factor 21 is associated with widening QRS complex and prolonged corrected QT interval in patients with stable angina. BMC Cardiovasc Disord 2022; 22:432. [PMID: 36180826 PMCID: PMC9523937 DOI: 10.1186/s12872-022-02868-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/21/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Fibroblast growth factor 21 (FGF21) is produced by cardiac cells, may acts in an autocrine manner, and was suggested to has a cardioprotective role in atherosclerosis. Wide QRS complex and heart rate-corrected QT interval (QTc interval) prolongation are associated to dangerous ventricular arrhythmias and cardiovascular disease mortality. Yet, the role of FGF21 in cardiac arrhythmia has never been studied. The aim of the study was to investigate the relationship between plasma FGF21 and the QRS duration and QTc interval in patients with stable angina. METHODS Three hundred twenty-one consecutive stable angina patients were investigated. Plasma FGF21 was measured through ELISA, and each subject underwent 12-lead electrocardiography. RESULTS FGF21 plasma levels were positively associated with the QRS duration (β = 0.190, P = 0.001) and QTc interval (β = 0.277, P < 0.0001). With increasing FGF21 tertiles, the patients had higher frequencies of wide QRS complex and prolonged QTc interval. After adjusting for patients' anthropometric parameters, the corresponding odd ratios (ORs) for wide QRS complex of the medium and high of FGF21 versus the low of FGF21 were 1.39 (95% CI 0.51-3.90) and 4.41 (95% CI 1.84-11.59), respectively, and p for trend was 0.001. Furthermore, multiple logistic regression analysis also showed the corresponding odd ratios (ORs) for prolonged QTc interval of the medium and high of FGF21 versus the low of FGF21 were 1.02 (95% CI 0.53-1.78) and 1.93 (95% CI 1.04-3.60) respectively with the p for trend of 0.037. In addition, age- and sex-adjusted FGF21 levels were positively associated with fasting glucose, HbA1c, creatinine, and adiponectin, but negatively associated with albumin, and the estimated glomerular filtration rate. CONCLUSIONS This study indicates that plasma FGF21 is associated with wide QRS complex and prolonged corrected QT interval in stable angina patients, further study is required to investigate the role of plasma FGF21 for the underlying pathogenesis.
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Affiliation(s)
- Wei-Chin Hung
- grid.414686.90000 0004 1797 2180Division of Cardiology, Department of Internal Medicine, E-Da Hospital, No. 1, Yi-Da Rd., Jiau-Shu Village, Yan-Chao Township, Kaohsiung, 82445 Taiwan ,grid.411447.30000 0004 0637 1806School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Teng-Hung Yu
- grid.414686.90000 0004 1797 2180Division of Cardiology, Department of Internal Medicine, E-Da Hospital, No. 1, Yi-Da Rd., Jiau-Shu Village, Yan-Chao Township, Kaohsiung, 82445 Taiwan ,grid.411447.30000 0004 0637 1806School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Chao-Ping Wang
- grid.414686.90000 0004 1797 2180Division of Cardiology, Department of Internal Medicine, E-Da Hospital, No. 1, Yi-Da Rd., Jiau-Shu Village, Yan-Chao Township, Kaohsiung, 82445 Taiwan ,grid.411447.30000 0004 0637 1806School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Chia-Chang Hsu
- grid.414686.90000 0004 1797 2180Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, 82445 Taiwan ,grid.411447.30000 0004 0637 1806The School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Yung-Chuan Lu
- grid.411447.30000 0004 0637 1806School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan ,grid.414686.90000 0004 1797 2180Division of Endocrinology and Metabolism, Department of Internal Medicine, E-Da Hospital, Kaohsiung, 82445 Taiwan
| | - Ching-Ting Wei
- grid.411447.30000 0004 0637 1806School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan ,grid.414686.90000 0004 1797 2180Division of General Surgery, Department of Surgery, E-Da Hospital, Kaohsiung, 82445 Taiwan ,grid.411447.30000 0004 0637 1806Department of Biomedical Engineering, I-Shou University, Kaohsiung, 82445 Taiwan ,grid.411447.30000 0004 0637 1806Department of Electrical Engineering, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Fu-Mei Chung
- grid.414686.90000 0004 1797 2180Division of Cardiology, Department of Internal Medicine, E-Da Hospital, No. 1, Yi-Da Rd., Jiau-Shu Village, Yan-Chao Township, Kaohsiung, 82445 Taiwan
| | | | - Cheng-Ching Wu
- grid.414686.90000 0004 1797 2180Division of Cardiology, Department of Internal Medicine, E-Da Hospital, No. 1, Yi-Da Rd., Jiau-Shu Village, Yan-Chao Township, Kaohsiung, 82445 Taiwan ,grid.411447.30000 0004 0637 1806School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Wei-Hua Tang
- grid.278247.c0000 0004 0604 5314Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Yuli Branch, No. 91, Xinxing St., Yuli Township, Hualien County, 981002 Taiwan ,grid.260539.b0000 0001 2059 7017Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112304 Taiwan
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Rodríguez-Sánchez E, Navarro-García JA, González-Lafuente L, Aceves-Ripoll J, Vázquez-Sánchez S, Poveda J, Mercado-García E, Corbacho-Alonso N, Calvo-Bonacho E, Fernández-Velasco M, Álvarez-Llamas G, Barderas MG, Ruilope LM, Ruiz-Hurtado G. Oxidized Low-Density Lipoprotein Associates with Ventricular Stress in Young Adults and Triggers Intracellular Ca 2+ Alterations in Adult Ventricular Cardiomyocytes. Antioxidants (Basel) 2020; 9:antiox9121213. [PMID: 33271910 PMCID: PMC7761043 DOI: 10.3390/antiox9121213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022] Open
Abstract
Oxidized low-density lipoprotein (oxLDL) is associated with cardiac damage and causes injury to multiple cell types. We aimed to investigate the role of oxLDL in ventricular stress. We first examined the association between circulating oxLDL and N-terminal pro-brain natriuretic peptide (NT-proBNP), a marker of myocardial stress, in young subjects (30-50 years) with or without stable coronary artery disease (SCAD). oxLDL and NT-proBNP were significantly higher in subjects at high cardiovascular risk (CVR) than in subjects at low CVR and were associated independently of traditional CVR factors and C-reactive protein. Furthermore, the levels of oxLDL and NT-proBNP were significantly lower in subjects with SCAD than in peers at high CVR. To determine the intracellular mechanisms involved in the cardiac effects of oxLDL, we analyzed the in vitro effect of oxLDL on intracellular Ca2+ handling in adult rat ventricular cardiomyocytes using confocal microscopy. Acute challenge of adult ventricular cardiomyocytes to oxLDL reduced systolic Ca2+ transients and sarcoplasmic reticulum Ca2+ load. Moreover, diastolic spontaneous Ca2+ leak increased significantly after acute exposure to oxLDL. Thus, we demonstrate that oxLDL associates with NT-proBNP in young subjects, and can directly induce Ca2+ mishandling in adult ventricular cardiomyoyctes, predisposing cardiomyocytes to cardiac dysfunction and arrhythmogenicity.
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Affiliation(s)
- Elena Rodríguez-Sánchez
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - José Alberto Navarro-García
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Laura González-Lafuente
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Jennifer Aceves-Ripoll
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Sara Vázquez-Sánchez
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Jonay Poveda
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Elisa Mercado-García
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
| | - Nerea Corbacho-Alonso
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, SESCAM, 45004 Toledo, Spain; (N.C.-A.); (M.G.B.)
| | | | - María Fernández-Velasco
- IdiPAZ Institute for Health Research/Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, CIBER-CV, 28029 Madrid, Spain;
| | | | - María G. Barderas
- Department of Vascular Physiopathology, Hospital Nacional de Parapléjicos, SESCAM, 45004 Toledo, Spain; (N.C.-A.); (M.G.B.)
| | - Luis M. Ruilope
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
- Hypertension Unit, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- CIBER-CV, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- European University of Madrid, Madrid, Spain
| | - Gema Ruiz-Hurtado
- Cardiorenal Translational Laboratory, Institute of Research i+12, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain; (E.R.-S.); (J.A.N.-G.); (L.G.-L.); (J.A.-R.); (S.V.-S.); (J.P.); (E.M.-G.); (L.M.R.)
- Hypertension Unit, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- CIBER-CV, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- Correspondence: ; Tel.: +34-91-390-8001
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Conti CR. Sudden Cardiac Death in Adult Patients with Stable Ischemic Heart Disease. CARDIOVASCULAR INNOVATIONS AND APPLICATIONS 2019. [DOI: 10.15212/cvia.2016.0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Rai V, Agrawal DK. Role of risk stratification and genetics in sudden cardiac death. Can J Physiol Pharmacol 2016; 95:225-238. [PMID: 27875062 DOI: 10.1139/cjpp-2016-0457] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Sudden cardiac death (SCD) is a major public health issue due to its increasing incidence in the general population and the difficulty in identifying high-risk individuals. Nearly 300 000 - 350 000 patients in the United States and 4-5 million patients in the world die annually from SCD. Coronary artery disease and advanced heart failure are the main etiology for SCD. Ischemia of any cause precipitates lethal arrhythmias, and ventricular tachycardia and ventricular fibrillation are the most common lethal arrhythmias precipitating SCD. Pulseless electrical activity, bradyarrhythmia, and electromechanical dissociation also result in SCD. Most SCDs occur outside of the hospital setting, so it is difficult to estimate the public burden, which results in overestimating the incidence of SCD. The insufficiency and limited predictive value of various indicators and criteria for SCD result in the increasing incidence. As a result, there is a need to develop better risk stratification criteria and find modifiable variables to decrease the incidence. Primary and secondary prevention and treatment of SCD need further research. This critical review is focused on the etiology, risk factors, prognostic factors, and importance of risk stratification of SCD.
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Affiliation(s)
- Vikrant Rai
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE 68178, USA.,Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE 68178, USA
| | - Devendra K Agrawal
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE 68178, USA
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Kunutsor SK, Kurl S, Zaccardi F, Laukkanen JA. Baseline and long-term fibrinogen levels and risk of sudden cardiac death: A new prospective study and meta-analysis. Atherosclerosis 2016; 245:171-80. [DOI: 10.1016/j.atherosclerosis.2015.12.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/07/2015] [Accepted: 12/11/2015] [Indexed: 12/31/2022]
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Peripheral arterial occlusive disease (PAOD). PHLEBOLOGIE 2014. [DOI: 10.12687/phleb2241-6-2014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
SummaryLeg pain on exertion is the cardinal symptom of both arterial occlusive disease. Patients with PAOD complain of cramping pain in the calf, which disappears after standing still with a straight back for a few minutes. The diagnostic and therapeutic options are discussed.
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Fischer A, Fuster V. The Changing Epidemiology of Sudden Cardiac Death. Card Electrophysiol Clin 2009; 1:1-11. [PMID: 28770776 DOI: 10.1016/j.ccep.2009.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Sudden cardiac death (SCD) is a devastating complication of myocardial infarction. The global incidence of coronary artery disease and heart failure has been increasing greatly in recent years. As a consequence, there is expected to be an increase in the incidence of SCD manifesting as a shared worldwide public health problem. This article summarizes SCD epidemiology, with a focus on the anticipated global rise in incidence.
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Affiliation(s)
- Avi Fischer
- The Zena and Michael A. Wiener Cardiovascular Institute, Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, The Mount Sinai Medical Center, One Gustave L Levy Place, Box 1030, New York, NY 10029, USA
| | - Valentin Fuster
- The Zena and Michael A. Wiener Cardiovascular Institute, Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, The Mount Sinai Medical Center, One Gustave L Levy Place, Box 1030, New York, NY 10029, USA; The Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
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Chugh SS, Reinier K, Teodorescu C, Evanado A, Kehr E, Al Samara M, Mariani R, Gunson K, Jui J. Epidemiology of sudden cardiac death: clinical and research implications. Prog Cardiovasc Dis 2008; 51:213-28. [PMID: 19026856 DOI: 10.1016/j.pcad.2008.06.003] [Citation(s) in RCA: 485] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The current annual incidence of sudden cardiac death in the United States is likely to be in the range of 180,000 to 250,000 per year. Coinciding with the decreased mortality from coronary artery disease, there is evidence pointing toward a significant decrease in rates of sudden cardiac death in the United States during the second half of the 20th century. However, the alarming rise in prevalence of obesity and diabetes in the first decade of the new millennium both in the United States and worldwide, would indicate that this favorable trend is unlikely to persist. We are likely to witness a resurgence of coronary artery disease and heart failure, as a result of which sudden cardiac death will have to be confronted as a shared and indiscriminate, worldwide public health problem. There is also increasing recognition of the fact that discovery of meaningful and relevant risk stratification and prevention methodologies will require careful prospective community-wide analyses, with access to large archives of DNA, serum, and tissue that link with well-phenotyped databases. The purpose of this review is to summarize current knowledge of sudden cardiac death epidemiology. We will discuss the significance and strengths of community-wide evaluations of sudden cardiac death, summarize recent observations from such studies, and finally highlight specific potential predictors that warrant further evaluation as determinants of sudden cardiac death in the general population.
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Affiliation(s)
- Sumeet S Chugh
- Cardiac Arrhythmia Center, Division of Cardiovascular Medicine, Oregon Health and Science University, Portland, OR 97239, USA.
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Paraskevas KI, Baker DM, Vrentzos GE, Mikhailidis DP. The role of fibrinogen and fibrinolysis in peripheral arterial disease. Thromb Res 2007; 122:1-12. [PMID: 17669476 DOI: 10.1016/j.thromres.2007.06.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2006] [Revised: 06/11/2007] [Accepted: 06/15/2007] [Indexed: 10/23/2022]
Abstract
Peripheral arterial disease (PAD) is associated with high rates of cerebrovascular and cardiovascular events; PAD is a marker of systemic atherosclerosis. As a result, standard therapy for all PAD patients should be directed at both peripheral and systemic atherosclerosis. Modification of established risk factors in the form of smoking cessation, correcting hypertension, optimizing diabetic control and normalizing lipids is essential. Furthermore, novel risk factors have emerged including fibrinogen and other hemostatic factors. Fibrinogen is a coagulation factor and a marker of the acute phase response (inflammation), a platelet activator, a major determinant of plasma viscosity and a component of the atherosclerotic plaque. Fibrinogen appears not only to predict the severity of PAD, but also serves as a marker for future development of PAD. Whether reducing the levels of fibrinogen and other coagulation factors will decrease the incidence and progression of PAD remains to be resolved. This review summarizes the role of fibrinogen in the pathogenesis of PAD and its association with other hemostatic factors. The role of fibrinolysis in patients with PAD is also considered.
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Affiliation(s)
- Kosmas I Paraskevas
- Department of Clinical Biochemistry and Academic Department of Surgery, Royal Free Hospital, London, UK.
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Cuddy TE, Tate RB. Sudden unexpected cardiac death as a function of time since the detection of electrocardiographic and clinical risk factors in apparently healthy men: the Manitoba Follow-Up Study, 1948 to 2004. Can J Cardiol 2006; 22:205-11. [PMID: 16520850 PMCID: PMC2528914 DOI: 10.1016/s0828-282x(06)70897-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2005] [Accepted: 01/31/2006] [Indexed: 11/18/2022] Open
Abstract
PURPOSE As the first and only manifestation of ischemic heart disease, sudden unexpected cardiac death (SUCD) is a serious clinical and epidemiological concern. Prospective population studies permit the identification of risk factors for SUCD. Knowledge of the short-and long-term risks for SUCD are key to understanding the basis of any intervention. The present paper explores the effect of time since the detection of factors on the risk for SUCD. SUBJECTS AND METHODS The Manitoba Follow-Up Study is a longitudinal, prospective study of 3983 originally healthy young men who have been followed with routine medical examinations since 1948. During 56 years of follow-up, SUCD occurred in 171 men. This analysis examined 21 possible risk factors for SUCD, including clinical findings, social variables and electrocardiographic abnormalities. Time-dependent covariate Cox proportional hazard models were used to estimate age-adjusted relative risks for SUCD. In multivariate models, the relative risk of SUCD was estimated as a function of time since the documentation of each risk factor. RESULTS Excess alcohol consumption and T wave changes were associated with a high short-term risk for SUCD. Arterial hypertension and ST/T changes had sustained excess risk over both the short and long term. Newly developed left bundle branch block was a highly significant short-term risk that diminished with time. CONCLUSION These findings add new information for the clinical management of risk factors. The identification of time since the detection of these risk factors is an important consideration to reduce SUCD.
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Affiliation(s)
- T Edward Cuddy
- Manitoba Follow-up Study, University of Manitoba, Winnipeg, Manitoba
| | - Robert B Tate
- Manitoba Follow-up Study, University of Manitoba, Winnipeg, Manitoba
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Avogaro A, de Kreutzenberg SV. Mechanisms of endothelial dysfunction in obesity. Clin Chim Acta 2005; 360:9-26. [PMID: 15982646 DOI: 10.1016/j.cccn.2005.04.020] [Citation(s) in RCA: 130] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2005] [Revised: 04/12/2005] [Accepted: 04/12/2005] [Indexed: 01/04/2023]
Abstract
Obesity is a chronic disease, whose incidence is alarmingly growing, affecting not only adults but also children and adolescents. It is associated with severe metabolic abnormalities and increased cardiovascular morbidity and mortality. Adipose tissue secretes a great number of hormones and cytokines that not only regulate substrate metabolism but may deeply and negatively influence endothelial physiology, a condition which may lead to the formation of the atherosclerotic plaque. In this review, the physiology of the endothelium is summarised and the mechanisms by which obesity, through the secretory products of adipose tissue, influences endothelial function are explained. A short description of methodological approaches to diagnose endothelial dysfunction is presented. The possible pathogenetic links between obesity and cardiovascular disease, mediated by oxidative stress, inflammation and endothelial dysfunction are described as well.
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Affiliation(s)
- Angelo Avogaro
- Metabolic Diseases--Department of Clinical and Experimental Medicine, University of Padova, School of Medicine, Via Giustiniani 2, 35128 Padova, Italy.
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